Mendeley Data Showcase

Anesthesiology, Neurology, Acupuncture, Pain Management, Renal Failure, Cognitive Psychology, Surgical anesthesia

Chronic kidney disease (CKD) is defined as either a glomerular filtration rate (GFR) of <60 ml min−1 1.73 m−2 for 3 months or more, irrespective of cause, or kidney damage leading to a decrease in GFR, present for 3 months or more. The damage may manifest as abnormalities in the composition of blood or urine, on radiological imaging, or in histology. CKD is classified into five stages depending on GFR, ranging from Stage 1 - normal GFR to Stage 5 - established renal failure. Patients with kidney disease undergoing surgery and anesthesia are at high risk for increased adverse events that include, cardiovascular complications and mortality, and further deterioration of renal function and development of acute kidney injury (AKI) due to perioperative injuries that are caused by hemodynamic instability, hypovolemia, or drug toxicity. Special consideration should be placed on preventing further deterioration of renal function as well as protection of existing renal function in patients with moderate to severe impairment from the effects of anesthetics and pain medications. Analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) can contribute to a reduction of the residual renal function in CKD and should be avoided. Renal IR injury is a risk factor for acute renal failure and delayed graft function. Pathogenic factors for renal IR include, but are not limited to, the following: oxidative stress, inflammation, cellular necrosis, and apoptosis. Further clinical studies are required to address the optimal medication regimen that can be used for postoperative pain management in the more severe stages of CKD, including hemodialysis.

Autism is the fastest growing serious developmental disability. Infantile autism is associated with a characteristic cognitive, language and behavioral features. Autism spectrum disorders (ASD) have lifelong effects on areas of individual daily life functioning such as learning, relationships and independence. The future of anesthetic management of ASD will depend on how well we understand the etiology, psycho-social and medical issues with the disease. A wide spectrum of medical and behavioral symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Autism is a neurobehavioral and cognitive disorder characterized by impaired development of interpersonal and communication skills, limited interests, and repetitive behaviors. American Academy of Paediatric Dentistry's guidelines on Caries Risk Assessment has categorized them under High risk for physicians and other nondental health care providers and Moderate risk for dental providers. Attitude and knowledge of the oral health care professionals are of utmost importance while rendering oral health care to such children. The treatment rendered currently provides a long-term benefit for the patient. More focus had to be given for the long-term maintenance of oral health in special children. A 24-year-old autistic child with a history of seizures came to the operating room where he received general anesthesia for dental work. The awakening was particularly slow, as the patient's condition was characterized as severe autism with the corresponding medication, which interacts with the anesthetic drugs and makes awakening difficult.

The health-related quality of life (HRQL) contains many aspects under patients' health as physical, psychological, social function and a general prosperity. Numerous clinical studies have established the importance of quality of life in various diseases. It is extremely popular to assess the quality of life in clinical trials as a measure of the subjective state of health of patients. The HRQL, also gradually recognized as an important measure of outcome after organ transplantation. Along with other indicators related to the improvement of patient and graft survival, quality of life has been assessed as a valid outcome measure. Investigations on the quality of life are aimed to lead to a broader view of subjective health, consider that health is a puzzle of the general welfare. Kidney transplantation is the treatment of choice in end stage renal failure. Progress in renal transplantation and immunosuppressive therapies have increased significantly in recent decades, resulting in allograft survival rates at one year is now over 90%. The main goal of transplantation is to achieve maximum quality and longevity while minimizing the impact of disease and health care costs. In general, the quality of life improved after successful renal transplantation compared with patients on dialysis, and the result was more pronounced in men than in women. In these studies it seems clear that renal transplantation is not only cheaper replacement therapy over time, but also linked to lower mortality and better quality of life for patient

Background and purpose: Neuropathic pain (NP) is often refractory to pharmacologic and non-interventional treatment. Neuropathic pain can be distinguished from non-neuropathic pain by two factors. In neuropathic pain there is no transduction (conversion of a nociceptive stimulus into an electrical impulse). Finally, injury to major nerves is more likely than injury to non-nervous tissue to result in chronic pain. This review focuses on the clinical treatment of neuropathic pain as well aims to improve the care of adults with neuropathic pain. Methods: Clinical treatment of neuropathic pain depends on clinical evaluation, as treatment can be pharmacological or not; invasive treatment or other therapies. Results: Neuropathic pain because of its heterogeneity, there is often uncertainty regarding the nature and exact location of a lesion or health condition associated with neuropathic pain. Conclusions:Both peripheral and central nervous system mechanisms contribute to the persistence of most types of neuropathic pain. Patients with conditions as diverse as diabetic polyneuropathy, human immunodeficiency virus (HIV) sensory neuropathy, poststroke syndromes, and multiple sclerosis frequently experience daily pain that greatly impairs their quality of life. Implications: Progress in basic science will lead to a greater understanding of the pathophysiologic mechanisms of neuropathic pain.

Word "pain" derives its origin from the Indo-European root aleg meaning to suffer. Word "pain" is later and comes from the Latin word "poena" meaning punishment. Since ancient times there has been disagreement regarding the perception of pain and its evaluation. Unlike sight, hearing and smell, pain does not seem to be a primary sensation, but rather an emotional experience. Most pain researchers view pain as a complex perception, induced by noxious stimuli. Although pain is the most frequent symptom in medicine and despite the enormous advances that have been made in the field of analgesia and anesthesia, the pathophysiological mechanisms involved in its generation and maintenance are not fully understood. Definition of pain was given in 1979 by the classification committee of the international association for the study of pain (IASP) "as an unpleasant aesthetic and emotional experience, associated with actual or potential tissue damage or described in terms of such damage". In other words, although physiology and anatomy determine a precise point of reference for the detection and transmission of messages interpreted as painful, what differentiates the experience of pain is the fact that there is always an emotional gradient to the experience of pain. The purpose of the review is to investigate the analgesic system. Pain signals can be blocked at their initial point of entry into the spinal cord. Analgesia system may also inhibit pain transmission elsewhere in the nociceptive pathway.

Acupuncture involves activating specific points on the skin, usually by inserting needles. Acupuncture was based on the principles of traditional Chinese Medicine. Traditional acupuncturists understood health in terms of a vital force or energy called "Qi" that circulates between the organs along channels called meridians. The flow of 'Qi' energy must be of the right strength and quality in each of these meridians and organs so that health is maintained. Acupoints are located along the meridians and can alter the flow of energy and appear to correspond to nerve endings. There is a distinct difference between traditional and Western acupuncture, but the two approaches overlap significantly. In terms of Western theories, acupuncture induces signals in central nerves that modify the transmission through the spinal cord, as well as the perception of pain in the brain. Electrotherapy leads to stimulation of the sensory and motor nerves, and is especially used in the treatment of pain. Different set of parameters may lead to different physiological effects and treatment may be more specific. Electroacupuncture can be performed with or without needles, activating traditional acupuncture points or choosing points that have a neural background, such as trigger points or tender points. The purpose of this study is to verify that acupuncture works as an effective alternative and complementary treatment method. It is a safe, effective and natural approach, which helps to regain and maintain health and mental well-being.

The combined spinal-epidural (CSE) technique, a comparatively new anesthetic choice, includes an initial subarachnoid injection followed by epidural catheter placement and subsequent administration of epidural medications. Clinical studies have demonstrated that the CSE technique provides excellent surgical conditions as quickly as with single-shot subarachnoid block conditions that are better than with epidural block alone. A 72-year-old man with pelvic tumor undergoing laparotomy surgery underwent combined regional anesthesia (Th12 - O1) plus small doses of Ketamine via intravenus infusion. The combined spinal-epidural technique along with intravenous Ketamine offers a better analgesic and hemodynamic result.

Emergency defines the potential provision of rapid and effective Medical Nursing Care, in situations where life is threatened. Emergency medicine is defined as the branch of Medicine that operates within an organized EMS. Emergency Medicine System (EMS) is defined as the organized set of provision of immediate pre-hospital, in-hospital and inter-hospital care. Objectives of Emergency Medicine are the provision of an integrated system of pre-hospital, in-hospital and inter-hospital emergency care; improving the quality of emergency medical care; reduction of mortality, morbidity and disability related to injury and sudden illness. Collection of epidemiological data related to accident prevention and health promotion

Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Obese 10-year-old boy undergoes general anesthesia for emergency peritonitis surgery. The purpose of this study was to study the intraoperative behavior of obese children as they are accompanied by respiratory and metabolic disorders.