The role of breast milk beta-endorphin and relaxin-2 on infant colic

BACKGROUND

The relationship between infant colic and breast milk beta-endorphin (BE) and relaxin-2 (RLX-2) has not been studied before.

METHODS

Thirty colic infants and their mothers constituted the study group, and the same sex, similar age and healthy infants and their mothers formed the control group. Maternal predisposing factors were analysed with questionnaires.

RESULTS

The frequency of headache and myalgia in the mothers was significantly higher in the study group compared to the control group. Sleep quality of mothers in the study group was worse than in the control group (p = 0.028). While breast milk RLX-2 level in the study group was not different from the control group, breast milk BE level in the study group was significantly higher than the control group (p = 0.039). A positive correlation was found between breast milk BE levels and crying times, and between sleep quality scores and crying times. Headache, myalgia, sleep quality and breast milk BE levels were found to have a significant effect on infant colic.

CONCLUSIONS

Breast milk RLX-2 has no role on infant colic. Breast milk BE may act as a biological mediator in transmitting of maternal predisposing factors such as poor sleep quality, headache and myalgia from mother to infant.

IMPACT

The relationship between infant colic and breast milk beta-endorphin (BE) and elaxin-2 (RLX-2) has not been studied before. Maternal sleep quality, headache, and myalgia are predisposing factors associated with infant colic. Breast milk RLX-2 has no effect on infant colic. Breast milk BE may play a role as a biological mediator in transmitting the effects of predisposing factors from mother to infant. Breast milk BE may be a mediator in biological communication between mother and infant.

Sleep during and following critical illness: A narrative review

Sleep is a complex process influenced by biological and environmental factors. Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo. Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment. This review will outline the predisposing and precipitating factors for sleep disturbance, categorised into patient, environmental and treatment-related factors. The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed. While polysomnography remains the gold-standard, its use in the critical care setting still presents many barriers. Other methodologies are needed to better understand the pathophysiology, epidemiology and treatment of sleep disturbance in this population. Subjective outcome measures, including the Richards-Campbell Sleep Questionnaire, are still required for trials involving a greater number of patients and provide valuable insight into patients’ experiences of disturbed sleep. Finally, sleep optimisation strategies are reviewed, including intervention bundles, ambient noise and light reduction, quiet time, and the use of ear plugs and eye masks. While drugs to improve sleep are frequently prescribed to patients in the ICU, evidence supporting their effectiveness is lacking.

“Death drive” scientifically reconsidered: Not a drive but a collection of trauma-induced auto-addictive diseases

Over the last 102 years, a lot of discussion was being held about the psychoanalytic conception of the “death drive,” but still with inconclusive results. In this paper, we start with a brief review of Freud’s conception, followed by a comprised overview of its subsequent support or criticisms. The core of our argument is a systematic review of current biochemical research about two proposed manifestations of the “death drive,” which could hopefully move the discussion to the realm of science. It was already established that drive satisfaction leads to the secretion of beta-endorphins, and research evidence also shows that the same biochemical mechanisms get activated in the case of masochism and the gambling disorder but only if they are preceded by chronic frustration of the essential drives. We conclude that the actual situation is more complex than Freud hypothesized, and that a fundamental revision of the psychoanalytic drive theory is necessary.

Perioperative outcomes of patients with restless leg syndrome: a single center retrospective review

STUDY OBJECTIVES

There are multiple stressors in the perioperative period for patients with restless leg syndrome (RLS) that may by implicated in the worsening of symptoms. Our primary objective was to compare the perioperative course of patients with RLS to patients without the diagnosis.

METHODS

This was a single-center, matched cohort, retrospective chart review of patients with RLS undergoing inpatient procedures from 2015 to 2019 matched 1:1 with patients without the diagnosis.

RESULTS

Patients with RLS had a higher comorbidity burden specifically pulmonary, renal, diabetes mellitus, and congestive heart failure. The perioperative course was notable for higher maximum pain scores for RLS patients in the post-anesthesia care unit (PACU) (OR 1.29, 95% CI 1.19-1.40, p < 0.001). Postoperative RLS patients also had higher maximum pain scores on postoperative days 0, 1 and 2. Odds of rapid response calls were higher in RLS patients (OR 1.43, 95% CI 1.18 to 1.73, p < 0.001). There were no other significant differences in postoperative complications. The odds of using RLS triggering medications was lower in the RLS group (OR 0.85, 95% CI 0.78-0.92, p < 0.001).

CONCLUSIONS

Our single center retrospective review found that patients with RLS had higher pain scores in the PACU and on the first few postoperative days. Rapid response team calls were more common in patients with RLS. RLS-triggering medications were significantly less likely to be used in patients with RLS. There were no significant differences in other postoperative events.

[Potential complications of patient positioning in spine surgery]

Patient position on the operating table during spine surgery is important for optimal intraoperative manipulations. However, this position is far from physiological one. An unnatural position, surgery time and sometimes necessary intraoperative change in body position can lead to certain neurological and somatic complications. Most of these events can significantly reduce the patient's working capacity and quality of life and even result disability. Medical staff placing the patient on operating table, neurosurgeons and anesthesiologists should be aware of risk factors of similar complications and their prevention. The authors describe the most serious and difficult for correction conditions, such as peripheral neuropathy, damage to visual analyzer, as well as optimal method of patient positioning.

Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism

β-Endorphins are peptides that exert a wide variety of effects throughout the body. Produced through the cleavage pro-opiomelanocortin (POMC), β-endorphins are the primarily agonist of mu opioid receptors, which can be found throughout the body, brain, and cells of the immune system that regulate a diverse set of systems. As an agonist of the body's opioid receptors, β-endorphins are most noted for their potent analgesic effects, but they also have their involvement in reward-centric and homeostasis-restoring behaviors, among other effects. These effects have implicated the peptide in psychiatric and neurodegenerative disorders, making it a research target of interest. This review briefly summarizes the basics of endorphin function, goes over the behaviors and regulatory pathways it governs, and examines the variability of β-endorphin levels observed between normal and disease/disorder affected individuals.

Sleep as a Therapeutic Target in the Aging Brain

Sleep is a behavioral phenomenon conserved among mammals and some invertebrates, yet the biological functions of sleep are still being elucidated. In humans, sleep time becomes shorter, more fragmented, and of poorer quality with advancing age. Epidemiologically, the development of age-related neurodegenerative diseases such as Alzheimer's and Parkinson's disease is associated with pronounced sleep disruption, whereas emerging mechanistic studies suggest that sleep disruption may be causally linked to neurodegenerative pathology, suggesting that sleep may represent a key therapeutic target in the prevention of these conditions. In this review, we discuss the physiology of sleep, the pathophysiology of neurodegenerative disease, and the current literature supporting the relationship between sleep, aging, and neurodegenerative disease.