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Topic Review
Biography
Topic Review
General Anesthesia
Vertebral lumbar surgery can be performed under both general anesthesia (GA) and spinal anesthesia. A clear benefit from spinal anesthesia (SA) remains unproven.
574
20 Jan 2021
Topic Review
Cardiothoracic Surgical Critical Care Medicine
Cardiothoracic surgical critical care medicine (CT-CCM) is a medical discipline centered on the perioperative care of diverse groups of patients. With an aging demographic and an increase in burden of chronic diseases the utilization of cardiothoracic surgical critical care units is likely to escalate. Given these projections, it is important to assess the state of cardiothoracic surgical intensive care, to develop goals and objectives for the future, and to identify knowledge gaps in need of scientific inquiry.
565
09 Jan 2023
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.
551
04 Aug 2021
Topic Review
Intranasal Administration for Pain
Pain, and particularly chronic pain, remains one of the most debilitating and difficult to treat conditions in medicine. Chronic pain is difficult to treat, in part, because it is associated with plastic changes in the peripheral and central nervous systems. Polypeptides are linear organic polymers that are highly selective molecules for neurotransmitter and other nervous system receptors sites, including those associated with pain and analgesia, so have tremendous potential as pain therapeutics. However, delivery of polypeptides to the nervous system is largely limited due to rapid degradation within the peripheral circulation as well as the blood-brain barrier. One strategy that has been shown to be successful in nervous system deposition of polypeptides is intranasal (IN) delivery. In this narrative review, we discuss the delivery of polypeptides into the peripheral and central nervous systems following IN administration. We briefly discuss the mechanism of delivery via the nasal-cerebral pathway. We review recent studies that demonstrate that polypeptides such as oxytocin, delivered IN, not only reach key pain modulating regions in the nervous system but in doing so, evoke significant analgesic effects. IN administration of polypeptides has tremendous potential to provide non-invasive, rapid, and effective methods of delivery to the nervous system for chronic pain treatment and management.
537
23 Jul 2021
Topic Review
Treatment of Chronic Pain
The International Association for Study of Pain defines it as “an unpleasant sensory and emotional experience associated with or resembling that associated with, actual or potential tissue damage” .
517
30 Jun 2022
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.
505
12 Apr 2022
Topic Review
Volatile Anesthetic-Induced Organ Protection
Ischemia reperfusion injury (IRI) is inevitable in kidney transplantation and negatively impacts graft and patient outcome. Reperfusion takes place in the recipient and most of the injury following ischemia and reperfusion occurs during this reperfusion phase; therefore, the intra-operative period seems an attractive window of opportunity to modulate IRI and improve short- and potentially long-term graft outcome. Commonly used volatile anesthetics such as sevoflurane and isoflurane have been shown to interfere with many of the pathophysiological processes involved in the injurious cascade of IRI.
472
29 Apr 2021
Topic Review
Anesthesiology
Anesthesia literally means without sensation. There are a number of different types of anesthesia. They allow for safe and comfortable conscious or unconscious experiences during a surgical procedure.
464
10 May 2021
Topic Review
Ultrasound-Guided Saphenous Nerve Block in Rabbits
Ultrasound-guided (US-guided) loco-regional anesthesia techniques allow direct visualization and blockade of sensory nerves. The saphenous nerve (SN), a terminal branch of the femoral nerve (FN), is strictly a sensory nerve for which electrical locator devices are ineffective for localization as no effector muscle contractions can be evoked. US-guided SN block in species other than rabbits produces hind-limb analgesia without affecting FN motor function.
446
17 Mar 2022
Topic Review
Kynurenine's Role in Comorbid Chronic Pain and Depression
Chronic pain and depression affect millions of people worldwide, and their comorbidity tends to exacerbate the severity of each individual condition. Intersecting brain regions and molecular pathways could probably explain the unique yet complex bidirectional relationship between these two disorders. Recent studies have found that inflammatory reactions, frequently identified in both chronic pain and depression, stimulate certain enzymes in the kynurenine pathway, while concurrently suppressing others. Kynurenine, a major tryptophan derivative, and its metabolites have been implicated in several inflammation-associated pain syndromes and depressive mood disorders. Due to inflammation, 95% of tryptophan is metabolized via the kynurenine pathway, which drives the reaction towards the production of metabolites that have distinct roles in the pathophysiology of these disorders. Diminished levels of the neuroprotective metabolite, kynurenic acid (KYNA), and elevated levels of the neurotoxic metabolite, quinolinic acid (QUIN), have been frequently identified in human patients formally diagnosed with these disorders, as well as animal models commonly used in medical research. Researchers not only explored the epidemiology of comorbid chronic pain and depression, but also highlights the involvement of kynurenine and its metabolites, specifically KYNA and QUIN, in these pervasive conditions.
424
31 Oct 2022
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