Functional and anatomical deficits in visceral nociception with age: a mechanism of silent appendicitis in the elderly?

The ability to sense visceral pain during appendicitis is diminished with age leading to delay in seeking health care and poorer clinical outcomes. To understand the mechanistic basis of this phenomenon, we examined visceral nociception in aged mouse and human tissue. Inflamed and noninflamed appendixes were collected from consenting patients undergoing surgery for the treatment of appendicitis or bowel cancer. Supernatants were generated by incubating samples in buffer and used to stimulate multiunit activity in intestinal preparations, or single-unit activity from teased fibres in colonic preparations, of young and old mice. Changes in afferent innervation with age were determined by measuring the density of calcitonin gene-related peptide-positive afferent fibres and by counting dorsal root ganglia back-labelled by injection of tracer dye into the wall of the colon. Finally, the effect of age on nociceptor function was studied in mouse and human colon. Afferent responses to appendicitis supernatants were greatly impaired in old mice. Further investigation revealed this was due to a marked reduction in the afferent innervation of the bowel and a substantial impairment in the ability of the remaining afferent fibres to transduce noxious stimuli. Translational studies in human tissue demonstrated a significant reduction in the multiunit but not the single-unit colonic mesenteric nerve response to capsaicin with age, indicative of a loss of nociceptor innervation. Our data dem...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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Publication date: Available online 3 June 2020Source: Journal of the American College of RadiologyAuthor(s): Ruth C. Carlos, Katy Lowry, Gelareh Sadigh
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
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Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Cerebral Palsy Source Type: research
Conclusion: There are several risk factors for subsequent contralateral SCFE. On the basis of the available data, younger patients with a high PSA of the unaffected hip would most likely benefit from prophylactic fixation of the unaffected hip. Level of Evidence: Level II.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Hip Source Type: research
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Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
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Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
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Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
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Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Conclusion. Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of IDH. Results showed significantly greater improvements in patients treated surgically. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Conclusion. Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of spinal stenosis. Results showed significantly greater improvement through 4 year follow up in those patients that received surgical treatment, however the difference between the surgical and nonsurgical groups diminished at 8 year follow up. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Study Design. Retrospective, database review. Objective. The purpose of this study was to explore the association between preoperative opioid use and postoperative infection requiring operative wound washout in elective lumbar fusion patients. Summary of Background Data. Numerous peer-reviewed publications have conducted multivariate analyses of risk factors for surgical site infection. However, few have explored preoperative opioid use. Opioids have been widely prescribed preoperatively for pain management, but their effect on postsurgical infection is currently inconclusive. Methods. We retrospectively queried...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
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