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Article ; Online: Enhanced Recovery After Surgery Protocols for Head and Neck Cancer: Systematic Review and Meta-analysis.

Kattar, Nrusheel / Wang, Steven X / Trojan, Jeffrey D / Ballard, Craig R / McCoul, Edward D / Moore, Brian A

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023 Volume 168, Issue 4, Page(s) 593–601

Abstract: Objective: Enhanced recovery after surgery (ERAS) protocols aim to optimize the pre-, intra-, and postoperative care of patients to improve surgery outcomes, reduce complications, decrease length of stay, and more. We aim to perform a systematic review ... ...

Abstract	Objective: Enhanced recovery after surgery (ERAS) protocols aim to optimize the pre-, intra-, and postoperative care of patients to improve surgery outcomes, reduce complications, decrease length of stay, and more. We aim to perform a systematic review and meta-analysis of ERAS protocols for head and neck cancer surgery with or without microvascular reconstruction. Data sources: PubMed, Embase, and Web of Science databases were queried, and abstracts were screened independently by 2 investigators. Review methods: This review was conducted in accordance with the PRISMA guidelines. We included comparative observational studies but excluded animal studies, case reports, and case series. Results: Of 557 articles initially reviewed by title and/or abstract, we identified 30 for full-text screening, and 9 met the criteria for qualitative synthesis. Meta-analysis of length of stay revealed a mean decrease of 1.37 days (95% CI, 0.77-1.96; I Conclusion: Implementation of ERAS protocols can lead to decreases in length of stay and opioid drug utilization. However, further high-quality prospective studies of ERAS protocols are needed, especially with stratified analysis of outcomes based on the type of head and neck cancer surgery.
MeSH term(s)	Humans ; Enhanced Recovery After Surgery ; Head and Neck Neoplasms/surgery ; Length of Stay ; Postoperative Care ; Postoperative Complications/prevention & control ; Prospective Studies ; Clinical Protocols
Language	English
Publishing date	2023-02-05
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1177/01945998221082541
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Article: Intramuscular Tranexamic Acid Administration on the Battlefield.

Steele, David / Ballard, P Kjell / Burke, Riley / Ferguson, Brian

Case reports in emergency medicine

2022 Volume 2022, Page(s) 9689923

Abstract: Background: Tranexamic acid (TXA) is routinely administered intravenously (IV) and intraosseously (IO) in response to exsanguination.: Case: This report describes a patient who sustained multiple high-powered rifle gunshot wounds that received ... ...

Abstract	Background: Tranexamic acid (TXA) is routinely administered intravenously (IV) and intraosseously (IO) in response to exsanguination. Case: This report describes a patient who sustained multiple high-powered rifle gunshot wounds that received battlefield-environment intramuscular (IM) administration of TXA due to inability to obtain IV / IO access. This case represents the unlikely positive outcome in the setting of multiple remarkable obstacles, which may have been ameliorated by novel administration of TXA. Conclusion: Cases of IM TXA administration as a primary intervention are not well represented in the current body of medical literature. This case report highlights a clinical scenario where IM TXA was utilized as part of first-line treatment that led to a positive clinical outcome. Although IM TXA is not yet endorsed by current trauma guidelines, this case suggests that IM route administration of TXA should be further investigated. If indeed IM administration of TXA proves just as efficacious as alternative routes, this would hold considerable advantageous implications for austere situations were sterility and IV / IO placement are impractical. This would also represent another avenue by which to decrease the time-to-TXA for patients, allowing sooner correction of hemorrhage and trauma-associated coagulopathy.
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	2684646-9
ISSN	2090-6498 ; 2090-648X
ISSN (online)	2090-6498
ISSN	2090-648X
DOI	10.1155/2022/9689923
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Article: Building consensus on common features and interoperability use cases for community health information systems: a Delphi study.

Holeman, Isaac / Citrin, David / Albirair, Mohamed / Puttkammer, Nancy / Ballard, Madeleine / DeRenzi, Brian / O'Donovan, James / Wasunna, Beatrice

BMJ global health

2024 Volume 9, Issue 4

Abstract: Introduction: Information systems for community health have become increasingly sophisticated and evidence-based in the last decade and they are now the most widely used health information systems in many low-income and middle-income countries. This ... ...

