Articles: treatment.
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The Center for Disease Control and Prevention estimates that 75% of reported cases of traumatic brain injury (TBI) are mild, where chronic pain and depression are 2 of the most common symptoms. In this study, we used a murine model of repeated mild TBI to characterize the associated pain hypersensitivity and affective-like behavior and to what extent microglial reactivity contributes to these behavioral phenotypes. Male and female C57BL/6J mice underwent sham or repeated mild traumatic brain injury (rmTBI) and were tested for up to 9 weeks postinjury, where an anti-inflammatory/neuroprotective drug (minocycline) was introduced at 5 weeks postinjury in the drinking water. ⋯ Finally, we show that the antiepileptic drug, gabapentin, produced negative reinforcement in male rmTBI mice that was prevented by minocycline treatment, whereas rmTBI female mice showed a place aversion to gabapentin. Collectively, pain hypersensitivity, increased tonic-aversive pain components, and negative affective states were evident in both male and female rmTBI mice, but suppression of microglial reactivity was only sufficient to reverse behavioral changes in male mice. Neuroinflammation in limbic structures seems to be a contributing factor in behavioral changes resulting from rmTBI.
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The opioid crisis in the United States is of public health significance, with an estimated 128 opioid overdose-related deaths per day in 2018 and a relapse rate of 90% or higher. This crisis persists despite the adoption of Medication-Assisted Treatment (MAT), therefore, there is a need to prevent relapse. ⋯ Additional research is needed to ascertain other factors predicting relapse in patients with OUD in addiction treatment centers.
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Activity management is an important treatment component in chronic pain programs. However, there are shortcomings in measures of this construct, leading to inconsistencies in research findings. Here, we describe the development of the Activity Management Inventory for Pain (AMI-P). ⋯ The findings support the reliability and validity of the AMI-P scales, while also highlighting the complexity and multidimensional aspects of activity management.
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Increasing reports of resistance to newer anti-tuberculosis drugs have prompted the search for other alternative drugs. Streptomycin could be used for the treatment of drug-resistant tuberculosis if susceptibility of Mycobacterium tuberculosis isolate to streptomycin could be accurately detected. We performed phenotypic and genotypic drug susceptibility testing (DST) of 118 M. tuberculosis isolates for streptomycin. ⋯ Our data show that, like ifampicin, ethambutol and pyrazinamide, streptomycin also exhibits discordant phenotypic and genotypic DST results for some M. tuberculosis isolates. Hence, streptomycin should be included in therapy regimens only if both phenotypic and genotypic resistance testing indicate susceptibility to avoid amplification of resistance and drug toxicity.
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J Clin Monit Comput · Apr 2024
LetterReevaluating optic nerve sheath diameter in predicting postdural puncture headache: exploring clinical implications beyond threshold values.
The study by Boyaci et al. assessed using optic nerve sheath diameter (ONSD) ultrasound to predict postdural puncture headache (PDPH) in spinal anesthesia patients. In their single-center study of 83 patients, PDPH incidence was high at 22.9%, partly due to the use of a traumatic needle. ⋯ ONSD's relationship with intracranial pressure (ICP) is acknowledged, but a definitive ONSD cutoff for PDPH is lacking. Other studies suggest ONSD changes may be linked to treatment outcomes in related conditions, emphasizing the importance of investigating risks of epidural blood patch failure.