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1.
Brain Behav Immun ; 120: 471-487, 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38925417

RESUMEN

Activity-induced muscle pain increases interleukin-1ß (IL-1ß) release from muscle macrophages and the development of hyperalgesia is prevented by blockade of IL-1ß in muscle. Brain derived neurotrophic factor (BDNF) is released from sensory neurons in response to IL-1ß and mediates both inflammatory and neuropathic pain. Thus, we hypothesize that in activity-induced pain, fatigue metabolites combined with IL-1ß activate sensory neurons to increase BDNF release, peripherally in muscle and centrally in the spinal dorsal horn, to produce hyperalgesia. We tested the effect of intrathecal or intramuscular injection of BDNF-Tropomyosin receptor kinase B (TrkB) inhibitors, ANA-12 or TrkB-Fc, on development of activity-induced pain. Both inhibitors prevented the hyperalgesia when given before or 24hr after induction of the model in male but not female mice. BDNF messenger ribonucleic acid (mRNA) and protein were significantly increased in dorsal root ganglion (DRG) 24hr after induction of the model in both male and female mice. Blockade of IL-1ß in muscle had no effect on the increased BNDF mRNA observed in the activity-induced pain model, while IL-1ß applied to cultured DRG significantly induced BDNF expression, suggesting IL-1ß is sufficient but not necessary to induce BNDF. Thus, fatigue metabolites, combined with IL-1ß, upregulate BDNF in primary DRG neurons in both male and female mice, but contribute to activity-induced pain only in males.

2.
Brain Behav Immun ; 111: 4-20, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36972744

RESUMEN

Induction of muscle pain triggers a local immune response to produce pain and this mechanism may be sex and activity level dependent. The purpose of this study was to measure the immune system response in the muscle following induction of pain in sedentary and physically active mice. Muscle pain was produced via an activity-induced pain model using acidic saline combined with fatiguing muscle contractions. Prior to induction of muscle pain, mice (C57/BL6) were sedentary or physically active (24hr access to running wheel) for 8 weeks. The ipsilateral gastrocnemius was harvested 24hr after induction of muscle pain for RNA sequencing or flow cytometry. RNA sequencing revealed activation of several immune pathways in both sexes after induction of muscle pain, and these pathways were attenuated in physically active females. Uniquely in females, the antigen processing and presentation pathway with MHC II signaling was activated after induction of muscle pain; activation of this pathway was blocked by physical activity. Blockade of MHC II attenuated development of muscle hyperalgesia exclusively in females. Induction of muscle pain increased the number of macrophages and T-cells in the muscle in both sexes, measured by flow cytometry. In both sexes, the phenotype of macrophages shifted toward a pro-inflammatory state after induction of muscle pain in sedentary mice (M1 + M1/2) but toward an anti-inflammatory state in physically active mice (M2 + M0). Thus, induction of muscle pain activates the immune system with sex-specific differences in the transcriptome while physical activity attenuates immune response in females and alters macrophage phenotype in both sexes.


Asunto(s)
Hiperalgesia , Mialgia , Masculino , Femenino , Animales , Ratones , Hiperalgesia/metabolismo , Macrófagos/metabolismo , Dimensión del Dolor , Inmunidad
3.
Molecules ; 27(10)2022 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-35630737

RESUMEN

In retronasal aroma, the targeted aroma compounds are released from food during chewing. The changes in the food structures during chewing strongly influence the release of the compounds, therefore affecting the perception of food. Here, the relationship between retronasal aroma and food deliciousness based on the physicochemical properties of aroma compounds was examined. We considered the consumption of solid foods and the effect of oral parameters in elderly people. Beef pate was used as a model food sample to study the effect of the release of aroma compounds under controlled in vitro mastication and salivation conditions using a chewing simulator. We identified the effects of coexisting ingredients such as beef fat on the time course behavior of the release of aroma compounds. In particular, the release of the middle types of aromas was significantly faster with stronger chewing force, and higher with a high fat content of the sample. In addition, a larger release intensity was observed when soy proteins were partially substituted for beef proteins. Using an appropriate model saliva, a change in the salting-out effect from the saliva composition was found to be a factor, which could explain the lowering of aroma sensation in an elderly person.


Asunto(s)
Masticación , Odorantes , Anciano , Animales , Bovinos , Humanos , Saliva/química , Salivación , Sensación
4.
Appl Microbiol Biotechnol ; 103(12): 4899-4915, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31030285

RESUMEN

Coenzyme Q (CoQ) is an essential component of the electron transport system that produces ATP in nearly all living cells. CoQ10 is a popular commercial food supplement around the world, and demand for efficient production of this molecule has increased in recent years. In this study, we explored CoQ10 production in the fission yeast Schizosaccharomyces pombe. We found that CoQ10 level was higher in stationary phase than in log phase, and that it increased when the cells were grown in a low concentration of glucose, in maltose, or in glycerol/ethanol medium. Because glucose signaling is mediated by cAMP, we evaluated the involvement of this pathway in CoQ biosynthesis. Loss of Pka1, the catalytic subunit of cAMP-dependent protein kinase, increased production of CoQ10, whereas loss of the regulatory subunit Cgs1 decreased production. Manipulation of other components of the cAMP-signaling pathway affected CoQ10 production in a consistent manner. We also found that glycerol metabolism was controlled by the cAMP/PKA pathway. CoQ10 production by the S. pombe ∆pka1 reached 0.98 mg/g dry cell weight in medium containing a non-fermentable carbon source [2% glycerol (w/v) and 1% ethanol (w/v) supplemented with 0.5% casamino acids (w/v)], twofold higher than the production in wild-type cells under normal growth conditions. These findings demonstrate that carbon source, growth phase, and the cAMP-signaling pathway are important factors in CoQ10 production in S. pombe.


Asunto(s)
Proteínas Quinasas Dependientes de AMP Cíclico/genética , Proteínas Fúngicas/genética , Glucosa/química , Schizosaccharomyces/metabolismo , Ubiquinona/análogos & derivados , Dominio Catalítico , Medios de Cultivo/química , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Proteínas Fúngicas/metabolismo , Eliminación de Gen , Maltosa/química , Transducción de Señal , Ubiquinona/biosíntesis , Ubiquinona/metabolismo
5.
Pain Med ; 20(11): 2220-2227, 2019 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-30561722

RESUMEN

OBJECTIVE: Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. DESIGN: Cross-sectional study conducted between June 2017 and February 2018. SETTING: Tertiary center. SUBJECTS: Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. METHODS: QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. RESULTS: The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. CONCLUSIONS: Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.


Asunto(s)
Catastrofización/fisiopatología , Osteoartritis de la Cadera/fisiopatología , Osteoartritis de la Rodilla/fisiopatología , Dolor/fisiopatología , Calidad de Vida , Adulto , Anciano , Artroplastia de Reemplazo de Cadera/psicología , Catastrofización/complicaciones , Estudios Transversales , Femenino , Cadera/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/complicaciones , Osteoartritis de la Rodilla/complicaciones , Dolor/complicaciones , Dimensión del Dolor/métodos
6.
J Orthop Sci ; 23(3): 483-487, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29503036

RESUMEN

BACKGROUND: Current worldwide clinical practice guidelines recommend acetaminophen as the first option for the treatment of acute low back pain. However, there is no concrete evidence regarding whether acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) is more effective for treating acute low back pain (LBP) in Japan. The present study aimed to investigate whether acetaminophen treatment for acute musculoskeletal pain was comparable with loxoprofen (a traditional NSAID in Japan) treatment. METHODS: Of the 140 patients with acute LBP who visited out-patient hospitals, 127 were considered eligible and were randomly allocated to a group taking acetaminophen or one taking loxoprofen. As primary outcome measure, pain intensity was measured using a 0-10-numeric rating scale (NRS). Moreover, pain disability, pain catastrophizing, anxiety, depression, and quality of life, as well as adverse events, were assessed as secondary outcomes. The primary outcome was tested with a noninferiority margin (0.84 on changes in pain-NRS), and the secondary outcomes were compared using conventional statistical methods at week 2 and week 4. RESULTS: Seventy patients completed the study (acetaminophen: 35, loxoprofen: 35). The dropout rates showed no significant difference between the two medication-groups. We found that the mean differences of changes in pain-NRS from baseline to week 2 or 4 between the two medication groups were not statistically beyond the noninferiority margin (mean [95% confidence interval]: -0.51 [-1.70, 0.67], at week 2 and -0.80 [-2.08, 0.48] at week 4). There were no consistent differences between the two medication groups in terms of secondary outcomes. CONCLUSIONS: The results suggest that acetaminophen has comparable analgesic effects on acute LBP, based on at least a noninferiority margin, compared with loxoprofen at 4 weeks. Acetaminophen seems to be a reasonable first-line option for patients with acute LBP in Japan.


