Pain management in the elderly is complex. Nurse-caregiver pair work encourages team cohesion and strengthens trust and communication. Being part of a reflexive and humane approach to care enables better support for patients.Because of all the multiple forms of pain, its management is of variable geometry. The evaluation, its repercussion, the treatment, the assessment of the benefit and the side effects are each time a singular model.Treating the pain is essential. It requires knowledge, assessment and reassessment by trained professionals. Communication is essential between the different professionals involved for the benefit of the patient.The psychologist's perspective on the issue of pain opens the way to new issues. One of the psychologist's roles in chronic pain consultations is to allow a psychological elaboration of the painful complaint. It seems essential for the carers, whatever their specialities, to move away from a dualistic "body-mind" concept, so as not to undermine the reception of this complaint, with its multiple interactions.Pain has recently become a public health priority. It is effectively managed, health professionals are trained and patients are referred to dedicated structures.The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of tracheotomy, be it by puncture or open, clarifying its respective advantages and enumerating the ideal conditions under which they should be performed, as well as the necessary steps. Regular and emergency situations are displayed together with the postoperative measures.Background Cognitive dysfunction after surgery includes delirium and postoperative cognitive dysfunction. Important risk factors for these include increased age and pre-existing cognitive dysfunction. This study describes preoperative cognitive dysfunction and its associated factors in patients aged ≥60 yr awaiting elective noncardiac surgery in a developing country. Methods A prospective, contextual, descriptive study design with consecutive convenience sampling was used at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. Assessment of cognition was subjective (through casual conversation, henceforth referred to as observer assessment) and objective (using the Mini-Cog test). Results A total of 194 outpatients (median age 65 yr) were assessed. A score ≤3 (indicating mild cognitive impairment) was obtained by 111 patients (57.2%). Subjective memory complaints were reported by 124 patients (63.9%). Univariate analyses demonstrated significant associations between low Mini-Cog scores and increasing age (rs=-0.1901; P=0.0079), unskilled occupation (P=0.0033), low functional status (rs=-0.1831; P=0.0106), low level of education (P=0.0005), and frailty (rs=-0.3010; P less then 0.0001). Logistic regression showed level of education and frailty to be significant. A score ≤3 is more likely in frail patients (odds ratio 7.54; P=0.003) and those with only primary school education (odds ratio 3.54; P=0.003). Conclusions Undiagnosed pre-existing cognitive dysfunction was common in older patients awaiting surgery at a regional academic hospital in South Africa. Patients at risk for cognitive dysfunction should be identified through brief preoperative screening.Recent studies have revealed that protein arginine methyltransferases (PRMTs) are responsible for diverse neurodegenerative diseases. However, their pathophysiological role in dopaminergic neuronal death in Parkinson's disease (PD) has not been evaluated. In this study, we demonstrated that 1-Methyl-4-phenylpyridinium iodide (MPP+), rotenone and paraquat, which cause dopaminergic neuronal cell death, increased PRMT1 expression in dopaminergic cell line. Dopaminergic neuronal cell death was increased by PRMT1 overexpression. MPP+-induced cell death was attenuated by PRMT1 knockdown. Poly (ADP-ribose) polymerase-1 (PARP1) expression and activity, poly-ADP-ribosylation (PARylation), were elevated by MPP+. Moreover, we found that PRMT1 positively regulates nuclear translocation of apoptosis-inducing factor (AIF). Elevated PRMT1 expression was observed in the substantia nigra pars compacta of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-injected ****. Furthermore, MPTP-induced dopaminergic neuronal death was reduced in PRMT1 haploinsufficient (prmt1+/-) ****. These data suggest that PRMT1 is implicated in PARP1/AIF-mediated dopaminergic neuronal cell death, which might be involved in the pathology of PD. Therefore, our results propose PRMT1 as a new target to develop a potential treatment of PD.Radiotherapy is the most common strategy for treating cancer. However, the radiation-induced inflammatory responses, acute or chronic, in the normal tissues of the irradiated region may result in undesirable side effects, such as lung injury and atherosclerosis. MALAT1 is believed to function in the onset, development, progression and metastasis of various cancers. Silencing MALAT1 may be a promising treatment for rescuing cancer. Nevertheless, whether MALAT1 promotes the radiation-induced undesirable inflammatory response is still uncovered. The present study reveals that radiation-induced DNA damage triggers cGAS signaling and subsequently increases the expression of MALAT1. Overexpression of MALAT1 inhibits the function of miR146a in the suppression of STAT1, which results in the boost of adhesion molecules and eventually induces acute lung injury and atherosclerosis. Thus, silencing MALAT1 may facilitate the reduction of radiation-induced acute and chronic complications in the radiotherapy of cancer.Stomatological complications of allogeneic hematopoietic stem cell transplantation (HSCT) are frequent and very uncomfortable for patients. The primary complication is the graft versus host disease reaction. Other side effects of the procedure include infections, taste disorders and carcinogenic risks. Various local treatments are used but remain imperfect. https://www.selleckchem.com/products/nsc697923.html Within the framework of the 10th workshop of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held in Lille in September 2019, diagnostic approaches and treatments of tongue and oral complications following allogeneic HSCT were reviewed according to the analysis of published studies.
Pain management in the elderly is complex. Nurse-caregiver pair work encourages team cohesion and strengthens trust and communication. Being part of a reflexive and humane approach to care enables better support for patients.Because of all the multiple forms of pain, its management is of variable geometry. The evaluation, its repercussion, the treatment, the assessment of the benefit and the side effects are each time a singular model.Treating the pain is essential. It requires knowledge, assessment and reassessment by trained professionals. Communication is essential between the different professionals involved for the benefit of the patient.The psychologist's perspective on the issue of pain opens the way to new issues. One of the psychologist's roles in chronic pain consultations is to allow a psychological elaboration of the painful complaint. It seems essential for the carers, whatever their specialities, to move away from a dualistic "body-mind" concept, so as not to undermine the reception of this complaint, with its multiple interactions.Pain has recently become a public health priority. It is effectively managed, health professionals are trained and patients are referred to dedicated structures.The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of tracheotomy, be it by puncture or open, clarifying its respective advantages and enumerating the ideal conditions under which they should be performed, as well as the necessary steps. Regular and emergency situations are displayed together with the postoperative measures.Background Cognitive dysfunction after surgery includes delirium and postoperative cognitive dysfunction. Important risk factors for these include increased age and pre-existing cognitive dysfunction. This study describes preoperative cognitive dysfunction and its associated factors in patients aged ≥60 yr awaiting elective noncardiac surgery in a developing country. Methods A prospective, contextual, descriptive study design with consecutive convenience sampling was used at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. Assessment of cognition was subjective (through casual conversation, henceforth referred to as observer assessment) and objective (using the Mini-Cog test). Results A total of 194 outpatients (median age 65 yr) were assessed. A score ≤3 (indicating mild cognitive impairment) was obtained by 111 patients (57.2%). Subjective memory complaints were reported by 124 patients (63.9%). Univariate analyses demonstrated significant associations between low Mini-Cog scores and increasing age (rs=-0.1901; P=0.0079), unskilled occupation (P=0.0033), low functional status (rs=-0.1831; P=0.0106), low level of education (P=0.0005), and frailty (rs=-0.3010; P less then 0.0001). Logistic regression showed level of education and frailty to be significant. A score ≤3 is more likely in frail patients (odds ratio 7.54; P=0.003) and those with only primary school education (odds ratio 3.54; P=0.003). Conclusions Undiagnosed pre-existing cognitive dysfunction was common in older patients awaiting surgery at a regional academic hospital in South Africa. Patients at risk for cognitive dysfunction should be identified through brief preoperative screening.Recent studies have revealed that protein arginine methyltransferases (PRMTs) are responsible for diverse neurodegenerative diseases. However, their pathophysiological role in dopaminergic neuronal death in Parkinson's disease (PD) has not been evaluated. In this study, we demonstrated that 1-Methyl-4-phenylpyridinium iodide (MPP+), rotenone and paraquat, which cause dopaminergic neuronal cell death, increased PRMT1 expression in dopaminergic cell line. Dopaminergic neuronal cell death was increased by PRMT1 overexpression. MPP+-induced cell death was attenuated by PRMT1 knockdown. Poly (ADP-ribose) polymerase-1 (PARP1) expression and activity, poly-ADP-ribosylation (PARylation), were elevated by MPP+. Moreover, we found that PRMT1 positively regulates nuclear translocation of apoptosis-inducing factor (AIF). Elevated PRMT1 expression was observed in the substantia nigra pars compacta of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-injected mice. Furthermore, MPTP-induced dopaminergic neuronal death was reduced in PRMT1 haploinsufficient (prmt1+/-) mice. These data suggest that PRMT1 is implicated in PARP1/AIF-mediated dopaminergic neuronal cell death, which might be involved in the pathology of PD. Therefore, our results propose PRMT1 as a new target to develop a potential treatment of PD.Radiotherapy is the most common strategy for treating cancer. However, the radiation-induced inflammatory responses, acute or chronic, in the normal tissues of the irradiated region may result in undesirable side effects, such as lung injury and atherosclerosis. MALAT1 is believed to function in the onset, development, progression and metastasis of various cancers. Silencing MALAT1 may be a promising treatment for rescuing cancer. Nevertheless, whether MALAT1 promotes the radiation-induced undesirable inflammatory response is still uncovered. The present study reveals that radiation-induced DNA damage triggers cGAS signaling and subsequently increases the expression of MALAT1. Overexpression of MALAT1 inhibits the function of miR146a in the suppression of STAT1, which results in the boost of adhesion molecules and eventually induces acute lung injury and atherosclerosis. Thus, silencing MALAT1 may facilitate the reduction of radiation-induced acute and chronic complications in the radiotherapy of cancer.Stomatological complications of allogeneic hematopoietic stem cell transplantation (HSCT) are frequent and very uncomfortable for patients. The primary complication is the graft versus host disease reaction. Other side effects of the procedure include infections, taste disorders and carcinogenic risks. Various local treatments are used but remain imperfect. https://www.selleckchem.com/products/nsc697923.html Within the framework of the 10th workshop of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held in Lille in September 2019, diagnostic approaches and treatments of tongue and oral complications following allogeneic HSCT were reviewed according to the analysis of published studies.
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