A multisite validation of a two hours antibiotic susceptibility flow cytometry assay directly from positive blood cultures.

BACKGROUND: Rapid antimicrobial susceptibility testing (AST) is urgently needed to provide safer treatment to counteract antimicrobial resistance. This is critical in septic patients, because resistance increases empiric therapy uncertainty and the risk of a poor outcome. We validate a novel 2h flow cytometry AST assay directly from positive blood cultures (PBC) by using a room temperature stable FASTgramneg and FASTgrampos kits (FASTinov® Porto, Portugal) in three sites: FASTinov (site-1), Hospital Ramon y Cajal, Madrid, Spain (site-2) and Centro Hospitalar S. João, Porto, Portugal (site-3). A total of 670 PBC were included: 333 spiked (site-1) and 337 clinical PBC (151 site-2 and 186 site-3): 367 gram-negative and 303 gram-positive. Manufacturer instructions were followed for sample preparation, panel inoculation, incubation (1h/37ºC) and flow cytometry analysis using CytoFlex (Site-1 and -2) or DxFlex (site-3) both instruments from Beckman-Coulter, USA. RESULTS: A proprietary software (bioFAST) was used to immediately generate a susceptibility report in less than 2 h. In parallel, samples were processed according to reference AST methods (disk diffusion and/or microdilution) and interpreted with EUCAST and CLSI criteria. Additionally, ten samples were spiked in all sites for inter-laboratory reproducibility. Sensitivity and specificity were >95% for all antimicrobials. Reproducibility was 96.8%/95.0% for FASTgramneg and 95.1%/95.1% for FASTgrampos regarding EUCAST/CLSI criteria, respectively. CONCLUSION: FASTinov® kits consistently provide ultra-rapid AST in 2h with high accuracy and reproducibility on both Gram-negative and Gram-positive bacteria. This technology creates a new paradigm in bacterial infection management and holds the potential to significantly impact septic patient outcomes and antimicrobial stewardship.

Tributyltin (TBT) toxicity: Effects on enteric neuronal plasticity and intestinal barrier of rats' duodenum.

Tributyltin (TBT) is a biocide used in the formulation of antifouling paints and it is highly harmful. Despite the ban, the compound persists in the environment, contaminating marine foodstuffs and household products. Therefore, considering the route of exposure to the contaminant, the gastrointestinal tract (GIT) acts as an important barrier against harmful substances and is a potential biomarker for understanding the consequences of these agents. This work aimed to evaluate histological and neuronal alterations in the duodenum of male Wistar rats that received 20 ng/g TBT and 600 ng/g via gavage for 30 consecutive days. After the experimental period, the animals were euthanized, and the duodenum was intended for neuronal histochemistry (total and metabolically active populations) and histological routine (morphometry and histopathology). The results showed more severe changes in neuronal density and intestinal morphometry in rats exposed to 20 ng/g, such as total neuronal density decrease and reduction of intestinal layers. In rats exposed to 600 ng/g of TBT, it was possible to observe only an increase in intraepithelial lymphocytes. We conclude that TBT can be more harmful to intestinal homeostasis when consumed in lower concentrations.

Forage sources in total mixed rations early in life influence performance, metabolites, and behavior of dairy calves.

The objective of this study was to evaluate effects of forage inclusion and sources on performance, metabolism, and feeding behavior of dairy calves. Forty-eight Holstein calves were blocked and randomly assigned to 1 of 4 dietary treatments according to sex and BW at 28 d of life to determine the effects of feeding forage sources (ensiled and dry), with different quality on performance, metabolites, and behavior. Treatments consisted of a no-forage coarsely ground starter (CON); or total mixed ration (TMR) containing 7.5% on a dry matter (DM) basis of Tifton hay of either medium quality (MH) or low quality (LH); or 10% on a DM basis of corn silage (CS). During the first 28 d of life, all calves received 3 L of whole milk twice daily, a commercial pelleted starter and no forage, and water ad libitum. After that, the solid diet was changed to the respective dietary treatments. Calves were gradually weaned from 52 to 56 d of age, and followed for 14 d postweaning. Individual solid feed and milk intakes were recorded daily, and BW and metabolic indicators of intermediate metabolism were recorded weekly. Behavior was recorded, and the analysis was conducted on wk 7 (preweaning) and 10 (postweaning). Solid feed intake increased at wk 7 and 8 when MH, LH, and CS were included in TMR; the same results were observed postweaning. The diets did not affect the average daily gain and BW, but the feed efficiency increased with the CON diet. The ß-hydroxybutyrate concentration was greater in calves receiving TMR-containing forage than CON diet. Furthermore, calves supplemented with forage had a greater rumination time. In conclusion, all forage sources included in the TMR showed feed intake and behavior benefits, reinforcing the need for fiber from forage in pre- and postweaning diets.

