Edit Nagy

The role of TRPV1 receptors in the antinociceptive effect of anandamide at spinal level

&NA; While it is well known that the endogenous cannabinoid receptor ligand anandamide also activates the transient receptor potential vanilloid1 (TRPV1) receptors, there has been no in vivo study indicating the role of the TRPV1 receptors in the antinociceptive effect of anandamide at spinal level. The goal of this study was to determine the effect of inhibition of TRPV1 receptors by capsazepine on the antinociceptive potency of anandamide after intrathecal administration. Anandamide alone (1, 30 or 100 μg) dose‐dependently decreased carrageenan‐induced thermal hyperalgesia, however, the highest dose caused temporary excitation and vocalization, suggesting the pain‐inducing potential of anandamide. Capsazepine (10 or 20 μg) by itself did not change the pain sensitivity markedly, but the lower dose increased it, and the higher dose decreased the antinociceptive effect of 30 μg anandamide. Furthermore, both doses of capsazepine decreased the efficacy of the largest dose of anandamide. These results show that TRPV1 receptor activation plays a substantial role in the antinociceptive effects of anandamide at spinal level. The effect of the inhibition on TRPV1 receptors depended on the dose applied. We presume that coactivation of the cannabinoid and TRPV1 receptors by anandamide provides elevated antinociception through the release of antinociceptive endogenous ligands at spinal level.

Quantitative characterization of a repeated acute joint inflammation model in rats

1 Chronic pain owing to arthritis is a major clinical problem worldwide. To study the underlying pathological mechanisms of chronic pain and the effectiveness of different treatments, a number of experimental models have been developed over the years. 2 We introduced a new subchronic inflammatory model by repeated unilateral administration of carrageenan into the ankle joint of rats, and investigated the degree and the time‐course of the oedema, and thermal and mechanical hyperalgesia. 3 Carrageenan (450 µg) was injected on three occasions (on days 1, 4 and 7), and the resulting oedema, thermal hyperalgesia (paw withdrawal test) and weight load were characterized in voluntarily walking rats daily for 15 days. The effect of diclofenac sodium (3 mg/kg orally daily for 15 days) was also determined. 4 Repetitive administration of carrageenan caused fluctuating oedema and pain responses, which did not normalize within 3 days. Exacerbated inflammatory oedema was observed after the second and third injections. Oedema and a decreased weight load of the inflamed paw were observed throughout the investigation period, and paw withdrawal thresholds to noxious thermal stimuli returned to baseline pre‐carrageenan values from Day 13. 5 Oral diclofenac (3 mg/kg daily for 15 days) significantly decreased oedema within a few days (Day 3), whereas its anti‐allodynic effect developed only several days later (Day 9). However, diclofenac at the applied dose did not influence the thermal hyperalgesia. 6 The results suggest that the repeated administration of carrageenan might be a suitable model for determining the effects of long‐lasting treatment.

Deviation of the Atrial Septum Primum Predisposing to Local Thrombus Formation

In a substantial proportion of patients with recent systemic embolization, no evident source of embolism or predisposing factors can be verified. As yet unidentified cardiac abnormalities may play a role in the pathogenesis of the peripheral embolic events. The authors report the case of a 72-year-old man who presented with atrial fibrillation and recurrent in situ thrombus formation in the territory of the fossa ovalis. A deviated and malattached atrial septum primum without a patent foramen ovale may predispose to local thrombus formation in patients with atrial fibrillation. Further studies are required to establish the clinical importance of such an atrial septal malformation in specific subgroups of patients with ischemic stroke.

Postural control in degenerative diseases of the hip joint.

BACKGROUND Few studies investigated the postural control in patients with hip joint impairments; in some cases, balance impairments have been found, while other researchers have seen no significant changes. The goal of this study was to characterize postural stability in patients suffering from unilateral osteoarthritis or rheumatoid arthritis in different balance tasks and to reveal potential differences between the two diseases in this respect. METHODS Ten patients with hip osteoarthritis (mean age: 62.3years), 10 patients with rheumatoid arthritis (mean age: 55.4years) and 10 healthy control subjects (mean age: 54.3years) took part in the study. Displacement of centre of pressure was measured with a force plate in mediolateral and anteroposterior directions during two-leg standing on firm and compliant surfaces with eyes opened and closed. FINDINGS Standing on a firm surface sway path increased significantly in the anteroposterior direction in both patient groups and in the mediolateral direction in all groups with eyes closed as compared to eyes opened condition. Standing on a compliant surface, sway paths increased significantly in both directions in all groups with eyes closed as compared to eyes opened condition; furthermore, sway paths were significantly longer with eyes closed in patients with rheumatoid arthritis in comparison with control and osteoarthritis groups. INTERPRETATION Our data revealed that the manipulation of both visual and somatosensory information can reveal subtle impairments in balance control. Thus, this paradigm can unmask the effects of decreased proprioception due to joint capsule lesion in patients with rheumatoid arthritis.

The antinociceptive interaction of anandamide and adenosine at the spinal level.

Both anandamide and adenosine have significant roles in pain mechanisms, but no data are available concerning their interaction at the spinal level. The goal of this study was to determine how adenosine and the adenosine receptor antagonist caffeine affect the antinociceptive effect of anandamide. The pain sensitivity was assessed by the acute tail-flick test and by paw withdrawal test after carrageenan-induced inflammation. The substances were administered intrathecally to male Wistar rats. Anandamide alone (1, 30 and 100 microg) dose-dependently decreased the hyperalgesia, however it had low potency in the tail-flick test. Neither adenosine (100 microg) nor caffeine (400 microg) alone changed the pain sensitivity markedly. Their combination caused a short-lasting antihyperalgesia, but it did not influence the tail-flick latency. Both adenosine and caffeine decreased the antihyperalgesic potential of 100 microg anandamide, while adenosine-caffeine pretreatment temporarily enhanced its effect. As regards acute heat pain sensitivity, no combination with anandamide influenced the effect of anandamide. These findings provide new data concerning the interaction between two endogenous ligands and caffeine. Since these substances may exert effects on several receptors and/or systems, their interaction in vivo must be very complex and the net outcome after their coadministration could not been predicted from the in vitro results.

Trunk alignment in different standing positions in healthy subjects and stroke patients -a comparative study with a simple method for the everyday practice.: Trunk alignment in healthy and stroke subjects

ABSTRACT Objectives: Weight-bearing (WB) on the lower extremities is an important outcome parameter in the rehabilitation of poststroke hemiparesis. However, the patients often regain this ability by compensatory movement patterns. Methods: Our goal was to characterize with a simple method the trunk alignment of healthy subjects and stroke patients (n = 17 for both groups) during standing and following lateral weight shift (WS). To describe trunk alignment, five markers were placed on the subjects’ back, and the angles of the trunk at both sides were defined by the lines drawn from the posterior angle of the acromion and the iliac crest on the same body side to the seventh thoracic spinal process. Weight distributions on the lower extremities during standing and lateral WS were determined with a force platform. Results: The patients had significantly limited WB capacity on their paretic limb, which was accompanied with significant asymmetry in the trunk alignment during standing and following WS to the paretic side. Discussion: Our results show that this patient population tends to use abnormal compensatory movement patterns to optimize weight shifting, and changes of trunk alignment play a key role in this. This should be taken into consideration during rehabilitation.

Perceptual Aspects of Postural Control: Does Pure Proprioceptive Training Exist?:

As proprioceptive training is popular for injury prevention and rehabilitation, we evaluated its effect on balance parameters and assessed the frequency spectra of postural sway linked with the various sensory channels. We recorded the Center of Mass displacement of 30 healthy student research participants (mean age = 21.63; SD = 1.29 years) with a single force plate under eyes open (EO) and eyes closed (EC) positions while standing on either a firm or foam surface, both before and after an 8-week balance training intervention on a foam surface with EC. We subjected the data to frequency power spectral analysis to find any differences between the frequency bands, linked with various sensory data. On the foam surface in the EC condition, the sway path decreased significantly after proprioceptive training, but, on the firm surface in the EC condition, there was no change. On the foam surface in the EC condition, there was also a significant decrease in frequency power postproprioceptive training in the medium-to-low frequency band. While our data indicate better posttraining balance skills, improvements were task specific to the trained condition, with no transfer of the acquired skill, even to a similar, easier condition. As training improved the middle-low frequency band, linked with vestibular signals, this intervention is better described as balance than “proprioceptive” training.

Osteoporosis and the Role of Physical Therapy in the Different Domains

The authors emphasize the role of physical exercises in the prevention and treatment of osteoporosis through reviewing the most important evidences. With the increase of life expectancy, it becomes more and more challenging to fight against osteoporosis related fracture complications and functional restrictions. The article gives an insight into the different physical exercises that are able to influence the condition as prevention and also as treatment possibilities without having adverse side effects. Since improving balance and postural control are essential part of the interventions and they are under the influence of multiple sensory, motor and cognitive systems, this multisystem nature of balance should take into account in falls prevention even in terms of osteoporosis.

A gátizomtorna jelentősége a prevencióban

A szerzők jelen tanulmanyukban ket kulonboző korosztalynal ravilagitanak a medencealapi izmokat gyengitő tenyezőkre, amelyek okozhatnak vizeletvesztesi tuneteket. Vizsgaltak a fiatal nem szult nőknel jelentkező vizelettartasi zavar kezelesere alkalmas gatizomtorna hatasat. A vizsgalatokban a serdulő korosztaly (n=111; atlageletkor 16± SD 1.4) es a felnőtt nők (n=311; atlageletkor 40 ev± SD 10,4) vettek reszt. A resztvevők kerdőiveket toltottek ki. 14 fiatal nem szult nő ezen kivul izomerő felmeresen vettek reszt, akiknel a gatizomtorna 10 hetig heti 1x1 ora iranyitott tornaztatasbol es otthoni gyakorlasbol allt. Az eredmenyek alapjan a problema nem csak a felnőtt populaciot, hanem a fiatal korosztalyt is erinti. A kerdőivekből kiderult, hogy az inkontinencia rizikotenyezői kozul a helytelen szokasok jelenlete szamottevő. A tornacsoportnal a gatizmok izometrias feszites mertekenek valtozasa szignifikansan novekedett a tornaprogram vegere (25 masodperccel atlagosan), csakugy, mint a gatizmok dinamikus allokepesseget jelző 1 perc alatti osszehuzodasok szama is (atlagosan 13 ismetlesszammal). A gatizomtorna program eredmenyesseget tamasztja ala, hogy a resztvevők a tunetek csokkeneset vagy megszűneset tapasztaltak. Az eredmenyek eszkozos bizonyitasa tovabbi kutatasi celok felallitasat surgetik.