1 1147 152 CONDYLE MODELING STABILITY, CRANIOFACIAL ASYMMETRY AND ACTN3 GENOTYPES: CONTRIBUTION TO TMD PREVALENCE IN A COHORT OF DENTOFACIAL DEFORMITIES. CRANIOFACIAL ASYMMETRY, MANDIBULAR CONDYLAR MODELING AND TEMPOROMANDIBULAR JOINT DISORDERS ARE COMMON COMORBIDITIES OF SKELETALLY DISPROPORTIONATE MALOCCLUSIONS, BUT ETIOLOGY OF OCCURRENCE TOGETHER IS POORLY UNDERSTOOD. WE COMPARED ASYMMETRY, CONDYLE MODELING STABILITY AND TEMPOROMANDIBULAR HEALTH IN A COHORT OF 128 PATIENTS HAVING ORTHODONTICS AND ORTHOGNATHIC SURGERY TO CORRECT DENTOFACIAL DEFORMITY MALOCCLUSIONS. WE ALSO COMPARED ACTN3 AND ENPP1 GENOTYPES FOR ASSOCIATION TO CLINICAL CONDITIONS. PRE-SURGICAL POSTERIOR-ANTERIOR CEPHALOMETRIC AND PANOMETRIC RADIOGRAPHIC ANALYSES; JAW PAIN AND FUNCTION QUESTIONNAIRE AND CLINICAL EXAMINATION OF TMD; AND SNP-GENOTYPE ANALYSIS FROM SALIVA SAMPLES WERE COMPARED TO ASSESS INTERRELATIONSHIPS. ALMOST HALF HAD ASYMMETRIES IN NEED OF SURGICAL CORRECTION, WHICH COULD BE SUBDIVIDED INTO FOUR DISTINCT MORPHOLOGICAL PATTERNS. ASYMMETRIC CONDYLE MODELING BETWEEN SIDES WAS SIGNIFICANTLY GREATER IN CRANIOFACIAL ASYMMETRY, BUT MOST COMMONLY HAD AN UNANTICIPATED PATTERN. OFTEN, LONGER OR LARGER CONDYLES OCCURRED ON THE SHORTER MANDIBULAR RAMUS SIDE. SUBJECTS WITH LONGER RAMUS BUT DIMENSIONALLY SMALLER CONDYLES WERE MORE LIKELY TO HAVE SELF-REPORTED TMD SYMPTOMS (P = 0.023) AND SIGNIFICANTLY GREATER CLINICAL DIAGNOSIS OF TMD (P = 0 .000001), WITH MASTICATORY MYALGIA MOST PROMINENT. GENOTYPING FOUND TWO SIGNIFICANT GENOTYPE ASSOCIATIONS FOR ACTN3 RS1671064 (Q523R MISSENSE) P = 0.02; RS678397 (INTRONIC SNP) P = 0.04 AND ONE SIGNIFICANT ALLELE ASSOCIATION RS1815739 (R577X NONSENSE) P = 0.00. SKELETAL ASYMMETRY, UNUSUAL CONDYLE MODELING AND TMD ARE COMMON AND INTERRELATED COMPONENTS OF MANY DENTOFACIAL DEFORMITIES. IMBALANCED MUSCULOSKELETAL FUNCTIONAL ADAPTATIONS AND GENETIC OR EPIGENETIC INFLUENCES CONTRIBUTE TO THE ETIOLOGY, AND REQUIRE FURTHER INVESTIGATION. 2020 2 3004 19 GENETIC, EPIGENETIC, AND MECHANISTIC STUDIES OF TEMPOROMANDIBULAR DISORDERS AND OVERLAPPING PAIN CONDITIONS. LEADERS IN THE FIELDS OF TEMPOROMANDIBULAR DISORDERS (TMD) AND ITS ACCOMPANYING OVERLAPPING PAIN CONDITIONS PRESENTED THEIR LATEST FINDINGS AT THE SEVENTH SCIENTIFIC MEETING OF THE TMJ ASSOCIATION, SEPTEMBER 7-9, 2014, IN BETHESDA, MD. THE MEETING WAS CO-SPONSORED BY THE TMJ ASSOCIATION AND THE NATIONAL INSTITUTES OF HEALTH. TOPICS OF THE SCIENTIFIC SESSIONS INCLUDED EPIDEMIOLOGY AND DIAGNOSTIC CRITERIA, BASIC MECHANISMS OF CHRONIC PAIN INCLUDING THE GENETIC AND EPIGENETIC BASIS OF CHRONIC PAIN, AND THE DEVELOPMENT OF NOVEL DRUGS FOR TREATMENT OF THESE CONDITIONS. DISCUSSIONS WERE DIRECTED TOWARD FORMULATING A SET OF RECOMMENDATIONS TO ADVANCE RESEARCH IN THIS FIELD. 2014 3 3400 32 HOW CAN PRECISION MEDICINE BE APPLIED TO TEMPOROMANDIBULAR DISORDERS AND ITS COMORBIDITIES? THE EIGHTH SCIENTIFIC MEETING OF THE TMJ ASSOCIATION, LTD. WAS HELD IN BETHESDA, MARYLAND, SEPTEMBER 11-13, 2016. AS IN THE PAST, THE MEETING WAS COSPONSORED BY COMPONENTS OF THE NATIONAL INSTITUTES OF HEALTH WITH SPEAKERS INVITED TO REVIEW THE STATE OF TEMPOROMANDIBULAR DISORDER SCIENCE AND PROPOSE RECOMMENDATIONS TO FURTHER PROGRESS. THE THEME OF PRECISION MEDICINE, WHICH AIMS TO TAILOR DISEASE TREATMENT AND PREVENTION TO MATCH THE CHARACTERISTICS OF AN INDIVIDUAL PATIENT (GENETIC, EPIGENETIC, ENVIRONMENTAL, LIFESTYLE) UNDERSCORED THE CURRENT CONSENSUS THAT TEMPOROMANDIBULAR DISORDERS ARE NO LONGER VIEWED AS LOCAL CONDITIONS OF JAW PAIN AND DYSFUNCTION. RATHER, THEY REPRESENT A COMPLEX FAMILY OF BIOPSYCHOSOCIAL DISORDERS THAT CAN PROGRESS TO CHRONIC PAIN, MOST OFTEN ACCOMPANIED BY ONE OR MORE OTHER CHRONIC PAIN CONDITIONS. TEMPOROMANDIBULAR DISORDERS AND THESE COMORBIDITIES, CALLED CHRONIC OVERLAPPING PAIN CONDITIONS, PREDOMINANTLY OR EXCLUSIVELY AFFECT WOMEN IN THEIR CHILDBEARING YEARS AND REFLECT CENTRAL NERVOUS SYSTEM SENSITIZATION. PRESENTERS AT THE MEETING INCLUDED LEADERS IN TEMPOROMANDIBULAR DISORDER AND PAIN RESEARCH, TEMPOROMANDIBULAR DISORDER PATIENTS AND ADVOCATES, AND EXPERTS IN OTHER FIELDS OR IN THE USE OF TECHNOLOGIES THAT COULD FACILITATE THE DEVELOPMENT OF PRECISION MEDICINE APPROACHES IN TEMPOROMANDIBULAR DISORDERS. 