The erector spinae plane block: a narrative review

Pablo Kot,Pablo Rodriguez,Manuel Granell,Beatriz Cano,Lucas Rovira,Javier Morales,Ana Broseta,Jose De Andrés 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.3

Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.

Long-term consistency of clinical sensory testing measures for pain assessment

Pablo Bellosta-López,Víctor Doménech-García,Thorvaldur Skuli Palsson,Pablo Herrero,Steffan Wittrup Mcphee Christensen 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.2

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96–0.99; MDC, 22–55 kPa) and from good to excellent at 6 months (ICC, 0.88–0.95; MDC, 47–91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91–0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57–0.74; MDC, 24%–35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

Dr. Pablo Mendes de Leon Director, International Institute of Air and Space Law Leiden University, Leiden, The Netherlands

Pablo Mendes de Leon 숭실대학교 법학연구소 1998 法學論叢 Vol.11 No.-

Most Rev. Pablo Virgilio S. David

Pablo Virgilio S,David 신학과사상학회 2018 가톨릭 신학과 사상 Vol.- No.81

THE EFFECT OF LIPID TYPE ON LIPID DIGESTION ENZYMES DURING LARVAL DEVELOPMENT IN CALIFORNIA HALIBUT (Paralichthys californicus)

Juan Pablo Lazo,Pablo Fuentes,Benjamin Baron-Sevilla 한국수산과학회 양식분과 2015 한국수산과학회 양식분과 학술대회 Vol.2015 No.5

Seasonal Variations in Sex Steroids in a Young Male Population and Their Relationship with Plasma Levels of Vitamin D

Costanzo Pablo René,Suárez Sebastián Matías,Kozak Andrea Elina,Knoblovits Pablo 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.2

Purpose:Purpose: Vitamin D (VD) acts on sperm motility, capacitation and survival but its role in steroidogenesis is less clear. Aims: To analyze seasonal variations in sex steroids and VD in a healthy male population. Materials and Methods:Materials and Methods: Twenty-nine healthy males, 34.0±4.8 years were included. Blood collection in winter (W) and sum-mer (S) was performed to measure: 25OHD, total testosterone (TT), free testosterone (FT), estradiol (E2), luteinizing hormone (LH), and sex hormone binding globulin (SHBG). Testosterone/estradiol (T/E2) ratio was calculated. Results:Results: In W, lower levels of 25OHD: 18.8±7.2 ng/mL vs. 38.8±11.9 ng/mL (p<0.0001) and LH: 3.5±1.2 mU/mL vs. 3.9±1.5 mU/mL (p=0.05), and higher levels of TT: 501.9±157.7 ng/dL vs. 405.0±128.0 ng/dL (p=0.0003), FT: 11.8±4.1 ng/dL vs. 10.2±3.7 ng/dL (p=0.017), SHBG: 28.5±10.9 nmol/L vs. 23.6±7.9 nmol/L (p=0.002) and T/E2 ratio: 30.7±19.7 ng/dL/pg/mL vs. 17.3±3.6 ng/dL/pg/mL (p=0.0015) with no variation in E2 levels were observed. A positive correlation between 25OHD and E2 (r=0.28, p=0.04) and negative correlations between 25OHD and TT (r=-0.27, p=0.049), 25OHD and FT (r=-0.32, p=0.01), and 25OHD and T/E2 (r=-0.44, p=0.0008) were found. Conclusions:Conclusions: In healthy young male population, seasonal variations were observed in 25OHD and LH levels (higher in S) and in TT, FT, SHBG levels, and T/E2 (higher in W). Lower values of TT and FT in S are accompanied by higher levels of LH, which rules out a central mechanism for lowering testosterone. 25OHD negatively correlated with TT, FT, and T/E2 and posi-tively correlated with E2, suggesting a relationship between VD status and changes in gonadal steroids.

I Can Not Wear My Sunglasses: An Unusual Sarcoidosis Presentation

José Pablo Miramontes González,Virginia Velasco Tirado,Pablo González García,Marta Sánchez García,Ángeles Fidalgo Fernández 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.4

A 39-year-old Caucasian man was referred to University Hospital Salamanca from a primary care unit due to the presence of an erythematous violaceous nodule at the superior portion of his nose. Physical examination indicated that the firm, fixed erythematous violaceous nodule measured approximately 2 cm in diameter and was located in-ferior to a scar on the nasal bridge. Cutaneous involvement in sarcoidosis occurs in 25% of cases. A wide range of clinical presentations of cutaneous sarcoidosis is recognized. Skin lesions are classified as either non-specific, of which erythema nodosum is the most representative and specific, or as granulomatous, which includes maculo-papular nodules, plaques, infiltrated scars, lupus pernio, ulcerations, warty lesions and erythroderma. Scar sarcoid-osis is a type of cutaneous sarcoidosis.

