The antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in ...masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann-Whitney test was used for all comparisons between groups. The BoNT-A group had a significant decrease in pain intensity at follow-ups compared with the SS group (p < 0.001). QST assessment revealed higher pressure pain threshold values in the masseter muscle for BoNT-A group compared to SS (p < 0.03) at all follow-ups. No differences were found for mechanical pain threshold and wind-up ratio values (p > 0.05) in the entire study. The BoNT-A group presented the most efficient CPM effect (p < 0.03) only at the 1 month follow-up in the masseter muscle. There was a significant time effect for BoNT-A in all psychosocial variables (p < 0.05) and a drug effect in the Central Sensitization Inventory (p < 0.01), Pittsburgh Sleep Quality Index (p < 0.004), and Healthy Survey 36 (p < 0.05) at 6 months follow-up. The study demonstrates that a single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.
Objective
To study and estimate the impact of clinical, somatosensory, and psychosocial variables associated with the concomitant presence of temporomandibular joint (TMJ) pain in patients with TMJ ...clicking.
Materials and methods
Ninety-three individuals composed the sample: patients with painful TMJ clicking (
n
= 47) and patients with painless TMJ clicking (
n
= 46). Four categories of data were evaluated: clinical features (gender, maximal interincisal distance (MID), side of complaint, age); bruxism (sleep bruxism (SB), awake bruxism (AB)); somatosensory (mechanical pain threshold (MPT), wind-up ratio (WUR), pressure pain threshold (PPT), conditioned pain modulation (CPM)); and psychosocial (Pittsburgh Sleep Quality Index (PSQI), pain vigilance and awareness questionnaire (PVAQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD), Oral Behaviors (OBs)).
Results
Female gender, AB, WUR, CPM, PSQI, PCS, and OBs significantly (
p
< 0.05) increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. On the other hand, MID, MPT, and PPT significantly (
p
< 0.05) decreased this chance. The other variables had no association.
Conclusion
It can be concluded that being a woman, having AB, hyperalgesia in WUR, less efficient CPM, poor sleep quality, pain catastrophizing, and harmful OBs significantly increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. In the opposite, high figures of MID, MPT, and PPT decreased the chance.
Clinical relevance
Most patients with TMJ clicking usually postpone seeking treatment until the clicking truly disturbs or there is a concomitant presence of TMJ pain. Understanding the variables associated with this concomitance can be important in clinical practice.
Tuberous breast deformity is characterized by a deficiency in the vertical and horizontal dimensions of the breast, as well as breast underdevelopment and asymmetry. Concomitant chest wall ...deformities are not uncommon and increase the difficulty when planning breast augmentation in such patients. We present a unique case of tuberous breasts and chest wall deformity successfully treated employing a novel technique that incorporated breast implants and fat grafting. A 24-year-old patient with no significant past medical history presented to the plastic surgery clinic seeking correction of a severe breast asymmetry and desiring increase in breast volume. The right breast was Grolleau type 1 cup A, while the left breast was Grolleau type 3 cup C. The left hemithorax presented an accentuated prominence of the costochondral junction of 4th left rib, along with minor prominence of the 3rd and 5th left ribs. In addition, the 5th and 6th ribs were fused together. The surgical plan involved bilateral augmentation with implant and fat grafting. A 285 cc Motiva implant was placed subfascial on the right. Multiple refinements were necessary to the left breast, including areolar reduction, inframammary fold adjustment, and medial glandular modifications. A 140 cc Motiva implant was placed subfascial. Fat grafting was used in both breasts to enhance contour, projection and conceal the chest wall deformity. Postoperative recovery was uneventful, and results at 3-month follow-up showed improved breast symmetry and aesthetics.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.
