Noxious counterirritation in patients with advanced osteoarthritis of the knee reduces MCC but not SII pain generators: A combined use of MEG and EEG

Chronic pain is mainly a result of two processes: peripheral and central sensitization, which can result in neuroplastic changes. Previous psychophysical studies suggested a decrease of the so-called pain-inhibiting-pain effect (DNIC) in chronic pain patients. We aimed to study the DNIC effect on the neuronal level using magnetoencephalography and electroencephalography in 12 patients suffering from advanced unilateral knee osteoarthritis (OA). DNIC was induced in patients by provoking the typical OA pain by a slightly hyperextended joint position, while they received short electrical pain stimuli. Although the patients did not report a reduction of electrical pain perception, the cingulate gyrus showed a decrease of activation during provoked OA pain, while activity in the secondary somatosensory cortex did not change. Based on much stronger DNIC induction at comparable intensities of an acute counterirritant pain in healthy subjects this result suggests a deficit of DNIC in OA patients. We suggest that the strength of DNIC is subject to neuronal plasticity of descending inhibitory pain systems and diminishes during the development of a chronic pain condition

Ammonia emissions in Europe, part I: Development of a dynamical ammonia emission inventory

Nitrogen input from agricultural ammonia emissions into the environment causes numerous environmental and health problems. The purpose of this study is to present and evaluate an improved ammonia emission inventory based on a dynamical temporal parameterization suitable to compare and assess ammonia abatement strategies. The setup of the dynamical time profile (DTP) consists of individual temporal profiles for ammonia emissions, calculated for each model grid cell, depending on temperature, crop type, fertilizer and manure application, as well as on local legislation. It is based on the method of Skjøth et al., 2004 and Gyldenkærne et al., 2005. The method has been modified to cover the study area and to improve the performance of the emission model. To compare the results of the dynamical approach with the results of the static time profile (STP) the ammonia emission parameterizations have been implemented in the SMOKE for Europe emission model. Furthermore, the influence on secondary aerosol formation in the North Sea region and possible changes triggered through the use of a modified temporal distribution of ammonia emissions were analysed with the CMAQ chemistry transport model. The results were evaluated with observations of the European Monitoring and Evaluation Programme (EMEP). The correlation coefficient of NH3 improved significantly for 12 out of 16 EMEP measurement stations and an improvement in predicting the Normalized Mean Error can be seen for particulate NH4+ and NO3−. The prediction of the 95th percentile of the daily average concentrations has improved for NH3, NH4+ and NO3−. The NH3 concentration modelled with the STP is 157% higher in winter, and about 22% lower in early summer than the one modelled with the new DTP. Consequently, the influence of the DTP on the formation of secondary aerosols is particularly noticeable in winter, when the PM2.5 concentration is 25% lower in comparison to the use of STP for temporal disaggregation. Besides, the formation of particulate SO42− is not influenced by the use of the DTP

MODELLING OF BENZO(A)PYRENE CONCENTRATIONS IN NORTH SEA COASTAL AREAS: CONTRIBUTION OF SHIP EMISSIONS

The effect of benzo(a)pyrene (BaP) ship emissions in the greater North Sea region is investigated in this study. The carcinogenic BaP which belongs to the group of polycyclic aromatic hydrocarbons (PAHs) occurs mainly particle bound at temperatures prevailing in the mid-latitudes. The BaP concentration and deposition distribution is investigated by means of the Community Multiscale Air Quality modelling system (CMAQ). CMAQ is a chemistry transport model developed by the US EPA that is here set up on a 54x54 km2 grid for Europe. Two different model runs, one excluding and one including ship emissions were performed for January and July 2000. For a sensitivity study three additional model runs considering also ship emissions of NOx, SO2, and PM10 were performed for January 2000. It is shown that the contribution of BaP ship emissions to the total BaP emissions is generally small but shows a noticeable seasonal variation. Furthermore, the sensitivity study shows indirect effects of other ship emissions on BaP concentration and deposition over land that are larger than those by the added BaP ship emissions alone

Oedema of the metatarsal heads II-IV and forefoot pain as an unusual manifestation of Lyme disease: a case report

We report the case of a healthy 36 year old man who suffered from foot pain lasting for weeks, without having a specific medical history relating to it. The clinical evaluation was interpreted as a transfer metatarsalgia caused by a splayfoot. The radiographs revealed no pathology except the splayfoot deformity. Due to persistent pain and swelling of the entire forefoot, after two weeks of conventional treatment, magnet resonance images (MRI) and a blood sample were taken. The laboratory investigation showed raised levels of white blood cell count and C-reactive protein. The MRI showed up oedema in the metatarsal heads II-IV, as well as soft tissue swelling of the forefoot without any signs of decomposition

The ash dispersion over Europe during the Eyjafjallajökull eruption e Comparison of CMAQ simulations to remote sensing and air-borne in-situ observations

The dispersion of volcanic ash over Europe after the outbreak of the Eyjafjallajökull on Iceland on 14 April 2010 has been simulated with a conventional three-dimensional Eulerian chemistry transport model system, the Community Multiscale Air Quality (CMAQ) model. Four different emission scenarios representing the lower and upper bounds of the emission height and intensity were considered. The atmospheric ash concentrations turned out to be highly variable in time and space. The model results were compared to three different kinds of observations: Aeronet aerosol optical depth (AOD) measurements, Earlinet aerosol extinction profiles and in-situ observations of the ash concentration by means of optical particle counters aboard the DLR Falcon aircraft. The model was able to reproduce observed AOD values and atmospheric ash concentrations. Best agreement was achieved for lower emission heights and a fraction of 2% transportable ash in the total volcanic emissions. The complex vertical structure of the volcanic ash layers in the free troposphere could not be simulated. Compared to the observations, the model tends to show vertically more extended, homogeneous aerosol layers. This is caused by a poor vertical resolution of the model at higher altitudes and a lack of information about the vertical distribution of the volcanic emissions. Only a combination of quickly available observations of the volcanic ash cloud and atmospheric transport models can give a comprehensive picture of ash concentrations in the atmosphere

Primary pyogenic spondylitis following kyphoplasty: a case report

<p>Abstract</p> <p>Introduction</p> <p>Only ten cases of primary pyogenic spondylitis following vertebroplasty have been reported in the literature. To the best of our knowledge, we present the first reported case of primary pyogenic spondylitis and spondylodiscitis caused by kyphoplasty.</p> <p>Case presentation</p> <p>A 72-year old Caucasian man with an osteoporotic compression fracture of the first lumbar vertebra after kyphoplasty developed sensory incomplete paraplegia below the first lumbar vertebra. This was caused by myelon compression following pyogenic spondylitis with a psoas abscess. Computed tomography guided aspiration of the abscess cavity yielded group C <it>Streptococcus</it>. The psoas abscess was percutaneously drained and laminectomy and posterior instrumentation with an internal fixator from the eleventh thoracic vertebra to the fourth lumbar vertebra was performed. In a second operation, corpectomy of the first lumbar vertebra with cement removal and fusion from the twelfth thoracic vertebra to the second lumbar vertebra with a titanium cage was performed. Six weeks postoperatively, the patient was pain free with no neurologic deficits or signs of infection.</p> <p>Conclusion</p> <p>Pyogenic spondylitis is an extremely rare complication after kyphoplasty. When these patients develop recurrent back pain postoperatively, the diagnosis of pyogenic spondylitis must be considered.</p

NAD+ protects against EAE by regulating CD4+ T-cell differentiation

CD4+ T cells are involved in the development of autoimmunity, including multiple sclerosis (MS). Here we show that nicotinamide adenine dinucleotide (NAD+) blocks experimental autoimmune encephalomyelitis (EAE), a mouse model of MS, by inducing immune homeostasis through CD4+IFNγ+IL-10+ T cells and reverses disease progression by restoring tissue integrity via remyelination and neuroregeneration. We show that NAD+ regulates CD4+ T-cell differentiation through tryptophan hydroxylase-1 (Tph1), independently of well-established transcription factors. In the presence of NAD+, the frequency of T-bet−/− CD4+IFNγ+ T cells was twofold higher than wild-type CD4+ T cells cultured in conventional T helper 1 polarizing conditions. Our findings unravel a new pathway orchestrating CD4+ T-cell differentiation and demonstrate that NAD+ may serve as a powerful therapeutic agent for the treatment of autoimmune and other diseases