Perioperative Analgesia in Pediatric Surgery.

Perioperative analgesia in pediatric surgery.

Curr Opin Anaesthesiol. 2013 Jun 10;
Russell P, von Ungern-Sternberg BS, Schug SA

PURPOSE OF REVIEW: Poor pain management has continued to be a problem after pediatric surgery. This review examines the current situation and recent advances in the area. RECENT FINDINGS: Nonopioids such as paracetamol and NSAIDs play an increasing role as components of multimodal analgesia in children. However, studies on the safety and efficacy of many adjuvants in pediatrics are still lacking. The use of opioids is influenced understandably by safety concerns about respiratory depression, but data on its incidence are poor. The role of regional techniques in the treatment of pain after pediatric surgery is growing in line with the developments in adults; the emphasis here is more on peripheral techniques too. SUMMARY: The concept of multimodal analgesia including the use of regional analgesic techniques is governing the current developments and discussions in the area of pediatric postoperative analgesia. HubMed – depression


Rosmarinic Acid Ameliorates Depressive-Like Behaviors in a Rat Model of CUS and Up-Regulates BDNF Levels in the Hippocampus and Hippocampal-Derived Astrocytes.

Neurochem Res. 2013 Jun 12;
Jin X, Liu P, Yang F, Zhang YH, Miao D

Rosmarinic acid (RA), a primary constituent of a Chinese herbal medicine, has been shown to have some therapeutic effects in an animal model of depression, but its underlying mechanisms are poorly understood. Sprague-Dawley rats were exposed to chronic unpredictable stress (CUS) for 21 days, and received RA for 14 days from the last week of CUS, then the behavioral changes, hippocampal pERK1/2 and BDNF levels were observed. Rats were further treated with U0126 (an ERK1/2 phosphorylation inhibitor) 30 min before RA treatment to assess the effects of RA and ERK1/2 signaling in depressive-like behavior and hippocampal BDNF levels. In addition, brains of newly born Sprague-Dawley rats were used to harvest and expand hippocampal astrocytes. Cells were exposed to different concentrations of RA (sham, 1, 5, 10, 20, and 40 ?g/mL) or U0126 (2 ?M as a final concentration) + RA (sham, 1, 5, 10, 20, and 40 ?g/mL) for 48 h, and the pERK1/2 and BDNF levels were assessed by western and ELISA assays. RA administration (10 mg/kg daily) reversed depressive-like behaviors in rats exposed to a chronic unpredictable stress paradigm and restored pERK1/2 protein expression and hippocampal brain-derived neurotrophic factor (BDNF). Moreover, in vitro experiments revealed that 20 ?g/mL RA increased pERK1/2 and BDNF levels in cultured astrocytes. Interestingly, the effects of RA were inhibited by U0126. RA might be a useful treatment for depression and the changes in ERK1/2 signaling and BDNF levels may play a critical role in the pharmacological action of RA. HubMed – depression


Impact of Mental Health Training on Village Health Workers Regarding Clinical Depression in Rural India.

Community Ment Health J. 2013 Jun 12;
Paudel S, Gilles N, Hahn S, Hexom B, Premkumar R, Arole S, Katz C

Village health worker (VHW) programs are known to be effective means of promoting health of communities. Comprehensive rural health project in India recently trained VHWs to identify, refer, and help people with mental health issues. This study evaluated knowledge, attitude, and behavior of VHWs regarding depression. Cluster sampling was used including all 36 VHWs trained in mental health. Among these, 24 were available and willing to participate in the study. Five FGDs were conducted among 24 VHWs, and the results were analyzed qualitatively. Four out of five groups were able to diagnose the presented case correctly as depression. VHWs were able to identify many symptoms and to suggest management options for depression. They showed supportive and empathetic attitudes towards depressed patients. VHWs are likely to be useful at identifying and assisting people with depression in the communities with lack of adequate resources provided they receive ongoing training and supervision. HubMed – depression



Sangat Health – Mental Health with Herginder Kaur MBACP (Accred) – Herginder Kaur a counselling psychotherapist speaks to Dr Mandeep Singh Bindra. They discuss the role of talking therapies in the treatment of mental health …