1
|
Rouhi S, Egorova-Brumley N, Jordan AS. Chronic sleep deficiency and its impact on pain perception in healthy females. J Sleep Res 2024:e14284. [PMID: 38972675 DOI: 10.1111/jsr.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024]
Abstract
Acute sleep deprivation in experimental studies has been shown to induce pain hypersensitivity in females. However, the impact of natural sleep deficiency and fluctuations across the week on pain perception remains unclear. A sleep-monitoring headband and self-reports were utilized to assess objective and subjective sleep in longer (> 6 hr) and short sleepers (< 6 hr). Pain sensitivity measures including heat, cold, pressure pain thresholds, pain inhibition (conditioned pain modulation) and facilitation (tonic pain summation) were assessed on Mondays and Fridays. Forty-one healthy young (23.9 ± 0.74 years) women participated. Short sleepers slept on average 2 hr less than longer sleepers (297.9 ± 8.2 min versus 418.5 ± 10.9 min) and experienced impaired pain inhibitory response (mean = -21.14 ± 7.9°C versus mean = 15.39 ± 9.5°C; p = 0.005). However, no effect was observed in pain thresholds and pain summation (p > 0.05). Furthermore, pain modulatory responses differed between Mondays and Fridays. Chronic sleep deficiency (< 6 hr) compromises pain responses, notably on Mondays. Maintaining a consistent sleep pattern with sufficient sleep (> 6 hr) throughout the week may protect against pain sensitization and the development of chronic pain in females. Further research is needed, especially in patients with chronic pain.
Collapse
Affiliation(s)
- Shima Rouhi
- The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Amy S Jordan
- The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Iezzi D, Cáceres-Rodríguez A, Strauss B, Chavis P, Manzoni OJ. Sexual differences in neuronal and synaptic properties across subregions of the mouse insular cortex. Biol Sex Differ 2024; 15:29. [PMID: 38561860 PMCID: PMC10983634 DOI: 10.1186/s13293-024-00593-4] [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: 10/11/2023] [Accepted: 02/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The insular cortex (IC) plays a pivotal role in processing interoceptive and emotional information, offering insights into sex differences in behavior and cognition. The IC comprises two distinct subregions: the anterior insular cortex (aIC), that processes emotional and social signals, and the posterior insular cortex (pIC), specialized in interoception and perception of pain. Pyramidal projection neurons within the IC integrate multimodal sensory inputs, influencing behavior and cognition. Despite previous research focusing on neuronal connectivity and transcriptomics, there has been a gap in understanding pyramidal neurons characteristics across subregions and between sexes. METHODS Adult male and female C57Bl/6J mice were sacrificed and tissue containing the IC was collected for ex vivo slice electrophysiology recordings that examined baseline sex differences in synaptic plasticity and transmission within aIC and pIC subregions. RESULTS Clear differences emerged between aIC and pIC neurons in both males and females: aIC neurons exhibited distinctive features such as larger size, increased hyperpolarization, and a higher rheobase compared to their pIC counterparts. Furthermore, we observed variations in neuronal excitability linked to sex, with male pIC neurons displaying a greater level of excitability than their female counterparts. We also identified region-specific differences in excitatory and inhibitory synaptic activity and the balance between excitation and inhibition in both male and female mice. Adult females demonstrated greater synaptic strength and maximum response in the aIC compared to the pIC. Lastly, synaptic long-term potentiation occurred in both subregions in males but was specific to the aIC in females. CONCLUSIONS We conclude that there are sex differences in synaptic plasticity and excitatory transmission in IC subregions, and that distinct properties of IC pyramidal neurons between sexes could contribute to differences in behavior and cognition between males and females.
Collapse
Affiliation(s)
- Daniela Iezzi
- INMED, INSERM U1249, Marseille, France
- Aix-Marseille University, Marseille, France
| | | | - Benjamin Strauss
- INMED, INSERM U1249, Marseille, France
- Aix-Marseille University, Marseille, France
| | - Pascale Chavis
- INMED, INSERM U1249, Marseille, France
- Aix-Marseille University, Marseille, France
| | - Olivier J Manzoni
- INMED, INSERM U1249, Marseille, France.
- Aix-Marseille University, Marseille, France.
- INMED, INSERM U901, Parc Scientifique de Luminy, BP13 13273, Marseille Cedex 09, France.
| |
Collapse
|
3
|
Anger JT, Case LK, Baranowski AP, Berger A, Craft RM, Damitz LA, Gabriel R, Harrison T, Kaptein K, Lee S, Murphy AZ, Said E, Smith SA, Thomas DA, Valdés Hernández MDC, Trasvina V, Wesselmann U, Yaksh TL. Pain mechanisms in the transgender individual: a review. FRONTIERS IN PAIN RESEARCH 2024; 5:1241015. [PMID: 38601924 PMCID: PMC11004280 DOI: 10.3389/fpain.2024.1241015] [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: 06/15/2023] [Accepted: 01/25/2024] [Indexed: 04/12/2024] Open
Abstract
Specific Aim Provide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research. Methods A team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research. Results While transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain. Conclusions While significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.
Collapse
Affiliation(s)
- Jennifer T. Anger
- Department of Urology, University of California San Diego, San Diego, CA, United States
| | - Laura K. Case
- Department of Anesthesiology, University of California San Diego, San Diego, CA, United States
| | - Andrew P. Baranowski
- Pelvic Pain Medicine and Neuromodulation, University College Hospital Foundation Trust, University College London, London, United Kingdom
| | - Ardin Berger
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States
| | - Rebecca M. Craft
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Lyn Ann Damitz
- Division of Plastic and Reconstructive Surgery, University of North Carolina, Chapel Hill, NC, United States
| | - Rodney Gabriel
- Division of Regional Anesthesia, University of California San Diego, San Diego, CA, United States
| | - Tracy Harrison
- Department of OB/GYN & Reproductive Sciences, University of California San Diego, San Diego, CA, United States
| | - Kirsten Kaptein
- Division of Plastic Surgery, University of California San Diego, San Diego, CA, United States
| | - Sanghee Lee
- Department of Urology, University of California San Diego, San Diego, CA, United States
| | - Anne Z. Murphy
- Neuroscience Institute, Georgia State University, Atlanta, GA, United States
| | - Engy Said
- Division of Regional Anesthesia, University of California San Diego, San Diego, CA, United States
| | - Stacey Abigail Smith
- Division of Infection Disease, The Hope Clinic of Emory University, Atlanta, GA, United States
| | - David A. Thomas
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, United States
| | - Maria del C. Valdés Hernández
- Department of Neuroimaging Sciences, Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Victor Trasvina
- Department of Urology, University of California San Diego, San Diego, CA, United States
| | - Ursula Wesselmann
- Departments of Anesthesiology and Perioperative Medicine/Division of Pain Medicine, Neurology and Psychology, and Consortium for Neuroengineering and Brain-Computer Interfaces, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tony L. Yaksh
- Department of Anesthesiology, University of California San Diego, San Diego, CA, United States
| |
Collapse
|
4
|
Yap AU, Liu C, Lei J, Park JW, Kim SH, Lee BM, Fu KY. DC/TMD axis I subtyping: generational and gender variations among East Asian TMD patients. BMC Oral Health 2023; 23:823. [PMID: 37904146 PMCID: PMC10614357 DOI: 10.1186/s12903-023-03478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/01/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVES This study examined the generational-gender distinctions in Diagnostic Criteria for Temporomandibular disorders (DC/TMD) subtypes among East Asian patients. METHODS Consecutive "first-visit" TMD patients presenting at two university-based TMD/orofacial pain clinics in China and South Korea were enlisted. Demographic information along with symptom history was gathered and clinical examinations were performed according to the DC/TMD methodology. Axis I physical diagnoses were rendered with the DC/TMD algorithms and categorized into painful and non-painful TMDs. Patients were categorized into three birth cohorts, specifically Gen X, Y, and Z (born 1965-1980, 1981-1999, and 2000-2012 respectively) and the two genders. Data were evaluated using Chi-square/Kruskal-Wallis plus post-hoc tests and logistic regression analyses (α = 0.05). RESULTS Gen X, Y, and Z formed 17.2%, 62.1%, and 20.7% of the 1717 eligible patients examined (mean age 29.7 ± 10.6 years; 75.7% women). Significant differences in prevalences of arthralgia, myalgia, headache (Gen X ≥ Y > Z), and disc displacements (Gen Z > Y > X) were observed among the three generations. Gen Z had substantially fewer pain-related and more intra-articular conditions than the other generations. Women presented a significantly greater frequency of degenerative joint disease and number of intra-articular conditions than men. After controlling for generation-gender interactions, multivariate analyses showed that "being Gen X" and female increased the risk of painful TMDs (OR = 2.20) and reduced the odds of non-painful TMDs (OR = 0.46). CONCLUSIONS Generational-gender diversities in DC/TMD subtypes exist and are important for guiding TMD care and future research endeavors.
Collapse
Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, China
- Department of Dentistry, Ng Teng Fong General Hospital, Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Chengge Liu
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ji Woon Park
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
- Department of Oral Medicine & Oral Diagnosis, Seoul National University School of Dentistry, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Seong Hae Kim
- Dental Research Institute, Seoul National University, Seoul, Korea
- Department of Dental Biomaterials Science, Seoul National University School of Dentistry, Seoul, Korea
| | - Byeong-Min Lee
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Kai Yuan Fu
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, China.
