Glutamatergic pathways mediate transmission of pain. Strategies to reduce glutamatergic neurotransmission may have beneficial effects to mitigate nociception. Recent work revealed that overexpression of the astrocytic glutamate transporter (GLT-1) by transgenic or pharmacologic approaches produced a diminished visceral nociceptive response to colonic distension. The purpose of this study was to...

A married woman aged 76 years gave a history of left visual loss for 2 days. There had been no pain, but streaks of light had been noted to cross the vision from left to right. There had been no previous eye trouble and her general health was good, apart from phlebitis in the left leg 6 months previously, and "head pulsations" for 10 years which had been investigated by a neurologist, no abnorm...

CASE A 63-year-old man presented with abdominal distension and shortness of breath for two days. He reported flatus and denied chest pain, anorexia, vomiting, or abdominal pain. Surgical history was notable for left hepatectomy, cholecystectomy and choledochojejunostomy with a Rouxen-Y. He was afebrile with a pulse in the 100s, blood pressure of 130/60, respiratory rate of 34, and oxygen satura...

Palatable gustatory stimuli promote feeding, whereas gastric distension generally inhibits this behavior. We explored a neural basis for integration of these opposing sensory signals by evaluating the effect of gastric distension on gustatory responses in the parabrachial nucleus (PBN) of anesthetized rats. Sixteen percent of 92 taste cells were coactivated; they responded to independent taste ...

Volker Wenzel, MD, MSc* A half century ago, a patient with impaired ventilation was at high risk of imminent death. Successful airway management profoundly reduces the risk of morbidity and mortality in a severely injured or ill patient. Unsuccessful airway management kills patients. Studies have questioned the usefulness of endotracheal intubation by relatively inexperienced rescuers because o...

Chronic intestinal pseudo-obstruction (CIPO) is a rare gastrointestinal motility disorder that presents with symptoms, physical exam, and imaging findings of mechanical bowel obstruction without an anatomical obstruction. Multiple etiologies, including enteric or extrinsic neuropathic dysfunction, myopathic dysfunction the interstitial cells Cajal, cause CIPO’s pathogenesis. The presentation CI...