Asunto(s)
Acetaminofén/uso terapéutico , Dolor Agudo/tratamiento farmacológico , Antiinflamatorios no Esteroideos/uso terapéutico , Dolor de la Región Lumbar/tratamiento farmacológico , Fenilpropionatos/uso terapéutico , Dolor Agudo/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Equivalencia como Asunto , Femenino , Humanos , Japón , Dolor de la Región Lumbar/diagnóstico , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Adulto Joven
7.
Pain Med ; 17(3): 606-613, 2016 03.
Artículo en Inglés | MEDLINE | ID: mdl-26352158

RESUMEN

OBJECTIVE: Patients with lower limbs osteoarthritis (OA) had slower walking speeds than healthy. Gait speed, which is associated with leg muscle strength, is a consistent predictor of health and functional status. The effects of pain and pain-related psychological constructs for gait speeds have been uncertain. Therefore, we investigated whether gait speed in patients with OA of lower limbs is associated with pain-related psychological constructs using a performance-based measure. METHODS: The study group comprised 59 patients with advanced knee or hip OA. Gait speeds were measured at comfortable and maximum levels during 10-m walks. Covariates included 1) pain intensity measured with a visual analogue scale (VAS), 2) psychological constructs measured with a short-version pain anxiety symptoms scale (PASS-20) and the hospital anxiety and depression scale (HADS), and 3) bilateral knee extensor and hip abductor muscle strength. Each variable was subjected to multivariate analysis with gait speed. RESULTS: Single regression analysis showed that gait speeds were significantly correlated with VAS and PASS-20 scores, and muscle strength, not with HADS. Multiple regression analysis showed that PASS-20 score was significant correlating factor for gait speeds. CONCLUSIONS: Anxiety-related responses to pain were significant correlating factor for gait speeds, in patients with OA of lower limbs.


Asunto(s)
Ansiedad/psicología , Marcha/fisiología , Osteoartritis de la Cadera/psicología , Osteoartritis de la Rodilla/psicología , Dolor/psicología , Anciano , Ansiedad/etiología , Ansiedad/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/complicaciones , Osteoartritis de la Cadera/fisiopatología , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/fisiopatología , Dolor/complicaciones , Dolor/fisiopatología
8.
Heart Vessels ; 31(4): 578-83, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25666952

RESUMEN

Early ambulation after open abdominal aortic aneurysm (AAA) surgery is assumed to play a key role in preventing postoperative complications and reducing hospital length of stay. However, the factors predicting early ambulation after open AAA surgery have not yet been sufficiently investigated. Here, we investigated which preoperative and intraoperative variables are associated with start time for ambulation in patients after open AAA surgery. A total of 67 consecutive patients undergoing open AAA surgery were included in the study [male, 62 (92 %); mean age, 68 years (range, 47-82 years), mean AAA diameter, 53 mm (range, 28-80 mm)]. Preoperative physical activity was examined by means of 6-min walk distance (6MWD) and a medical interview. Patients were divided into two groups, according to when independence in walking was attained: early group <3 days (n = 36) and late group ≥3 days (n = 31), and the pre-, intra-, and postoperative recovery data were compared. There were no significant differences in patient baseline characteristics or intraoperative data between the two groups. The number of patients engaging in preoperative regular physical activity and 6MWD were significantly greater (p = 0.042 and p = 0.034, respectively) in the early group than in the late group. In addition, time to hospital discharge was significantly shorter in the early group than in the late group (p = 0.031). Binary logistic regression analysis showed that preoperative regular physical activity was the only independent factor for identifying patients in the early group (odds ratio 2.769, 95 % confidence interval 1.024-7.487, p = 0.045). These results suggest that engaging in regular physical activity is an effective predictor of early ambulation after open AAA surgery.


