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  1. Article ; Online: Clinical Diagnosis and Treatment of Chronic Pain

    Sadiq Rahman / Ali Kidwai / Emiliya Rakhamimova / Murad Elias / William Caldwell / Sergio D. Bergese

    Diagnostics, Vol 13, Iss 24, p

    2023  Volume 3689

    Abstract: More than 600 million people globally are estimated to be living with chronic pain. It is one of the most common complaints seen in an outpatient setting, with over half of patients complaining of pain during a visit. Failure to properly diagnose and ... ...

    Abstract More than 600 million people globally are estimated to be living with chronic pain. It is one of the most common complaints seen in an outpatient setting, with over half of patients complaining of pain during a visit. Failure to properly diagnose and manage chronic pain is associated with substantial morbidity and mortality, especially when opioids are involved. Furthermore, it is a tremendous financial strain on the healthcare system, as over USD 100 billion is spent yearly in the United States on healthcare costs related to pain management and opioids. This exceeds the costs of diabetes, heart disease, and cancer-related care combined. Being able to properly diagnose, manage, and treat chronic pain conditions can substantially lower morbidity, mortality, and healthcare costs in the United States. This review will outline the current definitions, biopsychosocial model, subclassifications, somatosensory assessments, imaging, clinical prediction models, and treatment modalities associated with chronic pain.
    Keywords chronic pain ; pain diagnostics ; pain classification ; pain approach ; biopsychosocial ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Clevidipine-induced Dyspnea Relief in Acute Heart Failure Patients

    Nicoleta Stoicea / Nicholas Joseph / Sergio D. Bergese

    EBioMedicine, Vol 10, Iss C, Pp 23-

    2016  Volume 24

    Keywords Medicine ; R ; Medicine (General) ; R5-920
    Language English
    Publishing date 2016-08-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Anesthetics impact on cancer recurrence

    Sachidanand Jee Bharati / Tumul Chowdhury / Sergio D Bergese / Subhamay Ghosh

    Journal of Cancer Research and Therapeutics, Vol 12, Iss 2, Pp 464-

    What do we know?

    2016  Volume 468

    Abstract: Surgery is an important component of treatment in cancer patients. However, surgical stress, anesthesia, and perioperative analgesia interfere with the host immune defense mechanisms and may contribute to metastatic dissemination of malignant tumors and ... ...

    Abstract Surgery is an important component of treatment in cancer patients. However, surgical stress, anesthesia, and perioperative analgesia interfere with the host immune defense mechanisms and may contribute to metastatic dissemination of malignant tumors and cancer progression. Little is known about the effects of anesthesia on tumor recurrence. In vivo studies and clinical data show some evidence that regional anesthesia is beneficial for cancer patients as it may decrease the risk of metastasis. This short review summarizes the clinical data on the possible association between anesthesia, perioperative analgesia, and the risk of cancer recurrence. Most of the clinical reports are based on retrospective studies, and properly designed prospective trials including a sufficient number of patients is required to reveal the interaction of various anesthetic drugs and methods and cancer progression.
    Keywords Anesthetics ; cancer ; immunomodulation ; recurrence ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review

    Olufunke Dada / Alicia Gonzalez Zacarias / Corinna Ongaigui / Marco Echeverria-Villalobos / Michael Kushelev / Sergio D. Bergese / Kenneth Moran

    International Journal of Environmental Research and Public Health, Vol 16, Iss 18, p

    2019  Volume 3257

    Abstract: Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or ... ...

    Abstract Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. A search of relevant keywords was performed using PubMed, EMBASE, and Web of Science. Twenty-eight articles (n = 28) were included in our review. Perioperative considerations for peripheral nerve blocks and other alternatives used for postoperative pain management in patients undergoing orthopedic surgeries were discussed. Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.
    Keywords rebound pain ; hyperalgesia ; peripheral nerve blocks ; orthopedic surgeries ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2019-09-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Control of Bleeding in Endoscopic Skull Base Surgery

    Sergio D. Bergese / Ricardo L. Carrau / Pornthep Kasemsiri / Cattleya Thongrong

    ISRN Surgery, Vol

    Current Concepts to Improve Hemostasis

    2013  Volume 2013

    Keywords Surgery ; RD1-811 ; Medicine ; R ; DOAJ:Surgery ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Hindawi Publishing Corporation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Clevidipine for Perioperative Blood Pressure Control in Infants and Children

    Sergio D. Bergese / David B. Tulman / Joseph D. Tobias

    Pharmaceuticals, Vol 6, Iss 1, Pp 70-

    2013  Volume 84

    Abstract: Various pharmacologic agents have been used for perioperative BP control in pediatric patients, including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. Of the calcium antagonists, the majority ...

    Abstract Various pharmacologic agents have been used for perioperative BP control in pediatric patients, including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. Of the calcium antagonists, the majority of the clinical experience remains with the dihydropyridine nicardipine. Clevidipine is a short-acting, intravenous calcium channel antagonist of the dihydropyridine class. It undergoes rapid metabolism by non-specific blood and tissue esterases with a half-life of less than 1 minute. As a dihydropyridine, its cellular and end-organ effects parallel those of nicardipine. The clevidipine trials in the adult population have demonstrated efficacy in rapidly controlling BP in various clinical scenarios with a favorable adverse effect profile similar to nicardipine. Data from large clinical trials regarding the safety and efficacy of clevidipine in children is lacking. This manuscript aims to review the commonly used pharmacologic agents for perioperative BP control in children, discuss the role of calcium channel antagonists such as nicardipine, and outline the preliminary data regarding clevidipine in the pediatric population.
    Keywords clevidipine ; pediatric hypertension ; acute hypertension ; Medicine ; R ; Pharmacy and materia medica ; RS1-441
    Subject code 610
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: On Better Estimating and Normalizing the Relationship between Clinical Parameters

    Paul S. Addison / Rui Wang / Alberto A. Uribe / Sergio D. Bergese

    Computational and Mathematical Methods in Medicine, Vol

    Comparing Respiratory Modulations in the Photoplethysmogram and Blood Pressure Signal (DPOP versus PPV)

    2015  Volume 2015

    Keywords Computer applications to medicine. Medical informatics ; R858-859.7 ; Medicine (General) ; R5-920 ; Medicine ; R
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Hindawi Publishing Corporation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Total intravenous anaesthesia versus inhaled anaesthetics in neurosurgery

    Alix Zuleta-Alarcón / Karina Castellón-Larios / María Claudia Niño-de Mejía / Sergio D Bergese

    Colombian Journal of Anesthesiology, Vol 43, Iss suppl 1, Pp 9-

    2015  Volume 14

    Abstract: Introduction: The way neurosurgery has evolved has led to increased emphasis on anaesthetic techniques aimed at improving patient well-being. In the United States alone, the number of neurosurgeries has increased significantly, with growth reflected in ... ...

    Abstract Introduction: The way neurosurgery has evolved has led to increased emphasis on anaesthetic techniques aimed at improving patient well-being. In the United States alone, the number of neurosurgeries has increased significantly, with growth reflected in approximately 12,000 spine procedures per year and another 2700 different neurosurgical procedures per year. For anaesthetists, this means that they are faced more frequently with the need to select the most adequate neuroanaesthesia technique for each patient. Objectives: The purpose of this review is to analyze the role of inhaled and intravenous anaesthetics in neurosurgical procedures. Methodology: A search was conducted in PubMed using the terms TIVA, inhaled anaesthetics, neurosurgery and spine surgery. Results: The articles included in the review show that the adequate anaesthetic technique, besides ensuring a rapid onset of action, contributes to ease of titration with minimum effect on systemic and cerebral haemodynamics; it must enable intraoperative neurophysiological monitoring and rapid emergence, in order to allow early assessment of the patient’s neurological function and improved outcome. Conclusions: In recent years, the question regarding the use of inhaled vs. intravenous anaesthetics in neurosurgery has given rise to several research studies. Although TIVA is the technique used most frequently, inhaled anaesthetics have also been shown to be safe, titratable, and to provide for adequate intraoperative monitoring and cerebral haemodynamic stability. In patients with normal intracranial compliance, inhaled agents (IA) are a good alternative to TIVA, especially in places where hospital resources are limited.
    Keywords Anesthesia intravenous ; Evoked potentials ; Neurosurgery ; Anesthesia ; Spine ; Anestesia intravenosa ; Potenciales evocados ; Neurocirugía ; Anestesia ; Columna vertebral ; Anesthesiology ; RD78.3-87.3 ; Surgery ; RD1-811 ; Medicine ; R
    Subject code 610
    Language Spanish
    Publishing date 2015-02-01T00:00:00Z
    Publisher Sociedad Colombiana de Anestesiología
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: On Better Estimating and Normalizing the Relationship between Clinical Parameters

    Paul S. Addison / Rui Wang / Alberto A. Uribe / Sergio D. Bergese

    Computational and Mathematical Methods in Medicine, Vol

    Comparing Respiratory Modulations in the Photoplethysmogram and Blood Pressure Signal (DPOP versus PPV)

    2015  Volume 2015

    Abstract: DPOP (ΔPOP or Delta-POP) is a noninvasive parameter which measures the strength of respiratory modulations present in the pulse oximeter waveform. It has been proposed as a noninvasive alternative to pulse pressure variation (PPV) used in the prediction ... ...

    Abstract DPOP (ΔPOP or Delta-POP) is a noninvasive parameter which measures the strength of respiratory modulations present in the pulse oximeter waveform. It has been proposed as a noninvasive alternative to pulse pressure variation (PPV) used in the prediction of the response to volume expansion in hypovolemic patients. We considered a number of simple techniques for better determining the underlying relationship between the two parameters. It was shown numerically that baseline-induced signal errors were asymmetric in nature, which corresponded to observation, and we proposed a method which combines a least-median-of-squares estimator with the requirement that the relationship passes through the origin (the LMSO method). We further developed a method of normalization of the parameters through rescaling DPOP using the inverse gradient of the linear fitted relationship. We propose that this normalization method (LMSO-N) is applicable to the matching of a wide range of clinical parameters. It is also generally applicable to the self-normalizing of parameters whose behaviour may change slightly due to algorithmic improvements.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 621
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Hindawi Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Impact and Implementation of Simulation-Based Training for Safety

    Federico F. Bilotta / Samantha M. Werner / Sergio D. Bergese / Giovanni Rosa

    The Scientific World Journal, Vol

    2013  Volume 2013

    Abstract: Patient safety is an issue of imminent concern in the high-risk field of medicine, and systematic changes that alter the way medical professionals approach patient care are needed. Simulation-based training (SBT) is an exemplary solution for addressing ... ...

    Abstract Patient safety is an issue of imminent concern in the high-risk field of medicine, and systematic changes that alter the way medical professionals approach patient care are needed. Simulation-based training (SBT) is an exemplary solution for addressing the dynamic medical environment of today. Grounded in methodologies developed by the aviation industry, SBT exceeds traditional didactic and apprenticeship models in terms of speed of learning, amount of information retained, and capability for deliberate practice. SBT remains an option in many medical schools and continuing medical education curriculums (CMEs), though its use in training has been shown to improve clinical practice. Future simulation-based anesthesiology training research needs to develop methods for measuring both the degree to which training translates into increased practitioner competency and the effect of training on safety improvements for patients.
    Keywords Technology ; T ; Medicine ; R ; Science ; Q
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Hindawi Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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