A Proposed Psychologic Clearance Algorithm for Spinal Cord Stimulation Implantation: Mini Review
DOI: 10.29245/2768-5365/2025/2.1163 View / Download PdfTerrance C. Jenkins1*, Kristy Fisher2
1Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine, Atlanta GA, USA
2Spine and Orthopedic Center, Deerfield Beach FL, USA
Commentary on: Catecholamines in Sepsis: Pharmacological Insights and Clinical Applications – A Narrative Review
Jacopo Belfiore
Anesthesia and Transplant Intensive Care Unit, University of Pisa, Italy
The review by Belfiore et al. offers a comprehensive examination of catecholamine pharmacology and clinical application in septic shock, emphasizing their cardiovascular, metabolic, immunomodulatory, and endothelial effects. The authors highlight the dual role of catecholamines, which are essential for hemodynamic support yet capable of exacerbating sepsis through immune dysregulation and endothelial dysfunction. Key topics include catecholamine refractoriness, β2-adrenergic immunomodulation, corticosteroid synergy, and endothelial permeability. While the review provides a robust mechanistic framework and updates classical knowledge with recent immunologic and metabolic insights, future research directions are identified. These include expanding vasoactive strategies, advancing precision medicine approaches, investigating metabolic consequences, addressing catecholamine-resistant shock, and developing endothelial-targeted therapies. Overall, the review is a valuable resource for critical care clinicians, though further integration of individualized therapeutic strategies and broader exploration of emerging treatments would enhance future discourse.
DOI: 10.29245/2768-5365/2025/1.1162 View / Download PdfBenefits of Maintaining Mitochondrial Health in Multiple Sclerosis
Vitória Carvalho Troitiño1,3,a, Natália Pressuto Pennachioni1,3,a, Natália Gabriele Hösch1, Gisele Picolo1, Vanessa Olzon Zambelli1,2*
1Laboratory of Pain and Signalling, Butantan Institute, Sao Paulo - SP, Brazil
2Centre of Excellence in New Target Discovery, Butantan Institute, Sao Paulo – SP, Brazil
3Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo – SP, Brazil
aThese authors have contributed equally to this work, and share first authorship
Impaired mitochondrial functions are implicated in the pathogenesis of the neurodegenerative process of Multiple Sclerosis (MS). MS is an autoimmune disease that leads to neurodegeneration, axonal loss, and demyelination in the brain and spinal cord white and grey matter areas. The existing treatments for this autoimmune disease primarily target acute neuroinflammation episodes. While this strategy effectively reduces relapse occurrences, it has limited effectiveness in protecting against neurodegeneration, especially in the progressive stages of MS. In this mini review we highlight studies showing how misfunctioned mitochondria may contribute to MS pathogenesis. We also bring evidence that targeting mitochondria may open new perspectives for future prevention of neuroinflammation and neuronal loss in MS.
DOI: 10.29245/2768-5365/2025/1.1161 View / Download PdfEvidence based medicine underpinning the ERAS protocol in elective colorectal patients: A mini review
Roisin Taplin, Gavin David O’Connor*
Department of Anaesthesiology and Intensive Care, University Hospital Limerick, Ireland
Introduction: The enhanced recovery after surgery (ERAS) protocol is a set of international guidelines developed with the purpose of decreasing the hospital stay of a patient undergoing elective colorectal surgery. The ERAS protocol outlines a variety of measures that should be taken throughout a patients’ surgical stay, including at the first meeting in the preoperative phase, perioperatively and postoperatively.
Methods: PubMed database was accessed with the aim of finding relevant material on the subject of the ERAS protocol and colorectal surgery, and the outcomes for patients pre and post implementation of the ERAS protocol. The keywords chosen included ERAS protocol, implementation and colorectal surgery. Filters included access to full free text, available in English, published in the last 5 years and included clinical trials, meta-analysis, randomised controlled trials and systematic reviews. This returned 32 results of which 9 articles were included. These nine articles were reviewed and the outcomes pre and post implementation of the ERAS protocol were examined.
Results: The opinion of all the articles reviewed recommend implementation of the ERAS protocol. Each site reported improvements in various factors from length of stay, to post op complications and patient satisfaction. Implementation of ERAS protocols in elective colorectal surgery is associated with improved outcomes.
Conclusion: The ERAS protocol is a highly effective protocol for patients undergoing elective colorectal surgery. It has proven benefit in terms of decreased postoperative complications, and reduced length of hospital stay. The ERAS protocol has been successfully implemented in a variety of hospitals around the world with great effect. Future research should focus on the implementation of the protocol on other patient demographics, such as patients undergoing emergency colorectal surgery to explore its benefits in such situations.
DOI: 10.29245/2768-5365/2025/1.1156 View / Download Pdf