1,721,178 research outputs found
Nociceptive input to spinal interneurones in reflex pathways from group II muscle afferents in cats
No full textEffects of noxious stimulation of the skin by radiant heat were tested on responses of first order interneurones in reflex pathways from group Il muscle efferents in mid-lumbar, lower-lumbar and sacral segments of the spinal cord. In mid- and lower-lumbar segments both background discharges and monosynaptically evoked responses of intermediate zone interneurones were facilitated. Those of mid-lumbar dorsal horn interneurones were also facilitated suggesting that both these interneuronal populations contribute to the facilitation of flexion reflexes by nociceptors. In contrast, the dominating effects of noxious heat on sacral dorsal horn group Ii interneurones were inhibitory. The effects evoked by selective activation of C fibres, after A-delta fibres had been blocked by TTX, were similar to those obtained before TTX application. (C) 2000 Elsevier Science Ireland Ltd & Japan Neuroscience Society. All rights reserved
Nociceptive input to ascending tract neurones forwarding information from low threshold cutaneous and muscle afferents in cats
No full textEffects of noxious skin stimulation (central foot pad and fool dorsum) by radiant heat were tested on neurones of ascending tracts with a main input from non-nociceptors. The dominating effect on ventral spinocerebellar tract neurones was a depression (mainly from the pad). Responses of spinocervical tract neurones were either facilitated (predominantly from the foot dorsum) or depressed (predominantly from the pad). The dominating effect on neurones tentatively classified as dorsal horn dorsal spinocerebellar tract neurones was facilitatory from both skin areas. Similar effects were evoked by selective actions of C-fibres when A-delta fibres were blocked by TTX. (C) 1999 Elsevier Science Ireland Ltd and the Japan Neuroscience Society. All rights reserved
Nociceptive projection to interneurones in spinal reflex pathways from group II muscle afferents in cats
No full textNociceptive projection to interneurones in spinal reflex pathways from group II muscle afferents in cats
No full textUric acid and xanthine oxidase in heart failure — Emerging data and therapeutic implications
No full textThe influence of confounders in the analysis of mid-regional pro-atrial natriuretic peptide in patients with chronic heart failure
Full text linkNatriuretic peptides play an important role in the diagnosis and risk stratification of patients with acute and chronic heart failure. Multiple studies have shown that these peptides are liable to the influence of individual factors. For N-terminal-pro-B-type natriuretic peptide (NT-proBNP) some of these confounding factors have been evaluated over the years such as age, gender, New York Heart Association (NYHA) class and body mass index (BMI). The aim of this study was to establish confounding factors of mid-regional pro-atrial natriuretic peptide (MR-proANP) assessment
Iron deficiency is related to low functional outcome in patients at early rehabilitation after acute stroke
No full textAbstract Background Iron deficiency (ID) is a common co‐morbidity in patients with cardiovascular disease and contributes to impaired functional capacity. The relevance of ID in patients in recovery after acute stroke is not known. We assessed the prevalence of ID and anaemia in relation to functional capacity and to recovery during early rehabilitation after stroke. Methods This observational study enrolled consecutively 746 patients with ischaemic or haemorrhagic stroke at in‐patient early rehabilitation (age 68 ± 13 years, female 47%, ischaemic stroke 87%). Functional capacity was assessed before and after rehabilitation using Barthel index (reha‐BI), motricity index (MI), trunk control test (TCT), and functional ambulatory category (FAC). ID was defined as ferritin 5 mg/L. Anaemia was defined as Hb < 12 g/dL (women) and <13 g/dL (men). Results The prevalence of ID and anaemia before rehabilitation were 45% and 46%, respectively, and remained high at discharge (after 27 ± 17 days) at 40% and 48%, respectively. Patients with ID had lower functional capacity compared with patients without ID (reha‐BI 20 [±86] vs. 40 [±80], MI 64 [±66] vs. 77 [±41], TCT 61 [±76] vs. 100 [±39], FAC 1 [±4] vs. 4 [±4]; median [IQR], all P < 0.001). ID was related to inflammation (OR 2.68 [95% CI 1.98–3.63], P < 0.001), female sex (OR 2.13 [95% CI 1.59–2.85], P < 0.001), haemorrhagic stroke (OR 1.70 [95% CI 1.11–2.61], P = 0.015), initial treatment on stroke unit (OR 3.59 [95% CI 1.08–11.89], P < 0.001), and anaemia (OR 2.94 [95% CI 2.18–3.96], P < 0.001), while age, BMI, and renal function were not related to ID. In adjusted analysis, ID was associated with low functional capacity in all functional scores: reha‐BI (OR 1.66 [95% CI 1.08–2.54], P = 0.02), motricity index (OR 1.94 [95% CI 1.36–2.76], P < 0.001), trunk control test (OR 2.34 [95% CI] 1.64–3.32, P < 0.001) and functional ambulatory category (OR 1.77 [95% CI 1.2–2.63], P < 0.02). Functional capacity improved during rehabilitation regardless of presence of ID, but functional outcome remained significantly lower in patients with ID at the end of rehabilitation (rehab BI and MI, both P < 0.001). Conclusions Iron deficiency and anaemia are common and persistent findings in patients after acute stroke. ID and anaemia are independently related to lower functional capacity after acute stroke and to poor functional outcome after rehabilitation. Regular assessment of iron status may identify patients at risk of low functional recovery
A Mechanistic Link to Peripheral Endothelial Dysfunction
Full text linkBackground: Sleep‐disordered breathing (SDB) after acute ischemic stroke is
frequent and may be linked to stroke‐induced autonomic imbalance. In the
present study, the interaction between SDB and peripheral endothelial
dysfunction (ED) was investigated in patients with acute ischemic stroke and
at 1‐year follow‐up. Methods and Results: SDB was assessed by transthoracic
impedance records in 101 patients with acute ischemic stroke (mean age, 69
years; 61% men; median National Institutes of Health Stroke Scale, 4) while
being on the stroke unit. SDB was defined by apnea‐hypopnea index ≥5 episodes
per hour. Peripheral endothelial function was assessed using peripheral
arterial tonometry (EndoPAT‐2000). ED was defined by reactive hyperemia index
≤1.8. Forty‐one stroke patients underwent 1‐year follow‐up (390±24 days) after
stroke. SDB was observed in 57% patients with acute ischemic stroke. Compared
with patients without SDB, ED was more prevalent in patients with SDB (32%
versus 64%; P<0.01). After adjustment for multiple confounders, presence of
SDB remained independently associated with ED (odds ratio, 3.1; [95%
confidence interval, 1.2–7.9]; P<0.05). After 1 year, the prevalence of SDB
decreased from 59% to 15% (P<0.001). Interestingly, peripheral endothelial
function improved in stroke patients with normalized SDB, compared with
patients with persisting SDB (P<0.05). Conclusions: SDB was present in more
than half of all patients with acute ischemic stroke and was independently
associated with peripheral ED. Normalized ED in patients with normalized
breathing pattern 1 year after stroke suggests a mechanistic link between SDB
and ED
Iron deficiency and cardiovascular disease
No full textIron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations
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