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7 Numbers That Show The Fight Against Hepatitis Is Far From Over
July 28 is World Hepatitis Day, a sorely-needed awareness campaign for diseases that affect more than 400 million people alive today. In the U.S., more people die from hepatitis C than they do from HIV/AIDS. And despite being preventable with vaccine, hepatitis B causes an estimated 1 million deaths every year and is the leading cause of liver cancer worldwide. Despite these shocking numbers, the virus is little understood and discussed, and that&#8217;s got to change, according to Dr.&#160;H. Nina Kim, director of the&#160;Madison HIV/Hepatitis Coinfection Clinic in Washington. &#8220;In some ways, the HIV epidemic is tied really closely with the gay movement and very vocal patient advocacy arose from this demographic,&#8221; said Kim.&#160;&#8220;A lot of my patients have a sort of shame...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Oral lichen planus: salival biomarkers cortisol, immunoglobulin A, adiponectin
ConclusionsOLP patients presented worse psychological profiles and sleep disturbances, as well as higher values for IgA, cortisol, and total proteins than control subjects. (Source: Journal of Oral Pathology and Medicine)


Surgical reduction and ligament reconstruction for chronic dorsal dislocation of the lesser metatarsophalangeal joint associated with hallux valgus
Conclusion Our surgical procedure achieved significant correction of HV, a low rate of postoperative re-dislocation of the lesser MTP joints, and significant improvement of pain and function for symptomatic moderate-to-severe HV with dislocation of the lesser MTP joints. Level of evidence Level IV, retrospective case series. (Source: Journal of Orthopaedic Science)


Is your back pain all in the mind?
Like millions of others, Marie Lovell, from Durham, now a fit and healthy fortysomething, was living with crippling chronic back pain. (Source: the Mail online | Health)


Tech-Assisted Pain Self-management: Which Modality Works Best?Tech-Assisted Pain Self-management: Which Modality Works Best?
Three self-management modalities for chronic noncancer, nonheadache pain are compared. What's the verdict? Medscape Psychiatry (Source: Medscape Psychiatry Headlines)


Age moderates response to acceptance and commitment therapy vs. cognitive behavioral therapy for chronic pain
ConclusionsThese data suggest that ACT may be an effective and acceptable treatment for chronic pain in older adults. Copyright © 2015 John Wiley & Sons, Ltd. (Source: International Journal of Geriatric Psychiatry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


What is the perceived impact of Alexander technique lessons on health status, costs and pain management in the real life setting of an English hospital? The results of a mixed methods evaluation of an Alexander technique service for those with chronic back pain
Conclusions: Alexander Technique lessons may be used as another approach to pain management. The findings suggests that Alexander Technique lessons can help improve self-efficacy for those who are sufficiently motivated, which in turn may have an impact on service utilisation levels. (Source: BMC Health Services Research)


Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial
The objective of this paper is to describe the design of a noninferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain.Methods/DesignA noninferiority study design will be applied. The study population consists of workers who are on part-time or full-time sick leave due to subacute or chronic nonspecific musculoskeletal pain. Two multidisciplinary vocational rehabilitation programs following the bio-psychosocial approach will be evaluated in this study: 40-h vocational rehabilitation and 100-h vocational rehabilitation, both delivered over a maximum of 15 weeks. The 100...


Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study
Conclusion We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes. (Source: Medical Journal Armed Forces India)


The Psychological Inflexibility in Pain Scale (PIPS) &#8211; validation, factor structure and comparison to the Chronic Pain Acceptance Questionnaire (CPAQ) and other validated measures in German chronic back pain patients
Conclusions: The PIPS subscale Avoidance may be a valuable instrument to assess treatment processes in future RCTs. The PIPS subscale Fusion seemed more problematic in the German sample with chronic back pain. More research on the comparison between PIPS and other questionnaires assessing psychological flexibility and the usefulness of the concept ‘Fusion’ for chronic pain are needed. (Source: BMC Musculoskeletal Disorders)


Spontaneous iliopsoas tendon rupture: an uncommon cause of hip pain in the elderly
Iliopsoas tendon rupture is a relatively rare cause of hip pain. It has been described in children, in adults with pathologic avulsion secondary to metastatic disease, and in older individuals with multiple chronic illnesses. We are reporting a case of apparently spontaneous iliopsoas tendon rupture which occurred in an elderly patient presenting with severe debilitating hip pain whose etiology was initially unrecognized. Magnetic resonance imaging (MRI) of the hip confirmed the diagnosis. This case highlights the importance of considering iliopsoas tear in the differential diagnosis of unexplained acute onset hip pain, and illustrates that geriatric patients with this condition can be treated conservatively with satisfactory functional outcome. (Source: PM and R)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Rotational Ankle Instability- A case series study
Conclusions Anatomical reconstruction of chronic, rotationally unstable, ankle with normal hindfoot alignment may yield a favourable short-term outcome. However, there is a need for a larger cohort to examine both short and long term clinical outcome in such cases. Level of evidence Level 4, case series. (Source: Sports Orthopaedics and Traumatology)


Techniques for counseling clients who have chronic pain
Clients or patients facing chronic pain require a special counseling approach that can be applied universally, no matter their source of pain or the number of months or years they have tried to deal with the pain. We have honed and practiced these techniques at the Betty Ford Center in Rancho Mirage, California, because many...continue reading (Source: Counseling Today)


High Praise: Medical Marijuana Dispensaries Save Lives
It helps alleviate pain of chronic illness, one of its isolated compounds helps hurry the mending of broken bones, and it makes eating Funyons a transformative&#160;experience. But medical marijuana&#8217;s greatest benefit may be that it prevents numerous cases of pain-killer addiction and death. A new study released by the University of California-Irvine in conjunction with the RAND corporation, a non-profit global think tank, shows a correlation between states that have&#160;legalized marijuana and reduced rates of opioid addiction. They studied treatment admissions for opioid addiction and opioid-related deaths in the eighteen states were pot is legal. They also factored in the impact of dispensaries that were open for business. In the 18 states that had legalized&#160;medical marijuan...


Children who use iPads could suffer from chronic neck and back pain
Stephanie Cassidy, a Melbourne-based occupational therapist, said children should spend a maximum of half an hour in a fixed position before moving again. (Source: the Mail online | Health)


Determinants of Patient Satisfaction in an Academic Rheumatology Practice
Conclusions: Factors contributing to satisfaction scores differed for median satisfaction level and lower satisfaction level. Most of the factors identified as influencing patient satisfaction were unrelated to the physician or the skills of that physician. (Source: JCR: Journal of Clinical Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps strength and pain in individuals with knee synovitis: a prospective observational study
IntroductionSubstantial weakness of the quadriceps muscles is typically observed in patients with arthritis. This is partly due to ongoing neural inhibition that prevents the quadriceps from being fully activated. Evidence from animal studies suggests enhanced flexion reflex excitability may contribute to this weakness. This prospective observational study examined the effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps muscle strength and knee pain in individuals with knee synovitis. Methods: Sixteen patients with chronic arthritis and clinically active synovitis of the knee participated in this study. Knee pain flexion reflex threshold, and quadriceps peak torque were measured at baseline, immediately after knee joint aspira...


The placebo effect can still work, even if people know it's a placebo
Conclusion This experimental study suggests reinforcing an expectation of a positive outcome – as with the long conditioning in this study – can create a placebo effect. Some pain relief seemed to be experienced, even when the placebo was finally revealed to be as inactive as the control. In terms of any implications from these findings, there are a few points to bear in mind. This was a fairly small, select group of healthy adults. In fact, they were preferentially selected from the group of volunteers as being people who experienced sufficient pain response to the heat stimulus. They are not representative of everyone, and the results could have been different in other groups. This was a very experimental scenario involving a heat sensor applied to the skin. The participants...


Children who spend more than 30 minutes a time on their iPads could suffer from chronic neck and back pain in later life
Stephanie Cassidy, a Melbourne-based occupational therapist, said children should spend a maximum of half an hour in a fixed position before moving again. (Source: the Mail online | Health)


Identification of acute myocardial infarction in patients with atrial fibrillation and chest pain with a contemporary sensitive troponin I assay
Troponin I concentration at hospital admission and after 3 hours identifies acute coronary syndrome (ACS) in patients with chronic atrial fibrillation, suggesting that measuring troponin kinetics could provide useful diagnostic information. (Source: BMC Medicine)


Calibration and Validation of the Dutch-Flemish PROMIS Pain Interference Item Bank in Patients with Chronic Pain
by Martine H. P. Crins, Leo D. Roorda, Niels Smits, Henrica C. W. de Vet, Rene Westhovens, David Cella, Karon F. Cook, Dennis Revicki, Jaap van Leeuwen, Maarten Boers, Joost Dekker, Caroline B. Terwee The Dutch-Flemish PROMIS Group translated the adult PROMIS Pain Interference item bank into Dutch-Flemish. The aims of the current study were to calibrate the parameters of these items using an item response theory (IRT) model, to evaluate the cross-cultural validity of the Dutch-Flemish translations compared to the original English items, and to evaluate their reliability and construct validity. The 40 items in the bank were completed by 1085 Dutch chronic pain patients. Before calibrating the items, IRT model assumptions were evaluated using confirmatory factor analysis (CFA). Items were c...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain
ConclusionResults demonstrate differences in relationships among menstrual pain, acute laboratory pain, and psychological variables in girls with no pain compared with girls with chronic pain. In addition, pain catastrophizing may be a particularly salient factor associated with menstrual pain in girls with chronic pain that warrants further investigation. (Source: Pain Medicine)


Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice
This study confirms that QoL could be related to physical and psychological symptoms, and this reiterates the importance of faith in end‐of‐life care. (Source: European Journal of Cancer Care)


Subcutaneous Peripheral Nerve Field Stimulation for the Treatment of Chronic Back Pain: Patient Selection and Technical Aspects
J Neurol Surg A Cent Eur NeurosurgDOI: 10.1055/s-0035-1547362A wide variety of therapeutic options are available for the treatment of chronic back pain, a very common condition in Western countries with high related social and economic costs. Nevertheless, it is not always possible to achieve adequate long-term pain relief in spite of intensive analgesic therapies. Subcutaneous peripheral nerve field stimulation (sPNFS) is a newly approved neuromodulative treatment for back pain. In previously reported case series, it has provided encouraging results on long-term pain relief, improvement in quality of life, and a reduced need for analgesic drugs. Although the surgical technique is simple, there is neither consensus for patient management nor a standardized procedure for the implantation pr...


Opioids and breast cancer recurrence: A Danish population‐based cohort study
CONCLUSIONSThis large, prospective cohort study provided no clinically relevant evidence of an association between opioid prescriptions and breast cancer recurrence. The current findings are important to cancer survivorship, because opioids are frequently used to manage pain associated with comorbid conditions. Cancer 2015. © 2015 American Cancer Society. (Source: Cancer)


Neuropathic pain depends upon d-serine co-activation of spinal NMDA receptors in rats
Publication date: 31 August 2015 Source:Neuroscience Letters, Volume 603 Author(s): Yan Lefèvre, Aurélie Amadio, Peggy Vincent, Amélie Descheemaeker, Stéphane H.R. Oliet, Radhouane Dallel, Daniel L. Voisin Activation of N-methyl-d-aspartate (NMDA) receptors is critical for hypersensitivity in chronic neuropathic pain. Since astroglia can regulate NMDA receptor activation by releasing the NMDA receptor co-agonist d-serine, we investigated the role of NMDA receptor and d-serine in neuropathic chronic pain. Male Wistar rats underwent right L5–L6 spinal nerve ligation or sham surgery and were tested for mechanical allodynia and hyperalgesia after 14 days. Acute intrathecal administration of the NMDA receptor antagonist d-AP5 as well as chronic administration of the glia metaboli...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


P-002 flat panel c-arm and ct-guided selective trigeminal and glossopharyngeal radiofrequency rhizotomy for facial pain syndromes: a step-by-step case-based instruction and multidisciplinary single center experience
ConclusionWe present a step-by-step method using representative examples targeting V3, V2, and the glossopharyngeal nerve, as well as our single-center experience with dyna-CT guided RF ablation of chronic facial pain. Using this multidisciplinary approach, we demonstrate 100% technical success with needle guidance to difficult locations. Treatment results are excellent for CTN and GPN (100% NRS reduction &gt;50% up to 3 months), with more variable results in ATN (40% NRS reduction &gt;50% up to 3 months), which is known to be more refractory to therapies.Abstract P-002 Figure 1DisclosuresN. Telischak: None. J. Heit: None. O. Choudhri: None. H. Do: None. X. Qian: None. (Source: Journal of NeuroInterventional Surgery)


Back pain-related disability and quality of life in patients affected by vertebral fractures: data from baseline characteristics of population enrolled in Denosumab In Real Practice (DIRP).
CONCLUSIONS: Baseline characteristics of DIRP study cohort indicate that patients who received a prescription of denosumab in Campania region are affected by severe osteoporosis with highly prevalent vertebral fractures, disabling back pain and poor health-related quality of life. This is in contradiction with what it is expected by a front-line drug for osteoporosis. PMID: 26210371 [PubMed - as supplied by publisher] (Source: Aging Clinical and Experimental Research)


Value of SPECT-CT Imaging for Middle-Aged Patients with Chronic Anterior Knee Pain
Conclusions: Increased subchondral bone metabolism in the patella is associated with responsiveness to conservative therapy. SPECT-CT can benefit clinicians by predicting the treatment response from conservative management. (Source: Epidemiologic Perspectives and Innovations)


ICYMI: Drone Doctors, Trump Psychology And The Science Of Songs
This week, we read up medical technology. A new army task force is in charge of improving the mental health of its drone operators, who are essentially shift workers suffering from chronic fatigue and the stigma associated with their profession. We also tuned in to the story of a mother who tracked down the organs she donated to science when her newborn son passed away days after his birth.&#160; And finally, we took note of a disturbing new trend -- the caffeine inhaler -- that we hope won't stick around for long.&#160; Read on and tell us in the comments: What did you read, listen to and love this week? 1. Donald Trump Is Proud That He Makes Big Decisions Without Input From Others. He Shouldn't Be. --&#160;Science of Us People who receive cues that they are powerful are more likely to ig...


Comparison of calcium alginate and carboxymethyl cellulose for nasal packing after endoscopic sinus surgery: a prospective, randomised, controlled single‐blinded trial
ConclusionsCalcium alginate nasal packing is associated with reduced severity of oedema and adhesions after endoscopic sinus surgery.This article is protected by copyright. All rights reserved. (Source: Clinical Otolaryngology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Porphyrias: A 2015 update
Publication date: Available online 2 July 2015 Source:Clinics and Research in Hepatology and Gastroenterology Author(s): Zoubida Karim, Said Lyoumi, Gael Nicolas, Jean-Charles Deybach, Laurent Gouya, Hervé Puy The hereditary porphyrias comprise a group of eight metabolic disorders of the heme biosynthesis pathway. Each porphyria is caused by abnormal function at a separate enzymatic step resulting in a specific accumulation of heme precursors. Porphyrias are classified as hepatic or erythropoietic, based on the organ system in which heme precursors (δ-aminolevulinic acid [ALA], porphobilinogen and porphyrins) are overproduced. Clinically, porphyrias are characterized by acute neurovisceral symptoms, skin lesions or both. However, most if not all the porphyrias impair hepatic or g...


Scientific Impact Paper No. 46: Therapies Targeting the Nervous System for Chronic Pelvic Pain Relief
(Source: The Obstetrician and Gynaecologist)


Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. A systematic&#160;review
Conclusions: GLS measurements at rest only have modest diagnostic accuracy in predicting CAD+ among patients presenting with acute or chronic chest pain. The results from regional strain, layer specific strain and DSE need to be verified in larger studies. (Source: BMC Medical Imaging)


Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial.
Conclusion. Fourth ventricle compression seems not to have any effect in plasmatic catecholamine levels, blood pressure, or heart rate. Further studies are needed to clarify the CV-4 physiologic mechanisms and clinical efficacy in autonomic regulation and pain treatment. PMID: 26199632 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


The New Science on the Health Benefits of Yoga
This article originally appeared on Sonima.com -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Delayed pseudoaneurysm after below-knee amputation
A 50-year-old man presented to our outpatient department with a 5-week history of worsening pain and a pulsatile lump within his right below-knee amputation stump. The patient had a previous work-related crush injury to the leg, with 10 operations and eventual below-knee amputation 18 years earlier. Chronic pain in his stump, ascribed to painful neuroma, required three hospital admissions in the previous 2 years under the chronic pain team to titrate opioid, neuromodulatory, and antidepressant medications. (Source: Journal of Vascular Surgery)


Do 25% of Patients Taking Opioids For Chronic Pain Abuse Them?
No abstract available (Source: The Back Letter)


Ketamine-Pain Relief for the Chronic Pain Surgical Patient
Increased Narcan usage in 2010, from 0.02 to 0.09, prompted two focus studies revealing patients with chronic and acute post-operative pain were over-sedated. An interdisciplinary pain team was established to review, monitor and explore pain relieving narcotic alternatives. Knowledge obtained from research and evidence-based practices led the team to explore sub-anesthetic Ketamine dosing. (Source: Journal of PeriAnesthesia Nursing)


Psychological Interventions for the Management of Chronic Pain: a Review of Current Evidence
Abstract Chronic pain is a complex disorder to which medical and psychological factors both contribute and react. While there are numerous chronic pain conditions, they share certain experiences. This review examines some of the psychological factors that are common to the pain experience and some of the psychologically-based treatments that have been utilized in conduction with medical treatments for pain. In light of the fact that there is not yet a “gold standard” in this regard, it ends with the challenge to develop coherent and effective multi-model treatments that draw upon the successes that have been demonstrated so far. (Source: Current Pain and Headache Reports)


Coupled cell networks are target cells of inflammation, which can spread between different body organs and develop into systemic chronic inflammation
Several organs in the body comprise cells coupled into networks. These cells have in common that they are excitable but do not express action potentials. Furthermore, they are equipped with Ca 2+ signaling systems, which can be intercellular and/or extracellular. The transport of small molecules between the cells occurs through gap junctions comprising connexin 43. Examples of cells coupled into networks include astrocytes, keratinocytes, chondrocytes, synovial fibroblasts, osteoblasts, connective tissue cells, cardiac and corneal fibroblasts, myofibroblasts, hepatocytes, and different types of glandular cells. These cells are targets for inflammation, which can be initiated after injury or in disease. If the inflammation reaches the CNS, it develops into neuroinflammati...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Perspectives on next steps in classification of oro‐facial pain – Part 3: biomarkers of chronic oro‐facial pain – from research to clinic


Oral steroids for improved function but not pain in acute radiculopathy due to disc herniation
Commentary on: Goldberg H, Firtch W, Tyburski M, et al. Oral steroids for acute radiculopathy due to a herniated lumbar disk: a randomised clinical trial. JAMA 2015;313:1915&ndash;23. Context The toll low back pain (LBP) exerts on society is enormous. Approximately 40% of cases of chronic LBP are primarily neuropathic in nature,1 which may make them responsive to corticosteroids. A randomised trial performed in 208 patients with acute radiculopathy found that 30% of those who received piroxicam or placebo continued to experience symptoms at 3&nbsp;months, with few people reporting resolution afterwards.2 These results are consistent with other studies suggesting that radicular pain that persists for longer than 3&nbsp;months after injury is likely to become chronic. For systemic steroids, ...


Low back pain has a poor prognosis for recovery among seniors
This study by Rundell and colleagues is a large longitudinal study and a major step in addressing this gap. Methods The study used registry data from patients aged 65&nbsp;years and older and were followed over 12&nbsp;months after a... (Source: Evidence-Based Medicine)


Acute and chronic postsurgical pain after living liver donation: Incidence and predictors
(Source: Liver Transplantation)


A review on quality of life in systemic sclerosis
Publication date: Available online 23 July 2015 Source:Autoimmunity Reviews Author(s): Cristiana Almeida, Isabel Almeida, Carlos Vasconcelos Systemic sclerosis (SSc) is a chronic multi-system autoimmune disease associated with disability and reduced quality of life. There is no effective treatment or cure to SSc, so it is important improve global health of these patients and reduce morbidity and mortality associated with SSc. It was made a literature review about quality of life in patients with SSc, regarding the several factors that should be considered and evaluated when attending to SSc patients. It was also considered the validated scales and questionnaires used to measure outcomes in patients with SSc. We concluded that it is important to have an interdisciplinary approach to SS...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The revised FLACC score: Reliability and validation for pain assessment in children with cerebral palsy
Conclusion and implications This study benefits from a systematical approach to the validation and reliability parameters by using the COSMIN checklist as a guideline. It is evident that the r-FLACC pain score maintains its psychometric properties after translation. In conclusion, the r-FLACC pain score is valid and reliable in assessing postoperative pain in children with CP not able to self-report pain. With the r-FLACC pain score clinicians have a valid tool for assessing postoperative pain, hence increasing the quality of pain management in children with CP. In addition the validated r-FLACC score has the potential for use in interventional research regarding pain management in this vulnerable group of patients. Future perspectives include validation of the r-FLACC score for procedural...


A rare case of neurofibromatosis type 1 presenting as giant pelvic mass
A-49-year old man presented with chronic pelvic and lombar pain for six months. He had neurofibromatosis type 1 medical history since childhood. The clinical examination revealed palpable pelvic mass. Pelvic ultrasound and magnetic resonance (MR) imaging were performed. Pelvic ultrasound revealed heterogeneous hypoechoic mass in the right pelvic areas (fig. 1). MR imaging revealed heterogeneously enhancing and containing cystic-necrotic areas mass lesion. Mass lesion was originated S2-S3 level and protruding into the pelvis (fig. (Source: The Spine Journal)


Feasibility and results of a case study of yoga to improve physical functioning in people with chronic traumatic brain injury.
CONCLUSIONS: Yoga, delivered in a one-to-one setting, appears to be feasible and beneficial to people with chronic TBI. Implications for Rehabilitation Chronic traumatic brain injury (TBI) leads to many aspects of physical functioning impairment. Yoga delivered in a one-to-one setting may be feasible and beneficial for people with chronic TBI. PMID: 26208245 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)


Well: Not Telling Your Doctor You Use Acupuncture and Chiropractic
People with chronic back, neck or joint pain commonly seek acupuncture and chiropractic care for relief, but many don’t tell their doctors about it, a new study reports. (Source: NYT)


Nondrug Tx Best for Fibromyalgia: The Pain Medicine News Report
(MedPage Today) -- Also, new evidence supports medical marijuana use for chronic pain. (Source: MedPage Today Psychiatry)


Determinants for Quantitative Sensory Testing and the Association with Chronic Musculoskeletal Pain in the General Elderly Population
ConclusionHigher sensitivity for heat pain, one feature of central sensitization, is present in community‐dwelling elderly with chronic pain. Additional determinants should be considered when analyzing and interpreting QST measurements. (Source: Pain Practice)


Interactions of pannexin 1 with NMDA and P2X7 receptors in central nervous system pathologies: Possible role on chronic pain
Publication date: Available online 23 July 2015 Source:Pharmacological Research Author(s): D. Bravo, C.J. Maturana, T. Pelissier, A. Hernández, L. Constandil Pannexin 1 (panx1) is a glycoprotein that acts as a membrane channel in a wide variety of tissues in mammals. In the central nervous system (CNS) panx1 is expressed in neurons, astrocytes and microglia, participating in the pathophysiology of some CNS diseases, such as epilepsy, anoxic depolarization after stroke and neuroinflamation. In these conditions panx1 acts as an important modulator of the neuroinflammatory response, by secreting ATP, by interacting with the P2X7 receptor (P2X7R), and as an amplifier of NMDA receptor (NMDAR) currents, particularly in conditions of pathological neuronal hyperexcitability. Here, we brief...


Reassessing cortical reorganization in the primary sensorimotor cortex following arm amputation
The role of cortical activity in generating and abolishing chronic pain is increasingly emphasized in the clinical community. Perhaps the most striking example of this is the maladaptive plasticity theory, according to which phantom pain arises from remapping of cortically neighbouring representations (lower face) into the territory of the missing hand following amputation. This theory has been extended to a wide range of chronic pain conditions, such as complex regional pain syndrome. Yet, despite its growing popularity, the evidence to support the maladaptive plasticity theory is largely based on correlations between pain ratings and oftentimes crude measurements of cortical reorganization, with little consideration of potential contributions of other clinical factors, such as adaptive b...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Distress improves after mindfulness training for progressive MS: A pilot randomised trial
Conclusions: A mindfulness intervention delivered through Skype video conferences appears accessible, feasible and potentially effective and cost-effective for people with progressive MS. (Source: Multiple Sclerosis)


Ultrasound-Guided Intratendinous Injections With Platelet-Rich Plasma or Autologous Whole Blood for Treatment of Proximal Hamstring Tendinopathy: A Double-Blind Randomized Controlled Trial
Conclusions&mdash; Both PRP and WB groups showed improvements in all outcome measures at 6 months. The PRP group showed significant improvements in 6-month ADL and IHOT-33 scores. The WB group reached significance in 15-minute sitting pain. No significant between-group differences were observed at any time point. (Source: Journal of Ultrasound in Medicine)


Design and acceptance of Rheumates@Work, a combined internet-based and in person instruction model, an&#160;interactive, educational, and cognitive behavioral program for children with juvenile idiopathic arthritis
Background: Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease. Patients suffer daily discomforts such as pain, fatigue, stiffness, and mood disturbances. Their exercise capacity is decreased to a variable degree and physical activity levels may be impaired. To prevent long-term cardiovascular risks associated with JIA and medication, it is important to encourage physical activity. To achieve this we developed Rheumates@Work (R@W), a combined internet-based and in person instruction model, an interactive, educational, and cognitive behavioral program. The aim of this study is twofold: to describe the theoretical background and design of R@W based on Pender’s Health Promotion Model, and to assess its acceptance. Methods: We enrolled 8 to 13-year-old JIA patients, from 3 ou...


Primary renal squamous cell carcinoma mimicking the renal cyst: a case report and review of the recent literature
Conclusions: Our present case emphasizes that the careful diagnostic work-up and use of multiple imaging modalities in cases of unusual renal calculi is quite necessary, since they may carry the risk of co-existing hidden malignancy. (Source: BMC Urology)


A technical report on ultrasound-guided scapulocostal syndrome injection
Conclusion Serratus posterior superior injection can confirm a diagnosis of scapulocostal syndrome and be therapeutically beneficial. (Source: Irish Journal of Medical Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Treatment of Lateral Epicondylosis by Using Allogeneic Adipose‐Derived Mesenchymal Stem Cells: A Pilot Study
This article is protected by copyright. All rights reserved. (Source: Stem Cells)


Group‐based task‐oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain
ConclusionThis light group‐based multidisciplinary cognitive behavioural rehabilitation programme was superior to traditional exercises in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life of subjects with CLBP. The effects lasted for at least 2 years after the end of the intervention. (Source: European Journal of Pain)


&#8216;I think positivity breeds positivity&#8217;: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work
Conclusions: This research presents novel insights about the specific contribution made by significant others in helping their relatives with chronic musculoskeletal pain to stay at work. These findings add to the under-represented ‘social’ dimension of the biopsychosocial model currently applied to our understanding and treatment of pain, and point to harnessing support from significant others as a potentially effective management strategy. (Source: BMC Family Practice)


Automated assessment of pain in rats using a voluntarily accessed static weight-bearing test
Conclusion The VASIC device should enhance the hands-free parallel collection of unbiased weight-bearing data in a high throughput manner, allowing further testing of this behavioral measure as an effective assessment of pain in rodents. (Source: Physiology and Behavior)


Insidious: Takayasu arteritis
Hypertensive crisis in a 39-year-old Haitian woman with a history of hypertension proved secondary to an underlying chronic disease. Having arrived in the emergency department for evaluation of a severe headache and shortness of breath, she added that for several months, she had been experiencing chest pain, both at rest and with exertion. Episodes lasted for 10-15 minutes and were substernal and squeezing in nature, often reaching 10/10 in severity. These were intermittently associated with shortness of breath and nausea. (Source: The American Journal of Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads
Abstract Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), mode...


CRPS A contingent hypothesis with prostaglandins as crucial conversion factor
This article addresses the functional control mechanism of a biological organism, a comparison of techniques, and the way the negative feedback mechanisms fail in regulated feedback systems.The measurement and regulation system is controlled at the local, regional, and central levels in a biological system. (Source: Medical Hypotheses)


Voltage-Gated Sodium Channels as Therapeutic Targets for Treatment of Painful Diabetic Neuropathy.
Authors: Kharatmal SB, Singh JN, Sharma SS Abstract Painful diabetic neuropathy (PDN) is one of most common complication of diabetes, usually affecting 50% of diabetic patients and remains important cause of morbidity, mortality and deterioration of quality of life. PDN is well characterised by chronic hyperglycemia, alterations in expression and kinetics of voltage-gated sodium channels (VGSCs) and neuro-inflammation which together may result into sensorimotor deficits in peripheral nervous system. Peripheral nociceptive neurons express variety of sodium channel isoforms particularly Nav1.3, Nav1.7, Nav1.8 and Nav1.9, each play a key role in physiology of nociception by undergoing respective dynamic changes in expression and voltage-dependent gating properties. Thus, they are crit...


CRPS: A contingent hypothesis with prostaglandins as crucial conversion factor
This article addresses the functional control mechanism of a biological organism, a comparison of techniques, and the way the negative feedback mechanisms fail in regulated feedback systems.The measurement and regulation system is controlled at the local, regional, and central levels in a biological system. (Source: Medical Hypotheses)


G protein-gated inwardly rectifying potassium channel subunits 1 and 2 are down-regulated in rat dorsal root ganglion neurons and spinal cord after peripheral axotomy
Background: Increased nociceptive neuronal excitability underlies chronic pain conditions. Various ion channels, including sodium, calcium and potassium channels have pivotal roles in the control of neuronal excitability. The members of the family of G protein-gated inwardly rectifying potassium (GIRK) channels, GIRK1–4, have been implicated in modulating excitability. Here, we investigated the expression and distribution of GIRK1 and GIRK2 in normal and injured dorsal root ganglia (DRGs) and spinal cord of rats. Results: We found that ~70% of the DRG neurons expressed GIRK1, while only (Source: Epidemiologic Perspectives and Innovations)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Why Science Doesn't Need Mice
A recent editorial called "Why Science Needs Female Mice" by the New York Times Editorial Review Board relies on a new study published in Nature Neuroscience by Robert Sorge and his colleagues titled "Different immune cells mediate mechanical pain hypersensitivity in male and female mice." The abstract for this essay reads: "A large and rapidly increasing body of evidence indicates that microglia-to-neuron signaling is essential for chronic pain hypersensitivity. Using multiple approaches, we found that microglia are not required for mechanical pain hypersensitivity in female mice; female mice achieved similar levels of pain hypersensitivity using adaptive immune cells, likely T lymphocytes. This sexual dimorphism suggests that male mice cannot be used as proxies for females in pain resea...


Wide nervous section to prevent post-operative inguinodynia after prosthetic hernia repair: a single center experience
Conclusions Despite the apparent paradox of an higher tissue damage, elective neurectomy of selected segments of inguinal nerves, appears an effective technique in preventing chronic postherniorraphy pain, considering both the lower incidence and the faster resolution of painful symptomatology. (Source: Hernia)


Prognostic value of age for chronic postoperative inguinal pain
Conclusions Almost one out of three patients experiences CPIP. The younger the patient, the higher the risk of CPIP. Hernia type and surgical technique did not influence CPIP. (Source: Hernia)


Long-term outcome of surgical treatment of chronic postoperative groin pain: a word of caution
Conclusion The success of surgery for chronic postoperative groin pain is difficult to predict. In this study, one in three patients benefits from an operative treatment. The ratio of VASmax (post/pre) is suggested as a useful pain assessment tool. A further prospective study of sufficient sample size is necessary to identify possible factors associated with favorable outcome after surgery for chronic groin pain. (Source: Hernia)


Acupuncture impacts same biologic pathways in rats that pain drugs target in humans
In animal models, acupuncture appears to impact the same biologic pathways ramped up by pain and stress, analogous to what drugs do in humans. The researchers say their animal study provides the strongest evidence to date on the mechanism of this ancient Chinese therapy in chronic stress. (Source: ScienceDaily Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Rats help scientists get closer to solving the mystery of acupuncture
Study finds that form of therapy which uses electric current blunted activity in rats’ hormonal pathway linked to stress, chronic pain and mood A biological mechanism explaining part of the mystery of acupuncture has been pinpointed by scientists studying rats. Stimulation with electroacupuncture – a form of the therapy in which a small electric current is passed between a pair of needles – blunted activity in a key hormonal pathway linked to stress, chronic pain and mood, the researchers found. Continue reading... (Source: Guardian Unlimited Science)


Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man
We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights th...


Veterans Exposed To Toxic Chemicals Accuse VA Of Foot-Dragging
Retired Senior Master Sgt. Leslie Howe has battled two cancers -- non-Hodgkin lymphoma and prostate cancer, both of which have been linked with exposure to Agent Orange, the herbicide used by the U.S. military to destroy enemy cover and crops during the Vietnam War. Howe, 71, was never actually in Vietnam during the conflict, but in the 1980s he served aboard Air Force planes that contained trace amounts of the defoliant. Still, the U.S. Department of Veterans Affairs twice denied Howe's benefits claim, telling him in a letter that it "could not find a link" between his medical conditions and his military service. "I flew in good conscience on that aircraft, not knowing the danger," said Howe, who recalled a distinct "aroma" at times while he worked in the aircraft as an air medical evacua...


Diagnosis and Treatment of Chronic Lunotriquetral Ligament Injuries
Chronic lunotriquetral (LT) injuries are less common than scapholunate ligament injuries and difficult to diagnose. They may be associated with positive ulnar variance. Clinical diagnostic tests elicit pain at the LT interval. Although radiographs are typically normal, MRI and wrist arthroscopy can help confirm the diagnosis. When conservative treatments fail, surgical options include LT ligament reconstruction, LT arthrodesis, and ulnar-shortening osteotomy (in patients with positive ulnar variance). (Source: Hand Clinics)


St. Jude Medical Announces FDA Approval for Industry's Only MR-Conditional 5-Column Paddle Lead for the Management of Chronic Pain
St. Jude Medical, Inc. has announced FDA approval of MR-conditional labeling for the company&rsquo;sPenta 5-column paddle leadfor spinal cord stimulation (SCS) therapy to manage chronic pain. The Penta lead is the only five-column paddle lead on the market that allows patients to safely undergo head and extremity MRI scans. (Source: Medical Design Online News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report
Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient’s abdominal symptoms. Since hydrostatic reduction was unsuccessful, la...


Increased water intake to reduce headache: learning from a critical appraisal
Abstract Critically Appraised Topic (CAT): Water Intake to Reduce Headache Clinical Bottom LineWater intake is a cost effective, non‐invasive and low‐risk intervention to reduce or prevent headache pain. Rationale: Chronic mild dehydration may trigger headache. Increased water intake could help. A small trial shows modest benefit; however, a larger methodologically sound randomized controlled trial is needed to confirm efficacy. Critically Appraised PaperSpigt, M., Weerkamp, N., Troost, J., van Schayck, C. P., & Knottnerus, J. A. (2012). ‘A randomized trial on the effects of regular water intake in patients with recurrent headaches.’ Family practice, 29(4), 370–5. Doi: 10.1093/fampra/cmr112 Clinical scenarioPatients from primary care registered as ‘headache’, ‘tension h...


Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases
ConclusionsThe clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear‐cut clinical pictures with excellent consistency both inter‐ and intra‐individually. (Source: Headache: The Journal of Head and Face Pain)


Development of a New Adult Sickle-Cell Disease Center Within an Academic Cancer Center: Impact on Hospital Utilization Patterns and Care Quality
Conclusion Findings suggest that embedding adult SCD centers within existing cancer centers can positively impact patterns of health care utilization and improve the quality of care. (Source: Journal of Racial and Ethnic Health Disparities)


Use of long-acting, vs short-acting, opioids for chronic pain was linked to unintentional overdose.
Authors: Holbrook A PMID: 26192579 [PubMed - in process] (Source: Annals of Internal Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Long-Term Opioid Therapy for Chronic Pain.
Authors: Chou R PMID: 26192568 [PubMed - in process] (Source: Annals of Internal Medicine)


Moving towards conscious pain processing detection in chronic disorder of consciousness: the Anterior Cingulate Cortex neuromodulation
It has been assumed that patients suffering from chronic disorders of consciousness (DOC) do not feel pain, but it is possible that some of them just cannot report it. The modulation of γ-band oscillatory activity (γBO) in centro-parietal areas (considered as a marker of either subjective pain perception processes or pain-related motor behavior preparation) by part of the anterior cingulate cortex (ACC) has been proposed to be suggestive of conscious pain perception, and could therefore be used to assess the maintenance of some level of conscious pain perception in DOC patients. (Source: The Journal of Pain)


Pain perception in major depressive disorder: A neurophysiological case-control study
Depression and pain may sometimes be related conditions. Occasionally, depression may be associated with physical symptoms, such as back pain and headache. Moreover, depression may impair the subjective response to pain and is likely to influence the pain feeling. Conversely, chronic pain may represent an emotional condition as well as physical sensation, and can influence both the mood and behaviour. (Source: Journal of the Neurological Sciences)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases
We describe three cases of MS patients who have had moderate to severe complaints of bruxism in the two weeks following their relevant MS attacks. None of the three patients had a diagnosis of bruxism prior to her attack. The diagnosis was confirmed in one out of three by a polysomnography. One patient did not have any complaints related to bruxism previous to her attack, whereas two had mild and infrequent complaints. The symptoms of the relevant attacks were left hemihypesthesia in all and hemiparesis in two. None of the patients had spasticity that could result in severe teeth clenching. All three patients presented with morning headaches and jaw pain or tightness and were treated successfully with botulinum toxin (Btx) injections applied to their masseter and temporalis muscles. The ca...


Healthcare providers' accuracy in assessing patients' pain: A systematic review
Healthcare providers satisfy an important role in providing appropriate care in the prevention and management of acute and chronic pain, highlighting the importance of providers' abilities to accurately assess patients' pain. We systematically reviewed the literature on healthcare providers' pain assessment accuracy. (Source: Patient Education and Counseling)


Clinical and radiological cervical spine evaluation in retired professional rugby players.
CONCLUSIONS A few years after retirement, former professional rugby players seem to have more frequent cervical spine pain and MRI degenerative lesions, such as foraminal stenosis and narrowing of the spinal canal, compared with controls who had not been professional rugby players. A longer evaluation is necessary to determine if these findings persist over time. PMID: 26194609 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)


Ways of Hoping: Navigating the Paradox of Hope and Despair in Chronic Pain.
Authors: Eaves ER, Nichter M, Ritenbaugh C Abstract In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in participants' descriptions of expectations and hopefulness, particularly with regard to the work involved in counterbalancing positive thinking with buffers against disappointment. We found hope to be a dynamic and multifaceted mindset as distinct from being a single entity to be measured. Drawing upon Polanyi's concept of tacit knowing, we explore how different ways of hoping emerge and index ...


Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases.
CONCLUSIONS: The clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear-cut clinical pictures with excellent consistency both inter- and intra-individually. PMID: 26198298 [PubMed - as supplied by publisher] (Source: Headache)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Healthcare providers’ accuracy in assessing patients’ pain: A systematic review
Uncontrolled acute and chronic pain is a major healthcare challenge and public health problem [1]. Estimates suggest that more than one-third of American adults and one-fifth of European adults suffer from some type of chronic pain [1,2]. Although the majority of pain sufferers seek medical attention for their pain [3], pain is often undertreated. Considerable undertreatment of pain has been documented in patients with cancer [4], AIDS and HIV [5,6], emergency department patients [7], children [8], and older adults and dementia patients [9]. (Source: Patient Education and Counseling)


Half of chronic pain patients have tried alternative therapy
Most patients with chronic pain use complementary and alternative therapies, but many keep it a secret from clinicians, suggests US research. (Source: Nursing Times Breaking News)


Most chronic pain patients use alternative therapies, but many don't tell their doctors
More than half of chronic pain patients in a managed care setting reported using chiropractic care or acupuncture or both, but many of these patients didn't discuss this care with their primary care providers. These study results suggest that better care coordination is needed among patients and physicians. (Source: ScienceDaily Headlines)


St. Jude Medical wins MR-conditional nod from FDA for Penta chronic pain lead
St. Jude Medical (NYSE:STJ) said today that the FDA approved MR-conditional labeling for its Penta spinal cord stimulation lead for treating chronic pain. The 5-column Penta paddle lead is designed to be used with St. Jude&#8217;s Protégé MRI device, the company said, claiming it as the only such lead on the U.S. market to &#8220;allow patients to safely undergo head and extremity MRI scans.&#8221; Protégé MRI won pre-market approval from the FDA in April. &#8220;We are excited to receive MR-conditional labeling approval for our Penta paddle lead alongside the recent approval of the Protégé MRI system and MR-conditional labeling for our Octrode percutaneous leads,&#8221; group president Dr. Eric Fain said in prepared remarks. &#8220;When taken together, the approvals of these...


Many Don't Tell Docs about Using Alternative Therapies for Pain
Although most said they'd let their physician know if asked, survey finds Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Complementary and Integrative Medicine (Source: MedlinePlus Health News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Better Sleep May Mean Less Chronic Pain
Title: Better Sleep May Mean Less Chronic PainCategory: Health NewsCreated: 7/17/2015 12:00:00 AMLast Editorial Review: 7/20/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Many Don't Tell Docs About Using Alternative Therapies for Pain
Title: Many Don't Tell Docs About Using Alternative Therapies for PainCategory: Health NewsCreated: 7/20/2015 12:00:00 AMLast Editorial Review: 7/20/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Vulvovaginal photodynamic therapy versus topical corticosteroids in genital erosive lichen planus: a randomized controlled trial
ConclusionVulvovaginal HAL‐PDT seems to be a feasible, effective and safe treatment for GELP in women.This article is protected by copyright. All rights reserved. (Source: British Journal of Dermatology)


Synergistic effect of pain and deficits in ADL towards general practitioner visits
Conclusion. There is a strong synergistic effect of CP and deficits in ADL in patients &ge;65 years on visiting the GP. Prevention, screening, treatment and rehabilitation in this population should focus on both CP and ADL deficits. (Source: Family Practice)


Rest pain and movement‐evoked pain as unique constructs in hip and knee replacement
Conclusions SEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work which explore the mechanisms underlying pain‐on‐movement and pain‐at‐rest. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Moderate alcohol consumption is associated with lower risk (and severity) of chronic widespread pain: Results from a UK population‐based study
Conclusions: This study has demonstrated strong associations between level of alcohol consumption and CWP . However the available evidence does not allow us to conclude that the association is causal. The strength of the associations means that specific studies to examine this potential relationship are warranted. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)


Activation of satellite glial cells in the trigeminal ganglion contributes to masseter mechanical allodynia induced by restraint stress in rats
Publication date: 18 August 2015 Source:Neuroscience Letters, Volume 602 Author(s): Ya-Juan Zhao, Yang Liu, Yin-Hua Zhao, Qiang Li, Min Zhang, Yong-Jin Chen It is commonly accepted that psychological stress contributes to the development of chronic orofacial pain. However, the neural mechanism underlying this process has remained unclear. The present study was performed to determine the involvement of satellite glia cells (SGCs) in the trigeminal ganglion (TG) in stress-induced increases in masseter muscle allodynia in rats. Using a chronic restraint stress model, we found that exposure to a 14-day stress but not a 3-day stress (6h/day) caused decreased body weight gain, behavioral changes and marked masseter allodynia in rats. SGCs were dramatically activated, and substance P (SP)...


Unexpected venous thrombosis in the superior vena cava
A 77 years old woman, with chronic heart failure, Horton disease, and dementia, was referred to our hospital for acute abdominal pain. A rectal squamous-cell carcinoma stage T4N3M0 treated by palliative radiotherapy alone was diagnosed 6 months earlier. The patient’s WHO performance status was Grade 4, and physical examination revealed abdominal distension without bowel sounds. No sign consistent with superior vena cava syndrome was found. (Source: The American Journal of Medicine)


Health-Related Quality of Life and Pain Intensity Among Ethnically Diverse Community-Dwelling Older Adults
This study compared HRQoL, including physical health and mental health, in persons of differing ethnicities, and identified factors associated with pain intensity and HRQoL in ethnically diverse older adults. Older adults with chronic pain from four ethnic groups (African Americans, Afro-Caribbeans, Hispanics, and European Americans) were recruited from the Florida Atlantic University Healthy Aging Research Initiative (HARI) registry. (Source: Pain Management Nursing)


Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation.
CONCLUSIONS: There is some very low quality evidence that goal setting may improve some outcomes for adults receiving rehabilitation for acquired disability. The best of this evidence appears to favour positive effects for psychosocial outcomes (i.e. health-related quality of life, emotional status, and self-efficacy) rather than physical ones. Due to study limitations, there is considerable uncertainty regarding these effects however, and further research is highly likely to change reported estimates of effect. PMID: 26189709 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Sleep Quality and Reexperiencing Symptoms of PTSD Are Associated With Current Pain in U.S. OEF/OIF/OND Veterans With and Without mTBIs
This study investigated how commonly reported clinical factors were associated with pain and whether these associations differed for individuals with a history of chronic pain. From the Boston metropolitan area, 171 veterans enrolled in the Veterans Affairs Center of Excellence were assessed for current posttraumatic stress disorder (PTSD) symptom severity, current mood and anxiety diagnoses, lifetime traumatic brain injury, combat experiences, sleep quality, and alcohol use. Hierarchical regression models were used to determine the association of these conditions with current pain. Average pain for the previous 30 days, assessed with the McGill Pain Questionnaire, was 30.07 out of 100 (SD = 25.43). Sleep quality, PTSD symptom severity, and alcohol use were significantly associated with pa...


Vulvovaginal photodynamic therapy versus topical corticosteroids in genital erosive lichen planus: a randomized controlled trial.
CONCLUSION: Vulvovaginal HAL-PDT seems to be a feasible, effective and safe treatment for GELP in women. This article is protected by copyright. All rights reserved. PMID: 26189484 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)


The unique role of transdermal buprenorphine in the global chronic pain epidemic.
Authors: Pergolizzi JV, Scholten W, Smith KJ, Leighton-Scott J, Willis JC, Henningfield JE Abstract Pain is a global epidemic, exacerbated by barriers to access of opioid analgesics. Regulations about opioids attempt to protect public health from the risks of harmful use of opioids, diversion, and dependence. Transdermal buprenorphine is an effective opioid analgesic agent with unique properties that may make it particularly well suited for more widespread use. It is a versatile analgesic product with demonstrated safety and effectiveness in cancer and noncancer pain populations. Its pharmacological properties make it a first-line opioid analgesic for geriatric patients and patients with renal dysfunction; no dosing adjustments need to be made. The 7-day transdermal delivery system...


Antiallodynic and antihyperalgesic effects of zerumbone on a mouse model of chronic constriction injury-induced neuropathic pain.
In this study, we investigated the antiallodynic and antihyperalgesic effects of zerumbone, a bioactive sesquiterpene from Zingiber zerumbet in chronic constriction injury (CCI)-induced neuropathic pain animal model. Our findings showed that single and repeated dose of intra-peritoneal administration of zerumbone (5, 10, 50, 100mg/kg) significantly attenuated the CCI-induced neuropathic pain when evaluated using the electronic von Frey anesthesiometer, cold plate, Randall Selitto analgesiometer and the Hargreaves plantar test. Zerumbone significantly alleviated tactile and cold allodynia as well as mechanical and thermal hyperalgesia. Our findings are in comparison to the positive control drugs used gabapentin (20mg/kgi.p.) and morphine (1mg/kgi.p.). Together, these results showed that the...


Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation.
This study aimed to examine the effects of kinesiology taping (KT) and different TRX suspension workouts on the amplitude of electromyographic (EMG) activity in the core muscles among people with chronic low back pain (LBP). Each participant (total n = 21) was exposed to two KT conditions: no taping and taping, while performing four TRX suspension exercises: (1) hamstring curl, (2) hip abduction in plank, (3) chest press, and (4) 45-degree row. Right transversus abdominis/internal oblique (TrAIO), rectus abdominis (RA), external oblique (EO), and superficial lumbar multifidus (LMF) activity was recorded with surface EMG and expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. Hip abduction in plank increased TrA...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Value of epsilon wave in lead aVR in a 83-year old male patient with arrhythmogenic cardiomyopathy
A 83-year old male patient was admitted to hospital because of chest pain. The patient was on chronic atrial fibrillation. (Source: International Journal of Cardiology)


Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes
Abstract The diagnosis and treatment of chronic pelvic pain have shifted from organ-specific to multifactorial, multidisciplinary, and individualized approach. While many organizations have had diverse outlooks on classification and treatment plans, new research has identified varied clinical phenotypes and updated classification systems. These phenotypes are based on pain, gender, symptomatology, and comorbid pain syndromes. These new classification systems allow a multimodal therapeutic approach and evaluation of patients. Multidisciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy, and pain medicine, is also further recognized for adequate management of patients with chronic pelvic pain because of its variable etiology. The purp...


Prevalence, consequences and predictors of low back pain among nurses in a tertiary care setting
Conclusion The prevalence of LBP among nurses at HGH is high and should be actively addressed, however, it was not a major cause of sick leave. Preventive measures should be taken to reduce the risk of lower back pain, such as arranging proper rest periods, educational programs to teach the proper use of body mechanics and sports activity programs. (Source: International Orthopaedics)


Rasch analysis of the Neck Bournemouth Questionnaire to measure disability related to chronic neck pain.
CONCLUSION: The Neck Bournemouth Questionnaire with the purposed modification may provide useful clinical profiles and change scores of subjects with chronic neck pain for research purposes. PMID: 26182201 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)


Dynamic view of postoperative pain and quality of life evolution after total knee arthroplasty - a prospective observational study.
CONCLUSION: The trajectories of the different types of pain after TKA show their nonlinear evolution, highlighting the need of a better pain control at precise moments. Sleep disturbances and alterations of quality of life are still present one year after the surgery. PMID: 26184701 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Opioids for chronic non-cancer pain: A critical view from the other side of the pond.
Authors: Fanelli G, Tölle TR, De Andrés J, Häuser W, Allegri M, Montella S, Kress HG Abstract Opioid analgesics are important therapeutic options for chronic non-cancer pain (CNCP), recognized as a major public health issue with high social and economic burden. The increasing therapeutic opioid use for CNCP, misuse and abuse of prescription opioids have become matters of severe concern in USA. The recent position paper of the American Academy of Neurology (AAN) about the use of opioids in USA expresses growing alarms about opioid misuse/abuse, and has alerted physicians worldwide to rethink about their prescription practice. Current US practice in opioid prescription has been associated with morbidity and mortality of epidemic proportions: over 100,000 people directly or indirec...


EEG-Based Tonic Cold Pain Characterization Using Wavelet Higher Order Spectral Features
A novel approach in tonic cold pain characterization, based on electroencephalograph (EEG) data analysis using wavelet higher order spectral (WHOS) features, is presented here. The proposed WHOS-based feature space extends the relative power spectrum-based (phase blind) approaches reported so far a step forward; this is realized via dynamic monitoring of the nonlinerities of the EEG brain response to tonic cold pain stimuli by capturing the change in the underlying quadratic phase coupling at the bifrequency wavelet bispectrum&#x002F;bicoherence domain due to the change of the pain level. Three pain characterization scenarios were formed and experimentally tested involving WHOS-based analysis of EEG data, acquired from 17 healthy volunteers that were subjected to trials of tonic cold pain ...


Beneficial properties of maraviroc on neuropathic pain development and opioid effectiveness in rats
In this study, we investigated the influence of chronic administration of maraviroc (CCR5 antagonist) on nociception and opioid effectiveness during neuropathy, which develops as a result of chronic constriction injury (CCI) of the sciatic nerve. To investigate the mechanism of action of maraviroc, we measured the expression of glial cell markers, CCR5 and certain CCR5 ligands (CCL3, CCL4, CCL5, CCL7, CCL11), in the spinal cord and dorsal root ganglia (DRG) of vehicle- and maraviroc-treated, CCI-exposed rats. Our results demonstrate that chronic intrathecal administration of maraviroc diminished neuropathic pain symptoms on day 7 post-CCI. Western blot analysis showed that maraviroc diminished protein level of Iba-1 and GFAP and reversed the up-regulated CCR5 expression observed in spinal ...


Ultrasound-guided versus palpation-guided local corticosteroid injection therapy for treatment of plantar fasciitis
Conclusions Ultrasound-guided and palpation-guided local corticosteroid injections were effective and successful in treatment of PF. Both techniques improved PF clinically and ultrasonographically without statistically significant superior results for the ultrasound-guided injection. (Source: The Egyptian Rheumatologist)


The association between psychosis and severe pain in community-dwelling adults: Findings from 44 low- and middle-income countries
This study assessed the association between psychosis and severe pain among community-dwelling adults in 44 low- and middle-income countries (LMICs) where no data exists. Data on 235,370 adults aged &gt;18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past 12-month psychotic symptoms was established using four questions from the Composite International Diagnostic Interview. Participants were categorized into four mutually exclusive groups based on whether they had at least one psychotic symptom and/or a lifetime psychosis or schizophrenia diagnosis. Multivariable logistic regression was used to estimate the association between psychosis and past-30 day severe pain. The prevalence of severe pain among those with 0, 1, 2, &gt;3 psychotic symptoms w...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Bilateral lumbar pedicle fractures in the absence of a neurological deficit or concomitant osseous injury
A 61-year-old male with a history of recurrent syncopal episodes and chronic obstructive pulmonary disease had a low energy fall and sustained an injury to his lower back four months prior to presentation. He did not have any imaging performed at the time and gradually over the following months the pain improved. (Source: The Spine Journal)


[Management of ureteral strictures and hydronephrosis].
Authors: Ganzer R, Franz T, Rai BP, Siemer S, Stolzenburg JU Abstract Patients who develop hydronephrosis due to an acute cause often have colic-like pain but hydronephrosis secondary to a chronic cause is often asymptomatic. Ureteral obstruction can be due to a variety of intrinsic and extrinsic causes, such as trauma, radiation, iatrogenic injury, urolithiasis, malignancies and congenital causes. Management planning is dictated by the underlying cause, patient comorbidity and life expectancy. Malignant ureteral obstructions can be managed with segmental metal stents with advantages in the quality of life and provide an alternative to long-term treatment with a DJ stent. Endoscopic balloon dilatation and endoureterotomy are options for benign ureteral strictures up to 2 cm in len...


The mechanism of μ-opioid receptor (MOR)-TRPV1 crosstalk in TRPV1 activation involves morphine anti-nociception, tolerance and dependence.
Authors: Bao Y, Gao Y, Yang L, Kong X, Yu J, Hou W, Hua B Abstract Initiated by the activation of various nociceptors, pain is a reaction to specific stimulus modalities. The μ-opioid receptor (MOR) agonists, including morphine, remain the most potent analgesics to treat patients with moderate to severe pain. However, the utility of MOR agonists is limited by the adverse effects associated with the use of these drugs, including analgesic tolerance and physical dependence. A strong connection has been suggested between the expression of the transient receptor potential vanilloid type 1 (TRPV1) ion channel and the development of inflammatory hyperalgesia. TRPV1 is important for thermal nociception induction, and is mainly expressed on sensory neurons. Recent reports suggest that opi...


Statin Use Is Associated with Bladder Pain Syndrome/Interstitial Cystitis: A Population-Based Case-Control Study
Conclusion: We concluded that there was an association between statin use and BPS/IC.Urol Int (Source: Urologia Internationalis)


Duplex ultrasonography findings are not related to menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease
ConclusionsReflux was not specific to a particular phase of menstrual cycle in women with early symptoms of chronic venous disease. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound, 2015; (Source: Journal of Clinical Ultrasound)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Nociceptive and Anti-Inflammatory Effects of Artemisia dracunculus L. Aqueous Extract on Fructose Fed Male Rats.
Conclusion. Results in the present study show that FDW causes the pain response score to increase and cause proinflammatory cytokines in rat model but A. dracunculus L. leaf aqueous extract improves values of these parameters. PMID: 26170888 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


Efficacy of Pulsed Radiofrequency on Cervical 2-3 Posterior Medial Branches in Treating Chronic Migraine: A Randomized, Controlled, and Double-Blind Trial.
Conclusion. PRF on the cervical 2-3 posterior medial branches could provide satisfactory efficacy in the treatment of CM without obvious adverse effects. PMID: 26170880 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


Peripheral Neuropathic Facial/Trigeminal Pain and RANTES/CCL5 in Jawbone Cavitation.
Conclusions. To the best of our knowledge, no other research has identified RANTES overexpression in silent inflamed jawbones as a possible cause for AFP/TRN. Thus, we hypothesize that the surgical clearing of FDOJ might diminish RANTES signaling pathways in neurons and contribute to resolving chronic neurological pain in AFP/TRN patients. PMID: 26170877 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


The Anti-Inflammatory Actions of Auricular Point Acupressure for Chronic Low Back Pain.
Conclusion. These findings suggest that APA treatment affects pain intensity through modulation of the immune system, as reflected by APA-induced changes in serum inflammatory cytokine and neuropeptide levels. PMID: 26170869 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


Regulation of Neurotrophin-3 and Interleukin-1β and Inhibition of Spinal Glial Activation Contribute to the Analgesic Effect of Electroacupuncture in Chronic Neuropathic Pain States of Rats.
In this study, the mechanical withdrawal threshold and thermal withdrawal latency were recorded. We used immunofluorescence and western blots methods to investigate the effect of EA on the expression of NT-3 and IL-1β in DRG and spinal cord of CCI rats; we also examined the expression of spinal GFAP and OX-42 in spinal cord. In present study, the MWT and TWL of CCI group rats were lower than those in the Sham CCI group rats, but EA treatment increased the pain thresholds. Furtherly, we found that EA upregulates the expression of NT-3 in DRG and spinal cord of CCI rats, while EA downregulates the expression of IL-1β. Additionally, immunofluorescence exhibited that CCI-induced activation of microglia and astrocytes was inhibited significantly by EA treatment. These results demonstrated tha...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effect of Repeated Electroacupuncture Intervention on Hippocampal ERK and p38MAPK Signaling in Neuropathic Pain Rats.
Authors: Wang JY, Chen SP, Gao YH, Qiao LN, Zhang JL, Liu JL Abstract Results of our past studies showed that hippocampal muscarinic acetylcholine receptor (mAChR)-1 mRNA and differentially expressed proteins participating in MAPK signaling were involved in electroacupuncture (EA) induced cumulative analgesia in neuropathic pain rats, but the underlying intracellular mechanism remains unknown. The present study was designed to observe the effect of EA stimulation (EAS) on hippocampal extracellular signal-regulated kinases (ERK) and p38 MAPK signaling in rats with chronic constrictive injury (CCI) of the sciatic nerve, so as to reveal its related intracellular targets in pain relief. After CCI, the thermal pain thresholds of the affected hind were significantly decreased compared wi...


