Articles: chronic.
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Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. ⋯ Among TMD-pain cases, Italians reported the highest pain-related disability (P < 0·01). Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation.
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Chronic widespread musculoskeletal pain (CWP), has a considerable heritable component, which remains to be explained. Epigenetic factors may contribute to and account for some of the heritability estimate. We analysed epigenome-wide methylation using MeDIPseq in whole blood DNA from 1708 monozygotic and dizygotic Caucasian twins having CWP prevalence of 19.9%. ⋯ Bioinformatics analyses of the associated methylation bins showed enrichment for neurological pathways in CWP. We estimate that the variance explained by epigenetic factors in CWP is 6%. This, the largest study to date of DNA methylation in CWP, points towards epigenetic modification of neurological pathways in CWP and provides proof of principle of this method in teasing apart the complex risk factors for CWP.
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Observational Study
Pharmacodynamics of intravenous frusemide bolus in critically ill patients.
To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. ⋯ In a cohort of critically ill patients without chronic renal impairment, frusemide increased UO and urinary sodium, potassium and chloride losses, and induced hypochloraemia and metabolic alkalosis. However, its diuretic effects were extremely variable and were modified by age, MAP and creatinine and albumin levels.
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Perceived injustice has been defined as an appraisal regarding the severity and irreparability of loss associated with pain, blame, and a sense of unfairness. Recent findings suggest that perceived injustice is an important risk factor for elevated disability associated with chronic pain. However, the mechanisms by which this perception leads to disability are not well understood. Therefore, the current study aimed to examine the mediating role of pain acceptance on the relation between perceived injustice and chronic pain outcomes (pain intensity, pain-related disability, and psychological distress). ⋯ Clinical and theoretical implications are discussed along with future research directions.