Bacterial lipopolysaccharide forms aggregates with apolipoproteins in male and female rat brains after ethanol binges.

Alcohol binge drinking allows the translocation of bacterial lipopolysaccharide (LPS) from the gut to the blood, which activates the peripheral immune system with consequences in neuroinflammation. A possible access/direct signaling of LPS to/in the brain has not yet been described under alcohol abuse conditions. Apolipoproteins are compounds altered by alcohol with high affinity to LPS which may be involved in its transport to the brain or in its elimination. Here, we explored the expression of small components of LPS, in its free form or bound to apolipoproteins, in the brain of female and male rats exposed to alcohol binges. Animals received ethanol oral gavages (3 g/kg every 8 h) for 4 days. LPS or its components (Lipid A and core), LPS-binding protein, corticosterone, lipoproteins (HDL, LDL), apolipoproteins (ApoAI, ApoB, and ApoE), and their receptors were measured in plasma and/or in nonperfused prefrontal cortex (PFC) and cerebellum. Brain LipidA-apolipoprotein aggregates were determined by Western blotting and confirmed by co-immunoprecipitation. In animals exposed to alcohol binges: 1) plasma LPS-binding protein was elevated in both sexes; 2) females showed elevations in plasma ApoAI and corticosterone levels; 3) Lipid A formed aggregates with ApoAI in the female PFC and with ApoB in males, the latter showing Toll-like receptor 4 upregulation in PFC but not females. These results suggest that small bacterial components are present within the brain, forming aggregates with different apolipoproteins, depending on the sex, after alcohol binge intoxications. Results may have implications for the crosstalk between alcohol, LPS, and neuroinflammation.

Green synthesis of BiVO4/Eco-graphene nanostructures for the elimination of sulfamethoxazole by adsorption and photo-degradation using blue LED light.

Photo-catalysts based on BiVO4 (BV) and Eco-graphene (EG) were synthesized and obtained in a single step with high-quality properties. These nanostructures (NEs) were obtained through a green chemistry route and by adding 2, 3, and 5 wt% of a homemade EG. The BV/X EG NEs (where X = corresponds to the weight % of EG) demonstrated high photocatalytic activity, obtaining Sulfamethoxazole degradation percentages of 40, 45, 52, and 57 for BV, BV/2 EG, BV/3 EG, and BV/5 EG respectively, using a blue LED light. In addition, it was observed that the presence of EG slightly affected the surface area and porosity of BV. Moreover, it was observed that the presence of EG stabilized the scheelite monoclinic phase (m-s), and decreased the crystal size and band-gap values of BV-based samples. It was detected that EG contents increased the BV reduction, creating oxygen vacancies and V4+ states, which favored electron transfer, enhanced the photo-catalytic activity, and decreased the recombination rate. The adsorption influence of the BV/EG system was also studied. Finally, the stability tests of these materials after four cycles of reuse allowed keeping practically the full degradation capacity, demonstrating that these NEs represent a promising material driven by visible light that can be used for wastewater decontamination in the presence of drugs.

Diffusion coefficients and MSD measurements on curved membranes and porous media.

We study some geometric aspects that influence the transport properties of particles that diffuse on curved surfaces. We compare different approaches to surface diffusion based on the Laplace-Beltrami operator adapted to predict concentration along entire membranes, confined subdomains along surfaces, or within porous media. Our goal is to summarize, firstly, how diffusion in these systems results in different types of diffusion coefficients and mean square displacement measurements, and secondly, how these two factors are affected by the concavity of the surface, the shape of the possible barriers or obstacles that form the available domains, the sinuosity, tortuosity, and constrictions of the trajectories and even how the observation plane affects the measurements of the diffusion. In addition to presenting a critical and organized comparison between different notions of MSD, in this review, we test the correspondence between theoretical predictions and numerical simulations by performing finite element simulations and illustrate some situations where diffusion theory can be applied. We briefly reviewed computational schemes for understanding surface diffusion and finally, discussed how this work contributes to understanding the role of surface diffusion transport properties in porous media and their relationship to other transport processes.

Surface diffusion in narrow channels on curved domains.

We study the transport properties of diffusing particles restricted to confined regions on curved surfaces. We relate particle mobility to the curvature of the surface where they diffuse and the constraint due to confinement. Applying the Fick-Jacobs procedure to diffusion in curved manifolds shows that the local diffusion coefficient is related to average geometric quantities such as constriction and tortuosity. Macroscopic experiments can record such quantities through an average surface diffusion coefficient. We test the accuracy of our theoretical predictions of the effective diffusion coefficient through finite-element numerical solutions of the Laplace-Beltrami diffusion equation. We discuss how this work contributes to understanding the link between particle trajectories and the mean-square displacement.

Ácido úrico herramienta de tamización para preeclampsia. Una revisión sistemática de la literatura / Uric acid screening tool for preeclampsia a systematic review

Introducción: El ácido úrico se ha descrito como un posible marcador de riesgo para la aparición de preeclampsia; sin embargo, hasta el momento no hay evidencia sólida que lo soporte. El objetivo de este estudio es sintetizar la literatura disponible que permita conocer la utilidad del ácido úrico como una herramienta de tamización para preeclampsia. Metodología: Revisión sistemática de la literatura de estudios primarios que analicen los niveles séricos de ácido úrico en el primer y segundo trimestre de gestación con el desarrollo de preeclampsia. Búsqueda en Pubmed (n: 639). Resultados: Se incluyeron 2 estudios de cohorte con un total de 9.746 gestantes y 398 casos de preeclampsia. En los estudios se encontraron mayores niveles séricos de ácido úrico en las gestantes que desarrollaron preeclampsia (OR 1,8 a 2,0). Conclusiones: El ácido úrico se relaciona con la aparición de preeclampsia y su fisiopatología. Se invita a la comunidad científica a seguir investigando acerca de la utilidad del ácido úrico para su implementación como herramienta de tamización en el primer y el segundo trimestre de embarazo.(AU)

Introduction: Uric acid has been described as a possible risk marker for the appearance of pre-eclampsia. However, so far there is no solid evidence to support it. The objective of this study is to synthesize the available literature to determine the usefulness of uric acid as a screening tool for pre-eclampsia. Methodology: Systematic review of the literature of primary studies that analyse serum uric acid levels in the first and second trimesters of gestation with the development of pre-eclampsia. Search in PubMed (n: 639). Results: Two studies (2 cohort studies) were included with a total of 9,746 pregnant women and 398 cases of pre-eclampsia. In the studies, higher serum uric acid levels were found in pregnant women who developed preeclampsia (OR 1.8 to 2.0). Conclusions: Uric acid is related to the presence of preeclampsia and its pathophysiology. The scientific community is invited to continue investigating the applicability of uric acid for its implementation as a screening tool in the first and second trimester of pregnancy.(AU)

Current status of inclusion of black participants in neuropsychological studies: A scoping review and call to action.

In recognition that insufficient diversity in research impedes the generalizability of findings and negatively impacts clinical outcomes, the 1993 National Institutes of Health (NIH) Revitalization Act required NIH-funded clinical trials to include and assess outcomes for women and minority participants. Since that time, the American Psychological Association (APA) and the American Academy of Clinical Neuropsychology (AACN) have also acknowledged the reporting of this information as an essential element of research, and they have established similar aspirational goals. Nevertheless, Black communities remain disproportionately underrepresented in neuropsychology research. The objective of this study was to investigate current levels of inclusion and reporting of Black research participation in neuropsychological studies.Publications from high impact neuropsychology journals between 2019-2020 were selected via established methodologies. Studies were analyzed to determine the rates of demographic inclusion and reporting of minority, particularly Black, participants.A total of 1,764 articles were reviewed across seven neuropsychology journals. Of the 653 studies not excluded for other reasons, 43% neglected to include sufficient information about participants' race/ethnicity. Of the subset of eligible studies that did include racial/ethnic demographic information (n = 349), only 61% included any Black participants at all. Only 34.1% of them included enough Black participants equal to or greater than the proportion of Black individuals within the United States.Setting a standard of routinely reporting and analytically reflecting on demographic information is necessary to make valid inferences regarding disease sequelae, treatment, and public health strategies. The authors offer specific recommendations to improve the inclusion and reporting of Black research participation, ensure compliance with established policies, and improve the quality of neuropsychological research.