Biologic mesh versus synthetic mesh in open inguinal hernia repair: system review and meta‐analysis
ConclusionsFrom the data of this study, biologic mesh had no superiority to synthetic mesh in open inguinal hernia repair with similar recurrence rates and incidence of chronic groin pain, but higher rate of seroma and longer operating time. However, this mesh still needs to be assessed in a large, multicentre, well‐designed randomized controlled trial. (Source: ANZ Journal of Surgery)


Prevalence of smoking in adults with chronic pain
Conclusion: The prevalence of smoking in patients with chronic pain has not declined when compared to the general population. The higher prevalence of smoking was consistently observed in commonly occurring pain diagnoses including fibromyalgia, back pain, and headache. Further research is needed to identify the potential factors that contribute to the high prevalence of smoking in this patient population. (Source: Tobacco Induced Diseases)


Pain Catastrophising Affects Cortical Responses to Viewing Pain in Others
by Nicholas Fallon, Xiaoyun Li, Andrej Stancak Pain catastrophising is an exaggerated cognitive attitude implemented during pain or when thinking about pain. Catastrophising was previously associated with increased pain severity, emotional distress and disability in chronic pain patients, and is also a contributing factor in the development of neuropathic pain. To investigate the neural basis of how pain catastrophising affects pain observed in others, we acquired EEG data in groups of participants with high (High-Cat) or low (Low-Cat) pain catastrophising scores during viewing of pain scenes and graphically matched pictures not depicting imminent pain. The High-Cat group attributed greater pain to both pain and non-pain pictures. Source dipole analysis of event-related potentials during ...


Immunoglobulin G4-related ophthalmic disease presenting as uveitis
This report documents a 47-year-old man who presented with back pain, uveitis and an elevated Westergren sedimentation rate. On biopsy, a paraspinal lesion showed a nonspecific chronic inflammatory cell infiltrate. The eye symptoms, after initially responding to immunosuppressive therapy, worsened and progressed to pain, resulting in an extirpation of the right eye. The histopathology of the excised eye showed an inflammatory pseudotumor marked by a lymphoplasmacytic infiltrate, areas of fibrosis, rare evidence of obliterative phlebitis and, focally, over 20 Immunoglobulin G4 (IgG4)-positive staining cells per high power microscopic field. IgG4-related ophthalmic disease is a relatively rare inflammatory lesion involving the eye and periorbital region. It is defined by a marked lymphoplasm...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain-Related Anxiety Mediates the Relationship between Depressive Symptoms and Pain Interference in Veterans with Hepatitis C
Depression and chronic pain are common in persons chronically infected with the hepatitis C virus (HCV), although little is known about the rate of co-occurrence or mechanisms by which they are associated. We evaluated whether pain-related anxiety mediates the relationship between depressive symptoms and pain-related physical functioning in patients with HCV. (Source: General Hospital Psychiatry)


Building the evidence for CRPS research from a lived experience perspective
Conclusions Little is known about the lived experience of CRPS. There appears to be a clear indication that research needs to be conducted into CRPS from a lived experience perspective in order to provide information to patients, the general public, health practitioners and policy makers of previously unknown characteristics of this condition which may improve health outcomes for this patient cohort. It has been identified that patients and their families should be active participants in education of health practitioners and in providing information to inform the development of National Pain Strategies currently being devised throughout the world. Implications Research into the lived experience of chronic pain conditions, and CRPS in particular, can help to provide information to enhance ...


Systemic administration of WY-14643, a selective synthetic agonist of peroxisome proliferator activator receptor-alpha, alters spinal neuronal firing in a rodent model of neuropathic pain
Conclusion The observation that levels of PPARα protein were increased in ipsilateral spinal cord of neuropathic rats supports a contribution of spinal sites of action mediating the effects of systemic WY-14643. Our data suggests that the inhibitory effects of a PPARα agonist on spinal neuronal responses may account, at least in part, for their analgesic effects of in neuropathic pain. Implication Selective activation of PPARα in the spinal cord may be therapeutically relevant for the treatment of neuropathic pain. (Source: Scandinavian Journal of Pain)


Recurrence of migraine with aura after a 24-year free period following rTMS treatment for fibromyalgia pain
We report the case of recurrence of migraine with aura following rTMS treatment for fibromyalgia pain in a patient with history of migraines. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)


Effect of coenzyme Q plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome - A randomized, controlled, double-blind trial
Chronic Fatigue Syndrome (CFS) is a complex condition, characterized by severe disabling fatigue with no known cause, no established diagnostic tests, and no universally effective treatment. Several studies have proposed symptomatic treatment with coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) supplementation. The primary endpoint was to assess the effect of CoQ10 plus NADH supplementation on age-predicted maximum heart rate (max HR) during a cycle ergometer test. Secondary measures included fatigue, pain and sleep. (Source: Clinical Nutrition)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Painful Bladder Filling and Painful Urgency Are Distinct Characteristics in Men and Women with Urologic Chronic Pelvic Pain Syndromes – A MAPP Research Network Study
To describe bladder-associated symptoms in patients with urologic chronic pelvic pain syndromes (UCPPS) and to correlate these symptoms with urologic, non-urologic, psychosocial, and quality of life measures. (Source: The Journal of Urology)


St. Jude receives FDA 510(k) clearance for mobile-enabled spinal cord stimulation trial system
St. Jude Medical has announced that it received FDA 510(k) clearance for the St. Jude Medical Invisible Trial System, which is a mobile-enabled discreet spinal cord stimulation (SCS) trial system. Patients who need spinal cord stimulation therapy, which helps them manage chronic pain, can have small device implanted in their body. The implant connects to thin wires, called leads, which deliver [&#8230;] (Source: mobihealthnews)


Validity and Reliability of Turkish Translation of Neuropathic Pain Impact on Quality‐of‐Life (NePIQoL) Questionnaire
ConclusionsThe Turkish version of NePIQoL appears to be reliable and valid for neuropathic pain impact on quality of life in patients with neuropathic pain. (Source: Pain Practice)


Differences in Neural Mechanosensitivity Between Patients with Chronic Nonspecific Neck Pain With and Without Neuropathic Features. A Descriptive Cross‐Sectional Study
ConclusionsThe findings of this study suggest that chronic nonspecific neck pain patients with NF have greater neural mechanosensitivity, pain intensity, and neck disability than those with No‐NF. (Source: Pain Medicine)


Does the gastroprotective action of a medicinal plant ensure healing effects? An integrative study of the biological effects of Serjania marginata Casar. (Sapindaceae) in rats
Conclusions Despite the anti-H. pylori and gastroprotective actions of S. marginata in experimental models, the gastric injuries aggravation induced after chronic treatment with the HESM argues against the use of this plant species in folk medicine. Graphical abstract (Source: Journal of Ethnopharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Synaptic ultrastructure changes in trigeminocervical complex posttrigeminal nerve injury
Trigeminal nerves collecting sensory information from the orofacial area synapse on second‐order neurons in the dorsal horn of subnucleus caudalis and cervical C1/C2 spinal cord (Vc/C2, or trigeminocervical complex), which is critical for sensory information processing. Injury to the trigeminal nerves may cause maladaptive changes in synaptic connectivity that plays an important role in chronic pain development. Here we examined whether injury to the infraorbital nerve, a branch of the trigeminal nerves, led to synaptic ultrastructural changes when the injured animals have developed neuropathic pain states. Transmission electron microscopy was used to examine synaptic profiles in Vc/C2 at 3 weeks postinjury, corresponding to the time of peak behavioral hypersensitivity following chronic ...


Nuclear factor-kappa B regulates pain and COMT expression in a rodent model of inflammation
Publication date: Available online 15 July 2015 Source:Brain, Behavior, and Immunity Author(s): Jane E. Hartung, Olivia Eskew, Terrence Wong, Inna E. Tchivileva, Folabomi A. Oladosu, Sandra C. O’Buckley, Andrea G. Nackley Nuclear factor-kappa B (NF-κB) is a ubiquitously expressed protein complex regulating the transcription of genes involved in inflammation and pain. Increased NF-κB activity in immune and nervous system cells is linked to several chronic pain conditions in humans as well as inflammationand nerve injury-evoked pain in animals. A recent in vitro study further demonstrates that increased NF-κB activity in astrocytes decreases transcription of catechol-o-methyltransferase (COMT), an enzyme that inactivates catecholamines that cause pain. The purpose of the presen...


Clinical presentation of patients suffering from recent onset chronic inflammatory back pain suggestive of spondyloarthritis: The DESIR cohort
Conclusion These data represent the base of evaluation of the follow-up of this cohort, allowing future specific studies. (Source: Joint Bone Spine)


Uveitis in adults: What do rheumatologists need to know?
Publication date: Available online 14 July 2015 Source:Joint Bone Spine Author(s): Pascal Sève, Laurent Kodjikian, Léopold Adélaïde, Yvan Jamilloux Rheumatologists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. To date, no diagnostic strategy for uveitis has been validated by prospective studies. Investigations are selected based on the clinical features and on the anatomic location of the ocular abnormalities. Infections such as syphilis, Lyme disease, tuberculosis, and Whipple's disease may cause uveitis, with concomitant joint inflammation in a few cases. In patients with a known history of chronic inflammatory joint disease, causes of uveitis include bisphosphonate therapy and immunodepression-related infections (...


Early-developed hand osteoarthritis in treated HIV-positive patients: Four cases
We describe four cases of hand osteoarthritis in patients with HIV infection under antiretroviral treatment. A 36-year-old HIV-infected man came for consultation in 2007 with hand osteoarthritis. He was diagnosed HIV positive by sexual transmission in 1997. A 52-year-old HIV-infected woman came for consultation with hand osteoarthritis started in 2006. She was diagnosed HIV positive in 1986 by sexual transmission. A 57-year-old man presented hand osteoarthritis. This former IV drug user was diagnosed HIV positive in 1989. A 61-year-old HIV-infected man presented with hand osteoarthritis started in 2010. He had been contaminated with HIV in 1990 by sexual transmission. For all patients, there were neither clinical nor biological manifestations suggesting inflammatory arthritis. X-rays showe...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Retroperitoneal course of iliohypogastric, ilioinguinal, and genitofemoral nerves: A study to improve identification and excision during triple neurectomy
Triple neurectomy of the iliohypogastric (IHN), ilioinguinal (IIN), and genitofemoral (GFN) nerves is an available treatment option for chronic groin pain when conservative measures are ineffective. This research study attempted to define the variability of IHN, IIN, and GFN by categorizing variation and establishing a relationship to clinically significant landmarks. 22 cadavers (43 specimens) were dissected. Age, gender, ethnicity, BMI, and pertinent medical history were recorded for each specimen. Nerve emergence, insertion, and split points were measured in relation to clinically significant landmarks. Retroperitoneal trajectories of IHN, IIN, and GFN were analyzed and categorized based on nerve branching patterns. IIN and IHN had three branching patterns – type A (47%) in which the ...


Serum and synovial fluid C-reactive protein level variations in dogs with degenerative joint disease and their relationships with physiological parameters
Abstract Degenerative joint disease (DJD) is a progressive, chronic joint disease with an inflammatory component promoting an acute phase protein (APP) response. C-reactive protein (CRP) is one of the most important APPs, used as an inflammation marker in human, but not veterinary medicine. The study was developed in a sample of 48 dogs (n = 48) with DJD and aimed to: 1) identify and quantify the synovial fluid CRP (SFCRP) in these specimens using a validated ELISA test for serum CRP (SCRP) detection and quantification; and 2) to study the possible relationship between SCRP and SFCRP levels variations in DJD patients evaluating the influence of some physical parameters such as gender, body weight, pain level, DJD grade, and the physical activity (PA) of the patients. Statistical...


Colorado Rejects Giving PTSD Patients Access To Medical Marijuana
Colorado rejected adding post-traumatic stress disorder to the list of conditions that qualify for treatment with medical marijuana on Wednesday. After hours of emotional testimony from researchers, veterans and others who suffer from PTSD, the state Board of Health voted 6-2 not to include the disorder on the list of eligible conditions, citing a lack of science supporting marijuana's medical efficacy in treating PTSD. Had the board approved the amendment, PTSD would have been the first new ailment added to the list since Colorado's medical marijuana program began about 15 years ago. The board has rejected including PTSD twice before. "We've let down our veterans today, and [the Board of Health] should be ashamed. I really believed that this year it would pass, especially since it only fa...


Many opioid overdoses linked to lower prescribed doses, intermittent use
Overdoses of opioid pain medications frequently occur in people who aren't chronic users with high prescribed opioid doses -- the groups targeted by current opioid prescribing guidelines, reports a new study. (Source: ScienceDaily Headlines)


Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: a prospective, randomized controlled trial
This study was planned to assess and compare the effectiveness of cervical and scapulothoracic stabilization exercise treatment with and without connective tissue massage (CTM) on pain, anxiety, and the quality of life in patients with chronic mechanical neck pain (MNP). Sixty patients with chronic MNP (18-65 years) were recruited and randomly allocated into stabilization exercise with (Group 1, n=30) and without the CTM (Group 2, n=30). The program was carried out for 12 sessions, 3 days/week in 4 weeks. (Source: Manual Therapy)


Implementation of HIV Palliative Care: Interprofessional Education to Improve Patient Outcomes in Resource-Constrained Settings, 2004-2012
Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with human immunodeficiency virus (HIV) has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCS) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness. (Source: Journal of Pain and Symptom Management)


A Clinical Comparison of Pycnogenol, Antistax, and Stocking in Chronic Venous Insufficiency
Int J AngiolDOI: 10.1055/s-0035-1556060This 8-week registry study was a comparative evaluation of Pycnogenol (French Maritime Pine Bark extract; Horphag Research, Geneva) and Antistax (grape leaf extract [GLE, Boehringer Ingelheim, Germany]) in controlling symptoms of chronic venous insufficiency (CVI). “Standard management” for CVI is compression; a group of comparable subjects was monitored to evaluate the effects of stockings. The registry included 183 patients (166 completing). Supplementation with Antistax (two tablets of 360 mg/d) or Pycnogenol (100 mg/d) was used. The groups were comparable for age, symptoms, venous incompetence, and microcirculation (with increased capillary filtration and skin flux) at inclusion. At 8 weeks, the rate of swelling (p &lt; 0.05) and skin flux...


Men, fire, and burns: Stories of fighting, healing, and emotions
Recovery from burn is often a long and arduous process comprised of painful procedures, lengthy hospital stays, physical and cosmetic disfigurement, and numerous psychosocial issues [1]. Most burn survivors encounter pain, disability, and psychological difficulties which can have a chronic impact on their lives [2]. In the past, research dedicated to understanding the psychological outcomes of burn survivors was often overshadowed by an emphasis on the physical damage caused by these injuries. This is despite data which suggested that burn severity may not be the best predictor of psychosocial functioning or psychological distress [3,4]. (Source: Burns : Journal of the International Society for Burn Injuries)


TRPV1 sensitization mediates postinflammatory visceral pain following acute colitis
This study aimed at establishing the role of TRPV1 in the peripheral sensitization underlying chronic visceral pain in the context of colitis. Wild-type and TRPV1-deficient mice were separated into three groups (control, acute colitis, and recovery), and experimental colitis was induced by oral administration of dextran sulfate sodium (DSS). Recovery mice showed increased chemically and mechanically evoked visceral hypersensitivity 5 wk post-DSS discontinuation, at which point inflammation had completely resolved. Significant changes in nonevoked pain-related behaviors could also be observed in these animals, indicative of persistent discomfort. These behavioral changes correlated with elevated colonic levels of substance P (SP) and TRPV1 in recovery mice, thus leading to the hypothesis th...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Development and validation of a screening tool to predict the risk of chronic low back pain in patients presenting with acute low back pain: a study protocol
Introduction Around 40% of people presenting to primary care with an episode of acute low back pain develop chronic low back pain. In order to reduce the risk of developing chronic low back pain, effective secondary prevention strategies are needed. Early identification of at-risk patients allows clinicians to make informed decisions based on prognostic profile, and researchers to select appropriate participants for secondary prevention trials. The aim of this study is to develop and validate a prognostic screening tool that identifies patients with acute low back pain in primary care who are at risk of developing chronic low back pain. This paper describes the methods and analysis plan for the development and validation of the tool. Methods/analysis The prognostic screening tool will be ...


[Fibromyalgia syndrome : A disease of the small nerve fibers?]
Authors: Üçeyler N, Sommer C Abstract Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain and additional associated symptoms, such as fatigue, sleep disturbances and depressive moods. The pathophysiology of pain in FMS is unclear. In recent years, an involvement of the thinly myelinated A-delta and the unmyelinated C-nerve fibers has been reported in FMS patients. Independent research groups published consistent objective and multidimensional findings of damage to these small nerve fibers, such as disturbances of fiber function, electrical properties and morphological changes. All these alterations are not specific for FMS; however, they were described for the first time in subgroups of FMS patients. While the reasons for this small fiber pathology and its con...


Implementing an acceptance and commitment therapy group protocol with veterans using VA’s stepped care model of pain management
Abstract The purpose of the current study was to replicate and extend previous findings; further demonstrating the effectiveness of an ACT outpatient, group-based treatment for Veterans who suffer from mixed idiopathic, chronic, non-cancer pain. This course of treatment utilized the VA’s Stepped Care Model of Pain Management as a framework. A sample of 50 Veterans who participated in an ACT for chronic pain group intervention was evaluated after completing a pain health education program at a Midwestern VA Medical Center between February 16, 2010 and November 9, 2010. All participants completed a standard set of pre- and post-intervention measures. Paired-samples t tests were conducted to evaluate the impact of the manualized intervention on Veterans’ scores. The current s...


Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan ® instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis
Conclusion Intravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients. (Source: Clinical Drug Investigation)


Inhibition of spinal microglia and astrocytes contributes to the anti-allodynic effect of electroacupuncture in neuropathic pain induced by spinal nerve ligation.
CONCLUSIONS: EA stimulation alleviates SNL-induced neuropathic pain, at least in part through inhibition of spinal glial activation. Moreover, inhibition of spinal microglia and astrocyte activation may contribute to the immediate effects and maintenance of EA analgesia, respectively. PMID: 26177687 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Anodal transcranial direct current stimulation for chronic pain in the elderly: a pilot study.
CONCLUSIONS: Our results indicate that anodal tDCS may be a viable treatment to control pain and psychological comorbidity in elderly patients with treatment-resistant foot pain. PMID: 26174129 [PubMed - as supplied by publisher] (Source: Aging Clinical and Experimental Research)


Nuclear factor-kappa B regulates pain and COMT expression in a rodent model of inflammation.
Authors: Hartung JE, Eskew O, Wong T, Tchivileva IE, Oladosu FA, O'Buckley SC, Nackley AG Abstract Nuclear factor-kappa B (NF-κB) is a ubiquitously expressed protein complex regulating the transcription of genes involved in inflammation and pain. Increased NF-κB activity in immune and nervous system cells is linked to several chronic pain conditions in humans as well as inflammation and nerve injury-evoked pain in animals. A recent in vitro study further demonstrates that increased NF-κB activity in astrocytes decreases transcription of catechol-o-methyltransferase (COMT), an enzyme that inactivates catecholamines that cause pain. The purpose of the present study was to examine the relationship between systemic and astrocytic NF-κB activity, pain, and COMT expression in an anim...


Methylene blue and chronic neuropathic pain
Miclescu AA, Svahn M, Gordh TE (Source: Journal of Pain Research)


High-pressure oxygen can effectively treat fibromyalgia
Women with fibromyalgia, a chronic pain syndrome, were able to drastically reduce, or even eliminate, their use of pain medication following hyperbaric oxygen treatment, according to new research.. The researchers also believe they have identified the primary factor causing fibromyalgia: the disruption of the brain mechanism for processing pain. (Source: ScienceDaily Headlines)


Antinociceptive activity of astragaloside IV in the animal model of chronic constriction injury
In conclusion, in our animal model, AG effectively inhibited the neuropathic pain induced by chronic constriction injury. (Source: Behavioural Pharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Opioid Use, Misuse, and Abuse in Chronic PainOpioid Use, Misuse, and Abuse in Chronic Pain
Some physicians say, 'Opioids have an important role.' Others ask, 'How did we get into this mess?' Medscape Family Medicine (Source: Medscape Today Headlines)


Cytomegalovirus ileocolitis in a rheumatoid arthritis patient: case report and literature review.
Authors: Dag MS, Turkbeyler IH, Ozturk ZA, Kısacık B, Tutar E, Kadayıfçı A Abstract Rheumatoid arthritis (RA) is an autoimmune, systemic, chronic, inflammatory disease generally treated with various immunosuppressive drugs. Cytomegalovirus (CMV) is an opportunistic, viral infection that is commonly seen in immunosuppressed patients. A sixty-four-year old female diagnosed with RA and treated with immunosuppressive agents was admitted to our rheumatology outpatient service with complaints of diarrhea and abdominal pain, which had lasted longer than four weeks. The patient's colonoscopy revealed inflamed and ulcerated areas in the colon and in the terminal ileum. A biopsy showed intra-nuclear inclusion particles consistent with CMV. We started an oral valganciclovir therapy in th...


European Medicines Agency launches HPV vaccine review
The European Medicines Agency has launched a review into the safety of the HPV vaccine, which is given to all girls aged 12 to 15, amid concerns the jab causes chronic pain, fainting and dizziness. (Source: the Mail online | Health)


Intrathecal bone marrow stromal cells inhibit neuropathic pain via TGF-β secretion
Neuropathic pain remains a pressing clinical problem. Here, we demonstrate that a local, intrathecal (i.t.) injection of bone marrow stromal cells (BMSCs) following lumbar puncture alleviates early- and late-phase neuropathic pain symptoms, such as allodynia and hyperalgesia, for several weeks in murine chronic constriction injury (CCI) and spared nerve injury models. Moreover, i.t. BMSCs reduced CCI-induced spontaneous pain and axonal injury of dorsal root ganglion (DRG) neurons and inhibited CCI-evoked neuroinflammation in DRGs and spinal cord tissues. BMSCs secreted TGF-β1 into the cerebrospinal fluid, and neutralization of TGF-β1, but not IL-10, reversed the analgesic effect of BMSCs. Conversely, i.t. administration of TGF-β1 potently inhibited neuropathic pain. TGF-β1 acted as a p...


High-pressure oxygen can effectively treat fibromyalgia
(American Friends of Tel Aviv University) A new study by Tel Aviv University researchers found that women with fibromyalgia, a chronic pain syndrome, were able to drastically reduce, or even eliminate, their use of pain medication following hyperbaric oxygen treatment. The researchers also believe they have identified the primary factor causing fibromyalgia: the disruption of the brain mechanism for processing pain. (Source: EurekAlert! - Medicine and Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Dendritic spine dysgenesis in neuropathic pain
Publication date: 5 August 2015 Source:Neuroscience Letters, Volume 601 Author(s): Andrew M. Tan , Stephen G. Waxman Neuropathic pain is a significant unmet medical need in patients with variety of injury or disease insults to the nervous system. Neuropathic pain often presents as a painful sensation described as electrical, burning, or tingling. Currently available treatments have limited effectiveness and narrow therapeutic windows for safety. More powerful analgesics, e.g., opioids, carry a high risk for chemical dependence. Thus, a major challenge for pain research is the elucidation of the mechanisms that underlie neuropathic pain and developing targeted strategies to alleviate pathological pain. The mechanistic link between dendritic spine structure and circuit function could expla...


Herbs for Low Back Pain, Acupuncture for Psychological Distress, Osteopathic Manipulative Therapy for Chronic Migraine, Honey Dressings for Burns, Vegetarian Diet and Risk of Colorectal Cancer
Publication date: Available online 6 July 2015 Source:EXPLORE: The Journal of Science and Healing Author(s): Peter Berberian , Chinyere Obimba , Richard Glickman-Simon , Tanmeet Sethi (Source: EXPLORE: The Journal of Science and Healing)


A lumbar canal cystic mass lesion in a man with a history of chronic lower back pain
(Source: Neuropathology)


Working with severely traumatized, chronically depressed analysands
Surprisingly often in the psychoanalyses of chronically depressed patients, depression represents an unconscious attempt to psychically cope with unbearable psychic pain following severe traumatisation: dissociative states, a chronified psychic state of shock, a disappearance of emotions, an emptying of the self and the object relationships, as well as a disappearance of the psyche in the body are among the possible consequences. The treatment of these difficult groups of analysands can also frequently bring analysts to the limits of the endurable. Often related to this is the repeated danger of denying the trauma, and a re‐traumatisation of the analysand in the analytic situation. The lecture discusses the fact that in comparison with other therapeutic approaches, psychoanalysis has a h...


Fibromyalgia: epidemiology and risk factors, a population‐based case‐control study in Lebanon
ConclusionThis was the first study to address the epidemiology of FM in Lebanon and the region. The chronic nature of FM that is characterized by frequent bouts of intense disabling pain and symptoms constitutes a significant health and economic burden. Clustering of cases in coastal areas was partially explained by other factors such as body mass index, distress level, smoking and work status. The high burden of FM found in our study calls for further investigation of potential risk factors of this condition. (Source: APLAR Journal of Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Risk and self‐managing chronic joint pain: looking beyond individual lifestyles and behaviour
Abstract Self‐managing chronic musculoskeletal pain is predominantly framed within a discourse of modifying behaviour, or lifestyle risk factors such as diet, weight loss and exercise by policymakers, researcher and clinicians. Little research has been conducted which explores how ‘risk’ is understood or encountered by those with joint pain and how it may relate to self‐management. Drawing from serial interviews and a diary study with 22 participants, the findings demonstrate that people with chronic pain engage in a process of assessing and adapting to hazardous or pain conferring situations in relation to daily activities. ‘Risks’ are embedded within a dialectic between corporeal experience and the design features of everyday social environments. Self‐management, in this co...


Pseudoachondroplasia and painful sequelae
This study documents for the first time that pain is the most common presenting symptom in PSACH and is often overlooked until short stature becomes obvious. The recognition of chronic pain as one of the earliest manifestations of PSACH is important to allow for prompt diagnosis. © 2015 Wiley Periodicals, Inc. (Source: American Journal of Medical Genetics Part A)


Nucleus accumbens dopaminergic neurotransmission switches its modulatory action in chronification of inflammatory hyperalgesia
This article is protected by copyright. All rights reserved. (Source: European Journal of Neuroscience)


The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA‐lesioned rats
This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6‐hydroxydopamine‐lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low‐frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint. Thermal and mechanical sensory thresholds are reduced in 6‐hydroxydopamine lesioned parkinsonian rats compared to sham controls. Subthalamic deep brain stimulation at both 150 and 50 Hz improves thermal and mechanical thresholds in parkinsonian rats. Our results suggest that low frequency stimulation could be considered a treatment option for patients with Parkinson's disease with chronic pain as a predominant complaint. (Source: European Journal of Neu...


A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: a cluster randomized controlled trial protocol
Prescription opioid misuse is a significant public health problem as well as a patient safety concern. Primary care providers (PCPs) are the leading prescribers of opioids for chronic pain, yet few PCPs follow standard practice guidelines regarding assessment and monitoring. This cluster randomized controlled trial will determine whether four implementation strategies; nurse care management, use of a patient registry, academic detailing, and electronic tools, will increase PCP adherence to chronic opioid therapy guidelines and reduce opioid misuse among patients, relative to electronic tools alone. (Source: Journal of Substance Abuse Treatment)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Reliability and Validity of the Cantonese Version of the Pain Treatment Satisfaction Scale (ChPTSS) in a Sample of Chinese Patients with Chronic Pain
ConclusionOur results offer preliminary evidence for the reliability and concurrent predictive validity of the ChPTSS, which can be applied in Cantonese speaking context. (Source: Pain Medicine)


Short‐Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program
ConclusionsThis study demonstrates short‐term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well‐being as of equal value and relevance to pain reduction. (Source: Pain Medicine)


The Number of Ratings Needed for Valid Pain Assessment in Clinical Trials: Replication and Extension
ConclusionsComposite pain intensity scores created from two individual ratings of recalled pain appear to be adequately valid for detecting treatment effects. Moreover, the findings indicate that the selection of the pain intensity domain to use as a primary outcome variable may play a more important role than increasing reliability by obtaining more assessments; specifically, ratings of recalled worst pain may be more valid for detecting treatment effects than ratings of average pain. (Source: Pain Medicine)


Correlation of 99mTc‐DPD SPECT/CT Scan Findings and Diagnostic Blockades of Lumbar Medial Branches in Patients with Unspecific Low Back Pain in a Randomized‐Controlled Trial
ConclusionCompared with diagnostic infiltrations SPECT/CT scans showed only a moderate sensitivity and specificity and, therefore, may not be recommended as a first line diagnostic tool prior to diagnostic infiltrations. (Source: Pain Medicine)


Emergency Department Staff Attitudes Toward People Presenting in Chronic Pain: A Qualitative Study
ConclusionsED staff found people presenting at ED with chronic pain to be a challenging and frustrating population to treat. Staff was constrained by the fast‐paced nature of their jobs as well as the need to prioritise emergency cases, and so were unable to spend the time needed by chronic pain patients. This was seen as being bad for staff, and for the patient experience. Staff suggested that care could be improved by appropriate information, signposting and with time invested in communication with the patient. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain Phenotypes and Associated Clinical Risk Factors Following Traumatic Amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER)
ConclusionsMost military service members in this cohort suffered both phantom and residual limb pain following amputation. Neuroma was a common cause of neuropathic pain in this group. Associated risk factors for significant neuropathic pain included PTSD and depression. PTSD, depression, catastrophizing, and the absence of a regional analgesia catheter were associated with neuropathic pain of any severity. (Source: Pain Medicine)


Shortening the Screener and Opioid Assessment for Patients with Pain‐Revised (SOAPP‐R): A Proof‐of‐Principle Study for Customized Computer‐Based Testing
ConclusionsCurtailment and stochastic curtailment have potential to improve the SOAPP‐R's efficiency in computer‐based administrations. (Source: Pain Medicine)


Effects of Therapy in Patients Suffering from Chronic Back Pain Treated with Spinal Cord Stimulation
Pain in the lumbosacral part of the spine in the course of degenerative disease is the most common cause of physical activity limitation in adults. Treatment includes pharmacotherapy, physiotherapy, psychotherapy, health promotion, and sometimes surgery. Surgical treatment is not always successful, and the various clinical and psychosomatic symptoms that result from surgical treatment failure are known as failed back surgery syndrome. For some patients with this condition, spinal cord stimulation can provide relief. (Source: Pain Management Nursing)


Interventions for bronchiectasis: an overview of Cochrane systematic reviews.
CONCLUSIONS: This overview clearly points to significant opportunities for further research aimed at improving outcomes for people with bronchiectasis. We have highlighted important endpoints for studies (particularly exacerbations, quality of life and lung function), and areas of clinical practice that are in most urgent need of evidence-based support (including long-term antibiotics, ICSs and mucolytics).As the evidence is confined to small trials of short duration, it is not currently possible to assess the balance between the benefits and potential harms of treatments for bronchiectasis. PMID: 26171905 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Applying refinement to the use of mice and rats in rheumatoid arthritis research
Abstract Rheumatoid arthritis (RA) is a painful, chronic disorder and there is currently an unmet need for effective therapies that will benefit a wide range of patients. The research and development process for therapies and treatments currently involves in vivo studies, which have the potential to cause discomfort, pain or distress. This Working Group report focuses on identifying causes of suffering within commonly used mouse and rat ‘models’ of RA, describing practical refinements to help reduce suffering and improve welfare without compromising the scientific objectives. The report also discusses other, relevant topics including identifying and minimising sources of variation within in vivo RA studies, the potential to provide pain relief including analgesia, welfare ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Inadequacy of 12-Week Miltefosine Treatment for Indian Post-Kala-Azar Dermal Leishmaniasis.
Authors: Ghosh S, Das NK, Mukherjee S, Mukhopadhyay D, Barbhuiya JN, Hazra A, Chatterjee M Abstract Post-kala-azar dermal leishmaniasis (PKDL) is a chronic dermatosis that generally occurs after apparent cure of visceral leishmaniasis caused by Leishmania donovani. In view of the prolonged treatment regimens necessary for PKDL, noncompliance is a major limitation; an optimal regimen is yet to be defined, but 12 weeks of therapy with miltefosine is generally recommended. We performed a single-arm open-label trial of miltefosine administered daily for 16 weeks in 27 patients in Kolkata with PKDL. After 4 weeks of treatment, nine patients were lost to follow-up because of unacceptable side effects, including severe abdominal pain, nausea, and vomiting. Of the 18 remaining patients, se...


Interleukin-17A Acts to Maintain Neuropathic Pain Through Activation of CaMK II /CREB Signaling in Spinal Neurons
This study was designed to investigate whether spinal IL-17A acted to maintain neuropathic pain and to elucidate the underlying mechanisms in IL-17A knockout or wild-type (WT) mice following L4 spinal nerve ligation (L4 SNL). WT mice were treated with anti-IL­17A neutralized monoclonal antibody (mAb) or recombinant IL-17A (rIL-17A). We showed that IL-17A levels were significantly increased 1, 3, 7, and 14 days after SNL in spinal cord. Double immunofluorescence staining showed that astrocytes were the major cellular source of spinal IL-17A. IL-17A knockout or anti-IL-17A mAb treatment significantly ameliorated hyperalgesia 7 days after SNL, which was associated with a significant reduction of p-CaMKII and p-CREB levels in spinal cord, whereas rIL-17A treatment conferred the opposite eff...


Establishment of a liaison clinic for patients with intractable chronic pain
Conclusions This liaison clinic for patients with intractable chronic pain was able to improve patient anxiety. Severe anxiety at the initial visit represented a risk factor for dropout from the clinic. (Source: Journal of Orthopaedic Science)


An update on complex regional pain syndromes in children and adolescents
Purpose of review: Complex regional pain syndrome (CRPS) is a chronic pain condition typically involving a limb, which is characterized by neuropathic pain, sensory abnormalities and neurovascular findings. The exact cause of CRPS is unknown; however, proposed theories include alterations in the sympathetic and central nervous system (CNS), small fibre changes in the peripheral nervous system and psychological factors. Although this condition was previously considered rare among children and adolescents, it has been increasingly recognized in paediatric patients and can result in significant disability. Recent findings: The diagnosis of paediatric CRPS is based upon clinical criteria obtained from a thorough history and physical examination. Other possible causes, such as orthopaedic, infe...


Chronic pain and obesity
Okifuji A, Hare BD (Source: Journal of Pain Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Validation of the Roland Morris Questionnaire in Colombia to Evaluate Disability in Low Back Pain
Conclusion. The RMQ is a useful and reliable instrument for the evaluation of patients with low back pain, and it allows an adequate clinical postintervention follow-up. Level of Evidence: 3 (Source: Spine)


Stem cells provide lasting pain relief in mice
Researchers have identified a promising stem cell based-therapy to address the chronic pain that affects more than one-third of the US adult population. In mice, bone marrow stromal cells were found to provide lasting relief for chronic pain caused by nerve damage. The findings also may advance cell-based therapies in chronic pain conditions, lower back pain and spinal cord injuries. (Source: ScienceDaily Headlines)


FDA strengthens warning that NSAIDs increase heart attack and stroke risk
Back in 2005, the FDA warned that taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen increased the risk of having a heart attack or stroke. Last week it took the unusual step of further strengthening this warning. This was done on the advice of an expert panel that reviewed new information about NSAIDs and their risks. Because NSAIDs are widely used, it&#8217;s important to be aware of downsides of taking an NSAID and to take steps to limit the risk. Many people take NSAIDs to relieve mild to moderate pain. These medications may be particularly effective in conditions in which pain results primarily from inflammation, such as arthritis or athletic injury. Examples of commonly used over-the-counter NSAIDs include ibuprofen (Motrin, Advil) and naproxen (Aleve); ...


Gastroparesis: A Review of Current Diagnosis and Treatment Options
Gastroparesis (GP) is a chronic neuromuscular disorder of the upper gastrointestinal tract. The incidence of GP is not well described; however, the number of individuals affected by symptoms of GP in the United States is estimated to be over 4 million. The etiology of GP is diverse. Approximately 25% of cases are associated with diabetes, whereas nearly 50% are classified as idiopathic; many of these latter cases likely represent a postinfectious process. Connective tissue disorders, autoimmune disorders, prior gastric surgery, ischemia, and medications make up the vast majority of the remaining cases. The pathophysiology of GP is also diverse. Abnormalities in fundic tone, antroduodenal dyscoordination, a weak antral pump, gastric dysrhythmias, and abnormal duodenal feedback all contribut...


Just how safe is the HPV vaccine?
The European Medicines Agency has launched a review into the safety of the HPV vaccine, which is given to all girls aged 12 to 15, amid concerns the jab causes chronic pain, fainting and dizziness. (Source: the Mail online | Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


FDA Strengthens Warning on NSAIDs and Heart Risk
Title: FDA Strengthens Warning on NSAIDs and Heart RiskCategory: Health NewsCreated: 7/11/2015 12:00:00 AMLast Editorial Review: 7/13/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Clinical Characteristics and Outcome of Primary Sjogren's Syndrome: A Large Asian Indian Cohort.
CONCLUSION: Our cohort of patients with SS has characteristic clinical features; some of them are in contrast with previous observations reported in European patients. This cohort consisted of two distinct patient clusters. The first cluster was associated with major systemic illness and high antibody titers, where as the second cluster comprised of seronegative patients with mild disease. Association of antibody positivity with systemic features was further confirmed on logistic regression analysis. PMID: 26161156 [PubMed] (Source: Open Rheumatology Journal)


The role of AST-120 and protein-bound uremic toxins in irritable bowel syndrome: a therapeutic perspective
AST-120 (kremezin) exhibits its favourable effects in reducing the levels of renal toxins by selective adsorption of low molecular weight substances from the intestinal lumen. So far, a vast majority of studies were focused on the role of AST-120 in the treatment of chronic kidney diseases and cardiovascular disorders, and positive therapeutic effects of the agent have already been confirmed in clinical conditions. Up to the present, there are only a few studies regarding the role of AST-120 in irritable bowel syndrome (IBS). Compelling data suggest the ability of the compound to adsorb protein-bound uremic toxins and mast cell derived mediators and to modulate the farnesoid X receptor, which is a bile acid sensor indispensable for maintaining homeostasis in the intestine. In this review w...


Pregabalin and pain after total knee arthroplasty: a double-blind, randomized, placebo-controlled, multidose trial
Conclusions Pregabalin had no beneficial effects, but increased sedation and decreased patient satisfaction. This study does not support routine perioperative pregabalin for total knee arthroplasty patients. Clinical trial registration. ClinicalTrials.gov: http://www.clinicaltrials.gov/ct2/show/study/NCT01333956. (Source: British Journal of Anaesthesia)


Trust and the Ethics of Chronic Pain Management in HIV
The American Nurses Association has designated 2015 as the Year of Ethics, and accordingly has published a revised code of nursing ethics (Willard, 2015). This code explicitly identifies promoting social justice and reducing health care disparities as ethical imperatives. These themes will resonate strongly with health care providers devoted to HIV care, given the disproportionate effects of HIV on predominantly minority, socioeconomically disadvantaged communities. One area in which HIV care providers must be particularly alert to the potential for health care disparities and injustice is chronic pain. (Source: Journal of the Association of Nurses in AIDS Care)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic joint pain in the lower body is associated with gait differences independent from radiographic osteoarthritis
Chronic pain is very common in elderly people and affects daily functioning. Chronic lower body pain often causes decreased mobility and lower quality of life. Especially in older individuals, this decreased mobility is related to higher mortality.[1–5] (Source: Gait and Posture)


Chronic Mesenteric Ischemia Presenting as Exercise-Induced Abdominal Pain
Patients with a stenosis of the superior mesenteric artery and a widely patent celiac axis are often asymptomatic due to a rich network of collaterals between the two. Compression of the celiac axis by the diaphragm is, in patients without additional vascular disease, also frequently asymptomatic. Here we describe an unual case of exercise-induced abdominal pain caused by a combination of these two pathologies. In our patient with a previously occluded inferior mesenteric artery and a 90% superior mesenteric artery stenosis, celiac compression by the diaphragm, worsened with exercise, caused severe abdominal pain. (Source: Annals of Vascular Surgery)


Analgetic effect of docosahexaenoic acid is mediated by modulating the microglia activity in the dorsal root ganglia in a rat model of neuropathic pain.
Authors: Manzhulo IV, Ogurtsova OS, Lamash NE, Latyshev NA, Kasyanov SP, Dyuizen IV Abstract The analgetic activity of docosahexaenoic acid (DHA, 22:6 n-3) was studied using a chronic constriction injury (CCI) model in rats, and the dynamics of iba-1 (+) microglia/macrophages in the dorsal root ganglia (DRG) were characterized. DHA reduced the intensity and duration of neurogenic pain. The application of DHA led to an earlier stabilization of weight bearing in the incapacitance test and prevented the development of cold allodynia and degenerative changes in tissues of the denervated limb. DHA treatment significantly reduced satellite glia reaction and expression of the pro-apoptotic p53 protein in the DRG. Thus, DHA's anti-pain effect may be a result of the modulation of microglia/...


Proctor Chiropractic Seeks to Raise Awareness About Chronic Pain
(Source: Medical News (via PRIMEZONE))


Immediate changes in electroencephalography activity in individuals with nonspecific chronic low back pain after cranial osteopathic manipulative treatment: study protocol of a randomized, controlled crossover trial
DiscussionThe investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation.Trial registrationNCT02111382 (Source: BioMed Central)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medical News Today: New study reveals dangers of opioid abuse for chronic back pain sufferers
Scientists discovered that chronic back patients suffering from high levels of depression or anxiety are more prone to opioids abuse. (Source: Health News from Medical News Today)


Xiphoidectomy for xiphoid process-induced pain in a surfer - Sano A, Inui M.
A 53-year-old man who had been surfing for more than 30 years was referred to our hospital with upper abdominal wall pain. Computed tomography showed that his xiphoid process was protruding forward and the overlying skin was thickened. We diagnosed chronic... (Source: SafetyLit: All (Unduplicated))


Large Prepatellar Glomangioma: A Case Report
CONCLUSION The following case report details an atypical presentation of a benign glomangioma anterior to the knee in a patient experiencing chronic minor trauma to the area. Diagnosis was suggested by clinical presentation and MR imaging, and was confirmed histologically. (Source: International Journal of Surgery Case Reports)


The trues behind TRUS in the setting of chronic prostatitis/chronic pelvic pain syndrome
Conclusion The findings of TRUS studies in patients with suspected CP/CPPS are not pathognomonic for this entity, and TRUS is therefore considered as having very little yield in this setting. (Source: Urological Science)


Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report.
Authors: Lee HY, Park JH, Kim SG Abstract Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroeso...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pancreatic and Gastric Heterotopia with Associated Submucosal Lipoma Presenting as a 7-cm Obstructive Tumor of the Ileum: Resection with Double Balloon Enteroscopy
We report a novel case of pancreatic and gastric heterotopia with an associated submucosal lipoma in a 38-year-old female with a recent history of rectal cancer and chronic crampy abdominal pain. On computed tomography, a 7-cm luminal polypoid mass extending into the distal ileum was discovered. The mass was successfully resected using retrograde double balloon enteroscopy. We believe this is the first report of all three histological entities co-existing in an obstructive ileal lesion in an adult. It highlights endoscopic resection trough double enteroscopy as a safe alternative to more invasive surgical approaches for this type of lesion.Case Rep Gastroenterol 2015;9:233-240 (Source: Case Reports in Gastroenterology)


Kuttner Tumor in Submandibular Gland: A Case Report
Kuttner tumor (KT) is a rare chronic inflammation of the salivary glands. A 58-year-old male sought treatment at a dental clinic, complaining of “swelling under the tongue, pain, secretion, and expulsion of solid material”. Extraoral examination revealed swelling in the left submandibular region, sensitive to palpation, lasting for 2 months. Intraoral examination showed a nodular lesion, on the left side of the floor of the mouth, with a hard consistency and purulent discharge, measuring approximately 1 cm. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)


Patients With Neck Pain are Less Likely to Improve if They Experience Poor Sleep Quality: A Prospective Study in Routine Practice
Discussion: NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients. (Source: The Clinical Journal of Pain)


National Dissemination of Cognitive-Behavioral Therapy for Chronic Pain in Veterans: Therapist and Patient-level Outcomes
Discussion: Training in and implementation of CBT-CP in the VA health care system were associated with significant increases in therapist competencies to deliver CBT-CP and improvements in several domains for Veteran patients. Results support the feasibility and effectiveness of broad dissemination of CBT-CP in routine, nonpain specialty settings. (Source: The Clinical Journal of Pain)


Natural Variation in Testosterone is Associated With Hypoalgesia in Healthy Women
Discussion: Although future research is needed to replicate and extend these findings to clinical populations (ie, chronic pain, premenstrual dysphoric disorder), results from the present study indicate that menstrual phase-related changes in sex hormones have minimal influence on experimental pain. However, individual differences in testosterone may play a protective role against pain in healthy women. (Source: The Clinical Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Exploring Attentional Bias for Real-World, Pain-related Information in Chronic Musculoskeletal Pain Using a Novel Change Detection Paradigm
This study is the first to show individuals with chronic pain possess attentional biases for pain-related information presented as part of complex, real-world scenes. Possible future research includes the use of real-world scenes in visual-search paradigms modifying attentional biases, and exploration into the relations and effects of combined cognitive biases (eg, attention, memory, and interpretation) in chronic pain. (Source: The Clinical Journal of Pain)


Parenting in the Context of Chronic Pain: A Controlled Study of Parents With Chronic Pain
This study aims to describe what adults with chronic pain experience in their role as parents, utilizing quantitative and qualitative methods. The first aim was to compare parents with chronic pain to parents without chronic pain on perceptions of their adolescent’s pain, parental response to pain, and catastrophizing beliefs about pain. The study also examined predictors of parental protective behaviors, and examined whether these associations differed by study group. Materials and Methods: Parents with chronic pain (n=58) and parents without chronic pain (n=72) participated, and completed questionnaire measures of pain characteristics and pain interference, as well as measures of parental catastrophizing and protective pain responses. Parents with chronic pain also completed a structur...


Acute Myocardial Infarction That Resulted From Poor Adherence to Medical Treatment for Giant Coronary Aneurysm.
Authors: Motozawa Y, Uozumi H, Maemura S, Nakata R, Yamamoto K, Takizawa M, Kumagai H, Ikeda Y, Komuro I, Ikenouchi H Abstract Coronary arterial complications associated with Kawasaki disease (KD), such as a giant coronary aneurysm, determine the relative risk of future cardiac events and require lifelong medical treatment. Here, we describe a 24-year-old man who developed myocardial infarction due to poor adherence to medical treatment for a giant coronary aneurysm in the chronic phase of KD. He was hospitalized two hours after the onset of chest pain. The presence of the giant coronary aneurysm made primary percutaneous coronary intervention (PCI) difficult. However, we were able to perform primary PCI successfully utilizing previous coronary computed tomography (CT) angiographic...


Modulatory effects by CB1 receptors on rat spinal locomotor networks after sustained application of agonists or antagonists
Publication date: 10 September 2015 Source:Neuroscience, Volume 303 Author(s): P. Veeraraghavan , A. Nistri Sustained administration of cannabinoid agonists acting on neuronal CB1 receptors (CB1Rs) are proposed for treating spasticity and chronic pain. The impact of CB1Rs on mammalian locomotor networks remains, however, incompletely understood. To clarify how CB1Rs may control synaptic activity and locomotor network function, we used the rat spinal cord in vitro which is an advantageous model to investigate locomotor circuit mechanisms produced by the local central pattern generator. Neither the CB1 agonist anandamide (AEA) nor the CB1R antagonist AM-251 evoked early (&lt;3h) changes in mono or polysynaptic reflexes or in locomotor rhythms. Application of AEA (24h) significantly dec...


Thalidomide reduces mechanical hyperalgesia and depressive-like behavior induced by peripheral nerve crush in mice
Conclusions: The sciatic nerve crush model represents a good model to study to mechanisms underlying both pain and depressive-like behaviors. Furthermore, inhibitors of TNF-α synthesis, like thalidomide, have a potential to treat depressive disorders associated with neuropathic pain. Graphical abstract (Source: Neuroscience)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Swedish version of the Insomnia Severity Index: Factor structure analysis and psychometric properties in chronic pain patients
Conclusions and implications Although short, the four-item Insomnia Severity Index (ISI-4) version seemed to effectively assess insomnia in chronic pain patients. An important clinical implication is that the four-item Swedish Insomnia Severity Index can be used in chronic pain cohorts when screening for insomnia problems. Its measurement and structural invariance property across the two sexes shows that the ISI-4 is a valid measure of the insomnia across groups of chronic patients. Our results also suggest its utility both in pain clinical practice and research purposes. (Source: Scandinavian Journal of Pain)


Sternoclavicular dislocation: case report and surgical technique
Publication date: Available online 10 July 2015 Source:Revista Brasileira de Ortopedia (English Edition) Author(s): Bernardo Barcellos Terra , Leandro Marano Rodrigues , David Victoria Hoffmann Pádua , Marcelo Giovanini Martins , João Carlos de Medeiros Teixeira , Anderson De Nadai Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve...


Arthroscopic treatment for chronic lateral epicondylitis
Conclusion Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure. (Source: Revista Brasileira de Ortopedia)


Completion pancreatectomy and islet cell autotransplantation as salvage therapy for patients failing previous operative interventions for chronic pancreatitis
Traditional decompressive and/or pancreatic resection procedures have been the cornerstone of operative therapy for refractory abdominal pain secondary to chronic pancreatitis. Management of patients that fail these traditional interventions represents a clinical dilemma. Salvage therapy with completion pancreatectomy and islet cell autotransplantation (CPIAT) is an emerging treatment option for this patient population; however, outcomes after this procedure have not been well-studied. (Source: Surgery)


Headaches after Concussion in Pediatrics: a Review
Abstract Concussion and mild traumatic brain injury (TBI) are common pediatric injuries. Headaches are one of the most common and disabling complaints following concussion in the acute phase and are pervasive in those who have prolonged symptoms following concussion. The body of evidence regarding the epidemiology of and risk factors for pediatric concussion and post-traumatic headache is growing rapidly, but there still is a distinct lack of strong scientific evidence to support the best treatment strategies for post-traumatic headaches in either children or adults. In this article, we will review the current evidence regarding the epidemiology of acute and chronic headaches following concussion in the pediatric population, as well as current recommendations for the management o...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Why Do People Do Yoga?
After my last weekend of yoga teacher training, a friend asked me over dinner, "Why do you do yoga? So you can learn to do what... headstands?" Why do people do yoga? More than 90 percent of people come to yoga for flexibility, stress relief, health, and physical fitness. But, for most people, their primary reason for doing yoga will change. Two-thirds of yoga students and 85 percent of yoga teachers have a change of heart regarding why they do yoga -- most often changing to spirituality or self-actualization, a sense of fulfilling their potential. Yoga offers self-reflection, the practice of kindness and self-compassion, and continued growth and self-awareness. Yet the health benefits are very real. Yes, yoga can increase your flexibility, improve your balance, and decrease your cholest...


Understanding the Real Source of Back Pain
By Pete Egoscue In the United States, back pain is one of the top complaints people bring to their doctors. What is the cause of this back pain that is so prevalent in our culture? First, some basic anatomy. The human spine is called "the segmented bone," meaning it's a bone that the body recognizes as one bone, in the same way it recognizes, say, the femur (thigh) or humerus (biceps), but unlike those bones, it is segmented, a bone in parts, and those parts are called vertebrae. That said, when it comes to function, the body does not recognize the individual parts of the spine; it stimulates and responds to the spine as if it is a single unit, a lone bone. But a really flexible bone. That flexible spine is why, regarding range of motion, humans have more capability than all other vertebra...


Back Pain and Depression Combo Lessens Pain Relief from Narcotic Painkillers
Title: Back Pain and Depression Combo Lessens Pain Relief from Narcotic PainkillersCategory: Health NewsCreated: 7/9/2015 12:00:00 AMLast Editorial Review: 7/10/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


FDA Strengthens Heart Attack, Stroke Warning for Popular Painkillers
Title: FDA Strengthens Heart Attack, Stroke Warning for Popular PainkillersCategory: Health NewsCreated: 7/10/2015 12:00:00 AMLast Editorial Review: 7/10/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


A single thalamic target for deep brain stimulation to treat hemi-body pain syndrome
Conclusion To our knowledge this was the first time this pattern of pain was treated by a single thalamic DBS electrode, suggesting stimulation in this region may be a feasible target for achieving relief from chronic severe hemi-body pain. (Source: Acta Neurochirurgica)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Paradoxical pain perception in PTSD: The unique role of anxiety and dissociation
Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, PTSD patients with chronic pain were found to demonstrate a unique, paradoxical pain profile: hyper-responsiveness together with hyposensitivity to pain. Our aim was to examine whether two seemingly paradoxical facets of PTSD - anxiety and dissociation - underlie this paradoxical profile.PTSD patients (n=32) and healthy controls (n=43) underwent psychophysical testing and completed questionnaires. (Source: The Journal of Pain)


Comorbidity of mental disorders and chronic pain: chronology of onset in adolescents of a national representative cohort
This study sought to estimate i) the prevalence of the co-occurrence of, ii) the association between, and iii) the sequence of onset of chronic pain and mental disorders in adolescents. We used weighted data (N=6483) from the National Comorbidity Survey Replication Adolescent Supplement (participants’ age: 13-18 years). Lifetime chronic pain was assessed by adolescent self-report, lifetime DSM-IV mental disorders by the WHO CIDI, complemented by parent report. Among the study’s subjects, 1600 out of 6476 (25.93%) had experienced any type of chronic pain and any mental disorder in their lifetime. (Source: The Journal of Pain)


Tonsillar colonisation of Fusobacterium necrophorum in patients subjected to tonsillectomy
Conclusion: Fusobacterium necrophorum was frequently found in throat cultures in this cohort of patients with recurrent or chronic throat pain leading to tonsillectomy. Colonisation was equally frequent in the asymptomatic cohort post-tonsillectomy, indicating that F. necrophorum is not alone causative of the symptoms. In an individual perspective, colonisation with F. necrophorum was transient over time. (Source: BMC Infectious Diseases)


Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study
Conclusions Chronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain. (Source: BMJ Open)


Spinal sensory projection neuron responses to spinal cord stimulation are mediated by circuits beyond gate control
Spinal cord stimulation (SCS) is a therapy used to treat intractable pain with a putative mechanism of action based on the Gate Control Theory. We hypothesized that sensory projection neuron responses to SCS would follow a single stereotyped response curve as a function of SCS frequency, as predicted by the Gate Control circuit. We recorded the responses of antidromically identified sensory projection neurons in the lumbar spinal cord during 1- to 150-Hz SCS in both healthy rats and neuropathic rats following chronic constriction injury (CCI). The relationship between SCS frequency and projection neuron activity predicted by the Gate Control circuit accounted for a subset of neuronal responses to SCS but could not account for the full range of observed responses. Heterogeneous responses we...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Treatment of discogenic back pain with autologous bone marrow concentrate injection with minimum two year follow-up
Conclusions This study provides evidence of safety and feasibility in the non-surgical treatment of discogenic pain with autologous BMC, with durable pain relief (71 % VAS reduction) and ODI improvements (&gt; 64 %) through two years. (Source: International Orthopaedics)


Mental Health Disorders Among Women Victims of Conflict-Related Sexual Violence in the Democratic Republic of Congo
To assess the effects of sexual violence (SV) in armed conflicts on women&rsquo;s mental health, on its own and in conjunction with reproductive health issues such as fistula or chronic pelvic pain (CPP). A cross-sectional population-based study of 320 women living in Goma, the Democratic Republic of Congo, aged 15 to 45 years, was conducted. Women who experienced conflict-related sexual violence (CRSV) were compared with those who experienced non-conflict-related sexual violence (NCRSV) and those who never experienced such acts. Data were gathered through individual interviews by local staff using standardized questionnaires. The outcomes investigated were post-traumatic stress disorder (PTSD) symptoms severity and psychological distress symptoms (PDS) severity. Experience of SV in either...


