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Opioid induced hyperalgesia in the postoperative setting presents a significant challenge for clinicians managing postoperative pain in opioid tolerant patients. Remifentanil is a fentanyl analog frequently utilized in anesthesia for its favorable pharmacokinetic profile. However, as described in the case report, it may also increase the risk of postoperative hyperalgesia. Management of postoperative pain in the setting of hyperalgesia should be approached in a stepwise fashion, emphasizing therapy options with analgesic effects achieved outside of the opioidergic system while maintaining a neutral opioid balance.
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http://dx.doi.org/10.1080/15360288.2024.2400901 | DOI Listing |
J Pathol Transl Med
September 2025
Department of Pathology and Laboratory Medicine, University of California, Irvine (UCI), Irvine, CA, USA.
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a clinically indolent lymphoproliferative disorder characterized by accumulation of mature B-cell lymphocytes. Given the common CD5 co-expression, mantle cell lymphoma (MCL) is one of the most important entities in the differential diagnosis. MCL and CLL/SLL might exhibit overlapping morphologic and immunohistochemical features, making diagnosis particularly difficult in cases of composite lymphomas.
View Article and Find Full Text PDFMov Disord Clin Pract
September 2025
Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Br J Dermatol
September 2025
Department of Dermatology, Sainte-Justine University Hospital Center, Montreal, QC, Canada.
Zhong Nan Da Xue Xue Bao Yi Xue Ban
May 2025
Department of Nephropathy and Rheumatology, Third Xiangya Hospital, Central South University, Changsha 410013.
Dent disease is a rare X-linked recessive inherited renal tubular disorder characterized by low molecular weight proteinuria (LMWP), hypercalciuria, nephrocalcinosis, and other clinical features, and can lead to progressive renal failure. It is primarily caused by mutations in the gene. This article reports the case of a 10-year-old male patient of Chinese descent who was incidentally found to have asymptomatic proteinuria during a routine health examination.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
September 2025
Kawasaki Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Japan.
Kommerell's diverticulum (KD) combined with a right-sided aortic arch (RAA) and an aberrant left subclavian artery (ALSA) is a rare congenital vascular anomaly causing significant compressive dysphagia. Treatment options, including open surgery, thoracic endovascular aortic repair and hybrid approaches, are debated due to anatomical complexities. We report a 48-year-old female with dysphagia from symptomatic KD, RAA and ALSA, clearly delineated by preoperative computed tomography angiography.
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