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1.
J Acoust Soc Am ; 150(1): 43, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34340470

RESUMEN

Blowing a recorder at a low to moderate blowing speed with the toneholes all closed yields the lowest note in the range of the instrument. As the blowing speed is increased, the tone abruptly changes to the tone an octave higher. This "jump" in the frequency of the dominant spectral component of the tone is referred to as "regime change." Interestingly, in conversations with recorder players, several have mentioned that regime change seems to occur at a significantly lower blowing speed for bass recorders than for instruments that sound an octave or more higher. In this paper we study regime change in the recorder and use Navier-Stokes modeling to confirm and study differences in the behavior of different instruments in the recorder family. We show, using modeling, how the regime change threshold in a model of the bass recorder can be increased by changing the geometry in the vicinity of the labium. These results are then confirmed through experimental studies of real recorders with designs inspired by the modeling results. The insights gained from these results suggest new recorder designs that may produce instruments that in some respects are more playable than current instruments.

2.
J Acoust Soc Am ; 148(6): 3827, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33379909

RESUMEN

A model of a single reed instrument is studied in which the reed is described as an Euler-Bernoulli beam, and the air flow through the instrument is calculated using the Navier-Stokes equations. The hypothetical instrument resembles a clarinet, but is smaller than a real clarinet to keep the numerical modeling feasible on available supercomputers. This article explores the conditions under which the frequency of the reed oscillations and the emitted sound are determined by the resonant frequency of the bore of the instrument. The effect of the contact between the reed and the player's lips is also studied, and quantitative results for the air density and pressure in the mouthpiece and throughout the instrument bore are also presented.

3.
J Acoust Soc Am ; 145(3): 1521, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31067948

RESUMEN

When modeling a brass instrument such as the trumpet, an estimate of the pressure at the player's lips is essential, since the resulting force drives the oscillations of the lips which are needed to produce a musical tone. In most work to date, the calculation of the force on the lips has relied on values of the pressure derived from the Bernoulli equation, even though that relation assumes steady flow in contrast to the pulsating flow caused by vibrations of the lips. This paper uses a quantitative application of the Navier-Stokes equations to calculate the flow through a model of vibrating lips attached to a toy model of the trumpet. The results are used to explore when the Bernoulli equation can and cannot be used. The Bernoulli equation is found to fail badly during significant portions of each oscillation cycle of the lips. The reasons for this breakdown are elucidated.

4.
J Acoust Soc Am ; 143(1): 38, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29390784

RESUMEN

A model of a brass instrument is described in which the air flow and pressure inside the instrument are computed with the Navier-Stokes equations and the motion of the player's lips are described using the swinging lip model of Adachi and Sato [J. Acoust. Soc. Am. 99, 1200-1209 (1996)]. Using the Navier-Stokes equations to treat the air motion allows the calculation of the spatial variations and time dependences of the pressure and velocity near the lips, which has not been possible with previous modeling approaches. Detailed results for these quantities and for the lip motion are presented, and compared with the results of previous modeling of lip reed instruments and with available experimental results. Shortcomings are found in previous treatments of the aerodynamic force on the lips, and the implications of this result for first-principles modeling of brass instruments are discussed.

5.
Int J Biometeorol ; 61(12): 2153-2158, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28785809

RESUMEN

The aim of this study was to evaluate the whole-blood levels of miR-155, miR-223, miR-181a, miR-146a, and miR-let-7e in patients with bilateral knee osteoarthritis (OA) after a cycle of mud-bath therapy (MBT). Thirty-two patients with knee OA defined by the ACR criteria were included. Twenty-one patients (MBT group) were daily treated with a combination of local mud-packs at 42 °C and baths in mineral water, at 37 °C for 15 min, for 12 applications over a period of 2 weeks, in addition to standard therapy; 11 patients (control group) continued their conventional treatment alone. Global pain score evaluated by visual analog scale (VAS), WOMAC subscores, and microRNA expression were evaluated at baseline and after 2 weeks. Peripheral whole blood was collected into PAXgene™ Blood RNA tubes, stored at - 80 °C, and total RNA was extracted. The expression of miR-155, miR-223, miR-181a, miR-146a, and miR-let-7e was determined by qRT-PCR. After MBT, we observed a statistically significant improvement of clinical parameters and a significant decrease of miR-155, miR-181a, miR-146a (p < 0.001), and miR-223 (p < 0.01) expression levels. No clinical and biochemical modifications were detected in the control group. No significant variations of miR-let-7e were shown in both groups after 2 weeks. In conclusion, MBT can modify the expression of miR-155, miR-181a, miR-146a, and miR-223, which are upregulated in OA. It could be due to the heat stress and the hydrostatic pressure, since some miRNAs were found to be temperature- and mechano-responsive. Further studies are needed to better explain the mechanism of action of MBT and the role of miRNAs in OA.


Asunto(s)
Balneología , MicroARNs/sangre , Osteoartritis de la Rodilla/genética , Osteoartritis de la Rodilla/terapia , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/sangre , Dimensión del Dolor , Método Simple Ciego , Resultado del Tratamiento
6.
J Acoust Soc Am ; 140(3): 1887, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27914440

RESUMEN

Direct numerical solutions of the Navier-Stokes equations have been used to compute tones produced by a model of the piccolo. The behavior depends on the angle at which the air jet is directed at the embouchure hole and the displacement of the jet center from the embouchure edge. Values of the jet angle and displacement are found that produce pure tones with spectra similar to those of real piccolo tones. The behavior of calculated tones as a function of the blowing speed u is studied, and it is found that unsteady behavior can occur depending on the value of u, the jet angle, and the jet displacement. Detailed analysis of these unsteady tones suggests that the model piccolo studied here exhibits chaotic behavior with a positive Lyapunov exponent. The implications for piccolo tones produced with real piccolos by real piccolo players are discussed.

7.
Int J Immunopathol Pharmacol ; 28(1): 93-103, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25816411

RESUMEN

Systemic sclerosis (SSc) is an autoimmune disease characterized by skin and internal organ fibrosis, caused by microvascular dysfunction. In recent years, the hypothesis that anti-endothelial cell antibodies (AECA) play a key role in microvascular damage seems to be increasingly convincing. In fact, AECA can induce antibody-dependent cellular apoptosis and stimulate the microvasculature to release pro-inflammatory and pro-fibrotic cytokines. Human-microvascular-endothelial-cells (MVECs) were stimulated with SSc sera (with and without AECA) and with sera from healthy donors. The conditioned MVEC culture media were then added to fibroblast cultures obtained from control skin (CTR), non-affected skin of SSc patients (NA), and affected skin of the same sclerodermic (SSc) patients, respectively. AECA contributed to the MVEC increased release of endothelin-1 (ET-1) in the culture medium and to MVEC apoptosis. Fibroblast (CTR, NA, and SSc) proliferation was increased after treatment with AECA-positive conditioned media, compared to AECA-negative and control conditioned media. Furthermore, both AECA-positive (in major contribution) and AECA-negative conditioned media were responsible for alpha-smooth-muscle-actin (αSMA) over-expression in all fibroblast cultures, compared to control conditioned media. Fibroblast type I collagen synthesis was upregulated by both SSc conditioned media (with and without AECA). Finally, the synthesis of fibroblast transforming-growth-factor-beta (TGF-ß) was statistically higher in AECA-positive conditioned media, compared to AECA-negative and control conditioned media. These findings support the concept that AECA may mediate the crosstalk between endothelial damage and dermal-fibroblast activation in SSc.


Asunto(s)
Autoanticuerpos/efectos adversos , Autoanticuerpos/inmunología , Fibroblastos/patología , Microvasos/patología , Esclerodermia Sistémica/patología , Actinas/metabolismo , Células Cultivadas , Colágeno Tipo I/metabolismo , Medios de Cultivo Condicionados/metabolismo , Células Endoteliales/inmunología , Células Endoteliales/metabolismo , Células Endoteliales/patología , Endotelina-1/metabolismo , Endotelio/inmunología , Endotelio/metabolismo , Endotelio/patología , Femenino , Fibroblastos/inmunología , Fibroblastos/metabolismo , Humanos , Microvasos/inmunología , Microvasos/metabolismo , Persona de Mediana Edad , Esclerodermia Sistémica/inmunología , Esclerodermia Sistémica/metabolismo , Piel/inmunología , Piel/metabolismo , Piel/patología , Factor de Crecimiento Transformador beta/metabolismo
8.
J Acoust Soc Am ; 138(4): 2359-66, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26520317

RESUMEN

The perceptual results of Plomp and Levelt [J. Acoust. Soc. Am. 38, 548-560 (1965)] for the sensory dissonance of a pair of pure tones are used to estimate the dissonance of pairs of piano tones. By using the spectra of tones measured for a real piano, the effect of the inharmonicity of the tones is included. This leads to a prediction for how the tuning of this piano should deviate from an ideal equal tempered scale so as to give the smallest sensory dissonance and hence give the most pleasing tuning. The results agree with the well known "Railsback stretch," the average tuning curve produced by skilled piano technicians. The authors' analysis thus gives a quantitative explanation of the magnitude of the Railsback stretch in terms of the human perception of dissonance.


Asunto(s)
Música , Percepción de la Altura Tonal , Equipos y Suministros , Humanos , Modelos Teóricos , Placer , Sonido , Vibración
9.
Calcif Tissue Int ; 95(4): 340-8, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25139040

RESUMEN

Currently used diagnostic measures for sarcopenia are based on the evaluation of appendicular skeletal muscle mass (ASMM) divided by height-squared (ASMMI). This study aimed to investigate the associations between different operational definitions of appendicular muscle mass and BMD at different skeletal sites in aging Italian men and women. In 1199 consecutive healthy Italian subjects, aged 55 years or more (854 women, age 64.2 ± 6.4 years and 165 men, age 65.3 ± 6.1 years), we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD),at total hip (TH-BMD), at total body (WB-BMD) and at the right hand (H-BMD) and body composition parameters [ASMM, ASMMI, ASMM/Weight, total lean mass and total fat mass by DXA]. In all subjects, we also measured sex hormones, 25-hydroxyvitamin D and bone turnover markers. In men, both ASMM and ASMMI were positively correlated with BMD at all sites, whereas in women, ASMM and ASMMI did not show any significant correlation with BMD. In men, multiple regression analyses showed that ASMM was positively associated (p < 0.01) with FN-BMD, TH-BMD and H-BMD; however, these associations were no longer present when lean mass was included. In women, both fat mass and lean mass were found positively associated with BMD at all sites. In conclusion, among the different operational measures of the ASMM, only ASMM was significantly associated with BMD in elderly men, but not in elderly women.


Asunto(s)
Densidad Ósea , Músculo Esquelético/patología , Factores Sexuales , Anciano , Anciano de 80 o más Años , Composición Corporal , Huesos , Estudios Transversales , Estrógenos/sangre , Femenino , Cadera/patología , Humanos , Italia , Vértebras Lumbares/patología , Masculino , Persona de Mediana Edad , Análisis de Regresión , Vitamina D/análogos & derivados , Vitamina D/sangre
10.
Int J Immunopathol Pharmacol ; 27(1): 97-102, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24674683

RESUMEN

Osteopontin (OPN) is an extracellular matrix protein implicated in bone remodeling, but it presents also pro-inflammatory and pro-fibrotic properties. OPN expression also occurs upon exposure of cells to classical mediators of acute inflammation such as tumor necrosis growth factor alpha (TNF-alpha) and interleukin-1 beta (IL-1beta), as well as fibrogenic cytokines such as transforming growth factor beta (TGF-beta), although a detailed understanding of these regulatory pathways is still unknown. Plasma OPN levels in both limited and diffuse systemic sclerosis patients (lSSc and dSSc) were statistically higher compared to those of control subjects. Immunohistology demonstrated that high TGF-beta levels, alpha smooth muscle actin (alphaSMA) levels and consequently high OPN levels were found in the affected skin of sclerodermic patients (lSSc and dSSc) compared to levels found in healthy skin. In order to better understand how OPN interferes with the fibrotic process, healthy skin fibroblasts were treated for 24 and 48 hours with bleomycin and with endothelin-1 (ET-1) plus TGF-beta in order to induce the fibrogenesis. After 48 hours of stimulation, healthy treated fibroblasts showed statistically increased alphaSMA levels (index of differentiation into myofibroblasts) and simultaneously statistically increased OPN levels compared to healthy untreated ones. This study demonstrates that OPN levels increase simultaneously with the increasing of alphaSMA levels, therefore it is reasonable to hypothesize that OPN interferes in the pathogenesis of Systemic Sclerosis in the early stage of fibroblast differentiation process.


Asunto(s)
Actinas/metabolismo , Diferenciación Celular , Fibroblastos/metabolismo , Osteopontina/metabolismo , Esclerodermia Sistémica/etiología , Bleomicina/farmacología , Western Blotting , Estudios de Casos y Controles , Células Cultivadas , Endotelina-1/farmacología , Ensayo de Inmunoadsorción Enzimática , Femenino , Fibroblastos/efectos de los fármacos , Fibroblastos/patología , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Osteopontina/sangre , Esclerodermia Sistémica/sangre , Esclerodermia Sistémica/metabolismo , Esclerodermia Sistémica/patología , Factor de Crecimiento Transformador beta/farmacología
12.
J Acoust Soc Am ; 135(2): 906-916, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25234898

RESUMEN

The aeroacoustics of a recorder are explored using a direct numerical simulation based on the Navier-Stokes equations in three dimensions. The qualitative behavior is studied using spatial maps of the air pressure and velocity to give a detailed picture of jet dynamics and vortex shedding near the labium. In certain cases, subtle but perhaps important differences in the motion of the air jet near the edge of the channel as compared to the channel center are observed. These differences may be important when analyzing experimental visualizations of jet motion. The quantitative behavior is studied through analysis of the spectrum of the sound pressure outside the instrument. The effect of chamfers and of changes in the position of the labium relative to the channel on the tonal properties are explored and found to be especially important in the attack portion of the tone. Changes in the spectrum as a result of variations in the blowing speed are also investigated as well as the behavior of the spectrum when the dominant spectral component switches from the fundamental to the second harmonic mode of the resonator tube.

13.
J Biol Regul Homeost Agents ; 27(2): 455-62, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23830395

RESUMEN

Systemic sclerosis (or scleroderma) is an autoimmune disease characterized by skin and internal organ fibrosis, caused by microvascular dysfunction. The microvascular damage seems to be a consequence of an endothelial autoimmune response, followed by activation of the inflammatory cascade and massive deposition of collagen. Endothelin-1 (ET-1) contributes to the inflammatory and fibrotic processes by increasing the concentration of pro-inflammatory and pro-fibrotic cytokines, and it is considered one of the most relevant mediators of vascular damage in scleroderma. It is indeed found in very high concentration in serum of sclerodermic patients. Moreover, in these pathological conditions there is an increased expression of ET-1 receptors (ETA and ETB), which mediate the detrimental action of ET-1, and often a change of ETA/ETB ratio. The aim of the present study is to evaluate the in vitro effect of macitentan, an orally active tissue-targeting dual endothelin receptor antagonist, and its major metabolite (ACT-132577) on alpha smooth muscle actin (alphaSMA) expression, evaluated on dermal fibroblasts from healthy subjects and on dermal fibroblasts from lesional and non-lesional skin from sclerodermic patients. The combination of macitentan and its major metabolite reduced the levels of αSMA after 48 h in sclerodermic fibroblasts from lesional skin. No relevant changes in αSMA levels were found in fibroblasts from non-lesional skin, whose behavior is similar to that of dermal fibroblasts from healthy patients.


Asunto(s)
Antagonistas de los Receptores de la Endotelina A , Antagonistas de los Receptores de la Endotelina B , Pirimidinas/farmacología , Esclerodermia Sistémica/tratamiento farmacológico , Piel/patología , Sulfonamidas/farmacología , Actinas/análisis , Anciano , Femenino , Fibrosis , Humanos , Persona de Mediana Edad , Pirimidinas/uso terapéutico , Esclerodermia Sistémica/patología , Sulfonamidas/uso terapéutico
14.
J Acoust Soc Am ; 133(2): 1111-8, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23363126

RESUMEN

The aeroacoustics of a recorder are studied using a direct numerical simulation based on the Navier-Stokes equations in two dimensions. Spatial maps for the air pressure and velocity give a detailed picture of vortex shedding near the labium. Changes in the spectrum as a result of variations in the blowing speed are also investigated. The results are in good semi-quantitative agreement with general results for these phenomena from experiments.


Asunto(s)
Acústica , Simulación por Computador , Modelos Teóricos , Música , Análisis Numérico Asistido por Computador , Sonido , Presión del Aire , Movimiento (Física) , Factores de Tiempo
15.
J Psychopharmacol ; 37(12): 1190-1200, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37937505

RESUMEN

BACKGROUND: There is a growing interest in studying ibogaine (IBO) as a potential treatment for substance use disorders (SUDs). However, its clinical use has been hindered for mainly two reasons: First, the lack of randomized, controlled studies informing about its safety and efficacy. And second, IBO's mechanisms of action remain obscure. It has been challenging to elucidate a predominant mechanism of action responsible for its anti-addictive effects. OBJECTIVE: To describe the main targets of IBO and its main metabolite, noribogaine (NOR), in relation to their putative anti-addictive effects, reviewing the updated literature available. METHODS: A comprehensive search involving MEDLINE and Google Scholar was undertaken, selecting papers published until July 2022. The inclusion criteria were both theoretical and experimental studies about the pharmacology of IBO. Additional publications were identified in the references of the initial papers. RESULTS: IBO and its main metabolite, NOR, can modulate several targets associated with SUDs. Instead of identifying key targets, the action of IBO should be understood as a complex modulation of multiple receptor systems, leading to potential synergies. The elucidation of IBO's pharmacology could be enhanced through the application of methodologies rooted in the polypharmacology paradigm. Such approaches possess the capability to describe multifaceted patterns within multi-target drugs. CONCLUSION: IBO displays complex effects through multiple targets. The information detailed here should guide future research on both mechanistic and therapeutic studies.


Asunto(s)
Conducta Adictiva , Ibogaína , Trastornos Relacionados con Sustancias , Humanos , Ibogaína/efectos adversos , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Sistemas de Liberación de Medicamentos
16.
Sci Rep ; 13(1): 14052, 2023 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-37696900

RESUMEN

The COVID-19 pandemic has had a devastating impact on the health and wellbeing of the global population. This paper presents the results of a longitudinal transcultural study that was begun at the peak of the pandemic (in April, 2020). An online survey was used to collect data from English-, Spanish-, and Portuguese-speaking participants. The survey collected information about sociodemographics, lifestyle activities, COVID-19-related circumstances, and drug use (with an emphasis on hallucinogenic drugs), as well as involving psychometric questionnaires. Users of hallucinogenic drugs had higher psychological well-being and lower scores on psychopathology scales, both at baseline and during follow-ups. This difference was larger when users were distinguished by frequency of use, as regular users scored higher on psychological well-being and lower on psychopathology scales. Subjects with more psychological distress had lower scores for all scales of post-traumatic growth, but if they were regular hallucinogens users, they had higher scores for post-traumatic growth. When comparing the results between cultural contexts, heterogeneous results were obtained. There were more English-speaking regular users of hallucinogenic drugs. Further research should analyse the potential role of hallucinogens in large-scale catastrophes, with a special focus on post-traumatic growth.


Asunto(s)
COVID-19 , Alucinógenos , Crecimiento Psicológico Postraumático , Humanos , COVID-19/epidemiología , Pandemias , Etnicidad
18.
Scand J Rheumatol ; 41(5): 391-5, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23043266

RESUMEN

OBJECTIVES: Relaxin (RLX) is involved in extracellular matrix and collagen remodelling. The therapeutic role of the circulating isoform RLX-2 as an anti-fibrotic factor in systemic sclerosis (SSc) has been investigated. Several RLX family peptide receptors (RXFPs) are recognized in humans: RLX-2 is a ligand for RXFP1/LGR7 and RXFP2/LGR8. The aim of this study was to define the pattern of expression of LGR7 in different types of human skin cells and to compare normal skin with lesional and unaffected skin from patients with limited SSc (lSSc). METHOD: We analysed RXFP1 immunolocalization on skin biopsies and cultured fibroblasts from lSSc patients and control subjects. Western blot analysis was carried out on fibroblast lysates. RESULTS: RXFP1 showed cytoplasmic localization on skin cells from control subjects and non-lesional skin from lSSc patients: keratinocytes, gland epithelial cells, endothelium, smooth muscle cells, and fibroblasts. Immunogold electron microscopy confirmed a diffuse epithelial cytoplasmic localization of RXFP1. A substantially lower RXFP1 expression was observed in scleroderma skin, with a lack of staining in most cells. Occasional weak reactivity was observed in cultured scleroderma fibroblasts, while control fibroblasts showed a diffuse cytoplasmic immunoreactivity of RXFP1, confirmed by Western blot analysis. CONCLUSIONS: The decreased cellular expression of RLX-2 receptor RXFP1 in scleroderma skin might represent a pro-fibrotic factor and contribute to the substantial inefficacy of RLX treatment in SSc, as reported in the literature. The pathophysiology of the decrease in RXFP1 may be linked to high RLX-2 serum levels previously detected in SSc, but it has yet to be elucidated.


