The Beneficial Effects of Heme Oxygenase 1 and Hydrogen Sulfide Activation in the Management of Neuropathic Pain, Anxiety- and Depressive-like Effects of Paclitaxel in Mice

Chemotherapy-induced peripheral neuropathy constitutes an unresolved clinical problem that severely decreases the quality of the patient’s life. It is characterized by somatosensory alterations, including chronic pain, and a high risk of suffering mental disorders such as depression and anxiety. Unfortunately, an effective treatment for this neuropathology is yet to be found. We investigated the therapeutic potential of cobalt protoporphyrin IX (CoPP), a heme oxygenase 1 inducer, and morpholin-4-ium 4-methoxyphenyl(morpholino) phosphinodithioate dichloromethane complex (GYY4137), a slow hydrogen sulfide (H2S) donor, in a preclinical model of paclitaxel (PTX)-induced peripheral neuropathy (PIPN) in mice. At three weeks after PTX injection, we evaluated the effects of the repetitive administration of 5 mg/kg of CoPP and 35 mg/kg of GYY4137 on PTX-induced nociceptive symptoms (mechanical and cold allodynia) and on the associated emotional disturbances (anxiety- and depressive-like behaviors). We also studied the mechanisms that could mediate their therapeutic properties by evaluating the expression of key proteins implicated in the development of nociception, oxidative stress, microglial activation, and apoptosis in prefrontal cortex (PFC) and dorsal root ganglia (DRG) of mice with PIPN. Results demonstrate that CoPP and GYY4137 treatments inhibited both the nociceptive symptomatology and the derived emotional alterations. These actions were mainly mediated through potentiation of antioxidant responses and inhibiting oxidative stress in the DRG and/or PFC of mice with PIPN. Both treatments normalized some plasticity changes and apoptotic reactions, and GYY4137 blocked microglial activation induced by PTX in PFC. In conclusion, this study proposes CoPP and GYY4137 as good candidates for treating neuropathic pain, anxiety- and depressive-like effects of PTX.

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Pur Balance CBD Gummies - CBD Edibles For Pain, Anxiety And Inflammation| Cannabis Gummies On Sale In 2022

Protocol for RCT: Effectiveness of Traditional Breast Stimulations as Adjuvant Techniques to Breast Milk Expression on Lactational and Maternal Outcomes

Background: Mothers of infants who are dependent on expressed breast milk often find difficulty to express adequate quantity of breast milk to ensure exclusive breast feeding to their babies and it has become a major stress factor among these mothers. Many cost-effective adjuvant techniques are proved to be very useful in improving the quantity and quality of expressed breast milk. Objective: To determine the effect of two traditional breast stimulation techniques such as warm compress and breast massage as adjuvant to breast milk expression on maternal and lactational outcomes. Methodology: A hospital-based cross over trial will be considered to compare the effects of two interventions such as breast massage and warm compress, adjuvant to breast milk expression method (breast pump) on lactational outcomes (Quantity and quality of expressed breast milk) and maternal outcomes (Nipple pain, anxiety and experience of breast milk expression). The setting of the study will be selected tertiary level hospital of New Delhi. Approval from Institutional the Ethical approval is obtained from Institutional Ethical Committee, DMIMS (DMIMS (DU)/IEC/2017-18/6979) and also from the institutional ethical committee of armed forces medical services hospital of New Delhi where the study will be conducted. The data collected will be entered to an electronic data sheet and analysis will be done using SPSS. Expected Results: There will be a positive impact of interventions on locational outcomes such as quantity of expressed breast milk and quality of expressed breast milk. There will be a positive impact of interventions on maternal outcomes such as nipple pain. Anxiety and breast milk expression experience. This nurse led interventions will be made as a part of hospital policy to provide routine care to the mothers who are expressing breast milk in hospital settings. Conclusion: Conclusion will be drawn after the analysis of data collected from the predetermined sample size. The findings of the study will be published in an open access peer reviewed journal.

Effect of Music on Pain in Cancer Patients in Palliative Care Service: A Randomized Controlled Study

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.

Investigating The Effect of Psychological Variables On Postoperative Pain In Children

Background and Purpose: Despite the progress of pain management in children, the prevalence of postoperative pain remains a caring challenge. Given the multidimensional nature of pain and the effect of various factors on pain, the need to identify risk factors in preventing postoperative pain is felt. The purpose of this study was therefore to investigate the effect of psychological variables on postoperative pain in childrenMethods: This study was conducted following a descriptive-correlational study design. The samples of the study were 171 children aged 6-13 years who were conveniently selected from the selected children's hospital in Tehran according to the inclusion criteria. Data were collected using the “demographic questionnaire”, “Child Pain Anxiety Symptoms Scale (CPASS)”, the Spielberger’s State-Trait Anxiety Inventory (STAI), and “Coping Strategies Questionnaire (CSQ)” and analyzed using SPSS21 software.Results: Most of the 171 children participated were boys (65.5%) with a mean age of 9.58 years. The most common type of surgery was abdominal (53.2%), with an average surgery duration of 134.29 minutes. The results of regression analysis showed that postoperative pain was positively affected by child and parent anxiety and negatively affected by coping strategies. The postoperative pain increased 0.31 and 0.30 per unit increase in child and parent anxiety, respectively, and decreased 0.14 per unit increase in coping strategies.Conclusion: Based on the confirmation of the relationship between child and parent psychological variables on postoperative pain, identifying children at risk and presenting psychological interventions can be an effective step for managing postoperative pain and improving child and family comfort.

The effect of a smartphone-based perioperative nursing intervention: prayer, education, exercise therapy, hypnosis, and music toward pain, anxiety, and early mobilization on cardiac surgery

Background: Cardiac surgery can elicit both physical and psychological responses. Prayer, exercise therapy, education, hypnosis, and music are expected to be able to overcome pain, anxiety, and immobilization in the cardiac surgery. This study was to create a smartphone-based peri-operative nursing intervention model that was able to reduce pain, anxiety, and increase early mobilization cardiac surgery patients.Design and Methods: This study consisted of three stages. The first stage was research and development, the second was true experimental design, and the third was cross sectional design. The samples size was 86 respondents. The intervention models for the treatment group comprised of a smartphone-based therapy of prayer, education, exercise, hypnosis, and music. The control group was given standard hospital intervention according to the clinical pathway.Results: The majority of respondents were adults, male, high school graduate in the treatment group and bachelor graduate in the control group, CABG type of surgery, and having pain history. The intervention had a significant effect on reducing pain scale and anxiety level as well as increasing early mobilization (p<0.05). The intervention had a direct effect on pain and anxiety, but it had no direct effect on early mobilization. However, it gave indirect effect on early mobilization that was mediated by anxiety.Conclusion: The models can be used by nurses to reduce pain, anxiety and to increase early mobilization on cardiac surgery patients.

Application of hypnosis in psychOncology: A review of the literature

Hypnosis is useful for multiple somatic and psychological disorders, particularly cancer disease-related issues. In fact, the literature points out that hypnosis is effective in helping patients deal with aspects disease related, as well as in reducing the side effects of treatment. This review of the literature aims to summarize and assess the evidence of the usefulness of hypnosis in cancer patients and was conducted based on articles published between 2012 and 2019. The databases used were: B-on, SciELO, MEDLINE, and Web of Science. Randomized controlled trials and non-randomized studies were assessed. Among 837 studies identified, nine met the inclusion criteria and were selected. The studies were consensual to the effectiveness of hypnosis in reducing a set of symptoms in cancer patients, mainly pain, anxiety, depression, fatigue, and insomnia. However, several methodological limitations were identified. The practice of hypnosis is related to a significant number of techniques and approaches that differ from each other, thus compromising the interpretation and generalization of its effects. This review updates the evidence and suggests that the study of the efficacy of hypnosis in cancer patients is still limited. Further research into the effectiveness and acceptability of hypnosis for cancer patients is recommended.

Changing Pain Management Strategy from Opioid-Centric towards Improve Postoperative Cognitive Dysfunction with Dexmedetomidine

Objective: This study was aimed to investigate the effectiveness of dexmedetomidine (DEX) on improving the level of pain and disability to find out the possible correlation between psychological factors with pain management satisfaction and physical function in patients with femoral neck fractures. Methods: One hundred twenty-four adult patients with stable femoral neck fractures (type I and II, Garden classification) who underwent internal fixation, were prospectively enrolled including 62 patients in the DEX group and 62 patients in the control group. The magnitude of disability using Harris Hip Score, Postoperative Cognitive Dysfunction (POCD) using Mini-Mental State Examination (MMSE score), Quality of Recovery (QoR-40), pain-related anxiety (PASS-20), pain management and pain catastrophizing scale (PCS) were recorded on the first and second day after surgery. Results: The DEX group on the first and second days after surgery exhibited higher quality of recovery scores, greater satisfaction with pain management, low disability scores, less catastrophic thinking, lower pain anxiety, greater mini mental state examination scores and less opioid intake and the differences were statistically significant compared with the control group (P<0.001). Emergence agitation and incidence of POCD were significantly less in the DEX group (P<0.001). Decreased disability was associated with less catastrophic thinking and lower pain anxiety, but not associated with more opioid intake (P<0.001). Higher QoR-40 scores had a negative correlation with more catastrophic thinking and more opioid intake (P<0.001). Greater satisfaction with pain management was correlated with less catastrophic thinking and less opioid intake (P<0.001). Conclusion: Using DEX as an adjunct to anesthesia could significantly improve postoperative cognitive dysfunction and the quality of recovery and these improvements were accompanied by decrease in pain, emergence agitation, and opioid consumption by DEX administration. Since pain relief and decreased disability were not associated with prescribing greater amounts of opioid intake in the patients, improving psychological factors, including reducing catastrophic thinking or self-efficacy about pain, could be a more effective strategy to reduce pain and disability, meanwhile reducing opioid prescription in the patients. Our findings showed that DEX administration is safe sedation with anti-inflammatory, analgesic and antiemetic effects and it could help change pain management strategy from opioid-centric towards improved postoperative cognitive dysfunction.

