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1.
Oral Maxillofac Surg Clin North Am ; 34(1): 61-81, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802616

RESUMO

This article aims to provide the practitioner with therapeutic options to treat a broad spectrum of acute and chronic orofacial pain syndromes. The focus will be nonsurgical that the oral health care physician can implement to treat this population of patients. The World Health Organization estimated that more than 1 in every 3 people suffers from acute or chronic pain. This article is primarily devoted to medication management once the diagnosis of neuropathic pain, a true trigeminal neuralgia, or a variant of trigeminal neuralgia often referred to as traumatic neuropathic pain or traumatic trigeminal neuralgia.


Assuntos
Dor Crônica , Neuralgia , Neuralgia do Trigêmeo , Dor Crônica/tratamento farmacológico , Dor Facial/tratamento farmacológico , Humanos , Neuralgia/tratamento farmacológico , Síndrome , Neuralgia do Trigêmeo/tratamento farmacológico
2.
Zhonghua Yi Xue Za Zhi ; 101(43): 3521-3524, 2021 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-34808743

RESUMO

Minimally invasive interventional analgesia technique is one of the core diagnosis and treatment techniques of the pain department. It can diagnose and treat many pain diseases such as chronic musculoskeletal pain, chronic neuropathic pain and chronic cancer pain with less trauma and good effect. With the emergence of new ideas and materials, minimally invasive interventional analgesia will be widely used in the setting of chronic pain diseases, achieve the precise diagnosis and treatment and whole-process management of chronic pain diseases.


Assuntos
Analgesia Epidural , Dor Crônica , Neuralgia , Analgésicos , Humanos , Neuralgia/terapia , Manejo da Dor
3.
Zhonghua Yi Xue Za Zhi ; 101(43): 3569-3574, 2021 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-34808750

RESUMO

Objective: To explore the efficacy and safety of high-voltage long-duration pulsed radiofrequency (PRF) treatment in patients with neuralgia resulting from failed back surgery syndrome (FBSS). Methods: The clinical data of 58 patients diagnosed with neuralgia resulting from FBSS in the Department of Pain Medicine, Peking University Third Hospital from January 2017 to January 2020 were retrospectively analyzed. The patients were divided into two groups according to the treatment method. Experimental group (n=28) underwent high-voltage long-duration PRF therapy, using ultrasound and X-ray guidance to target the spinal nerve of the affected side, while control group (n=30) was applied with the standard pulsed radiofrequency therapy. Visual analogue scale (VAS), Oswestry disability index (ODI), 36-item short form health survey (SF-36), patient health questionnaire (PHQ-9) before treatment and at 1 week, 1 month, and 6 months after treatment were recorded. Meanwhile, postprocedural complications and adverse reactions were also collected. Results: VAS, ODI, SF-36 and PHQ-9 scores at 1 week, 1 month, and 6 months after treatment were significantly improved in both groups compared with their respective pre-treatment baseline scores (all P<0.01). The differences of VAS, ODI, and PHQ-9 scores between the two groups were not statistically significant at 1 month after treatment (all P>0.05). However, VAS, ODI, and PHQ-9 scores were lower in experiment group than those in control group at 6 months after treatment (all P<0.05). The marked improvement rate and total effective rate at 6 months after treatment in experiment group was 78.6% (22/28) and 92.9% (26/28), respectively, which were higher than that of control group [60.0% (18/30) and 83.3% (25/30), respectively], but the differences were not statistically significant (both P>0.05). No serious complications occurred during the whole period of treatment. Conclusions: Both treatments can effectively relieve the lower limb neuralgia. High-voltage long-term PRF has better efficacy and longer duration than standard PRF.


Assuntos
Síndrome Pós-Laminectomia , Neuralgia , Tratamento por Radiofrequência Pulsada , Síndrome Pós-Laminectomia/terapia , Humanos , Neuralgia/terapia , Medição da Dor , Estudos Retrospectivos , Resultado do Tratamento
4.
Zhonghua Yi Xue Za Zhi ; 101(43): 3581-3587, 2021 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-34808752

RESUMO

Objective: To investigate the molecular mechanism of oxaliplatin-induced chemotherapy-induced peripheral neuropathic pain (CIPNP). Methods: A total of 16 male Sprague-Dawley rats of specific pathogen-free grade were randomly divided into two groups: oxaliplatin experimental group (2.4 mg/kg oxaliplatin dissolved in 5.0% glucose solution, n=8) and control group (equal volume 5% glucose solution, n=8). The rat model of CIPNP was established by continuous administration with oxaliplatin. In addition, mechanical allodynia, thermal hyperalgesia and cold hyperalgesia were measured and compared between the two groups. To explore the molecular mechanism of oxaliplatin-induced CIPNP, the gene expression of dorsal root ganglia (DRG) from the rat model of CIPNP was analyzed using RNA sequencing (RNA-Seq). Results: Mechanical and thermal hypersensitivity was exhibited on day 7 and a stronger hypersensitivity was observed on day 14. A total of 20 152 genes were quantified by RNA-Seq, and 379 differentially expressed genes (DEGs) were obtained with absolute fold change cut-offs ≥ 2 and P value<0.05. There were 7 genes (Npy, Car3, Cdkn1a, Nts, Prc1, Ms4a7 and Ecel1) that were involved in peripheral nerve injury-related neuropathic pain. Gene ontology (GO) functional enrichment analyses indicated that the DEGs induced by oxaliplatin were involved in oxygen transport, cell division, intermediate, centromere, oxygen transporter activity, oxygen binding. Moreover, the result of Kyoto Encyclopedia of genes and genomes (KEGG) analyses highlighted that the DEGs induced by oxaliplatin were involved in malaria, African trypanosomiasis, primary immunodeficiency, peroxisome proliferator activated receptor (PPAR) signaling pathway. Conclusion: Oxaliplatin induces CIPNP via pain-related genes and signaling pathways.


Assuntos
Neuralgia , Animais , Gânglios Espinais , Hiperalgesia/induzido quimicamente , Masculino , Neuralgia/induzido quimicamente , Oxaliplatina , Ratos , Ratos Sprague-Dawley
5.
Pol Merkur Lekarski ; 49(293): 379-381, 2021 Oct 22.
Artigo em Polonês | MEDLINE | ID: mdl-34800029

RESUMO

According to International Association for the Study of Pain (IASP) neuropathic pain is defined as a pain caused by a lesion or disease of the somatosensory nervous system. In general population 7-8% adults suffer from chronic pain with neuropathic characteristic. The most common causes include: lumbar radiculopathy, postherpetic neuropathy, HIV infection, autoimmune diseases (multiple sclerosis), metabolic diseases (diabetic neuropathy), stroke or spinal cord injury. Current pharmacotherapy of neuropathic pain has insufficient effectiveness, so comprehension of neuropathic pain mechanism is necessary for research of new therapeutic methods. In the study we verify the analgesic effect of maraviroc (antagonist of the chemokine receptor - CCR5) and its potential role in the treatment of neuropathic pain. In the study we focused on dependency between opioid and chemokine receptors, because of similar structure between this receptors occurs cross-desensitization phenomenon. Chemokine antagonist maraviroc belongs to a group of entry inhibitors, antiretroviral drug. It enhances analgesic properties of opioids by inhibition of crossdesensitization of opioid's receptor. Application of maraviroc with morphine can reduce effective dosage of morphine 2,3 fold. Moreover, research show that prophylactic administration of maraviroc without opioid analgesics suppresses development of neuropathic pain symptoms. It has influence on glial phenotype, decreases secretion of proinflammatory cytokines and increases anti-inflammatory cytokine secretion. Furthermore it decreases expression of chemikine receptor mRNA and chemikine ligand's secreted by microglia and astrocytes as a result of nerve injury. We conclude that maraviroc has immunomodulatory properties, potentiates opioid analgesics effect, and can be used in neuropathic pain therapy as a potential co-analgesic.


