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1.
J Headache Pain ; 19(1): 103, 2018 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-30400770

RESUMEN

BACKGROUND: Better tools are required for the earlier identification and management of orofacial pain with different aetiologies. The painDETECT questionnaire is a patient-completed screening tool with utility for identification of neuropathic pain in a range of contexts. 254 patients, referred from primary care for management of orofacial pain and attending a secondary care centre, were prospectively recruited, and completed the painDETECT prior to consultation. The aim of this study was to determine the accuracy of the painDETECT to detect neuropathic components of orofacial pain, when compared to a reference standard of clinical diagnosis by experienced physicians, in a cohort of hospital-based patients. RESULTS: For the 251 patients included in the analysis, the painDETECT had a modest ability to detect neuropathic components of orofacial pain (AUROC, 0.63; 95% CI, 0.58-0.70; p = 0.001). Patients with orofacial pain diagnoses associated with neuropathic components had higher painDETECT scores than those with non-neuropathic components. However, the painDETECT was weaker at distinguishing patients with mixed pain types, and multiple diagnoses were associated with poor accuracy of the painDETECT. CONCLUSION: In secondary care settings, the painDETECT performed modestly at identifying neuropathic components, and underestimates the complexity of orofacial pain in its mixed presentations and with multiple diagnoses. Prior to clinical applications or research use, the painDETECT and other generic screening tools must be adapted and revalidated for orofacial pain patients, and separately in primary care, where orofacial pain is considerably less common.


Asunto(s)
Dolor Facial/diagnóstico , Hospitalización , Neuralgia/diagnóstico , Dimensión del Dolor/normas , Adulto , Anciano , Estudios de Cohortes , Dolor Facial/psicología , Femenino , Hospitalización/tendencias , Humanos , Pacientes Internos/psicología , Masculino , Persona de Mediana Edad , Neuralgia/psicología , Estudios Prospectivos , Encuestas y Cuestionarios/normas
2.
Nat Biomed Eng ; 7(2): 94-109, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36581694

RESUMEN

Decellularized extracellular matrix in the form of patches and locally injected hydrogels has long been used as therapies in animal models of disease. Here we report the safety and feasibility of an intravascularly infused extracellular matrix as a biomaterial for the repair of tissue in animal models of acute myocardial infarction, traumatic brain injury and pulmonary arterial hypertension. The biomaterial consists of decellularized, enzymatically digested and fractionated ventricular myocardium, localizes to injured tissues by binding to leaky microvasculature, and is largely degraded in about 3 d. In rats and pigs with induced acute myocardial infarction followed by intracoronary infusion of the biomaterial, we observed substantially reduced left ventricular volumes and improved wall-motion scores, as well as differential expression of genes associated with tissue repair and inflammation. Delivering pro-healing extracellular matrix by intravascular infusion post injury may provide translational advantages for the healing of inflamed tissues 'from the inside out'.


Asunto(s)
Materiales Biocompatibles , Infarto del Miocardio , Ratas , Porcinos , Animales , Miocardio/metabolismo , Infarto del Miocardio/terapia , Hidrogeles , Matriz Extracelular/metabolismo
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