Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome.

A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients' positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for and ; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid throat swab and no known exposure to On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines.

Events Leading to Hospital-Related Disenrollment of Home Hospice Patients: A Study of Primary Caregivers' Perspectives.

Background: Approximately 25% of hospice disenrollments in the United States occur as the result of hospitalization, which can lead to burdensome transitions and undesired care. Informal caregivers (e.g.

Why Do Home Hospice Patients Return to the Hospital? A Study of Hospice Provider Perspectives.

Background: Hospice provides an opportunity for patients to receive care at home at the end of life (EOL); however, approximately 25% of patients who disenroll from hospice are hospitalized. Hospitalization can lead to poor care transitions and result in unwarranted care and adverse patient outcomes. Research examining reasons for hospitalization in this patient population is limited.

Postpartum vertebral artery dissection.

We report a case of a right vertebral artery dissection in a 35-year-old woman, 3 weeks post partum, with manifestations of vertebrobasilar disease. She was 3 weeks out from the uneventful delivery of her fourth child, with presentation of acute neurological symptoms, predominantly intractable vertigo. Vertigo can have many non-specific generalised symptoms and clinical findings.

In vivo phenotypic screening for treating chronic neuropathic pain: modification of C2-arylethynyl group of conformationally constrained A3 adenosine receptor agonists.

(N)-Methanocarba adenosine 5'-methyluronamides containing 2-arylethynyl groups were synthesized as A3 adenosine receptor (AR) agonists and screened in vivo (po) for reduction of neuropathic pain. A small N(6)-methyl group maintained binding affinity, with human > mouse A3AR and MW < 500 and other favorable physicochemical properties. Emax (maximal efficacy in a mouse chronic constriction injury pain model) of previously characterized A3AR agonist, 2-(3,4-difluorophenylethynyl)-N(6)-(3-chlorobenzyl) derivative 6a, MRS5698, was surpassed.

Rational design of sulfonated A3 adenosine receptor-selective nucleosides as pharmacological tools to study chronic neuropathic pain.

(N)-Methanocarba(bicyclo[3.1.0]hexane)adenosine derivatives were probed for sites of charged sulfonate substitution, which precludes diffusion across biological membranes, e.

Sphingosine 1-phosphate mediates hyperalgesia via a neutrophil-dependent mechanism.

Novel classes of pain-relieving molecules are needed to fill the void between non-steroidal anti-inflammatory agents and narcotics. We have recently shown that intraplantar administration of sphingosine 1-phosphate (S1P) in rats causes peripheral sensitization and hyperalgesia through the S1P(1) receptor subtype (S1PR(1)): the mechanism(s) involved are largely unknown and were thus explored in the present study. Intraplantar injection of carrageenan in rats led to a time-dependent development of thermal hyperalgesia that was associated with pronounced edema and infiltration of neutrophils in paw tissues.

Role for peroxynitrite in sphingosine-1-phosphate-induced hyperalgesia in rats.

Sphingosine-1-phosphate (S1P) is an important mediator of inflammation recently shown in in vitro studies to increase the excitability of small-diameter sensory neurons, at least in part, via activation of the S1P(1) receptor subtype. Activation of S1PR(1) has been reported to increase the formation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived superoxide (O(2)(·-)) and nitric oxide synthase (NOS)-derived nitric oxide (NO). This process favors the formation of peroxynitrite (ONOO(-) [PN]), a potent mediator of hyperalgesia associated with peripheral and central sensitization.

Axon sprouting in adult mouse spinal cord after motor cortex stroke.

Functional reorganization of brain cortical areas occurs following stroke in humans, and many instances of this plasticity are associated with recovery of function. Rodent studies have shown that following a cortical stroke, neurons in uninjured areas of the brain are capable of sprouting new axons into areas previously innervated by injured cortex. The pattern and extent of structural plasticity depend on the species, experimental model, and lesion localization.

Ankle plantarflexor strength and endurance in 7-9 year old children as measured by the standing single leg heel-rise test.

Background And Purpose: The standing single-leg (SSL) heel-rise test is a measure of plantarflexor strength and endurance. However, reference values have yet to be determined for children. The purposes of this study were to: (1) determine the average number, minimum number (cut-off score) of SSL heel-rises for healthy, 7-9 year old children, (2) examine the influence of age, gender, height, weight, and physical activity characteristics upon the number of heel-rises completed, (3) examine inter-rater reliability, and (4) examine reliability between the number of repetitions counted by observation, and by video-analysis.