Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning

Abstract Objective. The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Pain medicine (Malden, Mass.) Mass.), 2016-09, Vol.17 (9), p.1602-1611
Hauptverfasser: das Neves de Araújo Lima, Emeline, Barbosa, Natália Guimarães, dos Santos, Ana Celly Souza, AraújoMouraLemos, Telma Maria, de Souza, Cleber Machado, Trevilatto, Paula Cristina, da Silveira, Ericka Janine Dantas, de Medeiros, Ana Miryam Costa
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1611
container_issue 9
container_start_page 1602
container_title Pain medicine (Malden, Mass.)
container_volume 17
creator das Neves de Araújo Lima, Emeline
Barbosa, Natália Guimarães
dos Santos, Ana Celly Souza
AraújoMouraLemos, Telma Maria
de Souza, Cleber Machado
Trevilatto, Paula Cristina
da Silveira, Ericka Janine Dantas
de Medeiros, Ana Miryam Costa
description Abstract Objective. The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. Design . Cross sectional study. Setting. Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. Subjects. The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). Methods. The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. Results. The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p 
doi_str_mv 10.1093/pm/pnv087
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1818335177</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/pm/pnv087</oup_id><sourcerecordid>2127390224</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-9732c5aded65e13058cb7f465aeab7ccc2414d51ef519a3a3ba968fc0acc246d3</originalsourceid><addsrcrecordid>eNp90ctKxDAUBuAgiveFLyABXSg4mmvTLnXwBoqCui5n0lOttElNWmU2PrsdZ3ThwlUO5MvPCT8hO5wdc5bJk7Y5ad07S80SWedaJCOVSLO8mIU0eo1sxPjKGE9UKlfJmkhSlWWarZPPsW9aCNBV70hPHdTTWEXqS3ofp_bF1_65slAf0SsfGu9mE7iCXqLDrrL0AmznQ6Rn2H0gOnrWB1e5Z3rr--6FPkxdEXyD308e0HpXQJjSuwD1j9wiKyXUEbcX5yZ5ujh_HF-Nbu4ur8enNyOrlOxGmZHCaiiwSDRyyXRqJ6ZUiQaEibHWCsVVoTmWmmcgQU4gS9LSMphdJYXcJAfz3Db4tx5jlzdVtFjX4ND3MecpT6XU3JiB7v2hr35YdtguF1wYmTEh1KAO58oGH2PAMm9D1QzfyznLZ6XkbZPPSxns7iKxnzRY_MqfFgawPwe-b__J-QLNyZXz</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2127390224</pqid></control><display><type>article</type><title>Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>das Neves de Araújo Lima, Emeline ; Barbosa, Natália Guimarães ; dos Santos, Ana Celly Souza ; AraújoMouraLemos, Telma Maria ; de Souza, Cleber Machado ; Trevilatto, Paula Cristina ; da Silveira, Ericka Janine Dantas ; de Medeiros, Ana Miryam Costa</creator><creatorcontrib>das Neves de Araújo Lima, Emeline ; Barbosa, Natália Guimarães ; dos Santos, Ana Celly Souza ; AraújoMouraLemos, Telma Maria ; de Souza, Cleber Machado ; Trevilatto, Paula Cristina ; da Silveira, Ericka Janine Dantas ; de Medeiros, Ana Miryam Costa</creatorcontrib><description>Abstract Objective. The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. Design . Cross sectional study. Setting. Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. Subjects. The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). Methods. The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. Results. The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p &lt; 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS. Conclusion. These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnv087</identifier><identifier>PMID: 26849950</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Anxiety ; Burning mouth syndrome ; Burning Mouth Syndrome - genetics ; Burning Mouth Syndrome - metabolism ; Burning Mouth Syndrome - psychology ; Comparative analysis ; Cortisol ; Cross-Sectional Studies ; Dehydroepiandrosterone ; Dehydroepiandrosterone - blood ; Depression - complications ; Female ; Genetic analysis ; Genetic factors ; Genotype ; Humans ; Interleukin 6 ; Male ; Mental depression ; Middle Aged ; Mouth Diseases - genetics ; Mouth Diseases - metabolism ; Mouth Diseases - psychology ; Real-Time Polymerase Chain Reaction ; Saliva ; Xerostomia</subject><ispartof>Pain medicine (Malden, Mass.), 2016-09, Vol.17 (9), p.1602-1611</ispartof><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2016</rights><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>Copyright © 2016 American Academy of Pain Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-9732c5aded65e13058cb7f465aeab7ccc2414d51ef519a3a3ba968fc0acc246d3</citedby><cites>FETCH-LOGICAL-c443t-9732c5aded65e13058cb7f465aeab7ccc2414d51ef519a3a3ba968fc0acc246d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1583,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26849950$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>das Neves de Araújo Lima, Emeline</creatorcontrib><creatorcontrib>Barbosa, Natália Guimarães</creatorcontrib><creatorcontrib>dos Santos, Ana Celly Souza</creatorcontrib><creatorcontrib>AraújoMouraLemos, Telma Maria</creatorcontrib><creatorcontrib>de Souza, Cleber Machado</creatorcontrib><creatorcontrib>Trevilatto, Paula Cristina</creatorcontrib><creatorcontrib>da Silveira, Ericka Janine Dantas</creatorcontrib><creatorcontrib>de Medeiros, Ana Miryam Costa</creatorcontrib><title>Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Abstract Objective. The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. Design . Cross sectional study. Setting. Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. Subjects. The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). Methods. The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. Results. The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p &lt; 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS. Conclusion. These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS.</description><subject>Adult</subject><subject>Aged</subject><subject>Anxiety</subject><subject>Burning mouth syndrome</subject><subject>Burning Mouth Syndrome - genetics</subject><subject>Burning Mouth Syndrome - metabolism</subject><subject>Burning Mouth Syndrome - psychology</subject><subject>Comparative analysis</subject><subject>Cortisol</subject><subject>Cross-Sectional Studies</subject><subject>Dehydroepiandrosterone</subject><subject>Dehydroepiandrosterone - blood</subject><subject>Depression - complications</subject><subject>Female</subject><subject>Genetic analysis</subject><subject>Genetic factors</subject><subject>Genotype</subject><subject>Humans</subject><subject>Interleukin 6</subject><subject>Male</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Mouth Diseases - genetics</subject><subject>Mouth Diseases - metabolism</subject><subject>Mouth Diseases - psychology</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Saliva</subject><subject>Xerostomia</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp90ctKxDAUBuAgiveFLyABXSg4mmvTLnXwBoqCui5n0lOttElNWmU2PrsdZ3ThwlUO5MvPCT8hO5wdc5bJk7Y5ad07S80SWedaJCOVSLO8mIU0eo1sxPjKGE9UKlfJmkhSlWWarZPPsW9aCNBV70hPHdTTWEXqS3ofp_bF1_65slAf0SsfGu9mE7iCXqLDrrL0AmznQ6Rn2H0gOnrWB1e5Z3rr--6FPkxdEXyD308e0HpXQJjSuwD1j9wiKyXUEbcX5yZ5ujh_HF-Nbu4ur8enNyOrlOxGmZHCaiiwSDRyyXRqJ6ZUiQaEibHWCsVVoTmWmmcgQU4gS9LSMphdJYXcJAfz3Db4tx5jlzdVtFjX4ND3MecpT6XU3JiB7v2hr35YdtguF1wYmTEh1KAO58oGH2PAMm9D1QzfyznLZ6XkbZPPSxns7iKxnzRY_MqfFgawPwe-b__J-QLNyZXz</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>das Neves de Araújo Lima, Emeline</creator><creator>Barbosa, Natália Guimarães</creator><creator>dos Santos, Ana Celly Souza</creator><creator>AraújoMouraLemos, Telma Maria</creator><creator>de Souza, Cleber Machado</creator><creator>Trevilatto, Paula Cristina</creator><creator>da Silveira, Ericka Janine Dantas</creator><creator>de Medeiros, Ana Miryam Costa</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160901</creationdate><title>Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning</title><author>das Neves de Araújo Lima, Emeline ; Barbosa, Natália Guimarães ; dos Santos, Ana Celly Souza ; AraújoMouraLemos, Telma Maria ; de Souza, Cleber Machado ; Trevilatto, Paula Cristina ; da Silveira, Ericka Janine Dantas ; de Medeiros, Ana Miryam Costa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-9732c5aded65e13058cb7f465aeab7ccc2414d51ef519a3a3ba968fc0acc246d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anxiety</topic><topic>Burning mouth syndrome</topic><topic>Burning Mouth Syndrome - genetics</topic><topic>Burning Mouth Syndrome - metabolism</topic><topic>Burning Mouth Syndrome - psychology</topic><topic>Comparative analysis</topic><topic>Cortisol</topic><topic>Cross-Sectional Studies</topic><topic>Dehydroepiandrosterone</topic><topic>Dehydroepiandrosterone - blood</topic><topic>Depression - complications</topic><topic>Female</topic><topic>Genetic analysis</topic><topic>Genetic factors</topic><topic>Genotype</topic><topic>Humans</topic><topic>Interleukin 6</topic><topic>Male</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Mouth Diseases - genetics</topic><topic>Mouth Diseases - metabolism</topic><topic>Mouth Diseases - psychology</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Saliva</topic><topic>Xerostomia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>das Neves de Araújo Lima, Emeline</creatorcontrib><creatorcontrib>Barbosa, Natália Guimarães</creatorcontrib><creatorcontrib>dos Santos, Ana Celly Souza</creatorcontrib><creatorcontrib>AraújoMouraLemos, Telma Maria</creatorcontrib><creatorcontrib>de Souza, Cleber Machado</creatorcontrib><creatorcontrib>Trevilatto, Paula Cristina</creatorcontrib><creatorcontrib>da Silveira, Ericka Janine Dantas</creatorcontrib><creatorcontrib>de Medeiros, Ana Miryam Costa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>das Neves de Araújo Lima, Emeline</au><au>Barbosa, Natália Guimarães</au><au>dos Santos, Ana Celly Souza</au><au>AraújoMouraLemos, Telma Maria</au><au>de Souza, Cleber Machado</au><au>Trevilatto, Paula Cristina</au><au>da Silveira, Ericka Janine Dantas</au><au>de Medeiros, Ana Miryam Costa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>17</volume><issue>9</issue><spage>1602</spage><epage>1611</epage><pages>1602-1611</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract Objective. The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. Design . Cross sectional study. Setting. Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. Subjects. The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). Methods. The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. Results. The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p &lt; 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS. Conclusion. These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>26849950</pmid><doi>10.1093/pm/pnv087</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1526-2375
ispartof Pain medicine (Malden, Mass.), 2016-09, Vol.17 (9), p.1602-1611
issn 1526-2375
1526-4637
language eng
recordid cdi_proquest_miscellaneous_1818335177
source MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection
subjects Adult
Aged
Anxiety
Burning mouth syndrome
Burning Mouth Syndrome - genetics
Burning Mouth Syndrome - metabolism
Burning Mouth Syndrome - psychology
Comparative analysis
Cortisol
Cross-Sectional Studies
Dehydroepiandrosterone
Dehydroepiandrosterone - blood
Depression - complications
Female
Genetic analysis
Genetic factors
Genotype
Humans
Interleukin 6
Male
Mental depression
Middle Aged
Mouth Diseases - genetics
Mouth Diseases - metabolism
Mouth Diseases - psychology
Real-Time Polymerase Chain Reaction
Saliva
Xerostomia
title Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T12%3A13%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparative%20Analysis%20of%20Psychological,%20Hormonal,%20and%20Genetic%20Factors%20Between%20Burning%20Mouth%20Syndrome%20and%20Secondary%20Oral%20Burning&rft.jtitle=Pain%20medicine%20(Malden,%20Mass.)&rft.au=das%20Neves%20de%20Ara%C3%BAjo%20Lima,%20Emeline&rft.date=2016-09-01&rft.volume=17&rft.issue=9&rft.spage=1602&rft.epage=1611&rft.pages=1602-1611&rft.issn=1526-2375&rft.eissn=1526-4637&rft_id=info:doi/10.1093/pm/pnv087&rft_dat=%3Cproquest_cross%3E2127390224%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2127390224&rft_id=info:pmid/26849950&rft_oup_id=10.1093/pm/pnv087&rfr_iscdi=true