Articles: chronic.
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Jordanian cancer patients' information needs and information-seeking behaviour: a descriptive study.
Cancer diagnosis can leave patients with uncertainty and anxiety that can be reduced by providing timely information and effective communication. Despite information provision being highly important in improving the quality of provided care, no study had been conducted to assess the information needs of Jordanian cancer patients. ⋯ Many factors may cause variations in patients' information-seeking behaviour. Therefore, a notational policy for information provision is needed to satisfy different patients' information needs. Healthcare providers should be aware that cancer patients' will continue to need information at all stages.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
Review[Nutrition of the critically ill - Is less more? How much energy for the ICU patient?].
Decreased nutritional intake or preexisting malnutrition is associated with increased morbidity and mortality during hospital stay. However nutritional support in particular for the ICU patient is not trivial. ⋯ Ideally about 25 kcal/kg/d should be targeted over a few days during metabolic monitoring. Alternatively indirect calorimetry should be applied where available.
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Am. J. Respir. Crit. Care Med. · Feb 2014
Regulation of Hypoxia-Induced Pulmonary Hypertension by Vascular Smooth Muscle HIF-1alpha.
Chronic hypoxia induces pulmonary vascular remodeling, pulmonary hypertension, and right ventricular hypertrophy. At present, little is known about mechanisms driving these responses. Hypoxia-inducible factor-1α (HIF-1α) is a master regulator of transcription in hypoxic cells, up-regulating genes involved in energy metabolism, proliferation, and extracellular matrix reorganization. Systemic loss of a single HIF-1α allele has been shown to attenuate hypoxic pulmonary hypertension, but the cells contributing to this response have not been identified. ⋯ These results indicate that HIF-1α in smooth muscle contributes to pulmonary vascular remodeling and pulmonary hypertension in chronic hypoxia. However, loss of HIF-1 function in smooth muscle does not affect hypoxic cardiac remodeling, suggesting that the cardiac hypertrophy response is not directly coupled to the increase in pulmonary artery pressure.
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The persistence of pain after surgery increases the recovery interval from surgery to a normal quality of life. AYX1 is a DNA-decoy drug candidate designed to prevent post-surgical pain following a single intrathecal injection. Tissue injury causes a transient activation of the transcription factor EGR1 in the dorsal root ganglia-dorsal horn network, which then triggers changes in gene expression that induce neuronal hypersensitivity. ⋯ Administered in the peri-operative period, AYX1 dose dependently prevents mechanical hypersensitivity in models of acute incisional (plantar), inflammatory (CFA), and chronic neuropathic pain (SNI) in rats. Furthermore, in a knee surgery model evaluating functional measures of postoperative pain, AYX1 improved weight-bearing incapacitance and spontaneous rearing compared to control. These data illustrate the potential clinical therapeutic benefits of AYX1 for preventing the transition of acute to chronic post-surgical pain.
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Chronic pain after surgery is a major public health problem and a major concern for perioperative physicians. Thoracic surgery presents a unique challenge, as thoracotomy is among the highest risk surgeries to develop persistent postsurgical pain. The purpose of this review is to discuss the relevance of research in pain epigenetics to patients with persistent pain after thoracic surgery. ⋯ The transition from acute to chronic pain after thoracic surgery may be mediated by epigenetics. Here, we discuss epigenetic modifications that have been discovered in animal models of chronic pain that may predispose patients to persistent neuropathic pain after thoracic surgery.