Factors related to acupuncture response in patients with chronic prostatitis/chronic pelvic pain syndrome: secondary analysis of a randomized controlled trial.

PURPOSE: Acupuncture has been recommended as an effective therapy to improve symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We conducted this secondary analysis to explore the factors that may influence the response of patients with CP/CPPS to acupuncture. METHODS: This secondary analysis was based on a randomized controlled trial demonstrating the efficacy of acupuncture among patients with CP/CPPS. Responder is defined as a patient with a decrease of ≥ 6 points in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score from baseline at the 32 week. 206 patients who received acupuncture treatment and completed 32-week follow-up were included in this secondary analysis. Descriptive statistics were used to describe the demographic and clinical characteristics of both responders and non-responders in acupuncture group. Logistic regression analysis with bootstrapping was made to identify potential factors that contributed to the effectiveness of acupuncture for treating CP/CPPS. Responders and non-responders were listed as dependent variables. RESULTS: In this study, 130 (63.11%) patients were assessed as responders. The results showed that men with non-sedentariness (OR 4.170 [95%CI 1.837 to 9.463; P = 0.001]), non-smoking habit (OR 2.824 [95%CI 1.453 to 5.487; P = 0.002]), without comorbidity (OR 8.788 [95%CI 1.912 to 40.295; P = 0.005]), and severe NIH-CPSI total score (OR 0.227 [95%CI 0.114 to 0.450; P < 0.0001]) benefited more from acupuncture intervention. CONCLUSION: CP/CPPS patients who are active, non-smokers, without comorbidity, and had severe symptoms may be more likely to respond to acupuncture.

Consistency of inconsistency in long-COVID-19 pain symptoms persistency: A systematic review and meta-analysis.

INTRODUCTION: Individuals recovering from acute COVID-19 episodes may continue to suffer from various ongoing symptoms, collectively referred to as Long-COVID. Long-term pain symptoms are amongst the most common and clinically significant symptoms to be reported for this post-COVID-19 syndrome. OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the proportions of persisting pain symptoms experienced by individuals past the acute phase of COVID-19 and to identify their associated functional consequences and inflammatory correlates. METHODS: Two online databases were systematically searched from their inception until 31 March 2022. We searched primary research articles in English, which evaluated individuals after laboratory-confirmed COVID-19 acute phase resolution and specifically reported on pain symptoms and their inflammatory and/or functional outcomes. RESULTS: Of the 611 identified articles, 26 were included, used for data extraction, and assessed for their methodological quality and risk of bias by two independent reviewers. Pain symptoms were grouped under one of six major pain domains, serving as our primary co-outcomes. Proportional meta-analyses of pooled logit-transformed values of single proportions were performed using the random-effects-restricted maximum-likelihood model. An estimated 8%, 6%, 18%, 18%, 17%, and 12% of individuals continued to report the persistence of chest, gastrointestinal, musculoskeletal joint, musculoskeletal muscle, general body, and nervous system-related pain symptoms, respectively, for up to one year after acute phase resolution of COVID-19. Considerable levels of heterogeneity were demonstrated across all results. Functional and quality-of-life impairments and some inflammatory biomarker elevations were associated with the persistence of long-COVID pain symptoms. CONCLUSION: This study's findings suggest that although not well characterized, long-COVID pain symptoms are being experienced by non-negligible proportions of those recovering from acute COVID-19 episodes, thus highlighting the importance of future research efforts to focus on this aspect.

Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women's Health.

BACKGROUND: Endometriosis has been linked to higher rates of a variety of symptoms; however, the findings from longitudinal studies are scarce and inconsistent. OBJECTIVE: This study aimed to examine the association between endometriosis and common symptoms in a prospective cohort study. STUDY DESIGN: This study included 7606 women born from 1973 to 1978 using data from the Australian Longitudinal Study on Women's Health that were collected every 3 years from 2009 to 2018. We identified women with endometriosis based on self-reported incidence from each survey and linked administrative health data. At each survey, women also completed a checklist on the presence of 24 symptoms. Generalized estimating equations for multinomial responses were used for analyses. RESULTS: Women with endometriosis had significantly more menstrual symptoms than those without endometriosis with an adjusted odds ratio (95% confidence interval) of 3.61 (3.11-4.19) for severe period pain, 2.40 (2.10-2.74) for heavy menstrual bleeding, 1.76 (1.52-2.03) for irregular bleeding, and 1.52 (1.32-1.76) for premenstrual tension. They also had higher odds of mental health problems with adjusted odds ratios of 1.67 (1.39-2.01) for depression and 1.59 (1.24-2.03) for anxiety and higher odds of allergies and nonspecific symptoms with adjusted odds of 1.62 (1.40-1.89) for allergies or hay fever or sinusitis, 1.79 (1.56-2.05) for severe tiredness, 1.56 (1.35-1.81) for sleep difficulty, and 1.77 (1.37-2.18) for palpitations. There was also a strong association with other forms of pain with an adjusted odds ratio of 1.76 (1.53-2.04) for backpain, 1.50 (1.29-1.74) for headaches or migraines, and 1.65 (1.41-1.93) for stiff or painful joints. Women with endometriosis also had increased odds of developing bowel and urinary symptoms with an adjusted odds ratio (95% confidence interval) of 1.67 (1.35-2.08) for constipation, 1.46 (1.12-1.90) for hemorrhoids or piles, 1.25 (1.03-1.52) for indigestion or heartburn, 2.80 (1.71-4.58) for urine burn or stings, and 1.37 (1.03-1.82) for vaginal discharge or irritation. The association between each symptom and endometriosis was similar whether endometriosis was surgically confirmed or clinically suspected. No association was found between endometriosis and the risk for skin problems, leaking urine, or breathing difficulty. CONCLUSION: This study suggests that women with endometriosis are more likely to report not only menstrual symptoms but are also at an increased risk for mental health problems, other pain symptoms, bowel and urinary symptoms, and nonspecific symptoms, such as severe tiredness and difficulty sleeping.

Orofacial pain among Chinese older adults in the last year of life.

OBJECTIVE: To examine the prevalence of orofacial pain and associated factors in Chinese older adults at the end of life. METHODS: This cross-sectional study included 1646 participants (65 years or older) in their last year of life from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used the 6-month prevalence questions to measure two specific orofacial pain symptoms: toothache, and jaw or facial pain. Logistic regression analyses were used to examine factors, such as socioeconomic status, health behaviours and chronic diseases, that were associated with these two orofacial pain symptoms in the last year of life. RESULTS: The 6-month prevalence estimates for toothache and jaw pain or facial pain for older adults in the last year of life were 14.1% and 4.5% respectively. Higher socioeconomic status was associated with lower odds of toothache and jaw pain or facial pain. Smoking was associated with high odds of toothache. Participants who brushed their teeth at least once a day were more likely to have toothache and jaw or facial pain than those who did not. Having any chronic conditions was associated with higher odds of toothache and jaw or facial pain. Older adults who had at least one tooth were more likely to have jaw or facial pain than those without any teeth. CONCLUSION: A considerable proportion of Chinese older adults in their last year of life reported toothache and/or jaw pain or facial pain. These findings suggest that appropriate measures need to be taken to address the oral health needs in these vulnerable individuals, especially those of low socioeconomic status and chronic conditions.

Evaluation of musculoskeletal discomfort using item response theory: creation of a scale based on the self-reported pain symptoms.

This study aims to build a scale for musculoskeletal discomfort based on the self-reported musculoskeletal pain by individuals. For this, methods such as factorial analysis and item response theory were used. A sample of 1821 workers of a footwear industry participated in this study. The scale consists of four levels ranging from mild to maximum discomfort. In mild discomfort (level 60), pain symptoms are rare or frequent in regions such as cervical and trapezoidal area, low back, shoulders, wrists, ankles and feet. At level 70, rare or frequent symptoms affect regions of the upper and lower limbs. At level 80, frequent symptoms become common in the trunk and in most of the upper and lower limbs. At level 90, the symptoms become daily in elbows, thighs and knees. The scale showed signs of validity and proved useful for studies in ergonomics. Practitioner Summary: Methods such as factor analysis and item response theory were used to build a four-level musculoskeletal discomfort scale that can be useful to complement the screening process for workers with musculoskeletal pain. The scale shows signs of accuracy, in addition to validity and reliability. Abbreviations: WMSD: work-related musculoskeletal disorders; CTT: classic test theory; IRT: item response theory; KMO: Kaiser-Meyer-Olkin; PR: pain rarely; PO: pain often; PE: pain everyday; DIF: differential item functioning.

[Cannabis medicines in pain management : Interim analysis of the survey accompanying the prescription of cannabis-based medicines in Germany with regard to pain as primarily treated symptom]. / Cannabisarzneimittel in der Schmerztherapie : Zwischenauswertung der Cannabisbegleiterhebung hinsichtlich der primär behandelten Symptomatik Schmerz.

BACKGROUND: In Germany, physicians who prescribe cannabis-based medicines at the expense of the statutory health insurance are obliged to take part in an accompanying survey. Pain was the most commonly reported diagnosis, making an interim evaluation for the indication of pain feasible. METHODS: Patient-related data was transmitted to the German Federal Institute for Drugs and Medical Devices via an online portal. In addition to demographic data, information on the treated disease or symptoms, the course of therapy, adverse reactions and treatment success were evaluated. RESULTS: A total of 3138 data sets were evaluated for the main diagnosis of pain. Dronabinol was the most frequently (64%) prescribed cannabis-based drug. On average, patients were 57 years old and women and men were equally represented. Patients treated with cannabis flowers were significantly younger (48 years). The proportion of men in this group was 68% and 83% in the group of 18- to 40-year-olds. According to the assessment by treating physicians, pain was significantly improved in 35.5% of the patients. The most frequent side effects (fatigue, dizziness, nausea) corresponded to those already known from the product information of the cannabis-based medicinal products authorized under the pharmaceutical law. Treatment was discontinued in 1179 patients within 1 year. CONCLUSION: Physicians should comply with their legal obligation to participate in the accompanying survey. Pain is by far the most common diagnosis in cannabis drugs. For about one third of these patients, physicians reported a clear improvement in pain. Due to the amount of data hitherto and the limitations in the accompanying survey, the results should not be overinterpreted in terms of efficacy and should always be related to existing reviews. The lower age and higher proportion of men among patients treated with cannabis flowers were remarkable. At 37.6%, the overall drop-out rate was high. The most frequent side effects related to vigilance and are therefore highly relevant in terms of driving ability, work ability and risk of falling. For a differentiated evaluation of treatment success, more data needs to be available.

Pain and fertility outcomes of nerve-sparing, full-thickness disk or segmental bowel resection for deep infiltrating endometriosis-A prospective cohort study.

INTODUCTION: Choosing the optimal treatment for bowel endometriosis, ie, conservative vs radical surgery, is under debate. We aimed to evaluate the surgical outcomes of segmental resection and disk resection regarding fertility, pain symptoms, and quality of life score of women with colorectal deep infiltrating endometriosis. MATERIAL AND METHODS: From March 2011 to December 2016, 134 consecutive patients with symptomatic deep infiltrating endometriosis of the rectosigmoid up to 25 cm from the anal verge undergoing segmental resection or disk resection were prospectively evaluated regarding reduction in pain symptoms, fertility outcomes, and complication rates according to Clavien-Dindo classification. RESULTS: Of the 134 women included, segmental resection was performed in 102 (76.1%) women and disk resection was performed in 32 (23.9%) women. There was no difference in duration of surgery, complication rates, mean hospital stay, or discrepancy in hemoglobin level comparing the two groups. There was no significant difference regarding reduction of pain symptoms, fertility, and functional outcomes. One hundred and twelve (83.6%) women were followed up long-term. In both cohorts, there was a significant reported decrease in pain symptoms and increase in quality of life scores. Of all the 61 infertile women, 26 (42.6%) became pregnant spontaneously, and 13 (21.3%) by in vitro fertilization with an overall pregnancy rate of 63.4%. The overall complication rate (Clavien-Dindo III-IV) was 8 of 134 (5.9%) without statistically significant difference between the cohorts. CONCLUSIONS: Both conservative surgery with disk resection, and nerve- and vessel-sparing segmental resection reduce pain symptoms with equal morbidity. Fertility is improved with surgery with both techniques.

