Heat Sensation Research Articles

PACAP-38 and PACAP(6-38) Degranulate Rat Meningeal Mast Cells via the Orphan MrgB3-Receptor.

Infusion of pituitary adenylate cyclase activating peptide-38 (PACAP-38) provokes migraine attacks in migraineurs and headache in non-migraineurs. Adverse events like long-lasting flushing and heat sensation can be terminated with oral antihistamine treatment, indicating the involvement of mast cell activation after PACAP-infusion. Degranulation of rat peritoneal mast cells was provoked by several isoforms of PACAP via previously unknown receptor pharmacology. The effect might thus be mediated either via specific splice variants of the PAC1-receptor or via an unknown receptor for PACAP-38. In the present study, we characterize degranulation of rat meningeal mast cells in response to PACAP-receptor ligands. Furthermore, we investigate if PACAP-38-induced mast cell degranulation is mediated via PAC1-receptor splice variants and/or via the orphan Mas-related G-protein coupled member B3 (MrgB3)-receptor. To address this, the pharmacological effect of different PACAP isoforms on meningeal mast cell degranulation was investigated in the hemisected skull model after toluidine blue staining followed by microscopic quantification. Presence of mRNA encoding PAC1-receptor splice variants and the MrgB3-receptor in rat mast cells was investigated by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) analysis. The effect of PACAP isoforms on PAC1- and MrgB3-receptor-expressing Xenopus laevis oocytes were performed by two-electrode voltage-clamp (TEVC) electrophysiology. PACAP-38 is a more potent mast cell degranulating agent than Pituitary Adenylate Cyclase Activating Peptide-27 (PACAP-27) in the meninges. Presence of mRNA encoding the PAC1-receptor and its different splice variants could not be detected in peritoneal mast cells by RT-PCR, whereas the orphan MrgB3-receptor, recently suggested to be a mediator of basic secretagogues-induced mast cell degranulation, was widely present. In PAC1-receptor-expressing Xenopus laevis oocytes both PACAP-38, PACAP-27 and the specific PAC1-receptor agonist maxadilan were equipotent, however, only PACAP-38 showed a significant degranulatory effect on mast cells. We confirmed Pituitary Adenylate Cyclase Activating Peptide(6–38) [PACAP(6–38)] to be a PAC1-receptor antagonist, and we demonstrated that it is a potent mast cell degranulator and have an agonistic effect on MrgB3-receptors expressed in oocytes. The present study provides evidence that PACAP-induced mast cell degranulation in rat is mediated through a putative new PACAP-receptor with the order of potency being: PACAP-38 = PACAP(6–38) > > PACAP-27 = maxadilan. The results suggest that the observed responses are mediated via the orphan MrgB3-receptor.

Efficiency of special cooling liquid on thermal state of athletes at high temperatures

The article presents results of evaluating efficiency of special cooling liquid influence on heat state of athletes at high temperatures. The study covered 7 male athletes of cyclic sports, with sport rank at least 1 adult, average age 19.29±1.80 years. All the athletes underwent double examination including: anamnesis and complaints records, doctor’s examination, subjective evaluation of heat sensations, weight measurements, thermometry (tympanic, sublingual, rectal and skin (in 5 points)), ergospirometric stress testing. Changes in the athletes’ heat state were evaluated via dynamics of weighted average skin temperature and rectal temperature. Moreover, subjective evaluation of heat sensations was considered. Efficiency of the cooling liquid was assessed via dynamics of exercises performance time, maximal oxygen consumption and anaerobic metabolism threshold. The cooling liquid use appeared to be expedientin sport teams of summer sports for specific exertion after individual tests for adverse allergic reactions.

