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https://www.readbyqxmd.com/read/29775120/successful-improvement-of-pain-symptomatology-in-a-suspected-case-of-cramp-fasciculation-syndrome-via-interventional-pain-treatment
#1
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
May 18, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#2
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29753264/perineural-dexamethasone-successfully-prolongs-adductor-canal-block-when-assessed-by-objective-pinprick-sensory-testing-a-prospective-randomized-dose-dependent-placebo-controlled-equivalency-trial
#3
James D Turner, Daryl S Henshaw, Robert S Weller, J Douglas Jaffe, Christopher J Edwards, J Wells Reynolds, Gregory B Russell, Sean W Dobson
STUDY OBJECTIVE: To determine whether perineural dexamethasone prolongs peripheral nerve blockade (PNB) when measured objectively; and to determine if a 1 mg and 4 mg dose provide equivalent PNB prolongation compared to PNB without dexamethasone. SETTING: Multiple studies have reported that perineural dexamethasone added to local anesthetics (LA) can prolong PNB. However, these studies have relied on subjective end-points to quantify PNB duration. The optimal dose remains unknown...
May 8, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29749407/peripheral-n-methyl-d-aspartate-receptor-localization-and-role-in-gastric-acid-secretion-regulation-immunofluorescence-and-pharmacological-studies
#4
Iuliia Golovynska, Tatiana V Beregova, Tatiana M Falalyeyeva, Ludmila I Stepanova, Sergii Golovynskyi, Junle Qu, Tymish Y Ohulchanskyy
The enteric nervous system (ENS) and a glutamate receptor (GluR), N-methyl-D-aspartate receptor (NMDAR), participate in gastric acid secretion (GAS) regulation. NMDARs are localized in different stomach cells; however, knowledge of NMDAR expression and function in the ENS is limited. In the present study, we clarified the types of stomach cells that express the NMDARs that are involved in GAS regulation. The pharmacological method of isolated stomach perfusion by Ghosh and Shild combined with direct mapping of NMDARs by fluorescence microscopy in the rat stomach was employed...
May 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29747078/mechanisms-of-acetylcholinesterase-protection-against-sarin-and-soman-by-adenosine-a-1-receptor-agonist-n-6-cyclopentyladenosine
#5
Ariana Beste, DeCarlos E Taylor, Tsung-Ming Shih, Thaddeus P Thomas
Organophosphorus nerve agents (NAs) irreversibly inhibit acetylcholinesterase (AChE), the enzyme responsible for breaking down the neurotransmitter acetylcholine (ACh). The over accumulation of ACh after NA exposure leads to cholinergic toxicity, seizure, and death. Current medical countermeasures effectively mitigate peripheral symptoms, however; the brain is often unprotected. Alternative acute treatment with the adenosine A1 receptor agonist N6 -cyclopentyladensosine (CPA) has previously been demonstrated to prevent AChE inhibition as well as to suppress neuronal activity...
May 7, 2018: Computational Biology and Chemistry
https://www.readbyqxmd.com/read/29746989/increased-expression-of-transcription-factor-sry-box-containing-gene-11-sox11-enhances-neurite-growth-by-regulating-neurotrophic-factor-responsiveness
#6
Michael P Jankowski, Lauren Miller, H Richard Koerber
The peripherally projecting axons of dorsal root ganglion (DRG) neurons readily regenerate after damage while their centrally projecting branches do not regenerate to the same degree after injury. One important reason for this inconsistency is the lack of pro-regeneration gene expression that occurs in DRG neurons after central injury relative to peripheral damage. The transcription factor SRY-Box containing gene 11 (Sox11) may be a crucial player in the regenerative capacity of axons as previous evidence has shown that it is highly upregulated after peripheral axon damage but not after central injury...
May 7, 2018: Neuroscience
https://www.readbyqxmd.com/read/29742785/-peripheral-regional-anesthesia-without-any-complications-a-dream-comes-true
#7
Thomas Wiesmann, Jens Döffert, Thorsten Steinfeldt
Peripheral regional anesthesia procedures, such as femoral nerve block, are relatively safe procedures in clinical anesthesia. Nevertheless, it may lead to typical, usually transient and rarely even persistent complications. This article aims to highlight key aspects of complications in peripheral regional anesthesia and, in particular, strategies to reduce risk. Moreover, beside general complications, which might potentially occur in any peripheral nerve blockade ("bleeding/infection/nerve damage"), accidental co-blockades of other nerval structures are discussed using the example of the brachial plexus...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29742684/myocardial-injury-after-noncardiac-surgery-incidence-and-predictors-from-a-prospective-observational-cohort-study-at-an-indian-tertiary-care-centre
#8
Rubin George, Vidya P Menon, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Preetha Prasanna, Gokuldas S, Jerry Paul, Chandrababu K K, Lakshmi Kumar, Ashok Pillai
Asymptomatic myocardial injury following noncardiac surgery (MINS) is an independent predictor of 30-day mortality and may go unrecognized based on standard diagnostic definition for myocardial infarction (MI). Given lack of published research on MINS in India, our study aims to determine incidence of MINS in patients undergoing noncardiac surgery at our tertiary care hospital, and evaluate the clinical characteristics including 30-day outcome.The prospective observational study included patients >65 years or >45 years with either hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), cerebrovascular accident (CVA), or peripheral arterial disease undergoing noncardiac surgery...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29738328/persistent-postsurgical-pain-pathophysiology-and-preventative-pharmacologic-considerations
#9
Philippe Richebé, Xavier Capdevila, Cyril Rivat
The development of chronic pain is considered a major complication after surgery. Basic science research in animal models helps us understand the transition from acute to chronic pain by identifying the numerous molecular and cellular changes that occur in the peripheral and central nervous systems. It is now well recognized that inflammation and nerve injury lead to long-term synaptic plasticity that amplifies and also maintains pain signaling, a phenomenon referred to as pain sensitization. In the context of surgery in humans, pain sensitization is both responsible for an increase in postoperative pain via the expression of wound hyperalgesia and considered a critical factor for the development of persistent postsurgical pain...
May 7, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29732591/differential-conduction-and-cgrp-release-in-visceral-versus-cutaneous-peripheral-nerves-in-the-mouse
#10
Roberto De Col, Karl Messlinger, Tali Hoffmann
Cutaneous afferent nerves convey sensory information from the external, visceral nerves from the internal environment. The saphenous nerve arising from lumbar dorsal root ganglia and the vagus nerve originating in the nodosum ganglia are prototypic examples of such cutaneous and visceral nerves. Despite a common sensory role, these two nerves have distinct embryonic origin and vary in neuropeptide expression. Because of their distinct physiological roles, it is plausible that they differ also in conductive properties...
May 6, 2018: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/29729779/interventional-anesthetic-methods-for-pain-in-hematology-oncology-patients
#11
REVIEW
Holly Careskey, Sanjeet Narang
This article reviews anesthetic interventional approaches to the management of pain in hematology and oncology patients. It includes a discussion of single interventions including peripheral nerve blocks, plexus injections, and sympathetic nerve neurolysis, and continuous infusion therapy through implantable devices, such as intrathecal pumps, epidural port-a-caths, and tunneled catheters. The primary objective is to inform members of hematology and oncology care teams regarding the variety of interventional options for patients with cancer-related pain for whom medical pain management methods have not been effective...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29727758/deliberate-practice-using-validated-metrics-improves-skill-acquisition-in-performance-of-ultrasound-guided-peripheral-nerve-block-in-a-simulated-setting
#12
Osman M A Ahmed, Imran Azher, Anthony G Gallagher, Dara S Breslin, Brian D O'Donnell, George D Shorten
STUDY OBJECTIVES: The aim of this study was to compare the effects of deliberate vs. self-guided practices (both using validated metrics) on the acquisition of needling skills by novice learners. DESIGN: Randomized Controlled Study. SETTING: Simulation lab, Department of Anesthesia, St.Vincent's Hospital, Dublin. SUBJECTS: Eighteen medical students. INTERVENTIONS: Students were assigned to either (i) deliberate practice (n = 10) or (ii) self-guided practice (n = 8) groups...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29722913/the-tsc1-mtor-plk-axis-regulates-the-homeostatic-switch-from-schwann-cell-proliferation-to-myelination-in-a-stage-specific-manner
#13
Minqing Jiang, Rohit Rao, Jincheng Wang, Jiajia Wang, Lingli Xu, Lai Man Wu, Jonah R Chan, Huimin Wang, Q Richard Lu
Proper peripheral myelination depends upon the balance between Schwann cell proliferation and differentiation programs. The serine/threonine kinase mTOR integrates various environmental cues to serve as a central regulator of cell growth, metabolism, and function. We report here that tuberous sclerosis complex 1 (TSC1), a negative regulator of mTOR activity, establishes a stage-dependent program for Schwann cell lineage progression and myelination by controlling cell proliferation and myelin homeostasis. Tsc1 ablation in Schwann cell progenitors in mice resulted in activation of mTOR signaling, and caused over-proliferation of Schwann cells and blocked their differentiation, leading to hypomyelination...
May 3, 2018: Glia
https://www.readbyqxmd.com/read/29721648/comparison-of-adductor-canal-block-and-ipack-block-interspace-between-the-popliteal-artery-and-the-capsule-of-the-posterior-knee-with-adductor-canal-block-alone-after-total-knee-arthroplasty-a-prospective-control-trial-on-pain-and-knee-function-in-immediate
#14
S R Sankineani, A R C Reddy, Krishna Kiran Eachempati, Ajit Jangale, A V Gurava Reddy
BACKGROUND: Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves. MATERIALS AND METHODS: A prospective study was conducted from September 2016 to March 2017 in a total of 120 patients undergoing unilateral total knee arthroplasty...
