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Topic Review
Local Anesthesia in Cancer Surgeries
The application of local anaesthetics is frequently involved in anaesthesia in the surgical treatment of various cancers. It is used in addition to or instead of general anaesthesia as a way to provide control of sensation and pain to specific regions or parts of the patients' bodies. They are thought to reduce the requirement for volatile anaesthetics and opioids used in the surgery.
  • 1.2K
  • 28 Feb 2021
Topic Review
Neuro-Monitoring in Intravenous Anaesthesia
The monitoring of hypnosis depth by means of electroencephalogram-based (EEG-based) systems is emerging in paediatric anaesthesia common practice. This monitor system measures specific EEG signs which derive from anaesthetic-induced changes in neuronal firing.
  • 1.1K
  • 30 Jun 2021
Topic Review
Vasovagal Reactions during Interventional Pain Management Procedures
Vasovagal reactions—defined as a rapid drop in heart rate and/or blood pressure, usually in response to a stressful trigger—are a common complication of interventional pain management procedures. Three types of vasovagal responses have been described in the literature: a cardioinhibitory form (HR < 40 bpm), vasodepressor form (SBP < 80 mmHg or decrease by >30% without significant HR reduction), or mixed form (HR < 40 bpm and SBP < 80 mmHg or decrease by >30%). Typical symptoms of a vasovagal reaction are lightheadedness or dizziness, palpitations, weakness, blurred vision, nausea, feelings of warmth or coldness, and sweating. When a vasovagal reaction results in a loss of consciousness, it is termed vasovagal syncope. Although vasovagal reactions are usually benign in nature, they can lead to more serious complications for both patients and providers, such as aborted procedures, cardiac arrythmias, or fear of future procedures. It is thus useful for pain medicine clinicians to identify the risk factors, prevention, and management of vasovagal reactions in an outpatient setting.
  • 1.0K
  • 03 Aug 2022
Topic Review
Xenograft Model in Animal Models of Cancer
Animal models of cancer may be classified in a variety of ways. Most simply, they are either spontaneous or induced and mammalian or non-mammalian. Alternatively, they may be categorized by the method of inducing cancer occurrence. A xenograft model involves the transplantation of cancer cells from one species (e.g., human) into a host animal of a different species (e.g., mouse).
  • 880
  • 18 Oct 2022
Topic Review
Anesthesia in Children with Neuroblastoma
Neuroblastoma (NB) is the most common extracranial, solid, pediatric malignancy and, despite the constant progress of treatment and development of innovative therapies, remains a complex, challenging disease causing major morbidity and mortality in children.
  • 871
  • 03 Jun 2021
Topic Review
Neuropathic Pain
Neuropathic pain in humans arises as a consequence of injury or disease of somatosensory nervous system at peripheral or central level. Peripheral neuropathic pain is more common than central neuropathic pain, and is supposed to result from peripheral mechanisms, following nerve injury. The animal models of neuropathic pain show extensive functional and structural changes occurring in neuronal and non-neuronal cells in response to peripheral nerve injury. These pathological changes following damage lead to peripheral sensitization development, and subsequently to central sensitization initiation with spinal and supraspinal mechanism involved. The aim of this narrative review paper is to discuss the mechanisms engaged in peripheral neuropathic pain generation and maintenance, with special focus on the role of glial, immune, and epithelial cells in peripheral nociception. Based on the preclinical and clinical studies, interactions between neuronal and non-neuronal cells have been described, pointing out at the molecular/cellular underlying mechanisms of neuropathic pain, which might be potentially targeted by topical treatments in clinical practice. The modulation of the complex neuro-immuno-cutaneous interactions in the periphery represents a strategy for the development of new topical analgesics and their utilization in clinical settings.
  • 850
  • 18 Feb 2021
Topic Review
Patient-Controlled Analgesia
Patient-controlled analgesia (PCA) is an effective method for controlling acute pain, including postoperative pain in adults and in children from five years of age, pain resulting from labor, trauma, or other medical situations, or chronic and malignant pain. The treatment consists of a mini-computer-controlled infusion pump permitting the administration of on-demand, continuous, or combined doses of analgesic (mainly opioid) variations in response to therapy, which allows pain to be significantly controlled. Intravenous (IV)-PCA minimizes individual pharmacodynamics and pharmacokinetic differences and is widely accepted as a reference method for mild or severe postoperative pain. IV-PCA is the most studied route of PCA; other delivery methods have been extensively reported in the literature. In addition, IV-PCA usually voids the gap between pain sensation and analgesic administration, permitting better recovery and fewer side effects. The most commonly observed complications are nausea and vomiting, pruritus, respiratory depression, sedation, confusion and urinary retention. However, human factors such as pharmacy preparation and device programming can also be involved in the occurrence of these complications, while device failure is much less of an issue. 
  • 738
  • 10 Mar 2022
Topic Review
Nociceptive TRP Channel
Transient receptor potential (TRP) channels have emerged as key molecular identities in the sensory transduction of pain-producing stimuli. The ability of nociceptors to behave as noxious stimuli detectors relies on the presence of specialized transducing molecules at their peripheral nerve terminals capable of transforming the harmful physical (thermal and mechanical) and chemical stimuli into generator potentials. Upon nerve terminal stimulation, the output signal conveying to the central nervous system depends on the properties of transducer channels which produce generator potentials. Voltage-gated channels subsequently translate it into action potential firing. Nociceptive TRP channels are among the most studied transducer channels expressed in nociceptors and play a pivotal role in the study of pain.
  • 681
  • 09 Feb 2021
Topic Review
The Coupling in Biological Membranes
Cell membrane structure is proposed as a lipid matrix with embedded proteins, and thus, their emerging mechanical and electrostatic properties are commanded by lipid behavior and their interconnection with the included and absorbed proteins, cytoskeleton, extracellular matrix and ionic media. Structures formed by lipids are soft, dynamic and viscoelastic, and their properties depend on the lipid composition and on the general conditions, such as temperature, pH, ionic strength and electrostatic potentials. The dielectric constant of the apolar region of the lipid bilayer contrasts with that of the polar region, which also differs from the aqueous milieu, and these changes happen in the nanometer scale. Besides, an important percentage of the lipids are anionic, and the rest are dipoles or higher multipoles, and the polar regions are highly hydrated, with these water molecules forming an active part of the membrane. Therefore, electric fields (both, internal and external) affects membrane thickness, density, tension and curvature, and conversely, mechanical deformations modify membrane electrostatics. As a consequence, interfacial electrostatics appears as a highly important parameter, affecting the membrane properties in general and mechanical features in particular.
  • 614
  • 12 Jul 2021
Topic Review
Endocrine Challenges with Continuous-Flow LVADs
Heart failure (HF) remains a leading cause of morbidity, hospitalization, and mortality worldwide. Advancement of mechanical circulatory support technology has led to the use of continuous-flow left ventricular assist devices (LVADs), reducing hospitalizations, and improving quality of life and outcomes in advanced HF. Recent studies have highlighted how metabolic and endocrine dysfunction may be a consequence of, or associated with, HF, and may represent a novel (still neglected) therapeutic target in the treatment of HF. On the other hand, it is not clear whether LVAD support, may impact the outcome by also improving organ perfusion as well as improving the neuro-hormonal state of the patients, reducing the endocrine dysfunction. Moreover, endocrine function is likely a major determinant of human homeostasis, and is a key issue in the recovery from critical illness. Care of the endocrine function may contribute to improving cardiac contractility, immune function, as well as infection control, and rehabilitation during and after a LVAD placement.
  • 611
  • 02 Jul 2021
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