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Medworm: Chronic Pain - Recent Medical Updates

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Adrenal insufficiency in acute oral opiate therapy.
Authors: Policola C, Stokes V, Karavitaki N, Grossman A Abstract UNLABELLED: Opiate drugs such as morphine are in extensive use for pain relief and palliation. It is well established that these drugs can cause changes in endocrine function, but such effects are not always sufficiently appreciated in clinical practice, especially in relation to the hypothalamic-pituitary-adrenal (HPA) axis. Herein, we report on an 18-year-old man who was diagnosed with a slipped left femoral epiphysis following a long history of pain in his leg. On examination, he was thought to look relatively young for his age and therefore the orthopaedic surgeons arranged an endocrine assessment, which showed an undetectable concentration of serum cortisol and a suppressed concentration of testosterone; therefor...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


How Chronic Pain and Illness Fan the Flames of Uncertainty
No one is immune from life’s uncertainty. But for the chronically ill—which includes those who suffer from chronic pain—it can feel as if the number of life factors subject to uncertainty has multiplied geometrically. Indeed, perhaps the hardest thing about being chronically ill is the uncertainty it brings to almost every aspect of life.read more (Source: Psychology Today Anxiety Center)


Original Research: Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease
Conclusions: Guided imagery is an effective technique for managing and limiting sickle cell disease–related pain in a pediatric population. (Source: AJN)


Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain—A Retrospective Review
ConclusionsEarly findings suggest that neuromodulation of the DRG may be an effective treatment for chronic neuropathic pain conditions in the groin region. This technique offers a useful alternative for pain conditions that do not always respond optimally to traditional SCS therapy. Neuromodulation of the DRG provided excellent cross‐dermatomal paresthesia coverage, even in cases with patients with discrete pain areas. The therapy can be specific, sustained, and independent of body position. (Source: Pain Practice)


Suicidality in Chronic Pain: Predictors of Suicidal Ideation in Fibromyalgia
ConclusionsThe presence of suicidal ideation in FM patients is closely related to comorbid depression, anxiety and to a higher impact of the disease in daily life. (Source: Pain Practice)


Effects of Testosterone Treatment on Bone Mineral Density in Hypogonadal Men Receiving Intrathecal Opioids
ConclusionTestosterone supplementation was found to largely correct the effects of intrathecal opioids on testosterone levels and BMD. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Are Multiple Platelet-Rich Plasma Injections Useful for Treatment of Chronic Patellar Tendinopathy in Athletes?: A Prospective Study
Conclusion: In this study, application of 3 consecutive US-guided PRP injections significantly improved symptoms and function in athletes with chronic PT and allowed fast recovery to their presymptom sporting level. The PRP treatment permitted a return to a normal architecture of the tendon as assessed by MRI. (Source: The American Journal of Sports Medicine)


Use of human fibrin glue (Tisseel) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty (TISTA): a randomized controlled trial (NCT01641718)
DiscussionPatients with bilateral hernias will receive two meshes, one fixed with glue, and the other fixed with staples. This design will eliminate the inter-individual bias inherent in comparing pain measurements between two groups of patients.Trial registration: ClinicalTrials.gov: NCT01641718 (Source: BMC Surgery)


Mp76-03 regression to the mean in a prospective study of urological chronic pelvic pain syndrome (ucpps)
(Source: The Journal of Urology)


Pd20-08 microsurgical spermatic cord denervation for chronic scrotal content pain: results of a multicenter prospective study
(Source: The Journal of Urology)


Pd9-09 i-stop/pmp: a tool for monitoring prescription drug abuse in patients with chronic pain syndromes
(Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Pd9-04 receptor cascade mediating post-uti chronic pain
(Source: The Journal of Urology)


Mp16-09 trus characteristics of chronic prostatitis/chronic pelvic pain syndrome: comparison with age-matched controls
(Source: The Journal of Urology)


Mp16-08 search for microorganisms in men with urologic chronic pelvic pain syndrome: a culture-independent analysis of cases and controls enrolled in the trans-mapp epidemiology/phenotyping (ep) study
(Source: The Journal of Urology)


Mp16-06 clinical efficacy of roxithromycin in men with chronic prostatitis/chronic pelvic pain syndrome in comparison with ciprofloxacin and aceclofenac: a prospective, randomized, multicenter pilot trial
(Source: The Journal of Urology)


Mp16-05 eviprostat has an identical effect compared to pollen extract (cernilton) in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized, prospective study
(Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Mp16-04 immunostimulation in chronic prostatitis/chronic pelvic pain syndrome (cp/cpps). a one-year prospective, double-blind, placebo-controlled study
(Source: The Journal of Urology)


Mp16-02 "getting to zero": phenotype, symptom severity and treatment in chronic prostatitis/chronic pelvic pain syndrome patients who self report symptom resolution
(Source: The Journal of Urology)


Methadone Overdose and Cardiac Arrhythmia Potential: Findings From a Review of the Evidence for an American Pain Society and College on Problems of Drug Dependence Clinical Practice Guideline
This article summarizes evidence related to unintentional overdose due to methadone and harms related to cardiac arrhythmia potential. We searched Ovid MEDLINE, the Cochrane Library, and PsycINFO databases through January 2014 for studies assessing harms associated with methadone use; we judged 70 studies to be relevant and to meet inclusion criteria. The majority of studies on overdose and cardiac arrhythmia risk are observational and provide weak evidence on which to base clinical guidelines. In patients prescribed methadone for treatment of opioid dependence, data suggest that mortality benefits related to reduction in illicit drug use outweigh harms. Despite epidemiologic data showing marked increases in the numbers of methadone-related deaths that have been primarily attributed to inc...


Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Society
Abstract: Methadone is used for the treatment of opioid addiction and for treatment of chronic pain. The safety of methadone has been called into question by data indicating a large increase in the number of methadone-associated overdose deaths in recent years that has occurred in parallel with a dramatic rise in the use of methadone for chronic pain. The American Pain Society and the College on Problems of Drug Dependence, in collaboration with the Heart Rhythm Society, commissioned an interdisciplinary expert panel to develop a clinical practice guideline on safer prescribing of methadone for treatment of opioid addiction and chronic pain. As part of the guideline development process, the American Pain Society commissioned a systematic review of various aspects related to safety of metha...


Chronic Noncancer Pain Treatment Published by Dove Medical Press
In primary care, patients’ level of satisfaction with their pain treatment is not optimal.(PRWeb March 30, 2014)Read the full story at http://www.prweb.com/releases/2014/03/prweb11712593.htm (Source: PRWeb: Medical Pharmaceuticals)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Influence of self‐management and self‐management support on chronic low back pain patients in primary care
ConclusionsSMS was found to significantly influence SM and mental health. Overall health significantly influenced functional ablement and pain intensity. Participants described using medications, exercising, and making lifestyle changes as most common SM strategies. Prescribing medications, giving encouragement, and providing information were main participant‐perceived SMS activities. Depression and anxiety were key responses to perceptions on functional ablement. Implications for practiceStudy findings increase our understanding of the SM, SMS, and functional ablement of CLBP patients with relevance to application in practice. There is a great need to develop evidence‐based SM and SMS programs specific to CLBP patients’ needs. Nurses and nurse practitioners play major roles in leadi...


Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament
Conclusions: Operative treated patients with a chronic PCL insufficiency achieve an improvement of the clinical result. Patients with low physical load at their workplace achieve less restrictions. (Source: BMC Research Notes)


Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: A 3-year prospective study
Conclusions Under the tested conditions, immediate implant placement can be considered a predictable treatment option for the restoration of fresh postextraction infected sockets. Clinical significance Immediate implants may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history when appropriate preoperative procedures are taken to clean and decontaminate the surgical sites. (Source: Journal of Dentistry)


Development of acute pancreatitis caused by sodium valproate in a patient with bipolar disorder on hemodialysis for chronic renal failure: a case report
Conclusion: It has been reported that acute pancreatitis induced by VPA is caused by intermediate metabolites of VPA. We consider that patients with renal failure are prone to pancreatitis caused by VPA because of the accumulation of these intermediate metabolites. We need close monitoring for serious adverse effects such as pancreatitis when we prescribe VPA to patients with bipolar disorder on hemodialysis for chronic renal failure, although VPA is safer than other mood stabilizers. (Source: BMC Psychiatry - Latest articles)


Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study
Conclusions: Identification of facilitators and barriers to high ULT adherence in African-Americans with gout in this study lays the foundation for designing interventions to improve ULT adherence in racial minorities. (Source: BioMed Central)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Cover Image
On the Cover: A 65-year-old man with chronic right shoulder pain refractory to conservative treatment presented to us. He described an episode of “trivial” trauma in the past. Left: View from superior medial portal shows a reverse HAGL (humeral avulsion of glenohumeral ligament). Note the capsule retracted medially allowing unobstructed view of the infraspinatus tendon. Right: Same view after arthroscopic repair of the HAGL. The repair was accomplished using a percutaneously placed posterior anchor while viewing from the anterior superior portal. The sutures were retrieved through the capsular tissue and tied extra-articularly. Courtesy of John D. Kelly IV, M.D. (Source: Arthroscopy)


Axonics raises $33M for its neuromodulation tech
Alfred Mann Foundation spinout Axonics Modulation Technologies raises nearly $33 million in a Series A round for its neuromodulation technology. Axonics Modulation Technologies said it drummed up a $32.6 million Series A round for the neuromodulation technology it's developing to treat chronic pain and overactive bladder. Irvine, Calif.-based Axonics said the round was led by Edmond de Rothschild Investment Partners and included NeoMed Management, Legend Capital and &quot;a select group of private individuals.&quot; Axonics Modulation Technologies, Vessix Vascular Inc.News Well, Funding Roundup, Neuromodulation/Neurostimulation, Personnelread more (Source: Mass Device)


Clinical characteristics of foot ulceration in people with chronic gout
Abstract Gout is the most common form of inflammatory arthritis and it has an affliction to the foot. Foot involvement in gout has been linked to foot pain, impairment and disability. There has been limited research on the effect of ulceration on foot pain, impairment, disability and health‐related quality of life in patients already living with gout. The aim of the study was to describe the wound characteristics and the effect on foot pain, disability and health‐related quality of life in patients with foot ulceration associated with gout. Participants were recruited from rheumatology clinics in Auckland, New Zealand. All the current foot ulceration sites and wound characteristics were recorded using the TIME wound assessment tool. The outcome measures included general pain, patient g...