[Clinical results in arthroscopic rotator cuff repair with the modified Mason-Allen technique]. / Resultados clínicos en la reparación artroscópica de manguito rotador con la técnica de Mason-Allen modificada.

INTRODUCTION: rotator cuff tears are one of the most common shoulder injuries. The treatment of choice is arthroscopic repair with the use of anchors. The modified Mason-Allen technique, which combines the benefits of suture bridge and mattress sutures, has shown satisfactory results. This study aims to report and analyze the clinical results using these suture techniques in rotator cuff tears. RESULTS: preoperative mean active flexion 126o, 169o at three months, 175o at 12 months (p < 0.0001), active abduction 98o, 159o at three months and 167o at 12 months (p < 0.0001), internal rotation preoperative value 4.4 ± 3, at three months 7.1 ± 1.7 (p < 0.05) and 12 months 7.6 ± 1.1 (p < 0.001). Constant score 45.76 ± 16.35 (p < 0.0001) at three months 87.27 ± 10.94 and 12 months 91.30 ± 6.00. SSV 41.30 ± 20.89, three months 81.43 ± 18.31 and 12 months 94.37 ± 6.90 (p = 0.0001). Initial mean VAS 6.6 ± 1.6 and 12 months 0.63 ± 1.02 (p < 0.0001). CONCLUSION: in rotator cuff tears, using a single row with the modified Mason-Allen technique is a recommended and replicable option with satisfactory results and statistically significant clinical improvement at three and 12 months post-surgery.

INTRODUCCIÓN: la lesión del manguito de los rotadores es una de las lesiones más comunes del hombro. El tratamiento por elección es la reparación artroscópica con uso de anclas. La técnica Mason-Allen modificada, que integra los beneficios de las suturas puente y colchonero, ha demostrado resultados satisfactorios. El propósito de este estudio es reportar y analizar los resultados clínicos del uso de dicha sutura en rupturas del manguito de los rotadores. RESULTADOS: flexión activa media 126o inicial, 169o a tres meses, 175o a 12 meses (p < 0.0001), abducción activa 98o, tres meses 159o y 167o a 12 meses (p < 0.0001), rotación interna valor prequirúrgico 4.4 ± 3, a los tres meses 7.1 ± 1.7 (p < 0.05) y 12 meses 7.6 ± 1.1 (p < 0.001). Constant Score 45.76 ± 16.35 con un valor de p < 0.0001, a tres meses 87.27 ± 10.94 y 12 meses 91.30 ± 6.00. SSV 41.30 ± 20.89, tres meses 81.43 ± 18.31 y 12 meses 94.37 ± 6.90 (p = 0.0001). EVA media inicial 6.6 ± 1.6 y 12 meses 0.63 ± 1.02 (p < 0.0001). CONCLUSIÓN: en rupturas del manguito de los rotadores, el uso de hilera simple con técnica Mason-Allen modificada es una opción recomendada y replicable con resultados satisfactorios y mejoría clínica estadísticamente significativa a los tres y 12 meses postquirúrgicos.

Erratum: Publisher's Note: "Skin-on-a-chip models: General overview and future perspectives" [APL Bioengineering 5, 030901 (2021)].

[This corrects the article DOI: 10.1063/5.0046376.].

Super-resolution microscopy reveals photoreceptor-specific subciliary location and function of ciliopathy-associated protein CEP290.

