Pediatric Vasoocclusive Crisis and Weather Conditions

Rogovik, Alexander L.; Persaud, Jeeshan; Friedman, Jeremy; Kirby, Melanie; Goldman, Ran D.

doi:10.1016/j.jemermed.2010.05.006

Cited by 33 publications

(31 citation statements)

References 27 publications

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“…Some of the inconsistencies may also reflect the influence of location-specific features, including housing, clothing, and social and geographic factors, on the effects of temperature. 2 Although not usually noted by patients, wind speed has emerged as a factor that is consistently associated with pain in sickle cell disease, and higher wind speeds have been associated with increased hospital admissions for pain in England, 68 France, 69 Canada, 64 and the United States. 70 It is unclear how high wind speeds might precipitate episodes of acute pain, although there is evidence that skin cooling can provoke vaso-occlu- sion, 71 possibly as a result of impaired control of vascular tone.…”

Section: Climatic and Meteorologic Factorsmentioning

confidence: 99%

“…71 Both high and low humidity have been associated with increased hospital admissions for pain, 2 and higher pain scores were associated with increased humidity in a study in Canada. 64 Increased episodes of acute pain are reported during the rainy season in regions with tropical climates, such as Jamaica 62 and Nigeria, 59 although no consistent effects of rain emerge where the climate is temperate, such as France 69 and England. 68 Again, the inconsistencies may be due to differences in housing and social factors.…”

Section: Climatic and Meteorologic Factorsmentioning

confidence: 99%

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Sickle Cell Disease

2017

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Section: Climatic and Meteorologic Factorsmentioning

confidence: 99%

Section: Climatic and Meteorologic Factorsmentioning

confidence: 99%

Sickle Cell Disease

2017

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“…In contrast, no signiicant diferences were observed in these patients in response to mechanical stimuli [8]. Cold hypersensitivity under cold weather conditions has been found to be associated with pain and VOC in pediatric [18]. and adult patients [19,20].…”

Section: Subjects With Scd Transgenic Mice Expressing Sickle Hemoglobinmentioning

confidence: 99%

Mechanisms of Pain in Sickle Cell Disease

Aich¹,

Beitz²,

Gupta³

2016

Sickle Cell Disease - Pain and Common Chronic Complications

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Pain is one of the most common features of sickle cell disease SCD lacking efective therapy. Pain in SCD is relatively more complicated than other conditions associated with pain requiring understanding of the pathobiology of pain speciic to SCD. The characterization of pain to deine the diverse modalities of nociception in SCD is currently under progress via human studies accompanied by transgenic mouse models of SCD. Sickle pathobiology characterized by oxidative stress, inlammation and vascular dysfunction contributes to both peripheral and central nociceptive sensitization via mast cell activation in the periphery, and reactive oxygen species and glial activation and endoplasmic reticulum stress in the spinal cord among other efectors. These efects are mediated via several cellular receptors, which can be targeted to produce positive therapeutic outcomes. In this chapter, we will discuss the present understanding of molecular mechanisms of SCD pain and outline the mechanism-based translational potential of novel actionable targets to treat SCD pain.Keywords: pain, sickle cell disease, neurogenic inlammation, substance P, mast cell . IntroductionPain is a hallmark feature of sickle cell disease SCD , which can start in infancy, leading to hospitalization, reduced survival and poor quality of life. Pain in SCD is unique because of unpredictable and recurrent episodes of acute pain due to vaso-occlusive crises VOC , in addition to chronic pain experienced by a majority of adult patients on a daily basis [1]. Treatment choices remain limited to opioids, which impose liabilities of their own including constipation, mast cell activation, fear of addiction and respiratory depression [2]. Moreover, signiicantly larger doses of opioids are required to treat pain in SCD as compared to other acute and chronic pain conditions [1]. Pain can be lifelong in SCD and may therefore inluence © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.cognitive function and lead to depression and anxiety, which can in turn promote the perception of pain [1].Treatment of chronic pain remains unsatisfactory overall, perhaps due to the diverse pathobiology in diferent diseases. Therefore, it is critical to understand the mechanisms speciic to the genesis of sickle pain to develop targeted therapies. Vascular dysfunction, inlammation, ischemia/reperfusion injury and oxidative stress in the wake of VOC can each evoke activation of the nociceptive nerve ibers leading to acute pain. On the other hand, con...

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“…Painful episodes increase during times of cold weather and windy weather, suggesting a possible cool/cold sensitivity in SCD patients. [16,17] In clinical tests, patients with SCD-associated chronic pain show increased sensitivity to cold and heat compared to the matched control patients. [18,19] Brandow et al reported that the median heat painful threshold for SCD patients was 42.7°C compared to 45.2°C in the matched controls.…”

Section: Clinical Characterization Of Scd-associated Painmentioning

confidence: 99%

“…[52] This light touch resembles soft strokes or wind, which have been reported to cause pain in SCD patients. [16,17] Additionally, using sine-wave electrical stimulation, Kenyon et al, found that HBSS-BERK and HBSS mice possess reduced threshold firing in sensory fibers (Aδ, Aβ, and C fibers). [49] The sensitization of both un-myelinated and myelinated sensory fibers could explain the thermal hypersensitivity and mechanical sensitivity displayed by SCD mouse models and patients.…”

Section: Potential Mechanisms Of Scd-associated Painmentioning

confidence: 99%

Updated Mechanisms of Sickle Cell Disease-Associated Chronic pain

Lutz

Meiler

Bekker

et al. 2015

Transl Perioper & Pain Med

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Sickle cell disease (SCD), a hemoglobinopathy, can cause sickling of red blood cells, resulting in vessel blockage, stroke, anemia, inflammation, and extreme pain. A vast majority of SCD patients experience pain on a chronic basis, and many turn to opioids to provide limited relief. The side effects that come with chronic opioid use push for research into understanding the specific mechanisms of SCD-associated chronic pain. Current advances in SCD-associated pain have focused on alterations in the pain pathway including nociceptor sensitization and endogenous pain inducers. This article reviews the underlying pathophysiology of SCD, potential pain mechanisms, current treatments and their mechanism of action, and future directions of SCDassociated pain management. The information provided could help propel research in SCD-associated chronic pain and uncover novel treatment options for

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Pediatric Vasoocclusive Crisis and Weather Conditions

Cited by 33 publications

References 27 publications

Sickle Cell Disease

Sickle Cell Disease

Mechanisms of Pain in Sickle Cell Disease

Updated Mechanisms of Sickle Cell Disease-Associated Chronic pain

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