EQUINE VETERINARY JOURNAL, Issue 4 2003
Part 1: Maintenance of surgical arytenoid abduction, complications of surgery
Summary Reasons for performing study: Laryngoplasty (LP) is currently the most common surgical treatment for equine laryngeal paralysis, however, there have been no reports quantifying the degree of retention of arytenoid abduction following L P. ADitionally, the complications of LP have been poorly documented. Objectives: To record the degree of arytenoid abduction retention following LP and to accurately document all complications of surgery. Methods: A study (1986,1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP (using 2 stainless steel wires) and combined ventriculocordectomy was undertaken; 198 owners completed questionnaires, a median of 19 months following surgery. The degree of arytenoid abduction achieved was endoscopically, semi-quantitatively evaluated using a 5-grade system, at 1 day, 7 days, and 6 weeks after surgery. Results: On the day following LP, 62% of horses had good (median grade 2) arytenoid abduction, 10% had excessive (grade 1), and 5% had minimal (grade 4) abduction (overall - median grade 2). Due to progressive loss of abduction, moderate (median grade 3, range 1,5) abduction was present overall at 1 and 6 weeks after LP. Further surgery was required to re-tighten prostheses in 10% of cases with excessive loss of abduction, or to loosen prostheses in 7% of horses which had continuing high levels of LP abduction and significant post operative dysphagia. LP wound problems (mainly seromas and suture abscesses) were reported to last <2 weeks in 9% of cases, <4 weeks in 4% and >4 weeks in 4%. The (partially sutured) laryngotomy wounds discharged post operatively for <2 weeks in 22% of cases, <4 weeks in 7% and for >4 weeks in 2%. Coughing occurred at some stage post operatively in 43% of cases and its presence correlated significantly with the degree of surgical arytenoid abduction. This coughing occurred during eating in 24% of cases and was not associated with eating (or dysphagia) in the other 19% of cases. Chronic (>6 months duration) coughing occurred in 14% of cases, but appeared to be due to intercurrent pulmonary disease in half of these horses. Conclusions: Suturing the cricotracheal membrane allows most laryngotomy wounds to heal quickly. Laryngoplasty wound problems were of little long-term consequence when stainless steel wire prostheses were used. Potential relevance: A significant loss of LP abduction occurs in most horses in the 6 weeks following surgery and efforts should be made to find ways to prevent such loss. However, excessive LP abduction is associated with post operative dysphagia and coughing. [source]

Chronic interleukin-6 alters the level of synaptic proteins in hippocampus in culture and in vivo

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 12 2007
Elly J. F. Vereyken
Abstract There is now considerable evidence that the level of expression of the proinflammatory cytokine, interleukin-6 (IL-6), is increased in the central nervous system (CNS) during neuroinflammatory conditions such as occurs in neurological disorders and in disease and injury. However, our understanding of the consequences of increased expression of IL-6 on the CNS is still limited, especially with respect to the developing nervous system, which is known to be particularly vulnerable to environmental factors. To address this issue, we investigated the properties of cultured hippocampal neurons exposed chronically to IL-6 during the main period of morphological and physiological development, which occurs during the first 2 weeks of culture. IL-6 was tested at 500 U/mL, considered to reflect a pathophysiologic concentration. The morphological features of neuronal development in the control and IL-6-treated cultures appeared similar. However, Western blot analysis showed a significant reduction in the level of Group-II metabotropic receptors (mGluR2/3) and L-type Ca2+ channels in the IL-6-treated cultures. A similar reduction in mGluR2/3 and L-type Ca2+ channel protein was observed in transgenic mice that over-express IL-6 in the CNS through astrocyte production starting early in development. Analysis of Ca2+ signals produced by spontaneous synaptic network activity in the hippocampal cultures and effects of a mGluR2/3 agonist and antagonist showed that the reduced levels of mGluR2/3 impact on the functional properties of hippocampal synaptic network activity. These results have important implications relative to the mechanisms responsible for altered CNS function during conditions associated with increased levels of IL-6 in the CNS. [source]

Insulin promotes functional induction of silent synapses in differentiating rat neocortical neurons

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2001
Daniela Plitzko
Abstract Long-term synaptic plasticity is thought to underlie synaptic reorganization phenomena that occur during neocortical development. Recently, it has been proposed, that the functional induction of AMPA receptors at silent glutamatergic synapses is of major importance in activity-dependent, developmental plasticity. To investigate the mechanisms involved in the developmental regulation of silent synapses, we analysed the functional maturation of the thalamocortical projection in culture. A large proportion of the thalamocortical synapses were functionally silent at an early stage in vitro. During further differentiation, the incidence of silent synapses decreased drastically, indicating a conversion of silent into functional synapses. Chronic blockade of spontaneous network activity by addition of tetrodotoxin to the culture medium strongly impaired this developmental maturation. Moreover, the developmental decline in the proportion of silent synapses was dramatically accelerated by chronic addition of the neurotrophic factor, insulin. This effect of insulin was partly dependent on spontaneous activity. Thus, insulin appears to be involved in the modulation of long-term developmental plasticity at immature glutamatergic synapses. [source]

Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed Migraine

HEADACHE, Issue 4 2003
Charles A. Popeney DO
Background.,Up to 5% of the general population suffers from transformed migraine. This study analyzes clinical responses of transformed migraine to cervical peripheral nerve stimulation. Methods.,Headache frequency, severity, and disability (Migraine Disability Assessment [MIDAS] scores) were independently measured in an uncontrolled consecutive case series of 25 patients with transformed migraine implanted with C1 through C3 peripheral nerve stimulation. All patients met International Headache Society (IHS) criteria for episodic migraine, as well as suggested criteria for transformed migraine, and had been refractory to conventional treatment for at least 6 months. Responses to C1 through C3 peripheral nerve stimulation were recorded. Results.,Prior to stimulation, all patients experienced severe disability (grade IV on the MIDAS) with 75.56 headache days (average severity, 9.32; average MIDAS score, 121) over a 3-month period. Following stimulation, 15 patients reported little or no disability (grade I), 1 reported mild disability (grade II), 4 reported moderate disability (grade III), and 5 continued with severe disability (grade IV), with 37.45 headache days (average severity, 5.72; average MIDAS score, 15). The average improvement in the MIDAS score was 88.7%, with all patients reporting their headaches well controlled after stimulation. Conclusions.,These results raise the possibility that C1 through C3 peripheral nerve stimulation can help improve transformed migraine symptoms and disability. A controlled study is required to confirm these results. [source]

Current Awareness in Hematological Oncology

HEMATOLOGICAL ONCOLOGY, Issue 2 2008
Article first published online: 28 MAY 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Reviews; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non-Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source]

Current Awareness in Hematological Oncology

HEMATOLOGICAL ONCOLOGY, Issue 4 2003
Article first published online: 15 JAN 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non-Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source]

Current Awareness in Hematological Oncology

HEMATOLOGICAL ONCOLOGY, Issue 4 2002
Article first published online: 5 DEC 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non-Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source]

Current Awareness in Hematological Oncology

HEMATOLOGICAL ONCOLOGY, Issue 3 2002
Article first published online: 29 AUG 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non-Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source]

Current Awareness in Hematological Oncology

HEMATOLOGICAL ONCOLOGY, Issue 4 2001
Article first published online: 17 DEC 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non-Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source]

The Role of Lad Magazines in Priming Men's Chronic and Temporary Appearance-Related Schemata: An Investigation of Longitudinal and Experimental Findings

HUMAN COMMUNICATION RESEARCH, Issue 1 2009
Jennifer Stevens Aubrey
We present a program of research investigating the effects of lad magazines on male body self-consciousness and appearance anxiety. Study 1, based on panel data from undergraduate men, showed that lad magazine exposure in Year 1 predicted body self-consciousness in Year 2. Study 2 was an experiment that showed that men assigned to view objectified women in lad magazines reported significantly higher levels of appearance anxiety and appearance-related motivations for exercise than men assigned to view male fashion models. We speculated that participants believed that to be romantically successful with these women would require them to conform to an idealized appearance standard. Study 3 replicated the finding that exposure to sexually objectified women primed body self-consciousness, and it further showed that this effect was mediated by romantic confidence. Résumé Le rôle des magazines masculins dans le déclenchement de schémas chroniques et temporaires liés à l'apparence : une étude de résultats longitudinaux et expérimentaux Nous présentons un programme de recherche étudiant les effets des magazines masculins sur la gêne par rapport au corps et sur les inquiétudes liées à l,apparence chez les hommes. La première étude, fondée sur des données recueillies au moyen d'un panel auprès d,hommes étudiant au premier cycle universitaire, démontre que l'exposition aux magazines masculins à l,année 1 a prédit la gêne par rapport à son corps à l'année 2. La deuxième étude a démontré que les hommes assignés à voir des femmes objectivées dans les magazines masculins ont déclaré des niveaux d,inquiétude face à leur apparence et des niveaux d'intentions, liées à l,apparence, de faire de l'exercice beaucoup plus hauts que les hommes assignés à regarder des mannequins masculins. Nous avons spéculé que les participants croyaient que pour avoir du succès romantique avec ces femmes, ils devraient se conformer à un standard d,apparence idéalisée. La troisième étude a répliqué le résultat selon lequel l'exposition à des femmes sexuellement objectivées déclenchait la gêne et elle a, de plus, démontré que cet effet était médié par la confiance amoureuse. Abstract Die Rolle von Männermagazinen für das Priming von dauerhaften und vorübergehenden aussehensbezogenen Schemata bei Männern: Eine Untersuchung von Langzeit- und experimentellen Ergebnissen Wir präsentieren ein Forschungsprogramm, welches die Wirkung von Männermagazinen auf die Körperwahrnehmung von Männern und die Besorgnis um ihr Aussehen untersucht. Studie 1, basierend auf Panel-Daten von männlichen BA-Studierenden, zeigte, dass die Wahrnehmung von Männermagazinen im Jahr 1 die eigene Körperwahrnehmung im Jahr 2 vorhersagt. Studie 2 zeigte experimentell, dass Männer, die objektivierte Frauen in Männermagazinen vorgelegt bekamen, ein signifikant höheres Maß an Angst um ihr Aussehen und die aussehensbezogenen Motivationen für sportliche Aktivitäten angaben als Männer, die männliche Modemodelle sahen. Wir nehmen an, dass die Teilnehmer glaubten, dass sie sich diesem idealisierten Aussehensstandard angleichen müssen, um bei Frauen romantisch erfolgreich zu sein. Studie 3 replizierte die Ergebnisse, dass die Rezeption sexualisierter, objektivierter Frauen eine Körperselbstwahrnehmung primed - zudem wird dieser Effekt durch romantisches Vertrauen vermittelt. Resumen El Rol las Revistas de Muchachos en la Detonación en los Hombres de la Pauta Relacionada con la Apariencia Crónica y Temporaria: Una Investigación de Resultados Longitudinales y Experimentales Presentamos un programa de investigación que investiga los efectos de las revistas de muchachos sobre la auto consciencia del cuerpo del hombre y la ansiedad dada la apariencia. El estudio 1, que se basó en un panel de datos de estudiantes de grado masculinos, demostró que la exposición a una revista de muchachos en el año 1 predijo la auto consciencia del cuerpo en el año 2. El estudio 2 fue un experimento que mostró que los hombres asignados a ver mujeres objetivadas por las revistas de muchachos, reportaron niveles significativamente mayores de ansiedad de la apariencia y cosas relacionadas con la apariencia tales como motivación para hacer ejercicio, más que los hombres que fueron asignados a mirar moda de modelos masculinos. Especulamos que los participantes creyeron que para tener éxito, desde el punto de vista romántico con esas mujeres requiere conformar con la apariencia idealizada estándar. El estudio 3 replicó este hallazgo que la exposición a mujeres objetivadas detonó la auto consciencia sobre el cuerpo, y demostró más aún que el efecto fue mediado por la confianza romántica. ZhaiYao Yo yak [source]