Mutations in the cilium-associated protein CEP290 cause retinal degeneration as part of multiorgan ciliopathies or as retina-specific diseases. The precise location and the functional roles of CEP290 within cilia and, specifically, the connecting cilia (CC) of photoreceptors, remain unclear. We used super-resolution fluorescence microscopy and electron microscopy to localize CEP290 in the CC and in the primary cilia of cultured cells with subdiffraction resolution and to determine effects of CEP290 deficiency in 3 mutant models. Radially, CEP290 localizes in close proximity to the microtubule doublets in the region between the doublets and the ciliary membrane. Longitudinally, it is distributed throughout the length of the CC whereas it is confined to the very base of primary cilia in human retinal pigment epithelium-1 cells. We found Y-shaped links, ciliary substructures between microtubules and membrane, throughout the length of the CC. Severe CEP290 deficiencies in mouse models did not prevent assembly of cilia or cause obvious mislocalization of ciliary components in early stages of degeneration. There were fewer cilia and no normal outer segments in the mutants, but the Y-shaped links were clearly present. These results point to photoreceptor-specific functions of CEP290 essential for CC maturation and stability following the earliest stages of ciliogenesis.

Skin-on-a-chip models: General overview and future perspectives.

Over the last few years, several advances have been made toward the development and production of in vitro human skin models for the analysis and testing of cosmetic and pharmaceutical products. However, these skin models are cultured under static conditions that make them unable to accurately represent normal human physiology. Recent interest has focused on the generation of in vitro 3D vascularized skin models with dynamic perfusion and microfluidic devices known as skin-on-a-chip. These platforms have been widely described in the literature as good candidates for tissue modeling, as they enable a more physiological transport of nutrients and permit a high-throughput and less expensive evaluation of drug candidates in terms of toxicity, efficacy, and delivery. In this Perspective, recent advances in these novel platforms for the generation of human skin models under dynamic conditions for in vitro testing are reported. Advances in vascularized human skin equivalents (HSEs), transferred skin-on-a-chip (introduction of a skin biopsy or a HSE in the chip), and in situ skin-on-a-chip (generation of the skin model directly in the chip) are critically reviewed, and currently used methods for the introduction of skin cells in the microfluidic chips are discussed. An outlook on current applications and future directions in this field of research are also presented.

A new microfluidic method enabling the generation of multi-layered tissues-on-chips using skin cells as a proof of concept.

Microfluidic-based tissues-on-chips (TOCs) have thus far been restricted to modelling simple epithelia as a single cell layer, but likely due to technical difficulties, no TOCs have been reported to include both an epithelial and a stromal component despite the biological importance of the stroma for the structure and function of human tissues. We present, for the first time, a novel approach to generate 3D multilayer tissue models in microfluidic platforms. As a proof of concept, we modelled skin, including a dermal and an epidermal compartment. To accomplish this, we developed a parallel flow method enabling the deposition of bilayer tissue in the upper chamber, which was subsequently maintained under dynamic nutrient flow conditions through the lower chamber, mimicking the function of a blood vessel. We also designed and built an inexpensive, easy-to-implement, versatile, and robust vinyl-based device that overcomes some of the drawbacks present in PDMS-based chips. Preliminary tests indicate that this biochip will allow the development and maintenance of multilayer tissues, which opens the possibility of better modelling of the complex cell-cell and cell-matrix interactions that exist in and between the epithelium and mesenchyme, allowing for better-grounded tissue modelling and drug screening.

Structure and dynamics of photoreceptor sensory cilia.

The rod and cone photoreceptor cells of the vertebrate retina have highly specialized structures that enable them to carry out their function of light detection over a broad range of illumination intensities with optimized spatial and temporal resolution. Most prominent are their unusually large sensory cilia, consisting of outer segments packed with photosensitive disc membranes, a connecting cilium with many features reminiscent of the primary cilium transition zone, and a pair of centrioles forming a basal body which serves as the platform upon which the ciliary axoneme is assembled. These structures form a highway through which an enormous flux of material moves on a daily basis to sustain the continual turnover of outer segment discs and the energetic demands of phototransduction. After decades of study, the details of the fine structure and distribution of molecular components of these structures are still incompletely understood, but recent advances in cellular imaging techniques and animal models of inherited ciliary defects are yielding important new insights. This knowledge informs our understanding both of the mechanisms of trafficking and assembly and of the pathophysiological mechanisms of human blinding ciliopathies.

Nivel de conocimiento del profesional de enfermería al administrar el activador plasminógeno tisular en pacientes con ICTUS / Level of knowledge of the nursing professional when applying tissue plasminogen activator in patients with STROKE

Introducción: el tratamiento con activador recombinante del plasminógeno tisular (siglas en inglés rt-PA), aplicado vía intravenosa (IV) es el procedimiento de primera línea en casos de evento vascular cerebral (EVC) en una ventana de 4,5 horas a partir del inicio de los síntomas y con bajo riesgo de transformación hemorrágica del infarto cerebral. El personal de enfermería es un elemento clave para el tratamiento de las personas que han padecido un EVC y se encuentra en su etapa aguda. La fibrinólisis con alteplasa (rt-PA) se ha establecido como tratamiento de primera línea para los casos de ictus isquémico, la administración de este fármaco, control y seguimiento de estos pacientes idealmente debe realizarse por el personal de enfermería en las unidades de ictus. Objetivo: investigar el nivel de conocimiento del personal de enfermería en la administración del activador recombinante del plasminógeno tisular (rt-PA) en el servicio de urgencias en una institución de tercer nivel. Material y métodos: se realizó un estudio descriptivo y transversal en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez de la Ciudad de México, con un muestreo por conveniencia, participaron 33 profesionales de enfermería que laboran en el servicio de urgencias, se observaron las 24 horas del día. Se tomó en cuenta a enfermeras de todas las categorías, excluyendo a personal médico, camilleros y enfermeras suplentes. Se aplicó un instrumento para evaluar el conocimiento sobre enfermedad vascular isquémica e intervenciones de enfermería en el cuidado inmediato y mediato en la administración del fármaco activador tisular de plasminógeno (rt-PA). Resultados: llama la atención que sólo 58 % del personal de enfermería conozca el tiempo vital para recuperar al cerebro, otro dato que alarma es que el 30 % no tiene claro el concepto de ictus y al ser una institución de especialidad neurológica de debe establecer un programa de capacitación para establecer intervenciones oportunas con (rt-PA) para reducir secuelas o daño neurológico. Discusión: el papel del personal de enfermería en unidades especializadas en afecciones neurológicas a los pacientes con ictus es proporcionar un cuidado de calidad, eficaz y eficiente, además de participar en la valoración integral del paciente y en la administración del actilyse cuando se trata de una terapia fibrinolítica. En consecuencia, la enfermera debe estar formada sobre los cuidados que requiere este tipo de pacientes, las complicaciones propias de la patología, tratamiento y efectos secundarios del mismo. Proponer un plan de cuidados integral, porque ya el personal tiene conocimientos al respecto de la enfermedad y la aplicación del activador tisular, pero sería interesante implementar para los profesionales en formación, sin olvidar la elaboración de una propuesta como guía de actuación. Conclusión: los cuidados que el personal de enfermería lleva a cabo deben ser especializados en constante actualización y capacitación para ser capaces de detectar y prevenir las complicaciones del proceso patológico y tratamiento.