HPV-related oropharyngeal carcinoma remains infrequent over 25 years in a Brazilian Oral Pathology Center: A cross-sectional study with literature review.

BACKGROUND: The aim was to evaluate the frequency, clinicopathological features, and HPV status of oropharyngeal squamous cell carcinoma (OP-SCC) and benign HPV-related epithelial lesions of the oropharynx over the last 25 years. Moreover, a literature review was performed to investigate HPV frequency in OP-SCC samples diagnosed in Brazilian Centers. MATERIAL AND METHODS: A cross-sectional study analyzed OP-SCC, squamous papilloma, verruca vulgaris, and condyloma accuminatum, diagnosed from 1997 to 2021. HPV status of OP-SCC was determined by immunohistochemistry and "in situ" hybridization. Bivariate statistics were performed (p≤0.05). For the literature review, MEDLINE/PubMed, Web of Science, EMBASE, and Scopus were searched. Two independent reviewers assessed the studies for eligibility. RESULTS: Cross-sectional: 211 OP-SCC (63.0%) and 124 benign lesions (37.0%) were included. OP-SCC frequency increased gradually over time, whereas benign lesions had steady trends. OP-SCC affected more males (n= 171; 81.0%), though the relative frequency in females rose over time. Smoking (n= 127; 60.2%) was common in OP-SCC. Nineteen OP-SCC (13.0%) were positive for HPV. HPV-positive and HPV-negative tumors had similar clinicopathological features (p>0.05). Benign lesions predominated in middle-aged (n= 32; 26.7%) women (n= 71; 57.3%), in the soft palate (n=101; 81.5%). LITERATURE REVIEW: 32 studies were included, and in 60% of them, HPV frequency in OP-SCC was less than 25%. CONCLUSIONS: OP-SCC prevalence has been increasing, and it was mostly associated with smoking and alcohol rather than with HPV infection in Brazil. Benign lesions had a stationary frequency over the evaluated period.

Far-UV-C irradiation promotes synergistic bactericidal action against adhered cells of Escherichia coli and Staphylococcus epidermidis.

The contamination of indoor areas is a global health problem that can cause the dispersion of infectious diseases. In that sense, it is urgent to find new strategies applying a lower concentration of the traditional chemicals used for cleaning and disinfection. Ultraviolet radiation (UV), in particular far-UV-C (200-225 nm), has emerged as a successful, powerful, easy-to-apply, and inexpensive approach for bacterial eradication that still requires scientific assessment. This study investigated new strategies for disinfection based on far-UV-C (222 nm) combined with chlorine and mechanical cleaning, providing an innovative solution using low doses. The bactericidal activity of far-UV-C (222 nm) was tested at an intensity of irradiation from 78.4 µW/cm2 to 597.7 µW/cm2 (for 1 min) against Escherichia coli and Staphylococcus epidermidis adhered on polystyrene microtiter plates. It was further tested in combination with mechanical cleaning (ultrasounds for 1 min) and free chlorine (0.1, 0.5, and 1 mg/L for 5 min). The triple combination consisting of mechanical cleaning + free chlorine (0.5 mg/L) + far-UV-C (54 mJ/cm2) was tested against cells adhered to materials found in hospital settings and other public spaces: polyvinyl chloride (PVC), stainless steel (SS), and polyetheretherketone (PEEK). Disinfection with far-UV-C (54 mJ/cm2) and free chlorine at 0.5 mg/L for 5 min allowed a total reduction of culturable E. coli cells and a logarithmic reduction of 2.98 ± 0.03 for S. epidermidis. The triple combination of far-UV-C, free chlorine, and mechanical cleaning resulted in a total reduction of culturable cells for both adhered bacteria. Bacterial adhesion to PVC, SS, and PEEK occurred at distinct extents and influenced the bactericidal activity of the triple combination, with logarithmic reductions of up to three. The overall results highlight that, based on culturability assessment, far-UV-C (54 mJ/cm2) with chlorine (0.5 mg/L; 5 min) and mechanical cleaning (1 min) as an efficient disinfection strategy using mild conditions. The combination of culturability and viability assessment of disinfection is recommended to detect regrowth events and increase the effectiveness in microbial growth control.

