A PRELIMINARY INVESTIGATION OF THE RELATIONSHIP BETWEEN PAIN SENSITIVITY, BODY FAT DISTRIBUTION AND BLOOD LEVELS OF IL-6, CRP, TNF-Α AND LEPTIN.

Background and aims: Obese individuals have increased concentrations of pro-inflammatory cytokines and some other markers of inflammationand an increased risk of metabolic disorders. The relationship between obesity, pro-inflammatory cytokines and pain sensitivity response is not fully understood. Aim of the Study:To investigate associations between body fat distribution, C reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-a), leptin and pain sensitivity in adults. Methods: 38 adults (n=18 women) were grouped as normal weight(n=22) or obese (n=16), based on body mass index (BMI).Measurements of pressure pain and cold pressor pain sensitivity response, biomarkers (venous blood), and body composition (dual X-ray absorptiometry) were evaluated for each participant. Results: Pressure pain threshold was significantly lower in obese(mean+SD=340.93±93.58 kpa)compared to the normal weight group(447.45±203.72 kpa, p=0.039, t-test). Forward regression suggested that high gynoid fat (g)was associated with lower pressure pain thresholds (ß=-0.383, p=0.028), high lower limb fat (g) was associated with lower cold pain thresholds (ß=-0.495, p=0.003)and high IL-6 predicted higher cold pain tolerance (ß=0.345, p = 0.049). Women were more sensitive to pressure pain (P=0.03). Conclusion: Gynoid and lower limb fat content correlated with pain sensitivity response in adults, whereby those with greater fat content were more sensitive to pain. However, this may be a reflection of the sex differences in pain sensitivity as women have greater gynoid and leg fat contents

Methods of producing new nutrient data for popularly consumed multi ethnic foods in the UK

Minority ethnic groups in UK disproportionately suffer from nutrition related diseases compared to the mainstream population, contributing to widening health inequalities. However, reliable nutrient composition data of the traditional foods of these ethnic groups, which play an important part in their diets, is lacking. This makes it impossible to provide adequate and culturally acceptable nutrition interventions to reduce prevalent metabolic disorders. This study aimed to identify and analyse popularly consumed African and Caribbean foods in the UK for macro and micronutrients. Various approaches including focus group discussions, individual interviews and 24 hr dietary recalls were used to identify traditional foods. Defined criteria were used to prioritise and prepare 33 composite samples (26 dishes, 4 snacks and 3 beverages) for nutrient analyses in a UK accredited laboratory. This study methodology is novel because it uses various approaches to generate new data of commonly consumed ethnic foods and traditional recipes. In addition, the approach used in preparation of the food samples enhanced their authenticity and representativeness compared to previously published work. This paper describes the procedures undertaken and analytical methods used to develop a multi ethnic nutrient data for inclusion in UK food composition tables

Transcutaneous Electrical Nerve Stimulation (TENS) A Possible Aid for Pain Relief in Developing Countries?

Transcutaneous electrical nerve stimulation (TENS) refers to the delivery of electrical currents through the skin to activate peripheral nerves. The technique is widely used in developed countries to relieve a wide range of acute and chronic pain conditions, including pain resulting from cancer and its treatment. There are many systematic reviews on TENS although evidence is often inconclusive because of shortcomings in randomised control trials methodology. In this overview the basic science behind TENS will be discussed, the evidence of its effectiveness in specific clinical conditions analysed and a case for its use in pain management in developing countries will be made

The epidemiology of chronic pain in Libya: a cross-sectional telephone survey.

BACKGROUND: Chronic pain is a public health problem although there is a paucity of prevalence data from countries in the Middle East and North Africa. The aim of this study was to estimate the prevalence of chronic pain and neuropathic pain in a sample of the general adult population in Libya. METHODS: A cross-sectional telephone survey was conducted before the onset of the Libyan Civil War (February 2011) on a sample of self-declared Libyans who had a landline telephone and were at least 18 years of age. Random sampling of household telephone number dialling was undertaken in three major cities and interviews conducted using an Arabic version of the Structured Telephone Interviews Questionnaire on Chronic Pain previously used to collect data in Europe. In addition, an Arabic version of S-LANSS was used. 1212 individuals were interviewed (response rate = 95.1 %, mean age = 37.8 ± 13.9 years, female = 54.6 %). RESULTS: The prevalence of chronic pain ≥ 3 months was 19.6 % (95 % CI 14.6 % to 24.6 %) with a mean ± SD duration of pain of 6 · 5 ± 5 · 7 years and a higher prevalence for women. The prevalence of neuropathic pain in the respondents reporting chronic pain was 19 · 7 % (95 % CI 14 · 6-24 · 7), equivalent to 3 · 9 % (95 % CI 2 · 8 to 5 · 0 %) of the general adult population. Only, 71 (29 · 8 %) of respondents reported that their pain was being adequately controlled. CONCLUSIONS: The prevalence of chronic pain in the general adult population of Libya was approximately 20 % and comparable with Europe and North America. This suggests that chronic pain is a public health problem in Libya. Risk factors are being a woman, advanced age and unemployment. There is a need for improved health policies in Libya to ensure that patients with chronic pain receive effective management

Educational, behavioral, and social interventions for autistic children, with particular reference to those at the more severe end of spectrum: An overview of systematic reviews

This paper presents an analysis of the available systematic reviews of educational, behavioral, and social interventions for children on the autism spectrum. Forty-six out of 1299 full-text articles were assessed against eligibility criteria, with a further 16 articles excluded for different reasons. The quality of the remaining 30 reviews was variable, and a further five were excluded due to low methodological quality. In the remaining 25 systematic reviews, none of the intervention types was found superior to the others, and there is generally weak evidence for the effectiveness of the reviewed interventions in improving autism-related impairments. Applicability of this evidence on children with severe autism is generally questionable. While there have been repeated calls for more large-scale studies, specifically randomized controlled trials, we conclude that the environments in which interventions typically take place are not conducive to this. Instead, researchers are advised to adopt sensitive, evidence-based approaches that work well with small sample groups

A systematic review of the epidemiology of echinococcosis in domestic and wild animals

Human echinococcosis is a neglected zoonosis caused by parasites of the genus Echinococcus. The most frequent clinical forms of echinococcosis, cystic echinococcosis (CE) and alveolar echinococcosis (AE), are responsible for a substantial health and economic burden, particularly to low-income societies. Quantitative epidemiology can provide important information to improve the understanding of parasite transmission and hence is an important part of efforts to control this disease. The purpose of this review is to give an insight on factors associated with echinococcosis in animal hosts by summarising significant results reported from epidemiological studies identified through a systematic search.The systematic search was conducted mainly in electronic databases but a few additional records were obtained from other sources. Retrieved entries were examined in order to identify available peer-reviewed epidemiological studies that found significant risk factors for infection using associative statistical methods. One hundred studies met the eligibility criteria and were suitable for data extraction. Epidemiological factors associated with increased risk of E. granulosus infection in dogs included feeding with raw viscera, possibility of scavenging dead animals, lack of anthelmintic treatment and owners' poor health education and indicators of poverty. Key factors associated with E. granulosus infection in intermediate hosts were related to the hosts' age and the intensity of environmental contamination with parasite eggs. E. multilocularis transmission dynamics in animal hosts depended on the interaction of several ecological factors, such as hosts' population densities, host-prey interactions, landscape characteristics, climate conditions and human-related activities.Results derived from epidemiological studies provide a better understanding of the behavioural, biological and ecological factors involved in the transmission of this parasite and hence can aid in the design of more effective control strategies