Suffering as an independent component of the experience of pain.

BACKGROUND: Pain has consistently been viewed as containing two dimensions, a sensory (intensity) and an emotional (unpleasantness). It has been suggested that pain involves higher order cognitive processes that go beyond unpleasantness. We therefore aimed at extending the assessment of pain by introducing an additional dimension of pain-related suffering and identifying noxious stimulation protocols that are most adequate for its psychophysical and psychophysiological characterization. METHODS: Twenty-four healthy volunteers received separate series of tonic and phasic noxious mechanical stimuli. Visual analogue scales were used to rate intensity, unpleasantness and suffering and psychophysiological measurements such as heart rate, skin conductance and corrugator electromyography were recorded. Acoustically evoked startle responses were measured in part of the assessments to obtain additional indicators of pain aversiveness. RESULTS: Spearman's correlation coefficients and partial correlations analyses as well as principal component analyses confirmed that suffering constitutes an integral component of pain processing that is distinct from intensity and unpleasantness. Tonic, rather than phasic, stimulation method was more effective in eliciting pain and suffering and under this condition startle responses where higher during long compared to short stimuli. CONCLUSIONS: These results suggest that in acute pain, suffering is a constitutive dimension that might even be more crucial in clinical states of pain.

PCR-based molecular discrimination between Maritrema eroliae and Probolocoryphe uca (Digenea: Microphallidae) in Kuwait Bay.

Microphallid trematodes are common parasites in marine snails and crustacean hosts at Kuwait Bay. The larval stages of two microphallids, Maritrema eroliae and Probolocoryphe uca, are difficult to differentiate morphologically. In this study, two PCR-based techniques were established for quick and accurate discrimination between the larval stages of the two microphallid species, employing restriction fragment length polymorphism (PCR-RFLP) and species-specific primers. Both techniques utilized nucleotide differences in the second internal transcribed region (ITS2) of the ribosomal DNA (rDNA) in the two species. For the PCR-RFLP technique, restriction enzyme AvaII was selected and it generated different restriction profiles among the two microphallids. In addition, species-specific primers were prepared for each microphallid species that amplified distinctive fragments. Both techniques showed that the larval stages of the two microphallid species can be identified accurately. However, direct PCR amplification using species-specific primers was more advantageous than the PCR-RFLP technique since it allowed rapid and specific discrimination between the two species. This technique provides a useful tool that can be used in future studies for the study of the distribution of microphallid species and their definitive hosts at different localities of Kuwait Bay.

Molecular identification of Austrobilharzia species parasitizing Cerithidea cingulata (Gastropoda: Potamididae) from Kuwait Bay.

Avian schistosomes belonging to the genus Austrobilharzia (Digenea: Schistosomatidae) are among the causative agents of cercarial dermatitis in humans. In this paper, ribosomal and mitochondrial DNA sequences were used to study schistosome cercariae from Kuwait Bay that have been identified morphologically as Austrobilharzia sp. Sequence comparison of the ribosomal DNA (rDNA) 28S and 18S regions of the collected schistosome cercariae with corresponding sequences of other schistosomes in GenBank revealed high sequence similarity. This confirmed the morphological identification of schistosome cercariae from Kuwait Bay as belonging to the genus Austrobilharzia. The finding was further supported by the phylogenetic tree that was constructed based on the combined data set 18S-28S-mitochondrial cytochrome oxidase I (mtCO1) sequences in which Austrobilharzia sp. clustered with A. terrigalensis and A. variglandis. Sequence comparison of the Austrobilharzia sp. from Kuwait Bay with A. variglandis and A. terrigalensis based on mtCO1 showed a variation of 10% and 11%, respectively. Since the sequence variation in the mtCO1 was within the interspecific range among trematodes, it seems that the Austrobilharzia species from Kuwait Bay is different from the two species reported in GenBank, A. terrigalensis and A. variglandis.

Epidemiological and genetic study of 121 cases of oral clefts in Kuwait.

AIM: The aim of the study was to ascertain some epidemiological factors such as sex and consanguinity that may be associated with cleft lip with or without cleft palate (CL +/- CP) in Kuwait as well as to conduct genetic segregation analysis of these families. SETTING AND SAMPLE POPULATION: A total of 113 families ascertained through 121 CL +/- CP and CP surgical probands in Kuwait. The frequencies of cleft types and the epidemiological variables were calculated using SPSS version 5.0 software. Chi-square for goodness-of-fit test was used to test the significance of the associated epidemiological variables to facial clefts. Genetic segregation analysis was performed on 76 families with extended pedigrees and included only those with non-syndromic CL +/- CP (NS CL +/- CP). Major locus segregation analysis was used to fit models to the observed family patterns under Class A regressive models as implemented by REGD routine in S.A.G.E. release 4.0. A test for heterogeneity was also conducted to complete data set in addition to two subsets: Arabs and nomads. RESULTS: Of the 121 patients, 34(28.1%) had CP, 30(24.8%) had CL and 57 (47.1%) had CL + CP. The male to female ratio was 0.89 for CP, 1.14 for CL, 1.35 for CL + CP and 1.2 for all the clefts. The percentage of consanguineous families among those with a positive family history (60%) was not significantly different from that of the general population (54.3%), whereas for all the families with clefts the percent consanguineous was significantly lower (38%). No evidence of heterogeneity in the results between the Arab and nomad subsets was observed. The results for the major locus segregation analysis were inconclusive. CONCLUSION: No definite association was observed between consanguinity and the occurrence of facial clefts in Kuwait. General transmission models in the full data set showed no evidence of heterogeneity in the results between the Arab and nomad subsets.