Electroacupuncture at Quchi and Zusanli Treats Cerebral Ischemia-Reperfusion Injury Through Activation of ERK Signaling.

Electroacupuncture at Quchi and Zusanli treats cerebral ischemia-reperfusion injury through activation of ERK signaling.

Exp Ther Med. 2013 Jun; 5(6): 1593-1597
Xie G, Yang S, Chen A, Lan L, Lin Z, Gao Y, Huang J, Lin J, Peng J, Tao J, Chen L

The extracellular signal-regulated kinase (ERK) pathway, a critical mediator of cell proliferation, is activated in cerebral ischemia/reperfusion (I/R) injury and is therefore a key target in the treatment of ischemic stroke. Acupuncture has long been used in China to clinically treat stroke. However, the precise mechanism of its neuroprotective activities remains largely unknown. In the present study, a focal cerebral I/R-injured rat model was used to evaluate the in vivo therapeutic efficacy of electroacupuncture (EA) and investigate the underlying molecular mechanisms. EA significantly ameliorated neurological deficits and cerebral infarction in cerebral I/R-injured rats. Moreover, EA significantly increased the phosphorylation levels of ERK, as well as the protein expression levels of Ras, cyclin D1 and cyclin-dependent kinase (CDK)4. Consequently, EA-mediated activation of the ERK pathway resulted in the stimulation of cerebral cell proliferation. The present data suggest that EA at the Quchi and Zusanli acupoints exerts a neuroprotective effect in ischemic stroke via the activation of ERK signaling. HubMed – rehab


Pregabalin versus tramadol for postoperative pain management in patients undergoing lumbar laminectomy: a randomized, double-blinded, placebo-controlled study.

J Pain Res. 2013; 6: 471-8
Kumar KP, Kulkarni DK, Gurajala I, Gopinath R

Prevention and treatment of postoperative pain continues to be a major challenge in postoperative care. Opioid analgesics, with their well-known side effects, continue to represent a cornerstone in postoperative pain control. Anticonvulsant medications are established treatments for neuropathic pain. Pregabalin (S-[+]-3-isobutylgaba), a structural analog of gamma-Aminobutyric acid, has been used for the treatment of various neuropathic pain and also as an adjunctive therapy for adults with partial onset seizures. This study was thus taken up to primarily assess and compare the analgesic and anxiolytic effects of administering pregabalin and tramadol preoperatively for patients undergoing elective decompressive lumbar laminectomy. The study group included 75 patients between the ages of 20-60 years belonging to American Society of Anesthesiology-1 (ASA) and ASA-2 patients. The patients were randomly allocated into three groups of 25 patients each. The placebo group received a placebo capsule, the tramadol group received a 100 mg capsule, while the pregabalin group received a 150 mg capsule orally 1 hour before anesthetic induction. Pregabalin showed statistically significant analgesic effects compared to placebo, but the effect was found to be less prevalent compared to tramadol. The need for rescue analgesia was the least prevalent in tramadol patients followed by pregabalin patients, and reached a maximum in the control group. Pregabalin showed statistically significant anxiolytic effects compared to placebo, and this was associated with less sedation in comparison to tramadol. Pregabalin had fewer numbers of postoperative complications of nausea, vomiting, and drowsiness in comparison to tramadol. The results of this study support the clinical use of pregabalin in the postsurgical setting for pain relief, as it is well tolerated, and usually presents with transient adverse effects. HubMed – rehab


The costs of traumatic brain injury: a literature review.

Clinicoecon Outcomes Res. 2013; 5: 281-7
Humphreys I, Wood RL, Phillips CJ, Macey S

The purpose of this study was to review the literature relating to the psychosocial costs associated with traumatic brain injury (TBI).Nine online journal databases, including MEDLINE, CINAHL, PsychINFO, and PUBMED, were queried for studies between July 2010 and May 2012 pertaining to the economic burden of head injuries. Additional studies were identified through searching bibliographies of related publications and using Google internet search engine.One hundred and eight potentially relevant abstracts were identified from the journal databases. Ten papers were chosen for discussion in this review. All but two of the chosen papers were US studies. The studies included a cost-benefit analysis of the implementation of treatment guidelines from the US brain trauma foundation and a cost-effectiveness analysis of post-acute traumatic brain injury rehabilitation.Very little research has been published on the economic burden that mild and moderate traumatic brain injury patients pose to their families, careers, and society as a whole. Further research is needed to estimate the economic burden of these patients on healthcare providers and social services and how this can impact current health policies and practices. HubMed – rehab


Participation in Cardiac Rehabilitation and Survival Following Coronary Artery Bypass Graft Surgery: A Community Based Study.

Circulation. 2013 Jul 8;
Pack QR, Goel K, Lahr BD, Greason KL, Squires RW, Lopez-Jimenez F, Zhang Z, Thomas RJ

Cardiac rehabilitation (CR) is recommended for all patients following coronary artery bypass surgery (CABG), yet little is known about the long term mortality effects of CR in this population.We performed a community-based analysis on residents of Olmsted County, Minnesota who underwent CABG between 1996 and 2007. We assessed the association between subsequent outpatient CR attendance and long-term survival. Propensity analysis was performed. Cox PH regression was then used to assess the association between CR attendance and all-cause mortality adjusted for the propensity to attend CR. We identified 846 eligible patients (age 66 ± 11 years, 76% men, and 96% non-Hispanic whites) who survived at least 6 months after surgery, of whom 582 (69%) attended CR. During a mean (± SD) follow-up of 9.0 ± 3.7 years, the 10-year all-cause mortality rate was 28% (193 deaths). Adjusted for the propensity to attend CR, participation in CR was associated with a 10-year relative risk reduction in all-cause mortality of 46% (HR=0.54; 95% CI, 0.40-0.74; p<0.001), and a 10-year absolute risk reduction of 12.7% (NNT=8). There was no evidence of a differential effect of CR on mortality with respect to age (?65 vs <65 yrs.), gender, diabetes, or prior myocardial infarction.Cardiac rehabilitation attendance is associated with a significant reduction in 10 year all-cause mortality following CABG. Our results strongly support national standards that recommend CR for this patient group. HubMed – rehab


Put Disease Prevention First.

Circulation. 2013 Jul 8;
Briffa TG, Tonkin A

Worldwide, non-communicable diseases are the dominant cause of death, with atherosclerotic cardiovascular disease (CVD) a major contributor(1). These deaths are spread across high- to low-income countries, with about one in three of all CVD deaths occurring in under 70 year-olds, amounting to an estimated six million cases annually(1). Analyses in many countries have shown that both an improvement in risk factors and advances in medical therapies have contributed to the fall in age-standardised mortality from coronary heart disease (CHD)(2). Importantly, leading a healthy lifestyle has broader implications for the prevention and management of other non-communicable diseases including cancer, diabetes and chronic respiratory diseases. Following decades of major advances in the treatment of acute CHD events it is being appreciated increasingly that evidence-based long-term management of CHD is critical to achieve optimal reductions in mortality and morbidity. Each year, approximately 50 percent of major coronary events occur in those with a hospital discharge diagnosis of CHD(3). Half of these recurrent events are fatal(3). A significant number of such CHD events will occur within the first year after hospitalization for non-fatal acute coronary syndromes(4). HubMed – rehab