bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural and functional alterations in the retrosplenial cortex following neuropathic pain
Authors: Barrière David André , Hamieh Al Mahdy , Magalhães Ricardo , Traoré Amidou , Barbier Julie , Bonny Jean-Marie , Ardid Denis , Busserolles Jérôme , Mériaux Sébastien , Marchand Fabien 
Published: May 2019

Abstract
Human and animal imaging studies demonstrated that chronic pain profoundly alters the structure and the functionality of several brain regions. In this article, we conducted a longitudinal and multimodal study to assess how chronic pain affects the brain. Using the spared nerve injury model which promotes both long-lasting mechanical and thermal allodynia/hyperalgesia but also pain-associated comorbidities, we showed that neuropathic pain deeply modified the intrinsic organization of the brain functional network 1 and 2 months after injury. We found that both functional metrics and connectivity of the part A of the retrosplenial granular cortex (RSgA) were significantly correlated with the development of neuropathic pain behaviours. In addition, we found that the functional RSgA connectivity to the subiculum and the prelimbic system are significantly increased in spared nerve injury animals and correlated with peripheral pain thresholds. These brain regions were previously linked to the development of comorbidities associated with neuropathic pain. Using a voxel-based morphometry approach, we showed that neuropathic pain induced a significant increase of the gray matter concentration within the RSgA, associated with a significant activation of both astrocytes and microglial cells. Together, functional and morphological imaging metrics of the RSgA could be used as a predictive biomarker of neuropathic pain.
The contribution of obesity to prescription opioid use in the United States
Authors: Stokes Andrew , Berry Kaitlyn M. , Collins Jason M. , Hsiao Chia-Wen , Waggoner Jason R. , Johnston Stephen S. , Ammann Eric M. , Scamuffa Robin F. , Lee Sonia , Lundberg Dielle J. , Solomon Daniel H. , Felson David T. , Neogi Tuhina , Manson JoAnn E. 
Published: May 2019

Abstract
The prevalence of obesity has grown rapidly over the past several decades and has been accompanied by an increase in the prevalence of chronic pain and prescription opioid use. Obesity, through its association with pain, may represent an important contributor to opioid use. This cross-sectional study investigated the relationship between obesity and prescription opioid use among adults aged 35 to 79 years using data from the National Health and Nutrition Examination Survey (NHANES, 2003-2016). Relative to normal weight, body mass indices in the overweight {odds ratio (OR), 1.11 (confidence interval [CI], 0.88-1.39)}, obese I (OR, 1.26 [CI, 1.01-1.57]), obese II (OR, 1.69 [CI, 1.34-2.12]), and obese III (OR, 2.33 [CI, 1.76-3.08]) categories were associated with elevated odds of prescription opioid use. The association between excess weight and opioid use was stronger for chronic opioid use than for use with a duration of less than 90 days (P-value, <0.001). We estimated that 14% (CI, 9%-19%) of prescription opioid use at the population level was attributable to obesity, suggesting there might have been 1.5 million fewer opioid users per year under the hypothetical scenario where obese individuals were instead nonobese (CI, 0.9-2.0 million users). Back pain, joint pain, and muscle/nerve pain accounted for the largest differences in self-reported reasons for prescription opioid use across obesity status. Although interpretation is limited by the cross-sectional nature of the associations, our findings suggest that the obesity epidemic may be partially responsible for the high prevalence of prescription opioid use in the United States.
Beyond pain: can antidepressants improve depressive symptoms and quality of life in patients with neuropathic pain? A systematic review and meta-analysis
Authors: Caruso Rosangela , Ostuzzi Giovanni , Turrini Giulia , Ballette Francesca , Recla Elisabetta , Dall'Olio Riccardo , Croce Enrico , Casoni Beatrice , Grassi Luigi , Barbui Corrado 
Published: May 2019

