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1.
J Oral Sci ; 62(2): 165-169, 2020 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-32161235

RESUMO

Burning mouth syndrome (BMS) is one of the most frequently seen idiopathic pain conditions in a dental setting. Peri- and postmenopausal women are most frequently affected, and patients who experience BMS complain of persistent burning pain mainly at the tip and the bilateral border of the tongue. Recent studies have assessed whether BMS is a neuropathic pain condition, based on morphologic changes in biopsied tongue specimens, and whether there are abnormal pain responses in patients with this disease. Somatosensory studies have reported some abnormal findings in sensory and pain detection thresholds with inconsistency; however, the most distinct finding was exaggerated responses to painful stimuli. Imaging and electrophysiologic studies have suggested the possibility of dysregulation of the pain-modulating system in the central nervous system, which may explain the enhanced pain responses despite the lack of typical responses toward quantitative sensory tests. Basic studies have suggested the possible involvement of neuroprotective steroids, although the underlying mechanisms of this condition have not been elucidated. Experimental studies are looking for preferable supportive therapies for BMS patients despite the obscure pathogenesis.


Assuntos
Síndrome da Ardência Bucal , Neuralgia , Feminino , Humanos , Limiar da Dor , Língua
2.
Medicine (Baltimore) ; 99(12): e19496, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195949

RESUMO

BACKGROUND: Dysmenorrhea seriously affects the ability of women to perform normal social activities and decreases their quality of life. Primary dysmenorrhea can be effectively treated with acupuncture. Based on the wrist-ankle acupuncture (WAA) theory, we designed a portable WAA point compression treatment strap that treats diseases by automatically applying pressure to acupuncture points. The proposed study aims to evaluate the immediate analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. METHODS: The study will be a randomized controlled trial conducted from May 1, 2019 to May 30, 2020 that includes 78 students from Shanghai University of Traditional Chinese Medicine who have primary dysmenorrhea and meet the eligibility criteria. Participants will be randomly divided into 2 groups in a 1:1 allocation ratio. The intervention group will use the acupressure wrist-ankle strap equipped with tip compression component parts on the internal side; the control group will use the nonacupressure wrist-ankle strap with the tip compression parts removed. All participants will be treated for 30 minutes on the 1st day of menstruation. The primary outcome is the pain intensity score measured by the visual analog scale. The secondary outcomes are the onset time of analgesia, the pain threshold at Yinlingquan (SP 9), skin temperature at Guanyuan (CV 4), and expectations and satisfaction of patients as investigated via the expectation and treatment credibility scale. DISCUSSION: This trial will be the 1st study to evaluate the analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. The quality of this study is ensured by the randomization, nonacupressure control, and blinded design. The results may provide evidence for a potential alternative treatment for primary dysmenorrhea and evidence-based proof of the analgesic effect of WAA.


Assuntos
Acupressão/efeitos adversos , Pontos de Acupuntura , Terapia por Acupuntura/métodos , Dismenorreia/terapia , Analgesia por Acupuntura/instrumentação , Analgesia por Acupuntura/estatística & dados numéricos , Adolescente , Adulto , Tornozelo , China/epidemiologia , Dismenorreia/epidemiologia , Dismenorreia/psicologia , Feminino , Humanos , Limiar da Dor , Satisfação do Paciente , Qualidade de Vida , Escala Visual Analógica , Punho , Adulto Jovem
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(1): 51-57, 2020 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-32071463

RESUMO

OBJECTIVE: To compare the orofacial pain sensitivity with operant test and mechanical hyperalgesia with von Frey filaments of two orofacial pain models (EOI: experimental occlusal interference; pIONX: partial infraorbital nerve transection). To investigate the operant and evoked characteristics of EOI-rats. METHODS: The orofacial operant behaviors were tested by Ugo Basile Orofacial Stimulation Test System. The mechanical thresholds of vibrissal pads were tested by von Frey filaments. Male Sprague-Dawley rats were randomly divided into eight groups: von Frey group: sham-EOI, EOI, sham-pIONX, pIONX (sham: sham-operated group); operant test group: sham-EOI, EOI, sham-pIONX, pIONX (sham: sham-operated group). The mechanical thresholds and orofacial operant behaviors were tested on pre-operation and post-operation days l, 3, 7, 10, 14 and 21. RESULTS: In pIONX of von Frey group, the mechanical withdrawal threshold decreased from days 1 to 21 (P<0.05), peaking from days 7 to 10, and lasted until the end of the experiment. There was no significant difference between the bilateral sides. In pIONX of operant test group, the total contact time decreased from days 10 to 21 (P<0.05), peaking from days 10 to 14, and lasted until the end of the experiment. In EOI of von Frey group, the mechanical withdrawal threshold decreased from days 3 to 21 (P<0.05), peaking on day 7, and lasted until the end of the experiment. There was no significant difference between the bilateral sides. In EOI of operant test group, the total contact time decreased from days 1 to 21 (P<0.05), peaking from days 7 to 10, and lasting until the end of experiment. CONCLUSION: Orofacial operant test is a stable method to evaluate orofacial pain behaviors, which could discriminate the feature of neuropathic and EOI orofacial pain. In these two animal models, both of the operant behaviors and the mechanical hyperalgesia exhibited different time courses. Orofacial operant test provides a novel method for evaluating the orofacial pain sensitivity and studying the orofacial pain mechanism thoroughly.


Assuntos
Dor Facial , Limiar da Dor , Animais , Modelos Animais de Doenças , Hiperalgesia , Masculino , Ratos , Ratos Sprague-Dawley
4.
Eur J Med Chem ; 188: 111920, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31901745

RESUMO

γ-Aminobutyric acid (GABA) uptake transporters are membrane transport proteins that are involved in the pathophysiology of a number of neurological disorders. Some types of chronic pain appear to result from the dysfunction of the GABAergic system. The deficiency of mouse GAT1 transporter (mGAT1) abolishes the nociceptive response, which means that mGAT1 inhibition is an appropriate medical approach to achieve analgesia. The mGAT4 transporter is the second most abundant GAT subtype in the brain; however, its physiological role has not yet been fully understood in the central nervous system. In this study, we examined whether the combination of mGAT1 and mGAT3/mGAT4 inhibition in a single molecule might lead to potentially synergistic effects improving analgesic activity to relieve neuropathic pain. To study this hypothesis, new GABA uptake inhibitors were designed, synthesized, and evaluated in terms of their activity and subtype selectivity for mGAT1-4. Among new functionalized amino acid derivatives of serine and GABA analogs, compounds with preferential mGAT3/4 inhibitory activity were discovered. Two selected hits (19b and 31c) were subjected to in vivo tests. We found a statistically significant antiallodynic activity in the von Frey test in diabetic and oxaliplatin-induced neuropathic pain model. The novel compounds (4-hydroxybutanoic, 4-hydroxypentanoic, and 4-aminobutanoic acid derivatives and serine analogs) provide new insights into the structure-activity relationship of mGAT3/mGAT4 inhibitors and indicate a new direction in the search for potential treatment of neuropathic pain of various origin.


Assuntos
Analgésicos/uso terapêutico , Proteínas da Membrana Plasmática de Transporte de GABA/metabolismo , Inibidores da Captação de GABA/uso terapêutico , Hiperalgesia/tratamento farmacológico , Neuralgia/tratamento farmacológico , Limiar da Dor/efeitos dos fármacos , Analgésicos/síntese química , Analgésicos/metabolismo , Animais , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/complicações , Proteínas da Membrana Plasmática de Transporte de GABA/química , Inibidores da Captação de GABA/síntese química , Inibidores da Captação de GABA/metabolismo , Hiperalgesia/induzido quimicamente , Hiperalgesia/etiologia , Masculino , Camundongos , Simulação de Acoplamento Molecular , Estrutura Molecular , Neuralgia/induzido quimicamente , Neuralgia/etiologia , Oxaliplatina , Ligação Proteica , Estreptozocina , Relação Estrutura-Atividade
5.
Br J Anaesth ; 124(1): 92-100, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31711605

RESUMO

BACKGROUND: Intravenous dexamethasone is thought to prolong the duration of peripheral nerve block, but the dose-response relationship remains unclear. The aim of this volunteer study was to evaluate the dose-response effect of i.v. dexamethasone on the prolongation of median nerve block. METHODS: In a double-blind, randomised controlled study, 18 volunteer subjects received two median nerve blocks separated by a washout period. One block was conducted alongside an infusion of saline and the other alongside i.v. dexamethasone 2, 4, or 8 mg. The primary outcome was time to return of normal pinprick sensation. Secondary outcomes included thermal quantitative sensory testing (QST) for the time to return of cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), area under QST curves, grip strength, and the incidence of adverse effects. RESULTS: The primary outcome, time to recovery of pinprick sensation, was similar between volunteers receiving saline or i.v. dexamethasone, regardless of dose (P=0.99). The time to recovery of QST milestones was similar between groups, although area under QST curves indicated prolongation of CDT (0 vs 8 mg, P=0.002) and WDT (0 vs 2 mg, P=0.008; 0 vs 4 mg, P=0.001; 0 vs 8 mg, P<0.001). There was no difference in motor recovery or adverse effects. CONCLUSIONS: Intravenous dexamethasone failed to significantly prolong the duration of pinprick anaesthesia regardless of dose. However, area under QST curve analysis indicated a dose-independent prolongation of CDT and WDT, the clinical significance of which is unclear. CLINICAL TRIAL REGISTRATION: NCT02864602 (clinicaltrials.gov).