2017 4 2995 40 GENETIC POLYMORPHISMS IN FOLATE PATHWAY ENZYMES, DRD4 AND GSTM1 ARE RELATED TO TEMPOROMANDIBULAR DISORDER. BACKGROUND: TEMPOROMANDIBULAR DISORDER (TMD) IS A MULTIFACTORIAL SYNDROME RELATED TO A CRITICAL PERIOD OF HUMAN LIFE. TMD HAS BEEN ASSOCIATED WITH PSYCHOLOGICAL DYSFUNCTIONS, OXIDATIVE STATE AND SEXUAL DIMORPHISM WITH COINCIDENTAL OCCURRENCE ALONG THE PUBERTAL DEVELOPMENT. IN THIS WORK WE STUDY THE ASSOCIATION BETWEEN TMD AND GENETIC POLYMORPHISMS OF FOLATE METABOLISM, NEUROTRANSMISSION, OXIDATIVE AND HORMONAL METABOLISM. FOLATE METABOLISM, WHICH DEPENDS ON GENES VARIATIONS AND DIET, IS DIRECTLY INVOLVED IN GENETIC AND EPIGENETIC VARIATIONS THAT CAN INFLUENCE THE CHANGES OF LAST GROWING PERIOD OF DEVELOPMENT IN HUMAN AND THE APPEARANCE OF THE TMD. METHODS: A CASE-CONTROL STUDY WAS DESIGNED TO EVALUATE THE IMPACT OF GENETIC POLYMORPHISMS ABOVE DESCRIBED ON TMD. A TOTAL OF 229 INDIVIDUALS (69% WOMEN) WERE INCLUDED AT THE STUDY; 86 WERE PATIENTS WITH TMD AND 143 WERE HEALTHY CONTROL SUBJECTS. SUBJECTS UNDERWENT TO A CLINICAL EXAMINATION FOLLOWING THE GUIDELINES BY THE RESEARCH DIAGNOSTIC CRITERIA FOR TEMPOROMANDIBULAR DISORDERS (RDC/TMD). GENOTYPING OF 20 SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS), DIVIDED IN TWO GROUPS, WAS PERFORMED BY MULTIPLEX MINISEQUENCING PRECEDED BY MULTIPLEX PCR. OTHER SEVEN GENETIC POLYMORPHISMS DIFFERENT FROM SNPS (DELETIONS, INSERTIONS, TANDEM REPEAT, NULL GENOTYPE) WERE ACHIEVED BY A MULTIPLEX-PCR. A CHI-SQUARE TEST WAS PERFORMED TO DETERMINE THE DIFFERENCES IN GENOTYPE AND ALLELIC FREQUENCIES BETWEEN TMD PATIENTS AND HEALTHY SUBJECTS. TO ESTIMATE TMD RISK, IN THOSE POLYMORPHISMS THAT SHOWN SIGNIFICANT DIFFERENCES, ODDS RATIO (OR) WITH A 95% OF CONFIDENCE INTERVAL WERE CALCULATED. RESULTS: SIX OF THE POLYMORPHISMS SHOWED STATISTICAL ASSOCIATIONS WITH TMD. FOUR OF THEM ARE RELATED TO ENZYMES OF FOLATES METABOLISM: ALLELE G OF SERINE HYDOXYMETHYLTRANSFERASE 1 (SHMT1) RS1979277 (OR = 3.99; 95%CI 1.72, 9.25; P = 0.002), ALLELE G OF SHMT1 RS638416 (OR = 2.80; 95%CI 1.51, 5.21; P = 0.013), ALLELE T OF METHYLENTETRAHYDROFOLATE DEHYDROGENASE (MTHFD) RS2236225 (OR = 3.09; 95%CI 1.27, 7.50; P = 0.016) AND ALLELE A OF METHIONINE SYNTHASE REDUCTASE (MTRR) RS1801394 (OR = 2.35; 95CI 1.10, 5.00; P = 0.037). AN INFLAMMATORY OXIDATIVE STRESS ENZYME, GLUTHATIONE S-TRANFERASE MU-1(GSTM1), NULL ALLELE (OR = 2.21; 95%CI 1.24, 4.36; P = 0.030) AND A NEUROTRANSMISSION RECEPTOR, DOPAMINE RECEPTOR D4 (DRD4), LONG ALLELE OF 48 BP-REPEAT (OR = 3.62; 95%CI 0.76, 17.26; P = 0.161). CONCLUSIONS: SOME GENETIC POLYMORPHISMS RELATED TO FOLATES METABOLISM, INFLAMMATORY OXIDATIVE STRESS, AND NEUROTRANSMISSION RESPONSES TO PAIN, HAS BEEN SIGNIFICANTLY ASSOCIATED TO TMD SYNDROME. 2011 5 4865 26 ORO-FACIAL PAIN AND TEMPOROMANDIBULAR DISORDERS CLASSIFICATION SYSTEMS: A CRITICAL APPRAISAL AND FUTURE DIRECTIONS. IT IS A DIFFICULT UNDERTAKING TO DESIGN A CLASSIFICATION SYSTEM FOR ANY DISEASE ENTITY, LET ALONE FOR ORO-FACIAL PAIN (OFP) AND MORE SPECIFICALLY FOR TEMPOROMANDIBULAR DISORDERS (TMD). A FURTHER COMPLICATION OF THIS TASK IS THAT BOTH PHYSICAL AND PSYCHOSOCIAL VARIABLES MUST BE INCLUDED. TO AUGMENT THIS PROCESS, A TWO-STEP SYSTEMATIC REVIEW, ADHERING TO PRISMA GUIDELINES, OF THE CLASSIFICATION SYSTEMS PUBLISHED DURING THE LAST 20 YEARS FOR OFP AND TMD WAS PERFORMED. THE FIRST SEARCH STEP IDENTIFIED 190 POTENTIAL CITATIONS WHICH ULTIMATELY RESULTED IN ONLY 17 ARTICLES BEING INCLUDED FOR IN-DEPTH ANALYSIS AND REVIEW. THE SECOND STEP RESULTED IN ONLY 5 ARTICLES BEING SELECTED FOR INCLUSION IN THIS REVIEW. FIVE ADDITIONAL ARTICLES AND FOUR CLASSIFICATION GUIDELINES/CRITERIA WERE ALSO INCLUDED DUE TO EXPANSION OF THE SEARCH CRITERIA. THUS, IN TOTAL, 14 DOCUMENTS COMPRISING ARTICLES AND GUIDELINES/CRITERIA (8 PROPOSALS OF CLASSIFICATION SYSTEMS FOR OFP; 6 FOR TMD) WERE SELECTED FOR INCLUSION IN THE SYSTEMATIC REVIEW. FOR EACH, A DISCUSSION AS TO THEIR ADVANTAGES, STRENGTHS AND LIMITATIONS WAS PROVIDED. SUGGESTIONS REGARDING THE FUTURE DIRECTION FOR IMPROVING THE CLASSIFICATION PROCESS WITH THE USE OF ONTOLOGICAL PRINCIPLES RATHER THAN TAXONOMY ARE DISCUSSED. FURTHERMORE, THE POTENTIAL FOR EXPANDING THE SCOPE OF AXES INCLUDED IN EXISTING CLASSIFICATION SYSTEMS, TO INCLUDE GENETIC, EPIGENETIC AND NEUROBIOLOGICAL VARIABLES, IS EXPLORED. IT IS THEREFORE RECOMMENDED THAT FUTURE CLASSIFICATION SYSTEM PROPOSALS BE BASED ON COMBINED APPROACHES AIMING TO PROVIDE ARCHETYPAL TREATMENT-ORIENTED CLASSIFICATIONS. 2018 6 6779 16 [BIO-PSYCHO-SOCIAL THERAPY FOR STRESS-INDUCED CHRONIC PAIN]. BIO-PSYCHO-SOCIAL THERAPY FOR STRESS-INDUCED CHRONIC PAIN ABSTRACT. AGAINST THE BACKGROUND OF LATEST NEUROBIOLOGICAL AND EPIGENETIC FINDINGS THE BIO-PSYCHO-SOCIAL MODEL OF DISEASE IS OUTLINED OFTEN MISINTERPRETED IN THE CONTEXT OF CHRONIC PAIN. IT REPRESENTS THE BASIC PRINCIPLE FOR A PERSONALIZED TREATMENT OF STRESS-INDUCED CHRONIC PAIN. CONSEQUENCES FOR DIAGNOSTIC PROCEDURES ARE DELINEATED TO DETECT THIS PATHOGENETIC SUBGROUP OF CHRONIC PAIN PATIENTS (E.G. FIBROMYALGIA, BACK PAIN, TEMPOROMANDIBULAR DYSFUNCTION, TENSION HEADACHE). FINALLY, THE PRINCIPLES OF A BIO-PSYCHO-SOCIAL TREATMENT PROGRAM WITH HIGH EFFICIENCY ARE PRESENTED. 2020 7 6472 25 TNFALPHA IN THE TRIGEMINAL NOCICEPTIVE SYSTEM IS CRITICAL FOR TEMPOROMANDIBULAR JOINT PAIN. PREVIOUS STUDIES HAVE SHOWN THAT TUMOR NECROSIS FACTOR ALPHA (TNFALPHA) IS SIGNIFICANTLY INCREASED IN COMPLETE FREUND'S ADJUVANT (CFA)-TREATED TEMPOROMANDIBULAR JOINT (TMJ) TISSUES. HOWEVER, IT IS UNCLEAR WHETHER TNFALPHA IN THE TRIGEMINAL NOCICEPTIVE SYSTEM CONTRIBUTES TO THE DEVELOPMENT OF TMJ PAIN. IN THE PRESENT STUDY, WE INVESTIGATED THE ROLE OF TNFALPHA IN TRIGEMINAL GANGLIA (TG) AND SPINAL TRIGEMINAL NUCLEUS CAUDALIS (SP5C) IN CFA-INDUCED INFLAMMATORY TMJ PAIN. INTRA-TMJ INJECTION OF CFA (10 MUL, 5 MG/ML) INDUCED INFLAMMATORY PAIN IN THE TRIGEMINAL NERVE V2- AND V3-INNERVATED SKIN AREAS OF WT MICE, WHICH WAS PRESENT ON DAY 1 AFTER CFA AND PERSISTED FOR AT LEAST 10 DAYS. TNFALPHA IN BOTH TG AND SP5C OF WT MICE WAS UPREGULATED AFTER CFA INJECTION. THE CFA-INDUCED TMJ PAIN WAS SIGNIFICANTLY INHIBITED IN TNFALPHA KO MICE. THE IMMUNOFLUORESCENCE STAINING SHOWED THAT INTRA-TMJ CFA INJECTION NOT ONLY ENHANCED CO-LOCALIZATION OF TNFALPHA WITH IBA1 (A MARKER FOR MICROGLIA) IN BOTH TG AND SP5C BUT ALSO MARKEDLY INCREASED THE EXPRESSION OF TNFALPHA IN THE SP5C NEURONS. BY THE METHYLATED DNA IMMUNOPRECIPITATION ASSAY, WE ALSO FOUND THAT DNA METHYLATION AT THE TNF GENE PROMOTER REGION IN THE TG WAS DRAMATICALLY DIMINISHED AFTER CFA INJECTION, INDICATING THAT EPIGENETIC REGULATION MAY BE INVOLVED IN THE CFA-ENHANCED TNFALPHA EXPRESSION IN OUR MODEL. OUR RESULTS SUGGEST THAT TNFALPHA IN THE TRIGEMINAL NOCICEPTIVE SYSTEM PLAYS A CRITICAL ROLE IN CFA-INDUCED INFLAMMATORY TMJ PAIN. 2019 8 5615 23 SAHA INHIBITS SOMATIC HYPERALGESIA INDUCED BY STRESS COMBINED WITH OROFACIAL INFLAMMATION THROUGH TARGETING DIFFERENT SPINAL 5-HT RECEPTOR SUBTYPES. EPIGENETIC REGULATION OF GENE EXPRESSION HAS BEEN IMPLICATED IN THE DEVELOPMENT OF CHRONIC PAIN. HOWEVER, LITTLE IS KNOWN ABOUT WHETHER THIS REGULATION IS INVOLVED IN THE DEVELOPMENT AND TREATMENT OF CHRONIC PAIN COMORBIDITIES SUCH AS FIBROMYALGIA SYNDROME (FMS) AND TEMPOROMANDIBULAR DISORDER (TMD), A COMORBIDITY PREDOMINANTLY OCCURRING AMONG WOMEN. HERE WE EXPLORED THE IMPACT OF THE HISTONE DEACETYLASE (HDAC) INHIBITOR SUBEROYLANILIDE HYDROXAMIC ACID (SAHA) ON SOMATIC HYPERALGESIA INDUCED BY STRESS OR STRESS COMBINED WITH OROFACIAL INFLAMMATION, WHICH MIMICKED THE COMORBIDITY OF FMS AND TMD IN RATS. OUR DATA SHOWED THAT SOMATIC THERMAL HYPERALGESIA AND MECHANICAL ALLODYNIA INDUCED BY BOTH CONDITIONS WERE COMPLETELY PREVENTED BY INTRATHECAL INJECTION OF SAHA, WHICH UPREGULATED 5-HT(2C) RECEPTORS BUT DOWNREGULATED 5-HT(3) RECEPTORS IN THE SPINAL DORSAL HORN. SUBSEQUENT SPINAL ADMINISTRATION OF RS102221 TO INHIBIT 5-HT(2C) RECEPTORS OR SR57227 TO ACTIVATE 5-HT(3) RECEPTORS REVERSED THE ANALGESIC EFFECT OF SAHA UNDER BOTH CONDITIONS. THESE RESULTS INDICATE THAT SAHA ATTENUATES THE PRO-NOCICEPTIVE EFFECTS OF STRESS COMBINED WITH OROFACIAL INFLAMMATION AND THE EFFECTS OF STRESS ALONE. THIS LIKELY OCCURS THROUGH EPIGENETIC REGULATION OF SPINAL 5-HT(2C) AND 5-HT(3) RECEPTOR EXPRESSION, SUGGESTING THAT SAHA HAS POTENTIAL THERAPEUTIC VALUE IN FMS OR COMORBID FMS-TMD PATIENTS WITH SOMATIC HYPERALGESIA. 2022 9 1037 17 CLASSIFICATION AND DIAGNOSIS OF TEMPOROMANDIBULAR DISORDERS AND TEMPOROMANDIBULAR DISORDER PAIN. DESIGNING CLASSIFICATION SYSTEMS AND DEVELOPING DIAGNOSTIC CRITERIA FOR TEMPOROMANDIBULAR DISORDERS IS DIFFICULT. AN APPRECIATION OF THE UTILITY AND APPLICABILITY OF THESE ENTITIES REQUIRES AN UNDERSTANDING OF THE IMPORTANCE OF EACH, THE DIFFERENCES BETWEEN THE TWO, AND HOW THEY MAY BE OPTIMALLY OPERATIONALIZED FOR BOTH CLINICAL AND RESEARCH ACTIVITIES IN LIGHT OF THEIR INHERENT ADVANTAGES AND LIMITATIONS. IN ADDITION, CONSIDERATION FOR ADOPTING NEWER APPROACHES, SUCH AS FOLLOWING ONTOLOGICAL AND PRECISION-BASED MEDICINE PRINCIPLES, ACCOUNTING FOR GENETICS/EPIGENETIC AND NEUROBIOLOGICAL FACTORS, AND THE INCLUSION OF BIOMARKERS WILL POTENTIALLY RESULT IN MORE THOROUGH AND COMPREHENSIVE CLASSIFICATION SYSTEMS AND DIAGNOSTIC CRITERIA. 2023 10 514 29 ASSOCIATION OF SHMT1, MAZ, ERG, AND L3MBTL3 GENE POLYMORPHISMS WITH SUSCEPTIBILITY TO MULTIPLE SCLEROSIS. MULTIPLE SCLEROSIS (MS) IS THE MOST COMMON INFLAMMATORY AND CHRONIC DISEASE OF THE CENTRAL NERVOUS SYSTEM (CNS). A COMPLEX INTERACTION BETWEEN GENETIC, ENVIRONMENTAL, AND EPIGENETIC FACTORS IS INVOLVED IN THE PATHOGENESIS OF MS. WITH THE ADVANCEMENT OF GWAS, VARIOUS VARIANTS ASSOCIATED WITH MS HAVE BEEN IDENTIFIED. THIS STUDY AIMED TO EVALUATE THE ASSOCIATION OF SINGLE-NUCLEOTIDE POLYMORPHISMS (SNPS) RS4925166 AND RS1979277 IN THE SHMT1, MAZ RS34286592, ERG RS2836425, AND L3MBTL3 RS4364506 WITH MS. IN THIS CASE-CONTROL STUDY, THE ASSOCIATION OF FIVE SNPS IN SHMT1, MAZ, ERG, AND L3MBTL3 GENES WITH RELAPSING-REMITTING MS (RR-MS) WAS INVESTIGATED IN 190 PATIENTS AND 200 HEALTHY INDIVIDUALS. FOUR SNPS INCLUDING SHMT1 RS4925166, SHMT1 RS1979277, MAZ RS34286592, AND L3MBTL3 RS4364506 WERE GENOTYPED USING PCR-RFLP AND GENOTYPING OF ERG RS2836425 WAS PERFORMED BY TETRA-PRIMER ARMS PCR. OUR FINDINGS SHOWED A SIGNIFICANT DIFFERENCE IN THE ALLELIC FREQUENCIES FOR THE FOUR SNPS OF SHMT1 RS4925166, SHMT1 RS1979277, MAZ RS34286592, AND ERG RS2836425, WHILE THERE WERE NO DIFFERENCES IN THE ALLELE AND GENOTYPE FREQUENCIES FOR L3MBTL3 RS4364506. THESE SIGNIFICANT ASSOCIATIONS WERE OBSERVED FOR THE FOLLOWING GENOTYPES: TT AND GG GENOTYPES OF SHMT1 RS4925166 (OR 0.47 AND 1.90, RESPECTIVELY) GENOTYPE GG OF SHMT1 RS1979277 (OR 0.63), GENOTYPE GG OF MAZ RS34286592 (OR 0.61), TC AND CC GENOTYPES OF ERG RS2836425 (OR 1.89 AND 0.50, RESPECTIVELY). OUR STUDY HIGHLIGHTED THAT PEOPLE WHO ARE CARRYING GENOTYPES INCLUDING GG (SHMT1 RS4925166) AND TC (ERG RS2836425) HAVE THE HIGHEST SUSCEPTIBILITY CHANCE FOR MS, RESPECTIVELY. HOWEVER, GENOTYPES TT (SHMT1 RS4925166), CC (ERG RS2836425), GG (MAZ RS34286592), AND GG (SHMT1 RS1979277) HAD THE HIGHEST NEGATIVE ASSOCIATION (PROTECTIVE EFFECT) WITH MS, RESPECTIVELY. L3MBTL3 RS4364506 WAS FOUND NEITHER AS A PREDISPOSING NOR A PROTECTIVE VARIANT. 2019 11 5176 26 PREFACE TO COAST 2016 INNOVATORS' WORKSHOP ON PERSONALIZED AND PRECISION ORTHODONTIC THERAPY. OBJECTIVE: A SECOND FOCUSED WORKSHOP EXPLORED HOW TO TRANSFER NOVEL FINDINGS INTO CLINICAL ORTHODONTIC PRACTICE. SETTING AND SAMPLE POPULATION: PARTICIPANTS MET IN WEST PALM BEACH (FLORIDA, USA), ON 9-11 SEPTEMBER 2016 FOR THE CONSORTIUM FOR ORTHODONTIC ADVANCES IN SCIENCE AND TECHNOLOGY 2016 INNOVATORS' WORKSHOP (COAST). APPROXIMATELY 65 REGISTERED ATTENDEES CONSIDERED AND DISCUSSED INFORMATION FROM 27 TO 34 SPEAKERS, 8 TO 15 POSTER PRESENTERS AND FOUR LUNCH-HOUR FOCUS GROUP LEADERS. MATERIAL AND METHODS: THE INNOVATORS' WORKSHOPS WERE ORGANIZED ACCORDING TO FIVE THEMED SESSIONS. THE AIMS OF THE DISCUSSION SESSIONS WERE TO IDENTIFY THE FOLLOWING: I) THE STRENGTH AND IMPACT OF THE EVIDENCED-BASED DISCOVERIES, II) REQUIRED STEPS TO ENABLE FURTHER DEVELOPMENT AND III) REQUIRED STEPS TO TRANSLATE THESE NEW DISCOVERIES INTO ORTHODONTIC PRACTICE. RESULTS: THE ROLE OF GENE-ENVIRONMENT INTERACTIONS THAT UNDERLIE COMPLEX CRANIOFACIAL TRAITS WAS THE FOCUS OF SEVERAL SESSIONS. IT WAS AGREED THAT DIVERSE APPROACHES ARE CALLED FOR, SUCH AS (I) LARGE-SCALE COLLABORATIVE EFFORTS FOR FUTURE GENETIC STUDIES OF COMPLEX TRAITS; (II) DEEP GENOME SEQUENCING TO ADDRESS THE ISSUES OF ISOLATED MUTATIONS; (III) QUANTIFYING EPIGENETIC-ENVIRONMENTAL VARIABLES IN DIVERSE AREAS MYOFASCIAL PAIN, ALVEOLAR REMODELLING AND MANDIBULAR GROWTH. COMMON NEEDS IDENTIFIED FROM THE THEMED SESSIONS WERE MULTISCALE/MULTISPECIES MODELLING AND EXPERIMENTATION USING CONTROLLED AND QUANTIFIED MECHANICS AND TRANSLATION OF THE FINDINGS IN BONE BIOLOGY BETWEEN SPECIES. PANEL DISCUSSIONS LED TO THE CONSENSUS THAT A CONSORTIUM APPROACH TO ESTABLISH STANDARDS FOR INTRA-ORAL SCANNING AND 3D IMAGING SHOULD BE INITIATED. CONCLUSIONS: CURRENT AND EMERGING TECHNOLOGIES STILL REQUIRE SUPPORTED RESEARCH TO TRANSLATE NEW FINDINGS FROM THE LABORATORY TO ORTHODONTIC PRACTICE. 2017 12 5866 23 SUPPRESSION OF MICRORNA-9-5P RESCUES LEARNING AND MEMORY IN CHRONIC CEREBRAL HYPOPERFUSION RATS MODEL. CHRONIC CEREBRAL HYPOPERFUSION HAS BEEN ASSOCIATED WITH COGNITIVE IMPAIRMENT IN DEMENTIAS, SUCH AS ALZHEIMER'S DISEASE (AD) AND VASCULAR DISEASE (VAD), THE TWO MOST COMMON NEURODEGENERATIVE DISEASES IN AGED PEOPLE. HOWEVER, THE EFFECTIVE THERAPEUTIC APPROACHES FOR BOTH AD AND VAD ARE STILL MISSING. MICRORNAS (MIRNAS) ARE SMALL NON-CODING RNAS THAT PLAY IMPORTANT ROLES IN THE EPIGENETIC REGULATION IN MANY NEUROLOGICAL DISORDERS; THE CRITICAL ROLES OF MIRNADEREGULATION HAD BEEN IMPLICATED IN BOTH AD AND VAD. IN THE CURRENT STUDY, WE REPORTED THAT MIR-9-5P IS ELEVATED IN THE SERUM AND CEREBROSPINALFLUID OF PATIENTSWITH VAD. THE MIR-9-5P WASALSO INCREASED IN BOTH THE HIPPOCAMPUS AND CORTEX OF RATS WITH 2-VESSEL OCCLUSIONSURGERY. FURTHERMORE, APPLICATION OFMIR-9-5P ANTAGOMIRS ATTENUATED THE MEMORY IMPAIRMENTS IN RATS WITH 2-VESSEL OCCLUSION SURGERY BOTH IN THE MORRIS WATER MAZE AND INHIBITORY AVOIDANCE STEP-DOWN TASKS. FURTHERMORE, MIR-9-5P ANTAGOMIRS REDUCEDTHE INHIBITION OFLONG-TERM POTENTIATION AND LOSS OF DENDRITIC SPINES IN CHRONIC CEREBRAL HYPOPERFUSIONRATS. ADDITIONALLY, THE CHOLINERGIC NEURONAL FUNCTION WAS RESCUED BY MIR-9-5P ANTAGOMIRS, AS WELL AS THE NEURONAL LOSS AND THE OXIDATIVE STRESS. WE CONCLUDED THAT MIR-9-5P INHIBITION MAY BE A POTENTIAL THERAPEUTIC TARGET FOR THE MEMORY IMPAIRMENTS CAUSED BY CHRONIC CEREBRAL HYPOPERFUSION. 2017 13 3598 13 IMPLICATIONS ON HYPNOTHERAPY: NEUROPLASTICITY, EPIGENETICS AND PAIN. WE PROVIDE A BRIEF REVIEW ABOUT THE SIGNIFICANCE OF HYPNOSIS WITH RESPECT TO APPLICATIONS AND PHYSIOLOGICAL PROCESSES IN HYPNOTHERAPY. OUR REVIEW CONCLUDES THAT HYPNOSIS IS A PROMISING METHOD TO MANAGE ACUTE AND CHRONIC PAIN. IN ADDITION, WE DISCUSS INDICATIONS POINTING TOWARD THE VIEW THAT HYPNOSIS CAN INDUCE CHANGES IN NEUROPLASTICITY POSSIBLY INVOLVING EPIGENETIC MECHANISMS. 2021 14 5356 21 REAC-INDUCED ENDOGENOUS BIOELECTRIC CURRENTS IN THE TREATMENT OF VENOUS ULCERS: A THREE-ARM RANDOMIZED CONTROLLED PROSPECTIVE STUDY. INTRODUCTION: ENDOGENOUS BIOELECTRIC FIELDS (EBFS) PLAY A FUNDAMENTAL ROLE IN PROMOTING REPAIR AND REGENERATION PROCESSES, INCLUDING IN LEG VENOUS ULCERS (LVUS). UNFORTUNATELY, THE MECHANISM UNDERLYING THE PRODUCTION OF EBFS IS EASILY ALTERED BY INFECTIOUS, TRAUMATIC, AND EPIGENETIC FACTORS. THIS ALTERATION IS ONE OF THE DETERMINING FACTORS FOR THE CHRONICITY OF LVUS. THIS STUDY INVESTIGATES HOW RADIOELECTRIC ASYMMETRIC CONVEYER (REAC) TECHNOLOGY TREATMENTS, SPECIFICALLY DESIGNED TO OPTIMIZE EBFS, AND IN PARTICULAR TISSUE OPTIMIZATION-REPARATIVE (TO-RPR) TREATMENT, CAN IMPROVE THE RESULTS OF STANDARD DRESSING WITH AND WITHOUT ELASTIC COMPRESSION IN LVU PATIENTS. METHODS: A TOTAL OF 30 PATIENTS WERE ENROLLED (12 MALES AND 18 FEMALES) AND RANDOMIZED INTO THREE GROUPS. ALL PATIENTS COMPLETED THE STUDY. GROUP A WAS TREATED WITH STANDARD DRESSING, ELASTIC COMPRESSION, AND REAC TO-RPR TREATMENT; GROUP B WAS TREATED WITH STANDARD DRESSING AND REAC TO-RPR TREATMENT; AND GROUP C WAS TREATED WITH STANDARD DRESSING AND ELASTIC COMPRESSION. RESULTS: THE RESULTS SHOW THAT THE COMBINATION OF REAC TREATMENT AND STANDARD DRESSING ASSOCIATED WITH ELASTIC COMPRESSION HAS THE GREATEST THERAPEUTIC EFFICACY IN PROMOTING THE HEALING PROCESS FOR ULCERS, REDUCING PERCEIVED PAIN, AND IMPROVING THE QUALITY OF LIFE OF THE PATIENTS TREATED. CONCLUSIONS: FURTHER STUDIES WILL BE USEFUL TO INVESTIGATE THESE PROSPECTIVE RESULTS. 2020 15 5137 24 POTENTIAL MECHANISMS OF NON-SUICIDAL SELF-INJURY (NSSI) IN MAJOR DEPRESSIVE DISORDER: A SYSTEMATIC REVIEW. BACKGROUND: NON-SUICIDAL SELF-INJURY (NSSI) IS A FREQUENT AND PROMINENT PHENOMENON IN MAJOR DEPRESSIVE DISORDER (MDD). EVEN THOUGH ITS PREVALENCE AND RISK FACTORS ARE RELATIVELY WELL UNDERSTOOD, THE POTENTIAL MECHANISMS OF NSSI IN MDD REMAIN ELUSIVE. AIMS: TO REVIEW PRESENT EVIDENCE RELATED TO THE POTENTIAL MECHANISMS OF NSSI IN MDD. METHODS: ACCORDING TO PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSES 2020 GUIDELINES, ARTICLES FOR THIS SYSTEMATIC REVIEW WERE SEARCHED ON MEDLINE (THROUGH PUBMED), EMBASE (THROUGH ELSEVIER), PSYCINFO (THROUGH OVID) AND WEB OF SCIENCE DATABASES FOR ENGLISH ARTICLES, AS WELL AS CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), SINOMED, WANFANG DATA, AND THE CHONGQING VIP CHINESE SCIENCE AND TECHNOLOGY PERIODICAL (VIP) DATABASES FOR CHINESE ARTICLES PUBLISHED FROM THE DATE OF INCEPTION TO 2 AUGUST 2022. TWO RESEARCHERS (BW, HZ) INDEPENDENTLY SCREENED STUDIES BASED ON INCLUSION AND EXCLUSION CRITERIA AND ASSESSED THEIR QUALITY. RESULTS: A TOTAL OF 25 157 STUDIES WERE SEARCHED. ONLY 25 OF THEM WERE ULTIMATELY INCLUDED, CONTAINING 3336 SUBJECTS (1535 PATIENTS WITH MDD AND NSSI, 1403 PATIENTS WITH MDD WITHOUT NSSI AND 398 HCS). INCLUDED STUDIES WERE DIVIDED INTO 6 CATEGORIES: PSYCHOSOCIAL FACTORS (11 STUDIES), NEUROIMAGING (8 STUDIES), STRESS AND HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS (2 STUDIES), PAIN PERCEPTION (1 STUDY), ELECTROENCEPHALOGRAM (EEG) (2 STUDIES) AND EPIGENETICS (1 STUDY). CONCLUSIONS: THIS SYSTEMATIC REVIEW INDICATES THAT PATIENTS WITH MDD AND NSSI MIGHT HAVE SPECIFIC PSYCHOSOCIAL FACTORS, ABERRANT BRAIN FUNCTIONS AND NEUROCHEMICAL METABOLISMS, HPA AXIS DYSFUNCTIONS, ABNORMAL PAIN PERCEPTIONS AND EPIGENETIC ALTERATIONS. 2023 16 6507 12 TRAINING VOCATIONAL REHABILITATION COUNSELORS WHO WORK WITH CHRONIC MENTAL PATIENTS. BECAUSE OF THE INEFFICACY OF DISPARATE PSYCHIATRIC AND REHABILITATIVE APPROACHES TO PSYCHOSOCIAL RESTORATION OF CHRONIC MENTAL PATIENTS, THE AUTHORS DESIGNED THE NEW ENGLAND PSYCHIATRIC REHABILITATION TRAINING PROGRAM FOR VOCATIONAL REHABILITATION COUNSELORS WHO WORK WITH THESE PATIENTS. THE PROGRAM EXTENDS ERIKSON'S EPIGENETIC SEQUENCE TO DEVELOPMENT OF WORK CAPACITY AND EMPHASIZES A COMPREHENSIVE, MULTIAXIAL APPROACH TO PSYCHOPATHOLOGY AND VOCATIONAL REHABILITATION. AFTER 6 WEEKS OF SEMINARS, CLINICAL WORK, AND SUPERVISION, COUNSELORS RETURN TO THEIR AGENCIES AND RECEIVE AN ADDITIONAL 8 WEEKS OF PART-TIME SUPPORT FROM FIELD FACULTY INSTRUCTORS. 1981 17 5692 22 SILENCING OF LNCRNA PKIA-AS1 ATTENUATES SPINAL NERVE LIGATION-INDUCED NEUROPATHIC PAIN THROUGH EPIGENETIC DOWNREGULATION OF CDK6 EXPRESSION. NEUROPATHIC PAIN (NP) IS AMONG THE MOST INTRACTABLE COMORBIDITIES OF SPINAL CORD INJURY. DYSREGULATION OF NON-CODING RNAS HAS ALSO BEEN IMPLICATED IN THE DEVELOPMENT OF NEUROPATHIC PAIN. HERE, WE IDENTIFIED A NOVEL LNCRNA, PKIA-AS1, BY USING LNCRNA ARRAY ANALYSIS IN SPINAL CORD TISSUE OF SPINAL NERVE LIGATION (SNL) MODEL RATS, AND INVESTIGATED THE ROLE OF PKIA-AS1 IN SNL-MEDIATED NEUROPATHIC PAIN. WE OBSERVED THAT PKIA-AS1 WAS SIGNIFICANTLY UPREGULATED IN SNL MODEL RATS AND THAT PKIA-AS1 KNOCKDOWN ATTENUATED NEUROPATHIC PAIN PROGRESSION. ALTERNATIVELY, OVEREXPRESSION OF PKIA-AS1 WAS SUFFICIENT TO INDUCE NEUROPATHIC PAIN-LIKE SYMPTOMS IN UNINJURED RATS. WE ALSO FOUND THAT PKIA-AS1 MEDIATED SNL-INDUCED NEUROPATHIC PAIN BY DIRECTLY REGULATING THE EXPRESSION AND FUNCTION OF CDK6, WHICH IS ESSENTIAL FOR THE INITIATION AND MAINTENANCE OF NEUROINFLAMMATION AND NEUROPATHIC PAIN. THEREFORE, OUR STUDY IDENTIFIES PKIA-AS1 AS A NOVEL THERAPEUTIC TARGET FOR NEUROINFLAMMATION RELATED NEUROPATHIC PAIN. 2019 18 6156 18 THE GENETIC INFLUENCE ON THE CORTICAL PROCESSING OF EXPERIMENTAL PAIN AND THE MODERATING EFFECT OF PAIN STATUS. BACKGROUND: RESEARCH SUGGESTS THAT THE COMT VAL(158)MET, BDNF VAL(66)MET AND OPRM1 A(118)G POLYMORPHISMS MODERATE THE EXPERIENCE OF PAIN. IN ORDER TO OBTAIN EXPERIMENTAL CONFIRMATION AND EXTENSION OF FINDINGS, CORTICAL PROCESSING OF EXPERIMENTALLY-INDUCED PAIN WAS USED. METHOD: A SAMPLE OF 78 INDIVIDUALS WITH CHRONIC LOW BACK PAIN COMPLAINTS AND 37 HEALTHY CONTROLS UNDERWENT EEG REGISTRATION. EVENT-RELATED POTENTIALS WERE MEASURED IN RESPONSE TO ELECTRICAL NOCICEPTIVE STIMULI AND MODERATION BY COMT VAL(158)MET, BDNF VAL(66)MET AND OPRM1 A(118)G POLYMORPHISMS WAS ASSESSED. RESULTS: GENETIC VARIATION DID NOT HAVE A DIRECT EFFECT ON CORTICAL PROCESSING OF EXPERIMENTAL PAIN. HOWEVER, GENETIC EFFECTS (COMT VAL(158)MET AND BDNF VAL(66)MET) ON EXPERIMENTAL PAIN WERE MODERATED BY THE PRESENCE OF CHRONIC PAIN. IN THE PRESENCE OF CHRONIC PAIN, THE COMT MET ALLELE AND THE BDNF MET ALLELE AUGMENTED CORTICAL PAIN PROCESSING, WHILST REDUCING PAIN PROCESSING IN PAIN-FREE CONTROLS. NO SIGNIFICANT EFFECTS WERE FOUND CONCERNING THE OPRM1 A(118)G POLYMORPHISM. CONCLUSIONS: THE CURRENT STUDY SUGGESTS THAT CHRONIC EXPERIENCE OF PAIN ENHANCES GENETIC SENSITIVITY TO EXPERIMENTALLY INDUCED MILDLY PAINFUL STIMULI, POSSIBLY THROUGH A PROCESS OF EPIGENETIC MODIFICATION. 