Trending Articles
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Current drug targets · Feb 2013
ReviewCan we delay the accelerated lung aging in COPD? Anti-aging molecules and interventions.
Chronic obstructive pulmonary disease (COPD) has been recently characterized as a disease of accelerated lung aging. The prevalence of COPD is age-dependent suggesting an intimate relationship between the pathogenesis of COPD and aging. Lung function decline, the hallmark feature of COPD evolution, is more prominent with increasing age and this decline is greater in smoking individuals. ⋯ The above mechanisms have been associated with the accelerated lung aging in COPD patients. Numerous therapeutic interventions have been studied in an attempt to reverse accelerated lung aging, and some of them have already been tested in clinical trials. The aim of the present review is to summarize the mechanisms associated with the accelerated lung aging in COPD and to provide information about the possible therapeutic implications targeting those mechanisms.
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Anesthesia and analgesia · Aug 2010
Randomized Controlled Trial Comparative StudyThe effect of intraoperative dexmedetomidine on postoperative analgesia and sedation in pediatric patients undergoing tonsillectomy and adenoidectomy.
The immediate postoperative period after tonsillectomy and adenoidectomy, one of the most common pediatric surgical procedures, is often difficult. These children frequently have severe pain but postoperative airway edema along with increased sensitivity to the respiratory-depressant effects of opioids may result in obstructive symptoms and hypoxemia. Opioid consumption may be reduced by nonsteroidal antiinflammatory drugs, but these drugs may be associated with increased bleeding after this operation. Dexmedetomidine has mild analgesic properties, causes sedation without respiratory depression, and does not have an effect on coagulation. We designed a prospective, double-blind, randomized controlled study to determine the effects of intraoperative dexmedetomidine on postoperative recovery including pain, sedation, and hemodynamics in pediatric patients undergoing tonsillectomy and adenoidectomy. ⋯ The total postoperative rescue opioid requirements were similar in tonsillectomy patients receiving intraoperative dexmedetomidine or morphine. However, the use of dexmedetomidine 1 microg/kg and morphine 100 microg/kg had the advantages of an increased time to first analgesic and a reduced need for additional rescue analgesia doses, without increasing discharge times.
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Clin. Orthop. Relat. Res. · Aug 2012
Reason for revision influences early patient outcomes after aseptic knee revision.
Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Twenty-four basic and clinical studies and case reports are included in this quarterly review of the myofascial pain literature. The majority of publications focus on invasive techniques, especially dry needling. ⋯ While some physiotherapists have bought into the notion that hands-on approaches are a thing of the past, since "pain is in the brain" and "the issues are not in the tissues," there is also a body of research that aims to combine so-called top-down and bottom-up therapies. Combining manual therapy and dry needling with pain neuroscience education is likely the preferred method using a multimodal approach (Puentedura and Flynn, 2016; Lluch Girbes et al., 2015).
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Comparative Study
Up-regulation of P2X4 receptors in spinal microglia after peripheral nerve injury mediates BDNF release and neuropathic pain.
ATP is a known mediator of inflammatory and neuropathic pain. However, the mechanisms by which specific purinergic receptors contribute to chronic pain states are still poorly characterized. Here, we demonstrate that in response to peripheral nerve injury, P2X(4) receptors (P2X(4)R) are expressed de novo by activated microglia in the spinal cord. ⋯ Furthermore, ATP stimulation is unable to stimulate BDNF release from P2X(4)-deficient mice microglia in primary cultures. These results indicate that P2X(4)R contribute to chronic pain through a central inflammatory pathway. P2X(4)R might thus represent a potential therapeutic target to limit microglia-mediated inflammatory responses associated with brain injury and neurodegenerative disorders.