BACKGROUND: The pathophysiology of abnormal temperature sensation in Parkinson's disease (PD) remains unclear. Abnormal thermal detection does not seem to depend on the dopaminergic deficit, suggesting that other systems play a role in these changes, probably both central and peripheral. METHODS: We measured thermal detection thresholds (TDT) using quantitative sensory testing (QST) in 28 patients with PD and compared them with 15 healthy controls. RESULTS: Of 28 patients, 21% had increased TDT according to the normative data. TDT were higher on the dominant side. No correlation between TDT and disease duration, severity of motor impairment, and dopaminergic therapy was observed. 50% of the patients had difficulty differentiating between warm and cold stimuli, as TDT were within the normal range in most of these patients. CONCLUSIONS: Twenty-one percent of the patients in our study had increased TDT according to the normative data. Abnormal thermal detection was more pronounced on the dominant side. Abnormal differentiation between the thermal stimuli suggest impaired central processing of thermal information.
- MeSH
- Sensation physiology MeSH
- Humans MeSH
- Cold Temperature MeSH
- Parkinson Disease * diagnosis MeSH
- Case-Control Studies MeSH
- Temperature MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Topically applied camphor elicits a sensation of cool, but nothing is known about how it affects cold temperature sensing. We found that camphor sensitizes a subpopulation of menthol-sensitive native cutaneous nociceptors in the mouse to cold, but desensitizes and partially blocks heterologously expressed TRPM8 (transient receptor potential cation channel subfamily M member 8). In contrast, camphor reduces potassium outward currents in cultured sensory neurons and, in cold nociceptors, the cold-sensitizing effects of camphor and menthol are additive. Using a membrane potential dye-based screening assay and heterologously expressed potassium channels, we found that the effects of camphor are mediated by inhibition of Kv7.2/3 channels subtypes that generate the M-current in neurons. In line with this finding, the specific M-current blocker XE991 reproduced the cold-sensitizing effect of camphor in nociceptors. However, the M-channel blocking effects of XE991 and camphor are not sufficient to initiate cold transduction but require a cold-activated inward current generated by TRPM8. The cold-sensitizing effects of XE991 and camphor are largest in high-threshold cold nociceptors. Low-threshold corneal cold thermoreceptors that express high levels of TRPM8 and lack potassium channels are not affected by camphor. We also found that menthol--like camphor--potently inhibits Kv7.2/3 channels. The apparent functional synergism arising from TRPM8 activation and M-current block can improve the effectiveness of topical coolants and cooling lotions, and may also enhance TRPM8-mediated analgesia.
- MeSH
- Camphor pharmacology MeSH
- TRPM Cation Channels genetics metabolism MeSH
- Menthol pharmacology MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Nerve Fibers, Unmyelinated drug effects metabolism MeSH
- Cold Temperature MeSH
- Nociceptors metabolism physiology MeSH
- Signal Transduction drug effects physiology MeSH
- Ganglia, Spinal drug effects metabolism MeSH
- Thermoreceptors metabolism physiology MeSH
- Thermosensing drug effects physiology MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Autorka ve svém sdělení uvádí přehled dětských dermatóz, se kterými se dermatolog a praktický dětský lékař setkává v zimním období nejčastěji. Jde o skupinu chronicky probíhajících dermatóz s obdobím exacerbace a remise (atopická dermatitida, seborrhoická dermatitida, psoriasis vulgaris), další skupinu tvoří sezónní virová exantémová onemocnění, třetí skupinu pak kožní onemocnění způsobená účinkem chladu a nakonec funkční angiolopatie.
The author presents an overview of paediatric dermatitides most commonly encountered by the dermatologist and general paediatrician in the winter time. They include the group of chronic dermatitides with periods of exacerbation and remission (atopic dermatitis, seborrhoeic dermatitis, psoriasis vulgaris); another group consists of seasonal viral exanthem conditions, another one of skin diseases caused by cold, and, finally, there are functional angiolopathies. caused by cold, functional angiolopathies.