A perspective on the epidemiology of acetaminophen exposure and toxicity in the United States.
Authors: Blieden M, Paramore LC, Shah D, Ben-Joseph R Abstract Acetaminophen is a commonly-used analgesic in the US and, at doses of more than 4 g/day, can lead to serious hepatotoxicity. Recent FDA and CMS decisions serve to limit and monitor exposure to high-dose acetaminophen. This literature review aims to describe the exposure to and consequences of high-dose acetaminophen among chronic pain patients in the US. Each year in the US, approximately 6% of adults are prescribed acetaminophen doses of more than 4 g/day and 30,000 patients are hospitalized for acetaminophen toxicity. Up to half of acetaminophen overdoses are unintentional, largely related to opioid-acetaminophen combinations and attempts to achieve better symptom relief. Liver injury occurs in 17% of adults with unin...


Chronic Low-Back Pain and Complementary Health Approaches
This issue of the digest summarizes current scientific evidence about spinal manipulation, acupuncture, massage, and yoga, the complementary approaches most often used by people for chronic low back pain. (Source: NCCAM Featured Content)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


5 Things To Know About Chronic Low-Back Pain and Complementary Health Practices
Low-back pain is a very common condition, but often the cause is unknown. Most people have significant acute back pain at least once in their lives. Usually it resolves on its own without specific treatment. (Source: NCCAM Featured Content)


Electrical Brain Stimulation Might Help Fibromyalgia Patients
Title: Electrical Brain Stimulation Might Help Fibromyalgia PatientsCategory: Health NewsCreated: 3/26/2014 4:35:00 PMLast Editorial Review: 3/27/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


A18: Risk Factors for Symptomatic Avascular Necrosis in Childhood‐Onset Systemic Lupus Erythematous
Conclusion:cSLE patients with severe organ involvement including nephritis and CNS disease, higher maximal daily dose of prednisone, and more frequent use of pulse methylprednisolone are more likely to develop symptomatic AVN. (Source: Arthritis and Rheumatism)


A55: Clostridium difficile Infection‐Associated Reactive Arthritis in a Pediatric Cohort
Conclusion:CDIAReA is an under‐recognized pediatric condition characterized by a painful, migratory, often polyarticular arthritis of large and small joints in the setting of CDI. Though a self‐limited condition in this cohort, its acuity led to considerable morbidity and resource utilization, in some cases due to confusion with septic arthritis. Further research is needed to determine the incidence and risk factors for pediatric CDIAReA. (Source: Arthritis and Rheumatism)


A61: Prevalence of Streptococcal Antibodies in Pediatric Non‐Rheumatic Fever Syndromes in Areas of Low Rheumatic Fever Incidence
Conclusion:In low Rheumatic Fever Incidence areas, abnormal SAT in Pediatric non‐rheumatic fever syndromes have poor diagnostic & therapeutic value; repeat testing adds cost without treatment value. (Source: Arthritis and Rheumatism)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


A75: Proposal of the Bristol Criteria for the Diagnosis of Chronic Non‐bacterial Osteitis From a Cohort of 41 Patients
Conclusion:We suggest that using the Bristol diagnostic criteria (table 18) with an experienced clinician may obviate the need for biopsy in some patients. Pamidronate was found to be a useful second‐line agent with objective MRI evidence of benefit. (Source: Arthritis and Rheumatism)


A80: Skeletal Features of Neonatal‐Onset Multisystem Inflammatory Disease (NOMID) on Anakinra Treatment: Long‐Term Follow‐up
Conclusion:1. Unique bony findings in NOMID are due to persistence of immature osteoblast precursors with abnormal enchondral bone growth which continues until physeal fusion despite anakinra treatment, often with premature fusion at affected sites, with eventual normal ossification. 2. Surgical intervention can be safely considered for those with significant pain/disability from NOMID arthropathy. 3. Consideration of horizontal linear pseudofractures in long bones and risk of hip avascular necrosis is important in those with NOMID (). (Source: Arthritis and Rheumatism)


A81: Spectrum of Mevalonate Kinase Deficiency: Is Colitis More Common Than We Think?
Conclusion:The persistence of ESR elevation outside of febrile episodes seen in patients with HIDS/MKD may indicate the presence of chronic subclinical inflammation. Hematochezia was commonly seen, and could indicate the presence of colitis. Of the immunomodulatory medications used in this small patient population, anakinra appeared to be effective. (Source: Arthritis and Rheumatism)


A134: Validation of Patient Reported Outomes Measurement Information System Modules for use in Childhood‐;onset Lupus
Conclusion:This pilot study supports QoL measurement using the PROMIS™ Short Forms as feasible and concurrently valid. PROMIS™ measures can now be utilized by clinicians treating cSLE for a more efficient patient reported health outcomes measure, taking advantage of their easy interpretation of scores and changes in scores, thereby, reducing respondent burden and making QoL assessment feasible in both research and clinical care settings. (Source: Arthritis and Rheumatism)


A155: Development of an Intensive Interdisciplinary Pediatric Pain Rehabilitation Program: Improving Pain, Functioning, and Psychological Outcomes
Conclusion:Children with amplified pain syndromes successfully restore and maintain function and improve pain without pharmacotherapy. Baseline functional disability and psychological factors correlate with treatment program duration. Prospective studies are warranted to determine long‐term efficacy and effectiveness of this interdisciplinary program. (Source: Arthritis and Rheumatism)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


A164: Development of Pediatric Item Banks to Measure Pain Behavior in the Patient Reported Outcomes Measurement Information System
Conclusion:The PROMIS pediatric pain behavior item‐banks for self and proxy report are suitable for use in non‐adaptive format as short forms or in dynamic format as computerized adaptive tests in clinical research with the potential for adoption into clinical care. (Source: Arthritis and Rheumatism)


A172: Metaphyseal Chondrodysplasia, Ectodermal Dysplasia, Short Stature, Hypergammaglobulinemia, and Spontaneous Inflammation Without Infections in an Extended Family Due to Mutation in NFKB1A
Conclusion:This series demonstrates the clinical variability that can occur due to mutations in NFKB1A. Infections were not prevalent in this family, but spontaneous inflammation was common. In addition, this is the first report of metaphyseal chondrodysplasia as a complication of NEMO or related disorders. (Source: Arthritis and Rheumatism)


Amantadine, an N‐Methyl‐D‐Aspartate antagonist, for treatment of chronic neuropathic pain in a dog
(Source: Veterinary Anaesthesia and Analgesia)


Low Back Pain Leading Cause of Disability Worldwide: Study
Title: Low Back Pain Leading Cause of Disability Worldwide: StudyCategory: Health NewsCreated: 3/25/2014 12:35:00 PMLast Editorial Review: 3/26/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post‐lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis
ConclusionThis cost utility analysis of percutaneous adhesiolysis in the treatment of post‐lumbar surgery syndrome and lumbar central spinal stenosis shows the clinical effectiveness and cost utility of these procedures at USD $2,650 per one year of QALY when performed in an ambulatory surgery center. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Autosomal dominant brachyolmia in a large Swedish family: Phenotypic spectrum and natural course
Autosomal dominant brachyolmia (Type 3, OMIM #113500) belongs to a group of skeletal dysplasias caused by mutations in the transient receptor potential cation channel, subfamily V, member 4 (TRPV4) gene, encoding a Ca++‐permeable, non‐selective cation channel. The disorder is characterized by disproportionate short stature with short trunk, scoliosis and platyspondyly. The phenotypic variability and long‐term natural course remain inadequately characterized. The purpose of this study was to describe a large Swedish family with brachyolmia type 3 due to a heterozygous TRPV4 mutation c.1847G&gt;A (p.R616Q) in 11 individuals. The mutation has previously been detected in another family with autosomal dominant brachyolmia [Rock et al., 2008]. Review of hospital records and patient assessm...


Identifying ligand‐specific signaling within biased responses: focus on delta opioid receptor (Dop) ligands
Abstract Opioids activate G protein‐coupled receptors (GPCRs) to produce powerful analgesic actions but at the same time induce side effects and generate tolerance which restrict their clinical use. Reducing this undesired response profile has remained a major goal of opioid research and the notion of “biased agonism” is raising increasing interest as a means of separating therapeutic responses from unwanted side effects. However, to fully exploit this opportunity it is necessary to confidently identify biased signals and evaluate which type of bias may support analgesia and which may lead to undesired effects. The development of new computational tools has made it possible to quantify ligand‐dependent signaling and discriminate this component from confounders that may also yield b...


In vivo opioid receptor heteromerization: where do we stand?
Summary Opioid receptors are highly homologous G protein coupled receptors that modulate brain function at all levels of neural integration, including autonomous, sensory, emotional and cognitive processing. Opioid receptors functionally interact in vivo, but the underlying mechanisms involving direct receptor‐receptor interactions, affecting signaling pathways or engaging different neuronal circuits remain unsolved. Heteromer formation through direct physical interaction between two opioid receptors or between an opioid receptor and a non‐opioid one has been postulated and can be characterized by specific ligand binding, receptor signaling and trafficking properties. However, despite numerous studies in heterologous systems, evidence for in vivo physical proximity is only available fo...


The TRPA1 Channel in Inflammatory and Neuropathic Pain and Migraine.
Authors: Nassini R, Materazzi S, Benemei S, Geppetti P Abstract The transient receptor potential ankyrin 1 (TRPA1), a member of the TRP superfamily of channels, is primarily localized to a subpopulation of primary sensory neurons of the trigeminal, vagal, and dorsal root ganglia. This subset of nociceptors produces and releases the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP), which mediate neurogenic inflammatory responses. TRPA1 is activated by a number of exogenous compounds, including molecules of botanical origin, environmental irritants, and medicines. However, the most prominent feature of TRPA1 resides in its unique sensitivity for large series of reactive byproducts of oxidative and nitrative stress. Here, the role of TRPA1 in models of differe...


Biofeedback for treatment of chronic idiopathic constipation in adults.
CONCLUSIONS: Currently there is insufficient evidence to allow any firm conclusions regarding the efficacy and safety of biofeedback for the management of people with chronic constipation. We found low or very low quality evidence from single studies to support the effectiveness of biofeedback for the management of people with chronic constipation and dyssynergic defecation. However, the majority of trials are of poor methodological quality and subject to bias. Further well-designed randomised controlled trials with adequate sample sizes, validated outcome measures (especially patient reported outcome measures) and long-term follow-up are required to allow definitive conclusions to be drawn. PMID: 24668156 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Rev...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Tactile Acuity Training for Those With Chronic Low Back PainTactile Acuity Training for Those With Chronic Low Back Pain
Can tactile acuity training improve pain and function in patients with chronic low back pain? BMC Musculoskeletal Disorders (Source: Medscape Orthopaedics Headlines)


Spinal Manipulation’s Effects May Go Beyond Those of Placebo or Expectation, Study Finds
A recent clinical trial has added to knowledge about what goes on in the body and brain when people with chronic low-back pain receive spinal manipulation (also known as spinal manipulative therapy). The researchers found that spinal manipulation, compared with placebo and no treatment, significantly reduced pain sensitivity. They also reported there was support for a potential biological target to address central sensitization of pain, a phenomenon of heightened pain sensitivity that is linked with acute pain’s transition to chronic pain, and the persistence of chronic pain. (Source: NCCAM Featured Content)


Back pain 'leading cause of disability,' study finds
Conclusion This systematic review used a disability rating to quantify the severity of lower back pain in combination with data on prevalence throughout the world. As the authors point out, this study had some limitations, however. Some of the information it used came from questionnaires asking people to recall their back pain, which could make the results prone to bias. Also, the categories of disability used referred to the effect of back pain on bodily functions such as washing and dressing, rather than broader aspects of life, such as wellbeing or economic impact. This means it cannot estimate the full impact of back pain in a population. However, with this in mind, it could be the case that the study actually underestimates, rather than overestimates, the burden of lower back pain....


New FDA-approved treatment gives hope to Psoriatic Arthritis patients
Celgene Corporation has announced that the U.S. Food and Drug Administration (FDA) has approved OTEZLA&reg; (apremilast), the Company's oral, selective inhibitor of phosphodiesterase 4 (PDE4), for the treatment of adult patients with active psoriatic arthritis. A chronic disorder, psoriatic arthritis is characterized by pain, stiffness, swelling and tenderness of the joints, inflammation of specific ligaments and tendons, and a decrease in physical functioning. OTEZLA is the only FDA-approved oral treatment for psoriatic arthritis. (Source: Health News from Medical News Today)


Glenmark receives USD 4 mn from Forest Lab as research fee
The company through its Swiss unit has received USD 4 million as research fee payment from Forest Laboratories Inc for the development of novel mPGES-1 inhibitors to treat chronic inflammatory conditions, including pain, it said. (Source: The Economic Times Healthcare and Biotech News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Alleviation of chronic venous leg ulcers with a hand‐held dielectric barrier discharge plasma generator (PlasmaDerm® VU‐2010): results of a monocentric, two‐armed, open, prospective, randomized and controlled trial (NCT01415622)
ConclusionCold atmospheric plasma displays favourable antibacterial effects. We demonstrated that plasma treatment with the PlasmaDerm® VU‐2010 device is safe and effective in patients with chronic venous leg ulcers. Thus, larger controlled trials and the development of devices with larger application surfaces are warranted. (Source: Journal of the European Academy of Dermatology and Venereology)


Aberrant Drug‐Related Behavior Observed During a 12‐Week Open‐Label Extension Period of a Study Involving Patients Taking Chronic Opioid Therapy for Persistent Pain and Fentanyl Buccal Tablet or Traditional Short‐Acting Opioid for Breakthrough Pain
ConclusionsIncidence of aberrant drug‐related behaviors was similar between patients taking fentanyl buccal tablet and traditional short‐acting opioids over 12 weeks. (Source: Pain Medicine)


‘Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: a three-year prospective study’.
Conclusions Under the tested conditions, immediate implant placement can be considered a predictable treatment option for the restoration of fresh postextraction infected sockets. Clinical significance Immediate implants may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history when appropriate preoperative procedures are taken to clean and decontaminate the surgical sites. (Source: Journal of Dentistry)


Epidemiology of Headache Disorders in the Asia‐Pacific Region
This article reviews epidemiological surveys of primary headache disorders including migraine and tension‐type headache (TTH) among adults in the Asia‐Pacific region using the International Classification of Headache Disorders (ICHD), first or second edition. Chronic daily headache (CDH), which is not an official diagnosis in the ICHD, was also reviewed. In the Asia‐Pacific region, the median (range) 1‐year prevalence of primary headache disorders was 9.1% (1.5‐22.8%) for migraine, 16.2% (10.8‐33.8%) for TTH, and 2.9% (1.0‐3.9%) for CDH. The 1‐year prevalence of migraine and TTH were rather consistent; however, the extremes in the 1‐year prevalence of migraine in earlier studies from Hong Kong (1.5%) and South Korea (22.3%) were not repeated in later surveys (Hong Kong: 1...


A single trial of transcutaneous electrical nerve stimulation reduces chronic neuropathic pain following median nerve injury in rats.
Authors: Cho HY, Suh HR, Han HC Abstract Neuropathic pain is a devastating chronic condition and is often induced in the upper limb following nerve injury or damage. Various drugs or surgical methods have been used to manage neuropathic pain; however, these are frequently accompanied by undesirable side effects. Transcutaneous electrical nerve stimulation (TENS) is a safe and non-invasive intervention that has been used to alleviate different types of pain in the clinic, but it is unclear whether TENS can improve chronic neuropathic pain in the upper limb. Thus, the aim of this study was to investigate the effects of a single trial of TENS on chronic neuropathic pain following median nerve injury. Male rats weighing 200-250 g received median nerve-ligation of the right forearm, whi...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


The burden of musculoskeletal conditions
Abstract: Musculoskeletal conditions (MsC) are a major burden to the individual, society and the health service; 15–20% of all GP consultations involve patients with MsC. Incident cases of osteoarthritis are ten times more common than rheumatoid arthritis (RA). The prevalence of MsC is higher in women, rises with age and is likely to continue to rise as life expectancy increases. The costs of MsC include those to healthcare services, to society and indirect costs. MsC are among the most commonly reported causes of work-related ill health. Rheumatoid arthritis alone costs the UK economy between £3.8 and 4.8 billion a year. The average cost of a major hip procedure is £7800 and of a major knee procedure £6000. Risk factors for MsC include age and gender. The prevalence of certain MsC va...


Catheter-Directed Thrombolysis–Assisted Angioplasty for Chronic Lower Limb Ischemia
Background: Thrombolysis is an appropriate treatment for acute arterial occlusion. There remains controversy as to whether thrombolysis before angioplasty helps to identify the underlying lesion and improve results for chronic ischemia of the lower extremity. We sought to investigate the feasibility of catheter-directed thrombolysis–assisted angioplasty for chronic lower limb ischemia.Methods: Between July 2008 and December 2009, the data of patients with chronic lower limb ischemia undergoing catheter-directed thrombolysis–assisted angioplasty were retrospectively analyzed.Results: Twenty consecutive patients (18 men with a mean age of 56.35 ± 8.5 years) underwent thrombolysis-assisted angioplasty for occlusion of a native artery (n = 18) or bypass graft (n = 2). The median dur...


Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: A randomized controlled study. Falla D, Lindstrøm R, Rechter L, Boudreau S, Petzke F. Eur J Pain. 2013 Nov;17(10):1517-28. doi: 10.1002/j.1532-2149.2013.00321.x. Epub 2013 May 6
Although exercise can be effective for relief of neck pain, little is known about the effect of exercise on the neural control of neck muscles. A randomized controlled trial was conducted on 46 women with chronic neck pain to investigate the immediate effectiveness of an 8-week exercise programme on pain and directional specificity of neck muscle activity. At baseline, the patients completed questionnaires including the neck disability index (NDI) and performed a circular contraction of their head in the horizontal plane at 15 N force, with continuous change in force direction in the range 0-360°. Electromyography (EMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SCap) muscles. Tuning curves of the EMG amplitude were computed, which depicts muscle activity ove...


Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease. Johnsen LG, Hellum C, Nygaard OP, Storheim K, Brox JI, Rossvoll I, Leivseth G, Grotle M. BMC Musculoskelet Disord. 2013 Apr 26;14:148. doi: 10.1186/1471-2474-14-148
The need for cost effectiveness analyses in randomized controlled trials that compare treatment options is increasing. The selection of the optimal utility measure is important, and a central question is whether the two most commonly used indexes - the EuroQuol 5D (EQ5D) and the Short Form 6D (SF6D) - can be used interchangeably. The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties. The psychometric properties of the two utility indexes were compared to a disease-specific instrument, the Oswestry Disability Index (ODI), in the setting of a randomized controlled trial for degenerative disc disease. (Source: The Spine Journal)


Abdominal pain in pregnancy: a rational approach to management
Abstract: Abdominal pain is a relatively common symptom during pregnancy and may be due to anatomical and physiological changes of the pregnant state, such as the ‘round ligament strain’ or may be due to an underlying pathological process. Various obstetric conditions such as placental abruption, clinical chorioamnionitis, threatened pre-term labour and uterine rupture may present with acute abdominal pain. Pregnancy also may predispose to certain clinical conditions such as urinary tract infection that may present with abdominal pain. Conversely, inflammatory or neoplastic processes that are totally unrelated to the pregnant state may first make their presentation during pregnancy, with acute or chronic abdominal pain. Acute abdomen refers to an intra-abdominal process that is charact...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Doctors Often Comply When Patients Ask for Advertised Drugs: Study
Title: Doctors Often Comply When Patients Ask for Advertised Drugs: StudyCategory: Health NewsCreated: 3/21/2014 4:36:00 PMLast Editorial Review: 3/24/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


TPR Podcast Episode #3: Kaboom! – Exploding Toxicology
Episode 3 kaboom v2Episode 3: Kaboom! &#8211; Exploding Tox Written by Theresa Kim   Outline 1)     “Wax” or “dab” 2)     Meth lab explosions 3)     Smoking stool syndrome 4)     Ingestion of fireworks 5)     Nitropatch 6)     Bonus topic related to the prior discussion of Hunan hand and food related tox &nbsp; Wax or Dab A nearly pure form of THC called “wax” or “dab” can be extracted from marijuana using a volatile hydrocarbon solvent (usually butane) Name derived from the wax-like quality of the final product Numerous reports of explosions at home “wax” labs Legal in Colorado &nbsp; Meth Lab Explosions Several methods of manufacturing methamphetamines exist, but all ultimately reduce pseudoephedrine or ephedrine to methamphetamine Hydroio...