A Quantitative Sensory Testing Approach to Pain in Autism Spectrum Disorders

Sensory abnormalities in autism has been noted clinically, with pain insensitivity as a specified diagnostic criterion. However, there is limited research using psychophysically robust techniques. Thirteen adults with ASD and 13 matched controls completed an established quantitative sensory testing (QST) battery, supplemented with measures of pain tolerance and central modulation. The ASD group showed higher thresholds for light touch detection and mechanical pain. Notably, the ASD group had a greater range of extreme scores (the number of z-scores outside of the 95% CI > 2), dynamic mechanical allodynia and paradoxical heat sensation; phenomena not typically seen in neurotypical individuals. These data support the need for research examining central mechanisms for pain in ASD and greater consideration of individual difference.

Activation of TRPV1 by Lipids: Can Lipid Tails Bridge the Gap between the Vanilloid Binding Site and the Peripheral Cavities?

The transient receptor potential vanilloid receptor 1 (TRPV1) is a nonselective cation channel, member of the transient receptor potential superfamily of ion channels. TRPV1 is expressed in peripheral sensory neurons, where it transduces noxious stimuli into electrical signals, and is responsible for body temperature regulation, heat sensation, noxious and chronic pain. TRPV1 is activated by a variety of stimuli, including ligand binding at the vanilloid site. We previously discovered that rotation of a conserved residue on the S6 segment from the S4-S5 linker towards the pore is also implicated in TRPV1 activation. This movement is correlated with dehydration of peripheral cavities (PCs) located between S6 and the S4-S5 linker, and with hydration of the pore. However, the structural details for this mechanism remain to be elucidated. Here we explore the hypothesis that annular lipids mediate the allosteric coupling between the vanilloid site and the PCs, ultimately leading to TRPV1 activation. Our multi-microseconds molecular dynamics simulations and free energy calculations of several TRPV1 systems (i.e. TRPV1 bound to vanilloid ligands and/or to the spider venom toxin, Dk/Tx) revealed that annular lipids have a peculiar “buried” conformation upon concomitant binding of vanilloids and Dk/Tx. Interestingly, lipids in this conformation project the hydrophobic tails into the PCs, thereby triggering their dehydration and the consequent opening of the channel. In conclusion, our results elucidate the molecular underpinnings of TRPV1 allosteric regulation by annular lipids, and sheds light on the mechanism by which the binding of vanilloid ligands is coupled to gating motion.

Trigeminal nociceptive function and oral somatosensory functional and structural assessment in patients with diabetic peripheral neuropathy

This case-control study primarily compared the trigeminal nociceptive function, the intraoral somatosensory profile and possible structural nerve changes between diabetic peripheral neuropathy (DPN, n = 12) patients and healthy participants (n = 12). The nociceptive blink reflex (nBR) was recorded applying an electrical stimulation over the entry zone of the right supraorbital (V1R), infraorbital (V2R) and mental (V3R) and left infraorbital (V2L) nerves. The outcomes were: individual electrical sensory (I0) and pain thresholds (IP); root mean square (RMS), area-under-the-curve (AUC) and onset latencies of R2 component of the nBR. Furthermore, a standardized full battery of quantitative sensory testing (QST) and intraepidermal nerve fibre density (IENFD) or nerve fibre length density (NFLD) assessment were performed, respectively, on the distal leg and oral mucosa. As expected, all patients had altered somatosensory sensitivity and lower IENFD in the lower limb. DPN patients presented higher I0, IP, RMS and AUC values (p < 0.050), lower warm detection thresholds (WDT) (p = 0.004), higher occurrence of paradoxical heat sensation (PHS) (p = 0.040), and a lower intraoral NFLD (p = 0.048) than the healthy participants. In addition, the presence of any abnormal intraoral somatosensory finding was more frequent in the DPN patients when compared to the reference group (p = 0.013). Early signs of trigeminal nociceptive facilitation, intraoral somatosensory abnormalities and loss of intraoral neuronal tissue can be detected in DPN patients.

