Biomedical subjects

Marcia A Ciol

Publications and source records attributed to Marcia A Ciol.

24 records · Page 2Linked to original sources

PubMed2003

Pain sensitization in male chronic pelvic pain syndrome: why are symptoms so difficult to treat?

PURPOSE: Male chronic pelvic pain syndrome (CPPS) is a chronic and debilitating symptom complex, and inconsistent outcomes of antibiotic and anti-inflammatory treatments have created an interest in investigating the neurological mechanisms of CPPS pain. Because chronic pelvic pain likely results in hyperexcitability of dorsal horn neurons, ie central sensitization, thermal algometry may be useful in the assessment of CPPS. We evaluated men with and without CPPS to determine if there were differences between the 2 groups in their responses to noxious heat stimuli. MATERIALS AND METHODS: We recruited 66 healthy men without CPPS and 36 men with a history of CPPS for the study. Mean age of CPPS subjects was 43.1 years (range 18 to 62) and mean age of controls was 35.1 (range 21 to 61). All subjects with pain completed a National Institutes of Health-Chronic Prostatitis Symptom Index. We conducted thermal sensory tests with a small thermode programmed to deliver 2 series of 4 rapid bursts of noxious heat stimuli to the perineum and the anterior thigh. The subjects reported sensation on a computerized visual analog scale (COVAS) with a manual sliding lever. The average peak COVAS values and time to peak values from thigh and perineum of each series of thermal bursts were compared between CPPS and controls. RESULTS: The mean pain score on questionnaires was 9.7 (4 or greater indicating significant pain), mean urinary score was 4.7 (range 0 to 10) and mean quality of life impact score was 7.3 (range 3 to 13). Compared to controls men with CPPS reported higher mean peak COVAS values in the perineum. There was no difference between groups in the peak COVAS value on the thigh. CONCLUSIONS: Men with CPPS have altered heat sensation/pain sensitization in the perineum compared to controls. This finding is another that supports the resemblance of CPPS to other chronic pain syndromes and may help explain why CPPS is often refractory to treatment. Further investigations into male CPPS should focus on the mechanisms inducing and maintaining pain in an effort to treat this condition effectively.

Adult↗

PubMed2002

Platelet-activating factor and Escherichia coliO157:H7 infections.

The role of platelet-activating factor (PAF), a phospholipid inflammatory mediator, in Escherichia coli O157:H7-associated hemolytic uremic syndrome (HUS) is unknown. PAF is synthesized by diverse cells and is degraded by PAF-acetylhydrolase (PAF-AH). Deficient PAF-AH activity results from a G-->T transversion at position 994 of exon 9. We examined children infected with E. coliO157:H7 to determine if PAF levels or the PAF-AH ( G994T) mutation reflects the risk of developing HUS. Plasma PAF concentrations were determined using chloroform/methanol extraction, thin layer chromatography purification, and scintillation proximity assay in 10 patients with uncomplicated infection (UI), 10 infected patients who subsequently developed HUS (pre-HUS), 5 HUS patients, and 8 healthy controls. The PAF-AH ( G994T) allele frequency was determined in 52 UI children, 15 with HUS, and 11 controls. Wilcoxon rank sum tests were performed to test differences in location (median) of pairs of groups. PAF levels were higher in the UI ( P=0.04) and pre-HUS ( P=0.01) groups than in healthy controls. No subject had the PAF-AH ( G994T) allele. Thus, elevated plasma PAF levels occur in E. coliO157:H7-infected children, even without HUS, but diminish when HUS develops. The PAF-AH ( G994T) allele does not contribute to the risk of developing HUS.

Blood Cell Count↗

PubMed2002

Escherichia coli O157:H7 infections: discordance between filterable fecal shiga toxin and disease outcome.