Testing and modelling of shape memory alloy plates for energy dissipators

Pablo Heresi,Ricardo A. Herrera,Maria O. Moroni 국제구조공학회 2014 Smart Structures and Systems, An International Jou Vol.14 No.5

Shape memory alloys (SMA) can dissipate energy through hysteresis cycles without significant residual deformation. This paper describes the fabrication and testing of copper-based SMA hourglass-shaped plates for use in energy dissipation devices and the development of a numerical model to reproduce the experiments. The plates were tested under cyclic flexural deformations, showing stable hysteresis cycles without strength degradation. A detailed nonlinear numerical model was developed and validated with the experimental data, using as input the constitutive relationship for the material determined from cyclic tests of material coupons under tension loading. The model adequately reproduces the experimental results. The study is focused on the exploitation of SMA in the martensite phase.

Energy dissipation by friction for sliding blocks subjected to near-fault seismic base motion

Pablo M. Barlek Mendoza,Daniel Ambrosini,Bibiana M. Luccioni 국제구조공학회 2021 Smart Structures and Systems, An International Jou Vol.27 No.5

The objective of this study was to determine friction ratios that maximize energy dissipation on a seismic damper. The aforementioned friction damper basically consists of mass blocks that are able to slide on a flat surface. To carry out this analysis, a numerical-experimental approach was used. Firstly, the theoretical background and equations of motion for a SDOF system consisting of a mass supported on a flat surface with friction are introduced. Special emphasis is made on the fundamentals of stick-slip motion as well as energy considerations. Secondly, experimental studies carried out on a shaking table with harmonic and seismic records are described. These tests consisted of lead blocks contained on a U-shaped channel type aluminum section with its open end facing upwards. This configuration allowed blocks to slide solely in the direction of the base motion. Five different types of contact interfaces were considered to determine potential friction coefficients for the damper's design. Additionally, computational models based on rigid-body dynamics are presented. Numerical results were satisfactory particularly when comparing model's dissipated energy with empirical results. An analysis was carried out by calculating dissipated energy for the experimentally-calibrated models with varying friction ratios. For this purpose, eight near-fault seismic records were selected. Intervals with friction coefficients that maximize energy dissipation are proposed for each record. Finally, relationships between the computed friction ratios and register's peak ground acceleration (PGA) and root mean square acceleration (RMS) are discussed.

Nitric oxide-inhibited chloride transport in cortical thick ascending limbs is reversed by 8-iso-prostaglandin-F2α

( Pablo D. Cabral ),( Guillermo B. Silva ),( Sandra T. Baigorria ),( Luis I. Juncos ),( Ebenezer I. O. Ajayi ),( Néstor H. García ) 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.6

Background: Sodium chloride (NaCl) reabsorption in the cortical thick ascending limb (cTAL) is regulated by opposing effects. Nitric oxide (NO) inhibits NaCl reabsorption while 8-iso-prostaglandin-F2α (8-iso-PGF2α) stimulates it. Their interaction has not been evaluated in the cTAL. Because 8-iso-PGF2α has considerable stability while NO is a free radical with a short half-life, we hypothesized that, in the cTAL, the inhibition of NaCl absorption will be reversed by 8-iso-PGF2α. Methods: Chloride absorption (J_Cl) was measured in isolated perfused cTALs and whether the activation of protein kinase A (PKA) is required for this interaction. Since cyclic adenosine monophosphate (cAMP) is a major messenger for the 8-iso-PGF2α signaling cascade, and NO inhibits J_Cl by decreasing cAMP bioavailability, we measured 8-iso-PGF2α-stimulated cAMP in the presence of sodium nitroprusside (SNP). Results: The NO donor, SNP (10^-6 M), decreased J_Cl by 41%, while luminal 8-iso-PGF2α (100 μM) increased J_Cl to 315 ± 46 pmol/ min/mm (p < 0.003), reversing the effects of the NO donor. SNP inhibited J_Cl, 8-iso-PGF2α failed to increase J_Cl in the presence of H89. Basal cAMP was 56 ± 13 fmol/min/mm, in the presence of SNP 57 ± 6 fmol/min/mm, and 8-iso-PGF2α increased it to 92 ± 2 fmol/min/mm (p < 0.04). Conclusion: We concluded that 1) NO-induced inhibition of J_Cl in the cTAL can be reversed by 8-iso-PGF2α, 2) 8-iso-PGF2α and NO interaction requires PKA to control J_Cl, and 3) in the presence of NO, 8-iso-PGF2α continues to stimulate J_Cl because NO cannot reverse 8-iso-PGF2α-stimulated cAMP level.