Incidence and Risk Factors for Chronic Anterior Knee Pain
This study is the first report of incidence and risk factors for chondromalacia patellae in a large athletic population. We determined that sex, age, race, branch of service, and rank all correlated with the incidence of chondromalacia patellae in an active population.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Knee Surgery)


UCLA mind-body programs help people de-stress
This article has been edited from the original story in U Magazine. Read the complete story here. (Source: UCLA Newsroom: Health Sciences)


On the Horizon: Virtual Reality Therapy That Treats Chronic Pain
Retraining the brain can restore mobility for people with injuries or difficulty moving -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Treatment of chronic migraine with transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): a randomized, monocentric clinical trial
Conclusion Treatment of chronic migraine by t-VNS at 1 Hz was safe and effective. The mean reduction of headache days after 12 weeks of treatment exceeded that reported for other nerve stimulating procedures. (Source: The Journal of Headache and Pain)


Incidence of Chronic and Other Knee Pain in Relation to Occupational Risk Factors in a Large Working Population
Conclusions: This study highlights the high frequency of chronic KP in the working population and the role of occupational factors in its incidence, in particular those kneeling and handling loads. (Source: Annals of Occupational Hygiene)


The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?
Learning objectives To recognise the causes and natural history of non-cardiac chest pain. To recognise features in the history and examination which differentiate cardiac pain from non-cardiac chest pain. To explore and treat the psychological factors initiating and maintaining non-cardiac chest pain. CURRICULUM TOPIC: Chronic ischaemic heart disease Introduction Chest pain is common and usually non-cardiac in origin. The lifetime population prevalence of non-cardiac chest pain (NCCP) is approximately 20&ndash;33%1&ndash;7 compared with approximately 6&ndash;7% for angina.3 8 The incidence of NCCP depends on the clinical setting. It is 70&ndash;80% for patients presenting to a general practitioner or a rapid access chest pain clinic9&ndash;11 and around 50% attending emergency department...


Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes: The Diabetes and Aging Study
Discussion: Among these insured older adults, ethnic health patterns varied substantially; differences were frequently small and rates were often better among select minority groups, suggesting progress toward the Healthy People 2020 objective to reduce health disparities. (Source: Journal of Aging and Health)


Disaccharidase Deficiencies in Children With Chronic Abdominal Pain.
CONCLUSIONS: A large proportion of patients with CAP have deficiencies in disaccharidases. Bowel frequency, vomiting, or location of pain was no different between groups, suggesting that these clinical features cannot be used to predict disaccharidase deficiencies. PMID: 26160252 [PubMed - as supplied by publisher] (Source: JPEN Journal Of Parenteral And Enteral Nutrition)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Paracetamol: is all the concern valid?
Given the widespread use and availability of paracetamol, we appreciate the ongoing need to evaluate its safety. However the review by Roberts et al1 appears to be one in a string of recent articles drawing dubious or misleading conclusions regarding the safety of paracetamol.2 3 We question these conclusions about the safety of taking properly dosed paracetamol. The alternatives for chronic pain, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, carry risks of significant morbidity and mortality.4 5 In the systematic review, the authors only included cohort studies. While cohorts can be valuable when studying the risk of long-term adverse events from an exposure, they can also introduce significant bias due to multiple other uncontrolled variables. While the included stud...


Response to: 'Paracetamol: is all the concern valid?' by Schwarz and Mullins
We thank Drs Schwarz and Mullins for their comments1 on our paper,2 and we agree with many of their points. The absolute risks of the studied adverse events were small, and paracetamol still has a better adverse event profile than traditional non-steroidal anti-inflammatory drugs (NSAIDs) or opioids. However, we would like to highlight that there are also non-pharmacological alternatives for chronic pain conditions, especially those of the musculoskeletal system: muscle strengthening, increased activity and weight loss if overweight.3 We appreciate that biases (including non-complete adjustment for confounders, narrow population of the included studies and the reliance on self-report and paracetamol prescription as methods to calculate the total ingested amount of paracetamol) make the obs...


Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis
The aim of this work was to develop a consensual recommendation under the auspices of the Assessment of SpondyloArthritis international Society (ASAS) for early referral of patients with a suspicion of axial spondyloarthritis by non-rheumatologists. The development of a referral recommendation consisted of four phases: (1) systematic literature review, (2) the first Delphi round aiming at identification of unmet needs and development of a candidate list of referral parameters, (3) the second Delphi round aiming at identification of the most useful combination of referral parameters and (4) final discussion and formal endorsement by ASAS membership. The following consensus on a referral recommendation was achieved as a result of the Delphi processes and final voting: "Patients with chronic ...


From Modic 1 vertebral-endplate subchondral bone signal changes detected by MRI to the concept of 'active discopathy'
Late-1980s MRI-detected vertebral-endplate subchondral bone signal changes associated with degenerative disc disease as well as recent studies suggest that in some patients, non-specific chronic low back pain (NS cLBP) can be defined by specific clinical, radiological and biological features, for a concept of active discopathy. This concept allows for associating a particular NS cLBP phenotype to a specific anatomical lesion, namely those with Modic 1 signal changes seen on MRI. Local inflammation is thought to play a pivotal role in these changes. Other etiopathogenic processes may include local infection and mechanical or biochemical stress combined with predisposing genetic factors; treatment strategies remain debated. Modic 1 changes detected by MRI can be considered a first biomarker ...


Gait Retraining for Injured and Healthy Runners Using Augmented Feedback: A Systematic Literature Review.
Conclusion In conjunction with traditional therapeutic interventions, real-time auditory and visual feedback should be considered in treating injured runners or addressing potentially injurious running mechanics in a healthy population. J Orthop Sports Phys Ther, Epub 9 Jul 2015. doi:10.2519/jospt.2015.5823. PMID: 26158882 [PubMed - as supplied by publisher] (Source: Physical Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain.
Conclusions This preliminary study of concurrent and discriminant validity of the test provides a foundation to further investigate its utility to characterise thoracolumbar movement patterns in individuals with LBP. J Orthop Sports Phys Ther, Epub 9 Jul 2015. doi:10.2519/jospt.2015.5590. PMID: 26158881 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Chronic Cough.
Authors: Pacheco A, de Diego A, Domingo C, Lamas A, Gutierrez R, Naberan K, Garrigues V, Lopez-Vilme R Abstract Chronic cough (CC), or cough lasting more than 8 weeks, has attracted increased attention in recent years following advances that have changed opinions on the prevailing diagnostic and therapeutic triad in place since the 1970s. Suboptimal treatment results in two thirds of all cases, together with a new notion of CC as a peripheral and central hypersensitivity syndrome similar to chronic pain, have changed the approach to this common complaint in routine clinical practice. The peripheral receptors involved in CC are still a part of the diagnostic triad. However, both convergence of stimuli and central nervous system hypersensitivity are key factors in treatment success. ...


JAMA Meta-analysis Finds Mixed Results for Medical Marijuana Use
A meta-analysis published in JAMA: the Journal of the American Medical Association found there was moderate-quality evidence to support the use of cannabinoids for treating chronic pain but only low-quality evidence for a number of other indications. (Source: AAFP News)


Internet-based tools help ease chronic pain
Stephen FellerPULLMAN, Wash., July 8 (UPI) -- With the help of an Internet-based program, people with chronic pain were able to manage their symptoms and reduce their reliance on opioid drugs. (Source: Health News - UPI.com)


Online tools may help patients manage chronic pain
Patients can manage chronic pain and reduce their reliance on opioids through an internet-based programme that teaches non-medical alternatives, according to US nurse researchers. (Source: Nursing Times Breaking News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Health status and health-related quality of life of municipal waste collection workers – a cross-sectional survey
Background: Waste collection workers are exposed to several occupational stressors which may affect their quality of life. Our aim was to assess the health status and health-related quality of life (HRQoL) of municipal waste collection workers of a big German city. Methods: Cross-sectional study with a non-random sample of 65 (62 male, 3 female) workers of the Hamburg sanitation department, volunteering to participate in the study. We assessed the prevalence of reported health complaints and health problems. HRQoL was assessed with the self-administered EQ-5D-5L questionnaire and its visual analogue scale (VAS). Results: The most common health problems were musculoskeletal complaints (back pain reported by 67.2 %, other musculoskeletal complaints 15.4 %). Asthma or chronic obstructive pu...


Health status and health-related quality of life of municipal waste collection workers &#8211; a cross-sectional survey
Background: Waste collection workers are exposed to several occupational stressors which may affect their quality of life. Our aim was to assess the health status and health-related quality of life (HRQoL) of municipal waste collection workers of a big German city. Methods: Cross-sectional study with a non-random sample of 65 (62 male, 3 female) workers of the Hamburg sanitation department, volunteering to participate in the study. We assessed the prevalence of reported health complaints and health problems. HRQoL was assessed with the self-administered EQ-5D-5L questionnaire and its visual analogue scale (VAS). Results: The most common health problems were musculoskeletal complaints (back pain reported by 67.2 %, other musculoskeletal complaints 15.4 %). Asthma or chronic obstructive pu...


Recall Bias in Patients with Chronic Low Back Pain: Individual Pain Response Patterns Are More Important Than Pain Itself!
Conclusion Recall biases in CLBP patients are not only a result of experiencing pain but also effected by patients’ pain response pattern with respect to fear-avoidance versus endurance. (Source: International Journal of Behavioral Medicine)


Association between chronic pain and the sperm motion characteristics
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): F. Dardmeh , H. Alipour , H.I. Nielsen , S. Rasmussen , J.T. Yousefi , N.E. Ditlevsen , H.A.A.K.T. Yassin , E. Morina , R.K. Duus , P. Gazerani (Source: Scandinavian Journal of Pain)


Spontaneous burrowing behavior as an outcome measure of the global impact of chronic pain in preclinical models of arthritis
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): A. Delaney , J. Su , T. Gao , N. Agalave , C.I. Svensson (Source: Scandinavian Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic nonmalignant pain at a mono-disciplinary pain clinic. Identifying the key patient groups for targeted health promotion – A cohort study
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): C. Hansen (Source: Scandinavian Journal of Pain)


Characterization of complex chronic pain patients
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): E.-B. Hysing , T. Gordh , R. Karlsten , L. Smith (Source: Scandinavian Journal of Pain)


Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): T. Jonsdottir , S. Gunnarsdottir , H. Jonsdottir (Source: Scandinavian Journal of Pain)


Gender differences in chronic pain related health care utilization
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): T. Jonsdottir , H. Jonsdottir , S. Gunnarsdottir (Source: Scandinavian Journal of Pain)


Re: Effectiveness of Acupuncture on Chronic Prostatitis-Chronic Pelvic Pain Syndrome Category IIIB Patients: A Prospective, Randomized, Nonblinded, Clinical Trial
E. V. Küçük, F. Y. Suçeken, A. Bindayı, U. Boylu, F. F. Onol and E. Gümüş (Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Amoebic liver abscess: a report from central India.
We describe our experience of clinical presentation, laboratory parameters, radiological findings and treatment strategies. This is a retrospective analysis of 114 patients who were admitted from January 2012 to September 2014 at our centre. The mean age of presentation was 41.7 ± 13.9 years, the majority of patients were male (86.8%) with chronic alcoholism (63.2%). Most of the patients had a solitary right lobe liver abscess. Abdominal pain, fever, tachycardia and hepatomegaly were the most common clinical findings while hypoalbuminaemia, anaemia, leucocytosis and electrolyte imbalance were the most common laboratory abnormalities. A significant number of patients could be managed with antibiotics only (45.6%), percutaneous radiological drainage techniques being an important adjunct...


Pressure Ulcers: Evidence-Based Prevention and Management
Abstract There is limited good-quality research focused on the prevention and management of pressure ulcers. Current available evidence reveals that the following approaches may help to prevent pressure ulcers: the use of support surfaces such as specialized foam and specialized sheepskin overlays, mattress overlays on operating tables, consultation with a dietician to ensure adequate general nutrition, but it is not known whether any specific supplementation is useful, and moisturizing dry sacral skin. For management of existing pressure ulcers, it is unknown whether any specific support surface or dressing is preferable to any others; whether routine nutritional supplementation is beneficial, or if adjunctive therapies improve healing compared with standard care. Current evidenc...


Key mechanism that causes neuropathic pain found
A biological process called endoplasmic reticulum stress appears to play a key role in causing neuropathic pain, according to a new study. The discovery could eventually lead to new therapeutics for controlling chronic pain associated with trauma, diabetes, shingles, multiple sclerosis or other conditions that cause nerve damage. (Source: ScienceDaily Headlines)


Transcranial direct current stimulation (tDCS) reverts behavioral alterations and brainstem BDNF levels increase induced by neuropathic pain model: Long-lasting effect
Conclusion tDCS reverts behavioral alterations associated to neuropathic pain, indicating possible analgesic and anxiolytic tDCS effects. tDCS treatment induces changes in the BDNF levels in different regions of the central nervous system (CNS), and this effect can be attributed to different cellular signaling activations. (Source: Progress in Neuro Psychopharmacology and Biological Psychiatry)


Perspectives on Canadian core fellowship training in pediatric anesthesia: a survey of graduate fellows
Conclusions This survey reports perceived deficiencies in domains of pediatric anesthesia fellowship training. These findings should help guide the future development of core and advanced fellowship training programs in pediatric anesthesia. (Source: Canadian Journal of Anesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Comorbidities in patients with all‐positive symptoms on sinonasal outcomes test quality‐of‐life instrument
ConclusionThe SNOT‐20 questionnaire assists clinicians to monitor outcomes in patients treated for CRS. However, clinicians should suspect other underlying chronic conditions in SNOT‐20 pan‐positive patients. Level of Evidence3B. Laryngoscope, 2015 (Source: The Laryngoscope)


Early Single Aspirin-Triggered Lipoxin Blocked Morphine Anti-nociception Tolerance through Inhibiting NALP1 Inflammasome: Involvement of PI3k/Akt Signaling Pathway
Publication date: Available online 7 July 2015 Source:Brain, Behavior, and Immunity Author(s): Yu Tian , Ming Liu , Qi-Liang Mao-Ying , Huan Liu , Zhi-Fu Wang , Meng-Ting Zhang , Jun Wang , Qian Li , Shen-Bin Liu , Wen-Li Mi , Hong-Jian Ma , Gen-Cheng Wu , Yan-Qing Wang Clinical usage of opioids in pain relief is dampened by analgesic tolerance after chronic exposure, which is related to opioid-associated neuroinflammation. In the current study, which is based on a chronic morphine tolerance rat model and sustained morphine treatment on primary neuron culture, it was observed that Akt phosphorylation, cleaved-Caspase-1-dependent NALP1 inflammasome activation and IL-1 beta maturation in spinal cord neurons were significantly enhanced by morphine. Moreover, treatment with LY294002, a speci...


Management of Pain and Quality of Life in Patients with Chronic Kidney Disease Undergoing Hemodialysis
An important dimension that influences the quality of life of hemodialysis patients is the pain they experience. Quality of life and self-efficacy in pain can play an important role in chronic kidney disease and treatment outcomes. The purpose of the study was to examine self-efficacy in pain and quality of life among patients with end stage renal disease undergoing hemodialysis. Between April 2013 and June 2013, 224 hemodialysis patients completed the Missoula-VITAS Quality of Life Index-15 and the Pain Self-Efficacy Questionnaire. (Source: Pain Management Nursing)


Development and Validation of a Pain Behavior Assessment in Patients with Chronic Low Back Pain
Conclusions The PBA is a valid assessment tool to describe pain behavior in CNSLBP patients. The high PSI-value justifies the use of the PBA in individuals. The PBA may help to screen patients for high levels of pain behavior. (Source: Journal of Occupational Rehabilitation)


Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects
Abstract Rheumatoid arthritis (RA), a chronic progressive inflammatory autoimmune disorder characterized by chronic pain and swelling primarily, affects the peripheral joints. RA had attained global concern in the last few decades, affecting more than 1.5 % of the world’s population with higher female percentage than male. In the advanced stage, the disease is associated with the destruction of cartilage and bone along with a variety of systemic manifestations leading to functional disability. Inadequate early/preliminary diagnosis and non-specific therapeutics are the major challenges in the management of RA. Till date, the exact cause(s) of the disease remain(s) obscure, and several genetic, hormonal, and environmental factors are associated with the beginning and the pro...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain in Older Adults
Publication date: Available online 7 July 2015 Source:Anesthesiology Clinics Author(s): Mark C. Bicket , Jianren MaoTeaser This review summarizes existing evidence relevant to the epidemiology of chronic pain in older adults, age-related differences relevant to pain, pain assessment, and important considerations regarding pain management in later life. Features unique to pain assessment in older adults include the likelihood of multiple diagnoses contributing to chronic pain, the ability of older adults to self-report, including those with mild to moderate cognitive impairment, and recognition that some older adults with cognitive impairment may demonstrate various behaviors to communicate pain. Management is best accomplished through a multimodal approach, including pharmacologic and no...


Perspectives on Canadian core fellowship training in pediatric anesthesia: a survey of graduate fellows.
CONCLUSIONS: This survey reports perceived deficiencies in domains of pediatric anesthesia fellowship training. These findings should help guide the future development of core and advanced fellowship training programs in pediatric anesthesia. PMID: 26149597 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)


Antinociceptive properties of selective MT2 melatonin receptor partial agonists.
Authors: López-Canul M, Comai S, Domínguez-López S, Granados-Soto V, Gobbi G Abstract Melatonin is a neurohormone involved in the regulation of both acute and chronic pain whose mechanism is still not completely understood. We have recently demonstrated that selective MT2 melatonin receptor partial agonists have antiallodynic properties in animal models of chronic neuropathic pain by modulating ON/OFF cells of the descending antinociceptive system. Here, we examined the antinociceptive properties of the selective MT2 melatonin receptor partial agonists N-{2-[(3-methoxyphenyl)phenylamino]ethyl}acetamide (UCM765) and N-{2-[(3-bromophenyl)-(4-fluorophenyl)amino]ethyl}acetamide (UCM924) in two animal models of acute and inflammatory pain: the hot-plate and formalin tests. UCM765 and...


Early Single Aspirin-Triggered Lipoxin Blocked Morphine Anti-nociception Tolerance through Inhibiting NALP1 Inflammasome: Involvement of PI3k/Akt Signaling Pathway.
Authors: Tian Y, Liu M, Mao-Ying QL, Liu H, Wang ZF, Zhang MT, Wang J, Li Q, Liu SB, Mi WL, Ma HJ, Wu GC, Wang YQ Abstract Clinical usage of opioids in pain relief is dampened by analgesic tolerance after chronic exposure, which is related to opioid-associated neuroinflammation. In the current study, which is based on a chronic morphine tolerance rat model and sustained morphine treatment on primary neuron culture, it was observed that Akt phosphorylation, cleaved-Caspase-1-dependent NALP1 inflammasome activation and IL-1 beta maturation in spinal cord neurons were significantly enhanced by morphine. Moreover, treatment with LY294002, a specific inhibitor of PI3k/Akt signaling, significantly reduced Caspase-1 cleavage, NALP1 inflammasome activation and attenuated morphine tolerance...


Sleep problems and working memory in chronic pain
Elvemo NA, Landrø NI, Borchgrevink PC, Håberg AK (Source: Journal of Pain Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Sneak Peek At Stem Cell Breakthrough
Today I want to tell you about an advance in anti-aging that will affect us all. It&#8217;s a powerful way to heal your body and rejuvenate damaged tissue. I&#8217;m talking about stem cells. Stem cells are perhaps the ultimate natural healer. In fact, they are so important to the future of anti-aging medicine, I&#8217;ve given them one of the biggest platforms at my upcoming anti-aging conference on October 8 and 9. That means the next generation of anti-aging therapy is taking shape right now in South Florida. In the next couple of months, work will be finished on my new Palm Beach Institute for Anti-Aging Medicine&#8230; just in time to coincide with the anti-aging event of the year. My anti-aging conference will be held at Mar-a-Lago, the majestic 126-room estate of billionaire propert...


Health Tip: Risk Factors for Back Pain
Title: Health Tip: Risk Factors for Back PainCategory: Health NewsCreated: 7/6/2015 12:00:00 AMLast Editorial Review: 7/6/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Muscles and their role in episodic tension‐type headache: implications for treatment
ConclusionMuscular factors play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice. (Source: European Journal of Pain)


Herbs for Low Back Pain, Acupuncture for Psychological Distress, Osteopathic Manipulative Therapy for Chronic Migraine, Honey Dressings for Burns, Vegetarian Diet and Risk of Colorectal Cancer
DynaMed is an evidence-based clinical reference, which is updated daily through systematic surveillance and critical appraisal of the research literature. DynaMed editors and reviewers select content of interest for integrative medicine, summarize the current evidence, and describe challenges in evidence analysis and application. Evidence quality is rated level 1 (likely reliable) evidence for studies with clinical outcomes and minimal risk of bias, level 2 (mid-level) evidence for studies with clinical outcomes and significant methodological or statistical limitations, and level 3 (lacking direct) evidence for reports that do not include scientific analysis of clinical outcomes. (Source: Explore)


Milnacipran for neuropathic pain in adults.
CONCLUSIONS: There was no evidence to support the use of milnacipran to treat neuropathic pain conditions. PMID: 26148202 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Amitriptyline for neuropathic pain in adults.
CONCLUSIONS: Amitriptyline has been a first-line treatment for neuropathic pain for many years. The fact that there is no supportive unbiased evidence for a beneficial effect is disappointing, but has to be balanced against decades of successful treatment in many people with neuropathic pain. There is no good evidence of a lack of effect; rather our concern should be of overestimation of treatment effect. Amitriptyline should continue to be used as part of the treatment of neuropathic pain, but only a minority of people will achieve satisfactory pain relief. Limited information suggests that failure with one antidepressant does not mean failure with all. PMID: 26146793 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Morphine Regulated Synaptic Networks Revealed by Integrated Proteomics and Network Analysis.
In this study we used subcellular fractionation and quantitative proteomics combined with computational approaches to investigate the morphine-induced protein profile changes at the striatal postsynaptic density. Over 2,600 proteins were identified by mass spectrometry analysis of subcellular fractions enriched in postsynaptic density associated proteins from saline or morphine-treated striata. Among these, the levels of 38 proteins were differentially altered in response to morphine. These include proteins involved in G-protein coupled receptor signaling, regulation of transcription and translation, chaperones, and protein degradation pathways. The altered expression levels of several of these proteins was validated by Western blotting analysis. Using Genes2Fans software suite we connecte...


Potential application of miRNAs as diagnostic and therapeutic tools in chronic pancreatitis.
Authors: Hu LH, Ji JT, Li ZS Abstract Chronic pancreatitis (CP) is a progressive inflammatory disease typified by end-stage fibrosis. This disease can also increase the risk of pancreatic cancer. The associated diagnosis, pain and other complications further add to the burden of disease management. In recent years, significant progress has been achieved in identifying miRNAs and their physiological functions, including mRNA repression and protein expression control. Given the extensive effort made on miRNA research, a close correlation has been discovered between certain types of miRNAs and disease progression, particularly for tissue fibrosis. Designing miRNA-related tools for disease diagnosis and therapeutic treatments presents a novel and potential research frontier. In the cur...


Current concepts in vulvodynia with a focus on pathogenesis and pain mechanisms.
Authors: Thornton AM, Drummond C Abstract Vulvodynia is a common and debilitating chronic pain syndrome characterised by neuropathic-type pain. Localised provoked vulvodynia is the most common type, followed by generalised unprovoked vulvodynia. Vulvodynia is a diagnosis of exclusion. The cause is unknown but current research suggests an underlying predisposition to increased sensitivity to pain and peripheral and central neural sensitisation. Musculoskeletal factors also play an important role. Vulvodynia has a significant impact on the quality of life, mood, functional ability and relationships of patients and their partners. It is highly associated with anxiety and depression. Treatment needs to follow a biopsychosocial model and be tailored to the patient. A multimodal and mult...


V31. Learned control over spinal nociception in chronic back pain patients
The descending pain inhibition is a top-down system exerting powerful endogenous pain inhibition. It originates in the brainstem and sends serotonergic and noradrenergic pathways to the spinal dorsal horn, where they inhibit spinal nociceptive transmission and therefore reduce nociceptive input to the brain. The brainstem centers at the origin of descending inhibition are targeted by cortical regions like the prefrontal cortex and the anterior cingulate cortex, and are susceptible to cognitive-emotional modulation (Bingel and Tracey, 2008). (Source: Clinical Neurophysiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


P27. Altered regional and interregional interrelations of glutamate and GABA in patients with chronic low back pain – A H-MR spectroscopic study
Chronic pain is in many cases associated with a poor quality of life and high health care costs. Due to the multimodal disease origin, therapeutic methods are often rather unspecific. By applying modern functional imaging methods, neuronal dysfunction has been recently identified in patients and has been hypothesized to reflect the disease related central sensitization of neuronal pain processing (Farmer, 2012). However, the underlying neurochemical processes, especially changes in neurotransmitter turnover, remain widely unexplored although their understanding might be essential to improve current therapeutic approaches (Borsook, 2007). (Source: Clinical Neurophysiology)


P160. Transcranial magnetic stimulation in chronic neuropathic pain – A prospective study of 45 patients
Chronic neuropathic disorders remain difficult to treat. Analgesic medication often achieve only an insufficient effect, therefore other non-pharmacological treatment has to be considered. One option for management of intractable pain is stimulation of the motor cortex by implantation of an epidural electrode. This effect of invasive stimulation could be replaced by transcranial magnetic stimulation. (Source: Clinical Neurophysiology)


P193. Small fiber neuropathy after lightning injuries
Survivors of lightning injuries suffer from several acute or delayed neurological symptoms. As a delayed complication chronic pain syndrome and signs of polyneuropathy are common. (Source: Clinical Neurophysiology)


Osteoporosis in Children with Chronic Disease.
Authors: Högler W, Ward L Abstract Serious illness in children and its therapy can cause osteoporosis, manifesting as vertebral and nonvertebral fractures, pain, skeletal deformity and temporary or even permanent loss of ambulation. In contrast to adults, skeletal growth in children offers tremendous potential to recover bone mineral density and to reshape fractured vertebral bodies, even without bone-targeted therapy, provided that bone health threats are transient and residual growth is sufficient. Here, we outline the principles of bone strength development and the risk factors for osteoporosis due to various paediatric systemic illnesses. We also explain why the approach to the diagnosis and monitoring of childhood osteoporosis has moved away from a bone density-centric focus ...


Two-port totally extraperitoneal inguinal hernia repair: a 10-year experience
Conclusion Two-port TEP appears to be a feasible, safe, and effective method for laparoscopic inguinal hernia repair and should be considered a viable, less invasive alternative to conventional three-port techniques. (Source: Hernia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effects of daily mood and couple interactions on the sleep quality of older adults with chronic pain
We examined the effect of daily negative and positive mood on the sleep quality of knee osteoarthritis (OA) patients (N = 152) and whether a partner’s daily responses to a patient’s pain behaviors moderated these associations. Patients and their partners completed a baseline interview and 22 daily diary assessments. After controlling for demographic characteristics, OA severity, comorbidities, medication use, relationship satisfaction, and depressed mood, multilevel modeling analyses demonstrated main effects of negative and positive mood on sleep quality indicators. Mood and partner responses interacted such that high solicitous and punishing responses strengthened the association between negative mood and worse sleep. Further, high solicitous responses increased the degree of assoc...


TRPC3: A New Target for Therapeutic Strategies in Chronic Pain-DAG-mediated Activation of Non-selective Cation Currents and Chronic Pain (Mol Pain 2014;10:43).
Authors: Xia M, Liu D, Yao C PMID: 26130641 [PubMed] (Source: Journal of Neurogastroenterology and Motility)


Intestinal Pseudoobstruction Caused by Chronic Lyme Neuroborreliosis. A Case Report.
Authors: Schefte DF, Nordentoft T Abstract Chronic intestinal pseudoobstruction is often classified as idiopathic. The condition is associated with poor quality of life and high morbidity, and treatment options are often unsatisfactory. A case of chronic intestinal pseudoobstruction in a 66-year-old woman, presenting with back and abdominal pain, urinary retention and severe constipation is described. The patient lived in an area in which Lyme disease is endemic and had been bitten by ixodes ticks. Intrathecal synthesis of anti-borrelia IgM and IgG and lymphocytosis in the cerebrospinal fluid was found, consistent with chronic Lyme neuroborreliosis since symptoms had lasted for more than six months. The patient's gastrointestinal function recovered and the pain subsided significant...


Targeting Opioid-Induced Hyperalgesia in Clinical Treatment: Neurobiological Considerations
Abstract Opioid analgesics have become a cornerstone in the treatment of moderate to severe pain, resulting in a steady rise of opioid prescriptions. Subsequently, there has been a striking increase in the number of opioid-dependent individuals, opioid-related overdoses, and fatalities. Clinical use of opioids is further complicated by an increasingly deleterious profile of side effects beyond addiction, including tolerance and opioid-induced hyperalgesia (OIH), where OIH is defined as an increased sensitivity to already painful stimuli. This paradoxical state of increased nociception results from acute and long-term exposure to opioids, and appears to develop in a substantial subset of patients using opioids. Recently, there has been considerable interest in developing an efficac...


Sedation methods for intra-articular corticosteroid injections in Juvenile Idiopathic Arthritis: a review
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. Intra-articular corticosteroid injection (IASI), one of the cornerstones of treatment for this disease, is usually associated with anxiety and pain. IASI in JIA may be performed under general anesthesia, conscious sedation, or local anesthesia alone. Currently, there is no widely accepted standard of care regarding the sedation method for IASI. This review discusses the different methods of anesthesia and sedation in this procedure, emphasizing the advantages and shortcomings of each method. (Source: Pediatric Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Application of photoluminescent bioceramic material for different chronic illnesses by selecting “trigger points” and “propagated sensation along meridians” phenomenon
Conclusions To explain our clinical observations, we simply deduced that PLB treatment induced or promoted fluid/water diffusion along meridian channels. There was a gradually dredging of the meridian channels thus relieving stagnation and a vital change in the flow of dynamic patterns of meridians. This conforms to, or validates, the old traditional Chinese theory of “Bu Tong Ze Tong” and “Tong Ze Bu Tong”, that is, where there is obstruction, there is pain; where there is no obstruction, there is no pain. (Source: Chinese Journal of Integrative Medicine)


High-Definition and Non-invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD
Conclusion Putative M1 stimulation by HD-tDCS selectively improved meaningful clinical sensory-discriminative pain and motor measures during stimulation, and up to four-weeks post-treatment in chronic myofascial TMD pain patients. (Source: Brain Stimulation)


Myofascial Pain Syndromes in the Emergency Department: What Are We Missing?
Myofascial pain syndrome (MPS), pain originating in the myofascial tissue, is a widely recognized pathology characterized by the presence of referred pain (often distant from its origin and specific to each muscle) that can resemble other pathologies and by the presence of a trigger point, a localized hyperirritable band able to reproduce the pain and its associated symptoms. Patients with acute or chronic MPS are commonly seen in the emergency department (ED), usually complaining of pain of undetermined origin. (Source: The Journal of Emergency Medicine)


Emerging targets in treating pain
Purpose of review: To provide an overview on drug targets and emerging pharmacological treatment options for chronic pain. Recent findings: Chronic pain poses an enormous socioeconomic burden for the more than 30% of people who suffer from it, costing over $600 billion per year in the USA. In recent years, there has been a surge in preclinical and clinical research endeavors to try to stem this epidemic. Preclinical studies have identified a wide array of potential targets, with some of the most promising translational research being performed on novel opioid receptors, cannabinoid receptors, selective ion channel blockers, cytokine inhibitors, nerve growth factor inhibitors, N-methyl-D-aspartate receptor antagonists, glial cell inhibitors, and bisphosphonates. Summary: There are many obst...


Analgesic management of acute pain in the opioid-tolerant patient
Purpose of review: The management of acute pain in the opioid-tolerant patient is an area in perioperative medicine that is growing, as the use of opioids for chronic noncancer pain has been tolerated in the USA. Adding to this population is an increase in opioid abusers, addicts and those in recovery and maintenance programmes. These patients will continue to present for surgery and with acute pain that anaesthesiologists and other members of the healthcare team must become more adept at managing. Recent findings: This review covers some of the strategies that may be used by practitioners in the management of acute pain in the opioid-tolerant patient. It is important to collect a detailed history of opioid and drugs of abuse, including the timing of the last dose in order to avoid precipi...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Stretchy mesh heater for sore muscles
If you suffer from chronic muscle pain a doctor will likely recommend for you to apply heat to the injury.  But how do you effectively wrap that heat around a joint? Now scientists have come up with an ingenious way of creating therapeutic heat in a light, flexible design.  (Source: ScienceDaily Headlines)


Spontaneous cervical haemorrhage of a parathyroid adenoma.
This report describes a previously fit and well 54-year-old woman who presented with acute neck swelling and pain with an overlying ecchymosis. Admission laboratory tests revealed a raised parathyroid hormone and hypercalcaemia. A computed tomography (CT) scan showed widespread anterior cervical haemorrhage and a lesion at the inferior pole of the left thyroid gland. A working diagnosis of spontaneous haemorrhage from a parathyroid adenoma was made. As she was haemodynamically stable, she was treated conservatively with a period of observation in hospital to monitor for signs of neck organ compression. Follow-up imaging with CT, ultrasound and sestamibi confirmed the likely source of haemorrhage as a parathyroid nodule with significant vascularity. The diagnosis was confirmed on histopatho...


The novel PAR2 ligand C391 blocks multiple PAR2 signaling pathways in vitro and in vivo
CONCLUSION AND IMPLICATIONSThis is the first small molecule antagonist demonstrated to block both PAR2 Ca2+ and MAPK signaling pathways activated by peptidomimetics and/or proteinase activation. C391 represents a new molecular structure for PAR2 antagonism that can serve as a basis for further development for this important therapeutic target. (Source: British Journal of Pharmacology)


Treatment of Chronic Facial Pain Including Cluster Headache by Repetitive Transcranial Magnetic Stimulation of the Motor Cortex With Maintenance Sessions: A Naturalistic Study
Conclusion This long-term maintenance rTMS protocol can be a therapeutic option in the clinical management of patients with chronic refractory facial pain, including cluster headache. However, only part of the patients respond to this technique and session duration should not be reduced. (Source: Brain Stimulation)


High-Definition and Non-Invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD
Conclusion Putative M1 stimulation by HD-tDCS selectively improved meaningful clinical sensory-discriminative pain and motor measures during stimulation, and up to four weeks post-treatment in chronic myofascial TMD pain patients. (Source: Brain Stimulation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prevalence of the different lumbar back pain etiologies in Spain: results from a large observational study in 306 centers (the SMILE study)
Conclusions Despite of specialist, the study indicate a low rate of characterization system utilization and an overuse of complementary imaging in common practice but improvement in pain, patients’ functionality, and HQoL. (Source: European Orthopaedics and Traumatology)


Treatment of Patellar Tendinopathy Refractory to Surgical Management Using Percutaneous Ultrasonic Tenotomy and Platelet-Rich Plasma Injection: A Case Presentation
We present a case of a collegiate athlete with chronic proximal patellar tendinopathy who was effectively treated with percutaneous ultrasonic tenotomy after failing to improve with extensive non-operative treatment, surgical debridement, and platelet rich plasma injections. Percutaneous ultrasonic tenotomy can be considered as a treatment option in patients presenting with refractory proximal patellar tendinopathy, including those failing prior operative intervention. (Source: PMandR)


Health related quality of life in adolescents with chronic fatigue syndrome: a cross-sectional study
Conclusion: The difference in HRQOL between CFS patients and healthy adolescents was even larger than we expected. The large sample of adolescents with CFS in our study confirms previous findings from smaller studies, and emphasizes that CFS is a seriously disabling condition that has a strong impact on their HRQOL. Even though depressive symptoms were found in the group of patients, they could not statistically explain the poor HRQOL. (Source: Health and Quality of Life Outcomes)


Myelopathy-mimicking symptoms of epidural venous engorgement and syringomyelia due to inferior vena cava stenosis at the thoracolumbar junction in a patient with Budd-Chiari syndrome.
Authors: Lee JH, Song WJ, Kang KC Abstract Epidural venous engorgement can result from various lesions, such as arteriovenous malformation, thrombosis or occlusion of the inferior vena cava (IVC), or an abdominal masslike lesion. Most patients with these problems complain of low-back pain, radicular pain, or neurogenic claudication, which are symptoms suggestive of disc herniation or spinal stenosis. However, these patients rarely exhibit neurological deficits or cauda equina syndrome. The authors encountered a case of a 60-year-old man presenting with lower-extremity weakness and voiding difficulty for a period of 1 year. To investigate the patient's myelopathy-mimicking symptoms, a lumbar spine MRI scan was performed. The MR images exhibited tortuous and dilated spinal vessels co...


[Drug interactions in pain therapy].
CONCLUSION: Many drug interactions can be avoided by careful and continuous evaluation of pharmacotherapy and if necessary its adaptation; however, a sound knowledge of the underlying pharmacological mechanisms and the properties of currently used analgesics is necessary. PMID: 26137862 [PubMed - as supplied by publisher] (Source: Schmerz)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Optimizing Bone Health in Duchenne Muscular Dystrophy.
Authors: Buckner JL, Bowden SA, Mahan JD Abstract Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of...


Efficacy and safety profile of prolonged release oxycodone in combination with naloxone (OXN PR) in Parkinson’s disease patients with chronic pain
Abstract Pain is a relevant and often underestimated non-motor symptom affecting the quality of life of patients with Parkinson’s disease (PD). Although some pain symptoms can be effectively treated by dopaminergic medication, a correct diagnosis of the different types and distribution of pain in PD is challenging, and accordingly, its treatment remains troublesome. We evaluated the efficacy and the safety of a prolonged release oral formulation of oxycodone hydrochloride combined with naloxone hydrochloride dehydrate, in a fixed ratio of 2:1 (OXN PR). A total of 16 PD patients with history of pain with a minimum intensity of four on numerical rating scale (NRS) received low-dose OXN PR (5/2.5 mg twice daily) and were observed for a period of 8 weeks. The primary efficacy meas...


Effectiveness of extracorporeal shockwave therapy in three major tendon diseases
Conclusions Extracorporeal shockwave therapy may be considered a safe, economic, and effective treatment for several chronic musculoskeletal disorders, allowing satisfactory pain relief and improvement of function ability. Level of evidence Level IV. (Source: Journal of Orthopaedics and Traumatology)


Treatment of Patellar Tendinopathy Refractory to Surgical Management Using Percutaneous Ultrasonic Tenotomy and Platelet-Rich Plasma Injection: A Case Presentation
We present a case of a collegiate athlete with chronic proximal patellar tendinopathy who was effectively treated with percutaneous ultrasonic tenotomy after failing to improve with extensive non-operative treatment, surgical debridement, and platelet rich plasma injections. (Source: PM and R)


Transfer of Opiorphin Through a Blood-Brain Barrier Culture Model
Opioid peptides are potent analgesics with therapeutic potential in the treatment of acute and chronic pain. Their efficacy is limited by peptidases (enkephalinases). Opiorphin pentapeptide (QRFSR) is the first characterized human endogenous inhibitor of enkephalinases. The peptide is able to increase the binding and affinity of endogenous opiates to mu opioid receptors; thus, the mechanism of opiorphin may provide a new therapeutic approach in pain management. The analgesic effect of opiorphin was proven in several earlier published in vitro and in vivo studies. (Source: Archives of Medical Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Randomized, Double‐blind, Placebo‐controlled, 16‐Week Study of Subcutaneous Golimumab in Patients With Active Non‐radiographic Axial Spondyloarthritis
Conclusion Patients with active nr‐axSpA treated with GLM had significantly greater improvements in symptoms than patients treated with PBO. GLM was well‐tolerated and had a favorable benefit‐risk profile. This article is protected by copyright. All rights reserved. (Source: Arthritis and Rheumatism)


Does adding cognitive-behavioural physiotherapy to exercise improve outcome in patients with chronic neck pain? A randomised controlled trial
To determine whether adding a physiotherapist-led cognitive-behavioural intervention to an exercise programme improved outcome in patients with chronic neck pain (CNP). (Source: Physiotherapy)


Pilates for low back pain.
CONCLUSIONS: We did not find any high quality evidence for any of the treatment comparisons, outcomes or follow-up periods investigated. However, there is low to moderate quality evidence that Pilates is more effective than minimal intervention for pain and disability. When Pilates was compared with other exercises we found a small effect for function at intermediate-term follow-up. Thus, while there is some evidence for the effectiveness of Pilates for low back pain, there is no conclusive evidence that it is superior to other forms of exercises. The decision to use Pilates for low back pain may be based on the patient's or care provider's preferences, and costs. PMID: 26133923 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Antinociceptive effects of hydroalcoholic extract from Euterpe oleracea Mart. (A&#231;a&#237;) in a rodent model of acute and neuropathic pain
Conclusion: ASE showed significant antinociceptive effect via a multifactorial mechanism of action, indicating that the extract may be useful in the development of new analgesic drugs. (Source: BMC Complementary and Alternative Medicine)


Professional knowledge among Swedish and Saudi healthcare practitioners regarding oro‐facial pain in children and adolescents
This study shows that professional knowledge regarding OFP/TMD in children and adolescents is limited among Swedish and Saudi Arabian dental and medical professionals compared to Swedish OFP/TMD specialists. In Swedish groups, the professional knowledge is more accurate than in the corresponding Saudi Arabian. With these results in mind, and the frequent prevalence of OFP/TMD in children and adolescents, one can draw the conclusion that there is a need for modern medical education regarding OFP/TMD among both physicians and dentists, especially in Saudi Arabia. (Source: Journal of Oral Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Structural Model of Health-Related Quality of Life in Parkinson's Disease Patients
This study utilized structural equation modeling (SEM) to predict the HRQOL of patients with PD. Participants (N = 217) were patients diagnosed with PD (M age = 66.01). Demographic and disease-related characteristics, sleep quality, pain, depression, and HRQOL were investigated via a structured questionnaire. Participants&rsquo; functional factors were measured using physical function evaluations. The hypothetical model verified disease-related factors, depression, and pain as direct factors that significantly predicted HRQOL of patients with PD (Goodness of Fit Index = 0.93 and Comparative Fit Index = 0.96). These findings are useful for developing comprehensive interventions to improve the HRQOL of patients with PD. (Source: Western Journal of Nursing Research)


Dyspnea-related cues engage the prefrontal cortex: Evidence from functional brain imaging in COPD.
Conclusions: Our findings suggest that engagement of the brain's emotional circuitry is important for interpretation of dyspnea-related cues in COPD, and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and our findings suggest such mechanisms may be relevant in COPD. PMID: 26134891 [PubMed - as supplied by publisher] (Source: Chest)


Elements of the Biopsychosocial Interview of the Chronic Pain Patient: A New Expanded Model Using Rational Emotive Behavior Therapy
This article will briefly explore the history of the biopsychosocial model, relay the major tenants of rational emotive behavior therapy (REBT), and propose an expanded biopsychosocial model (rational emotive behavior therapy-health) for the assessment and conceptualization of those suffering from chronic pain disorders. Detailed are specific interview topics and related questions important to the assessment of client functioning with emphasis REBT hypothesis formulations. Discussion of conceptualization will integrate perspectives from the biopsychosocial interview with the addition of REBT hypothesis formulations. (Source: Journal of Rational-Emotive and Cognitive-Behavior Therapy)


Assessing quality of life in Welsh carers with and without back pain.
Conclusion Nearly one in five Welsh adults, with or without back pain, have provided care for other people. Future socioeconomic structure, health policy, and nursing programmes to reinvest in long-term care, such as a national psychiatric care initiative, should be encouraged, to lessen mental suffering alongside chronic pains and to optimise adult mental health and quality of life in all people, with or without back pain. PMID: 26140319 [PubMed - as supplied by publisher] (Source: British Journal of Community Nursing)


Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention
Conclusions The low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure. (Source: International Journal of Behavioral Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Palliative care: Not just end of life care
My daughter Esmé is a four-and-one-half-year-old girl who loves listening to &#8220;The Muppets Movie&#8221; soundtrack, laughing at silly jokes and reading books. Esmé has been a patient at Boston Children&#8217;s Hospital since she was 8 months old, when she started seeing the Aerodigestive Clinic for chronic aspiration. She is followed by a number of specialists to treat her epilepsy, low tone, kidney and heart abnormalities, developmental delay, poor growth, lack of verbal communication, among other things. Esmé is presumed to have a genetic disorder, but, so far, she does not have a clear diagnosis. Last week I had an appointment that I was both really looking forward to and dreading, simultaneously. The appointment was with Pediatric Advanced Care Team (PACT) at Boston Children&#...


Zydus gets USFDA nod for morphine sulfate tablets
Zydus Group today announced receipt of approval to sell chronic pain reliever morphine sulfate tablets from the US Food and Drug Administration. (Source: The Economic Times Healthcare and Biotech News)


Evaluating the Statistical Properties of the Pain Interference Index in Children and Adolescents with Chronic Pain
Conclusion: Results support the use of PII as an adequate instrument to assess pain interference in children and adolescents with chronic pain. (Source: Journal of Developmental and Behavioral Pediatrics)


Risk of Associated Conditions in Relatives of Subjects With Interstitial Cystitis
ABSTRACT: Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic bladder pain condition. Symptoms include urgency, frequency, and/or nocturia. The incidence of IC/PBS in women in the United States based on self-report ranges between 2.7% and 6.5%. Some studies have provided evidence that IC/PBS can co-occur with other associated conditions such as irritable bowel syndrome and fibromyalgia not only within patients with IC/PBS but also across their first-degree relatives. The underlying etiology of IC/PBS is poorly understood. It is often considered to be a multifactorial disease, with genetic and environmental components. The aim of this study was to estimate the heritability of approximately 20 associated conditions in first-degree relatives of patients with IC/PBS (and if ap...


An Overview of Treatments for Endometriosis
Endometriosis is a chronic disease affecting up to 10% of women in the general population and up to 40% in subfertile women. The most common symptom is pain, which can recur even after treatment. Fertility problems are common among women of reproductive age with this disease. There is no cure. The main goal of treatment is to relieve pain and improve fertility. The primary aim of this overview was to summarize data on treatments associated with improved outcomes in women with endometriosis. Data were analyzed in studies published from 1979 to 2012 from 140 randomized clinical trials (included in 18 Cochrane systematic reviews). Primary treatment outcomes evaluated were self-reported pain relief for dysmenorrhea and live birth rate. Secondary outcomes examined included clinical improvement ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Five Patients With Burning Mouth Syndrome in Whom an Antidepressant (Serotonin-Noradrenaline Reuptake Inhibitor) Was Not Effective, but Pregabalin Markedly Relieved Pain
In this study, we report 5 patients with BMS in whom there was no response to SNRI (milnacipran or duloxetine), or administration was discontinued because of adverse reactions, but in whom pregabalin therapy markedly reduced or led to the disappearance of pain in a short period. Pregabalin, whose mechanism of action differs from that of SNRIs, may become a treatment option for BMS patients who are not responsive to or are resistant to SNRIs. (Source: Clinical Neuropharmacology)


Plasmacytoma of Liver Mimicking Hepatocellular Carcinoma at Multiphasic Computed Tomography Evaluation
Abstract: Plasmacytoma of liver is a rare hepatic tumor more often seen at autopsy than described in the literature; it is also more likely diagnosed in the setting of multiple myeloma than as isolated extramedullary plasmacytoma. However, when found in the setting of multiple myeloma, it is associated with worse clinical outcome. The authors describe a case of an elderly man presenting with nonspecific chronic abdominal pain and a new 4-cm hepatic mass. At multiphasic computed tomography, the mass demonstrated an enhancement pattern identical to that expected of hepatocellular carcinoma; however, thorough history failed to uncover necessary risk factors for hepatic cirrhosis. Ultrasound-guided core biopsy of the mass, as well as additional clinical and radiologic assessment, subsequently ...


Pain‐related psychological distress, self‐rated health and significance of neuropathic pain in Danish soldiers injured in Afghanistan
ConclusionsThe results from the present study suggest that neuropathic pain is related to increased psychological distress and deterioration in self‐rated health in injured soldiers. (Source: Acta Anaesthesiologica Scandinavica)


Acne inversa complicated by Actinomyces neuii
Conclusion Primary cutaneous Actinomycosis is a rare entity and the combination of AI and Actinomycosis has never been reported before. Failure to detect superinfections of AI lesions with slow-growing pathogens like Actinomyces spp. might contribute to high recurrence rates after immunosuppressive therapy of AI. The present case underlines the potentially multifactorial pathogenesis of the disease and the importance of considering and treating potential infections before initiating immunosuppressive regimens for AI patients. (Source: Infection)


Sacroiliac joint luxation after pedicle subtraction osteotomy: report of two cases and analysis of failure mechanism
Conclusion Patients with high PI might seek for further compensation at their SIJ when lacking LL after PSO. Chronic anterior imbalance might lead to progressive weakening of sacroiliac ligaments. Initial circumferential lumbosacral fusion and accurate iliac screw fixation might reduce stress on implants, risk for pseudarthrosis, implant failure and finally SIJ deterioration. Bone mineral density should further be investigated preoperatively. (Source: European Spine Journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Systematic Review on Intensive Interdisciplinary Pain Treatment of Children With Chronic Pain
CONCLUSIONS: Effects in nonrandomized treatment studies cannot be attributed to IIPT alone. Because of substantial heterogeneity in measures for school functioning and anxiety, meta-analyses could not be computed. There is preliminary evidence for positive treatment effects of IIPT, but the small number of studies and their methodological weaknesses suggest a need for more research on IIPTs for children. (Source: PEDIATRICS)


The 'Best Practice Guide to Conservative Management of Patellofemoral Pain': incorporating level 1 evidence with expert clinical reasoning
Conclusions and relevance Effective management of PFP requires consideration of a number of proven conservative interventions. An individually tailored multimodal intervention programme including gluteal and quadriceps strengthening, patellar taping and an emphasis on education and activity modification should be prescribed for patients with PFP. We provide a &lsquo;Best Practice Guide to Conservative Management of Patellofemoral Pain&rsquo; outlining key considerations. (Source: British Journal of Sports Medicine)


Opioid Analgesics
Chronic pain is an international health issue of immense importance that is influenced by both physical and psychological factors. Opioids are useful in treating chronic pain but have accompanying complications. It is important for clinicians to understand the basics of opioid pharmacology, the benefits and adverse effects of opioids, and related problematic issues of tolerance, dependence, and opioid-induced hyperalgesia. In this article, the role of psychiatric comorbidity and the use of validated assessment tools to identify individuals who are at the greatest risk for opioid misuse are discussed. (Source: Mayo Clinic Proceedings)


Early menarche and chronic widespread musculoskeletal complaints‐ Results from the HUNT study
ConclusionIn this cross‐sectional study, there was an association between early age at menarche and chronic WMSC later in life, but the difference in absolute risk was low (3%). (Source: European Journal of Pain)


Open surgical management of sialolithiasis
This article highlights the open surgical interventions that are frequently used in sialolithiasis management, when sialoendoscopy is not the most appropriate option, has failed, or is not available. They range from minimally invasive to open techniques. Mastering the anatomy of the salivary ducts and surrounding structures is of exquisite importance. The management of sialolithiasis should aim for gland sparing procedures before considering gland excision. (Source: Operative Techniques in Otolaryngology Head and Neck Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Synaptic ultrastructure changes in trigeminocervical complex post trigeminal nerve injury
This article is protected by copyright. All rights reserved. Using electron microscopy techniques, the authors show an increase in the number of R‐type excitatory synaptic profiles (as shown) within laminae I of the trigeminocervical complex after trigeminal nerve injury. Synaptic alterations to the excitatory circuitry within the superficial dorsal horn may contribute to the development of orofacial pain states. d. dendrite. (Source: The Journal of Comparative Neurology)


A clinician's quick guide of evidence‐based approaches: Chronic pain
(Source: Clinical Psychologist)


Neuroscience: Male mice process pain differently
Nature 523, 7558 (2015). doi:10.1038/523009c Male and female mice use different types of immune cell to process chronic pain.Studies of male mice have shown that immune cells called microglia in the spinal cord have an important role in chronic pain. To see whether this is the same in female (Source: Nature)


Fibromyalgia incidence among patients with hepatitis B infection
ConclusionsThe results of the present study demonstrate that FMS incidence is greater among HBV patients relative to control subjects. However, there were no differences in FMS incidence among the subgroups of HBV diagnoses. (Source: APLAR Journal of Rheumatology)


Pathogenesis of Endometriosis: Roles of Retinoids and Inflammatory Pathways
Semin Reprod Med 2015; 33: 246-256DOI: 10.1055/s-0035-1554920Endometriosis is a nonmalignant, but potentially metastatic, gynecological condition manifested by the extrauterine growth of inflammatory endometrial implants. Ten percent of reproductive-age women are affected and commonly suffer pelvic pain and/or infertility. The theories of endometriosis histogenesis remain controversial, but retrograde menstruation and metaplasia each infer mechanisms that explain the immune cell responses observed around the ectopic lesions. Recent findings from our laboratories and others suggest that retinoic acid metabolism and action are fundamentally flawed in endometriotic tissues and even generically in women with endometriosis. The focus of our ongoing research is to develop medical therapies as ad...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain Management in Nursing Practice Wright Shelagh Pain Management in Nursing Practice 288pp Sage, Los Angeles/London/Washington DC/New Delhi/Singapore 978 1 4462 8199 4 144628199X [Formula: see text].
Authors: Abstract Written by a registered psychologist, who is also a retired nurse with experience of teaching undergraduate nurses, this is a comprehensive resource that summarises most of the essential knowledge required to manage pain across the continuum from acute pain to cancer pain via chronic pain. PMID: 26136021 [PubMed - as supplied by publisher] (Source: Nursing Standard)


Is Chronic Pain a Disease in Its Own Right? Discussions from a Pre-OMERACT 2014 Workshop on Chronic Pain.
Discussions from a Pre-OMERACT 2014 Workshop on Chronic Pain. J Rheumatol. 2015 Jul 1; Authors: Taylor AM, Phillips K, Taylor JO, Singh JA, Conaghan PG, Choy EH, Tugwell PS, Kaiser U, Strand V, Simon LS, Mease PJ Abstract At the pain workshop held prior to the Outcome Measures in Rheumatology (OMERACT) 12 conference, chronic nonmalignant pain (CP) as a "disease" was discussed, in response to growing interest in this concept and in terms of the effect on the OMERACT Filter 2.0 framework. CP is often assessed as a unidimensional outcome measure; however, if CP is a disease, then outcome measures need to define the disease state and identify all its manifestations as well as its effects, as specified by Filter 2.0. The aim was to write a discussion piece, reflecting the w...


Therapeutic Developments Targeting Toll-like Receptor-4-Mediated Neuroinflammation.
Authors: Li J, Csakai A, Jin J, Zhang F, Yin H Abstract Toll-like receptors (TLRs) have been shown to play an important role in the immune system, which warrants study of their remarkable potential as pharmacological targets. Activation of TLRs requires participation from specific pathogen-associated molecular patterns (PAMPs) and accessory proteins such as myeloid differentiation protein 2 (MD2), lipopolysaccharide binding protein (LBP), and cluster differentiation antigen 14 (CD14). Assembly of the TLR4-MD2-LPS complex is essential in TLR4 activation. Recent studies have revealed that TLR4 activation is a significant trigger of signal transmission pathways in the nervous system, which could result in chronic pain as well as opioid tolerance and dependence. Researchers of the mo...


The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms.
Authors: Crawford-Faucher A, Huijon RM PMID: 26132123 [PubMed - in process] (Source: American Family Physician)


Atrophy, inducible satellite cell activation and possible denervation of supraspinatus muscle in injured human rotator-cuff muscle.
Authors: Gigliotti D, Leiter JR, Macek B, Davidson MJ, MacDonald PB, Anderson JE Abstract The high frequency of poor outcome and chronic pain after surgical repair of shoulder rotator-cuff injury (RCI) prompted this study to explore the potential to amplify muscle regeneration using nitric oxide- (NO-) based treatment. After pre-operative magnetic resonance imaging (MRI), biopsies of supraspinatus and ipsilateral deltoid (as a control) were collected during reparative surgery for RCI. Muscle fiber diameter, the pattern of neuromuscular junctions observed with alpha-bungarotoxin staining, and the γ:ε subunit ratio of acetylcholine receptors in western blots were examined in tandem with experiments to determine the in vitro responsiveness of muscle satellite cells to activation (in...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Nonanalgesic benefits of combined thoracic epidural analgesia with general anesthesia in high risk elderly off pump coronary artery bypass patients.
CONCLUSION: Thoracic epidural anesthesia decreases stress and inflammatory response to surgery and decreases hospital stay. However a large multicentre study may be needed to confirm it. PMID: 26139745 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)


Assessment of feasibility and efficacy of Class IV laser therapy for postoperative pain relief in off-pump coronary artery bypass surgery patients: A pilot study.
CONCLUSION: Class IV laser can be an effective technique for postoperative analgesia following OPCABG surgery through sternotomy when included as a component of MMA technique. PMID: 26139735 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)


Potential application of miRNAs as diagnostic and therapeutic tools in chronic pancreatitis
Abstract Chronic pancreatitis (CP) is a progressive inflammatory disease typified by end‐stage fibrosis. This disease can also increase the risk of pancreatic cancer. The associated diagnosis, pain and other complications further add to the burden of disease management. In recent years, significant progress has been achieved in identifying miRNAs and their physiological functions, including mRNA repression and protein expression control. Given the extensive effort made on miRNA research, a close correlation has been discovered between certain types of miRNAs and disease progression, particularly for tissue fibrosis. Designing miRNA‐related tools for disease diagnosis and therapeutic treatments presents a novel and potential research frontier. In the current review, we discuss various m...


Retroperitoneal course of iliohypogastric, ilioinguinal and genitofemoral nerves: A study to improve identification and excision during triple neurectomy
Conclusions: Variations in the iliohypogastric, ilioinguinal, and genitofemoral nerves outlined in this study will provide surgeons with clinically useful information aiding in successful and efficient localization of these nerves during retroperitoneal procedures, including laparoscopic triple neurectomy. This article is protected by copyright. All rights reserved. (Source: Clinical Anatomy)


Distress in patients with bleeding disorders: a single institutional cross‐sectional study
ConclusionDistress among patients with congenital bleeding disorders followed at a comprehensive HTC was high and similar to that reported among patients with cancer. Future research should determine whether distress impacts clinical outcomes in patients with bleeding disorders as demonstrated in other chronic disorders. (Source: Haemophilia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain and problems: a prospective cross‐sectional study of the impact of dental emergencies
In conclusion, a large number of patients attend the emergency dental services despite being ‘registered’ with a general dental practitioner. A proportion of these individuals will re‐attend for the same condition. Patients will often be in pain for over 2 weeks before attending, which may have a significant impact on their quality of life. Further research is warranted to investigate these care‐seeking behaviours and patterns. (Source: Journal of Oral Rehabilitation)


Influence of Defensiveness on Disability in a Chronic Musculoskeletal Pain Population
ConclusionsThe interaction between defensiveness and anxiety plays an important role in patients' perceptions of, and outcomes from, chronic pain. Differentiating the defensive high‐anxious group revealed different patterns of relationship between a range of cognitive factors and disability. This highlights the necessity of assessing personality characteristics that include defensiveness in order to identify those individuals who may be more vulnerable to cognitive factors influencing their perceptions of disability. If personality type is identified as a predictor of poor adjustment, interventions could be customized to the unique needs of this group (eg. high defensive and anxious individuals). (Source: Pain Practice)


Retroperitoneal fibrosis: A retrospective review of clinical presentation, treatment and outcomes.
Authors: Labidi J, Ariba YB, Chargui S, Bousetta N, Louzir B, Othmani S Abstract Retroperitoneal fibrosis (RPF) is a rare disease and has a high risk of developing chronic kidney disease (CKD). This retrospective study was carried out with the objective to study the epidemiological, clinical and therapeutic characteristics of RPF and identify the risk factors associated with its progression to CKD. All 30 cases (24 males and five females) of RPF admitted from January 1985 to December 2013 in the Military Hospital of Tunis were included in this study. The mean age was 50.5 years. Presentation was with lower back pain, acute renal failure and inflammatory syndrome in 93%, 56% and 43% of the cases, respectively. Sixteen patients (54%) had a creatinine clearance &lt;60 mL/min at the ti...


Additive effect of elcatonin to risedronate for chronic back pain and quality of life in postmenopausal women with osteoporosis: a randomized controlled trial
In conclusion, the use of elcatonin in addition to risedronate for more than 3 months reduced chronic back pain. The additional therapy of risedronate with elcatonin may be a useful and practical choice for the treatment of osteoporosis with chronic back pain persisting more than 3 months. (Source: Journal of Bone and Mineral Metabolism)


Prevalence and Characteristics of Discogenic Pain in Tertiary Practice: 223 Consecutive Cases Utilizing Lumbar Discography
ConclusionThe prevalence of discogenic pain in this community practice is below the range, but within confidence intervals, previously reported. Prevalence is considerably elevated, however, among well‐selected patients and discography enabled a firm diagnosis in most such cases. These findings are broadly in keeping with those reached in key publications and support the clinical utility of discography. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


We Need More Research On Medical Marijuana
A new study revealed that&nbsp;there was "moderate-quality evidence" to support the use of cannabinoid compounds for the treatment of chronic pain and spasticity. The same report also found that&nbsp;there was "lower-quality evidence" suggesting that cannabinoids were associated with improvements in nausea and vomiting&nbsp;chemotherapy, sleep disorders and Tourette syndrome. (Source: Forbes.com Healthcare News)


Daily vitamin D supplement may prolong remission from Crohn's disease
(NaturalNews) Crohn's disease is a difficult digestive condition marked by chronic inflammation, abdominal pain and bouts of diarrhea. According to the Centers for Disease Control, this disease effects around 200 out of every 10,000 adults here in America and can lead to serious,... (Source: NaturalNews.com)


Non-invasive vagus nerve stimulation for acute treatment of high-frequency and chronic migraine: an open-label study
Conclusion Non-invasive vagus nerve stimulation may be effective as acute treatment for HFEM or CM and may help to reduce medication overuse and medication-associated adverse events. (Source: The Journal of Headache and Pain)


Temporal dynamics of anxiety phenotypes in a dental pulp injury model
Conclusions: Together, these results suggest a temporally progressive causal relationship between orofacial pain and anxiety, calling for more in-depth mechanistic studies on concomitant pain and anxiety disorders. (Source: Molecular Pain)


Evidences of Reduced Antioxidant Activity in Patients With Chronic Migraine and Medication‐Overuse Headache
ConclusionsThe data from the present study suggest that antioxidant capacity is lower in chronic migraine patients and medication‐overuse headache compared to healthy headache‐free subjects, with no differences between patients with triptan or nonsteroidal anti‐inflammatory drug overuse. Further investigation is certainly necessary in order to define the causal or consequential role of an imbalance between pro‐oxidants and antioxidant defenses in migraine pathogenesis and “chronification” and the possible therapeutic implications in clinical practice. (Source: Headache: The Journal of Head and Face Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Painful bladder syndrome
is a chronic debilitating condition which is both difficult to diagnose and to treat. Its aetiology and pathogenesis is very poorly understood. It is thought that mast cells and inflammation have a key role in pathogenesis.A diagnosis is generally made after all other potential causes of pain and lower urinary tract symptoms are excluded. Treatment options are very limited but are generally targeted to providing symptomatic relief. (Source: Obstetrics, Gynaecology and Reproductive Medicine)


Management of Pain After Spinal Cord Injury
Abstract Chronic pain affects most people with spinal cord injury (SCI). It often impedes performance of activities of daily living and negatively impacts quality of life. Pain after SCI can be classified into subtypes through use of the International SCI Pain Classification with key attributes of the pain necessary for effective monitoring and treatment collected within the International SCI Pain Basic Data Set. Many nociceptive causes of pain seen after SCI are potentially treatable and preventable through the implementation of strategies for preventing overuse injuries. Neuropathic pain, in contrast, has been historically difficult to treat. Options for the treatment of neuropathic pain types which have demonstrated some effectiveness include various adjuvant pharmacological ag...


Platelet-Rich Plasma Intra-articular Knee Injections Show No Superiority Versus Viscosupplementation: A Randomized Controlled Trial
Conclusion: PRP does not provide a superior clinical improvement with respect to HA, and therefore it should not be preferred to viscosupplementation as injective treatment of patients affected by knee cartilage degeneration and OA. (Source: The American Journal of Sports Medicine)


Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population: A 6-Year Review of 894 Cases
Conclusion: Chronic hip and groin pain is often associated with multiple clinical entities. Hip joint pathology is the most common clinical entity and is most likely to relate to femoroacetabular impingement, labral tears, and osteoarthritis. These pathologies seem to be associated with secondary breakdown of surrounding structures; however, underpinning mechanisms are unclear. (Source: The American Journal of Sports Medicine)


Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial
Conclusion: The results of this study show that both traditional ECC and HSR yield positive, equally good, lasting clinical results in patients with Achilles tendinopathy and that the latter tends to be associated with greater patient satisfaction after 12 weeks but not after 52 weeks. (Source: The American Journal of Sports Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes
Conclusion: Anterior tension band plating for chronic tibial stress fractures provides a reliable alternative to intramedullary nailing with excellent results. Compression plating avoids the anterior knee pain associated with intramedullary nailing but may result in symptomatic hardware requiring subsequent removal. (Source: The American Journal of Sports Medicine)


Evidence for the Durability of Autologous Tenocyte Injection for Treatment of Chronic Resistant Lateral Epicondylitis: Mean 4.5-Year Clinical Follow-up
Conclusion: ATI significantly improved clinical function and MRI tendinopathy scores for up to 5 years in patients with chronic resistant LE who had previously undergone unsuccessful nonsurgical treatment. This study provides evidence for the midterm durability of ATI for treatment of LE tendinopathy. (Source: The American Journal of Sports Medicine)


Blood transfusion and 30-day readmission rate in adult patients hospitalized with sickle cell disease crisis.
CONCLUSION: Our findings point to blood transfusion as a potential means to reduce the 30-day readmission rate among Medicaid patients hospitalized with sickle cell crisis. There is a need for a prospective study to examine the potential benefit and safety of simple blood transfusion for this purpose. PMID: 26126756 [PubMed - as supplied by publisher] (Source: Transfusion)


Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions.
CONCLUSIONS: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain. Implications for Rehabilitation Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach. PMID: 26122546 [PubM...


Gut feelings 2. Mind, mood and gut in inflammatory bowel disease: approaches to psychiatric care.
CONCLUSIONS: IBD is a chronic, debilitating and potentially body integrity altering condition with significant morbidity and a slight increase in mortality. Co-morbidity with anxiety and depression is common. Onset in the younger years can disturb development. Psychotherapy may be most useful for addressing fatigue, pain and assisting with coping. There is a lack of evidence to guide treatment of depression in this population. PMID: 26133813 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Quality of life after deep pelvic endometriosis surgery: Evaluation of a French version of the EHP-30].
CONCLUSION: This study showed that the EHP-30 is a sensitive tool to change the health status and an appropriate instrument for the assessment of treatment effects in patients with deep pelvic endometriosis. PMID: 26142209 [PubMed - as supplied by publisher] (Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction)


Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1.
CONCLUSIONS: Venous disorders show significant associations with several leg symptoms. Itching, feeling of heaviness, or tightness seem to be more closely related than other symptoms. The associations between C classes and symptoms seem to be restricted to classes C2 or higher. PMID: 26141786 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)


Women DO suffer more pain than men and could lead to 'his n hers' painkillers
Scientists at McGill University and Toronto University found the way each sex processes pain is different, with women more likely to suffer chronic pain than men. (Source: the Mail online | Health)


Pediatric Posterior Sternoclavicular Joint Injuries.
Authors: Chaudhry S Abstract Posterior sternoclavicular joint injuries are increasingly diagnosed in children and young adults. Most of these injuries are the result of indirect mechanisms, typically lateral compression, with a posterior-to-anterior force applied to the shoulder during sports. Less frequently, these injuries are caused by direct impact on the medial clavicle, which can occur in rollover motor vehicle accidents, or may represent atraumatic instability. In patients younger than 25 years, physeal separation is more common than true dislocation. Theoretically, these patients have increased remodeling potential. Reduction is recommended to prevent and/or manage the compression of mediastinal structures, which can lead to life-threatening injury. Open surgical stabilizat...


Closed Sagittal Band Injury of the Metacarpophalangeal Joint.
Authors: Kleinhenz BP, Adams BD Abstract Although it is an uncommon injury, traumatic rupture of the sagittal band often results in subluxation or dislocation of the extensor digitorum communis tendon. The radial sagittal band prevents ulnar subluxation of the extensor tendon at the metacarpophalangeal joint. Injury may result from a direct blow to the hand or from relatively low-energy mechanisms. Symptoms range from metacarpophalangeal joint pain and edema to dislocation of the extensor tendon. Associated injuries include collateral ligament sprains, capsular injury, and osteochondral fractures. Many acute injuries can be managed nonsurgically with extension splints. Optimal management of subacute or chronic injuries remains undefined. Surgical management consists of repair or re...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Expression changes of microRNA-1 and its targets Connexin 43 and brain-derived neurotrophic factor in the peripheral nervous system of chronic neuropathic rats.
CONCLUSIONS: This study demonstrates that CCI leads to a regulation of miRNAs (miR-1) in the peripheral nervous system. This regulation is associated with alterations in the expression and localization of the miR-1 dependent pain-relevant proteins BDNF and Cx43. Further studies will have to explore the function of miRNAs in the context of neuropathic pain in the peripheral nervous system. PMID: 26111928 [PubMed - in process] (Source: Molecular Medicine)


Self‐management support for chronic pain in primary care: a cross‐sectional study of patient experiences and nursing roles
ConclusionThere are several opportunities for primary care practices to facilitate self‐management of chronic pain, including the optimization of the primary care nursing role. (Source: Journal of Advanced Nursing)


Many Doctors Underestimate Risks of Prescription Painkillers: Survey
Title: Many Doctors Underestimate Risks of Prescription Painkillers: SurveyCategory: Health NewsCreated: 6/26/2015 12:00:00 AMLast Editorial Review: 6/29/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


His and her pain circuitry in the spinal cord
(McGill University) New research released today in Nature Neuroscience reveals for the first time that pain is processed in male and female mice using different cells. These findings have far-reaching implications for our basic understanding of pain, how we develop the next generation of medications for chronic pain -- which is by far the most prevalent human health condition -- and the way we execute basic biomedical research using mice. (Source: EurekAlert! - Medicine and Health)


A Randomized Controlled Trial of the Effects of Isolated Lumbar Extension Exercise on Lumbar Kinematic Pattern Variability during Gait in Chronic Low Back Pain
Conclusions Considering the role of the lumbar extensors in gait, and their common deconditioning in CLBP, an isolated lumbar extension resistance exercise intervention may reduce gait variability. These results suggest isolated lumbar extension exercise may specifically reduce sagittal plane variability, indicating improved motor pattern replication through this movement plane, perhaps due to the plane of movement utilized during the exercise. (Source: PMandR)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Open surgical management of sialolithiasis
Sialolithiasis should be considered in the differential diagnosis of any patient with chronic or recurrent salivary gland swelling or inflammation. It occurs most frequently in Wharton's duct followed by Stenson's duct, and rarely in the sublingual glands. Sialolithiasis typically presents with pain and swelling of the involved gland that is aggravated by eating.In the acute setting, patients with sialadenitis secondary to calculi are treated conservatively with antibiotics, and stones less than 2mm may pass spontaneously. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)


Defining the treatment targets and active ingredients of rehabilitation: Implications for rehabilitation psychology.
Conclusions/implications: This type of systematic approach to defining and, ultimately, measuring the quality and quantity (dose) of specific treatments stands to enhance research, practice, and training in rehabilitation as well as communication across the treatment team and other stakeholders in the process and outcomes of rehabilitation. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (Source: Rehabilitation Psychology)


A brief cognitive–behavioral intervention for sleep in individuals with chronic noncancer pain: A randomized controlled trial.
Conclusions/Implications: Our findings suggest that there is potential for a brief educational intervention to have a positive impact on some aspects of sleep in the chronic pain population. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (Source: Rehabilitation Psychology)


Different immune cells mediate mechanical pain hypersensitivity in male and female mice
Nature Neuroscience 18, 1081 (2015). doi:10.1038/nn.4053 Authors: Robert E Sorge, Josiane C S Mapplebeck, Sarah Rosen, Simon Beggs, Sarah Taves, Jessica K Alexander, Loren J Martin, Jean-Sebastien Austin, Susana G Sotocinal, Di Chen, Mu Yang, Xiang Qun Shi, Hao Huang, Nicolas J Pillon, Philip J Bilan, YuShan Tu, Amira Klip, Ru-Rong Ji, Ji Zhang, Michael W Salter & Jeffrey S Mogil A large and rapidly increasing body of evidence indicates that microglia-to-neuron signaling is essential for chronic pain hypersensitivity. Using multiple approaches, we found that microglia are not required for mechanical pain hypersensitivity in female mice; female mice achieved similar levels of pain hypersensitivity using adaptive immune cells, likely T lymphocytes. This sexual dimorphism suggests...


Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland-Prevalence and Correlates.
CONCLUSIONS: Physical pain is a prevalent and potentially impairing experience in adults seeking treatment for alcohol dependence. Therapeutic interventions aimed at reducing pain in alcohol-dependent individuals should be studied to evaluate their impact on improving overall treatment outcomes. PMID: 26098037 [PubMed - in process] (Source: Journal of Studies on Alcohol and Drugs)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Painful Problem: The Importance of Mitigating Pain and Stress for Better Sleep
This article originally appeared on the Amerisleep blog. Rosie Osmun is the Creative Content Manager at Amerisleep, a progressive memory foam mattress brand focused on eco-friendly sleep solutions. Rosie writes more posts on the Amerisleep blog about the science of sleep, eco-friendly living, leading a healthy lifestyle and more. ___________________ Also on The Huffington Post: -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)


History of Abuse in Women With Vulvar Pruritus, Vulvodynia, and Asymptomatic Controls
Conclusions: Patients with vulvar pruritus and vulvodynia report similar rates of sexual and physical abuse. (Source: Journal of Lower Genital Tract Disease)


A multicenter, randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of single-entity, once-daily hydrocodone tablets in patients with uncontrolled moderate to severe chronic low back pain
Expert Opinion on Pharmacotherapy, Ahead of Print. (Source: Expert Opinion on Pharmacotherapy)


Activation of P2X7 receptors in the midbrain periaqueductal gray of rats facilitates morphine tolerance
This study aimed to determine whether the P2X7 receptor in the ventrolateral midbrain periaqueductal gray (vlPAG) is involved in morphine tolerance. Development of tolerance to the antinociceptive effect of morphine was induced in normal adult male Sprague–Dawley (SD) rats through subcutaneous injection of morphine (10mg/kg). The analgesic effect of morphine (5mg/kg, i.p.) was assessed by measuring mechanical withdrawal thresholds (MWTs) in rats with an electronic von Frey anesthesiometer. The expression levels and distribution of the P2X7 receptor in the vlPAG was evaluated through Western blot analysis and immunohistochemistry. The acute effects of intra-vlPAG injection of the selective P2X7 receptor agonist Bz-ATP, the selective P2X7 receptor antagonist A-740003, or antisense oligodeo...


Clinical Implications of Tapering Chronic Opioids in a Veteran Population
ConclusionsPatients in the population studied can be successfully tapered to lower opioid doses and may not necessarily experience more pain. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain, Comorbid Medical Conditions, and Associated Risk Factors in Kuwait: Gender and Nationality Differences
ConclusionsThis extensive survey study that found female Kuwaitis to have a higher incidence of pain and medical comorbidities than males and non‐Kuwaitis highlights the role of cultural factors in contributing to pain and comorbid medical conditions. This information is critical in organizing resources to implement adequate healthcare services and behavioral interventions in Kuwait and other Arab countries to improve pain and health‐related conditions. (Source: Pain Medicine)


Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients
Conclusions: The good long-term results of the targeted therapeutic local anesthesia (NT) in the most problematic group of chronic pain patients (unresponsive to all evidence based conventional treatment options) indicate that a vicious circle has been broken. The specific contribution of the intervention to these results cannot be determined. The low costs of local anesthetics, the small number of consultations needed, the reduced intake of analgesics, and the lack of adverse effects also suggest the practicality and cost-effectiveness of this kind of treatment. Controlled trials to evaluate the true effect of NT are needed. (Source: BMC Complementary and Alternative Medicine)


The impact of pain on systemic rheumatic diseases
Publication date: Available online 27 June 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Piercarlo Sarzi-Puttini , Fabiola Atzeni , Daniel J. Clauw , Serge Perrot Pain is associated with the different types of rheumatic syndromes because it is often the most troubling symptom of patients affected by any of these diseases. Some risk factors clearly play a major role in the clinical expression of pain and related syndromes, including genetics, age, gender, co-morbidities, traumas and psychological patterns, but there are no specific clinical, laboratory or neuroimaging markers that can indicate why and when a patient's localised pain will become chronic and widespread. Any type of pain must be treated not only appropriately, but also rapidly because the like...


Consumption of and satisfaction with health care among opioid users with chronic non‐malignant pain
ConclusionsCombined with previous findings of high levels of pain in spite of opioid treatment, the present findings indicate that symptomatic relief is not a prerequisite for patient satisfaction. The study shows higher patient satisfaction compared to previous studies. (Source: Acta Anaesthesiologica Scandinavica)


Stress-Test for French Intellectualism as Mindfulness Makes Waves
Mocking the French is pass&#233;. Fun, but pass&#233;. There&#8217;s much to be admired in the French. Theirs is a cultural of intellectual rigor, deeply entrenched identity and a healthy disdain for dimwits. What a shame, then, to learn that today&#8217;s Gauls are rushing to the so-called Mindfulness Movement, known to them as pleine conscience. According to this Worldcrunch report, translating from Le Monde, at its center is 71-year-old American Jon Kabat-Zinn, who&#8217;s been pushing peaceful platitudes for 30 years. Le Monde&#8217;s reporter, Yoanna Sultan-R'bibo, attended one of Kabat-Zinn&#8217;s workshops: On the sidewalk of rue Richer before his presentation, people were elbowing their way into line for the Folies Berg&#232;re. "It's the first time one of our conferences was book...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Online tools can help manage pain
(Reuters Health) - People with chronic pain may be able to use online tools to manage their symptoms, lessening the need for frequent doctor visits, an Australian study suggests. (Source: Reuters: Health)


Brewing a great doctor-patient relationship
“I love working with Brooke and her mom. They are a great pair, and Brooke has grown into a wonderful, independent young woman who can advocate for herself. She went from being a sweet kid who couldn’t walk five steps without pain to this vibrant college student who treks over here from Northeastern University, bringing me a latte, ready to conquer the world,” says Dr. Kate Ackerman, medical director of Boston Children’s Hospital’s Female Athlete Program. Brooke Lombardi, her mother Shari and Ackerman have a pretty special relationship. Brooke, who grew up in Miami, started seeing Ackerman in 2010 when she was 15. Today, Ackerman helps Brooke, a college student who continues to have minor medical issues, navigate the health care system, helping to provide a safety net for a young...


Death by aortoesophageal fistula due to disseminated tuberculosis: a case study.
Authors: Na JY, Kim YS, Choi YD, Kim HS, Park JT Abstract Tuberculosis remains a serious public health problem worldwide, especially in Korea. Although tuberculosis is generally considered a non-fatal chronic disease, deaths have occurred. In this case study, a 68-year-old man was admitted to the hospital with dyspepsia, vomiting, and abdominal pain. Nine hours later, he suffered severe hematemesis and died despite cardiopulmonary resuscitation. A medico-legal autopsy was performed and an external examination revealed no external injuries. However, an internal examination revealed an aortoesophageal fistula and a large amount of blood in the stomach. A histologic examination confirmed tuberculous mediastinitis with disseminated tuberculosis involving multiple organs, including the ...


Value of Antral Nodularity for the Diagnosis of Helicobacter pylori Infection in Children.
CONCLUSIONS Antral nodularity is reliable test. Physicians could start treatment of H. pylori infection whenever gastric nodularity is observed and the urease test result is positive, without waiting for histopathology results. PMID: 26105000 [PubMed - in process] (Source: Medical Science Monitor)


The SCOPE Protocol for Primary Care-Based Chronic Pain Management (Frederic Stuart Leeds MD)
(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Expression changes of microRNA-1 and its targets Connexin 43 and brain-derived neurotrophic factor in the peripheral nervous system of chronic neuropathic rats
Conclusions: This study demonstrates that CCI leads to a regulation of miRNAs (miR-1) in the peripheral nervous system. This regulation is associated with alterations in the expression and localization of the miR-1 dependent pain-relevant proteins BDNF and Cx43. Further studies will have to explore the function of miRNAs in the context of neuropathic pain in the peripheral nervous system. (Source: Molecular Pain)


Repeated forced swim stress prior to complete Freund’s adjuvant injection enhances mechanical hyperalgesia and attenuates the expression of pCREB and ΔFosB and the acetylation of histone H3 in the insular cortex of rat
Publication date: 20 August 2015 Source:Neuroscience, Volume 301 Author(s): H. Imbe , A. Kimura Exposure to stressors causes substantial effects on the perception and response to pain. In several animal models, chronic stress produces hyperalgesia. The insular (IC) and anterior cingulate cortices (ACC) are the regions exhibiting most reliable pain-related activity. And the IC and ACC play an important role in pain modulation via descending pain modulatory system. In the present study we examined the expression of phospho-cAMP response element-binding protein (pCREB) and ΔFosB and the acetylation of histone H3 in the IC and ACC after forced swim stress (FS) and complete Freund’s adjuvant (CFA) injection to clarify changes in the cerebral cortices that affect the activity of the descend...


Persistent hindlimb inflammation induces changes in activation properties of hyperpolarization-activated current (Ih) in rat C-fiber nociceptors in vivo
Publication date: 20 August 2015 Source:Neuroscience, Volume 301 Author(s): L. Djouhri , M. Al Otaibi , K. Kahlat , T. Smith , J. Sathish , X. Weng A hallmark of chronic inflammation is hypersensitivity to noxious and innocuous stimuli. This inflammatory pain hypersensitivity results partly from hyperexcitability of nociceptive dorsal root ganglion (DRG) neurons innervating inflamed tissue, although the underlying ionic mechanisms are not fully understood. However, we have previously shown that the nociceptor hyperexcitability is associated with increased expression of hyperpolarization-activated cyclic nucleotide-gated channel 2 (HCN2) protein and hyperpolarization-activated current (Ih ) in C-nociceptors. Here we used in vivo voltage-clamp and current-clamp recordings, in deeply anesth...


Glycine transporter GlyT1, but not GlyT2, is expressed in rat dorsal root ganglion—Possible implications for neuropathic pain
Publication date: 23 July 2015 Source:Neuroscience Letters, Volume 600 Author(s): Lukas Schlösser , Franziska Barthel , Timo Brandenburger , Elena Neumann , Inge Bauer , Volker Eulenburg , Robert Werdehausen , Henning Hermanns Glycinergic inhibitory neurotransmission plays a pivotal role in the development of neuropathic pain. The glycine concentration in the synaptic cleft is controlled by the glycine transporters GlyT1 and GlyT2. GlyT1 is expressed throughout the central nervous system, while GlyT2 is exclusively located in glycinergic neurons. Aim of the present study was to investigate whether GlyTs are also expressed in the peripheral sensory nervous system and whether their expression is modulated in experimental neuropathic pain. Neuropathic pain was induced in male Wistar rats b...


Use of a high‐sensitivity troponin T assay in the assessment and disposition of patients attending a tertiary Australian emergency department: A cross‐sectional pilot study
ConclusionsDespite high‐sensitivity TnT assay having a high sensitivity and specificity for myocardial necrosis, the majority of unselected consecutive patients attending ED in whom TnT levels were elevated did not have an acute coronary syndrome. Our pilot study suggests that a larger study is needed to provide evidence to modify management algorithms. (Source: Emergency Medicine Australasia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effect of heating and cooling combination therapy on patients with chronic low back pain: study protocol for a randomized controlled trial
DiscussionThis research will determine the efficacy and safety of heating and cooling combination therapy on chronic low back pain. The results of this trial may have important implications for the more widespread use of heating and cooling combination therapy for treatment of musculoskeletal pain.Trial RegistrationNCT02289170 (14 October 2014) (Source: Trials)


‘’Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases. ‘’
We describe three cases of MS patients who have had moderate to severe complaints of bruxism in the two weeks following their relevant MS attacks. None of the three patients had a diagnosis of bruxism prior to her attack. The diagnosis was confirmed in one out of three by a polysomnography. One patient did not have any complaints related to bruxism previous to her attack, whereas two had mild and infrequent complaints. The symptoms of the relevant attacks were left hemihypesthesia in all and hemiparesis in two. None of the patients had spasticity that could result in severe teeth clenching. All three patients presented with morning headaches and jaw pain or tightness and were treated successfully with botulinum toxin (Btx) injections applied to their masseter and temporalis muscles. The ca...


Łagodny guz cewki moczowej jako rzadka przyczyna przewlekłej choroby nerek u 2-letniego chłopca
Conclusions Urethral polypus can be a rare cause of CKD even in small children. Late diagnosis can lead to bladder dysfunction, which accompanied by reccurrent urinary tract infections can cause kidney function deterioration. (Source: Pediatria Polska)


Deep brain stimulation for chronic pain
Publication date: Available online 26 June 2015 Source:Journal of Clinical Neuroscience Author(s): Sandra G.J. Boccard , Erlick A.C. Pereira , Tipu Z. Aziz Deep brain stimulation (DBS) is a neurosurgical intervention popularised in movement disorders such as Parkinson’s disease, and also reported to improve symptoms of epilepsy, Tourette’s syndrome, obsessive compulsive disorders and cluster headache. Since the 1950s, DBS has been used as a treatment to relieve intractable pain of several aetiologies including post stroke pain, phantom limb pain, facial pain and brachial plexus avulsion. Several patient series have shown benefits in stimulating various brain areas, including the sensory thalamus (ventral posterior lateral and medial), the periaqueductal and periventricular grey, or, ...


Endometriosis with an acute colon obstruction: a case report
Conclusions Infiltrating endometriosis is an invalidating disease that can be misdiagnosed for a wide range of other diseases. Emergency room physicians and surgeons should be aware that it can present as an acute obstruction and should be considered in diagnosing women of childbearing age. After initial colonoscopy, emergency surgery is the best therapeutic approach if there is a complete obstruction. (Source: Journal of Medical Case Reports)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Inhibition of Hyperpolarization-Activated Cation Current in Medium-Sized DRG Neurons Contributed to the Antiallodynic Effect of Methylcobalamin in the Rat of a Chronic Compression of the DRG.
We examined the effect of MeCbl on the spontaneous activity (SA), the excitability, and hyperpolarization-activated nonselective cation ion current in compressed medium-sized dorsal root ganglion (DRG) neurons using extracellular single fiber recording in vivo and whole-cell patch clamp in vitro. We found that MeCbl significantly inhibited the SA of A-type sensory neurons in a dose-dependent manner and inhibited the excitability of medium-sized DRG neurons. In addition, MeCbl also decreased I h current density in injured medium-sized DRG neurons. Our results proved that MeCbl might exert an analgesic effect through the inhibition I h current and then might inhibit the hyperexcitability of primary sensory neurons under neuropathic pain state. PMID: 26101670 [PubMed - in process] (Sourc...


Is It Bedtime for Benzos?
“Bernard also laughed; after two grams of soma the joke seemed, for some reason, good. Laughed and then, almost immediately, dropped off to sleep.” — Aldous Huxley, Brave New World It’s been a tough few years for benzodiazepines, the pharmaceutical industry’s top-selling family of prescription drugs. Tough in every way, that is, except sales: Xanax remains the world’s most popular pill, and U.S. prescriptions for it and other benzos grow by 12 percent every year. It’s their reputation, long enjoyed, as harmless and effective medicines that’s taking a flurry of hits — some glancing, others on the nose. For starters, researchers have recently posited a link between benzos and Alzheimer’s; they’ve documented an explosion in overdoses and ER visits by people mixing benzo...


Study reports mixed findings on medical efficacy of cannabis
A large-scale review that evaluated the medical efficacy of cannabinoids — the active chemical compounds in marijuana — across a range of conditions found there is moderate evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity in patients with multiple sclerosis. The meta-analysis, led by the University of Bristol and published in the Journal of the American Medical Association, analysed the results of 79 different randomised-controlled studies involving more than 6,400 patients to investigate the benefits and side effects of medical cannabinoids. (Source: University of Bristol news)


Conditioned pain modulation is not decreased after partial sleep restriction
ConclusionsThe results indicate that SR leads to increased heat pain perception, but not reduced inhibitory CPM. This contradicts general assumptions on the relation between SR and the CPM effect. (Source: European Journal of Pain)


Neuroimaging of chronic pain
Publication date: Available online 19 June 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Tobias Schmidt-Wilcke Chronic pain is an important public health problem, and there is a need to understand the mechanisms that lead to pain chronification. From a neurobiological perspective, the mechanisms contributing to the transition from acute to subacute and chronic pain are heterogeneous and are thought to take place at various levels of the peripheral and central nervous system. In the past decade, brain imaging studies have shed light on neural correlates of pain perception and pain modulation, but they have also begun to disentangle neural mechanisms that underlie chronic pain. This review summarizes important and recent findings in pain research using magne...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


How to measure chronic pain: New concepts
This article reviews some of the instruments used to assess chronic pain, including newly developed and well-established validated multidimensional instruments and health-care monitoring systems based on information and communication technology, and it discusses their advantages and limitations. (Source: Best Practice and Research Clinical Rheumatology)


Long-term effects of neonatal morphine infusion on pain sensitivity: Follow-up of a randomized controlled trial
This study aimed to identify long-term effects of continuous morphine infusion on thermal pain sensitivity in the neonatal period, incidence of chronic pain and neurological functioning.Eighty-nine of the 150 participants of a neonatal RCT on continuous morphine infusion versus placebo during mechanical ventilation underwent quantitative sensory testing and neurological examination at the age of 8 or 9 years. (Source: The Journal of Pain)


Narrow, Highly Mobile Structure in the Right Atrium: Large Eustachian Valve, Prominent Chiari Network, Thrombus, Vegetation, or Flail Tricuspid Chordae Tendineae?
A 78-YEAR-OLD, 112-kg, 178-cm man, with a history of essential hypertension, hyperlipidemia, radiofrequency ablation for paroxysmal atrial fibrillation, and obstructive sleep apnea complicated by pulmonary arterial hypertension, presented to the authors’ institution for evaluation of progressive fatigue and dyspnea on exertion. The patient reported that he developed shortness of breath after walking fewer than 50 feet. He also reported stable chronic lower extremity swelling but denied chest pain, dizziness, syncope, palpitations, fever, chills, and malaise. (Source: Journal of Cardiothoracic and Vascular Anesthesia)


Effects of Kramecyne on LPS Induced Chronic Inflammation and Gastric Ulcers
ABSTRACT Krameria cytisoides is used for the treatment of inflammation, stomach pain, and gastric ulcers. The active ingredient from this plant is a peroxide, kramecyne (KACY) which has anti‐inflammatory effects. The aim of the present study was to evaluate the anti‐inflammatory activities of KACY in lipopolysaccharide (LPS)‐induced systemic chronic inflammation in mice for 60 days, using dexamethasone (DEX) as the positive control, vehicle (the LPS group) as the negative control and the control group (mice without inflammation). KACY did not affect survival, body weight or relative organ weight in mice but it: decreased nitric oxide (NO) production by 68%; prostaglandin E2 (PGE2) by 67%; increased release of anti‐inflammatory cytokine IL‐10 (2.0‐fold), and reduced produ...


Efficacy of Tailored Physical Activity or Chronic Pain Self-Management Programme on return to work for sick-listed citizens: A 3-month randomised controlled trial.
CONCLUSIONS: The results suggest that TPA is a promising intervention to facilitate return to work and reduce pain among sick-listed citizens with pain related to the back or upper body compared to REF. PMID: 26113171 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Public Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Rib cage ostheosynthesis. Literature review and case reports].
CONCLUSION: Rib fracture fixation offers a good alternative in selected patients to decrease associated morbidity, leading to a patient's fast return to his or her working life. PMID: 26118783 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Exchange protein directly activated by cAMP encoded by the mammalian rapgef3 gene: Structure, function and therapeutics.
Authors: Banerjee U, Cheng X Abstract Mammalian exchange protein directly activated by cAMP isoform 1 (EPAC1), encoded by the RAPGEF3 gene, is one of the two-member family of cAMP sensors that mediate the intracellular functions of cAMP by acting as guanine nucleotide exchange factors for the Ras-like Rap small GTPases. Extensive studies have revealed that EPAC1-mediated cAMP signaling is highly coordinated spatiotemporally through the formation of dynamic signalosomes by interacting with a diverse array of cellular partners. Recently functional analyses of genetically engineered mouse models further suggest that EPAC1 functions as an important stress response switch and is involved in pathophysiological conditions of cardiac stresses, chronic pain, cancer and infectious diseases. ...


Study: Medical Marijuana Not As Effective As Previously Thought
BOSTON (CBS) &#8211; A review published in this week&#8217;s Journal of the American Medical Association, looked at dozens of previous studies on marijuana and found very little evidence to support the use of the drug for medicinal purposes. For certain types of chronic pain and spasticity, they found there was moderate-quality evidence supporting it, at best, but for other conditions like nausea from chemotherapy, weight gain in people with HIV, sleep disorders, the data was of poor quality and not compelling. Potential side effects were also concerning including dizziness, confusion, and even serious kidney, liver, and psychiatric disorders. Experts at Yale University, in a separate letter, suggested that marijuana should be subjected to the same strict standards as other drugs when tryi...


Mindfulness Training among Individuals with Parkinson's Disease: Neurobehavioral Effects.
Conclusions. To the best of our knowledge, this is the first quantitative analysis of neurobehavioral effects of MBI in PD. PMID: 26101690 [PubMed] (Source: Parkinsons Disease)


5 Findings From The First Major Analysis Of Medical Pot Benefits
CHICAGO (AP) — Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette's syndrome and the authors recommend more research. The analysis is among several medical marijuana articles published Tuesday in the Journal of the American Medical Association. They include a small study suggesting that many brand labels for edible marijuana products list inaccurate amounts of active ingredients. More ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Managing Comorbidities in Patients With Chronic Heart FailureManaging Comorbidities in Patients With Chronic Heart Failure
Find out which medications used to treat diabetes, pain, arrhythmias, and depression may be associated with increased risk in patients with heart failure. American Journal of Cardiovascular Drugs (Source: Medscape Today Headlines)


Alcohol, Tobacco Use in Youth With and Without Chronic PainAlcohol, Tobacco Use in Youth With and Without Chronic Pain
Health risk behaviors including alcohol and tobacco use are often established during adolescence. Does having chronic pain contribute to the risk of alcohol or tobacco use in this age group? Journal of Pediatric Psychology (Source: Medscape Today Headlines)


Oxygen Chamber Therapy May Ease Fibromyalgia, Study Suggests
Title: Oxygen Chamber Therapy May Ease Fibromyalgia, Study SuggestsCategory: Health NewsCreated: 6/24/2015 12:00:00 AMLast Editorial Review: 6/24/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Turmeric-Ginger Tea - A powerful anti-inflammatory remedy for pain relief
(NaturalNews) In recent years, the topic of inflammation has become more widely studied, and more is understood about this condition than in the past. Medical researchers are beginning to realize just how much of a toll chronic, low-level inflammation can take on the body and are... (Source: NaturalNews.com)


Epidemiology of Functional Gastrointestinal Disorders in Japan and in the World.
Authors: Oshima T, Miwa H Abstract Functional gastrointestinal disorders (FGIDs), represented by functional dyspepsia (FD) and irritable bowel syndrome (IBS), are a group of disorders that include variable combinations of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. FGIDs account for a significant percentage of patients seen in primary care settings with abdominal symptoms. Although the definition of FGIDs can easily affect the prevalence, the prevalences of dyspepsia/FD and IBS diagnosed by the Rome III criteria in the general population are 5.3-20.4% and 1.1-29.2%, respectively. Recent reports of FD and IBS defined by the Rome III criteria indicated a female predominance. Regarding the subtype prevalence of FD, postprand...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Survey of Chronic Pain Due to Spinal Dural Arteriovenous Fistulae
CONCLUSION: Most of our SDAVF patients reported moderate to severe chronic leg pain characterized by spontaneous pain and paresthesia/dysesthesia. Spinal cord atrophy on magnetic resonance imaging scans was a characteristic in patients with chronic pain. ABBREVIATIONS: ALS, Aminoff-Logue scale NPSI, neuropathic pain symptom inventory NRS, numeric rating scale SCI, spinal cord injury SDAVF, spinal dural arteriovenous fistulae (Source: Neurosurgery)


Open synovectomy of the ankle joint in young haemophiliacs: mid‐term to long‐ term results of a single‐centre series of 32 procedures
ConclusionOur long‐term results support that clinical scores are improved even if radiological scores progress. Open synovectomy retards the progression of the arthropathy, but not stops it. Bleeding and pain are controlled and even if recurrence of bleedings is frequent, it is less severe, less painful and requiring less factors replacement. (Source: Haemophilia)


Individual characteristics of reliable lumbar coupling motions
Conclusions Lumbar CM measurements obtained using the MEMS-IMU are reliable, and identifying the individual variations of lumbar CMs may be helpful for alleviating chronic or recurrent LBP. (Source: European Spine Journal)


Neurobiological phenotypes of familial chronic pain in adolescence: a pilot fMRI study
Parental history of chronic pain has been associated with self-reported pain in child offspring. This suggests that there may be neurobiological mechanisms associated with pain heritability. Because emotional circuitry is an important component of pain processing and may also influence cognition, we used functional magnetic resonance imaging to examine affective processing and cognitive control using an Emotional Go/NoGo Task in youth with (FH+Pain, N=8) and without (FH-Pain, N=8) a parental history of chronic pain (mean age = 14.17±.34). (Source: The Journal of Pain)


Confronting Chronic Pain- A Pain Doctor's Guide to Relief Richeimer Steven H with Steligo Kathy Confronting Chronic Pain- A Pain Doctor's Guide to Relief 256pp £12.83 Johns Hopkins University Press 978 1 4214 1253 5 1421412535 [Formula: see text].
Authors: Abstract Written by a Californian pain doctor and a medical author with an easy writing style, this book is packed with helpful tables, illustrations and case histories. PMID: 26103858 [PubMed - in process] (Source: Nursing Standard)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study.
CONCLUSIONS: Poorer attitudes towards LTPA may partially explain why ambulatory individuals are less active. The qualitative and quantitative data suggest ambulators are an often-overlooked subgroup in need of targeted resources to enhance their attitudes, wheelchair skill self-efficacy and awareness of LTPA opportunities. Implications for Rehabilitation Rehabilitation practitioners must be sensitive to the unique needs of spinal cord injured individuals who are ambulatory, and tailor physical activity promotional strategies to suit the needs of this distinct group. Lack of wheelchair skills is a participation barrier for ambulators; ambulators should be introduced to activities that do not require wheelchair use, such as swimming, hand-cycling and adapted forms of circuit training. Strate...


An open multicenter comparative randomized clinical study on chitosan
In conclusion this open multicenter comparative prospective randomized clinical study has provided compelling evidence that the next generation chitosan wound dressing can enhance wound progression towards healing by facilitating wound reepithelialization and reducing the patients pain level. Furthermore the dressing was shown to be clinically safe and effective in the management of chronic wounds. (Source: Wound Repair and Regeneration)


Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial
To evaluate the effect of training and pain education versus pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. (Source: Manual Therapy)


Case report: Limb-threatening femoral vein thrombosis in a healthy carpet fitter: Carpet fitter's thrombosis.
CONCLUSIONS: Deep vein thrombosis is typically associated with factors such as increasing age and prolonged periods of immobility; however, certain 'active' occupations can increase its risk. Crouched and cramped working conditions including repetitive active movement with flexed hips and knees can predispose to increased risk of venous thromboembolism. PMID: 26111944 [PubMed - as supplied by publisher] (Source: Phlebology)


Pathway-Focused Genetic Evaluation of Immune and Inflammation Related Genes with Chronic Fatigue Syndrome.
This study was done to explore the association of functionally important genetic variants in inflammation and immune pathways with CFS. Peripheral blood DNA was isolated from 50 CFS and 121 non-fatigued (NF) control participants in a population-based study. Genotyping was performed with the Affymetrix Immune and Inflammation Chip that covers 11K single nucleotide polymorphisms (SNP) following the manufacturer's protocol. Genotyping accuracy for specific genes was validated by pyrosequencing. Golden Helix SVS software was used for genetic analysis. SNP functional annotation was done using SPOT and GenomePipe programs. CFS was associated with 32 functionally important SNPs: 11 missense variants, 4 synonymous variants, 11 untranslated regulatory region (UTR) variants and 6 intronic variants. ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


150 patient experiences with a soft silicone foam dressing.
Authors: Bateman SD Abstract Pain, malodour and exudate from acute and chronic wounds can be catastrophic to the patient. Excessive exudate results in significant tissue damage to the wound bed and surrounding skin, reduces quality of life, and often requires costly specialist service input. Effective wound assessment and management including appropriate dressing choice is, therefore, paramount to ensure wound healing can take place in a timely manner. This observational evaluation explores 150 ward-based patients who presented with acute and chronic exuding wounds; it examines and evaluates the proposed benefits of the Cutimed(®) Siltec foam dressing range over a 4-month period in an acute hospital setting. The outcomes of the evaluation were exudate management, maceration reduct...


MicroRNA expression profiles differentiate chronic pain condition subtypes.
Authors: Ciszek BP, Khan AA, Dang H, Slade GD, Smith S, Bair E, Maixner W, Zolnoun D, Nackley AG Abstract Chronic pain is a significant health care problem, ineffectively treated because of its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs (miRNAs) regulate the expression of pain-relevant genes, yet little is known about their role in chronic pain. Here, we evaluate the relationship among pain, psychological characteristics, plasma cytokines, and whole blood miRNAs in 22 healthy controls (HCs); 33 subjects with chronic pelvic pain (vestibulodynia, VBD); and 23 subjects with VBD and irritable bowel syndrome (VBD + IBS). VBD subjects were similar to HCs in self-reported pain, psychological profiles, and remote bodily pain. V...


DePuy sponsor’s Anika’s IDE bid for Monovisc hip treatment
Anika Therapeutics (NSDQ:ANIK) said today that DePuy Orthopedics will support its submission of an investigational device exemption to conduct a trial to expand the indication of Monovisc for the treatment of pain caused by osteoarthritis of the hip. Johnson & Johnson (NYSE:JNJ) subsidiary DePuy Orthopedics are the exclusive distributors of the Monovisc in the U.S., Bedford, Mass.-based Anika Therapeutics said. &#8220;The submission of this IDE represents an important step towards extending the benefits of Monovisc to patients living with the chronic pain associated with hip osteoarthritis, for whom non-surgical treatment options are currently limited. We believe the expanded indication will further enhance the clinical and commercial value of Monovisc, and strengthen our position in t...


Epigenetic modulation of Wnt signaling contributes to neuropathic pain in rats.
Authors: Feng W, Teng R, Zhao Y, Gao J, Chu H Abstract Previous studies have demonstrated that the Wnt/β‑catenin signaling pathway is critical to the induction and maintenance of chronic neuropathic pain caused by peripheral inflammation and nerve damage. Emerging evidence from recent studies suggests that epigenetic mechanisms may also be critical to the pathogenesis of chronic pain. The present study aimed to elucidate the epigenetic mechanisms underlying altered Wnt signaling and their involvement in CCI‑induced neuropathic pain in rat sciatic nerves. The results of the present study demonstrated a significant increase in the expression levels of Wnt3a in the dorsal horn of the rats with CCI. In addition, a significant increase in histone H3 acetylation, and a significant d...


Evidence Supports Marijuana as Medical Treatment for Some Conditions, Not All
Researchers found moderate support for using marijuana to treat chronic pain and muscle spasms and involuntary movements -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medical marijuana unproven to help many illnesses it's used for, studies find
Evidence was weak that marijuana helps anxiety and sleep disordersMany edible products list inaccurate amounts of active ingredientsMedical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits.The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette’s syndrome and the authors recommend more research. Continue reading... (Source: Guardian Unlimited Science)


Studies find medical marijuana unproven to help many illnesses
Evidence was weak that marijuana helps anxiety and sleep disordersMany edible products list inaccurate amounts of active ingredientsMedical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits.The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette’s syndrome and the authors recommend more research. Continue reading... (Source: Guardian Unlimited Science)


Mixed findings regarding quality of evidence supporting benefit of medical marijuana
In an analysis of the findings of nearly 80 randomized trials that included about 6,500 participants, there was moderate-quality evidence to support the use of cannabinoids (chemical compounds that are the active principles in cannabis or marijuana) for the treatment of chronic pain and lower-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, sleep disorders, and Tourette syndrome. (Source: ScienceDaily Headlines)


Vasoactive Intestinal Peptide in Early Spondyloarthritis: Low Serum Levels as a Potential Biomarker for Disease Severity
Abstract Spondyloarthritis (SpA) is a family of inflammatory diseases sharing clinical, genetic, and radiological features. While crucial for tailoring early interventions, validated prognostic biomarkers are scarce in SpA. We analyze the correlation between serum levels of vasoactive intestinal peptide (VIP) and disease activity/severity in patients with early chronic inflammatory back pain. The study population comprised 54 patients enrolled in our early chronic inflammatory back pain register. We collected demographic information, clinical data, laboratory data, and imaging findings. VIP levels were measured by enzyme immunoassay in serum samples from 162 visits. The association between independent variables and VIP levels was analyzed using longitudinal multivariate analysis ...


Spontaneous Chronic Pain After Experimental Thoractomy Revealed by Conditioned Place Preference:
Chronic pain following surgery limits social activity, interferes with work and causes emotional suffering. A major component of such pain is is reported as “resting” or spontaneous pain with no apparent external stimulus. Although experimental animal models can simulate the stimulus-evoked chronic pain that occurs after surgery, there have been no studies of spontaneous chronic pain in such models. Here the Conditioned Place Preference (CPP) paradigm was used to reveal resting pain after experimental thoracotomy. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Cannabinoids for Medical Use
This meta-analysis summarizes the effectiveness of cannabis and cannabinoids for managing medical and psychotic disorders, including chemotherapy-induced nausea and vomiting, chronic pain, and mood and sleep disorders. (Source: JAMA)


Medical Marijuana for Treatment of Chronic Pain and Other Problems
This synopsis of a medicine grand rounds conference uses an example of a patient with chronic low back pain as the basis for discussing the use of medical marijuana for treating chronic pain and other disorders. (Source: JAMA)


Systemic inflammation activates satellite glial cells in the mouse nodose ganglion and alters their functions
Satellite glial cell (SGCs) in trigeminal and dorsal root ganglia are altered structurally and functionally under pathological conditions associated with chronic pain. These changes include reactive gliosis, augmented coupling by gap junctions, and increased responses to ATP via purinergic P2 receptors. Similar information for nodose ganglia (NG), which receive sensory inputs from internal organs via the vagus nerves, is missing. Here, we investigated changes in SGCs in mouse NG after the intraperitoneal administration of lipopolysaccharide (LPS), which induces systemic inflammation. Using calcium imaging we found that SGCs in intact, freshly isolated NG are sensitive to ATP, acting largely via purinergic P2 receptors (mixed P2X and P2Y), with threshold at 0.1 μM. A single systemic inject...


Palliative Care in the Emergency Department
Patients seek care in the emergency department (ED) for immediate relief of pain or other symptoms. Emergency physicians are trained to provide care that focuses on disease-directed treatment of acute illnesses; the ED is not considered an entry point for palliative care. Despite this, many patients with chronic or end-stage diseases seek treatment in the ED each year. Improving quality of life (QOL) is an overarching principle of palliative care. The ED is poised to improve patients’ QOL by providing palliative interventions to manage pain and exacerbations of chronic illnesses or care near the end of life. (Source: Critical Care Nursing Clinics of North America)


MicroRNA expression profiles differentiate chronic pain condition subtypes
Chronic pain is a significant healthcare problem, ineffectively treated due to its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs regulate the expression of pain-relevant genes, yet little is known about their role in chronic pain. Here, we evaluate the relationship between pain, psychological characteristics, plasma cytokines and whole blood microRNAs in 22 healthy controls (HC); 33 subjects with chronic pelvic pain (vestibulodynia: VBD); and 23 subjects with VBD and irritable bowel syndrome (VBD+IBS). (Source: Translational Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Efficacy of epidural steroid injections for chronic lumbar pain syndromes without neurological deficits : A randomized, double blind study as part of a multimodal treatment concept].
DISCUSSION: After the epidural injection the decrease in pain and increase in treatability was statistically significant. The mechanism of the improvement is not clear and should be examined further. The epidural injection of a steroid in this subgroup of patients did not lead to a clinical improvement in the outcome. PMID: 26099752 [PubMed - as supplied by publisher] (Source: Schmerz)


Fatal hemorrhage following sacroiliac joint fusion surgery: a case report
The sacroiliac (SI) joint is a common though under-recognized source of chronic low back pain. Despite recent efforts to characterize the role of the sacroiliac joint in chronic low pain back, no definitive conservative, interventional, or surgical options exist for managing chronic pain originating from this joint. In patients suffering from sacroiliac joint degeneration or disruption with unsuccessful non-surgical care, joint arthrodesis has been reported to relieve pain and improve quality of life [1–3]. (Source: Legal Medicine)


Clitorodynia: A Descriptive Study of Clitoral Pain
ConclusionOur findings indicate that women with clitoral pain suffer from significant, distressing, and often long‐term pain, which interferes with sexual and daily activities. Two subtypes of clitoral pain may exist, each with distinct pain characteristics and subjective experiences. Parada M, D'Amours T, Amsel R, Pink L, Gordon A, and Binik YM. Clitorodynia: A descriptive study of clitoral pain. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)


Increased excitability of medium-sized dorsal root ganglion neurons by prolonged interleukin-1β exposure is k(+) channel dependent and reversible.
This article is protected by copyright. All rights reserved. PMID: 26110238 [PubMed - as supplied by publisher] (Source: The Journal of Physiology)


Vitamin D and Pain: Vitamin D and Its Role in the Aetiology and Maintenance of Chronic Pain States and Associated Comorbidities.
Authors: Shipton EA, Shipton EE Abstract The emergence of new data suggests that the benefits of Vitamin D extend beyond healthy bones. This paper looks at Vitamin D and its role in the aetiology and maintenance of chronic pain states and associated comorbidities. The interfaces between pain and Vitamin D and the mechanisms of action of Vitamin D on pain processes are explored. Finally the association between Vitamin D and pain comorbidities such as sleep and depression is investigated. The paper shows that Vitamin D exerts anatomic, hormonal, neurological, and immunological influences on pain manifestation, thereby playing a role in the aetiology and maintenance of chronic pain states and associated comorbidities. More research is necessary to determine whether Vitamin D is useful...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Uncovering male and female experiences of irritable bowel syndrome
Commentary on: Bjorkman I, Dellenborg L, Ringstrom G, et al. The gendered impact of irritable bowel syndrome: a qualitative study of patients&rsquo; experiences. J Adv Nurs 2014;70:1334&ndash;43. Implications for practice and research A more gender sensitive approach in the healthcare setting could increase understanding of patients&rsquo; experience of irritable bowel syndrome (IBS). Intervention studies from a person centred, gender-sensitive perspective should be conducted. Context IBS is a common, chronic functional bowel disorder characterised by altered bowel function, with lower abdominal pain or discomfort and associated with high levels of psychosocial morbidity.1 IBS is experienced by more women than men, but there is poor understanding of what differences exist, if any, between ...


Physical and sexual intimate partner violence negatively affects women's mental health and their children's behaviour
Commentary on: Symes L, Maddou J, McFarlane J, et al. Physical and sexual intimate partner violence, women's health and children's behavioural functioning: entry analysis of a seven-year prospective study. J Clin Nurs 2014;23:19&ndash;20. Implications for practice and research Screening for intimate partner violence (IPV) may help connect women to support services, which may in turn reduce the risk of death related to IPV. Research should continue to explore the effect of physical and sexual IPV on women and children's health outcomes. Context Seven million women each year experience physical, sexual or psychological abuse by an intimate partner and approximately 16% of children are exposed to IPV (also known as domestic violence) during their lifetime.1 2 Women who experience IPV report m...


Cognitive dysfunction associated with pain and quality of life in chronic rhinosinusitis
ConclusionIn patients with CRS, increasing pain and worse QOL are associated with cognitive dysfunction. Possible mechanisms for this cognitive dysfunction include differential neural activation secondary to chronic pain and/or the sequela of a chronic inflammatory state. (Source: International Forum of Allergy and Rhinology)


High-Definition and Non-Invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD
Temporomandibular disorders (TMD) have a relatively high prevalence and in many patients pain and masticatory dysfunction persist despite a range of treatments. Non-invasive brain neuromodulatory methods, namely transcranial direct current stimulation (tDCS), can provide relatively long-lasting pain relief in chronic pain patients. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)


Potential economic impact on hospitalisations of the Palliative Care Clinical Studies Collaborative (PaCCSC) ketamine randomised controlled trial.
Conclusions The findings from the modelled impact analysis suggest that dissemination of the PaCCSC ketamine RCT results may have saved the Australian healthcare system approximately A$663 000 in annual hospitalisation costs and freed up 443 in-patient bed-days, although there was high uncertainty within the study. Wider dissemination over time and targeted, local de-adoption strategies could result in further savings. PMID: 26093387 [PubMed - as supplied by publisher] (Source: Australian Health Review)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Enhanced serotonin and mesolimbic dopamine transmissions in a rat model of neuropathic pain.
We report that, two weeks following peripheral nerve injury, discharge rate of serotonin DRN neurons and burst firing of VTA dopamine cells are enhanced, when compared with sham-operated animals. We also observed higher extracellular dopamine levels and reduced expression of D2, but not D1, receptors and TH in the nucleus accumbens. Our study confirms that peripheral neuropathy induces changes in the serotonin and dopamine systems that might be the early result of chronic maladaptation to persistent pain. The allostatic activation of these neural systems, which mirrors that already described as a consequence of stress, might lead to depression and anxiety previously observed in neuropathic animals but also an attempt to cope positively with the negative experience. PMID: 26113399 [PubM...


High-Definition and Non-invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD
Temporomandibular disorders (TMD) have a relatively high prevalence and in many patients pain and masticatory dysfunction persist despite a range of treatments. Non-invasive brain neuromodulatory methods, namely transcranial direct current stimulation (tDCS), can provide relatively long-lasting pain relief in chronic pain patients. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)


How to Avoid Nightmares and Bad Dreams to Get More Restful Sleep
This article originally appeared on the Amerisleep blog. Rosie Osmun is the Creative Content Manager at Amerisleep, a progressive memory foam mattress brand focused on eco-friendly sleep solutions. Rosie writes more posts on the Amerisleep blog about the science of sleep, eco-friendly living, leading a healthy lifestyle and more. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)


Mindfulness-Based Stress Reduction: pilot study of a treatment group for patients with chronic pain in a primary care setting.
Authors: Beaulac J, Bailly M Abstract UNLABELLED: Aim The study objective was to evaluate an eight-week Mindfulness-Based Stress Reduction (MBSR) treatment group for chronic pain in terms of effects on pain disability, subjective ratings of pain and psychological distress related to pain, and activity level and willingness to experience pain. This pilot study evaluated the impact of two eight-week MBSR treatment groups that were delivered in a clinic in Winnipeg, Manitoba. BACKGROUND: Chronic pain is one of the most common presenting problems in primary care settings. METHODS: Adult patients with chronic pain were recruited from 20 clinics that are part of a collaborative care programme and outcome measures were administered at baseline and programme completion. Findings De...


