Articles: function.
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Anesthesia and analgesia · Jul 2023
Practice Advisory for Preoperative and Intraoperative Pain Management of Cardiac Surgical Patients: Part 2.
Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure. ⋯ This Practice Advisory provides recommendations for providers caring for patients undergoing cardiac surgery. This entails developing customized pain management strategies for patients, including preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various cardiac surgical procedures. The literature related to this field is emerging, and future studies will provide additional guidance on ways to improve clinically meaningful patient outcomes.
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Previous clinical trials have reported that the brain-computer interface (BCI) is a useful management tool for upper limb function recovery (ULFR) in stroke. However, there is insufficient evidence regarding this topic. Thus, this study aimed to investigate the effectiveness of verum versus sham BCI on the ULFR in stroke patients. ⋯ BCI may be an effective management strategy for ULFR in stroke patients. Future studies with larger sample size and strict design are still needed to warrant the current findings.
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Acute rupture of the fibular ligament complex is one of the commonest injuries in sports. Prospective randomized trials in the 1980s led to a paradigm shift from primary surgical repair to conservative functional treatment. ⋯ Conservative functional treatment is now the standard treatment in acute fibular ligament rupture of the ankle because it is low-risk, low-cost, and safe. Primary surgery is indicated in only 0.5% to 4% of cases. Physical examination for tenderness to palpation and for stability, as well as stress ultrasonography, can be used to differentiate sprains from ligamentous tears. MRI is superior only for the detection of additional injuries. Stable sprains can be successfully treated with an elastic ankle support for a few days, and unstable ligamentous ruptures with an orthosis for 5 to 6 weeks. Subsequent physiotherapy with proprioceptive exercises is the best way to prevent recurrent injury.
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Review Case Reports
Mature cystic teratoma of the ovary with a grossly visible, completely developed intestinal loop: A case report and review of the literature.
The mature cystic teratoma of the ovary (MCTO), is composed of mature differentiated elements, thus showing highly differentiated tissue and highly morphological heterogeneity. Although gastrointestinal epithelium can be identified in 7% to 13% of cases of MCTO, the occurrence of visible, functional, and fully developed loop tissue is rare in clinical practice. ⋯ The immune signature of CK7-/CK20+ is characteristic of tumors of gastrointestinal origin and can be used to distinguish tumors associated with mature cystic teratoma. Besides, gynecologists should keep an eye on the possibility of malignant transformation malignant transformation of MCTO.
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Review
A review of physiological functions of orexin: From instinctive responses to subjective cognition.
Orexin, also known as hypocretin, is an excitatory neuropeptide secreted by the hypothalamus. Orexin is divided into orexin-A (OXA) and orexin-B (OXB), which are derived from a common precursor secreted by hypothalamic neurons. Orexin acts on orexin receptor-1 (OX1R) and orexin receptor-2 (OX2R). ⋯ It is precisely because orexin has physiological functions in multiple systems that orexin, as a new target for the treatment of the above diseases, has potential contradictions. For example, it promotes the function of 1 system and may inhibit the function of another system. How to study a new drug, which can not only treat the diseases of this system, but also do not affect other system functions, is what we need to focus on.