Asunto(s)
Aneurisma de la Aorta Abdominal/fisiopatología , Ejercicio Físico/fisiología , Procedimientos Quirúrgicos Vasculares/métodos , Caminata/fisiología , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Periodo Preoperatorio , Pronóstico , Estudios Retrospectivos , Factores de Tiempo
9.
Pain Pract ; 15(4): 300-7, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24571521

RESUMEN

BACKGROUND: Pain drawings have frequently been used for documentation of pain and a convenient diagnosis tool. Pain drawings were found to be associated with psychological states in chronic patients with low back pain. Few researchers have investigated pain drawings except in low back pain. The aim of this study was to investigate the pain, pain drawings, psychological characteristics, and pain interference in the head, neck-shoulder (NS), and low-back/lower-limb (LB-LL) regions among patients with chronic pain. METHODS: We included a total of 291 patients with new chronic pain (headache, 62; NS pain, 87; LB-LL pain, 142). The pain drawings and scores of 10-cm Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), Short-Form McGill Pain Questionnaire (SF-MPQ), and Pain Disability Assessment Scale (PDAS) were extracted from medical records. A subset of 60 pain drawings was scored by senior and junior evaluators to assess inter-rater agreement. We investigated the correlation between pain drawings and VAS, HADS, PCS, SF-MPQ, and PDAS in each body region group at the initial visit. Moreover, almost all patients received nonsurgical treatment as a follow-up and were investigated using VAS after treatment. RESULTS: The reliability of pain drawings was substantial with an interevaluator reliability in headache, NS, and LB-LL pain. Nonorganic pain drawings were associated with psychological disturbances in NS and LB-LL pain, but not headache. Poor outcomes were associated with nonorganic drawings in LB-LL pain, but not in the case of headache or NS pain. CONCLUSIONS: Our results suggest that the characteristics of patients with nonorganic drawings differ according to body regions.


Asunto(s)
Imagen Corporal/psicología , Dolor Crónico/diagnóstico , Dolor Crónico/psicología , Dimensión del Dolor/métodos , Adulto , Anciano , Catastrofización/diagnóstico , Catastrofización/psicología , Evaluación de la Discapacidad , Femenino , Cefalea/diagnóstico , Cefalea/psicología , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/psicología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
10.
J Phys Ther Sci ; 27(9): 2901-5, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26504321

RESUMEN

[Purpose] Multidisciplinary treatments are recommended for treatment of chronic low back pain. The aim of this study was to show the associations among multidisciplinary treatment outcomes, pretreatment psychological factors, self-reported pain levels, and history of pain in chronic low back pain patients. [Subjects and Methods] A total of 221 chronic low back pain patients were chosen for the study. The pretreatment scores for the 10-cm Visual Analogue Scale, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Short-Form McGill Pain Questionnaire, Pain Disability Assessment Scale, pain drawings, and history of pain were collected. The patients were divided into two treatment outcome groups a year later: a good outcome group and a poor outcome group. [Results] One-hundred eighteen patients were allocated to the good outcome group. The scores for the Visual Analogue Scale, Pain Disability Assessment Scale, and affective subscale of the Short-Form McGill Pain Questionnaire and number of nonorganic pain drawings in the good outcome group were significantly lower than those in the poor outcome group. Duration of pain in the good outcome group was significantly shorter than in the poor outcome group. [Conclusion] These findings help better predict the efficacy of multidisciplinary treatments in chronic low back pain patients.

13.
Pain Pract ; 14(5): 413-8, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23656601

RESUMEN

PURPOSE: Apparent organic abnormalities are sometimes not identified among patients suffering from chronic pain in the craniocervical region. In some cases, parafunctional activities (PAs) are recognized. PAs are nonfunctional oromandibular activities that include jaw clenching and bruxism, but are considered as factors that contribute to craniomandibular disorders (CMDs). It is now recognized that PAs and CMDs influence musculoskeletal conditions of the upper quarter. Exercise therapy (ET) to improve jaw movement and psychological intervention (PI) to reduce PAs are useful for PAs and CMDs. We hypothesized that ET and PI would be effective for craniocervical pain without organic abnormalities. METHODS: Thirty-nine subjects suffering from craniocervical chronic pain were allocated into 3 groups: The control group received only pharmacological treatment; the ET group received jaw movement exercise (JME); and the ET-PI group received JME and PI. Pain and jaw movement were evaluated using a numerical rating scale (NRS). RESULTS: After interventions, the NRS scores were significantly lower in the ET-PI group, compared with those in the other groups. Jaw movement improved 100% in the ET group, 92% in the ET-PI group, and 0% in the control group. CONCLUSION: A combination of jaw exercise and psychological intervention to reduce parafunctional activities is more effective than jaw exercise alone for the improvement of craniocervical pain without apparent organic abnormalities.


