PubMed · 10798021
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K U Ansari. 1999. Foetal medicines.. https://pubmed.ncbi.nlm.nih.gov/10798021/
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Specialized nutrition support, particularly enteral feeding, has been used for centuries. Technologic advancements have affected the provision of enteral feeding. Feeding solutions and devices, as well as the techniques to place the feeding devices, have evolved. This article reviews the history of bedside placement methods for short-term enteral access devices.
This article presents a narrative review of the non-medical, medical and endovascular aspects of the management of acute ischaemic stroke in the posterior circulation, a potentially devastating condition with high mortality and substantial disability in many of those who survive. Optimal management requires a combination of supportive measures and specific interventions and is best delivered within a high-dependency or intensive care environment. Non-medical measures include management of physiological parameters, respiratory support where necessary and prompt treatment of complications such as the development of hydrocephalus. Deterioration in conscious state and progression of symptoms may occur some time after initial presentation and after admission to hospital; when such progression is detected, very rapid therapeutic reperfusion may be feasible. Reperfusion strategies include intravenous and intra-arterial thrombolysis (IAT) and mechanical methods to aid reperfusion, including the use of mechanical clot disruption, clot retrieval or stenting devices. The optimal reperfusion strategy, including considerations of whether to use intravenous or intra-arterial thrombolytic approaches, the use of bridging intravenous treatment prior to intra-arterial treatment, and the use of pharmacological or mechanical adjuncts to IAT is not known. However, it seems likely that the important determinant of therapeutic efficacy is the speed and safety with which reperfusion can be achieved. It may also be that the time available to achieve reperfusion is longer than in the anterior circulation.
The large successive studies on the treatment of erectile disorders started with local injections of papaverine in 1982, followed by the marketing of intracavernous injections of alprostadil in 1994 and, in 1998, sildenafil, the first type 5 phosphodiesterase inhibitor. An efficient alternative to improve the quality and duration of an erection is presently represented by intra-cavernous injections of alprostadil alfadex when oral treatments are insufficient, inefficient or contraindicated.