Treatment preferences amongst physical therapists and chiropractors for the management of neck pain: results of an international survey
Conclusions: This survey indicates that exercise and manual therapy are core treatments provided by chiropractors and physical therapists. Future research should address gaps in evidence associated with variable practice patterns and knowledge translation to reduce usage of some interventions that have been shown to be ineffective. (Source: Chiropractic and Osteopathy)


The socio‐economic impact of chronic pancreatitis: a systematic review
ConclusionsPatients with CP consume a disproportionately high volume of resources. (Source: Journal of Evaluation in Clinical Practice)


Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete
The scapula functions as a bridge between the shoulder complex and the cervical spine and plays a very important role in providing both mobility and stability of the neck/shoulder region. The association between abnormal scapular positions and motions and glenohumeral joint pathology has been well established in the literature, whereas studies investigating the relationship between neck pain and scapular dysfunction have only recently begun to emerge. Although several authors have emphasised the relevance of restoring normal scapular kinematics through exercise and manual therapy techniques, overall scapular rehabilitation guidelines decent for both patients with shoulder pain as well as patients with neck problems are lacking. The purpose of this paper is to provide a science-based clinic...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Topical combinations to treat microvascular dysfunction of chronic postischemia pain.
CONCLUSIONS: The present results support the hypothesis that allodynia in an animal model of CRPS is effectively relieved by topical combinations of α2A receptor agonists or NO donors with PA or PDE inhibitors. This suggests that topical treatments aimed at improving microvascular function by increasing both arterial and capillary blood flow produce effective analgesia for CRPS. PMID: 24651238 [PubMed - in process] (Source: Anesthesia and Analgesia)


Differential suppression of intracranial self-stimulation, food-maintained operant responding, and open field activity by paw incision and spinal nerve ligation in rats.
CONCLUSIONS: The acute effects of INC on decreasing lever pressing for VTA ICSS and FR (1-2 days after incision) correspond to the timeframe in which ongoing spontaneous pain is expected to occur after INC. Therefore, these decreases are likely mediated by ongoing spontaneous pain, which may be unrelated to mechanical hypersensitivity that persists for up to 4 days after INC. PWT is decreased similarly by SNL, yet operant behavior (lever pressing for VTA ICSS and FR) was not decreased by SNL. SNL, but not INC, decreased rearing behavior but not total distance traveled during OFA. This further indicates that the presence and the extent of hypersensitivity are not predictive of many behavioral changes in rats thought to be mediated by the presence of ongoing pain. Surprisingly, the behaviora...


In reply
We thank Dr. Nguyen et al for their insightful thoughts about when to prescribe an opioid pain reliever in the first place. We agree that evidence for opioid use in chronic noncancer pain is limited and that guidelines are a way forward in curbing the overuse of opioid pain relievers. However, the 3 complaints we studied (back pain, headache, and dental pain) may also be the result of an acute physical insult, and there is evidence that opioids can relieve this type of pain, though their benefit over other medications is questionable. Regardless, current research and existing guidelines are not yet by themselves sufficient to address the problem. (Source: Annals of Emergency Medicine)


ERs Dispensing More Narcotic Painkillers: Study
Title: ERs Dispensing More Narcotic Painkillers: StudyCategory: Health NewsCreated: 3/21/2014 9:35:00 AMLast Editorial Review: 3/21/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


St. Jude Medical Announces European Launch Of Prodigy Spinal Cord Stimulation System With Burst Technology
St. Jude Medical, Inc., a global medical device company, recently announced the CE Mark approval and European launch of its Prodigy Chronic Pain System with Burst Technology. (Source: Medical Design Online News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


On the inflammatory response in metal-on-metal implants
Conclusion: Our data support the concept that metallosis is the result of a local inflammatory response, which according to histomorphology and the composition of the cellular infiltrate classifies as an acute phase of a chronic inflammatory disease. The proinflammatory environment, particularly the generation of the osteoclast-inducing cytokines CXCL8 and IL1-Ss, promotes bone resorption. Loss of bone results in implant loosening, which then causes the major symptoms of metallosis, pain and reduced range of motion. (Source: BioMed Central)


Fistula and Other Adverse Reproductive Health Outcomes among Women Victims of Conflict‐Related Sexual Violence: A Population‐Based Cross‐Sectional Study
ConclusionConflict‐related sexual violence can contribute to women's adverse reproductive health outcomes. Its impact is more devastating than that of NCRSV. (Source: Birth)


A qualitative study of influences on older women's practitioner choices for back pain care
Conclusions: Choice of practitioner appears to be unrelated to the therapeutic approaches, treatment practices or the scientific basis of therapeutic practices. Moreover, anecdotal lay reports of effectiveness and the 'treatment experience' may be more influential than formal qualifications in guiding women's choice of practitioner for their back pain. Further work is needed on the interpersonal, collective and subjective underpinnings of practitioner choice, particularly over time, in order to better understand why women utilise certain practitioners for back pain. (Source: BMC Health Services Research)


A qualitative study of influences on older women¿s practitioner choices for back pain care
Conclusions: Choice of practitioner appears to be unrelated to the therapeutic approaches, treatment practices or the scientific basis of therapeutic practices. Moreover, anecdotal lay reports of effectiveness and the ‘treatment experience’ may be more influential than formal qualifications in guiding women’s choice of practitioner for their back pain. Further work is needed on the interpersonal, collective and subjective underpinnings of practitioner choice, particularly over time, in order to better understand why women utilise certain practitioners for back pain. (Source: BMC Health Services Research)


Irritable Bowel Syndrome (IBS) and BDNF
Conclusion: Chronic prenatal stress followed by a second exposure to HeICS in adult offspring exacerbated visceral hypersensitivity (VHS) greater in female offspring that persisted longer than in male offspring. Chronic prenatal stress up-regulated BDNF expression in the lumbar-sacral dorsal horn that correlated with the exacerbation of VHS in female, but not in male offspring by increasing RNA Pol II binding and histone H3 acetylation, and decreasing histone deacetylase 1 association with the core promoter of BDNF in female offspring. (Source: Neuromics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


St. Jude's Prodigy chronic pain Nuristan device lands CE Mark
St. Jude Medical says its Prodigy neurostimulation device won CE Mark approval in the European Union for a chronic pain indication. St. Jude Medical (NYSE:STJ) said it's putting its Prodigy neurostimulation device on the market in Europe for patients with chronic back pain after winning CE Mark approval. St. Jude MedicalNews Well, CE Mark, Neuromodulation/Neurostimulation, Regulatory/Complianceread more (Source: Mass Device)


Glucosamine supplements 'do not reduce' chronic knee pain
Oral glucosamine supplements do not lessen knee cartilage deterioration among patients with chronic knee pain, a short-term study has concluded. (Source: Nursing Times Breaking News)


The FDA's Dilemma With The Opioid Pain Medication Zohydro ER
Although these drugs have significant abuse potential, that does not negate the fact that there are significant numbers of people suffering chronic pain who cannot live a functional - or even a remotely tolerable - life without them. (Source: Forbes.com Healthcare News)


Cohort protocol paper: The Pain and Opioids In Treatment (POINT) study
This study will rigorously examine prescription opioid use among CNCP patients, and examine its relationship to important health outcomes. The extent to which opioids for chronic pain is associated with pain reduction, quality of life, mental and physical health, aberrant medication behavior and substance use disorders will be extensively examined. Improved understanding of the longer-term outcomes of chronic opioid therapy will direct community-based interventions and health policy in Australia and internationally. The results of this study will assist clinicians to better identify those patients who are at risk of adverse outcomes and who therefore require alternative treatment strategies. (Source: BMC Clinical Pharmacology)


Management of Pancreatic Ductal Leaks and Fistulae
Abstract Pancreatic duct leaks can occur as a result of both acute and chronic pancreatitis or in the setting of pancreatic trauma. Manifestations of leaks include pseudocysts, pancreatic ascites, high amylase pleural effusions, disconnected duct syndrome and internal and external pancreatic fistulas. Patient presentations are highly variable and range from asymptomatic pancreatic cysts to patients with severe abdominal pain and sepsis from infected fluid collections. The diagnosis can often be made by high quality cross‐sectional imaging or during ERCP. Because of their complexity, pancreatic leak patients are best managed by a multidisciplinary team comprised of therapeutic endoscopists, interventional radiologists and surgeons in the field of pancreatic interventions. Minor leaks will...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Schedules for home visits in the early postpartum period
Abstract BackgroundMaternal complications including psychological and mental health problems and neonatal morbidity have been commonly observed in the postpartum period. Home visits by health professionals or lay supporters in the weeks following the birth may prevent health problems from becoming chronic with long‐term effects on women, their babies, and their families. ObjectivesTo assess outcomes for women and babies of different home‐visiting schedules during the early postpartum period. The review focuses on the frequency of home visits, the duration (when visits ended) and intensity, and on different types of home‐visiting interventions. Search methodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 January 2013) and reference lists of retrieved art...


Eccentric exercise training in chronic mid‐portion Achilles tendinopathy: A systematic review on different protocols
Although eccentric exercise training has shown favorable results in chronic mid‐portion Achilles tendinopathy, the optimum dosage remains unknown. A systematic review of the literature was performed in accordance with the PRISMA guidelines, in order to describe different exercise protocols and to determine the most effective training parameters. An extensive search in MEDLINE, EMBASE, CINAHL, and CENTRAL revealed 14 randomized and clinical controlled trials. Strong evidence was found for the Alfredson exercise protocol. In this 12‐week protocol, exercises are performed 3 × 15 repetitions twice daily, both with a straight and bent knee. Exercises are performed at slow speed, and load is increased when exercises are without pain. Strong evidence was also found for gradual onset of e...


Painful, degenerating intervertebral discs up‐regulate neurite sprouting and CGRP through nociceptive factors
Abstract Intervertebral disc degeneration (IVD) can result in chronic low back pain, a common cause of morbidity and disability. Inflammation has been associated with IVD degeneration, however the relationship between inflammatory factors and chronic low back pain remains unclear. Furthermore, increased levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) are both associated with inflammation and chronic low back pain, but whether degenerating discs release sufficient concentrations of factors that induce nociceptor plasticity remains unclear. Degenerating IVDs from low back pain patients and healthy, painless IVDs from human organ donors were cultured ex vivo. Inflammatory and nociceptive factors released by IVDs into culture media were quantified by enzyme‐l...


[Changes in basic emotion recognition in patients with chronic low back pain : A cross-sectional study analyzing emotion recognition and alexithymia.]
CONCLUSION: The results suggest changes in the recognition of emotions and that patients with CLBP show signs of alexithymia. Further studies with larger sample sizes are required to confirm the detected trends. PMID: 24643754 [PubMed - as supplied by publisher] (Source: Schmerz)


[Evaluation of the German new back school : Muscular physiological characteristics.]
CONCLUSION: The adjustment effects at 12 months follow-up indicate a delayed positive influence of the new back school program on muscular physiological parameters. Individuals with chronic non-specific back pain showed a long-term profit from participation in the new back school program due to the initiated orientation to a modified more active lifestyle. PMID: 24643752 [PubMed - as supplied by publisher] (Source: Schmerz)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Short- and long-term effects of intensive training and motivational programme for continued physical activity in patients with inflammatory rheumatic diseases.
Conclusion: The rehabilitation programme that included intensive training was perceived to be better than the conventional programme and the patients benefited more from the motivation intervention. Long-term improvements in all participants may be indicators of the positive effects of conventional rheumatic rehabilitation in Germany. Intensive training with motivation also improves physical activity and may have positive socio-economic effects. Future research needs to identify the most effective factors of the intervention and the patient groups that benefit most. Clinical rehabilitation impact: Intensive training with motivation is appropriate for patients with inflammatory rheumatic diseases aged up to at least 60 years and without severe health impairments. It enhances patients' exerc...


Painful, degenerating intervertebral discs up-regulate neurite sprouting and CGRP through nociceptive factors.
Authors: Krock E, Rosenzweig DH, Chabot-Doré AJ, Jarzem P, Weber MH, Ouellet JA, Stone LS, Haglund L Abstract Intervertebral disc degeneration (IVD) can result in chronic low back pain, a common cause of morbidity and disability. Inflammation has been associated with IVD degeneration, however the relationship between inflammatory factors and chronic low back pain remains unclear. Furthermore, increased levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) are both associated with inflammation and chronic low back pain, but whether degenerating discs release sufficient concentrations of factors that induce nociceptor plasticity remains unclear. Degenerating IVDs from low back pain patients and healthy, painless IVDs from human organ donors were cultured e...


Back schools in Brazil: a review of the intervention methodology, assessment tools, and results
A Escola Postural se caracteriza como um programa educativo direcionado a indivíduos que apresentam dores crônicas na coluna vertebral. No Brasil observou-se, nas últimas décadas, um número crescente de pesquisas sobre os efeitos desses programas. Assim, o objetivo desta revisão foi identificar as pesquisas sobre as Escolas Posturais desenvolvidas no Brasil com a população de adultos e idosos, comparando-se metodologias de intervenção, instrumentos de coleta de dados e resultados. Realizou-se uma busca sistemática de artigos científicos e teses e dissertações em várias bases de dados. As palavras-chave utilizadas na busca foram Postural Program; Postural School; Back School; Back Care Education; Back Education, e os respectivos termos em português. Foram encontrados dezoito...


Increasing substance P levels in serum and synovial tissues from patients with developmental dysplasia of the hip (DDH)
Conclusions: These findings indicated that the increasing SP levels in serum and synovial tissues, observed from patients with DDH to patients with DDH&OA, might associate with the loss of function and chronic pain sensation in hip joint. SP along with its receptors NK-1R might be involved in the progression of DDH into DDH&OA. In the future, inhibitors of SP as well as NK-1R may represent a novel pharmacotherapy target for pain relieving, inflammation alleviating and joint degeneration delaying for patients with DDH. (Source: BioMed Central)


Psychometric properties of the pain stages of change questionnaire as evaluated by rasch analysis in patients with chronic musculoskeletal pain
Conclusion: The present analysis revealed that all four subscales in PSOCQ fitted the Rasch model. No common construct for all subscales were identified, but the Action and Maintenance subscales were closely related. (Source: BMC Musculoskeletal Disorders)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Validation of the German version of the Neck Disability Index (NDI)
Conclusions: The German version of the NDI has a comparable factor structure as the original version, acceptable psychometric properties, and is sensitive to change after physical activity. Neck disability is associated with other measures of neck pain. (Source: BMC Musculoskeletal Disorders)


Abnormal vaginal bleeding after epidural steroid injection: is there a cause for concern?
Commentary on: Suh-Burgmann E, Hung YY, Mura J. Abnormal vaginal bleeding after epidural steroid injection: a paired observation cohort study. Am J Obstet Gynecol 2013;209:206.e1&ndash;6. Context Epidural steroid injections (ESI) are the most commonly performed intervention for chronic axial pain. In the USA alone, the number of ESIs administered to Medicare recipients almost doubled between 2000 and 2004 (from 740&nbsp;845 to 1&nbsp;437&nbsp;962 procedures/year).1 A recent systematic review found high-quality evidence that ESI for sciatica results in small, short-term (&gt;2&nbsp;weeks but &le;3&nbsp;months) improvements in pain and disability; however, neither effects remained significant at &ge;12&nbsp;months of follow-up.1 ESI are associated with adverse effects that may be related to ...


Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome
This study aimed to answer three questions related to chronic myofascial pain syndrome (MPS): 1) Is the motor cortex excitability, as assessed by transcranial magnetic stimulation parameters (TMS), related to state-trait anxiety? 2) Does anxiety modulate corticospinal excitability changes after evoked pain by Quantitative Sensory Testing (QST)? 3) Does the state-trait anxiety predict the response to pain evoked by QST if simultaneously receiving a heterotopic stimulus [Conditional Pain Modulation (CPM)]? We included females with chronic MPS (n = 47) and healthy controls (n = 11), aged 19 to 65 years. Motor cortex excitability was assessed by TMS, and anxiety was assessed based on the State-Trait Anxiety Inventory. The disability related to pain (DRP) was assessed by the Profile of Chronic ...


Re: Hypogonadism in Men with Chronic Pain Linked to the Use of Long-Acting Rather than Short-Acting Opioids
(Source: The Journal of Urology)


Alzheimer's onset could be triggered by sleep disturbances
Chronic sleep problems can inflame a number of health problems, from widespread pain to speeding up cancer. Though sleep disturbances have been observed in people with Alzheimer's disease, whether this is a cause or effect has been unknown. Now, researchers say individuals with chronic sleep disruptions could face earlier onset of Alzheimer's.The researchers, from Temple University in Philadelphia, PA, have published the results of their pre-clinical study in the journal Neurobiology of Aging. (Source: Health News from Medical News Today)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Chronic Pain
Title: Chronic PainCategory: Diseases and ConditionsCreated: 5/14/2002 12:00:00 AMLast Editorial Review: 3/18/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Urinary Retention
Title: Urinary RetentionCategory: Diseases and ConditionsCreated: 2/12/2010 4:02:00 PMLast Editorial Review: 3/18/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Tennis Elbow (Lateral Epicondylitis)
Title: Tennis Elbow (Lateral Epicondylitis)Category: Diseases and ConditionsCreated: 1/31/2005 7:14:00 AMLast Editorial Review: 3/18/2014 7:50:41 PM (Source: MedicineNet Chronic Pain General)


Chronic dissecting aneurysm of the ascending aorta developed in a patient who had rejected surgical treatment for type II acute ascending aortic dissection three years earlier.
Authors: Erkut B, Dag O, Kaygïn MA, Lïmandal HK, Aydïn A, Calïk ES Abstract A 66-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of type II ascending aortic dissection in the history of the patient. He had refused emergency surgical intervention three years earlier. Computed tomography revealed that the ascending aorta was dilated to about 10 cm in diameter, and there was a chronic aortic type II dissection. The patient had second- to third-degree aortic insufficiency and he had a calcified bicuspid aortic valve on echocardiography. Two-vessel disease and a 90-...


Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial
Conclusion: PRP and autologous whole blood injections are both effective methods to treat chronic lateral epicondylitis and their efficacy persisted during long term follow up. PRP was not superior to AWB in long term follow up. (Source: Epidemiologic Perspectives and Innovations)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Inhibition of G protein-coupled P2Y2 receptor induced analgesia in a rat model of trigeminal neuropathic pain
Conclusions: Our data suggest that inhibition of P2Y2 receptors leads to down-regulation of ERK-mediated phosphorylation and increase of the expression of IA-related Kv channels in trigeminal ganglion neurons, which might contribute to the clinical treatment of trigeminal neuropathic pain. (Source: Epidemiologic Perspectives and Innovations)


Single-shot intraoperative local anaesthetic infiltration does not reduce morphine consumption after total hip arthroplasty: a double-blinded placebo-controlled randomized study
Conclusions Ropivacaine infiltration alone did not reduce morphine consumption at 24 h after operation nor did it improve postoperative rehabilitation. (Source: British Journal of Anaesthesia)


The Role of the Dorsal Root Ganglion in the Development of Neuropathic Pain
ConclusionsThe DRG is as involved in the process of generating NP as is the nociceptor and the dorsal horn of the spinal cord. (Source: Pain Medicine)


Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease
Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin condition that typically occurs after puberty. The primary clinical presentation is painful inflamed nodules or boils in the apocrine gland-bearing regions (armpits, genital area, groin, breasts and buttocks/anus) that progress to abscesses, sinus tracts and scarring. Severity is typically described according to three Hurley categories, with most patients having mild or moderate disease. Estimated prevalence is 1&ndash;4% worldwide and HS is three times more common in women than men. Patients&rsquo; disease burden includes intense pain, work disability and overall poor quality of life. Although the clinical signs of the disease can often be hidden by clothing, active HS is associated with a malodorous discharge that c...


Chronic pain after surgery: pathophysiology, risk factors and prevention
Interest in chronic pain after surgery has grown since the finding that more than a fifth of patients attending chronic pain clinics cite surgery as the cause for their chronic pain. The problem is not limited to major surgery; even common minor procedures such as hernia repair have a significant risk of chronic pain. Surgical technique can influence the development of chronic postsurgical pain (CPSP) and techniques to minimise nerve injury should be used where possible. Central nervous system changes contribute to the development of persistent pain following surgical trauma and nerve injury. Pharmacological agents that interrupt the mechanisms contributing to central sensitisation may be helpful in reducing the incidence of CPSP. Psychosocial factors are also important in the development ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Sarcoidosis with ocular involvement
Introduction Sarcoidosis presents with abnormal collections of chronic inflammatory cells in the lymph nodes, lungs, liver, eyes, skin or other tissues. Although first reported in 1875, it still remains a diagnostic and therapeutic challenge.1 While the condition can be asymptomatic, common symptoms include fatigue, lack of energy, weight loss, aches and pains, arthritis, dry eyes, skin lesions, swelling of the knees, blurry vision, shortness of breath and a dry, hacking cough. Ocular sarcoidosis may be noticed by accident or present before systemic disease is detected. Ocular damage caused by sarcoidosis can range from mild irritation to blindness. However, minor symptoms can be clinically important as early detection and treatment results in better prognosis.2 Therefore, we describe a ca...


