Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

【症例】55歳の男性.現病歴:X-7年にHIV感染症と診断され,多剤併用療法を開始された.診断時より両足底部の痛みがあり,徐々に日常生活に支障が生じたことからX年当科紹介受診となった.初診時現症:常に両足底部に剣山で刺されるような痛みとしびれがあり,歩行時の数値評価スケール(numerical rating scale:NRS,0～10)は10であった.四肢末梢の温度覚と振動覚の低下がみられた.治療経過:HIV関連末梢神経障害と診断し,薬物療法を開始したが改善に乏しい状態であった.仙骨硬膜外ブロック(0.5%メピバカイン10ml)を施行したところ最大のNRS(歩行時)は7まで低下し,その状態が数週間持続した.その後も仙骨硬膜外ブロックを1回/月で継続し,X+5年のNRSは0～2となり長距離歩行も可能となった.【まとめ】HIV関連末梢神経障害はHIVウイルスによる慢性的な末梢神経炎および薬剤性末梢神経障害が原因と考えられている.本症例では仙骨硬膜外ブロックによる末梢血流改善や抗炎症作用が痛みを改善したと推測し,本ブロックは簡便で有用な治療である可能性が示唆された.(著者抄録)

Language：English   Publisher：JA Clinical Reports  

Background: Bisphosphonates may cause serious adverse events, including osteonecrosis of the jaw. This article describes a case of successful application of radiofrequency thermocoagulation for pain caused by osteonecrosis of the jaw. Case presentation: An 86-year-old woman who had received alendronate sodium hydrate for osteoporosis was diagnosed with osteonecrosis of the right mandible after dental treatment. Despite repeated conservative and debridement treatments, the patient could not eat due to intractable pain; accordingly, her condition was debilitated. The patient was referred to our pain management clinic for radiofrequency thermocoagulation of the right mandibular nerve. Immediately after the procedure, her pain drastically improved and she could eat; moreover, the pain has not recurred for 3 years. Conclusion: Our findings demonstrate that minimally invasive radiofrequency thermocoagulation may have long-term effects in patients with chronic pain caused by osteonecrosis of the jaw that is refractory to conservative treatment.

DOI： 10.1186/s40981-024-00696-2

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PubMed

Language：English   Publisher：(一社)日本疫学会  

＜Highlight＞●本研究は、血清リポ多糖結合蛋白(LBP)値とメタボリックシンドローム(MetS)発症との関連を検討した最初の前向きコホート研究である。●血清LBP値の上昇に伴いメタボリックシンドロームおよびその構成要素の発症リスクは上昇した。●媒介解析において、HOMA-IRと血清高感度CRPは血清LBPとMetS発症との関連に、部分的に介在していた。●血清LBP値とメタボリックシンドロームの発症リスクの関連はインスリン抵抗性と慢性炎症を介した機序が示唆された。(著者抄録)

Language：English   Publisher：Springer Berlin Heidelberg  

86歳女性。骨粗鬆症の治療のため、77歳時からアレンドロン酸ナトリウム水和物が投与されていた。歯周炎のため右下大臼歯を抜歯後、右下顎歯肉の腫脹と疼痛が持続した。口腔外科に紹介され、薬剤関連顎骨壊死と診断された。切開排膿や右下残存大臼歯の抜歯、抗菌薬投与、鎮痛剤投与量の増量を行ったが奏功せず、5ヵ月後に当ペインクリニックに紹介された。極度の疼痛で食事や睡眠がとれずQOLに支障が生じていることから、低侵襲処置として右下顎神経の高周波熱凝固療法(RFT)を施行した。RFT直後より疼痛は解消され、術後4日目で鎮痛薬を停止した。合併症はなく、予後良好で、3年の経過後も症状の再燃は認めていない。

Language：English   Publisher：Japan Epidemiological Association  

<p><b>Background:</b> The association between chronic lipopolysaccharide exposure and the development of metabolic syndrome (MetS) is unclear. In this study we examined the association between serum lipopolysaccharide-binding protein (LBP) levels, an indicator of lipopolysaccharide exposure, and the development of MetS in a general Japanese population.</p><p><b>Methods:</b> 1,869 community-dwelling Japanese individuals aged ≥40 years without MetS at baseline examination in 2002–2003 were followed up by repeated examination in 2007–2008. MetS was defined according to the Japanese criteria. Serum LBP levels were classified into quartiles (quartiles 1–4: 2.20–9.56, 9.57–10.78, 10.79–12.18, and 12.19–24.34 µg/mL, respectively). Odds ratios (ORs) for developing MetS were calculated using a logistic regression model.</p><p><b>Results:</b> At the follow-up survey, 159 participants had developed MetS. Higher serum LBP levels were associated with greater risk of developing MetS after multivariable adjustment for age, sex, smoking, drinking, and exercise habits (OR [95% confidence interval] for quartiles 1–4: 1.00 [reference], 2.92 [1.59–5.37], 3.48 [1.91–6.35], and 3.86 [2.12–7.03], respectively; <i>P</i> for trend <0.001). After additional adjustment for homeostasis model assessment of insulin resistance, this association was attenuated but remained significant (<i>P</i> for trend = 0.007). On the other hand, no significant association was observed after additional adjustment for serum high-sensitivity C-reactive protein (<i>P</i> for trend = 0.07).</p><p><b>Conclusion:</b> In the general Japanese population, our findings suggest that higher serum LBP levels are associated with elevated risk of developing MetS. Low-grade endotoxemia could play a role in the development of MetS through systemic chronic inflammation and insulin resistance.</p>

DOI： 10.2188/jea.je20220232

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CiNii Research

Language：English  

DOI： 10.7759/cureus.37276

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Language：English   Publishing type：Research paper (scientific journal)  

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1409210878

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Pain  

Chronic low back pain (CLBP) is the leading cause of years lived with disability. Recently, it has been reported that CLBP is associated with alterations in the central nervous system. The present study aimed to investigate the association between CLBP and regional brain atrophy in an older Japanese population. A total of 1106 community-dwelling participants aged ≥65 years underwent brain magnetic resonance imaging scans and a health examination in 2017 to 2018. We used the FreeSurfer software for the analysis of brain magnetic resonance imaging. Chronic pain was defined as subjective pain for ≥3 months. Participants were divided into 3 groups according to the presence or absence of chronic pain and the body part that mainly suffered from pain: a "no chronic pain (NCP)" group (n = 541), "CLBP" group (n = 189), and "chronic pain in body parts other than the lower back (OCP)" group (n = 376). The brain volumes of the ventrolateral and dorsolateral prefrontal cortex, the posterior cingulate gyrus, and the amygdala were significantly lower in the CLBP group than in the NCP group after adjustment for sociodemographic, physical, and lifestyle factors and depressive symptoms. In addition, the left superior frontal gyrus was identified as a significant cluster by the Query, Design, Estimate, Contrast interface. There were no significant differences in the brain volumes of pain-related regions between the NCP and the OCP groups. The present study suggests that CLBP is associated with lower brain volumes of pain-related regions in a general older population of Japanese.

DOI： 10.1097/j.pain.0000000000002612

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1161/JAHA.119.013628.

Event date： 2022.10

Language：Japanese  

Venue：東京都千代田区   Country：Japan  

Event date： 2021.6

Language：Japanese  

Venue：Web   Country：Japan  

Event date： 2020.7 - 2020.8

Language：Japanese  

Venue：Web   Country：Japan  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese