Chronic brain inflammation leads to a decline in hippocampal NMDA-R1 receptors

BACKGROUND: Neuroinflammation plays a prominent role in the progression of Alzheimer's disease and may be responsible for degeneration in vulnerable regions such as the hippocampus. Neuroinflammation is associated with elevated levels of extracellular glutamate and potentially an enhanced stimulation of glutamate N-methyl-D-aspartate receptors. This suggests that neurons that express these glutamate receptors might be at increased risk of degeneration in the presence of chronic neuroinflammation. METHODS: We have characterized a novel model of chronic brain inflammation using a slow infusion of lipopolysaccharide into the 4(th )ventricle of rats. This model reproduces many of the behavioral, electrophysiological, neurochemical and neuropathological changes associated with Alzheimer's disease. RESULTS: The current study demonstrated that chronic neuroinflammation is associated with the loss of N-methyl-D-aspartate receptors, as determined both qualitatively by immunohistochemistry and quantitatively by in vitro binding studies using [(3)H]MK-801, within the hippocampus and entorhinal cortex. CONCLUSION: The gradual loss of function of this critical receptor within the temporal lobe region may contribute to some of the cognitive deficits observed in patients with Alzheimer's disease

Plasma high density lipoprotein small subclass is reduced in Alzheimer’s disease patients and correlates with cognitive performance

Background: The link between cholesterol and Alzheimer’s disease (AD) has received much attention, as evidence suggests high levels of cholesterol might be an AD risk factor. The carriage of cholesterol and lipids through the body is mediated via lipoproteins, some of which, particularly apolipoprotein E (ApoE), are intimately linked with AD. In humans, high density lipoprotein (HDL) is regarded as a “good” lipid complex due to its ability to enable clearance of excess cholesterol via ‘cholesterol reverse transport’, although its activities in the pathogenesis of AD are poorly understood. There are several subclasses of HDL; these range from the newly formed small HDL, to much larger HDL. Objective: We examined the major subclasses of HDL in healthy controls, mild cognitively impaired, and AD patients who were not taking statins to determine whether there were HDL profile differences between the groups, and whether HDL subclass levels correlated with plasma amyloid-β (Aβ) levels or brain Aβ deposition. Methods: Samples from AIBL cohort were used in this study. HDL subclass levels were assessed by Lipoprint while Aβ1–42 levels were assessed by ELISA. Brain Aβ deposition was assessed by PET scan. Statistical analysis was performed using parametric and non-parametric tests. Results: We found that small HDL subclass is reduced in AD patients and it correlates with cognitive performance while plasma Aβ concentrations do not correlate with lipid profile or HDL subfraction levels. Conclusion: Our data indicate that AD patients exhibit altered plasma HDL profile and that HDL subclasses correlate with cognitive performances

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Psychometric properties of a Spanish version of the McGill Pain Questionnaire in several Spanish-speaking countries

Objective: Versions of the McGill Pain Questionnaire are available in a several languages and are used in clinical studies and sociocultural or ethnic comparisons of pain issues. However, there is a lack of studies that compare the validity and reliability of the instrument in the countries where it is used. The current study investigates the psychometric properties of a Spanish version of the McGill Pain Questionnaire in five Spanish-speaking countries.Design: The authors conducted a multicenter and transnational study with one investigator in each center. Patients were evaluated once with a Spanish version of the McGill Pain Questionnaire, a visual analog scale, and a verbal rating scale.Setting: The study was performed in pain clinics and acute pain units of four Latin American countries (Argentina, Costa Rica, Mexico, and Panama) and Spain.Patients: The study included 205 patients (84 with acute pain, 121 with chronic pain) from Latin America. Their data were compared with those of 282 Spanish patients.Interventions: The McGill Pain Questionnaire, visual analog scale, and verbal rating scale were administered once to all patients. The McGill Pain Questionnaire was administered again to patients from Latin America countries to ascertain descriptor comprehension.Outcome measures: Demographic data, McGill Pain Questionnaire parameters, and visual analog scale and a verbal rating scale scores were obtained from patients with chronic and acute pain. Psychometric properties of the Spanish version of the McGill Pain Questionnaire were established for each country by calculating the ordinal consistency by means of rank-scale correlation (Spearman test), intercategory correlation, and interparameter correlation (Pearson test). Concurrent validity was also calculated by comparing scores from the visual analog scale (Pearson test) and verbal rating scale (Spearman test) with questionnaire parameters (qualitative-to-quantitative comparisons).Results: The Spanish version of the McGill Pain Questionnaire maintained a high internal validity when tested in different countries. Ordinal consistency, intercategory, interparameter, and qualitative-to-quantitative parameter correlations were similar in all countries. Few descriptors were considered to be inappropriate or difficult to understand.Conclusions: The psychometric properties of the Spanish version of the McGill Pain Questionnaire assessed in different Latin-American countries suggest that the questionnaire may be used to evaluate Spanish-speaking patients. The validity of this test should be extended with reliability studies to further establish its usefulness in the evaluation of pain

Sacral area complete sonographic assessment to identify pressure ulcers: SACS study

Learning Objectives: Pressure ulcer (PU) development in hospitalized patients is a major problem with a significant impact on patients and the health care system. Duration to development of PU is unknown. Detecting changes in the Subcutaneous (SC) tissue before clinical skin changes, may help management and prevent progression. Methods: A prospective observational study conducted in a Surgical Intensive Care Unit (SICU), in a tertiary care teaching hospital. Patients studied to identify SC tissue changes in the sacral area while in a supine position for at least 24 hours. High Frequency Ultrasound (US) transducer of 14 MHz was used to evaluate the sacral area to detect any SC tissue changes. The US transducer was placed in a sagittal plane at the sacral area to examine the SC tissue. Abnormal signs in the SC tissue were identified as 1) Dermal-Epidermal interface changes. 2) Edema or hypoechoic area development 3) Disruption in the fascia layer. A sample t-test was used to examine the effect of being in supine position on the SC tissue compared to normal and to test the null hypothesis to determine if supine position for \u3e 24 hours can lead to developing abnormal SC tissue changes. Results: 12 patients in the SICU were randomly selected in this study. All patients had no visual evidence of skin breakdown at the sacral area at the time of the exam. No moisture or sacral edema was noted. All patients were in a supine position for at least 24 hours. Mean age was 52.7 years, 66% were females, 7 Caucasians and 5 African Americans. Five patients were admitted to the SICU from the operating room, 4 from home and 3 from an outside hospital. 33% (4), receiving vasopressor support and 50% (6) were on mechanical ventilation. The patients were in a supine position for a period of time, ranging from 24-144 hours with a mean of 59.9 hours. Average body mass index was 29.2 Kg/m. The Dermal-Epidermal interface changes were noted in 33%. The Edema or hypoechoic area development noted in 58%. Disruption in the fascia layer noted in 75% with t-value 2.3, 3.9 and 3.9 respectively and a p-value \u3c 0.005 in all three categories. Conclusions: Changes in the SC tissue in the sacral area can happen when patients are in supine position for a mean time of about 59 hours or more. Early detection maybe helpful to prevent further injury

Intravascular volume assessment by sonography (VAS) score

Learning Objectives: Intravascular volume Status assessment (IVSA) by bedside ultrasound (BU) usually focus on individual organs. Combining different organs and using a scoring system to compare to the standard methods (SM) and the clinical impression, may aid in the diagnosis and standardize BU applications. Methods: A Prospective, observational study, in the surgical intensive care unit (SICU), of a single academic tertiary center. Patients with IVSA were included. IVSA identified by the SM of heart rate, mean arterial pressure, central venous pressure, serum lactate, Oxygen Saturation of central venous blood (SCVO2), and cardiac index. BU studies included the heart, lungs, Inferior Vena Cava (IVC), and Internal Jugular Vein (IJV). VAS score developed to assess IVSA; A) Heart: Hyperkinetic=-1, Normal=0, hypokinetic=+ 1. B) Lungs: Absence of B-Lines=-1, 1-2 B-Lines=0, 3 B-Lines=+1. C) IVC: \u3c 2.5 cm and \u3e 50% respiratory variation in diameter=-1, 1.5-2.5 cm, \u3c 50% respiratory variation = 1, \u3e 2.5 cm and \u3c 50% respiratory variation = +1. D) IJV: \u3e 40% respiratory variation =-1, 20-40% respiratory variation = 1, \u3c 20%=+1. VAS score ranges from-4 to +4. A score near zero indicates euvolemia, a score near-4 indicates hypovolemia, and a score near +4 indicate hypervolemia. Data for SM and BU compared to each other. Comparisons were performed using the Spearman\u27s correlation coefficient tests, the nonparametric equivalent to a paired t-test. Results: 23 patients with IVSA included in the study. Twelve (52%) were female, 12 (57%) were White and the mean age was 55.5 years with a range from 27-90. There were no clear cut-points to divide the total scores into the three categories of hypovolemia, euvolemia and hypervolemia. There was a trend toward a zero or negative score for hypovolemia and euvolemia. The positive (\u3e 0) total score, was significant in the VAS score hypervolemia compared to SM (correlation coefficient=0.51, p = 0.013). Overall there was a significant association between the VAS score using BU and the clinical impression of volume status (correlation coefficient= 0.51, p = 0.013). Conclusions: VAS score using BU correlates with the clinical impression of volume status measurements. This can help standardize and aid in the diagnosis of volume status during BU

Psychometric properties of a Spanish version of the McGill pain questionnaire in several Spanish-speaking countries

Objective: Versions of the McGill Pain Questionnaire are available in a several languages and are used in clinical studies and sociocultural or ethnic comparisons of pain issues. However, there is a lack of studies that compare the validity and reliability of the instrument in the countries where it is used. The current study investigates the psychometric properties of a Spanish version of the McGill Pain Questionnaire in five Spanish-speaking countries. Design: The authors conducted a multicenter and transnational study with one investigator in each center. Patients were evaluated once with a Spanish version of the McGill Pain Questionnaire, a visual analog scale, and a verbal rating scale. Setting: The study was performed in pain clinics and acute pain units of four Latin American countries (Argentina, Costa Rica, Mexico, and Panama) and Spain. Patients: The study included 205 patients (84 with acute pain, 121 with chronic pain) from Latin America. Their data were compared with those of 282 Spanish patients. Interventions: The McGill Pain Questionnaire, visual analog scale, and verbal rating scale were administered once to all patients. The McGill Pain Questionnaire was administered again to patients from Latin America countries to ascertain descriptor comprehension. Outcome measures: Demographic data, McGill Pain Questionnaire parameters, and visual analog scale and a verbal rating scale scores were obtained from patients with chronic and acute pain. Psychometric properties of the Spanish version of the McGill Pain Questionnaire were established for each country by calculating the ordinal consistency by means of rank-scale correlation (Spearman test), intercategory correlation, and interparameter correlation (Pearson test). Concurrent validity was also calculated by comparing scores from the visual analog scale (Pearson test) and verbal rating scale (Spearman test) with questionnaire parameters (qualitative-to-quantitative comparisons). Results: The Spanish version of the McGill Pain Questionnaire maintained a high internal validity when tested in different countries. Ordinal consistency, intercategory, interparameter, and qualitative-to-quantitative parameter correlations were similar in all countries. Few descriptors were considered to be inappropriate or difficult to understand. Conclusions: The psychometric properties of the Spanish version of the McGill Pain Questionnaire assessed in different Latin-American countries suggest that the questionnaire may be used to evaluate Spanish-speaking patients. The validity of this test should be extended with reliability studies to further establish its usefulness in the evaluation of pain