2010 19 486 26 ASENAPINE TRANSDERMAL PATCH FOR THE MANAGEMENT OF SCHIZOPHRENIA. PURPOSE OF REVIEW: THIS IS A COMPREHENSIVE REVIEW OF THE LITERATURE REGARDING THE USE OF ASENAPINE FOR THE TREATMENT OF SCHIZOPHRENIA (SZ) IN ADULTS. IT COVERS AN INTRODUCTION, EPIDEMIOLOGY, RISK FACTORS, PATHOPHYSIOLOGY, AND CURRENT TREATMENT MODALITIES REGARDING SZ, PROVIDES A BACKGROUND ON THE MECHANISM OF ACTION OF ASENAPINE, AND THEN REVIEWS THE EXISTING EVIDENCE FOR USE OF ASENAPINE IN BOTH ITS SUBLINGUAL AND TRANSDERMAL FORMULATION IN THE TREATMENT OF SZ. RECENT FINDINGS: SZ IS A COMPLEX AND MULTIFACTORIAL MENTAL DISORDER WHICH IS THOUGHT TO COMBINE SEVERAL GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS CAUSING ABNORMALITIES IN THE DOPAMINERGIC SYSTEM. SYMPTOMS ARE CATEGORIZED IN DELUSIONS, HALLUCINATIONS, DISORGANIZATION, AND NEGATIVE PRESENTATIONS LIKE AFFECTIVE FLATTENING AND APATHY. CURRENT TREATMENT FOCUSES ON ANTIPSYCHOTIC MEDICATIONS BY MEANS OF ORAL ADMINISTRATION OR LONG-ACTING INJECTION. ASENAPINE IS A SECOND-GENERATION ANTIPSYCHOTIC WITH 5HT-2A ANTAGONIST AND 5HT-1A/1B PARTIAL AGONIST PROPERTIES, WHICH PROVIDES A FAVORABLE PROFILE IN TARGETING SCHIZOPHRENIC SYMPTOMS, WHILE REDUCING MOTOR SIDE EFFECTS AND IMPROVING MOOD AND COGNITION. ASENAPINE IN ITS SUBLINGUAL FORMULATION WAS FDA APPROVED FOR TREATMENT OF SZ AND BIPOLAR I DISORDER IN ADULTS IN AUGUST OF 2009 AND HAS BEEN PROVEN TO BE BOTH EFFECTIVE AND SAFE. TRANSDERMAL PATCH OF ASENAPINE (SECUADO) WAS FDA APPROVED IN OCTOBER OF 2019, THE FIRST AND ONLY FDA APPROVED PATCH FOR SZ IN ADULTS, WHICH OFFERS ANOTHER STRATEGY FOR TREATMENT TO IMPROVE COMPLIANCE AND EASE OF ADMINISTRATION. SUMMARY: SZ IS A CHRONIC AND DEBILITATING DISEASE WHICH IS STILL NOT WELL UNDERSTOOD AND COMES AT GREAT COST WITH REGARDS TO THE QUALITY OF LIFE FOR PATIENTS. MEDICATION SIDE-EFFECTS AND COMPLIANCE ARE ENORMOUS ISSUES WHICH TAKE A TOLL ON HEALTH CARE SYSTEMS IN INDUSTRIALIZED NATIONS AND KEEP PATIENTS FROM ACHIEVING STABILITY WITH THEIR DISEASE. TRANSDERMAL ASENAPINE IS A NEW FIRST-IN-CLASS DOSAGE FORM AND PROVIDES A NOVEL MODALITY OF ADMINISTRATION. IT HAS BEEN SHOWN TO BE EFFECTIVE IN REDUCING POSITIVE, AS WELL AS NEGATIVE SYMPTOMS, WHILE STILL MAINTAINING A FAVORABLE SIDE-EFFECT PROFILE. 2020 20 257 26 ADVANCES IN ONCOANAESTHESIA AND CANCER PAIN. INTRODUCTION: THE GROWING INTEREST ON HOW PERI-?OPERATIVE INTERVENTIONS, ESPECIALLY REGIONAL ANESTHESIA, DURING CANCER SURGERY CAN ALTER ONCOLOGICAL OUTCOME INCREASING DISEASE FREE SURVIVAL IS PROBABLY RESPONSIBLE FOR THE BIRTH OF THE NEW SUBSPECIALTY CALLED ONCO-ANESTHESIA. A PARADIGM SHIFT IN THE CONCEPT OF ANESTHETIC MANAGEMENT HAS OCCURRED RECENTLY OWING TO THE INNUMERABLE DIVERSE REVELATIONS FROM THE ONGOING RESEARCH IN THIS FIELD. DISCUSSION: LONG LASTING BUT REVERSIBLE EPIGENETIC CHANGES CAN OCCUR DUE TO SURGICAL STRESS AND PERIOPERATIVE ANESTHETIC MEDICATIONS. THE EXACT RELATIONSHIP BETWEEN THESE FACTORS AND TUMOR BIOLOGY IS BEING STUDIED FURTHER. A POPULAR TOPIC UNDER RESEARCH NOW IS THE INFLUENCE OF REGIONAL ANESTHESIA ON CANCER RECURRENCE. COMBINING NERVE BLOCKS WITH TOTAL INTRAVENOUS ANESTHESIA (TIVA) BRINGS DOWN THE REQUIREMENT OF OPIOIDS AND VOLATILE ANESTHETIC AGENTS IMPLICATED IN CANCER RECURRENCE. THE STUDY OF MECHANISM OF PAIN AT THE MOLECULAR LEVEL HAS LED TO THE DISCOVERY OF NOVEL MODES OF PREVENTION OF CHRONIC POST-SURGICAL PAIN. NEWER COMBINATION AGGRESSIVE TREATMENT THERAPIES -INTRAOPERATIVE CHEMOTHERAPY AND RADIOTHERAPY, ISOLATED LIMB PERFUSION, PHOTODYNAMIC THERAPY AND ROBOTIC SURGERY REQUIRE SPECIALIZED ANESTHETIC MANAGEMENT. THE COVID PANDEMIC INTRODUCED NEW GUIDELINES FOR SAFE MANAGEMENT OF ONCOSURGICAL PATIENTS .USE OF GENOMIC MAPPING TO PERSONALIZE PAIN MANAGEMENT WILL BE THE BREAKTHROUGH OF THE DECADE. CONCLUSION: THE DISCOVERY THAT ANESTHETIC STRATEGY COULD HAVE SIGNIFICANT ONCOLOGICAL SEQUEL IS A QUANTUM LEAP FORWARD. AVOIDING SOME ANESTHETIC MEDICATIONS MAY DECREASE CANCER RECURRENCE. COMPREHENSIVE CANCER CARE AND TRANSLATIONAL RESEARCH WILL PAVE THE WAY TO UNCOVER SAFE ANESTHETIC PRACTICES. 2021