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1.
Front Immunol ; 15: 1444010, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39372422

RESUMEN

We report on a patient with ciltacabtagene autoleucel-induced movement and neurocognitive toxicity, which was refractory to immunosuppression but responsive to combination dopaminergic therapy (carbidopa/levodopa, ropinirole, amantadine). Response was seen upon both initial treatment and rechallenge after unintended withdrawal. This is the first report of a successful symptomatic treatment of this well-described neurotoxic syndrome.


Asunto(s)
Carbidopa , Inmunoterapia Adoptiva , Levodopa , Humanos , Carbidopa/administración & dosificación , Levodopa/administración & dosificación , Levodopa/efectos adversos , Inmunoterapia Adoptiva/efectos adversos , Inmunoterapia Adoptiva/métodos , Trastornos Parkinsonianos/tratamiento farmacológico , Trastornos Parkinsonianos/inducido químicamente , Combinación de Medicamentos , Resultado del Tratamiento , Amantadina/administración & dosificación , Amantadina/uso terapéutico , Masculino , Persona de Mediana Edad , Dopaminérgicos/administración & dosificación , Dopaminérgicos/efectos adversos , Femenino , Quimioterapia Combinada , Indoles/administración & dosificación , Indoles/efectos adversos , Agonistas de Dopamina/administración & dosificación , Agonistas de Dopamina/efectos adversos , Agonistas de Dopamina/uso terapéutico , Antiparkinsonianos/administración & dosificación , Antiparkinsonianos/efectos adversos , Productos Biológicos/administración & dosificación , Productos Biológicos/efectos adversos , Productos Biológicos/uso terapéutico , Receptores Quiméricos de Antígenos/inmunología
2.
Support Care Cancer ; 32(10): 695, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39352516

RESUMEN

PURPOSE: Ductal carcinoma in situ (DCIS) of the breast is one of the most common pre-invasive cancers diagnosed in women. Quality of life (QoL) is extremely important to assess in studies including these patients due to the favorable prognosis of the disease. The primary objective of this systematic review was to compile a comprehensive list of QoL issues, all existing QoL assessment tools, and patient-reported outcome measures used to assess DCIS. METHODS: A search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to August 2023, using keywords such as "ductal carcinoma in-situ", "quality of life", and "patient-reported outcomes." QoL issues and QoL tools in primary research studies were extracted. RESULTS: A total of 67 articles identified issues pertaining to patients with DCIS spanning physical, functional, and psychosocial QoL domains. Physical and functional issues observed in patients included pain, fatigue, and impaired sexual functioning. Psychosocial issues such as anxiety, depression, and confusion about one's disease were also common. QoL tools included those that assessed general QoL, breast cancer-specific tools, and issue-specific questionnaires. CONCLUSION: The current instruments available to assess QoL in patients with DCIS do not comprehensively capture the issues that are pertinent to patients. Thus, the modification of existing tools or the creation of a DCIS-specific QoL tool is recommended to ensure that future research will be sensitive towards challenges faced by patients with DCIS.


Asunto(s)
Neoplasias de la Mama , Carcinoma Intraductal no Infiltrante , Medición de Resultados Informados por el Paciente , Calidad de Vida , Humanos , Neoplasias de la Mama/psicología , Femenino , Carcinoma Intraductal no Infiltrante/psicología , Carcinoma Intraductal no Infiltrante/terapia
3.
Support Care Cancer ; 32(10): 670, 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39292351

