Preterm newborn adaptive responses to daily nursing, during NICU stay, associate with the neurodevelopment, two years later

Objective: To evaluate if adaptive responses of very preterm newborns to NICU daily nursing, specifically bathing and weighing procedures, are associated with their neurodevelopment two years later. Study design: Twenty-six very preterm newborns, with a gestational age < 32 weeks, were enrolled. Infants' adaptive responses to daily nursing were evaluated, at 30-32-35 postmenstrual age (PMA) weeks, by an observational sheet. Neurodevelopment was assessed, at 24 months of corrected age, by the Bayley Scales of Infant and Toddler Development, third edition. Autonomic, motor, and self-regulatory responses to NICU nursing were analyzed, by Spearman's correlation coefficient and multivariate linear regression, with Bayley’s cognitive, language, and motor scales. Results: Significant (P < 0.05) positive correlations of self-regulatory and autonomic responses to nursing with all Bailey’s scales were found at 30- and 32-weeks PMA. At 35 weeks PMA, only self-regulatory responses had significant positive correlations with all Bailey’s scales. When adjusted for birth weight and sex, the significant associations were confirmed only at 30- and 32-weeks PMA. Conclusion: Very preterm newborn adaptive responses to NICU daily nursing reveal to be positively related to forthcoming neurodevelopment two years later, as early as the 30th week PMA. Helping preterm babies to adapt to daily NICU nursing may promote their future neurobeahaviour.

Recurrent soft tissue infections associated with complex regional pain syndrome type ll: Reports of two unusual cases

Complex Regional Pain Syndrome (CRPS) (Synonyms: Reflex Sympathetic Dystrophy, Causalgia, Sudeck’s atrophy, Algodystrophy) is a chronic neurological condition, usually involving the limbs, that is characterized by severe pain along with sensory, autonomic, motor and trophic involvement. CRPS type ll is when there is an identifiable preceding event causing nerve damage. We present 2 unusual cases: 1. spontaneous bleeding from left leg associated with recurrent infections 2. a calcified mass in abdominal wall with recurrent infections. Recurrent soft tissue infections are rare in CRPS. Both presentations were unique.

Diagnostic and Treatment Approaches Involving Transthyretin in Amyloidogenic Diseases

Transthyretin (TTR) is a thyroid hormone-binding protein which transports thyroxine from the bloodstream to the brain. The structural stability of TTR in tetrameric form is crucial for maintaining its original functions in blood or cerebrospinal fluid (CSF). The altered structure of TTR due to genetic mutations or its deposits due to aggregation could cause several deadly diseases such as cardiomyopathy and neuropathy in autonomic, motor, and sensory systems. The early diagnoses for hereditary amyloid TTR with cardiomyopathy (ATTR-CM) and wild-type amyloid TTR (ATTRwt) amyloidosis, which result from amyloid TTR (ATTR) deposition, are difficult to distinguish due to the close similarities of symptoms. Thus, many researchers investigated the role of ATTR as a biomarker, especially its potential for differential diagnosis due to its varying pathogenic involvement in hereditary ATTR-CM and ATTRwt amyloidosis. As a result, the detection of ATTR became valuable in the diagnosis and determination of the best course of treatment for ATTR amyloidoses. Assessing the extent of ATTR deposition and genetic analysis could help in determining disease progression, and thus survival rate could be improved following the determination of the appropriate course of treatment for the patient. Here, the perspectives of ATTR in various diseases were presented.

Pain Perception and Response: Central Nervous System Mechanisms

ABSTRACT:Although several decades of studies have detailed peripheral and ascending nociceptive pathways to the thalamus and cerebral cortex, pain is a symptom that has remained difficult to characterize anatomically and physiologically. Positron emission tomography (PET) and functional magnetic imaging (fMRI) have recently demonstrated a number of cerebral and brain stem loci responding to cutaneous noxious stimuli. However, intersubject variability, both in the frequency and increased or decreased intensity of the responses, has caused uncertainty as to their significance. Nevertheless, the large number of available imaging studies have shown that many areas with recognized functions are frequently affected by painful stimuli. With this evidence and recent developments in tracing central nervous system connections between areas responding to noxious stimuli, it is possible to identify nociceptive pathways that are within, or contribute to, afferent spinothalamo-cortical sensory and efferent skeletomotor and autonomic motor systems. In this study it is proposed that cortical and nuclear mechanisms for pain perception and response are hierarchically arranged with the prefrontal cortex at its highest level. Nevertheless, all components make particular contributions without which certain nociceptive failures can occur, as in pathological pain arising in some cases of nervous system injury.