Human Studies

As opioid prescribing has declined, it is unclear how the landscape of prescription pain treatment across the US has changed. We used nationally-representative data from the Medical Expenditure Health Survey, 2014-2018 to examine trends in prescriptions for opioid and non-opioid pain medications, including acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, and antidepressants among US adults with self-reported pain. Overall, from 2014-2018, the percentage of participants receiving a prescription for opioids declined, (38.8% vs. 32.8%), remained stable for NSAIDs (26.8% vs. 27.7%), and increased for acetaminophen (1.6% vs. 2.3%), antidepressants (9.6% vs. 12.0%) and gabapentinoids (13.2% vs. 19.0%). In this period, the adjusted odds of receiving an opioid prescription decreased (aOR=0.93, 95% CI=0.90-0.96), while the adjusted odds of receiving antidepressant, gabapentinoid and acetaminophen prescriptions increased (antidepressants: aOR=1.08, 95% CI=1.03-1.13 gabapentinoids: aOR=1.11, 95% CI=1.06-1.17; acetaminophen: aOR=1.10, 95% CI: 1.02-1.20). Secondary analyses stratifiying within the 2014-2016 and 2016-2018 periods revealed particular increases in prescriptions for gabapentinoids (aOR=1.13, 95% CI=1.05-1.21) and antidepressants (aOR=1.23, 95% CI=1.12-1.35) since 2016.

Black patients in the USA are disproportionately affected by chronic pain, yet there are few interventions that address these disparities.

Endometriosis is a common chronic gynaecological disease causing various symptoms, such as infertility and chronic pain. The gold standard for its diagnosis is still laparoscopy and the biopsy of endometriotic lesions. Here, we aimed to compare the eutopic endometrium from women with or without endometriosis to identify proteins that may be considered as potential biomarker candidates. Eutopic endometrium was collected from patients with endometriosis (n = 4) and women without endometriosis (n = 5) during a laparoscopy surgery during the mid-secretory phase of their menstrual cycle. Total proteins from tissues were extracted and digested before LC-MS-MS analysis. Among the 5301 proteins identified, 543 were differentially expressed and enriched in two specific KEGG pathways: focal adhesion and PI3K/AKT signaling. Integration of our data with a large-scale proteomics dataset allowed us to highlight 11 proteins that share the same trend of dysregulation in eutopic endometrium, regardless of the phase of the menstrual cycle. Our results constitute the first step towards the identification of potential promising endometrial diagnostic biomarkers. They provide new insights into the mechanisms underlying endometriosis and its etiology. Our results await further confirmation on a larger sample cohort.

Some osteoarthritis (OA) patients experience inadequate pain relief from analgesics like acetaminophen and nonsteroidal anti-inflammatory drugs. This could be the result of experienced non-nociceptive centralized pain. Placebo-controlled randomized trials (RCT) have proven the effectiveness of duloxetine for OA and several chronic pain conditions where central sensitization (CS) is one of the key underlying pain mechanisms.

Migraine is a risk factor for ischemic stroke, but the mechanisms of stroke associated with migraine are debated. The aim of this study was to investigate the association between migraine and large artery atherosclerosis (LAA) in young adults with ischemic stroke.

This study investigated the association between serological biomarkers at hospital admission with the development of long-term post-COVID pain symptoms in previously hospitalized COVID-19 survivors. A cohort study including patients hospitalised due to COVID-19 in one urban hospital of Madrid (Spain) during the first wave of the outbreak was conducted. Hospitalisation data, clinical data and eleven serological biomarkers were collected at hospital admission. Participants were scheduled for an individual telephone interview after hospital discharge for collecting data about post-COVID pain symptoms. A total of 412 (mean age: 62, SD: 15 years; 46.1% women) were assessed twice, a mean of 6.8 and 13.2 months after discharge. The prevalence of post-COVID pain symptoms was 42.7% (n=176) and 36.2% (n=149) at 6.8 and 13.2 months after hospital discharge. Patients reporting post-COVID pain exhibited a greater number of COVID-19 associated symptoms at hospital admission, more medical comorbidities, higher lymphocyte count, and lower glucose and creatine kinase (CK) levels (all, P<0.01) than those not reporting post-COVID pain. The multivariate analysis revealed that lower CK and glucose levels were significantly associated, but just explaining 6.9% of the variance of suffering post-COVID pain. In conclusion, the association between serological biomarkers associated with COVID-19 severity at hospital admission and the development of post-COVID pain is small. Other factors, e.g., higher number of COVID-19 onset symptoms (higher symptom load) could be more relevant for the development of post-COVID pain. As inflammatory biomarkers were not directly analyzed, they may have stronger predictive strengths for the development of post-COVID pain symptoms.