Articles: function.
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Comparative Study
Poor symptom control is associated with reduced CT segmental airway lumen area in asthmatic smokers.
Cigarette smoking is associated with worse symptoms in asthma and abnormal segmental airways in healthy subjects. We tested the hypothesis that current symptom control in smokers with asthma is associated with altered segmental airway dimensions measured by CT scan. ⋯ The CT scan segmental airway lumen area is reduced in smokers with asthma compared with never smokers with asthma, particularly in severe disease, and is associated with worse current symptom control and small airway dysfunction.
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Patients with chronic pain usually suffer from cognitive impairment, with memory deterioration being the most common deficit that affects daily functioning and quality of life. The causes for this impairment are not clear despite intensive clinical studies. Few studies have evaluated impaired learning using animal models of persistent pain. ⋯ The results of this study suggest that trigeminal neuralgia induced by cobra venom in adult rats can impair spatial learning and memory function over time and results in demonstrable changes in the ultrastructure of the medulla oblongata. This new animal model may be useful for future studies on the effect of chronic pain on learning and cognition.
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Intensive care medicine · Mar 2015
Observational StudyIncidence and impact of skin mottling over the knee and its duration on outcome in critically ill patients.
Skin mottling is frequent and can be associated with an increased mortality rate in ICU patients with septic shock. Its overall incidence in ICU and its impact on outcome is unknown. We aimed to assess the incidence of skin mottling over the knee among all critically ill patients admitted in ICU and its role on their outcome. ⋯ Skin mottling is frequent in the general population of patients admitted in ICU. Occurrence and persistence of skin mottling are independently associated with in-ICU mortality.
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Chronic widespread pain is a serious medical problem, yet the mechanisms of nociception and pain are poorly understood. Using a reserpine-induced pain model originally reported as a putative animal model for fibromyalgia, this study was undertaken to examine the following: (1) expression of several ion channels responsible for pain, mechanotransduction, and generation/propagation of action potentials in the dorsal root ganglion (DRG), (2) activities of peripheral nociceptive afferents, and (3) alterations in spinal microglial cells. A significant increase in mRNA expression of the acid-sensing ion channel (ASIC)-3 was detected in the DRG, and the behavioral mechanical hyperalgesia was significantly reversed by subcutaneous injection of APETx2, a selective blocker of ASIC3. ⋯ The activated microglia and behavioral hyperalgesia were significantly tranquilized by intraperitoneal injection of minocycline. These results suggest that the increase in ASIC3 in the DRG facilitated mechanical response of the remaining C-nociceptors and that activated spinal microglia may direct to intensify pain in this model. Pain may be further amplified by reserpine-induced dysfunction of the descending pain inhibitory system and by the decrease in peripheral drive to this system resulting from a reduced proportion of mechanoresponsive C-nociceptors.
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: Despite the increase in studies and media coverage, concussion continues to threaten the futures of young athletes and cause a great deal of concern among parents and practitioners. Questions continue regarding the management and return to play for injured adolescents and young adults, and regarding the long term consequences of repeated concussion in our youth. There appears to be a huge disparity between what health care professionals know and understand about concussion and what the average athlete and parent understands about what concussion is and the real risks involved. ⋯ We recommend athletes be assessed at their yearly physical in order to properly determine their baseline function and readiness to return to play after concussion. Additionally, we recommend providing anticipatory guidance and a simple concussion evaluation tool to be used by parents and guardians to also annually assess a young person's baseline functional status and subsequent alterations. The goal of this review is to create an evidence-based, simple, cost-effective parental survey; increase awareness, understanding and diagnosis of concussion; and finally, expedited proper treatment and facilitate return to play.