Assuntos
Infecções por HIV , Neuralgia , Analgésicos Opioides , Infecções por HIV/complicações , Humanos , Maraviroc , Morfina , Neuralgia/tratamento farmacológico , Neuralgia/etiologia
6.
BMC Musculoskelet Disord ; 22(1): 962, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789204

RESUMO

BACKGROUND: Up to 25% of people who have had carpal tunnel release surgery (CTR) fail to report improvement; however, evidence for prognostic indicators in this surgical cohort is limited. To identify candidate prognostic factors, this study investigated the association of quantitative sensory testing (QST) derived sensory phenotype and attendant impairment with patient-reported surgical outcome. METHODS: With ethical approval and informed consent, this prospective observational longitudinal study recruited patients from two London hospitals. Multimodal phenotyping measures including quantitative sensory testing (QST), pain parameters, insomnia, pain-related worry, mood and function, were evaluated prior to; and at 3- and 6-months post-surgery. Pain in median nerve distribution with electrophysiologically confirmed conduction delay and DN4 score ≥ 4 was defined as neuropathic. Primary outcome was patient-rated change at 6 months, dichotomised as poor outcome; "worse" or "no change" and good outcome; "slightly better", "much better" or "completely cured". RESULTS: Seventy-six patients participated. Prior to surgery, substantial heterogeneity in established categories of somatosensory function was observed with 21% of participants categorised as having a healthy sensory phenotype; 29% with thermal hyperalgesia; 32% mechanical hyperalgesia and 18% sensory loss. Seventy six percent of participants were classified as having neuropathic pain, 33% with high levels of pain related worry and 64% with clinical insomnia. Observed differences in pain, sleep impairment, psychological factors and function, between sensory phenotypic groups, was not significant. At 3- and 6-months post-surgery there was significant improvement in all phenotyping measures with a moderate to large effect size. Thermal and mechanical measures of somatosensation improved (p < 0.001), as did functional ability (p < 0.001). Symptom severity diminished (p < 0.001), as did pain-related worry (p < 0.001), anxiety (p = 0.02) and insomnia (p < 0.001). Patient-rated surgical outcome was good in 92% of the cohort, poor in 8%. Baseline sensory phenotype category was not associated with surgical outcome however pain-related worry, anxiety and functional interference were significantly associated with outcome (p ≤ 0.05). CONCLUSION: In patients undergoing carpal tunnel surgery, pain-related worry, anxiety and pain functional interference are candidate prognostic outcome factors and require further elucidation.


Assuntos
Síndrome do Túnel Carpal , Neuralgia , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/epidemiologia , Síndrome do Túnel Carpal/cirurgia , Humanos , Estudos Longitudinais , Fenótipo , Sono
7.
J Indian Prosthodont Soc ; 21(4): 430-433, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34810373

RESUMO

Oral traumatic neuromas (TrNs) are relatively rare lesions and they originate from a damaged nerve. They present a diagnostic challenge, due to the complex clinical features that may mimic odontogenic, musculoskeletal, and other neuropathic pain conditions. We describe an interesting and challenging case of painful bilateral intraoral lesions in a 56-year-old South Indian female patient who presented with clinical features consistent with TrN lesions bilaterally, in relation to different branches of the trigeminal nerve. The patient had undergone numerous aggressive dental treatments and interventions over the past three decades, with little or no pain relief. Topical treatment with lidocaine gel utilizing a custom-made neurosensory stent rendered the patient significant and sustained pain relief.


Assuntos
Neuralgia , Neuroma , Administração Tópica , Feminino , Humanos , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Neuroma/diagnóstico , Manejo da Dor
8.
JAAPA ; 34(12): 54-56, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34813535

RESUMO

ABSTRACT: A review of the recent literature found that compared with placebo or other pain medications, gabapentin did not significantly reduce nonneuropathic pain. The drug also is associated with an increased risk of adverse reactions, including somnolence, dizziness, and nausea. Given the lack of efficacy and risk of adverse reactions, gabapentin should not be used for nonneuropathic pain.


Assuntos
Ácidos Cicloexanocarboxílicos , Neuralgia , Aminas/efeitos adversos , Analgésicos/efeitos adversos , Ácidos Cicloexanocarboxílicos/efeitos adversos , Gabapentina , Humanos , Neuralgia/tratamento farmacológico , Ácido gama-Aminobutírico/efeitos adversos
9.
Eur J Neurosci ; 54(10): 7409-7421, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34618385

RESUMO

The activation of spinal astrocytes and release of neuroinflammatory mediators are important events in neuropathic pain (NP) pathogenesis. In this study, we investigated the role of Wnt10a/ß-catenin signalling in kindlin-1-mediated astrocyte activation using a chronic constriction injury (CCI) NP rat model. Using kindlin-1 overexpression and knockdown plasmids, we assessed hyperalgesia, changes in spinal astrocyte activation and the release of inflammatory mediators in a NP rat model. We also performed coimmunoprecipitation, Western blotting and real-time polymerase chain reaction (PCR) to characterize the underlying mechanisms of kindlin-1 in astrocyte cultures in vitro. Kindlin-1 was significantly upregulated in CCI rats and promoted hyperalgesia. Moreover, we observed increased kindlin-1, Wnt10a and glial fibrillary acidic protein (GFAP; biomarker for astroglial injury) levels and the release of inflammatory mediators in NP rats (p < 0.05). Inhibiting GFAP in vitro led to decreased kindlin-1 levels, prevented astrocyte activation, decreased Wnt10a level and the release of inflammatory mediators (p < 0.05). Coimmunoprecipitation showed that kindlin-1 can interact with Wnt10a. We showed that kindlin-1-mediated astrocyte activation was associated with Wnt10a/ß-catenin signalling and the downstream release of inflammatory mediators in a CCI NP rat model. Our findings provide novel insights into the molecular mechanisms of kindlin-1-mediated astrocyte activation after CCI.


Assuntos
Astrócitos , Neuralgia , Animais , Hiperalgesia , Ratos , Ratos Sprague-Dawley , Proteínas Wnt , beta Catenina
10.
Molecules ; 26(20)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34684749

RESUMO

The current protocols for neuropathic pain management include µ-opioid receptor (MOR) analgesics alongside other drugs; however, there is debate on the effectiveness of opioids. Nevertheless, dose escalation is required to maintain their analgesia, which, in turn, contributes to a further increase in opioid side effects. Finding novel approaches to effectively control chronic pain, particularly neuropathic pain, is a great challenge clinically. Literature data related to pain transmission reveal that angiotensin and its receptors (the AT1R, AT2R, and MAS receptors) could affect the nociception both in the periphery and CNS. The MOR and angiotensin receptors or drugs interacting with these receptors have been independently investigated in relation to analgesia. However, the interaction between the MOR and angiotensin receptors has not been excessively studied in chronic pain, particularly neuropathy. This review aims to shed light on existing literature information in relation to the analgesic action of AT1R and AT2R or MASR ligands in neuropathic pain conditions. Finally, based on literature data, we can hypothesize that combining MOR agonists with AT1R or AT2R antagonists might improve analgesia.


Assuntos
Dor Crônica/tratamento farmacológico , Receptores de Angiotensina/efeitos dos fármacos , Receptores Opioides mu/efeitos dos fármacos , Analgésicos/farmacologia , Analgésicos Opioides/farmacologia , Animais , Humanos , Neuralgia/tratamento farmacológico , Nociceptividade/efeitos dos fármacos , Manejo da Dor/métodos , Receptores de Angiotensina/metabolismo , Receptores Opioides/agonistas , Receptores Opioides mu/agonistas , Receptores Opioides mu/metabolismo
11.
Molecules ; 26(20)2021 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-34684842

RESUMO

Products derived from the plant Cannabis sativa are widely appreciated for their analgesic properties and are employed for the treatment of chronic neuropathic pain. Only nabiximols, a product composed of two extracts containing similar percentages of the two cannabinoids cannabidiol and delta-9-tetrahydrocannabinol, is approved by regulatory authorities for neuropathic pain and spasticity due to multiple sclerosis in many European countries and Canada. It is also included in pharmacovigilance systems monitoring the occurrence of adverse drug reactions. However, it is not the same for the great variety of other cannabis preparations widely used for medical purposes. This creates a situation characterized by insufficient knowledge of the safety of cannabis preparations and the impossibility of establishing a correct risk-benefit profile for their medical use in the treatment of chronic neuropathic pain. With the aim to explore this issue more deeply, we collected data on adverse reactions from published clinical studies reporting the use of cannabis for neuropathic relief.


Assuntos
Analgésicos/farmacologia , Cannabis/química , Dor Crônica/tratamento farmacológico , Maconha Medicinal/farmacologia , Neuralgia/tratamento farmacológico , Animais , Canadá , Europa (Continente) , Humanos , Manejo da Dor/métodos
12.
J Oral Facial Pain Headache ; 35(3): 218-229, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34609380

RESUMO

AIMS: To conduct a systematic review compiling an update on the pathophysiology of burning mouth syndrome (BMS) by reviewing the theories and studies published in the last 5 years that consider BMS a neuropathic disease. METHODS: A literature review was carried out in April 2020 on the PubMed database by using the following MeSH terms: "(burning mouth OR burning mouth syndrome OR burning mouth pain OR sore mouth OR burning tongue OR oral neuropathic pain OR glossodynia OR stomatopyrosis) AND (etiopathogenesis OR etiopathological factors OR etiology)." RESULTS: The research carried out according to the methodology found 19 case-control studies (1 of which was in vivo) and 1 RCT. Of the 19 included studies, 8 showed an evidence score of 2-; 8 showed 2+; another 2 showed 2++; and 1 showed 1+. Quality studies on this topic are insufficient and heterogenous. CONCLUSION: In the pathogenesis of BMS, both peripheral and central neuropathies appear to play a pivotal role. Nevertheless, the balance between them varies from case to case and tends to overlap. BMS does not seem to be a result of direct damage to the somatosensory nervous system, but a dysfunction in it and in the brain network.


Assuntos
Síndrome da Ardência Bucal , Neuralgia , Síndrome da Ardência Bucal/etiologia , Estudos de Casos e Controles , Humanos , Neuralgia/etiologia
13.
J Transl Med ; 19(1): 430, 2021 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-34656120

RESUMO

BACKGROUND: Central itch syndrome has been previously described in conditions such as stroke. The neurophysiology of central itch syndrome has been investigated in non-human primates but remains incompletely understood. METHODS: We report an observational study of a rare case of severe central itch following thalamic deep brain stimulation and postulate the location of the central itch centre in humans. RESULTS: The patient was a 47-year-old female, with congenital spinal malformations, multiple previous corrective spinal surgeries and a 30-year history of refractory neuropathic pain in her back and inferior limbs. Following multidisciplinary pain assessment and recommendation, she was referred for spinal cord stimulation, but the procedure failed technically due to scarring related to her multiple previous spinal surgeries. She was therefore referred to our centre and underwent bilateral deep brain stimulation (DBS) of the ventral posterolateral nucleus of the thalamus for management of her chronic pain. Four weeks after switching on the stimulation, the patient reported significant improvement in her pain but developed a full body progressive itch which was then complicated with a rash. Common causes of skin eczema were ruled out by multiple formal dermatological evaluation. A trial of unilateral "off stimulation" was performed showing improvement of the itchy rash. Standard and normalized brain atlases were used to localize the active stimulating contact within the thalamus at a location we postulate as the central itch centre. CONCLUSIONS: Precise stereotactic imaging points to the lateral portion of the ventral posterolateral and posteroinferior nuclei of the thalamus as critical in the neurophysiology of itch in humans.


Assuntos
Dor Crônica , Estimulação Encefálica Profunda , Neuralgia , Animais , Feminino , Humanos , Neuralgia/terapia , Medição da Dor , Tálamo
14.
ACS Chem Neurosci ; 12(20): 3855-3863, 2021 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-34610235

RESUMO

Local tissue ischemic hypoxia is a peripheral process that can be targeted with topical treatment to alleviate pain under chronic pain conditions such as complex regional pain syndrome (CRPS) and peripheral neuropathic pain. We recently reported three novel salts and a co-crystal composed of vasoactive agents and antioxidant nutraceuticals, all of which produced potent topical anti-allodynic effects in the chronic postischemic pain (CPIP) rat model of CRPS. One of the products, pentx-pca, is a co-crystal synthesized from pentoxifylline (pentx) and protocatechuic acid (pca). Pentx-pca exhibited potent topical anti-allodynic effects in CPIP and rats with chronic constriction injury of the sciatic nerve exceeding effects produced individually by pentx and pca. We hypothesized that the anti-allodynic effects of pentx-pca in CPIP rats were due to its impact on local tissue oxygenation and subsequent oxygen-dependent mitochondrial respiration. Percutaneous tissue oxygen saturation (SaO2) measurements taken from the hind paw of the CPIP rats revealed that anti-allodynic doses of topical pentx-pca increased local tissue SaO2. Moreover, assessment of the oxygen-dependent mitochondrial function using a triphenyl tetrazolium chloride assay revealed that mitochondrial dysfunction significantly declined in the plantar muscle collected from CPIP rats topically treated with anti-allodynic doses of pentx-pca as compared to vehicle-treated CPIP rats. Furthermore, time-dependent resolution of plantar muscle mitochondrial dysfunction, that occurred in the CPIP rats at 6-week post procedure, paralleled the loss of the anti-allodynic response to topical treatment with pentx-pca. Our results indicated that pentx-pca produced potent anti-allodynic effects in the CPIP rat model of CRPS by alleviating peripheral tissue ischemia/hypoxia and downstream hypoxia-driven mitochondrial dysfunction.


Assuntos
Síndromes da Dor Regional Complexa , Neuralgia , Pentoxifilina , Animais , Modelos Animais de Doenças , Hidroxibenzoatos , Hiperalgesia/tratamento farmacológico , Hipóxia , Neuralgia/tratamento farmacológico , Pentoxifilina/farmacologia , Ratos
15.
Agri ; 33(4): 268-271, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34671951

RESUMO

Duloxetine is a serotonin-norepinephrine reuptake inhibitor that is widely used in chronic pain treatment in various diseases. Hyperprolactinemia and galactorrhea are rare side effects of this medication. Here, we reported a 34-year-old female with multiple sclerosis who used duloxetine for pain management and mood disorder and experienced galactorrhea.


Assuntos
Galactorreia , Hiperprolactinemia , Neuralgia , Adulto , Cloridrato de Duloxetina/efeitos adversos , Feminino , Galactorreia/induzido quimicamente , Humanos , Hiperprolactinemia/induzido quimicamente , Hiperprolactinemia/tratamento farmacológico
17.
Int J Surg ; 95: 106140, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34628075

RESUMO

BACKGROUND: Neuropathic pain (NP) severely affects the quality of life; however, there is no effective long-term treatment. The spinal dorsal horn (SDH) is an essential target for studying NP mechanisms and clinical treatments. MATERIALS AND METHODS: We searched the Gene Expression Omnibus (GEO) for the datasets of SDH microarray changes in mice NP models. Bioinformatics analysis was conducted to identify differentially expressed genes (DEGs), DEG enrichment pathways, and critical hub genes in the datasets. Finally, we explored the expression, function, and relevant mechanisms of the mouse NP model's most critical hub gene. RESULTS: Two SDH microarray datasets for the mice NP model were retrieved from GEO, GSE75072, and GSE111216. We found 43 overlapping DEGs in the datasets, primarily in the inflammatory and immune pathways. The most essential hub gene was the colony-stimulating factor 1 receptor (CSF1R). Seven days after creating the mouse NP model-spared nerve injury (SNI) model or Sham model, the expression of CSF1R and microglia increased significantly in the SDH of SNI group. PLX3397, an inhibitor of CSF1R, reduced the SDH CSF1R and microglia expression after SNI and significantly alleviated the hyperalgesia in the SNI mice. CONCLUSION: SDH CSF1R participates in regulation NP, which is related to changes in the activity of microglia in the SDH.


Assuntos
Biologia Computacional , Neuralgia , Animais , Modelos Animais de Doenças , Genes Essenciais , Camundongos , Neuralgia/genética , Qualidade de Vida , Receptores de Fator Estimulador das Colônias de Granulócitos e Macrófagos , Corno Dorsal da Medula Espinal
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