Psycho-Neuroendocrinology in the Rehabilitation Field: Focus on the Complex Interplay between Stress and Pain

Chronic stress and chronic pain share neuro-anatomical, endocrinological, and biological features. However, stress prepares the body for challenging situations or mitigates tissue damage, while pain is an unpleasant sensation due to nociceptive receptor stimulation. When pain is chronic, it might lead to an allostatic overload in the body and brain due to the chronic dysregulation of the physiological systems that are normally involved in adapting to environmental challenges. Managing stress and chronic pain (CP) in neurorehabilitation presents a significant challenge for healthcare professionals and researchers, as there is no definitive and effective solution for these issues. Patients suffering from neurological disorders often complain of CP, which significantly reduces their quality of life. The aim of this narrative review is to examine the correlation between stress and pain and their potential negative impact on the rehabilitation process. Moreover, we described the most relevant interventions used to manage stress and pain in the neurological population. In conclusion, this review sheds light on the connection between chronic stress and chronic pain and their impact on the neurorehabilitation pathway. Our results emphasize the need for tailored rehabilitation protocols to effectively manage pain, improve treatment adherence, and ensure comprehensive patient care.

Does oxidative stress play a role in altered plasma protein homeostasis in pregnancy-induced hypertension?

BACKGROUND

Pregnancy-induced hypertension (PIH) is associated with oxidative stress and low plasma proteins. This study explored the effect of oxidative stress on plasma protein level in PIH.

METHODS

Serum total proteins (TP), albumin, globulin, malondialdehyde, protein carbonyls (PC) and protein bound sialic acid (PBSA) were measured in gestational hypertensive, pre-eclamptic, eclamptic and healthy pregnant women (n=20/group). Serum proteins were separated by electrophoresis for assessing protein damage.

RESULTS

Serum TP and albumin decreased and malondialdehyde, PC & PBSA increased significantly in all PIH subgroups as compared to healthy pregnant subjects. Serum globulin levels decreased only in eclampsia. Malondialdehyde and PC negatively correlated with albumin level. Protein fragmentation and aggregation in eclampsia were evident from electrophoretogram.

CONCLUSION

We conclude that oxidative damages to proteins contribute to decreased serum protein levels in PIH and hypersialylation of plasma proteins is probably body’s protective mechanism to combat oxidative protein damage in PIH.

[Verification of maxillary and mandibular asymmetry via orthopantogram's analysis]

AIM

The purpose of this study was to analyse the homologous variables' symmetry (horizontal, vertical, angular and of area surface) of the right and left segment in the maxilla and in the mandible of subjects with a normal occlusion and a malocclusion.

METHODS

Two-hundred and two orthopantomograms were analysed (162 with malocclusion, 40 with normal occlusion). These points of reference were used: orbital, condilion, gonion, menton, point A (intersection point between the vertical line passing through the centre of the nasal septum and the horizontal line which links the 2 points O), point B (intersection point between the mandibular margin and the vertical line passing through point O) and point T (intersection point of A-Cn on the maxillary tuberosity).

RESULTS

This study did not confirm any statistically significant differences between the right and left analysed variables studied in both groups.

CONCLUSION

Orthopantomography may be a useful test in the screening for facial asymmetry.

Ectopic uterine stem cell tumors in the hamster kidney. A unique model for estrogen-induced oncogenesis

Estrogens are intimately involved in the causation of some of the most prevalent cancers afflicting women, particularly, breast, endometrial, cervico-vaginal, and possibly ovarian. Therefore, it has become particularly pertinent to elucidate the molecular mechanisms whereby estrogens elicit their oncogenic actions so that better prevention strategies can be developed. The estrogen-induced Syrian hamster tumors of the kidney have emerged as one of the most intensively studied in vivo models in solely estrogen oncogenesis. An advantage of this model is that the tumors occur in the absence of any intervening morphologic changes, but rather they are the result of the continuous progression of some interstitial stem cells in the kidney leading to tumor formation. Evidence is presented that the origin of these tumors is derived from ectopic "uterine" stem cells, which are responsive to estrogenic hormones. Their steroid receptor and many other gene alterations have been delineated. Importantly, a crucial early event in this solely estrogen-induced oncogenic process is the overexpression and amplification of c-myc and its protein product. Chromosomal instability, in both early and large frank tumors, is another important characteristic of this process. This later feature has commonly been shown in solely estrogen-induced murine mammary tumors, and in ductal carcinomas in situ and in primary invasive ductal breast carcinomas. These changes are considered crucial in eliciting estrogen-induced tumorigenesis.

[Estimating facial asymmetries in individuals with malocclusion and normocclusion]

BACKGROUND

The en face photographs taken in standard conditions were used to examine the facial symmetry in examinees with normocclusion and malocclusion.

METHODS

A total of 80 examinees were included in the study (40 of whom had normocclusion and another 40 had malocclusion) without any prior orthodontic therapy. The face was divided into six squares by the mediosagittal line drawn through the Trihion, Glabella, Subnasals and Gnathion as well as by horizontal lines drawn through the same points. The four lower squares - the middle and the lower thirds of the face were taken into account to analyse facial symmetry. The symmetry between individual squares was measured by applying transparent paper with a millimetre-sized squares web and a planimetry.

RESULTS

The results did not show any asymmetry between left and right parts of the face in either group of examinees.

CONCLUSIONS

A high correlation was established among all the analysed variables.