Assuntos
Adjuvantes Anestésicos , Dexametasona , Bloqueio Nervoso/métodos , Nervos Periféricos , Adjuvantes Anestésicos/administração & dosagem , Adjuvantes Anestésicos/efeitos adversos , Administração Intravenosa , Adulto , Estudos Cross-Over , Dexametasona/administração & dosagem , Dexametasona/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Força da Mão , Voluntários Saudáveis , Humanos , Masculino , Nervo Mediano , Pessoa de Meia-Idade , Bloqueio Nervoso/efeitos adversos , Limiar da Dor/efeitos dos fármacos , Sensação/efeitos dos fármacos , Sensação Térmica/efeitos dos fármacos , Adulto Jovem
6.
J Oral Facial Pain Headache ; 34(1): 83­91, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31247058

RESUMO

AIMS: To investigate the associations between signs of painful temporomandibular disorders (TMD) and number of tender points (TPs) and fibromyalgia in adolescents, as well as the relationship between TPs and pressure-pain threshold (PPT) in individuals presenting with local, regional, or widespread pain as a way to investigate the presence of central sensitization (CS). METHODS: The sample consisted of 690 Brazilian adolescents with and without signs of painful TMD, aged 12 to 14 years old. Painful TMD was classified according to the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I. The criteria established by Yunus were applied to assess juvenile fibromyalgia and TPs. Mann-Whitney and chi-square tests were applied to test the associations between signs of painful TMD and demographic variables. Regression models were used to estimate the association between signs of painful TMD and number of TPs and to determine which additional predictive variables were associated with TPs. Regression analyses were performed to test the associations between PPT values and number of TPs. Fisher test was used to estimate the association between signs of painful TMD and FM. RESULTS: Significant associations between signs of painful TMD and the number of TPs (P < .001), as well as between TPs and the PPT values for local, regional, and widespread pain (P < .001), were found. No association between signs of painful TMD and fibromyalgia was found (P = .158). CONCLUSION: Individuals with signs of painful TMD presented with more TPs compared to pain-free adolescents. Moreover, the higher the number of TPs, the lower the PPT. This finding suggests that adolescents with signs of painful TMD are at increased risk of presenting with CS.


Assuntos
Fibromialgia , Transtornos da Articulação Temporomandibular , Adolescente , Brasil , Sensibilização do Sistema Nervoso Central , Criança , Dor Facial , Humanos , Limiar da Dor
7.
Clin Oral Investig ; 24(2): 875-882, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31222434

RESUMO

OBJECTIVES: This study aimed to assess the mechanical and thermal sensory thresholds of the gingiva in patients with plaque-induced gingivitis compared with a control group to help characterize effects of an inflammatory condition in the oral mucosa on somatosensory function. MATERIALS AND METHODS: Quantitative sensory testing (QST) was used in 22 patients (men 10, women 12, age 20-30 years) with plaque-induced gingivitis at the lower lateral incisors and in 22 age- and gender-matched healthy volunteers as a control group. One lower lateral incisor (32 or 42) was randomly identified for each included subject. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), and heat pain threshold (HPT) of the attached gingiva at the identified lower lateral incisors were assessed in both groups. Pressure pain threshold (PPT) at the teeth was also tested from vertical and lateral directions and analyzed. One-way ANOVA was used to compare the mean values of the identified lower lateral incisors between the two groups. RESULTS: The results showed that the CDT (P = 0.027), WDT (P = 0.021), and HPT (P = 0.005) at the gingiva and PPT (P < 0.001) at the identified lower lateral incisors from the vertical direction were significantly less sensitive, whereas the PPT (P = 0.016) at the gingiva of the identified lateral incisors were significantly more sensitive in the gingivitis group compared to the control group. Plaque-induced gingivitis and the inflammatory response appear to be associated with significant changes in somatosensory sensitivity at the gingiva and periodontal tissue in a bidirectional mode, i.e., both increased and decreased sensitivity to different types of stimuli. CONCLUSIONS: Inflammatory reactions in the gingiva seem to be associated with demonstrable changes in somatosensory function including both hypo- and hyperesthesia. CLINICAL RELEVANCE: These findings may have significance for general oral health and well-being in patients with even plaque-induced gingivitis.


Assuntos
Gengivite , Limiar da Dor , Adulto , Estudos de Casos e Controles , Feminino , Temperatura Alta , Humanos , Masculino , Limiar Sensorial , Adulto Jovem
8.
J Oral Rehabil ; 47(2): 113-122, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31418881

RESUMO

BACKGROUND: Changes in quantitative sensory testing (QST) parameters following topical anaesthesia could contribute to better elucidate underlying mechanisms of somatosensory alterations in temporomandibular disorder (TMD) pain patients. This placebo-controlled crossover investigation compared the somatosensory profile following topical anaesthesia between TMD patients (n = 20) and healthy participants (n = 20). METHODS: Cold detection threshold, warm detection threshold, cold pain threshold, heat pain threshold, mechanical detection threshold, mechanical pain threshold, wind-up ratio and pressure pain threshold were assessed on the skin overlying the masseter at three consecutive days (baseline and immediately after lidocaine 4%/placebo cream). Mixed ANOVA and a coding system that accounts for the diversity of types of peripheral axons associated with the somatosensory parameters were applied for data analysis. RESULTS: The lidocaine application caused no changes in the somatosensory sensitivity in the masseter region in TMD patients (P > .050), but sensitivity to cold, cold pain, touch and pinprick stimuli were reduced after topical anaesthesia in healthy participants (P < .050). Also, the degree of topical anaesthesia was greater in healthy participants (P = .008). The coding system suggested that TMD patients presented only Aδ-fibre block, whereas a combination of either Aß- and/or C-fibre block was observed in 35% of healthy participants in addition to Aδ-fibre block following lidocaine application. CONCLUSION: Quantitative sensory testing can be successfully applied to identify meaningful differences in the degree of hypoalgesia and hypoesthesia following short-time topical anaesthesia.


Assuntos
Anestesia Local , Lidocaína , Limiar da Dor , Transtornos da Articulação Temporomandibular , Humanos , Dor , Medição da Dor
9.
J Am Dent Assoc ; 151(2): 145-151, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31879015

RESUMO

BACKGROUND AND OVERVIEW: The authors report the case of a patient with mixed connective tissue disease (MCTD) and Sjögren syndrome, showing signs and symptoms of bilateral trigeminal neuropathy and aseptic meningitis. The patient was assessed by means of quantitative sensory testing (QST) according to the German Research Network on Neuropathic Pain standards, in both the gingiva and forearm, and the results were compared with those of healthy control participants. CASE DESCRIPTION: A 27-year-old woman, who had received a diagnosis of MCTD and Sjögren syndrome from a rheumatologist, sought treatment at an orofacial pain clinic for bilateral electriclike pain in the maxillary anterior gingiva, eyelids, and cheeks. QST indicated allodynia and hyperalgesia in response to mechanical and thermal stimuli in both her gingiva and forearm, and cold hyperalgesia in her forearm only. She had been prescribed an oral corticosteroid (prednisone, 7 milligrams per day) by the rheumatologist, and was given lidocaine gel and systemic pregabalin (400 mg/d) at the clinic. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The cause of trigeminal neuropathy in MCTD and Sjögren syndrome (SS) is unknown. The QST data in this case showed that the somatosensory disturbance severity was higher in the gingiva than in the forearm, suggesting that the trigeminal nerve may be more susceptible than other parts of the nervous system in patients with MCTD. If reproducible in future studies, the finding of greater hypersensitivity in the gingiva than in the forearm may provide an opportunity for dentists to play a role in the detection, diagnosis, or both of MCTD and SS. Dentists must be sufficiently familiar with MCTD and SS to include them in their differential diagnoses and should consider performing simple neurosensory testing such as via intraoral cotton swab or pinprick test.


Assuntos
Doença Mista do Tecido Conjuntivo , Síndrome de Sjogren , Adulto , Feminino , Humanos , Hiperalgesia , Lidocaína , Limiar da Dor
10.
Health Psychol ; 39(1): 10-20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31380682

RESUMO

OBJECTIVE: Distraction is a well-established pain management technique for children experiencing acute pain, although the mechanisms underlying the effectiveness of distraction are not well understood. It has been postulated that engagement of executive functions, such as working memory, may be a critical factor in attenuating pain via distraction. To test this hypothesis, we compared a 1-back task requiring engagement of working memory with a simple visual discrimination task demanding focused attention, but lower cognitive load (0-back). METHOD: Seventy-nine children (6-12 years old) underwent a baseline cold pressor trial followed by cold pressor trials in which they completed the visual discrimination and 1-back tasks in counterbalanced order. Executive functioning ability was assessed via the Wechsler Intelligence Scale for Children (5th Edition) working memory subscales and by parent report on the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF®2). RESULTS: Children's pain tolerance improved in both the visual discrimination and 1-back conditions though a differential response to the 2 tasks was not observed. Age moderated the relation between executive functioning and response to distraction; older children with better executive functioning skills demonstrated greater improvements in both distraction interventions. CONCLUSIONS: Findings demonstrate the benefits of both visual discrimination and working memory distraction tasks for elementary-aged children experiencing acute pain. Further research is required in order to elucidate the role of executive functioning skills and cognitive load in enhancing distraction analgesia in children, with particular focus on determining optimal load and task difficulty in light of emerging executive functioning abilities in this age group. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
/fisiologia , Memória de Curto Prazo/fisiologia , Limiar da Dor/psicologia , Dor/psicologia , Criança , Feminino , Humanos , Masculino
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1160-1165, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31801715

RESUMO

OBJECTIVE: To observe the effect of occlusal interference on the afferent pathway of the trigeminal nerve and neuronal excitability in the trigeminal subnucleus caudalis (SPVC) of rats by electrical stimulation of the trigeminal ganglion (TG) and extracellular recordings of SPVC activities. METHODS: Twenty male Wistar rats were randomly divided into control group and model group (n=10). In the model group, occlusal interference for 30 consecutive days was induced using light-cured flowable resin on the right maxillary molars. During occlusal interference, the pain sensitivity was scored with von Frey Fibers in the masseter. Simultaneous recordings of electrical activities from the SPVC, electrocardiogram, body temperature and electromyogram of the breath muscles of the anesthetized rats were performed, and the responses evoked by electrical stimulation of the TG were analyzed. RESULTS: Compared with the control rats, the rats in the model group showed significantly increased pain sensitivity scores (P < 0.05) and increased spontaneous discharge frequency of the SPVC (P < 0.05). The amplitude of the SPVC responses induced by electrical stimulation of the TG showed stimulus intensity-dependent changes (P < 0.05), and the amplitude evoked by 4 mA and 8 mA stimulation was similar between the model group and the control group (P>0.05). Train stimulation (0.2 ms, 1 mA, 30 s, 100 Hz) of the TG significantly increased the discharge frequency of the SPVC only in the rats in the model group (P < 0.05). CONCLUSIONS: The functional activities of the pain afferent pathway of the trigeminal nerve can be electrophysiologically monitored by electrical stimulation of the TG and extracellular recordings of SPVC activities in rats. Occlusal interference can increase the excitability of the neurons in the SPVC and enhance their sensitivities to TG afferent activation, suggesting the neural plasticity of the pain afferent pathway.


Assuntos
Vias Aferentes , Medição da Dor , Limiar da Dor , Dor/fisiopatologia , Nervo Trigêmeo/fisiologia , Animais , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Núcleos do Trigêmeo
12.
Zhongguo Zhen Jiu ; 39(12): 1301-7, 2019 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-31820606

RESUMO

OBJECTIVE: To analyze the characteristics of the temperature-time curve in warm needling manipulation with the acupuncture needles made of copper, silver, gold and stainless steel and explore the applicable temperature range and most suitable needle materials of warm needling manipulation in clinical practice. METHODS: A total of 10 healthy subjects were included. Using the digital thermometer, with different moxibustion dose (1.2 g or 1.5 g, moxa), the temperature was measured at the site where the skin contacts with the needle body during the warm needling manipulation with stainless steel needle, copper needle, gold needle and sliver needle separately. The initial heat pain threshold (the temperature when hot feeling started) and the burning pain threshold (feeling very hot but tolerable) were recorded when using the different needles mentioned above. Through the subject questionnaire, the comfort degree, the heat sensation, the adverse reaction and the acceptability to warm needling manipulation with the different needles were investigated. RESULTS: During the warm needling manipulation, the initial heat pain threshold was (42.8±2.7) ℃ and the burning pain threshold was (46.7±2.9) ℃. The strongest warm stimulation was presented in the warm needling manipulation with 1.5 g moxa and silver needle and the highest temperature was (55.5±6.3) ℃, followed by (52.9±4.2) ℃ with 1.2 g moxa and silver needle, (46.6±3.7) ℃ with 1.5 g moxa and gold needle, (46.6±1.9) ℃ with 1.5 g moxa and copper needle, (43.1±1.5) ℃ with 1.2 g moxa and copper needle and (41.7±0.9) ℃ with 1.5 g moxa and stainless steel needle. The sequence of the maintaining time of the initial heat pain threshold over 43℃ was 480 s with silver needle and 1.5 moxa, 325 s with silver needle and 1.2 g moxa, 270 s with gold needle and 1.5 g moxa, 185 s with copper needle and 1.5 g moxa, 42 s with copper needle and 1.2 g moxa and 0 s with stainless steel needle and 1.5 g moxa successively. The heat score graded by the subjects to the warm needling manipulation with different needles, from high to low, was presented in the manipulation with 1.5 g moxa and silver needle, 1.2 g moxa and silver needle, 1.5 g moxa and copper needle, 1.5 g moxa and gold needle, 1.2 g moxa and copper needle and 1.5 g moxa and stainless steel needle. The VAS score was different significantly in comparison among the six needles in warm needling manipulation (P<0.001). The comfort degree of the subjects in the warm needling manipulation with silver needle and 1.5 g moxa was significantly lower than the warm needling manipulation with the other 5 materials (P<0.05). Three subjects complained that the warm needling manipulation with silver needle and 1.5 g moxa was too hot to be tolerable and the most of subjects were willing to accept warm needling manipulation with these 6 materials (acceptability 70.0% to 100.0%). Except blisters presented in 9 subjects after warm needling manipulation with silver needle and 1.5 g moxa, no severe adverse reaction occurred in warm needling manipulation with 6 materials. CONCLUSION: In the warm needling manipulation in the human body, the initial heat pain and the burning pain threshold were 43 ℃ and 47 ℃ respectively, which is the applicable temperature range of moxibustion in clinical practice. The warm needling manipulation with silver needle induces a quite strong heat stimulation and the discomfort may be caused when the temperature is exceeded to some threshold. The warm needling manipulation with copper needle generates the onset temperature, without inducing adverse reactions, e.g. discomfort and burning in the subjects.


Assuntos
Terapia por Acupuntura , Temperatura Alta , Humanos , Agulhas , Limiar da Dor , Temperatura Ambiente
13.
Acta Cir Bras ; 34(11): e201901105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31859818

RESUMO

PURPOSE: To evaluate the effects of Dexmedetomidine (Dex) on spinal pathology and inflammatory factor in a rat model of Diabetic neuropathic pain (DNP). METHODS: The rats were divided into 3 groups (eight in each group): normal group (N group), diabetic neuropathic pain model group (DNP group), and DNP model with dexmedetomidine (Dex group). The rat model of diabetes was established with intraperitoneal streptozotocin (STZ) injections. Nerve cell ultrastructure was evaluated with transmission electron microscopy (TEM). The mechanical withdrawal threshold (MWT) and motor nerve conduction velocity (MNCV) tests documented that DNP rat model was characterized by a decreased pain threshold and nerve conduction velocity. RESULTS: Dex restored the phenotype of neurocytes, reduced the extent of demyelination and improved MWT and MNCV of DNP-treated rats (P=0.01, P=0.038, respectively). The expression of three pain-and inflammation-associated factors (P2X4, NLRP3, and IL-IP) was significantly upregulated at the protein level in DNP rats, and this change was reversed by Dex administration (P=0.0022, P=0.0092, P=0.0028, respectively). CONCLUSION: The P2X4/NLRP3 signaling pathway is implicated in the development and presence of DNP in vivo, and Dex protects from this disorder.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/farmacologia , Dexmedetomidina/farmacologia , Neuropatias Diabéticas/tratamento farmacológico , Proteína 3 que Contém Domínio de Pirina da Família NLR/análise , Receptores Purinérgicos P2X4/análise , Coluna Vertebral/efeitos dos fármacos , Animais , Western Blotting , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/patologia , Neuropatias Diabéticas/patologia , Modelos Animais de Doenças , Interleucina-1beta/análise , Interleucina-1beta/efeitos dos fármacos , Masculino , Microscopia Eletrônica de Transmissão , Proteína 3 que Contém Domínio de Pirina da Família NLR/efeitos dos fármacos , Condução Nervosa/efeitos dos fármacos , Limiar da Dor , Distribuição Aleatória , Ratos Sprague-Dawley , Receptores Purinérgicos P2X4/efeitos dos fármacos , Reprodutibilidade dos Testes , Transdução de Sinais/efeitos dos fármacos , Coluna Vertebral/patologia , Estreptozocina , Nervo Sural/efeitos dos fármacos , Nervo Sural/patologia , Fatores de Tempo
14.
Zhongguo Zhen Jiu ; 39(11): 1193-8, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31724356

RESUMO

OBJECTIVE: To observe the correlation between referred pain distribution and acupoint sensitization in patients with intestinal diseases. METHODS: In clinical research, 443 patients from 8 hospitals were recruited, including the outpatients and inpatients of Crohn's disease (n=143), ulcerative colitis (n=108), chronic appendicitis (n=87) and other intestinal diseases (n=105). The site with tenderness on the body surface and the morphological changes of local skin were observed and recorded in the patients. Using a sensory tenderness instrument, the pain threshold at the sensitization point was measured in 60 patients with ulcerative colitis. In animal experiment, SD rats were used and divided into a enteritis group (n=8), in which the enteritis model were established, and a control group (n=3), in which no any intervention was given. After the injection of Evans blue (EB) at caudal vein, the blue exudation points on the body surface were observed and the distribution rule was analyzed statistically. RESULTS: The referred pain on the body surface in the patients with intestinal diseases was mainly located in the lower abdomen (93.9%, 416/443), the lumbar region (70.9%, 314/443) and the lower legs (33.0%, 146/443). The diameter of tenderness region was 1.5 to 2.5 cm. Compared with the region without sensitization, the pain threshold of the sensitization point in the patients with ulcerative colitis was reduced significantly (P<0.001). The referred pain on the body surface in the patients with appendicitis was located in the right lower abdomen (97.7%, 85/87), the waist and back (54.0%, 47/87) and the right lower limbs on the medial side (71.3%, 62/87). The tenderness region was 1 to 2 cm in diameter and was irregular in form. After modeling of enteritis in the rats, the EB exudation points were visible from T12 to L2. CONCLUSION: Intestinal diseases induce referred pain on the body surface where is the same as or adjacent to the location of the spinal segment corresponding to the affected intestinal section. These sensitization regions are related to the locations of acupoints.


Assuntos
Pontos de Acupuntura , Enteropatias , Dor Referida , Animais , Colite Ulcerativa , Humanos , Limiar da Dor , Dor Referida/diagnóstico , Dor Referida/terapia , Ratos , Ratos Sprague-Dawley , Sensação
15.
Kathmandu Univ Med J (KUMJ) ; 17(65): 51-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31734679