RESUMEN

PURPOSE: Previous literature has produced heterogeneous results on StrataXRT for prevention of acute radiation dermatitis (RD) in breast cancer. This pilot study aimed to assess the feasibility and efficacy of StrataXRT in a cancer center. METHODS: The study consisted of five cohorts: (1) patients with large breasts treated with local radiation therapy (RT) either in the supine position or (2) the prone position, (3) patients receiving locoregional breast RT with any breast size, and (4) patients receiving chest wall RT, either locally or (5) locoregionally. The primary endpoint of the study was RD grade as assessed using the Common Terminology Criteria for Adverse Events. Secondary endpoints included incidence of moist desquamation (MD), patient- and clinician-reported skin assessments, patient quality of life as assessed by the Skindex-16, and patient satisfaction. These outcomes were compared with those from a published trial from the same institution assessing standard of care and Mepitel Film (MF) as prevention of breast RD. RESULTS: Forty-five patients receiving RT to the breast or chest wall were enrolled. Two withdrew, leaving 43 evaluable patients. Overall, two (4.7%) patients had grade 3 RD, 14 (32.6%) had grade 2 RD, and 27 (62.8%) had grade 1 RD. Ten patients (23.3%) developed MD during/after RT. CONCLUSION: StrataXRT is effective in preventing grade 3 RD in patients, and the most promising results were observed within the prone cohort. Further research includes evaluating the efficacy of StrataXRT against the standard of care for the prophylaxis of RD. TRIAL REGISTRATION: The study protocol was registered at ClinicalTrials.gov (identifier: NCT05594498) on October 13, 2022.


Asunto(s)
Neoplasias de la Mama , Calidad de Vida , Radiodermatitis , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Enfermedad Aguda , Neoplasias de la Mama/radioterapia , Estudios de Factibilidad , Satisfacción del Paciente , Proyectos Piloto , Posición Prona , Radiodermatitis/prevención & control , Radiodermatitis/etiología , Posición Supina
4.
Breast Cancer Res Treat ; 207(3): 477-496, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39112742

RESUMEN

BACKGROUND: Barrier films or dressings were reported to be effective in preventing radiation dermatitis (RD) in breast cancer patients, but their comparative efficacy is unknown. METHODS: A systematic literature search was performed on Embase, MEDLINE and Cochrane CENTRAL Registry of Clinical Trials from inception to October 20, 2023. Randomised controlled trials (RCTs) comparing barrier films or dressings to the standard of care (SOC) or other interventions were included. We estimated summary odds ratios and mean differences using network meta-analysis with random effects. This study was registered with PROSPERO (ID: CRD42023475021). RESULTS: Fourteen RCTs met inclusion criteria. Six interventions were analysed: 3M™ Moisturizing Double Barrier Cream (MDBC), 3M™ No Sting Barrier Film (BF), Hydrofilm® (HF), Mepitel® Film (MF), Silver Leaf Nylon Dressing and StrataXRT®. HF, MF and StrataXRT® reduced the incidence of moist desquamation compared to SOC (HF: OR = 0.08; p = 0.02; MF: OR = 0.31 p < 0.01; StrataXRT®: OR = 0.22, p = 0.04). The ranking of agents from most to least effective in preventing moist desquamation according to P-scores was HF (92.5%), MF (78.5%), StrataXRT® (70.1%), BF (46.4%), Silver Leaf Nylon Dressing (24.9%), MDBC (22.9%) and SOC (14.7%). Only four RCTs on HF and MF included patient-reported outcome (PRO) assessments that allowed pooling for analysis. HF and MF were more effective in reducing pain, itchiness and burning sensation compared to SOC (p < 0.01 for all symptoms). CONCLUSION: HF and MF were effective in preventing RD in breast cancer. Future RCTs should compare these interventions to effective cream preparations, such as topical corticosteroids.


Asunto(s)
Vendajes , Neoplasias de la Mama , Metaanálisis en Red , Radiodermatitis , Humanos , Neoplasias de la Mama/radioterapia , Radiodermatitis/prevención & control , Radiodermatitis/etiología , Femenino , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
5.
Asia Pac J Oncol Nurs ; 11(8): 100530, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39051046

RESUMEN

Objective: This review aimed to summarize the benefits, side effects, physics measurements, and patient- and clinician-reported outcomes of Mepitel film (MF) in preventing radiation dermatitis (RD) for cancer patients. Methods: The online database PubMed was searched from inception to April 15, 2024 with the search terms "Mepitel film" or "Mepitel." Articles of any study design evaluating MF for the prevention of RD were included. Non-human studies were excluded. Results: The database search identified 119 articles and 13 of them were included in this review. Across these studies, MF was found to be beneficial in reducing RD and improved patient- and clinician-reported outcomes in breast and head and neck cancers. Side effects of MF included itchiness, acne, allergic reaction, tightness, discomfort, and poor film adherence, but patient dropouts were uncommon. MF did not cause a bolus effect or increased skin dose in physics measurements. Conclusions: MF is a safe and effective intervention for preventing acute RD. It should be recommended in breast cancer patients where the data is more robust. Further research is needed to evaluate MF's efficacy on patients with different skin tones, its cost-effectiveness, and identifying patients who most benefit from MF relative to other effective interventions.

6.
Pain ; 165(1): 115-125, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-37530649

RESUMEN

ABSTRACT: Abdominal pain is a common symptom of several debilitating conditions (eg, inflammatory bowel disease, irritable bowel syndrome, and endometriosis) and affects individuals throughout their lifespan. Quantitative sensory testing (QST) reference values exist for many body sites but not the abdomen. Using a QST battery adapted from the German Research Network on Neuropathic Pain, we collected QST data on the upper and lower abdomen in 181 pain-free participants, ages 12 to 50 years, to establish reference values by age and biological sex. The normative values are presented as medians for each QST measure by sex (male, n = 63; female, n = 118) and across 3 age categories (adolescents: 12-19 years, n = 48; young adults: 20-30 years, n = 87; and adults: 31-50 years, n = 46). Evaluating the sensory functioning of the abdomen and characterizing ranges of QST measures is an essential first step in understanding and monitoring the clinical course of sensory abnormalities in patients with underlying diseases affecting the abdomen and pelvis. The impact of age and development on sensory functioning is necessary, given age-related changes in pain perception and modulation.


Asunto(s)
Neuralgia , Umbral del Dolor , Adolescente , Adulto Joven , Humanos , Masculino , Femenino , Niño , Adulto , Valores de Referencia , Neuralgia/diagnóstico , Percepción del Dolor , Abdomen
7.
J Neurosci ; 43(43): 7073-7083, 2023 10 25.
Artículo en Inglés | MEDLINE | ID: mdl-37648450

RESUMEN

Neuronal Kv7 voltage-gated potassium channels generate the M-current and regulate neuronal excitability. Here, we report that dehydroepiandrosterone sulfate (DHEAS) is an endogenous Kv7 channel modulator that attenuates Gq-coupled receptor-induced M-current suppression. DHEAS reduced muscarinic agonist-induced Kv7-current suppression of Kv7.1, Kv7.2, Kv7.4, or Kv7.5 homomeric currents and endogenous M-currents in rat sympathetic ganglion neurons. However, DHEAS per se did not alter the voltage dependence of these Kv7 homomeric channels or the m1 receptor-induced activation of phospholipase C or protein kinase C. DHEAS-treated Kv7.2 homomeric currents became resistant to depletion of phosphatidylinositol 4,5-bisphosphate (PIP2) induced by voltage-activated phosphatase, Ci-VSP or eVSP. Our computational models predicted a novel binding site for DHEAS in the cytoplasmic domain of Kv7 subunits. A single-point mutation of the predicted key histidine into cysteine in the rat Kv7.2 subunit, rKv7.2(H558C), resulted in a loss of effects of DHEAS on muscarinic Kv7 current suppression. Furthermore, in vivo administration of DHEAS in mice of both sexes reduced late phase pain responses in the formalin paw test. However, it did not have effects on early phase responses in the formalin paw test or responses in the hot plate test. Coadministration of a selective Kv7 inhibitor, XE991, and DHEAS eliminated analgesic effects of DHEAS in late phase responses in the formalin paw test. Collectively, these results suggest that DHEAS attenuates M-current suppression by stabilizing PIP2-Kv7 subunit interaction and can mitigate inflammatory pain.SIGNIFICANCE STATEMENT M-current suppression induced by stimulation of Gq-coupled receptors is a form of Kv7 current modulation that can reversibly increase neuronal excitability. This study demonstrates that DHEAS, an endogenous steroid hormone, is a novel Kv7 channel modulator that can attenuate M-current suppression without affecting basal Kv7 channel kinetics. Administration of DHEAS in vivo alleviated inflammatory pain in rodents. These results suggest that the degree of M-current suppression can be dynamically regulated by small molecules. Therefore, this novel form of Kv7 channel regulation holds promising potential as a therapeutic target for sensitized nervous activities, such as inflammatory pain.


Asunto(s)
Canal de Potasio KCNQ2 , Agonistas Muscarínicos , Masculino , Femenino , Ratones , Ratas , Animales , Sulfato de Deshidroepiandrosterona , Canal de Potasio KCNQ2/metabolismo , Agonistas Muscarínicos/farmacología , Dolor/tratamiento farmacológico , Formaldehído , Canal de Potasio KCNQ3/genética , Canal de Potasio KCNQ3/metabolismo
8.
Nanoscale ; 15(3): 1119-1127, 2023 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-36594352

RESUMEN

Water electrolysis can use renewable electricity to produce green hydrogen, a portable fuel and sustainable chemical precursor. Improving electrolyzer efficiency hinges on the activity of the oxygen evolution reaction (OER) catalyst. Earth-abundant, ABO3-type perovskite oxides offer great compositional, structural, and electronic tunability, with previous studies showing compositional substitution can increase the OER activity drastically. However, the relationship between the tailored bulk composition and that of the surface, where OER occurs, remains unclear. Here, we study the effects of electrochemical cycling on the OER activity of La0.5Sr0.5Ni1-xFexO3-δ (x = 0-0.5) epitaxial films grown by oxide molecular beam epitaxy as a model Sr-containing perovskite oxide. Electrochemical testing and surface-sensitive spectroscopic analyses show Ni segregation, which is affected by electrochemical history, along with surface amorphization, coupled with changes in OER activity. Our findings highlight the importance of surface composition and electrochemical cycling conditions in understanding OER performance, suggesting common motifs of the active surface with high surface area systems.

9.
Pain Manag Nurs ; 24(1): 27-34, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36564325

RESUMEN

PURPOSE: Chronic post-surgical pain (CPSP) is a significant concern and contributes to the opioid epidemic; however, little is known about CPSP in young people. DESIGN: This prospective study aimed to identify sensory, psychological, and demographic factors that may increase the risk of CPSP after spinal fusion surgery for children and adolescents with idiopathic scoliosis. METHODS: 32 children and adolescents from two children's hospitals completed quantitative sensory testing (QST) and the Pain Catastrophizing Scale Child (PCS-C) pre-and 4-6 months post spinal fusion surgery. Between-group differences were assessed using an independent samples t-test. Pearson's correlations and stepwise linear regression were used to assess the relationship between variables at both time points. RESULTS: 56% of patients endorsed pain post-surgery. They were more sensitive tomechanical detection on both a control non-pain site (r = -2.87, p = .004) and the back (r = -1.83, p = .04), as well as pressure pain (r=-2.37, p = .01) on the back. This group also reported worse pain scores pre-surgery. Pre-surgery helplessness positively correlated with preoperative pain (r = .67 p < .001), and age was negatively correlated with the post-surgical catastrophizing total score (r =-.39, p = .05), suggesting that younger patients endorsed more pain-related worry after surgery. CONCLUSIONS: Patients who present with pain during their preoperative appointment may need to be monitored with increased vigilance throughout the perioperative period, possibly with bedside QST and psychological questionnaires, which nurses could administer. Biobehavioral interventions targeting pain intensity and feelings of helplessness and anxiety during the preoperative period may alleviate the transition to CPSP.


Asunto(s)
Dolor Crónico , Fusión Vertebral , Adolescente , Humanos , Niño , Estudios Prospectivos , Fusión Vertebral/efectos adversos , Proyectos Piloto , Catastrofización/psicología , Dolor Postoperatorio/psicología , Dolor Crónico/epidemiología
10.
J Surg Case Rep ; 2022(9): rjac414, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36131804

RESUMEN

Retrograde intussusception (RI) is a rare long-term complication of gastric bypass surgery, which usually happens within the first few years after operation. The clinical presentation is vague with overlapping symptoms of bowel obstruction or ischemia. This is a case of a 37-year-old lady who presented with severe abdominal pain. She has background of Roux-en-Y gastric bypass surgery 23 years ago. She underwent emergency laparotomy, bowel resection and Roux-en-Y reconstruction due to finding of ischemic bowel segment. Unfortunately, she had recurrent presentation of RI after 6 months and similar operation was necessitated. She recovered well post-operatively, but there was no definitive cause established for the recurrence. While RI remains a rare diagnosis, clinicians should have high index of suspicion in encountering patients with acute abdomen post gastric bypass surgery. Early imaging is required for the diagnosis and surgical intervention is often warranted.

11.
NASN Sch Nurse ; 37(1): 42-47, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34836466

RESUMEN

The importance of students feeling connected in school cannot be overstated, as this perception is crucial to support their health and well-being. A lack of school connectedness can lead to adverse physical and mental health outcomes, including bully victimization. Numerous factors, including individual, social, and environmental, influence students' perceived sense of school connectedness. School nurses are well positioned to establish and maintain school connectedness due to their knowledge, accessibility to students, and familiarity with the school environment. This article details the importance of school connectedness and describes the associations between school connectedness, bullying, and mental health. In addition, we offer recommendations geared toward school nurses regarding strengthening school connectedness and promoting a culture of care and inclusivity within school environments, especially salient in the context of the COVID-19 pandemic.


Asunto(s)
Acoso Escolar , COVID-19 , Servicios de Enfermería Escolar , Adolescente , Acoso Escolar/prevención & control , Humanos , Pandemias , SARS-CoV-2 , Instituciones Académicas
12.
Small ; 17(49): e2103632, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34677915

RESUMEN

Electrocatalytic reactions are known to take place at the catalyst/electrolyte interface. Whereas recent studies of size-dependent activity in nanoparticles and thickness-dependent activity of thin films imply that the sub-surface layers of a catalyst can contribute to the catalytic activity as well, most of these studies consider actual modification of the surfaces. In this study, the role of catalytically active sub-surface layers was investigated by employing atomic-scale thickness control of the La0.7 Sr0.3 MnO3 (LSMO) films and heterostructures, without altering the catalyst/electrolyte interface. The activity toward the oxygen evolution reaction (OER) shows a non-monotonic thickness dependence in the LSMO films and a continuous screening effect in LSMO/SrRuO3 heterostructures. The observation leads to the definition of an "electrochemically-relevant depth" on the order of 10 unit cells. This study on the electrocatalytic activity of epitaxial heterostructures provides new insight in designing efficient electrocatalytic nanomaterials and core-shell architectures.

13.
Pain Manag Nurs ; 22(1): 44-49, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32771349

RESUMEN

BACKGROUND: Adolescent idiopathic scoliosis is one of the most common spinal deformities in children and adolescents requiring extensive surgical intervention. Due to the nature of surgery, spinal fusion increases their risk of experiencing persistent postsurgical pain. Up to 20% of adolescents report pain for months or years after corrective spinal fusion surgery. AIMS: To examine the influence of preoperative psychosocial factors and mRNA expression profiles on persistent postoperative pain in adolescents undergoing corrective spinal fusion surgery. DESIGN: Prospective, longitudinal cohort study. SETTING: Two freestanding academic children's hospitals. METHODS: Utilizing a longitudinal approach, adolescents were evaluated at baseline (preoperatively) and postoperatively at ±1 month and ±4-6 months. Self-report of pain scores, the Pain Catastrophizing Scale-Child, and whole blood for RNA sequencing analysis were obtained at each time point. RESULTS: Of the adolescents enrolled in the study, 36% experienced persistent pain at final postoperative follow-up. The most significant predictors of persistent pain included preoperative pain severity and helplessness. Gene expression analysis identified HLA-DRB3 as having increased expression in children who experienced persistent pain postoperatively, as opposed to those whose pain resolved. A prospective validation study with a larger sample size is needed to confirm these findings. CONCLUSIONS: While adolescent idiopathic scoliosis is not often classified as a painful condition, providers must be cognizant of pre-existing pain and anxiety that may precipitate a negative recovery trajectory. Policy and practice change are essential for early identification and subsequent intervention.


Asunto(s)
Catastrofización , Fusión Vertebral , Adolescente , Niño , Expresión Génica , Humanos , Estudios Longitudinales , Dolor Postoperatorio , Fusión Vertebral/efectos adversos
15.
Neurotoxicology ; 70: 91-98, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30408495

RESUMEN

The cognitive impairment caused by Alzheimer's disease (AD) is associated with beta-amyloid (Aß) and tau proteins, and is accompanied by inflammation. Recently, a novel inflammasome signaling pathway has been uncovered. Inflammasomes are implicated in the execution of inflammatory responses and pyroptotic death leading to neurodegeneration. Thus, the inflammasome signaling pathway could be a potential therapeutic target for AD. Neural stem cells (NSCs) are multipotent cells that can self-renew and differentiate into distinct neural cells. NSC therapy has been considered to be a promising therapeutic approach in protecting the central nervous system and restoring it following damage. However, the mechanisms involved remain unclear. The aims of this study were to investigate the protective effects of NE4C neural stem cells against microglia-mediated neurotoxicity and to explore molecular mechanisms mediating their actions. NE4C decreased the levels of caspase-1 and IL-1ß, and attenuated the level of the NLRP3 inflammasome and its associated protein adapter, apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain (ASC) in LPS-stimulated BV2 microglial cells, possibly by regulating the phosphorylation of p38α MAPK. The conditioned media obtained from co-culture of LPS-stimulated BV2 and NE4C cells exhibited protective effects on SH-SY5Y cells against microglia-mediated neurotoxicity; this was associated with an attenuation of tau phosphorylation and amyloidogenesis and accompanied by down-regulation of GSK-3ß and p38α MAPK signalling pathways. In conclusion, the present study suggested that NSC therapy could be a potential strategy against microglia-mediated neurotoxicity. NSCs regulate NLRP3 activation and IL-1ß secretion, which are critical in the initiation of the inflammatory responses, hence preventing the release of neurotoxic pro-inflammatory factors by microglia. This eventually reduces tau hyperphosphylation and amyloidogenesis, possibly through the regulation of GSK-3ß and p38α MAPK signalling pathways, and thus protects SH-SY5Y cells against microglia-mediated neurotoxicity.


Asunto(s)
Amiloidosis/metabolismo , Microglía/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Células-Madre Neurales/metabolismo , Neuroprotección/fisiología , Proteínas tau/metabolismo , Amiloidosis/prevención & control , Animales , Apoptosis/efectos de los fármacos , Apoptosis/fisiología , Línea Celular Tumoral , Técnicas de Cocultivo , Medios de Cultivo Condicionados/farmacología , Humanos , Ratones , Proteína con Dominio Pirina 3 de la Familia NLR/administración & dosificación , Células-Madre Neurales/efectos de los fármacos , Neuroprotección/efectos de los fármacos , Fosforilación/efectos de los fármacos , Fosforilación/fisiología , Proteínas tau/antagonistas & inhibidores
16.
Pain Rep ; 3(3): e651, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29922743

RESUMEN

BACKGROUND: Epidemiological studies in patients with neuropathic pain demonstrate a strong association with psychiatric conditions such as anxiety; however, the precipitating pathology between these symptoms remains unclear. To investigate this, we studied the effects of lifelong stress on levels of neuropathic pain-like behavior and conversely, the effects of chronic neuropathic injury on anxiety-like status in male and female mice. In addition, we assayed this link in painful and painless diabetic peripheral neuropathy patients. METHODS: Male and female mice were subject to ongoing life-stress or control living conditions. Baseline sensitivity and anxiety tests were measured followed by spared nerve injury (SNI) to the sciatic nerve. Subsequent sensory testing occurred until 3 weeks after SNI followed by anxiety tests between 4 and 6 weeks after SNI. RESULTS: Levels of tactile or cold allodynia did not differ between adult mice subject to lifelong chronic stress, relative to nonstressed controls, for at least 3 weeks after SNI. By contrast, longer-term neuropathic mice of both sexes displayed pronounced anxiety-like behavior, regardless of exposure to stress. If sex differences were present, females usually exhibited more pronounced anxiety-like behavior. These ongoing anxiety behaviors were corroborated with plasma corticosterone levels in distinct animal groups. In addition, data from patients with painful and nonpainful diabetic neuropathy showed a clear relationship between ongoing pain and anxiety, with females generally more affected than males. DISCUSSION: Taken together, these data demonstrate a strong link between chronic neuropathic pain and chronic anxiety, with the driver of this comorbidity being neuropathic pain as opposed to on-going stress.

17.
Dermatol Surg ; 44(6): 826-832, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29799826

RESUMEN

BACKGROUND: Hyaluronic acid (HA) fillers are commonly used in treating facial wrinkles and folds but have not been studied with standardized methodology to include assessment of standard facial expressions. OBJECTIVE: To assess perceived naturalness of facial expression after treatment with 2 HA fillers manufactured with XpresHAn Technology (also known as Optimal Balance Technology). MATERIALS AND METHODS: Treatment was directed to the nasolabial folds (NLFs) and at least 1 additional lower face wrinkle or fold. Maintenance of naturalness, attractiveness, and age at 1 month after optimal treatment were assessed using video recordings and photographs capturing different facial animations. Global aesthetic improvement, subjects' satisfaction, and safety were also evaluated. RESULTS: The treatment was well tolerated. Naturalness of facial expression in motion was determined to be at least maintained in 95% of subjects. Attractiveness was enhanced in 89% of subjects and 79% of subjects were considered to look younger. Most subjects assessed their aesthetic appearance as improved and were satisfied with their treatment. CONCLUSION: Naturalness and attractiveness can be assessed using video recordings and photographs capturing different facial animations. XpresHAn Technology HA filler treatments create natural-looking results with high subject satisfaction.


Asunto(s)
Fármacos Dermatológicos/administración & dosificación , Ácido Hialurónico/administración & dosificación , Surco Nasolabial , Satisfacción del Paciente , Fotograbar , Envejecimiento de la Piel/efectos de los fármacos , Grabación en Video , Adulto , Anciano , Técnicas Cosméticas , Femenino , Estudios de Seguimiento , Alemania , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Percepción Social , Resultado del Tratamiento , Grabación en Video/métodos
18.
J Matern Fetal Neonatal Med ; 31(11): 1407-1411, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28391737

RESUMEN

BACKGROUND: Failure of first course of indomethacin (FCI) for patent ductus arteriosus (PDA) treatment in preterm neonates often prompts clinicians to consider a second course (SCI). OBJECTIVE: To identify factors including baseline characteristics and response to FCI that are associated with non-response to SCI for PDA treatment in preterm neonates. METHODS: In this retrospective observational study, neonates ≤32 weeks admitted to a tertiary NICU over 5 years who received two indomethacin courses for PDA treatment were reviewed. Only neonates with echocardiograms (ECHO) immediately before and after receipt of each indomethacin course were included. Primary outcome was non-response to SCI. Baseline characteristics and response to FCI were compared between responders and non-responders of SCI. RESULTS: Of the 98 neonates enrolled, 47 (48%) had non-response to SCI. Of them, 27 patients (57%) had prior non-response to FCI, while of the 51 neonates who responded to SCI, 24 neonates (47%) had prior non-response to FCI. The adjusted risk of non-response to SCI in patients who had non-response to FCI was 37% higher (relative risk = 1.37, 95%CI: 0.87-1.80; p = .07) compared to those who had response to FCI. Multivariable analysis showed that increasing gestational age (AOR: 1.6, 95%CI: 1.1-2.3, p = .03) was associated with a higher odds of non-response to SCI while the odds of non-response to SCI increased by 90% in patients with non-response to FCI (AOR: 1.9, 95%CI: 0.8-4.5; p = .15) compared to those with success of FCI, although no statistical significance was observed. CONCLUSIONS: Advanced gestational age was the predictor of non-response to SCI in preterm neonates.


Asunto(s)
Fármacos Cardiovasculares/administración & dosificación , Conducto Arterioso Permeable/tratamiento farmacológico , Indometacina/administración & dosificación , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Estudios Retrospectivos , Insuficiencia del Tratamiento
19.
Dermatol Surg ; 44(2): 261-269, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29059146

RESUMEN

BACKGROUND: Hyaluronic acid (HA) fillers may differ in terms of gel characteristics and ease of use and it is of interest whether this might affect safety and duration of effect. OBJECTIVE: To compare the long-term safety and effect of 2 HA fillers produced by 2 different technologies for lip enhancement. MATERIALS AND METHODS: Subjects with very thin to moderately thick lips were randomized and treated with HA-RK (N = 31) or HA-JV (N = 29) to improve lip fullness by ≥ 1 grade on a 5-point scale, using a maximum of 3 mL of product. RESULTS: A smaller volume of HA-RK compared with HA-JV was required to improve lip fullness by ≥ 1 grade (mean: 1.54 mL vs 1.94 mL, p < .001). Despite the smaller volume, lip fullness and global aesthetic improvement were comparably sustained in both groups. At 6 months, 60.0% versus 57.7% of subjects (HA-RK vs HA-JV) had improved lip fullness. At 12 months, 71.4% versus 76.0% had aesthetic improvement (blinded evaluations) and 85.7% versus 86.2% felt more attractive. Both products were well tolerated. CONCLUSION: Both products achieved durable improvement in lip fullness and aesthetic appearance. A significantly smaller amount of HA-RK was required compared with HA-JV to achieve optimal treatment effect.


Asunto(s)
Técnicas Cosméticas , Rellenos Dérmicos/uso terapéutico , Ácido Hialurónico/análogos & derivados , Labio/efectos de los fármacos , Adulto , Femenino , Geles , Humanos , Ácido Hialurónico/uso terapéutico , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Método Simple Ciego , Adulto Joven
20.
J Hip Preserv Surg ; 4(1): 45-53, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28630720

RESUMEN

Factors contributing to chronic postoperative pain (CPOP) are poorly defined in young people and developmental considerations are poorly understood. With over 5 million children undergoing surgery yearly and 25% of adults referred to chronic pain clinics identifying surgery as the antecedent, there is a need to elucidate factors that contribute to CPOP in surgical patients. The present study includes patients undergoing hip preservation surgery at a children's hospital. The HOOS and SF-12 Health Survey were administered to 614 pre-surgical patients with 421 patients completing follow-up (6-months, 1-year and 2-years post-surgery). Pain, quality of life, and functioning across time were examined for each group within the population. A three trajectory model (low pain, pain improvement and high pain) emerged indicating three categories of treatment responders. Pain trajectory groups did not differ significantly on gender, pre-surgical age, BMI, prior hip surgery, surgical type, joint congruence or Tönnis grade. The groups differed significantly from each other on pre-surgical pain, pain chronicity, quality of life and functioning. Those in the high pain and pain improvement groups endorsed having pre-surgical depression at significantly higher rates and lower pre-surgical quality of life compared to those in the low pain group (P < 0.01). Those in the high pain group reported significantly worse pre-surgical functioning compared to those in the pain improvement (P < 0.0001) and low pain groups (P < 0.0001).The results demonstrate the need for preoperative screening prior to hip preservation surgery, as there may be a subset of patients who are predisposed to chronic pain independent of hip health.

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