Abstract	Introduction: Information systems for community health have become increasingly sophisticated and evidence-based in the last decade and they are now the most widely used health information systems in many low-income and middle-income countries. This study aimed to establish consensus regarding key features and interoperability priorities for community health information systems (CHISs). Methods: A Delphi study was conducted among a systematically selected panel of CHIS experts. This impressive pool of experts represented a range of leading global health institutions, with gender and regional balance as well as diversity in their areas of expertise. Through five rounds of iterative surveys and follow-up interviews, the experts established a high degree of consensus. We supplemented the Delphi study findings with a series of focus group discussions with 10 community health worker (CHW) leaders. Results: CHISs today are expected to adapt to a wide range of local contextual requirements and to support and improve care delivery. While once associated with a single role type (CHWs), these systems are now expected to engage other end users, including patients, supervisors, clinicians and data managers. Of 30 WHO-classified digital health interventions for care providers, experts identified 23 (77%) as being important for CHISs. Case management and care coordination features accounted for more than one-third (14 of 37, 38%) of the core features expected of CHISs today, a higher proportion than any other category. The highest priority use cases for interoperability include CHIS to health management information system monthly reporting and CHIS to electronic medical record referrals. Conclusion: CHISs today are expected to be feature-rich, to support a range of user roles in community health systems, and to be highly adaptable to local contextual requirements. Future interoperability efforts, such as CHISs in general, are expected not only to move data efficiently but to strengthen community health systems in ways that measurably improve care.
MeSH term(s)	Humans ; Delphi Technique ; Consensus ; Health Information Systems/standards ; Health Information Interoperability ; Community Health Services ; Female ; Focus Groups ; Community Health Workers ; Male
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2023-014001
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Article ; Online: Novel 3D-printed foot orthoses with variable hardness: A comfort comparison to traditional orthoses.

Walker, Kyle J / Przestrzelski, Breanne T / Kaluf, Brian / Driggers, Nikki H / Ballard, W Daniel / Pruett, Timothy C / Hoeffner, Steve L / DesJardins, John D

Medical engineering & physics

2023 Volume 115, Page(s) 103978

Abstract: Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D ... ...

Abstract	Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D printed orthosis and fabrication method that utilizes custom architectures to produce variable-hardness regions. These novel orthoses are compared to traditionally fabricated orthoses during a 2-week user comfort study. Twenty (n = 20) male volunteers underwent orthotic fitting for both traditional and 3D-printed foot orthoses prior to engaging in treadmill walking trials and 2 weeks of wear. Each participant undertook a regional comfort, acceptance, and comparison analysis of the orthoses at three time points throughout the study (0, 1, and 2 weeks). Both the 3D-printed and the traditionally fabricated foot orthoses demonstrated statistically significant increases in comfort when compared to the factory fabricated shoe insert. Additionally, the two orthosis groups were not significantly different from each other in comfort rankings both regionally and overall at any time point. The similar comfort achieved by the 3D-printed orthosis to the traditionally fabricated orthosis after 7 days and 14 days emphasizes the potential of the future use of the more reproducible and adaptable 3D-printed orthosis manufacturing methodology.
MeSH term(s)	Humans ; Male ; Foot Orthoses ; Hardness ; Foot ; Walking ; Printing, Three-Dimensional ; Equipment Design
Language	English
Publishing date	2023-04-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1181080-4
ISSN	1873-4030 ; 1350-4533
ISSN (online)	1873-4030
ISSN	1350-4533
DOI	10.1016/j.medengphy.2023.103978
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Article: Safety and efficacy of self-expanding metal stents for biliary drainage in patients receiving neoadjuvant therapy for pancreatic cancer.

Ballard, Darren D / Rahman, Syed / Ginnebaugh, Brian / Khan, Abdul / Dua, Kulwinder S

Endoscopy international open

2018 Volume 6, Issue 6, Page(s) E714–E721

Abstract: Background and study aims: Durable biliary drainage is essential during neoadjuvant therapy (NAT) in patients with pancreatic cancer who present with biliary obstruction. Plastic stents (PS) tend to occlude readily, resulting in delay/interruption of ... ...

Abstract	Background and study aims: Durable biliary drainage is essential during neoadjuvant therapy (NAT) in patients with pancreatic cancer who present with biliary obstruction. Plastic stents (PS) tend to occlude readily, resulting in delay/interruption of treatment. Our aim was to evaluate the safety and efficacy of self-expanding metal stents (SEMS) for biliary drainage in patients receiving NAT for pancreatic cancer. Patients and methods: From 2009 to 2014, all consecutive patients with resectable pancreatic cancer at one tertiary center had SEMS placed for biliary drainage before NAT was started. Data on biliary drainage efficacy, stent malfunction rates and procedural adverse events were collected. Results: One hundred forty-two consecutive patients with pancreatic cancer (mean age 66 ± 9 SD years; 81 male, 61 female; 67 resectable, 75 borderline resectable) were enrolled. Eight-seven patients (61 %) had prior PS exchanged to SEMS and 55 (39 %) had SEMS placed upfront. Median duration from SEMS placement to the end of NAT/surgery was 111 days (range 44 - 282). During NAT, SEMS malfunction requiring reintervention occurred in 16 patients (11.2 %): tissue ingrowth 11, stent occlusion from food 6, stent migration 3, incomplete expansion 1, "tissue cheese-cutter" effect 1, and cystic duct obstruction 1. On subgroup analysis, no correlation between SEMS malfunction and stage of disease, prior PS, or duration of NAT was found (r Conclusion: SEMS provide safe, effective and durable biliary drainage during NAT for pancreas cancer. Previously placed PS can be exchanged for SEMS. SEMS do not require removal prior to surgery.
Language	English
Publishing date	2018-05-25
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-0599-6190
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Article ; Online: Fertility Potential and Gonadal Function in Survivors of Reduced-Intensity Hematopoietic Stem Cell Transplantation.

Rotz, Seth J / Hamilton, Betty K / Wei, Wei / Ahmed, Ibrahim / Winston, Sameeya Ahmed / Ballard, Sherri / Bernard, Robyn J / Carpenter, Paul / Farhadfar, Nosha / Ferraro, Christina / Friend, Brian D / Gloude, Nicholas J / Hayashi, Robert J / Hoyle, Kerry / Jenssen, Kari / Koo, Jane / Lee, Catherine J / Mariano, Livia / Nawabit, Rawan /

Ngwube, Alexander / Lalefar, Nahal / Phelan, Rachel / Perkins, Laynie / Rao, Anandini / Rayes, Ahmad / Sandheinrich, Taryn / Stafford, Lauren / Tomlinson, Kathryn / Whiteside, Stacy / Wiedl, Christina / Myers, Kasiani

Transplantation and cellular therapy

2024 Volume 30, Issue 5, Page(s) 534.e1–534.e13

Abstract: The use of reduced-intensity conditioning (RIC) regimens has increased in an effort to minimize hematopoietic stem cell transplantation (HCT) end-organ toxicity, including gonadal toxicity. We aimed to describe the incidence of fertility potential and ... ...

