Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2020
Improved diagnostic accuracy of pathology with the implementation of a perioperative point-of-care ultrasound service: quality improvement initiative.
The utility of perioperative point-of-care ultrasound (P-POCUS) is rapidly growing. The successful implementation of a comprehensive P-POCUS curriculum, Focused PeriOperative Risk Evaluation Sonography Involving Gastro-abdominal, Hemodynamic, and Trans-thoracic Ultrasound (FORESIGHT), has been demonstrated. This project sought to further evaluate the utility of P-POCUS with the following aims: (1) to assess the ability to train the FORESIGHT curriculum via a free, open-access, online platform; (2) to launch a P-POCUS clinical service as a quality improvement (QI) initiative; (3) to evaluate the diagnostic accuracy of the P-POCUS examinations to formal diagnostic studies; and (4) to compare the P-POCUS diagnostic accuracy with the diagnostic accuracy of traditional assessment (TA). ⋯ A P-POCUS service can be developed after training facilitated by an online curriculum. P-POCUS examinations can be performed by anesthesiologists with a high degree of accuracy to formal studies, which is superior to TA.
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Reg Anesth Pain Med · Feb 2020
Sonic hedgehog signaling pathway promotes pancreatic cancer pain via nerve growth factor.
Many patients with pancreatic cancer (PC) suffer from abdominal pain and back pain. However, the cause of pain associated with PC is largely unclear. In this study, we tested the potential influence of the sonic hedgehog (sHH) signaling pathway on PC pain. ⋯ Our results demonstrate that PC pain originates from the sHH signaling pathway, and NGF mediates the pain mechanism via regulating SP and CGRP.