Identifying the molecular mechanisms underlying radioresistance is a priority for the treatment of RMS, a myogenic tumor accounting for approximately 50% of all pediatric soft tissue sarcomas. We ...found that irradiation (IR) transiently increased phosphorylation of Akt1, Src, and Cav1 in human RD and RH30 lines. Synthetic inhibition of Akt1 and Src phosphorylation increased ROS levels in all RMS lines, promoting cellular radiosensitization. Accordingly, the elevated activation of the Akt1/Src/Cav1 pathway, as detected in two RD lines characterized by overexpression of a myristoylated Akt1 form (myrAkt1) or Cav1 (RDCav1), was correlated with reduced levels of ROS, higher expression of catalase, and increased radioresistance. We found that treatment with cholesterol-lowering drugs such as lovastatin and simvastatin promoted cell apoptosis in all RMS lines by reducing Akt1 and Cav1 levels and increasing intracellular ROS levels. Combining statins with IR significantly increased DNA damage and cell apoptosis as assessed by γ histone 2AX (γH2AX) staining and FACS analysis. Furthermore, in combination with the chemotherapeutic agent actinomycin D, statins were effective in reducing cell survival through increased apoptosis. Taken together, our findings suggest that the molecularly linked signature formed by Akt1, Src, Cav1, and catalase may represent a prognostic determinant for identifying subgroups of RMS patients with higher probability of recurrence after radiotherapy. Furthermore, statin-induced oxidative stress could represent a treatment option to improve the success of radiotherapy.
Multifaceted microorganisms such as the bacterium Pantoea colonize a wide range of habitats and can exhibit both beneficial and harmful behaviors, which provide new insights into microbial ecology. ...In the agricultural context, several strains of Pantoea spp. can promote plant growth through direct or indirect mechanisms. Members of this genus contribute to plant growth mainly by increasing the supply of nitrogen, solubilizing ammonia and inorganic phosphate, and producing phytohormones (e.g., auxins). Several other studies have shown the potential of strains of Pantoea spp. to induce systemic resistance and protection against pests and pathogenic microorganisms in cultivated plants. Strains of the species Pantoea agglomerans deserve attention as a pest and phytopathogen control agent. Several of them also possess a biotechnological potential for therapeutic purposes (e.g., immunomodulators) and are implicated in human infections. Thus, the differentiation between the harmful and beneficial strains of P. agglomerans is mandatory to apply this bacterium safely as a biofertilizer or biocontroller. This review specifically evaluates the potential of the strain-associated features of P. agglomerans for bioprospecting and agricultural applications through its biological versatility as well as clarifying its potential animal and human health risks from a genomic point of view.
Background
Determining the somatosensory and psychosocial profile of patients with painful temporomandibular joint (TMJ) clicking can help to understand the pain mechanisms in cases of TMJ clicking.
...Objective
To characterise the somatosensory and psychosocial profile of patients with painful TMJ clicking when compared to patients with painless TMJ clicking and healthy control group.
Methods
Somatosensory and psychosocial functions were assessed in 90 individuals: patients with painful TMJ clicking (n = 30); patients with painless TMJ clicking (n = 30); and healthy controls (n = 30). Somatosensory profile included: mechanical pain threshold (MPT); wind‐up ratio (WUR); pressure pain threshold (PPT); and conditioned pain modulation (CPM). Psychosocial profile included some questionnaires: Pittsburgh Sleep Quality Index (PSQI); Pain Vigilance‐Awareness Questionnaire (PVAQ); Pain Catastrophizing Scale (PCS); Tampa Scale for Kinesiophobia (TSK); Perceived Stress (PSS); and State‐Trait Anxiety Inventory (STAI). All variables were compared among all groups.
Results
Higher values of MPT and WUR; lower PPT; less efficient CPM; and higher scores of PSQI, PVAQ, PCS, and TSK were found in patients with painful TMJ clicking when compared to the other two groups (P < .001). Patients with painless TMJ clicking showed lower PPT and higher scores of PVAQ and TKS than the healthy control group. PSS and STAI data had no differences.
Conclusion
Patients with painful TMJ clicking had abnormalities in the somatosensory profile, with a significant somatosensory gain of function (more sensitive) to mechanical pain tests and less efficient CPM. Poor sleep quality along with higher levels of hypervigilance, pain catastrophising, and kinesiophobia were features of psychosocial profile of these patients.
Patients asking for cosmetic breast surgery often appreciate that their breasts have an unpleasing appearance, but they often do not have a full appreciation of the degree of potential anatomic ...abnormalities of the chest wall and of the specific anatomical characteristics, which require a meticulous surgical planning and techniques in comparison with a standard breast cosmetic surgery. Failure to recognize this will predispose the patient to an unsatisfactory outcome and secondary deformities. To maximize surgical predictability and patients' satisfaction, the authors proposed a two-stage approach in the scenario of patients presenting with chest wall deformities and asking for breast augmentation. However, as we contemplate adopting the authors' approach to our case, we anticipate encountering two primary challenges. Firstly, utilizing custom-made 3D silicone implants might exacerbate the projection of the chondrocostal prominence present in our patient. Indeed, we believe that these implants are more beneficial for addressing concave defects (such as pectus excavatum) rather than convex prominences, as observed in our case.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Background
Understanding the profile of the individual complaining of TMJ clicking can help in the clinical approach of these patients.
Objective
To identify clinical variables associated with ...individuals who complain about and seek treatment for TMJ clicking.
Methods
Seventy‐two individuals, composed the sample: Group 1 – patients with a complaint of TMJ clicking who sought treatment; (n = 36); Group 2 – individuals with TMJ clicking who have no complaints about it (n = 36). Three categories of data were evaluated: clinical (gender; age; side of TMJ clicking; TMJ pain; self‐reported level of bother; previous TMJ clicking information); somatosensory (mechanical pain threshold MPT, wind‐up ratio WUR, pressure pain threshold PPT); and, psychosocial (Pain Vigilance and Awareness Questionnaire PVAQ; Pain Catastrophising Scale PCS; Tampa Scale for Kinesiophobia for Temporomandibular Disorders TSK/TMD); The Perceived Stress Scale (PSS); The State‐Trait Anxiety Inventory (STAI).
Results
Group 1 was composed mostly of female patients, with TMJ pain, without previous orientation about the condition, bothered by the clicking, with lower PPT and higher scores in the PVAQ, PCS, TKS/TMD, PSS and STAI scales than Group 2. The groups did not differ significantly for side of TMJ clicking, age, MPT and WUR.
Conclusion
Individuals who have a TMJ clicking complaint and seek treatment are mostly female, have TMJ pain, have not received previous orientation about TMJ clicking, are bothered by the clicking, have a lower pain threshold and higher scores of hypervigilance, catastrophising, kinesiophobia, stress and anxiety than people with TMJ clicking who do not report it.
Mediator is a large multiprotein complex that is required for the transcription of most, if not all, genes transcribed by RNA Polymerase II. A core set of subunits is essential to assemble a ...functional Mediator
and, therefore, the corresponding loss-of-function mutants are expected to be lethal. The MED30 subunit is essential in animal systems, but is absent in yeast. Here, we report that MED30 is also essential for both male gametophyte and embryo development in the model plant
Mutant
pollen grains were viable and some were able to germinate and target the ovules, although the embryos aborted shortly after fertilization, suggesting that MED30 is important for the paternal control of early embryo development. When gametophyte defects were bypassed by specific pollen complementation, loss of MED30 led to early embryo development arrest. Later in plant development, MED30 promotes flowering through multiple signaling pathways; its downregulation led to a phase change delay, downregulation of
(
),
(
) and
(
), and upregulation of
(
).
The IFAPA research center "Rancho de la Merced" (Jerez, Spain) hosts one of the oldest and most diverse grapevine germplasm repositories in Europe, and is aimed at providing feasible solutions to ...deal with any agronomic trait by exploring its genetic variability and by means of association and Deoxyribonucleic Acid (DNA) editing studies. In this work, we focused on a wine and dual-use grapevine subcollection that consists of 930 accessions. Genetic analysis allowed to identify 521 unique genotypes. After comparing them with several databases, matches were found for 476 genetic profiles while the remaining 45 have not been previously described. Combination with clustering analysis suggested a total pool of 481
accessions that included some table cultivars. Several synonymies, homonymies and mislabeling have also been detected. Structure analysis allowed identifying six clusters according to eco-geographic cultivation areas and one additional group including non-
accessions. Diversity analysis pointed out that Spanish Mediterranean varieties are genetically closer to oriental genotypes than to European varieties typical of oceanic and continental climates. The origin of Spanish varieties is discussed in depth considering our data and previous studies. Analysis of molecular variance partition confirmed a well-structured germplasm, although differentiation among groups had a much lower effect on genetic variability than differences within groups, which are strongly related to a very high heterozygosity. A core collection that covers all allele richness is proposed. It is constituted of about 13% of total accessions, and each cluster inferred by structure analysis is represented.
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