New Treatment for Pain Uses Ultrasound at Home
Ultrasound energy is widely used by physical therapists and other clinicians to treat sports injuries and chronic pain. New devices let patients treat their pain with ultrasound almost anywhere and for longer periods. (Source: WSJ.com: Health)


Nanotechnology so good you can eat it
Electroednics that dissolve in the environment or are even edible are the answer to the ever-growing problem of e-waste&nbsp;If you could safely give your old mobile for lunch to your dog, you would not only save space in those drawers full of old electronic junk at home. E-waste is a much wider problem: almost half of the 500,000 tonnes of household hazardous waste produced in the UK in 2004 were electronic products and plastics. And the numbers have likely increased exponentially since then.In the last few years, the idea of electronics that can be literally eaten – or at least can safely dissolve in the body or in the environment – has unexpectedly evaded the science fiction realm, mostly thanks to advances in nanotechnology.In 2010, a group led by Siegfried Bauer – a physicist at...


Scientists hope to develop an oral pain reliever derived from debilitating snail venom
Scientists have reported that they have created at least five new experimental substances - based on a tiny protein found in cone snail venom - that could someday lead to the development of safe and effective oral medications for treatment of chronic nerve pain. They say the substances could potentially be stronger than morphine, with fewer side effects and lower risk of abuse. (Source: Health News from Medical News Today)


Timing Is Key to Massage's Benefits for Neck Pain: Study
Title: Timing Is Key to Massage's Benefits for Neck Pain: StudyCategory: Health NewsCreated: 3/14/2014 4:35:00 PMLast Editorial Review: 3/17/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Knee Ligament Tears Don't Permanently Sideline Most College Football Players
Title: Knee Ligament Tears Don't Permanently Sideline Most College Football PlayersCategory: Health NewsCreated: 3/15/2014 9:35:00 AMLast Editorial Review: 3/17/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Health Tip: Understanding Chronic Fatigue Syndrome
Title: Health Tip: Understanding Chronic Fatigue SyndromeCategory: Health NewsCreated: 3/17/2014 7:35:00 AMLast Editorial Review: 3/17/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Comparative effectiveness of advanced wound dressings for patients with chronic venous leg ulcers: A systematic review
Abstract The purpose of this study was to systematically review the literature on the benefits and harms of advanced wound dressings on wound healing, mortality, quality of life, pain, condition of the wound bed, and adverse events for patients with chronic venous leg ulcers as compared with treatment with compression alone. We searched for primary studies in the databases of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature® from January 1980 through July 2012. Each study title, abstract, and full article was evaluated by two independent reviewers. Thirty‐seven studies met our specific search criteria, although most evidence was of low or insufficient quality. Cellular dressings, collagen, and some anti...


Onset of Response with Duloxetine Treatment in Patients with Osteoarthritis Knee Pain and Chronic Low Back Pain: A Post Hoc Analysis of Placebo-Controlled Trials.
CONCLUSIONS: Patients taking duloxetine for OA or CLBP who have &lt;10% reduction in pain after 4 weeks of treatment have limited possibility for eventually achieving even moderate pain reduction by the end of 12 weeks. ClinicalTrials.gov identifier: NCT00433290, NCT00408421, NCT00424593, NCT00408876, NCT00767806. PMID: 24650448 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)


Re: Th1-Th17 Cells Contribute to the Development of Uropathogenic Escherichia coli-Induced Chronic Pelvic Pain
(Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Advance toward developing an oral pain reliever derived from debilitating snail venom
At least five new experimental substances — based on a tiny protein found in cone snail venom — could someday lead to the development of safe and effective oral medications for the treatment of chronic nerve pain, researchers have reported. They say the substances could potentially be stronger than morphine, with fewer side effects and lower risk of abuse. (Source: ScienceDaily Headlines)


Scientists use venom of cone snails to create painkillers that could be more powerful than morphine
The painkillers, based on a tiny protein found in cone snails' venom, could one day lead to the development of a drug to treat severe and chronic nerve pain. (Source: the Mail online | Health)


Numerical simulations of clinical focused ultrasound functional neurosurgery.
This study found that the computational model and the simulation parameters predicted an average of 24 ± 13% lower focal temperature elevations than observed in the treatments. The size of the simulated thermal focus was found to be 40 ± 13% smaller in the anterior-posterior direction and 22 ± 14% smaller in the inferior-superior direction than in the treatments. The location of the simulated thermal focus was off from the prescribed target by 0.3 ± 0.1 mm, while the peak focal temperature elevation observed in the measurements was off by 1.6 ± 0.6 mm. Although the results of the simulations suggest that there could be some inaccuracies in either the tissue parameters used, or in the simulation methods, the simulations were able to predict the focal spot locations and temperature ...


Advance toward developing an oral pain reliever derived from debilitating snail venom
(American Chemical Society) Scientists reported today on at least five new experimental substances -- based on a tiny protein found in cone snail venom -- that could someday lead to the development of safe and effective oral medications for the treatment of chronic nerve pain. They say the substances could potentially be stronger than morphine, with fewer side effects and lower risk of abuse. They presented the research at the 247th National Meeting & Exposition of the American Chemical Society. (Source: EurekAlert! - Medicine and Health)


[The primary pulmonary MALT lymphoma: A rare lung tumor.]
We report a confirmed case of MALT lung lymphoma that is managed in our hospital. Mr. S.B., 68-year-old man, not smoking, without particular professional exhibition, is admitted for a chronic cough with blood-streaked sputum, dyspnea, chest pain and loss of weight. His symptomatology is evolving for 4months. In the examination, the general health was passable and he presented a pulmonary condensation syndrome at right. The physical examination of others systems was normal. There was a biological inflammatory syndrome. The bacteriological examinations of the bronchial expectorations were negative. The chest CT showed bilateral alveolar opacities at the upper, with attraction of the fissures, without nodes. The bronchoscopy showed anomalies of the bronchial mucous membrane in 2 superior lobe...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Isosorbide dinitrate ointment versus botulinum toxin A (Dysport®) as primary treatment for chronic anal fissure: a randomized multicentre study
ConclusionDysport® is more effective with fewer side effects than ISDN ointment in the primary treatment of chronic anal fissure. The recurrence rates within one year in both treatment groups is high.This article is protected by copyright. All rights reserved. (Source: Colorectal Disease)


Simple Tricks for Avoiding Everyday Pain
Some pain may be caused by chronic underlying medical conditions and requires a doctor’s care. But some pain can be avoided with simple steps, like changing the way you walk or sit. Learn more here from the experts. (Source: WebMD Health)


Medium-/long-term effects of a specific exercise protocol combined with patient education on spine mobility, chronic fatigue, pain, aerobic fitness and level of disability in fibromyalgia.
Conclusion. The proposed programme was well tolerated and produced immediate and medium-term beneficial effects improving function and strain endurance. This trial is registered with DRKS00005071 on DRKS. PMID: 24616894 [PubMed - in process] (Source: Biomed Res)


Pooled analysis of the safety and tolerability of onabotulinumtoxinA in the treatment of chronic migraine
ConclusionsMultiple treatments with onabotulinumtoxinA at doses of 75–260 U administered every 12 weeks, and up to five treatment cycles, were well tolerated for the prophylaxis of headache in adults with CM. (Source: European Journal of Neurology)


A Novel Role of Spinal Astrocytic Connexin 43: Mediating Morphine Antinociceptive Tolerance by Activation of NMDA Receptors and Inhibition of Glutamate Transporter-1 in Rats.
CONCLUSIONS: The spinal astrocytic Cx43 contributes to the development of morphine antinociceptive tolerance by activating astrocytes and NMDA receptors, and inhibiting GLT-1 expression. We also demonstrate that the role of interaction between the spinal astrocytic Cx43 and neuronal NMDA receptors is important in morphine tolerant rats. PMID: 24629168 [PubMed - as supplied by publisher] (Source: CNS Neuroscience and Therapeutics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Chronic neck pain alters muscle activation patterns to sudden movements.
Authors: Boudreau SA, Falla D Abstract The aim of this study was to assess the activation of the sternocleidomastoid (SCM) and splenius capitis (SC) muscles in response to unanticipated, full body perturbations in individuals with chronic neck pain (NP) and age-matched healthy controls (HC). Individuals with NP had a history of NP for 8.9 ± 7.8 years, rated the intensity of NP as 4.2 ± 2.0 (score out of 10), and scored 15.3 ± 6.5 on the Neck Disability Index. Participants stood on a moveable platform during which 32 randomized postural perturbations (eight repetitions of four perturbation types: 8 cm forward slide (FS), 8 cm backward slides, 10° forward tilt, and 10° backward tilt) with varying inter-perturbation time intervals were performed over a period of 5 min. ...


Timing Is Key to Massage's Benefits for Neck Pain
Two or three one-hour sessions a week reduced pain, improved functioning Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Complementary and Alternative Medicine, Neck Injuries and Disorders (Source: MedlinePlus Health News)


Insight into the cause of chronic pain
New insights into how the human brain responds to chronic pain could eventually lead to improved treatments for patients, according to University of Adelaide researchers.Neuroplasticity is the term used to describe the brain's ability to change structurally and functionally with experience and use."Neuroplasticity underlies our learning and memory, making it vital during early childhood development and important for continuous learning throughout life," says Dr Ann-Maree Vallence, a Postdoctoral Fellow in the University of Adelaide's Robinson Institute. (Source: Health News from Medical News Today)


Sex hormones in the modulation of irritable bowel syndrome.
Authors: Mulak A, Taché Y, Larauche M Abstract Compelling evidence indicates sex and gender differences in epidemiology, symptomatology, pathophysiology, and treatment outcome in irritable bowel syndrome (IBS). Based on the female predominance as well as the correlation between IBS symptoms and hormonal status, several models have been proposed to examine the role of sex hormones in gastrointestinal (GI) function including differences in GI symptoms expression in distinct phases of the menstrual cycle, in pre- and post-menopausal women, during pregnancy, hormonal treatment or after oophorectomy. Sex hormones may influence peripheral and central regulatory mechanisms of the brain-gut axis involved in the pathophysiology of IBS contributing to the alterations in visceral sensitivity...


