scholarly journals AB1062 LIPODERMATOSCLEROSIS AS A TYPE OF LOBULAR PANNICULITIS: THE EFFECTIVENESS OF NON-PHARMACOLOGICAL TREATMENT METHODS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1821.1-1821
Author(s):  
M. Sukhareva ◽  
O. Egorova ◽  
B. Belov
Keyword(s):  
Subcutaneous Fat ◽  
Lymphatic Drainage ◽  
Normal Body Mass Index ◽  
Positive Trend ◽  
Group I ◽  
Positive Clinical Effect ◽  
Group Ii ◽  
The Cost ◽  
Lobular Panniculitis

Background:In medical practice lobular panniculitis-lipodermatosclerosis (LDS) is becoming more and more common. It is manifested by degenerative-dystrophic changes in subcutaneous fat (SCF) and occurs more often in middle-aged women affected by chronic venous insufficiency.Objectives:to evaluate the effectiveness of mesotherapy (MT) and shockwave ultrasound therapy (UST) for LDSMethods:among 539 patients referred to the V.A. Nasonova Research Institute of Rheumatology with the referral diagnoses of erythema nodosum or panniculitis 8.5% (46) of patients (44 women, 2 men) aged 18 to 82 with overweight (32) LDS with the disease duration of 11,8±6.4 months was verified. Patients were randomized into two groups of 23 patients each: group I received daily MT (10 sessions) therapy with drugs that have antioxidant, anti-inflammatory, lymphatic drainage and lipolytic effects, and 3 MHz UST of the node area twice a week (5 sessions). In group II MT was performed daily with 9% Natrii chloridum solution at a dose comparable to group I. The control methods included general clinical examination (characterization of induration on the lower legs with an assessment of the effect of pain pressing according to visual analogue scale (VAS pain), general blood and urine tests and ultrasound with elastography (USE) of the compaction. The main stages of control: initial (T0), after 14 days (T1), 1 month (T2) and 3 months (T3).Results:before treatment 38 patients with LDS demonstrated asymmetric (83%) inflammation of SCF of the lower legs (100%) on its medial surface (91%). LDS regressed faster with normal body mass index (p = 0,04). In all patients of group I, after a course of physiotherapy a positive trend was registered, that is a decrease in VAS pain intensity (T0 50±18 mm; T1 35±11 mm), decrease in diameter (T0 6±2.2 cm; T1 4.5±1, 7 mm) and color intensity of the node (p<0.002), SCF thickening which results in “lumping” with macrovascularization according to USE, and decrease in ESR and CRP. In 44% of cases the treatment effect increased to T2 (p <0.05). After 3 months of observation, 15 patients required a second course of physiotherapy. In group II a positive clinical effect was registered for T2 in 14 patients (60.8%) and for T3 in 19 patients (83%) (p<0.05). Over the entire observation period LDS recurrence was registered in 19 patients (41%), the median of recurrence was 3 [1; 6] months, mainly in patients of group I. Recurrence was associated with node fusion into conglomerates (OR 4.33, 95% CI 1.05-17.8; p = 0.037). MT and UST were tolerated well, no side effects were detected.Conclusion:the use of MT with 9% Natrii chloridum solution allowed us to achieve positive dynamics in patients with LDS, which significantly reduced the cost of treatment. Further studies are needed to evaluate the significance of these techniques.Disclosure of Interests:None declared

Thermogravimetric Characterization of the Microstructure Composition of Polyamide Injection Molded Denture Base Material vs Conventional Compression Molded Heat-cured Denture Base Material

2016 ◽  
Vol 17 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Ayman Al-Dharrab ◽  
Lana Shinawi
Keyword(s):  
Weight Loss ◽  
Base Material ◽  
Thermoplastic Resin ◽  
Denture Base ◽  
Excellent Thermal Stability ◽  
Rapid Injection ◽  
Group I ◽  
Injection Molded ◽  
Group Ii

ABSTRACT Background Thermoplastic resin polymers are widely used in medicine due to their biostability and hypoallergenic properties, making them a possible alternative to poly-methylmethacrylate (PMMA). The current research examined the microstructure of a rapid injection molding system thermoplastic resin for construction of flexible denture compared with that of heatcured PMMA. Materials and methods A total of 40 disk-shaped specimens (25 mm in diameter and 3 mm in thickness) were prepared and divided into two groups of 20 disks each (group I samples were of thermoplastic acrylic resin while group II was heat-cured PMMA resin). Results In group I, thermogravimetric analyzer showed that increasing the temperature up to 169°C resulted in about 1.3% of the material loss, and after that the material remains thermally stable up to 200°C. Group II showed 2.24% weight loss at 171°C, and further weight loss (12.025%) was observed on heating to 230°C. Fourier transform infrared (FTIR) spectrophotometer analysis in the range of 400–4000 cm-1 detected the presence of an amine group (N-H) in group I samples and the presence of methylene group attached to inorganic Si as reinforcement filler (Si-CH3). Conclusion Thermoplastic resin displayed excellent thermal stability and the absence of residual monomer within the polymerized material, suggesting its suitability for the fabrication dentures. How to cite this article Al-Dharrab A, Shinawi L. Thermogravimetric Characterization of the Microstructure Composition of Polyamide Injection Molded Denture Base Material vs Conventional Compression Molded Heat-cured Denture Base Material. J Contemp Dent Pract 2016;17(2):99-104.

Heterogeneity of the εγδβ Thalassemias: Characterization of 3 Novel English Deletions.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3609-3609
Author(s):  
Helen Rooks ◽  
Jean Bergounioux ◽  
Laurence Game ◽  
James P. Close ◽  
Steve Best ◽  
...  
Keyword(s):  
Gene Cluster ◽  
Olfactory Receptor ◽  
De Novo ◽  
Globin Gene ◽  
Inherited Disorders ◽  
Chromosome 11P15 ◽  
Globin Gene Cluster ◽  
Group I ◽  
Group Ii

Abstract The thalassemias are inherited disorders classified genetically into α, β, γ, δβ, δ and εγδβ varieties according to the type of globin(s) that are underproduced. At the molecular level, the εγδβ thalassemias fall into two categories; Group I removes all, or a greater part, of the β globin gene cluster which is embedded in an array of olfactory receptor genes on chromosome 11p15. Group II removes extensive upstream regions leaving the β globin gene itself intact despite which, its expression is silenced due to inactivation of the upstream locus control region (β LCR). Recently, two novel deletions causing εγδβ thalassemia have been reported; a 153 kb deletion removing the entire β globin cluster in a Chilean family (Game, L., et al., Br J Haematol2003, 123:154–9) and an upstream deletion of 112 kb in a Dutch family (Dutch III) (Harteveld, C.L., et al., Br J Haematol2003,122: 855–8). We describe here the characterization of another three novel εγδβ thalassemia deletions, in three English families, named English II, III and IV, to differentiate them from the previously reported English (I) deletion (Curtin, P., et al., J Clin Invest1985, 76: 1554–8). Deletion English II removed 98 kb extending 90 kb upstream of the ε gene to 8 kb upstream of the Gγ gene, and included 4 upstream olfactory receptor (HOR) genes. Deletion English III removed 114 kb extending 60 kb upstream of the ε gene to 9 kb downstream of the β globin gene, thus including the entire β globin gene cluster as well as two upstream HOR genes. English IV is the largest deletion (439 kb) reported so far; starting 326 kb upstream of the ε gene to 70 kb downstream of the β gene and included 13 upstream, and 3 downstream, HOR genes plus the intervening β globin gene cluster. Breakpoints of all the 3 deletions occurred within regions of L1 or Alu repeat elements and contained short regions of direct homology between the flanking sequences, a feature that is likely to have contributed to the illegitimate recombinations. Deletions English II and III appear to be de novo while English IV is not. The proband for the English IV deletion had neonatal hemolytic anemia and required blood transfusions while 3 other family members who were heterozygous for the same deletion, had uneventful post-natal periods. The English III proband also required a blood transfusion soon after birth while the English II proband did not. Although in later life, heterozygotes for εγδβ thalassemia are transfusion-independent, and have a blood picture typical of β thalassemia trait but with normal Hb A2 levels, our data suggest that heterozygotes for εγδβ thalassemias have more severe microcytosis and hypochromia than β thalassemia carriers. To date, a total of 15 deletions causing εγδβ thalassemia have been described - five upstream deletions (Group II) associated with intact β globin genes and ten (Group I) that include the entire β globin gene cluster. These deletions are all unique and illustrate the heterogeneity of the εγδβ thalassemias.

scholarly journals CHEMICAL CHARACTERIZATION OF GLYCOPEPTIDES FROM HUMAN γM-GLOBULINS

1968 ◽  
Vol 128 (4) ◽  
pp. 699-713 ◽  
Author(s):  
Joseph M. Davie ◽  
C. Kirk Osterland
Keyword(s):  
Molecular Weight ◽  
Sialic Acid ◽  
Gel Filtration ◽  
Chemical Characterization ◽  
Carbohydrate Composition ◽  
Total Percentage ◽  
Group I ◽  
Group Ii ◽  
Group 1

A survey of human pathological macroglobulins revealed that γM can be divided into at least two groups on the basis of carbohydrate composition. Differences between the two groups exist in the total percentage of carbohydrate (10.69 ± 1.49% for group 1, 7.71 ± 0.65% for group II) which is attributable to variation in hexose content. Glycopeptides from macroglobulins of each group were purified from pronase digests and characterized chemically. Macroglobulins from each group contain three types of oligosaccharides. Glycopeptide I for each group consisted of mannose, galactose, and NAG with a ratio of 3:2:1 for group I and a ratio of 2:1:2 for group II. Glycopeptide II consisted of mannose, galactose, and NAG (9:1:2) for group I, and mannose, fucose, galactose, and NAG (2:1:3:2) for group II. Glycopeptide III in both groups consisted of mannose, fucose, galactose, NAG, and sialic acid with a ratio of 6:2.5:2.5:5.5:2 for group I and a ratio of 5:1:1:6:1 for group II. Molecular weight estimations by gel filtration indicates that there are 10 glycopeptides I and II and 20 units of glycopeptide III per molecule of γM.

scholarly journals Evaluation of outcome of early appendectomy in appendicular lump

2020 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
A. S. M. Rezbanul Haque ◽  
Bablu Kumar Saha ◽  
M. Mahfuzul Haque ◽  
M. Abdus Sattar ◽  
Upendra Nath Ray ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Recovery Period ◽  
Medical College ◽  
Group I ◽  
Perforated Appendix ◽  
Early Exploration ◽  
The Mean ◽  
Group Ii ◽  
Surgery Department ◽  
The Cost

Background: Appendicular lump is a well-known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. This study aims to evaluate the outcome of early appendectomy in an appendicular lump.Methods: A total of 210 patients were admitted in surgery and pediatric surgery department of Rangpur medical college and hospital with the diagnosis of acute appendicitis and its sequalae over two years.Results: In this study, sixty patients were included who were presented with an appendicular lump. Maximum patients (50%) were found in the age group of 21-30 years. Males (66.67%) were more affected. Eighty percent of patients were coming from below-average socio-economic conditions. In group I, early appendicectomy had done and outcomes were satisfactory and favorable. In group II, eighteen patients were operated who were admitted at 6 to 8 days after an attack of acute appendicitis, and twelve patients were continued the conservative treatment. In group II, who had done surgery, among them, fourteen patients (77.78%) were found an appendicular abscess, and four patients (22.22%) were found perforated appendix per-operatively. In group I, the mean recovery period was less and they had minimum complications. In group II, the mean recovery period was more and they had more complications.Conclusions: Based on these findings, it can be concluded that early exploration in appendicular lump patients confirm the diagnosis, cures the problem, reduces the cost of management, and shortens the convalescence period and hospital stay with reasonably satisfactory outcomes.

scholarly journals Coronary Atherosclerotic Plaque Vulnerability Rather than Stenosis Predisposes to Non-ST Elevation Acute Coronary Syndromes

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laimoud ◽  
Farouk Faris ◽  
Helmy Elghawaby
Keyword(s):  
Stable Angina ◽  
Acute Coronary Syndromes ◽  
Syntax Score ◽  
Atherosclerotic Lesions ◽  
Group I ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Coronary Lesions ◽  
Group Ii

Background. Non-ST elevation acute coronary syndromes (NSTE-ACS) may arise from moderately stenosed atherosclerotic lesions that suddenly undergo transformation to vulnerable plaques complicated by rupture and thrombosis. Objective. Assessment and tissue characterization of the coronary atherosclerotic lesions among NSTE-ACS patients compared to those with stable angina. Methodology. Evaluation of IVUS studies of 312 coronary lesions was done by 2 different experienced IVUS readers, 216 lesions in 66 patients with NSTE-ACS (group I) versus 96 lesions in 50 patients with stable angina (group II). Characterization of coronary plaques structure was done using colored-coded iMap technique. Results. The Syntax score was significantly higher in group I compared to group II (18.7 ± 7.8 vs. 8.07 ± 2.5, p=0.001). Body mass index (BMI) was significantly higher in group II while triglycerides levels were higher in group I (P=0.01 & P=0.04, respectively). History of previous MI and PCI was significantly higher in group I (P=0.016 & P=0.001, respectively). The coronary lesions of NSTE-ACS patients had less vessel area (9.86 ± 3.8 vs 11.36 ± 2.9, p=0.001), stenosis percentage (54.7 ± 14.9% vs 68.6 ± 8.7%, p=0.001), and plaque burden (54.4 ± 14.7 vs 67.8 ± 9.8, p=0.001) with negative remodeling index (0.95 ± 20 vs 1.02 ± 0.14, p=0.008) compared to the stable angina group. On the other hand, they had more lipid content (21.8 ± 7.03% vs 7.26 ± 3.47%, p=0.001), necrotic core (18.08 ± 10.19% vs 15.83 ± 4.9%, p=0.02), and calcifications (10.4 ± 5.2% vs 4.19 ± 3.29%, p=0.001) while less fibrosis (51.67 ± 7.07% vs 70.37 ± 11.7%, p=0.001) compared to the stable angina patients. Syntax score and core composition especially calcification and lipid content were significant predictors to NSTE-ACS. Conclusions. The vulnerability rather than the stenotic severity is the most important factor that predisposes to non-ST segment elevation acute coronary syndromes. The vulnerability is related to the lesion characteristics especially lipidic core and calcification while lesion fibrosis favours lesion stability.

scholarly journals Isolation and characterization of β- and γ-caseins from horse milk

1982 ◽  
Vol 203 (1) ◽  
pp. 131-139 ◽  
Author(s):  
S Visser ◽  
R Jenness ◽  
R J Mullin
Keyword(s):  
Room Temperature ◽  
Sodium Dodecyl ◽  
Sulphate Group ◽  
Group Iii ◽  
Isolation And Characterization ◽  
Group I ◽  
Beta Casein ◽  
Group Ii ◽  
Phosphate Groups

Three groups of casein components were isolated from horse milk. Group I is almost insoluble at acid and neutral pH, and is rather heterogeneous on alkaline gels with or without sodium dodecyl sulphate. Group II shows strong similarity to beta-casein from other species, as concluded from its amino acid composition and its N- and C-terminal sequences. This group consists of five electrophoretically distinguishable forms, all containing ester phosphate groups but no carbohydrate. Group III is composed of C-terminal fragments of the beta-like (group II) fraction and probably arises from the action of a plasmin-like enzyme present in horse milk. It does not contain phosphate or carbohydrate. Homology of this group with bovine gamma-caseins is demonstrated. Both beta- and gamma-like caseins are more soluble at 4 degrees C than at room temperature.

scholarly journals Assessment of anterior positioning splint in conjunction with lateral pterygoid BTX injection to treat TMJ disc displacement with reduction — a preliminary report

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Maram Taema ◽  
Nouran Abdel Nabi ◽  
Samira Ibrahim ◽  
Heba Ahmed Kamal ◽  
Aala’a Emara
Keyword(s):  
Preliminary Report ◽  
Disc Displacement ◽  
Lateral Pterygoid Muscle ◽  
Postoperative Mri ◽  
Pain Scores ◽  
Group I ◽  
Disc Position ◽  
Group Ii ◽  
The Cost ◽  
Disc Displacement With Reduction

Abstract Objective Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases. Methods Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months. Results Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores. Conclusions Group I  showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.

scholarly journals Parenteral Nutrition Combined with Enteral Nutrition for Severe Acute Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Akanand Singh ◽  
Ming Chen ◽  
Tao Li ◽  
Xiao-Li Yang ◽  
Jin-Zheng Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Nutritional Support ◽  
Combined Treatment ◽  
Apache Ii Score ◽  
Group I ◽  
Group Ii ◽  
The Cost

Background and Aims. Nutritional support in severe acute pancreatitis (SAP) is controversial concerning the merits of enteral or parenteral nutrition in the management of patients with severe acute pancreatitis. Here, we assess the therapeutic efficacy of gradually combined treatment of parenteral nutrition (PN) with enteral nutrition (EN) for SAP. Methods. The clinical data of 130 cases of SAP were analyzed retrospectively. Of them, 59 cases were treated by general method of nutritional support (Group I) and the other 71 cases were treated by PN gradually combined with EN (Group II). Results. The APACHE II score and the level of IL-6 in Group II were significantly lower than Group I (P<0.05). Complications, mortality, mean hospital stay, and the cost of hospitalization in Group II were 39.4 percent, 12.7 percent, 32 ± 9 days, and 30869.4 ± 12794.6 Chinese Yuan, respectively, which were significantly lower than those in Group I. The cure rate of Group II was 81.7 percent which is obviously higher than that of 59.3% in Group I (P<0.05). Conclusions. This study indicates that the combination of PN with EN not only can improve the natural history of pancreatitis but also can reduce the incidence of complication and mortality.

scholarly journals Effect of Using Zornia glochidiata (shelini) Meal in Replacement of Wheat Bran on Lamb Performance and Feeding Cost Decreasing

2021 ◽  
pp. 123-126
Author(s):  
Idris Idris Adam ◽  
Saed Kiir Mohamed Tagi ◽  
Mohamed Abdalla Suleiman Eshag ◽  
Hammad Dahia Salah Basar ◽  
Jadalla Jumaa Barram ◽  
...  
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Wheat Bran ◽  
Feed Intake ◽  
Body Weight Gain ◽  
Daily Weight Gain ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Cost

This trial was aimed to study the effects of replacing wheat bran with different levels of Zornia glochidiata meal on feed intake, general performance of Desert lambs and feeding cost decreasing. Twelve lambs of four months old and weighing 19.500 kg +500g were divided into three groups each with four animals. Feed intake and body weight change were monitored every ten days up to fifty days. The data were statistically analyzed via analysis of variance and the differences among means were detected least significance (LSD) test. The results indicated that voluntary dry matter intake significantly (P<0.05) increased in the group that consumed a ration with 26% Zornia glochidiata meal (II) followed by those were on a ration with wheat bran only (I) and lastly that had a ration with 42% Z. glochidiata (III). Feed intake was 1090, 970 and 910 for group II, I and III, respectively. Similarly body weight gain was significantly (P<0.05) higher in group II, (6.1kg/50 days) followed by group I (4.9 kg/50 days) and group III with 4.3 kg/50 days. The daily weight gain was 98, 122, 89 g when the lambs consumed rations with 0.00, 26 and 42 % of Z. glochidiata meal, respectively. The cost of kilogram of the first ration was 6.8 SDG when only wheat bran was used, and it decreased to 5.7 SDG when 26% wheat was replaced by Z. glochidiata meal and when Z. glochidiata meal was increased to 41% the cost was further decreased to 5 SDG.

Characterization of Pain, Vasculature and Innervation in Sickle Cell Disease.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2248-2248
Author(s):  
Kalpna Gupta ◽  
Chunsheng Chen ◽  
Marna E. Ericson ◽  
Robert P. Hebbel ◽  
Yunfang Li
Keyword(s):  
Sickle Cell Disease ◽  
Blood Vessels ◽  
Sickle Cell ◽  
Thermal Hyperalgesia ◽  
Cell Disease ◽  
Morphine Treatment ◽  
Group I ◽  
Group Ii ◽  
And Control

Abstract Pain in sickle cell disease (SCD) is characterized by chronic vasculopathy. Characterization of pain and vasculature may be critical to improve the analgesic ability of opioids in treating pain in SCD. Therefore, we examined the association between vasculature, innervation and pain in a transgenic mouse model of SCD (BERK) and control mice (HbABERK). Pain behavior was analyzed using paw withdrawal latencies (PWL) using Hargreave’s device for thermal hyperalgesia. A radiant heat stimulus was applied to the plantar surface of each hind paw from underneath the glass floor with a projector lamp bulb (CXL/CXR, 8 V, 50 W). PWL to the nearest 0.1 s was automatically recorded upon paw withdrawal. Paws were alternated randomly to preclude “order” effects. We observed that 5 mo old sickle mice showed significantly lower thresholds to noxious heat than controls (p=0.002 for females; and p=0.04 for males; n=5–7 and 15 observations/mouse). Females showed a significantly shorter latency than their respective males (control, p=0.03 and sickle, p=0.01), i.e., they were more sensitive to thermal stimuli. No significant difference was observed between sickle and control nor male and female mice (p &gt; 0.05, n = 5–7) for mechanical allodynia using von Frey filaments, suggesting that sickle mice show increased sensitivity to thermal hyperalgesia. BERK mice were subcutaneously injected with 0.7 mg morphine/Kg mice/day (equivalent to 50 mg/70 kg /day/ human adult) with an added increment of 0.14 mg/day/Kg for each week for three different time periods; Group I, treated for 6 weeks, Group II treated for 6 weeks followed by withdrawal for 6 weeks and Group III treated for 12 weeks. Morphine treatment for 6 weeks as well as 12 weeks resulted in a ∼50–75% increase in PWL vs PBS, suggesting that chronic morphine treatment decreased hyperalgesia in sickle mice. The anti-hyperalgesic effect of morphine was antagonized by simultaneous co-administration of naloxone (2 mcg/Kg/day), suggesting an opioid receptor mediated effect. Naloxone treatment alone did not show any significant effect on PWL. In Group II, withdrawal of morphine for 6 weeks following 6 wks of treatment showed about 35% increase in PWL vs PBS (p&lt;0.005), suggesting that the anti-hyperalgesic effect of morphine continues after its withdrawal. The continued anti-hyperalgesic effect of morphine following withdrawal could be secondary to its vasoregulatory effect. Indeed, confocal microscopy of skin sections revealed disorganized and stringy blood vessels, nerves and lymphatics in sickle mice vs. control. Deep blood vessels and nerve plexus, as well as the skin, were appreciably thicker in controls vs sickle. The diameter of lymphatics and densities of both blood vessels and nerves were significantly lower in sickle vs HbA controls (p= 0.0001 and 0.002, for sub-epidermal and dermal blood vessels, respectively; p=0.04 for lymphatic diameter; p=0.0001 for sub-epidermal, dermal and deep dermal nerve fibers). Functionally, we observed about 30% decrease in subcutaneous O2 measured by Laser Doppler (in real-time) in BERK vs HbA control (p&lt;0.05). Thus, complementary alteration in vasculature and innervation may underlie the chronic pain in SCD. Given that morphine promotes angiogenesis and vasodilation, its prolonged anti-hyperalgesic activity could be due to its vasoregulatory function. Together, these data suggest that intermittent therapy with morphine in SCD may provide analgesia similar to continued therapy and may even be devoid of side-effects.

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