RESUMO

Background Pain interests clinicians and researchers alike. Several animal and human studies have attempted to establish and explain the relationship between blood pressure and nociception. Many studies have reported sex differences in pain perception in humans. However, there is no consistent evidence that authoritatively explains the relationship between resting systemic arterial blood pressure and pain sensitivity parameters in human subjects. Objective To investigate the relationship between resting systemic arterial blood pressure and pain sensitivity parameters. Secondary objectives were to investigate blood pressure response to cold pain and sex differences in response to cold pain and pain perception. Method Out of a total of 331 volunteers, 200 students (100 males and 100 females) were selected for study as per the inclusion and exclusion criteria. Cold Pressor Test was used to apply experimental pain. To study response, cardiovascular parameters (systolic blood pressure and diastolic blood pressure) and pain sensitivity parameters (pain threshold, pain tolerance and pain rating) were measured. Result Rise in resting systolic and diastolic blood pressure following Cold Pressor Test was similar between both the sexes (p > 0.05). Pain rating was found to be significantly higher in females whereas pain threshold and pain tolerance were significantly higher in males (p < 0.05). Resting blood pressure showed a positive relationship with pain threshold and pain tolerance whereas a negative relationship with pain rating. Conclusion Resting systemic arterial blood pressure and pain sensitivity are inversely correlated. Females are more sensitive to pain than males.


Assuntos
Pressão Sanguínea/fisiologia , Limiar da Dor/fisiologia , Adulto , Temperatura Baixa , Feminino , Nível de Saúde , Humanos , Índia , Masculino , Dor/diagnóstico , Fatores Sexuais , Estudantes de Medicina , Adulto Jovem
16.
Life Sci ; 239: 116961, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31654745

RESUMO

Neuropathic pain (NP) is a difficult condition to treat because of the modest efficacy of available drugs. New treatments are required. In the study we aimed to investigate the effects of the essential oil from Lippia grata alone or complexed in ß-cyclodextrin (LG or LG-ßCD) on persistent inflammatory and neuropathic pain in a mouse model. We also investigated Ca2+ currents in rat dorsal root ganglion (DRG) neurons. Male Swiss mice were treated with LG or LG/ß-CD (24 mg/kg, i.g.) and their effect was evaluated using an acute inflammatory pleurisy model and nociception triggered by intraplantar injection of an agonist of the TRPs channels. We also tested their effect in chronic pain models: injection of Freund's Complete Adjuvant and partial sciatic nerve ligation (PSNL). In the pleurisy model, LG reduced the number of leukocytes and the levels of TNF-α and IL-1ß. It also inhibited cinnamaldehyde and menthol-induced nociceptive behavior. The pain threshold in mechanical and thermal hyperalgesia was increased and paw edema was decreased in models of inflammatory and neuropathic pain. PSNL increased inflammatory protein contents and LG and LG-ßCD restored the protein contents of TNF-α, NF-κB, and PKA, but not IL-1ß and IL-10. LG inhibited voltage gated Ca2+ channels from DRG neurons. Our results suggested that LG or LG-ßCD produce anti-hyperalgesic effect in chronic pain models through reductions in TNF-α levels and PKA, and inhibited voltage-gated calcium channels and may be innovative therapeutic agents for the management of NP.


Assuntos
Hiperalgesia/tratamento farmacológico , Lippia/metabolismo , beta-Ciclodextrinas/farmacologia , Animais , Dor Crônica/tratamento farmacológico , Modelos Animais de Doenças , Gânglios Espinais/efeitos dos fármacos , Hiperalgesia/metabolismo , Masculino , Camundongos , Neuralgia/tratamento farmacológico , Nociceptividade/efeitos dos fármacos , Óleos Voláteis/farmacologia , Dor/tratamento farmacológico , Dor/metabolismo , Medição da Dor/efeitos dos fármacos , Limiar da Dor/efeitos dos fármacos , Extratos Vegetais/farmacologia , Ratos , Ratos Wistar , beta-Ciclodextrinas/metabolismo
17.
J Stroke Cerebrovasc Dis ; 28(12): 104418, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31585772

RESUMO

BACKGROUND: A concept of sensory tracts in the spinal cord has been established in relation to a dorsolateral pathway which is located in the posterior part of the lateral column and conveys the deep sense. METHODS: The clinical status at onset, neurological symptoms, and magnetic resonance imaging (MRI) findings in 13 patients of spinal cord infarction were studied. RESULTS: The clinical status was acute in 11 patients and subacute in 2 patients. Palsy of the extremities was noted in 11 patients. Segmental sensory disturbance was shown in all patients. One patient showed disturbance of all senses and paraplegia, which indicated transverse myelopathy. In the other 12 patients, 11 patients showed impairment of pain sense although joint position sense was preserved, excluding 1 patient whose sensory disturbance showed dysesthesia alone. In these 11 patients, soft touch and vibration senses were impaired in 7 patients. Abnormality of spinal cord MRI was detected 7 patients. The lesions were located in the cervical cord in 3 patients, cervical to thoracic cord in 1 patient, and thoracic cord in 3 patients. CONCLUSIONS: In the 11 patients in whom pain sense was impaired and joint position sense was preserved, involvement of the anterior spinal cord artery (ASCA) was the mainstay. Impairment of vibration sense was accompanied in 7 patients in patients of ASCA infarction. It was speculated that impairment of vibration sense can occur in patients with ASCA infarction whose ischemia spread to the dorsolateral pathway in the posterior part of the lateral column.