СОСТОЯНИЕ ТЕРМОРЕГУЛЯЦИИ ОРГАНИЗМА ВОДИТЕЛЕЙ ПАССАЖИРСКОГО АВТОТРАНСПОРТА ПРИ РАБОТЕ В РАЗНЫЕ СЕЗОНЫ ГОДА

Objective: To evaluate the state of body thermoregulation of drivers of passenger vehicles when working in different seasons of the year. Methods: 113 drivers of AKIA (Turkey), ISUZU (Japan), LiAZ buses and TIU trolleybuses (Russia) participated in the study. Studies were carried out on the processes of body thermoregulation of drivers of passenger vehicles when working in different seasons of the year in the work shift dynamics in the city of Dushanbe. Results: It has been established that when the temperature of the outdoor air rises, there is a parallel increase in temperature in the cabin buses and trolleybuses, which leads to an increase in body temperature and average weighted skin temperature, to significant moisture loss, and also discomfort body sensation. It should be noted that when working in the warm period of the year with the increase in air temperature in the workplace, the drivers of buses AKIA, ISUZU and LiAZ observed a gradual decline in the shift of systolic pressure from an average of 116.0±2.3 to 112.8±2.2; from 120.3±3.0 to 111.8±2.93, and from 118.6±3.8 to 108.0±3.4 mm Hg, respectively, compared to the baseline levels. Conclusion: Thus, drivers of passenger vehicles perform stressful work in uncomfortable microclimatic conditions, especially when working during the warm period of the year, which causes significant tensions of thermoregulatory processes of their body. Keywords: Body temperature, skin, temperature gradient, moisture loss , heat sensation , heart rate, arterial pressure

Science and Human Animality in Mary Shelley’sFrankenstein

Science and Human Animality in Mary Shelley’s<i>Frankenstein</i>

Menopausal Hot Flashes: A Concise Review.

Hot flashes (HFs), defined as transient sensations of heat, sweating, flushing, anxiety, and chills lasting for 1–5 min, constitute one of the most common symptoms of menopause among women though only a few seek treatment for these. The basis of HFs lies in abnormal hypothalamic thermoregulatory control resulting in abnormal vasodilatory response to minor elevations of core body temperature. Recent data suggest an important role for calcitonin gene-related peptide, hypothalamic kisspeptin, neurokinin B and dynorphin signal system, serotonin, norepinephrine in causation of HFs in addition to estrogen deficiency which plays a cardinal role. The mainstay of treatment includes hormonal replacement therapy, selective serotonin, and norepinephrine reuptake inhibitors in addition to lifestyle modification. In this review, we address common issues related to menopause HFs and suggest a stepwise approach to their management.

Psychophysical and psychophysiological effects of heat stimulation by electric moxibustion

ObjectivesTraditional moxibustion might be not safe due to the excessive heat stimulation or toxic chemical components involved. Electric moxibustion (EM), which has been recently developed as an alternative, offers adjustable and constant heat stimulation. This study aimed to investigate the psychophysical and psychophysiological responses to EM heat stimulation. MethodsTwenty-seven healthy volunteers received two different levels of heat stimulation using EM. High-temperature (HT) and medium-temperature (MT) heat stimulations were randomly delivered at the TE5 acupoint on the left or right arm. Participants rated the intensity and the spatial information of the heat sensations immediately after each EM stimulation. Local blood flow around the acupoint was measured with Laser Doppler perfusion imaging before and after heat stimulation. ResultsBoth HT-EM and MT-EM induced considerable heat sensations and enhanced local blood flow around the acupoints. HT-EM resulted in greater heat sensation compared to MT-EM. HT-EM induced a higher increase in local blood flow around the stimulation site compared to MT-EM. No remarkable adverse effects were noted. ConclusionTwo different levels of EM heat stimulation induced two different levels of heat sensations and enhanced local blood flow. This preliminary study suggests that the newly developed EM can be further applied to examine the effectiveness of moxibustion in clinical trials.

Somatosensory profiles in acute herpes zoster and predictors of postherpetic neuralgia.

This prospective cohort study aimed to characterize the sensory profile during acute herpes zoster (AHZ) and to explore sensory signs as well as physical and psychosocial health as predictors for postherpetic neuralgia (PHN). Results of quantitative sensory testing of 74 patients with AHZ at the affected site and at the distant contralateral control site were compared to a healthy control group. Pain characteristics (Neuropathic Pain and Symptom Inventory and SES), physical functioning, and psychosocial health aspects (Pain Disability Index, SF-36, and STAI) were assessed by questionnaires. Patients with PHN (n = 13) at 6-month follow-up were compared to those without PHN (n = 45). Sensory signs at the affected site were thermal and vibratory hypesthesia, dynamic mechanical allodynia (DMA), pressure hyperalgesia, and high wind-up (18%-29%), as well as paradoxical heat sensations and pinprick hypalgesia (13.5%). The unaffected control site exhibited thermal and vibratory hypesthesia, DMA, and pressure hyperalgesia. Dynamic mechanical allodynia and pinprick hypalgesia were mutually exclusive. Postherpetic neuralgia was associated with DMA (38.5% vs 6.7%; P = 0.010) and vibratory hypesthesia (38.5% vs 11.1%; P = 0.036) at the control site, with mechanical gain and/or loss combined with normal thermal detection (affected site: 69.2% vs 31.1%; P = 0.023; control site: 53.8% vs 15.5%; P = 0.009). Pain Disability Index (P = 0.036) and SES affective pain perception scores (P = 0.031) were over 50% higher, and 6 of 8 SF-36 subscores were over 50% lower (P < 0.045) in PHN. Sensory profiles in AHZ indicate deafferentation and central but not peripheral sensitization. Sensory signs at distant body sites, strong affective pain perception, as well as reduced quality of life and physical functioning in the acute phase may reflect risk factors for the transition to PHN.

Effect of Heat-Producing Needling Technique on the Local Skin Temperature: Clinical Dataset

The heat-producing needling technique is a special compound manipulating procedure on the acupuncture needle which has been recorded to produce a warm sensation in the body in ancient TCM literature. This randomized, subject-blinded clinical study was performed to examine the effect of heat-producing acupuncture treatment on the ST36 local skin temperature. A total of 30 healthy participants received four successive sessions of heat-producing acupuncture treatment, non-acupoint heat-producing acupuncture treatment, normal stable acupuncture treatment, and non-invasive sham acupuncture treatment at the ST36 acupoint in a random sequence. Within each session, the local ST36 skin temperature and basal body temperature of each participant were measured at 1 min before needle insertion, just after needle insertion and manipulation (if any), 5 min after needle insertion with needle removal immediately after temperature taking, and 5 min after needle removal. Furthermore, the participants were also required to declare their needling and heat sensation felt during the acupuncture needling treatment period using a visual analogue scale from 1 to 10 immediately after each treatment session. This data descriptor presents all the clinical data obtained in the above mentioned study.

Development and initial evaluation of deqi sensation scale of heat-sensitive moxibustion

Based on heat-sensitive moxibustion (HSM) theory, a widely applicable scale was developed to reflect the deqi (arrival of qi) sensation of HSM. By documentary method and interviewing method, the items of describing deqi sensation of HSM were collected to establish the pool of candidate items. With expert questionnaire, patient questionnaire and core expert discussion, the items were screened and quantified by method of subjective evaluation to develop the initial draft of the scale. A total of 121 patients were pre-surveyed with the initial draft, and the structural validity of the scale was examined by exploratory factor analysis (principal component) and its internal consistency was assessed by Cronbach's coefficient. As a result, the items in the scale was reduced from 36 to 9; 110 effective questionnaires were reclaimed for statistical analysis. Finally, the scale (Version 1.0) contained 9 items and 4 dimensions, of which, 3 items highlighted the comfort emotional experience, 3 items highlighted autonomic response, 2 items highlighted heat sensation, and 1 item highlighted non-heat sensation. In conclusion, the deqi sensation scale of HSM containes 9 items, which has fair content and structure validity. It is in line with the current clinical understanding of deqi sensation of HSM and has strong clinical operability and wide adaptability.

Hypoxia-inducible factor 1α protects peripheral sensory neurons from diabetic peripheral neuropathy by suppressing accumulation of reactive oxygen species.

Diabetic peripheral neuropathy (DPN) is one of the most common diabetic complications. Mechanisms underlying nerve damage and sensory loss following metabolic dysfunction remain largely unclear. Recently, hyperglycemia-induced mitochondrial dysfunction and the generation of reactive oxygen species (ROS) have gained attention as possible mechanisms of organ damage in diabetes. Hypoxia-inducible factor 1 (HIF1α) is a key transcription factor activated by hypoxia, hyperglycemia, nitric oxide as well as ROS, suggesting a fundamental role in DPN susceptibility. We analyzed regulation of HIF1α in response to prolonged hyperglycemia. Genetically modified mutant mice, which conditionally lack HIF1α in peripheral sensory neurons (SNS-HIF1α-/-), were analyzed longitudinally up to 6months in the streptozotocin (STZ) model of type1 diabetes. Behavioral measurements of sensitivity to thermal and mechanical stimuli, quantitative morphological analyses of intraepidermal nerve fiber density, measurements of ROS, ROS-induced cyclic GMP-dependent protein kinase 1α (PKG1α), and levels of vascular endothelial growth factor (VEGF) in sensory neurons in vivo were undertaken over several months post-STZ injections to delineate the role of HIF1α in DPN. Longitudinal behavioral and morphological analyses at 5, 13, and 24weeks post-STZ treatment revealed that SNS-HIF1α-/- developed stronger hyperglycemia-evoked losses of peripheral nociceptive sensory axons associated with stronger losses of mechano- and heat sensation with a faster onset than HIF1αfl/fl mice. Mechanistically, these histomorphologic, behavioral, and biochemical differences were associated with a significantly higher level of STZ-induced production of ROS and ROS-induced PKG1α dimerization in sensory neurons of SNS-HIF1α-/- mice as compared with HIF1αfl/fl. We found that prolonged hyperglycemia induced VEGF expression in the sciatic nerve which is impaired in SNS-HIF1α mice. Our results indicate that HIF1α is as an upstream modulator of ROS in peripheral sensory neurons and exerts a protective function in suppressing hyperglycemia-induced nerve damage by limiting ROS levels and by inducing expression of VEGF which may promote peripheral nerve survival. Our data suggested that HIF1α stabilization may be thus a new strategy target for limiting sensory loss, a debilitating late complication of diabetes. KEY MESSAGES: • Impaired hypoxia-inducible factor 1α (HIF1α) signaling leads to early onset of STZ-induced loss of sensation in mice. • STZ-induced loss of sensation in HIF1α mutant mice is associated with loss of sensory nerve fiber in skin. • Activation of HIF1α signaling in diabetic mice protects the sensory neurons by limiting ROS formation generated due to mitochondrial dysfunction and by inducing VEGF expression.

The effect of carbetocin compared to misoprostol in management of the third stage of labor and prevention of postpartum hemorrhage: a systematic review

BackgroundPostpartum hemorrhage (PPH) and the amount of blood loss are directly related to management of the third stage of labor. No previous report has compared the effects of carbetocin to those of misoprostol. The aim of this systematic review was to compare the effects of carbetocin to those of misoprostol for management of the third stage of labor and for the prevention of PPH.MethodsWe searched the Cochrane Library (Central), Web of Science, Scopus, Science Direct, Ovid, clinicaltrial.gov, and PubMed databases on December 28, 2017. Data extraction and risk of bias assessment were performed by 2 of the authors independently. Individual and pooled incidences were calculated for the included studies, with 95% confidence intervals (CIs). We used a fixed model for forest plots without heterogeneity and a random effect model for those with heterogeneity.ResultsOur search identified 117 studies; however, 29 studies were duplicate. Of the 88 non-duplicate studies, 5 met the inclusion criteria. Of these five studies, two are currently underway. Hence, three studies were finally included in our meta-analysis. The pooled estimate of the impact of carbetocin on PPH (500–1000 ml) was (OR 0.27, 95% CI 0.14–0.50). Carbetocin significantly reduced the need for additional uterotonics (RR 0.28, 95% CI 0.15 to 0.49). Reduction in the hemoglobin level and blood loss during the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The length of the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The incidence of side effects, such as heat sensation, metallic taste, fever, and shivering, were significantly lower in women who received carbetocin than in those who received misoprostol.ConclusionAlthough this review showed that carbetocin is effective for decreasing PPH, blood loss, the length of the third stage of labor, and the need for additional uterotonics, this conclusion should be considered with caution. Because assessment of PPH is a subjective issue and it is uncertain whether outcomes were assessed blindly in respect to treatment. We recommend future research to verify our findings. Also clinicians may like to consider use of carbetocin for women with low risk for PPH.

Prolonged Sitting Interrupted by 6-Min of High-Intensity Exercise: Circulatory, Metabolic, Hormonal, Thermal, Cognitive, and Perceptual Responses.

The aim was to examine certain aspects of circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses while sitting following a brief session of high-intensity interval exercise. Twelve students (five men; age, 22 ± 2 years) performed two trials involving either simply sitting for 180 min (SIT) or sitting for this same period with a 6-min session of high-intensity exercise after 60 min (SIT+HIIT). At T0 (after 30 min of resting), T1 (after a 20-min breakfast), T2 (after sitting for 1 h), T3 (immediately after the HIIT), T4, T5, T6, and T7 (30, 60, 90, and 120 min after the HIIT), circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses were assessed. The blood lactate concentration (at T3–T5), heart rate (at T3–T6), oxygen uptake (at T3–T7), respiratory exchange ratio, and sensations of heat (T3–T5), sweating (T3, T4) and odor (T3), as well as perception of vigor (T3–T6), were higher and the respiratory exchange ratio (T4–T7) and mean body and skin temperatures (T3) lower in the SIT+HIIT than the SIT trial. Levels of blood glucose and salivary cortisol, cerebral oxygenation, and feelings of anxiety/depression, fatigue or hostility, as well as the variables of cognitive function assessed by the Stroop test did not differ between SIT and SIT+HIIT. In conclusion, interruption of prolonged sitting with a 6-min session of HIIT induced more pronounced circulatory and metabolic responses and improved certain aspects of perception, without affecting selected hormonal, thermoregulatory or cognitive functions.

Heating sensation in patients with and without spinal fixation devices during MRI examination at different magnetic field strengths.

Radiofrequency (RF) heating during MRI theoretically increases with magnetic field strength. In addition, implanted metallic devices are reported to further increase RF heating. However, a detailed evaluation of this type of heating remains scarce in clinical practice. To assess possible risks and discomfort related to RF heating during MRI examinations of patients with and without metallic implantable devices. A retrospective study of previous questionnaire results on the heating sensation during MRI examinations of the lumbar spine. In all, 715 patients, of whom 101 had implanted lumbar spine fixation devices. 1T and 3T/T1 - and T2 -weighted imaging. The number of patients who perceived heating around the lumbar spine or other regions during the MRI examination. A chi-square test with respect to static field strength B0 , presence of lumbar spine fixation devices, and duration of the MRI examination. The number of patients who perceived heating around the lumbar spine during the MRI examination significantly increased from 5.0% at 1T to 47.5% at 3T (P < 0.001), without a significant difference between patients with and without lumbar spine fixation devices (P = 0.23 at 1T, P = 0.48 at 3T), and regardless of the duration of the MRI examination (P = 0.88 at 1T, P = 0.15 at 3T). Sensation of RF heating increased by around 10 times from 1T to 3T MRI examination, but the influence of implanted lumbar spine fixation devices on the RF heating sensation has not been observed. 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:525-533.

Panic disorders: The role of genetics and epigenetics.

