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Pain critic

Robert Strohal, Martina Mittlböck, Gilbert Hämmerle
OBJECTIVE: Critical colonization or local infection is very common in chronic wounds, but clinically problematic. Because therapeutic options for these conditions are limited in number and efficacy, the study authors tested a new acid-oxidizing solution (AOS [Nexodyn]; APR Applied Pharma Research S.A., Balerna, Switzerland) to determine its ancillary antimicrobial properties and potential support for wound healing. DESIGN AND SETTING: This open-label clinical case series was conducted with a prospective, single-arm design at the Federal County Hospital in Bregenz, Austria...
April 2018: Advances in Skin & Wound Care
Rose Z Hill, Benjamin U Hoffman, Takeshi Morita, Stephanie M Campos, Ellen A Lumpkin, Rachel B Brem, Diana M Bautista
Somatosensory neurons mediate responses to diverse mechanical stimuli, from innocuous touch to noxious pain. While recent studies have identified distinct populations of A mechanonociceptors (AMs) that are required for mechanical pain, the molecular underpinnings of mechanonociception remain unknown. Here, we show that the bioactive lipid sphingosine 1-phosphate (S1P) and S1P Receptor 3 (S1PR3) are critical regulators of acute mechanonociception. Genetic or pharmacological ablation of S1PR3, or blockade of S1P production, significantly impaired the behavioral response to noxious mechanical stimuli, with no effect on responses to innocuous touch or thermal stimuli...
March 21, 2018: ELife
Ping-An Zhang, Hong-Yan Zhu, Qi-Ya Xu, Wan-Jie Du, Shufen Hu, Guang-Yin Xu
Aims Insular cortex is a brain region critical for processing of the sensation. Purinergic receptors are involved in the formation of chronic pain. The aim of the present study was to explore the role and mechanism of P2X3 receptors (P2X3Rs) in insular cortex in chronic visceral pain. Methods Chronic visceral pain in adult rats was induced by neonatal maternal deprivation and measured by detecting the threshold of colorectal distension. Western blotting, immunofluorescence, and real-time quantitative polymerase chain reaction techniques were used to detect the expression and distribution of P2X3Rs...
January 2018: Molecular Pain
R Johnston, R Cahalan, M O'Keeffe, K O'Sullivan, T Comyns
OBJECTIVES: To determine the associations between training load, baseline characteristics (e.g. age or previous injury) and rate of musculoskeletal injury and/or pain specifically within an Endurance Sporting Population (ESP). DESIGN: Prospectively registered systematic review. METHODS: Eight electronic databases were searched by two independent reviewers. Studies were required to prospectively monitor both (i) training loads and (ii) musculoskeletal injury and/or pain for >3 months...
March 14, 2018: Journal of Science and Medicine in Sport
Jennifer Bido, Roya Ghazinouri, Jamie E Collins, Desirée Diez Portela, Luis Alcantara, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually. However, these missions have received little critical evaluation. This paper describes the research program Operation Walk (Op-Walk) Boston, and proposes an evaluation model for similar surgical missions. METHODS: We propose an evaluation model, borrowing from the work of Donabedian and enriched by evidence from our research program...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Magdalena Harris, Tim Rhodes
A life history approach enables study of how risk or health protection is shaped by critical transitions and turning points in a life trajectory and in the context of social environment and time. We employed visual and narrative life history methods with people who inject drugs to explore how hepatitis C protection was enabled and maintained over the life course. We overview our methodological approach, with a focus on the ethics in practice of using life history timelines and life-grids with 37 participants...
March 1, 2018: Qualitative Health Research
Bin Zhang, Wei Guo, Chao Sun, Hui-Quan Duan, Bing-Bing Yu, Kun Mu, Yue-Yan Guan, Yan Li, Shen Liu, Yang Liu, De-Xiang Ban, Wen-Dong Ruan, Xiao-Hong Kong, Cong Xing, Guang-Zhi Ning, Shi-Qing Feng
BACKGROUND/AIMS: Low back pain has become one of the most common musculoskeletal diseases in the world. Studies have shown that intervertebral disc degeneration (IDD) is an important factor leading to low back pain, but the mechanisms underlying IDD remain largely unknown. Research over the past decade has suggested critical roles for microRNAs (miRNAs) in natural growth and disease progression. However, it remains poorly understood whether circular RNAs participate in IDD. METHODS: Clinical IDD samples were collected from 20 patients who underwent discectomy...
March 15, 2018: Cellular Physiology and Biochemistry
Alexandra M Durrant, Matthew N Swift, Nicholas Beazley-Long
PURPOSE OF REVIEW: The importance of the blood-brain barrier (BBB) and neuroinflammation in neurodegenerative conditions is becoming increasingly apparent, yet very little is known about these neurovascular functions in nonmalignant disease chronic pain. Neural tissue pericytes play critical roles in the formation and maintenance of the BBB. Herein, we review the important roles of neural pericytes and address their potential role in chronic pain. RECENT FINDINGS: Pericytes are implicated in the function of neural microvasculature, including BBB permeability, neuroimmune factor secretion and leukocyte transmigration...
March 16, 2018: Current Opinion in Supportive and Palliative Care
Albert Dahan, Rutger van der Schrier, Terry Smith, Leon Aarts, Monique van Velzen, Marieke Niesters
The ventilatory control system is highly vulnerable to exogenous administered opioid analgesics. Particularly respiratory depression is a potentially lethal complication that may occur when opioids are overdosed or consumed in combination with other depressants such as sleep medication or alcohol. Fatalities occur in acute and chronic pain patients on opioid therapy and individuals that abuse prescription or illicit opioids for their hedonistic pleasure. One important strategy to mitigate opioid-induced respiratory depression is cotreatment with nonopioid respiratory stimulants...
March 19, 2018: Anesthesiology
Modupe Akinola, Elizabeth Page-Gould, Pranjal H Mehta, Zaijia Liu
Prior research has found inconsistent effects of diversity on group performance. The present research identifies hormonal factors as a critical moderator of the diversity-performance connection. Integrating the diversity, status, and hormone literatures, we predicted that groups collectively low in testosterone, which orients individuals less toward status competitions and more toward cooperation, would excel with greater group diversity. In contrast, groups collectively high in testosterone, which is associated with a heightened status drive, would be derailed by diversity...
March 1, 2018: Psychological Science
Yi-Chen Lee, Shui-Chin Lu, Yu-Lin Hsieh
Patients with diabetes mellitus (DM) or those experiencing the neurotoxic effects of chemotherapeutic agents may develop sensation disorders due to degeneration and injury of small-diameter sensory neurons, referred to as small fiber neuropathy. Present animal models of small fiber neuropathy affect both large- and small-diameter sensory fibers and thus create a neuropathology too complex to properly assess the effects of injured small-diameter sensory fibers. Therefore, it is necessary to develop an experimental model of pure small fiber neuropathy to adequately examine these issues...
February 13, 2018: Journal of Visualized Experiments: JoVE
Chun-Hsiang Tan, Peter A McNaughton
The abilities to detect warmth and heat are critical for the survival of all animals, both in order to be able to identify suitable thermal environments for the many different activities essential for life and to avoid damage caused by extremes of temperature. Several ion channels belonging to the TRP family are activated by non-noxious warmth or by heat and are therefore plausible candidates for thermal detectors, but identifying those that actually regulate warmth and heat detection in intact animals has proven problematic...
March 19, 2018: Pflügers Archiv: European Journal of Physiology
Sabrina Drexel, Daniel Tseng
Introduction: Primary peritonitis in healthy immunocompetent individuals is rare. Several case reports of Streptococcus species causing peritonitis have been described. Here, we present the first case of Mycoplasma hominis as the cause of primary peritonitis in a healthy woman. Case Report: A 42-year-old female with history of uterine fibroids was admitted with abdominal pain and intraperitoneal fluid of unknown etiology. She was initially managed nonoperatively and empirically treated with broad spectrum antibiotics...
2018: Case Reports in Surgery
Crystle J Kelly, Marco Martina
Functional deactivation of the prefrontal cortex (PFC) is a critical step in the neuropathic pain phenotype. We performed optogenetic circuit dissection to study the properties of ventral hippocampal (vHipp) and thalamic (MDTh) inputs to L5 pyramidal cells in acute mPFC slices and to test whether alterations in these inputs contribute to mPFC deactivation in neuropathic pain. We found that: (1) both the vHipp and MDTh inputs elicit monosynaptic excitatory and polysynaptic inhibitory currents. (2) The strength of the excitatory MDTh input is uniform, while the vHipp input becomes progressively stronger along the dorsal-ventral axis...
March 17, 2018: Brain Structure & Function
Hasan Qayyum, Sherif Hemaya, Justin Squires, Zulfiquar Adam
The de Winter ECG pattern is associated with proximal left anterior descending artery occlusion, being a significant risk factor for anterior wall ST elevation myocardial infarction. We present a case of a patient who attended our Emergency Department with chest pain and a prehospital ECG demonstrating transient infero-lateral lead ST segment elevation, which changed to the de Winter ECG pattern in our Emergency Department. She subsequently underwent primary PCI of the culprit lesion within the left anterior descending artery (LAD)...
March 6, 2018: Journal of Electrocardiology
Rosechelle M Ruggiero
The entity of chronic critical illness (CCI) has shown a rise in the past decades for popularity and prevalence. CCI is loosely defined as the group of patients who require the intensive care setting for weeks to months; its hallmark is prolonged mechanical ventilation. The outcomes of chronically critically ill patients have been dismal and have not improved over time; 1-year survival hovers at approximately 50%. Given the high mortality, prognostic variables are important when making medical decisions. CCI encompasses a syndrome that includes altered pathophysiology across a variety of organ systems...
March 2018: American Journal of the Medical Sciences
Douglas A Salguero, Pamela A Barletta, Willaim Sierraalta
BACKGROUND: Multiple myeloma is a hematologic disease with high mortality rates all over the world. The diagnosis has always been challenging since the first case was reported in 1844. For that reason the diagnostic criteria have evolved over years to include the features of the disease more comprehensively. Unusual presentations are infrequent and a diagnostic challenge. For this reason we report this rare case in which diarrhea and abdominal pain were the initial presenting symptoms of multiple myeloma with a plasmacytoma...
March 18, 2018: Journal of Medical Case Reports
Suman K Paine, Analabha Basu, Rajib Gon Choudhury, Basudev Bhattacharya, Sidhartha Chatterjee, Chandra Bhattacharya
AIM: Genital tuberculosis (GTB) is a potent contributor to irreversible damage to the reproductive system and infertility in females. As no gold standard diagnostic tool is yet available, clinical suspicion and relatively insensitive approaches such as histopathology, laparoscopy and hysterosalpingogram are currently critical determinants in the diagnosis of GTB. Although a polymerase chain reaction (PCR)-based assay using endometrial tissue seems promising, sampling does require an invasive procedure...
March 16, 2018: Molecular Diagnosis & Therapy
Irmela Gnass, Michaela Ritschel, Silke Andrich, Silke Kuske, Kai Moschinski, Annegret Herrmann-Frank, Maria-Inti Metzendorf, Sascha Flohé, Johannes Sturm, Joachim Windolf, Andrea Icks
INTRODUCTION: Survivors of polytrauma experience long-term and short-term burden that influences their lives. The patients' view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments' application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function)...
March 16, 2018: BMJ Open
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
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