Conventional and Complementary Approaches to Chronic Widespread Pain and Its Comorbidities.
Conventional and complementary approaches to chronic widespread pain and its comorbidities.
Acupunct Med. 2013 Jul 5;
Foell J
The concept of comorbidities as a challenge for healthcare systems has recently been given increasing attention in leading medical journals. Many patients suffering from chronic pain, especially those who are older or poorer, have more than one pathology (multimorbidity) or more than one set of manifestation of one pathology (comorbidity). These patients present a difficult problem in industrialised societies, with services that are highly specialised and compartmentalised. Systematic reviews of interventions for patients of this kind do not mention acupuncture. Acupuncturists claim that their treatment promotes general well-being and can help with multiple symptoms, but evidence for this claim is currently lacking. Longitudinal research with prospective data collection regarding the effect on morbidity burden is needed. HubMed – rehab
Regulation of PTHrP expression by cyclic mechanical strain in postnatal growth plate chondrocytes.
Bone. 2013 Jul 3;
Xu T, Yang K, You H, Chen A, Wang J, Xu K, Gong C, Shao J, Ma Z, Guo F, Qi J
Mechanical loading has been widely considered to be a crucial regulatory factor for growth plate development, but the exact mechanisms of this regulation are still not completely understood. In the growth plate, parathyroid hormone-related protein (PTHrP) regulates chondrocyte differentiation and longitudinal growth. Cyclic mechanical strain has been demonstrated to influence growth plate chondrocyte differentiation and metabolism, whereas the relationship between cyclic mechanical strain and PTHrP expression is not clear. The objective of this study was to investigate whether shortterm cyclic tensile strain regulates PTHrP expression in postnatal growth plate chondrocytes in vitro and to explore whether the organization of cytoskeletal F-actin microfilaments is involved in this process. To this end, we obtained growth plate chondrocytes from 2-week-old Sprague-Dawley rats and sorted prehypertrophic and hypertrophic chondrocytes using immunomagnetic beads coated with anti-CD200 antibody. The sorted chondrocytes were subjected to cyclic tensile strain of varying magnitude and duration at a frequency of 0.5 Hz. We found that cyclic strain regulates PTHrP expression in a magnitude- and time-dependent manner. Incubation of chondrocytes with cytochalasin D, an actin microfilament-disrupting reagent, blocked the induction of PTHrP expression in response to strain. The results suggest that short-term cyclic tensile strain induces PTHrP expression in postnatal growth plate prehypertrophic and hypertrophic chondrocytes and that PTHrP expression by these chondrocytes may subsequently affect growth plate development. The results also support the idea that the organization of cytoskeletal F-actin microfilaments plays an important role in mechanotransduction. HubMed – rehab
Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury.
Pain. 2013 Jul 4;
Ritchie C, Hendrikz J, Kenardy J, Sterling M
Recovery following a whiplash injury is varied, approximately: 50% of individuals fully recover, 25% develop persistent moderate/severe pain and disability, and 25% experience milder levels of disability. Identification of individuals likely to develop moderate/severe disability or to fully recover may help direct therapeutic resources and optimise treatment. A clinical prediction rule (CPR) is a research-generated tool used to predict outcomes such as likelihood of developing moderate/severe disability or experiencing full recovery from whiplash injury. The purpose of this study was to assess the plausibility of developing a CPR. Participants from two prospective, longitudinal studies that examined prognostic factors for poor functional recovery following whiplash injury were used to derive this tool. Eight factors, previously identified as predictor variables of poor recovery, were included in the analyses: initial neck disability index (NDI), initial neck pain (VAS), cold pain threshold, range of neck movement, age, gender, presence of headache and posttraumatic stress symptoms (PDS). An increased probability of developing chronic moderate/severe disability was predicted in the presence of older age, and initially higher levels of NDI and hyperarousal symptoms (PDS) (positive predictive value (PPV)=71%). The probability of full recovery was increased in younger individuals with initially lower levels of neck disability (PPV= 71%). This study provides initial evidence for a CPR to predict both chronic moderate/severe disability and full recovery following a whiplash injury. Further research is needed to validate the tool, determine the acceptability of the proposed CPR by practitioners, and assess the impact of inclusion in practice. HubMed – rehab
Sarcopenia: the gliogenic perspective.
Mech Ageing Dev. 2013 Jul 4;
Kwan P, Ng G
It has been approximately 25 years since Dr. Rosenberg first brought attention to sarcopenia. To date, this aging-associated condition is recognized as a chronic loss of muscle mass and is usually accompanied by dynapenia. Despite its poly-etiological factors, sarcopenia has a strong neurogenic component underlying this chrono-degeneration of muscle mass, as shown in recent studies. As it seems plausible to explain the origin of sarcopenia through a motor neuron degeneration model, the focus of sarcopenia research should combine neuroscience with the study of the original myocyte and satellite cells. Although a complete mechanism underlying the development of sarcopenia has yet to be elucidated, we propose that the primary trigger of sarcopenia could be gliogenic in origin based on the close relationship between the glia, neurons and non-neural cells, for example, the motor unit and its associated glia in both the central nervous system (CNS) and the peripheral nervous system (PNS). In addition to muscle cells, both of the neural cells are affected by aging. HubMed – rehab
Holistic Rehab Centers – Rehab.