Papers by Jabril Eldufani, MD
Heliyon, 2020
Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which is characterized ... more Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which is characterized by significant autonomic and inflammatory features. CRPS occurs in patients who have limb surgery, limb fractures, or trauma. Many patients may have pain resolve within twelve months of the inciting incident; however, a small subset progresses to the chronic form. This transitional process often happens by changing from warm CRPS with dominant inflammatory phase to cold CRPS, in which autonomic characteristics or manifestations dominate. Several peripheral and central mechanisms are involved, which might vary among individuals over a period of time. Other contributors include peripheral and central sensitization, autonomic alterations, inflammatory and immune changes, neurochemical changes, and psychological and genetic factors. Although effective management of the chronic CRPS form is often challenging, there are a few high quality randomized controlled trials that support the efficacy of the most commonly used therapeutic approaches.
The American Journal of Medicine, 2018
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Ketamine has a variety of pharmacological effects including sedation, analgesia, bronchodilation, and nervous system stimulation. It is used as an active adjuvant that prolongs the duration of analgesic effect of painkillers in pain management.
International Journal of Basic & Clinical Pharmacology, Nov 24, 2018
In the past, there was a scientific theory of adrenergic mechanisms: it was thought that adrenerg... more In the past, there was a scientific theory of adrenergic mechanisms: it was thought that adrenergic receptors consisted of two classes and the actions of these groups resulted in either excitation or inhibition of effector cells. 1 This theory was the accepted concept until Ahlquist demonstrated that there were subtypes of receptors in the class, which he termed α and β1. Researchers later discovered that one of α receptors inhibited neurotransmitter release from the presynaptic neuron (Figure 1). 2 The α-2 adrenergic agonists were developed for their use in clinical practice, including as anesthesia and analgesic adjuncts. The administration of α-2 AR agonists as adjuncts gained popularity, as reported by Brodsky and Bravo in 1976. 2
Alzheimer's & Dementia: Translational Research & Clinical Interventions
Chronic pain in patients with Alzheimer's disease or dementia is a complex issue in the medical f... more Chronic pain in patients with Alzheimer's disease or dementia is a complex issue in the medical field; these patients suffer from the common causes of chronic pain, especially in geriatric medicine. To ensure the correct type and level of given treatment, medical care should be taken to avoid the contribution of chronic pain and cognitive impairment in the elderly population. Acetylcholinesterase inhibitors (AChE-Is) have been proven as an efficient therapeutic resource for significant improvement in dementia of Alzheimer's disease and chronic pain due to the fact that cholinergic deficit is considered as an early finding in cognitive impairment and persisting pain. Some AChE-Is are investigated here in terms of treatment of dementia and chronic pain management. Neostigmine has been used as an adjunct analgesic in the postoperative period and in combination with other analgesic medications in an intrathecal approach. Rivastigmine has, over the past ten years, become the approved agent for the management of dementia of mild to moderate Alzheimer's disease and has gained approval for treating different types of non-Alzheimer's dementia. In this review, we will focus on the two types of AChE-Is (rivastigmine and neostigmine) in the development of their clinical use and their respective mechanisms of actions on improving cognitive function and managing chronic pain.
Journal of Health & Medical Informatics, 2018
Subjects diagnosed with chronic low back pain lasting for more than three months were identified ... more Subjects diagnosed with chronic low back pain lasting for more than three months were identified and referred to the pain clinic by their primary care physician. The study took place between August 2004
A B S T R A C T Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which i... more A B S T R A C T Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which is characterized by significant autonomic and inflammatory features. CRPS occurs in patients who have limb surgery, limb fractures, or trauma. Many patients may have pain resolve within twelve months of the inciting incident; however, a small subset progresses to the chronic form. This transitional process often happens by changing from warm CRPS with dominant inflammatory phase to cold CRPS, in which autonomic characteristics or manifestations dominate. Several peripheral and central mechanisms are involved, which might vary among individuals over a period of time. Other contributors include peripheral and central sensitization, autonomic alterations, inflammatory and immune changes, neurochemical changes, and psychological and genetic factors. Although effective management of the chronic CRPS form is often challenging, there are a few high quality randomized controlled trials that support the efficacy of the most commonly used therapeutic approaches.
Health, Neurosciences & Mental Health, 2019
Chronic pain in patients with Alzheimer's disease or dementia is a complex issue in the medical f... more Chronic pain in patients with Alzheimer's disease or dementia is a complex issue in the medical field; these patients suffer from the common causes of chronic pain, especially in geriatric medicine. To ensure the correct type and level of given treatment, medical care should be taken to avoid the contribution of chronic pain and cognitive impairment in the elderly population. Acetylcholinesterase inhibitors (AChE-Is) have been proven as an efficient therapeutic resource for significant improvement in dementia of Alzheimer's disease and chronic pain due to the fact that cholinergic deficit is considered as an early finding in cognitive impairment and persisting pain. Some AChE-Is are investigated here in terms of treatment of dementia and chronic pain management. Neostigmine has been used as an adjunct analgesic in the postoperative period and in combination with other analgesic medications in an intrathecal approach. Rivastigmine has, over the past ten years, become the approved agent for the management of dementia of mild to moderate Alzheimer's disease and has gained approval for treating different types of non-Alzheimer's dementia. In this review, we will focus on the two types of AChE-Is (rivastigmine and neostigmine) in the development of their clinical use and their respective mechanisms of actions on improving cognitive function and managing chronic pain.
Ketamine is considered a dissociative anesthetic medication, and it is commonly administered by a... more Ketamine is considered a dissociative anesthetic medication, and it is commonly administered by a parenteral route. It works mainly by blocking the N-methyl-D-aspartate receptor. It inhibits the voltage-gated Na and K channels and serotonin and dopamine reuptake; also, it affects specific receptors, such as a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid, kainate, and aminobutyric acid A receptors. Ketamine appears to have particular mechanisms that are potentially involved during analgesic induction, including enhancing of descending inhibition and antiinflammatory effects. More recently, it has been shown that ketamine has potential in clinical practice for the management of chronic pain, cognitive function, depression, acute brain injury, and disorders of the immune system.
The alpha-2 adrenergic receptor (α-2 AR) agonists have a long history of use in
treating differen... more The alpha-2 adrenergic receptor (α-2 AR) agonists have a long history of use in
treating different clinical conditions, such as hypertension, psychiatric entities
(e.g., attention-deficit hyperactivity disorder), chronic pain, panic disorders, and,
lately, for treating opioid withdrawal syndrome. In recent years, α-2 AR
medications have been administered as adjuncts for managing inflammatory
conditions, depression, chronic pain, sleep and cognitive disorders. This review
will provide some clinical applications in neuroscience for this class of drugs.
Understanding the pharmacological mechanisms is essential to obtaining
neurochemical data that demonstrate that α-2 AR agonists have potential clinical
significance in neuroscience.
Thesis Chapters by Jabril Eldufani, MD
Chronic pain is a multifactorial clinical condition that has negative impacts on physical, social... more Chronic pain is a multifactorial clinical condition that has negative impacts on physical, social, and emotional states of the patients. Globally, it affects approximately 20% of the population, especially in developed countries, and continues to exist as a significant problem in the elderly. However, in last two decades, there have been advances in pain treatment regarding analgesic medications and technical procedures. This review will provide a mechanism- and evidence-based approach to enhance the outcome for the pharmacologic management of chronic refractory pain while minimizing the negative impact on cognitive function. Therefore, this approach will discuss different types of medications that affect chronic pain, as well as the cognitive function (morphine, ketamine, bupivacaine, naloxone, clonidine, and neostigmine).
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Papers by Jabril Eldufani, MD
treating different clinical conditions, such as hypertension, psychiatric entities
(e.g., attention-deficit hyperactivity disorder), chronic pain, panic disorders, and,
lately, for treating opioid withdrawal syndrome. In recent years, α-2 AR
medications have been administered as adjuncts for managing inflammatory
conditions, depression, chronic pain, sleep and cognitive disorders. This review
will provide some clinical applications in neuroscience for this class of drugs.
Understanding the pharmacological mechanisms is essential to obtaining
neurochemical data that demonstrate that α-2 AR agonists have potential clinical
significance in neuroscience.
Thesis Chapters by Jabril Eldufani, MD
treating different clinical conditions, such as hypertension, psychiatric entities
(e.g., attention-deficit hyperactivity disorder), chronic pain, panic disorders, and,
lately, for treating opioid withdrawal syndrome. In recent years, α-2 AR
medications have been administered as adjuncts for managing inflammatory
conditions, depression, chronic pain, sleep and cognitive disorders. This review
will provide some clinical applications in neuroscience for this class of drugs.
Understanding the pharmacological mechanisms is essential to obtaining
neurochemical data that demonstrate that α-2 AR agonists have potential clinical
significance in neuroscience.