Asunto(s)
Fibroblastos/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Receptores de Péptidos/metabolismo , Esclerodermia Sistémica/metabolismo , Piel/metabolismo , Anciano , Células Cultivadas , Femenino , Fibroblastos/patología , Fibrosis/metabolismo , Fibrosis/patología , Humanos , Persona de Mediana Edad , Esclerodermia Sistémica/patología , Piel/patología
19.
J Biol Regul Homeost Agents ; 26(1): 39-49, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22475096

RESUMEN

Osteoarthritis (OA) is the most frequently occurring rheumatic disease, caused by metabolic changes in chondrocytes, the cells that maintain cartilage. Treatment with electromagnetic fields (MF) produces benefits in patients affected by this pathology. Isolated human osteoarthritic (OA) chondrocytes were cultured in vitro under standard conditions or stimulated with IL-1beta or IGF-1, to mimic the imbalance between chondroformation and chondroresorption processes observed in OA cartilage in vivo. The cells were exposed for a specific time to extremely low frequency (ELF; 100-Hz) electromagnetic fields and to the Therapeutic Application of Musically Modulated Electromagnetic Fields (TAMMEF), which are characterized by variable frequencies, intensities, and waveforms. Using flow cytometry, we tested the effects of the different types of exposure on chondrocyte metabolism. The exposure of the cells to both systems enhances cell proliferation, does not generate reactive oxygen species, does not cause glutathione depletion or changes in mitochondrial transmembrane potential and does not induce apoptosis. This study presents scientific support to the fact that MF could influence OA chondrocytes from different points of view (viability, ROS production and apoptosis). We can conclude that both ELF and TAMMEF systems could be recommended for OA therapy and represent a valid non-pharmacological approach to the treatment of this pathology.


Asunto(s)
Condrocitos/metabolismo , Campos Electromagnéticos , Osteoartritis/patología , Anciano , Apoptosis/efectos de los fármacos , Ciclo Celular/efectos de los fármacos , Proliferación Celular , Células Cultivadas , Condrocitos/efectos de los fármacos , Femenino , Glutatión/metabolismo , Humanos , Factor I del Crecimiento Similar a la Insulina/farmacología , Interleucina-1beta/farmacología , Magnetoterapia/métodos , Masculino , Persona de Mediana Edad , Música , Osteoartritis/terapia , Estrés Oxidativo , Especies Reactivas de Oxígeno/metabolismo
20.
BMJ Mil Health ; 168(5): 359-361, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32753538

RESUMEN

INTRODUCTION: Ketamine is a vital component for acute pain management in emergency trauma care for both civilian and military hospitals. This preliminary analysis examined whether combat-injured US service members sustaining traumatic brain injuries (TBI) experienced increased odds of ketamine side effects compared with those without TBI. METHODS: This preliminary analysis included combat-injured service members, ages ≥18 years with documented pain scores during the 24 hours before and 48 hours after receiving an intravenous ketamine infusion at Walter Reed National Military Medical Center (WRNMMC) between 2007 and 2014. Logistic regression modeling examined the association between TBI and ketamine side effects (eg, hallucinations, nightmares, dysphoria, nausea, decreased oxygen saturation) during hospitalisation. RESULTS: Of the 77 patients, 62% presented with a documented TBI. Side effects were documented for 18.8% of those without TBI and 24.4% of those with TBI. Analyses were unable to find evidence against the null hypothesis with the current sample size, even when adjusting for injury characteristics and preinfusion opioid doses (adjusted OR=0.90 (95% CI 0.26 to 3.34), p=0.87). CONCLUSION: In this small sample of combat-injured service members, we were unable to detect a difference in ketamine-related side effects by documented TBI status. These hypothesis-generating findings support the need for future studies to examine the use of intravenous ketamine infusions for pain management, and subsequent care outcomes in patients who experience polytraumatic trauma inclusive of TBI.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Ketamina , Personal Militar , Adolescente , Analgésicos Opioides , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/tratamiento farmacológico , Hospitales Militares , Humanos , Ketamina/efectos adversos , Estados Unidos
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