Streptomycin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
In Madrid, Spain, 27 patients with tuberculosis were treated with 31 courses of i.v. streptomycin to avoid injection-related pain and to investigate tolerability of i.v. streptomycin. The patients were mainly men, about half were HIV positive, and the average age was 37 ± 11 years. Patients with pre-existing renal failure were excluded. Streptomycin was administered i.v. at 15 mg/kg/24 hours in 100 ml of saline over 45–60 minutes. Therapeutic drug monitoring was performed 1 hour after the end of the infusion and prior to the next dose. Mean ± SD peak and trough levels of streptomycin were 39.8 ± 21.6 and 2.0 ± 0.3 µg/ml. The only side effects observed were brief oral and circumoral paresthesia in some patients. No renal impairment of 7th or 8th nerve-related symptoms occurred. Serum levels were in keeping with those previously reported with this dose, and in general i.v. streptomycin was well tolerated (Perez Tanoira et al., 2014).
Inflammatory Disorders of the Nervous System
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Favorable factors for long-term survival free of disability: Early age of onset.Female sex.Sensory dysfunction (paresthesia) at onset.Relapsing–remitting clinical course.Longer interattack interval.Low initial RR.Fewer lesions on baseline MRI.CSF oligoclonal band negative.
Adrenoleukodystrophy
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop in Atlas of Inherited Metabolic Diseases, 2020
Symptoms in the female heterozygote may resemble those of adrenomyeloneuropathy. In a few, there is severe disability with paraparesis [29, 30]. These women may be thought to have multiple sclerosis, if there is no family history of involved males [31]. One patient had intermittent paresthesia from the age of 40 years [31]. Some asymptomatic patients have had hyperreflexia and impaired vibration sensation in the legs. Some have been diagnosed only after they had an affected son [31]. Adrenal insufficiency is rare in most heterozygotes [32]. Some have had dementia. Others have had an adolescent onset of the kind of progressive cerebral disease seen in the male, even with adrenal insufficiency [30, 33].
Guillain-Barré syndrome after bortezomib therapy in a child with relapsed acute lymphoblastic leukemia
Published in Pediatric Hematology and Oncology, 2022
Valeria Ceolin, Rosita Cenna, Francesca Resente, Manuela Spadea, Franca Fagioli, Nicoletta Bertorello
Peripheral neuropathy (PN) has been described in patients receiving bortezomib, which is predominantly sensory. Symptoms include paresthesia, numbness in distal areas, particularly the lower limbs, burning sensations, dysesthesias, sensory loss, reduced proprioception, vibratory sensation, reduction of deep tendon reflexes and autonomic skin innervation. Neuropathic pain has also been described and happens more frequently than with other neurotoxic drugs.14 PN usually appears after a number of cycles of treatment and is associated with dose accumulation, but symptoms may also appear after the first few doses; recent studies28 did not find a clear linear correlation between the cumulative dose or dose intensity and the severity of polyneuropathy, indicating that certain patients developed a severe polyneuropathy following a relatively low dose of BZM. The pathophysiology of bortezomib induced neuropathy is not completely clear yet. Experimental studies suggest that aggresome formation, endoplasmic reticulum stress, myotoxicity, microtubule stabilization, inflammatory response, and DNA damage could contribute to this neurotoxicity.29
A randomized trial of ultrasound-guided adductor canal block versus fascia iliaca compartment block for postoperative analgesia after arthroscopic knee surgery
Published in Egyptian Journal of Anaesthesia, 2019
Mohamed M. Abu Elyazed, Shaimaa F. Mostafa
Neostigmine (0.05 mg/kg) and atropine (0.02 mg/kg) IV were used for neuromuscular block reversal and patients were extubated. All patients were admitted to Post Anesthesia Care Unit (PACU) where IV paracetamol (1 g) was administered every 6 h. Postoperative pain was surveyed over 24 h utilizing VAS, where zero score corresponds to no pain and 100 mm to the worst pain. A rescue analgesic of IV pethidine 20 mg was given to patients in both groups when VAS ≥ 40 mm at rest and the total consumption of postoperative rescue analgesia was recorded. Any adverse events such as nausea, vomiting, respiratory complications, shivering, pruritus or any block-related postoperative neurologic symptoms (persistent numbness or paresthesia, weakness, or nonsurgical pain in the operative extremity) were recorded. All measurements and study outcomes were assessed by another research anesthesiologist who was blinded to group assignment.
Device profile of the Proclaim XR neurostimulation system for the treatment of chronic pain: an overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2020
Jonathan M. Hagedorn, Alyson M. Engle, Priyanka Ghosh, Timothy R. Deer
If paresthesia settings are used, these should be turned off before operating motorized vehicles. If patients are using BurstDR™ stimulation therapy, most patients will not feel paresthesias but it has not been evaluated for its safety while operating motorized vehicles. There can be other unwanted effects with paresthesia stimulation if using this setting such as unpleasant sensations or motor disturbances, stimulation in unwanted areas, weakness, clumsiness, and numbness. If any of those unwanted or dangerous adverse effects are present, it is advised the device be turned off immediately and the patient should seek medical attention. Persistent pain is another potential adverse effect including pain below the level of the implant, persistent pain or seroma at the IPG site, or skin erosion around the implant. Allergic responses or rejection of materials is another possible adverse effect, though rare. If any adverse reactions should occur, the patient should discontinue use of the device and immediately seek medical attention [21].
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