Pain patterns and descriptions in patients with radicular pain: Does the pain necessarily follow a specific dermatome?

<p>Abstract</p> <p>Background</p> <p>It is commonly stated that nerve root pain should be expected to follow a specific dermatome and that this information is useful to make the diagnosis of radiculopathy. There is little evidence in the literature that confirms or denies this statement. The purpose of this study is to describe and discuss the diagnostic utility of the distribution of pain in patients with cervical and lumbar radicular pain.</p> <p>Methods</p> <p>Pain drawings and descriptions were assessed in consecutive patients diagnosed with cervical or lumbar nerve root pain. These findings were compared with accepted dermatome maps to determine whether they tended to follow along the involved nerve root's dermatome.</p> <p>Results</p> <p>Two hundred twenty-six nerve roots in 169 patients were assessed. Overall, pain related to cervical nerve roots was non-dermatomal in over two-thirds (69.7%) of cases. In the lumbar spine, the pain was non-dermatomal in just under two-thirds (64.1%) of cases. The majority of nerve root levels involved non-dermatomal pain patterns except C4 (60.0% dermatomal) and S1 (64.9% dermatomal). The sensitivity (SE) and specificity (SP) for dermatomal pattern of pain are low for all nerve root levels with the exception of the C4 level (Se 0.60, Sp 0.72) and S1 level (Se 0.65, Sp 0.80), although in the case of the C4 level, the number of subjects was small (n = 5).</p> <p>Conclusion</p> <p>In most cases nerve root pain should not be expected to follow along a specific dermatome, and a dermatomal distribution of pain is not a useful historical factor in the diagnosis of radicular pain. The possible exception to this is the S1 nerve root, in which the pain does commonly follow the S1 dermatome.</p

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

High percentage of regeneration and transformation in chickpea

Efficient tissue culture and gene transfer systems of Cicer arietinum L. cvs. Red chickpea, Canitez 87 and MB-10 varieties were established. The explants were taken from the shoot primordium part of the mature embryo. For callus induction MS+0.1 mg/l NAA+ 0.5 mg/l 2,4-D and for plant regeneration MS+0.2 mg/l IAA+ 0.5 mg/l Kn+ 0.2 mg/l 6-BAP containing media were used. Best regeneration response was for the MB-10 variety (85%). Young and wounded regenerated shoots were co-cultivated with A. tumefaciens 4404 and A. rhizogenes 9402 both containing pBI-121 plasmids. Explants cocultivated with A. tumefaciens produced crown gall and plantlets on selective media. However, applications with A. rhizogenes produced hairy roots. The existence of GUS and NPT II genes in the DNA isolated from plantlets and hairy roots was confirmed with Southern blot and digoxigenin labeling. The best transformation response was in Canitez 87 (12.7%) with A. tumefaciens and MB-10 variety (10.4%) with A. rhizogenes

High frequency plant regeneration from nodal explants of Paulownia elongata

High frequency of plant regeneration from Paulownia elongata was obtained on Murashige and Skoog (MS) medium and Woody Plant Medium (WPM), with appropriate supplements of growth regulators. Leaves, leaves with petioles, internodes and nodes excised from 3-month-old non-aseptically grown P. elongata were used as explants. The highest shoot regeneration efficiency (93.7%) was obtained from the nodes of P. elongata on MS medium supplemented with 0.1 mg/ml naphthaleneacetic acid (NAA) and 1 mg/ml 6-benzylaminopurine (BAP). The highest root formation efficiency (100%) from the regenerated shoots was obtained on WPM supplemented with 1 mg/ml indolebutyric acid (IBA). Rooted plantlets were transplanted to soil with a survival efficiency of almost 100%. The regeneration system reported here could be useful for rapid multiplication of elite genotypes of P. elongata in a short period of time

TRANSFORMATION OF POTATO (SOLANUM-TUBEROSUM L) USING TUBER DISCS AND STEM EXPLANTS

Transformation of three potato cultivars (Desiree, Isola and Anac) was achieved using tuber discs and callus tissue derived from cultured stems via co-cultivation with Agrobacterium tumafaciens Ti plasmid based vectors. Neomycin phosphotransferase (NPT II) marker and beta-glucuronidase (GUS) reporter genes were used in transfer-optimization studies. First selection of transgenics was done on selective Murashige and Skoog (MS) media containing 100 mg/l kanamycin and 500 mg/l cefotaxime. Histochemical assays were done for GUS activity using X-Gluc substrat. In addition polymerase chain reaction based Southern blot analyses revealed the existence of the transferred genes. The highest transformation frequency (10%) was obtained with cultivar Desiree in MS media supplied with 5 mg/l zeatin riboside and 1.5 mg/l indolacetic acid However; Anac gave the lowest frequency using tuber discs (3% and stem explants (2%). This protocol could be useful for the improvement of potato through gene manipulation

Direct and indirect plant regeneration from various explants of eastern cottonwood clones (Populus deltoides Bartram ex Marsh.) with tissue culture

Populus species are important resource for certain branches of industry and have special roles for scientific study on biological and agricultural systems. Plant regeneration via direct and indirect organogenesis of four Populus deltoides Bartram ex Marsh. ssp. deltoides × Populus deltoides Bartram ex Marsh. ssp. deltoides hybrid clones (89 M 011, 89 M 044, 89 M 048, 89 M 066) and P. deltoides ssp. deltoides clone (Samsun) were investigated. Direct organogenesis was established from nodes and internodes on woody plant medium (WPM) supplemented with cytokinins and/or auxins. The 89 M 011 clone gave the highest percentage (100%) of regeneration on WPM with 1 mg/l zeatine from internode explants. Indirect organogenesis via callus phase was obtained from nodes and petioles on WPM supplemented with different concentrations of 2,4-Dichlorophenoxy acetic acid (2,4-D). The nodes part of the 89 M 066 clone gave the highest rate of generative callus (100%)  on WPM supplemented with 2 mg/l 2,4-D. Indirect shoots were obtained from the node callus on WPM with cytokinins. There was root formation from directly regenerative shoots which were cultured on WPM or Murashige and Skoog Basal Medium (MS) containing different ratios of indole butyric acid (IBA). Rooted seedlings in vitro were successfully acclimatized. Data on in vitro study were subjected to statistical evaluation. The in vitro regeneration system will allow this study to set reliable procedures for the genus and clones.Key words: Poplar, tissue culture, regeneration, organogenesis