Assessment of exercise‐induced hypoalgesia in chronic low back pain and potential associations with psychological factors and central sensitization symptoms: A case‐control study

alexandrossfakianakis shared this article with you from Inoreader Assessment of exercise‐induced hypoalgesia in chronic low back pain and potential associations with psychological factors and central sensitization symptoms: A case‐control study via Pain Practice Abstract Introduction Exercise is the most recommended treatment for chronic low back pain (CLBP) and is effective in reducing pain, but the mechanisms underlying its effects remain poorly understood. Exercise-induced hypoalgesia (EIH) may play a role and is thought to be driven by central pain modulation mechanisms. However, EIH appears to be disrupted in many chronic pain conditions and its presence in people with CLBP remains unclear. As people suffering from chronic pain often exhibit psychological factors and central sensitization symptoms influencing pain perception, EIH might be associated to these factors. Objective To compare the level of EIH between participants with and without CLBP following back and wrist exercises and to assess the associations between EIH, psychological factors and central sensitization inventory score (CSI) in CLBP. Method Twenty-eight participants with CLBP and 23 without pain were recruited. Pressure pain thresholds (PPT) were measured at 4 sites (2 bony sites = capitate, S1 | 2 muscle sites = wrist flexors, lumbar erector spinae) before and after each of two exercises (wrist flexion and lumbar extension). EIH was defined as percent change in PPT from pre-to-post-exercise. Participants with CLBP also completed questionnaires to measure psychological factors (e.g. kinesiophobia, catastrophizing, anxiety, self-efficacy) and symptoms of central sensitization (CSI), and correlations with EIH was calculated. Results After wrist exercise, EIH measured at the muscle sites was lower in the CLBP group compared to the pain-free group (p=0.047) but no differences were found at bony sites (p=0.49). No significant differences for EIH were observed following back exercise at muscle sites (p=0.14) or at bony sites (p=0.65). EIH was not correlated with any psychological factors or to the CSI score. Conclusion The lower EIH following wrist exercises may represent an alteration in pain modulation control in CLBP. However, psychological factors and central sensitization symptoms may not explain the differences observed. View on Web

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Tideglusib enhances odontogenic differentiation in human dental pulp stem cells in vitro

alexandrossfakianakis shared this article with you from Inoreader Tideglusib enhances odontogenic differentiation in human dental pulp stem cells in vitro via International Endodontic Journal Abstract Aim Tideglusib is a small molecule agonist of the canonical Wnt pathway. The present study investigated the influence of Tideglusib on human dental pulp stem cell (hDPSC) proliferation, apoptosis, migration, and odonto/osteogenic differentiation. Methodology hDPSCs were treated with 50 nM, 100 nM, or 200 nM Tideglusib. β-catenin accumulation was detected by immunofluorescence staining. Colony forming unit ability was assessed by staining with Coomassie blue. Cell cycle progression and cell apoptosis were investigated using flow cytometry. Cell migration was examined using an in vitro wound healing assay. Osteogenic differentiation was examined using alkaline phosphatase (ALP) staining, alizarin red s staining, and osteogenic-related gene expression. The gene expression profile was examined using a high throughput RNA sequencing technique. All experiments were repeated using cells derived from at least four different donors (n = 4). The Mann Whitney U test was used to identify significant differences for two independent group comparisons. For three or more group comparison, statistical differences were assessed using the Kruskal Wallis test followed by a pairwise comparison. The significance level was set at 5% (p< /i> < 0.05). Results Tideglusib activated the Wnt signaling pathway in hDPSCs as demonstrated by an increase in cytoplasmic β-catenin accumulation and nuclear translocation. Tideglusib did not affect hDPSC proliferation, cell cycle progression, cell apoptosis, or cell migration. In contrast, 50 nM and 100 nM Tideglusib significantly enhanced mineralisation and osteogenic marker gene expression (RUNX2, ALP, BMP2, and DSPP) (p < 0.05). Conclusions Tideglusib enhanced the odonto/osteogenic differentiation of hDPSCs. Therefore, incorporating this bioactive molecule in a pulp capping material could be a promising strategy to promote dentine repair. View on Web

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The impact of clinical trial enrollment on specialty palliative care utilization in pediatric patients with high‐grade gliomas

alexandrossfakianakis shared this article with you from Inoreader The impact of clinical trial enrollment on specialty palliative care utilization in pediatric patients with high‐grade gliomas via Pediatric Blood & Cancer Abstract Background Palliative care (PC) provides numerous benefits for children with cancer. Pediatric patients with high-grade glioma (HGG) are particularly well suited for early PC involvement given their high symptom burden and poor prognosis. However, studies continue to reveal that children with cancer, including HGG, have delayed PC involvement. We hypothesized that clinical trial enrollment may lead to a lack of or delay in PC involvement in this population. Procedure For each patient in our cohort of 43 pediatric patients with HGG, demographic, diagnostic, therapeutic, clinical trial enrollment, and PC information were collected. Statistical analysis was performed comparing PC characteristics between patients who did and did not enroll in a clinical trial. Results Seventy-two percent of patients had at least one visit with a PC provider. Fifty-six percent of patients enrolled in a clinical trial with HGG-directed therapy. Seventy-one percent of patients who enrolled in a clinical trial received specialty PC compared to 74% of non-trial participants (p = 1.000). Patients who enrolled in clinical trials received PC earlier in their disease course measured in days before death (mean = 177 days) compared to those who did not enroll (mean = 113 days, p = .180), though not statistically significant. Conclusions The prevalence of clinical trial enrollment is high in patients with HGG and will likely increase as the genomic/epigenomic landscape of these tumors is better understood. As such, our data reassuringly suggest that trial participation does not interfere with the receipt of specialty PC in this population. View on Web

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Comparison of quality of life and psychological distress in patients with tongue cancer undergoing a total/subtotal glossectomy or extended hemiglossectomy and free flap transfer: a prospective evaluation

alexandrossfakianakis shared this article with you from Inoreader Comparison of quality of life and psychological distress in patients with tongue cancer undergoing a total/subtotal glossectomy or extended hemiglossectomy and free flap transfer: a prospective evaluation via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to assess changes in the quality of life and psychological distress of patients with tongue cancer undergoing total/subtotal glossectomy (TG) or extended hemiglossectomy (HG) and free flap transfer. Differences between the two groups were compared using the Short Form 8-Item Health Survey (SF-8) and Hospital Anxiety and Depression Scale (HADS). Of the 43 patients with tongue cancer, 24 (56%) underwent TG and 19 (44%) underwent HG. The general health and social functioning scores in the SF-8 and depression in the HADS were significantly worse in the TG group than in the HG group at 12 months after surgery, indicating that patients in the TG group may experience social isolation and psychological distress, and have difficulty in employability even 12 months after su... View on Web

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The Management of Salivary Fistulas

alexandrossfakianakis shared this article with you from Inoreader The Management of Salivary Fistulas via Seminars in Plastic Surgery Semin Plast Surg DOI: 10.1055/s-0042-1759561 Postoperative salivary fistula is an especially undesirable complication because it can be difficult to address, may delay postoperative radiation, and always delays enteral nutrition. Patients who are malnourished, have already undergone radiotherapy, or are hypothyroid are at higher risk of developing this problem. Conservative measures work in most patients, but a significant percentage of patients require intervention beyond pr essure dressings and tincture of time. Medications, hyperbaric oxygen therapy, and surgical intervention may be required when fistulas do not heal in a timely manner. Decisions about the approach and timing of more aggressive interventions are part of the art of medicine since definitive scientific protocols are lacking. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA Article in Thieme eJournals: Table of contents  |  Abstract&nbs p; |  Full text View on Web

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Household versus incentive-based contact investigation for tuberculosis

alexandrossfakianakis shared this article with you from Inoreader Household versus incentive-based contact investigation for tuberculosis in rural South Africa: a cluster-randomized trial via Clinical Infectious Diseases Advance Access Abstract Background Household contact investigation for people newly diagnosed with tuberculosis (TB) is poorly implemented, particularly in low- and middle-income countries. Conditional cash incentives may improve uptake. Methods We conducted a pragmatic, cluster randomized cross-over trial of two TB contact investigation approaches (household-based and incentive-based) in 28 public primary care clinics in South Africa. Each clinic used one approach for 18 months, followed by a six-month washout period, after which the opposite approach was used. Fourteen clinics were randomized to each approach. In the household-based arm, we conducted TB screening and testing of contacts at the household. In the incentive-based arm, both index patients and up to ten of their close contacts (either within or outside the household). were given small cash incentives for presenting to study clinics for tuberculosis screening. The primary outcome was the number of people with incident tuberculosis who were diagnosed and started on treatment at study clinics. Results From July 2016 to January 2020, we randomized 28 clinics to each study arm, and enrolled 782 index tuberculosis patients and 1882 contacts in the household-based arm, and 780 index patients and 1940 contacts in the incentive-based arm. 1,413 individuals started on tuberculosis treatment in the household-based arm, and 1,510 in the incentive-based arm. The adjusted incidence rate ratio of tuberculosis treatment initiation in the incentive versus household-based arm was 1.05 (95% CI:0.97-1.13). Conclusion Incentive-based contact investigation for tuberculosis has similar effectiveness to traditional household-based approaches and may be a viable alternative or complementary approach to household-based investigation. View on Web

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The Omicron BA.4/BA.5 Sub-Variants

alexandrossfakianakis shared this article with you from Inoreader Trends in Cases, Hospitalization and Mortality Related to the Omicron BA.4/BA.5 Sub-Variants in South Africa via Clinical Infectious Diseases Advance Access ABSTRACT Background This study compared admission incidence risk across waves, and the risk of mortality in the Omicron BA.4/BA.5 wave, to the Omicron BA.1/BA.2 and Delta waves. Methods Data from South Africa's national hospital surveillance system, SARS-CoV-2 case linelist and Electronic Vaccine Data System were linked and analysed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100,000 people. In-hospital case fatality ratios (CFR) in the Delta, Omicron BA.1/BA.2 and Omicron BA.4/BA.5 wave periods were compared by post-imputation random effect multivariable logistic regression models. Results The CFR was 25.9% (N = 37,538/144,778), 10.9% (N = 6,123/56,384) and 8.2% (N = 1,212/14,879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves respectively. After adjusting for age, sex, race, comorbidities, health sector and province, compared to the Omicron BA.4/BA.5 wave, pati ents had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR] 1.3; 95% confidence interval [CI] 1.2-1.4) and Delta (aOR 3.0; 95% CI 2.8-3.2) wave. Being partially vaccinated (aOR 0.9, CI 0.9-0.9), fully vaccinated (aOR 0.6, CI 0.6-0.7) and boosted (aOR 0.4, CI 0.4-0.5); and prior laboratory-confirmed infection (aOR 0.4, CI 0.3-0.4) were associated with reduced risks of mortality. Conclusion Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa's first three waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased. View on Web

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