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https://www.readbyqxmd.com/read/27911122/an-update-on-the-use-of-cerebrospinal-fluid-analysis-as-a-diagnostic-tool-in-multiple-sclerosis
#1
Matteo Gastaldi, Elisabetta Zardini, Diego Franciotta
Intrathecal B-lymphocyte activation is a hallmark of multiple sclerosis (MS), a multi-factorial inflammatory-demyelinating disease of the central nervous system. Such activation has a counterpart in the cerebrospinal fluid (CSF) oligoclonal IgG bands (OCB), whose diagnostic role in MS has been downgraded within the current McDonald's criteria. With a theoretico-practical approach, the authors review the physiopathological basis of the CSF dynamics, and the state-of-the-art of routine CSF analysis and CSF biomarkers in MS...
December 2, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27910870/antinociceptive-profile-of-levo-tetrahydropalmatine-in-acute-and-chronic-pain-mice-models-role-of-spinal-sigma-1-receptor
#2
Dong-Wook Kang, Ji-Young Moon, Jae-Gyun Choi, Suk-Yun Kang, Yeonhee Ryu, Jin Bong Park, Jang-Hern Lee, Hyun-Woo Kim
We have recently reported that repeated systemic treatments of extract from Corydalis yanhusuo alleviate neuropathic pain and levo-tetrahydropalmatine (l-THP) is one of active components from Corydalis. We designed this study to investigate antinociceptive effect of l-THP in acute and chronic pain models and related mechanism within the spinal cord. We found that intraperitoneal pretreatment with l-THP significantly inhibited the second phase of formalin-induced pain behavior. In addition, intrathecal as well as intraperitoneal pretreatment with l-THP reduced the mechanical allodynia (MA) induced by direct activation of sigma-1 receptor (Sig-1)...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#3
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27903018/intrathecal-baclofen-therapy-for-the-treatment-of-spasticity-in-lithuania
#4
Robertas Kvascevicius, Ona Lapteva, Jurate Kesiene, Alfredas Vaitkus, Laima Mikulenaite, Ramunas Raugalas, Jurate Sipylaite, Saulius Rocka, Alvydas Juocevicius
Spasticity of cerebral or spinal origin severely impairs an individual's functional ability and quality of life. Intrathecal baclofen (ITB) therapy via an implantable pump is indicated for use in patients unresponsive to oral antispasmodics. ITB therapy improves the daily caring for and relief of painful spasms. In Lithuania, ITB therapy was introduced in clinical practice just recently. We share our experience of spasticity management with the ITB pump system in five patients at Vilnius University Hospital Santariskiu Klinikos...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27899552/prognostic-value-of-free-light-chains-lambda-and-kappa-in-early-multiple-sclerosis
#5
Margarete M Voortman, Tatjana Stojakovic, Lukas Pirpamer, Margit Jehna, Christian Langkammer, Hubert Scharnagl, Markus Reindl, Stefan Ropele, Thomas Seifert-Held, Juan-Jose Archelos, Siegrid Fuchs, Christian Enzinger, Franz Fazekas, Michael Khalil
BACKGROUND: Cerebrospinal fluid (CSF) immunoglobulin free light chains (FLC) have been suggested as quantitative alternative to oligoclonal bands (OCB) in the diagnosis of multiple sclerosis (MS). However, little is known on their role in predicting clinical and paraclinical disease progression, particularly in early stages. OBJECTIVE: To assess the prognostic value of FLC in OCB-positive patients with clinically isolated syndrome (CIS) suggestive of MS and early MS...
November 29, 2016: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/27895138/urotensin-ii-inhibitor-eases-neuropathic-pain-by-suppressing-the-jnk-nf-%C3%AE%C2%BAb-pathway
#6
Jing Li, Pan-Pan Zhao, Ting Hao, Dan Wang, Yu Wang, Yang-Zi Zhu, Yu-Qing Wu, Cheng-Hua Zhou
Urotensin II (U-II), a cyclic peptide originally isolated from the caudal neurosecretory system of fishes, can produce proinflammatory effects through its specific G protein-coupled receptor, GPR14. Neuropathic pain, a devastating disease, is related to excessive inflammation in the spinal dorsal horn. However, the relationship between U-II and neuropathic pain has not been reported. This study was designed to investigate the effect of U-II antagonist on neuropathic pain and to understand the associated mechanisms...
February 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/27892594/chloroprocaine-10-mg-ml-for-low-dose-spinal-anaesthesia-in-perianal-surgery-a-randomised-dose-finding-study
#7
V Gebhardt, L Mueller-Hansen, A Schwarz, D Bussen, C Weiss, M D Schmittner
BACKGROUND: Low-dose spinal anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery. Regarding its short duration of action and its trend to hyperbaric characteristics, plain chloroprocaine 10 mg/ml seems to be ideal to perform low-dose spinal anaesthesia. The aim of this trial was to determine the optimal dosage of chloroprocaine for this indication. METHODS: Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally...
November 28, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27892451/upregulation-of-c-x-c-motif-ligand-13-cxcl13-attenuates-morphine-analgesia-in-rats-with-cancer-induced-bone-pain
#8
Shi-Feng Wang, Cheng-Gong Dong, Xue Yang, Jian-Jun Yin
BACKGROUND The aim of this study was to investigate the role of chemokine (C-X-C motif) ligand 13 (CXCL13) in morphine tolerance in rats with cancer-induced bone pain (CIBP). MATERIAL AND METHODS We established a rat CIBP model and a rat CIBP-morphine tolerance (BM) model. BM rats were intrathecally administered rmCXCL13, neutralizing anti-CXCL13, and normal saline, while the control group rats underwent a sham operation and were injected with normal saline. The morphine analgesia was assessed by measuring mechanical withdrawal threshold (MWT) and mechanical withdrawal duration (MWD) at various time points...
November 28, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27891620/modulation-of-formalin-induced-pain-related-behaviour-by-clonidine-and-yohimbine-in-the-speke-s-hinged-tortoise-kiniskys-spekii
#9
C M Makau, P K Towett, K S P Abelson, T I Kanui
The study was designed to investigate the involvement of noradrenergic and serotonergic receptor systems in the modulation of formalin-induced pain-related behaviour in the Speke's hinged tortoise. Intradermal injection of 100 μL of formalin at a dilution of 12.5% caused pain-related behaviour (hindlimb withdrawal) that lasted for a mean time of 19.28 min (monophasic response). Intrathecal administration of clonidine (α2 -adrenergic receptor agonist) and yohimbine (α2 -adrenergic receptor antagonist) at a dose of 40 μg/kg and 37...
November 27, 2016: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27889175/inhibition-of-adenylyl-cyclase-in-the-spinal-cord-alleviates-painful-diabetic-neuropathy-in-zucker-diabetic-fatty-rats
#10
Hao Feng, Guodong Lu, Qingsong Li, Zhonghao Liu
OBJECTIVES: Diabetic neuropathy is the most common complication of both type 1 and type 2 diabetes. In this study, we tested the hypotheses that impaired Gi protein expression/function in the spinal cord is associated with the development of painful neuropathy in people with type 2 diabetes and that reduction of cyclic adenosine monophosphate (cAMP) production by inhibiting adenylyl cyclase in the spinal cord can alleviate diabetic neuropathy. METHODS: To this end, we examined the levels of cAMP, cAMP-dependent protein kinase (PKA) and cAMP response element-binding protein (CREB) in the spinal cord after the development of neuropathic pain in Zucker diabetic fatty (ZDF) rats with type 2 diabetes...
November 23, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27888114/limonene-reduces-hyperalgesia-induced-by-gp120-and-cytokines-by-modulation-of-il-1-%C3%AE-and-protein-expression-in-spinal-cord-of-mice
#11
Ana Claudia Piccinelli, Priscila Neder Morato, Marcelo Dos Santos Barbosa, Julio Croda, Jared Sampson, Xiangpeng Kong, Elisabete Castelon Konkiewitza, Edward B Ziff, Jaime Amaya-Farfan, Cândida Aparecida Leite Kassuya
AIMS: We have investigated the antihyperalgesic effects of limonene in mice that received intrathecal injection of gp120. MAIN METHODS: Male Swiss mice received gp120, IL-1β or TNF-α intrathecally or sterile saline as a control. A mechanicalsensitivity test was performed at 2 and 3h after the injection. Spinal cord and blood samples were isolated for protein quantification. KEY FINDINGS: Intrathecal administration of gp120 increased mechanical sensitivity measured with an electronic Von Frey apparatus, at 2 and 3h after the injections...
November 22, 2016: Life Sciences
https://www.readbyqxmd.com/read/27885944/letter-to-the-editor-ascenda-catheter-versus-silicone-catheter-in-intrathecal-baclofen-therapy
#12
Nathalie Draulans, Tom Theys, Bart Nuttin, Carlotte Kiekens
No abstract text is available yet for this article.
November 25, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#13
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27879539/clinically-mild-encephalitis-encephalopathy-with-a-reversible-splenial-lesion-accompanied-by-epstein-barr-virus-hemophagocytic-lymphohistiocytosis-a-case-report-and-review-of-the-literature
#14
Hiroshi Yamaguchi, Toshiaki Ishida, Takehito Yokoi, Tsukasa Tanaka, Azusa Maruyama, Hiroaki Nagase, Daiichiro Hasegawa, Ken-Ichi Imadome, Hiroki Takeda, Yoshiyuki Kosaka, Yoshiyuki Uetani
Central nervous system involvement in hemophagocytic lymphohistiocytosis (HLH) is associated with a poor outcome. For such patients, it is unknown whether more aggressive therapies, such as intrathecal methotrexate or hydrocortisone, are inevitably required. We present a very rare case of 3-year-old Japanese girl who developed mild encephalitis/encephalopathy with a reversible splenial lesion, accompanied by Epstein-Barr virus-associated HLH, and review previous similar reports. Our case and previous reports suggest that mild encephalitis/encephalopathy with a reversible splenial lesion accompanied by Epstein-Barr virus-associated HLH has a relatively good prognosis, even in the absence of intrathecal treatments...
November 22, 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27879509/surgical-site-infections-following-the-transoral-approach-a-review-of-172-consecutive-cases
#15
QingShui Yin, Hong Xia, ZengHui Wu, XiangYang Ma, FuZhi Ai, Kai Zhang, JianHua Wang, Tao Zhang, ZhaoHui Bai, ZhiYun Wang
STUDY DESIGN: A retrospective review. OBJECTIVE: The aim of this study was to discuss the characteristics, treatment, and incidence of surgical site infection (SSI) following transoral approach surgery. SUMMARY OF BACKGROUND DATA: One of the primary risks associated with transoral approach surgery is postoperative SSI. Few reports exist detailing the specific circumstances, treatment options, and incidence of SSIs following transoral approach surgery in a large series of consecutive cases...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#16
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27874212/dorsal-column-myelopathy-after-intrathecal-chemotherapy-for-leukemia
#17
Chelsea C Pinnix, Linda Chi, Elias J Jabbour, Sarah A Milgrom, Grace L Smith, Naval Daver, Naveen Garg, Matthew D Cykowski, Greg Fuller, David Cachia, Carlos Kamiya, Karin Woodman, Courtney Dinardo, Nitin Jain, Tapan M Kadia, Naveen Pemmaraju, Maro Ohanian, Marina Konopleva, Hagop M Kantarjian, Bouthaina S Dabaja
Intrathecal chemotherapy with methotrexate, a folate antagonist, is widely used to treat central nervous system malignancies. The mechanisms underlying methotrexate-induced neurotoxicity are unclear but may be related to increased homocysteine levels. Intrathecal methotrexate-induced myelopathy mimicking sub-acute combined degeneration, with normal B12 levels, has been documented. We examined treatment and magnetic resonance imaging (MRI) characteristics of 13 patients with leukemia who received intrathecal methotrexate and developed urinary and bowel incontinence, ascending motor weakness, and sensory loss with dorsal column hyper-intensity on MRI between 2000 and 2016...
November 22, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27871236/the-timing-of-administration-of-intravenous-dexmedetomidine-during-lower-limb-surgery-a-randomized-controlled-trial
#18
Eunsu Kang, Ki Hwa Lee, Sang Yoon Jeon, Kyu Won Lee, Myoung Jin Ko, Hyojoong Kim, Yong Han Kim, Jae-Wook Jung
BACKGROUND: Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause a biphasic cardiovascular response, and induce transient hypertension. Hypotension is a common complication of spinal anesthesia. Decreasing anxiety of patients before procedure is important for high quality of procedure. This study aimed to compare the incidence of hypotension and patients' anxiety and comfort levels when dexmedetomidine was intravenously administered before and after spinal anesthesia...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#19
T C Ngaka, J F Coetzee, R A Dyer
BACKGROUND: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery (CD). In this prospective, observational, noninferiority study, we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. METHODS: Two groups of 25 parturients, group O (body mass index [BMI] >40 kg/m) and group N (BMI <32 kg/m) requiring elective CD were recruited...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27868581/2016-updated-american-society-of-clinical-oncology-oncology-nursing-society-chemotherapy-administration-safety-standards-including-standards-for-pediatric-oncology
#20
Michael N Neuss, Terry R Gilmore, Kristin M Belderson, Amy L Billett, Tara Conti-Kalchik, Brittany E Harvey, Carolyn Hendricks, Kristine B LeFebvre, Pamela B Mangu, Kristen McNiff, MiKaela Olsen, Lisa Schulmeister, Ann Von Gehr, Martha Polovich
Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards...
November 21, 2016: Journal of Oncology Practice
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