Abstract
Neuropathic pain can be a predictor of severe emotional distress, up to full-blown depressive states. In these patients, it is important to move beyond the sole treatment of pain, to recognize depressive symptoms, and to ultimately improve the quality of life. We systematically searched for published and unpublished clinical trials assessing the efficacy and tolerability of antidepressants vs placebo on depression, anxiety and quality of life in patients with neuropathic pain, and pooled data in a meta-analysis. A total of 37 studies fulfilled eligibility criteria and 32 provided data for meta-analysis. Antidepressants were more effective than placebo in improving depressive symptoms (standardized mean difference −0.11; 95% confidence interval −0.20 to −0.02), although the magnitude of effect was small, with a number needed to treat of 24. No significant difference emerged between antidepressants and placebo in reducing anxiety. Quality of life seemed improved in patients on antidepressants, as did pain. Acceptability and tolerability were higher in patients on placebo. To the best of our knowledge, this is the first meta-analysis specifically focusing on the effect of antidepressants on psychiatric symptoms and quality of life in patients with neuropathic pain. Our findings suggest that despite their potential benefit in patients with neuropathic pain, antidepressants should be prescribed with particular care because they might be less tolerable in such a fragile population. However, our findings warrant further research to explore how a correct use of antidepressants can help patients to cope with the consequences of neuropathic pain on their psychosocial health and quality of life.
Investigating intraindividual pain variability: methods, applications, issues, and directions
Authors: Mun Chung Jung , Suk Hye Won , Davis Mary C. , Karoly Paul , Finan Patrick , Tennen Howard , Jensen Mark P. 
Published: May 2019

AbstractPain is a dynamic experience subject to substantial individual differences. Intensive longitudinal designs best capture the dynamical ebb and flow of the pain experience across time and settings. Thanks to the development of innovative and efficient data collection technologies, conducting an intensive longitudinal pain study has become increasingly feasible. However, the majority of longitudinal studies have tended to examine average level of pain as a predictor or as an outcome, while conceptualizing intraindividual pain variation as noise, error, or a nuisance factor. Such an approach may miss the opportunity to understand how fluctuations in pain over time are associated with pain processing, coping, other indices of adjustment, and treatment response. The present review introduces the 4 most frequently used intraindividual variability indices: the intraindividual SD/variance, autocorrelation, the mean square of successive difference, and probability of acute change. In addition, we discuss recent development in dynamic structural equation modeling in a nontechnical manner. We also consider some notable methodological issues, present a real-world example of intraindividual variability analysis, and offer suggestions for future research. Finally, we provide statistical software syntax for calculating the aforementioned intraindividual pain variability indices so that researchers can easily apply them in their research. We believe that investigating intraindividual variability of pain will provide a new perspective for understanding the complex mechanisms underlying pain coping and adjustment, as well as for enhancing efforts in precision pain medicine. Audio accompanying this abstract is available online as supplemental digital content at http://links.lww.com/PAIN/A817.
Effects of smoking on patients with chronic pain: a propensity-weighted analysis on the Collaborative Health Outcomes Information Registry
Authors: Khan James S. , Hah Jennifer M. , Mackey Sean C. 
Published: May 2019

Abstract
Tobacco smoking is associated with adverse health effects, and its relationship to pain is complex. The longitudinal effect of smoking on patients attending a tertiary pain management center is not well established. Using the Collaborative Health Outcomes Information Registry of patients attending the Stanford Pain Management Center from 2013 to 2017, we conducted a propensity-weighted analysis to determine independent effects of smoking on patients with chronic pain. We adjusted for covariates including age, sex, body mass index, depression and anxiety history, ethnicity, alcohol use, marital status, disability, and education. We compared smokers and nonsmokers on pain intensity, physical function, sleep, and psychological and mood variables using self-reported NIH PROMIS outcomes. We also conducted a linear mixed-model analysis to determine effect of smoking over time. A total of 12,368 patients completed the CHOIR questionnaire of which 8584 patients had complete data for propensity analysis. Smokers at time of pain consultation reported significantly worse pain intensities, pain interference, pain behaviors, physical functioning, fatigue, sleep-related impairment, sleep disturbance, anger, emotional support, depression, and anxiety symptoms than nonsmokers (all P < 0.001). In mixed-model analysis, smokers tended to have worse pain interference, fatigue, sleep-related impairment, anger, emotional support, and depression over time compared with nonsmokers. Patients with chronic pain who smoke have worse pain, functional, sleep, and psychological and mood outcomes compared with nonsmokers. Smoking also has prognostic importance for poor recovery and improvement over time. Further research is needed on tailored therapies to assist people with chronic pain who smoke and to determine an optimal strategy to facilitate smoking cessation.
Alterations in evoked and spontaneous activity of dorsal horn wide dynamic range neurons in pathological pain: a systematic review and analysis
Authors: Zain Maham , Bonin Robert P. 
Published: May 2019

Abstract
Wide dynamic range (WDR) neurons of the spinal dorsal horn respond to a wide range of innocuous and noxious mechanical stimulation and encode the intensity of mechanical stimuli as changes in firing rate. However, there are inconsistent findings regarding whether WDR neuron stimulus encoding activity is altered in pathological pain states. This inconsistency may arise from differences in the pain models used or in the experimental conditions themselves. In this study, we use a meta-regression approach to examine which variables modulate and determine WDR activity. We pooled data from in vivo electrophysiological studies of WDR activity evoked by von Frey filament stimulation of the hind paw in rats across a number of pathological pain models. We observed that WDR firing rate was better predicted by the calculated pressure of von Frey stimulation rather than applied filament force, as reported in all studies. The pressure-evoked firing rate of WDR neurons was not altered by any experimental pain model except for arthritis and inflammation models, where mechanical stimuli evoked a higher firing rate than controls. Conversely, there was a consistent increase in the spontaneous firing rate of WDR neurons in neuropathic pain, arthritis and inflammation, and chemoneuropathy pain models. Overall, these data indicate that changes in WDR encoding of applied pressure are unlikely to significantly contribute to pathological sensory processing but suggest a possible role for these neurons in spontaneous pain.
The prognostic value of pre-treatment prognostic nutritional index in esophageal squamous cell carcinoma
Authors: Li Pengfei , Wang Xin , Lai Yutian , Zhou Kun , Tang Yuxin , Che Guowei 
Published: May 2019

Abstract

Background:
Prognostic nutritional index (PNI) is an easily obtained index inflecting both one's nutritional and inflammatory status. Its clinical role in esophageal squamous cell carcinoma (ESCC) remains still in debate. The aim of this meta-analysis was to assess the prognostic value and the clinical-pathological features of pre-treatment PNI in ESCC patients.

Methods:
A comprehensive search of online databases (PubMed, Embase, Web of Science) was performed. Studies explored the relationship between pre-treatment PNI and long-term survival of ESCC patients were regarded eligible for this meta-analysis. Outcomes were extracted and synthesized. Hazard ratio (HR) and relative ratio (RR) with 95% confidence interval (CI) were used to evaluate the prognostic value of PNI on long-term survival and association with clinical-pathological features, respectively. The heterogeneity levels and publication bias between studies were also estimated.

Results:
Nine observational studies involving 2276 patients were considered eligible for this meta-analysis. The pooled results showed that low PNI score was significantly correlated with poorer overall survival (OS) of esophageal cancer (pooled HR = 1.418 95%CI: 1.200–1.676, P = .000), poorer recurrence free survival (HR = 1.880 95%CI: 1.207–2.929, P = .005) but not cancer specific survival (CSS) (HR = 1.948 95%CI: 0.544–6.977, P = .306). The PNI value was not related with patient age, sex, depth of tumor invasion, nodular metastasis, and differential grade but the TNM stage (III/IV vs 0/I/II, RR = 1.276, 95% CI 1.146–1.420).

Conclusions:
Low pre-treatment PNI was significantly related with OS and recurrence free survival but not CSS for ESCC. PNI was a reliable prognostic factor of ESCC, and higher stage ESCC have higher incidence of low PNI.
Incidence and risk of fatigue in cancer patients treated with MET inhibitors
Authors: Tong Hongxuan , Zhu Yutian , Liu Yihua 
Published: May 2019

Abstract

Background:
The N-methyl-N′-nitroso-guanidine human osteosarcoma transforming gene (MET) inhibitors show a surprising survival benefit in the treatment of numerous tumors especially in MET-high tumor. Besides their impressive efficacy, fatigue reduced by MET inhibitors is still the safety issue during treatment. Thus, an understanding of this risk in the context of expanding MET-inhibitors use is an important cost and patient safety issue.

Methods:
We searched PubMed, Embase, and the Cochrane Library databases for relevant studies up to October 2017. Eligibility criteria included phase II/III trials of MET inhibitors that reported adequate safety profiles of fatigue. The principal summary measures were incidence and relative risk (RR) of all-grade (grade 1–4) and high-grade (grade 3–4) fatigue, respectively. Random-effects model was applied to consider within-study and between-study variation.

Results:
A total of 5028 patients from 17 clinical trials were identified. The results revealed that the incidences of MET inhibitors-associated all-grade and high-grade fatigue were 41.9% and 9.6%, respectively. The RR of high-grade fatigue was (RR = 1.37; 95% confidence interval, 1.14–1.66; P = .0009), whereas the RR of all-grade fatigue was (RR = 1.02; 95% confidence interval, 0.91–1.15; P = .71).

Conclusion:
Our meta-analysis has demonstrated that MET inhibitors-based treatment is associated with an increased risk of high-grade fatigue compared with control.
Full-endoscopic interlaminar discectomy for the treatment of a dorsal migrated thoracic disc herniation
Authors: Hur Jung-Woo , Kim Jin-Sung , Seung Ji-Hoon 
Published: May 2019

Abstract

Rationale:
Thoracic disc herniation (TDH) is an infrequent spinal disease and difficult to treat well. Various surgical approaches and procedures were introduced in many literatures. The authors report a patient with dorsal migrated TDH compressing the spinal cord at T10-11 level.

Patient concerns:
A 65-year-old male patient presented with complaints of severe paresthesia of both legs and progressive motor weakness for 1 week.

Diagnoses:
Magnetic resonance imaging (MRI) of the thoracic and lumbar spine revealed TDH and migration of dorsal side on spinal cord at T10-11 level.

Interventions:
Successful decompressive surgery was performed through a posterior interlaminar approach using only endoscopic instruments.

Outcomes:
After the operation, patient's symptoms, paraparesis and paresthesia, immediately improved.

Lessons:
The successful results of this case suggest that full endoscopic laminotomy and discectomy may be an attractive minimally invasive surgical technique for treating TDH with dorsal migrated fragments.
Targeted therapy with anlotinib for patient with recurrent glioblastoma
Authors: Lv Yajuan , Zhang Jiandong , Liu Fengjun , Song Meijuan , Hou Yong , Liang Ning 
Published: May 2019

Abstract

Rationale:
Glioblastoma (GBM) is the most aggressive malignant brain tumor in adults. The first choice for GBM is surgery, and followed by a combination of radiotherapy and chemotherapy. There are limited treatments for patients with recurrent GBM. Relapsed patients usually have a worse prognosis, and with a median survival time of <6 months. Anlotinib is a novel small molecule multi-target tyrosine kinase inhibitor that can inhibit tumor angiogenesis and inhibit tumor cell growth. This drug has been used to treat advanced lung cancer.

Patient concerns:
We present a case of recurrent GBM was treated with anlotinib in this report. The patient was diagnosed with GBM in August 2016 and treated with surgery and temozolomide (TMZ) chemotherapy. She was diagnosed with recurrence in February 2017 following which she was treated with gamma knife and TMZ chemotherapy. In November 2017, the patient presented with decreased vision in left eye. She was given radiation and her left eye vision returned to normal after radiation. On May23, 2018, the patient reported a decrease in left visual acuity again.

Diagnoses:
Brain magnetic resonance imaging (MRI) showed progression of the disease, and the tumor invaded the left optic nerve.

Interventions:
This patient was administer anlotinib 12 mg po qd (d1–14, 21days as a cycle). Three cycles anlotinib were given to this patient.

Outcomes:
The patient reported her left visual acuity increased over 10 days after first cycle of anlotinib treatment. MRI scan revealed tumor volume shrinks, especially the part that invades the left optic nerve shrinks significantly at 26 days after anlotinib treatment on August 11, 2018. However, the tumor progressed in 2 months after using of anlotinib. From the beginning of the application of anlotinib to death, her survival time was 110 days.

Lessons:
Anlotinib treatment with mild side effects may be a new option for the patients with recurrent glioblastoma.
RhACE2 – playing an important role in inhibiting apoptosis induced by Ang II in HUVECs
Authors: Zhang Hongli , Zhang Xiaocui , Hou Zhaoyu , Deng Fang 
Published: May 2019

Abstract

Background:
Henoch-Schonlein purpura (HSP) is a common hemorrhagic disease, which manifests the inflammation in the body's most microvasculars. Angiotensin II (Ang II) can induce the damage and apoptosis of vascular endothelial cells while angiotensin converting enzyme 2 (ACE2) can antagonist the action of Ang II. However, the effect of ACE2 on Ang II-induced endothelial damage remains unknown.

Objective:
To evaluate the effect of recombinant human angiotensin converting enzyme 2 (rhACE2) on the Ang II-induced damage of human umbilical vein endothelial cells (HUVECs) and the release of inflammatory mediator in vitro.

Methods:
Cultured HUVECs were randomly divided into 6 groups: the control group, rhACE2 group, Ang II group, and Ang II+ rhACE2 groups (3 subgroups). The cell vitality, cell cycle, apoptosis rate of the HUVECs and the levels of reactive oxygen species (ROS), interleukin 8 (IL-8), tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1) and lactate dehydrogenase (LDH) were measured, respectively.

Results:
Compared with the control group, the cell viability and the rate of S phase cells in Ang II group significantly decreased (P < .05) while the apoptosis percentage and the levels of ROS, IL-8, TNF-α, TGF-β1, and LDH in Ang II group significantly increased (P < .05). There were no significant differences between the control group and rhACE2 group. Compared with the Ang II group, the cell viability and the rate of S phase cells in Ang II+rhACE2 groups were higher (P < .05) and the apoptosis percentage, the level of ROS, IL-8, TNF-α, TGF-β1, LDH in Ang II+rhACE2 groups were lower (P < .05).

Conclusions:
Ang II can induce the apoptosis of HUVECs and the release of inflammatory mediator, while rhACE2 can inhibit the detrimental effects of Ang II. The results of this study suggest that rhACE2 has a protective effect on HSP, which is probably a new way for the prevention and treatment of HSP.
Surgical treatment of the severely damaged atlantoaxial joint with C1–C2 facet spacers
Authors: Tominaga Hiroyuki , MacDowall Anna , Olerud Claes 
Published: May 2019

Abstract

Rationale:
Atlantoaxial subluxation (AAS), caused by congenital factors, inflammation such as rheumatoid arthritis, infection, neoplasia, or trauma, is rare and severely erodes and subluxates atlantoaxial (AA) joints. For these patients, surgical reduction, and stabilization are difficult. Surgery, including anterior transoral decompression and posterior fixation, anterior endonasal decompression and fixation, and posterior decompression with AA or occipitocervical fixation, is often the only treatment available. However, there have only been 2 reports of C1–C2 facet spacer use in treating AAS. Here, we report the case histories of 3 patients with severely damaged and subluxated AA joints and symptomatic basilar invagination (BI), malalignment, or C2 root compression.

Patient concerns:
The cases included 2 women with rheumatoid arthritis and 1 man with spondyloarthropathy secondary to ulcerative colitis.

Diagnosis:
Radiographic imaging revealed severely damaged and subluxated AA joints. Their symptoms included worsening pain in the neck or occiput with or without myelopathy and neuralgia.

Interventions:
After realignment with C1–C2 spacers and posterior C1–C2 screw fixation, the patient symptoms were resolved.

Outcomes:
Of note, 2 of the 3 patients were healed without complications. One patient who underwent secondary revision surgery because of rod breakage and obvious nonunion at C0–C2 was determined to be healed at 1-year follow-up after the revision surgery.

Lessons:
We confirmed that C1–C2 facet spacers both reduced BI and occipitocervical coronal malalignment as well as releasing C2 root compression. Therefore, surgical restoration and fixation should be a required treatment in this very rare group of patients.