Asunto(s)
Bruxismo/terapia , Dolor Crónico/terapia , Terapia por Ejercicio/métodos , Maxilares/fisiología , Movimiento/fisiología , Dolor de Cuello/terapia , Adolescente , Adulto , Anciano , Bruxismo/diagnóstico , Bruxismo/psicología , Vértebras Cervicales/patología , Dolor Crónico/diagnóstico , Dolor Crónico/psicología , Terapia por Ejercicio/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Dolor de Cuello/diagnóstico , Dolor de Cuello/psicología , Cráneo/patología , Resultado del Tratamiento , Adulto Joven
14.
Res Sq ; 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38798501

RESUMEN

Introduction: Physical activity is commonly used for both measuring and treating dysfunction. While preclinical work has been historically biased towards males, the use of both male and female animals is gaining popularity after multiple NIH initiatives. With increasing inclusion of both sexes, it has become imperative to determine sex differences in common behavioral assays. The purpose of this study was to determine baseline sex differences in 3 activity assays: voluntary wheel running, forced treadmill running, and open field testing. Methods: This was a secondary analysis of sex differences in healthy mice in 3 different assays: Separate mice were used for each assay. Specifically, 16 mice underwent 28 days of voluntary wheel running, 178 mice underwent forced treadmill running, and 88 mice underwent open field testing. Differences between sex across several activity parameters were examined for each assay. Results: In voluntary wheel running, sex differences with larger effect sizes were observed in distance run, running time, and bout duration, with smaller effect size differences in speed, and no difference in total bouts. In forced treadmill running, differences were shown in time to exhaustion, but no difference in max speed attained. In open field, there were sex differences in active time but not in distance and speed in data aggregated over 30 minutes; however, distance and speed in male mice showed a downward trajectory over the final 20 minutes of testing, whereas females maintained the same trajectory. Conclusion: These data suggest that male mice demonstrate comparable activity intensity as female mice but do not match female's duration of activity, especially for volitional tasks. Researchers utilizing these assays should account for sex differences as they could potentially mask true findings in an experiment. Plain English Summary: Physical activity is a common measure to examine function in human subjects with and without disease. Animal models often use measures of physical activity to assess function, yet most of these measures have been done in males only, making interpretation and translation to females and humans difficult. Several measures have been used to measure activity in animals, including those examining voluntary running behavior, maximum capacity, and general activity levels; sex differences between these measures are unclear. We discovered sex differences throughout each of three activity tests. In voluntary running behavior there were large differences between sexes with females running a greater distance and spending more time running. There were small differences in the maximum capacity with females running for a longer period at high intensity. General activity levels showed small differences with females being less active than males. Thus, the greatest differences were found for voluntary running and small differences were found for maximum capacity and general activity levels; differences observed were dependent on the task. Researchers utilizing these assays should account for sex differences as they could potentially mask true findings in an experiment.

15.
J Am Chem Soc ; 135(37): 13644-7, 2013 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-24007282

RESUMEN

A novel conformational motif constructed with a robust intramolecular hydrogen-bonding (H-bonding) network was discovered. A pyrrolidine derivative possessing four identical amide substituents at C(2) and C(5) formed a strong intramolecular H-bonding network consisting of all the amide groups. This conformation yielded a cyclochiral structure with a handedness that depended on the directionality of the H-bonding network. The most stable compound was isolated and applied to the acylative kinetic resolution of secondary alcohol. The handedness of the H-bonding network was biased by the presence of chiral substituents, and the preferred direction could be switched under an external stimulus. A structural analysis using NMR, X-ray crystallography, and theoretical calculation techniques indicated that the conformation of the substituents was highly ordered and depended on the directionality of the H-bonding network.


Asunto(s)
Malonatos/química , Cristalografía por Rayos X , Ciclización , Enlace de Hidrógeno , Conformación Molecular , Piridinas/química , Estereoisomerismo
16.
Aesthet Surg J ; 33(5): 691-7, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23689034

RESUMEN

Localized scleroderma in the chest region of adolescent girls leads to incomplete breast development and breast asymmetry, for which patients may require treatment. The site of localized scleroderma, its activity, the surgeon, and the patient's desires influence the selection of treatment method. There have been few reports on surgical treatment of this disease. In the current report, we present a case in which improved breast asymmetry was achieved through multiphased surgery, and we review treatment methods and indications of this disease.


Asunto(s)
Enfermedades de la Mama/cirugía , Implantes de Mama , Mamoplastia/métodos , Esclerodermia Localizada/complicaciones , Adolescente , Mama/anomalías , Mama/cirugía , Enfermedades de la Mama/etiología , Terapia Combinada , Estética , Femenino , Humanos , Medición de Riesgo , Esclerodermia Localizada/diagnóstico , Resultado del Tratamiento
17.
Phys Ther ; 103(3)2023 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-37172124

RESUMEN

OBJECTIVE: Preoperative exercise (prehabilitation) is commonly used as a method to reduce pain and improve function postoperatively. The purpose of this systematic review was to determine therapeutic benefits of preoperative exercise on postoperative pain, function, quality of life (QOL), and risk of complications across various types of surgeries. METHODS: Three electronic databases were used to perform a literature search. Full articles with randomized designs comparing a preoperative exercise program vs no formal program were included. The primary outcome was postoperative pain. QOL, function, and postoperative complications were analyzed as secondary outcomes. The primary meta-analysis was performed in those with joint replacement surgery because there were only 5 with other surgical types. RESULTS: A total of 28 articles were included, of which 23 were from individuals with total joint replacement surgery. Preoperative exercise resulted in lower pain ≤2 months and 3 to 5 months after joint replacement surgery with a moderate standardized mean difference (95% CI at <2 months = -0.34 [-0.59 to -0.09]; at 3 to 5 months = -0.41 [-0.70 to -0.11]) compared with nonexercised controls. However, ≥6 months after joint replacement surgery, preoperative exercise groups showed no significant differences in postoperative pain (standardized mean difference = -0.17 [-0.35 to 0.01]) compared with nonexercised controls. QOL and subjective and objective function were improved ≤2 months after joint replacement surgery but were not different ≥6 months post-surgery. Reduction in risk of postoperative complications was favored with preoperative exercise. CONCLUSION: Preoperative exercise has a modest effect on postoperative pain, function, and quality of life within the first 6 months after surgery and reduces the risk of developing postoperative complications in individuals undergoing joint replacement surgery. The effect of preoperative exercise on other surgery types is inconclusive. IMPACT: This systematic review supports using preoperative exercise to improve pain and function outcomes for those with joint replacement surgery.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Calidad de Vida , Humanos , Ejercicio Preoperatorio , Cuidados Preoperatorios/métodos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Dolor Postoperatorio/prevención & control , Complicaciones Posoperatorias/prevención & control
18.
Pain ; 164(8): 1860-1873, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-36930885

RESUMEN

ABSTRACT: We developed an animal model of activity-induced muscle pain that is dependent on local macrophage activation and release of interleukin-1ß (IL-1ß). Activation of purinergic type 2X (P2X) 7 receptors recruits the NOD-like receptor protein (NLRP) 3 and activates Caspase-1 to release IL-1ß. We hypothesized that pharmacological blockade of P2X7, NLRP3, and Caspase-1 would prevent development of activity-induced muscle pain in vivo and release of IL-1ß from macrophages in vitro. The decrease in muscle withdrawal thresholds in male, but not female, mice was prevented by the administration of P2X7, NLRP3, and Caspase-1 inhibitors before induction of the model, whereas blockade of IL-1ß before induction prevented muscle hyperalgesia in both male and female mice. Blockade of P2X7, NLRP3, Capsase-1, or IL-1ß 24 hours, but not 1 week, after induction of the model alleviated muscle hyperalgesia in male, but not female, mice. mRNA expression of P2X7, NLRP3, Caspase-1, and IL-1ß from muscle was increased 24 hours after induction of the model in both male and female mice. Using multiplex, increases in IL-1ß induced by combining adenosine triphosphate with pH 6.5 in lipopolysaccharide-primed male and female macrophages were significantly lower with the presence of inhibitors of P2X7 (A740003), NLRP3 (MCC950), and Caspase-1 (Z-WEHD-FMK) when compared with the vehicle. The current data suggest the P2X7/NLRP3/Caspase-1 pathway contributed to activity-induced muscle pain initiation and early maintenance phases in male but not female, and not in late maintenance phases in male mice.


Asunto(s)
Hiperalgesia , Proteína con Dominio Pirina 3 de la Familia NLR , Animales , Masculino , Ratones , Adenosina Trifosfato/farmacología , Caspasa 1/metabolismo , Hiperalgesia/inducido químicamente , Interleucina-1beta/metabolismo , Mialgia/inducido químicamente , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Receptores Purinérgicos P2X7/genética , Transducción de Señal , Femenino
19.
Front Med (Lausanne) ; 10: 1189748, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37404806

RESUMEN

Introduction: Perspectives regarding the disease state often differ between patients with rheumatoid arthritis (RA) and physicians. The aim of the present longitudinal cohort study was to investigate the impact of the discordance in global assessments between patients and physicians on 9-year pain-related outcomes in patients with rheumatoid arthritis. Method: Sixty-eight consecutive outpatients with rheumatoid arthritis on their first visit to a tertiary center were included. Baseline measurements included demographic data, drugs used, disease activity, and a modified Health Assessment Questionnaire (mHAQ). Discordance in global assessment between patients and physicians at baseline was defined as 10 mm higher in the patient global assessment (PGA) than in the physician global assessment. A 9-year follow-up assessment included pain intensity, the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) scale, Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). Results: The number of patients with discordance was 26 (38%) in 68 patients. Patients with a 10 mm higher PGA than the physician global assessment at baseline measurements had significantly worse pain intensity, PCS score, PSEQ score, and EQ-5D-3L score measurements at the 9-year follow-up than those with concordance. A higher mHAQ score and 10 mm higher PGA at baseline were significantly independently associated with the EQ-5D-3L scale score and pain intensity at the 9-year follow-up. Conclusion: This longitudinal cohort study suggested that discordance in global assessment between patients and physicians modestly predicted worse 9-year pain-related outcomes in patients with rheumatoid arthritis.

20.
Pain ; 164(2): 385-401, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36006296

RESUMEN

ABSTRACT: A growing number of individuals report prolonged symptoms following acute Coronavirus-19 (COVID-19) infection, known as post-COVID-19 condition (post-COVID-19). While studies have emerged investigating the symptom sequelae of post-COVID-19, there has been limited investigation into the characterization of pain, fatigue, and function in these individuals, despite initial reports of a clinical phenotype similar to fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME). This study aimed to characterize multiple symptom domains in individuals reporting post-COVID-19 and compare its clinical phenotype with those with FMS and CFS. A total of 707 individuals with a single or comorbid diagnosis of post-COVID-19, FMS, and/or CFS completed multiple surveys assessing self-reported pain, fatigue, physical and cognitive function, catastrophizing, kinesiophobia, anxiety, depression, dyspnea, and sleep quality. In all 3 diagnoses, elevated pain, fatigue, anxiety, depression, catastrophizing, and kinesiophobia were reported. Physical and cognitive function were similarly impacted among individuals with post-COVID-19, FMS, and CFS; however, individuals with post-COVID-19 reported lower pain and fatigue than FMS and CFS. The comorbid diagnosis of post-COVID-19 with FMS and/or CFS further exacerbated pain, fatigue, and psychological domains when compared with post-COVID-19 alone. In summary, individuals with post-COVID-19 report a symptom phenotype similar to FMS and CFS, negatively impacting cognitive and physical function, but with less severe pain and fatigue overall. These findings may help direct future investigations of the benefit of a biopsychosocial approach to the clinical management of post-COVID-19.


Asunto(s)
COVID-19 , Síndrome de Fatiga Crónica , Fibromialgia , Humanos , Síndrome de Fatiga Crónica/epidemiología , Síndrome de Fatiga Crónica/diagnóstico , Síndrome de Fatiga Crónica/psicología , COVID-19/complicaciones , Dolor/psicología , Comorbilidad
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