Medical hypotheses
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Fibromyalgia (FM) is the most frequent cause of generalized pain in the community. Trauma and infection are frequent FM triggering events. A consistent line of investigation suggests that autonomic dysfunction may explain the multi-system features of FM, and that FM is a sympathetically maintained neuropathic pain syndrome. ⋯ High levels of NGF have been reported in the cerebro-spinal fluid of FM patients. These post-traumatic (or post-infective) phenotypic changes would induce a sympathetically maintained neuropathic pain syndrome resulting in widespread pain, allodynia and paresthesias - precisely, the key clinical features of FM. If this hypothesis proves to be true, then sodium channel blockers could become therapeutic options for FM pain.
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Editorial
On establishing priority of ideas: revisiting the "pli cacheté" (deposition of a sealed envelope).
This article proposes that individuals should have the option to deposit with journals and editors ideas, hypotheses, theories and other research material in "sealed envelopes". This "pli cacheté" approach could allow to establish priority of thinking and doing a posteriori, i.e., when the envelope is opened. Such concept can be important in two ways: (i) it offers the opportunity to claim priority of sealed scientific rationale and data which may not be substantiated enough and might mislead when published too early or even erroneously; (ii) it could facilitate research in connection with patents because scientific information which is available in the public domain will not receive patent protection in most cases. Roots of the pli cacheté in the French Academie des Sciences in the 1700s, three empirical examples between 1798 and 1982 and recommendations as to how to handle sealed envelopes proceduraly today are provided.
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The mechanisms by which blast pressure waves cause mild-to-moderate traumatic brain injury (mTBI) are an open question. Possibilities include acceleration of the head, direct passage of the blast wave via the cranium, and propagation of the blast wave to the brain via a thoracic mechanism. The hypothesis that the blast pressure wave reaches the brain via a thoracic mechanism is considered in light of ballistic and blast pressure wave research. ⋯ While vagotomy reduces apnea and bradycardia due to ballistic or blast pressure waves, it does not eliminate neural damage in the brain, suggesting that the pressure wave directly affects the brain cells via a thoracic mechanism. An experiment is proposed which isolates the thoracic mechanism from cranial mechanisms of mTBI due to blast wave exposure. Results have implications for evaluating risk of mTBI due to blast exposure and for developing effective protection.