Articles: trauma.
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Hypersensitivity to mechanical stimulation is a well documented symptom of neuropathic pain, for which there is currently no effective therapy. Src-family kinases (SFKs) are involved in proliferation and differentiation and in neuronal plasticity, including long-term potentiation, learning, and memory. Here we show that activation of SFKs induced in spinal cord microglia is crucial for mechanical hypersensitivity after peripheral nerve injury. ⋯ In contrast, there was no change in SFK phosphorylation in primary sensory neurons, and PP2 did not decrease the induction of transient receptor potential ion channel TRPV1 and TRPA1 in sensory neurons. Together, these results demonstrate that SFK activation in spinal microglia contributes to the development of mechanical hypersensitivity through the ERK pathway. Therefore, preventing the activation of the Src/ERK signaling cascade in microglia might provide a fruitful strategy for treating neuropathic pain.
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Review Meta Analysis
Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesia/anesthesia.
Of the 4 million annual births in the United States, 2.4 million involve epidural analgesia. Serious adverse events are rare but are important in young women. Robust estimates for the risk of harm are not available. ⋯ A total of 1.37 million women received an epidural for childbirth, reported in 27 articles. Most information (85% of women) was in larger (> 10,000 women) studies published after 1990, with risk estimates as follows: epidural hematoma, 1 in 168,000; deep epidural infection, 1 in 145,000; persistent neurologic injury, 1 in 240,000; and transient neurologic injury, 1 in 6,700. Earlier and smaller studies produced significantly higher risk estimates for transient neurologic injury plus injury of unknown duration.
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Sports-related injuries to the wrist range from minor sprains to severe soft tissue disruption that can pose a risk to the normal function of the upper extremity. It is important to identify the specific nature of such injuries so as to establish an accurate diagnosis and deliver appropriate treatment. MRI of the wrist has greatly benefited from the use of dedicated surface coils, which allow fine depiction of soft tissue and cartilaginous structures. A review of the normal anatomy, MR interpretation pitfalls, and most common abnormalities of the tendons, ligaments, triangular fibrocartilage complex, and nerves of the wrist are presented.
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To investigate the efficacy of single injection femoral nerve block (FNB) on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty (TKA). ⋯ Single injection FNB provided effective analgesia in patients undergoing TKA. However, the independence level in functional activities in the early postoperative period was not influenced by the analgesia method.