Assuntos
Infarto/diagnóstico , Imagem por Ressonância Magnética , Exame Neurológico , Transtornos das Sensações/diagnóstico , Sensação , Medula Espinal/irrigação sanguínea , Medula Espinal/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Humanos , Infarto/diagnóstico por imagem , Infarto/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Limiar da Dor , Valor Preditivo dos Testes , Prognóstico , Propriocepção , Reprodutibilidade dos Testes , Transtornos das Sensações/diagnóstico por imagem , Transtornos das Sensações/fisiopatologia , Tato , Vibração
18.
Stomatologija ; 21(1): 18-21, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31619659

RESUMO

OBJECTIVE: The aim of this study was to compare the Pressure Pain Threshold (PPT) of the masseter and temporal muscles in the contracted and relaxed state between patients with myofascial pain (MFP) and asymptomatic individuals. MATERIALS AND METHODS: Were included 40 women divided into two groups: test group - 20 individuals with MFP; control group - 20 asymptomatic individuals. The PPT was measured using a digital algometer. First. PPT was obtained with the relaxed muscles and soon after with the contracted muscles. To compare the mean value of the PPT of each muscle between the groups the independent Student's t-test was used. To compare the means value of the PPT between contracted and relaxed musculature within each group, the Paired Student's t-test was used. All the tests were conducted with a 5% significance level. RESULTS: Patients in Test group presented lower mean PPT values in relation to Control group (p<0.05). There was an increase in the mean PPT values with contracted muscles, but this increase was not statistically significant (p>0.05). CONCLUSION: Patients with MFP present lower PPT than asymptomatic individuals. Muscle contraction was able to increase PPT in relation to relaxed muscles, but not in a statistically significant way.


Assuntos
Limiar da Dor , Músculo Temporal , Estudos Transversais , Feminino , Humanos , Medição da Dor
19.
Clin Exp Rheumatol ; 37 Suppl 120(5): 96-99, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621573

RESUMO

Knee pain in osteoarthritis is complex and complicated by the fact that osteoarthritis is considered to be a disorder of multiple phenotypes. This complexity challenges our understanding as to why some people remain relatively symptom-free, while others progress to persistent pain. One approach to understanding the mechanisms underlying the transition to persistent pain is by identifying pain susceptibility phenotypes in people with or at risk of knee osteoarthritis. Using variables representative of the multidimensional nature of pain in people who were free of persistent pain, we identified four phenotypes characterised by low pressure pain thresholds and temporal summation and not psychosocial factors in those who developed persistent pain two years later. The group with the highest proportion of low pressure pain thresholds and a moderate proportion with facilitated temporal summation had twice the odds of developing persistent knee pain. This work provides preliminary insights into the critical importance of altered neurobiological mechanisms of pain signalling that contributes to development of chronic, persistent pain in knee osteoarthritis.


Assuntos
Dor Crônica , Osteoartrite do Joelho , Medição da Dor , Humanos , Articulação do Joelho , Osteoartrite do Joelho/patologia , Limiar da Dor , Fenótipo
20.
Artigo em Russo | MEDLINE | ID: mdl-31626213

RESUMO

AIM: To assess the efficacy of elastic kinesiotaping in the treatment of upper crossed syndrome of muscle imbalance (UCSMI) in adolescents with tension type headache (TTH). MATERIAL AND METHODS: The authors examined 65 adolescents, aged 14-17 years, with TTH with trigger zones of the pericranial muscles (myogenic trigger zones - MTZ). UCSMI was identified in all patients. The method of elastic kinesiotaping was used for the treatment of UCSMI. A number of days with headache (HA), intensity of HA assessed by the Visual Analogue Scale (VAS), pain threshold and pain tolerance threshold were evaluated. In the second stage of the study, patients were randomized into group A (33 adolescents, mean age 14.73±1.29 years, the number of days with HA 10.6±6.2, the intensity of HA 39.98±18.4 according to VAS); 2) group B (32 adolescents, mean age 13.59±2.27 years, the number of days with HA 12.4±4.5, the intensity of HA 44.8±18.8). For the next 28 days, patients of group A underwent elastic kinesio-taping, and patients of group B were taped with a medical non-elastic hypoallergenic patch (placebo). The third stage of the study included one month training. RESULTS AND CONCLUSION: By the end of the study, a statically significant positive dynamics was noted (p<0.001) for all indicators in group A (number of days with HA 1.2±1.1, intensity of HA 9.42±2.7) compared to the results before treatment and to the results in group B after treatment (the number of days with HA 9.9±4.2, the intensity of HA 41.2±15.60).


Assuntos
Albinismo Oculocutâneo , Cefaleia do Tipo Tensional , Adolescente , Albinismo Oculocutâneo/complicações , Albinismo Oculocutâneo/diagnóstico , Albinismo Oculocutâneo/tratamento farmacológico , Criança , Humanos , Medição da Dor , Limiar da Dor , Cefaleia do Tipo Tensional/complicações , Cefaleia do Tipo Tensional/diagnóstico , Cefaleia do Tipo Tensional/tratamento farmacológico
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