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Topic review
Updated time: 03 Jun 2021
Submitted by: Federica Fati
Definition: 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.
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Topic review
Updated time: 10 May 2021
Submitted by: Alan David Kaye
Definition: 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.
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Topic review
Updated time: 02 Jul 2021
Submitted by: Gennaro Martucci
Definition: 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.
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Topic review
Updated time: 20 Jan 2021
Submitted by: De Cassai Alessandro
Definition: Vertebral lumbar surgery can be performed under both general anesthesia (GA) and spinal anesthesia. A clear benefit from spinal anesthesia (SA) remains unproven.
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Topic review
Updated time: 23 Jul 2021
Submitted by: Vimala Bharadwaj
Definition: 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.
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Topic review
Updated time: 28 Feb 2021
Submitted by: Hengrui Liu
Definition: 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.
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Topic review
Updated time: 30 Jun 2021
Submitted by: Nicola Disma
Definition: 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.
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Topic review
Updated time: 18 Feb 2021
Definition: 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.
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Topic review
Updated time: 09 Feb 2021
Definition: 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.
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Topic review
Updated time: 04 Aug 2021
Submitted by: Rafael Linhares
Definition: 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.
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