The diagnostic value of tau protein, ,-amyloid (1,42) and their ratio for the discrimination of alcohol-related cognitive disorders from Alzheimer's disease in the early stages

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2005
Elisabeth Kapaki
Abstract Background Chronic and heavy alcohol abuse or dependence may result in impaired cognition and dementia. The increased risk of Alzheimer's disease (AD) in older individuals interferes with the differential diagnosis, especially when dealing with elderly patients with a long history of alcohol abuse. The aim of the present study was to evaluate the diagnostic value of the putative cerebrospinal fluid (CSF) biomarkers tau, ,-amyloid 1,42 (A,42) and their ratio in differentiating alcohol related cognitive disorder (ARCD) from AD. Methods Double-sandwich ELISA (Innotest htau antigen and ,-Amyloid (1,42), Innogenetics) were used to quantify the above markers in a total of 20 patients with ARCD, 33 AD patients with mild to moderate dementia and 50 mentally intact subjects. Results Tau protein successfully differentiated AD from normal ageing with 96% specificity and 93.9% sensitivity and from ARCD with 95% specificity, and 87.9% sensitivity. A,42 alone had a specificity of 88% and a sensitivity of 69.7% in differentiating AD from normal ageing, while the corresponding values for differentiating AD from ARCD were 80% and 84.8% respectively. The tau/A,42 ratio was better than tau alone for differentiating AD from normal ageing (specificity 94%, sensitivity 97%) and better than any of the candidate markers alone, for differentiating AD from ARCD (specificity 100%, sensitivity 97%). Conclusions The combined use of CSF tau and A,42 may be a useful tool in the differential diagnosis of ARCD from AD, especially in the early stages, where diagnostic uncertainty is greater. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Chronic, painful lower extremity wounds: postoperative pain management through the use of continuous infusion of regional anaesthesia supplied by a portable pump device

INTERNATIONAL WOUND JOURNAL, Issue 3 2010
Christy L Scimeca
Reducing and preventing postoperative pain are currently a topic of great interest. There are different modalities for providing analgesia that can provide an alternative or adjunct to opioid therapy. One mode of therapy involves the use of portable pain pump devices that can deliver continuous local anaesthesia directly to the site of interest. A considerable amount of attention in literature has been dedicated to using regional anaesthesia postoperatively for various surgical applications. However, to our knowledge, little or no work has been published concerning the use of infusion of regional anaesthesia in the treatment of painful lower extremity wounds. We present a case report of a 55-year-old gentleman with a complex past medical history, 2-year history of opioid dependency and a 2-week history of intractable pain associated with the combination of debilitating painful diabetic neuropathy and painful lower extremity wounds. After surgical debridement of the lower extremity wounds, substantial analgesia was achieved postoperatively through the implantation of a portable direct infusion pump device. The device supplied 2 ml/hour of 0·25% bupivacaine and resulted in a reduction in pain within the first hour of implantation. Although the device achieved maximal analgesia at 6 hours, we found that this could have been likely reduced through the use of a 5-ml bolus dose of 0·25% bupivacaine at the time of implantation. The device provided sufficient analgesia to the patient without any observed adverse effects, and showed significant potential in avoiding an increase in his requirement for other systemic analgesia including opioids. [source]