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China.
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
| |
Collapse
|
5
|
Lezzi D, Céceres-Rodríguez A, Strauss B, Chavis P, Manzoni O. Sexual differences in neuronal and synaptic properties across subregions of the mouse insular cortex. RESEARCH SQUARE 2023:rs.3.rs-3431502. [PMID: 37961241 PMCID: PMC10635310 DOI: 10.21203/rs.3.rs-3431502/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background The insular cortex (IC) plays a pivotal role in processing interoceptive and emotional Information, offering insights into sex differences in behavior and cognition. The IC comprises two distinct subregions: the anterior insular cortex (alC), that processes emotional and social signals, and the posterior insular cortex (pIC), specialized in interoception and perception of pain. Pyramidal projection neurons within the IC integrate multimodal sensory inputs, influencing behavior and cognition. Despite previous research focusing on neuronal connectivity and transcriptomics, there has been a gap in understanding pyramidal neurons characteristics across subregions and between sexes. Methods Adult male and female C57BI/6J mice were sacrificed and tissue containing the IC was collected for ex vivo slice electrophysiology recordings that examined baseline sex differences in synaptic plasticity and transmission within alC and pIC subregions. Results Clear differences emerged between alC and pIC neurons In both males and females: alC neurons exhibited distinctive features such as larger size, increased hyperpolarizatlon, and a higher rheobase compared to their pIC counterparts. Furthermore, we observed variations in neuronal excitability linked to sex, with male pIC neurons displaying a greater level of excitability than their female counterparts. We also identified region-specific differences in excitatory and inhibitory synaptic activity and the balance between excitation and inhibition in both male and female mice. Adult females demonstrated greater synaptic strength and maximum response in the alC compared to the pIC. Lastly, synaptic long-term potentiation occurred in both subregions in males but was specific to the alC in females. Conclusions We conclude that there are sex differences in synaptic plasticity and excitatory transmission in IC subregions, and that distinct properties of IC pyramidal neurons between sexes could contribute to differences in behavior and cognition between males and females.
Collapse
|
6
|
Iezzi D, Cáceres-Rodríguez A, Strauss B, Chavis P, Manzoni OJ. Sexual differences in neuronal and synaptic properties across subregions of the mouse insular cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.18.562844. [PMID: 37905125 PMCID: PMC10614858 DOI: 10.1101/2023.10.18.562844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Background The insular cortex (IC) plays a pivotal role in processing interoceptive and emotional information, offering insights into sex differences in behavior and cognition. The IC comprises two distinct subregions: the anterior insular cortex (aIC), that processes emotional and social signals, and the posterior insular cortex (pIC), specialized in interoception and perception of pain. Pyramidal projection neurons within the IC integrate multimodal sensory inputs, influencing behavior and cognition. Despite previous research focusing on neuronal connectivity and transcriptomics, there has been a gap in understanding pyramidal neurons characteristics across subregions and between sexes. Methods Adult male and female C57Bl/6J mice were sacrificed and tissue containing the IC was collected for ex vivo slice electrophysiology recordings that examined baseline sex differences in synaptic plasticity and transmission within aIC and pIC subregions. Results Clear differences emerged between aIC and pIC neurons in both males and females: aIC neurons exhibited distinctive features such as larger size, increased hyperpolarization, and a higher rheobase compared to their pIC counterparts. Furthermore, we observed variations in neuronal excitability linked to sex, with male pIC neurons displaying a greater level of excitability than their female counterparts. We also identified region-specific differences in excitatory and inhibitory synaptic activity and the balance between excitation and inhibition in both male and female mice. Adult females demonstrated greater synaptic strength and maximum response in the aIC compared to the pIC. Lastly, synaptic long-term potentiation occurred in both subregions in males but was specific to the aIC in females. Conclusions We conclude that there are sex differences in synaptic plasticity and excitatory transmission in IC subregions, and that distinct properties of IC pyramidal neurons between sexes could contribute to differences in behavior and cognition between males and females. Highlights - Distinctions specific to sex are present within subregions of the insular cortex (IC) in C57Bl/6J mice.- Pyramidal neurons in the anterior IC (aIC) exhibited larger size and distinct electrical properties. Adult females exhibited stronger synaptic responses in the aIC.- Conversely, male posterior insular cortex neurons displayed increased excitability.- Synaptic long-term potentiation was observed in both subregions in males, but it was exclusive to the aIC in females.- Sex-based variations in various aspects of excitatory transmission within IC subregions could contribute to differences in behavior and cognition between males and females. Plain language summary This study investigates differences in the insular cortex (IC), a region of the brain responsible for emotions and sensory perceptions, between male and female mice. The IC has two parts: the front (aIC) deals with emotions and social cues, while the back (pIC) is focused on sensing pain and bodily sensations. We examined specific brain cells called pyramidal neurons in both aIC and pIC and discovered noteworthy distinctions between these neurons in adult male and female mice. Firstly, aIC neurons were larger and had unique electrical properties in both male and female mice. Males had more excitable pIC neurons compared to females, indicating that their neurons were more likely to transmit signals. We also explored how these neurons communicate with each other through connections known as synapses. In adult females, the aIC had stronger connections than the pIC. Finally, we observed that specific types of basic synaptic learning occurred exclusively in males in the aIC.These findings underscore significant disparities in the IC between males and females, offering valuable insights into the potential reasons behind variations in behaviors and emotions between sexes.
Collapse
|
7
|
Paudel A, Ann Mogle J, Kuzmik A, Resnick B, BeLue R, Galik E, Liu W, Behrens L, Jao YL, Boltz M. Gender differences in interactions and depressive symptoms among hospitalized older patients living with dementia. J Women Aging 2023; 35:476-486. [PMID: 36433792 DOI: 10.1080/08952841.2022.2146972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 11/28/2022]
Abstract
Alzheimer's disease or a related dementia (ADRD) disproportionately affects women with two-thirds of individuals with ADRD comprised of women. This study examined gender-related differences in the quality of staff-patient interactions and depressive symptoms among hospitalized older patients living with dementia. This secondary analysis utilized baseline data of 140 hospitalized older patients with dementia who participated in the final cohort of a randomized controlled trial (ClinicalTrials.gov identifier: NCT03046121) implementing Family centered Function-focused Care (Fam-FFC). On average, the participants (male = 46.1%, female = 52.9%) were 81.43 years old (SD = 8.29), had positive interactions with staff and lower depressive symptoms based on Quality of Interaction Schedule (QUIS) scores and Cornell Scale for Depression in Dementia (CSDD) scores, respectively. Although males had more positive interactions (male = 6.06, SD = 1.13; female = 5.59, SD = 1.51) and lesser depressive symptoms (male = 7.52, SD = 4.77; female = 8.03, SD = 6.25) than females, no statistically significant gender differences were observed in linear models with appropriate covariates or multivariant analysis of covariant (MANCOVA). However, the multigroup regression conducted to further probe marginally significant moderation effect of gender and pain on staff-patient interactions demonstrated that greater pain was significantly related to lower quality or less positive staff-patient interactions for females compared to males (χ2diff (1) = 4.84, p = .03). Continued evaluation of gender differences is warranted to inform care delivery and interventions to improve care for hospitalized older patients with dementia.
Collapse
Affiliation(s)
- Anju Paudel
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jacqueline Ann Mogle
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ashley Kuzmik
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Rhonda BeLue
- College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Wen Liu
- The University of Iowa College of Nursing, Iowa City, Iowa, USA
| | - Liza Behrens
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ying-Ling Jao
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Marie Boltz
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| |
Collapse
|
8
|
Engskov AS, Ydrefors A, El-Jaleb K, Åkeson J. Prospective paired crossover evaluation of potential impact of investigator gender on perceived pain intensity early after acute or scheduled surgery. Biol Sex Differ 2023; 14:23. [PMID: 37095547 PMCID: PMC10127324 DOI: 10.1186/s13293-023-00508-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Postoperative pain is common but often difficult to assess, and there are many potential confounders. Over the last decades, the gender of investigator as well as participant has been found to influence pain perception in both preclinical and clinical studies. However, to our knowledge this has not been studied in various postoperative patients. Objectives of this study were to test the hypotheses that pain intensity levels early after acute or scheduled in- or out-hospital surgery are lower when evaluated by a female investigator, and higher when reported by a female patient. METHODS In this prospective observational paired crossover study, two investigators of opposite genders independently obtained individually reported pain intensity levels with a visual analogue scale in a mixed cohort of adult postoperative study patients at Skåne University Hospital in Malmö, Sweden. RESULTS In total, 245 (129 female) study patients were included and then one female excluded. The study patients rated their intensity of postoperative pain lower when evaluated by a female than by a male investigator (P = 0.006), where the male patients constituted the significant difference (P < 0.001). Pain intensity levels did not differ between female and male study patients (P = 0.210). CONCLUSIONS Main findings of lower pain intensity reported by males to a female than to a male investigator early after surgery in this paired crossover study in mixed postoperative patients, indicate that potential impact of investigator gender on pain perception should be considered and further evaluated in clinical bedside practice. Trial registration Retrospectively registered in the ClinicalTrials.gov research database on 24th June 2019 with TRN number NCT03968497.
Collapse
Affiliation(s)
- Anna Sellgren Engskov
- Department of Clinical Sciences, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden.
- Skåne University Hospital, Carl Bertil Laurells Gata 9, 3rd floor, SE-20502, Malmö, Sweden.
| | - Andreas Ydrefors
- Department of Clinical Sciences, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden
| | - Karolin El-Jaleb
- Department of Clinical Sciences, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden
| | - Jonas Åkeson
- Department of Clinical Sciences, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
9
|
Salik E, Ozden AV, Alptekin HK. Chiropractic Care and Quality of Life Among Office Workers With Nonspecific Pain: A Cross-Sectional Study. J Chiropr Med 2022; 21:157-167. [PMID: 36118107 PMCID: PMC9479198 DOI: 10.1016/j.jcm.2022.03.006] [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: 12/23/2020] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to evaluate the quality of life by a self-administered World Health Organization Quality of Life short version survey (WHOQoL-BREF) among office workers with nonspecific pain receiving chiropractic care in Istanbul, Turkey. Methods This cross-sectional study included 77 office workers (age interval, 18-65) with nonspecific neck, thoracic, back and/or extremity pain who underwent chiropractic care. Two weeks later, the quality of life was evaluated by a self-administered WHOQoL-BREF. The Numeric Pain Scale to evaluate the perceived pain was administered to all of the participants in the beginning and at the end of the study. Group-level changes on WHOQoL-BREF total score and subdimensions were compared according to descriptive data of office workers. The significance level was set at P ≤ .05. Results WHOQoL-BREF scale scores after chiropractic care (mean ± standard deviation) were 71.21% ± 7.91% (total score), 81.49% ± 14.43% (general health), 80.38% ± 10.49% (physical health), 73.16% ± 11.68% (psychological), 70.41% ± 12.43% (social), and 65.58% ± 10.91% (environment). Numeric Pain Scale scores decreased in a statistically significant way when compared with baseline (P ≤ .05). The descriptive statistical analysis of WHOQoL-BREF dimensions revealed that women had significantly higher scores than men, the 18-to-35 age group had higher scores compared with the 50-to-65 age group, and those married had significantly higher scores than those who were not married (P ≤ .05). Conclusion The findings of our study suggest that chiropractic care had positive effects on the quality of life of office workers.
Collapse
Affiliation(s)
- Emsal Salik
- Corresponding author: Emsal Salik, MD, PhD, DC, Faculty of Health Sciences, Bahcesehir University, Abbasaga, Ihlamur Yildiz Cd. No:8, 34353 Besiktas, Istanbul, Turkey
| | | | | |
Collapse
|
10
|
Bedel C, Selvi F, Akçimen M. Vapocoolant Spray for Pain Control in Intramuscular Injection Applications: A Prospective, Randomized Controlled Trial. IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2022. [DOI: 10.1055/s-0042-1748778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Background Many pharmacological and nonpharmacological methods have been investigated along with advances in pain treatment. One of these nonpharmacological methods is the use of vapocoolant spray.
Objective This study aimedto demonstrate the effectiveness of vapocoolant spray to reduce pain during intramuscular (IM) injection.
Patients and Methods The study included ≥18 years old patients admitted to the emergency department who were asked to undergo IM injection. Patients were randomly divided into two groups as vapocoolant spray and control group. Demographic data, injection side, and visual analog scale (VAS) of the patients were recorded.
Results Mean VAS values during IM injection were significantly lower in patients treated with vapocoolant spray compared with the control group. The severity of pain during IM injection was lower in the vapocoolant spray group as both moderate pain (VAS > 3 cm) and severe pain (VAS > 5.4 cm) compared with the control group.
Conclusion Vapocoolant spray to be applied before IM injection is effective in reducing pain caused by the injection.
Collapse
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mehmet Akçimen
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
11
|
Sellgren Engskov A, Lejbman I, Åkeson J. Randomized cross-over evaluation of investigator gender on pain thresholds in healthy volunteers. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2021; 19:Doc14. [PMID: 34955699 PMCID: PMC8662746 DOI: 10.3205/000301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/30/2021] [Indexed: 11/15/2022]
Abstract
Background and aims: This randomized cross-over study in healthy volunteers was designed primarily to evaluate the potential impact of investigator gender on electrical pain threshold (EPT) and corresponding pain intensity levels, and secondly to evaluate potential differences in those interventions between female and male study participants. Methods: Forty adult volunteers (22 females) were included. An electrical stimulation device was used to determine EPT levels (in pain magnitude scores) in series of three in each study participant - once by a female, and once by a male investigator - according to a predefined cross-over design schedule. Corresponding levels of pain intensity were scored on a visual analog scale (VAS) slide ruler. Results: Study data was obtained and analysed in all participants. Significantly higher EPT levels were determined by the female investigator compared with the male investigator (median 22 (IQR 12-31) vs. 8 (6-10) pain magnitude scores; p<0.0001), despite similar levels of reported pain intensity (1.9 (1.2-3.0) vs. 2.0 (1.1-3.4) VAS units; p>0.300). There were no differences in EPT levels between female and male subjects evaluated by female (p>0.300) and male (p=0.125) investigators, or between the first and second series of stimulation (p>0.300). Conclusions: Our finding of significantly higher EPT levels when study participants of both genders - despite no difference in reported pain intensity - were evaluated by a female than by a male investigator, indicates a potential impact of investigator gender on the individual perception of pain. Implications: By contributing to a better understanding of how individual pain threshold levels are potentially influenced by investigator gender, this study might facilitate future evaluation of pain conditions in both preclinical and clinical settings.
Collapse
Affiliation(s)
- Anna Sellgren Engskov
- Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden,*To whom correspondence should be addressed: Anna Sellgren Engskov, Lund University, Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Skåne University Hospital, Carl Bertil Laurells Gata 9, 3rd Floor, 20502 Malmö, Sweden, Phone: +46 40331000, E-mail:
| | - Ilja Lejbman
- Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden
| | - Jonas Åkeson
- Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
12
|
Sreeja SS, Bhandary R, Bhat AR, Shenoy N. An Assessment of Dental Anxiety in Patients Before and After Scaling and Polishing Procedures. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1736453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Introduction As of now, there are not many investigations about the improvement of dental apprehension and dental participation in various populations over time. This investigation includes an examination of emotional appraisals of levels of dental apprehension in patients selected at the AB Shetty Memorial Institute of Dental Sciences. The investigation also aimed to discover the causes of dental apprehension as well as the effect of sexuality on the distinguished dental apprehension.
Materials and Methods The level of dental apprehension was assessed using questionnaires that included 15 questions before and after the scaling and polishing procedures for 78 patients. The typical features were drawn such as gender, age, and oral hygiene habits. The data analysis was analyzed using paired t-test or Wilcoxon signed rank test to assess pre- and postanxiety levels.
Results A total of 78 responses were collected, resulting in a participation rate of 100%. Despite the fact that women had significantly higher overall dental apprehension levels compared with men, the discrepancy among the two genders was substantial and could be clarified.
Conclusion Dental fear was common in females, especially among those with dental problems, and a larger degree of dental fear can contribute to periodontal disease.
Collapse
Affiliation(s)
- Sai S. Sreeja
- Department of Periodontics, AB Shetty Memorial institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, Karnataka, India
| | - Rahul Bhandary
- Department of Periodontics, AB Shetty Memorial institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, Karnataka, India
| | - Amitha Ramesh Bhat
- Department of Periodontics, AB Shetty Memorial institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, Karnataka, India
| | - Nina Shenoy
- Department of Periodontics, AB Shetty Memorial institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, Karnataka, India
| |
Collapse
|
13
|
Akutay S, Yilmaz M. The relationship between pain severity and sleep quality: Posttube thoracostomy. Nurs Forum 2021; 56:860-868. [PMID: 34263967 DOI: 10.1111/nuf.12630] [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: 11/16/2020] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The presence of a chest tube is a factor significantly associated with pain and pain posttube thoracostomy that negatively affects sleep quality (SQ). AIM To determine the relationship between the pain severity and SQ of patients who underwent the tube thoracostomy (TT). METHODS This was a descriptive and cross-sectional survey conducted from May 1, 2018, to December 30, 2018, in the thoracic surgery department of Sivas Cumhuriyet University Hospital in Central Anatolia/Turkey. Data were collected using a questionnaire form, a Numerical Rating Scale to determine pain severity, and the Richard-Campbell Sleep Questionnaire to assess SQ. RESULTS The study was carried out with 102 patients who underwent the TT. The mean age of the participants were 48.94 years. The mean scores for the scale items indicated that during the procedure and on the first day of post-TT, the pain severity of the patients was very high, their SQ was low. Pain level decreased gradually in the following days, and the SQ increased. There was a positive, strong correlation between the post-TT first day pain and first night SQ (r = 0.380, p = 0.000), second day pain and second night SQ (r = -0.537, p = 0.000), and third day pain and third night SQ (r = -0.507, p = 0.000). CONCLUSION The results of this study highlight that the pain severity of post-TT significantly affect the quality of the patients' night sleep.
Collapse
Affiliation(s)
- Seda Akutay
- Division of Nursing, Department of Surgical Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Meryem Yilmaz
- Division of Nursing, Department of Surgical Nursing, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
14
|
Ludwig H, Bailey AL, Marongiu A, Khela K, Milligan G, Carlson KB, Rider A, Seesaghur A. Patient-reported pain severity and health-related quality of life in patients with multiple myeloma in real world clinical practice. Cancer Rep (Hoboken) 2021; 5:e1429. [PMID: 34110106 PMCID: PMC8789609 DOI: 10.1002/cnr2.1429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/22/2021] [Accepted: 05/05/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The association between patient self-reported pain severity and health-related quality-of-life (HRQoL) is poorly understood. AIMS This real-world study of symptomatic multiple myeloma (MM) patients sought to determine how pain severity from a single question asked during routine clinical consultation was associated with HRQoL. METHODS AND RESULTS Point-in-time data on HRQoL of 330 patients with MM (median age 70 years) receiving anti-myeloma therapy in Germany and Italy from November 2017 through February 2018 were analyzed. HRQoL was assessed using validated questionnaires (Work Productivity and Activity Impairment [WPAI], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire -C30 and -MY20). Physical pain severity was assessed during clinical consultation by a single question, asking patients to describe their pain as "no pain," "mild," "moderate," or "severe." Associations between patient-reported pain severity and HRQoL scores were assessed by analysis of variance or χ2 tests. Ninety-six of the 330 patients (29.1%) reported moderate to severe pain. Increase in pain severity, from "no" to "severe" pain, was associated with significantly decreased overall HRQoL (mean score 70.2 to 33.3); significant decreases in levels of physical (82.7 to 35.1), social (81.1 to 44.4), emotional (78.1 to 48.3), and role functioning (79.5 to 38.9); and increased levels of WPAI usual activity impairment (35.4 to 71.4), and fatigue burden (26.0 to 68.9) (all p < .001). CONCLUSION Higher pain severity, based on a single self-report question, was associated with poorer HRQoL in patients with MM, thereby supporting the clinical relevance of directly asking patients to self-evaluate their pain severity.
Collapse
Affiliation(s)
- Heinz Ludwig
- Medical Department Center for Oncology, Hematology and Palliative Medicine, Wilhelminen Cancer Research Institute, Vienna, Austria
| | | | | | - Keerun Khela
- Oncology, Adelphi Real World, Adelphi Mill, Bollington, UK
| | - Gary Milligan
- Oncology, Adelphi Real World, Adelphi Mill, Bollington, UK
| | | | - Alex Rider
- Oncology, Adelphi Real World, Adelphi Mill, Bollington, UK
| | | |
Collapse
|
15
|
Han D, Kim H, Kim S, Park Y, Cho KJ. Comparative study on the effect of hyperthermic massage and mechanical squeezing in the patients with mild and severe meibomian gland dysfunction: An interventional case series. PLoS One 2021; 16:e0247365. [PMID: 33684150 PMCID: PMC7939575 DOI: 10.1371/journal.pone.0247365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Meibomian glands exist beneath the palpebral conjunctiva; thus, it is invisible to the naked eye without infrared imaging. This study used meibography to group patients with meibomian gland dysfunction (MGD) and assessed the effects of hyperthermic massage and mechanical squeezing in both groups. MATERIALS AND METHODS Patients with MGD were divided into two groups, according to the degree of meibomian gland loss: group 1, in which the sum of eyelid scores ranged from 0 to 4 (mild to moderate gland loss) and group 2, in which the sum of eyelid scores ranged from 5 to 6 (severe gland loss). Hyperthermic massage and mechanical squeezing were given to both groups once a week for 4 weeks, and only non-preservative artificial tears were allowed. Ocular surface disease index (OSDI), Schirmer's test, meibography score, tear break-up time (TBUT), ocular surface staining, expressible meibomian gland, and quality before and after treatment were compared. RESULTS Of the 49 patients who completed the 4 weeks of treatment and the evaluation at week 5, 29 were assigned to group 1 and 20 were assigned to group 2. Meibography scores, OSDI, TBUT, and expressibility of meibum had significant differences before and after treatments in both groups. However, there was no significant difference between the changes in clinical signs between group 1 and 2 after treatment. Without grouping, all patients showed significant decreases in meibography score, OSDI, cornea staining score, and increases in TBUT and expressibility of meibum after treatment. CONCLUSIONS Considering the results of the current study, hyperthermic massage and mechanical squeezing may be effective in patients with meibomian gland loss, regardless of the degree of severity.
Collapse
Affiliation(s)
- Dongkyun Han
- Department of Ophthalmology, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hoon Kim
- Department of Ophthalmology, College of Medicine, Dankook University, Cheonan, Republic of Korea
- Beckman Laser Institute Korea, Dankook University, Cheoan, Republic of Korea
| | - Sehwan Kim
- Beckman Laser Institute Korea, Dankook University, Cheoan, Republic of Korea
- Department of Biomedical Engineering, School of Medicine, Dankook University, Cheoan, Republic of Korea
| | - Yuli Park
- Department of Ophthalmology, College of Medicine, Dankook University, Cheonan, Republic of Korea
- Beckman Laser Institute Korea, Dankook University, Cheoan, Republic of Korea
| | - Kyong Jin Cho
- Department of Ophthalmology, College of Medicine, Dankook University, Cheonan, Republic of Korea
- Beckman Laser Institute Korea, Dankook University, Cheoan, Republic of Korea
| |
Collapse
|
16
|
Impact of the Timing of Rocuronium Injection after Propofol Administration on Temporal Summation of Pain in Gynecologic Laparoscopic Surgery: A Prospective and Controlled Study. Pain Res Manag 2020; 2020:6642460. [PMID: 33376568 PMCID: PMC7744223 DOI: 10.1155/2020/6642460] [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: 10/29/2020] [Revised: 11/17/2020] [Accepted: 11/25/2020] [Indexed: 11/19/2022]
Abstract
Purpose Temporal summation of pain, which is defined as the perception of greater pain evoked by repetitive painful stimuli, varies among individuals. This study aimed at determining the impact of the timing of rocuronium after induction with propofol on the temporal summation of pain. Methods One hundred patients aged 19–60 years underwent gynecologic laparoscopic surgery. Patients were randomly assigned to one of the two groups: group PRi received immediate injections of rocuronium after propofol administration and group PRd received rocuronium injections when the bispectral index score (BIS) decreased to <60 after propofol administration. The grade of rocuronium-induced withdrawal movement (RIWM) according to the timing of propofol injection, the incidence and severity of propofol injection pain (PIP), rescue analgesics, visual analog scale (VAS) score after surgery for postoperative pain, patient-controlled analgesia (PCA) opioid consumption, association between PIP and the grade of RIWM, and associations between PIP, the grade of RIWM, and postoperative pain outcomes were measured. Results The differences between the incidence and severity of PIP in the two groups were not significant. The grade of the RIWM in the PRd group was significantly reduced compared with the PRi group. Rescue analgesics, severity for postoperative pain, and PCA opioid consumption were not significant. Correlations between the incidence and severity of PIP and the grade of RIWM were weakly negative. Correlations between the grade of RIWM and pain outcomes were moderately positive, but correlations between the severity for PIP and the postoperative pain outcomes were negligible. Conclusion The timing of rocuronium administration after propofol injection played a role in reducing RIWM. The grade of RIWM was significantly related to pain outcomes compared with the severity of PIP. Therefore, delayed rocuronium injection after induction with propofol reduced temporal summation of pain.
Collapse
|
17
|
Wahba G, Neshkova E, Vuille-Lessard É, Bouin M. Is topical lidocaine beneficial before catheter insertion in esophageal manometry and ambulatory pH monitoring? Neurogastroenterol Motil 2019; 31:e13687. [PMID: 31321837 DOI: 10.1111/nmo.13687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/06/2019] [Accepted: 07/09/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Conventionally, topical anesthesia is applied to improve the tolerance of esophageal manometry (EM) and ambulatory pH monitoring (apH) but there is presently no evidence supporting this practice. We aimed to compare the tolerance of EM and apH with vs without topical lidocaine anesthesia. METHODS A prospective study was conducted at our center between January 2017 and January 2019. All patients who underwent EM or apH and completed a systematically distributed standardized patient survey were included. From January 2017 to June 2018, all patients had a viscous lidocaine solution applied before EM and apH ("lidocaine" group). After June 2018, we ceased applying any topical anesthesia ("no lidocaine" group). Patient-reported adverse effects and satisfaction scores were compared between these two patient groups. KEY RESULTS Two hundred forty-nine patient surveys were included. "Lidocaine" (n = 124) and "no lidocaine" (n = 125) groups were similar in age (56.9 ± 14.0 vs 56.0 ± 13.7; P = .77) and gender distributions (65.9% vs 63.3% female; P = .68). Patients in the "lidocaine" group were less likely to report pain during catheter insertion (33.6% vs 50.8%; P = .007, OR: 0.49 [95% CI 0.29-0.83]) and reported a lower overall pain score (2.82 ± 1.38 vs 3.20 ± 1.42 on 5; P = .04). There was a tendency toward increased global satisfaction with lidocaine application but that was not statistically significant (4.36 ± 1.05 vs 4.11 ± 1.13; P = .08). In subgroup analyses, female patients, younger patients, and patients who underwent EM were more likely to benefit from lidocaine application. CONCLUSIONS AND INFERENCES Application of topical lidocaine before esophageal motility tests reduces pain during catheter insertion and overall pain.
Collapse
Affiliation(s)
- George Wahba
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | | | | | - Mickael Bouin
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| |
Collapse
|