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Plas SL, Oleksiak CR, Pitre C, Melton C, Moscarello JM, Maren S. Acute stress yields a sex-dependent facilitation of signaled active avoidance in rats. Neurobiol Stress 2024; 31:100656. [PMID: 38994219 PMCID: PMC11238190 DOI: 10.1016/j.ynstr.2024.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating disorder characterized by excessive fear, hypervigilance, and avoidance of thoughts, situations or reminders of the trauma. Among these symptoms, relatively little is known about the etiology of pathological avoidance. Here we sought to determine whether acute stress influences avoidant behavior in adult male and female rats. We used a stress procedure (unsignaled footshock) that is known to induce long-term sensitization of fear and potentiate aversive learning. Rats were submitted to the stress procedure and, one week later, underwent two-way signaled active avoidance conditioning (SAA). In this task, rats learn to prevent an aversive outcome (shock) by performing a shuttling response when exposed to a warning signal (tone). We found that acute stress significantly enhanced SAA acquisition rate in females, but not males. Female rats exhibited significantly greater avoidance responding on the first day of training relative to controls, reaching similar levels of performance by the second day. Males that underwent the stress procedure showed similar rates of acquisition to controls but exhibited resistance to extinction. This was manifest as both elevated avoidance and intertrial responding across extinction days relative to non-stressed controls, an effect that was not observed in females. In a second experiment, acute stress sensitized footshock unconditioned responses in males, not females. However, males and females exhibited similar levels of stress-enhanced fear learning (SEFL), which was expressed as sensitized freezing to a shock-paired context. Together, these results reveal that acute stress facilitates SAA performance in both male and female rats, though the nature of this effect is different in the two sexes. We did not observe sex differences in SEFL, suggesting that the stress-induced sex difference in performance was selective for instrumental avoidance. Future work will elucidate the neurobiological mechanisms underlying the differential effect of stress on instrumental avoidance in male and female rats.
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Affiliation(s)
- Samantha L. Plas
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Cecily R. Oleksiak
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Claire Pitre
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Chance Melton
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Justin M. Moscarello
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Stephen Maren
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
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Zaneva-Hristova D, Borisova-Papancheva T. Incidence of Postoperative Flare-Up After Single-Visit and Multi-visit Endodontic Therapy. Cureus 2024; 16:e57995. [PMID: 38738161 PMCID: PMC11088455 DOI: 10.7759/cureus.57995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
This article presents results obtained from a survey, including patients who underwent endodontic treatment by the single-visit or multi-visit method, after confirmation of the diagnosis of chronic apical periodontitis. OBJECTIVE The aim of the survey was to obtain data from the studied patients on the frequency and the type of postoperative pain after treatment of chronic apical periodontitis, as well as whether there is a relation between gender, age, and postoperative pain. MATERIALS AND METHODS A visual analog scale was used to study the intensity of postoperative pain in the treatment of teeth diagnosed with CPP, which are treated by one of two methods - single-visit or multi-visit method. The total number of surveyed patients is 71. The patients were examined and treated at the Dental Clinic "Imperial" in Varna, Bulgaria, in 2020. Thirty-one of them were treated by the single-visit method, and the remaining 40 by the multi-visit method with placement of a temporary dressing or sterile swab. RESULTS A relatively large proportion (70%) of patients reported mild pain immediately after the root canal filling. A relatively large proportion (90.3%) of patients did not report pain one week after the root canal filling. The more frequent symptoms were observed in cases treated by the multi-visit method, after the application of a temporary dressing. Patients who reported taking analgesics were treated in the multi-visit method. More frequent pain symptoms with both methods of treatment were observed in men aged 36-60 years. CONCLUSION Although exacerbation has been shown to have no significant effect on the outcome of endodontic treatment, it is highly undesirable. In the short term, the postoperative pain in patients treated by the multi-visit method through the use of intracanal medication is more pronounced. Patients receiving the single-visit treatment reported less postoperative pain.
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Affiliation(s)
- Denitsa Zaneva-Hristova
- Department of Conservative Dentistry and Endodontics, The Faculty of Dental Medicine-Varna, Varna, BGR
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3
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Dekamin S, Ghasemi M, Dehpour AR, Ghazi-Khansari M, Shafaroodi H. Protective Effects of Glatiramer Acetate Against Paclitaxel-Induced Peripheral Neuropathy in Rats: A Role for Inflammatory Cytokines and Oxidative Stress. Neurochem Res 2024; 49:1049-1060. [PMID: 38252396 DOI: 10.1007/s11064-023-04088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a major challenge for cancer patients who undergo chemotherapy with paclitaxel. Therefore, finding effective therapies for CIPN is crucial. Glatiramer acetate is used to treat multiple sclerosis that exerts neuroprotective properties in various studies. We hypothesized that glatiramer acetate could also improve the paclitaxel-induced peripheral neuropathy. We used a rat model of paclitaxel (2 mg/kg/every other day for 7 doses)-induced peripheral neuropathy. Rats were treated with either different doses of glatiramer acetate (1, 2, 4 mg/kg/day) or its vehicle for 14 days in separate groups. The mechanical and thermal sensitivity of the rats by using the Von Frey test and the Hot Plate test, respectively, were assessed during the study. The levels of oxidative stress (malondialdehyde and superoxide dismutase), inflammatory markers (TNF-α, IL-10, NF-kB), and nerve damage (H&E and S100B staining) in the sciatic nerves of the rats were also measured at the end of study. Glatiramer acetate (2 and 4 mg/kg) exerted beneficial effects on thermal and mechanical allodynia tests. It also modulated the inflammatory response by reducing TNF-α and NF-κB levels, enhancing IL-10 production, and improving the oxidative stress status by lowering malondialdehyde and increasing superoxide dismutase activity in the sciatic nerve of the rats. Furthermore, glatiramer acetate enhanced nerve conduction velocity in all treatment groups. Histological analysis revealed that glatiramer acetate (2 and 4 mg/kg) prevented paclitaxel-induced damage to the nerve structure. These results suggest that glatiramer acetate can alleviate the peripheral neuropathy induced by paclitaxel.
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Affiliation(s)
- Sajad Dekamin
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Ghasemi
- Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA, 01803, USA
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Ghazi-Khansari
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Shafaroodi
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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4
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Snell GE, Seage CH, Mercer J. A phenomenological study on the lived experience of men with Chronic Fatigue Syndrome. J Health Psychol 2024; 29:225-237. [PMID: 37455618 PMCID: PMC10913334 DOI: 10.1177/13591053231186385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Whilst chronic fatigue syndrome (CFS) has been widely researched amongst women, studies investigating how men experience a CFS diagnosis is limited. This study utilised an interpretative phenomenological approach to interview five men who have a medical diagnosis of CFS. Six themes emerged to demonstrate the participants' experiences prior to, during and after obtaining their CFS diagnosis. Findings revealed that participants were initially reluctant to accept their condition, confounded by their perception that symptoms compromised their sense of masculinity. They also felt that healthcare professionals had limited recognition of CFS leading them to seek social support and legitimisation from other sources. The struggle to come to terms with a different lifestyle and sense of masculinity prevailed. Such knowledge could be effectively utilised by researchers, practitioners and employers to facilitate an increased understanding of male accounts of the condition and more bespoke interventions where required.
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Secci ME, Kelley LK, Avegno EM, Holmgren EB, Chen L, Rein SL, Engi SA, Quinlan V, Wilson L, Gilpin NW, Wills TA. Adolescent Alcohol Exposure Produces Sex-Specific Long-term Hyperalgesia via Changes in Central Amygdala Circuit Function. Biol Psychiatry 2024; 95:207-219. [PMID: 37717844 PMCID: PMC10866691 DOI: 10.1016/j.biopsych.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Exposure to alcohol during adolescence produces many effects that last well into adulthood. Acute alcohol use is analgesic, and people living with pain report drinking alcohol to reduce pain, but chronic alcohol use produces increases in pain sensitivity. METHODS We tested the acute and lasting effects of chronic adolescent intermittent ethanol (AIE) exposure on pain-related behavioral and brain changes in male and female rats. We also tested the long-term effects of AIE on synaptic transmission in midbrain (ventrolateral periaqueductal gray [vlPAG])-projecting central amygdala (CeA) neurons using whole-cell electrophysiology. Finally, we used circuit-based approaches (DREADDs [designer receptors exclusively activated by designer drugs]) to test the role of vlPAG-projecting CeA neurons in mediating AIE effects on pain-related outcomes. RESULTS AIE produced long-lasting hyperalgesia in male, but not female, rats. Similarly, AIE led to a reduction in synaptic strength of medial CeA cells that project to the vlPAG in male, but not female, rats. Challenge with an acute painful stimulus (i.e., formalin) in adulthood produced expected increases in pain reactivity, and this effect was exaggerated in male rats with a history of AIE. Finally, CeA-vlPAG circuit activation rescued AIE-induced hypersensitivity in male rats. CONCLUSIONS Our findings are the first, to our knowledge, to show long-lasting sex-dependent effects of adolescent alcohol exposure on pain-related behaviors and brain circuits in adult animals. This work has implications for understanding the long-term effects of underage alcohol drinking on pain-related behaviors in humans.
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Affiliation(s)
- Maria E Secci
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Leslie K Kelley
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Elizabeth M Avegno
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Eleanor B Holmgren
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Lily Chen
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Sydney L Rein
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Sheila A Engi
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Virginia Quinlan
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Lisa Wilson
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Nicholas W Gilpin
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Neuroscience Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Veterans Affairs Southeast Louisiana Healthcare System, New Orleans, Louisiana
| | - Tiffany A Wills
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
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Golomb D, Shemesh A, Goldberg H, Hen E, Atmana F, Barkai E, Shalom B, Cooper A, Raz O. Effect of gender on presentation and outcome of renal colic. Urologia 2023; 90:653-658. [PMID: 36635856 DOI: 10.1177/03915603221150039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones. METHODS Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected. RESULTS 778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% (n = 609) were males and 22% (n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively (p = 0.08). Female patients presented with a higher body temperature (p = 0.01), pulse rate (p < 0.0001), nausea and vomiting (p < 0.0001), elevated serum C-reactive protein (CRP) (p = 0.002) compared to males. The prevalence of elevated serum creatinine was higher in males (p < 0.0001). Alpha-blockers were recommended on discharge in 54.8% (334) of males, compared to only 29.6% (50) of females (p < 0.0001). Spontaneous stone expulsion was significantly higher in males compared to females (p = 0.01). CONCLUSIONS Our results demonstrate that gender does effect presentation and outcome of patients presenting with renal colic. Females were found to have elevated infectious parameters, more nausea and vomiting and a higher incidence of positive urine cultures. Males admitted to the ED were found to have significantly higher serum creatinine levels. Medical expulsive therapy (MET) with alpha-blockers was prescribed significantly less in female patients, which may have resulted in a lower spontaneous stone expulsion rate.
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Affiliation(s)
- Dor Golomb
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Amit Shemesh
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Hanan Goldberg
- Department of Urology, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Eyal Hen
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Fahed Atmana
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Eyal Barkai
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Ben Shalom
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Amir Cooper
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Orit Raz
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
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Buonanno P, Marra A, Iacovazzo C, Vargas M, Nappi S, Squillacioti F, de Siena AU, Servillo G. The PATIENT Approach: A New Bundle for the Management of Chronic Pain. J Pers Med 2023; 13:1551. [PMID: 38003866 PMCID: PMC10672627 DOI: 10.3390/jpm13111551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/15/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Chronic pain is one of the most challenging diseases for physicians as its etiology and manifestations can be extremely varied. Many guidelines have been published and many therapeutic options are nowadays available for the different types of pain. Given the enormous amount of information that healthcare providers must handle, it is not always simple to keep in mind all the phases and strategies to manage pain. We here present the acronym PATIENT (P: patient's perception; A: assessment; T: tailored approach; I: iterative evaluation; E: education; N: non-pharmacological approach; T: team), a bundle which can help to summarize all the steps to follow in the management of chronic pain. METHODS We performed a PubMed search with a list of terms specific for every issue of the bundle; only English articles were considered. RESULTS We analyzed the literature investigating these topics to provide an overview of the available data on each bundle's issue; their synthesis lead to an algorithm which may allow healthcare providers to undertake every step of a patient's evaluation and management. DISCUSSION Pain management is very complex; our PATIENT bundle could be a guide to clinicians to optimize a patient's evaluation and treatment.
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Lamberti N, Traina L, Savriè C, Tsolaki E, Rinaldo N, Straudi S, Guerzoni F, Napoli N, Manfredini R, Gasbarro V, Manfredini F. Lower All-Cause Mortality Risk in Females and Males with Peripheral Artery Disease following Pain-Free Home-Based Exercise: A 7-Year Observational Study. J Pers Med 2023; 13:jpm13040636. [PMID: 37109022 PMCID: PMC10143366 DOI: 10.3390/jpm13040636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
We evaluated the sex-specific difference in response upon participation in an exercise program with respect to the risk of adverse clinical outcomes among patients with peripheral artery disease (PAD) and claudication. The records of 400 PAD patients were assessed between 2012 and 2015. Two hundred of them were addressed to a walking program prescribed at the hospital and executed at home at symptom-free walking speed (Ex), while the remaining 200 acted as a control group (Co). The number and date of deaths, all-cause hospitalizations, and amputations for a 7-year period were collected from the regional registry. At baseline, no differences were observed (MEXn = 138; FEXn = 62; MCOn = 149; FCOn = 51). The 7-year survival rate was significantly higher in FEX (90%) than in MEX (82% hazard ratio, HR: 0.542 95% CI 0.331-0.885), FCO (45%, HR: 0.164 95% CI 0.088-0.305), and MCO (44%; HR: 0.157 95% CI 0.096-0.256). A significantly lower rate of hospitalization (p < 0.001) and amputations (p = 0.016) was observed for the Ex group compared to the Co group, without differences by sex. In conclusion, in PAD patients, active participation in a home-based pain-free exercise program was associated with a lower rate of death and better long-term clinical outcomes, particularly among women.
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Affiliation(s)
- Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Luca Traina
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Caterina Savriè
- Clinica Medica Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Elpiniki Tsolaki
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Franco Guerzoni
- Health Statistics Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Nicola Napoli
- Health Statistics Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Roberto Manfredini
- Clinica Medica Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
| | - Vincenzo Gasbarro
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
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Ghodrati M, Walton DM, MacDermid JC. Exploring the contributions of sex and traditionally genderized interpersonal-expressive traits to variability in post-trauma pain ratings. PLoS One 2022; 17:e0278399. [PMID: 36477297 PMCID: PMC9728931 DOI: 10.1371/journal.pone.0278399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Multiple intra- and inter-individual variabilities sculpt the experience of pain. However, integration of sex and gender has been under-explored in explanatory models of pain. This study aimed to examine the role of sex and traditionally genderized interpersonal-expressive traits, and their interactions in explaining the variability of pain ratings. METHODS Data from 113 participants following acute non-catastrophic musculoskeletal (MSK) injuries were included. Participants completed the Brief Pain Inventory (BPI) and the Gender, Pain and Expectations Scale (GPES). An independent T-test was used to compare differences in BPI subscales between the sexes. Pearson correlations explored the associations between BPI and GPES subscale scores for the overall sample and also for the sample when disaggregated by sex. Multiple linear regression was used to investigate the interaction of sex and gender traits in explaining the BPI scores. RESULTS No differences were found between the sexes in mean BPI Severity and Interference. Across sexes, Relationship-oriented was positively associated with greater BPI Severity (r = 0.20) and Emotive was positively associated with BPI Interference (r = 0.24). In sex-disaggregated analyses, these associations were significant in females only. Goal-oriented was associated with neither BPI Severity nor Interference. In multivariate regression, only Emotive was a significant predictor of BPI Interference. DISCUSSION The findings suggest that variances in pain-related interference are partially explained by scores on a scale measuring self-perceptions of Emotive qualities. Sex was not predictive of either pain outcome in both bivariate and multivariate analyses. Researchers and clinicians are encouraged to consider both sex- and gender-based variables when interpreting patient pain reports.
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Affiliation(s)
- Maryam Ghodrati
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - David M. Walton
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
- * E-mail:
| | - Joy C. MacDermid
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
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Tetui M, Grindrod K, Waite N, VanderDoes J, Taddio A. Integrating the CARD (Comfort Ask Relax Distract) system in a mass vaccination clinic to improve the experience of individuals during COVID-19 vaccination: a pre-post implementation study. Hum Vaccin Immunother 2022; 18:2089500. [PMID: 35723609 PMCID: PMC9620984 DOI: 10.1080/21645515.2022.2089500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Many people have negative experiences with vaccination due to stress-related reactions including fear and pain. We used a pre-post study design to evaluate the impact of implementing a modified version of the CARD (Comfort-Ask-Relax-Distract) system on stress-related reactions in individuals aged 12 y or older undergoing COVID-19 vaccinations in mass vaccination clinics. Vaccine recipients reported their level of pain, fear and dizziness during vaccination. Clinic staff reported their attitudes about CARD and use of CARD interventions. CARD improved client symptoms across genders and ages with an average reduction in needle pain, fear and dizziness of 75%, 40% and 44%, respectively. CARD was more effective in younger individuals. Clinic staff reported positive attitudes about CARD and uptake of selected CARD interventions. In summary, the modified CARD system reduced stress-related responses in a general population undergoing COVID-19 vaccinations in a mass vaccination clinic, was feasible and acceptable to staff. Future implementation efforts are recommended that include more diverse cultural contexts and incorporate education of individuals about CARD ahead of time.
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Affiliation(s)
- Moses Tetui
- School of Pharmacy, University of Waterloo, Waterloo, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - Jeremy VanderDoes
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
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Romanescu M, Buda V, Lombrea A, Andor M, Ledeti I, Suciu M, Danciu C, Dehelean CA, Dehelean L. Sex-Related Differences in Pharmacological Response to CNS Drugs: A Narrative Review. J Pers Med 2022; 12:jpm12060907. [PMID: 35743692 PMCID: PMC9224918 DOI: 10.3390/jpm12060907] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 02/07/2023] Open
Abstract
In the last decades, both animal and human studies have neglected female subjects with the aim of evading a theorized intricacy of feminine hormonal status. However, clinical experience proves that pharmacological response may vary between the two sexes since pathophysiological dissimilarities between men and women significantly influence the pharmacokinetics and pharmacodynamics of drugs. Sex-related differences in central nervous system (CNS) medication are particularly challenging to assess due to the complexity of disease manifestation, drugs’ intricate mechanisms of action, and lack of trustworthy means of evaluating the clinical response to medication. Although many studies showed contrary results, it appears to be a general tendency towards a certain sex-related difference in each pharmacological class. Broadly, opioids seem to produce better analgesia in women especially when they are administered for a prolonged period of time. On the other hand, respiratory and gastrointestinal adverse drug reactions (ADRs) following morphine therapy are more prevalent among female patients. Regarding antidepressants, studies suggest that males might respond better to tricyclic antidepressants (TCAs), whereas females prefer selective serotonin reuptake inhibitors (SSRI), probably due to their tolerance to particular ADRs. In general, studies missed spotting any significant sex-related differences in the therapeutic effect of antiepileptic drugs (AED), but ADRs have sex variations in conjunction with sex hormones’ metabolism. On the subject of antipsychotic therapy, women appear to have a superior response to this pharmacological class, although there are also studies claiming the opposite. However, it seems that reported sex-related differences regarding ADRs are steadier: women are more at risk of developing various side effects, such as metabolic dysfunctions, cardiovascular disorders, and hyperprolactinemia. Taking all of the above into account, it seems that response to CNS drugs might be occasionally influenced by sex as a biological variable. Nonetheless, although for each pharmacological class, studies generally converge to a certain pattern, opposite outcomes are standing in the way of a clear consensus. Hence, the fact that so many studies are yielding conflicting results emphasizes once again the need to address sex-related differences in pharmacological response to drugs.
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Affiliation(s)
- Mirabela Romanescu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
| | - Valentina Buda
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
- Correspondence: ; Tel.: +40-755-100-408
| | - Adelina Lombrea
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Minodora Andor
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.A.); (L.D.)
| | - Ionut Ledeti
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Advanced Instrumental Screening Center, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Maria Suciu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
| | - Corina Danciu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Cristina Adriana Dehelean
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Liana Dehelean
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.A.); (L.D.)
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Both Gender and Agonistic Experience Affect Perceived Pain during the Cold Pressor Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042336. [PMID: 35206523 PMCID: PMC8872125 DOI: 10.3390/ijerph19042336] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 01/12/2023]
Abstract
Background. Differences in pain perception in athletes have recently been highlighted in the literature. Objectives. To compare gender ratings of perceived pain in athletes with low and high agonistic experiences (N = 200) using the Cold Pressor Test (CPT). Methods. A three-way repeated measures ANOVA to assess both the effects of the athletes’ gender and lower vs. higher agonistic experiences in the intensity of perceived pain at the beginning of the cold box hand immersion (L0) and after a 90 s interval (L1). Results. There was a statistically significant interaction effect between the level of the agonistic experience and gender in the two moments: p < 0.001; ηp2 = 0.266; F(1,49) = 9.771. Simple main effects analysis showed a significative difference for females at L0: F(1,99) = 93.567, p < 0.025, partial η2 = 0.302) and for males at L1: F(1,99) = 173.420, p < 0.025, partial η2 = 0.666. At the initial moment of CPT, the female athletes showed significantly higher perceived intensity than males, regardless of their experience level. After a 90 s interval, a significantly lower pain perception effect associated with the increased competitive experience of male athletes was observed. Female athletes did not appear to benefit from the experience effect on their pain tolerance. Conclusions. The study confirmed a significant difference in pain perception associated with the athletes’ gender and agonistic experience. Separate explanations related to the pattern of pain inhibition and the acquired reduction in pain sensitivity are reported.
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Behrens R, Pliske G, Umbreit M, Piatek S, Walcher F, Elkmann N. A Statistical Model to Determine Biomechanical Limits for Physically Safe Interactions With Collaborative Robots. Front Robot AI 2022; 8:667818. [PMID: 35187090 PMCID: PMC8850785 DOI: 10.3389/frobt.2021.667818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
Collaborative robots (cobots) provide a wide range of opportunities to improve the ergonomics and efficiency of manual work stations. ISO/TS 15066 defines power and force limiting (PFL) as one of four safeguarding modes for these robots. PFL specifies biomechanical limits for hazardous impacts and pinching contacts that a cobot must not exceed to protect humans from serious injuries. Most of the limits in ISO/TS 15066 are preliminary, since they are based on unverified data from a literature survey. This article presents a human-subject study that provides new and experimentally verified limits for biomechanically safe interactions between humans and cobots. The new limits are specifically tailored to impact and pinching transferred through blunt and semi-sharp surfaces as they can occur in the event of human error or technical failures. Altogether 112 subjects participated in the study and were subjected to tests with emulated impact and pinching loads at 28 different body locations. During the experiments, the contact force was gradually increased until the load evoked a slightly painful feeling on the subject’s body location under test. The results confirm that the pain thresholds of males and females are different in specific body regions. Therefore, when defining biomechanical limits, the gender difference must be taken into account. A regression model was utilized to incorporate the gender effect as a covariate into a conventional statistical distribution model that can be used to calculate individual limits, precisely fitted to a specific percentile of a mixed group of male and female workers which interacting with cobots.
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Affiliation(s)
- R. Behrens
- Robotic Systems, Fraunhofer IFF, Magdeburg, Germany
- *Correspondence: R. Behrens ,
| | - G. Pliske
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | | | - S. Piatek
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | - F. Walcher
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | - N. Elkmann
- Robotic Systems, Fraunhofer IFF, Magdeburg, Germany
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14
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Adverse Effects Associated with Multiple Classes of Dietary Supplements: The Military Dietary Supplement Use Study. J Acad Nutr Diet 2022; 122:1851-1863. [DOI: 10.1016/j.jand.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/06/2022] [Accepted: 01/27/2022] [Indexed: 11/21/2022]
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15
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Simultaneous measurement of intra-epidermal electric detection thresholds and evoked potentials for observation of nociceptive processing following sleep deprivation. Exp Brain Res 2022; 240:631-649. [PMID: 34993590 PMCID: PMC8739349 DOI: 10.1007/s00221-021-06284-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022]
Abstract
Sleep deprivation has been shown to increase pain intensity and decrease pain thresholds in healthy subjects. In chronic pain patients, sleep impairment often worsens the perceived pain intensity. This increased pain perception is the result of altered nociceptive processing. We recently developed a method to quantify and monitor altered nociceptive processing by simultaneous tracking of psychophysical detection thresholds and recording of evoked cortical potentials during intra-epidermal electric stimulation. In this study, we assessed the sensitivity of nociceptive detection thresholds and evoked potentials to altered nociceptive processing after sleep deprivation in an exploratory study with 24 healthy male and 24 healthy female subjects. In each subject, we tracked nociceptive detection thresholds and recorded central evoked potentials in response to 180 single- and 180 double-pulse intra-epidermal electric stimuli. Results showed that the detection thresholds for single- and double-pulse stimuli and the average central evoked potential for single-pulse stimuli were significantly decreased after sleep deprivation. When analyzed separated by sex, these effects were only significant in the male population. Multivariate analysis showed that the decrease of central evoked potential was associated with a decrease of task-related evoked activity. Measurement repetition led to a decrease of the detection threshold to double-pulse stimuli in the mixed and the female population, but did not significantly affect any other outcome measures. These results suggest that simultaneous tracking of psychophysical detection thresholds and evoked potentials is a useful method to observe altered nociceptive processing after sleep deprivation, but is also sensitive to sex differences and measurement repetition.
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Sharifi R, Bahrami H, Safaei M, Mozaffari HR, Hatami M, Imani MM, Moradpoor H, Golshah A. A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Roohollah Sharifi
- Kermanshah University of Medical Sciences, Iran; Kermanshah University of Medical Sciences, Iran
| | | | | | - Hamid Reza Mozaffari
- Kermanshah University of Medical Sciences, Iran; Kermanshah University of Medical Sciences, Iran
| | | | - Mohammad Moslem Imani
- Kermanshah University of Medical Sciences, Iran; Kermanshah University of Medical Sciences, Iran
| | - Hedaiat Moradpoor
- Kermanshah University of Medical Sciences, Iran; Kermanshah University of Medical Sciences, Iran
| | - Amin Golshah
- Kermanshah University of Medical Sciences, Iran; Kermanshah University of Medical Sciences, Iran
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17
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Machado R, Comparin D, Ignácio SA, da Silva Neto UX. Postoperative pain after endodontic treatment of necrotic teeth with large intentional foraminal enlargement. Restor Dent Endod 2021; 46:e31. [PMID: 34513637 PMCID: PMC8411006 DOI: 10.5395/rde.2021.46.e31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 01/01/2023] Open
Abstract
Objectives To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE. Trial Registration The Brazilian Clinical Trials Registry Identifier: RBR-3r967t
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Statistics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Statistics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Noboa K, Keller J, Hergenrader K, Housh T, Anders JP, Neltner T, Schmidt R, Johnson G. Men Exhibit Greater Pain Pressure Thresholds and Times to Task Failure but Not Performance Fatigability Following Self-Paced Exercise. Percept Mot Skills 2021; 128:2326-2345. [PMID: 34313524 DOI: 10.1177/00315125211035028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The purpose of the current study was to determine if, and to what extent, sex differences in performance fatigability after a sustained, bilateral leg extension, anchored to a moderate rating of perceived exertion (RPE), could be attributed to muscle size, muscular strength, or pain pressure threshold (PPT) in young, healthy adults. Thirty adults (men: n = 15, women: n = 15) volunteered to complete a sustained leg extension task anchored to RPE = 5 (10-point OMNI scale) as well as pretest and posttest maximal voluntary isometric contraction (MVIC) trials. The fatigue-induced decline in MVIC force was defined as performance fatigability. We used muscle cross-sectional area (mCSA) to quantify muscle size and a dolorimeter to assess PPT. The sustained task induced fatigue such that both men and women exhibited significant (p < 0.05) decreases in MVIC force from pretest to posttest (M = 113.3, SD =24.2 kg vs. M = 98.3, SD = 23.1 kg and M = 73.1, SD =14.5 kg vs. M = 64.1, SD = 16.2 kg, respectively), with no significant sex differences in performance fatigability (grand M = 12.6, SD =10.6%). Men, however, exhibited significantly (p < 0.05) longer time to task failure (TTF) than women (M = 166.1, SD =83.0 seconds vs. M = 94.6, SD =41.7) as well as greater PPT (M = 5.9, SD = 2.2 kg vs. M = 3.4, SD =1.1 kg). The only significant predictor of performance fatigability was PPT. In conclusion, differences in PPT, at least in part, mediate variations in TTF during self-paced exercise anchored to a specific RPE and resulting in performance fatigability.
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Affiliation(s)
- Karina Noboa
- Performance and Physique Enhancement Laboratory, Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, United States
| | - Joshua Keller
- Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, United States
| | - Kipp Hergenrader
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
| | - Terry Housh
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
| | - John Paul Anders
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
| | - Tyler Neltner
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
| | - Richard Schmidt
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
| | - Glen Johnson
- Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education, University of Nebraska - Lincoln, Lincoln, United States
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Silva PUJ, Meneses-Santos D, Vieira WDA, Ramacciato JC, da Silva RP, da Silva MCP, Rode SDM, Paranhos LR. Preemptive use of intravenous ibuprofen to reduce postoperative pain after lower third molar surgery: a systematic review of randomized controlled trials. Clinics (Sao Paulo) 2021; 76:e2780. [PMID: 34190850 PMCID: PMC8221561 DOI: 10.6061/clinics/2021/e2780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to systematically review the literature to assess the effect of preemptive intravenous ibuprofen on pain reduction after lower third molar surgery. Nine databases (PubMed, Scopus, LILACS, SciELO, Embase, Web of Science, Cochrane, Open Gray, and Open Thesis) were used as sources of research, including "grey literature." The protocol was registered in PROSPERO. Only randomized clinical trials evaluating the effects of preemptive intravenous ibuprofen on pain during and immediately after the extraction of lower third molars were included, without restrictions of year and language. Two reviewers independently performed the study selection, data extraction, and assessment of the risk of bias. The "Joanna Briggs Institute for Randomized Controlled Trials" tool was used to assess the risk of bias. Each study was categorized according to the percentage of positive responses to the questions corresponding to the assessment instrument. The results were measured narratively/descriptively. The initial search resulted in 3,257 records, of which only three studies (n=150 participants) met the eligibility criteria and were included in the qualitative analysis. All studies were published in 2019. The risk of bias ranged from low to moderate. Two studies found significant pain reduction within 48 h after the procedure. In conclusion, the use of preemptive intravenous ibuprofen for extracting third molars reduces pain and analgesic consumption after the surgical procedure.
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Affiliation(s)
- Pedro Urquiza Jayme Silva
- Program de Pos-Graduacao em Odontologia, Faculdade de Odontologia, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Daniela Meneses-Santos
- Programa de Residencia, Departamento de Cirurgia e Traumatologia Buco-Maxilo-Facial, Faculdade de Odontologia, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Walbert de Andrade Vieira
- Departamento de Odontologia Restauradora, Divisao de Endodontia, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, BR
| | - Juliana Cama Ramacciato
- Departamento de Farmacologia, Anestesiologia e Terapeutica, Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontologicas Sao Leopoldo Mandic, Campinas, SP, BR
| | - Ricardo Pedro da Silva
- Program de Pos-Graduacao em Odontologia, Faculdade de Odontologia, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Marcelo Caetano Parreira da Silva
- Departamento de Cirurgia e Traumatologia Buco-Maxilo-Facial, Faculdade de Odontologia, Universidade Federal de Uberlandia (UFU), Uberlandia, MG, BR
| | - Sigmar de Mello Rode
- Departamento de Materiais Odontologicos e Protese, Instituto de Ciencia e Tecnologia, Universidade Estadual Paulista Julio de Mesquita Filho, Campus Sao Jose dos Campos, Sao Jose dos Campos, SP, BR
| | - Luiz Renato Paranhos
- Area de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal de Uberlandia (UFU), Uberlandia, MG, BR
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20
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Ghodrati M, Walton DM, MacDermid JC. Exploring the Domains of Gender as Measured by a New Gender, Pain and Expectations Scale. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:87-96. [PMID: 33937906 PMCID: PMC8080910 DOI: 10.1089/whr.2020.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 05/03/2023]
Abstract
Background: While sex- or gender-based differences in pain expression have been documented, exploration of traditionally genderized traits on pain has been hampered by the lack of strong measurement tools. This study evaluated the structural validity of a 16-item "Gender personality traits" subscale of a recently developed Gender, Pain and Expectations Scale (GPES). Methods: Data were drawn from an existing database of 248 participants (65.7% female). Maximum likelihood-based confirmatory factor analysis was carried out while considering the conceptual meaningfulness of subscales to evaluate the factor structure identified by these traits. Construct validity was explored using a priori hypotheses regarding anticipated mean differences in scores between biological male and female participants. Results: A meaningful factor structure could not be defined with all 16 items. Through conceptual and statistical triangulation a three-factor structure informed by 10 items was identified that satisfied acceptable fit criteria. The factors were termed "Emotive," "Relationship-Oriented," and "Goal-Oriented." Evidence of construct validity was supported through significant sex-based differences (p ≤ 0.02) in the expected directions for all three subscales. Conclusions: Review of the items in the three factors led the researchers to endorse a move away from naming these "masculine" and "feminine," rather focusing on the nature of the traits: "Relationship-oriented," "Emotive," and "Goal-oriented." Implications for researchers conducting sex/gender-based pain research are discussed. Clinical Trial Registration number: NCT02711085.
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Affiliation(s)
- Maryam Ghodrati
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - David M. Walton
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - Joy C. MacDermid
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
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21
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Maerz T, Nepple JJ, Bedi A, Zaltz I, Belzile É, Beaulé PE, Sink EL, Clohisy JC. Sex Differences in Clinical Outcomes Following Surgical Treatment of Femoroacetabular Impingement. J Bone Joint Surg Am 2021; 103:415-423. [PMID: 33439607 DOI: 10.2106/jbjs.20.00394] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sex-based differences in clinical outcomes following surgical treatment of femoroacetabular impingement remain largely uncharacterized; this prospective, multicenter study evaluated these differences both directly and adjusted for covariates. METHODS Hips undergoing surgical treatment of symptomatic femoroacetabular impingement were prospectively enrolled in a multicenter cohort. Patient demographics, radiographic parameters, intraoperatively assessed disease severity, and history of surgical procedures, as well as patient-reported outcome measures, were collected preoperatively and at a mean follow-up of 4.3 years. A total of 621 (81.6%) of 761 enrolled hips met the minimum 1 year of follow-up and were included in the analysis; 56.7% of analyzed hips were female. Univariate and multivariable statistics were utilized to assess the direct and adjusted differences in outcomes, respectively. RESULTS Male hips had greater body mass index and larger α angles. Female hips had significantly lower preoperative and postoperative scores across most patient-reported outcome measures, but also had greater improvement from preoperatively to postoperatively. The preoperative differences between sexes exceeded the threshold for the minimal clinically important difference of the modified Harris hip score (mHHS) and all Hip disability and Osteoarthritis Outcome Score (HOOS) domains except quality of life. Preoperative sex differences in mHHS, all HOOS domains, and Short Form-12 Health Survey physical function component score were greater than the postoperative differences. A greater proportion of female hips achieved the minimal clinically important difference for the mHHS, but male hips were more likely to meet the patient acceptable symptom state for this outcome. After adjusting for relevant covariates with use of multiple regression analysis, sex was not identified as an independent predictor of any outcome. Preoperative patient-reported outcome scores were a strong and highly significant predictor of all outcomes. CONCLUSIONS Significant differences in clinical outcomes were observed between sexes in a large cohort of hips undergoing surgical treatment of femoroacetabular impingement. Despite female hips exhibiting lower baseline scores, sex was not an independent predictor of outcome or reoperation. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jeffrey J Nepple
- Department of Orthopaedic Surgery, Washington University, St Louis, Missouri
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ira Zaltz
- Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, Michigan
| | - Étienne Belzile
- Department of Orthopaedic Surgery, CHU de Québec, Quebec City, Quebec, Canada
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ernest L Sink
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY
| | - John C Clohisy
- Department of Orthopaedic Surgery, Washington University, St Louis, Missouri
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Delay L, Gonçalves Dos Santos G, Dias EV, Yaksh TL, Corr M. Sexual Dimorphism in the Expression of Pain Phenotype in Preclinical Models of Rheumatoid Arthritis. Rheum Dis Clin North Am 2021; 47:245-264. [PMID: 33781493 DOI: 10.1016/j.rdc.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Rheumatoid arthritis is one of most frequent rheumatic diseases, affecting around 1% of the population worldwide. Pain impacting the quality of life for the patient with rheumatoid arthritis, is often the primary factor leading them to seek medical care. Although sex-related differences in humans and animal models of rheumatoid arthritis are described, the correlation between pain and sex in rheumatoid arthritis has only recently been directly examined. Here we review the literature and explore the mechanisms underlying the expression of the pain phenotype in females and males in preclinical models of rheumatoid arthritis.
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Affiliation(s)
- Lauriane Delay
- Department of Anesthesiology, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | | | - Elayne Vieira Dias
- Department of Anesthesiology, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Tony L Yaksh
- Department of Anesthesiology, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Maripat Corr
- Division of Rheumatology, Allergy and Immunology, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
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23
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Exercise-induced muscle damage: mechanism, assessment and nutritional factors to accelerate recovery. Eur J Appl Physiol 2021; 121:969-992. [PMID: 33420603 DOI: 10.1007/s00421-020-04566-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
There have been a multitude of reviews written on exercise-induced muscle damage (EIMD) and recovery. EIMD is a complex area of study as there are a host of factors such as sex, age, nutrition, fitness level, genetics and familiarity with exercise task, which influence the magnitude of performance decrement and the time course of recovery following EIMD. In addition, many reviews on recovery from exercise have ranged from the impact of nutritional strategies and recovery modalities, to complex mechanistic examination of various immune and endocrine signaling molecules. No one review can adequately address this broad array of study. Thus, in this present review, we aim to examine EIMD emanating from both endurance exercise and resistance exercise training in recreational and competitive athletes and shed light on nutritional strategies that can enhance and accelerate recovery following EIMD. In addition, the evaluation of EIMD and recovery from exercise is often complicated and conclusions often depend of the specific mode of assessment. As such, the focus of this review is also directed at the available techniques used to assess EIMD.
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Omidpanah N, Shahrzad N, Safari R. The Effect of Topical Anesthetic Gel versus Relaxation Exercise in Controlling the Pain of Anterior Maxillary Injection. Open Dent J 2020. [DOI: 10.2174/1874210602014010752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Aim:
Adequate intraoral anesthesia is a major prerequisite for many dental procedures. Bubble breath exercise, distraction, and play therapy technique may be used as relaxation exercises to decrease pain. This study aimed to compare the efficacy of bubble breath exercise versus topical anesthetic gel in controlling the pain of anterior maxillary infiltration.
Methods:
This crossover clinical trial was performed on 50 children aged 10-12 years. Subjects received a total of 100 maxillary injections (two per person) in the buccal mucosal area of canine teeth of both sides at intervals of 2 to 3 days. On one side, the injection was performed after applying 20% benzocaine gel. On the other side, a similar injection was performed after the bubble breath exercise. The injection solution was 1/4 of 1.8 mL cartridge of 2% lidocaine containing 1:200,000 epinephrine using a 30-gauge needle. The pain was measured immediately after anesthesia injection using a Visual Analogue Scale (VAS). Data analysis was carried out using SPSS Version 18.0 (IBM Inc., Chicago, IL, USA). Wilcoxon signed-rank tests were used to compare with the 10-mm visual analog scale (VAS) scores obtained from all participants. The level of significance was considered at 5% (p <0.05). The correlation between gender and pain score (VAS) for the two methods was analyzed using the Mann-Whitney U test.
Results:
The results showed no statistically significant difference between injection pain after topical anesthetic gel application and injection pain after bubble breath exercise (p value=0.30). Also, no statistically significant difference was found between injection pain after gel application and injection pain after bubble breath exercise in boys (p value=0.59) or girls (p value=0.32). There were statistically significant differences between boys and girls in terms of injection pain after gel application (p value=0.001) and also injection pain after e bubble breath exercise (pvalue=0.004).
Conclusion:
There is no significant difference between perceived injection pain after bubble breath exercise and after applying the topical anesthetic gel. Furthermore, future studies should explore the role of age, dental fear, and anxiety, previous painful experiences, the pain thresholds.
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Tan B, Philipp M, Hill S, Che Muhamed AM, Mündel T. Pain Across the Menstrual Cycle: Considerations of Hydration. Front Physiol 2020; 11:585667. [PMID: 33132918 PMCID: PMC7578918 DOI: 10.3389/fphys.2020.585667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/16/2020] [Indexed: 11/20/2022] Open
Abstract
Chronic pain – pain that persists for more than 3 months – is a global health problem and is associated with tremendous social and economic cost. Yet, current pain treatments are often ineffective, as pain is complex and influenced by numerous factors. Hypohydration was recently shown to increase ratings of pain in men, but studies in this area are limited (n = 3). Moreover, whether hypohydration also affects pain in women has not been examined. In women, changes in the concentrations of reproductive hormones across menstrual phases may affect pain, as well as the regulation of body water. This indicates potential interactions between the menstrual phase and hypohydration on pain, but this hypothesis has yet to be tested. This review examined the literature concerning the effects of the menstrual phase and hypohydration on pain, to explore how these factors may interact to influence pain. Future research investigating the combined effects of hypohydration and menstrual phase on pain is warranted, as the findings could have important implications for the treatment of pain in women, interpretation of previous research and the design of future studies.
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Affiliation(s)
- Beverly Tan
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Michael Philipp
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Stephen Hill
- School of Psychology, Massey University, Palmerston North, New Zealand
| | | | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
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Kim D, Kim KR, Kwon Y, Kim M, Kim MJ, Sim Y, Ji H, Park JJ, Cho JH, Choi H, Kim S. AAV-Mediated Combination Gene Therapy for Neuropathic Pain: GAD65, GDNF, and IL-10. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2020; 18:473-483. [PMID: 32728596 PMCID: PMC7378317 DOI: 10.1016/j.omtm.2020.06.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/26/2022]
Abstract
Neuropathic pain is a chronic pain state characterized by nerve damage, inflammation, and nociceptive neuron hyperactivity. As the underlying pathophysiology is complex, a more effective therapy for neuropathic pain would be one that targets multiple elements. Here, we generated recombinant adeno-associated viruses (AAVs) encoding three therapeutic genes, namely, glutamate decarboxylase 65, glial cell-derived neurotrophic factor, and interleukin-10, with various combinations. The efficacy for pain relief was evaluated in a rat spared nerve injury model of neuropathic pain. The maximal analgesic effect was achieved when the AAVs expressing all three genes were administered to rats with neuropathic pain. The combination of two virus constructs expressing the three genes was named KLS-2031 and evaluated as a potential novel therapeutic for neuropathic pain. Single transforaminal epidural injections of KLS-2031 into the intervertebral foramen to target the appropriate dorsal root ganglion produced notable long-term analgesic effects in female and male rats. Furthermore, KLS-2031 mitigated the neuroinflammation, neuronal cell death, and dorsal root ganglion hyperexcitability induced by the spared nerve injury. These results suggest that KLS-2031 represents a promising therapeutic option for refractory neuropathic pain.
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Affiliation(s)
- Daewook Kim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Kyung-Ran Kim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Yejin Kwon
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Minjung Kim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Min-Ju Kim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Yeomoon Sim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Hyelin Ji
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Jang-Joon Park
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Jong-Ho Cho
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Heonsik Choi
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
| | - Sujeong Kim
- Institute of BioInnovation Research, Kolon Life Science, 110 Magokdong-ro, Gangseo-gu, Seoul 07793, Republic of Korea
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Cunha TC, Matos FDS, Paranhos LR, Bernardino ÍDM, Moura CCG. Influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain: a systematic review of randomized clinical trials. BMC Oral Health 2020; 20:175. [PMID: 32571285 PMCID: PMC7310418 DOI: 10.1186/s12903-020-01164-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/12/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Preliminary canal enlargement (glide path preparation) may play a significant role in the development of pain. The aim of this systematic review of randomized clinical trials was to assess the influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain. METHODS A search was performed in June 2019 in six electronic databases (PubMed, Scopus, LILACS, SciELO, Embase and Web of Science) and two grey literature databases (OpenGrey and OpenThesis). The bibliographic references of the eligible articles were also hand-searched. The included clinical studies assessed the occurrence and intensity of intraoperative and/or postoperative pain after root canal preparation without glide path preparation (WGP) or with glide path preparation using manual (M-GP), continuous rotary (CR-GP), or reciprocating (R-GP) instruments. The primary outcome was the occurrence and intensity of intraoperative and postoperative pain, while analgesic consumption was the secondary outcome. The full texts of the eligible studies were analyzed by two reviewers who performed calibration exercises to verify the risk of bias and quality of the individual studies using the Joanna Briggs Institute Critical Appraisal tool. RESULTS From 1283 identified articles, only six studies were included in the qualitative analysis of the results, with a total sample of 884 patients/teeth. Three studies presented a high risk of bias, while three studies presented a moderate risk. Two studies reported that CR-GP causes lower pain levels than M-GP and WGP, and three studies showed no differences between CR-GP and R-GP. Regarding analgesic consumption, two studies found no differences among glide path kinematics, and one study reported lower consumption for CR-GP than for M-GP. Because of the limited number of studies and methodological differences, no statistical analyses were performed for the glide path kinematics comparisons. CONCLUSIONS Compelling evidence indicating a significantly different occurrence and intensity of pain among glide path kinematics is lacking. The systematic review protocol was registered in the PROSPERO database [CRD42020139989].
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Affiliation(s)
- Thaís Christina Cunha
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Felipe de Souza Matos
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Luiz Renato Paranhos
- Department of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2G, sala 1, Umuarama, Uberlândia, MG, CEP 38405-320, Brazil.
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Abstract
Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes modulate autonomic output to mitigate excessive fluctuations in arterial blood pressure and to maintain intravascular volume, increasing evidence suggests that baroreflex pathways also project to key regions of the central nervous system that regulate somatosensory, somatomotor, and central nervous system arousal. In addition to maintaining autonomic homeostasis, baroreceptor activity modulates the perception of pain, as well as neuroimmune, neuroendocrine, and cognitive responses to physical and psychologic stressors. This review summarizes the role that baroreceptor pathways play in modulating acute and chronic pain perception. The contribution of baroreceptor function to postoperative outcomes is also presented. Finally, methods that enhance baroreceptor function, which hold promise in improving postoperative and pain management outcomes, are presented.
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Quantifying Pain Associated With Rib Fractures. J Surg Res 2019; 246:476-481. [PMID: 31668607 DOI: 10.1016/j.jss.2019.09.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 08/19/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Rib fractures are a major problem in trauma patients, and the associated pain is not well understood. Measuring total pain experience, duration, and intensity could facilitate comparisons of treatments. This study was intended to evaluate the feasibility of quantifying pain over the course of an admission and identify factors associated with increased pain experience in adults with rib fractures. METHODS Patients admitted to a level I trauma center with rib fractures between 2015 and 2017 were included. Maximum pain score (verbal or nonverbal) was captured for each hospital day. Total pain was defined as the sum of the area under the curve (AUC) of the max pain scores plotted against time. A general linear model was used to determine demographic, injury, and clinical predictors of the pain AUC. RESULTS We identified 3713 patients. Increased pain experienced (greater AUC) was associated with age group 40-59 y compared with 18-39 y (B = 6.1, P = 0.002); Injury Severity Score 9-14 (B = 11.5, P < 0.001) and ≥16 (B = 36.9, P < 0.0001); patients with flail chest versus multiple rib fractures (B = 17.1, P < 0.001); and patients who underwent rib fixation (B = 20.7, P = 0.004). Decreased pain experience was observed for male gender (B = -3.7, P = 0.032) and blunt mechanism of injury (B = -13.7, P < 0.0001). CONCLUSIONS This study demonstrates the feasibility of measuring patients' total pain experience over the duration of their admission. Pain is a subjective but relevant measure of patients' experience. Our study identifies a number of predictive factors, some expected and some unexpected. Increased overall experience pain following fixation may be the result of severe pain before intervention.
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Chae KL, Park SY, Hong JI, Yim WJ, Lee SC, Chung CJ. The effect of gender and age on postoperative pain in laparoscopic cholecystectomy: a prospective observational study. Anesth Pain Med (Seoul) 2019. [DOI: 10.17085/apm.2019.14.3.364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Kyoung Lin Chae
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sang Yoong Park
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Jeong In Hong
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Woo Jae Yim
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Seung Cheol Lee
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Chan Jong Chung
- Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea
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Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis. Clin Oral Investig 2019; 24:1217-1227. [DOI: 10.1007/s00784-019-02985-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/20/2019] [Indexed: 12/18/2022]
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Abstract
PURPOSE OF REVIEW The current review will discuss the current literature on genetics of pain and analgesia, with special emphasis on perioperative setting. We will also discuss pharmacogenetics-based management guidelines, current clinical status and future perspectives. RECENT FINDINGS Recent literature suggests that the interindividual variability in pain and postoperative analgesic response is at least in part because of one's genetic make-up. Some of the well characterized polymorphisms that are associated with surgical pain and opioid-related postoperative adverse outcomes are described in catechol-O-methyl transferase, CYP2D6 and μ-opioid receptor (OPRM1), ATP-binding cassette subfamily B member 1, ABCC3, organic cation transporter 1 genes. Clinical Pharmacogenetics Implementation Consortium has put forth recommendations on CYP2D6 genotype-based opioid selection and dosing. The list of drug-gene pairs studied continue to expand. SUMMARY Pharmacogenetic approach marks the dawn of personalized pain medicine both in perioperative and chronic pain settings.
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Fukui T, Rahman M, Ohde S, Hoshino E, Kimura T, Urayama KY, Omata F, Deshpande GA, Takahashi O. Reassessing the Ecology of Medical Care in Japan. J Community Health 2018; 42:935-941. [PMID: 28364318 DOI: 10.1007/s10900-017-0337-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Studies on ecology of medical care can provide valuable information on how people seek healthcare in a specific geographic area. The objective of this study was to update a 2003 report on the ecology of medical care in Japan, identifying relevant changes in healthcare patterns. We collected information based on a prospective health diary recorded for a month in 2013 (n = 4548; 3787 adults and 797 children) using a population-weighted random sample from a nationally representative panel. We compared our overall and stratified findings with a similar study conducted in 2003. During a one-month period, per 1000 adults and children living in Japan, we estimated that 794 report at least one symptom, 447 use an over-the-counter (OTC) drug, 265 visit a physician's office, 117 seek help from a professional provider of complementary or alternative medicine (CAM), 70 visit a hospital outpatient clinic (60 community-based and 10 university-based), 6 are hospitalized, and 4 visit a hospital emergency department. After adjusting for demographic variables, we found that healthcare seeking behaviors were influenced by age, gender and area of living. Compared with the 2003 study, participants in this study had fewer symptoms, fewer physician and emergency room visits, and less OTC use, but reported higher frequency of CAM use (p < .01 for all). Compared with 2003, reported symptoms, physician visits and OTC use has decreased, while CAM use has increased. Our findings may be useful to policymakers in Japan in a context where healthcare expenditure and a rapidly aging population are two challenging issues.
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Affiliation(s)
- Tsuguya Fukui
- St. Luke's International Hospital, Akashi-cho 9-1, Chuo-ku, Tokyo, 104-8560, Japan.,St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Mahbubur Rahman
- St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sachiko Ohde
- St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Eri Hoshino
- St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takeshi Kimura
- St. Luke's International Hospital, Akashi-cho 9-1, Chuo-ku, Tokyo, 104-8560, Japan.,St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kevin Y Urayama
- St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Fumio Omata
- St. Luke's International Hospital, Akashi-cho 9-1, Chuo-ku, Tokyo, 104-8560, Japan
| | - Gautam A Deshpande
- St. Luke's International Hospital, Akashi-cho 9-1, Chuo-ku, Tokyo, 104-8560, Japan.,St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Osamu Takahashi
- St. Luke's International Hospital, Akashi-cho 9-1, Chuo-ku, Tokyo, 104-8560, Japan. .,St. Luke's Center for Clinical Academia, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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Tracy LM, Koenig J, Georgiou-Karistianis N, Gibson SJ, Giummarra MJ. Heart rate variability is associated with thermal heat pain threshold in males, but not females. Int J Psychophysiol 2018; 131:37-43. [DOI: 10.1016/j.ijpsycho.2018.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 12/16/2022]
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Honda Y, Handa T, Fukuda KI, Koukita Y, Ichinohe T. Comparison of Risk Factors in Patients With Acute and Chronic Orofacial Pain. Anesth Prog 2018; 65:162-167. [PMID: 30235431 PMCID: PMC6148695 DOI: 10.2344/anpr-65-02-05] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 05/16/2017] [Indexed: 12/20/2022] Open
Abstract
Management of patients with orofacial pain may benefit from a better understanding about patient factors that may lead pain chronicity. In this study, we retrospectively compared physical and psychological factors in patients with acute and chronic orofacial pain. We analyzed data from 854 patients presenting to the Orofacial Pain Center, Department of Dental Anesthesiology, Tokyo Dental College, Suidobashi Hospital between April 2010 and March 2014. We categorized patients into the acute group if their condition had persisted <6 months and the chronic group if their condition had lasted 6 months or longer, based on the classification by the International Association for the Study of Pain. The retrospective data were analyzed by using univariate analysis on background factors from a health questionnaire, pain evaluation sheet, and psychological test completed at the time of presentation. Multiple logistic regression was applied on these factors. Our results suggest that female gender and high trait anxiety may be involved in orofacial pain becoming chronic.
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Affiliation(s)
- Yoshifumi Honda
- Department of Dental Anesthesiology, Tokyo Dental College, Japan
| | - Toshiyuki Handa
- Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Japan
| | - Ken-ichi Fukuda
- Professor, Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Japan
| | - Yoshihiko Koukita
- Clinical Professor, Department of Dental Anesthesiology, Tokyo Dental College, Japan
| | - Tatsuya Ichinohe
- Professor, Department of Dental Anesthesiology, Tokyo Dental College, Japan
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Tran M, Kuhn JA, Bráz JM, Basbaum AI. Neuronal aromatase expression in pain processing regions of the medullary and spinal cord dorsal horn. J Comp Neurol 2017. [PMID: 28649695 DOI: 10.1002/cne.24269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In both acute and chronic pain conditions, women tend to be more sensitive than men. This sex difference may be regulated by estrogens, such as estradiol, that are synthesized in the spinal cord and brainstem and act locally to influence pain processing. To identify a potential cellular source of local estrogen, here we examined the expression of aromatase, the enzyme that catalyzes the conversion of testosterone to estradiol. Our studies focused on primary afferent neurons and on their central targets in the spinal cord and medulla as well as in the nucleus of the solitary tract, the target of nodose ganglion-derived visceral afferents. Immunohistochemical staining in an aromatase reporter mouse revealed that many neurons in laminae I and V of the spinal cord dorsal horn and caudal spinal trigeminal nucleus and in the nucleus of the solitary tract express aromatase. The great majority of these cells also express inhibitory interneuron markers. We did not find sex differences in aromatase expression and neither the pattern nor the number of neurons changed in a sciatic nerve transection model of neuropathic pain or in the Complete Freund's adjuvant model of inflammatory pain. A few aromatase neurons express Fos after cheek injection of capsaicin, formalin, or chloroquine. In total, given their location, these aromatase neurons are poised to engage nociceptive circuits, whether it is through local estrogen synthesis or inhibitory neurotransmitter release.
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Affiliation(s)
- May Tran
- Department of Anatomy, University of California, San Francisco, San Francisco, California
| | - Julia A Kuhn
- Department of Anatomy, University of California, San Francisco, San Francisco, California
| | - João M Bráz
- Department of Anatomy, University of California, San Francisco, San Francisco, California
| | - Allan I Basbaum
- Department of Anatomy, University of California, San Francisco, San Francisco, California
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Increasing Optimism Protects Against Pain-Induced Impairment in Task-Shifting Performance. THE JOURNAL OF PAIN 2017; 18:446-455. [DOI: 10.1016/j.jpain.2016.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/02/2016] [Accepted: 12/07/2016] [Indexed: 11/19/2022]
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39
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Ling TE, Othman K, Yan OP, Rashid RA, Tet CM, Yaakob A, Tajudin LSA. Evaluation of Ocular Surface Disease in Asian Patients with Primary Angle Closure. Open Ophthalmol J 2017; 11:31-39. [PMID: 28400889 PMCID: PMC5362968 DOI: 10.2174/1874364101711010031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/09/2017] [Accepted: 01/11/2017] [Indexed: 11/24/2022] Open
Abstract
Objective: To evaluate the incidence of ocular surface disease (OSD) and to determine the effects of topical pressure-lowering drugs on ocular surface disease in primary angle closure patients. Methods: This was a cross-sectional comparative study comparing primary angle closure glaucoma (PACG) patients (Group A) with primary angle closure and primary angle closure suspect (Group B). Group A was treated with topical pressure-lowering drugs; Group B was not. Data on ocular diagnosis and details of treatment were obtained from medical records. Ocular surface disease incidence was assessed using the Ocular Surface Disease Index (OSDI) questionnaire and from clinical signs using Schirmer’s test, tear break-up time and corneal fluorescein stain. Predictive Analytic Software 20 and STATA analysis software were used for statistical analyses. Results: Group A demonstrated a higher rate of OSD (OSDI 52.3%, Schirmer’s test 70.5%, tear break-up time (TBUT) 75%, corneal staining 77.3%) compared to Group B (OSDI 39.0%, Schirmer’s test 73.2%, TBUT 58.5% and cornea staining 14.6%) except for Schirmer’s test. There was a significant difference in mean score of OSDI (p=0.004), TBUT (p=0.008) and cornea staining (p<0.001) between two groups. Primary angle closure glaucoma treated with more than two medications and for more than three years had worse ocular surface disease parameters but without statistical significant difference. Conclusion: Ocular surface disease is common in PACG patients treated with topical pressure-lowering drugs. Topical pressure-lowering drugs caused significant OSD symptoms and signs except for tear production in PACG patients. Thorough evaluation of ocular surface disease is important to ensure appropriate treatment and intervention in PACG patients.
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Affiliation(s)
- Tan Ee Ling
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia
| | - Khairuddin Othman
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Ong Poh Yan
- Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia
| | - Rasdi Abdul Rashid
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Cheong Min Tet
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Azhany Yaakob
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Liza-Sharmini Ahmad Tajudin
- Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, Tan SC, Mohamad N, Ismail R. Relationship Between ABCB1
Polymorphisms and Cold Pain Sensitivity Among Healthy Opioid-naive Malay Males. Pain Pract 2017; 17:930-940. [DOI: 10.1111/papr.12546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/21/2016] [Accepted: 10/26/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Zalina Zahari
- Department of Pharmacy; Hospital Universiti Sains Malaysia; Kelantan Malaysia
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
| | - Chee Siong Lee
- Department of Emergency Medicine; School of Medical Sciences; Universiti Sains Malaysia; Kelantan Malaysia
| | - Muslih Abdulkarim Ibrahim
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
- Department of Pharmacology and Toxicology; College of Pharmacy; Hawler Medical University; Hawler Iraq
| | - Nurfadhlina Musa
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
| | - Mohd Azhar Mohd Yasin
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
- Department of Psychiatry; School of Medical Sciences; Universiti Sains Malaysia; Kelantan Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences; Universiti Sains Malaysia; Kelantan Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
- Faculty of Medicine & Health Sciences; Universiti Sultan Zainal Abidin; Terengganu Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster; Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Kelantan Malaysia
- Centre of Excellence for Research in AIDS; University of Malaya; Kuala Lumpur Malaysia
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Lundgren D, Rutegård J, Eklöf V, Palmqvist R, Karling P. Patients with longstanding ulcerative colitis in remission do not have more irritable bowel syndrome-like symptoms than controls. BMC Gastroenterol 2016; 16:139. [PMID: 27881072 PMCID: PMC5121960 DOI: 10.1186/s12876-016-0553-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 11/17/2016] [Indexed: 12/14/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is more common in patients with ulcerative colitis (UC) than expected. The prevalence of IBS in patients with UC with longstanding disease is not known. We investigated the prevalence of IBS-like symptoms in patients with UC in remission and longstanding disease in comparison to control subjects. Methods Sixty-eight patients with UC and 33 patients with hereditary familiar colon cancer and who underwent colonoscopy surveillance were included. Faecal calprotectin (FC), Gastrointestinal Symptoms Rating Scale-Irritable Bowel Syndrome (GSRS-IBS) and Hospital Anxiety and Depression scale were fulfilled prior to endoscopy. UC in remission was define by steroid-free clinical remission, a Mayo Score ≤ 1 on endoscopy, a FC ≤ 200 μg/g and no significant active inflammation on colon biopsies. Results Fifty-five UC patients met the criteria for being in remission. The median disease duration was 17 years. The patients with UC in remission tended to have lower scores on total GSRS-IBS score (6 vs 10.5; p = 0.062) and lower or equal scores on all specific IBS symptoms in comparison to controls. There was a moderate but significant correlation between diarrhoea scores and FC levels (in the span ≤ 200 μg/g) (rs 0.38; p = 0.004) in the UC in remission group. Conclusion Patients with UC with longstanding disease and in remission do not have more IBS symptoms than controls. In UC patients in remission the FC level in the lower span showed a moderate correlation to symptoms of diarrhoea. Electronic supplementary material The online version of this article (doi:10.1186/s12876-016-0553-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D Lundgren
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, SE-90187, Umeå, Sweden.
| | - J Rutegård
- Department of Surgery and Perioperative Science, Surgery, Umeå University, SE-90187, Umeå, Sweden
| | - V Eklöf
- Department of Medical Biosciences, Pathology, Umeå University, SE-90187, Umeå, Sweden
| | - R Palmqvist
- Department of Medical Biosciences, Pathology, Umeå University, SE-90187, Umeå, Sweden
| | - P Karling
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, SE-90187, Umeå, Sweden
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Norris T, Deere K, Tobias JH, Crawley E. Chronic Fatigue Syndrome and Chronic Widespread Pain in Adolescence: Population Birth Cohort Study. THE JOURNAL OF PAIN 2016; 18:285-294. [PMID: 27845196 PMCID: PMC5340566 DOI: 10.1016/j.jpain.2016.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/21/2016] [Accepted: 10/31/2016] [Indexed: 11/03/2022]
Abstract
Although many studies have investigated the overlap between pain phenotypes and chronic fatigue syndrome (CFS) in adults, little is known about the relationship between these conditions in adolescents. The study's aim was therefore to identify whether a relationship exists between chronic widespread pain (CWP) and CFS in adolescents and investigate whether the two share common associations with a set of covariates. A questionnaire was administered to offspring of the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 17, asking about site, duration, and pain intensity, from which participants with CWP were identified. At the same research clinic, a computer-based Revised Clinical Interview Schedule was filled out, from which a classification of CFS was obtained. The relationship between selected covariates and CFS and CWP was investigated using a variety of logistic, ordinal logistic, and multinomial regressions. We identified 3,214 adolescents with complete data for all outcomes and covariates. There were 82 (2.6%) individuals classified as CFS and 145 (4.5%) as CWP. A classification of CFS resulted in an increased likelihood of having CWP (odds ratio = 3.87; 95% confidence interval, 2.05-7.31). Female adolescents were approximately twice as likely to have CFS or CWP, with multinomial regression revealing a greater sex effect for CWP compared with CFS. Those with exclusive CFS were more likely to report higher levels of pain and greater effect of pain compared with those without CFS, although associations attenuated to the null after adjustment for covariates, which did not occur in those with exclusive CWP. Multinomial regression revealed that relative to having neither CFS nor CWP, a 1-unit increase in the depression and anxiety scales increased the risk of having exclusive CFS and, to a greater extent, the risk of having comorbid CFS and CWP, but not exclusive CWP, which was only related to anxiety. PERSPECTIVE In this cohort, 14.6% of adolescents with CFS have comorbid CWP. The likely greater proportion of more mild cases observed in this epidemiological study means that prevalence of overlap may be underestimated compared with those attending specialist services. Clinicians should be aware of the overlap between the 2 conditions and carefully consider treatment options offered.
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Affiliation(s)
- Tom Norris
- Centre for Child and Adolescent Health, School of Social and Community Medicine, Bristol, United Kingdom.
| | - Kevin Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, Bristol, United Kingdom
| | - Jon H Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, Bristol, United Kingdom
| | - Esther Crawley
- Centre for Child and Adolescent Health, School of Social and Community Medicine, Bristol, United Kingdom
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Kann S, Zhang S, Manza P, Leung HC, Li CSR. Hemispheric Lateralization of Resting-State Functional Connectivity of the Anterior Insula: Association with Age, Gender, and a Novelty-Seeking Trait. Brain Connect 2016; 6:724-734. [PMID: 27604154 PMCID: PMC5105339 DOI: 10.1089/brain.2016.0443] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Resting-state functional connectivity (rsFC) is widely used to examine cerebral functional organization. The imaging literature has described lateralization of insula activations during cognitive and affective processing. Evidence appears to support a role of the right-hemispheric insula in attentional orientation to salient stimulus, interoception, and physiological arousal, and a role of the left-hemispheric insula in cognitive and affective control, as well as perspective taking. In this study, in a large data set of healthy adults, we examined lateralization of the rsFC of the anterior insula (AI) by computing a laterality index (LI) of connectivity with 54 regions from the Automated Anatomic Labeling atlas. At a corrected threshold (p < 0.001), the AI is left lateralized in connectivity with the dorsomedial prefrontal cortex, superior frontal gyrus, inferior frontal cortex, and posterior orbital gyrus and right lateralized in connectivity with the postcentral gyrus, supramarginal gyrus, and superior parietal lobule. In gender differences, women, but not men, showed right-lateralized connectivity to the thalamus. Furthermore, in a subgroup of participants assessed by the tridimensional personality questionnaire, novelty seeking is correlated with the extent of left lateralization of AI connectivity to the pallidum and putamen in men and with the extent of right lateralization of AI connectivity to the parahippocampal gyrus in women. These findings support hemispheric functional differentiation of the AI.
