Background: Chronic pain models are commonly defined as either nerve-injury or inflammation models, but recent work suggests inflammatory processes are important in nerve injury-induced pain.
Methods: In the rat spinal nerve ligation model, the authors examined effects of systemic corticosteroid triamcinolone acetonide (TA) on the cytokine protein profile and sympathetic sprouting in the axotomized sensory ganglia, excitability of sensory neurons, and mechanical sensitivity.
Results: By postoperative day 3, marked increases (5- to 16-fold) in monocyte chemoattractant protein-1, growth-related oncogene (GRO/KC or CXCL1), and interleukin (IL)-6 were observed, whereas IL-4 and IL-2 levels fell more than fourfold. The increased cytokines and number of sympathetic basket formations in the sensory ganglia were reduced toward normal values by TA given starting at the time of injury. Interleukin-4 and IL-2 levels were not restored by TA. Systemic TA also reduced the firing rate and incidence of bursting activity, but not the overall incidence of spontaneous activity, in large- and medium-sized neurons. Mechanical hypersensitivity on postoperative day 3 was reduced by TA, and some effect could still be observed 4 days after cessation of TA. However, starting TA at day 7 was ineffective. 相似文献
A patient with neutropenia and life-threatening infections secondary to T-γ lymphoproliferative disease, who did not respond to treatment with recombinant human G-CSF (filgrastim), was treated with filgrastim plus cyclosporine A (CyA). The patient achieved a good response in the absolute neutrophil count and subsequently required a dose reduction in the filgrastim. The patient was eventually discontinued from the CyA but continues on filgrastim alone. While on therapy, the large granular lymphocytes disappeared from the circulation and the beta-TCR rearrangement, which was present prior to beginning therapy, became undetectable. The patient had no significant toxicity to the CyA or the filgrastim and he has not experienced any serious infections or required hospitalization. Filgrastim has proven to be relatively nontoxic and of some benefit to patients with this disease and should probably be utilized first when treatment is necessary. However, if improvement is not observed, these findings suggest that a trial of the combination of CyA plus filgrastim may be beneficial. 相似文献
The current model for delivery of prenatal care was developed more than 100 years ago. Evidence suggests that this model is no longer appropriate for meeting national health objectives or for meeting the needs of a diverse population of pregnant women. This article provides a historical overview of prenatal care; describes the current system for care delivery and problems associated with it; and suggests strategies for transforming care into an effective, comprehensive model. JOGNN, 25, 17–23; 1996. 相似文献
Tolerance to mercury in two populations of the grass shrimpPalaemonetes pugio was examined at different stages of this animal's life cycle. One population came from a mercury-contaminated creek, Piles Creek (PC), near industrialized Linden, New Jersey. The other population came from a relatively clean area, Big Sheepshead Creek (BSC), near non-industrialized Tuckerton, New Jersey. Larval grass shrimp showed no significant difference between populations in terms of mortality in 0.01 mg/L HgCl2, although treated BSC larvae metamorphosed significantly (P < 0.05) more slowly than their respective control group. While no BSC larvae survived the 0.0125 mg/L methylmercuric chloride (meHg) treatment, PC larvae exposed to 0.0125 mg/L meHg survived as well as their controls, indicating enhanced tolerance to meHg in this population.Adult shrimp were exposed for 14 days to control, 0.025 mg/L meHg, 0.025 mg/L HgCl2, 0.05 mg/L meHg, or 0.05 mg/L HgCl2 PC shrimp were significantly (P < 0.05) more tolerant to both 0.025 mg/L meHg, and 0.025 mg/L HgCl2 than were the BSC adults.Polyacrylamide gel electrophoresis suggests that both populations of shrimp are capable of producing a metallothionein like protein (MT) in response to treatment with HgCl2; MT is found in higher levels in field-caught PC shrimp than in field-caught BSC shrimp. MT was not present in field-collected, viable eggs from either population. 相似文献
Abstract. Medical and social problems related to alcohol use are frequently seen in the ED. Often, the tempo of emergency medicine practice seems to preclude assessment beyond that required by the acute complaint. However, detection of ED patients with alcohol problems can occur using brief screening tools. This article was developed by members of the SAEM Substance Abuse Task Force, and describes screening tools that have been used successfully to identify atrisk and dependent drinkers. Their brevity, reproducibility, and accuracy vary somewhat, but screening can be realistically performed in the busy ED setting. The early detection of patients with alcohol problems would provide the opportunity for early intervention, and may reduce subsequent morbidity and mortality in this patient population. 相似文献