Acute inflammation and risk factors for complex regional pain syndrome

An aberrant immune response to injury has been implicated in the pathogenesis of complex regional pain syndrome (CRPS). However, there has been very little investigation of the normal response to injury, and no investigation of the potential relationship between acute inflammation after injury and the known risk factors for CRPS. The central aim of this thesis was to address this gap, thereby facilitating the investigation of the role of acute inflammation in the subsequent development of CRPS. Study 1 used a systematic review and meta-analysis to identify the immune markers associated with CRPS. Study 2 applied Rasch analysis to examine the psychometric properties of the Depression Anxiety and Stress Scales (DASS-21), the most suitable tool for a subsequent study, but one that has not been fully tested. Study 3 was an experiment designed to measure the effect of blood sample type and thaw-freeze cycles on cytokine concentrations. Study 4 replicated the sampling and analysis methods of Study 3, in a cross-sectional study of 240 blood samples, to characterise inflammation in the first 28 days after a fracture. Study 5 was a cross-sectional study designed to investigate the relationships between acute inflammation after a fracture and the risk factors for the development of CRPS. This thesis showed that established CRPS is associated with a pro-inflammatory cytokine balance and revealed new information about different inflammatory profiles that are associated with different durations of the disorder. By applying best practice methods, based on the outcomes of Studies 2 and 3, this thesis showed that in the acute post-fracture stage, the chemokines IP-10 and eotaxin are associated with pain intensity, which is reported to be the strongest predictor of who will develop CRPS. By characterising the normal response to a fracture, the most common risk factor for CRPS, and relating it to other risk factors for CRPS, the current thesis provides the critical platform from which to investigate the relationship between acute stage inflammation and the subsequent development of CRPS

Analysis of qualitative criteria for railway passenger transport between chosen voivodeship cities

The article presents an attempt to use synthetic and partial qualitative criteria to analyse the qualitative workings of railway transport enterprises providing passenger transport on the Kraków–Katowice route. Both cities are capitals of the largest industrial, scientific, cultural, touristic and trade centres in the south of Poland. They are placed a small distance from each other, and thanks to a well developed road and railway net, a quick journey between those cities is theoretically possible

Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity

The purpose of this longitudinal blood sampling study was to examine relationships between sex hormones and fibromyalgia pain. Eight women meeting case definition criteria for fibromyalgia provided venous blood samples and reported their fibromyalgia pain severity over 25 consecutive days. All women exhibited normal menstrual cycles and were not taking oral contraceptives. Corti- sol, and the sex hormones estradiol, progesterone, and testosterone, were assayed from serum. A linear mixed model was used to determine if fluctuations of sex hormones were associated with changes in pain severity. In the entire sample, day to day changes in progesterone (P = .002) as well as tes- tosterone (P = .015) were significantly and inversely correlated with pain severity. There was no relationship between estradiol and pain (P = .551) or cortisol and pain (P = .633). These results suggest that progesterone and testosterone play a protective role in fibromyalgia pain severity. Sex and other hormones may serve to increase as well as decrease fibromyalgia pain severity.Publisher PDFPeer reviewe

Functional changes in the primary somatosensory cortex in complex regional pain syndrome (CRPS): A systematic review

The brain plays a key role in CRPS. A widely-studied brain region in pain research is the primary somatosensory cortex (S1), a somatotopic map of our body’s surface which functionally reorganises in pain [1]. Changes in the S1 representation of the CRPS-affected body part have contributed to new CRPS treatments, e.g. graded motor imagery. This systematic review and meta-analysis aimed to determine whether CRPS is associated with: a) a change in the size of the S1 representation of the affected body part; b) altered S1 activity, in terms of activation levels and latency of responses

Changes in the clinical characteristics of women with gestational diabetes mellitus : a retrospective decade-long single center analysis

Aims: Gestational diabetes mellitus (GDM) is an emerging worldwide problem. Changes in clinical characteristics of women affected by GDM in a long-term perspective are still not properly investigated. We aimed to examine such changes over a decade in a retrospective single-center analysis. Methods: The medical documentation from Department of Metabolic Diseases, Krakow, Poland was analyzed. We included 633 women consecutively diagnosed with GDM in one of three time intervals: 2007-2008 (N = 157), 2012-2013 (N = 272), 2016-2017 (N = 234). Statistical analyses were performed. Results: Comparison of the three groups identified differences in the mean age of women at the GDM diagnosis (30.7 ± 5.0 years vs. 31.2 ± 4.7 vs. 32.5 ± 4.7, respectively, starting from the earliest 2007-2008 group), pregnancy week at GDM diagnosis (28.0 ± 5.3 wks. vs. 25.9 ± 4.9 vs. 23.4 ± 6.8), the proportion of women diagnosed before the 24th week of pregnancy (12.8% vs. 16.5% vs. 31.3%), and gestational weight gain (12.4 ± 5.0 kg vs. 10.4 ± 5.2 vs. 10.0 ± 5.7); (p = 0.001 or less for all comparisons). We also found differences for glucose values on fasting and at 2 hours with the highest (0 min) and lowest level (120 min) in the 2016–2017, respectively. Finally, a borderline difference for the weight, but not for BMI, was found (64.1 ± 14.1 kg vs. 66.2 ± 13.1 vs. 67.8 ± 15.6; p = 0.04). Differences were also identified in the post hoc analysis between cohorts. Conclusion: This retrospective analysis illustrates changes in characteristics of women with GDM occurring over the period of decade in Poland. They likely result from both epidemiological trends and modifications of the WHO criteria for the GDM diagnosis

BASP1 labels neural stem cells in the neurogenic niches of mammalian brain

The mechanisms responsible for determining neural stem cell fate are numerous and complex. To begin to identify the specific components involved in these processes, we generated several mouse neural stem cell (NSC) antibodies against cultured mouse embryonic neurospheres. Our immunohistochemical data showed that the NSC-6 antibody recognized NSCs in the developing and postnatal murine brains as well as in human brain organoids. Mass spectrometry revealed the identity of the NSC-6 epitope as brain abundant, membrane-attached signal protein 1 (BASP1), a signaling protein that plays a key role in neurite outgrowth and plasticity. Western blot analysis using the NSC-6 antibody demonstrated multiple BASP1 isoforms with varying degrees of expression and correlating with distinct developmental stages. Herein, we describe the expression of BASP1 in NSCs in the developing and postnatal mammalian brains and human brain organoids, and demonstrate that the NSC-6 antibody may be a useful marker of these cells.We are grateful to Grigori Enikolopov for critically reviewing the manuscript, Dwight Martin for expert technical assistance, and Huda Zoghbi for the use of flow cytometer. This work was supported by the NIGMS (5R01GM120033), U.S. Army Medical Research (DAMD170110754), Cynthia and Antony Petrello Endowment, and Mark A. Wallace Endowment (M.M.S.); the National Institute of Diabetes and Digestive and Kidney Diseases (T32DK07521-16) (L.N.M.); MINECO SAF-2015-70866R (J.M.E), FPI MICINN predoctoral Fellowship (I.D.); the Proteomics Center at Stony Brook University (NIH/NCRR 1S10 RR023680), and the BCM IDDRC Grant (P50HD10355) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development for use of the Microscopy Core facilities, the RNA In Situ Hybridization Core facility, and the Human Neuronal Differentiation Core facilit

Body Fluid Cytokine Levels in Mild Cognitive Impairment and Alzheimer’s Disease: a Comparative Overview

This article gives a comprehensive overview of cytokine and other inflammation associated protein levels in plasma, serum and cerebrospinal fluid (CSF) of patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). We reviewed 118 research articles published between 1989 and 2013 to compare the reported levels of 66 cytokines and other proteins related to regulation and signaling in inflammation in the blood or CSF obtained from MCI and AD patients. Several cytokines are evidently regulated in (neuro-) inflammatory processes associated with neurodegenerative disorders. Others do not display changes in the blood or CSF during disease progression. However, many reports on cytokine levels in MCI or AD are controversial or inconclusive, particularly those which provide data on frequently investigated cytokines like tumor necrosis factor alpha (TNF-α) or interleukin-6 (IL-6). The levels of several cytokines are possible indicators of neuroinflammation in AD. Some of them might increase steadily during disease progression or temporarily at the time of MCI to AD conversion. Furthermore, elevated body fluid cytokine levels may correlate with an increased risk of conversion from MCI to AD. Yet, research results are conflicting. To overcome interindividual variances and to obtain a more definite description of cytokine regulation and function in neurodegeneration, a high degree of methodical standardization and patients collective characterization, together with longitudinal sampling over years is essential

Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods. We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5–88.5] vs. 63.5 [51–77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality