Ricardo Vallejo - Academia.edu (original) (raw)
Papers by Ricardo Vallejo
Journal of Pain and Symptom Management, Apr 1, 2003
Pain physician
The perpetual pursuit of pain elimination has been constant throughout human history and pervades... more The perpetual pursuit of pain elimination has been constant throughout human history and pervades human cultures. In some ways it is as old as medicine itself. Cultures throughout history have practiced the art of pain management through remedies such as oral ingestion of herbs or techniques believed to have special properties. In fact, even Hippocrates wrote about the practice of trepanation, the cutting of holes in the body to release pain. Current therapies for management of pain include the pervasive utilization of opioids, which have an extensive history, spanning centuries. There is general agreement about the appropriateness of opioids for the treatment of acute and cancer pain, but the long-term use of these drugs for treatment of chronic non-malignant pain remains controversial. The pros and cons regarding these issues are beyond the scope of this review. Instead, the purpose of this review will be directed towards the pharmacology of commonly prescribed opioids in the trea...
Journal of the European Academy of Dermatology and Venereology : JEADV, Jan 23, 2015
The purpose of this study was to delineate the relationship of the terminal extensor hallucis lon... more The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad(®) software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. The main re...
Pain physician
The perpetual pursuit of pain elimination has been constant throughout human history and pervades... more The perpetual pursuit of pain elimination has been constant throughout human history and pervades human cultures. In some ways it is as old as medicine itself. Cultures throughout history have practiced the art of pain management through remedies such as oral ingestion of herbs or techniques believed to have special properties. In fact, even Hippocrates wrote about the practice of trepanation, the cutting of holes in the body to release pain. Current therapies for management of pain include the pervasive utilization of opioids, which have an extensive history, spanning centuries. There is general agreement about the appropriateness of opioids for the treatment of acute and cancer pain, but the long-term use of these drugs for treatment of chronic non-malignant pain remains controversial. The pros and cons regarding these issues are beyond the scope of this review. Instead, the purpose of this review will be directed towards the pharmacology of commonly prescribed opioids in the trea...
Beliefs and Values, 2010
... Travel Medicine and Infectious Disease, 6, 411. Marin Sanchez, M., Infante Rejano, E., &... more ... Travel Medicine and Infectious Disease, 6, 411. Marin Sanchez, M., Infante Rejano, E., & Trojano Rodriguez, Y. (2001). Personality and academic productivity in the univer-sity student. ... Jerusalem: Van Leer Institute & Elka. Monroy de Velasco, A. (1985). ...
Journal of the European Academy of Dermatology and Venereology, 2010
Journal of the European Academy of Dermatology and Venereology, 2013
Journal of the American Academy of Dermatology, 2011
Journal of the American Academy of Dermatology, 2009
Orthopedic surgical procedures involving the foot and ankle are associated with high rates of inf... more Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown. This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions. In this prospective, randomized study, 4 methods of skin and nail preparation were compared in terms of their efficacy in eliminating bacteria from the hallux nailfold and first web space of the normal foot in 28 healthy adult volunteers. Efficacy was determined by evaluating the difference in the total bacterial load before and after skin preparation. The foot-preparation solutions evaluated were 4% chlorhexidine gluconate, 70% isopropyl alcohol, and 7.5% to 10% povidone-iodine. The addition of alcohol to povidone-iodine was found to increase the efficacy of the preparation method. The nailfold remained contaminated after any of the preoperative skin- and nail-preparation methods studied. This study did not measure clinically relevant infections, and the results may not correlate with decreased rates of infection after surgery. Incorporation of alcohol and povidone-iodine into the preoperative skin- and nail-preparation process may help reduce the bacterial load. Every effort should be made to lower the risk of contamination from the nail.
Journal of Pain and Symptom Management, 2003
Dermatologic Surgery, 2008
Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studi... more Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studies have documented the safety of phenol matrixectomy for the patient, few studies have investigated the procedure's safety for the physician and auxiliary health care personnel. This study was undertaken to evaluate the safety of phenol vapor inhalation for health care personnel during performance of chemical matrixectomy. The environmental concentrations of phenol in the respiration zones of the physician and an assistant were measured during an in-office surgical procedure consisting of two partial chemical matrixectomies using a 95% phenol solution. The samples were analyzed using gas chromatography with a flame ionization detector. The phenol concentration measured in the physician's respiration zone was close to Spain's established environmental limit of daily exposure, with an index of exposure of 60%. The concentration measured in the assistant's respiration zone was well below the environmental limit of daily exposure, with an index of exposure of only 10%. The performance of chemical matrixectomies is safe for health care personnel when they are exposed to the vapor of phenol solutions of up to 95% concentration for up to 21 minutes. The degree of safety would be greater with lower phenol concentrations and shorter exposure times.
Dermatologic Surgery, 2010
The Clinical Journal of Pain, 2003
Anesthesia & Analgesia, 2002
We describe the first case of Shy-Drager syndrome diagnosed on the basis of intraoperative hemody... more We describe the first case of Shy-Drager syndrome diagnosed on the basis of intraoperative hemodynamic changes. The initial hypertension in the supine position followed by severe hypotension after hydralazine administration, ultimately responsive to vasopressin, led to a diagnosis of Shy-Drager syndrome. We suggest that vasopressin may be the drug of choice in patients with Shy-Drager syndrome with refractory hypotension.
Regional anesthesia and pain medicine
Perioperative management of patients on anticoagulant therapy prior to interventional pain proced... more Perioperative management of patients on anticoagulant therapy prior to interventional pain procedures creates a challenge when balancing the risk of bleeding against thromboembolic events. We report a case of epidural hematoma formation in the cervical spine following interlaminar epidural steroid injection in an elderly woman with chronic neck and arm pain, who was on clopidogrel therapy. This is the first reported case of hematoma formation immediately following an epidural steroid injection possibly associated with clopidogrel, even though established guidelines on the timing of the discontinuation of clopidogrel prior to the procedure were exceeded. Severe pain appears to be the first symptom of hematoma formation, and therefore immediate diagnostic workup and evacuation of hematoma are essential in preventing neurological damage. It may be advisable to carry out a test specific for clopidogrel such as the P2Y12 to ensure that there is no residual action on platelet aggregation ...
The Journal of Immunology, Apr 1, 2007
The Faseb Journal, Mar 1, 2008
Neuromodulation : journal of the International Neuromodulation Society, 2016
Currently available central nervous system treatment strategies are often insufficient in managem... more Currently available central nervous system treatment strategies are often insufficient in management of peripheral neuropathic pain, prompting a resurgence of neuromodulation focused on peripheral pain. A new peripheral nerve stimulation device was investigated in a prospective, randomized, double blind, crossover study, looking specifically at efficacy and safety, with Food and Drug Administration oversight. Prospective, multicenter, randomized, double-blind, partial crossover study to assess safety and efficacy. After IRB approval, patients were enrolled, implanted, and then followed for three months to assess efficacy and one year for safety based on Food and Drug Administration guidance. One hundred forty-seven patients were consented and screened for the study. Thirty-five did not meet inclusion or exclusion criteria. Ninety-four patients were implanted and then randomized to the treatment (45) or the Control group (49). The primary efficacy endpoint, three months after randomi...
The Faseb Journal, Apr 1, 2009
Journal of Pain and Symptom Management, Apr 1, 2003
Pain physician
The perpetual pursuit of pain elimination has been constant throughout human history and pervades... more The perpetual pursuit of pain elimination has been constant throughout human history and pervades human cultures. In some ways it is as old as medicine itself. Cultures throughout history have practiced the art of pain management through remedies such as oral ingestion of herbs or techniques believed to have special properties. In fact, even Hippocrates wrote about the practice of trepanation, the cutting of holes in the body to release pain. Current therapies for management of pain include the pervasive utilization of opioids, which have an extensive history, spanning centuries. There is general agreement about the appropriateness of opioids for the treatment of acute and cancer pain, but the long-term use of these drugs for treatment of chronic non-malignant pain remains controversial. The pros and cons regarding these issues are beyond the scope of this review. Instead, the purpose of this review will be directed towards the pharmacology of commonly prescribed opioids in the trea...
Journal of the European Academy of Dermatology and Venereology : JEADV, Jan 23, 2015
The purpose of this study was to delineate the relationship of the terminal extensor hallucis lon... more The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad(®) software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. The main re...
Pain physician
The perpetual pursuit of pain elimination has been constant throughout human history and pervades... more The perpetual pursuit of pain elimination has been constant throughout human history and pervades human cultures. In some ways it is as old as medicine itself. Cultures throughout history have practiced the art of pain management through remedies such as oral ingestion of herbs or techniques believed to have special properties. In fact, even Hippocrates wrote about the practice of trepanation, the cutting of holes in the body to release pain. Current therapies for management of pain include the pervasive utilization of opioids, which have an extensive history, spanning centuries. There is general agreement about the appropriateness of opioids for the treatment of acute and cancer pain, but the long-term use of these drugs for treatment of chronic non-malignant pain remains controversial. The pros and cons regarding these issues are beyond the scope of this review. Instead, the purpose of this review will be directed towards the pharmacology of commonly prescribed opioids in the trea...
Beliefs and Values, 2010
... Travel Medicine and Infectious Disease, 6, 411. Marin Sanchez, M., Infante Rejano, E., &... more ... Travel Medicine and Infectious Disease, 6, 411. Marin Sanchez, M., Infante Rejano, E., & Trojano Rodriguez, Y. (2001). Personality and academic productivity in the univer-sity student. ... Jerusalem: Van Leer Institute & Elka. Monroy de Velasco, A. (1985). ...