Shiga toxin (Stx)-producing Escherichia coli O157:H7 are the most common cause of hemolytic uremic syndrome (HUS). We detected free fecal Stx in 48%, 40%, and 17% of infected children with uncomplicated diarrhea, children who subsequently developed HUS, and children with HUS, respectively. Vero cell assay detected Stx more frequently than did a commercial Stx enzyme immunoassay. In children's stool samples obtained on or before day 4 of illness, each 10-fold decrease in titer was, paradoxically, associated with 3.8-fold increased odds of developing HUS (P=.03; 95% confidence interval, 0.77-19.7). The fecal Stx type did not correlate with the Stx expressed by bacteria grown in vitro and was not related to bacterial titer in the studied samples. These data suggest that therapeutic and diagnostic strategies directed toward binding or identifying intraintestinal fecal Stx may have limited success.

Animals↗

PubMed2002

Prothrombotic coagulation abnormalities preceding the hemolytic-uremic syndrome.

BACKGROUND: The hemolytic-uremic syndrome is a thrombotic complication of Escherichia coli O157:H7 infection. It is not known whether the coagulation abnormalities precede, and potentially cause, this disorder. METHODS: In 53 children infected with E. coli O157:H7, we measured a panel of markers indicating activation of the clotting cascade and renal function within four days after the onset of illness. These markers were measured again in as many as possible of the 16 children in whom the hemolytic-uremic syndrome developed. RESULTS: The children in whom the hemolytic-uremic syndrome subsequently developed had significantly higher median plasma concentrations of prothrombin fragment 1+2, tissue plasminogen activator (t-PA) antigen, t-PA-plasminogen-activator inhibitor type 1 (PAI-1) complex, and D-dimer than children with uncomplicated infection. These abnormalities preceded the development of azotemia and thrombocytopenia. When the hemolytic-uremic syndrome developed, the urinary concentrations of beta2-microglobulin and N-acetyl-beta-glucosaminidase rose significantly (P=0.03 for both increases); the plasma concentrations of t-PA antigen, t-PA-PAI-1 complex, D-dimer, and plasmin-antiplasmin complex also increased significantly. The concentration of t-PA antigen correlated with that of the t-PA-PAI-1 complex in a linear regression model (squared correlation coefficient, 0.80; P<0.001). CONCLUSIONS: In the hemolytic-uremic syndrome, thrombin generation (probably due to accelerated thrombogenesis) and inhibition of fibrinolysis precede renal injury and may be the cause of such injury.

Acetylglucosaminidase↗

PubMed2002

ABO and P1 blood group antigen expression and stx genotype and outcome of childhood Escherichia coli O157:H7 infections.

P1 and ABO antigens and bacterial stx genotypes might influence the risk of developing hemolytic uremic syndrome (HUS) after Escherichia coli O157:H7 infections. We determined ABO status and P1 antigen expression in 130 infected and 17 uninfected children, and we determined the stx genotype of the infecting isolate. P1 expression was weakly and directly related to HUS risk (P=.04), but this risk did not extend to the group with the greatest P1 expression. P1 expression remained constant as HUS evolved. The ABO frequency was similar in all groups. These associations were not affected by the stx genotype. stx1(-)/stx2(+) E. coli O157:H7 strains were more commonly associated with HUS than were stx1(+)/stx2(+) strains (P=.21), and 1 child with HUS was infected with a rare stx1(+)/stx2(-) isolate. In the present study, ABO antigens and stx genotypes were not major determinants of the outcome of E. coli O157:H7 infections, and P1 expression did not protect against the development of HUS.

ABO Blood-Group System↗

PubMed2002

Environmental demands associated with community mobility in older adults with and without mobility disabilities.

BACKGROUND AND PURPOSE: In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability. SUBJECTS: Subjects were 36 older adults ((> or = 70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk 1/2 mile (0.8 km) or climb stairs without assistance], physically disabled). METHODS: Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate. RESULTS: Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands. DISCUSSION AND CONCLUSION: Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.

Activities of Daily Living↗