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New issues for nosografic setting of "HELLP syndrome".

In 1982 Weinstein reported a syndrome marked by Hemolysis, Elevated Liver enzymes, Low Platelets (HELLP Syndrome). Following that report a critical review by MacKenna & Coll. reported that typical signs of the syndrome (observed in 223 cases of preeclampsia) were related to the preeclampsia so denying any nosografic autonomy to it. This report was confirmed by Killan that in 1974 described the classic HELLP syndrome as a complication of hypertensive syndrome in pregnancy. Our case report presents some patterns that may contribute to acquire new data in order to place the HELLP syndrome in its appropriate nosografic allocation.

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PubMedDate not supplied

Suprascapular nerve block by catheter for breakthrough shoulder cancer pain.

BACKGROUND AND OBJECTIVES: Incidental shoulder pain due to movement renders pain control difficult because it requires high basal dosages or additional doses of opioids. Shoulder pain can be alleviated by suprascapular nerve block, and the placement of a catheter can permit the injection of local anesthesia as needed. METHODS: In a patient with lung cancer and continuous chest pain well controlled by opioids but with shoulder breakthrough pain necessitating extra doses of opioids, a suprascapular nerve block was performed via an indwelling catheter. RESULTS: The breakthrough events due to scapular involvement were treated with local injections of 5 mL bupivacaine 0.5% until death (4 weeks later) without any complications. CONCLUSIONS: Continuous suprascapular nerve block is safe and simple and has proven to be useful in avoiding extra doses of opioids.

Aged↗