Therapeutic ultrasound for chronic low-back pain.
CONCLUSIONS: No high quality evidence was found to support the use of ultrasound for improving pain or quality of life in patients with non-specific chronic LBP. There is some evidence that therapeutic ultrasound has a small effect on improving low-back function in the short term, but this benefit is unlikely to be clinically important. Evidence from comparisons between other treatments and therapeutic ultrasound for chronic LBP were indeterminate and generally of low quality. Since there are few high quality randomised trials and the available trials are very small, future large trials with valid methodology are likely to have an important impact on our confidence in the estimate of effect and may change the estimate. PMID: 24627326 [PubMed - as supplied by publisher] (Source: Cochran...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomized study.
CONCLUSION: Closed lateral internal sphincterotomy is the treatment of choice for chronic fissures as it is effective, safe, less expensive, and associated with a lower rate of complications than the open sphincterotomy technique. PMID: 24637183 [PubMed - as supplied by publisher] (Source: Asian Journal of Surgery)


Investigating the size and dynamics of voltage-gated sodium channel fenestrations: A molecular dynamics study.
Authors: Kaczmarski JA, Corry B Abstract Eukaryotic voltage-gated sodium channels (VGSCs) are essential for the initiation and propagation of action potentials in electrically excitable cells, and are important pharmaceutical targets for the treatment of neurological disorders such as epilepsy, cardiac arrhythmias, and chronic pain. Evidence suggests that small, hydrophobic, VGSC-blocking drugs can gain access to binding residues within the central cavity of these channels by passing through lateral, lipid-filled 'fenestrations' which run between the exterior of the protein and its central pore. Here, we use molecular dynamics simulations to investigate how the size and shape of fenestrations change over time in several bacterial VGSC models and a homology model of Nav1.4. We show ...


Alpha9 Alpha10 Nicotinic Acetylcholine Receptors as Target for the Treatment of Chronic Pain.
Authors: Bufalo AD, Cesario A, Salinaro G, Fini M, Russo P Abstract Chronic pain is a widespread healthcare problem affecting not only the patient but in many ways all the society. Chronic pain is a disease itself that endures for long period of time and it is resistant to the majority of medical treatments that provide modest improvements in pain and minimum improvements in physical and emotional functioning. More co-existing chronic pain conditions may be present in the same individual (patient). The α9α10 nicotinic acetylcholine receptor (nAChR) may be a potential target in the pathophysiology of chronic pain, as well in the development of breast and lung cancers. -conotoxins (-CNT) are small peptides used offensively by carnivorous marine snails known as Conus that targ...


Dolphin Neurostim Receives CE Approval for European Distribution
FDA Approved Device Provides Pain Relief where Other Modalities Fail Jacksonville, FL -- (Healthcare Sales & Marketing Network) -- With more than 1 in 7 people living suffering from chronic pain, the Dolphin Neurostim, a huge success in North America, ... Devices, Neurology, RegulatoryAcumed Medical Ltd, Dolphin Neurostim (Source: HSMN NewsFeed)


Qualitative Investigation of a Brief Chronic Pain Screening Tool in HIV-Infected Patients
AIDS Patient Care and STDs , Vol. 0, No. 0. (Source: AIDS Patient Care and STDs)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Chronic pain and depression
(Source: Continuing Education in Anaesthesia, Critical Care)


Reversible Cerebral Vasoconstriction Syndrome After Blood Transfusion
ConclusionsRCVS with PRES is one complication of blood transfusion in patients under chronic severe anemia (especially when hemoglobin level increased for more than 5 g/dL), particularly in Asian women with menorrhagia. Blood pressure surge and the occurrence of severe headaches or other neurological symptoms should be aggressively monitored within 10 days after the last blood transfusion. (Source: Headache: The Journal of Head and Face Pain)


Early Neuroplastic Changes in Pancreatic Ductal Adenocarcinoma
Perineural tumor invasion of intrapancreatic nerves, neurogenic inflammation, and tumor metastases along extrapancreatic nerves are key features of pancreatic malignancies. Animal studies show that chronic pancreatic inflammation produces hypertrophy and hypersensitivity of pancreatic afferents and that sensory fibers may themselves drive inflammation via neurogenic mechanisms. Although genetic mutations are required for cancer development, inflammation has been shown to be a precipitating event that can accelerate the transition of precancerous lesions to cancer. These observations led us to hypothesize that inflammation that accompanies early phases of pancreatic ductal adenocarcinoma (PDAC) would produce pathologic changes in pancreatic neurons and innervation. Using a lineage-labeled g...


Use of biological treatments in patients with hidradenitis suppurativa
ConclusionsBiological drugs could be a potential and effective therapeutic option for patients with severe HS. Complete and persistent clinical responses are rarely obtained (15%) and partial responses are achieved in approximately 50% of patients. No specific markers for a therapeutic response have been identified. No definitive conclusions regarding the most effective biological drug for HS could be drawn. Higher dosage schedules seem to be associated with higher response rates. The lack of response of one particular drug does not preclude a potential efficacy to another biological treatment. (Source: Journal of the European Academy of Dermatology and Venereology)


Supraspinal metabotropic glutamate receptor subtype 8: a switch to turn off pain.
Authors: Palazzo E, de Novellis V, Rossi F, Maione S Abstract Glutamate is the main excitatory neurotransmitter in the central nervous system and as such controls the majority of synapses. Glutamatergic neurotransmission is mediated via ionotropic and metabotropic glutamate receptors (iGluRs and mGluRs). Signaling via mGluRs permits to finely tune, rather than turning on/off, the excitatory neurotransmission as the iGluRs do. Eight mGluRs (mGluR1-8) have been cloned so far, which have been divided into three groups based on sequence homology, pharmacological properties and second messenger signaling. mGluRs are widely expressed both on glia and neurons. On neurons they are located both at postsynaptic (group I) and presynaptic sites (group II and III). Group II and III mGluR stimul...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Older people and barriers to self-reporting of chronic pain.
Authors: Gammons V, Caswell G Abstract Too many older adults live with the negative consequences of chronic pain and its detrimental impact on quality of life. To explore this, an extended literature review was conducted to identify barriers the older person encountered in the self-reporting of their chronic pain. Four themes were found to mediate help-seeking behaviour. Attitudes such as stoicism, beliefs such as pain being a necessary part of ageing, and the external barriers generated by health professionals, all have a multidimensional relationship with the 'decision' to seek help for pain. Personality and the perceived importance of independence were found to influence these responses. The findings imply that communication between the health professional and patient needs to i...


Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease.
CONCLUSIONS: Guided imagery is an effective technique for managing and limiting sickle cell disease-related pain in a pediatric population. PMID: 24632887 [PubMed - as supplied by publisher] (Source: The American Journal of Nursing)


Mainstay Medical launches human trial of pain-relief stimulation implant
Irish medtech maker Mainstay Medical initiates an Australian clinical trial of its ReActiv8 neurostimulation implant in treatment of chronic low back pain. Dublin-based Mainstay Medical touted the launch of a new clinical trial evaluating its ReActiv8 implantable neurostimulator at 3 clinical sites in Australia. Mainstay MedicalNews Well, Clinical Trials, Neuromodulation/Neurostimulation, Pain Managementread more (Source: Mass Device)


Chronic pain research delves into brain: New insight into how brain responds to pain
New insights into how the human brain responds to chronic pain could eventually lead to improved treatments for patients, researchers say. Chronic pain is common throughout the world. More than 100 million Americans are believed to be affected by chronic pain. "People living with chronic headache and other forms of chronic pain may experience reduced quality of life, as the pain often prevents them from working, amongst other things. It is therefore imperative that we understand the causes of chronic pain, not just attempt to treat the symptoms with medication," the lead author said. (Source: ScienceDaily Headlines)


Adequate doses of massage treatment necessary for relief of neck pain
Neck pain is a common and debilitating condition, and massage therapy is commonly used to treat it, yet there is little quality research on the optimal dose of therapeutic massage for neck pain. Randomizing 228 patients with chronic neck pain to five different groups receiving various doses of massage for a five-week period, researchers found the benefits of massage treatments for chronic neck pain increase with dose. (Source: Health News from Medical News Today)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Chronic pain research explores the brain
(University of Adelaide) New insights into how the human brain responds to chronic pain could eventually lead to improved treatments for patients, according to University of Adelaide researchers. (Source: EurekAlert! - Medicine and Health)


Glucosamine Study: No Help for Knee Pain (CME/CE)
(MedPage Today) -- The popular dietary supplement glucosamine showed no evidence of structural benefits among patients with chronic knee pain typical of osteoarthritis, a randomized trial found. (Source: MedPage Today Radiology)


Pain Management Strategies for Thoracotomy and Thoracic Pain Syndromes
Pain after thoracic surgery can be severe and, in the acute phase, contribute to perioperative morbidity and mortality. Unfortunately, patients also incur a significant risk of chronic pain. Although there are guidelines for postoperative pain management in these patients, there is no widespread surgical or anesthetic "best practice." Here, we review the recent literature on techniques specific to perioperative pain control for thoracic patients, including medical management, neuraxial blockade, and other regional techniques, and suggest an algorithm for developing a multimodal pain management strategy. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)


Long‐ or short‐acting opioids for chronic non‐malignant pain? A qualitative systematic review
In selected patients with chronic non‐malignant pain, chronic opioid therapy is indicated. Published guidelines recommend long‐acting over short‐acting opioids in these patients. The aim of this systematic review was to investigate whether long‐acting opioids in chronic non‐malignant pain are superior to short‐acting opioids in pain relief, physical function, sleep quality, quality of life or adverse events. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for relevant trials up to July 2012. Reference lists of included trials and relevant reviews were in addition searched by hand. Of the 1168 identified publications, 6 random...


Modifications in gait as predictors of natural osteoarthritis progression in Str/ort mice
Conclusions: This study suggests that paw area and treadmill non‐compliance may be useful tools to monitor longitudinal non‐painful OA development in Str/ort mice. This will help in providing a non‐invasive means of assessing new therapies to slow spontaneous OA progression in mice and identifies an animal model for isolating OA severity and pain. © 2014 American College of Rheumatology. (Source: Arthritis and Rheumatism)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


A strange livedo
Abstract A 56‐year‐old woman consulted for a rash on the left thigh that she had had for the last 3 years. Her main antecedents were obesity (with bariatric surgery) and a prosthetic left knee placed 3 years before. (because of osteoarthritis). She first noticed red lesions in the affected areas that became progressively darker over the following months (A). Physical examination demonstrated a reticulated pattern of hyperpigmented lesions on the left thigh (B). Laboratory tests revealed no abnormality (the absence of cryoglobulinemia, antinuclear antibodies, ANCA, antiphospholipid and viral and bacterial serologies proved negative). A skin biopsy was performed finding an atrophic and hyperkeratotic epidermis and dilated capillaries with atypical endothelial cells (C). We concluded an e...


