Neuronal circuitry for pain processing in the dorsal horn

Neurons in the spinal dorsal horn process sensory information, which is then transmitted to several brain regions, including those responsible for pain perception. The dorsal horn provides numerous potential targets for the development of novel analgesics and is thought to undergo changes that contribute to the exaggerated pain felt after nerve injury and inflammation. Despite its obvious importance, we still know little about the neuronal circuits that process sensory information, mainly because of the heterogeneity of the various neuronal components that make up these circuits. Recent studies have begun to shed light on the neuronal organization and circuitry of this complex region

Monoclonal antibodies against carbohydrate differentiation antigens identify subsets of primary sensory neurones.

Dorsal root ganglion (DRG) neurones transmit cutaneous sensory information from the periphery to the spinal cord. Within the dorsal horn of the spinal cord, classes of sensory fibres that are activated by different cutaneous stimuli terminate in separate and highly restricted laminae. Although the developmental events resulting in the laminar organization of sensory afferent terminals have not been defined, it is likely that interactions between surface molecules on DRG and dorsal horn neurones are involved in the generation of afferent synaptic connections. The identification of surface antigens that distinguish functional subclasses of DRG neurones would represent a first step in establishing the existence and nature of such molecules. We report here that monoclonal antibodies directed against carbohydrate differentiation antigens identify cytoplasmic and cell surface molecules expressed selectively by functional subsets of DRG neurons

Associations between untreated depression and secondary health care utilization in patients with hypertension and/or diabetes

Purpose. We determined the prevalence of untreated depression in patients with hypertension (HT) and/or diabetes (DM) and estimated the extra health care use and expenditures associated with this comorbidity in a rural Hungarian adult population. We also assessed the potential workload of systematic screening for depression in this patient group.Methods. General health check database from a primary care programme containing survey data of 2027 patients with HT and/or DM was linked to the outpatient secondary care use database of National Institute of Health Insurance Fund Management. Depression was ascertained by Beck Depression Inventory score and antidepressant drug use. The association between untreated depression and secondary healthcare utilization indicated by number of visits and expenses was evaluated by multiple logistic regression analysis controlled for socioeconomic/lifestyle factors and comorbidity. The age-, sex- and education-specific observations were used to estimate the screening workload for an average general medical practice.Results. The frequency of untreated depression was 27.08%. The untreated severe depression (7.45%) was associated with increased number of visits (OR 1.60, 95% CI 1.11?2.31) and related expenses (OR 2.20, 95% CI 1.50?3.22) in a socioeconomic status-independent manner. To identify untreated depression cases among patients with HT and/or DM, an average GP has to screen 42 subjects a month.Conclusion. It seems to be reasonable and feasible to screen for depression in patients with HT and/or DM in the primary care, in order to detect cases without treatment (which may be associated with increase of secondary care visits and expenditures) and to initiate the adequate treatment of them