Articles: cations.
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Sepsis is one of the leading causes of morbidity and mortality worldwide. Monocytes seem to undergo functional reprogramming during sepsis, resulting in dysregulated host immune response. To clarify this dysregulation mechanism, we investigated three histone modifications found in promoters of genes involved in innate immune response, and associated these findings with gene transcription in septic patients. ⋯ In addition, we found moderate to strong correlation between gene transcription and the enzymes that modulate these histone modifications in the transcriptome data sets. Our study, one of the pioneering by evaluating septic patients' samples, suggests that epigenetic enzymes modulate the prevalent histone marks in promoters of genes involved in the immune-inflammatory response, altering the transcription of these specific genes during sepsis. Furthermore, nonsurviving sepsis patients have a more pronounced epigenetic dysregulation compared with survivors, suggesting a more dysfunctional response.
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Controlled Clinical Trial
Aftereffects of alpha transcranial alternating current stimulation over the primary sensorimotor cortex on cortical processing of pain.
Transcranial alternating current stimulation (tACS) is believed to modulate brain oscillations in a frequency-specific manner. Given the correlation between sensorimotor α-oscillations and pain perception, tACS that targets sensorimotor α-oscillations has the potential to reduce pain. Therefore, this study sought to determine the aftereffects of α-tACS over unilateral primary sensorimotor cortex (SM1) on the perceptual and neural responses to noxious painful stimulation of the contralateral hand. ⋯ Moreover, α-tACS decreased the functional connectivity between the targeted SM1 and a network of regions that are crucially involved in pain processing, including the middle cingulate cortex, contralateral somatosensory cortex, and dorsolateral prefrontal cortex. These results demonstrated that after α-tACS applied over the unilateral SM1 does attenuate subsequent neural processing of pain within bilateral sensorimotor regions as well as sensorimotor functional connectivity. The findings provide evidence that sensorimotor α-oscillations directly affect pain processing and support the application of sensorimotor α-tACS for inducing pain analgesia.
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Minerva anestesiologica · Jun 2023
Randomized Controlled TrialUltrasonographic assessment of metoclopramide effect on gastric volume in parturients females undergoing Caesarean section: a randomized double blind study.
The prokinetic effect of metoclopramide promotes gastric emptying and decreases stomach capacity. The aim of the present study was to assess the efficacy of metoclopramide in reducing gastric contents and volume using gastric point-of-care ultrasonography (PoCUS) in parturients females prepared for elective Cesarean section under general anesthesia. ⋯ Metoclopramide decreases gastric volume, reduces postoperative nausea and vomiting, and may lower the risk of aspiration when used as premedication before obstetric surgery. Preoperative gastric PoCUS has utility in objectively assessing stomach volume and contents.
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The association between breathing sounds and respiratory health or disease has been exceptionally useful in the practice of medicine since the advent of the stethoscope. Remote patient monitoring technology and artificial intelligence offer the potential to develop practical means of assessing respiratory function or dysfunction through continuous assessment of breathing sounds when patients are at home, at work, or even asleep. Automated reports such as cough counts or the percentage of the breathing cycles containing wheezes can be delivered to a practitioner via secure electronic means or returned to the clinical office at the first opportunity. ⋯ Little of this has appeared in the medical literature. The potential value of this technology for pulmonary medicine is compelling. We expect that these tiny, smart devices soon will allow us to address clinical questions that occur away from the clinic.