Journal of the European Academy of Dermatology and Venereology, 2010
Journal of the European Academy of Dermatology and Venereology, 2013
Journal of the American Academy of Dermatology, 2011
Journal of the American Academy of Dermatology, 2009
Orthopedic surgical procedures involving the foot and ankle are associated with high rates of inf... more Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown. This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions. In this prospective, randomized study, 4 methods of skin and nail preparation were compared in terms of their efficacy in eliminating bacteria from the hallux nailfold and first web space of the normal foot in 28 healthy adult volunteers. Efficacy was determined by evaluating the difference in the total bacterial load before and after skin preparation. The foot-preparation solutions evaluated were 4% chlorhexidine gluconate, 70% isopropyl alcohol, and 7.5% to 10% povidone-iodine. The addition of alcohol to povidone-iodine was found to increase the efficacy of the preparation method. The nailfold remained contaminated after any of the preoperative skin- and nail-preparation methods studied. This study did not measure clinically relevant infections, and the results may not correlate with decreased rates of infection after surgery. Incorporation of alcohol and povidone-iodine into the preoperative skin- and nail-preparation process may help reduce the bacterial load. Every effort should be made to lower the risk of contamination from the nail.
Journal of Pain and Symptom Management, 2003
Dermatologic Surgery, 2008
Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studi... more Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studies have documented the safety of phenol matrixectomy for the patient, few studies have investigated the procedure's safety for the physician and auxiliary health care personnel. This study was undertaken to evaluate the safety of phenol vapor inhalation for health care personnel during performance of chemical matrixectomy. The environmental concentrations of phenol in the respiration zones of the physician and an assistant were measured during an in-office surgical procedure consisting of two partial chemical matrixectomies using a 95% phenol solution. The samples were analyzed using gas chromatography with a flame ionization detector. The phenol concentration measured in the physician's respiration zone was close to Spain's established environmental limit of daily exposure, with an index of exposure of 60%. The concentration measured in the assistant's respiration zone was well below the environmental limit of daily exposure, with an index of exposure of only 10%. The performance of chemical matrixectomies is safe for health care personnel when they are exposed to the vapor of phenol solutions of up to 95% concentration for up to 21 minutes. The degree of safety would be greater with lower phenol concentrations and shorter exposure times.
Dermatologic Surgery, 2010
The Clinical Journal of Pain, 2003
Anesthesia & Analgesia, 2002
We describe the first case of Shy-Drager syndrome diagnosed on the basis of intraoperative hemody... more We describe the first case of Shy-Drager syndrome diagnosed on the basis of intraoperative hemodynamic changes. The initial hypertension in the supine position followed by severe hypotension after hydralazine administration, ultimately responsive to vasopressin, led to a diagnosis of Shy-Drager syndrome. We suggest that vasopressin may be the drug of choice in patients with Shy-Drager syndrome with refractory hypotension.
Regional anesthesia and pain medicine
Perioperative management of patients on anticoagulant therapy prior to interventional pain proced... more Perioperative management of patients on anticoagulant therapy prior to interventional pain procedures creates a challenge when balancing the risk of bleeding against thromboembolic events. We report a case of epidural hematoma formation in the cervical spine following interlaminar epidural steroid injection in an elderly woman with chronic neck and arm pain, who was on clopidogrel therapy. This is the first reported case of hematoma formation immediately following an epidural steroid injection possibly associated with clopidogrel, even though established guidelines on the timing of the discontinuation of clopidogrel prior to the procedure were exceeded. Severe pain appears to be the first symptom of hematoma formation, and therefore immediate diagnostic workup and evacuation of hematoma are essential in preventing neurological damage. It may be advisable to carry out a test specific for clopidogrel such as the P2Y12 to ensure that there is no residual action on platelet aggregation ...
The Journal of Immunology, Apr 1, 2007
The Faseb Journal, Mar 1, 2008
Neuromodulation : journal of the International Neuromodulation Society, 2016
Currently available central nervous system treatment strategies are often insufficient in managem... more Currently available central nervous system treatment strategies are often insufficient in management of peripheral neuropathic pain, prompting a resurgence of neuromodulation focused on peripheral pain. A new peripheral nerve stimulation device was investigated in a prospective, randomized, double blind, crossover study, looking specifically at efficacy and safety, with Food and Drug Administration oversight. Prospective, multicenter, randomized, double-blind, partial crossover study to assess safety and efficacy. After IRB approval, patients were enrolled, implanted, and then followed for three months to assess efficacy and one year for safety based on Food and Drug Administration guidance. One hundred forty-seven patients were consented and screened for the study. Thirty-five did not meet inclusion or exclusion criteria. Ninety-four patients were implanted and then randomized to the treatment (45) or the Control group (49). The primary efficacy endpoint, three months after randomi...
The Faseb Journal, Apr 1, 2009