Another crucial fact for the experimental aim was to affirm the assumed drug interaction by in vivo model examination. The assessment of anti-diabetic property on alloxan-induced Swiss albino mice proved significant in vivo interaction between the drugs. It was outlined from the animal study that the hypoglycemic activity of linagliptin might be significantly affected due to the complex formation of the drug with a proton pump inhibitor (PPI). Nonetheless, it is the primary outcome of the interaction, which recommends the bigger in vivo study or clinical monitoring on the human model.In an 81-year-old patient, acute hemodynamic instability requiring resuscitation occurred during an elective transurethral prostate resection. The procedure was ended prematurely and after ROSC a CT diagnosis was carried out, which confirmed the suspected diagnosis of fulminant pulmonary embolism. Anticoagulant therapy with heparin was initiated. About two hours after admission to the intensive care unit, hemorrhage requiring massive transfusion developed, which according to viscoelastometric diagnostics was most likely due to fulminant hyperfibrinolysis. This case report describes the pathophysiology of so-called post-cardiac arrest coagulopathy and discusses the use of antifibrinolytic therapy in patients with thrombotic complications such as pulmonary artery embolism.Surgical treatment of patients with alcohol use disorder can lead to disturbances (withdrawal syndrome, delirium) which require intensive care treatment. In a surgical ward, the diagnosis of an alcohol related disorder is not always simple. Oftentimes patients conceal or trivialize the issue and as a result are admitted to the hospital in a non-abstinent or unstable state. It is risky to assume that patients with alcohol use disorder will successfully be supplied with alcohol in general hospitals. The risk can be reduced through presurgical identification and alcohol withdrawal of such patients. A literature review concludes that there is no secured evidence for the application of alcohol as prophylaxis or therapy of alcohol withdrawal syndrome in a surgical intensive care unit. The use of intravenous and oral alcohol in intensive care is an unnecessary risk to patients. There are more secure alternatives.Future or reality? Treating acute and chronic pain is a part of the daily routine of clinical anesthesiologists. Commonly used analgesics have unwanted side effects or may even be insufficient as in chronic pain treatment. Virtual Reality (VR) could be a promising new approach which offers noninvasive therapy options for the treatment of pain. In case of the opioid misuse the adjunctive treatment is mandatory. Various phenomena occur in VR, such as immersion, presence, embodiment and Proteus effect, which can cause a change in body awareness and behavior. Selleckchem LY2874455 Experimental and clinical studies already yielded some promising results for analgesic effects for acute and chronic pain conditions using VR simulation. Potential analgesic mechanisms include distraction, cognitive behavioral change, and distance from reality, leading to neurophysiological changes at the cortical level. The quality of the virtual environment, personalized avatars, as well as the possibility of interaction and multisensory input can increase immersion, which leads to a state of presence, and thus effective VR. VR can be used as an immersive extension or alternative to mirror therapy, especially for pain disorders such as complex regional pain syndrome (CRPS) or phantom limb pain. VR can be supplemented by gamification, which increases intrinsic motivation, well-being and adherence to therapy. In summary, VR could be an effective and realistic therapy option for acute and chronic pain in clinical and home settings in the future.Interdisciplinary multimodal pain therapy (IMPT) is based on the biopsychosocial model of pain and describes an integrated treatment for patients with chronic pain. IMPT incorporates a close cooperation of different disciplines, including physicians, psychotherapists, physiotherapists, and others. IMPT mainly aims to restore and increase patients’ physical, social and psychological functional capacity. The efficacy of IMPT has been evidenced by systematic reviews and meta-analyses. A number of studies further indicate IMPT’s cost-efficiency. Psychotherapy is an essential component of IMPT. Its main goal within the framework of IMPT is to identify and modify dysfunctional patterns of pain coping, and to diagnose and potentially treat psychological comorbidities. Pain psychotherapy comprises mostly cognitive-behavioral interventions which address dysfunctional coping at the three levels of the pain experience (i.e., cognitive, emotional, and behavioral). Research into the efficacy of pain psychotherapy is rather sparse and studies have mostly focused on chronic back pain, yet existing results show promising evidence both for psychotherapy within IMPT and for psychotherapy as a monotherapy. This paper aims at providing an overview of (a) commonly employed cognitive-behavioral psychotherapeutic approaches and strategies in the treatment of chronic pain, and (b) the existing empirical evidence of pain psychotherapy both within the framework of IMPT and as a monotherapy. Future research should include a wider range of pain diagnoses and also investigate the potential benefit of individually-tailored treatments.Pain is agreed to be understood as a multi-causal, biopsychosocial phenomenon. A sufficient health care delivery shall therefore contain a corresponding interdisciplinary approach in diagnostic and therapy, respectively. Factors contributing to the process of chronification should be considered early in treating patients suffering from recurrent or persistent pain. Close collaboration of multidisciplinary protagonists in health care as well as interdisciplinary comprehensive medical treatment offer are two of the prerequisites for good practice in health care treating patients with pain.The article introduces into existing knowlegde about pain and risk factors for chronicity. The background (evidence and theoretical) of corresponding health care approaches and a detailed concept of interdisciplinary pain diagnostic by a multiprofessional team consisting of pain physician, physiotherapist and clinical psychologist are described and discussed.