Panic disorder is characterized by symptoms with abrupt surges of fear with palpitations, sweating, trembling, heat sensations. Considering its disease burden on each individual and on society, understanding its etiology is important. Though no one specific etiology has been known, like other psychiatric disorders, multiple factors such as genetic, environmental, neurobiological, psychopathological factors have been suggested. In this article, we reviewed currently known etiologies and related study results, regarding especially genetic and epigenetic aspects of the panic disorder. Early studies, including twin studies, family studies, adoption studies suggested highly familial trait of panic disorder. Linkage studies, either, found panic disorder is not a single gene disorder but confirmed existence of multiple related genes. Chromosome and candidate gene studies found few related genes, NPY, ADORA2A, COMT, IKBKE. Newer method, genome-wide association studies (GWAS) have been searching for newer genes. No genome-wide significant genes, however, were detected, confirming previously known candidate genes, NPY5R on 4q31.3-32, BDKRB2 on 14q32, instead. Epigenetic modification has also been studied on many different psychiatric disorders. Monoamine oxidase A (MAOA) hypomethylation, taken together with negative life events, showed relation with panic disorder. Glutamate decarbodylases 1 (GAD1) hypomethylation was also specific on panic disorder patients. Relation with noradrenaline transporter (NET) gene SLC6a2 promoter methylation has also been studied. In conclusion, no specific gene or epigenetic pattern can fully explain etiology of panic disorder. Few genes and epigenetic patterns, however, showed strong association with panic disorder compared to healthy controls. Considering its multivariable background, further studies with larger populations can confirm current results and clarify etiologies of panic disorder.

Study of Body Temperature Change after CT Contrast Media Injection

목적: 조영제 주입 후 발생하는 과민반응 중 환자의 열감은 가장 빈번히 발생하는 부작용중 하나로 실제 환자의 체온 측정을 통해 이 열감이 체온의 상승으로 나타나는지 확인해보고자 한다. 대상 및 방법: 2017년 8월 1일부터 2017년 12월 31일까지 Neck CT (contrast)검사를 시행한 100명의 환자를 대상으로 검사전 액와와 이마(오른쪽 눈썹)의 체온을 기준으로 하여 조영제 주입 후 2분(min)까지 10초 간격으로 측정하였다. 조영제 주입속도 (m/sec)와 양(ml)은 본원의 프로토콜 규정에 따라 2.7m/sec와 90ml로 고정하였다. 측정된 결과는 검사 전 측정값을 T0, 조영제 주입 후부터 30초까지를 T1, 40~70초까지 T2, 80~100초까지를 T3로 구분하여 통계적 분석을 통해 온도변화를 확인하였다. 검사 종료 후 열감의 유무와 정도를 알아보기 위에 리커트 척도(5점)로 기록하였다. 결과: 조영제 주입 시 100명중 88명(88%)이 열감을 느꼈고, 열감의 정도는 리커트 척도 5점기준 3.04점이 나왔다. 이 열감을 실제 측정해본 결과 T0 36.51℃을 기준으로 하였을 때 조영제 주입 후 30초까지 T1에서는 36.53℃로 체온의 변화가 없었고, 40~70초까지 T2에서는 36.72℃로 약 0.22℃ 체온이 상승하였다. 80~100초 구간(T3)은 36.75℃로 T2구간의 체온과 거의 비슷하게 유지되었다. 이 결과는 액와와 이마부위 두 군데 모두 거의 일치하였다. 결론: 조영제 주입으로 인한 열감은 100% 신체의 체온변화로 나타난다는 결과는 유추할 수 없었으나, 대부분의 환자에서 온도 변화를 발견할 수 있었다.Purpose: The heat sensation of the patient during hypersensitivity reactions after contrast media injection is one of the most frequent side effects. The actual patient s body temperature is measured to ascertain whether this heat sensation is caused by a rise in body temperature. Material and methods: A total of 100 patients who underwent Neck CT (contrast) test from August 1, 2017 to December 31, 2017 were measured for pre-test body temperature of axillary and forehead (right eyebrow) at intervals of 10 seconds after the injection of contrast agent. The contrast agent injection rate (m/sec) and volume (ml) were fixed at 2.7 m/sec and 90 ml according to the hospital’s protocol of this application. The measured results were divided into T0, before measurement, T1 for 30 seconds after the injection of contrast agent, T2 for 40 to 70 seconds, and T3 for 80 to 100 seconds and the temperature change was confirmed through statistical analysis. To determine the presence and degree of heat sensitivity after the test, it was recorded by a Likert scale (5 points). Result: 88 patients (88%) felt the feeling of heat, and the degree of sensation of heat was 3.04 points on the 5 points of the Likert scale. The result of the actual measurement of the heat sensation shows that there was no change in body temperature at T1 with 36.53°C for 30 seconds after injection of contrast agent, and at T2 with 36.72°C, an increase of 0.25°C during 40 to 70 seconds. The interval between 80 and 100 seconds (T3) was 36.75℃, which was almost similar to the T2 interval temperature. The results were almost identical in both axillary and forehead areas. Conclusion: It could not be referred from the results that the body temperature must change by heat sensation after injectiong contrast media. However, it was found that body temperature was changed in most patients.

SIGMA-1 Receptor Gene Variants Affect the Somatosensory Phenotype in Neuropathic Pain Patients

Pain sensitivity is characterized by interindividual variability, determined by factors including genetic variation of nociceptive receptors and pathways. The sigma-1 receptor (SIGMAR1) is involved in pain modulation especially under pre-sensitized conditions. However, the contribution of SIGMAR1 genetic variants to pain generation and sensitivity is unknown yet. This study aimed to identify effects of 5 SIGMAR1 variants on the somatosensory phenotype of neuropathic pain patients (n = 228) characterized by standardized quantitative sensory testing. Principal component analysis revealed that the SIGMAR1 variants −297G>T (rs10814130) and 5A>C (rs1800866) significantly lowered thermal detection and heat/pressure nociception in particular in neuropathic pain patients with mainly preserved somatosensory function. Compared to wild-type, the variant allele −297T was associated with loss of warm detection (P = .049), lower heat-pain sensitivity (P = .027) and wind-up ratio (P = .023) as well as increased paradoxical heat sensation (P = .020). Likewise for 5A>C the strongest genotype-associated differences observed were reduced peripheral (less heat hyperalgesia; P = .026) and central sensitization (lower mechanical pain sensitivity; P = .026) in variant compared to wild-type carriers. This study indicates lack of association of SIGMAR1 −297G>T and 5A>C genetic variants to susceptibility to develop chronic pain, but significant modulation of somatosensory function in neuropathic pain patients. PerspectiveThis article presents the first study indicating a modulation of somatosensory function in neuropathic pain patients by selected genetic variants in SIGMAR1. As our findings could contribute to the explanation of interindividual differences in drug response they might help to improve the treatment of neuropathic pain.

Somatic complaints in children and adolescents with social anxiety disorder.

SummaryBackgroundAssociations of social anxiety disorder (SAD) with various somatic symptoms have been already reported in the literature several times. The present study investigated somatic complaints in children and adolescents with SAD compared to controls and evaluated the relationship between social anxiety and somatic symptom severity.MethodsThirty children and adolescents with SAD were compared with 36 healthy age-matched controls. Self-reported fears were assessed using the Phobiefragebogen für Kinder und Jugendliche (PHOKI); emotional and behavioral problems were assessed using the Child Behavior Checklist (CBCL/4-18); and the Gießener Beschwerdebogen für Kinder und Jugendliche (GBB-KJ) was used to assess 59 somatic symptoms.ResultsParents and youth with SAD reported higher somatic symptom severity compared to controls. Youth with SAD more frequently reported stomach pain, circulatory complaints, and fatigue than controls. Specific group differences between SAD and control youth were found for the following single somatic symptoms: faintness, quickly exhausted, sensation of heat, stomachache, nausea, dizziness, and sudden heart complaints. Parents of girls with SAD reported higher somatic symptom severity than parents of boys with SAD.ConclusionsThe results demonstrated a significant positive association between somatic symptoms and social anxiety in youth. The results of the present study can help to develop improved screening measurements, which increase the proportion of children and adolescents with SAD receiving proper treatment.