Medicina
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Background and Objectives: The International Society for Modulation defines persistent spinal pain syndrome type 2 (PSPS-type 2), formerly known as failed back surgery syndrome, as a condition where patients continue to experience pain or develop new pain following spinal surgery intended to alleviate back or lower-limb discomfort. PSPS-type 2 is characterized by pain and significant disability, affecting quality of life. Spinal cord stimulation has proven effective in treating this syndrome, although the role of psychological factors, such as pain catastrophizing and central sensitization, remain unclear. ⋯ Finally, pain catastrophizing was significantly associated with pain perception (β = 0.075 and p = 0.008) and disability (β = 0.90 and p < 0.01). Conclusions: Catastrophizing plays a crucial role in pain perception and disability among patients with persistent spinal pain syndrome type 2 receiving spinal cord stimulation. Integrating psychological interventions may improve clinical outcomes for these patients.
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Background: The bite of the Loxosceles spider is a public health problem around the world, mainly in Latin America. The viscerocutaneous presentation is related to the inoculation of toxins (phospholipase-D) that generates a systemic inflammatory reaction with a subsequent increase in cytokines and chemokines. Hemoadsorption is proposed as a therapy that allows for the removal of the toxin and modulation of the inflammatory response in this disease. ⋯ Despite treatment with intravenous (IV) monovalent antiloxoscelism serum, antibiotic therapy, and corticosteroids, the patient's evolution was poor, and she was admitted to the critical care unit for severe multi-organ involvement, including hepatic and kidney damage and coagulation disorders, eventually requiring hemodialysis support and hemoadsorption therapy. After the therapy was administered, rapid improvement was evident with the suspension of vasopressor support and a decrease in inflammatory markers. Conclusions: This case presents hemoadsorption as a therapeutic option, based on its capacity to reduce the intensity of hyperinflammation and to regulate the immunological response.
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Background and Objectives: High fructose intake is associated with non-alcoholic fatty liver disease (NAFLD), a chronic liver disease that is on the rise worldwide. New alternatives for treatment, such as bioactive phytochemicals, are needed. The aim of this study was to investigate the beneficial role of resveratrol in treating non-alcoholic steatohepatitis (NASH). ⋯ Conclusions: This study specifically examines resveratrol's therapeutic effects in a high-fructose diet-induced NASH model, focusing on the AMPK/Nrf2 signaling pathway to address oxidative stress and autophagy, providing novel insights into its molecular mechanism of action. Resveratrol reduces NASH by boosting autophagy and activating the AMPK/Nrf2 pathway. These findings underscore the potential of resveratrol as a promising therapeutic agent that can support treatment alongside conventional medications in the management of non-alcoholic steatohepatitis (NASH).
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Background and Objectives: This study aimed to histologically evaluate the effects of local melatonin application at different doses on bone fracture healing. Materials and Methods: Thirty rats were divided into three groups, with ten rats in each group. In the control group (n = 10), a fracture line was created in the tibial bones, and fracture osteosynthesis was performed without any additional procedure. ⋯ Results: The percentage of bone formation was significantly higher in the MLT D-1 and MLT D-2 groups than in the control group. There was no statistically significant difference between the MLT D-1 and MLT D-2 groups. Conclusions: In conclusion, the study demonstrated that local melatonin application supports bone fracture by increasing bone formation, although different doses of melatonin did not lead to significant variations in fracture healing.
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Background and Objectives: Endothelial dysfunction (ED) and oxidative stress play major contributions in the initiation and progression of atherosclerosis. Diabetes is a pathological state associated with endothelial damage and enhanced oxidative stress. This study evaluated endothelial dysfunction and oxidative stress in patients with severe coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery, comparing those with and without type 2 diabetes mellitus (T2DM). ⋯ No statistically significant differences for oxidative stress markers (SOD-1 and LOX-1) were obtained when comparing T2DM and non-T2DM patients with severe CAD. Conclusions: ED (as assessed by brachial FMD and serum 5-HT) is more severe in in diabetic patients with severe CAD scheduled for CABG surgery, while oxidative stress (as evaluated through serum SOD-1 and LOX-1 concentrations) was not influenced by the presence of T2DM in this specific population. The most important finding of the present study is that circulating 5-HT levels are markedly influenced by T2DM. 5-HT receptor-targeted therapy might be of interest in patients undergoing CABG, but further studies are needed to confirm this hypothesis.