PubMed Health⌕ Search

Biomedical subjects

D L Simon

Publications and source records attributed to D L Simon.

8 recordsLinked to original sources
PubMed1997

Rapid opioid detoxification using opioid antagonists: history, theory and the state of the art.

Rapid opioid detoxification is a technique for detoxifying patients addicted to narcotics which is increasing in popularity. This technique is potentially useful in getting some patients through the withdrawal phase of substance abuse therapy so that they may engage in further treatment earlier in the course of their disease. However, this procedure, which can and should be done safely, has in the past been pushed to limits which approach boundaries outside of the provider's area of expertise. This paper attempts to present a critical review of previous publications relating to rapid opioid detoxification to address these and other issues. There appears to be a pharmacologic basis for the efficacy of this treatment on a longer-term basis which centers around upregulation of opioid receptors induced by opioid antagonists. This paper also attempts to offer evidence in support of this theory.

Humans↗
PubMed1982

Treatment of bladder pain with transsacral nerve block.

Fifteen patients with bladder spasticity and pain of three different etiologies were referred to the pain clinic by urologic specialists. These patients were refractory to all prior methods of treatment, excluding major surgical procedures. In a prospective study started in 1976, these patients were treated with transsacral nerve blocks using 0.25% bupivacaine and, in most cases, subsequent 6% aqueous phenol at the right S-3 ventral foramen. If indicated, transsacral nerve blocks were performed at other levels, as described in the text. Of the patients studied 53% have had significant or complete relief of pain for an average of 26.5 months. The associated morbidity was negligible and there was no mortality. This is in contrast to the morbidity and mortality associated with some major surgical "curative" procedures. The technique is proposed as a successful and economical approach to treatment that can be managed on an outpatient basis.

Bupivacaine↗
PubMed1976

Experience in the application of porcine xenografts to split-graft donor sites.

We have described our experience in the treatment of 336 donor sites with porcine xenografts. We have found this technique simple and quick for achieving rapid healing of these donor areas in burn patients, trauma patients, granulating ulcer patients, patients with carcinoma, patients with crossed-leg flap procedures, and other reconstructive surgery cases, and in practically all of these excellent healing occurred within an average of 12 days. The exceptions have been described. It is the authors' feeling that this modality of donor site care is of the greatest significance and a great advance over previous techniques. It minimizes the previously required care of these donor areas and significantly has reduced the associated pain and distress which skin-graft patients have suffered in the past. In the few instances in which the lyophilized porcine xenograft was used, it was our impression that these grafts did not adhere to the donor site as well and did not have the hemostatic effect of the fresh-refrigerated or fresh-frozen porcine xenografts.

Animals↗
PubMedDate not supplied

Allergic or pseudoallergic reaction following epidural steroid deposition and skin testing.

A 46-year-old female with a history of low back pain and sciatica was referred for evaluation for epidural steroid injection. Following appropriate history, physical examination and laboratory testing, an epidural injection was performed using triamcinolone diacetate (Aristocort Intralesional (R), Lederle Pharmaceuticals) and lidocaine. Despite good pain relief, the patient presented one week later to a hospital emergency room with signs and symptoms consistent with a delayed allergic or pseudoallergic reaction. Subsequent skin testing, performed one month following the epidural injection, with the same drug precipitated the onset of an accelerated but similar reaction 12 hours later. To our knowledge, this is the first known report of allergic or pseudoallergic reactions following epidural steroid deposition and subsequent skin testing in the medical literature.

Back Pain↗