Transitional object use in adolescence: a developmental phenomenon or a sign of problems?

BACKGROUND: Transitional object (TO) use is suggested to be related with various health problems. Prolonged TO use in adolescence is quite common, and research on its associations with health and psychosocial wellbeing is relevant because it does not necessarily represent pathologies in this age group. AIMS: To investigate the role of transitional phenomena and attachment to an inanimate object in adolescence, possible explanatory variables were studied, including sociodemographic and psychosocial factors and self-image. METHODS: The study group consisted of 992 subjects (433 boys and 559 girls), mean age 14.5 years (SD = 0.5), who were studying at comprehensive schools in the City of Turku, Finland. Information about the TO use and background data were collected with a semi-structured questionnaire. Mental distress and self-esteem were assessed by the Offer Self-Image Questionnaire (OSIQ). RESULTS: The multivariable logistic regression analysis revealed that, in the whole study group, significant explanatory factors for the TO use included female gender (p < 0.0001), frequent pain and aches (p = 0.008), and, of the OSIQ sub-scales, low Emotional Health (p = 0.006). For girls, significant explanatory factors for the TO use were pain and aches (p = 0.003) and low Emotional Health (p = 0.002). For boys, the only statistically significant explanatory factor was pain and aches (p = 0.02). CONCLUSIONS: The TO may serve as a soothing element for somatoform pain symptoms in adolescence. Identifying of the TO use may help one see an adolescent's possible distress, symptoms of pains, and problems in psychological resilience.

Effect of frequent WBC treatments on the back pain therapy in elderly men.

Cryotherapy is the application of a stimulus of a cryotherapeutic temperature below -100 °C in a period of 1-3 min in order to stimulate and use physiological reactions of human body to cold. It can be applied to specific body parts or to a whole body. Whole-body cryotherapy is a treatment method applied in treatment of motor organ issues, nervous system diseases, psychiatry, dermatology and laryngology. The research group consisted of 80 male in the age range of 65-77 suffering from chronic, lasting more than 3 months, lower back pain. The subjects qualified to the research were divided into two groups. Group A consisted of 40 patients who participated in whole-body cryotherapy (WBC) twice a week. Group B also contained 40 patients who participated in WBC whole week. Examinations were conducted twice. The first one was conducted before the commencement of the treatment while the second one after the therapy was over. The results of the research did not show any statistically significant improvement in patients from Group A. However, the results obtained by Group B have proven significant condition improvement and enable the researchers to conclude that WBC is effective in treating patients with lower back pain.

A modified Delphi survey on the signs and symptoms of low back pain: indicators for an interventional management approach.

BACKGROUND: Low back pain (LBP) symptoms and signs are nonspecific. If required, diagnostic blocks may find the source of pain, but indicators of suspect diagnosis must be defined to identify anatomical targets. OBJECTIVE: To reach a consensus from an expert panel on the indicators for the most common causes of LBP. MATERIAL AND METHODS: A 3-round (2 telematic and 1 face-to-face) modified Delphi survey with a questionnaire on 78 evidence-based indicators of 7 LBP etiologies was completed by 23 experts. RESULTS: 98.7% of the questionnaire was consensuated. The most accepted indicators were for zygapophysial joint pain, painful ipsilateral paravertebral palpation, worsening with trunk extension, paravertebral musculature spasm on the affected articulation, and referred pain above the knee, without radicular pattern. For sacroiliac joint pain, unilateral pain when seating, with at least 3 described provoking tests: Approximation; gapping; Patrick's; Gaenslen's; thigh thrust; Fortin finger; and Gillet's tests. For discogenic pain, midline pain that may be provoked by pressure on the spinal processes at the affected level; for quadratus lumborum muscle, painful palpation on both the L1 level paravertebral region, referred to iliac crest, and the iliac crest, referred to greater trochanter. For iliopsoas muscle, pain elicited by thigh flexion, referred to buttock, inguinal region, and anterior thigh. For pyramidal muscle, pain while sitting on the affected side and positive Freiberg's test. For radicular pain, paresthesias and positive Lassègue's test at 60°. CONCLUSION: Seventy-seven diagnostic suspect indicators of LBP conditions were consensuated. These may facilitate conservative or interventional pain management decision-making.

Effect of cryotherapy on the lumbar spine in elderly men with back pain.

Whole-body cryotherapy (WBC) is a procedure which is more and more often successfully applied in medicine. Used in physiotherapy programs improves the efficiency of physiotherapeutic exercises applied in different aliments. The aim of the research was to determine the influence of WBC treatment on the improvement of spine activity in elderly men. The evaluation was based on subjects suffering from chronic lower back pain. The research was conducted on 96 male in the age of 65-75 years suffering from chronic pain in the lumbar spine, lasting >3 months. All the subjects performed physical exercises at a gym. Half of the examined patients performed only physical exercises while the second half of the group participated in WBC before performing the same exercises. The research evaluated the mobility of lumbar spine at all movement planes and examined the values of active potentials of erector spinae in the lumbar part of the spine. The group of men who participated in WBC showed significantly lower values of active potentials of erector spinae muscles in the lumbar part of the spine and a significant increase in the range of the lumbar spine mobility, in comparison to the group which did not use WBC.

Assessment of the musculoskeletal discomfort scale for upper limb among workers in inner Brazil.

BACKGROUND: Work-related musculoskeletal disorders for upper limbs (UL-WMSDs) form a complex of occupational diseases common to many professions worldwide. UL-WMSDs are manifested in most cases by pain, resulting in musculoskeletal discomfort. OBJECTIVE: This research aimed to evaluate the perception of musculoskeletal discomfort in workers from the interior of the Brazilian states of Alagoas and Bahia through the construction of a scale to assess musculoskeletal discomfort for upper limb. METHODS: The discomfort assessment scale was constructed from self-reported pain symptoms by 420 workers from the inner regions of the Brazilian states of Alagoas and Bahia. The reliability and dimensionality of the collected data were analyzed by McDonald's Omega and exploratory factor analysis, respectively. Item Response Theory (IRT) was used to create parameters for the discomfort scale. RESULTS: The musculoskeletal discomfort metric was constructed from the workers' response with six levels (varying from minimum discomfort to maximum discomfort). At the lowest level of the scale, workers indicated symptoms in the shoulders and wrists were rare. At the highest level of the scale, daily pain symptoms are reported in all regions of the upper limbs. The shoulders are the last region to develop extreme pain symptoms. CONCLUSION: The metric was created to present satisfactory psychometric properties and capable measurement of the workers' level of musculoskeletal discomfort based on self-reported pain symptoms. Therefore, the metric can support measuring discomfort, contributing to decisions that improve a healthier occupational environment for the worker.

Perceived discrimination and its association with self-rated health, chronic pain, mental health, and utilization of health services among Syrian refugees in Norway: a cross-sectional study.

Background: There is a scarcity of research on discriminatory experiences and their association with health outcomes among Syrian Refugees in Norway. Thus, this study aims to examine the relationship between perceived discrimination, self-rated health (SRH), chronic pain, poor mental health, and healthcare utilization among Syrian refugees resettled in Norway. Methods: Cross-sectional data from the Integration for Health project were analyzed, including 154 Syrian refugees who resettled in Norway in 2018-19. Perceived discrimination, SRH, chronic pain, psychological distress, post-traumatic stress symptoms, and healthcare visits were assessed. Statistical analyses, including Poisson regression and multinomial logistic regression, were conducted. The significant statistical level was set at 0.05. Results: Approximately 30% of participants reported experiencing discrimination, with no significant associations between sociodemographic factors and perceived discrimination. Perceived discrimination was significantly associated with psychological distress (adjusted PR: 2.07, 95%CI: 1.21-3.55), post-traumatic stress symptoms (adjusted PR: 11.54, 95%CI: 1.25-106.16), and 4 or more psychologist visits (adjusted OR: 12.60, 95%CI: 1.72-92.16). However, no significant associations were found between perceived discrimination and SRH; pain symptoms, or general healthcare utilization. Conclusion: Experienced discrimination is highly prevalent and seems to be associated with mental health outcomes, but not clearly with SRH, pain, or general healthcare visits among Syrian refugees living in Norway. Efforts should focus on reducing discrimination, promoting social inclusion, and improving access to mental health services for refugees. Public awareness campaigns, anti-discrimination policies, and cultural training for healthcare professionals are recommended to address these issues and improve the well-being of Syrian refugees in Norway.

[Effects of Zhoutian moxibustion on pain symptoms and inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction].

OBJECTIVE: To observe the effects of Zhoutian moxibustion on pain symptoms and serum inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction. METHODS: Eighty-four patients with ankylosing spondylitis of cold-damp obstruction were randomly divided into a Zhoutian moxibustion group (42 cases, 2 cases dropped out) and a governor vessel moxibustion group (42 cases, 2 cases dropped out, 1 case discontinued). Both groups were given oral administration of sulfasalazine enteric-coated tablets as basic treatment. The governor vessel moxibustion group was treated with moxibustion box from Dazhui (GV 14) to Yaoyangguan (GV 3), one hour per treatment; the Zhoutian moxibustion group was treated with moxibustion box from Tiantu (CV 22) to Zhongji (CV 3) in addition to the governor vessel moxibustion group, two hours per treatment. Both groups were treated once every 3 days, twice a week, for a total of 9 weeks. The pain symptom scores of the two groups were observed before treatment and at the 3rd, 6th, and 9th weeks into treatment. ELISA was used to detect the levels of serum interleukin (IL)-1ß, IL-18, and tumor necrosis factor-α (TNF-α) before and after treatment, and the clinical efficacy of the two groups was evaluated after treatment. RESULTS: Except for the joint pain scores at the 3rd week into treatment, the total scores and the each sub-item score of pain symptom in the two groups were lower than those before treatment at the 3rd, 6th, and 9th weeks into treatment (P<0.05); at the 3rd, 6th, and 9th weeks into treatment, the total scores of pain symptom and the scores of lumbar sacral pain, back pain, joint cold pain, and limited mobility in the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group (P<0.05). After treatment, the levels of serum IL-1ß, IL-18 and TNF-α in both groups were lower than those before treatment (P<0.05), and the levels of serum IL-1ß, IL-18, and TNF-α in the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group (P<0.05). The total effective rate was 90.0% (36/40) in the Zhoutian moxibustion group, which was higher than 76.9% (30/39) in the governor vessel moxibustion group (P<0.05). CONCLUSION: Zhoutian moxibustion could effectively improve various pain symptoms in patients with ankylosing spondylitis of cold-damp obstruction, and reduce the expression of inflammatory factors.

Construction of a Musculoskeletal Discomfort Scale for the Lower Limbs of Workers: An Analysis Using the Multigroup Item Response Theory.

Musculoskeletal symptoms are a major occupational health problem in workers, and these can affect all professional occupations. Previous studies have proposed metrics capable of evaluating the musculoskeletal discomfort experienced by workers. However, no study has developed a metric that considers professional groups. Thus, this study aimed to develop a scale for musculoskeletal discomfort in the lower limbs to compare self-reported symptoms among education, health, and industry professionals. The sample included 159 teachers, 167 health professionals, and 401 industrial operators who relayed their symptoms using a diagram of the hips, thighs, knees, lower legs, and feet. Factor and multigroup item response theory analyses were used to construct a musculoskeletal discomfort scale consisting of seven levels and to assess and compare the identified symptoms. The results showed that the progressive evolution of discomfort differed for each profession, demonstrating that each context and work environment affects workers differently, which may explain the different patterns of symptom responses among professional groups.

Dietary Effects on Pain Symptoms in Patients with Fibromyalgia Syndrome: Systematic Review and Future Directions.

Fibromyalgia syndrome (FMS) is recognized for its difficulty to diagnose and its subjective symptomatology. There is neither a known cure nor a recommended therapeutic diet to aid in the multidisciplinary treatment. We conducted a systematic review to investigate if diets can improve pain symptoms of fibromyalgia. Through the PubMed search in March 2022, 126 abstracts were identified. We included both intervention and observational studies of diets and pain symptoms among patients with FMS. After screening titles, abstracts, and full-texts, 12 studies, including 11 intervention and one observational study, were selected. These studies included 546 participants and investigated plant-based diets (n = 3), anti-inflammatory diets (n = 1), gluten-free diets (n = 2), and elimination/restrictive diets (n = 6). These studies assessed pain symptoms through visual analogue scale for pain, fibromyalgia impact questionnaire/revised fibromyalgia impact questionnaire, tender point count, pain pressure threshold, and/or total myalgic score. Nine studies, including all three plant-based diet studies, reported statistically significant beneficial effects of their respective diets on pain symptom measurements. Given the small sample size and short intervention duration of the included studies, limited evidence currently exists to recommend any specific diet to patients with FMS. Further research is warranted to clarify specific diets to recommend and explore their potential mechanisms.

Pain in Huntington's disease and its potential mechanisms.

Pain is common and frequent in many neurodegenerative diseases, although it has not received much attention. In Huntington's disease (HD), pain is often ignored and under-researched because attention is more focused on motor and cognitive decline than psychiatric symptoms. In HD progression, pain symptoms are complex and involved in multiple etiologies, particularly mental issues such as apathy, anxiety and irritability. Because of psychiatric issues, HD patients rarely complain of pain, although their bodies show severe pain symptoms, ultimately resulting in insufficient awareness and lack of research. In HD, few studies have focused on pain and pain-related features. A detailed and systemic pain history is crucial to assess and explore pain pathophysiology in HD. This review provides an overview concentrating on pain-related factors in HD, including neuropathology, frequency, features, affecting factors and mechanisms. More attention and studies are still needed in this interesting field in the future.

The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review.

Chronic pain (CP) and mental illness (MI) are leading causes of years lived with disability and commonly co-occur. However, it remains unclear if available interventions are effective in improving pain outcomes in patients with co-existing CP and MI. This systematic review synthesised evidence for the effectiveness of interventions to improve pain outcomes for people with comorbid CP and clinically diagnosed MI. Ten electronic databases were searched from inception until May 2023. Randomised controlled trials (RCTs) were included if they evaluated interventions for CP-related outcomes among people with comorbid CP and clinically diagnosed MI. Pain-related and mental health outcomes were reported as primary and secondary outcomes, respectively. 26 RCTs (2,311 participants) were included. Four trials evaluated the effectiveness of cognitive-behavioural therapy, 6 mindfulness-based interventions, 1 interpersonal psychotherapy, 5 body-based interventions, 5 multi-component interventions, and 5 examined pharmacological-based interventions. Overall, there was considerable heterogeneity in sample characteristics and interventions, and included studies were generally of poor quality with insufficient trial details being reported. Despite the inconsistency in results, preliminary evidence suggests interventions demonstrating a positive effect on CP may include cognitive-behavioural therapy for patients with depression (with a small to medium effect size) and multi-component intervention for people with substance use disorders (with a small effect size). Despite the high occurrence/burden of CP and MI, there is a relative paucity of RCTs investigating interventions and none in people with severe MI. More rigorously designed RCTs are needed to further support our findings. PERSPECTIVE: This systematic review presents current evidence evaluating interventions for CP-related and MH outcomes for people with comorbid CP and clinically diagnosed MI. Our findings could potentially help clinicians identify the most effective treatments to manage these symptoms for this vulnerable patient group.

Effects of multiple risk factors on upper limb musculoskeletal disorders among workers in inner Brazil.

BACKGROUND: The literature discussing musculoskeletal diseases of inner northeastern workers is scarce, although 67,559 cases were reported in Brazil between 2007 and 2016. OBJECTIVE: This study aimed to evaluate the effect of multiple risk factors that influence the symptoms of work-related musculoskeletal disorders (WMSDs) in wrists, elbows, and shoulders in workers from four different economic sectors. METHODS: A sample included 420 workers from the inner regions of the Brazilian states of Alagoas and Bahia. The Nordic Musculoskeletal Questionnaire was used to capture pain symptoms on both sides of the body (left and right). Sociodemographic variables, items from the biomechanical exposure and organizational conditional, in addition to other questionnaires (JCQ, COPSOQ II, ERI) were used to assess the characteristics and occupational risks of the respondents. Ordinal logistic regression model was using to identify the relationship between symptoms and factors. RESULTS: This study highlights the psychosocial, biomechanical, occupational, and sociodemographic variables contributed to development of WMSDs. Use of hand-vibrating tool increased the likelihood of symptoms manifesting on the body. On the other hand, high job control and high job insecurity reduced the likelihood of developing symptoms. On the other hand, high job control and job satisfaction reduced the likelihood of developing symptoms. Factors such as age, curved spine, high job insecurity and excessive commitment contributed to the development of WMSDs only on one side of the body. CONCLUSIONS: The development of WMSDs is multifactorial. Sociodemographic, occupational, biomechanical, and psychosocial factors may commonly contribute to WMSD manifesting only on one side of the body more than on both sides.

Circulating estradiol and its biologically active metabolites in endometriosis and in relation to pain symptoms.

Objectives: Endometriosis (EM) is an estrogen-dominant inflammatory disease linked to infertility that affects women of reproductive age. EM lesions respond to hormonal signals that regulate uterine tissue growth and trigger inflammation and pain. The objective of this study was to evaluate whether estradiol (E2) and its biologically active metabolites are differentially associated with EM given their estrogenic and non-estrogenic actions including proliferative and inflammatory properties. Design: We performed a retrospective study of 209 EM cases and 115 women without EM. Methods: Pain-related outcomes were assessed using surveys with validated scales. Preoperative serum levels of estradiol (E2) and estrone (E1), their 2-, 4- and 16- hydroxylated (OH) and methylated (MeO) derivatives (n=16) were measured by mass spectrometry. We evaluated the associations between estrogen levels and EM anatomic sites, surgical stage, risk of EM, and symptoms reported by women. Spearman correlations established the relationships between circulating steroids. Results: Of the sixteen estrogens profiled, eleven were detected above quantification limits in most individuals. Steroids were positively correlated, except 2-hydroxy 3MeO-E1 (2OH-3MeO-E1). Higher 2OH-3MeO-E1 was linked to an increased risk of EM (Odd ratio (OR)=1.91 (95%CI 1.09-3.34); P=0.025). Ovarian EM cases displayed enhanced 2-hydroxylation with higher 2MeO-E1 and 2OH-E1 levels (P< 0.009). Abdominal, pelvic and back pain symptoms were also linked to higher 2OH-3MeO-E1 levels (OR=1.86; 95%CI 1.06-3.27; P=0.032). Conclusions: The 2-hydroxylation pathway emerges as an unfavorable feature of EM, and is associated with ovarian EM and pain related outcomes.