Sex differences in pain and opioid mediated antinociception: Modulatory role of gonadal hormones

Publication date: Available online 12 October 2019Source: Life SciencesAuthor(s): Suzanne A. Nasser, Elham A. AfifyAbstractSex-related differences in pain and opioids has been the focus of many researches. It is demonstrated that women experience greater clinical pain, lower pain threshold and tolerance, more sensitivity and distress to experimentally induced pain compared to men. Sex differences in response to opioid treatment revealed inconsistent results. However, the etiology of these disparities is not fully elucidated. It is, therefore, conceivable now that this literature merits to be revisited comprehensively. Possible multifaceted factors seem to be associated. These include neuroanatomical, hormonal, neuroimmunological, psychological, social and cultural aspects and comorbidities. This review aims at providing an overview of the substantial literature documenting the sex differences in pain and analgesic response to opioids from animal and human studies within the context of the modulatory effects of the aforementioned factors. A detailed and critical discussion of the cellular and molecular signaling pathways underlying the modulatory actions of gonadal hormones in the sexual dimorphism in pain processing and opioid analgesia is extensively presented. It is indicated that sexual dimorphic activation of certain brain regions contribute to differential pain sensitivity between female and males. Plausible crosstalk between sex hormones and neuroimmunological signaling...
Source: Life Sciences - Category: Biology Source Type: research

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Publication date: Available online 16 November 2019Source: Journal of Critical CareAuthor(s): Marie-José Roos-Blom, Dave Dongelmans, Willemke Stilma, Jan Jaap Spijkstra, Evert de Jonge, Nicolette de KeizerAbstractPurposeHalf of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist.Materials and methodsWe performed unadjusted an...
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
ConclusionUsing the data from this study, it was possible to calculate the odds ratio of the agricultural pilot suffering low back pain, based on eight personal and work-related factors.Relevance for the industryBased on the results of the present study, it was possible to define strategies to reduce whole-body exposure in agricultural aircraft and, consequently, improve the pilots’ health. Strategies included management of the exposure and aircraft improvement.Graphical abstract
Source: International Journal of Industrial Ergonomics - Category: Occupational Health Source Type: research
ConclusionIn selected cases, endoscopic management is more cost-effective, minimally invasive, has less post-operative complications, and leads to a more expeditious recovery. Therefore, the role of therapeutic endoscopy for gastric perforations secondary to foreign bodies should always be considered.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Peroneal tendon pathology is becoming an increasingly recognized source of lateral-sided ankle pain. High clinical suspicion, along with judicious physical examination coupled with confirmatory advanced imaging modalities, are necessary to make an accurate diagnosis and aid in guiding treatment. Peroneal pathology encompasses several distinct conditions. Peroneal tendon tears and injuries to the peroneal retinaculum must be identified to guide treatment. Patients with peroneal pathology report high levels of satisfaction after surgical management with most returning to their preinjury level of function. An early and accura...
Source: Orthopedic Clinics of North America - Category: Orthopaedics Authors: Source Type: research
Conclusion: Femoral nerve blocks for postoperative pain management in tibial plateau fractures did not demonstrate an improvement in pain relief or narcotic use. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Pain Management in Plastic Surgery
Source: Clinics in Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Enhanced recovery after surgery is an interdisciplinary, multimodal approach to improve postoperative outcomes by applying multiple evidenced-based interventions. It has been adapted at multiple institutions for patients undergoing spine surgery to combat the rising rate of opioid consumption. Various preoperative, intraoperative, and postoperative pharmacologic and nonpharmacologic interventions have been introduced to augment patient care with the goal to decrease hospital length of stay and improve postoperative outcomes. Future studies will focus on health care-related quality of life outcomes to evaluate the effective...
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
CONCLUSION: Australian law currently requires legal medicinal cannabis use to follow specific, regulated pathways that limit prescription by this method; however, self-reported illicit use of cannabis remains relatively common in Australian women with endometriosis. Women report good efficacy of cannabis in reducing pain and other symptoms, with few adverse effects reported. Further clinical research is warranted to determine the effectiveness of cannabis in managing endometriosis symptoms. In locations where medicinal cannabis is more accessible, there remains a paucity of evidence for its clinical efficacy with endometri...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Practice variation exists in pain management of children with long bone fractures (LBFs).
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Original Contributions Source Type: research
ConclusionsThese findings show the change in pain of older adults over time, with both marked improvement and deterioration being observed. Critically, the predictors of individuals transitioning between classes reflect the breadth of biopsychosocial factors involved in pain.Significant StatementThis article identified differing classes of pain in older adults, using latent transition analysis. The analysis demonstrated how the pain classes of older adults are broadly consistent over time, however both improvement and deterioration in pain impact were observed. Transitions between classes were associated with several biops...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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