Low level laser therapy for healing acute and chronic wounds , the extendicare experience

INTERNATIONAL WOUND JOURNAL, Issue 2 2008
Anita E Saltmarche
Abstract The purpose of the study is to assess the effectiveness of low level laser therapy for wound healing when combined with the Extendicare Wound Prevention and Management Program. Sixteen residents at a Canadian Extendicare nursing home had a total of 27 sites treated consisting of 23 open wounds and 4 ,at risk' areas. Of the 23 open wounds, two wounds in between toes were not able to be ,traced' and deemed ,immeasurable' wounds, resulting in 21 open, measured wounds. The four ,at risk' (closed) areas were treated preventatively. Pressure, venous insufficiency and diabetic wounds were included. The majority (12/21) or 57·1%, of the wounds were chronic (,3 months duration) and 42·9% were acute (<3 months duration). The primary outcome measures included the PUSH Tool score, EZ GraphTM tracings and photographs. Secondary outcome measures were employed to better understand potential barriers to successful integration into clinical practice. Feedback on the effectiveness of low level laser therapy, the education program and determinations of hands-on relevance was sought from staff. At the end of the 9-week trial, the majority (61·9%) of the 21 wounds achieved significant improvement (,50% wound closure). Nine (42·8%) had 100% closure. Some improvement was seen in 14·3% and 23·8% of wounds demonstrated no change. Chronic and acute wounds had similar improvement. None of the wounds in this debilitated, frail population deteriorated during the study and no negative consequences of treatment were encountered. Without staff support, even if new technology has positive clinical outcomes, success would be limited. Staff rated low level laser, easy to learn and use, effective for the majority of their residents worth the additional time. Staff requested a continuation of low level laser even after study completion. [source]

Cost Analysis of the Geriatric Resources for Assessment and Care of Elders Care Management Intervention

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009
Steven R. Counsell MD
OBJECTIVES: To provide, from the healthcare delivery system perspective, a cost analysis of the Geriatric Resources for Assessment and Care of Elders (GRACE) intervention, which is effective in improving quality of care and outcomes. DESIGN: Randomized controlled trial with physicians as the unit of randomization. SETTING: Community-based primary care health centers. PARTICIPANTS: Nine hundred fifty-one low-income seniors aged 65 and older; 474 participated in the intervention and 477 in usual care. INTERVENTION: Home-based care management for 2 years by a nurse practitioner and social worker who collaborated with the primary care physician and a geriatrics interdisciplinary team and were guided by 12 care protocols for common geriatric conditions. MEASUREMENTS: Chronic and preventive care costs, acute care costs, and total costs in the full sample (n=951) and predefined high-risk (n=226) and low-risk (n=725) groups. RESULTS: Mean 2-year total costs for intervention patients were not significantly different from those for usual care patients in the full sample ($14,348 vs $11,834; P=.20) and high-risk group ($17,713 vs $18,776; P=.38). In the high-risk group, increases in chronic and preventive care costs were offset by reductions in acute care costs, and the intervention was cost saving during the postintervention, or third, year ($5,088 vs $6,575; P<.001). Mean 2-year total costs were higher in the low-risk group ($13,307 vs $9,654; P=.01). CONCLUSION: In patients at high risk of hospitalization, the GRACE intervention is cost neutral from the healthcare delivery system perspective. A cost-effectiveness analysis is needed to guide decisions about implementation in low-risk patients. [source]

Chronic and Terminal Illness: New Perspectives on Caring and Carers

JOURNAL OF CLINICAL NURSING, Issue 6 2002
Brenda Roe
[source]

Feasibility of Myxomatous Mitral Valve Repair Using Direct Leaflet and Chordal Radiofrequency Ablation

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2008
JEFFREY L. WILLIAMS M.D., M.S.
Objective: Minimally invasive repair of mitral valve prolapse (MVP) causing severe mitral regurgitation (MR) should reduce MR and have chronic durability. Our ex vivo, acute in vivo, and chronic in vivo studies suggest that direct application of radiofrequency ablation (RFA) to mitral leaflets and chordae can effect these repair goals to decrease MR. Methods: A total of seven canines were studied to assess the effects of RFA on mitral valve structure and function. RFA was applied ex vivo (n = 1), acutely in vivo using a right lateral thoracotomy and cardiopulmonary bypass (n = 3), and chronically in vivo using percutaneous access to the heart (n = 3). RFA was applied to the mitral valve and its associated chordae. Mitral valve structure and function (in vivo preparations) were then assessed. Results: Ex vivo application of RFA resulted in qualitative reduction in mitral leaflet surface area and chordal length. Acute in vivo application of RFA to canines found to have MVP causing severe MR demonstrated a 43.7,60.7% statistically significant (P = 0.039) reduction in postablation MR. Chronic, in vivo, percutaneous application of RFA was found to be feasible and the engendered alterations durable. Conclusion: These data suggest that myxomatous mitral valve repair using radiofrequency energy delivered via catheter is feasible. [source]

Region-Specific Induction of FosB/,FosB by Voluntary Alcohol Intake: Effects of Naltrexone