May 2, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29719743/ultrasound-guided-erector-spinae-plane-block-in-a-child-undergoing-laparoscopic-cholecystectomy
#15
David Terence Thomas, Serkan Tulgar
Erector spinae plane block (ESP) is a recently described regional anesthesia technique that leads to the blockage of both visceral and somatic nerve fibers. While there are anecdotal reports of ESP used in children, none are for laparoscopic procedures. Herein we report a child undergoing laparoscopic cholecystectomy in which ESP was used as part of multimodal anesthesia. Ultrasound-guided ESP block is an easily performed peripheral nerve block that leads to long-lasting postoperative analgesia. It can be successfully used in pediatric laparoscopic procedures such as cholecystectomy and should be kept in mind as an option for multimodal analgesia in children...
February 27, 2018: Curēus
https://www.readbyqxmd.com/read/29712789/macrophage-depletion-ameliorates-peripheral-neuropathy-in-aging-mice
#16
Xidi Yuan, Dennis Klein, Susanne Kerscher, Brian L West, Joachim Weis, Istvan Katona, Rudolf Martini
Aging is known as a major risk factor for the structure and function of the nervous system. There is urgent need to overcome such deleterious effects of age-related neurodegeneration. Here we show that peripheral nerves of 24-month-old aging C57Bl6 mice of either sex show similar pathological alterations as nerves from aging human individuals while 12 months old adult mice lack such alterations. Specifically, nerve fibers showed de- and remyelination and axonal lesion. Moreover, in the aging mice, neuromuscular junctions showed features typical for dying-back neuropathies, as revealed by a decline of pre-synaptic markers, associated with α-bungarotoxin-positive postsynapses...
April 30, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29705538/peripheral-ionotropic-glutamate-receptors-contribute-to-fos-expression-increase-in-the-spinal-cord-through-antidromic-electrical-stimulation-of-sensory-nerves
#17
Jia-Heng Li, Pei-Yao He, Dan-Ni Fan, Dilinapa Alemujiang, Fu-Quan Huo, Yan Zhao, Dong-Yuan Cao
Previous studies have shown that peripheral ionotropic glutamate receptors are involved in the increase in sensitivity of a cutaneous branch of spinal dorsal ramus (CBDR) through antidromic electrical stimulation (ADES) of another CBDR in the adjacent segment. CBDR in the thoracic segments run parallel to each other and no synaptic contact at the periphery is reported. The present study investigated whether the increased sensitivity of peripheral sensory nerves via ADES of a CBDR induced Fos expression changes in the adjacent segments of the spinal cord...
April 26, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29703373/the-paper-that-restarted-modern-central-nervous-system-axon-regeneration-research
#18
James W Fawcett
Spinal cord repair research appeared to have run out of new ideas in the 1970s. In a 1981 paper, the Aguayo Laboratory revisited an experiment by Tello and Cajal that suggested that central nervous system (CNS) axons could regenerate into peripheral nerve grafts. Using modern axon tracing methods, David and Aguayo showed that axons from neurons in the spinal cord could regenerate for long distances within peripheral nervous system (PNS) grafts, but not back into the CNS. This proved that damaged CNS tissue is inhibitory to axon regeneration while PNS tissue is permissive...
May 2018: Trends in Neurosciences
https://www.readbyqxmd.com/read/29701410/digital-artery-aneurysm-case-report
#19
José Vidoedo, José Teixeira
INTRODUCTION AND METHODS: A 71-year-old patient, housewife, with a history of hypertension, elevated cholesterol and hypotyroidism was referred to the outpatient clinic for tumefaction of the right hand 5th finger noticed 3-4 months earlier. She denied past or recent history of trauma, cardiac or infectious disease and had no familial history of aneurysmatic disease. She was asymptomatic except for local slight discomfort when she had to press or push something with her hand. She had no sensitivity or mobility impairment...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697624/accessory-nerves-of-the-forehead-a-newly-discovered-frontotemporal-neurovascular-bundle-and-its-implications-in-the-treatment-of-migraine-headache-migraine-surgery-and-cosmetic-temple-filler-injection
#20
Bardia Amirlak, Michael H Chung, Ronnie A Pezeshk, Kyle Sanniec
BACKGROUND: Surgical decompression of peripheral cranial and spinal nerves at several anatomically studied trigger sites has demonstrated significant efficacy in bringing permanent relief to migraine sufferers. In their experience performing frontal nerve decompression on migraine patients, the authors noticed a previously undescribed accessory nerve and vessel in the frontotemporal area, and report its implication in migraine surgery and cosmetic filler injection. METHODS: A retrospective review of 113 patients who underwent frontal migraine decompression surgery at the University of Texas Southwestern Medical Center from July of 2011 to May of 2016 was performed...
May 2018: Plastic and Reconstructive Surgery
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