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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.
  • 632
  • 12 Jul 2021
Topic Review
Taming Postoperative Delirium with Dexmedetomidine
Postoperative delirium (POD) represents a perioperative neurocognitive disorder that has dreaded ramifications on a patient’s recovery from surgery. Dexmedetomidine displays multiple mechanisms of neuroprotection to assist in preventing POD as a part of a comprehensive anesthetic care plan.
  • 135
  • 18 Dec 2023
Topic Review
Sugammadex for Rocuronium-Induced Neuromuscular Blockade
Sugammadex (Bridion®, Merk Sharp and Dohme Corp., Kenilworth, NJ, USA) is a modified cyclodextrin designed to selectively encapsulate aminosteroidal neuromuscular blocking agents (NMBAs) such as rocuronium and vecuronium, which leads to the rapid reversal of neuromuscular block (NMB).
  • 356
  • 07 Dec 2021
Topic Review
Role of Brain-Derived Neurotrophic Factor in Chronic Pain
Chronic pain is sustained, in part, through the intricate process of central sensitization (CS), marked by maladaptive neuroplasticity and neuronal hyperexcitability within central pain pathways. Accumulating evidence suggests that CS is also driven by neuroinflammation in the peripheral and central nervous system. In any chronic disease, the search for perpetuating factors is crucial in identifying therapeutic targets and developing primary preventive strategies. The brain-derived neurotrophic factor (BDNF) emerges as a critical regulator of synaptic plasticity, serving as both a neurotransmitter and neuromodulator. Mounting evidence supports BDNF’s pro-nociceptive role, spanning from its pain-sensitizing capacity across multiple levels of nociceptive pathways to its intricate involvement in CS and neuroinflammation.
  • 56
  • 15 Mar 2024
Topic Review
Residual Neuromuscular Block
Residual neuromuscular block (RNMB) remains a significant safety concern for patients throughout the perioperative period and is still widely under-recognized by perioperative healthcare professionals. Current literature suggests an association between RNMB and an increased risk of postoperative pulmonary complications, a prolonged length of stay in the post anesthesia care unit (PACU), and decreased patient satisfaction. The 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade provide guidance for the use of quantitative neuromuscular monitoring coupled with neuromuscular reversal to recognize and reduce the incidence of RNMB. Using sugammadex for the reversal of neuromuscular block as well as quantitative neuromuscular monitoring to quantify the degree of neuromuscular block may significantly reduce the risk of RNMB among patients undergoing general anesthesia. Studies are forthcoming to investigate how using neuromuscular blocking agent reversal with quantitative monitoring of the neuromuscular block may further improve perioperative patient safety.
  • 94
  • 26 Feb 2024
Topic Review
Redox Disturbance and Inflammation during General Anesthesia
Worldwide, the prevalence of surgery under general anesthesia has significantly increased, both because of modern anesthetic and pain-control techniques and because of better diagnosis and the increased complexity of surgical techniques. Apart from developing new concepts in the surgical field, researchers and clinicians are now working on minimizing the impact of surgical trauma and offering minimal invasive procedures due to the recent discoveries in the field of cellular and molecular mechanisms that have revealed a systemic inflammatory and pro-oxidative impact not only in the perioperative period but also in the long term, contributing to more difficult recovery, increased morbidity and mortality, and a negative financial impact. Detailed molecular and cellular analysis has shown an overproduction of inflammatory and pro-oxidative species, responsible for augmenting the systemic inflammatory status and making postoperative recovery more difficult. Moreover, there are a series of changes in certain epigenetic structures, the most important being the microRNAs.
  • 332
  • 21 Jul 2022
Topic Review
Preoperative Anemia in Vascular Patients
Anemia is a common condition in preoperative period of peripheral arterial disease patients. Anemia has multifactorial causes, including: iron deficiency; vitamin deficiency and inflammation; and chronic kidney disease. Some retrospective researches demonstrated, that preprocedural anemia is a predictor adverse outcomes in patients undergoing percutaneous transluminal angioplasty for vascular disease treatment. These outcomes are increase likelihood of: A) transfusion; B) amputation; C) and major adverse cardiovascular events.It is not clear if preoperative anemia optimization with iron and/or erythropoietin, reduce major adverse outcomes in patients submitted to vascular peripheral surgeries. 
  • 559
  • 04 Aug 2021
Topic Review
Plasma Renin Concentration in Critically Ill COVID-19 Patients
Plasma renin concentration as a marker of organ perfusion in several intensive care settings have shown a significant correlation between its increase and a lack of perfusion in critical tissues, especially in septic patients.
  • 360
  • 04 Nov 2021
Topic Review
Phonomyography on Perioperative Neuromuscular Monitoring
Muscle contraction by lateral movement of muscle fibers can create acoustic signals with a low frequency, and the signals that occur can be transmitted to the surface of the skin. After collection and filtration, these sound signals will be transferred into electric signals, which can be evaluated quantitatively for perioperative neuromuscular monitoring.
  • 515
  • 12 Apr 2022
Topic Review
Pharmacological Management in Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is a common complication of longstanding diabetes mellitus. These neuropathies can present in various forms, and with the increasing prevalence of diabetes mellitus, a subsequent increase in peripheral neuropathy cases has been noted. Peripheral neuropathy has a significant societal and economic burden, with patients requiring concomitant medication and often experiencing a decline in their quality of life. There is currently a wide variety of pharmacological interventions, including serotonin norepinephrine reuptake inhibitors, gapentanoids, sodium channel blockers, and tricyclic antidepressants. 
  • 304
  • 08 Jun 2023
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