ALCOHOLISM, Issue 10 2010
Jing Li
Background:, ,FosB is the best characterized transcription factor induced by chronic stimulation. Although previous studies have demonstrated that chronic passive ethanol exposure alters ,FosB immunoreactivity (IR), the effect of chronic voluntary ethanol consumption on ,FosB remains unknown. Furthermore, although previous studies have demonstrated that the opioid antagonist naltrexone reduces alcohol consumption in clinical and preclinical settings, the effect of naltrexone on FosB/,FosB has not been explored. Here, we examined the effects of chronic voluntary ethanol intake and naltrexone on FosB/,FosB IR in striatal region and prefrontal cortex, and the effect of naltrexone on voluntary ethanol intake. Methods:, We utilized immunohistochemistry to define the changes in FosB/,FosB IR induced by chronic voluntary ethanol intake under a two-bottle intermittent access of 20% ethanol model and by systematic administration (intraperitoneal injection) of naltrexone in Sprague-Dawley rats. Results:, Chronic (15 drinking sessions in 35 days) voluntary ethanol intake robustly induces FosB/,FosB IR in nucleus accumbens core, dorsolateral striatum, and orbitofrontal cortex, but not in nucleus accumbens shell, dorsomedial striatum, and medial prefrontal cortex. Systemic administration of naltrexone for 6 days significantly reduced voluntary ethanol consumption and FosB/,FosB IR induced by chronic voluntary ethanol intake. Conclusion:, Our results suggest that chronic voluntary ethanol intake induces FosB/,FosB IR in a subregion-specific manner which involves the activation of endogenous opioid system. [source]

Chronic and High Alcohol Consumption Has a Negative Impact on Sleep and Sleep-Associated Consolidation of Declarative Memory

ALCOHOLISM, Issue 5 2009
Klaus Junghanns
Background., The importance of sleep for memory consolidation has become a major focus of research. While it is known that abstaining alcohol-dependent patients often have sleep disorders and that there is some cognitive impairment during early abstention a possible interaction of disturbed sleep with overnight memory consolidation has not been addressed in a study as yet. Methods., Twenty-four alcohol-dependent patients with a short abstention period (mean 21.9 ± 7.6 days) were compared with 12 patients with an abstention period of several months (115.7 ± 43.8 days). Groups did not differ with respect to daily alcohol consumption before treatment, duration of alcohol dependence, and age. Before sleep all patients learned a list of semantically associated word pairs and a face name association task to a fixed criterion (at least 60% of correct recall) and they performed a mirror tracing task. After a polysomnographically registered night the patients were tested for retention of the learned declarative material by cued recall and had to perform the mirror tracing task again. Results., The groups did not differ with respect to sleep parameters or sleep-associated memory consolidation. Across both groups the duration of alcohol dependence correlated negatively with the amount of non-REM sleep and recall in the face name association task correlated negatively with daily alcohol consumption before abstention. Among the longer-term abstainers the duration of abstention correlated with the amount of slow wave sleep. Conclusions., Our data support the hypothesis that chronic and high alcohol consumption negatively affects sleep and declarative memory consolidation during the first months of abstention. Between an abstention period of a few weeks and of several months no change in sleep parameters and nightly memory consolidation could be demonstrated, however. [source]

Upregulation of ,-Catenin Levels in Superior Frontal Cortex of Chronic Alcoholics

ALCOHOLISM, Issue 6 2008
Ali M. Al-Housseini
Background:, Chronic and excessive alcohol misuse results in neuroadaptive changes in the brain. The complex nature of behavioral, psychological, emotional, and neuropathological characteristics associated with alcoholism is likely a reflection of the network of proteins that are affected by alcohol-induced gene expression patterns in specific brain regions. At the molecular level, however, knowledge remains limited regarding alterations in protein expression levels affected by chronic alcohol abuse. Thus, novel techniques that allow a comprehensive assessment of this complexity will enable the simultaneous assessment of changes across a group of proteins in the relevant neural circuitry. Methods:, A proteomics analysis was performed using antibody microarrays to determine differential protein levels in superior frontal cortices between chronic alcoholics and age- and gender-matched control subjects. Seventeen proteins related to the catenin signaling pathway were analyzed, including ,-, ,-, and ,-catenins, their upstream activators cadherin-3 (type I cadherin) and cadherin-5 (type II cadherin), and 5 cytoplasmic regulators c-Src, CK1,, GSK-3,, PP2A-C,, and APC, as well as the nuclear complex partner of ,-catenin CBP and 2 downstream genes Myc and cyclin D1. ILK, G,1, G,1, and G,2, which are activity regulators of GSK-3,, were also analyzed. Results:, Both ,- and ,-catenin showed significantly increased levels, while ,-catenin did not change significantly, in chronic alcoholics. In addition, the level of the ,-catenin downstream gene product Myc was significantly increased. Average levels of the catenin regulators c-Src, CK1,, and APC were also increased in chronic alcoholics, but the changes were not statistically significant. Conclusion:, Chronic and excessive alcohol consumption leads to an upregulation of ,- and ,-catenin levels, which in turn increase downstream gene expressions such as Myc that is controlled by ,-catenin signaling. This study showed that the ,-catenin signal transduction pathway was upregulated by chronic alcohol abuse, and prompts further investigation of mechanisms underlying the upregulation of ,- and ,-catenins in alcoholism, which may have considerable pathogenic and therapeutic relevance. [source]

