Background: Pain and numbness in cancer survivors frequently have negative impacts on quality of life (QoL). This meta-analysis aimed to identify the current treatment options for pain and numbness in cancer survivors and to evaluate their effects.Methods: Cancer survivors were defined as patients diagnosed with cancer who had completed active cancer treatment, whose conditions were stable, and who had no evidence of recurrent or progressive disease.A systematic search through the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, PsycInfo, and CINAHL databases was conducted, which targeted randomized controlled trials (RCTs) published until April 2022 that evaluated any type of treatment for pain or numbness in cancer survivors. A meta-analysis was conducted using the random-effects model to obtain the effect sizes of 7 types of treatments: opioid therapy, nonopioid pharmacotherapy, interventional therapy, acupuncture, education/cognitive behavioral therapy (CBT), physical exercise, and alternative medicine.Results: A total of 36 studies involving 2,870 cancer survivors were included. Among them, 35 (n=2,813) were included in the meta-analysis for pain. The analysis suggested that physical exercise [n=761; 13 studies;
Background: Spinal metastases can cause intractable pain and neurological deficits, which can markedly worsen both patients' activities of daily living (ADL) and their health-related quality of life (QOL).Early intervention is essential to prevent irreversible neurological deficits and pain associated with spinal metastases. We investigated the imaging features of spinal metastases that led to neurological deficits.Methods: We analyzed axial cross-sectional computed tomography (CT) images of cervical and thoracic spinal metastases in patients with and without lower limb motor paralysis, neuropathic pain, and local nociceptive pain. We distinguished regions of the spine associated with these respective symptoms, and explored their inferable performance using images obtained before symptom onset. In addition, we analyzed the imaging features and type of bone metastasis (osteolytic and osteoblastic).Results: Spinal lesions occupied the area in and around the spinal canal and around the pedicle in patients with motor paralysis. Lesions around the pedicle and in the most posterior vertebral body part before symptom onset were inferable. In patients with neuropathic pain, spinal metastases spread along the pedicle before symptom onset, and had surrounded the spinal canal circumferentially at symptom onset. Local nociceptive pain was more common near the center of the vertebral body either at or before symptom onset.There was no difference in the imaging features according to the type of bone metastasis.Conclusions: Lesions in certain regions in the asymptomatic metastatic spine can indicate the onset of spinal metastasis-related symptoms in the next few months. Early therapeutic intervention might be applied to prevent neurological disorder.
People perceive the mind in two dimensions: intellectual and affective. Advances in artificial intelligence enable people to perceive the intellectual mind of a robot through their semantic interactions. Conversely, it has been still controversial whether a robot has an affective mind of its own without any intellectual actions or semantic interactions. We investigated pain experiences when observing three different facial expressions of a virtual agent modeling affective minds (i.e., painful, unhappy, and neutral). The cold pain detection threshold of 19 healthy subjects was measured as they watched a black screen, then changes in their cold pain detection thresholds were evaluated as they watched the facial expressions. Subjects were asked to rate the pain intensity from the respective facial expressions. Changes of cold pain detection thresholds were compared and adjusted by the respective pain intensities. Only when watching the painful expression of a virtual agent did, the cold pain detection threshold increase significantly. By directly evaluating intuitive pain responses when observing facial expressions of a virtual agent, we found that we ‘share’ empathic neural responses, which can be intuitively emerge, according to observed pain intensity with a robot (a virtual agent).
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