The impact of potassium peroxymonosulphate and chlorinated cyanurates on biofilms of Stenotrophomonas maltophilia: effects on biofilm control, regrowth, and mechanical properties.

The activity of two chlorinated isocyanurates (NaDCC and TCCA) and peroxymonosulphate (OXONE) was evaluated against biofilms of Stenotrophomonas maltophilia, an emerging pathogen isolated from drinking water (DW), and for the prevention of biofilm regrowth. After disinfection of pre-formed 48 h-old biofilms, the culturability was reduced up to 7 log, with OXONE, TCCA, and NaDCC showing more efficiency than free chlorine against biofilms formed on stainless steel. The regrowth of biofilms previously exposed to OXONE was reduced by 5 and 4 log CFU cm-2 in comparison to the unexposed biofilms and biofilms exposed to free chlorine, respectively. Rheometry analysis showed that biofilms presented properties of viscoelastic solid materials, regardless of the treatment. OXONE reduced the cohesiveness of the biofilm, given the significant decrease in the complex shear modulus (G*). AFM analysis revealed that biofilms had a fractured appearance and smaller bacterial aggregates dispersed throughout the surface after OXONE exposure than the control sample. In general, OXONE has been demonstrated to be a promising disinfectant to control DW biofilms, with a higher activity than chlorine. The results also show the impact of the biofilm mechanical properties on the efficacy of the disinfectants in biofilm control.

On the major role played by the lumen curvature of intracranial aneurysms walls in determining their mechanical response, local hemodynamics, and rupture likelihood.

The properties of intracranial aneurysms (IAs) walls are known to be driven by the underlying hemodynamics adjacent to the IA sac. Different pathways exist explaining the connections between hemodynamics and local tissue properties. The emergence of such theories is essential if one wishes to compute the mechanical response of a patient-specific IA wall and predict its rupture. Apart from the hemodynamics and tissue properties, one could assume that the mechanical response also depends on the local morphology, more specifically, the curvature of the luminal surface, with larger values at highly-curved wall portions. Nonetheless, this contradicts observations of IA rupture sites more often found at the dome, where the curvature is lower. This seeming contradiction indicates a complex interaction between the hemodynamics adjacent to the aneurysm wall, its morphology, and mechanical response, which warrants further investigation. This was the main goal of this work. We accomplished this by analyzing the stress and stretch fields in different regions of the wall for a sample of IAs, which have been classified based on particular hemodynamics conditions and lumen curvature. Pulsatile numerical simulations were performed using the one-way fluid-solid interaction strategy implemented in OpenFOAM (solids4foam toolbox). We found that the variable best correlated with regions of high stress and stretch was the lumen curvature. Additionally, our data suggest a connection between the local curvature and particular hemodynamics conditions adjacent to the wall, indicating that the lumen curvature is a property that could be used to assess both mechanical response and hemodynamic conditions, and, moreover, suggest new rupture indicators based on the curvature.

Impact of Treatment on Host Responses in Young Individuals with Periodontitis.

Grade C periodontitis in young individuals is characterized by severe/rapid periodontal destruction, usually early onset, in systemically healthy individuals. An individual's host response, triggered by a dysbiotic subgingival biofilm, has been reported as a contributor to the tissue destruction, although mechanisms of this response and contributions to such disease remain poorly understood. Nonsurgical treatment has resulted in positive clinical responses for both localized (now molar-incisor pattern) and generalized forms of grade C periodontitis, especially when adjunctive systemic antibiotics are used. Nonsurgical treatment may also affect host responses, although mechanisms leading to significant changes in this response remain unclear. Significant effects on inflammatory response to antigens/bacteria have been described posttreatment, but evidence for long-term effects remains limited. Nonsurgical treatment in these individuals may also modulate a variety of host markers in serum/plasma and gingival crevicular fluid along with clinical parameter improvements. The impact of other adjuncts to nonsurgical treatment focusing on controlling exacerbated immunoinflammatory responses needs to be further explored in grade C periodontitis in young individuals. Recent evidence suggests that nonsurgical treatment with adjunctive laser therapy may modulate host and microbial responses in those subjects, at least in the short term. Available evidence, while very heterogeneous (including variations in disease definition and study designs), does not provide clear conclusions on this topic yet provides important insights for future studies. In this review, studies within the past decade evaluating the impact of nonsurgical treatment on systemic/local host responses in young individuals with grade C periodontitis, as well as long-term clinical responses posttreatment, will be critically appraised and discussed.

Identification of reference genes for studies of quantitative gene expression in male and female quail tissues.

In industrial poultry, quail production has gained increasing prominence over the years. It is known that the intensification of genetic studies has contributed greatly to this growth, through techniques, such as analysis of gene expression by PCR, for example. This study aimed to evaluate stability and recommend reference genes for quantitative real-time PCR in different tissues from male and female broiler quails. The stability of 10 housekeeping genes (GAPDH, RPL5, MRPS27, MRPS30, TFRC, HMBS, EEF1, LDHA, B2M, and UBC) by means Bestkeeper, NormFinder, GeNorm softwares with ΔCq method. The tissues analyzed were: heart, thigh muscle, brain, and spleen, considering that they are tissues commonly used in nutrigenomic, immunological, and poultry performance research. As expected, the reference genes tested showed varying stability depending on the tissue evaluated. According to the present study, the most stable housekeeping genes were MRPS30, TFRC, and HMBS in heart; MRPS30, EEF1, and HMBS in thigh muscle; B2M, GAPDH, and UBC in brain; and EEF1, LDHA, and HMBS in spleen. Therefore, it is recommended to be used as reference genes for gene expression studies of male and female quails.

Bloqueo del plano erector de la columna para la cirugía de atresia esofágica en un recién nacido prematuro / Erector spinae plane block for surgery of esophageal atresia in a preterm neonate

El manejo del dolor durante una toracotomía y tras ella es difícil en neonatos prematuros. Las técnicas de bloqueo ecoguiado en el plano fascial, tales como el bloqueo en el plano del músculo erector de la columna, son técnicas de anestesia regional relativamente nuevas que han surgido como alternativa a la anestesia epidural torácica, debido a su efectividad clínica, facilidad de administración y ejecución, teóricamente más segura. La facilidad relativa de identificar las referencias anatómicas, en comparación con el bloqueo paravertebral, así como su perfil de seguridad comparado con la anestesia epidural, pueden haber contribuido a la creciente popularidad del bloqueo músculo erector de la columna. Sin embargo, actualmente la evidencia publicada en cuanto a la eficacia de las técnicas de anestesia regional en neonatos de bajo peso intervenidos con esta cirugía es limitada, debido a los pocos informes de casos aislados. Describimos aquí el uso del bloqueo unilateral en el plano del músculo erector de la columna, como parte de la anestesia y la analgesia postoperatoria en la corrección quirúrgica de la atresia esofágica en un recién nacido prematuro.(AU)

Pain management during and after thoracotomy is challenging in premature neonates. Ultrasound-guided fascial plane block techniques, such as the erector spinae plane block are a relatively new regional anesthesia technique and have emerged as an alternative to thoracic epidural due to its clinical effectiveness, ease of administration and theoretically being safer to perform. The relative ease of identifying anatomical landmarks compared to the paravertebral block, as well as its safety profile compared to an epidural, may have contributed to the erector spinae plane Bs growing popularity. Currently, however, the published evidence for the efficacy of regional anesthesia techniques in low birth weight newborns undergoing this surgery is limited to few isolated case reports. Herein we describe the use of unilateral erector spinae plane block as part of anesthesia and postoperative analgesia management of surgical correction of esophageal atresia in a preterm neonate.(AU)

The potential of mRNA expression evaluation in predicting HER2 positivity in gastroesophageal cancer.

Gastroesophageal cancer (GEC) is an aggressive disease characterized by a high frequency of metastasis and poor overall survival rates. GEC presents HER2 overexpression in 5 to 25% of tumors eligible for HER2-targeted therapy. HER2 evaluation requires protein levels and copy number alteration analyses by immunohistochemistry (IHC) and in situ hybridization (FISH or SISH), respectively. These are semiquantitative methodologies that need an expert and well-trained pathologist. Therefore, the use of new surrogate methods for HER2 evaluation in cancer, such as gene expression analysis, might improve GEC HER2 classification. We evaluated HER2 positivity in GEC through conventional IHC and SISH analyses and investigated the potential application of HER2 mRNA expression by quantitative PCR to categorize GEC samples as HER2-positive or HER2-negative. Among 270 GEC samples, 10.9% were HER2-positive by IHC and SISH analyses. HER2 mRNA was overexpressed in HER2-positive GEC samples and presented high accuracy in distinguishing those tumors from HER2-negative GEC. Nevertheless, HER2 mRNA analysis was not capable of classifying HER2-equivocal GEC samples into HER2-positive or -negative according to SISH data. Quantitative PCR analysis showed HER2 overexpression in HER2-positive GEC samples. Nevertheless, HER2 mRNA analysis failed to classify HER2-equivocal GEC according to SISH data.

Erector spinae plane block for surgery of esophageal atresia in a preterm neonate.

Pain management during and after thoracotomy is challenging in premature neonates. Ultrasound-guided fascial plane block techniques, such as the erector spinae plane block are a relatively new regional anesthesia technique and have emerged as an alternative to thoracic epidural due to its clinical effectiveness, ease of administration and theoretically being safer to perform. The relative ease of identifying anatomical landmarks compared to the paravertebral block, as well as its safety profile compared to an epidural, may have contributed to the erector spinae plane Bs growing popularity. Currently, however, the published evidence for the efficacy of regional anesthesia techniques in low birth weight newborns undergoing this surgery is limited to few isolated case reports. Herein we describe the use of unilateral erector spinae plane block as part of anesthesia and postoperative analgesia management of surgical correction of esophageal atresia in a preterm neonate.

A numerical investigation of the mechanics of intracranial aneurysms walls: Assessing the influence of tissue hyperelastic laws and heterogeneous properties on the stress and stretch fields.

Numerical simulations have been extensively used in the past two decades for the study of intracranial aneurysms (IAs), a dangerous disease that occurs in the arteries that reach the brain and affect overall 3.2% of a population without comorbidity with up to 60% mortality rate, in case of rupture. The majority of those studies, though, assumed a rigid-wall model to simulate the blood flow. However, to also study the mechanics of IAs walls, it is important to assume a fluid-solid interaction (FSI) modeling. Progress towards more reliable FSI simulations is limited because FSI techniques pose severe numerical difficulties, but also due to scarce data on the mechanical behavior and material constants of IA tissue. Additionally, works that have investigated the impact of different wall modeling choices for patient-specific IAs geometries are a few and often with limited conclusions. Thus our present study investigated the effect of different modeling approaches to simulate the motion of an IA. We used three hyperelastic laws - the Yeoh law, the three-parameter Mooney-Rivlin law, and a Fung-like law with a single parameter - and two different ways of modeling the wall thickness and tissue mechanical properties - one assumed that both were uniform while the other accounted for the heterogeneity of the wall by using a "hemodynamics-driven" approach in which both thickness and material constants varied spatially with the cardiac-cycle-averaged hemodynamics. Pulsatile numerical simulations, with patient-specific vascular geometries harboring IAs, were carried out using the one-way fluid-solid interaction solution strategy implemented in solids4foam, an extension of OpenFOAM®, in which the blood flow is solved and applied as the driving force of the wall motion. We found that different wall morphology models yield smaller absolute differences in the mechanical response than different hyperelastic laws. Furthermore, the stretch levels of IAs walls were more sensitive to the hyperelastic and material constants than the stress. These findings could be used to guide modeling decisions on IA simulations, since the computational behavior of each law was different, for example, with the Yeoh law being the fastest to converge.

Formation of topological defects in nematic shells with a dumbbell-like shape.

The present study investigates dumbbell-shaped nematic liquid crystal shells. Using molecular dynamics (MD) simulations, we consider the effects of an external electric field on nematic ordering by computing the average molecular alignment's time evolution and equilibrium configuration. We show that the number and location of topological defects are strongly affected by the external field, with the orientational ordering's equilibrium configuration depending on field direction about the shell's long axis. For a transverse external field, it is verified that the defect rearrangement presents a non-linear dynamics, with a field independent characteristic time scale delimiting the short and long time regimes. Effects associated with varying the shell's Gaussian curvature are also analyzed.

Hyperglycemia alters N-glycans on colon cancer cells through increased production of activated monosaccharides.

Diabetes Mellitus (DM) is both, correlated and a known risk factor for colorectal cancer (CRC). Besides favoring the incidence of CRC, DM also accelerates its progression, worsening its prognosis. Previously, hyperglycemia, the DM hallmark, has been shown to lead to aberrant glycosylation of CRC cells, heightening their malignancy both in vivo and in vitro. Here we use mass spectrometry to elucidate the composition and putative structures of N-glycans expressed by MC38 cultured in normoglycemic (LG) and hyperglycemic-like conditions (HG). N-glycans, 67, were identified in MC38 cells cultured in LG and HG. The cells grown in HG showed a greater abundance of N-glycans when compared to LNG cells, without changes in the proportion of sialylated, fucosylated and mannosylated N-glycans. Among the identified N-glycans, 16 were differentially expressed, mostly mannosylated and fucosylated, with a minority of them being sialylated. Metabolomics analysis indicates that the alterations observed in the N-glycosylation may be mostly due to increase of the activated monosaccharides pool, through an increased glucose entrance into the cells. The alterations found here corroborate data from the literature regarding the progression of CRC, advocating for development or repositioning of effective treatments against CRC in diabetic patients.

Ex vivo exposure to titanium dioxide and silver nanoparticles mildly affect sperm of gilthead seabream (Sparus aurata) - A multiparameter spermiotoxicity approach.

Nanoparticles (NP) are potentially reprotoxic, which may compromise the success of populations. However, the reprotoxicity of NP is still scarcely addressed in marine fish. Therefore, we evaluated the impacts of environmentally relevant and supra environmental concentrations of titanium dioxide (TiO2: 10 to 10,000 µg·L-1) and silver NP (Ag: 0.25 to 250 µg·L-1) on the sperm of gilthead seabream (Sparus aurata). We performed short-term direct exposures (ex vivo) and evaluated sperm motility, head morphometry, mitochondrial function, antioxidant responses and DNA integrity. No alteration in sperm motility (except for supra environmental Ag NP concentration), head morphometry, mitochondrial function, and DNA integrity occurred. However, depletion of all antioxidants occurred after exposure to TiO2 NP, whereas SOD decreased after exposure to Ag NP (lowest and intermediate concentration). Considering our results, the decrease in antioxidants did not indicate vulnerability towards oxidative stress. TiO2 NP and Ag NP induced low spermiotoxicity, without proven relevant ecological impacts.

On the body-mind nexus in chronic musculoskeletal pain: A scoping review.

BACKGROUND AND OBJECTIVE: Bodily experience disturbances are frequent among chronic musculoskeletal pain patients and associated with important pain-related psychosocial outcomes (e.g., disability, quality of life). However, the relationship between bodily experience and the psychological dimensions of chronic pain (e.g., affective, cognitive) has only recently garnered attention. This scoping review aimed to identify trends and gaps in research on the nexus between body awareness, body image, and body schema, and psychological processes/outcomes in adults with chronic musculoskeletal pain to inform future directions for research and practice. DATABASES AND DATA TREATMENT: This study was guided by Arksey and O'Malley's guidelines and PRISMA-ScR recommendations. Keywords related to body awareness/body image/body schema and pain were searched on PsycInfo and PubMed from database inception until 16 February 2021; 2045 articles were screened, and 41 met the inclusion criteria (i.e., primary quantitative studies investigating body awareness/body image/body schema in relation to pain-related psychological outcomes/processes in chronic musculoskeletal pain). RESULTS: The referred bodily experience constructs have been inconsistently defined. Body awareness was the most investigated construct, with consistent operationalization strategies. The links between body schema/body image and pain-related psychological processes/outcomes are still under-investigated. Most studies examined the role of bodily experience as a correlate/predictor of psychological outcomes/processes; overall, a better relationship with one's own body was associated with better pain-related psychological outcomes/processes. CONCLUSIONS: Our findings emphasize the relevance of further investigating body-mind relations in musculoskeletal pain and the development of therapies designed to improve the bodily experience within multidisciplinary treatment programmes. Suggestions for future research are discussed. SIGNIFICANCE: This scoping review identifies trends/gaps in current research on the relationship between body awareness/body image/body schema and pain-related psychological processes/outcomes in adults with musculoskeletal pain. Overall, findings suggest that better bodily experiences are associated to lower fear-avoidance beliefs, better self-regulation strategies and better chronic pain adjustment, being important targets in pain management interventions. Nonetheless, the results also emphasize the need to further investigate the causal relationships and other outcomes related to psychological resilience, as well as to develop gold standard treatments focused on bodily experience.

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial.

BACKGROUND: To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction. MATERIAL AND METHODS: The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student's t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides. RESULTS: There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration. CONCLUSIONS: Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars.