Comprehensive phenotyping of cutaneous afferents reveals early-onset alterations in nociceptor response properties, release of CGRP, and hindpaw edema following spinal cord injury.

Spinal cord injury (SCI) is a complex syndrome that has profound effects on patient well-being, including the development of medically-resistant chronic pain. The mechanisms underlying SCI pain have been the subject of thorough investigation but remain poorly understood. While the majority of the research has focused on changes occurring within and surrounding the site of injury in the spinal cord, there is now a consensus that alterations within the peripheral nervous system, namely sensitization of nociceptors, contribute to the development and maintenance of chronic SCI pain.

Does a waiting room video about what to expect during an emergency department visit improve patient satisfaction?

Objective: We created an instructional waiting room video that explained what patients should expect during their emergency department (ED) visit and sought to determine whether preparing patients using this video would 1) improve satisfaction, 2) decrease perceived waiting room times and 3) increase calls to an outpatient referral line in an ambulatory population.

Methods: This serial cross-sectional study took place over a period of 2 months before (control) and 2 months after the introduction of an educational waiting room video that described a typical patient visit to our ED. We enrolled a convenience sample of adult patients or parents of pediatric patients who were triaged to the ED waiting room; a research assistant distributed and collected the surveys as patients were being discharged after treatment.

Paraesophageal hernia in an elderly woman with vomiting.

We describe the case of a 79-year-old woman who presented with resolved episodes of vomiting and was found to have a paraesophageal hernia. Her initial evaluation was unremarkable, and the diagnosis was established only by the use of screening chest radiography. Once the diagnosis was confirmed, the patient required urgent surgical repair.

Preliminary Studies of in vitro and in vivo Effects of Misoprostol on Th-1 and Th-2 Cytokine Production.

Prostaglandins of the E series are known to suppress in vitro production of Th-1 cytokines such as interleukin-2 (IL-2) and interferon-gamma but have not been shown to suppress production of Th-2 cytokines such as IL-4 or IL-10. The present study used two new synthetic prostaglandin E(1) (PGE(1)) analogs with oral bioavailability, misoprostol (MP), and enisoprost (EP), to determine if these agents (1) exert suppressive effects in vitro on cytokine production by fresh unseparated mouse splenocytes and (2) are beneficial in vivo when used in conditions mediated by excessive Th-1 or Th-2 cytokine production. Preliminary in vitro studies demonstrated that both MP and EP can inhibit mitogen-stimulated Th-1 and Th-2 cytokine production in a dose-dependent fashion.

Interleukin-1, interleukin-2, interleukin-4, interleukin-6, tumor necrosis factor alpha, and interferon-gamma levels in sera from patients with scleroderma.

Objective: To determine whether interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-4, interferon-gamma (IFN gamma), IL-6, and tumor necrosis factor alpha (TNF alpha) are detected more frequently in sera from scleroderma patients than in sera from controls.

Methods: Serum concentrations of these cytokines were measured in 78 scleroderma patients and 73 controls, using enzyme-linked immunosorbent assay, radioimmunoassay, and bioassay techniques.

Results: IL-2, IL-4, and IL-6 were each detected more frequently in sera from scleroderma patients than in sera from controls.