Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age-and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

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Objective Chronic overlapping pain conditions (COPCs) represent a co‐aggregation of widespread pain disorders. We characterized differences in physical and psychosocial functioning in patients with chronic migraine (CM) and those with CM and COPCs. Background Patients with CM and COPCs have been identified as a distinct subgroup of patients with CM, and these patients may be vulnerable to greater symptom severity and burden. Methods Data were extracted from Collaborative Health Outcomes Information Registry (an open‐source learning health‐care system), completed at the patients' first visit at a large tertiary care pain management center and electronic medical records. In 1601 patients with CM, the number of non‐cephalic areas of pain endorsed on a body map was used to examine the differences in pain, physical and psychosocial function, adverse life experience, and health‐care utilization. Results Patients endorsing more body map regions reported significantly worse symptoms and function across all domains. Scored on a t‐score metric (mean = 50, SD = 10), endorsement of one additional body map region corresponded with a 0.69‐point increase in pain interference (95% CI = 0.55, 0.82; p < 0.001; Cohen's f = 0.328), 1.15‐point increase in fatigue (95% CI = 0.97, 1.32; p < 0.001; Cohen's f = 0.432), and 1.21‐point decrease in physical function (95% CI = −1.39, −1.03; p < 0.001; Cohen's f = 0.560). Patients with more widespread pain reported approximately 5% more physician visits (95% CI = 0.03, 0.07; p < 0.001), and patients reporting adverse life events prior to age 17 endorsed 22% more body map regions (95% CI = 0.11, 0.32; p < 0.001). Conclusions Patients with CM and other overlapping pain conditions as noted on the body map report significantly worse pain‐related physical function, psychosocial functioning, increased health‐care utilization, and greater association with adverse life experiences, compared with those with localized CM. This study provides further evidence that patients with CM and co‐occurring pain conditions are a distinct subgroup of CM and can be easily identified through patient‐reported outcome measures.

The results indicate that participation in MIAU leads to a decrease in stigmatization of mental illness and a greater sense of compassion among UCSF medical students. This finding is consistent with previous research suggesting social and cognitive congruence among peers and peer-teachers can result in meaningful learning experiences. MIAU may represent a sustainable model to supplement current systems to promote well-being of medical trainees.