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Affiliation(s)
- Sarah Kann
- 1 Department of Psychology, State University of New York , Stony Brook, New York
| | - Sheng Zhang
- 2 Department of Psychiatry, Yale University School of Medicine , New Haven, Connecticut
| | - Peter Manza
- 1 Department of Psychology, State University of New York , Stony Brook, New York
| | - Hoi-Chung Leung
- 1 Department of Psychology, State University of New York , Stony Brook, New York
| | - Chiang-Shan R Li
- 2 Department of Psychiatry, Yale University School of Medicine , New Haven, Connecticut.,3 Department of Neuroscience, Yale University School of Medicine , New Haven, Connecticut.,4 Interdepartmental Neuroscience Program, Yale University School of Medicine , New Haven, Connecticut
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Hasanvand A, Amini-Khoei H, Hadian MR, Abdollahi A, Tavangar SM, Dehpour AR, Semiei E, Mehr SE. Anti-inflammatory effect of AMPK signaling pathway in rat model of diabetic neuropathy. Inflammopharmacology 2016; 24:207-219. [PMID: 27506528 DOI: 10.1007/s10787-016-0275-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 07/29/2016] [Indexed: 02/06/2023]
Abstract
Diabetic neuropathy (DN) is characterized as Hyperglycemia activates thdisturbed nerve conduction and progressive chronic pain. Inflammatory mediators, particularly cytokines, have a determinant role in the pathogenesis of neuropathic pain. The activity of adenosine monophosphate protein kinase (AMPK), an energy charge sensor with neuroprotective properties, is decreased in diabetes. It has been reported that activation of AMPK reduces the systemic inflammation through inhibition of cytokines. In this study, we aimed to investigate the probable protective effects of AMPK on DN in a rat of diabetes. DN was induced by injection of streptozotocin (65 mg/kg, i.p.). Motor nerve conduction velocities (MNCV) of the sciatic nerve, as an electrophysiological marker for peripheral nerve damage, were measured. Plasma levels of IL-6, TNF-α, CRP were assessed as relevant markers for inflammatory response. Also, the expression of phosphorylated AMPK (p-AMPK) and non-phosphorylated (non-p-AMPK) was evaluated by western blotting in the dorsal root ganglia. Histopathological assessment was performed to determine the extent of nerve damage in sciatic nerve. Our findings showed that activation of AMPK by metformin (300 mg/kg) significantly increased the MNCV and reduced the levels of inflammatory cytokines. In addition, we showed that administration of metformin increased the expression of p-AMPK as well as decline in the level of non p-AMPK. Our results demonstrated that co-administration of dorsomorphin with metformin reversed the beneficial effects of metformin. In conclusion, the results of this study demonstrated that the activation of AMPK signaling pathway in diabetic neuropathy might be associated with the anti-inflammatory response.
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Affiliation(s)
- Amin Hasanvand
- Department of Pharmacology, School of Medicine, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Amini-Khoei
- Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Hadian
- Department of Physical Therapy, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Abdollahi
- Department of Pathology, Imam Khomini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Tavangar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elika Semiei
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Ejtemaei Mehr
- Department of Pharmacology, School of Medicine, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran. .,Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, Tan SC, Mohamad N, Ismail R. Relationship between CYP2B6*6 and cold pressor pain sensitivity in opioid dependent patients on methadone maintenance therapy (MMT). Drug Alcohol Depend 2016; 165:143-50. [PMID: 27289271 DOI: 10.1016/j.drugalcdep.2016.05.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/22/2016] [Accepted: 05/30/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND CYP2B6 polymorphisms contribute to inter-individual variations in pharmacokinetics of methadone. Increased pain sensitivity is frequently reported by opioid dependent patients on methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in CYP2B6, which affects the metabolism of methadone, influence pain sensitivity among patients on MMT. This study investigated CYP2B6 polymorphisms and pain sensitivity in this group. METHODS The cold pressor pain responses of 148 opioid dependent patients receiving MMT were evaluated using the cold pressor test (CPT). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR)-genotyping. RESULTS Of the 148 subjects, 77 (52.0%) were carriers of CYP2B6*6 allele. CYP2B6*6 allele carriers had shorter cold pain threshold and pain tolerance times than non-carriers of CYP2B6*6 allele (21.05s vs 33.69s, p=0.036 and 27.15s vs 44.51s, p=0.020, respectively). Pain intensity scores of the CYP2B6*6 allele carriers was 67.55, whereas that of the CYP2B6*6 allele non-carriers was 64.86 (p=0.352). CONCLUSION Our study indicates that the CYP2B6*6 allele is associated with a lower pain threshold and lower pain tolerance among males with opioid dependence on MMT. The CYP2B6*6 allele may provide a mechanistic explanation for clinical observations of heightened pain sensitivity among opioid dependent patients receiving MMT.
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Affiliation(s)
- Zalina Zahari
- Department of Pharmacy, Hospital Universiti Sains Malaysia, Kelantan, Malaysia; Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.
| | - Chee Siong Lee
- Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Muslih Abdulkarim Ibrahim
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia; Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Hawler, Iraq
| | - Nurfadhlina Musa
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia; Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia; Faculty of Medicine & Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia; Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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Abstract
Chronic pelvic pain in women is a key site through which explorations of the meanings of female gender and pain might further insights into the broader question of the embodied experience of women in relation to pain. A biocultural approach is used to present an analysis of interviews with 40 New Zealand women in which they reflect on ‘how come’ they have chronic pelvic pain. Women consistently employ a mechanistic rendition of medical discourse and understandings in their constructions of ‘how come’ they have pain, accompanied by a reiteration of ‘not knowing’ and a normalizing of their pelvic pain. We explore how this normalizing works within the narratives to establish women's pelvic pain as intrinsically gendered. Etiological meanings that are constructed in medical terms and yet are unable to be interpreted within a dualist frame of normality and pathology, we argue, permeate and shape gendered experience of chronic pain conditions.
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Affiliation(s)
- Victoria M Grace
- School of Sociology and Anthropology, University of Canterbury, Christchurch, New Zealand.
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Nummenmaa L, Suvilehto JT, Glerean E, Santtila P, Hietanen JK. Topography of Human Erogenous Zones. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1207-1216. [PMID: 27091187 DOI: 10.1007/s10508-016-0745-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/17/2016] [Accepted: 03/21/2016] [Indexed: 06/05/2023]
Abstract
Touching is a powerful means for eliciting sexual arousal. Here, we establish the topographical organization of bodily regions triggering sexual arousal in humans. A total of 704 participants were shown images of same and opposite sex bodies and asked to color the bodily regions whose touching they or members of the opposite sex would experience as sexually arousing while masturbating or having sex with a partner. Resulting erogenous zone maps (EZMs) revealed that the whole body was sensitive to sexual touching, with erogenous hotspots consisting of genitals, breasts, and anus. The EZM area was larger while having sex with a partner versus while masturbating, and was also dependent on sexual desire and heterosexual and homosexual interest levels. We conclude that tactile stimulation of practically all bodily regions may trigger sexual arousal. Extension of the erogenous zones while having sex with a partner may reflect the role of touching in maintenance of reproductive pair bonds.
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Affiliation(s)
- Lauri Nummenmaa
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Espoo, Finland.
- Turku PET Centre and Department of Psychology, University of Turku, Turku, Finland.
| | - Juulia T Suvilehto
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Espoo, Finland
| | - Enrico Glerean
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Espoo, Finland
| | - Pekka Santtila
- Department of Psychology and Logopedics, Åbo Akademi University, Turku, Finland
| | - Jari K Hietanen
- Human Information Processing Laboratory, School of Social Sciences and Humanities/Psychology, University of Tampere, Tampere, Finland
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Sheffer CE, Cassisi JE, Ferraresi LM, Lofland KR, McCracken LM. Sex Differences in the Presentation of Chronic Low Back Pain. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/1471-6402.00072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sex differences in 351 patients with chronic low back pain were examined. Biological, psychological, and psychosocial factors were considered. Sex differences in adaptive functioning were consistent with traditional gender roles. Significant interactions were found for sex and employment status, and sex and marital status. Retired women reported more pain and less activity than retired men. Retired men reported the least pain of any group. Outdoor work and social activities show opposite within-group patterns for men and women when stratifiedby employment status. Marriage was associated with more household work for women and less for men. The financial and social contexts of employment status and marriage are different for men and women. Results suggest the treatment of women with chronic low back pain requires attention to work in the home and the financial and social context of work outside the home.
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Azim AA, Azim KA, Abbott PV. Prevalence of inter-appointment endodontic flare-ups and host-related factors. Clin Oral Investig 2016; 21:889-894. [DOI: 10.1007/s00784-016-1839-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/24/2016] [Indexed: 11/24/2022]
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