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Jun 2020 DOI 10.14302/issn.2688-5328.ijp-20-3386
How to define pain? One of the most accredited definition is certainly “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" (IASP (International Association for the Study of Pain - 1986) and World Health Organization (WHO) 1. However, what are the essential components of pain experience? Certainly many factors are involved such as, among others: Perceptual ability / suitability / subjective threshold; The "subjective" experience; Multidimensionality; Occasionally or chronicity. All these components have to be taken into consideration in the treatment of these disorders which, very often, require a multidisciplinary approach. From a clinical psychological point of view, much can also be offered at a diagnostic level, from the reception to listening to the patient's suffering, to the evaluation with standardized tests and psychophysiological analysis procedures in order to arrive at an effective personalization of treatments
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1578
Frailty describes a medical syndrome that confers increased vulnerability to disproportionate changes in health status following minor stressors. With loss of homeostatic reserve in multiple physiological systems, frailty conveys an increased risk of adverse health outcomes. Despite the lack of a clear universal definition, the utilisation of two landmark operational models has allowed a rapid expansion in frailty-centred research. The pathophysiology of frailty is yet to be elucidated in the literature, but a critical role for a heightened inflammatory state is hypothesised. Raised levels of pro-inflammatory cytokines are associated with frailty, with emerging evidence relating their biochemical action with development of the frailty phenotype. Dysregulation of both the innate and adaptive immune system are key components of the frailty syndrome. Remodelling of the T cell compartment and upregulated inflammatory pathways are theorised to propagate the heightened inflammatory state critical in the frailty syndrome. Increased neutrophil counts, in conjunction with ineffective neutrophil migration associated with age, is theorised to produce tissue damage and secondary inflammation conducive of the inflammatory picture in frailty. Beyond the gold standard of the comprehensive geriatric assessment, management of frailty is a fast-evolving area of research. Exercise interventions have shown promising results, improving functional ability and showing beneficial immunomodulation. Vitamin D supplementation, with proposed anti-inflammatory effects, nutritional support and pharmacological treatments all provide promising areas for future therapeutic intervention.
Jul 2016 DOI 10.14302/issn.2574-4372.jesr-16-1055
Human-induced pluripotent stem cells (HiPSCs) demonstrate promise in their ability to differentiate into neural cells and ultimately replace the cell types and thereby brain tissue damaged by stroke. This may diminish cognitive impairment due to stroke. Prior to transplantation, an appropriate scaffold must be determined to allow for heightened accuracy by facilitating proper adhesion, differentiation, and proliferation, increasing the likelihood of success, as will be defined in this review, in vivo. This paper aims to provide a review of available biocompatible scaffolds and their efficacy, to provide insight for future research utilizing clinical trials to study stem cell therapy as a form of post-stroke recovery. A systematic review of scaffolds outlined in full-text, peer-reviewed articles with unique experimental data, available on PubMed, will be conducted to determine an ideal scaffold, based on article and scaffold selection criteria best suited for the transplantation of human-induced pluripotent stem cells.