Evaluation of Betulinic Acid Effects on Pain, Anxiety, Catalepsy, and Oxidative Stress in Animal Model of Parkinson’s Disease.

BackgroundParkinson’s disease (PD) is known by motor impairments. Betulinic acid (BA) is a natural active compound with potent antioxidant activity. The present study addresses the question whether BA affects motor dysfunctions, pain, anxiety and molecular changes in the rat model of PD.MethodsRight medial forebrain bundle (MFB) was lesioned by injection of 6-OHDA in Male Wistar rats. BA (0.5, 5 & 10 mg/kg) and L-dopa (20 mg/kg) were administrated for 7 days. rigidity, anxiety, analgesia and memory, were assessed by bar test, open-field, elevated plus-maze (EPM), tail-flick and shuttle box. Additionally, the malondialdehyde (MDA), Superoxide dismutase (SOD), glutathione peroxidase (GPx) activity as well as Brain-derived neurotrophic factor (BDNF) and Interleukin 10 (IL10) levels in the brain tissue were measured.ResultsTreatment with BA significantly reversed the 6-OHDA-induced motor complication in the bar test, but it modified anxiety like behavior neither in open-field nor in EPM, it only decreased the time spent in open arms. Moreover no significant changes were found in the tail-flick between treatment and sham groups. On the other hand, the level of MDA & IL10 were decreased, and the activity of GPx, levels of SOD & BDNF in the rats brains were increased.ConclusionOur results showed that BA could affect as a potent natural free radical scavenger which removes brain tissue oxidants in PD. It can account a possible promise as a good therapeutic agent for motor and non-motor complications in PD.

The Effect of Preoperative Behavioral Intervention on Pain, Anxiety, Opioid Use, and Function in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Study

ABSTRACT Objective To evaluate the efficacy of preoperative cognitive-behavioral psychoeducation (CBE) for improved pain, anxiety, opioid use, and postoperative function in total knee arthroplasty (TKA) patients. Methods A randomized controlled trial was conducted among 36 military health system beneficiaries attending preoperative education for TKA. The standard of care (SOC) group (n = 18) received information on home safety, rehabilitation, postoperative precautions, and pain management. In addition, the occupational therapy led CBE group (n = 16) received information on principles of holistic wellness (healing process, effects of stress on healing, heart-rate control through diaphragmatic breathing, anti-inflammatory nutrition, goal setting, and mental imagery). Outcomes of interest: knee active range of motion, pain (Defense and Veterans Pain Rating Scale), opioid medication use, heart-rate coherence (emwave2), anxiety (Generalized Anxiety Disorder Scale), and function (Knee Outcome Survey Activities of Daily Living [KOS-ADL], modified Functional Independence Measure, and Global Rate of Change). Results The CBE group demonstrated significantly greater decline in pain overall, with activity, and during sleep in relation to the SOC group when comparing visit 1 to visit 5. Opioid medication use was significantly lower for CBE versus SOC. Postoperative General Anxiety Disorder-7 scores decreased significantly among CBE participants with similar increase in high heart rate coherence. Function significantly improved postoperatively based on KOS-ADL and Global Rate of Change scores. Twice as many CBE participants had same-day discharge compared to SOC participants and most CBE participants continued with healthy lifestyle recommendations at the 3-month follow-up. Conclusion A cognitive-behavioral approach to preoperative education may improve postoperative pain, anxiety, and function while decreasing opioid use among TKA patients. Findings from this pilot study support further research to examine similar interventions among distinct surgical populations and encourage further evaluation on the effects of CBE to enhance health and healthcare delivery.