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Preoperative Acute Sleep Deprivation Causes Postoperative Pain Hypersensitivity and Abnormal Cerebral Function.

Preoperative sleep loss can amplify post-operative mechanical hyperalgesia. However, the underlying mechanisms are still largely unknown. In the current study, rats were randomly allocated to a control group and an acute sleep deprivation (ASD) group which experienced 6 h ASD before surgery. Then the variations in cerebral function and activity were investigated with multi-modal techniques, such as nuclear magnetic resonance, functional magnetic resonance imaging, c-Fos immunofluorescence, and electrophysiology. The results indicated that ASD induced hyperalgesia, and the metabolic kinetics were remarkably decreased in the striatum and midbrain. The functional connectivity (FC) between the nucleus accumbens (NAc, a subregion of the ventral striatum) and the ventrolateral periaqueductal gray (vLPAG) was significantly reduced, and the c-Fos expression in the NAc and the vLPAG was suppressed. Furthermore, the electrophysiological recordings demonstrated that both the neuronal activity in the NAc and the vLPAG, and the coherence of the NAc-vLPAG were suppressed in both resting and task states. This study showed that neuronal activity in the NAc and the vLPAG were weakened and the FC between the NAc and the vLPAG was also suppressed in rats with ASD-induced hyperalgesia. This study highlights the importance of preoperative sleep management for surgical patients.

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Development of the functional assessment of migraine scale using a patient guided approach.

A better understanding of the multi-dimensional burden and impact of migraine has grown over recent years, yet the tools used to measure these concepts have not been updated to reflect such findings. Additionally, due to the increase in the number of both prophylactic and acute therapeutic options for migraine, a comprehensive assessment of treatment response is necessary. The goal of this project was to develop a patient guided outcome measure which evaluates patient identified efficacy factors when appraising migraine treatment response.

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Definitions of Chronic Low Back Pain from a Scoping Review, and Analyses of Narratives and Self-Reported Health of Adults with Low Back Pain.

Among those with low back pain (LBP), individuals with chronic LBP (CLBP) face different treatment recommendations and incur the majority of suffering and costs. However, the way CLBP has been defined varies greatly. This study used a scoping review and qualitative and quantitative analyses of data from LBP patients to explore this variation. CLBP in most recent randomized controlled trials (RCTs) was defined by duration of pain, most commonly ≥3 months. However, individuals with LBP most often define CLBP by frequency. CLBP has also been defined using a combination of duration and frequency (16% of RCTs and 20% of individuals), including 6% of recent RCTs that followed the NIH Pain Consortium research task force (RTF) definition. Although not a defining characteristic of CLBP for individuals, almost 15% of recent RCTs required CLBP to have a healthcare provider diagnosis. In our LBP sample moving from ≥3 months to the RTF definition reduced the CLBP group size by 25% and resulted in a group that used more pain management options and reported worse health across all outcome measures. A pain duration definition offers ease of application. However, refinements to this definition (e.g., RTF) can identify those who may be better intervention targets. Perspective [max 50 words; now 50]: This article presents the definitions used for chronic low back pain by researchers and individuals, and the impact of these definitions on pain management and health outcomes. This information may help researchers choose better study inclusion criteria and clinicians to better understand their patients' beliefs about chronic low back pain.

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Dexmedetomidine alleviates pain in MPTP-treated mice by activating the AMPK/mTOR/NF-κB pathways in astrocytes.

Pain is a major non-motor symptom that contributes to impaired quality of life in Parkinson's disease (PD). However, the mechanisms and treatment of pain in PD have not been well studied. Dexmedetomidine (Dex) is used for analgesia and sedation during deep brain stimulation (DBS) and may reverse the progression of PD. Here, we explored the effect of Dex on Parkinson's pain and the underlying mechanism. C57BL/6 mice were intraperitoneally injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 30 mg/kg) to establish a PD model. Then, the mice were treated with Dex (50 µg/kg) or Compound C (CC, 10 mg/kg, AMPK inhibitor). A motor behavioral test was used to validate the PD model, and a plantar test was conducted to assess mechanical and thermal stimulation thresholds. Immunofluorescence and western blotting were used to analyze the level of tyrosine hydroxylase (TH) in the substantia nigra (SN) and the expression of c-Fos, GFAP, p-AMPK, mTOR, NF-κB, TNFα, and IL-6 in the dorsal horn of the spinal cord (DHSC). We found that mice exhibited motor dysfunction and mechanical allodynia and thermal hyperalgesia after MPTP injection, and these changes were partially reversed by Dex. Dex also reduced MPTP-induced astrocyte activation and TNFα and IL-6 expression, increased p-AMPK and reduced mTOR and NF-κB expression in DHSC. Moreover, the effects of Dex were partially reversed by the AMPK inhibitor Compound C. Conclusions: These findings reveal that Dex protects dopaminergic neurons in PD and alleviates pain by reducing the activation of DHSC astrocytes through the AMPK/mTOR/NF-κB pathway. Therefore, Dex may be a potential drug for treating Parkinson's pain.

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Antibiotic-disrupted Ribosome Biogenesis Facilitates Tumor Chemokine Superinduction.

Upon exposure to internal or external stressors, ribosomes stand sentinel via modulation of ribosome assembly and protein translation. Ribosome-dependent cellular dysfunctions have been associated with pathophysiological processes during inflammation and tumorigenesis. In the present study, ribosome biogenesis was assessed to determine its effects on tumor chemokines, potentially contributing to cancer cell malignant features. In particular, ribosome biogenesis inhibition by antibiotic actinomycin D (ActD) enhanced the expression of chemokines in intestinal cancer cells under endoplasmic reticulum stress that governs multiple pro-tumoral reprogramming. Mechanistically, ribosome biogenesis inhibition superinduced proinflammatory chemokines via transcriptional and post-transcriptional regulation. Moreover, ribosomal stress-responsive p53 and its target macrophage inhibitory cytokine 1 (MIC-1) mediated chemokine superinduction by activating TGF-β-activated kinase 1 (TAK-1) and nuclear factor-kappa B (NF-κB) in intestinal cancer cells. Cancer cell-based regulation of chemokine induction via MIC-1 signaling was verified using clinical transcriptome datasets. Clinical tumor tissue-derived MIC-1 was a positive regulator of chemokines and genes involved in the ribosome biogenesis pathway, supporting the in vitro assessments. Moreover, MIC-1-correlated chemokine expressions predicted poor prognoses in patients with colorectal cancer. Ribosome-based chemokine regulation via MIC-1 signaling would provide novel insights into translational interventions against malignant inflammatory insults.

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Upper airway multilevel radiofrequency under local anesthesia can improve CPAP adherence for severe OSA patients.

To evaluate the effect of upper airway radiofrequency (RF) tissue reduction under local anesthesia (LA) in severe obstructive sleep apnea (OSA) patients using continuous positive airway pressure (CPAP) in order to improve their compliance and adherence.

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Epidemiological and clinical characteristics of survivors of SARS-COV-2 infection: A descriptive study.

In March 2020, the World Health Organization (WHO) declared a pandemic for coronavirus 19. Typical symptoms were fever, cough, asthenia, dyspnea, and muscle pain. Pulmonary and central nervous system compromise presented challenging characteristics for healthcare physicians. The objectives of this study were to identify epidemiological and clinical characteristics of SARS-COV-2 infection survivors in a region of Argentina and to determine differences between gender, age groups, year of infection, and evolution time since diagnosis.

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Exploratory analyses of biomarkers in blood and stratum corneum in patients with atopic dermatitis.

The pathogenesis of atopic dermatitis (AD) involves various mediators, including cytokines and chemokines, which are produced by immune cells, such as dendritic cells and lymphocytes, and non-immune cells, such as epidermal cells. Several mediators, including thymus and activation-regulated chemokine (TARC), are used as biomarkers for AD severity and activity. However, additional local and systemic biomarkers of AD are required.

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Ustekinumab is effective against ulcerative colitis with intestinal stenosis: A case report.

Intestinal stricture and obstruction are rare complications of ulcerative colitis (UC). Currently, there are only a few studies on the treatment of UC with intestinal stenosis, however there are no reports on the treatment of UC with benign intestinal stenosis with ustekinumab (UST).

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Kinesio taping for ankle sprain in youth athlete: A protocol for systematic review and meta-analysis.

Ankle sprain is considered a major problem that may hinder youth athletes' athletic development because it will lead to ongoing dysfunction, reoccurrence of ankle sprain, chronic ankle instability, and posttraumatic osteoarthritis. Kinesio taping (KT) is a therapeutic taping technique that has been widely used in the treatment of various ankle issues including sprained ankles and in the prevention of ankle sprains. It can not only provide the injured ankle with support during the rehabilitation phase, but also enhance the ankle stability during activity. However, the available evidence regarding its effectiveness in the treatment and prevention of ankle sprain is inconsistent. Therefore, a systematic review will help clinicians and coaches better understand the application of KT in clinical and training practices. This study is to systematically review the literature on the use of KT to improve outcomes including ankle function, proprioception, and pain and to evaluate the effectiveness of KT in the treatment and prevention of ankle sprain injuries.

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