The open home of global research and emerging pain science, PAIN Reports is an official publication of IASP. View free articles at and learn more today!

t insights into epigenetics as a uniquely suited biological mechanism linking environmental stressors and pain disparities. Emerging evidence suggests that epigenetic modification of genes in pathways involved in stress dysregulation and neuroinflammation may play a central role in racial pain disparities and internalized stigma. These findings indicate that differential environmental exposure (ie, chronic stress) induces epigenetic changes (mediators) that explain pain disparities. Another putative mechanism by which differential epigenetic modifications contribute to pain disparities is epigenetic age acceleration. Emerging evidence suggests that epigenetic age acceleration mediates the relationship between lower socioeconomic status (household income, food insecurity, and neighborhood deprivation) and worse pain outcomes. Epigenetic modifications are dynamic and reversible, leaning toward pharmacological and nonpharmacological interventions. Logically, these will contribute to tailo

The open home of global research and emerging pain science, PAIN Reports is an official publication of IASP. View free articles at and learn more today!

w persistent opioid use after hip fracture surgery in Australia. Methods: A retrospective population-based cohort study was conducted using linked administrative health data in Australia. Adults aged ≥30 years discharged from hospital after a first hip fracture surgery between July 2012 and June 2017, opioid-naïve on admission, and alive 12 months postdischarge were included. Group-based trajectory modelling was utilised to determine trajectories and rates of opioid use 12 months postdischarge. Multivariate multinomial logistic regression analysis was performed to identify risk factors for persistent opioid use. Results: Among 10,309 opioid-naïve patients who had first hip fracture surgery, 5305 (51.5%) used opioids postdischarge. Opioid users were categorised as 58.9% (3127/5305) nonpersistent, 12.6% (670/5305) fluctuating, 12.1% (641/5305) late discontinuation, and 16.3% (867/5305) persistent. Key risk factors for persistent use were total oral morphine equivalent >600 mg in first 30

between degeneration and pain. We hypothesize that DNA methylation, an epigenetic mechanism previously linked to discogenic LBP, is dysregulated in symptomatic vs asymptomatic IVDs. Objectives: Identify differentially methylated genes and pathways in symptomatic vs asymptomatic IVDs. Methods: Three lumbar IVDs with similar degeneration severity were tested prior to surgery by discography to identify symptomatic IVDs. Methylation analysis was performed on ∼935,000 cytosine guanine dinucleotide sites on nucleus pulposus DNA. We explored differential methylation and pathway enrichment on cytosine guanine dinucleotide sites located within the promoter regions of genes. Results: Two IVDs (L3/L4 and L4/L5) evoked pain ratings of 10/10 and 8/10, one IVD (L5/S1) scored 0/10. DNA methylation differed between symptomatic and asymptomatic IVDs. Several identified genes have roles in extracellular matrix remodeling. Other differentially methylated genes were related to immunomodulation and ion cha

ted patient-reported outcomes (PROs) have not been extensively studied. Objective: Based on registry data, this study compared pain intensities summarized as a pain composite score (PCS) and postoperative opioid use between PNBc and PNBs nerve blocks in patients undergoing TKA, and evaluated additional PROs. Methods: Data from 4,328 adults undergoing TKA enrolled in the PAIN OUT registry (ClinicalTrials.gov NCT02083835) were analyzed. Patients were categorized into general anesthesia (GA) or spinal anesthesia (SA), with subgroups general anesthesia only (GA-o) or spinal anesthesia only (SA-o), and combinations with single-injection PNB (GA&PNBs and SA&PNBs) or continuous PNB via catheter (GA&PNBc and SA&PNBc). The primary end point was PCS, summarizing pain intensities and time in severe pain during the first 24 hours. Secondary end points included opioid use and additional PROs. Results: The use of GA&PNBc was associated with a higher PCS (+0.5 [0.0-0.9], P = 0.035) compared with GA&P

n breast cancer patients following breast-conserving surgery (BCS). Methods: This randomized controlled trial comprised 69 women with breast cancer scheduled for unilateral BCS under general anesthesia, randomly allocated into 3 equal groups. The RISS group had unilateral RISS block using 20 mL of 0.25% bupivacaine between rhomboid major and intercostal muscles and an equal volume between external intercostal and serratus anterior muscles. The PECs Group received a PECS II block using 20 mL of 0.25% bupivacaine between pectoralis major and minor muscles and 10 mL between pectoralis major and serratus muscles. The control group did not get any blocks. The primary outcome was total postoperative morphine consumption within 24 hours. The secondary outcomes were pain score, first request for rescue analgesia, intraoperative fentanyl consumption, and hemodynamics. Results: Requesting rescue morphine analgesia was significantly less frequent in the RISS and PECs groups compared to controls (

sexual function, as well as the relational dynamics of the couple. Objectives: The main aim of this study was to explore facilitative, solicitous, and negative male partner responses to women with PVD and their links to demographic and psychosexual characteristics. Further, we investigated the discrepancies in psychosexual health between currently sexually active and inactive participants, as well as levels of anxiety and depressive symptoms within our sample of male partners (N = 127). Methods: Cross-sectional associations were examined using bivariate correlations. Differences in psychosexual health between the two sub-samples were examined using Mann-Whitney U test. Results: Our results showed that facilitative partner responses were significantly associated with higher relationship and sexual satisfaction, as well as with lower sexual distress and more approach goals. Negative partner responses were significantly associated with higher sexual distress, as well as with lower relatio