While the term overlap syndrome has been defined as the comorbid association of COPD and OSA, the interaction between asthma and OSA has not been integrated yet nosologically; in this
review, the latter will be called alternative overlap syndrome. In an effort to bolster further investigations in this area, an integrated, lumping nomenclature for OSA in the setting of OLD is proposed here-OLDOSA (obstructive lung disease and obstructive sleep apnoea) syndrome.”
“Background.
US soldiers injured in Iraq, and civilian burn trauma patients are treated at the US Army Institute of Surgical Research. Burn patients experience extrem pain during wound care, and they typically receive opioid analgesics and anxiolytics for debridement. Virtual Reality (VR) has been applied as an adjunct to opioid analgesics for procedural pain. We describe the first use of ketamine Selleck Entinostat combined with immersive VR to reduce excessive pain during wound care.
Case Report.
A 21-year-old male US Army soldier stationed in Iraq, and a 41-year-old civilian male sustained a 13% and 50% total body surface area (TBSA) burn, respectively. Each patient
received 40 mg ketamine intraveneous (IV) for wound care. Using a within-subject design, nurses conducted half of a painful segment of wound care treatments with no VR and the other half with immersive VR. Graphic pain rating scores for each of the two treatment conditions served GSK2126458 inhibitor as the dependent variables.
Results.
Compared to ketamine + no VR, both patients reported less pain during ketamine + VR for all three pain ratings. Both patients
rated wound care during no VR as “”no fun at all”", but those same patients rated wound care during virtual reality as either “”pretty fun”" or “”extremely fun”", and rated nausea as either “”mild”" or “”none”".
Conclusions.
Results from these first two cases suggest that a moderate dose of ketamine combined with immersive virtual reality distraction may be an effective multimodal analgesic regimen for reducing acute procedural pain during severe selleck burn wound cleanings.”
“Immigration from high tuberculosis (TB) prevalence countries has a substantial impact on the epidemiology of TB in receiving countries with low TB incidence. Cross-border migration offers an ideal opportunity for active case finding that will result in a lower caseload in the host country and a reduced spread of disease to both the indigenous and migrant populations. Screening strategies can start ‘offshore’, thereby indirectly assisting and empowering public health systems in the source countries, or be performed at ports of entry with or without long-term engagement of ‘onshore’ facilities and systems to provide either preventive therapy or surveillance for reactivation of latent TB.