Ethanol Consumption Increases Nitric Oxide Production in Rats, and Its Peroxynitrite-Mediated Toxicity Is Attenuated by Polyenylphosphatidylcholine

ALCOHOLISM, Issue 6 2002
Enrique Baraona
Background: Nitric oxide generally mediates beneficial responses but becomes deleterious when coexistence with enhanced superoxide formation leads to the synthesis of peroxynitrite, a potent oxidant and nitrating agent. Methods: To study the effects of ethanol and polyenylphosphatidylcholine on nitric oxide metabolism and toxicity, 36 rats were pair-fed liquid diets with 36% of energy either as ethanol or as additional carbohydrate for 24 days and were killed 90 min after intragastric feeding. Half received polyenylphosphatidylcholine in the diet (3 g/liter), and the other half equivalent amounts of essential fatty acids and choline. Nitric oxide was measured by chemiluminescence in arterial blood and liver cytosol and as a product of the inducible nitric oxide synthase activity. Peroxynitrite formation was assessed by the increase in nitrotyrosine protein residues, measured immunochemically. Results: In blood, administration of ethanol with or without polyenylphosphatidylcholine doubled nitric oxide levels. In the liver, ethanol increased nitric oxide by 52% (p < 0.01), and polyenylphosphatidylcholine attenuated this effect. Ethanol consumption increased the cytosolic activity of the inducible nitric oxide synthase and induced microsomal cytochromes P-450 capable of producing both nitric oxide and superoxide. This was associated with an 18% (p < 0.01) increase in nitrotyrosine protein residues, products of peroxynitrite toxicity, which occurred predominantly in steatotic hepatocytes. Polyenylphosphatidylcholine attenuated these changes by decreasing the ethanol effect on both the cytosolic and the microsomal activities, in addition to acting as a powerful antioxidant. Acute administration of the same ethanol dose increased nitric oxide levels, but did not affect nitrotyrosine protein residues. Conclusions: Chronic, but not acute, ethanol administration increases peroxynitrite hepatotoxicity by enhancing concomitant production of nitric oxide and superoxide, both of which are prevented by polyenylphosphatidylcholine. [source]

Alcohol Consumption Attenuates Febrile Responses to Lipopolysaccharide and Interleukin-1, in Male Rats

ALCOHOLISM, Issue 1 2002
Anna N. Taylor
Background: Chronic and acute alcohol use exert profound modulatory effects on the immune system which manifest as impaired host defense against infections. An important feature of this response is the interaction between the immune and the central nervous systems. This study investigated the effects of 14 days of alcohol exposure on cytokine-mediated neuroimmune interactions that affect the febrile component of the host-defense response. Methods: Adult male rats were fed a liquid diet containing ethanol (EtOH, 5% w/v) for 14 days. Pair-fed and normal chow- and water-fed rats served as controls. Continuous biotelemetric recordings of body temperature and locomotor activity commencing after 14 days of EtOH feeding were used to determine the effects of chronic EtOH on the circadian pattern of temperature and activity, on the febrile response to intraperitoneal (ip) administration of lipopolysaccharide (LPS) and interleukin (IL)-1,, and on fever induced by IL-1, administered intracerebroventricularly. We also examined the effects of EtOH consumption on LPS-induced hypothalamic production of the pyrogenic cytokines IL-1, and tumor necrosis factor-, (TNF,) and on the blood levels of IL-1,, TNF,, IL-6, adrenocorticotropin, and corticosterone at 2, 4, and 6 hr after ip LPS. Results: Fourteen days of EtOH consumption blunted the circadian increases in temperature and activity that normally occur in the dark phase of the light/dark cycle without affecting light-phase temperature or activity. EtOH consumption attenuated fever induced by LPS or IL-1, administered ip during the light phase and significantly reduced hypothalamic production of IL-1,. LPS-induced increases in hypothalamic TNF, and blood cytokines, adrenocorticotropin, and corticosterone were unaffected. Central administration of IL-1, produced a normal febrile response in chronic-EtOH rats. Conclusions: The attenuated LPS- and IL-1,,induced febrile responses in EtOH-consuming rats and the corresponding deficit in hypothalamic production of IL-1, suggest that alcohol may impair IL-1,,mediated neuroimmune communication. [source]

Clinical trial: comparison of ibuprofen-phosphatidylcholine and ibuprofen on the gastrointestinal safety and analgesic efficacy in osteoarthritic patients