Long-term outcomes of 1326 laparoscopic incisional and ventral hernia repair with the routine suturing concept: a single institution experience
Conclusion Our long series confirms the unexpected high rate of feasibility in the suturing concept or augmentation technique, and confers additional benefits to the conventional advantages of LIVHR in terms of reducing the overall morbidity, with a low rate of recurrences. Based on our experience and study, the current best indications for a successful LIVHR procedure should be tailored upon the limitations of the defect’s width and proper patient selection, to restore adequately the optimal functionality of the abdominal muscles and provide better functional and cosmetic outcomes. (Source: Hernia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prescribing Methadone
This article discusses indications for initiating methadone and highlights important aspects of patient evaluation and monitoring when methadone is prescribed. In addition, government restrictions on the use of methadone are explained. (Source: Hospital Medicine Clinics)


A Randomized Controlled Trial of the Effects of Isolated Lumbar Extension Exercise on Lumbar Kinematic Pattern Variability during Gait in Chronic Low Back Pain
Chronic low back pain (CLBP) is a multifactorial condition with a variety of symptoms; one being abnormal gait. The lumbar spine and its musculature are important in controlling gait and in CLBP the lumbar extensors are often deconditioned. Because of this specific isolated lumbar extension exercise is often recommended. It was therefore of interest to examine its effects of upon gait variability. (Source: PM and R)


Parthenolide Relieves Pain and Promotes M2 Microglia/Macrophage Polarization in Rat Model of Neuropathy.
Authors: Popiolek-Barczyk K, Kolosowska N, Piotrowska A, Makuch W, Rojewska E, Jurga AM, Pilat D, Mika J Abstract Neuropathic pain treatment remains a challenge because pathomechanism is not fully understood. It is believed that glial activation and increased spinal nociceptive factors are crucial for neuropathy. We investigated the effect of parthenolide (PTL) on the chronic constriction injury to the sciatic nerve (CCI)-induced neuropathy in rat. We analyzed spinal changes in glial markers and M1 and M2 polarization factors, as well as intracellular signaling pathways. PTL (5 µg; i.t.) was preemptively and then daily administered for 7 days after CCI. PTL attenuated the allodynia and hyperalgesia and increased the protein level of IBA1 (a microglial/macrophage marker) but did ...


Giant Pulmonary Hydatid Cyst and Trauma in a 9 Year-Old Child: A Case Report.
In conclusion, giant hydatid cysts are probably misdiagnosed with massive pleural effusion in the endemic area. And, because of the risk of allergic reactions, anaphylactic shock and dissemination, it should not be aspirated. PMID: 26089993 [PubMed] (Source: Open Respiratory Medicine Journal)


Diagnosis and treatment of bacterial prostatitis.
Authors: Videčnik Zorman J, Matičič M, Jeverica S, Smrkolj T Abstract Prostate inflammation is a common syndrome, especially in men under 50. It usually presents with voiding symptoms and pain in the genitourinary area, and sometimes as sexual dysfunction. Based on clinical and laboratory characteristics, prostatitis is classified as acute bacterial prostatitis, chronic bacterial prostatitis, chronic inflammatory and non-inflammatory prostatitis or chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Bacterial prostatitis is most often caused by infection with uropathogens, mainly Gram-negative bacilli, but Gram-positive and atypical microorganisms have also been identified as causative organisms of chronic prostatitis. According to reports by several authors...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Botulinum Toxin Type B for Chronic Pain: Panacea or Snake Oil? The Need for More and Better Preclinical Studies.
Authors: Cohen SP PMID: 26086506 [PubMed - in process] (Source: Anesthesia and Analgesia)


Pain Among High-Risk Patients on Methadone Maintenance Treatment
This study explores the prevalence and correlates of pain among a prospective cohort of people who use illicit drugs in Vancouver, Canada, who reported enrollment in methadone maintenance treatment (MMT) between 2011 and 2014. (Source: The Journal of Pain)


Central and systemic inflammatory responses to thoracotomy - potential implications for acute and chronic postsurgical pain
Chronic postsurgical pain (CPSP) may affect up to 70% of patients after surgery. Glial and immune mediators have been implicated in the pathogenesis of chronic postsurgical pain. Our objective was to study cerebrospinal fluid (CSF) and serum concentrations of IL-1β, IL-6, IL-8, IL-10, IFNγ and TNFα patients undergoing a thoracotomy and oesophagectomy over a 72-hour period. Despite adequate pain control, thoracotomy was still associated with significant central and peripheral inflammation. This must be taken into consideration in planning future strategies to prevent CPSP. (Source: Journal of Neuroimmunology)


Risks and Benefits of Bisphosphonate Therapies
This article is protected by copyright. All rights reserved (Source: Journal of Cellular Biochemistry)


Central and systemic inflammatory responses to thoracotomy — Potential implications for acute and chronic postsurgical pain
Chronic postsurgical pain (CPSP) may affect up to 70% of patients after surgery. Glial and immune mediators have been implicated in the pathogenesis of chronic postsurgical pain. Our objective was to study cerebrospinal fluid (CSF) and serum concentrations of IL-1β, IL-6, IL-8, IL-10, IFNγ and TNFα over a 72-hour period in patients undergoing a thoracotomy and oesophagectomy. Despite adequate pain control, thoracotomy was still associated with significant central and peripheral inflammation. This must be taken into consideration in planning future strategies to prevent CPSP. (Source: Journal of Neuroimmunology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effectiveness of Electromyographic Biofeedback, Mirror Therapy, and Tactile Stimulation in Decreasing Chronic Residual Limb Pain and Phantom Limb Pain for a Patient with a Shoulder Disarticulation: A Case Report: Erratum
No abstract available (Source: JPO Journal of Prosthetics and Orthotics)


Combination of Antioxidant Cocktail and Pregabalin in the Management of Pain in Chronic Pancreatitis After Ductal Clearance: A Randomized, Double-Blinded, Placebo-Controlled Trial
A substantial proportion of patients with chronic pancreatitis (CP) have pain recurrence post-endotherapy/lateral pancreaticojejunistomy (LPJ). (Source: Clinical Gastroenterology and Hepatology)


Study of Gut Microbiome in Chronic Pancreatitis: Association With Pancreatogenic Diabetes (Type 3C Diabetes) and Exocrine Insufficiency
We report for the first time the alteration of gut microbiota in CP with and without Type3c diabetes and PEI. (Source: Clinical Gastroenterology and Hepatology)


Smartphones now causing permanent health problems in chronic users
(NaturalNews) Skull on fire, writhing in pain, one journalist tells his own story about the onset of searing headaches and the feeling of being "hit over the head with a rod of steel." That's how journalist Adam Estes described the mysterious "bolts of pain" that shot from the top... (Source: NaturalNews.com)


Current concepts in management of pain in children in the emergency department
Publication date: Available online 18 June 2015 Source:The Lancet Author(s): Baruch S Krauss , Lorenzo Calligaris , Steven M Green , Egidio Barbi Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive ro...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Maintenance of improvement in spinal mobility, physical function and quality of life in patients with ankylosing spondylitis after 5 years in a clinical trial of adalimumab
Conclusion. Treatment with adalimumab for up to 5 years demonstrated sustained benefits in spinal mobility, disease activity, physical function and HRQoL in patients with active AS. Spinal mobility was significantly associated with short- and long-term physical function in these patients. Trial registration: Clinicaltrials.gov; https://clinicaltrials.gov/ NCT00085644. (Source: Rheumatology)


Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort
(Source: Rheumatology)


Chronic Disabling Pain A Significant Public Health Problem
Publication date: July 2015 Source:American Journal of Preventive Medicine, Volume 49, Issue 1 Author(s): Fiona M. Blyth , Danielle A. Van Der Windt , Peter R. Croft (Source: American Journal of Preventive Medicine)


StressModEx – Physiotherapist-led Stress Inoculation Training integrated with exercise for acute whiplash injury: study protocol for a randomised controlled trial
This study (StressModEx) will target individuals in the acute stage of injury and address the stress responses associated with the accident or injury (event-related distress) with the aim of improving both physical and mental health outcomes. Research question Is SIT integrated with standard physiotherapy exercise and delivered by physiotherapists more effective than physiotherapy exercise alone in reducing neck pain and disability in individuals with acute whiplash associated disorders? Design Parallel randomised controlled trial with blinded outcome assessment. Participants and setting 100 individuals with grade II or III (no fracture/dislocation or neurological loss) acute whiplash associated disorder&lt;4 weeks duration and at least moderate neck pain-related disability and hype...


Short term results of the Mobility Total Ankle System: clinical and radiographic outcome
End-stage osteoarthritis of the ankle is a chronic condition associated with progressive joint pain and dysfunction. Patients with end-stage ankle arthritis report a severely affected health-related quality of life and experience more pain and reduced physical and social functioning compared to the general population.[1] (Source: Foot and Ankle Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Baker's Cyst: Diagnostic and Surgical Considerations
Conclusion: A capsular opening to the semimembranosus&ndash;medial head gastrocnemius bursa is a commonly found normal anatomic variant. It is thought that this can lead to the formation of a popliteal cyst in the presence of chronic knee effusions as a result of intra-articular pathology. Management of symptomatic popliteal cysts is conservative. The intra-articular pathology should be first addressed by arthroscopy. If surgical excision later becomes necessary, a limited posteromedial approach is often employed. Other treatments, such as arthroscopic debridement and closure of the valvular mechanism, are not well studied and cannot yet be recommended. (Source: Sports Health)


Successful Palliation of Octreotide-Resistant Diarrhea Using Glycopyrrolate in a Patient with Medullary Thyroid Cancer: A Case Report
Neuroendocrine tumors (NETs), including medullary thyroid cancer, can cause chronic diarrhea. This can be severe and debilitating, limiting self-care and may lead to hospitalization. The National Cancer Institute Common Terminology Criteria (CTC) for Adverse Events classifies cancer-related diarrhea into five grades 1 (Table 1). The American Thyroid Association recommends antimotility agents, such as loperamide or codeine; and the use of octreotide in resistant cases. Surgical tumor debulking may help as well 2. (Source: Journal of Pain and Symptom Management)


The Nature of the Association between Anxiety Sensitivity and Pain-Related Anxiety: Evidence from Correlational and Intervention Studies.
Authors: Olthuis JV, Watt MC, Mackinnon SP, Potter SM, Stewart SH Abstract High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and co...


Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic versus Skate Nordic Rollerskiing.
CONCLUSIONS:   Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic rollerskiing may increase discomfort during activity. Our results therefore suggest that Nordic rollerskiing contributes to increases in ICPs, which may lead to the development of CECS. PMID: 26090709 [PubMed - as supplied by publisher] (Source: J Athl Train)


Neuropelveology: New Groundbreaking Discipline in Medicine
Intractable chronic pelvic, genital, and low lumbar pain, often with distal radiation, are frequent complaints in the general population. In many cases no etiology is found, and these patients are treated with analgesics, often in combination with antipsychotics or anticonvulsants. Pathologies of the pelvic nerves might explain some of these cases, but this possibility is seldom explored clinically. Reasons are various: difficult access to the pelvic nerves make visualization, clinical assessment, and microneurosurgical procedures complicated and invasive; electrophysiologic explorations are unreliable because they can be abnormal after delivery or pelvic surgeries and fail to define the neurologic level of the pathology; or medical imaging might be useful but only when data interpretatio...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


BEMER Therapy Combined with Physiotherapy in Patients with Musculoskeletal Diseases: A Randomised, Controlled Double Blind Follow-Up Pilot Study.
Conclusions. Our study showed that BEMER physical vascular therapy reduced pain and fatigue in the short term in patients with chronic low back pain, while long-term therapy appears to be beneficial in patients with osteoarthritis of knee. PMID: 26078768 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


Chronic back pain may be helped by 'talking therapy'
Stephen FellerLONDON, June 18 (UPI) -- "Talking therapy" to treat fear-avoidant tendencies in patients with chronic back pain makes physiological treatments more effective, according to researchers. (Source: Health News - UPI.com)


Should We Prescribe Opioids for Chronic Pain?Should We Prescribe Opioids for Chronic Pain?
Dr Argoff defends the use of opioids for treatment of chronic pain, and posits how and to whom opioids should be prescribed. Medscape Neurology (Source: Medscape Nurses Headlines)


Lower back pain can be treated with 'talking therapy'
An innovative form of talking therapy could help people suffering from chronic lower back pain, according to new research. (Source: Nursing Times Breaking News)


Can We Identify Patients with High Risk of Osteoarthritis Progression Who Will Respond to Treatment? A Focus on Biomarkers and Frailty
Abstract Osteoarthritis (OA), a disease affecting different patient phenotypes, appears as an optimal candidate for personalized healthcare. The aim of the discussions of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group was to explore the value of markers of different sources in defining different phenotypes of patients with OA. The ESCEO organized a series of meetings to explore the possibility of identifying patients who would most benefit from treatment for OA, on the basis of recent data and expert opinion. In the first meeting, patient phenotypes were identified according to the number of affected joints, biomechanical factors, and the presence of lesions in the subchondral bone. In the second meeting, summarized ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Takotsubo syndrome after heart valve surgery
We present a 68-year-old woman who came to the Emergency Department complaining of palpitations and a 3 days progressive dyspnoea becoming rest dyspnoea. She denied chest pain, dizziness, syncope, fever or other symptoms. The patient had no known allergies and a prior history of dyslipidemia, chronic renal failure, secondary hypothyroidism and rheumatic heart disease, in treatment with atorvastatin, aspirin, levothyroxine, Candesartan/Hydrochlorothiazide and warfarin. She had undergone cardiac surgery a month before (double valve replacement was performed with Carbomedics metallic prosthesis: number 21 in aortic position and 27 in mitral position). (Source: International Journal of Cardiology)


MY APPROACH to Cardiac Troponin Elevations in Patients With Renal Disease
A 62-year-old male presented to the emergency department with chest pain radiating down his left arm that lasted 40minutes and awakened him 3hours prior to arrival. It was associated with shortness of breath, nausea, and diaphoresis. You note a history of hypertension and hypercholesterolemia controlled with hydrochlorothiazide and atorvastatin. In addition, he has chronic renal failure, for which he tells you that his doctor thinks he might soon require dialysis. His father had died of an acute myocardial infarction (AMI) at 70 years of age. (Source: Trends in Cardiovascular Medicine)


Clinical Pain Catastrophizing in Women With Migraine and Obesity
ConclusionsOne quarter of participants with migraine and obesity reported clinical catastrophizing. These individuals had more frequent attacks/chronicity, longer attack duration, higher pain sensitivity, greater headache impact, and lower headache management self‐efficacy. In all participants, PCS scores were related to several migraine characteristics, above and beyond the effects of obesity. Prospective studies are needed to determine sequence and mechanisms of relationships between catastrophizing, obesity, and migraine. (Source: Headache: The Journal of Head and Face Pain)


Randomized clinical trial assessing if additional massage treatments for chronic neck pain improve 12 and 26 week outcomes
This is the first study to systematically evaluate the value of a longer treatment period for massage. We provide a framework of how to conceptualize an optimal dose in this challenging setting of non-pharmacological treatments. (Source: The Spine Journal)


A rare cause of chronic neck pain: Accessory cervical spinous process
A 34-year-old female admitted to our hospital with the complaints of chronic neck pain. On physical examination hyperextension was painful. No other abnormality was observed. There was no history of trauma or systemic illness. Magnetic resonance imaging (MRI) demonstrated a posterior protrusion at C2 level on sagittal T2-weighted images. Axial MRI images showed a two centimeters bone causing posterolateral protrusion (Fig. 1). Computed tomography (CT) examination and 3D construction of CT images demonstrated an accessory spinous process causing posterior protrusion at C2 vertebrae level (Fig. (Source: The Spine Journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


An unusual cause of chronic abdominal pain in a child: Thoracic spinal dermoid cyst
A 3 year-old female patient was admitted with abdominal pain for six month. Routine laboratory tests and abdominal ultrasound findings were normal. Low dose abdominal computed tomography (CT) was performed. Incidentally, CT showed a intradural lesion at T8 level containing fat, millimetric calsifications and minimal solid component. Magnetic resonance imaging was performed and there was an intradural solid mass, which extends to intradural and extramedullary space on T8 and T9 spinal segments. The mass was measured 18x14x20 mm and was hyperintense on both T1 and T2 weighted images (WI). (Source: The Spine Journal)


Hip salvage surgery in cerebral palsy cases: a systematic review
Publication date: Available online 16 June 2015 Source:Revista Brasileira de Ortopedia (English Edition) Author(s): Rafael Carboni de Souza , Marcelo Valentim Mansano , Miguel Bovo , Helder Henzo Yamada , Daniela Regina Rancan , Patrícia de Moraes Fucs , Celso Svartman , Rodrigo Montezuma César de Assumpção Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients’ quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The...


Spinal Myeloid Sarcoma “Chloroma” Presenting as Cervical Radiculopathy: Case Report
Conclusions Spinal myeloid sarcoma presenting as cervical radiculopathy is rare, and it may be easily misdiagnosed. Knowledge of its clinical presentation, imaging, and histologic characterization can lead to early diagnosis and appropriate treatment.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  open access Full text (Source: Global Spine Journal)


Effect of subanaesthetic ketamine on plasma and saliva cortisol secretion
Conclusions Ketamine has an appreciable effect on cortisol production. This may impact on critical physiological and psychological functions. Clinical trial registration This study was registered in the Dutch Trial Register under number NTR2717 at www.trialregister.nl. (Source: British Journal of Anaesthesia)


Chronic intrathecal infusion of mibefradil, ethosuximide and nickel attenuates nerve ligation-induced pain in rats
Conclusions In this study, we demonstrated that intrathecal TCC blockers attenuate the development of nerve injury-induced mechanical allodynia and thermal hyperalgesia. Our data suggest that continuous intrathecal infusion of TCC or CaV3.2 blockers may be a promising alternative for the management of nerve injury-induced pain. (Source: British Journal of Anaesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Deconstructing Chronic Low Back Pain in the Older Adult–Step by Step Evidence and Expert‐Based Recommendations for Evaluation and Treatment: Part II: Myofascial Pain
ConclusionsThe algorithm presented gives a structured approach to guide primary care providers in planning treatment for patients with MP as a contributor to CLBP. (Source: Pain Medicine)


Off-Label Trazodone Prescription: Evidence, Benefits and Risks.
Authors: Letizia B, Anna C, Ilaria C, Jim B, Amodeo G, De Giorgi R, Fagiolini A Abstract Although trazodone is approved and marketed in most countries worldwide for the sole treatment of Major Depressive Disorder, the use for this medication is very common for many other conditions, such as primary or secondary insomnia, Generalised Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder and Obsessive-Compulsive Disorder. Other, not officially approved, uses of trazodone include: the treatment of bulimia, benzodiazepine and/or alcohol dependence or abuse, fibromyalgia, degenerative diseases of the central nervous system such as dementia and other organic disorders, schizophrenia, chronic pain, and diabetic neuropathy. In addition, due to its 5HT2A receptor antagonistic act...


Clinical Pain Catastrophizing in Women With Migraine and Obesity.
CONCLUSIONS: One quarter of participants with migraine and obesity reported clinical catastrophizing. These individuals had more frequent attacks/chronicity, longer attack duration, higher pain sensitivity, greater headache impact, and lower headache management self-efficacy. In all participants, PCS scores were related to several migraine characteristics, above and beyond the effects of obesity. Prospective studies are needed to determine sequence and mechanisms of relationships between catastrophizing, obesity, and migraine. PMID: 26087348 [PubMed - as supplied by publisher] (Source: Headache)


Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review.
CONCLUSION: There is low quality evidence to suggest that walking is as effective as other non-pharmacological management methods at improving disability, function, and quality of life in adults with chronic low back pain. PMID: 26088673 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)


Synthesis and evaluation of the anti-nociceptive and anti-inflammatory activity of 4-aminoquinoline derivatives.
Authors: de Meneses Santos R, Barros PR, Bortoluzzi JH, Meneghetti MR, da Silva YK, da Silva AE, da Silva Santos M, Alexandre-Moreira MS Abstract In this paper, we describe the synthesis and pharmacological evaluation of a series of 4-aminoquinolines. The compounds were characterised and tested in models of pain and inflammation, using the writhing test with acetic acid, formalin test, peritonitis test by zymosan and arthritis test with Freund's adjuvant complete assay. The results revealed that all of the 4-aminoquinolines that were prepared promoted anti-nociceptive activity as well as acute and chronic anti-inflammatory effects, with marked activity in the derivates labelled with BAQ and 7-CF3-MAQ. After 7days of treatment, 7-CF3-MAQ did not induce significant hepatotoxicity, ga...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Potent approach shows promise for chronic pain
Non-narcotic treatments for chronic pain that work well in people, not just mice, are sorely needed. Drawing from human pain genetics, an international team of researchers demonstrates a way to break the cycle of pain hypersensitivity without the development of addiction, tolerance or side effects. (Source: ScienceDaily Headlines)


Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins
Conclusions BMI, percent of fat mass and greater depositions of fat and mass around the hips are associated with increases in chronic LBP prevalence in women but these associations are small and appear to be confounded by the effects of genetics and early shared environment. Therefore, our results do not support a causal direct relationship between obesity and chronic LBP. (Source: European Spine Journal)


Peggy’s Pain and the Creation of Gone With the Wind
In this report, the details of her health problems are reviewed. During her life, her diagnoses were problematic and remain so now, but would most likely include fibromyalgia and irritable bowel syndrome. (Source: Regional Anesthesia and Pain Medicine)


Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation
Conclusions: The innervation of the anterior capsule of the knee joint seems to follow a constant pattern making at least 3 of these nerves accessible to percutaneous ablation. To optimize clinical outcome, well-aligned radiographs are critical to guide lesion placement. (Source: Regional Anesthesia and Pain Medicine)


Validation of the Danish‐language chronic pain acceptance questionnaire
ConclusionThe psychometric properties of the Danish version of the 20‐item CPAQ were satisfactory, showing that the Danish version of CPAQ is valid and reliable. (Source: Acta Anaesthesiologica Scandinavica)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Potent approach shows promise for chronic pain
(Boston Children's Hospital) Non-narcotic treatments for chronic pain that work well in people, not just mice, are sorely needed. (Source: EurekAlert! - Medicine and Health)


Enhanced analgesic effects of tramadol and common trace element coadministration in mice
Chronic pain is managed mostly by the daily administration of analgesics. Tramadol is one of the most commonly used drugs, marketed in combination with coanalgesics for enhanced effect. Trace elements are frequent ingredients in dietary supplements and may enhance tramadol's analgesic effect either through synergic mechanisms or through analgesic effects of their own. Swiss Weber male mice were divided into nine groups and were treated with a combination of the trace elements Mg, Mn, and Zn in three different doses and a fixed dose of tramadol. Two groups served as positive (tramadol alone) and negative (saline) controls. Nociceptive assessment by tail‐flick (TF) and hot‐plate (HP) tests was performed at baseline and at 15, 30, 45, and 60 min after intraperitoneal administration. Respo...


Comparing Genomic Profiles of Women With and Without Fibromyalgia
Conclusion: Activity of interrelated pathways related to immune response, and homeostasis appears to be relevant to the experience of FMS. Replication and exploration of the relationship between gene expression and symptom severity will help determine clinical relevance of these findings. (Source: Biological Research For Nursing)


Effects of low dose oral contraceptive pill containing drospirenone/ethinylestradiol in patients with endometrioma
Conclusion Low dose DRSP/EE therapy is a promising treatment not only to reduce the size of endometrioma but also for dysmenorrhea. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)


A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain
Conclusion Office pertubal hysteroscopic-guided diluted bupivacaine infusion could be used to manage endometriosis-associated CPP for at least 3months. AEARCTR-0000573 (Source: International Journal of Gynecology and Obstetrics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Alpine Skiing With total knee ArthroPlasty (ASWAP): physical self‐concept, pain, and life satisfaction
Physical self‐concept in the elderly is assumed to be structured in terms of different domains and to contribute substantially to life satisfaction. However, little is known about the role of the physical self‐concept in older persons that are engaged in physical activity while suffering from typical age‐related impairments or chronic diseases. The present study aimed to investigate the structure of physical self‐concept in a group of older persons with total knee arthroplasty (TKA), its development throughout a 12‐week skiing intervention, and its importance to life satisfaction. Factor analyses of the present data reveal that the physical self‐concept consists of four dimensions addressing strength, flexibility/coordination, endurance, and sportiness. One higher order factor ...


Reduction of Neuropathic and Inflammatory Pain through Inhibition of the Tetrahydrobiopterin Pathway
Publication date: 17 June 2015 Source:Neuron, Volume 86, Issue 6 Author(s): Alban Latremoliere , Alexandra Latini , Nick Andrews , Shane J. Cronin , Masahide Fujita , Katarzyna Gorska , Ruud Hovius , Carla Romero , Surawee Chuaiphichai , Michio Painter , Giulia Miracca , Olusegun Babaniyi , Aline Pertile Remor , Kelly Duong , Priscilla Riva , Lee B. Barrett , Nerea Ferreirós , Alasdair Naylor , Josef M. Penninger , Irmgard Tegeder , Jian Zhong , Julian Blagg , Keith M. Channon , Kai Johnsson , Michael Costigan , Clifford J. Woolf Human genetic studies have revealed an association between GTP cyclohydrolase 1 polymorphisms, which decrease tetrahydrobiopterin (BH4) levels, and reduced pain in patients. We now show that excessive BH4 is produced in mice by both axotomized sensory neu...


Activating therapy modalities in older individuals with chronic non-specific low back pain: a systematic review
Although there are many special exercise-based therapy approaches for the working population suffering chronic low back pain, similar programmes for older individuals are rare. (Source: Physiotherapy)


DISEASE-A-WEEK CHALLENGE #4: The California Stem Cell Program versus Arthritis
In the 1966 movie-so-bad-it-might-be-fun, 1966 BILLY THE KID VS. DRACULA, there is a scene that made me cringe, and not for the reasons the film-makers intended. As Dracula, John Carradine lurched toward whomever he was menacing-- but the camera focused on the actor's poor hands. Arthritis. The swollen-knuckled joints were unmistakable. The rest of the movie I found myself worrying for him, scared he might bump into something, or that somebody might shake his hand, and squeeze too hard. Arthritis may not sound like much: perhaps because it is so common, affecting more than 20 million people in America alone. But the pain can be excruciating: it would be classified as torture, if done deliberately. My wife Gloria and I have the condition in our knees. For me, it's a minor inconven...


PTSD and Chronic Pain
Post-traumatic stress disorder (PTSD) mostly is known for its effect on overall mental health. There is research, however, to support the fact that PTSD is increasingly being recognized for its effect on physical wellness as well. Many who suffer with PTSD (veterans in particular) have higher lifetime prevalence of circulatory, digestive, musculoskeletal, nervous system, respiratory and infectious disease. There is also an increased co-occurrence of chronic pain in those who suffer with PTSD. Chronic pain may be defined as pain that persists longer than three months that was initially accompanied with tissue damage or a disease which has already healed. In 1979, the International Association for the Study of Pain (IASP) officially redefined pain as “an unpleasant sensory and emotional ex...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Older African Americans' Beliefs about Pain, Biomedicine, and Spiritual Medicine
ABSTRACT: Persistent (chronic) pain prompts older African Americans (AAs) to utilize a combination of biomedicine (BM) and spiritual medicine (SM) for pain management. Because less is known about how older AAs use these pain management interventions, healthcare providers are unable to provide holistic care and optimal pain management. Using a Christian and Afrocentric perspective, this article reviews older AAs' use of BM and SM, offering recommendations on how to integrate BM and SM for pain management. (Source: Journal of Christian Nursing)


What outcome measures are commonly used for Complex Regional Pain Syndrome clinical trials? A systematic review of the literature
ConclusionsCurrently, CRPS clinical trials use a wide range of outcome measures making the potential to synthesize evidence problematic. There is no internationally agreed core measurement set. This diversity of outcome measures demonstrates a clear need for the development of a core measurement set to be used in CRPS clinical trials. (Source: European Journal of Pain)


A Review of the Use of Stellate Ganglion Block in the Treatment of PTSD
Abstract Current treatments for PTSD are often not effective or acceptable to the patient. There are a number of emerging new treatments. One promising new one is stellate ganglion block, an anesthetic treatment for pain which relieves symptoms of severe and chronic PTSD in some patients. The focus of this chapter is to summarize clinical evidence available for the effectiveness of cervical sympathetic ganglion injection called stellate ganglion block (SGB), as well as demonstrate possible clinical applications of its use. Cervical sympathetic blockade involves injecting a local anesthetic next to a group of nerves (ganglion) in the neck. The technique has been used clinically since 1925 with very few side effects. Finally, the neurobiology of SGB is discussed. Challenges to the ...


The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA lesioned rats
This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6‐hydroxydopamine lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint. This article is protected by copyright. All rights reserved. (Source: European Journal of Neuroscience)


Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency
Conclusions: Immediate PRF application on the proximal nerve injury site provided a significant inhibition of neuropathic pain formation, accompanied by the inhibition of ERK activation. (Source: BMC Anesthesiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Cognitive behaviour therapy in women with fibromyalgia: A randomized clinical trial
Conclusions Cognitive behaviour therapy improved the life control in a female population with FMS. Coping behaviour in response to chronic pain was improved at the same time and in spite of higher subjective ratings of pain. Positive effects were seen on depression, vital exhaustion and stress behaviour. The effects of therapy were maintained and enhanced during the follow up period. It appears that women with FMS after the CBT treatment, according to this protocol obtained tools leading to better acceptance of their disorder. Implications FMS is a disorder with great therapeutic challenges. Total abolishment of pain symptoms is extremely difficult or impossible to achieve. Thus, the development of individual strategies for coping with pain is essential to reduce its impact on daily life....


Living arrangements, social networks and onset or progression of pain among older adults in Singapore
ConclusionsChronic pain is common in Singaporean older adults. Living alone and weak social network were sociopsychological factors associated with the onset or progression of chronic pain. Geriatr Gerontol Int 2015; ●●: ●●–●●. (Source: Geriatrics and Gerontology International)


Pain Relief Without Paresthesia
Patients with chronic, intractable low back or leg pain have a new option for pain relief from an electrical stimulation device that doesn’t cause paresthesia. The Senza System, which delivers high-frequency stimulation, received FDA approval in early May. (Source: JAMA)


Effects of low dose oral contraceptive pill containing drospirenone/ethinylestradiol in patients with endometrioma
Low dose oral contraceptive pills (OCPs) that contain synthetic estrogen and progestin are often used to relieve chronic pelvic pain associated with endometriosis. We sought to evaluate the efficacy of drospirenone/ethinylestradiol (DRSP/EE) with low-dose estrogen in treating endometrioma. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)


Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?
Abstract This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. These antiepileptic drugs can potentially cause drug–drug...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Renal stone disease
(urolithiasis, nephrolithiasis) covers many conditions causing kidney, ureteric or bladder stones. These include metabolic and inherited disorders, anatomical defects of the upper or lower urinary tract, and chronic urinary infection. However, most cases of renal stones are idiopathic. They present with loin or abdominal pain, and visible or non-visible haematuria; this is followed by eventual passage of a stone and resolution, or the need for further investigation and intervention. (Source: Medicine)


Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?
Authors: Valkenburg AJ, de Leeuw TG, van Dijk M, Tibboel D Abstract This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. T...


The Pathophysiology of Sports Concussion
Abstract During concussion, the brain is exposed to rapid acceleration, deceleration, and rotational forces, resulting in the stretching and distortion of neural structures. This produces in an injury of transient neurological dysfunction, as evidenced by the clinical symptomatology. It is now evident that recurrent head trauma is also associated with the development of some chronic neurodegenerative disorders. Despite increased awareness of concussion over the past decade, large voids remain in our understanding of its pathophysiology. Prospective longitudinal studies are needed to better understand the underlying biological mechanism of acute concussive injury as it relates to chronic neuropathology. (Source: Current Pain and Headache Reports)


In a secondary care setting, differences between neck pain subgroups classified using the Quebec task force classification system were typically small – a longitudinal study
Conclusions: This study found baseline and outcome differences between neck pain subgroups classified using the Quebec Task Force Classification System. However, differences in outcome were typically small in size and mostly differentiated the local NP subgroup from the other subgroups. A caveat to these results is that they were obtained in a cohort of chronic neck pain patients who only displayed small improvements over time and the results may not apply to other cohorts, such as people at earlier stages of their clinical course and in other clinical settings. (Source: BioMed Central)


The effects of extracorporeal shock wave therapy on pain patients.
Authors: Fricova J, Rokyta R Abstract The method of shock wave therapy (ESWT) was used for the treatment of several symptoms of chronic pain. There were especially: cervical syndromes, lumbago, plantar fasciitis, achillodynia, metatarsalgia and humeral epicondylitis. We confirmed the positive effect of shock wave therapy for the pain relief on these syndromes. This method is also effective in other pain syndromes. The effect of this application is very individual and therefore it is necessary to indicate different number of therapeutic applications. We recommend this method as a very useful tool for complete our possibilities for the relief of chronic pain. PMID: 26071587 [PubMed - as supplied by publisher] (Source: Neuroendocrinology Letters)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pathogenesis of Bone Alterations in Gaucher Disease: The Role of Immune System.
Authors: Mucci JM, Rozenfeld P Abstract Gaucher, the most prevalent lysosomal disorder, is an autosomal recessive inherited disorder due to a deficiency of glucocerebrosidase. Glucocerebrosidase deficiency leads to the accumulation of glucosylceramide primarily in cells of mononuclear-macrophage lineage. Clinical alterations are visceral, hematological, and skeletal. Bone disorder in Gaucher disease produces defects on bone metabolism and structure and patients suffer from bone pain and crisis. Skeletal problems include osteopenia, osteoporosis, osteolytic lesions, and osteonecrosis. On the other hand a chronic stimulation of the immune system is a well-accepted hallmark in this disease. In this review we summarize the latest findings in the mechanisms leading to the bone pathology...


Race effects on conditioned pain modulation in youth
Race and ethnicity shape the experience of pain in adults, with African Americans typically exhibiting greater pain intensity and evoked pain responsiveness than Non-Hispanic Whites. However, it remains unclear whether there are racial differences in conditioned pain modulation (CPM) and if these are present in youth. CPM refers to a reduction in perceived pain intensity for a test stimulus during application of a conditioning stimulus and may be especially relevant in determining risk for chronic pain. (Source: The Journal of Pain)


Association between body height and chronic low back pain: a follow-up in the Nord-Trondelag Health Study
Conclusions In women without LBP, a body height &ge;170&nbsp;cm may predispose to chronic LBP 11&nbsp;years later. This may reflect mechanical issues or indicate a hormonal influence. (Source: BMJ Open)


Integrative Review of Co‐Occurring Symptoms Across Etiologies of Chronic Liver Disease and Implications for Symptom Management Research and Practice
ConclusionsThe symptom of fatigue was commonly reported across chronic liver disease populations and was often found to co‐occur with other distressing symptoms, including depression, sleep disturbance, pain, cognitive impairment, and dizziness associated with autonomic dysfunction. Due to the high prevalence and persistence of these “core” symptoms, the use of core symptom measures integrated longitudinally across populations would inform the development and delivery of symptom management interventions as well as enhance the ability of nurses to incorporate population‐level symptom management programs. Clinical RelevanceNurses play an important role in symptom assessment and may use the findings from the integrative review to incorporate core symptom measures across chronic liver ...


Empowering Patients with Persistent Pain Using an Internet-based Self-Management Program
New strategies are needed to improve access to cognitive and behavioral therapies for patients with persistent pain. The purpose of this randomized, controlled trial was to determine the effectiveness of the Chronic Pain Management Program, an 8-week online intervention targeting cognitive, emotional, behavioral, and social pain determinants. Program efficacy and engagement was evaluated for 92 individuals with a diagnosis of chronic noncancer pain who had a current opioid prescription. Participants were recruited from primary care practices and Internet sites, then randomly assigned to receive access to the intervention either immediately (treatment group) or after an 8-week delay (wait-list comparison). (Source: Pain Management Nursing)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Re: Prevalence of Myofascial Chronic Pelvic Pain and the Effectiveness of Pelvic Floor Physical Therapy
M. A. Bedaiwy, B. Patterson and S. Mahajan (Source: The Journal of Urology)


A closer look: Alternative pain management practices by heart failure patients with chronic pain
To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. (Source: Heart and Lung)


Equipment-based Pilates reduces work-related chronic low back pain and disability: A pilot study
This study investigated effectiveness of an equipment-based Pilates protocol for reducing pain and disability in individuals with work-related chronic low back pain (CLBP). (Source: Journal of Bodywork and Movement Therapies)


Chronic wounds should be one of Australia's National Health Priority Areas.
Authors: Kapp S, Santamaria N Abstract Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A$2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Areas, and to establish a profile of chronic wounds as a chronic disease of national significance in its own right. This approach has the potenti...


Equipment-based Pilates reduces work-related chronic low back pain and disability: A pilot study
This study investigated effectiveness of an equipment-based Pilates protocol for reducing pain and disability in individuals with work-related chronic low back pain (CLBP). (Source: Journal of Bodywork and Movement Therapies)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Autism Spectrum Disorder and Amplified Pain.
Conclusion. Pain in autism can be atypical in its experience and expression and for this reason may go unrecognised by physicians treating chronic pain disorders. PMID: 26064754 [PubMed] (Source: Case Reports in Psychiatry)


(18)F-FDG PET/CT and pain in metastatic bone cancer.
This study aims to determine if the pain intensity of patients with oncologic bone metastases (BM) correlates with metabolic activity measured by (18)F-FDG PET/CT. Twenty-eight patients, ages: 21-89 years (mean: 58.8) with BM were included in the study between September 2011 to September 2013. All patients completed a detailed questionnaire regarding pain symptoms on the visual analog scale (VAS), analgesic use, and areas of chronic pain, prior to obtaining an (18)F-FDG PET/CT. Pain symptoms were queried for 11 body regions including limbs, head, torso, etc. and the corresponding SUVmax of BMs within that region were modeled with the corresponding clinical data using a linear mixed effects model and a linear regression model. Overall 64 areas in the 28 subjects were found to have BM. SUVma...


Downregulation of Spinal G Protein-Coupled Kinase 2 Abolished the Antiallodynic Effect of Electroacupuncture.
This study was designed to investigate the possible role of spinal GRK2 in EA antiallodynic in a rat model with complete Freund's adjuvant (CFA) induced inflammatory pain. EA was applied to ST36 ("Zusanli") and BL60 ("Kunlun") one day after CFA injection. Single EA treatment at day 1 after CFA injection remarkably alleviated CFA induced mechanical allodynia two hours after EA. Repeated EA displayed significant antiallodynic effect from 2nd EA treatment and a persistent effect was observed during the rest of treatments. However, downregulation of spinal GRK2 by intrathecal exposure of GRK2 antisense 30 mins after EA treatment completely eliminated both the transient and persistent antiallodynic effect by EA treatment. These pieces of data demonstrated that the spinal GRK2 played an import...


Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.
Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability. PMID: 26064172 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)


Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats.
Authors: Meng F, Ge HY, Wang YH, Yue SW Abstract Myofascial trigger points (MTrPs) are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human) of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P &lt; 0.01), and immunohistochemistry with Neurofilament 200 indicated more myelinated afferents existed in MTrSs (P &lt; 0.01). Spontaneous electrical activity (SEA) recordings at MTrSs showed that specific block of myelinated afferents in sciatic nerve with tetrodotoxin (TTX) led to sign...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Surgery for Chronic Pancreatitis: The Role of Early Surgery in Pain Management
Conclusions: Results from a single institution analysis suggest early surgical intervention of 26.5 months or less of diagnosis is associated with improved pain control, and optimal timing for surgery may be earlier than previously thought. (Source: Pancreas)


Antioxidant Therapy for Pain Reduction in Patients With Chronic Pancreatitis: A Systematic Review and Meta-analysis
Conclusions: This is the first meta-analysis to summarize all the available evidence and show benefit of AOT in pain reduction in CP patients. There is a pressing need for well-designed larger studies with longer follow-up to better define the patient and disease factors favoring response, the optimal formulation, and duration of AOT. (Source: Pancreas)


Prisms for pain. Can visuo‐motor rehabilitation strategies alleviate chronic pain?
ConclusionBy highlighting open issues, our review provides guidelines for future studies on the use of prisms in pain. The assessment of neglect in patients with CRPS as well as other types of lateralized chronic pain should be characterized using a combination of neuropsychological methods assessing the multiple aspects of neglect in a more refined manner. In addition, further studies should investigate the mechanisms through which PA may modulate pain. (Source: European Journal of Pain)


Pubic symphysitis after transurethral resection of the prostate
Conclusion PS remains a rare complication after TUR-P. We could not identify a single cause for developing PS. In our study, suprapubic trocar placement (11/12), chronic prostatic inflammation (9/12), previous UTI (3/12) and extended resection (2/12) were overrepresented. Inflammatory, thermic and/or surgical damage of the capsule may be causative. Patients require antibiotic and symptomatic medication. However, prognosis for remission is excellent. (Source: World Journal of Urology)


Long Term Outcome of The Management of Chronic Neuropathic Pain – A Prospective Observational Study
This prospective observational cohort study addressed the long term clinical effectiveness of the management of chronic neuropathic non-cancer pain at seven Canadian tertiary pain centres. Patients were treated according to standard guidelines and followed at 3, 6, 12, 18 and 24 months. Standard outcome measures for pain, mood, quality of life and overall treatment satisfaction were administered with the primary outcome measure designated as the composite of 30% reduction in average pain intensity and one point drop in the mean Interference Scale Score (0-10) of the Brief Pain Inventory at 12 months relative to baseline. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Symptoms of depression are associated with opioid use regardless of pain severity and physical functioning among treatment-seeking chronic pain patients
This study investigated the association between opioid use, pain, and depression in patients evaluated at a university-based outpatient pain clinic. Of the 2,104 new patients included, 55.89% reported current opioid use and demonstrated a worse phenotypic profile (e.g. higher pain severity, worse physical functioning) compared to non-opioid users. Additionally, more opioid users reported symptoms suggestive of depression than those not taking opioids (43.6% vs. (Source: The Journal of Pain)


Resveratrol reverses morphine-induced neuroinflammation in morphine-tolerant rats by reversal HDAC1 expression
Conclusion Resveratrol restores the antinociceptive effect of morphine by reversing morphine infusion-induced spinal cord neuroinflammation and increase in TNFR1 expression. The reversal of the morphine-induced increase in TNFR1 expression by resveratrol is partially due to reversal of the morphine infusion-induced increase in HDAC1 expression. Resveratrol pretreatment can be used as an adjuvant in clinical pain management for patients who need long-term morphine treatment or with neuropathic pain. (Source: Journal of the Formosan Medical Association)


Metatarsophalangeal Fusion Techniques with First Metatarsal Bone Loss/Defects
First metatarsophalangeal joint disorder is a common cause of chronic forefoot pain that is frequently encountered in the orthopedic clinic. Numerous surgical techniques have been described to improve patient pain and function in this regard, including prosthetic joint replacement, resection arthroplasty, and arthrodesis. When these procedures fail, surgeons can be confronted with significant first metatarsal bone loss/defects. First metatarsophalangeal joint fusion remains the gold standard, and, in the setting of significant bone loss, the use of structural bone graft must be considered in order to restore length to the first ray and the normal biomechanics of the foot. (Source: Foot and Ankle Clinics)


Migraine and tension type headache in adolescents at grammar school in Germany - burden of disease and health care utilization.
CONCLUSIONS: Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache. PMID: 26055241 [PubMed - in process] (Source: Pain Physician)


Adipose-derived stem cells improve the viability of nucleus pulposus cells in degenerated intervertebral discs.
Authors: Song K, Gu T, Shuang F, Tang J, Ren D, Qin J, Hou S Abstract Patients with degenerative disc disease (DDD) experience serious clinical symptoms, including chronic low back pain. A series of therapies have been developed to treat DDD, including physical therapy and surgical treatment. However, the therapeutic effect of such treatments has remained insufficient. Recently, stem cell‑based therapy, in which stem cells are injected into the nucleus pulposus in degenerated intervertebral disc tissue, has appeared to be effective in the treatment of DDD. In the present study, the effect of adipose‑derived stem cells on degenerated nucleus pulposus cells was investigated using a co‑culture system to evaluate the biological activity of degenerated nucleus pulposus cells. Huma...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic pain patients’ treatment preferences: a discrete-choice experiment
Conclusions The results were intended to enable early selection of an individualized pain medication. The results of the study showed that DCE is an appropriate means for the identification of patient preferences when being treated with specific pain medications. Due to the fact that pain perception is subjective in nature, the identification of patients´ preferences will enable therapists to better develop and implement patient-oriented treatment of chronic pain. It is therefore essential to improve the therapists´ understanding of patient preferences in order to make decisions concerning pain treatment. DCE and direct assessment should become valid instruments to elicit treatment preferences in chronic pain. (Source: The European Journal of Health Economics)


Adaptation of an Evidence-Based Arthritis Program for Breast Cancer Survivors on Aromatase Inhibitor Therapy Who Experience Joint Pain
(Source: CDC Preventing Chronic Disease)


St. Jude Study: Axium Neurostimulator Outperforms Traditional Spinal Cord Stimulators
St. Jude Medical is touting positive results of a clinical trial that demonstrated the effectiveness of its Axium Neurostimulator System over traditional spinal cord stimulators (SCS) to relieve the chronic lower limb pain associated with complex regional pain syndrome (CRPS) or peripheral causalgia (nerve damage). The Axium system stimulates the dorsal root ganglion (DRG) for more selective targeting of pain areas that are hard to reach, like the groin, lower leg, and foot. (Source: Medical Design Online News)


Congress to VA: More Oversight Needed for Vets in Pain
(MedPage Today) -- House committee demands better management of vets with psych problems, chronic pain (Source: MedPage Today Infectious Disease)


Chronic inflammatory pain upregulates expression of P2Y 2 receptor in small-diameter sensory neurons
Abstract Roles of ionotropic purinergic (P2X) receptors in chronic pain have been intensively investigated. However, the contribution of metabotropic purinergic (P2Y) receptors to pathological pain is controversial. In the present study, using single cell RT-PCR (reverse transcription-polymerase chain reaction) and single cell nested-PCR techniques, we examined the expression of P2X2, P2X3, P2Y1 and P2Y2 mRNA transcripts in retrogradely labeled cutaneous sensory neurons from mouse lumber dorsal root ganglia (DRGs) following peripheral inflammation. The percentage of cutaneous sensory neurons expressing P2Y2 mRNA transcripts increased after complete Freund’s adjuvant (CFA) treatment. Particularly, the P2Y2 mRNA transcripts were more frequently detected in small-diameter cutaneous...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Role of Cardiac MRI in Patients with Troponin-Positive Chest Pain and Unobstructed Coronary Arteries
Abstract Acute coronary syndrome (ACS) still remains one of the leading causes of mortality and morbidity worldwide. Seven to fifteen percent of patients presenting with ACS have unobstructed coronary artery disease (CAD) on urgent angiography. Patients with ACS and unobstructed coronary arteries represent a clinical dilemma and their diagnosis and management is quite variable in current practice. Cardiovascular magnetic resonance imaging with its unique non-invasive myocardial tissue characterization property has the potential to identify underlying etiologies and reach a final diagnosis. These include acute and chronic myocarditis, embolic/spontaneous recanalization myocardial infarction, and Tako-Tsubo cardiomyopathy, and other conditions. Establishing a final diagnosis has a ...


Tolerance to the antinociceptive effects of chronic morphine requires c-Jun N-terminal kinase
Conclusions: These results demonstrate that JNK signaling plays a crucial role in mediating antinociception as well as chronic tolerance to the antinociceptive effects of morphine in acute, inflammatory, and neuropathic pain states. Thus, inhibition of JNK signaling pathway, via SP600125, represents an efficacious pharmacological approach to delay tolerance to the antinociceptive effects of chronic morphine in diverse pain models. (Source: Molecular Pain)


A novel method of anal fissure laser surgery: a pilot study
This study revealed that this new laser-based surgery is a simple, safe, and effective procedure to treat the anal fissure that can be performed with local anesthesia in an outpatient clinic with minimal postoperative morbidity. (Source: Lasers in Medical Science)


Multipronged diagnostic approaches for monitoring the treatment of Brucella abortus infected patient: a case report
Publication date: July 2015 Source:Asian Pacific Journal of Tropical Disease, Volume 5, Issue 7 Author(s): Rajeswari Shome , B Shankaranarayan Padmashree , Kalleshamurthy Triveni , Natesan Krithiga , Swati Sahay , Bibek Ranjan Shome , Nagarathna Chandrashekar , Habibur Rahman Brucellosis caused by Brucella species is readily transmissible to humans, causing acute febrile illness and undulant fever which may progress to a more chronic form and can also produce serious complications affecting the musculoskeletal, cardiovascular, and central nervous systems. A veterinary livestock inspector presented to the institute with symptoms of intermittent fever, pain involving muscles and joints, loss of weight, anxiety and weakness for about three months has been investigated. The isolation, serolo...


What is the impact of acute and chronic orofacial pain on quality of life?
Conclusion TMD, ADP, TN and PDAP have substantial impact on OHRQoL as measured by the OHIP-49 and the extracted items for the OHIP-14 and 5. Differences among the 4 groups of orofacial pain conditions are likely not to be substantial. (Source: Journal of Dentistry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A novel method of anal fissure laser surgery: a pilot study.
This study revealed that this new laser-based surgery is a simple, safe, and effective procedure to treat the anal fissure that can be performed with local anesthesia in an outpatient clinic with minimal postoperative morbidity. PMID: 26067925 [PubMed - as supplied by publisher] (Source: Anal Sci)


Improved capture of adverse events after spinal surgery procedures with a longitudinal administrative database.
CONCLUSIONS This study demonstrates the usefulness of a longitudinal administrative database in assessing postoperative complication rates after spine surgery. Use of this database gave results that were comparable to those in prospective studies and superior to those obtained with nonlongitudinal administrative databases. Longitudinal administrative data may improve the understanding of overall and procedure-specific complication rates after spine surgery. PMID: 26068273 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)


Menstrual cycle characteristics in women with persistent schizophrenia.
CONCLUSION: Regular menses are associated with higher oestradiol levels and higher rates of cyclical mood symptoms but are not associated with Positive and Negative Syndrome Scale scores. Understanding the effect the menstrual cycle can have on psychiatric illness, such as premenstrual exacerbations, is important for the holistic care of women with schizophrenia. PMID: 26070315 [PubMed - as supplied by publisher] (Source: The Australian and New Zealand Journal of Psychiatry)


Resveratrol reverses morphine-induced neuroinflammation in morphine-tolerant rats by reversal HDAC1 expression.
CONCLUSION: Resveratrol restores the antinociceptive effect of morphine by reversing morphine infusion-induced spinal cord neuroinflammation and increase in TNFR1 expression. The reversal of the morphine-induced increase in TNFR1 expression by resveratrol is partially due to reversal of the morphine infusion-induced increase in HDAC1 expression. Resveratrol pretreatment can be used as an adjuvant in clinical pain management for patients who need long-term morphine treatment or with neuropathic pain. PMID: 26078221 [PubMed - as supplied by publisher] (Source: J Formos Med Assoc)


Boston Scientific touts positive data from next-gen SCS
Boston Scientific (NYSE:BSX) said yesterday that data from its Precision Spectra spinal cord stimulator study showed 1.5 times better pain relief and 2 times better lower back pain relief than its previous generation SCS. The analysis examined 213 patients treated with the new Precision Spectra and 130 patients treated with the previous generation Precision Plus, as well as 25 patients treated with the Spectra and a different set of leads, the Marlborough, Mass.-based company said. &#8220;The results are exciting because we looked at consecutive patients – some with only low back pain – in a real-world setting. This is strong clinical evidence of the effectiveness of the Precision Spectra system in treating the types of challenging chronic pain patients that physicians see every d...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chest pain in the emergency department: risk stratification with Manchester triage system and HEART score
Background: Fast and accurate chest pain risk stratification in the emergency department (ED) is critical. The HEART score predicts the short-term incidence of major adverse cardiac events (MACE) in this population, dividing it in three risk categories. We aimed to describe the population with chest pain, to characterize the subgroup of patients with acute coronary syndrome (ACS) and to assess the prognostic value of Manchester triage system and of HEART score. Methods: Retrospective observational study including patients admitted to the ED of a tertiary hospital with chest pain as the presenting symptom. The primary outcome was a composite of all-cause mortality, myocardial infarction or unscheduled revascularization at 6 weeks. Results: We enrolled 233 patients (age 58 ± 19; 55.4 ...


Hyperbaric Oxygen in Lower Limb Trauma (HOLLT); protocol for a randomised controlled trial
This study will make a significant contribution to the trauma literature and should answer the question of whether hyperbaric oxygen therapy can significantly improve outcomes in severe lower limb trauma. Collective study results will be published in international journals and presented at relevant conferences. Trial registration number Clinicaltrials.gov: NCT00264511; Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12607000559415. (Source: BMJ Open)


Spinal pain—good sleep matters: a secondary analysis of a randomized controlled trial
Conclusion Patients with non-specific neck and/or back pain and self-reported good sleep are more likely to experience a minimal clinically important difference in pain and disability compared to patients with impaired sleep with daytime consequence. (Source: European Spine Journal)


Childhood scurvy: an unusual cause of refusal to walk in a child
We report a case of scurvy in a mentally handicapped Saudi child, who presented with new onset inability to walk with diffuse swelling and pain in the left leg. Skin examination revealed extensive ecchymoses, hyperkeratosis and follicular purpura with corkscrew hairs, in addition to gingival swelling with bleeding. Clinical diagnosis of scurvy was rendered and confirmed by low serum vitamin C level. The patient did extremely well with proper nutritional support and vitamin C supplementation.It has been noticed lately that there is increased awareness about scurvy in rheumatology literature. A high index of suspicion, together with taking a thorough history and physical examination, is required for diagnosis of scurvy in patient who presents with musculoskeletal symptoms. Nutritional defici...


Assessing patient-centred care for chronic pain: Validation of a new research paradigm.
Authors: Paul-Savoie E, Bourgault P, Gosselin E, Potvin S, Lafrenaye S PMID: 26069896 [PubMed - as supplied by publisher] (Source: Pain Research and Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Thursday consumer health tips
Migraines: Simple steps to head off the pain Phobias Do you know your blood pressure? Temporary vs. chronic fatigue Carbohydrates: How carbs fit into a healthy diet (Source: News from Mayo Clinic)


Super Nutrient’s Liver Surprise
I was one of the first doctors to talk about the incredible benefits of the super-nutrient pyrroloquinoline quinone, or PQQ for short. I was also one of the first doctors to recommend it to patients. Now I recommend this essential nutrient and powerful antioxidant to almost everyone who comes to see me at my wellness clinic. Researchers have only just recently begun to understand the many important roles of PQQ on the body’s cellular processes. Not only does it possess extraordinary energy-giving qualities and have the power to ease nerve pain and battle Alzheimer’s, it has the potential to become the world’s strongest known cancer killer.1,2,3,4 The key to PQQ’s power is the impact it has on mitochondria, the tiny power plants inside each of your cells. I combine PQQ with CoQ10 fo...


St. Jude Medical touts early results for Axium neurostim device
St. Jude Medical (NYSE:STJ) said Monday that a study of its Axium dorsal root ganglion neurostimulator showed superior pain relief compared to traditional spinal cord stimulation in treating chronic lower limb pain associated with complex regional pain syndrome. The the 152-patient Accurate study reported that 81.2% of patients treated with the Axium system achieved significant pain relief, compared to 55.7% treated with traditional SCS, St. Paul, Minn.-based St. Jude said. Patients also reported less posture-based paresthesia intensity with DRG, and were less likely to report stimulation outside the area of pain, the company added. &#8220;Data from the Accurate study are exciting because they demonstrate that DRG stimulation can offer meaningful improvement over traditional spinal cord s...


Stimwave wins nod from FDA for IDE trial
This study will represent for the 1st time an injectable high frequency platform utilized with different parameter settings to truly assess the patient response and the best mechanism to enable long-term control of chronic pain and ability to reduce opioid dependency,&#8221; principal investigator of the study Dr. Porter McRoberts of Ft. Lauderdale, Fl.&#8217;s Holy Cross Hospital said in a press release. Stimwave&#8217;s device is based on an injectable microchip designed to deliver pulses of energy to electrodes near surrounding nerves, the company said. The surgery to implant the device is minimally invasive, and uses a standard needle for insertion. &#8220;This device is capable of a multitude of programming options and configurations, high frequency, tonic stimulation, multiple approa...


Malawi: Man With Extremely Rare Form of Cancer in Urgent Need of Surgery
[Malawi24] A man in Malawi is living in chronic pain from an extremely rare testicular form of cancer known as congenital granulosa cell tumor. (Source: AllAfrica News: Health and Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Improving the Multidisciplinary Treatment of Chronic Pain by Stimulating Body Awareness: A Cluster-randomized Trial
Conclusions: No clinical meaningful differences were found between treatment conditions in the primary outcome measures health-related quality of life and disability. However, this is the first long-term RCT that has shown that PMT improves BA in patients with chronic pain and shows good effect size and a significant decrease for catastrophizing. (Source: The Clinical Journal of Pain)


Living Life With My Child’s Pain: The Parent Pain Acceptance Questionnaire (PPAQ)
Conclusions: The PPAQ is a valid measure of parent pain acceptance and may provide valuable insights into parent responses to child pain and the ways in which parent acceptance influences child outcomes. Clinical implications and suggestions for future research are discussed. (Source: The Clinical Journal of Pain)


Effectiveness and Safety of Transdermal Buprenorphine Versus Sustained-release Tramadol in Patients With Moderate to Severe Musculoskeletal Pain: An 8-Week, Randomized, Double-Blind, Double-Dummy, Multicenter, Active-controlled, Noninferiority Study
Conclusions: Our results suggest that BTDS is a good therapeutic option for patients experiencing chronic musculoskeletal pain of moderate to severe intensity that is insufficiently controlled by nonsteroidal anti-inflammatory drugs. (Source: The Clinical Journal of Pain)


What Do People Who Score Highly on the Tampa Scale of Kinesiophobia Really Believe?: A Mixed Methods Investigation in People With Chronic Nonspecific Low Back Pain
Discussion: The TSK may be better described as a measure of the “beliefs that painful activity will result in damage and/or increased suffering and/or functional loss.” (Source: The Clinical Journal of Pain)


Does Change Occur for the Reasons We Think It Does? A Test of Specific Therapeutic Operations During Cognitive-Behavioral Treatment of Chronic Pain
Discussion: Change with CBT may occur both by theory-specified mechanisms and general mechanisms. However, the results provide the most support for a General Mechanism model in which changes on coping skills have spreading effects on the use of other coping skills. Significant relationships between some skill changes and indexes of patient-therapist working alliance and outcome expectations suggest that nonspecific factors also play a role in treatment-related changes in the use of pain coping strategies. (Source: The Clinical Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Increased autophagic activity in dorsal root ganglion attenuates neuropathic pain following peripheral nerve injury
Publication date: 10 July 2015 Source:Neuroscience Letters, Volume 599 Author(s): Jian-Shuang Guo , Peng-Bo Jing , Ji-An Wang , Rui Zhang , Bao-Chun Jiang , Yong-Jing Gao , Zhi-Jun Zhang Autophagy is a process of cellular self-cannibalization, and provides an adaptive mechanism to protect cells against diverse pathological settings. Following peripheral nerve injury, autophagic process was changed in Schwann cells and spinal neurons and glial cells, implicating a vital role of autophagy in chronic pain. However, little is known about the role of autophagy in dorsal root ganglion (DRG) in neuropathic pain. In the present study, we investigated the autophagic process in DRG and its effect on neuropathic pain induced by L5 spinal nerve ligation (SNL). The level of microtubule associated pro...


Pain management in cryoglobulinaemic syndrome
Publication date: Available online 8 June 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Salvatore Scarpato , Fabiola Atzeni , Piercarlo Sarzi-Puttini , Antonio Brucato , Luca Quartuccio , Maurizio Pietrogrande , Giuseppe Monti , Massimo Galli Cryoglobulinaemic syndrome (CS) includes clinical signs and symptoms that range from the classic triad of Meltzer and Franklin (purpura, weakness and arthralgias) to multiple organ involvement, and it may be characterised by nociceptive or neuropathic pain. Both types of pain use the same pathways and neurotransmitters, but nociceptive pain has an adaptive system and biological function whereas neuropathic pain does not. Managing CS means dealing with often very different clinical patterns, activity and severity with ...


Pain in systemic connective tissue diseases
Publication date: Available online 6 June 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Manuela Di Franco , Laura Bazzichi , Roberto Casale , Piercarlo Sarzi-Puttini , Fabiola Atzeni Pain is frequent in patients with connective tissue diseases (CTDs), particularly those affected by systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) in which it is virtually ubiquitous and can have different causes. The SLE classification criteria include pain associated with musculoskeletal involvement, which are frequently the initial symptom of SLE and can include arthralgia, arthritis and/or myalgia. Chronic widespread pain, the cornerstone of fibromyalgia (FM), is also frequently associated with CTDs. Chronic pain has a considerable impact on mental health,...


Acute Pain Medicine in the United States: A Status Report
ConclusionThis report is the first step in a 3‐year initiative aimed at creating conditions and incentives for the optimal provision of APM services to facilitate and enhance the quality of patient recovery after surgery, illness, or trauma. The ultimate goal is to reduce the conversion of acute pain to the debilitating disease of chronic pain. (Source: Pain Medicine)


Pain sensitivity of children with Down syndrome and their siblings: quantitative sensory testing versus parental reports
AimThe aim of this study was to compare thermal detection and pain thresholds in children with Down syndrome with those of their siblings. MethodSensory detection and pain thresholds were assessed in children with Down syndrome and their siblings using quantitative testing methods. Parental questionnaires addressing developmental age, pain coping, pain behaviour, and chronic pain were also utilized. ResultsForty‐two children with Down syndrome (mean age 12y 10mo) and 24 siblings (mean age 15y) participated in this observational study. The different sensory tests proved feasible in 13 to 29 (33–88%) of the children with Down syndrome. These children were less sensitive to cold and warmth than their siblings, but only when measured with a reaction time‐dependent method, and not with a ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic pain in adults.
Authors: Ostler A Abstract Reading the CPD article helped improve my understanding of the importance of identifying chronic pain. Chronic pain may occur on its own or as a feature of other chronic conditions, and it may be nociceptive or neuropathic, or a combination of the two. PMID: 26058654 [PubMed - in process] (Source: Nursing Standard)


Assessment of psychosocial risk factors for the development of non-specific chronic disabling low back pain in Japanese workers-findings from the Japan epidemiological research of Occupation-related Back pain (JOB) study.
Authors: Matsudaira K, Kawaguchi M, Isomura T, Inuzuka K, Koga T, Miyoshi K, Konishi H Abstract To investigate the associations between psychosocial factors and the development of chronic disabling low back pain (LBP) in Japanese workers. A 1 yr prospective cohort of the Japan Epidemiological Research of Occupation-related Back Pain (JOB) study was used. The participants were office workers, nurses, sales/marketing personnel, and manufacturing engineers. Self-administered questionnaires were distributed twice: at baseline and 1 yr after baseline. The outcome of interest was the development of chronic disabling LBP during the 1 yr follow-up period. Incidence was calculated for the participants who experienced disabling LBP during the month prior to baseline. Logistic regressio...


Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury - Koren L, Peled E, Trogan R, Norman D, Berkovich Y, Israelit S.
PURPOSE: Initial pain level in the acute whiplash injury is the most consistent predictor of transformation to a chronic pain syndrome. The risk factors for those early pain levels were, to our knowledge, scarcely evaluate to this date. We set to evaluate ... (Source: SafetyLit: All (Unduplicated))


My hysterectomy for cancer – Carol’s story
The post My hysterectomy for cancer &#8211; Carol&#8217;s story appeared first on Hysterectomy Association. In March 2013 I went for my routine annual smear, I have been on yearly smears since the birth of my last daughter in 1997. Two weeks later I received a letter with an appointment to attend the colposcopy clinic which was scheduled for two weeks later (end of April). I attended this and was told I had cin3 pre-cancer cells on my cervix. They tried to do the leep whilst I was there but were unable to do it as the pain was horrendous. So I was advised it needed to be done under a general. The end of May I had my leep done. I took a week off work to rest, then went back to work to await the results. On June 27th I went to my local hospital to see a gynaecologist. My appointment was the...


orphenadrine (Norflex)
Title: orphenadrine (Norflex)Category: MedicationsCreated: 3/2/2005 12:00:00 AMLast Editorial Review: 6/9/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Poor sleep habits amplify knee pain
Patients with knee osteoarthritis with poor sleep habits display greater central sensitisationRelated items from OnMedicaAcupuncture doesn’t improve chronic knee painFirst-line approach to OA should be 10% weight lossCombined diet and exercise effective against knee osteoarthritisPhysios should be first point of contact for musculoskeletal problems (Source: OnMedica Latest News)


Barriers to chronic pain management in community-dwelling low-income older adults: Home-visiting nurses’ perspectives
This study identified barriers to effective chronic pain management for low-income community-dwelling older adults from home-visiting nurses’ perspectives. Four focus group discussions investigated 23 nurses (five to six participants in each focus group) at local home-visiting nursing care centres in Suwon, Korea for data collection. Data were analyzed with inductive thematic analysis. Patient-related, nurse-related, and organizational barriers were identified. Patient-related barriers included limited understanding, lack of success in achieving compliance, continued use of traditional medicines, and financial hardship. (Source: Collegian)


Lifestyle and risk of chronic prostatitis/chronic pelvic pain syndrome in a cohort of US male health professionals
Although chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological disorder among men of all ages, its etiology remains unknown. Only a few previous studies have examined associations between lifestyle factors and CP/CPPS, most of which were limited by their cross-sectional study design and lack of control for possible confounders. To address these limitations, we performed a cohort study of major lifestyle factors (obesity, smoking, and hypertension) with CP/CPPS risk in the Health Professionals Follow-up Study (HPFS), a large ongoing cohort of US-based male health professionals. (Source: The Journal of Urology)


Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): the views and experiences of people with stroke.
CONCLUSIONS: Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle. Implications for Rehabilitation Foot pain, sensory impairments and muscle weakness in the foot and ankle can impact on community ambulation, balance and fear of falling following stroke. Foot and ankle function post-stroke should be routinely assessed ...


WITHDRAWN: Topical negative pressure for treating chronic wounds.
CONCLUSIONS: Trials comparing TNP with alternative treatments for chronic wounds have methodological flaws and data do demonstrate a beneficial effect of TNP on wound healing however more, better quality research is needed. PMID: 26059170 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Small molecule inhibitors of PSD95-nNOS protein-protein interactions as novel analgesics.
Authors: Lee WH, Xu Z, Ashpole NM, Hudmon A, Kulkarni PM, Thakur GA, Lai YY, Hohmann AG Abstract Aberrant increases in NMDA receptor (NMDAR) signaling contributes to central nervous system sensitization and chronic pain by activating neuronal nitric oxide synthase (nNOS) and generating nitric oxide (NO). Because the scaffolding protein postsynaptic density 95kDA (PSD95) tethers nNOS to NMDARs, the PSD95-nNOS complex represents a therapeutic target. Small molecule inhibitors IC87201 (EC5O: 23.94 μM) and ZL006 (EC50: 12.88 μM) directly inhibited binding of purified PSD95 and nNOS proteins in AlphaScreen without altering binding of PSD95 to ErbB4. Both PSD95-nNOS inhibitors suppressed glutamate-induced cell death with efficacy comparable to MK-801. IC87201 and ZL006 preferentially s...


Sex differences in a Murine Model of Complex Regional Pain Syndrome.
Authors: Tajerian M, Sahbaie P, Sun Y, Leu D, Yang HY, Li W, Huang TT, Kingery W, David Clark J Abstract Complex Regional Pain Syndrome (CRPS) is a major cause of chronic pain after surgery or trauma to the limbs. Despite evidence showing that the prevalence and severity of many forms of chronic pain, including CRPS, differ between males and females, laboratory studies on sex-related differences in animal models of CRPS are not available, and the impact of sex on the transition from acute to chronic CRPS pain and disability are unexplored. Here we make use of a tibia fracture/cast mouse model that recapitulates the nociceptive, functional, vascular, trophic, inflammatory and immune aspects of CRPS. Our aim is to describe the chronic time course of nociceptive, motor and memory chan...


Imaging: CNS changes in interstitial cystitis/painful bladder syndrome
Nature Reviews Urology 12, 365 (2015). doi:10.1038/nrurol.2015.142 Authors: Rose Khavari & Tim Boone Brain white matter (axonal) abnormalities associated with interstitial cystitis/bladder pain syndrome in women suggest that neuropathological brain alterations exist in, and might contribute to, chronic pelvic pain syndromes. Advancing our knowledge of central neuropathic mechanisms, which might initiate and/or maintain these syndromes, will help target pain-related neuroplasticity and identify future treatments. (Source: Nature Reviews Urology)


Broad ligament defects as a cause of chronic pelvic pain
We report a case of a woman with chronic right-sided pelvic pain with an unusual combination of broad ligament defects and associated terminal ileum and caecum herniation. Reduction of the hernia and closure of the defects at laparoscopy resulted in resolution of the patient’s painful symptoms. Review of the literature suggests that, although rare, such defects should be considered in the differential diagnosis of persistent pelvic pain. Where found incidentally, broad ligament defects should be repaired in order to prevent sinister complications such as bowel obstruction and strangulation. (Source: Gynecological Surgery)


N -Palmitoylethanolamine and Neuroinflammation: a Novel Therapeutic Strategy of Resolution
Abstract Inflammation is fundamentally a protective cellular response aimed at removing injurious stimuli and initiating the healing process. However, when prolonged, it can override the bounds of physiological control and becomes destructive. Inflammation is a key element in the pathobiology of chronic pain, neurodegenerative diseases, stroke, spinal cord injury, and neuropsychiatric disorders. Glia, key players in such nervous system disorders, are not only capable of expressing a pro-inflammatory phenotype but respond also to inflammatory signals released from cells of immune origin such as mast cells. Chronic inflammatory processes may be counteracted by a program of resolution that includes the production of lipid mediators endowed with the capacity to switch off inflammation...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Publication date: Available online 7 June 2015 Source:The Lancet Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews...


Incidental diagnosis of bilateral synovial lipomatosis in long standing knee osteoarthritis
Conclusion Though most cases of synovial lipomatosis occur de-novo it may be associated with a degenerative process. Possibly it occurs as a secondary process following a chronic joint disease like osteoarthritis. (Source: Human Pathology: Case Reports)


Improving access to adequate pain management in Taiwan.
Authors: Scholten W Abstract There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring a...


CD-163 correlated with symptoms (pain or discomfort) of prostatic inflammation.
In conclusion, CD-163, related to immune-system (macrophage), correlated with symptoms (pain or discomfort) of prostatic inflammation and might represent a significant immune-system related biomarker for pain or LUTS score in potentially CP. PMID: 26045748 [PubMed - in process] (Source: Clinical Prostate Cancer)


Education and Hypnosis for Treatment of Functional Gastrointestinal Disorders (FGIDs) in Pediatrics.
Authors: Mahler T Abstract FGIDs in children and adolescents (ROME III classification) have a significant impact on the daily functioning and quality of life. Often it is the pain that is one of the main contributors to the burden of functional dyspepsia, functional abdominal pain (syndrome), and irritable bowel syndrome. Current knowledge confirms that a number of integrated networks at cortical and subcortical sites are responsible for the experience of pain. From the work of Mayer and Tillisch (2011), mainly based on structural and functional magnetic resonance imaging and positron emission tomography, it has become clear that abdominal pain syndromes are disorders of the bi-directional mind-brain-gut interactions. In this multi-factorial bio-psycho-social model we recognize the...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hypnotherapy for Inflammatory Bowel Disease Across the Lifespan.
Authors: Szigethy E Abstract Inflammatory bowel disease (IBD) is an autoimmune disorder characterized by lifelong relapsing gastrointestinal symptoms and associated with high rates of chronic pain, depression, and anxiety. In this review the author covers the existing literature including randomized controlled studies, open trials, and case reports as well as expert opinion in evaluating how hypnotherapy can be most beneficial in adolescents and adults with IBD. Hypnotherapy evidence for functional gastrointestinal disorders (FGIDs) is also reviewed as many of the gut-focused hypnotherapy (GHT) approaches used in IBD trials were developed for this latter population. Collectively, the strongest evidence of use of hypnotherapy is its association with reduced IBD-related inflammation ...


It’s All in Your Head review – enduring mystery of psychosomatic illness
Neurologist Suzanne O’Sullivan’s excellent book reveals that medicine remains as much an art as a scienceSuzanne O’Sullivan qualified as a doctor in 1991. She is now a consultant at the National Hospital of Neurology and Neurosurgery in London. This, her first book, is an account of her experience over 20 years of the many conditions that exist in that much disputed no man’s land between psychological and physical illness. The patients she examines in these pages often have dramatic symptoms – blindness, paralysis, seizures, intense pain and chronic fatigue – but they are symptoms related to no identified disease or physical cause. By the time these patients come to O’Sullivan they have generally exhausted every scan and endoscopy the NHS can provide, as well as the patience ...


Quality of life and pain control following laparoscopic retroperitoneal lymph node dissection in early-stage nonseminoma.
CONCLUSIONS: Almost all patients chose L-RPLND, which is associated with a rapid improvement of postoperative pain; QoL scores improved up to 6 months. The L-RPLND may be considered as an alternative only when performed in highly experienced centers. PMID: 26045105 [PubMed - as supplied by publisher] (Source: Tumori)


Myofascial Head Pain
Abstract Muscle nociception is mainly characterized by local tenderness and referred pain. The neurophysiological basis of muscle pain supports a role of sensitization mechanisms. From a clinical viewpoint, muscle pain is represented by the presence of myofascial trigger points (TrPs). Evidence suggests that TrPs are able to start a peripheral nociceptive mechanism and hence contributing to changes in the central nervous system. Several studies demonstrated that the referred pain elicited by TrPs reproduces the headache pattern in patients with tension-type headache (TTH), migraine, cervicogenic headache and, in some individuals, with cluster headache. In fact, sensitization of nociceptive pain pathways in the central nervous system due to prolonged nociceptive stimuli from TrPs ...


Deep Brain Stimulation for Chronic Pain
Abstract Deep brain stimulation (DBS) is a commonly performed procedure and has been used for the treatment of chronic pain since the early 1970s. A review of the literature was performed utilizing the PubMed database evaluating the use of DBS in the treatment of various pain syndromes. Literature over the last 30 years was included with a focus on those articles in the last 10 years dealing with pain conditions with the highest success as well as the targets utilized for treatment. DBS carries favorable results for the treatment of chronic pain, especially when other methods have not been successful such as medications, conservative measures, and extracranial procedures. Various chronic pain conditions reported in the literature respond to DBS including failed back surgery syn...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Supratrochlear and Supraorbital Nerve Stimulation for Chronic Headache: a Review
Abstract Chronic daily headache accounts for a significant socioeconomic burden due to decreased productivity, work absenteeism, multiple office and ER visits, and hospital admissions for pain control. Associated comorbidities add to this cost. Current traditional medical therapies may fail to provide adequate relief leading to the search for and use of other therapeutic modalities such as innovative medical devices. It is in this setting of the urgent demand for better pain control and to assimilate chronic headache sufferers back into society that a variety of neuromodulatory approaches have been emerging. This review aims to familiarize the reader with current literature regarding supraorbital and supratrochlear nerve stimulation for chronic headache, point out the advantages ...


Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy
Publication date: Available online 6 June 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Xu Yanbin , Chu Haikun , Ji Xiaofeng , Yang Wanshan , Liu Shuangping Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who ...


The relationship between subacromial bursa thickness on ultrasound and shoulder pain in open water endurance swimmers over time
Conclusions SAB thickness increases with increasing swimming training. Commonly, this increase is not correlated to pain, suggestive of a painless adaptive process. The significant correlation between pain and SAB thickness soon after an exacerbating event suggests that painful acute SAB thickening is a different entity to chronic, painless adaptive SAB thickening. These two entities can only be differentiated by clinical history and examination. (Source: Journal of Science and Medicine in Sport)


Reactive oxygen species induce Cox-2 expression via TAK1 activation in synovial fibroblast cells
Publication date: Available online 6 June 2015 Source:FEBS Open Bio Author(s): Yuta Onodera , Takeshi Teramura , Toshiyuki Takehara , Kanae Shigi , Kanji Fukuda Oxidative stress within the arthritis joint has been indicated to be involved in generating mediators for tissue degeneration and inflammation. COX-2 is a mediator in inflammatory action, pain and some catabolic reactions in inflamed tissues. Here, we demonstrated a direct relationship between oxidative stress and Cox-2 expression in the bovine synovial fibroblasts. Furthermore, we elucidated a novel mechanism, in which oxidative stress induced phosphorylation of MAPKs and NF-κB through TAK1 activation and resulted in increased Cox-2 and prostaglandin E2 expression. Finally, we demonstrated that ROS-induced Cox-2 expression was ...


Modulation of nociceptive ion channels and receptors via protein-protein interactions- implications for pain relief.
Authors: Rouwette T, Avenali L, Sondermann J, Narayanan P, Gomez-Varela D, Schmidt M Abstract In the last two decades biomedical research has provided great insights into the molecular signatures underlying painful conditions. However, chronic pain still imposes substantial challenges to researchers, clinicians and patients alike. Under pathological conditions, pain therapeutics often lack efficacy and exhibit only minimal safety profiles, which can be largely attributed to the targeting of molecules with key physiological functions throughout the body. In light of these difficulties, the identification of molecules and associated protein complexes specifically involved in chronic pain states is of paramount importance for designing selective interventions. Ion channels and recepto...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Kv3.4 channel function and dysfunction in nociceptors.
Authors: Dm R, Bm Z, Ac L, Covarrubias M Abstract Recently, we reported the isolation of the Kv3.4 current in dorsal root ganglion (DRG) neurons and described dysregulation of this current in a spinal cord injury (SCI) model of chronic pain. These studies strongly suggest that rat Kv3.4 channels are major regulators of excitability in DRG neurons from pups and adult females, where they help determine action potential (AP) repolarization and spiking properties. Here, we characterized the Kv3.4 current in rat DRG neurons from adult males and show that it transfers 40-70% of the total repolarizing charge during the AP across all ages and sexes. Following SCI, we also found remodeling of the repolarizing currents during the AP. In the light of these studies, homomeric Kv3.4 channels ex...


The treatment of simple elbow dislocation in adults.
CONCLUSION: Early functional treatment is the evidence-based therapeutic standard for simple elbow dislocation. The past few years have seen further developments in surgery for simple elbow dislocation. Further study is needed to determine whether surgery for elbow dislocation with high-grade instability can prevent persistent pain, limitation of motion, and chronic instability. PMID: 26037467 [PubMed - in process] (Source: Deutsches Arzteblatt International)


Solitary plasmacytoma of L3 vertebral body treated by minimal access surgery: Common problem different solution!
Discussion There is no consensus regarding appropriate surgical approach and perioperative strategies in treatment of solitary plasmacytoma. A solitary plasmacytoma was found in the spine of a patient with cardiac pacemaker where anaesthetic consideration, blood loss and the use of electrocautery were the limiting factors. Minimally invasive approach is a good option. (Source: Journal of Clinical Orthopaedics and Trauma)


Bilateral Iliopsoas Haemophilic “Soft Tissue Pseudotumours”: A case report
Publication date: Available online 6 June 2015 Source:International Journal of Surgery Case Reports Author(s): Achmad Fauzi Kamal , Ananto Satya Pradana , Yogi Prabowo Haemophilic soft tissue pseudotumour is one of the rarest complications of haemophilia that caused by repetitive bleeding resulting in an encapsulated mass of clotted blood and necrotic tissue. Soft tissue pseudotumour may not only cause flexion contracture but also chronic pain and femoral nerve compression that cause severe disability. Thus, surgical excision is the treatment of choice. It should only be carried out in a major haemophilic center by an integrated multidisciplinary surgical team. (Source: International Journal of Surgery Case Reports)


Meaning-focused coping, pain, and affect: a diary study of hospitalized women with rheumatoid arthritis
Conclusions Findings indicated that meaning-focused coping can be a crucial strategy for keeping daily positive affect in the face of chronic pain and how this effect is modified by interindividual differences. Even if restricted to the specific context, it may inform an intervention for hospitalized women with rheumatoid arthritis. (Source: Quality of Life Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Anatomical changes within the medullary dorsal horn in chronic temporomandibular disorder pain
Publication date: 15 August 2015 Source:NeuroImage, Volume 117 Author(s): S.L. Wilcox , S.M. Gustin , P.M. Macey , C.C. Peck , G.M. Murray , L.A. Henderson Accumulated evidence from experimental animal models suggests that neuroplastic changes at the dorsal horn are critical for the maintenance of various chronic musculoskeletal pain conditions. However, to date, no study has specifically investigated whether neuroplastic changes also occur at this level in humans. Using brain imaging techniques, we sought to determine whether anatomical changes were present in the medullary dorsal horn (spinal trigeminal nucleus caudalis) in subjects with the chronic musculoskeletal pain. In twenty-two subjects with painful temporomandibular disorders (TMDs) and forty pain-free controls voxel based morp...


Action identification and meaning in life in chronic pain
Conclusion Chronic pain patients holding higher levels of action identification report a greater sense of meaning in life. Meaning in life is also associated with the amount of interference of behavioural activity. The anticipated relationship between action identification and interference was not observed. The present evidence suggests that interference and action identification contribute independently to a person's sense of meaning in life. (Source: Scandinavian Journal of Pain)


Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy
Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. (Source: Journal of Foot and Ankle Surgery)


Exercise prescription for patients with non-specific chronic low back pain: a qualitative exploration of decision making in physiotherapy practice
Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. (Source: Physiotherapy)


Eurythmy therapy increases specific oscillations of heart rate variability
In this study, the simultaneous effects of two different EYT exercises on cardiac autonomic regulation as assessed by spectral analysis of heart rate variability (HRV) were investigated. Methods: Twenty healthy subjects (age: 29.1 ± 9.3 years, 13 female) performed two different EYT exercises (EYT-A and EYT-B) for 8 min. Each EYT exercise was compared against two matched control exercises: control exercise 1 (CE1-A and CE1-B) consisted of a repetition of the body movements of the EYT exercise but without guided imagery, control exercise 2 consisted of walking on the spot (CE2-A and CE2-B). Spectral power of HRV during each exercise was quantified on the basis of Holter ECG recordings. Results: During EYT-A the frequency of the peak oscillation in the very low frequency (VLF) band mat...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Failure of a numerical quality assessment scale to identify potential risk of bias in a systematic review: a comparison study
Conclusions: In this example, use of a numerical rating scale failed to identify studies at increased risk of bias, and could have potentially led to imprecise estimates of treatment effect. Although based on a small number of included studies within an existing systematic review, we found the domain based system provided a more structured framework by which qualitative decisions concerning overall quality could be made, and was useful for detecting potential sources of bias in the available evidence. (Source: BMC Research Notes)


Responding to Stress With Attention, Care and Connection
This article originally appeared in Ornish Living. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)


Prioritizing Comparative Effectiveness Research Questions for Systems Interventions to Improve the Management of Chronic Musculoskeletal Pain: A Stakeholder Workshop
Live attendance is by invitation only, but the public is welcome to view the webinar. The meeting will be held: Tuesday, June 9, 2015 - 10:00 am to 05:00 pm EDT (Source: HSR Information Central)


Aggressive gastrointestinal stromal tumor with spinal metastases: a case report.
We report a case of a 56-year-old male who presented with several month history of severe low back pain. Physical examination revealed generalized tenderness at his thoracolumbar spine without notable neuromuscular findings. Radiographs revealed a chronic compression fracture of T10 and T11 with anterior height loss. Subsequent magnetic resonance imaging demonstrated multiple lytic lesions in the thoracolumbar spine without canal compromise. During his hospital stay, he developed acute cord compression with loss of motor and sensory levels below T12 and an absence of sphincter tone. The patient was taken for emergent multilevel, posterior decompression and fusion with biopsy of the lesion. Microscopic examination of the tissue in addition to immunohistochemical analysis utilizing CD117-ant...


Medical evacuation for unrecognized abdominal wall pain: a case series.
CONCLUSION: This case series highlights the need for military physicians to be aware of abdominal wall pain. Early diagnosis of abdominal cutaneous nerve entrapment syndrome by eliciting Carnett's sign will limit symptom chronicity, avoid unnecessary testing, and even prevent medical evacuation. PMID: 25939119 [PubMed - in process] (Source: Military Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Should Physicians Prescribing Opioids Be Confident In Managing Chronic Pain?
A&nbsp;physician's confidence level when writing a prescription for a patient typically isn't questioned, but maybe it should be &mdash; especially when it comes to practitioners prescribing opioids for chronic pain. (Source: Forbes.com Healthcare News)


Proven Process client Flowonix Medical Inc. achieves FDA PMA Approval of Prometra II infusion device
MANSFIELD, MA – Proven Process Medical Devices, Inc., a global leader in the design, development, validation, and manufacture of Class II and Class III medical devices, announced today that its client Flowonix Medical Inc. has secured PMA-Supplemental approval from the FDA for its next-generation intrathecal infusion device, the Prometra® II system. Approval of this device, created with the assistance of Proven Process&#8217; design and manufacturing services, will enable Flowonix to proceed with product introduction in the coming months. The groundbreaking design for the Prometra II&#8217;s flow-activated valve was made possible in part by Proven Process&#8217; Concept-to-Customer approach which helped Flowonix achieve important milestones and approvals for a successful product introdu...


St. Jude, Boston Scientific tout European advances for SCS systems
St. Jude Medical (NYSE:STJ) and Boston Scientific (NYSE:BSX) are touting new developments in Europe for their spinal cord stimulation systems. St. Paul, Minn.-based St. Jude said it won CE Mark approval in the European Union for its Inivisible Trial app-based wireless neuromodulation system, the company said. The system leverages Apple (NSDQ:AAPL) iOS devices, specifically an iPod touch for the patient and an iPad mini for the treating physician. The Invisible Trial system uses an external pulse generator for power, which uses Bluetooth to communicate between the iOS device controllers and the stimulator, allowing the system to be worn under clothing and controlled externally, St. Jude said. The system is able to deliver both traditional and burst stimulation modes, which have been show...


Rasch analysis of the Chronic Pain Acceptance Questionnaire Revised in people with knee osteoarthritis.
CONCLUSION: The Activity Engagement and Pain Willingness subscales have good measurement properties for 2 distinct factors relevant to pain acceptance. CPAQ-R is a valid measurement tool that may help target and evaluate response to treatments that address low activity engagement and pain willingness in people with osteoarthritis. PMID: 26035839 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)


Intranasal drug delivery in neuropsychiatry: focus on intranasal ketamine for refractory depression.
This article examines the advantages and applications of INDD in neuropsychiatry; provides examples of test, experimental, and approved INDD treatments; and focuses especially on the potential of intranasal ketamine for the acute and maintenance therapy of refractory depression. PMID: 26035196 [PubMed - in process] (Source: Journal of Clinical Psychiatry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain.
CONCLUSIONS: A core stabilization exercise program significantly increased multifidus muscle CSAs in both healthy women and women with chronic LBP. PMID: 25881694 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Kinesiophobia in relation to physical activity in chronic neck pain.
CONCLUSIONS: Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men. PMID: 25812549 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain.
CONCLUSION: Present findings demonstrated that craniocervical flexion program which specifically recruiting deep cervical flexor muscles increased LC muscle dimension significantly and CF program as an endurance training program increased SCM thickness. PMID: 25812548 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Effectiveness of targeted home-based hip exercises in individuals with non-specific chronic or recurrent low back pain with reduced hip mobility: A randomised trial.
CONCLUSION: In individuals with non-specific LBP and reduced hip rotation, clinical intervention of providing exercises targeted at the hip can be beneficial in improving pain and function, with strengthening exercises most beneficial for improving function. PMID: 25736957 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Do psychological states associate with pain and disability in chronic neck pain patients?
CONCLUSIONS: It can be concluded that anxiety, depression and catastrophizing of patients with chronic neck pain is associated with their self-reported disability, whereas anxiety is also associated with their pain intensity. Anxiety and catastrophizing may be important predicting markers of patients' self-reported disability. PMID: 25736955 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey.
CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles. PMID: 25736952 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Effects of visual illusion and transcutaneous electrical nerve stimulation on neuropathic pain in patients with spinal cord injury: A randomised controlled cross-over trial.
CONCLUSION: TENS and VI therapies can be successfully used in clinical practice as an alternative treatment or as a supportive method separetely or together. PMID: 25502348 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Efficacy of core muscle strengthening exercise in chronic low back pain patients.
CONCLUSION: This study concludes that core muscle strengthening exercise along with lumbar flexibility and gluteus maximus strengthening is an effective rehabilitation technique for all chronic low back pain patients irrespective of different duration (less than one year and more than one year) of their pain. PMID: 25467999 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Prevalence of neck pain among cabin crew of Saudi Airlines.
CONCLUSION: The prevalence of neck pain among the cabin crews of Saudi Airlines was emphasized. The results show a high prevalence of neck pain in the participants of the study, with most cases appearing to run a chronic - episodic course. Further research is needed to help us understand more about the long-term course of neck pain and its broader outcomes and impacts. PMID: 25467997 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Meta-analysis of randomized trials comparing fusion surgery to non-surgical treatment for discogenic chronic low back pain.
CONCLUSIONS: Fusion surgery was not superior to nonsurgical treatment in terms of changes in ODI scores for DLBP. Fusion surgery resulted in surgical complications. Longer follow-up observation is necessary regarding condition-specific disability, pain, and life satisfaction. PMID: 25467996 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Rasch Analysis of the Italian version of Pain Catastrophizing Scale (PCS-I).
CONCLUSION: The Italian version of PCS, with the purposed modifications, seems to reflect a unidimensional construct of Pain Catastrophizing. The scale seemed to be quite robust across age, sex, marital status, BMI and smoking. Targeting of the scale was moderate. A raw score to metric conversion was proposed. PMID: 25408121 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


A brief intervention utilising visual feedback reduces pain and enhances tactile acuity in CLBP patients.
CONCLUSIONS: These findings imply that very simple feedback interventions without major technical requirements could be a valuable supplement to standard treatment in CLBP. PMID: 25391329 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Pharmacological, psychological, and patient education interventions for patients with neck pain: Results of an international survey.
CONCLUSION: This survey indicates that patient education and relaxation therapies are common treatments provided by chiropractors and physical therapists for patients with neck pain. Future research should address gaps associated with variable practice patterns and knowledge translation to reduce usage of interventions shown to be ineffective. PMID: 25391327 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Chiropractic and rehabilitation management of a patient with extraforaminal entrapment of L4 nerve with balance problem.
CONCLUSION: It seems that Chiropractic care and rehabilitation therapy may be a safe and effective modality in treatment of an L4 radiculopathy in a patient with an extraforaminal L4 nerve entrapment. Although it is rare, an L4 extraforaminal disc herniation should be considered as a possible cause of symptoms in patients with chronic mild low back pain and severe L4 radiculopathy. PMID: 25391323 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Effect of trunk muscles training using a star excursion balance test grid on strength, endurance and disability in persons with chronic low back pain.
CONCLUSION: The results of our study show that core muscles strengthening using a SEBT grid are more effective than conventional programs. We hypothesize SEBT training to have a significant role in skill learning. We recommend SEBT grid training to be incorporated in the treatment planning of persons with CLBP. PMID: 25373742 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effective chronic low back pain and knee pain treatment with acupuncture in geriatric patients.
CONCLUSION: These are important results as they give rationale to use acupuncture treatment widely in chronic low back pain and knee pain in the geriatric group of patients to reduce the side effects of polypharmacy in elderly. PMID: 25373741 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Efficacy of dry needling for treatment of myofascial pain syndrome.
This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems. PMID: 25322743 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain.
CONCLUSION: Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level. PMID: 25322739 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Persistent enthesitis and spondyloarthropathy: A case series of 71 Bangladeshi people.
CONCLUSION: Persistent enthesitis a common clinical presentation of SpA, associated with high ESR, HLA-B27 positivity. Definition and classification of enthesitisis important in early diagnosis of this rheumatologic condition. PMID: 25322736 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Sleep quality in patients with chronic low back pain: A cross-sectional study assesing its relations with pain, functional status and quality of life.
CONCLUSION: The sleep quality of patients with CLBP was worse compared to HCs, and there were positive relations between the sleep quality with pain and functional status. Also, the poor sleep quality had negative effect on the physical component of quality of life. PMID: 25322735 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain due to lumbar disc herniation two years after treatment.
CONCLUSIONS: There was negative correlation between the duration of treatment effect and the duration of pre-treatment symptoms. Additionally, clinical improvement of radicular low back pain increased significantly as the duration of pre-treatment symptoms decreased. Based on the present findings, we think that transforaminal epidural steroid injections can be used as an alternative treatment for managing chronic radicular low back pain. PMID: 25322733 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Discriminant analysis of neuromuscular variables in chronic low back pain.
CONCLUSION: Based on these findings, the clinical management of low back pain should consist of both resistance and strength training, particularly in the extensor muscles. PMID: 25171336 [PubMed - in process] (Source: Journal of Back and Musculoskeletal Rehabilitation)


A comparison of mckenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial.
CONCLUSION: McKenzie therapy reduces pain, and disability, among subjects with chronic LBP. This study revealed that the McKenzie therapy is more effective than EPAs group. PMID: 25159291 [PubMed - in process] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Randomized controlled trial on the effectiveness of cognitive behavior group therapy in chronic back pain patients.
CONCLUSIONS: The experience of pain can be altered directly and not only through improvement of depression or general somatoform complaints. The study replicates other research and increases the evidence base for this mode of treatment. The treatment effect can be called specific as it is found additional to a multimodal inpatient care programme. PMID: 25096315 [PubMed - in process] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Effects of intra-articular application of pulsed radiofrequency on pain, functioning and quality of life in patients with advanced knee osteoarthritis.
CONCLUSION: It is possible to state that intra-articular PRF application is effective and safe for the pain treatment of patients with advanced knee OA. Therefore, we think that PRF application will be included in chronic pain treatment guidelines in the future with the increase in the number of future studies. PMID: 25061031 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Cognitive-behavioral management training of depressive symptoms among inpatient orthopedic patients with chronic low back pain and depressive symptoms: A 2-year longitudinal study.
CONCLUSIONS: The long-term psychological rehabilitation success among patients with CLBP and depressive symptoms was improved by the newly developed program, whose clinical significance was also supported. Thus, significant factors for the further development of CLBP were ameliorated. PMID: 24968800 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Health locus of control and self-efficacy predict back pain rehabilitation outcomes.
CONCLUSIONS: In addition to supporting the multiple benefits of multidisciplinary rehabilitation, this study suggests that pain-related self-efficacy and health locus of control may be valuable predictors of treatment benefit for chronic back pain patients. These results provide direction in screening for factors that may maximize the potential to benefit from multidisciplinary intervention for chronic back pain. PMID: 25328476 [PubMed - in process] (Source: Iowa orthopaedic journal)


Progressive adult spinal deformity following placement of intrathecal opioid pump: a report of four cases.
CONCLUSION: In this series, we have shown an apparent association between the placement of ITOP and progression of deformity in both patients with and without existing spinal deformity. While it is impossible to discern causality, all patients in our series had radiographic and clinical evidence of spinal deformity progression after placement of intrathecal pumps. These findings may raise awareness of this rare, but major, complication. In those performing pump placement, we recommend continued clinical and radiographic monitoring, through routine follow-up. LEVEL OF EVIDENCE: Level 4--Case series; case control study (diagnostic studies); poor reference standard; analyses with no sensitivity analyses. PMID: 25328474 [PubMed - in process] (Source: Iowa orthopaedic journal)


Treatment of chronic osteomyelitis of the femur with combined technique.
Authors: Gülabi D, Erdem M, Ceçen GS Abstract Treatment of chronic osteomyelitis of the long bones is challenging due to infection and bone resection. The aim of this case presentation is to report an alternative method for chronic osteomyelitis of the femur. We aimed to provide acute and rapid shortening at the resected site, and lengthening from the metaphyseal bone of a 22-year-old male patient who applied with pain and discharge in the right thigh due to chronic osteomyelitis, and who had undergone three surgical procedures previously. A two-stage treatment was planned. At the first stage, bone resection, antibiotic-impregnated cement rod, and external fixator were applied. At the second stage, intramedullary femoral nail was applied, compression was continued to achieve the ...


[Radiation synovectomy therapy combined with surgical synovectomy in chronic nonspecific synovitis of the knee joint].
CONCLUSION: Our study results showed that RS procedure combined with the surgical synovectomy is an effective and safe treatment method for the treatment of cases of chronic nonspecific synovitis which recurs despite medical treatment. PMID: 23441736 [PubMed - in process] (Source: Eklem Hastaliklari ve Cerrahisi)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Perioperative pain management for total knee arthroplasty.
Authors: Baratta JL, Gandhi K, Viscusi ER Abstract Pain management following total knee arthroplasty (TKA) can be challenging. Inadequate pain management following TKA may inhibit rehabilitation, increase morbidity and mortality, decrease patient satisfaction, and lead to chronic persistent postsurgical pain. Traditionally the mainstay of postoperative pain management was opioids; however, the current recommendations to pain management emphasize a multimodal approach and minimizing opioids whenever possible. With careful planning and a multimodal analgesic approach instituted perioperatively, appropriate pain management following TKA can be achieved. Utilizing an extensive review of the literature, this article discusses the analgesic techniques available for the perioperative mana...


Consumer Information on: Senza Spinal Cord Stimulation (SCS) System - P130022
The Senza SCS System (Senza System) is an implanted, rechargeable spinal cord stimulation system for the treatment of chronic pain of the trunk and/or limbs that is difficult to manage (intractable). (Source: Food and Drug Adminstration (FDA): CDRHNew)


Postcardiac injury syndrome following vascular interventional radiofrequency ablation for paroxysmal atrial fibrillation
Publication date: 2015 Source:Respiratory Medicine Case Reports, Volume 15 Author(s): Shungo Yukumi , Hiraku Ichiki , Junichi Funada , Hideaki Suzuki , Masamitsu Morimoto , Teppei Fujita , Naoki Izumi , Masahiro Abe Postcardiac injury syndrome (PCIS) occurs following a pericardial or myocardial injury. On the other hand, PCIS following cardiac catheter intervention is rare and can be difficult to diagnose because of its delayed onset. A 24-year-old man underwent radiofrequency ablation (RFA) for paroxysmal atrial fibrillation and suffered from general fatigue and left-sided pleural effusion three months after the procedure. His symptoms and effusion were effectively treated within a month by administrating nonsteroidal anti-inflammatory drugs. However, seven months later, he developed le...


Beneficial Therapeutic Effects of Spinal Cord Stimulation in Advanced Cases of Parkinson's Disease With Intractable Chronic Pain: A Case Series
ConclusionOur results indicate that SCS may be a treatment option for both motor symptoms and chronic pain in PD, especially in cases complicated with lumbar canal stenosis or disc herniation. Further studies are needed to evaluate the efficacy of SCS in PD patients. (Source: Neuromodulation: Technology at the Neural Interface)


Treatment‐Limiting Complications of Percutaneous Spinal Cord Stimulator Implants: A Review of Eight Years of Experience From an Academic Center Database
ConclusionsSCS is an effective treatment for chronic noncancer pain. It is a minimally invasive procedure, safe, and with good long‐term outcomes. However, the surgical revision and explant rates are relatively high. As the use of SCS continues to grow, research into the causes of and risk factors for SCS‐related complications is paramount to decrease complication rates in the future. (Source: Neuromodulation: Technology at the Neural Interface)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effect of sexual dysfunction and sexual quality of life in type 2 diabetes women: a pilot study from Turkey
This study was conducted in order to determine the sexual dysfunction (SD) and sexual quality of life of women with type 2 diabetes. This cross-sectional and descriptive study was conducted at nine family health centers located in the city center of Kars. We used a questionnaire for data collection, and the Sexual Quality of Life Questionnaire-Female (SQLQ-F) and Female Sexual Function Index (FSFI) were used as the data collection tool. Sexual dysfunction and sexual quality of life of women with type 2 diabetes. The mean total FSFI was 67.36 ± 10.25 and the mean score for sexual desire was 3.28 ± 2.58, arousal 8.42 ± 4.33, lubrication 12.57 ± 4.89, orgasm 7.25 ± 3.52, satisfaction 9.06 ± 2.18, and pain 9.28 ± 4.45. The most common problem was sexual desir...


Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP Research Network Neuroimaging Study
Publication date: Available online 5 June 2015 Source:NeuroImage: Clinical Author(s): Jason J. Kutch , Moheb S. Yani , Skulpan Asavasopon , Daniel J. Kirages , Manku Rana , Louise Cosand , Jennifer S. Labus , Lisa A. Kilpatrick , Cody Ashe-McNalley , Melissa A. Farmer , Kevin A. Johnson , Timothy J. Ness , Georg Deutsch , Richard E. Harris , A. Vania Apkarian , Daniel J. Clauw , Sean C. Mackey , Chris Mullins , Emeran A. Mayer Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the br...


Renal Autotransplantation: 27-year Experience at Two Institutions
Renal autotransplantation is an infrequently performed procedure. It has been used for the management of complex ureteral disease, vascular anomalies, and chronic kidney pain. Herein is reviewed our 27-year experience with this procedure. (Source: The Journal of Urology)


Selective serotonin reuptake inhibitors for fibromyalgia syndrome.
CONCLUSIONS: There is no unbiased evidence that SSRIs are superior to placebo in treating the key symptoms of fibromyalgia, namely pain, fatigue and sleep problems. SSRIs might be considered for treating depression in people with fibromyalgia. The black box warning for increased suicidal tendency in young adults aged 18 to 24, with major depressive disorder, who have taken SSRIs, should be considered when appropriate. PMID: 26046493 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Are Chronic and Episodic Migraine Distinct Neurophysiological Entities? More Research is Needed
(Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Shingles Vaccine Appears to Cut Odds of Long-Term Pain
Findings support immunization of older adults Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Immunization, Shingles (Source: MedlinePlus Health News)


Mindfulness-based stress reduction in an integrated care delivery system: one-year impacts on patient-centered outcomes and health care utilization.
CONCLUSION: The MBSR program was associated with improvements in several patient-centered outcomes over 1 year and reductions in health services utilization up to 18 months. PMID: 25662520 [PubMed - in process] (Source: The Permanente journal)


Neuroendocrine and stress-related aspects of endometriosis.
In conclusion, endometriosis is a disease which affects reproductive and neuroendocrine functions with a great impact on women's health and quality of life. PMID: 25789593 [PubMed - as supplied by publisher] (Source: Neuroendocrinology Letters)


Current knowledge and future prospects for SAPHO syndrome.
Authors: Kim C Abstract SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a complex disorder characterized by osteoarticular and cutaneous symptoms. Most patients experience bone pain and dermatologic manifestations. Diagnosis of SAPHO syndrome is based on exclusion of infectious arthritis and septic osteomyelitis with findings of hyperostosis or chronic recurrent multifocal osteomyelitis involving axial or peripheral skeleton, with or without skin manifestations. The pathophysiology of SAPHO is unclear, although several hypotheses exist. Some of these hypotheses have led to the ever growing treatment options of medications. Broad varieties of medications have been used, such as nonsteroidal anti-inflammatory drugs and disease-modifying agents. New therapeu...


Bioavailability and pharmacokinetic profile of a newly-developed twice-a-day sustained-release paracetamol formulation.
CONCLUSIONS: The new SR formulation was well absorbed, with more than 90% relative bioavailability as compared to the currently marketed IR and ER products and better sustained-release PK characteristics, which make it suitable for twice-daily paracetamol treatment. PMID: 25500485 [PubMed - in process] (Source: International Journal of Clinical Pharmacology and Therapeutics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Noninterventional study of transdermal fentanyl (fentavera) matrix patches in chronic pain patients: analgesic and quality of life effects.
Authors: Heim M Abstract Fentanyl is considered to be an effective, transdermal treatment of chronic, cancer, and noncancer pain. This noninterventional, clinical practice-based study, on 426 patients attending 42 practices, assessed a proprietary, Aloe vera-containing, transdermal fentanyl matrix patch (Fentavera), for its analgesic effects, patients' quality of life (QoL) effects, tolerability, and adhesiveness. Study outcomes were mean changes from baseline of patient (11-point scales) and physician (5-point scales) ratings. After 1 and 2 months treatment, there were significant (P &lt; 0.0001) decreases in patients' ratings of pain intensity, and impairment of walking, general activity, sleep quality, and QoL. For each parameter, the patient response rate was &gt;30% at 2 month...


The Qualitative Hyperalgesia Profile: A New Metric to Assess Chronic Post-Thoracotomy Pain.
Authors: Chi-Fei Wang J, Hung CH, Gerner P, Ji RR, Strichartz GR Abstract Thoracotomy often results in chronic pain, characterized by resting pain and elevated mechano-sensitivity. This paper defines complex behavioral responses to tactile stimulation in rats after thoracotomy, shown to be reversibly relieved by systemic morphine, in order to develop a novel qualitative "pain" score. A deep incision and 1 hour of rib retraction in male Sprague-Dawley rats resulted in reduced threshold and a change in the locus of greatest tactile (von Frey filament) sensitivity, from the lower back to a more rostral location around the wound site, and extending bilaterally. The fraction of rats showing nocifensive responses to mild stimulation (10 gm) increased after thoracotomy (from a pre-operati...


Chronic Pain in a Biracial Cohort of Young Women.
Authors: Plesh O, Gansky SA, Curtis DA Abstract This is a longitudinal study of a large US biracial community cohort of 732 young women - 50% African-American and 50% Caucasian - specifically investigating incidence, remission, and progression of, as well as factors associated with common chronic pains (back, head, face, chest and abdomen). The results show back, head and abdominal pains were the most common, severe and persistent pains. Facial pain, although less common and severe, was the only pain presenting significant racial differences with Caucasians having higher prevalence, incidence and persistence; incidence per 1000 person-years was 58 for Caucasians and 18 for African-Americans while remission per 1000 person-years was 107 for Caucasians and 247 for African-Americans (...


Focal Inflammation Causes Carbenoxolone-Sensitive Tactile Hypersensitivity in Mice.
Authors: Hanstein R, Zhao JB, Basak R, Smith DN, Zuckerman YY, Hanani M, Spray DC, Gulinello M Abstract A focal and transitory inflammation induced by injection of complete Freund's adjuvant (CFA) in the submandibular skin of mice elicits pain behavior that persists for several weeks after the initial inflammation has resolved. Chronic pain, assessed as tactile hypersensitivity to stimulation with von Frey filaments, was evident from 1-7 weeks following CFA injection, although inflammation at the injection site was resolved by 3-4 weeks. In contrast, there were no changes in tactile sensitivity in the paw (un-injected site for comparison), no alterations in open field behavior and no differences in a functional observation battery evident in CFA-treated mice compared to controls (s...


The Role of Suggestions in Hypnosis for Chronic Pain: A Review of the Literature.
Authors: Dillworth T, Jensen MP Abstract Several controlled trials have demonstrated that hypnosis is an efficacious treatment for chronic pain. However, less attention has been given to the specific procedures and suggestions used in hypnotic treatments in research. The goal of this review was to address the issue of differences in the content of hypnotic suggestions, including pain management suggestions, non-pain related suggestions, and posthypnotic suggestions, in the context of published clinical trials of hypnosis for chronic pain management. This review focused on the types of suggestions used in twenty five studies comparing hypnosis to active treatments (e.g., relaxation, biofeedback), non-treatment control groups (e.g., standard care/wait-list control, supportive attenti...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Alcohol Abuse and Pancreatic Diseases: An Overview.
CONCLUSIONS: Chronic abuse of alcohol, but not occasional alcoholic intoxication, causes pancreatic damage. Regarding pancreatic neoplasms, the role of alcohol is under debate in ductal pancreatic adenocarcinoma as well as in pancreatic neuroendocrine tumors. Few relevant patents are also described in this review. PMID: 25925405 [PubMed - as supplied by publisher] (Source: Recent Patents on Inflammation and Allergy Drug Discovery)


Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
Conclusion This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated. (Source: International Journal of Behavioral Medicine)


Epigenetic Control of Pannexin-1 Expression in Chronic Pain [Neurobiology]
In this study, we determined the epigenetic mechanism involved in increased Panx1 expression in the DRG after nerve injury. Spinal nerve ligation in rats significantly increased the mRNA and protein levels of Panx1 in the DRG but not in the spinal cord. Immunocytochemical labeling showed that Panx1 was primarily expressed in a subset of medium and large DRG neurons in control rats and that nerve injury markedly increased the number of Panx1-immunoreactive DRG neurons. Nerve injury significantly increased the enrichment of two activating histone marks (H3K4me2 and H3K9ac) and decreased the occupancy of two repressive histone marks (H3K9me2 and H3K27me3) around the promoter region of Panx1 in the DRG. However, nerve injury had no effect on the DNA methylation level around the Panx1 promoter ...


A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study
Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. A posterior approach to these procedures under computed tomography guidance has been reported. Here, we report the clinical outcomes of 42 patients with chronic cervical radicular pain (CCRP) treated with a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. (Source: Journal of Clinical Anesthesia)


The mu opioid receptor: A new target for cancer therapy?
Mu opioids are among the most widely used drugs for patients with cancer with both acute and chronic pain as well as in the perioperative period. Several retrospective studies have suggested that opioid use might promote tumor progression and as a result negatively impact survival in patients with advanced cancer; however, in the absence of appropriate prospective validation, any changes in recommendations for opioid use are not warranted. In this review, the authors present preclinical and clinical data that support their hypothesis that the mu opioid receptor is a potential target for cancer therapy because of its plausible role in tumor progression. The authors also propose the hypothesis that peripheral opioid antagonists such as methylnaltrexone, which reverses the peripheral effects ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Examining patterns of multivariate, longitudinal symptom experiences among older adults with type 2 diabetes and cancer via cluster analysis
Diabetes and cancer are chronic conditions that produce symptoms, some unique to each condition and others common to both. Previous studies have reported on subgroups of patients who experience distinct combinations of symptoms in cross-sectional samples and the univariate longitudinal trajectories of individual symptoms. The literature currently lacks examples of research that take a multivariate longitudinal perspective to understanding patients' symptom experiences. The purpose of this study was to identify subgroups of patients who share distinct multivariate longitudinal profiles with respect to how symptom severity changes over time for a set of five symptoms (pain, fatigue, change in appetite, nausea, and numbness and tingling). (Source: European Journal of Oncology Nursing)


Chronic Pancreatic Inflammatory Granuloma Caused by Foreign Body Presenting as a Pancreatic Pseudotumor: A case report and literature review
In clinical practical work, a rare kind of chronic pancreatic inflammatory granuloma which is caused by the foreign body of gastrointestinal perforation could be misdiagnosed and treated as pancreatic neoplasm sometimes, and even brings irreparable harm to patients. Here, we depict a male presenting recurrent upper abdominal pain and gradual weight loss, besides, the computer tomography suggested pancreatic tumor strongly. Fortunately, it has been proved to be a chronic pancreatic inflammatory granuloma caused by fish bone through laparotomy finally. (Source: Pancreatology)


Chronic opioid induced constipation in patients with nonmalignant pain: challenges and opportunities
With the recent introduction and approval of medications directed at the treatment of opioid induced constipation (OIC) in patients with nonmalignant pain, there is increased interest and understanding of the unmet need and opportunities to enhance patient management. The high incidence of OIC is associated with rapid increase of narcotic analgesic prescriptions for nonmalignant chronic pain. This review addresses briefly the mechanisms of action of opioids that lead to OIC, the differential tolerance of gastrointestinal organs to the effects of opioids, the size and scope of the problem, the definition and outcome measures for OIC, current differential diagnosis and management algorithms, and the pharmacology and efficacy of treatments for OIC in patients with nonmalignant pain. (Source: ...


Troponins and other biomarkers in the early diagnosis of acute myocardial infarction
Chest pain is a common presenting symptom; however, the majority of emergency chest pain admissions are not due to acute myocardial infarction (AMI). AMI can be life threatening and early diagnosis or rule out of AMI might potentially improve morbidity and mortality, as well as reduce time to decision and therefore overall treatment costs. High-sensitivity troponin (hs-troponin) assays have been developed that enable precise quantification of extremely low troponin concentrations. Such hs-troponin assays are recommended in early rule-out protocols for AMI, when measured at presentation and again at 3&ndash;6&nbsp;h. However, troponin is less than ideally suited for early diagnosis of acute myocardial injury because of its slow rise, late peak and low specificity for coronary plaque rupture...


Diagnostic Value of Clinical Cervical Spine Tests in Patients With Cervicogenic Somatic Tinnitus.
CONCLUSIONS: Clinical cervical spine tests can support the diagnostic process of CST. An NBQ score &lt;14 points and the absence of trigger points can help to exclude CST. In contrast, a positive manual rotation and AST can help to include CST. We advise to include these test in a multidisciplinary assessment of patients with suspected CST. PMID: 26045606 [PubMed - as supplied by publisher] (Source: Physical Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Examining patterns of multivariate, longitudinal symptom experiences among older adults with type 2 diabetes and cancer via cluster analysis.
CONCLUSIONS: More research in this area is needed to further test this model, address limitations associated with analyzing a small sample, and explore factors that may be associated with changes in the overall symptom experience for patients with diabetes and cancer. PMID: 26051076 [PubMed - as supplied by publisher] (Source: European Journal of Oncology Nursing)


Migraine and tension type headache in adolescents at grammar school in Germany – burden of disease and health care utilization
Conclusions Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache. (Source: The Journal of Headache and Pain)


Recommendations for the management of sickle cell disease in South Africa.
Authors: Alli NA, Patel M, Alli HD, Bassa F, Coetzee MJ, Davidson A, Essop MR, Lakha A, Louw VJ, Novitzky N, Philip V, Poole JE, Wainwright RD Abstract The spectrum of sickle cell disease (SCD) encompasses a heterogeneous group of disorders that include: (I) homozygous SCD (HbSS), also referred to as sickle cell anaemia; (ii) heterozygous SCD (HbAS), also referred to as sickle cell trait; and (iii) compound heterozygous states such as HbSC disease, HbSβ thalassaemia, etc. Homozygous or compound heterozygous SCD patients manifest with clinical disease of varying severity that is influenced by biological and environmental factors, whereas subject with sickle cell trait are largely asymptomatic. SCD is characterized by vaso-occlusive episodes that result in tissue ischaemia and pain ...


Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study.
CONCLUSIONS: psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function. PMID: 26019683 [PubMed - in process] (Source: International Journal of Medical Sciences)


Analysis of efficacy differences between caudal and lumbar interlaminar epidural injections in chronic lumbar axial discogenic pain: local anesthetic alone vs. local combined with steroids.
CONCLUSION: This assessment shows that in patients with axial or discogenic pain in the lumbar spine after excluding facet joint and SI Joint pain, epidural injections of local anesthetic by the caudal or lumbar interlaminar approach may be effective in managing chronic low back pain with a potential superiority for a lumbar interlaminar approach over a caudal approach. PMID: 25678838 [PubMed - in process] (Source: International Journal of Medical Sciences)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Combined autologous bone marrow mononuclear cell and gene therapy as the last resort for patients with critical limb ischemia.
CONCLUSIONS: These data after 3-month follow-up indicate that intramuscular injection of MNC combined with gene therapy in patients with chronic CLI is safe, and a more feasible and effective method of treatment than the conventional therapy. However, both therapies are limited by the degree of microcirculation damage. PMID: 25995748 [PubMed] (Source: Archives of Medical Science)


Eagle's Syndrome Manifesting as Chronic Swallowing Pain.
Authors: Hagiya H, Waseda K, Ogawa H, Otsuka F PMID: 25986280 [PubMed - in process] (Source: Internal Medicine)


Demyelinating hypertrophic inferior alveolar nerve mimicking a nerve tumor.
Authors: Fujita H, Kokubun N, Sada T, Nagashima T, Komagamine T, Kawabe K, Hirata K Abstract We herein report a patient with demyelinating inferior alveolar nerve hypertrophy, which was initially suspected to have a nerve tumor. A 39-year-old woman with childhood-onset polyneuropathy presented with tooth pain and visited a dental clinic. An X-ray examination of the mandible revealed enlargement of the mandibular canal, and a nerve tumor was suspected. CT scan and MRI showed hypertrophy of the inferior alveolar nerve along its entire length. We diagnosed the patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which was supported by the spontaneous recovery reported in her childhood, the results from a nerve conduction study and MRI data. CIDP should be con...


Can a self-administered questionnaire identify workers with chronic or recurring low back pain?
Authors: Takekawa KS, Gonçalves JS, Moriguchi CS, Coury HJ, Sato TO Abstract To verify if the Nordic Musculoskeletal Questionnaire (NMQ), Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RDQ) and physical examination of the lumbar spine can identify workers with chronic or recurring low back pain, using health history for reference. Fifty office workers of both sexes, aged between 19 and 55 years, were evaluated using a standardized physical examination and the NMQ, VAS and RDQ. Discriminant analysis was performed to determine the discriminant properties of these instruments. A higher success rate (94%) was observed in the model including only the NMQ and in the model including the NMQ and the physical examination. The lowest success rate (82%) was observed i...


Cherry juice targets antioxidant potential and pain relief.
This article reviews the antioxidant and anti-inflammatory effects of tart cherries on prevention, treatment, and recovery of soft tissue injury and pain. PMID: 23075558 [PubMed - indexed for MEDLINE] (Source: Medicine and Sport Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Structural integration as an adjunct to outpatient rehabilitation for chronic nonspecific low back pain: a randomized pilot clinical trial.
Authors: Jacobson EE, Meleger AL, Bonato P, Wayne PM, Langevin HM, Kaptchuk TJ, Davis RB Abstract Structural Integration (SI) is an alternative method of manipulation and movement education. To obtain preliminary data on feasibility, effectiveness, and adverse events (AE), 46 outpatients from Boston area with chronic nonspecific low back pain (CNSLBP) were randomized to parallel treatment groups of SI plus outpatient rehabilitation (OR) versus OR alone. Feasibility data were acceptable except for low compliance with OR and lengthy recruitment time. Intent-to-treat data on effectiveness were analyzed by Wilcoxon rank sum, n = 23 per group. Median reductions in VAS Pain, the primary outcome, of -26 mm in SI + OR versus 0 in OR alone were not significantly different (P = 0.075). Med...


Nonpharmacological interventions for pain management in paramedicine and the emergency setting: a review of the literature.
Authors: Pak SC, Micalos PS, Maria SJ, Lord B Abstract Paramedicine and the emergency medical services have been moving in the direction of advancing pharmaceutical intervention for the management of pain in both acute and chronic situations. This coincides with other areas of advanced life support and patient management strategies that have been well researched and continue to benefit from the increasing evidence. Even though paramedic practice is firmly focused on pharmacological interventions to alleviate pain, there is emerging evidence proposing a range of nonpharmacological options that can have an important role in pain management. This review highlights literature that suggests that paramedicine and emergency medical services should be considering the application of complem...


Analysis of the effects of micronised purified flavonoid fraction versus placebo on symptoms and quality of life in patients suffering from chronic venous disease: from a prospective randomised trial.
CONCLUSIONS: A 4-month treatment with MPFF significantly reduced leg pain/heaviness and improved QOL when compared to placebo and was well tolerated. PMID: 25972136 [PubMed - as supplied by publisher] (Source: International Angiology)


Perioperative Pain Correlates and Prolonged Postoperative Pain Predictors: Demographic and Psychometric Questionnaires
Conclusion Only the BIPQ was predictive of developing prolonged postoperative pain. While none of the demographic factors observed significantly predicted the development of ‘prolonged pain’, the not significant data followed expected trends. Several relationships were detected in this study that should further efforts in developing preoperative predictors to promote the secondary prevention of postoperative pain states. (Source: Pain and Therapy)


Electro-acupuncture for treatment of knee pain from osteoarthritis and the possible endocrinology changes: a study protocol for a randomized controlled trial
This study is a placebo-controlled, randomized, double-blind, parallel design trial. One hundred sixty out-patients who are more than 50 years old and who have osteoarthritis of the knee will be recruited from the island of Mallorca, Spain. Each participant will be randomly placed into one of two groups: (sham) electro-acupuncture non-insertion technique and real electro-acupuncture.Acupuncture treatments will be the Traditional Chinese Medicine type. The patients will be evaluated after a period of 1 month (with two weekly sessions), 3 months (with one monthly session), 6 months (with one session every 45 days), and 1 year later with follow-up sessions at the end of the study (with one session every 2 months).The primary outcomes will be based on the observed changes from the baseline of ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


To Befriend or Not: Naturally Developing Friendships Amongst a Clinical Group of Adolescents with Chronic Pain
Adolescents with chronic pain frequently perceive a lack of support from friends. Support from a peer with a shared experience has been found to provide emotional, informational, and appraisal support. We sought to quantify the frequency with which adolescents with chronic pain want to befriend other adolescents with chronic pain, and to describe the features of these friendships. Adolescents with chronic pain who had attended a 10-week structured self-management program from 3 sites were invited to complete an online survey. (Source: Pain Management Nursing)


Recent Advances in Polymyalgia Rheumatica
Abstract Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder of unknown cause characterised by the subacute onset of shoulder and pelvic girdle pain, and early morning stiffness in men and women over the age of 50 years. Due to the lack of a gold standard investigation, diagnosis is based upon a clinical construct and laboratory evidence of inflammation. Heterogeneity in the clinical presentation and disease course of PMR has long been recognised. Aside from the evolution of alternate diagnoses such as late‐onset rheumatoid arthritis (RA), concomitant giant cell arteritis (GCA) is also recognised in 16‐21% of cases. In 2012, revised classification criteria were released by the European League Against Rheumatism and American College of Rheumatology (EULAR/ACR) in order to id...


Web-based interventions for comorbid depression and chronic illness: a systematic review
Web-based interventions offer potential benefits for managing and treating depression in the context of chronic physical illness, however their use with this population has yet to be quantitatively assessed. The present systematic review examined the biopsychosocial data from 11 independent studies (N = 1348 participants), including randomised controlled and quasi-experimental designs most commonly performed with diabetes and multiple sclerosis. Study quality was evaluated using the Downs and Black (1998) index, with most studies being statistically underpowered although internal validity was demonstrated. Treatment outcomes were quantified using Cohen&rsquo;s d effect sizes. Results indicated significant short-term improvements in depression severity (d w = 0.36, CI = 0.20-0.52, p...


Factors associated with the development of depression in chronic non-Cancer pain patients following the onset of opioid treatment for pain
This study aimed to identify factors associated with the onset of depression post-opioid use that differ to factors associated with depression post-pain. (Source: Journal of Affective Disorders)


A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain
To assess the effectiveness of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain (CPP). (Source: International Journal of Gynaecology and Obstetrics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Alexithymia and Early Maladaptive Schemas in chronic pain patients
Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale‐20, the Finnish version of the Young Schema Questionnaire short form‐extended, the Beck Depression Inventory‐II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co‐occurrence of alexithymia, Early Maladaptive Schemas and depression seems ...


Chronic anophthalmic socket pain treated by implant removal and dermis fat graft.
CONCLUSIONS: Orbital implant replacement with DFG was effective at relieving chronic ASP, and pain resolution was sustained in all cases. This surgical intervention may be a useful management option for patients in whom all detectable causes of chronic pain have been excluded and have failed medical pain management. PMID: 26041123 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)


Nerve Growth Factor Controls Development and Persistence of Experimental Pulmonary Hypertension.
CONCLUSIONS: Our study provide evidence for critical roles of NGF in PH. Owing the recent development of anti-NGF blocking antibodies as a possible new pain treatment, such therapeutic strategy of NGF inhibition may be of interest in PH. PMID: 26039706 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)


Long-term morbidity after multivisceral resection for retroperitoneal sarcoma.
CONCLUSION: Severe chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long-term renal function is not significantly impaired when nephrectomy is performed. PMID: 26041724 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)


The Local and Systemic Actions of Duloxetine in Allodynia and Hyperalgesia Using a Rat Skin Incision Pain Model.
CONCLUSIONS: Our results demonstrate that duloxetine can act as a local anesthetic and an analgesic drug via both local and systemic applications. Because duloxetine inhibits neuronal Na currents with high potency, it may exert its antihyperalgesic effects through inhibition of the spontaneous nerve impulses that result from peripheral injury, encompassing its actions on multiple central nervous system and peripheral targets. PMID: 26049779 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program
Conclusion sTMS may be a valuable addition to options for the treatment of both episodic and chronic migraine. (Source: The Journal of Headache and Pain)


Hyperbaric hope for fibromyalgia sufferers
Women who suffer from fibromyalgia benefit from a treatment regimen in a hyperbaric oxygen chamber, according to researchers. Fibromyalgia is a chronic pain syndrome that can be accompanied by -- and perhaps related to -- other physical and mental conditions that include fatigue, cognitive impairment, irritable bowel syndrome and sleep disturbance. (Source: ScienceDaily Headlines)


New care measures and their impact on pain medicine: One pain specialist's perspective.
Authors: Pergolizzi JV Abstract Value-based purchasing (VBP) goes into effect this year and it links the quality of care to payments for care. Starting in fiscal year 2013, the Centers for Medicare and Medicaid Services reduces all inpatient prospective payment system reimbursements by 1%. This money then can be returned to hospitals in the form of a bonus through VBP. Value-based purchasing holds hospitals accountable for both cost and quality. With VBP, hospitals get a score that is based on the process of care, the outcomes, and patient-centeredness. This means that reimbursements in health care, which keep hospitals in business, are transitioning from "volume of services" to VBP. Although VBP sounds like a great idea, particularly to politicians in Washington tasked with managi...


Treatment of a Medial Collateral Ligament Sprain Using Prolotherapy: A Case Study.
Authors: Ada AM, Yavuz F Abstract Prolotherapy is effective in treating refractory tendinopathies, but inadequate clinical evidence exists to recommend its use as a treatment for acute or chronic, medial collateral ligament (MCL) injuries. The current case study documents an illustrative case of a rugby player who had a grade 2 sprain of the MCL and shows the clinical and radiological outcomes following injections of 15% dextrose combined with 0.2% lidocaine. In his case, the prolotherapy, together with an exercise therapy, lasted 3 wk. At the end of the 3 wk, the patient was pain free, with a full range of motion (ROM), and he was able to perform all rugby-specific movements. The mean duration for recovery with conservative treatment of isolated, complete tears of the MCL is norma...


Internal Hernia After Laparoscopic Antecolic Roux-en-Y Gastric Bypass
Conclusion IH is a serious and potentially fatal complication of RYGB. Presentation can vary from chronic abdominal pain to bowel necrosis. CT is helpful in providing diagnosis; however, careful attention to the specific signs of small bowel volvulus, such as mesenteric swirl sign, should be given. IH should be considered in RYGB patients who present with even vague symptoms. (Source: Obesity Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Office workers of England - stand up for your health!
Workers have been warned to &quot;stand up for at least two hours a day in [the] office,&quot; according to The Daily Telegraph. It says these are the first official health guidelines on the issue. The guidance comes from a panel of experts, commissioned by Public Health England, which provides recommendations aimed at helping employers know what to aim for when trying to make workplaces less sedentary and more active. They say that this could potentially improve productivity and profitability, for example by reducing sickness. This guidance has been prompted by a growing body of evidence that sedentary behaviour can increase the risk of a range of chronic diseases such as obesity, type 2 diabetes and high blood pressure. Some experts have gone as far as saying that &quot;sitting is the ...


Assessment of acute oxaliplatin‐induced cold allodynia: a pilot study
Conclusionshe results showed that the palm of the hand is the most sensitive part of the body when detecting oxaliplatin‐induced cold allodynia, and the use of a cold metal cylinder seems as a promising sensitive method. (Source: Acta Neurologica Scandinavica)


Health Tip: Sleeping With Chronic Pain
Title: Health Tip: Sleeping With Chronic PainCategory: Health NewsCreated: 6/2/2015 12:00:00 AMLast Editorial Review: 6/2/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Responding to illicit drug use in family practice
Purpose of review: To examine and analyse recent published research on the impact and management of drug use and related disorders in primary care settings. Emerging trends in drug use and the development of new treatment approaches are making new demands on the primary care sector. Recent findings: Most recent publications relate to descriptions of the drugs used and their impact on mental health. The use of cannabis and newer stimulants and ‘legal highs’ tends to coexist with opiate use, and their physical and mental health sequelae often overlap. Several studies address methadone and buprenorphine prescribing, its efficacy and limitations, and organizational issues in delivery of treatment. Other areas identified in this review are pain control, adverse consequences of drug use incl...


Distribution of naloxone for overdose prevention to chronic pain patients
Publication date: Available online 27 May 2015 Source:Preventive Medicine Author(s): Marion A. Coe , Sharon L. Walsh In this commentary, we reflect on the growing opioid overdose epidemic and propose that chronic pain patients prescribed opioids are contributing to growing mortality rates. We advocate for expanding naloxone access and overdose prevention training, which has historically been directed when available to injection drug users, to chronic pain patients who may be at high risk for accidental opioid overdose. (Source: Preventive Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Revising the negative meaning of chronic pain - A phenomenological study
Conclusions Pain is an aversive sensation, which leads to the conclusion that the meaning of the experience is also negative, but it can be reversed. In clinical practice, the focus should be on revising the subjective meaning of pain in order to manage pain and to restore positivity in personal life. (Source: Chronic lllness)


Aerosol Delivery in the Treatment of Lung Cancer.
Authors: Storti C, Le Noci V, Sommariva M, Tagliabue E, Balsari A, Sfondrini L Abstract Intratumoral delivery of drugs, enabling increased local concentrations in the tumor microenvironment, might be superior to systemic administration in promoting antitumor activity and minimizing systemic side-effects of some drugs. Unfortunately, not all human cancers are amenable to drug injection into the tumor sites. Lung cancers are candidate tumors for taking advantage of local delivery, being accessible via the endobronchial space by aerosol administration. Inhalation of aerosolized drugs is a promising option in the management of lung diseases and currently represents the standard treatment for asthma and chronic obstructive pulmonary disease. Besides a high local concentration, advantage...


Assessment of health-related quality of life in end-stage chronic obstructive pulmonary disease and non-small-cell lung cancer patients in Serbia.
Authors: Maric D, Jovanovic D, Nagorni-Obradovic L, Stjepanovic M, Kisic-Tepavcevic D, Pekmezovic T Abstract OBJECTIVE: Under conditions in which palliative care has not yet become part of clinical practice, the differences in palliative care needs between patients with cancer and other life-limiting diseases can yield knowledge that will be very valuable for future planning. The aim of our investigation was to compare health-related quality of life (HRQoL) for patients with end-stage chronic obstructive pulmonary disease (COPD) and those with non-small-cell lung cancer (NSCLC) in Belgrade, Serbia. We also evaluated the influence of demographic, socioeconomic, and clinical factors on HRQoL for both patient groups. METHOD: This cross-sectional study included 100 NSCLC patients (...


Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.
CONCLUSIONS: Since the last version of this review, we have found new studies providing additional information. We reanalyzed the data but the results did not substantially alter any of our previously published conclusions. This review provides moderate to low quality evidence that PCA is an efficacious alternative to non-patient controlled systemic analgesia for postoperative pain control. PMID: 26035341 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Synergistic interaction between tapentadol and flupirtine in the rat orafacial formalin test.
Authors: Lee H, De Vito V, Giorgi M, Yun H Abstract Combination therapy with two or more analgesics is widely used for conditions associated with moderate to severe pain. Combinations of diverse analgesics with different modes of action can improve the risk-benefit ratio of analgesic treatments. The aim of this study is to evaluate the antinociceptive effect of tapentadol (TAP) and flupirtine (FLP), when administered separately or in combination, as well as their synergistic interaction in the orofacial formalin test in rats. After i.p. injection of TAP at different doses (2, 5, 10 and 15mg/kg), the biphasic nociceptive behavior was reduced in a dose-dependent manner in both phase I and II. Conversely, i.p. injection of FLP at different doses (0.6, 1.6, 3.3, 6.6, 16.6 and 22.2mg/kg...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Illness: How to Repair Your Life After a Flare-Up
I've found that the first step in pulling yourself up after a flare knocks you face-down on the pavement is to realize that you must have a plan. This epiphany should happen while you are still on the ground. Maybe you haven't been discharged from the hospital yet. Maybe you're home but are still in the throws of whatever pain or infection that started all this. Maybe you're thinking why should I even bother to make a plan when I can't even get out of bed? When your life feels directionless and you're in the midst of a post-illness sadness, you have to turn your attention not to what you have missed out on or let fall through the cracks -- but to what steps you're going to take, not to get back to where you were, but to an even better place. Recently I found myself in a two month long i...


The Comparison of Lightweight Mesh and Standard Mesh in Incisional Hernia Repair With the Open Sublay Technique: The Results of a Meta-Analysis
Conclusions: In the procedure of open incisional hernia repair, the use of lightweight mesh seems to be associated with less chronic pain, and without the increase of recurrence and other postoperative complications. However, based on the short-term follow-up of the included studies, long-term well-designed RCTs are needed to evaluate the real outcomes. (Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques)


Commercial Driver Medical Examinations: Prevalence of Obesity, Comorbidities, and Certification Outcomes
Conclusions: Obesity is related to multiple medical factors as well as increasing numbers of conditions that limit driving certification. (Source: Journal of Occupational and Environmental Medicine)


The Effect of the Modified Eighth Section of Eight-Section Brocade on Osteoporosis in Postmenopausal Women: A Prospective Randomized Trial
Abstract: Osteoporosis and related fragility fractures represent a serious and global public health problem. To evaluate whether the modified eighth section of Eight-section Brocade (MESE) exercise could improve the symptom and indexes associated with osteoporosis in postmenopausal women. Guangzhou and Liuzhou hospital of traditional Chinese medicine in China. Women (n = 198) aged 50 to 75 years were randomized into Control, Ca, MESE, and MESE + Ca. Subjects in Ca and MESE groups were separately asked to consume thrice daily Calcium Carbonate Chewable D3 tablet and to perform thrice daily MESE exercise by 7 repetitions per time for 12 months. Subjects in MESE + Ca group performed such the combined treatment project for 12 months. Body height and Hospital for Special Surgery (HS...


Change in lumbar lordosis during prone lying knee flexion test in subjects with and without low back pain
Conclusion: Increase in lumbar lordosis during this test may be due to excessive flexibility of movement of the lumbar spine in the direction of extension and abnormal movement patterns in the individuals with LBP. (Source: Chiropractic and Osteopathy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effect of daily walking steps on preventing neck and low back pain in sedentary workers: A 1-year prospective cohort study
The association between physical inactivity and several non-communicable diseases, including type II diabetes, cardiovascular disease, breast and colon cancer, is well established.1 A large scale population-based study suggests a similar association between physical inactivity and chronic musculoskeletal disorders.2 However, recent systematic reviews suggest that the link with back and neck pain may be less clear-cut, and indicate a need for more research in this area.3,4 Sitthipornvorakul et al.,5 suggest that previous research has been too broadly focused, arguing that the effects of physical activity are unlikely to be the same across a broad population with disparate occupational demands. (Source: International Journal of Osteopathic Medicine)


Adverse events among seniors receiving spinal manipulation and exercise in a randomized clinical trial
The rising number of chronic neck pain cases in the senior population is a public health concern of growing interest. While there are numerous pharmacological therapies available for symptom control, there is limited research supporting the use of non-pharmacological therapies such as Spinal Manipulative Therapy (SMT) and exercise in this population. This is extremely unfortunate given these two types of treatments have been informally considered two of the most effective ways to manage chronic conditions of this nature. (Source: International Journal of Osteopathic Medicine)


A New Integrated Clinical-Biohumoral Model to Predict Functionally Significant Coronary Artery Disease in Patients With Chronic Chest Pain
Conclusions The Genders model has a low accuracy for predicting functionally significant CAD. A new model integrating HDL cholesterol, AST, and hs-CRP levels with common clinical variables has a higher predictive accuracy for functionally significant CAD and allows the reclassification of patients from an intermediate/high to a low pretest likelihood of CAD. (Source: Canadian Journal of Cardiology)


Daily phosphodiesterase type 5 inhibitor therapy: a new treatment option for prostatitis/prostatodynia?
The management of patients with chronic pelvic pain attributed to chronic prostatitis has always been rather unsatisfactory. Even prolonged treatment with an aminoquinolone, such as ciprofloxacin, and an anti‐inflammatory agent, or, alternatively an alpha‐blocker, seldom results in rapid resolution of the symptoms, and is commonly completely ineffective. (Source: Trends in Urology, Gynaecology and Sexual Health)


The day‐to‐day concurrence of bodily complaints and affect in patients with severe somatoform disorder
Based on the concept of somatization, psychological distress can be experienced as symptoms of physical illness. This suggests a close‐fitting intra‐individual association between bodily complaints and mood in patients with somatoform disorder (SFD). The contemporaneous day‐to‐day complaints‐mood association was investigated in patients with severe chronic SFD using an ecological momentary assessment (EMA) design. Eleven patients, who had recently received specialized tertiary care treatment for severe chronic SFD, kept an online electronic diary for four consecutive weeks. They were prompted at intervals throughout the day to complete questions on their momentary primary symptoms (pain and fatigue), and mood state (negative and positive). For each measure, day‐mean aggregated ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Endovenous Laser Ablation of Perforating Veins: Feasibility, Safety, and Occlusion Rate Using a 1,470-nm Laser and Bare-Tip Fiber
Conclusions Three-month closure of perforating veins is achievable by using a 1,470-nm laser and bare-tip fiber and can be safely performed alone or in combination with microphlebectomy or sclerotherapy at all stages of CVI severity. (Source: Journal of Vascular and Interventional Radiology)


Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes
Conclusions This retrospective case series identifies pubic apophyseal stress (or &lsquo;apophysitis&rsquo;) as an important differential consideration in the adolescent athlete who presents with groin pain. (Source: British Journal of Sports Medicine)


Physical Examination of the Wrist: Useful Provocative Maneuvers
Chronic wrist pain resulting from partial interosseous ligament injury remains a diagnostic dilemma for many hand and orthopedic surgeons. Overuse of costly diagnostic studies including magnetic resonance imaging, computed tomography scans, and bone scans can be further frustrating to the clinician because of their inconsistent specificity and reliability in these cases. Physical diagnosis is an effective (and underused) means of establishing a working diagnosis of partial ligament injury to the wrist. (Source: The Journal of Hand Surgery)


Tapering Long-term Opioid Therapy in Chronic Noncancer Pain
Increasing concern about the risks and limited evidence supporting the therapeutic benefit of long-term opioid therapy for chronic noncancer pain are leading prescribers to consider discontinuing the use of opioids. In addition to overt addiction or diversion, the presence of adverse effects, diminishing analgesia, reduced function and quality of life, or the absence of progress toward functional goals can justify an attempt at weaning patients from long-term opioid therapy. However, discontinuing opioid therapy is often hindered by patients’ psychiatric comorbidities and poor coping skills, as well as the lack of formal guidelines for the prescribers. (Source: Mayo Clinic Proceedings)


44-Year-Old Man With Abdominal Pain, Fever, and Bloody Diarrhea
A 44-year-old man with a history of ulcerative colitis since age 20 years presented with acute-on-chronic epigastric abdominal pain associated with new-onset low-grade fever, chills, and night sweats of 2- to 3-months’ duration. Despite multiple immunosuppressive regimens, including oral prednisone, azathioprine, sulfasalazine, and methotrexate, his ulcerative colitis symptoms had never been fully controlled. Approximately 18 months before the current presentation, infliximab had been prescribed. (Source: Mayo Clinic Proceedings)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Change in lumbar lordosis during prone lying knee flexion test in subjects with and without low back pain
Conclusion Increase in lumbar lordosis during this test may be due to excessive flexibility of movement of the lumbar spine in the direction of extension and abnormal movement patterns in the individuals with LBP. (Source: Chiropractic and Manual Therapies)


Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: study protocol for a multicentre randomised controlled trial
This study is a multicentre RCT. 214 participants, aged 18&ndash;75&nbsp;years, with NSCLBP for at least 6&nbsp;months will be randomised to one of two interventions across three sites. The experimental group will receive individualised CFT and the length of the intervention will be varied in a pragmatic manner based on the clinical progression of participants. The control group will attend six classes which will be provided over a period of 6&ndash;8&nbsp;weeks. Participants will be assessed preintervention, postintervention and after 6 and12&nbsp;months. The primary outcomes will be functional disability and pain intensity. Non-specific predictors, moderators and mediators of outcome will also be analysed. Ethics and dissemination Ethical approval has been obtained from the Mayo General...


Knee Pain and a Prior Injury Are Associated with Increased Risk of a New Knee Injury: Data from the Osteoarthritis Initiative.
CONCLUSION: Knee pain and a history of injury are associated with new knee injuries. It may be beneficial for individuals with knee pain or a history of injury to participate in injury prevention programs. PMID: 26034152 [PubMed - as supplied by publisher] (Source: J Rheumatol)


Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes.
CONCLUSIONS: This retrospective case series identifies pubic apophyseal stress (or 'apophysitis') as an important differential consideration in the adolescent athlete who presents with groin pain. PMID: 26031648 [PubMed - in process] (Source: British Journal of Sports Medicine)


Long‐term morbidity after multivisceral resection for retroperitoneal sarcoma
ConclusionSevere chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long‐term renal function is not significantly impaired when nephrectomy is performed. (Source: British Journal of Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury
Conclusion Women have higher initial pain levels in the acute whiplash injury. Age and ethnicity have less impact on those pain levels. A pain management protocol might reduce bias in pain management in the acute whiplash injury in the ED. The Jewish population tends to be less receptive to pain medication administration. (Source: European Journal of Trauma and Emergency Surgery)


Successful Discontinuation of Systemic Opioids After Implantation of an Intrathecal Drug Delivery System
ConclusionsIDDS can provide significant and lasting pain relief and an alternate route of delivery compared with systemic opioids with their associated side‐effects. We demonstrated that systemic opioid elimination could be accomplished after IDDS implantation in the majority of cases through appropriate patient selection, monitoring, and participation. (Source: Neuromodulation: Technology at the Neural Interface)


The Editors' Choice
Eosinophilic esophagitis is an inflammation of the esophagus. Symptoms of this chronic (lifelong) allergic inflammatory disease include difficulty in swallowing food and abdominal pain. Evaluating treatments currently involves looking at changes in the tissues and cells of the esophagus. However, to improve both clinical outcomes and patients' quality of life, there is a need to objectively measure and consider patients' symptoms and how they feel. Using a questionnaire called the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS v2.0), Martin et al (p 1519) showed that categories of questions assessing related symptoms corresponded with clinical and biologic features of pediatric eosinophilic esophagitis. (Source: Journal of Allergy and Clinical Immunology)


160 The prevalence of chronic rhinosinusitis in paediatric cystic fibrosis
Chronic rhinosinusitis is an inflammation of the mucous membrane lining the paranasal sinuses, lasting longer than 12 weeks. Symptoms include nasal discharge and congestion, head or facial pain and sleep disturbances. There is evidence of an association between upper and lower airway pathogens. 30–67% of adult cystic fibrosis (CF) patients report symptoms. Incidence in children has not been investigated. (Source: Journal of Cystic Fibrosis)


The influence of age and gender on venous symptomatology. An epidemiological survey in Belgium and Luxembourg.
CONCLUSION: CVD is a very common progressive disease with age as a major risk factor. Increasing age results in a higher C-classification, more symptoms, and a lower GIS score (quality of life). Female gender interacts significantly with age and results in a more advanced stage of CVD. PMID: 26036248 [PubMed - as supplied by publisher] (Source: Phlebology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Deep brain stimulation of the dorsal anterior cingulate cortex for the treatment of chronic neuropathic pain.
Authors: Russo JF, Sheth SA Abstract Chronic neuropathic pain is estimated to affect 3%-4.5% of the worldwide population. It is associated with significant loss of productive time, withdrawal from the workforce, development of mood disorders such as depression and anxiety, and disruption of family and social life. Current medical therapeutics often fail to adequately treat chronic neuropathic pain. Deep brain stimulation (DBS) targeting subcortical structures such as the periaqueductal gray, the ventral posterior lateral and medial thalamic nuclei, and the internal capsule has been investigated for the relief of refractory neuropathic pain over the past 3 decades. Recent work has identified the dorsal anterior cingulate cortex (dACC) as a new potential neuromodulation target given ...


IL-1 receptor antagonist improves morphine and buprenorphine efficacy in a rat neuropathic pain model.
Authors: Pilat D, Rojewska E, Jurga AM, Piotrowska A, Makuch W, Przewlocka B, Mika J Abstract An interesting research and therapeutic problem is the reduced beneficial efficacy of opioids in the treatment of neuropathic pain. The present study sought to investigate the potential role of IL-1 family members in this phenomenon. We studied the time course of changes in IL-1alpha, IL-1beta, IL-1 receptor type I and IL-1 receptor antagonist mRNA and protein levels experienced by rats after chronic constriction injury (CCI) of the sciatic nerve using qRT-PCR and Western blot analysis. In CCI-exposed rats, spinal levels of IL-1alpha mRNA were slightly downregulated on the 7(th) day, and protein levels were not changed on the 7(th) and 14(th) days. Levels of IL-1 receptor antagonist and IL...


Characteristics of acupuncture users among internal medicine patients in Germany.
CONCLUSION: Acupuncture was used by more than half of internal medicine patients. Prevalence and rated helpfulness of acupuncture use was associated with the patients' medical condition, sociodemography, and health locus of control. PMID: 26051578 [PubMed - in process] (Source: Complementary Therapies in Medicine)


Effects of a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.
CONCLUSIONS: Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. PMID: 26051577 [PubMed - in process] (Source: Complementary Therapies in Medicine)


Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes.
CONCLUSIONS: Prolotherapy resulted in safe, significant, progressive improvement of knee pain, function and stiffness scores among most participants through a mean follow-up of 2.5 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care. PMID: 26051574 [PubMed - in process] (Source: Complementary Therapies in Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effect of an acupressure backrest on pain and disability in office workers with chronic low back pain: A randomized, controlled study and patients' preferences.
CONCLUSION: These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect. PMID: 26051569 [PubMed - in process] (Source: Complementary Therapies in Medicine)


Chronic generalized musculoskeletal pain, vitamin D levels, and the association with exocrine pancreatic insufficiency
Introduction: Chronic generalized musculoskeletal pain (CGMP), which includes fibromyalgia, is one of the most frequent reasons patients attend the rehabilitation service. Vitamin D deficiency is a habitual finding in CGMP, and even in fibromyalgia. (Source: Pancreatology)


Chronic pancreatitis. Multicentre prospective data collection and analysis by the Hungarian Pancreatic Study Group
Introduction: Chronic pancreatitis is an inflammatory disease associates with structural and functional damage of the pancreas causing pain, maldigestion and weight loss worsening the quality of life. (Source: Pancreatology)


Development of a patient-reported outcome measure in pancreatic exocrine insufficiency (PEI)
Introduction: Patients with chronic pancreatitis (CP) and cystic fibrosis (CF) often experience symptoms of Pancreatic Exocrine Insufficiency (PEI). PEI increases the risk of malnutrition which is associated with comorbidities and increased mortality. Clinicians recognise steatorrhoea, diarrhoea and abdominal pain as symptoms of PEI, but recognition of other symptoms is poor. A validated Patient-Reported Outcome (PRO) measure for PEI symptoms is lacking. (Source: Pancreatology)


Effectiveness of Tapentadol Prolonged Release (PR) Compared with Oxycodone/Naloxone PR for the Management of Severe Chronic Low Back Pain with a Neuropathic Component: A Randomized, Controlled, Open‐Label, Phase 3b/4 Study
ConclusionsThe study was formally shown to be positive and demonstrated, in the primary effectiveness endpoint, the noninferiority for tapentadol PR vs. oxycodone/naloxone PR. The effectiveness of tapentadol PR was superior to that of oxycodone/naloxone PR by means of clinical relevance and statistical significance (confirmatory evidence of superiority). Tapentadol PR was associated with significantly greater improvements in neuropathic pain‐related symptoms and global health status than oxycodone/naloxone PR and with a significantly better gastrointestinal tolerability profile. Tapentadol PR may be considered a first‐line option for managing severe chronic low back pain with a neuropathic pain component. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Characterization of facial pain associated with chronic rhinosinusitis using validated pain evaluation instruments
ConclusionSubjects with CRS have a greater burden of facial pain relative to control subjects across several standardized pain measures. Further, facial pain in CRS significantly correlated to quality of life and CRS‐specific disease severity measures. Study across larger cohorts using standardized pain measures is warranted to clarify the association of facial pain with CRS. (Source: International Forum of Allergy and Rhinology)


Occupational Therapy Interventions in Chronic Pain – A Systematic Review
Abstract The use of interventions based on the best available evidence in occupational therapy is essential, and evaluation of research is part of an evidence‐based practice. The aim of this study was to assess the quality of studies describing and evaluating the effects of occupational therapy interventions on chronic pain. A systematic review of studies with diverse designs was carried out. A quality assessment was conducted, and the level of evidence was defined using the Research Pyramid Model. Of 19 included studies, three received the highest evidence level, and three were considered to be of high quality. The clinical recommendations that can be derived from this study are the following: occupational therapy interventions should start from the identified needs of the person with c...


H19 lncRNA alters stromal cell growth via IGF signaling in the endometrium of women with endometriosis
Abstract Endometriosis affects approximately 15% of reproductive aged women and is associated with chronic pelvic pain and infertility. However, the molecular mechanisms by which endometriosis impacts fertility are poorly understood. The developmentally regulated, imprinted H19 long noncoding RNA (lncRNA) functions to reduce the bioavailability of microRNA let‐7 by acting as a molecular sponge. Here we report that H19 expression is significantly decreased in the eutopic endometrium of women with endometriosis as compared to normal controls. We show that decreased H19 increases let‐7 activity, which in turn inhibits Igf1r expression at the post‐transcriptional level, thereby contributing to reduced proliferation of endometrial stromal cells. We propose that perturbation of this newly ...


Editorial Comment
The complex network of etiologic and pathologic factors involving the chronic pelvic pain syndrome makes the diagnosis and treatment of this pathologic condition one of the most difficult challenge in current urologic daily clinical practice. Different conditions such as chronic prostatitis–chronic pelvic pain syndrome category III according the National Institutes of Health classification, interstitial cystitis, and painful bladder syndrome should be included in the list of diseases with multifactorial mechanisms of physiopathology and development, thus exposed to unsuccessful treatments in the absence of multimodal therapies. (Source: Urology)


Widespread Psychosocial Difficulties in Men and Women With Urologic Chronic Pelvic Pain Syndromes: Case-control Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network
To determine the extent, severity, and sex differences of psychosocial deficits in men and women with urologic chronic pelvic pain syndromes (UCPPS), which in the past have been considered separate bladder (interstitial cystitis–painful bladder syndrome) and prostate (chronic prostatitis–chronic pelvic pain syndrome) disorders. Evaluations of men and women separately suggest UCPPS is associated with increased anxiety and depression. However, studies directly testing deficits in broader psychosocial domains such as cognitive processes, intimate relationships, and trauma history, or tests of sex differences in the pattern of difficulties associated with UCPPS have not been performed. (Source: Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Animal Models of Urologic Chronic Pelvic Pain Syndromes: Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network
To describe the approach taken by the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network investigators to advance the utility of urologic chronic pelvic pain syndromes (UCPPS) animal models. (Source: Urology)


Safety and performance evaluation of a next‐generation antimicrobial dressing in patients with chronic venous leg ulcers
The objective of this study was to investigate the safety and performance of AQUACEL™ Ag+ dressing, a wound dressing containing a combination of anti‐biofilm and antimicrobial agents, in the management of chronic wounds. Patients (n = 42) with venous leg ulcers exhibiting signs of clinical infection were treated for 4 weeks with AQUACEL™ Ag+ dressing, followed by management with AQUACEL™ wound dressings for 4 weeks. Wound progression, wound size, ulcer pain and clinical evolution of the wound were assessed for up to 8 weeks. Adverse events were recorded throughout the study. AQUACEL™ Ag+ dressing had an acceptable safety profile, with only one patient discontinuing from the study, because of a non‐treatment‐related adverse event. After 8 weeks, substantial wound improvements ...


Is the Quebec provincial administrative database a valid source for research on chronic non‐cancer pain?
ConclusionsOur study provides evidence supporting the value of the RAMQ administrative database for conducting research on certain types of chronic pain disorders including back and neck pain. Users should, however, be cautious about the limitations of this database for studying other types of chronic pain syndromes such as complex regional pain syndrome, fibromyalgia, and neuropathic pain. Copyright © 2015 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)


Chronic Pain in HIV‐Infected Patients: Relationship to Depression, Substance Use, and Mental Health and Pain Treatment
ConclusionsDespite pharmacologic treatment, moderate‐severe chronic pain and elevated depression symptoms are common among HIV‐infected patients and frequently co‐occur. (Source: Pain Medicine)


Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.
Authors: Tesher MS Abstract A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Work ability in cancer patients: Six years assessment after diagnosis in a cohort of 153 workers].
CONCLUSIONS: Six years after returning to work, one employee out of two is still working in the same company. Far to disappear, the identified difficulties two years after the diagnosis are still present, long time after stopping the treatments. A successfull return to work needs an important support from both the company and the co-workers. PMID: 26118877 [PubMed - in process] (Source: Bulletin du Cancer)


Endometriosis: A Culprit for Chronic Pelvic Pain.
Authors: Seth N PMID: 26126387 [PubMed - in process] (Source: The Alabama Nurse)


Frequent and long‐term follow‐up of health‐related quality of life following allogeneic haematopoietic stem cell transplantation
Health‐related quality of life (HRQL) was evaluated in 94 patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) after myeloablative (MAC, n = 18) or reduced intensity conditioning (RIC, n = 76). HRQL was assessed with the EORTC QLQ C‐30 during the inpatient period as well as during the following 3 years, i.e. at baseline and 12 times thereafter. Functional status and global quality of life decreased from baseline to weeks 2 and 3, especially role and social functions. Symptoms increased significantly during the first 3 weeks, particularly appetite loss, nausea and vomiting, diarrhoea and fatigue. It took at least 1 year for HRQL to return to the baseline level. The only function that improved significantly 3 years after HSCT was role function. Patients ...


Parents can be 'too nice' to their children, neurologist warns
Psychosomatic conditions like chronic pain, seizures or even paralysis are not only triggered by trauma but also can too much love and attention (Source: Telegraph Health)


Chronic Abdominal Syndrome Due to Nervous Compression. Study of 100 Cases and Proposed Diagnostic-Therapeutic Algorithm
Conclusion Thoracic disc protrusion, as well as having a non-negligible incidence, is often associated with a digestive-urologic clinical syndrome, and this factor should be taken into account in all cases of chronic abdominal pain and other digestive-urologic symptoms when standard tests are negative, so that appropriate treatment may be given. (Source: Journal of Gastrointestinal Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Modified laparoscopic intraperitoneal onlay mesh in complicated inguinal hernia surgery
Conclusions The optimal treatment of these relatively rare and complicated patients is still an issue of debate, but in the light of the present study it seems that the IPOM technique is equal to or has a better profile compared to Lichtenstein in terms of re-recurrence and chronic pain. We believe that the IPOM technique has a place in the treatment of these patients. (Source: Hernia)


Importance and utility of laparoscopic inguinal exploration in cases with chronic groin pain
(Source: Hernia)


Correction
In the article by O'Connor et al, Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis, published in the April issue (Arch Phys Med Rehabil 2015;96:724-34), George D. Baxter's degree was incorrect. The correct degree is DPhil. (Source: Archives of Physical Medicine and Rehabilitation)


Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain
Abstract Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral and central pain mechanisms are not fully understood, and safe and efficient analgesic drugs are not available. The pain associated with joint pain is highly individual, and features from radiological imaging have not demonstrated robust associations with the pain manifestations. In recent years, a variety of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater unders...


Easy to Harm, Hard to Heal: Patient Views About the Back
Conclusion. Negative assumptions about the back made by those with LBP may affect information processing during an episode of pain. This may result in attentional bias toward information indicating that the spine is vulnerable, an injury is serious, or the outcome will be poor. Approaching consultations with this understanding may assist clinicians to have a positive influence on beliefs. Level of Evidence: 3 (Source: Spine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care
Discussion: The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs.Forsch Komplementmed (Source: Research in Complementary Medicine)


Treatment patterns, healthcare utilization, and costs of chronic opioid treatment for non-cancer pain in the United States.
CONCLUSIONS: These results demonstrated that healthcare resource utilization and costs increased during the first 6 months following clinical scenarios that necessitated opioid initiation and subsequently declined, suggesting the need to monitor patients beyond the acute care period. PMID: 26014310 [PubMed - in process] (Source: The American Journal of Managed Care)


A systematic review of the outcomes reported in multimodal pain therapy for chronic pain
ConclusionsThe current lack of standardization of outcome domains in MPT studies hinders to readily compare interventions from different trials and is a barrier towards evidence‐based decision making. Based on these results, the development of a core outcome set of domains for MPT has been initiated. (Source: European Journal of Pain)


Hacking The Nervous System
(Photo: © Job Boot) One nerve connects your vital organs, sensing and shaping your health. If we learn to control it, the future of medicine will be electric.When Maria Vrind, a former gymnast from Volendam in the Netherlands, found that the only way she could put her socks on in the morning was to lie on her back with her feet in the air, she had to accept that things had reached a crisis point. “I had become so stiff I couldn’t stand up,” she says. “It was a great shock because I’m such an active person.”It was 1993. Vrind was in her late 40s and working two jobs, athletics coach and a carer for disabled people, but her condition now began taking over her life. “I had to stop my jobs and look for another one as I became increasingly disabled myself.” By the time she w...


Variations in patient-reported physical health between cardiac and musculoskeletal diseases: systematic review and meta-analysis of population-based studies
We examined a cardiovascular disease spectrum which consisted of hypertension, ischaemic heart disease and heart failure, and a musculoskeletal disease spectrum of lower back pain, osteoarthritis and rheumatoid arthritis. Using Medline, EMBASE and CINAHL databases, articles which had examined these morbidities and used either the SF-12 or SF-36 in general or primary care populations were selected; data was extracted independently by three reviewers. Study characteristics were described and the mean physical component summary scores of the SF-12 or SF-36 was analysed by disease, using random-effects meta-analysis. The association between disease and physical health (mean physical component summary scores) was assessed using multilevel meta-regression analysis, adjusting for age, health sett...


MTOR, a New potential target for chronic pain and Opioid-induced tolerance and hyperalgesia
Chronic pain is a major public health problem with limited treatment options. Opioids remain a routine treatment for chronic pain, but extended exposure to opioid therapy can produce opioid tolerance and hyperalgesia. Although the mechanisms underlying chronic pain, opioid-induced tolerance, and opioid-induced hyperalgesia remain to be uncovered, mammalian target of rapamycin (mTOR) is involved in these disorders. The mTOR complex 1 and its triggered protein translation are required for the initiation and maintenance of chronic pain (including cancer pain) and opioid-induced tolerance/hyperalgesia. Given that mTOR inhibitors are FDA-approved drugs and an mTOR inhibitor is approved for treatment of several cancers, these findings suggest that mTOR inhibitors will likely have multiple clinic...


[Psychological assessment and psychotherapy for chronic pain in the elderly].
Authors: Mattenklodt P, Leonhardt C Abstract Systematic reviews of psychosocial assessment and effectiveness of psychotherapy for chronic pain syndromes in older patients are rare. However, it is of particular importance to consider the psychosocial aspects of elderly people with chronic pain. This narrative review describes recommended German-language assessments of the psychosocial dimensions of pain and summarizes existing studies of psychological therapy approaches for chronic pain in old age. Effective psychometric instruments are available for the assessment of cognitive function, pain-specific attitudes, depression, fear of falling, interpersonal processes and social activities, pain management, pain acceptance, disability, psychological well-being, and quality of life. Furt...


[Chronic myofacial pain : Reduced pain through psychoeducation and physiotherapy].
CONCLUSION: The results show the necessity of early identification of patients with severe pain chronification and the need for psychological pain therapy. PMID: 26024643 [PubMed - as supplied by publisher] (Source: Schmerz)


Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis.
CONCLUSION: There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required. PMID: 26009534 [PubMed - in process] (Source: The British Journal of General Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Safety and efficacy of oxycodone/naloxone vs. oxycodone vs. morphine for the treatment of chronic low back pain: results of a 12 week prospective, randomized, open-label blinded endpoint streamlined study with prolonged-release preparations
Current Medical Research & Opinion, Ahead of Print. (Source: Current Medical Research and Opinion)


Chronic venous disease and venous leg ulcers: An evidence-based update
Chronic venous disease (CVD) is a complex chronic vascular condition with multifaceted primary and secondary etiologies leading to structural and functional changes in veins and valves and blood flow of the lower legs. As a consequence, a spectrum of clinical manifestations arise, ranging from symptoms of mild leg heaviness and achiness to debilitating pain, and signs of skin changes, such as eczema and hemosiderosis, to nonhealing, heavily draining venous leg ulcers (VLUs). Triggers such as trauma to the skin are responsible for a large majority of VLU recurrences. (Source: Journal of Vascular Nursing)


Unravelling nocebo effect: the mediating effect of anxiety between anticipation and pain at wound dressing change
ConclusionAnticipation of pain triggers anxiety that can lead to increased pain. Relevance to clinical practiceThere is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience. (Source: Journal of Clinical Nursing)


Inflammatory Claims About Inflammation
We all appreciate the elegance of simple solutions to complex problems. But we know too that simplicity can often masquerade as truth, hiding a more nuanced reality. Such is the case with inflammation, where pseudoscience, exaggerated claims, false promises, and dangerous oversimplification have dominated for too long. Here is a typical missive: "Inflammation controls our lives. Have you or a loved one dealt with pain, obesity, ADD/ADHD, peripheral neuropathy, diabetes, heart disease, stroke, migraines, thyroid issues, dental issues, or cancer? If you answered yes to any of these disorders you are dealing with inflammation." Well, no, inflammation does not control our lives. Like many others, this author claims inflammation is responsible for a huge range of maladies, ranging from Alzhei...


Prostanoids and NSAIDs in Cardiovascular Biology and Disease
Abstract Prostanoids and related arachidonic acid derivatives are important physiologic modulators in arteries, as well as mediators of inflammation, hemostasis, and cell proliferation. Their participation in atherosclerosis and in acute thrombotic events is complex, as demonstrated by untoward cardiovascular (CV) effects associated with clinical use of inhibitors of prostaglandin synthesis for treatment of chronic pain, inflammatory states, or cancer prophylaxis. Newer understanding of the pathophysiology of atherosclerosis and the pharmacology of prostanoids promises potential resolution of current problems resulting from the hazards of available prostanoid-altering drugs. (Source: Current Atherosclerosis Reports)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effect of changing movement and posture using motion-sensor biofeedback, versus guidelines-based care, on the clinical outcomes of people with sub-acute or chronic low back pain-a multicentre, cluster-randomised, placebo-controlled, pilot trial
Conclusions: Individualised movement retraining using motion-sensor biofeedback resulted in significant and sustained improvements in pain and activity limitation that persisted after treatment finished. This pilot trial also refined the procedures and sample size requirements for a fully powered RCT.This trial (Australian New Zealand Clinical Trials Registry NCT01572779) was equally funded by dorsaVi P/L and the Victorian State Government. (Source: BMC Musculoskeletal Disorders)


An autopsy case of myocardial infarction due to idiopathic thrombotic thrombocytopenic purpura
This report is a critical teaching case considering that its cause of sudden death may be arrhythmia due to a myocardial infarction including cardiac conduction system disorder by platelet microthrombi.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2113354005156739 (Source: Diagnostic Pathology)


Molecules, Vol. 20, Pages 10047-10064: A 1H-NMR-Based Metabonomic Study on the Anti-Depressive Effect of the Total Alkaloid of Corydalis Rhizoma
In this study, the antidepressive effect of the total alkaloid of YuanHu (YHTA) was investigated in a chronic unpredictable mild stress (CUMS) rat model using 1H-NMR-based metabonomics. Plasma metabolic profiles were analyzed and multivariate data analysis was applied to discover the metabolic biomarkers in CUMS rats. Thirteen biomarkers of CUMS-introduced depression were identified, which are myo-inositol, glycerol, glycine, creatine, glutamine, glutamate, β-glucose, α-glucose, acetoacetate, 3-hydroxybutyrate, leucine and unsaturated lipids (L7, L9). Moreover, a metabolic network of the potential biomarkers in plasma perturbed by CUMS was detected. After YHTA treatment, clear separation between the model group and YHTA-treated group was achieved. The levels of all the abnormal metabolit...


Physiotherapist-led neck-specific exercise improves pain, disability and self-efficacy in chronic whiplash-associated disorders
Publication date: Available online 29 May 2015 Source:Journal of Physiotherapy Author(s): Mark Elkins (Source: Journal of Physiotherapy)


Living Well with Pain: Development and Preliminary Evaluation of the Valued Living Scale
Conclusions The VLS items can be administered and scored to assess: 1) the importance of as well as 2) confidence in and 3) success in achieving values‐consistent goals. The measure can be used by clinicians to monitor and track changes in patient's perceptions about their goals with treatment. Researchers can use the VLS to test theoretical models of the roles that patient perceptions about goal importance, confidence, and success play in chronic pain treatment outcome. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


In vivo luminescent imaging of NF‐κB activity and NF‐κB‐related serum cytokine levels predict pain sensitivities in a rodent model of peripheral neuropathy
ConclusionsUsing in vivo luminescent imaging of NF‐κB activity and serum cytokine measures, this work establishes NF‐κB and NF‐κB‐regulated cytokines as novel multivariate biomarkers of pain‐related sensitivity in this model of neuropathy that may be useful for the rapid screening of novel molecular therapeutics. (Source: European Journal of Pain)


Factors associated with pain and disability reduction following exercise interventions in chronic whiplash
ConclusionFactors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck‐specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck‐specific exercise for individuals with chronic WAD. (Source: European Journal of Pain)


Asymptomatic chronic gastritis decreases metformin tolerance in patients with type 2 diabetes
Summary What is known and ObjectiveDigestive disorders represent the most common metformin side effects for type 2 diabetes. The mechanism of these metformin side effects is unclear. The aim of this study was to assess whether asymptomatic chronic gastritis could influence metformin tolerance in patients with type 2 diabetes. MethodsDemographic, anthropometric, ultrasound and laboratory data were obtained from 144 metformin naïve patients with diabetes. The diagnosis of chronic gastritis was based on endoscopic and histopathological examination, and H. pylori infection was assessed based on 13C urea breath test (UBT). All subjects started metformin at 500 mg/day and increasing progressively to 1500 mg/day over 4 weeks. A score of gastrointestinal side effects (abdominal pain, diarrhoe...


Somatic Symptom Disorders Without Known Physical Causes: One Disease with Many Names?
Patients complaining of pain and/or fatigue in the absence of known physical diseases constitute a high percentage of those seeking general medical care. Depending upon the type of physician/specialist consulted, those individuals may receive disease labels that range from an implied psychological origin such as somatoform or psychosomatic disease, or to a presumed physical disease such as fibromyalgia. Although all these conditions are regularly associated with fatigue, we are now provided with a new label suggesting another disease category, "systemic exertion intolerance disease", which replaces the previous "chronic fatigue syndrome." All these conditions have common, overlapping features that usually consist of both fatigue and pain, and, in the absence of definitive objective confirm...


Multidisciplinary treatment for rheumatic pain
Publication date: Available online 29 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Irina Kudrina , Yoram Shir , Mary-Ann Fitzcharles Chronic pain experienced by patients with rheumatic conditions is recognized to contribute importantly to suffering. Multidisciplinary pain clinics that adhere to the biopsychosocial concept of pain management provide an effective treatment strategy for many with chronic pain. Other than for low back pain and fibromyalgia, little attention has been given to the specific experience of treating those with rheumatic diseases in such a setting. It is, however, reasonable to suggest that many patients with chronic rheumatic pain could benefit from exposure to a multidisciplinary pain treatment programme that incorporates comp...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Leg Pain in Athletes
Chronic leg pain is commonly treated by orthopaedic surgeons who take care of athletes. The sources are varied and include the more commonly encountered medial tibial stress syndrome, chronic exertional compartment syndrome, stress fracture, popliteal artery entrapment syndrome, nerve entrapment, Achilles tightness, deep vein thrombosis, and complex regional pain syndrome. Owing to overlapping physical examination findings, an assortment of imaging and other diagnostic modalities are employed to distinguish among the diagnoses to guide the appropriate management. Although most of these chronic problems are treated nonsurgically, some patients require operative intervention. For each condition listed above, the pathophysiology, diagnosis, management option, and outcomes are discussed in tur...


Small‐nerve‐fiber pathology in critical illness documented by serial skin biopsies
Conclusion: Serial IENFD measurements confirmed the development of small‐fiber sensory involvement in the acute phase of critical illness. Muscle Nerve, 2015 (Source: Muscle and Nerve)


[Erratum to: Opioids in chronic low back pain : A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration].
Authors: Petzke F, Welsch P, Klose P, Schaefert R, Sommer C, Häuser W PMID: 26022428 [PubMed - as supplied by publisher] (Source: Schmerz)


Atypical Cause of Lateral Hip Pain Due to Proximal Gluteus Medius Muscle Tear: A Report of 2 Cases
We report here 2 cases of traumatic tears of the gluteus medius muscle at its proximal attachment on the iliac crest. (Source: PM and R)


Seroprevalence of HSV-1/2 and correlation with aggravation of oral mucositis in patients with squamous cell carcinoma of the head and neck region submitted to antineoplastic treatment
Conclusion The reactivation of HSV-1/2 was shown to be relatively infrequent and there was no correlation between presence of the virus and aggravation of oral mucositis resulting from antineoplastic treatment. (Source: Supportive Care in Cancer)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


When acute pain becomes chronic
(Source: Anaesthesia)


Tattoos last, but for 1 out 10, so does the pain
A new study suggests people suffer infections, itching and chronic complications for their body art. (Source: CNN.com - Health)


Health Tip: Exercising Despite Chronic Fatigue Syndrome
Title: Health Tip: Exercising Despite Chronic Fatigue SyndromeCategory: Health NewsCreated: 5/28/2015 12:00:00 AMLast Editorial Review: 5/28/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Pulsed Radiofrequency Treatment Enhances Dorsal Root Ganglion Expression of Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels in a Rat Model of Neuropathic Pain
In conclusion, PRF can upregulate HCN channel expression in the DRG of rats with sciatic nerve CCI. How this regulation of Ih in nociceptive afferents contributes to the suppression of neuropathic pain by PRF remains to be determined. (Source: Journal of Molecular Neuroscience)


A multilevel path model analysis of the relations between sleep, pain, and pain catastrophizing in chronic pain rehabilitation patients
Conclusion and implications These results call into question previous evidence that pain catastrophizing indirectly affects pain by way of its impact on sleep. Rather, our findings suggest that pain mediates the relationship between sleep and levels of pain catastrophizing. These results therefore underscore importance and value in collecting longitudinal data and potential influence on the conclusions gained with regards to sleep, pain and psychological variables. These findings may be of clinical importance when tailoring interventions for individuals with chronic pain and perhaps even more so for those with comorbid pain and sleep disturbance; prioritizing the treatment of sleep difficulties could result in improvements to pain-related outcomes. (Source: Scandinavian Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Total knee arthroplasty – the optimal analgesic regime
This article examines and appraises the options for total knee arthroplasty in the current environment which mandates rapid discharge from hospital. Peripheral nerve blockade and multimodal analgesic options are covered in detail, along with newer techniques such as high volume local anaesthetic infiltration and infiltration with liposomal bupivacaine. Recommendations are made for the straightforward patient and the patient with chronic pain or opioid requirements. (Source: Trends in Anaesthesia and Critical Care)


Childbirth Pain and Postpartum Depression
Publication date: Available online 13 May 2015 Source:Trends in Anaesthesia and Critical Care Author(s): S. Kwok , D. Moo , S.T. Sia , A.S. Razak , B.L. Sng Childbirth pain is one of the most painful experiences of a mother’s life. In this review we investigate the association between childbirth pain and post partum depression. It is well documented that postpartum depression is an increasing concern which affects not only the mother but can impact the newborn’s development. Multiple factors seem to contribute to the likelihood of this depression developing such as the mother’s socio-econoimc background, age, education level, history of childhood abuse as well as pain catastrophizing traits. Severe acute pain is linked with an increased risk of chronic pain as well as postpartum de...


Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling
Conclusions: We conclude that the data available in a community practice can be a rich source of biopsychosocial information relevant to the phenotypes of chronic pain. It is anticipated that phenotype linkages to best treatments and outcomes can be constructed from this set of records. (Source: BMC Medical Informatics and Decision Making)


Machine-Based, Self-guided Home Therapy for Individuals With Severe Arm Impairment After Stroke: A Randomized Controlled Trial
This study compared self-guided, high-repetition home therapy with a mechanical device (the resonating arm exerciser [RAE]) to conventional therapy in patients with chronic stroke and explored RAE use for patients with subacute stroke. Methods. A total of 16 participants with severe upper-extremity impairment (mean Fugl-Meyer [FM] score = 21.4 &plusmn; 8.8 out of 66) &gt;6 months poststroke were randomized to 3 weeks of exercise with the RAE or conventional exercises. The primary outcome measure was FM score 1 month posttherapy. Secondary outcome measures included Motor Activity Log, Visual Analog Pain Scale, and Ashworth Spasticity Scale. After a 1-month break, individuals in the conventional group also received a 3-week course of RAE therapy. Results. The change in FM score was significa...


Belgian siblings of children with a chronic illness: Is their quality of life different from their peers?
To assess Belgian siblings&rsquo; self-reported quality of life (QoL) and the impact of illness on four different paediatric illnesses. Healthy siblings (n&nbsp;=&nbsp;131) of children with type 1 diabetes, cancer, congenital heart disease (CHD) and cystic fibrosis (CF) completed the Child Health Questionnaire and the Sibling Perception Questionnaire. Results were compared to those of a matched group of siblings of healthy children. Siblings reported a good QoL, similar to controls, with the exception that siblings reported better on the QoL domain pain (p&nbsp;&lt;&nbsp;.01). QoL was not related to time since diagnosis but the impact of illness was higher nearer to the time of diagnosis (r&nbsp;=&nbsp;&ndash;.39, p&nbsp;&lt;&nbsp;.001). QoL of siblings of children with CHD or cancer was l...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medical Management of Tumor Lysis Syndrome, Postprocedural Pain, and Venous Thromboembolism Following Interventional Radiology Procedures
Semin intervent Radiol 2015; 32: 209-216DOI: 10.1055/s-0035-1549379The rapid expansion of minimally invasive image-guided procedures has led to their extensive use in the interdisciplinary management of patients with vascular, hepatobiliary, genitourinary, and oncologic diseases. Given the increased availability and breadth of these procedures, it is important for physicians to be aware of common complications and their management. In this article, the authors describe management of select common complications from interventional radiology procedures including tumor lysis syndrome, acute on chronic postprocedural pain, and venous thromboembolism. These complications are discussed in detail and their medical management is outlined according to generally accepted practice and evidence from t...


Assessment of spinal pain
Publication date: Available online 28 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): J. Braun , X. Baraliakos , A. Regel , U. Kiltz Spinal pain or back pain is a very common symptom that can have many reasons. The most studied location is low back pain, and it is considered to be nonspecific in the majority of cases. Only a small proportion of patients have axial inflammation as the major cause of their back complaints with chronic inflammatory back pain (IBP) as the most prominent clinical feature of spondyloarthritis (SpA). The recognition of IBP and patients with axial spondyloarthritis (axSpA) is challenging in primary care, and it is important to further facilitate the early diagnosis of SpA. Proposals for improving the referral of patients with a ...


Sex differences in knee loading in recreational runners
This study aimed to determine whether female recreational runners exhibit distinct knee loading compared to males. Fifteen male and fifteen female recreational runners underwent 3D running analysis at 4.0m.s-1±5%. Sagittal/ coronal joint moments, patellofemoral contact forces (PTF) and pressures (PCP) were compared between sexes. (Source: Journal of Biomechanics)


Clinical Ratings of Pain Sensitivity Correlate With Quantitative Measures in People With Chronic Neck Pain and Healthy Controls: Cross-Sectional Study.
CONCLUSIONS: The ice-pain test may be useful as a clinical correlate with CPT at all sites except the wrist, whilst the pressure-pain test is less convincing as a clinical correlate of PPT. PMID: 26023218 [PubMed - as supplied by publisher] (Source: Physical Therapy)


TRPV1 sensitization mediates post-inflammatory visceral pain following acute colitis.
This study aimed at establishing the role of TRPV1 in the peripheral sensitization underlying chronic visceral pain in the context of colitis. Wild-type and TRPV1-deficient mice were separated into three groups (Control, Acute colitis, Recovery) and experimental colitis induced by oral administration of dextran sulfate sodium (DSS). Recovery mice showed increased chemically- and mechanically-evoked visceral hypersensitivity five weeks post-DSS discontinuation, at which point inflammation had completely resolved. Significant changes in non-evoked pain-related behaviours could also be observed in these animals, indicative of persistent discomfort. These behavioural changes correlated with elevated colonic levels of substance P (SP) and TRPV1 in recovery mice, thus leading to the hypothesis t...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Combined contraceptive pills 'increase risk of blood clots'
Conclusion It is already well known that the combined oral contraceptive pill (&quot;the pill&quot;) is associated with increased risk of venous blood clots. It is also already known that risk can differ according to the type of progestogen in the pill. This study adds further evidence helping to quantify these risks. The study has numerous strengths. It has used two large GP databases covering large samples of the UK population, and containing reliable information on medical diagnoses and prescriptions made. The analyses were also adjusted for various confounders known to be associated with risk of blood clots. It demonstrates pill use in the previous year almost tripled risk of venous blood clot, with risk generally higher with the newer pills than the older ones – though there were so...


Novel expression pattern of neuropeptide Y immunoreactivity in the peripheral nervous system in a rat model of neuropathic pain
Conclusions: This is the first study to provide a comprehensive description of changes in NPY expression in the periphery after nerve injury. Novel expression of NPY in the skin comes mostly from sprouted sympathetic fibers. This information is fundamental in order to understand where endogenous NPY is expressed, and how it might be acting to modulate pain in the periphery. (Source: Molecular Pain)


Effect of manual versus mechanically assisted manipulations of the thoracic spine in neck pain patients: study protocol of a randomized controlled trial
The objective of this study is to compare the short- and long-term effects of manual versus mechanically assisted manipulations of the thoracic spine for neck pain patients.Methods/DesignA 6-month, randomized controlled trial consisting of 54 patients with acute or chronic neck pain patients will be conducted. Patients with no signs of major pathology and with little or no interference with daily activities will be recruited. Three treatment sessions with 4-day intervals will be carried out. The patients will be randomly assigned to receive either manually performed manipulations or electromechanical manipulations at the thoracic spine. The primary outcome is pain intensity as measured by the Visual Analogue Pain Rating Scale. The secondary outcome measures are neck physical disability usi...


The effect of decompressive surgery on lumbar paraspinal and biceps brachii muscle function and movement perception in lumbar spinal stenosis: a 2-year follow-up
Conclusion Impaired lumbar proprioception seems to improve shortly after decompressive surgery but tends to deteriorate again with longer follow-up despite the sustaining favorable clinical outcome. The surgery did not affect either the feed-forward or the feed-back muscle function, which indicates that the abnormal muscle activity in LSS is at least partly irreversible. (Source: European Spine Journal)


Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease
Background: Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem.ObjectiveTo compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the technique of choice. Methods: 120 patients were treated between 2003 and 2010 at king Abdullah university hospital for lumber disc disease. The patients were divided into three groups: Group I (PLF n = 30 [59 levels]); Group II (PLIF n = 40 [70 levels]); and Group III (TLIF n = 50 [96 levels]...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Psychosocial, musculoskeletal and somatoform comorbidity in patients with chronic low back pain: original results from the Dutch Transition Project
Conclusions. General practitioners should consider all the musculoskeletal symptoms when caring for patients with chronic LBP. Rather than systematically screening for specific psychological, social or somatoform disorders, they should consider with the patient how LBP and any type of potential comorbidity interfere with his/her daily functioning. (Source: Family Practice)


Hurt, tired and queasy: Specific variants in the ATPase domain of the TRAP1 mitochondrial chaperone are associated with common, chronic “functional” symptomatology including pain, fatigue and gastrointestinal dysmotility
In this study, provided clinical information and the exon sequence of the TRAP1 mitochondrial chaperone were retrospectively reviewed with a focus on the functional categories of chronic pain, fatigue and gastrointestinal dysmotility. Very-highly conserved TRAP1 variants were identified in 73 of 930 unrelated patients. Functional symptomatology is strongly associated with specific variants in the ATPase binding pocket. In particular, the combined presence of all three functional categories is strongly associated with p.Ile253Val (OR 7.5, P=0.0001) and with two other interacting variants (OR 18, P=0.0005). Considering a 1-2% combined variant prevalence and high odds ratios, these variants may be an important factor in the etiology of functional symptomatology. (Source: Mitochondrion)


[Research Articles] Shaping mycolactone for therapeutic use against inflammatory disorders
Inflammation adversely affects the health of millions of people worldwide, and there is an unmet medical need for better anti-inflammatory drugs. We evaluated the therapeutic interest of mycolactone, a polyketide-derived macrolide produced by Mycobacterium ulcerans. Bacterial production of mycolactone in human skin causes a combination of ulcerative, analgesic, and anti-inflammatory effects. Whereas ulcer formation is mediated by the proapoptotic activity of mycolactone on skin cells via hyperactivation of Wiskott-Aldrich syndrome proteins, analgesia results from neuronal hyperpolarization via signaling through angiotensin II type 2 receptors. Mycolactone also blunts the capacity of immune cells to produce inflammatory mediators by an independent mechanism of protein synthesis blockade. In...


m-Trifluoromethyl-diphenyl diselenide, a multi-target selenium compound, prevented mechanical allodynia and depressive-like behavior in a mouse comorbid pain and depression model
This study evaluated the effect of m-trifluoromethyl diphenyl diselenide [(m-CF3-PhSe)2], an organoselenium compound that has been reported to have both antinociceptive and antidepressant-like actions, in the comorbidity of chronic pain and depression induced by partial sciatic nerve ligation (PSNL) in an inflammatory approach. Mice were submitted to PSNL during 4 weeks and treated with (m-CF3-PhSe)2 acutely (0.1 – 10 mg/kg, i.g.) or subchronically (0.1 mg/kg, i.g., once a day during the 3rd and 4th weeks). Both treatments prevented PSNL-increased pain sensitivity and depressive-like behavior observed in von-frey hair (VFH) and forced swimming (FST) tests, respectively. These effects could be mainly associated with an anti-inflammatory action of (m-CF3-PhSe)2 which reduced the levels of ...


Ultrasonography Leads to Accurate Diagnosis and Management of Painful Acromioclavicular Joint Cyst
DiscussionMusculoskeletal ultrasound is useful for diagnosis and management of refractory musculoskeletal conditions that are commonly misdiagnosed on physical examination and translucent to radiographic imaging. Musculoskeletal ultrasound allowed us to exclude rotator cuff pathology, identify ACJ cyst as the pain generator, classify it as a type 1 ACJ cyst, and aid in needle guidance for successful aspiration leading to full resolution of our patient's pain. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Tapentadol for chronic musculoskeletal pain in adults.
CONCLUSIONS: Tapentadol extended release is associated with a reduction in pain intensity in comparison to placebo and oxycodone. However, the clinical significance of the results is uncertain due to the following reasons: modest difference between interventions in efficacy outcomes, high heterogeneity in some comparisons and outcomes, high withdrawals rates, lack of data for the primary outcome in some studies and impossibility to use BOCF as imputation method. Tapentadol is associated with a more favourable safety profile and tolerability than oxycodone. PMID: 26017279 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


A synthesis of qualitative research exploring the barriers to staying in work with chronic musculoskeletal pain.
CONCLUSIONS: Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic. The papers span 15 years of qualitative research. A significant finding is that these themes continue to pervade the current work environment for those in pain, and this has clear implications for education, social care and policy. Implications for Rehabilitation People with chronic pain face an adversarial struggle to maintain their credibility at work. Strategies to maintain personal credibility can have an adverse effect on working lives. Changes at a systems level are needed to facilitate continuance and return to work. Cultural changes in the way that we view people with pain would help to keep people...


Pharmacoepidemiology of chronic noncancer pain patients requiring chronic opioid therapy: A nationwide population-based study.
CONCLUSION: COT-requiring CNCP patients were easily associated with adverse socioeconomic liabilities and often visited emergency department as well as pain clinics. Morphine was the main opioid used for their chronic pain. Transfer of COT-requiring CNCP patients to appropriate departments is strongly recommended for efficient long-term pharmacotherapy for their chronic pain. PMID: 26026843 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)


Cost of Chronic and Episodic Migraine: a pilot study from a tertiary headache centre in northern Italy
Conclusions CM is a disabling condition with a huge impact on the QoL of sufferers and a significant economic impact on the NHS. The adequate management of CM, reverting it back to EM, will provide a dual benefit: on the individual and on the society. (Source: The Journal of Headache and Pain)


New findings about mechanisms underlying chronic pain reveal novel therapeutic strategies
A critical role for a class of cells present in the brain and spinal cord, called microglia, has been discovered for those in pain. Researchers have found microglia to neuron signaling to be crucial in the development of pain hypersensitivity after injury, but also for one of the paradoxical effects morphine and other opioids sometimes produce, called hyperalgesia, which is an increase in pain sensitivity. (Source: ScienceDaily Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Occipital nerve stimulation for refractory chronic migraine].
CONCLUSIONS: ONS is an effective, well tolerated and safe treatment for the prevention of chronic migraine and could emerge as a useful option for those patients with medically refractory chronic migraine. PMID: 26005075 [PubMed - in process] (Source: Revista de Neurologia)


Effects of intrathecal injection of rapamycin on pain threshold and spinal cord glial activation in rats with neuropathic pain.
CONCLUSIONS: Intrathecal injection of rapamycin may attenuate CCI-induced hyperalgesia and inhibit the activation of astrocyte. PMID: 26004146 [PubMed - as supplied by publisher] (Source: Neurological Research)


Diagnostic criteria in 72 women with erosive vulvovaginal lichen planus
ConclusionsThe most frequent findings in women with EVLP were symptoms of pain or burning, well‐demarcated red shiny areas or erosions at the introitus and scarring with loss of architecture. Our findings support the recently described diagnostic criteria for EVLP. (Source: Australasian Journal of Dermatology)


Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain?
Abstract The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial evaluation, patients were classified into three groups. Group 1, those without any comorbid disease (N = 105), group 2, those having regional non-inflammatory painful disorders (N = 104), and group 3, those with a diagnosis of an inflammatory rheumatic disease (N = 75). Overall, 65 % of the patients fulfilled the 1990 criteria, while 94 % of them fulfilled the 2010 criteria. Almost all of the patients (97 %) with CWP did meet at least one of the criteria set, regardless of w...


Peripartum changes of the sacroiliac joints on MRI: increasing mechanical load correlating with signs of edema and inflammation kindling spondyloarthropathy in the genetically prone
In conclusion, pregnancy and puerperium are associated with a host of acute findings in and around the SIJ, including BME, capsulitis, and enthesitis, reflecting most probably, mechanical load and hormonal changes. While the vast majority of symptoms abate within weeks to several months postpartum, 3.8 % of women go on to develop spondyloarthropathy. Diffuse SIJ BME and the presence of risk factors for spondyloarthropathy are predictive of a chronic course. (Source: Clinical Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Fentanyl Buccal Tablet: A New Breakthrough Pain Medication in Early Management of Severe Vaso‐Occlusive Crisis in Sickle Cell Disease
ConclusionsWe propose that VOCs might require breakthrough pain drug strategy as vaso‐occlusive phenomena and enhanced vasoconstriction promoting acute ischemic pain component exacerbate the continuous pain of VOCs. FBT might be a powerful and feasible tool in early management of acute pain during VOCs in emergency departments. (Source: Pain Practice)


Pain Management in Four‐Limb Amputation: A Case Report
We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four‐limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four‐limb amputation. (Source: Pain Practice)


Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review
ConclusionIt is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required. (Source: Pain Practice)


Calibration of the Dutch‐Flemish PROMIS Pain Behavior item bank in patients with chronic pain
ConclusionsThe Dutch‐Flemish PROMIS Pain Behavior item bank was found to have good cross‐cultural validity, reliability and construct validity. The development of the Dutch‐Flemish PROMIS Pain Behavior item bank will serve as the basis for Dutch‐Flemish PROMIS short forms and computer adaptive testing (CAT). (Source: European Journal of Pain)


Abdominal Pain Caused by Spontaneous Rupture of a Liver Tumor
Question: A 47-year-old man was admitted to our hospital with an 8-hour history of intermittent abdominal pain that had developed suddenly. He had a history of liver cirrhosis and chronic hepatitis B virus infection for 10 years. Physical examination revealed tenderness of the right abdomen. His liver function was abnormal: γ-glutamyltransferase, 110U/L (normal range,10-60), alkaline phosphatase, 135U/L (normal range, 45-125), glutamate dehydrogenase, 22.4U/L (normal range, 0-7.4), prealbumin, 11.7 mg/dL (normal range, 17-40). (Source: Gastroenterology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study
Authors: A E Bunner, C L Wells, J Gonzales, U Agarwal, E Bayat & N D Barnard (Source: Nutrition and Diabetes)


Insulin‐Like Growth Factor II (IGF‐II) Inhibits IL‐1β‐Induced Cartilage Matrix Loss and Promotes Cartilage Integrity in Experimental Osteoarthritis
This article is protected by copyright. All rights reserved (Source: Journal of Cellular Biochemistry)


Diagnostic criteria in 72 women with erosive vulvovaginal lichen planus.
CONCLUSIONS: The most frequent findings in women with EVLP were symptoms of pain or burning, well-demarcated red shiny areas or erosions at the introitus and scarring with loss of architecture. Our findings support the recently described diagnostic criteria for EVLP. PMID: 26010759 [PubMed - as supplied by publisher] (Source: The Australasian Journal of Dermatology)


Cognitive-behavioural treatment for subacute and chronic neck pain.
CONCLUSIONS: With regard to chronic neck pain, CBT was found to be statistically significantly more effective for short-term pain reduction only when compared to no treatment, but these effects could not be considered clinically meaningful. When comparing both CBT to other types of interventions and CBT in addition to another intervention to the other intervention alone, no differences were found. For patients with subacute NP, CBT was significantly better than other types of interventions at reducing pain at short-term follow-up, while no difference was found for disability and kinesiophobia. Further research is recommended to investigate the long-term benefits and risks of CBT including for the different subgroups of subjects with NP. PMID: 26006174 [PubMed - as supplied by publisher...


Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls
Conclusion Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific LBP. Future investigations should validate these findings with quantitative measures as well as investigate the effect of gluteus medius strengthening in people with LBP. (Source: European Spine Journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Analgesia enhancement and prevention of tolerance to morphine: beneficial effects of combined therapy with omega‐3 fatty acids
ConclusionThis finding suggests a role for O3 as adjuncts to opioids in pain therapy and might contribute to the reduction of the occurrence of morphine side‐effects. (Source: Journal of Pharmacy and Pharmacology)


Healthcare costs associated with elderly chronic pain patients in primary care
Conclusion Healthcare costs increased rapidly over time, largely due to hospitalization. Prevention strategies to limit hospitalizations in elderly appear to be the most useful in order to achieve cost savings in the future. (Source: European Journal of Clinical Pharmacology)


Transurethral intraprostatic injection of botulinum neurotoxin type A for the treatment of chronic prostatitis/chronic pelvic pain syndrome: results of a prospective pilot double‐blind and randomized placebo‐controlled study
ConclusionsTransurethral intraprostatic BoNT‐A injection maybe an effective therapeutic option in patients with CP/CPPS as it reduces pain and improves QoL. (Source: BJU International)


Acute opioid withdrawal is associated with increased neural activity in reward-processing centers in healthy men: A functional magnetic resonance imaging study
The objective and subjective signs and symptoms of opioid withdrawal are well-documented, and validated scales have been developed for their assessment (Handelsman et al., 1987). (Source: Drug and Alcohol Dependence)


Clinical Reasoning: A case of unilateral facial pain
A 62-year-old man admitted with B cell chronic lymphocytic leukemia (CLL) reported 2 weeks of progressive left-sided jaw and facial pain. He first noticed the pain occurring during prolonged chewing. It was exacerbated by teeth clenching and resolved with jaw rest. The patient described the pain as dull and gnawing without radiation. He also described a "knot" within his left "jaw muscles" at the mandibular angle. He had decreased range of motion, could not fully open his mouth, and felt that his jaw was misaligned. He was therefore placed on a soft mechanical diet. He denied a temporal headache or transient loss of vision. He was on his second day of obinutuzumab chemotherapy but was not on any other new medications. He had no history of trauma to his face, head, or neck. (Source: Neurolo...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Metabolic analysis of knee synovial fluid as a potential diagnostic approach for osteoarthritis
This article is protected by copyright. All rights reserved (Source: Journal of Orthopaedic Research)


Editorial: Voltage‐Gated Calcium 2.2 Channels: Therapeutic Target for Chronic Arthritic Pain?
(Source: Arthritis and Rheumatism)


Suppression of Peripheral Pain by Blockade of Voltage‐Gated Calcium 2.2 Channels in Nociceptors Induces RANKL and Impairs Recovery From Inflammatory Arthritis in a Mouse Model
ConclusionTaken together, our results indicate that alleviation of peripheral pain by blockade of CaV2.2‐ mediated calcium influx and signaling in nociceptor sensory neurons impairs recovery from induced arthritis and point to the potentially devastating effects of using CaV2.2 channel blockers as analgesics during inflammation. (Source: Arthritis and Rheumatism)


Calcitonin Gene‐Related Peptide–Expressing Sensory Neurons and Spinal Microglial Reactivity Contribute to Pain States in Collagen‐Induced Arthritis
ConclusionSensory neuron–derived CGRP sustains mechanical hypersensitivity and spinal microglial reactivity in CIA, suggesting that central mechanisms play critical roles in chronic inflammatory pain. Blockade of these central events may provide pain relief in rheumatoid arthritis patients. (Source: Arthritis and Rheumatism)


Prevalence of Chronic Axial Pain, Inflammatory Back Pain, and Spondyloarthritis in Diagnosed Psoriasis
ConclusionThere is a higher prevalence of lower axial pain, IBP, SpA, and alternating buttock pain associated with a prior diagnosis of psoriasis. These data may influence the way psoriasis patients are approached in primary care and specialty clinics. (Source: Arthritis Care and Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Behcet Colitis
Clinics in Colon and Rectal Surgery 2015; 28: 099-102DOI: 10.1055/s-0035-1547336Behcet disease (BD) is a chronic, multisystem, inflammatory disease characterized by variable clinical manifestations involving systemic vasculitis of both the small and large blood vessels. The majority of BD patients present with recurrent oral ulcers in combination with other manifestations of the disease, including genital ulcers, skin lesions, arthritis, uveitis, thrombophlebitis, gastrointestinal or central nervous system involvement. Gastrointestinal BD occurs in 3 to 25% of the BD patients and shares many clinical characteristics with inflammatory bowel disease (IBD). Consequently, the differentiation between IBD and gastrointestinal manifestation of BD is very difficult. Intestinal BD should be conside...


Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been ….
CONCLUSION: The literature suggests that the medicinal use of cannabis may have a therapeutic role for a multitude of diseases, particularly chronic pain disorders including headache. Supporting literature suggests a role for medicinal cannabis and cannabinoids in several types of headache disorders including migraine and cluster headache, although it is primarily limited to case based, anecdotal, or laboratory-based scientific research. Cannabis contains an extensive number of pharmacological and biochemical compounds, of which only a minority are understood, so many potential therapeutic uses likely remain undiscovered. Cannabinoids appear to modulate and interact at many pathways inherent to migraine, triptan mechanisms ofaction, and opiate pathways, suggesting potential synergistic or ...


Transcriptional regulator PRDM12 is essential for human pain perception
Nature Genetics 47, 803 (2015). doi:10.1038/ng.3308 Authors: Ya-Chun Chen, Michaela Auer-Grumbach, Shinya Matsukawa, Manuela Zitzelsberger, Andreas C Themistocleous, Tim M Strom, Chrysanthi Samara, Adrian W Moore, Lily Ting-Yin Cho, Gareth T Young, Caecilia Weiss, Maria Schabh&#252;ttl, Rolf Stucka, Annina B Schmid, Yesim Parman, Luitgard Graul-Neumann, Wolfram Heinritz, Eberhard Passarge, Rosemarie M Watson, Jens Michael Hertz, Ute Moog, Manuela Baumgartner, Enza Maria Valente, Diego Pereira, Carlos M Restrepo, Istvan Katona, Marina Dusl, Claudia Stendel, Thomas Wieland, Fay Stafford, Frank Reimann, Katja von Au, Christian Finke, Patrick J Willems, Michael S Nahorski, Samiha S Shaikh, Of&#233;lia P Carvalho, Adeline K Nicholas, Gulshan Karbani, Maeve A McAleer, Maria Roberta Cilio...


Kaempferol and inflammation: From chemistry to medicine
Publication date: Available online 14 May 2015 Source:Pharmacological Research Author(s): Kasi Pandima Devi , Dicson Sheeja Malar , Seyed Fazel Nabavi , Antoni Sureda , Jianbo Xiao , Seyed Mohammad Nabavi , Maria Daglia Inflammation is an important process of human healing response, wherein the tissues respond to injuries induced by many agents including pathogens. It is characterized by pain, redness and heat in the injured tissues. Chronic inflammation seems to be associated with different types of diseases such as arthritis, allergies, atherosclerosis, and even cancer. In recent years natural product based drugs are considered as the novel therapeutic strategy for prevention and treatment of inflammatory diseases. Among the different types of phyto-constituents present in natural prod...


Benzodiazepines may be worse than opioids: negative medication effects in severe chronic pain - Gauntlett-Gilbert J, Gavriloff D, Brook P.
OBJECTIVES: Opioid prescription for non-malignant pain is increasing in Europe and the US. Research and guidance have focused on the potential for dependency and medical side effects with high doses. In contrast, benzodiazepines have received little attent... (Source: SafetyLit: All (Unduplicated))<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers
Abstract Although acupuncture is effective for treating pain, its site-specificity is questioned. The aim was to compare the cerebral responses of needling applied to an acupuncture point to the needling of a sham point, using functional magnetic resonance imaging (fMRI). Twenty-one healthy male volunteers were enrolled. Manual stimulation of the acupuncture (ST44) and sham points on the dorsum of the left foot was applied during fMRI in a crossover manner. fMRI data analysis was performed contrasting the ST44 and the sham conditions. Stimulation intensity, subjective discrimination of the needling site and the incidence of “Qi” sensation were additionally recorded. Stimulation of ST44 acupoint, in comparison to the sham procedure, was associated with an increased fMRI-activa...


Sympathetic innervation of human muscle spindles.
Authors: Radovanovic D, Peikert K, Lindström M, Domellöf FP Abstract The aim of the present study was to investigate the presence of sympathetic innervation in human muscle spindles, using antibodies against neuropeptide Y (NPY), NPY receptors and tyrosine hydroxylase (TH). A total of 232 muscle spindles were immunohistochemically examined. NPY and NPY receptors were found on the intrafusal fibers, on the blood vessels supplying muscle spindles and on free nerve endings in the periaxial space. TH-immunoreactivity was present mainly in the spindle nerve and vessel. This is, to our knowledge, the first morphological study concerning the sympathetic innervation of the human muscle spindles. The results provide anatomical evidence for direct sympathetic innervation of the intrafusal ...


EGb761 Ameliorates Neuropathic Pain by Scavenging Reactive Oxygen Species
Conclusion: Taken together, our results suggest that administration of EGb761 can ameliorate neuropathic pain, and further indicate that JNK, which is activated by both exogenous and endogenous ROS, might be the mechanism underlying the effects of EGb761 on CCI neuropathic pain.Pharmacology 2015;95:293-299 (Source: Pharmacology)


How to investigate: Chronic pain
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Matthew Hague , Nicholas Shenker Chronic pain is defined as an unpleasant sensory and emotional experience persisting longer than the normal process of healing, usually longer than 3 months. About a fifth of the world's population is believed to suffer from chronic pain. In Europe, chronic pain accounts for nearly 500 m lost working days, and it costs the European economy &gt;€34 billion (£28 billion) every year. Establishing a reliable diagnosis is the primary challenge in evaluating a patient with chronic pain. Common diagnoses not to miss include seronegative spondyloarthritides, endocrine abnormalities including severe vitamin D deficiency and polymyalgia rh...


Evolving spectrum of HIV-associated rheumatic syndromes
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Christine Fox , Karen Walker-Bone At the end of 2013, 35 million people worldwide were infected with HIV. The prognosis of HIV has been transformed by combination antiretroviral therapy (cART). Providing compliance is good, the use of cART has normalised the life expectancy of HIV-infected people leading to a growing population of people with chronic infection. Management of HIV patients has therefore needed to adapt in order to not only control viral activity but also manage long-term complications of HIV and cART. Rheumatological manifestations of HIV were first described in 1989. Since then, there have been case reports, case series and epidemiological studies descri...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Meta-analyses of pain studies: What we have learned
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Winfried Häuser , Thomas R. Tölle Meta-analysis is a statistical procedure that integrates the results of at least two independent studies. The biggest threats to meta-analysis are publication bias due to missing studies with negative results and low-quality evidence due to methodological limitations imposed by included studies. Tools to improve the quality of meta-analysis have been developed by the Cochrane Collaboration and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analyses of trials have demonstrated that pain responses in patients with chronic pain, following treatment, are not normally distributed but have a bimodal...


Physical exercise as non-pharmacological treatment of chronic pain: Why and when
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Kirsten R. Ambrose , Yvonne M. Golightly Chronic pain broadly encompasses both objectively defined conditions and idiopathic conditions that lack physical findings. Despite variance in origin or pathogenesis, these conditions are similarly characterized by chronic pain, poor physical function, mobility limitations, depression, anxiety, and sleep disturbance, and they are treated alone or in combination by pharmacologic and non-pharmacologic approaches, such as physical activity (aerobic conditioning, muscle strengthening, flexibility training, and movement therapies). Physical activity improves general health, disease risk, and progression of chronic illnesses such as c...


Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s)
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Daniel J. Clauw Until recently, most clinicians considered chronic pain to be typically due to ongoing peripheral nociceptive input (i.e., damage or inflammation) in the region of the body where the individual is experiencing pain. Clinicians are generally aware of a few types of pain (e.g., headache and phantom limb pain) where chronic pain is not due to such causes, but most do not realize there is not a single chronic pain state where any radiographic, surgical, or pathological description of peripheral nociceptive damage has been reproducibly shown to be related to the presence or severity of pain. The primary reason for this appears to be that both the peripheral a...


Cognitive behaviour therapy plus aerobic exercise training to increase activity in patients with myotonic dystrophy type 1 (DM1) compared to usual care (OPTIMISTIC): study protocol for randomised controlled trial
DiscussionOPTIMISTIC will not only provide effectiveness data on an intervention that could fill a treatment-gap for DM1 patients but will also improve our understanding of the relevant determinants of the prognosis of DM1.Trial registrationRegistration number: Cinicaltrials.gov NCT02118779; registered 11 April 2014. (Source: Epidemiologic Perspectives and Innovations)


Hope for People with IBD and Those at Risk
Marla Dubinsky, MD Chief, Pediatric Gastroenterology and Hepatology, and Co-Director of the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center Icahn School of Medicine at Mount Sinai Hope for People with IBD and Those at Risk Up to 1.3 million Americans have inflammatory bowel disease (IBD), a complex disorder of the immune system that results in uncontrolled inflammation of the gastrointestinal (GI) tract. Crohn's disease and ulcerative colitis are the two most common forms of IBD, causing severe GI symptoms, such as diarrhea, abdominal pain, and rectal bleeding, that can wreak havoc with everyday life. These symptoms can often be controlled with medication, but many people still cycle through periods of remission and flare-ups. Deep, long-term remission is possib...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Improving methodology when analyzing shockwave evidence
A recent publication showed that extracorporeal shockwave therapy (ESWT) was neither effective nor cost-effective for low back pain [1]. This conclusion came after performing a systematic review of shockwave treatments in chronic low back pain using a FairMed device. However, we believe these conclusions must be reviewed because FairMed used for these studies is not a shockwave device. No physical parameter characterizing the pressure curve of the FairMed device has been described. This system does not meet the International Society for Medical Shockwave Treatment standards [2]. (Source: The Spine Journal)


Screening method for major depressive disorders by questionnaire survey in patients with chronic spinal pain
I greatly appreciate the study by Choi et al. [1] on the screening ability of depression in patients with chronic spinal pain. The authors used five screening tests for depression, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) Axis I Disorders (SCID-I) was set as a gold standard of major depressive disorders (MDDs). They mainly used a receiver-operating characteristic (ROC) curve analysis to determine the superiority among screening tests. (Source: The Spine Journal)


Predictors of Chronic Abdominal Pain Affecting the Well-Being of ChildrenPredictors of Chronic Abdominal Pain Affecting the Well-Being of Children
Abdominal pain is frequent among children, and may persist for years. Are there specific patient characteristics at initial evaluation that might predict prognosis one year later? Annals of Family Medicine (Source: Medscape Today Headlines)


Acupuncture-brain interactions as hypothesized by mood scale recordings
Mood expressions encompassing positive scales like “activity, elation, contemplation, calmness” and negative scales like “anger, excitement, depression, fatigue” were applied for introducing a new tool to assess the effects of acupuncture on brain structures. Traditional acupuncture points defined in the literature for their effects on task negative and task positive brain structures were applied to chronic disease patients supposed to have dominant negative mood scales. Burn-out syndrome (n=10) and female chronic pain patients (n=22) showed a significant improvement on positive mood scales and a decline in negative mood scales after 10 acupuncture sessions. (Source: Medical Hypotheses)


Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances.
CONCLUSIONS: PEG was associated with a lower probability of intervention failure, suggesting the endoscopic procedure may be more effective and safe compared with NGT. There is no significant difference in mortality rates between comparison groups, or in adverse events, including pneumonia related to aspiration. Future studies should include details of participant demographics including underlying disease, age and gender, and the gastrostomy technique. PMID: 25997528 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Delayed complications after pancreatic surgery : Pancreatic insufficiency, malabsorption syndrome, pancreoprivic diabetes mellitus and pseudocysts].
CONCLUSION: As the evidence is limited, an interdisciplinary and individually tailored approach for delayed pancreatic morbidity is recommended. PMID: 25997699 [PubMed - as supplied by publisher] (Source: Der Chirurg)


Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.
CONCLUSION: The rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails. PMID: 26002783 [PubMed - as supplied by publisher] (Source: Vascular)


Acupuncture–brain interactions as hypothesized by mood scale recordings
Mood expressions encompassing positive scales like “activity, elation, contemplation, calmness” and negative scales like “anger, excitement, depression, fatigue” were applied for introducing a new tool to assess the effects of acupuncture on brain structures. Traditional acupuncture points defined in the literature for their effects on task negative and task positive brain structures were applied to chronic disease patients supposed to have dominant negative mood scales. Burn-out syndrome (n=10) and female chronic pain patients (n=22) showed a significant improvement on positive mood scales and a decline in negative mood scales after 10 acupuncture sessions. (Source: Medical Hypotheses)


Is chronic postherniorrhaphy pain always chronic
Sandblom G (Source: Journal of Pain Research)


Subacute combined degeneration of the spinal cord in a patient abusing nitrous oxide and self-medicating with cyanocobalamin.
CONCLUSION: A patient who abused nitrous oxide chronically developed ataxia, paresthesia, and urinary retention while self-medicating with cyanocobalamin. A diagnosis of SCD was supported by MRI findings, symptoms, and the known relationship between nitrous oxide exposure and vitamin B12 deficiency. PMID: 25987690 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Clinical implications of patient-provider agreements in opioid prescribing.
Authors: Kraus CN, Baldwin AT, Curro FA, McAllister RG Abstract In June, 2012 the United States Food and Drug Administration (FDA) developed a "blueprint" for prescriber education as a means of directing Certified Medical Education (CME) activities that included content which would meet the regulatory requirements of the class-wide, longacting/ extended-release (LA-ER) opioid Risk Evaluation Mitigation Strategies (REMS). Within the blueprint is the suggested adoption of Patient-Provider Agreements (PPAs) to be used in association with opioid prescribing, but, to our knowledge, there have been no reported evaluations of the role played by opioid-agent PPAs in clinical practice, or of the perceptions of this regulatory mandate by clinicians. Therefore, we conducted a survey regarding...


Mindfulness as Effective as CBT in Pain CatastrophizingMindfulness as Effective as CBT in Pain Catastrophizing
Mindfulness-based stress reduction may be as effective as cognitive-behavior therapy in countering the catastrophizing thought patterns of people with chronic back pain. Medscape Medical News (Source: Medscape Medical News Headlines)


Novus Medical Detox Addresses Opioids for Chronic Pain: The “Silent...
Although little scientific evidence exists to support the safety and efficacy of long-term opioid use and despite deadly results, an estimated 8 million Americans use opioids in lieu of many other...(PRWeb May 21, 2015)Read the full story at http://www.prweb.com/releases/2015/05/prweb12738054.htm (Source: PRWeb: Medical Pharmaceuticals)


Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia
In conclusion, the level of nociception during breast surgery is not significantly affected by preoperative anxiety. (Source: Journal of Anesthesia)


Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial
Publication date: Available online 18 May 2015 Source:The Lancet Author(s): Robert Pickard , Kathryn Starr , Graeme MacLennan , Thomas Lam , Ruth Thomas , Jennifer Burr , Gladys McPherson , Alison McDonald , Kenneth Anson , James N'Dow , Neil Burgess , Terry Clark , Mary Kilonzo , Katie Gillies , Kirsty Shearer , Charles Boachie , Sarah Cameron , John Norrie , Samuel McClinton Background Meta-analyses of previous randomised controlled trials concluded that the smooth muscle relaxant drugs tamsulosin and nifedipine assisted stone passage for people managed expectantly for ureteric colic, but emphasised the need for high-quality trials with wide inclusion criteria. We aimed to fulfil this need by testing effectiveness of these drugs in a standard clinical care setting. Methods For this mu...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Psychological aspects of chronic musculoskeletal pain
Publication date: Available online 21 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Leslie J. Crofford Chronic musculoskeletal pain, by its very nature, is associated with negative emotions and psychological distress. There are individual differences in personality, coping skills, behavioral adaptation, and social support that dramatically alter the psychological outcomes of patients with chronic pain. Patients who have an aspect of central pain amplification associated with mechanical or inflammatory pain and patients with fibromyalgia (FM) are likely to exhibit higher levels of psychological distress and illness behaviors. This manuscript discusses several different constructs for the association between chronic pain, central pain amplification, and ...


“Real-life” treatment of chronic pain: Targets and goals
Publication date: Available online 20 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Jacob N. Ablin , Dan Buskila Treating chronic pain is a complex challenge. While textbooks and medical education classically categorize pain as originating from peripheral (nociceptive), neuropathic, or centralized origins, in real life each and every patient may present a combination of various pain sources, types, and mechanisms. Moreover, individual patients may evolve and develop differing types of pain throughout their clinical follow-up, further emphasizing the necessity to maintain clinical diligence during the evaluation and follow-up of these patients. Rational treatment of patients suffering from chronic pain must attempt at deconstructing complex pain cases, ...


Pain in systemic inflammatory rheumatic diseases
Publication date: Available online 19 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Fabiola Atzeni , Ignazio Francesco Masala , Fausto Salaffi , Manuela Di Franco , Roberto Casale , Piercarlo Sarzi-Puttini The sometimes intense, persistent and disabling pain associated with rheumatoid arthritis (RA) and spondyloarthritis frequently has a multifactorial, simultaneously central and peripheral origin, and it may be due to currently active inflammation or joint damage and tissue destruction caused by a previous inflammatory condition. The symptoms of inflammatory pain symptoms can be partially relieved by non-steroidal anti-inflammatory drugs, but many patients continue to experience moderate pain due to alterations in central pain regulation mechanisms, a...


Oxytocin and the modulation of pain experience: Implications for chronic pain management
Publication date: August 2015 Source:Neuroscience &amp; Biobehavioral Reviews, Volume 55 Author(s): Lincoln M. Tracy , Nellie Georgiou-Karistianis , Stephen J. Gibson , Melita J. Giummarra In an acute environment pain has potential protective benefits. However when pain becomes chronic this protective effect is lost and the pain becomes an encumbrance. Previously unheralded substances are being investigated in an attempt to alleviate the burden of living with chronic pain. Oxytocin, a neuropeptide hormone, is one prospective pharmacotherapeutic agent gaining popularity. Oxytocin has the potential to modulate the pain experience due to its ubiquitous involvement in central and peripheral psychological and physiological processes, and thus offers promise as a therapeutic agent. In this...


Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders
Chronic pain is a global problem (Blyth et al., 2001; Gureje et al., 1998) and a frequent cause for seeking medical care (Andersson et al., 1999; Kroenke and Mangelsdorff, 1989; Mantyselka et al., 2001). Patients with a history of opioid use disorders appear to be particularly vulnerable to pain (Karasz et al., 2004; Rosenblum et al., 2003; Sheu et al., 2008). The prevalence of chronic pain among persons with opioid use disorders treated with opioid agonist therapy (OAT) ranges from 36 to 61% (Barry et al., 2009, 2013; Jamison et al., 2000; Rosenblum et al., 2003). (Source: Drug and Alcohol Dependence)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Islet Transplantation for Type 1 Diabetes, 2015: What Have We Learned From Alloislet and Autoislet Successes?
The therapeutic potential of pancreatic islet allotransplantation, in which human donor islets are used, as a treatment for type 1 diabetes (T1D) has fascinated diabetes researchers and clinicians for decades. At the same time, the therapeutic potential of total pancreatectomy and islet autotransplantation (TPIAT) (in which one&rsquo;s own islets are used) as a preventive treatment for diabetes in patients who undergo total pancreatectomy for chronic, painful pancreatitis has received relatively less attention. This is ironic, since the latter has been much more effective than the former in terms of successful glucose management and duration of efficacy. The reasons for this disparity can be partially identified. TPIAT receives very little attention in textbooks of internal medicine and ge...


Patient-centered care for chronic pain in the emergency department: a qualitative study
• Patient centered care must be individualized with culturally appropriate assessment.• Individualized care planning may ensure an effective transition of care.• Health care providers must deal ethically and respectfully with patients of all types.• Emergency department nurses can advocate for a model for patient centered care. (Source: International Emergency Nursing)


Muscle Monitoring and Maintenance as an End Point for Patients Treated for Cancer
In the past, people being treated for chronic disease, including cancer, were often advised by their physician to rest and reduce their physical activity. This is suitable advice if movement causes pain, cardiac or respiratory distress. Newer research indicates that exercise is not only safe but also feasible during cancer treatment, improving physical function and quality of life. (Source: Clinical Oncology)


Microsurgical Spermatic Cord Denervation as a Treatment for Chronic Scrotal Content Pain: A Multicenter Open Label Trial
To prospectively evaluate the results of microsurgical spermatic cord denervation in a series of patients with chronic scrotal content pain in a multicenter study, including one center in Germany and three centers in Chile. (Source: The Journal of Urology)


Cost-effectiveness of stimulation of the sphenopalatine ganglion (SPG) for the treatment of chronic cluster headache: a model-based analysis based on the Pathway CH-1 study
Conclusions Our model-based analysis suggests that SPG stimulation for the treatment of chronic cluster headache, under the assumption of sustained therapy effectiveness, leads to meaningful gains in health-related quality of life and is a cost-effective treatment strategy in the German healthcare system. (Source: The Journal of Headache and Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


WITHDRAWN: Botulinum toxin for subacute/chronic neck pain.
CONCLUSIONS: Current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for chronic neck pain associated with or without associated cervicogenic headache. Likewise, there was no benefit seen for disability and quality of life at four week and six months. PMID: 25994306 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


WITHDRAWN: Medicinal and injection therapies for mechanical neck disorders.
CONCLUSIONS: ??? PMID: 25994305 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Sex differences in cerebellar mechanisms involved in pain-related safety learning.
Authors: Labrenz F, Icenhour A, Thürling M, Schlamann M, Forsting M, Timmann D, Elsenbruch S Abstract Recent studies have suggested that the cerebellum contributes to the central processing of pain, including pain-related learning and memory processes. As a complex experience with multiple emotional and cognitive facets, the response to pain and its underlying neural correlates differ between men and women. However, it remains poorly understood whether and to what extent sex differences exist in the cerebellar contribution to pain-related associative learning processes. In the present conditioning study with experimental abdominal pain as unconditioned stimuli (US), we assessed sex-dependent differences in behavioral and neural responses to conditioned warning and safety cues in h...


Treatment of pain in fibromyalgia patients with testosterone gel: Pharmacokinetics and clinical response.
Authors: White HD, Brown LA, Gyurik RJ, Manganiello PD, Robinson TD, Hallock LS, Lewis LD, Yeo KT Abstract To test our hypothesis that testosterone deficiency plays an important role in chronic pain, a Phase I/II pilot study was initiated with 12 fibromyalgia patients to verify that a daily dose for 28days with transdermal testosterone gel would 1) significantly and safely increase mean serum testosterone concentrations from low baseline levels to mid/high-normal levels, and 2) effectively treat the pain and fatigue symptoms of fibromyalgia. Pharmacokinetic data confirmed that serum free testosterone concentrations were raised significantly above baseline levels, by assessment of maximum hormone concentration (Cmax) and area under the curve (AUC) parameters: free testosterone Cmax ...


A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients.
Authors: White HD, Robinson TD Abstract Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, "Gulf War Syndrome", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypot...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hypogonadism associated with long-term opioid therapy: A systematic review.
CONCLUSIONS: There is lack of high-quality studies to associate chronic opioid pain management with hypogonadism. At present, there is fair evidence to associate hypogonadism with chronic opioid pain management, and only limited evidence for treatment of OPISHD. PMID: 25985810 [PubMed - in process] (Source: Journal of Opioid Management)


Opioid regimens in patients with chronic pain with multiple cytochrome P450 defects.
Authors: Tennant F Abstract There is a subgroup of patients with chronic pain who have multiple cytochrome P450 enzyme defects. These patients tend to use opioids that are not metabolized by the CYP450 system and most apparently require a higher than average dosage. A significant number require nonoral administration. PMID: 25985808 [PubMed - in process] (Source: Journal of Opioid Management)


Functional Fecal Retention Visualized by 111In-DTPA Colon Transit Scintigraphy
We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of 111In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study. (Source: Clinical Nuclear Medicine)


[Editors' Choice] Which receptor underlies chronic pain?
Finding that nicotinic receptors containing the a6 subunit, but not the a4, inhibit chronic pain points to a new set of potential therapeutic drugs. (Source: Signal Transduction Knowledge Environment)


Microsurgical Varicocele Repair on Men with Grade III Lesions and Chronic Dull Scrotal Pain: A Pilot Study
Conclusion: These results indicated that microsurgical varicocele repair may benefit patients with grade III lesions and chronic dull scrotal pain.Curr Urol 2014;8:29-31 (Source: Current Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome
Summary There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide sy...


Combination Of Medical Marijuana, Opioids Does Not Increase Substance Abuse Risk, Study Finds
With nearly half of the country&nbsp;having already legalized&nbsp;the use of cannabis for medical purposes, physicians prescribing opioids for pain management have another alternative at their disposal. As medical marijuana laws become more relaxed, practitioners now have the option of treating&nbsp;chronic pain patients with prescription opioids, medical cannabis or both. Among many, however, there's a concern about the adverse effects in patients using both. (Source: Forbes.com Healthcare News)


Is Medicine Ignoring Key Influences on Chronic Pain? And Important Therapeutic Solutions?
No abstract available (Source: The Back Letter)


Steroids No Better for Sciatica Pain Than Placebo, Study Finds
Title: Steroids No Better for Sciatica Pain Than Placebo, Study FindsCategory: Health NewsCreated: 5/19/2015 12:00:00 AMLast Editorial Review: 5/20/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Antinociceptive Efficacy of Retigabine in the Monosodium Lodoacetate Rat Model for Osteoarthritis Pain
Conclusion: Retigabine showed antinociceptive effects for OA pain in the MIA model at different times during pain development. Retigabine may be an alternative therapeutic treatment for OA.Pharmacology 2015;95:251-257 (Source: Pharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prevalence and Role of a Low-Lying Peroneus Brevis Muscle Belly in Patients With Peroneal Tendon Pathologic Features: A Potential Source of Tendon Subluxation
Publication date: Available online 19 May 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Roya Mirmiran , Chad Squire , Daniel Wassell A peroneus brevis low-lying muscle belly (LLMB) is a rare anomaly. A few published studies have supported the presence of this anomaly as an etiology for a peroneal tendon tear. However, the association between a peroneus brevis LLMB and tendon subluxation has not been well explored. In the present retrospective study, the magnetic resonance imaging (MRI) and intraoperative findings of 50 consecutive patients undergoing primary peroneal tendon surgery during a 5-year period were assessed. The sensitivity and specificity of MRI compared with the intraoperative findings for identifying peroneal tendon disease were investigated. The presence of ...


Lateral Hindfoot Impingement After Nonunion of Fracture of the Lateral Process of the Talus
We present the case of a patient with such an injury. The patient was treated operatively and was followed for 18 months. (Source: The Journal of Foot and Ankle Surgery)


Pulse‐dose radiofrequency can reduce chronic pain in trapezio‐metacarpal osteoarthritis: A mini‐invasive therapeutic approach
ConclusionsThe PDRF may be a safe, repeatable and effective short‐term pain management technique in patients with trapezio‐metacarpal OA. Larger, randomized controlled studies are indicated to better clarify the efficacy and utility of the PDRF. (Source: APLAR Journal of Rheumatology)


Fibromyalgia with chronic rheumatic diseases in South Korea: a comparison of clinical and American College of Rheumatology criteria
ConclusionsWe found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases. (Source: APLAR Journal of Rheumatology)


Telephone interview strategy can be used for screening inflammatory back pain in the community
ConclusionThe results of our study indicate that telephone surveys based on Calin's criteria for IBP has a moderate, almost substantial agreement with face‐to‐face interviews and can be used as an easily applicable, less expensive and time‐saving method in screening subjects for IBP. (Source: APLAR Journal of Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hypothesis: Human papillomavirus vaccination syndrome—small fiber neuropathy and dysautonomia could be its underlying pathogenesis
This article forwards the hypothesis that small fiber neuropathy and dysautonomia could be the common underlying pathogenesis to the group of rare, but severe reactions that follow HPV vaccination. Clinicians should be aware of the possible association between HPV vaccination and the development of these difficult to diagnose painful dysautonomic syndromes. (Source: Clinical Rheumatology)


Update on the genetics of the fibromyalgia syndrome
Publication date: Available online 18 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Jacob N. Ablin , Dan Buskila Fibromyalgia syndrome (FMS), a condition characterized by chronic widespread pain and tenderness, is a complex condition considered to represent a paradigm of centralized pain. FMS has demonstrated a clear familial aggregation, and hence it is considered to have a genetic background. Multiple candidate-gene studies have been conducted in this field, focusing on target genes that play a role in the transmission and processing of pain. While many of these have focused in the past on markers related to neurotransmitter systems such as catecholamines (catechol-O-methyltransferase (COMT)) and serotonin, novel target genes have recently emerged. I...


Quality of life and sexual satisfaction in women suffering from endometriosis: An Italian preliminary study
Discussion and conclusion Our results showed that the disease has a negative impact on many areas of the overall functioning and sexuality quality of life of women. Nevertheless, the existence of mediatory variables emerged, emphasising how the presence of a partner could be considered a protective value in the experience of pain, therefore stressing the need to adopt a bio-psychosocial perspective to study and fully understand the disease. (Source: Sexologies)


Alcohol and Tobacco Use in Youth With and Without Chronic Pain
Conclusions&nbsp;Chronic pain may not increase risk for tobacco and alcohol use in adolescents. Research is needed to understand use of other substances in this medically vulnerable population. (Source: Journal of Pediatric Psychology)


Neuromuscular Ultrasound Imaging in Low Back Pain Patients with Radiculopathy
Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. (Source: Manual Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effects of focal muscle vibration on physical functioning in patients with knee osteoarthritis: a randomized controlled trial.
CONCLUSIONS: In this study, focal muscle vibration therapy has proven to be effective and safe in improving functioning of patients affected by mild to moderate chronic knee OA. CLINICAL REHABILITATION IMPACT: The use of focal muscle vibration therapy might be an additional and safe tool in the conservative management of knee OA. PMID: 25990196 [PubMed - as supplied by publisher] (Source: European Journal of Physical and Rehabilitation Medicine)


Evidence for a distinct neuro-immune signature in rats that develop behavioural disability after nerve injury
Conclusions: This study has defined individual differences in the immune response at peripheral and spinal sites following CCI in rats. These changes correlated with the degree of disability. Our data suggest that individual immune signatures play significant roles in the different behavioural trajectories following nerve injury, and in some cases may lead to persistent affective-motivational disturbances. (Source: Journal of Neuroinflammation)


Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration
Conclusion This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration. (Source: The Journal of Headache and Pain)


Neuromuscular ultrasound imaging in low back pain patients with radiculopathy
Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. (Source: Manual Therapy)


Depression: An important factor associated with disability among patients with chronic low back pain
Conclusion Depression was the most powerful factor associated with disability of CLBP among depression, anxiety, and somatic symptoms. Depression should be evaluated when investigating disability among patients with CLBP. (Source: International Journal of Psychiatry in Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Targeting the Affective Component of Chronic Pain: a Case Series of Deep Brain Stimulation of the Anterior Cingulate Cortex: Erratum
No abstract available (Source: Neurosurgery)


Endometriosis – Hope is at Hand
The post Endometriosis – Hope is at Hand appeared first on Hysterectomy Association. ‘Historically, the symptoms of inexplicable chronic pelvic pain have often been attributed to imagined madness, female weakness, promiscuity or hysteria’ Wikipedia on Endometriosis. Fortunately, the tide has turned on this outmoded way of thinking! Modern medicine recognises the painful truth about endometriosis and uterine fibroids to such an extent that Covance, the clinical research unit in Leeds, has an upcoming study which could provide hope for women suffering from these aggressive and often debilitating conditions. Currently, there is no existing drug which combats the full spectrum of endometriosis and fibroids symptoms. I have little doubt that these symptoms will be familiar to loads of you...


Newbridge Spine & Pain Now Offering Revolutionary Procedure for...
The top pain management clinics in Maryland, Newbridge Spine & Pain, are now offering a revolutionary treatment for chronic back and neck pain. The procedure, radiofrequency ablation, offers up to...(PRWeb May 19, 2015)Read the full story at http://www.prweb.com/releases/pain-clinic-md/frederick-dundalk-waldorf/prweb12732693.htm (Source: PRWeb: Medical Pharmaceuticals)


Buprenorphine Buccal Film Reduces Chronic Low Back PainBuprenorphine Buccal Film Reduces Chronic Low Back Pain
A new study has shown that buprenorphine delivered through a buccal film can reduce chronic low back pain with few adverse effects. Medscape Medical News (Source: Medscape Neurology and Neurosurgery Headlines)


ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)
Title: ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 5/19/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medical Pot-Painkiller Combo Isn't Always Recipe for Abuse
Title: Medical Pot-Painkiller Combo Isn't Always Recipe for AbuseCategory: Health NewsCreated: 5/18/2015 12:00:00 AMLast Editorial Review: 5/19/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Combined endovascular and endoscopic management of thoracic aortic pseudoaneurysm, mediastinal pseudocyst, and pancreatic pleural effusion due to chronic pancreatitis
A 49-year-old man presented to the cardiology unit with sudden-onset chest pain. His electrocardiogram and cardiac troponin levels were within normal limits. The patient had a history of alcohol abuse and had experienced episodes of abdominal pain for the previous 2 years. Contrast-enhanced CT (CECT) of the chest revealed bilateral pleural effusion and a descending thoracic aorta pseudoaneurysm (Fig. 1A). The surrounding mediastinum had a fluid collection that communicated with the abdominal pseudocyst (Fig. 1A, B). (Source: Gastrointestinal Endoscopy)


Erratum to: Relative frequency of chronic postoperative pain in patients operated for chronic otitis media
(Source: European Archives of Oto-Rhino-Laryngology)


Development of a High-Throughput Screening Assay to Identify Inhibitors of the Lipid Kinase PIP5K1C
Phosphatidylinositol 4-phosphate 5-kinases (PIP5Ks) regulate a variety of cellular processes, including signaling through G protein-coupled receptors (GPCRs), endocytosis, exocytosis, and cell migration. These lipid kinases synthesize phosphatidylinositol 4,5-bisphosphate (PIP2) from phosphatidylinositol 4-phosphate [PI(4)P]. Because small-molecule inhibitors of these lipid kinases did not exist, molecular and genetic approaches were predominantly used to study PIP5K1 regulation of these cellular processes. Moreover, standard radioisotope-based lipid kinase assays cannot be easily adapted for high-throughput screening. Here, we report a novel, high-throughput, microfluidic mobility shift assay to identify inhibitors of PIP5K1C. This assay uses fluorescently labeled phosphatidylinositol 4-p...