Abstract	The use of reduced-intensity conditioning (RIC) regimens has increased in an effort to minimize hematopoietic stem cell transplantation (HCT) end-organ toxicity, including gonadal toxicity. We aimed to describe the incidence of fertility potential and gonadal function impairment in adolescent and young adult survivors of HCT and to identify risk factors (including conditioning intensity) for impairment. We performed a multi-institutional, international retrospective cohort study of patients age 10 to 40 years who underwent first allogeneic HCT before December 1, 2019, and who were alive, in remission, and available for follow-up at 1 to 2 years post-HCT. For females, an AMH level of ≥.5 ng/mL defined preserved fertility potential; an AMH level of ≥.03 ng/mL was considered detectable. Gonadal failure was defined for females as an elevated follicle-stimulating hormone (FSH) level >30 mIU/mL with an estradiol (E2) level <17 pg/mL or current use of hormone replacement therapy (regardless of specific indication or intent). For males, gonadal failure was defined as an FSH level >10.4 mIU/mL or current use of hormone replacement therapy. A total of 326 patients (147 females) were available for analysis from 17 programs (13 pediatric, 4 adult). At 1 to 2 years post-HCT, 114 females (77.6%) had available FSH and E2 levels and 71 (48.3%) had available AMH levels. FSH levels were reported for 125 males (69.8%). Nearly all female HCT recipients had very low levels of AMH. One of 45 (2.2%) recipients of myeloablative conditioning (MAC) and four of 26 (15.4%) recipients of reduced-intensity conditioning (RIC) (P = .06) had an AMH ≥.5 ng/m, and 8 of 45 MAC recipients (17.8%) and 12 of 26 RIC recipients (46.2%) (P = .015) had a detectable AMH level. Total body irradiation (TBI) dose and cyclophosphamide equivalent dose (CED) were not associated with detectable AMH. The incidence of female gonadal hormone failure was 55.3%. In univariate analysis, older age at HCT was associated with greater likelihood of gonadal failure (median age, 17.6 versus 13.9; P < .0001), whereas conditioning intensity (RIC versus MAC), TBI, chronic graft-versus-host disease requiring systemic therapy, and CED were not significantly associated with gonadal function. In multivariable analysis, age remained statistically significant (odds ratio [OR]. 1.11; 95% confidence interval [CI], 1.03 to 1.22) for each year increase; P = .012), Forty-four percent of the males had gonadal failure. In univariate analysis, older age (median, 16.2 years versus 14.4 years; P = .0005) and TBI dose (P = .002) were both associated with gonadal failure, whereas conditioning intensity (RIC versus MAC; P = .06) and CED (P = .07) were not statistically significant. In multivariable analysis, age (OR, 1.16; 95% CI, 1.06-1.27 for each year increase; P = .0016) and TBI ≥600 cGy (OR, 6.23; 95% CI, 2.21 to 19.15; P = .0008) remained significantly associated with gonadal failure. Our data indicate that RIC does not significantly mitigate the risk for gonadal failure in females or males. Age at HCT and (specifically in males) TBI use seem to be independent predictors of post-transplantation gonadal function and fertility status. All patients should receive pre-HCT infertility counseling and be offered appropriate fertility preservation options and be screened post-HCT for gonadal failure.
MeSH term(s)	Humans ; Hematopoietic Stem Cell Transplantation/adverse effects ; Female ; Male ; Adult ; Adolescent ; Child ; Retrospective Studies ; Transplantation Conditioning/adverse effects ; Young Adult ; Fertility/physiology ; Survivors/statistics & numerical data ; Anti-Mullerian Hormone/blood ; Gonads/physiology ; Risk Factors
Chemical Substances	Anti-Mullerian Hormone (80497-65-0)
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	3062231-1
ISSN	2666-6367
ISSN (online)	2666-6367
DOI	10.1016/j.jtct.2024.02.002
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Article ; Online: In Vitro Pharmacokinetic/Pharmacodynamic Modeling of HIV Latency Reversal by Novel HDAC Inhibitors Using an Automated Platform.

Newhard, William / Patel, Munjal / Cassaday, Jason / Ballard, Jeanine / Squadroni, Brian / Wu, Guoxin / Liu, Jian / Yu, Wensheng / Kozlowski, Joe / Zuck, Paul / Howell, Bonnie / Hazuda, Daria / Vargo, Ryan / Barnard, Richard

SLAS discovery : advancing life sciences R & D

2021 Volume 26, Issue 5, Page(s) 642–654

Abstract: Antiretroviral therapy is able to effectively control but not eradicate HIV infection, which can persist, leading to the need for lifelong therapy. The existence of latently HIV-infected cells is a major barrier to the eradication of chronic HIV ... ...

Abstract	Antiretroviral therapy is able to effectively control but not eradicate HIV infection, which can persist, leading to the need for lifelong therapy. The existence of latently HIV-infected cells is a major barrier to the eradication of chronic HIV infection. Histone deacetylase inhibitors (HDACis), small molecules licensed for oncology indications, have shown the ability to produce HIV transcripts in vitro and in vivo. The pharmacologic parameters that drive optimal HIV latency reversal in vivo are unknown and could be influenced by such factors as the HDACi binding kinetics, concentration of compound, and duration of exposure. This study evaluates how these parameters affect HIV latency reversal for a series of novel HDACis that differ in their enzymatic on and off rates. Varying cellular exposure, using automated washout methods of HDACi in a Jurkat cell model of HIV latency, led to the investigation of the relationship between pharmacokinetic (PK) properties, target engagement (TE), and pharmacodynamic (PD) responses. Using an automated robotic platform enabled miniaturization of a suspension cell-based washout assay that required multiple manipulations over the 48 h duration of the assay. Quantification of histone acetylation (TE) revealed that HDACis showed early peaks and differences in the durability of response between different investigated HDACis. By expanding the sample times, the shift between TE and PD, as measured by green fluorescent protein, could be fully characterized. The comprehensive data set generated by automating the assays described here was used to establish a PK/PD model for HDACi-induced HIV latency reversal.
MeSH term(s)	Automation, Laboratory ; Cell Culture Techniques ; Cells, Cultured ; Gene Expression Regulation, Viral/drug effects ; HIV/drug effects ; HIV/genetics ; HIV Infections/drug therapy ; HIV Infections/virology ; Histone Deacetylase Inhibitors/pharmacokinetics ; Humans ; Jurkat Cells ; Models, Theoretical ; Virus Latency/drug effects ; Virus Replication/drug effects
Chemical Substances	Histone Deacetylase Inhibitors
Language	English
Publishing date	2021-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2885123-7
ISSN	2472-5560 ; 2472-5552
ISSN (online)	2472-5560
ISSN	2472-5552
DOI	10.1177/2472555220983810
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Zs.A 4911: Show issues

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Article ; Online: Guide for starting or optimizing a 3D printing clinical service.

Ganapathy, Aravinda / Chen, David / Elumalai, Anusha / Albers, Brian / Tappa, Karthik / Jammalamadaka, Udayabhanu / Hoegger, Mark J / Ballard, David H

Methods (San Diego, Calif.)

2022 Volume 206, Page(s) 41–52

Abstract: Three-dimensional (3D) printing has applications in many fields and has gained substantial traction in medicine as a modality to transform two-dimensional scans into three-dimensional renderings. Patient-specific 3D printed models have direct patient ... ...

Abstract	Three-dimensional (3D) printing has applications in many fields and has gained substantial traction in medicine as a modality to transform two-dimensional scans into three-dimensional renderings. Patient-specific 3D printed models have direct patient care uses in surgical and procedural specialties, allowing for increased precision and accuracy in developing treatment plans and guiding surgeries. Medical applications include surgical planning, surgical guides, patient and trainee education, and implant fabrication. 3D printing workflow for a laboratory or clinical service that produces anatomic models and guides includes optimizing imaging acquisition and post-processing, segmenting the imaging, and printing the model. Quality assurance considerations include supervising medical imaging expert radiologists' guidance and self-implementing in-house quality control programs. The purpose of this review is to provide a workflow and guide for starting or optimizing laboratories and clinical services that 3D-print anatomic models or guides for clinical use.
MeSH term(s)	Diagnostic Imaging ; Humans ; Models, Anatomic ; Patient Care Planning ; Printing, Three-Dimensional
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	1066584-5
ISSN	1095-9130 ; 1046-2023
ISSN (online)	1095-9130
ISSN	1046-2023
DOI	10.1016/j.ymeth.2022.08.003
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Article ; Online: Inflammatory panel cytokines are elevated in the neocortex of late-stage Alzheimer's disease but not Lewy body dementias.

Chai, Yuek Ling / Lee, Jasinda H / Chong, Joyce R / Ballard, Clive / Francis, Paul T / Kennedy, Brian K / Arumugam, Thiruma V / Chen, Christopher P / Aarsland, Dag / Lai, Mitchell K P

Journal of neuroinflammation

2023 Volume 20, Issue 1, Page(s) 111

Abstract: Background: Chronically dysregulated neuroinflammation has been implicated in neurodegenerative dementias, with separate studies reporting increased brain levels of inflammatory mediators and gliosis in Alzheimer's disease (AD) as well as in Lewy body ... ...

