Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement

BackgroundChronic postoperative pain affects approximately 20% of patients with knee osteoarthritis after total knee replacement. Circulating microRNAs can be found in serum and might act as biomarkers in a variety of diseases. The current study aimed to investigate the preoperative expression of circulating microRNAs as potential predictive biomarkers for the development of chronic postoperative pain in the year following total knee replacement.MethodsSerum samples, collected preoperatively from 136 knee osteoarthritis patients, were analyzed for 21 circulatory microRNAs. Pain intensity was assessed using a visual analog scale before and one year after total knee replacement. Patients were divided into a low-pain relief group (pain relief percentage 30%) based on their pain relief one year after total knee replacement, and differences in microRNAs expression were analyzed between the two groups.ResultsWe found that three microRNAs were preoperatively dysregulated in serum in the low-pain relief group compared with the high-pain relief group. MicroRNAs hsa-miR-146a-5p, -145-5p, and -130 b-3p exhibited fold changes of 1.50, 1.55, and 1.61, respectively, between the groups (all P values DiscussionThis study showed that patients with a low postoperative pain relief present a dysregulation of circulating microRNAs. Altered circulatory microRNAs expression correlated with postoperative pain relief, indicating that microRNAs can serve as predictive biomarkers of pain outcome after surgery and hence may foster new strategies for preventing chronic postoperative pain after total knee replacement (TKR)

sj-pdf-1-mpx-10.1177_1744806920962925 - Supplemental material for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement

Supplemental material, sj-pdf-1-mpx-10.1177_1744806920962925 for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement by Rocco Giordano, Kristian Kjær Petersen, Hjalte Holm Andersen, Jacek Lichota, Massimiliano Valeriani, Ole Simonsen and Lars Arendt-Nielsen in Molecular Pai

sj-pdf-2-mpx-10.1177_1744806920962925 - Supplemental material for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement

Supplemental material, sj-pdf-2-mpx-10.1177_1744806920962925 for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement by Rocco Giordano, Kristian Kjær Petersen, Hjalte Holm Andersen, Jacek Lichota, Massimiliano Valeriani, Ole Simonsen and Lars Arendt-Nielsen in Molecular Pai

sj-pdf-3-mpx-10.1177_1744806920962925 - Supplemental material for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement

Supplemental material, sj-pdf-3-mpx-10.1177_1744806920962925 for Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement by Rocco Giordano, Kristian Kjær Petersen, Hjalte Holm Andersen, Jacek Lichota, Massimiliano Valeriani, Ole Simonsen and Lars Arendt-Nielsen in Molecular Pai

International survey of neuromonitoring and neurodevelopmental outcome in children and adults supported on extracorporeal membrane oxygenation in Europe

Background:Adverse neurological events during extracorporeal membrane oxygenation (ECMO) are common and may be associated with devastating consequences. Close monitoring, early identification and prompt intervention can mitigate early and late neurological morbidity. Neuromonitoring and neurocognitive/neurodevelopmental follow-up are critically important to optimize outcomes in both adults and children.Objective:To assess current practice of neuromonitoring during ECMO and neurocognitive/neurodevelopmental follow-up after ECMO across Europe and to inform the development of neuromonitoring and follow-up guidelines.Methods:The EuroELSO Neurological Monitoring and Outcome Working Group conducted an electronic, web-based, multi-institutional, multinational survey in Europe.Results:Of the 211 European ECMO centres (including non-ELSO centres) identified and approached in 23 countries, 133 (63%) responded. Of these, 43% reported routine neuromonitoring during ECMO for all patients, 35% indicated selective use, and 22% practiced bedside clinical examination alone. The reported neuromonitoring modalities were NIRS (n = 88, 66.2%), electroencephalography (n = 52, 39.1%), transcranial Doppler (n = 38, 28.5%) and brain injury biomarkers (n = 33, 24.8%). Paediatric centres (67%) reported using cranial ultrasound, though the frequency of monitoring varied widely. Before hospital discharge following ECMO, 50 (37.6%) reported routine neurological assessment and 22 (16.5%) routinely performed neuroimaging with more paediatric centres offering neurological assessment (65%) as compared to adult centres (20%). Only 15 (11.2%) had a structured longitudinal follow-up pathway (defined followup at regular intervals), while 99 (74.4%) had no follow-up programme. The majority (n = 96, 72.2%) agreed that there should be a longitudinal structured follow-up for ECMO survivors.Conclusions:This survey demonstrated significant variability in the use of different neuromonitoring modalities during and after ECMO. The perceived importance of neuromonitoring and follow-up was noted to be very high with agreement for a longitudinal structured follow-up programme, particularly in paediatric patients. Scientific society endorsed guidelines and minimum standards should be developed to inform local protocols

International survey of neuromonitoring and neurodevelopmental outcome in children and adults supported on extracorporeal membrane oxygenation in Europe

Background:Adverse neurological events during extracorporeal membrane oxygenation (ECMO) are common and may be associated with devastating consequences. Close monitoring, early identification and prompt intervention can mitigate early and late neurological morbidity. Neuromonitoring and neurocognitive/neurodevelopmental follow-up are critically important to optimize outcomes in both adults and children.Objective:To assess current practice of neuromonitoring during ECMO and neurocognitive/neurodevelopmental follow-up after ECMO across Europe and to inform the development of neuromonitoring and follow-up guidelines.Methods:The EuroELSO Neurological Monitoring and Outcome Working Group conducted an electronic, web-based, multi-institutional, multinational survey in Europe.Results:Of the 211 European ECMO centres (including non-ELSO centres) identified and approached in 23 countries, 133 (63%) responded. Of these, 43% reported routine neuromonitoring during ECMO for all patients, 35% indicated selective use, and 22% practiced bedside clinical examination alone. The reported neuromonitoring modalities were NIRS (n = 88, 66.2%), electroencephalography (n = 52, 39.1%), transcranial Doppler (n = 38, 28.5%) and brain injury biomarkers (n = 33, 24.8%). Paediatric centres (67%) reported using cranial ultrasound, though the frequency of monitoring varied widely. Before hospital discharge following ECMO, 50 (37.6%) reported routine neurological assessment and 22 (16.5%) routinely performed neuroimaging with more paediatric centres offering neurological assessment (65%) as compared to adult centres (20%). Only 15 (11.2%) had a structured longitudinal follow-up pathway (defined followup at regular intervals), while 99 (74.4%) had no follow-up programme. The majority (n = 96, 72.2%) agreed that there should be a longitudinal structured follow-up for ECMO survivors.Conclusions:This survey demonstrated significant variability in the use of different neuromonitoring modalities during and after ECMO. The perceived importance of neuromonitoring and follow-up was noted to be very high with agreement for a longitudinal structured follow-up programme, particularly in paediatric patients. Scientific society endorsed guidelines and minimum standards should be developed to inform local protocols

sj-pdf-1-cep-10.1177_0333102420965139 - Supplemental material for I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children

Supplemental material, sj-pdf-1-cep-10.1177_0333102420965139 for I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children by Laura Papetti, Pierfrancesco Alaimo Di Loro, Samuela Tarantino, Licia Grazzi, Vincenzo Guidetti, Pasquale Parisi, Vincenzo Raieli, Vittorio Sciruicchio, Cristiano Termine, Irene Toldo, Elisabetta Tozzi, Paola Verdecchia, Marco Carotenuto, Matteo Battisti, Angela Celi, Daniela D'Agnano, Noemi Faedda, Michela AN Ferilli, Giovanni Grillo, Giulia Natalucci, Agnese Onofri, Maria Federica Pelizza, Fabiana Ursitti, Michelangelo Vasta, Margherita Velardi, Martina Balestri, Romina Moavero, Federico Vigevano and, Massimiliano Valeriani; on behalf of the Italian Headache Society (SISC) specific interest group on pediatric headaches in Cephalalgi

I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children

ObjectiveThe present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy.MethodsDuring the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis.ResultsWe collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p p p p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05).ConclusionsOur study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population

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Clinical data of a patient included at study at titl

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement