Prevalence of Orofacial Pain Among Women with Vulvodynia: Prospective Two Year Follow-Up Study

Background: Vulvar Vestibulitis (VVS) is the most common cause of vulvodynia in reproductive age women, affecting up to 15% of the general female population. Women with VVS have pain with intercourse, and sensitivity to touch on genital contact. Psychological characteristics such as anxiety and somatization are also common in the population. Evidence supports VVS as a complex pain disorder, akin to idiopathic musculoskeletal pain conditions, such as temporomandibular disorder, the most common form of orofacial pain (OFP). We have previously found that OFP was a common co-morbidity among women with VVS. Higher levels of anxiety, somatization, and psychological distress were found among women with VVS and OFP, than among those women with VVS and no OFP. Objective: The primary objective of this study was to assess the stability of our original findings and investigate the change in OFP symptoms over a 2 yr period among women with vulvar vestibulitis

Relationship Between Pain with Intercourse and Psychological Distress Among Women with Vulvar Vestibulitis Syndrome

Background: Vulvar Vestibulitis (VVS) is the most common cause of vulvo-vaginal pain in reproductive age women, affecting up to 15% of the general female population. Women with VVS have pain with intercourse, and sensitivity to touch on genital contact. Psychological characteristics such as anxiety and somatization are also common in the population. In this study, we sought to assess the relationship between self reported intercourse-related pain and psychological distress among women with VVS. We hypothesized that women who reported higher levels of intercourse related pain were more likely to have a higher level of psychological distress 1 year after their initial visit to the UNC Vulvar Pain Clinic.

Novel Medical Therapy for Refractory Endometriosis Associated Chronic Pelvic Pain: an Open Label Trial of Thalidomide

Background: Endometriosis affects 2.5-3.3% of reproductive age women and is a common diagnosis among women with chronic pelvic pain. Treatment for endometriosis ranges from conservative medical therapies to radical surgery. Endometriosis is an indication for 25-35% of laparoscopies and 10-15% of hysterectomies each year . Although the majority of women with endometriosis respond to conservative medical therapy, those with persistent pain often undergo hysterectomy. Based on clinical and experimental data that indicate that thalidomide may be a highly effective immune modulator, we sought to investigate the efficacy and tolerability of this novel therapy for endometriosis associated pain patients who desired fertility-sparing treatment after exhausting all other conservative modalities. Objective: To investigate the efficacy and tolerability of thalidomide as a treatment for endometriosis associated pain patient

Relationship between Pain with Intercourse and Psychological Distress Among Women with Vulvar Vestibulitis Syndrome

Background: Vulvar Vestibulitis (VVS) is the most common cause of vulvo-vaginal pain in reproductive age women, affecting up to 15% of the general female population. Women with VVS have pain with intercourse, and sensitivity to touch on genital contact. Psychological characteristics such as anxiety and somatization are also common in the population. In this study, we sought to assess the relationship between self reported intercourse-related pain and psychological distress among women with VVS. We hypothesized that women who reported higher levels of intercourse related pain were more likely to have a higher level of psychological distress 1 year after their initial visit to the UNC Vulvar Pain Clinic

History of Comorbid Orofacial Pain Among Women with Vulvar Vestibulitis Syndrome

Introduction: • Vestibulodynia is the most common from of chronic vulvovaginal pain affecting nearly 1 in 10 women at some point in their lifetime • The diagnosis of vestibulodynia is diagnosis of “exclusion” in that it is rendered only after excluding other “known causes” of persistent pain upon genital contact (i.e. tampon use) and tenderness to pressure localized within the vulvar mucosa (vestibule) and the etiology and natural history of vestibulodynia remains poorly understood • An emerging body of evidence supports the notion of vestibulodynia as a complex pain disorder of urogenital region • Women with vestibulodynia have higher pain sensitivity on mucosal contact in non-genital sites • Also, these women have a higher prevalence of psychological distress, such as somatization and anxiety • These observations suggest that women with vestibulodynia may have an alteration in pain processing pathways similar to that seen in other pain disorders • We hypothesize that vestibulodynia is a group of disorders characterized by dysfunctions in the vestibular mucosa (i.e., heightened inflammatory response) and central pain processing pathways • In previous work we identified that orofacial pain (OFP) might be a clinical marker for a state of pain amplification among women with vestibulodynia • Co-morbid OFP was highly prevalent in our cohort of vestibulodynia patients • The objective of this study is to examine the stability of OFP symptoms two years after the initial examination while investigating the reliability of our baseline observations on the clinical correlates of comorbid OFP

Tailored Approaches in Drug Development and Diagnostics: From Molecular Design to Biological Model Systems

Approaches to increase the efficiency in developing drugs and diagnostics tools, including new drug delivery and diagnostic technologies, are needed for improved diagnosis and treatment of major diseases and health problems such as cancer, inflammatory diseases, chronic wounds, and antibiotic resistance. Development within several areas of research ranging from computational sciences, material sciences, bioengineering to biomedical sciences and bioimaging is needed to realize innovative drug development and diagnostic (DDD) approaches. Here, an overview of recent progresses within key areas that can provide customizable solutions to improve processes and the approaches taken within DDD is provided. Due to the broadness of the area, unfortunately all relevant aspects such as pharmacokinetics of bioactive molecules and delivery systems cannot be covered. Tailored approaches within (i) bioinformatics and computer-aided drug design, (ii) nanotechnology, (iii) novel materials and technologies for drug delivery and diagnostic systems, and (iv) disease models to predict safety and efficacy of medicines under development are focused on. Current developments and challenges ahead are discussed. The broad scope reflects the multidisciplinary nature of the field of DDD and aims to highlight the convergence of biological, pharmaceutical, and medical disciplines needed to meet the societal challenges of the 21st century

Comparative evaluation of different loops for individual canine and en-masse retraction-a finite element method (fem) study

The aim and objective was to compare and evaluate the T loop, Mushroom loop and Opus loop for individual canine and en-masse retraction for space closure without preactivation bends using finite element method. The geometric model of maxilla was constructed using CBCT scan. The bracket system simulated was of standard MBT bracket system and arch wire used were 19*25 Stainless Steel and 17*25 TMA for fabrication of loops. There were six different models generated with segmented T loop, Mushroom loop & Opus loop and Continuous T loop, Mushroom loop & Opus loop. The software used for post-processing of the model was ANSYS Hypermesh 2019.0. When retraction forces were given with activation of loops, maximum amount of initial tooth displacement for individual canine retraction was observed for segmented T loop and for en masse retraction it was observed for continuous T loop. Although, there was intrusion of canine for all the three segmented loop, the preferred loop for canine retraction should be segmented T loop and for en masse retraction it should be continuous T loop as it shows least effect of retraction forces on anterior as well as posterior teeth during application of retraction force

Clinical outcomes and safety of colistin in treatment of gram negative infections: A prospective observational study

Background: Despite the fact that colistin has a significant activity against MDR gram-negative organisms, its toxicity limits its use. However, the limited therapeutic options due to increasing antibiotic resistance have made re-evaluation of older antibiotics inevitable. In contrast, lack of data to guide the usage of these drugs demands for studies on their safety and efficacy. This studies the clinical outcomes and safety of colistin at a tertiary care centre in Mumbai. Materials and methods: A prospective observational study was conducted at P.D. Hinduja Hospital, Mumbai for a period of seven months. Diagnosis of infection was based on CDC guidelines and APACHE II score was used to assess the severity of illness. Clinical and microbiological response to colistin was evaluated along with the incidence of nephrotoxicity (RIFLE criteria) and neurotoxicity. Results: Sixty-two patients (median age 56 years, with documented gram negative bacterial infection and mean APACHE II score 22) received colistin. Clinically favourable response was seen in 71% patients. However, the mortality among the study population was 27%. Univariate analysis identified pneumonia and ICU admission as independent factors for adverse outcome. Deterioration of renal function was observed in 35.89% as per RIFLE criteria. 6 (9.6%) patients demonstrated neurotoxicity. Conclusion: Colistin is effective in treatment of gram negative infections and its use should be reappraised. However since colistin is the last resort it is imperative to make its best use to ensure that it remains as a safe and effective mode of treatment when need be