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2008
F. L. LANZA
Summary Background, Chronic use of NSAIDs is associated with gastrointestinal (GI) toxicity that increases with age. Aim, To evaluate the GI safety and therapeutic efficacy of ibuprofen chemically associated with phosphatidylcholine (PC) in osteoarthritic (OA) patients. Methods, A randomized, double-blind trial of 125 patients was performed. A dose of 2400 mg/day of ibuprofen or an equivalent dose of ibuprofen-PC was administered for 6 weeks. GI safety was assessed by endoscopy. Efficacy was assessed by scores of analgesia and anti-inflammatory activity. Bioavailability of ibuprofen was pharmacokinetically assessed. Results, Ibuprofen-PC and ibuprofen provided similar bioavailability/therapeutic efficacy. In the evaluable subjects, a trend for improved GI safety in the ibuprofen-PC group compared with ibuprofen that did not reach statistical significance was observed. However, in patients aged >55 years, a statistically significant advantage for ibuprofen-PC treatment vs. ibuprofen in the prevention of NSAID-induced gut injury was observed with increases in both mean Lanza scores and the risk of developing >2 erosions or an ulcer. Ibuprofen-PC was well tolerated with no major adverse events observed. Conclusion, Ibuprofen-PC is an effective osteoarthritic agent with an improved GI safety profile compared with ibuprofen in older OA patients, who are most susceptible to NSAID-induced gastroduodenal injury. [source]

Disagreement between acute and chronic haemodynamic effects of nadolol in cirrhosis: a pathophysiological interpretation

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2005
C. MERKEL
Summary Background :,The acute effects of , -blockers may be different from chronic; mechanisms underlying this difference are poorly elucidated. Aim :,To assess portal pressure and its pathophysiological determinants after acute and chronic administration of nadolol. Methods :,In 24 patients with cirrhosis and portal hypertension hepatic venous pressure gradient, portal blood flow and resistance to portal blood flow were measured before, 60,90 min after acute administration of nadolol, and after 1 month. Patients were good-responders if hepatic venous pressure gradient was ,12 mmHg, or decreased by at least 20%. Results :,Eleven and 13 patients were good- and poor-responders to acute administration, respectively. Acute poor-responders showed a lower decrease in portal blood flow (P = 0.04) and a less evident decrease in mean arterial pressure (P < 0.001). Eleven and 13 patients were good- and poor-responders to chronic administration, respectively. Chronic poor-responders showed a larger increase in resistance to portal blood flow compared with good-responders (P = 0.01). Disagreement between acute and chronic effects was seen in 12 patients: six were acute good-responders chronic poor-responders and six were acute poor-responders chronic good-responders. Acute good-responders chronic poor-responders patients had the smallest decreases in portal blood flow and in mean arterial pressure after acute administration, while acute poor-responders chronic good-responders showed the largest (P = 0.05 and 0.01). Conclusions :,Disagreement between acute and chronic effects of nadolol on hepatic venous pressure gradient is common. The mechanism responsible is complex, the acute effect being mainly modulated by arterial hypotension and the chronic effect by changes in portal resistance. [source]

Collateral Capillary Arterialization following Arteriolar Ligation in Murine Skeletal Muscle

MICROCIRCULATION, Issue 5 2010
FEILIM MAC GABHANN
Microcirculation (2010) 17, 333,347. doi: 10.1111/j.1549-8719.2010.00034.x Abstract Objective:, Chronic and acute ischemic diseases,peripheral artery disease, coronary artery disease, stroke,result in tissue damage unless blood flow is maintained or restored in a timely manner. Mice of different strains recover from arteriolar ligation (by increasing collateral blood flow) at different speeds. We quantify the spatio-temporal patterns of microvascular network remodeling following arteriolar ligation in different mouse strains to better understand inter-individual variability. Methods:, Whole-muscle spinotrapezius microvascular networks of mouse strains C57Bl/6, Balb/c and CD1 were imaged using confocal microscopy following ligation of feeding arterioles. Results:, Baseline arteriolar structures of C57Bl/6 and Balb/c mice feature heavily ramified arcades and unconnected dendritic trees, respectively. This network angioarchitecture identifies ischemia-protected and ischemia-vulnerable tissues; unlike C57Bl/6, downstream capillary perfusion in Balb/c spinotrapezius is lost following ligation. Perfusion recovery requires arterialization (expansion and investment of mural cells) of a subset of capillaries forming a new low-resistance collateral pathway between arteriolar trees. Outbred CD1 exhibit either Balb/c-like or C57Bl/6-like spinotrapezius angioarchitecture, predictive of response to arteriolar ligation. Conclusions:, This collateral capillary arterialization process may explain the reported longer time required for blood flow recovery in Balb/c hindlimb ischemia, as low-resistance blood flow pathways along capillary conduits must be formed ("arterialization") before reperfusion. [source]

Widespread, chronic, and fluconazole-resistant Trichophyton rubrum infection in an immunocompetent patient

MYCOSES, Issue 6 2008
Didem Didar Balci
Summary Chronic, widespread and invasive cutaneous dermatophytoses due to Trichopyhton rubrum are common in immunocompromised patients. In immunocompetent individuals, however, chronic widespread dermatophytoses are more often associated with onychomycosis and tinea pedis. We describe a 54-year-old immunocompetent female who presented with a 2-year history of extensive erythematous and hyper-pigmented scaly plaques involving the abdominal, gluteal and crural regions without concomitant tinea pedis, tinea manus or onychomycosis. The diagnosis was made by mycological examination including culture. The pathogen identified was T. rubrum. The patient had a history of resistance to systemic fluconazole and topical ketoconazole. After an 8-week therapy period with systemic itraconazole and sertaconazole nitrate cream, a near-complete clearing of all lesions was observed. Trichophyton rubrum may thus present atypical aspects in immmunocompetent patients. [source]

Smooth muscle phenotypic plasticity in mechanical obstruction of the small intestine

NEUROGASTROENTEROLOGY & MOTILITY, Issue 7 2008
J. A. Macdonald
Abstract, Chronic, partial obstruction of the small intestine can dramatically alter peristaltic contractile properties. Morphological studies have revealed hypertrophy of the circular smooth muscle cells in the constricted part of the intestine. In this issue of Neurogastroenterology and Motility, Chen et al. show that hyperplasia and hypertrophy of intestinal smooth muscle cells occur at distinct times in response to partial obstruction of the ileum. Furthermore, the first evidence is provided to link intestinal smooth muscle remodelling during mechanical obstruction with changes in serum response factor and two of its co-regulating factors, myocardin and Elk-1. [source]

Spinal Cord Stimulation for the Treatment of Chronic Pain in Patients with Lumbar Spinal Stenosis

NEUROMODULATION, Issue 4 2010
Amedeo Costantini MD
Objective:, Chronic back and leg pain associated with lumbar spinal stenosis (LSS) is common in the elderly. Surgical decompression is usually performed when conservative treatments fail. We present an evaluation of the long-term outcome of patients suffering from symptomatic LSS treated with spinal cord stimulation (SCS). Materials and Methods:, Data were collected prospectively in three independent registries in three European centers. Pooled data were analyzed retrospectively. Changes in pain intensity, functional status, and analgesic medication were compared at baseline and at the last available follow-up. Demographic data as well as details regarding the implantation procedure and any adverse events were systematically recorded. Results:, Data were recorded in 69 patients with a mean follow-up period of 27 months. All patients showed clinically and statistically significant improvement in pain relief, the visual analog scale decreasing from 7.4 ± 2.3 to 2.8 ± 2.4 (p < 0.05). The use of analgesic medication decreased and the functional status improved. Conclusion:, Spinal cord stimulation seems to be effective in the treatment of patients suffering from chronic pain associated with LSS. Being less invasive and reversible, SCS should be considered before surgical decompression, particularly in patients with increased risks associated with back surgery. [source]

Evaluation of the Acceptability and Usability of a Decision Support System to Encourage Safe and Effective Use of Opioid Therapy for Chronic, Noncancer Pain by Primary Care Providers

PAIN MEDICINE, Issue 4 2010
Jodie Trafton PhD
Abstract Objective., To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. Design., CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Results., Volunteers provided detailed feedback to guide improvements in the graphical user interface, and content and design changes to increase clinical usefulness, understandability, clinical workflow fit, and ease of completing guideline recommended practices. Revisions based on feedback increased CDSS usability ratings over time. Practice concerns outside the scope of the CDSS were also identified. Conclusions., Usability testing optimized the CDSS to better address barriers such as lack of provider education, confusion in dosing calculations and titration schedules, access to relevant patient information, provider discontinuity, documentation, and access to validated assessment tools. It also highlighted barriers to good clinical practice that are difficult to address with CDSS technology in its current conceptualization. For example, clinicians indicated that constraints on time and competing priorities in primary care, discomfort in patient-provider communications, and lack of evidence to guide opioid prescribing decisions impeded their ability to provide effective, guideline-adherent pain management. Iterative testing was essential for designing a highly usable and acceptable CDSS; however, identified barriers may limit the impact of the ATHENA-Opioid Therapy system and other CDSS on clinical practices and outcomes unless CDSS are paired with parallel initiatives to address these issues. [source]

Chronic and persistent cough related to vulnerability to psychological stress: Tic or psychogenic?

PEDIATRICS INTERNATIONAL, Issue 3 2008
Yuko Ishizaki
No abstract is available for this article. [source]

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2005
Sunil Varughese MSc
Abstract Background Theatrical fogs (glycol or mineral oil aerosols) are widely used in the entertainment industry to create special effects and make lighting visible. Methods We studied 101 employees at 19 sites using fogs and measured personal fog exposures, across work shift lung function, and acute and chronic symptoms. Results were also compared to an external control population, studied previously. Results Chronic work-related wheezing and chest tightness were significantly associated with increased cumulative exposure to fogs (mineral oil and glycols) over the previous 2 years. Acute cough and dry throat were associated with acute exposure to glycol-based fogs; increased acute upper airway symptoms were associated with increased fog aerosol overall. Lung function was significantly lower among those working closest to the fog source. Conclusions Mineral oil- and glycol-based fogs are associated with acute and chronic adverse effects on respiratory health among employees. Reducing exposure, through controls, substitution, and elimination where possible, is likely to reduce these effects. Am. J. Ind. Med. 47:411,418, 2005. © 2005 Wiley-Liss, Inc. [source]