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Palliative Care and Advanced Directives in Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Melissa I. Owen, Debbie A. Gunter
Physical pain can be nociceptive, resulting from damage to non-neuronal tissue, or neuropathic, resulting from damage to the body's peripheral sensors. Nociceptive pain can be further divided into somatic pain and visceral pain. Somatic pain is usually musculoskeletal or superficial in nature, causing throbbing, aching, or stabbing. Visceral pain on the other hand, is described as an internal pain brought on by stretch, ischemia, or inflammation, and manifests as deep, diffuse, and dull discomfort. Assessment of pain in the advanced HF patient should be the same as in any other patient complaining of pain. Pharmacological and non-pharmacological measures should be used.31
How East Met West
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Somatic Therapy: Somatic means ‘of the body’, as somatic therapies use body/mind approaches that are psychotherapeutic and holistic. A kinesthetic approach can be accessed through dance-movement therapy, which has been the foundation of somatic approaches.
Basic genetics and patterns of inheritance
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Gene therapy involves insertion of normal copies of genes into individuals who have genetic diseases. This can potentially be accomplished by either somatic cell or germ cell gene therapy. Most work thus far has focused on somatic cell gene therapy. There are two ways to approach somatic cell gene therapy. Ex vivo gene therapy involves removing a patient’s cells from the body, inserting the normal gene copy into the cells, and then returning the cells to the body. In in vivo gene therapy, cells are treated while inside the patient’s body. For successful gene therapy, the cell requiring treatment must be easily accessible and relatively long-lived. Some of the earliest human gene therapy trials were performed for severe combined immune deficiency due to adenosine deaminase deficiency, using bone marrow stem cells. Other cells under consideration for therapy have included lymphocytes, hepatocytes, muscle cells, and respiratory epithelial cells. More recently, gene therapy for Leber’s congenital amaurosis has been accomplished by replacement of the defective gene locally to the retina of the eye. Types of genetic diseases that are amenable to somatic cell gene therapy are primarily autosomal recessive or X-linked disorders that result in almost total lack of normal protein. Reconstitution of even 5% to 10% of normal protein levels appears to be sufficient to treat these diseases. Dominant disorders that are caused by heterozygosity for mutant and normal genes (dominant-negative mutations) are not likely to be treatable by gene replacement; methods to block production of the mutant protein will be required.
Posterior communicating artery infundibulum with oculomotor nerve palsy treated with microvascular decompression: a case report and 2-dimensional technical operative video
Published in British Journal of Neurosurgery, 2023
Ehsan Dowlati, Juliana Rotter, Tianzan Zhou, R. Tushar Jha, Rocco A. Armonda
The oculomotor nerve, CNIII, has both somatic efferent and visceral efferent functions. Somatic fibers control ocular and eyelid movements. Parasympathetic visceral fibers that course along with the superficial portion control pupils through the pupillae and ciliary muscles.1–3 External compression can produce one or a combination of symptoms including ptosis, mydriasis of ipsilateral pupil, and ocular motor weakness.4,5 Some hypothesize that pupillary involvement is pathognomonic for aneurysm-induced ONP; however, 38% of diabetic patients have pupillary involvement and up to 17% of PCommA aneurysm patients present with pupil-sparing oculomotor nerve palsy (ONP). The pupil is more likely to be spared when the aneurysm evenly distributes compression on the nerve or compresses the inferior portion of the nerve.1,6,7
Potential Applications of Somatic Experiencing® in Applied Sport Psychology
Published in Journal of Sport Psychology in Action, 2023
In recent years, applied sport psychology (ASP) consultants have become more open-minded to third-wave therapies (e.g., acceptance and commitment therapy, mindfulness) that focus on the holistic promotion of psychological and behavioral processes associated with human well-being over the reduction of psychological and emotional symptoms. This approach often uses psychoeducation to teach athletes how the human brain works and why people experience certain thoughts and emotions (Birrer & Röthlin, 2017). In this article, a relatively new type of body psychotherapy, Somatic Experiencing® (SE™), is discussed. We begin by explaining the basic tenets of SE™ and presenting research that supported its effectiveness. Then, we discuss context and ethical considerations of SE™-based intervention and provide an example of this process. We conclude by discussing guidelines for how practitioners can adapt the intervention to their circumstances and evaluate its effectiveness.
A perspective toward mass spectrometry-based de novo sequencing of endogenous antibodies
Published in mAbs, 2022
Sebastiaan C. de Graaf, Max Hoek, Sem Tamara, Albert J. R. Heck
Because there is an endless and constantly evolving pool of pathogens, the antibody repertoire needs to be incredibly diverse and versatile to counteract these challenges.24,25 In humans, this enormous diversity in the potential antibody repertoire is achieved through several mechanisms. Starting at the genomic level, the light and heavy chains are encoded in four genes each: Variable (V), Diversity (D), Joining (J), and Constant (C), with the light chain lacking the D-gene. These genes are encoded in multiple alleles, which can recombine to a staggering number of combinations (Figure 1b).26 The recombination process is also error-prone, leading to insertions and deletions at the junctions between the regions, referred to as junctional diversity. By recombination alone, the number of possible variable domain sequences already reaches tens of thousands. However, the eventual antibody diversity is expanded even further by natural polymorphisms, mutations, and class switching. As the major contributor to antibody hypervariability, somatic hypermutations can occur during B-cell affinity maturation and do so at a million-fold increased rate compared to the usual mutation rates.11 These mutations are largely concentrated in the complementarity-determining regions (CDR1-3), separated by framework regions (FR1-4), which form the conserved backbone of the Fab structure (Figure 1c). Located at the tips of the Y-shaped antibody structure, CDRs are primarily responsible for antigen binding, and, therefore, elucidation of their sequences is of the utmost importance for antibody discovery.