Abstract	Background: Chronically dysregulated neuroinflammation has been implicated in neurodegenerative dementias, with separate studies reporting increased brain levels of inflammatory mediators and gliosis in Alzheimer's disease (AD) as well as in Lewy body dementias (LBD). However, it is unclear whether the nature and extent of neuroinflammatory responses in LBD are comparable to those in AD. In this study, we performed head-to-head measurements of a panel of cytokines in the post-mortem neocortex of AD versus the two major clinical subtypes of LBD, namely, dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Methods: Post-mortem tissues from the mid-temporal cortex (Brodmann area 21) of a cohort of neuropathologically well-defined AD, PDD and DLB patients were processed and measured for a comprehensive range of cytokines (IL-1α, IL-1Ra, IL-8, IL-10, IL-12p70, IL-13, IFN-γ, GM-CSF and FGF-2) using a multiplex immunoassay platform. Associations between inflammation markers and neuropathological measures of neuritic plaques, neurofibrillary tangles as well as Lewy bodies were also performed. Results: We found IL-1α, IFN-γ, GM-CSF and IL-13 to be elevated in the mid-temporal cortex of AD patients. In contrast, none of the measured cytokines were significantly altered in either DLB or PDD. Similar cytokine changes were observed in two other neocortical areas of AD patients. Furthermore, increases of IL-1α, IFN-γ, GM-CSF, IL-10 and IL-13 associated with moderate-to-severe neurofibrillary tangle burden, but not with neuritic plaques or Lewy bodies. Our findings of elevated neocortical pro- and anti-inflammatory cytokines in AD, but not in DLB or PDD, suggest that neuroinflammatory responses are strongly linked to neurofibrillary tangle burden, which is higher in AD compared to LBD. In conclusion, neuroinflammation may not play a prominent role in the pathophysiology of late-stage LBD.
MeSH term(s)	Humans ; Cytokines ; Granulocyte-Macrophage Colony-Stimulating Factor ; Interleukin-10 ; Neocortex ; Interleukin-13 ; Alzheimer Disease ; Dementia ; Neuroinflammatory Diseases ; Plaque, Amyloid ; Parkinson Disease
Chemical Substances	Cytokines ; Granulocyte-Macrophage Colony-Stimulating Factor (83869-56-1) ; Interleukin-10 (130068-27-8) ; Interleukin-13
Language	English
Publishing date	2023-05-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2156455-3
ISSN	1742-2094 ; 1742-2094
ISSN (online)	1742-2094
ISSN	1742-2094
DOI	10.1186/s12974-023-02789-8
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Article: Quantifying the influence of child abuse history on the cardinal symptoms of fibromyalgia.

Ortiz, Robin / Ballard, Elizabeth D / Machado-Vieira, Rodrigo / Saligan, Leorey N / Walitt, Brian

Clinical and experimental rheumatology

2016 Volume 34, Issue 2 Suppl 96, Page(s) S59–66

Abstract: Objectives: To quantify the influence of abuse, particularly in childhood, with pain sensitivity and other adverse symptoms experienced by women with fibromyalgia (FM).: Methods: Subjects with FM completed a detailed abuse interview, dolorimetry, and ...

Abstract	Objectives: To quantify the influence of abuse, particularly in childhood, with pain sensitivity and other adverse symptoms experienced by women with fibromyalgia (FM). Methods: Subjects with FM completed a detailed abuse interview, dolorimetry, and questionnaire-based assessments of fatigue, cognitive self-appraisal, and depression. Student's t- and chi-square tests were used to analyse differences in FM symptoms between those with and without a history of childhood abuse. Linear regression was used to evaluate the relationship between abuse and symptom severity, adjusting for possible confounders. Results: In 111 women with FM, physical abuse during childhood demonstrated a clinically modest, yet statistically significant, association with increased tenderness as measured by pain pressure thresholds (β=-0.25, p=0.011) and tender points (β=0.23, p=.022). Physical child abuse was also associated with cognitive language impairment after adjusting for depression (β=0.27, p=0.001). While emotional child abuse was associated with fatigue, the association did not persist after adjustment for depressive symptoms. Conclusions: Group differences are of small magnitude and might not directly impact clinical practice, however, the experience of child abuse is associated with FM symptom severity and may shape the biological development of interoception in ways that predispose to pain and polysymptomatic distress.
MeSH term(s)	Adult ; Adult Survivors of Child Abuse/psychology ; Adult Survivors of Child Abuse/statistics & numerical data ; Child ; Child Abuse/psychology ; Child Abuse/statistics & numerical data ; Chronic Pain/diagnosis ; Chronic Pain/etiology ; Chronic Pain/psychology ; Depression/diagnosis ; Depression/etiology ; Depression/physiopathology ; Diagnostic Self Evaluation ; Female ; Fibromyalgia/complications ; Fibromyalgia/diagnosis ; Fibromyalgia/physiopathology ; Fibromyalgia/psychology ; Humans ; Life Change Events ; Middle Aged ; Pain Perception/physiology ; Pain Threshold/physiology ; Pain Threshold/psychology ; Statistics as Topic ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2016-03
Publishing country	Italy
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
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In stock of ZB MED Cologne/Königswinter

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Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito