Gynecologic management of neuropathic pain

Tu, Frank F.; Hellman, Kevin M.; Bačkonja, Miroslav

doi:10.1016/j.ajog.2011.05.011

Cited by 27 publications

(11 citation statements)

References 100 publications

(82 reference statements)

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“…These results are in line with recent in vitro analyses in MCF-7 cells, which show that the activation of ERα36 expression triggers adaptive changes characterized by enhanced survival and migration during acquired tamoxifen resistance process [8, 21]. Similar data were obtained from endometrial cancer cells wherein ERα36 was shown to promote tamoxifen agonist action via the MAPK/ERK and PI3K/Akt pathways [22–24]. Taken together, our results and others clearly suggest that [ER+] tumors highly expressing ERα36 should not be cured by tamoxifen because the treatment could drive metastatic progression.…”

Section: Discussionsupporting

confidence: 86%

From ERα66 to ERα36: a generic method for validating a prognosis marker of breast tumor progression

Chamard-Jovenin

Jung²,

Chesnel

et al. 2015

BMC Syst Biol

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BackgroundEstrogen receptor alpha36 (ERalpha36), a variant of estrogen receptor alpha (ER) is expressed in about half of breast tumors, independently of the [ER+]/[ER-] status. In vitro, ERalpha36 triggers mitogenic non-genomic signaling and migration ability in response to 17beta-estradiol and tamoxifen. In vivo, highly ERalpha36 expressing tumors are of poor outcome especially as [ER+] tumors are submitted to tamoxifen treatment which, in turn, enhances ERalpha36 expression.ResultsOur study aimed to validate ERalpha36 expression as a reliable prognostic factor for cancer progression from an estrogen dependent proliferative tumor toward an estrogen dispensable metastatic disease. In a retrospective study, we tried to decipher underlying mechanisms of cancer progression by using an original modeling of the relationships between ERalpha36, other estrogen and growth factor receptors and metastatic marker expression. Nonlinear correlation analyses and mutual information computations led to characterize a complex network connecting ERalpha36 to either non-genomic estrogen signaling or to metastatic process.ConclusionsThis study identifies ERalpha36 expression level as a relevant classifier which should be taken into account for breast tumors clinical characterization and [ER+] tumor treatment orientation, using a generic approach for the rapid, cheap and relevant evaluation of any candidate gene expression as a predictor of a complex biological process.Electronic supplementary materialThe online version of this article (doi:10.1186/s12918-015-0178-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

From ERα66 to ERα36: a generic method for validating a prognosis marker of breast tumor progression

Chamard-Jovenin

Jung²,

Chesnel

et al. 2015

BMC Syst Biol

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“…This lack of training makes the diagnosis of acute iatrogenic nerve injury unlikely in the immediate postoperative period when early intervention is important for improving outcome. 8 , 10 , 11 Our team recognizes that this manuscript does not provide sufficient detail for rapid dissemination and clinical adaptation. Our primary objective was to highlight the clinical implications of our collective research and development efforts to date in order to lay the foundation for future technique- and method-specific manuscripts.…”

Section: Discussionmentioning

confidence: 99%

Dorsal clitoral nerve injury following transobturator midurethral sling

Moss¹,

Damitz²,

Gracely³

et al. 2016

JPR

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IntroductionTransobturator slings can be successfully used to treat stress urinary incontinence and improve quality of life through a minimally invasive vaginal approach. Persistent postoperative pain can occur and pose diagnostic and therapeutic dilemmas. Following a sling procedure, a patient complained of pinching clitoral and perineal pain. Her symptoms of localized clitoral pinching and pain became generalized over the ensuing years, eventually encompassing the entire left vulvovaginal region.AimThe aim of this study was to highlight the clinical utility of conventional pain management techniques used for the evaluation and management of patients with postoperative pain following pelvic surgery.MethodsWe described a prototypical patient with persistent pain in and around the clitoral region complicating the clinical course of an otherwise successful sling procedure. We specifically discussed the utility of bedside sensory assessment techniques and selective nerve blocks in the evaluation and management of this prototypical patient.ResultsNeurosensory assessments and a selective nerve block enabled us to trace the source of the patient’s pain to nerve entrapment along the dorsal nerve of the clitoris. We then utilized a nerve stimulator-guided hydrodissection technique to release the scar contractureConclusionThis case demonstrates that the dorsal nerve of the clitoris is vulnerable to injury directly and/or indirectly. Assimilation of a time-honored pain management construct for the evaluation and management of patients’ pain may improve outcomes while obviating the need for invasive surgery.

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“… Adapted from work by Frank F. Tu, Kevin M. Hellman, Miroslav M. Backonja, Titled Gynecologic management of neuropathic pain, 106 copyright of Elsevier, 2011. Used by permission of Elsevier from the Copyright Clearance Center's Rights Link.…”

Section: Diagnosismentioning

confidence: 99%