Anesthesia and analgesia
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As of November 2016, the Florida Department of Health (FDH) and the Centers for Disease Control and Prevention have confirmed more than 4000 travel-related Zika virus (ZIKV) infections in the United States with >700 of those in Florida. There have been 139 cases of locally acquired infection, all occurring in Miami, Florida. Within the US territories (eg, Puerto Rico, US Virgin Islands), >30,000 cases of ZIKV infection have been reported. ⋯ In an effort to meet anesthetic preparedness for the care of potential Zika-positive patients and perinatal management of babies born with ZIKA Congenital Syndrome, this review highlights the interim guidelines from the Centers for Disease Control and Prevention and also suggest anesthetic implications and recommendations. In addition, this article reviews guidance for the evaluation and anesthetic management of infants with congenital ZIKV infection. To better manage the perioperative care of affected newborns, this article also reviews the comparative anesthetic implications of babies born with related congenital malformations.
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Anesthesia and analgesia · Jun 2017
Quality Assessment of Meta-analyses Published in Leading Anesthesiology Journals From 2005 to 2014.
Meta-analysis, when preceded by a systematic review, is considered the "gold standard" in data aggregation; however, the quality of meta-analyses is often questionable, leading to uncertainty about the accuracy of results. In this study, we evaluate the quality of meta-analyses published in 5 leading anesthesiology journals from 2005 to 2014. A total of 220 meta-analyses published in Anesthesiology, Pain, British Journal of Anaesthesia, Anaesthesia, or Anesthesia & Analgesia were identified for inclusion. ⋯ Similarly, a temporal association was found for conflict of interest (rs = 0.51, P < .001) and comprised a list of included and excluded studies (rs = 0.32, P < .001). In conclusion, the quality of meta-analyses published in leading anesthesiology journals has increased over the last decade. Furthermore, assessing the scientific quality of included studies in meta-analyses (P = .60) and using this assessment to formulate conclusions and/or recommendations (P = .67) remains relatively low (median R-AMSTAR: 2, interquartile range [IQR]: 2-3]; median R-AMSTAR: 2, IQR: 1-2, respectively).
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Anesthesia and analgesia · Jun 2017
Comparative StudyExercise Combined With Ultrasound Attenuates Neuropathic Pain in Rats Associated With Downregulation of IL-6 and TNF-α, but With Upregulation of IL-10.
Although there are several evidences that suggest efficacies of therapeutic ultrasound (TU) or treadmill exercise (TE) to alleviate nerve injury-associated pain, molecular mechanisms are less clear. We aimed to investigate the impact of TU and/or TE on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve and their roles of proinflammatory and anti-inflammatory cytokines. ⋯ We found that TU + TE is better than TU or TE alone for treating neuropathic pain. TU and/or TE for pain management may be straightly associated with less TNF-α and IL-6 expression and more IL-10 expression.
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Anesthesia and analgesia · Jun 2017
Magic Mirror, on the Wall-Which Is the Right Study Design of Them All?-Part I.
The assessment of a new or existing treatment or intervention typically answers 1 of 3 research-related questions: (1) "Can it work?" (efficacy); (2) "Does it work?" (effectiveness); and (3) "Is it worth it?" (efficiency or cost-effectiveness). There are a number of study designs that on a situational basis are appropriate to apply in conducting research. ⋯ Attention is focused on the strengths and weaknesses of each study design to assist in choosing which is appropriate for a given study objective and hypothesis as well as the particular study setting and available resources and data. Specific studies and papers are highlighted as examples of a well-chosen, clearly stated, and properly executed study design type.
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Anesthesia and analgesia · Jun 2017
The Role of NR2B-CREB-miR212/132-CRTC1-CREB Signal Network in Pain Regulation In Vitro and In Vivo.
Chronic pain is a debilitating threat to human health, and its molecular mechanism remains undefined. Previous studies have illustrated a key role of cAMP response element-binding protein (CREB) in pain regulation; CREB-regulated transcription coactivator 1 (CRTC1) and microRNA212/132 (miR212/132) are also vital in synaptic plasticity. However, little is known about the interaction among these factors in pain condition. We conducted this experiment mainly to determine the crosstalk between CREB, CRTC1, and miR212/132 in vitro. Moreover, we explored the changes in hyperalgesia on chronic constrictive injury (CCI) mouse in vivo when given CREB-related adenovirus vectors, CRTC1-related adenovirus vectors, and miR212/132-locked nucleic acid (LNA). ⋯ The NR2B-CREB-miR212/132-CRTC1-CREB signal network plays an important role in the regulation of pain. Intervening with any molecule in this signal network would reduce pain perception.