RESUMO
Neuropathic pain (NP) is a complex and chronic disease caused by lesions or defects of the somatosensory nervous system. The treatments normally used for managing NP usually lack efficacy. Several animal models of NP have been engineered in order to understand the molecular mechanisms underlying NP and to find alternative molecules to use as new therapeutic agents. Preclinical in vivo studies identified the epigallocatechin-3-gallate (EGCG), a main active component of green tea (Camellia sinensis), as a possible therapeutic molecule for NP treatment due to its anti-inflammatory and antioxidant properties. Interestingly, it has been shown that EGCG reduced bone cancer pain. The purpose of this article is to discuss the potential use of EGCG for control and treatment of NP, by reviewing the preclinical studies reported in the literature and by shedding light on the potential schemes based on EGCG's application in clinical practices.
Assuntos
Antioxidantes/farmacologia , Catequina/análogos & derivados , Neuralgia/tratamento farmacológico , Animais , Anti-Inflamatórios/farmacologia , Camellia sinensis/química , Catequina/farmacologia , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , HumanosRESUMO
Access to complex conditions of the thoracic spine and of the posterior mediastinum offers significant challenges, especially if the surgeon wishes to comply with the principles of minimal invasiveness. We report a successful vertical, paraspinal incision along with the subperiosteal removal of the overlying 2-cm rib segments combined with video assistance through single-access video-assisted thoracic surgery to perform a total T6 and partial T7 corpectomy for a metastatic multiple myeloma in a 50-year old man. This approach appears to provide excellent exposure and minimal morbidity when a reliable approach to the complex spine is needed.
Assuntos
Laminectomia/efeitos adversos , Mieloma Múltiplo/cirurgia , Procedimentos Ortopédicos/métodos , Complicações Pós-Operatórias/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Cirurgia Torácica Vídeoassistida , Vértebras Torácicas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/secundário , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Reoperação , Neoplasias da Coluna Vertebral/secundário , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Among the new materials introduced for chest wall reconstruction, the use of collagen matrix is gaining increasing favor for its biomechanical properties. We describe the reconstruction of the chest wall with Veritas (Synovis, St Paul, MN) collagen matrix of a posterior chest wall defect after costovertebrectomy for Ewing's sarcoma. En bloc resection was performed, including partial D7 through D9 vertebrectomy along with the posterolateral segments of corresponding ribs. The collagen matrix patch was sutured to the spine stabilizer and the surrounding rib segments and was covered by previously raised latissimus dorsi and trapezius muscle flaps. Excellent stabilization was obtained.