**5. References**


Toxic derivatives of oxygen are referred to as free radicals and are either oxygen (ROS) or nitrogen-based (RNS) reactants. ROS/RNS are destructive to all key molecules, i.e. lipids, proteins and DNA, within all cells. Since the lungs of newborn infants are highly susceptible to oxidative damage by ROS/ RNS, care should be taken in the use of pure oxygen during resuscitation of infants. Also, avoidance of mechanical ventilation with the use of nasopharyngeal continuous positive air pressure may reduce respiratory tissue damage

Oxygen, which is obviously vital to survival, can obviously be highly damaging to tissues such as the lungs of newborns which are known to be poorly equipped to neutralise its toxic derivatives. Thus, the exposure of the newly born infant respiratory tree to oxygen at a higher percentage than exists in normal ambient air, i.e. 20%, or at a positive pressure should be performed with caution especially since it may be minimally or no better than using ambient air. Also, the use of antioxidants to quell molecular damage by ROS/RNS could be considered in situations in which pure oxygen or positive pressure are used. One antioxidant that may be useful in these situations is melatonin; this indoleamine has been

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**6** 

*Turkey* 

**Pain Management and Nursing** 

Nejla Canbulat1 and Ayşe Sonay Kurt2

*2Selcuk University, Faculty of Health Science, Konya,* 

*1Karamanoglu Mehmetbey University, Karaman School of Health, Karaman,* 

**Approaches in Pediatric Oncology** 

Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (Higginson&Murtagh 2010). Defining "pain" in a succinct manner is a great challenge. What is pain? It has been described as an emotional state, a physical experience, a spiritual sacrament, and a complex set of interconnected subcellular signals (Mirchandani et al., 2011). According to the International Association for the Study of Pain (IASP), pain is defined as "an unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both (Portenoy&Kanner 1996). In different places and in different points over time, both Eastern and Western medical traditions have included a concept of imbalance as an important etiology of painful symptoms (Helms, 1998) ... the difference between the body of a living man and that of a dead man is just like the difference between (Bias&Cope, 2011). Cancer pain may be either acute or chronic. Acute pain; acute pain is initially treated with short-acting non-opioid pharmacologic agents or combination opioid drugs. Acute versus chronic pain is important to clearly differentiate. Acute pain is rapid in onset, self-limiting, a symptom of the disease, and the patient often presents in acute distress. Examples of acute pain include postoperative pain, obstetrical labor pain, and trauma or injury-related pain and characteristically is described as sudden, sharp, and localized pain. It is usually self-limited and may be associated with physiologic changes such as diaphoresis and increases in heart rate and blood pressure (Mirchandani et al 2011). Chronic pain; chronic pain is long-term pain classified as acute, moderate, and severe. It is often differentiated as malignant or non-malignant pain. Chronic pain is often described as gnawing, aching, and diffuse and is more gradual in onset and cessation than acute pain, which can also be simultaneously superimposed on top of the former. It can vary in intensity, may remit briefly, and has definite impact psychologically and socially. Pain characteristics: Acute and chronic was given Table 1. The treatment for such pain is often successful with traditional pharmacologic measures; however, often less traditional drugs and even non-pharmacologic therapies are necessary to achieve relief (Mirchandani

**1. Introduction** 

et al., 2011).