Introduction: recombinant tissue plasminogen activator (rt-PA) therapy, given intravenously (IV), is the first-line procedure in cases of cerebral vascular event (CVE) within 4.5 hours of symptom onset and with low risk of haemorrhagic transformation of cerebral infarction. Nurses are a key element in the management of people who have suffered a stroke and are in the acute stage. Fibrinolysis with alteplase (rt-PA) has been established as the first-line treatment for ischaemic stroke, and the administration of this drug, control and follow-up of these patients should ideally be carried out by nurses in stroke units. Objective: to investigate the level of nursing staff knowledge in the administration of recombinant tissue plasminogen activator (rt-PA) in the emergency department of a tertiary care institution. Material and methods: a descriptive, cross-sectional study was carried out at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery in Mexico City, with convenience sampling. 33 nursing professionals working in the emergency department participated, and 24 hours a day were observed. All categories of nurses were considered, excluding medical staff, orderlies and substitute nurses. An instrument was used to assess knowledge of ischaemic vascular disease and nursing interventions in immediate and intermediate care in the administration of tissue plasminogen activator (rt-PA). Results: It is striking that only 58 % of nursing staff are aware of the vital time to recover the brain, another alarming fact is that 30 % are not clear about the concept of stroke and, being a neurological speciality institution, a training programme should be established to establish timely interventions with (rt-PA) to reduce sequelae or neurological damage. Discussion: the role of nurses in units specialising in neurological disorders in stroke patients is to provide quality, effective and efficient care, in addition to participating in the comprehensive assessment of the patient and in the administration of actilyse in the case of fibrinolytic therapy. Consequently, the nurse must be trained in the care required by this type of patient, the complications of the pathology, treatment and its side effects. Propose a comprehensive care plan, because the staff already has knowledge of the disease and the application of the tissue activator, but it would be interesting to implement it for professionals in training, without forgetting the development of a proposal as a guide for action. Conclusion: the care carried out by nursing staff must be specialised and constantly updated and trained in order to be able to detect and prevent complications of the pathological process and treatment.

Consensus document for multimodal intraoperatory neurophisiological monitoring in neurosurgical procedures. Basic fundamentals. / Documento de consenso para la monitorización neurofisiológica intraoperatoria multimodal en procedimientos neuroquirúrgicos. Fundamentos básicos.

The present work aims to establish a guide to action, agreed by anaesthesiologists and neurophysiologists alike, to perform effective intraoperative neurophysiological monitoring for procedures presenting a risk of functional neurological injury, and neurosurgical procedures. The first section discusses the main techniques currently used for intraoperative neurophysiological monitoring. The second exposes the anaesthetic and non-anaesthetic factors that are likely to affect the electrical records of the nervous system structures. This section is followed by an analysis detailing the adverse effects associated with the most common techniques and their use. Finally, the last section describes a series of guidelines to be followed upon the various intraoperative clinical events.

A new species of the grass-feeding leafhopper genus Amblysellus Sleesman (Hemiptera: Cicadellidae: Deltocephalinae) from western Mexico, with a checklist and key to species.

A new Mexican leafhopper species, Amblysellus raygozai sp. nov., is described and illustrated from western Mexico. Specimens were collected over perennial grasses. A key for all recognized species within the country is provided.

Circuitos postoperatorios en los pacientes sometidos a craneotomía programada. Revisión narrativa / Postoperative circuits in patients undergoing elective craniotomy. A narrative review

En 2017 la sección de Neurociencias de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor publicó una encuesta nacional sobre los circuitos de atención y tratamiento postoperatorio en neurocirugía. La encuesta evidenció una gran heterogeneidad de respuestas en función del centro, el anestesiólogo y la afección del paciente. En la actualidad, no disponemos de un estándar de circuito postoperatorio y existe evidencia suficiente para no indicar de forma rutinaria el ingreso en Unidades de Cuidados Críticos Postquirúrgicos a todos los pacientes intervenidos de craneotomía programada. El objetivo de este estudio es hacer una revisión narrativa de los circuitos postoperatorios en la craneotomía programada, para intentar homogeneizar nuestra práctica clínica a la luz de los estudios publicados. Se ha hecho una revisión bibliográfica de los últimos diez años, fecha de actualización noviembre 2019, utilizando las palabras clave neurosurgery and postoperative care y craniotomyand postoperative care en MEDLINE (PubMed)

In 2017, the Neurosciences section of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy published a national survey on postoperative care and treatment circuits in neurosurgery. The survey showed that practices vary widely, depending on the centre, the anaesthesiologist and the pathology of the patient. There is currently no standard postoperative circuit for cranial neurosurgical procedures in Spanish hospitals, and there is sufficient evidence to show that not all patients undergoing elective craniotomy should be routinely admitted to a postsurgical critical care unit. The aim of this study is to perform a narrative review of postoperative circuits in elective craniotomy in order to standardise clinical practice in the light of published studies. For this purpose, we searched MEDLINE (PubMed) to retrieve studies published in the last ten years, up to November 2019, using the keywords neurosurgery and postoperative care, craniotomyand postoperative care

Postoperative circuits in patients undergoing elective craniotomy. A narrative review. / Circuitos postoperatorios en los pacientes sometidos a craneotomía programada. Revisión narrativa.

In 2017, the Neurosciences section of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy published a national survey on postoperative care and treatment circuits in neurosurgery. The survey showed that practices vary widely, depending on the centre, the anaesthesiologist and the pathology of the patient. There is currently no standard postoperative circuit for cranial neurosurgical procedures in Spanish hospitals, and there is sufficient evidence to show that not all patients undergoing elective craniotomy should be routinely admitted to a postsurgical critical care unit. The aim of this study is to perform a narrative review of postoperative circuits in elective craniotomy in order to standardise clinical practice in the light of published studies. For this purpose, we searched MEDLINE (PubMed) to retrieve studies published in the last ten years, up to November 2019, using the keywords neurosurgery and postoperative care, craniotomyand postoperative care.

Revisión narrativa del dolor agudo poscraneotomía. Concepto y estrategias de prevención y tratamiento del dolor / Narrative review of acute post-craniotomy pain. Concept and strategies for prevention and treatment of pain

El objetivo de esta revisión narrativa es confirmar si el dolor agudo tras craneotomía es frecuente y presenta una intensidad entre moderada-severa. Además, pretende informar de la importancia de tratar no solo el dolor tras craneotomía, sino prevenirlo para disminuir la incidencia de la cronificación del dolor. Debemos conocer que entre las opciones actuales no solo disponemos de los analgésicos convencionales para el postoperatorio (antiinflamatorios no esteroideos, paracetamol, inhibidores de la ciclooxigenasa 2 y opiáceos). La realización de un bloqueo nervioso del cuero cabelludo previo a la incisión quirúrgica o tras la cirugía, el uso de dexmedetomidina intraoperatoria y la administración perioperatoria de pregabalina son alternativas que están ganando fuerza. El manejo del dolor poscraneotomía debe basarse, por tanto, en una analgesia multimodal durante todo el perioperatorio, enmarcándose dentro del concepto actual del protocolo enhaced recovery after surgery

The aim of this narrative review is to confirm that acute pain after craniotomy is frequent and presents with moderate to severe intensity. We also highlight the importance of not only treating post-craniotomy pain, but also of preventing it in order to reduce the incidence of chronic pain. Physicians should be aware that conventional postoperative analgesics (non-steroidal anti-inflammatory, paracetamol, cyclooxygenase inhibitors 2, opioids) are not the only options available. Performing a scalp block prior to surgical incision or after surgery, the use of intraoperative dexmedetomidine, and the perioperative administration of pregabalin are just some alternatives that are gaining ground. The management of post-craniotomy pain should be based on perioperative multimodal analgesia in the framework of an "enhaced recovery after surgery" (ERAS) approach

Narrative review of acute post-craniotomy pain. Concept and strategies for prevention and treatment of pain. / Revisión narrativa del dolor agudo poscraneotomía. Concepto y estrategias de prevención y tratamiento del dolor.

The aim of this narrative review is to confirm that acute pain after craniotomy is frequent and presents with moderate to severe intensity. We also highlight the importance of not only treating post-craniotomy pain, but also of preventing it in order to reduce the incidence of chronic pain. Physicians should be aware that conventional postoperative analgesics (non-steroidal anti-inflammatory, paracetamol, cyclooxygenase inhibitors 2, opioids) are not the only options available. Performing a scalp block prior to surgical incision or after surgery, the use of intraoperative dexmedetomidine, and the perioperative administration of pregabalin are just some alternatives that are gaining ground. The management of post-craniotomy pain should be based on perioperative multimodal analgesia in the framework of an "enhaced recovery after surgery" (ERAS) approach.