- MeSH
- Dermatitis, Atopic epidemiology complications therapy MeSH
- Child MeSH
- Humans MeSH
- Livedo Reticularis epidemiology etiology MeSH
- Adolescent MeSH
- Frostbite etiology prevention & control MeSH
- Pityriasis Rosea epidemiology drug therapy virology MeSH
- Psoriasis epidemiology classification therapy MeSH
- Seasons * MeSH
- Somatosensory Disorders epidemiology etiology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Review MeSH
Autorka ve svém sdělení uvádí přehled dětských dermatóz, se kterými se dermatolog a praktický dětský lékař setkává v zimním období nejčastěji. Jde o skupinu chronicky probíhajících dermatóz s obdobím exacerbace a remise (atopická dermatitida, seborrhoická dermatitida, psoriasis vulgaris), další skupinu tvoří sezónní virová exantémová onemocnění, třetí skupinu pak kožní onemocnění způsobená účinkem chladu a nakonec funkční angiolopatie.
The author presents an overview of paediatric dermatitides most commonly encountered by the dermatologist and general paediatrician in the winter time. They include the group of chronic dermatitides with periods of exacerbation and remission (atopic dermatitis, seborrhoeic dermatitis, psoriasis vulgaris); another group consists of seasonal viral exanthem conditions, another one of skin diseases caused by cold, and, finally, there are functional angiolopathies.
- MeSH
- Dermatitis, Atopic epidemiology complications therapy MeSH
- Child MeSH
- Humans MeSH
- Livedo Reticularis epidemiology etiology MeSH
- Adolescent MeSH
- Frostbite etiology prevention & control MeSH
- Pityriasis Rosea epidemiology drug therapy virology MeSH
- Psoriasis epidemiology classification therapy MeSH
- Seasons * MeSH
- Somatosensory Disorders epidemiology etiology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Review MeSH
- MeSH
- Electric Stimulation Therapy methods instrumentation MeSH
- Hyperalgesia diagnosis etiology therapy MeSH
- Massage MeSH
- Musculoskeletal System physiopathology MeSH
- Cold Temperature MeSH
- Physicians' Offices MeSH
- Rehabilitation classification methods instrumentation MeSH
- Physicians, Family MeSH
- Exercise Therapy contraindications methods MeSH
Úvod: Funkčné poruchy gastrointestinálneho systému (FGID – functional gastrointestinal disorders) predstavujú skupinu ochorení s pestrou symptomatikou. Etiopatogenéza FGID nie je úplne objasnená, predpokladá sa multifaktoriálny pôvod. Existuje predpoklad, že istú úlohu v etiopatogenéze FGID zohráva aj narušený vplyv autonómneho nervového systému (ANS) na organizmus. Cieľ: Zhodnotiť reaktivitu ANS u pacientov s FGID pri pôsobení rôznych stresových podnetov. Metódy: Do štúdie sú zaradení pacienti s diagnostikovanými FGID podľa kritérií ROME IV. Sledované sú tri skupiny diagnóz a to: syndróm dráždivého čreva (IBS – irritable bowel syndrome), funkčná dyspepsia a globus pharyngeus. Meranie pozostáva z piatich fáz, každá v trvaní 5 min. Úvodná fáza je pokojová, kedy sú zaznamenávané pokojové (bazálne) hodnoty sledovaných parametrov. Nasledujú dve rozdielne stresové fázy (mentálna aritmetika a chladový test), medzi ktorými je zaradená tzv. zotavovacia fáza (pokojová). Meranie je rovnako ukončené zotavovacou fázou. Merané parametre sú baroreflexná senzitivita (BRS) (vypovedajúca o parasympatikovej odpovedi) a nízkofrekvenčné pásmo zmien systolického tlaku krvi (NF-STK) (vypovedajúca o sympatikovej odpovedi). Výsledky: Vo všetkých fázach protokolu bola u pacientov s FGID pozorovaná štatisticky výrazne znížená hodnota BRS pri porovnaní s kontrolnou skupinou, pričom táto je najviac znížená u pacientov s globus pharyngeus. Vo fáze pôsobenia aktívneho stresoru dochádza u všetkých podskupín FGID k štatisticky významne vyšším hodnotám nízkofrekvenčného systolického tlaku krvi pri porovnaní s kontrolnou skupinou. U pacientov so IBS a dyspepsiou sú tieto zmeny signifikantné aj počas chladového testu. Diskusia a záver: Na základe publikovaných prác dochádza u pacientov s FGID s najväčšou pravdepodobnosťou k narušenej odpovedi ANS na stresové podnety, čo potvrdzujú naše pilotné výsledky. Detailný mechanizmus tejto dysregulácie však stále nie je presne opísaný. Kým parasympatiková regulácia je znížená v pokoji i počas stresu, sympatikové regulačné vplyvy sú alterované počas odpovede na stresový podnet.
Introduction: Functional gastrointestinal disorders (FGID) represent a group of diseases with various symptoms. The etiopathogenesis of FGID is not fully understood; most likely it is multifactorial. It is assumed that the impaired influence of the autonomic nervous system on the organism also plays some role in the etiopathogenesis of FGID. Aim: To evaluate the reactivity of the autonomic nervous system in patients with FGID under the various stress stimuli. Methods: Patients diagnosed with dysfunction according to the ROME IV criteria are included in the study. Three groups of diagnoses are monitored: irritable bowel syndrome, functional dyspepsia and globus pharyngeus. The measurement consists of five phases, each lasting 5 min. The initial phase is the resting phase, when the resting (basal) values of the monitored parameters are recorded. The following are two different stress phases (mental arithmetic and cold pressor test); between them, there is a recovery phase. The measurement is also completed by the recovery phase. The measured parameters are baroreflex sensitivity (BRS) (indicative of parasympathetic response) and low frequency band of systolic blood pressure variability (LF-SBP) (indicative of sympathetic response). Results: A statistically significant reduction in BRS was observed in patients with FGID compared to the control group in all of the protocol phases, with most reduced BRS in globus group patients. In the mental arithmetic phase, all FGID subgroups have statistically significantly higher LF-SBP values compared to the control group. These changes are also significant during the cold pressor test in patients with IBS and dyspepsia. Discussion and conclusion: Based on published works, patients with FGID are most likely to have an impaired response of the autonomic nervous system to stress stimuli. This is also confirmed by our pilot results. However, the detailed mechanism of this dysregulation is still not precisely described. While parasympathetic regulation is reduced at rest and during stress, sympathetic regulatory effects are altered during the response to a stress stimulus.
- MeSH
- Autonomic Nervous System physiopathology MeSH
- Baroreflex physiology MeSH
- Dyspepsia * diagnostic imaging pathology MeSH
- Globus Sensation * diagnostic imaging pathology MeSH
- Humans MeSH
- Heart Rate physiology MeSH
- Irritable Bowel Syndrome * diagnostic imaging pathology MeSH
- Exercise Test MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Slovakia MeSH
Použití vodní imerze při zavádění kolonoskopu je schopno snížit dyskomfort pacientů během kolonoskopie. Ve většině publikovaných studií byla použita teplá voda. Použití vody pokojové teploty je v praxi technicky méně náročné a průkaz srovnatelné efektivity by mohl podpořit použití vodní imerze v běžné endoskopické praxi. Metodika: Ve dvojitě zaslepené studii bylo celkem 201 pacientů náhodně zařazeno buď do skupiny kolonoskopie ve vodní imerzi s použitím chladné vody (20–24 °C), nebo do skupiny s použitím teplé vody (37 °C). Primárním cílem studie byl čas do intubace céka. Výsledky: Čas intubace céka byl srovnatelný; 6,9 ? 3,5 min ve větvi s chladnou vodou vs 7,0 ? 3,4 min ve větvi s teplou vodou (p = 0,64). Úspěšnost kolonoskopie při minimální sedaci (89,1 % při chladné vodě vs 90 % při teplé vodě; p = 1,00) a dyskomfort během kolonoskopie (p = 0,51) nebyly odlišné. Všechny ostatní parametry kromě častější potřeby zevní komprese břicha ve větvi s chladnou vodou (p = 0,04) byly srovnatelné – celkový čas, úspěšnost intubace terminálního ilea, detekce adenomů, délka zavedeného přístroje, objem spotřebované vody, nutnost komprese břicha a nestandardní polohy pacienta, obtížnost vyšetření z pohledu endoskopisty a teplotní vjemy pacientů. Závěr: Ve srovnání s vodní imerzí s teplou vodou nedošlo při použití chladné vody ke změně času do intubace céka. Ostatní charakteristiky s výjimkou potřeby komprese břicha byly také srovnatelné. Kolonoskopie ve vodní imerzi s použitím chladné vody se zdá být srovnatelnou a technicky méně náročnou alternativou vodní imerze s teplou vodou.
Water-aided insertion as an alternative colonoscopy technique reduces patient's discomfort during the procedure. Warm water has been used in most of the published trials. Infusion of cool water is technically less demanding and a proof of its efficacy could support the use of water-aided technique in routine practice. Method: In a double-blind, randomized, single-centre study, a total of 201 patients were randomized to either cool water (20–24 °C) or warm water (37 °C) immersion insertion. The main outcome was a caecal intubation time. Results: Caecal intubation time was comparable; 6.9 ? 3.5 min in cool water vs 7.0 ? 3.4 min in warm water arm (P = 0.64). Success rate of minimal sedation colonoscopy (89.1% for cool water vs 90% for warm water, P = 1.00) and discomfort during colonoscopy (P = 0.51) were not different. All other outcomes except higher need for abdominal compression in cool water arm (P = 0.04) were comparable – total procedure time, terminal ileum intubation rate, adenoma detection, length of the inserted scope, water volume, nonstandard position rate, difficulty of the procedure and patient‘s temperature sensation. Conclusion: In comparison with warm water immersion, the use of cool water did not modify the caecal intubation time. Other characteristics with the exception of abdominal compression rate were not different. Cool water immersion seems to be a comparable alternative to a technically more demanding warm water immersion colonoscopy. Key words: colonoscopy – colorectal cancer – water immersion – cool water The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers. Submitted: 2. 7. 2013 Accepted: 1. 8. 2013
- Keywords
- chladná voda,
- MeSH
- Adenoma diagnosis MeSH
- Conscious Sedation MeSH
- Time Factors MeSH
- Double-Blind Method MeSH
- Colonoscopy * methods standards statistics & numerical data MeSH
- Colorectal Neoplasms diagnosis MeSH
- Humans MeSH
- Pain Measurement statistics & numerical data MeSH
- Midazolam administration & dosage MeSH
- Cold Temperature * diagnostic use MeSH
- Posture MeSH
- Patient Satisfaction statistics & numerical data MeSH
- Statistics as Topic MeSH
- Water * administration & dosage diagnostic use MeSH
- Outcome and Process Assessment, Health Care statistics & numerical data MeSH
- Hot Temperature diagnostic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
Úvod: Přístrojově asistované kvantitativní testování senzitivity (QST) se stanovením termických (TPT) a vibračních (VPT) prahů patří v současnosti mezi klíčové metody v diagnostickém algoritmu senzitivních neuropatií. Cílem práce je derivace validních, věkově stratifikovaných normativních dat pro obě QST metodiky. Soubor a metodika: Věkově stratifikovaná normativní data (v podskupinách 20–40, 40–60 a 60+ let) byla derivována z nálezů souborů 88 (TPT), resp. 74 (VPT) zdravých dobrovolníků. Výsledky: Při vyšetření TPT i VPT byla prokázána mírně horší percepce všech testovaných modalit u mužů ve srovnání se ženami a signifikantní věkově podmíněný pokles termických prahů pro chlad (při použití metody Limity byl dolní normální limit (NL) pro jednotlivé věkové kategorie stanoven na úrovni 26,3–25,5–22,8 °C u mužů a 29,1–26,6–21,1 °C u žen) a vzestup prahů pro teplo (horní NL 40,8–44,9–46,2 °C u mužů a 39,5–41,2–48,2 °C u žen) i vibrační čití (horní NL 6,0–12,5–50,3 μm u mužů a 4,0–13,2–33,6 μm u žen). Výška prahu byla ovlivněna také volbou algoritmu testování, tj. byla mírně vyšší v metodách reakčního času (Limity) oproti metodám konstantního stimulu (Úrovně). Závěry: Senzitivní prahy pro teplo, chlad i vibrační čití vykazují signifikantní vliv věku a méně významný vliv pohlaví vyšetřených jedinců na nálezy ve skupině zdravých dobrovolníků. Při hodnocení výsledků obou metod u pacientů se senzitivní neuropatií je tedy vhodné použití věkově stratifikovaných normativních dat pro jednotlivá pohlaví se zohledněním příslušného algoritmu testování.
Introduction: Detection of thermal (TPT) and vibratory (VPT) perception thresholds using the computer-assisted quantitative sensory testing (QST) is currently one of the most important methods for diagnosing sensory neuropathies. The aim of the study was to establish valid, age-stratified normal limits for both the QST methods. Patients and methods: Findings from 88 (TPT) or 74 (VPT) healthy individuals provided the basis for establishing age-stratified normal values in subgroups of patients aged 20–40, 40–60 and 60+ years. Results: Slight but significant differences between men and women and highly significant age-related changes were found for all the TPTs and VPTs with lower cold thresholds and higher warm and vibratory thresholds in men and in older individuals. Using the method of limits, lower normal values for cold TPT were set at 26.3–25.5–22.8 °C for the respective age subgroups of men and 29.1–26.6–21.1 °C for the respective age subgroups of women. Similarly, upper normal limits for warm TPT were set at 40.8–44.9–46.2 °C, respectively, in men and 39.5–41.2–48.2 °C, respectively, in women, and at 6.0–12.5–50.3 μm, respectively, in men and 4.0–13.2–33.6 μm, respectively, in women for VPT. Threshold values also depend on the testing algorithm used, with slightly higher values in reaction time inclusive methods (Limits) compared to reaction time exclusive algorithms (Levels). Conclusions: Cold and warm TPT as well as VPT display significant age-effect and less significant effect of gender on perception threshold values. The evaluation of the VPT and TPT findings in patients with sensory neuropathies should thus be performed using the age- and gender-adjusted normal values for particular testing algorithm.
- Keywords
- senzitivní neuropatie, kvantitativní testování senzitivity, normativní data,
- MeSH
- Diabetic Neuropathies diagnosis complications MeSH
- Diagnostic Techniques, Neurological standards instrumentation MeSH
- Adult MeSH
- Electrodiagnosis methods instrumentation MeSH
- Middle Aged MeSH
- Humans MeSH
- Autonomic Nervous System Diseases diagnosis complications MeSH
- Sensation Disorders diagnosis complications MeSH
- Pain Threshold classification MeSH
- Aged MeSH
- Software MeSH
- Vibration adverse effects MeSH
- Thermosensing MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
Differences of sensation and sweating among the typical sites of cutaneous and fasciocutaneous flaps (scapular, lateral arm, radial forearm, groin and dorsalis pedis) were assessed in 30 healthy volunteers (20 males and 10 fe- males) aged 17-62 years (mean 38.2 years). Standard clinical methods were used: Semmes-Weinstein monofila- ments for testing light touch threshold, discriminator and blunt caliper for evaluation of static and dynamic two-point discrimination and the Marstock quantitative method for assessing the normative values of warm-cold difference limen and heat and cold pain thresholds. Spontaneous sweat secretion was observed and documented by the ninhydrin test. We established various physiological differences for distinct somatic sensory modalities and sweating among the body regions (donor sites of cutaneous and fasciocutaneous free flaps).