Efficacy of the Star Excursion Balance Test in Detecting Reach Deficits in Subjects with Chronic Low Back Pain
ConclusionStar Excursion Balance Test is an effective and simple tool to identify and measure reach deficits in patients with CLBP. We recommend using SEBT as an outcome measure to identify dynamic balance, multi‐planar excursion and postural control in patients with CLBP. Copyright © 2014 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)


Novel medical bathing with traditional Chinese herb formula alleviates paraplegia spasticity
Paraplegia spasm is a kind of chronic disease which lacks effective treatment; the patients have to endure long‐term pain, which is a tough problem for nursing practice. Lots of potential candidate medicines are under investigation, and a new Chinese herb formula is introduced in the current study. In the present study, we chose six different well‐known Chinese herbs to form a formula, and boiled them into the water with an optimized ratio to make bath water; 80 paraplegic patients received this medicinal bath, and 80 patients received perfume water bath as placebo group. Compared with placebo control patients, the herb‐treated patients have significant reduction in paraplegia spasm, visual analogue scale score, clinician global impression and sleep disorder. This novel six‐combine...


Glucosamine Fails to Improve Arthritic Knees (CME/CE)
(MedPage Today) -- The popular dietary supplement glucosamine showed no evidence of structural benefits among patients with chronic knee pain typical of osteoarthritis, a randomized trial found. (Source: MedPage Today Geriatrics)


Early and late oral features of chronic graft-versus-host disease
Conclusion: Oral chronic graft-versus-host disease lesions were identified early in the course of the disease. The changes observed in salivary gland function and in the range of mouth opening were not correlated with the time after transplantation. (Source: Revista Brasileira de Hematologia e Hemoterapia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


i-Fect, BDNF and Irritable Bowel Syndrome (IBS)
Conclusion: Chronic prenatal stress followed by a second exposure to HeICS in adult offspring exacerbated visceral hypersensitivity (VHS) greater in female offspring that persisted longer than in male offspring. Chronic prenatal stress up-regulated BDNF expression in the lumbar-sacral dorsal horn that correlated with the exacerbation of VHS in female, but not in male offspring by increasing RNA Pol II binding and histone H3 acetylation, and decreasing histone deacetylase 1 association with the core promoter of BDNF in female offspring. (Source: siRNA and DsiRNA Transfection Efficiency)


Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of S&#227;o Paulo State, Brazil
CONCLUSIONS: The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p&lt;0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p&lt;0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life. (Source: Anais Brasileiros de Dermatologia)


Glucosamine fails to prevent deterioration of knee cartilage, decrease pain
A short-term study found that oral glucosamine supplementation is not associated with a lessening of knee cartilage deterioration among individuals with chronic knee pain. Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR) journal, indicate that glucosamine does not decrease pain or improve knee bone marrow lesions - more commonly known as bone bruises and thought to be a source of pain in those with osteoarthritis (OA). (Source: Health News from Medical News Today)


Knee Pain May Not Be Helped by Glucosamine
Title: Knee Pain May Not Be Helped by GlucosamineCategory: Health NewsCreated: 3/11/2014 9:35:00 AMLast Editorial Review: 3/11/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Glucosamine fails to prevent deterioration of knee cartilage, decrease pain
(Wiley) A short-term study found that oral glucosamine supplementation is not associated with a lessening of knee cartilage deterioration among individuals with chronic knee pain. Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology journal, indicate that glucosamine does not decrease pain or improve knee bone marrow lesions -- more commonly known as bone bruises and thought to be a source of pain in those with osteoarthritis. (Source: EurekAlert! - Biology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Judge: Evidence Does Not Support Termination Of Benefits
SACRAMENTO, Calif. - An ERISA-governed disability insurer that terminated benefits to a claimant with chronic back pain abused its discretion, a California federal judge ruled Feb. 14 (Karen Bertelsen v. Hartford Life Insurance Co., No. 2:12-cv-01440, E.D. Calif.; 2014 U.S. Dist. LEXIS 19225). (Source: LexisNexis&#174; Mealey's&#8482; Disability Insurance Legal News)


Supraspinal characterization of the thermal grill illusion with fMRI
Conclusions: In short, the transient TG sensation is caused by a dissociated state derived from non-noxious warm and cold spatial summation interaction. The observed central dissociated state may share some parallels in certain chronic neuropathic pain states. (Source: BioMed Central)


Long‐term prognosis of clinical symptoms and health‐related quality of life in microscopic colitis: a case–control study
ConclusionsAlthough considered to be in clinical remission, patients with microscopic colitis suffer from persisting symptoms such as abdominal pain, fatigue, arthralgia or myalgia several years after diagnosis. (Source: Alimentary Pharmacology and Therapeutics)


Developing an algorithm capable of discriminating depressed mood in people with spinal cord injury
Authors: A Craig, D Rodrigues, Y Tran, R Guest, R Bartrop & J Middleton (Source: Spinal Cord)


Injury profile of brazilian athletes in olympic games 2012
Conclusion The high number of overuse, tendinopathies and long term injuries indicate that many athletes arrived injured at Olympic games. Therefore a preventive strategy for chronic conditions should be a priority in Pre-Olympic training. (Source: British Journal of Sports Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Shoulder injuries in highly trained competitive swimmers
Conclusions Injury incidence was not influenced by sex or level of competition, but was 50% lower for breaststroke swimmers. Despite the symmetrical nature of swimming the right shoulder seems to be at greater risk of injury. (Source: British Journal of Sports Medicine)


Decreased tumour necrosis factor alpha (tnf-a) in serum of patients with achilles tendinopathy: further evidence against the role of inflammation in the chronic stage
Conclusions The observations indicate a lowering of the TNF-&alpha; concentration in the chronic phase of Achilles tendinopathy. As TNF-&alpha; levels are elevated in chronic inflammatory conditions, this reinforces that chronic Achilles tendinopathy is not an inflammatory disorder. Collecting a blood sample to study disease biomarkers leaves the tendon intact and therefore this design can be used to study cytokine dynamics with multiple sampling during disease progression and recovery. (Source: British Journal of Sports Medicine)


Low back pain in cycling: does it matter how you sit?
Conclusions The findings of this first field study suggest that a well selected subgroup of cyclists with NSCLBP (FP) adopted and sustained increased lower lumbar flexion during cycling. This appears to reflect an inherent maladaptive motor control pattern at the lower lumbar spine during cycling. This posture is maintained and associated with a significant increase of LBP. These findings suggest that in this subgroup LBP during cycling is related to maladaptive lower lumbar kinematics. Investigating rehabilitation/prevention strategies that address the control over the lower lumbar region during cycling seems the logic next step. (Source: British Journal of Sports Medicine)


Eccentric training for elbow hypermobility
Conclusions The goal of this eccentric training is to avoid hypermobility by using the muscles as a protective brake in the control of joint positioning. Muscles can be reinforced in eccentric mode with starting position at the maximum length of these muscles when unstreched. The exercises can be carried out safely on an isokinetic device, at slow speed and limited range of joint motion to avoid risk of luxation. Thus, in this case report, the eccentric exercises using an isokinetic device were effective to safely reinforce the muscles as a protective brake for joint hypermobility and prevent pain during practicing tennis. (Source: British Journal of Sports Medicine)


Does ovarian suspension following laparoscopic surgery for endometriosis reduce postoperative adhesions? An RCT
STUDY QUESTION Is temporary ovarian suspension following laparoscopic surgery for severe pelvic endometriosis an effective method for reducing the prevalence of postoperative ovarian adhesions? SUMMARY ANSWER Temporary ovarian suspension for 36&ndash;48 h following laparoscopic treatment of severe endometriosis does not result in a significant reduction of postoperative ovarian adhesions. WHAT IS KNOWN ALREADY Pelvic adhesions often develop following laparoscopic surgery for severe pelvic endometriosis. Adhesions can cause chronic pelvic pain and fertility problems compromising the success of treatment. Small observational studies suggested that temporary postoperative ovarian suspension to the abdominal wall may significantly reduce the prevalence of postoperative ovarian adhesions. ST...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Predicting fibromyalgia, a narrative review: Are we better than fools and children?
Authors: Ablin JN, Buskila D Abstract Fibromyalgia syndrome (FMS) is a common and intriguing condition, manifest by chronic pain and fatigue. Although the pathogenesis of FMS is not yet completely understood, predicting the future development of FMS and chronic pain is a major challenge with great potential advantages, both from an individual as well as an epidemiological standpoint. Current knowledge indicates a genetic underpinning for FMS, and as increasing data are accumulated regarding the genetics involved, the prospect of utilizing these data for prediction becomes ever more attractive. The co-existence of FMS with multiple other functional disorders indicates that the clinical identification of such symptom constellations in a patient can alert the physician to the future d...


Use of Platelet-Rich Plasma in the Healing of Chronic Ulcers of the Lower Extremity.
CONCLUSION: The local application of PRP is a valuable and practical procedure that promotes the healing of chronic ulcers of the lower extremity; it can improve patient quality of life and is particularly effective in local pain relief. PMID: 24630241 [PubMed - as supplied by publisher] (Source: Actas Dermo-Sifiliograficas)


Interdisciplinary Care Best for Chronic Pain However Insurance Coverage Falls Short
In a position paper released today, AAPM asked all tiers of the health-care delivery system to recognize comprehensive, interdisciplinary modalities of treatment, including cognitive behavioral therapy (CBT), physical therapy, stress management, rehabilitation, complementary therapies, and medications that are known to be effective and safer than usual care. (Source: Disabled World)


Mainstay Medical Begins Clinical Trial of ReActiv8(R) for People with Chronic Low Back Pain
Dublin based medical device company hits key milestone. DUBLIN--(Healthcare Sales & Marketing Network)--Mainstay Medical today announced that it has secured approval from Ethics Committees in Australia to start a clinical trial of ReActiv8, its innovati... Devices, Neurosurgery, OrthopaedicMainstay Medical, ReActiv8, neurostimulation, Chronic Low Back Pain (Source: HSMN NewsFeed)


How scientists in Bristol aim to develop a life-changing pain killer
A Bristol professor will give a unique insight into the field of chronic pain at a free public lecture on 1 April. (Source: University of Bristol news)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Link found between osteoarthritis and fibromyalgia pain
Researchers at the University of Manchester have uncovered brain abnormalities that could be behind the chronic pain suffered by osteoarthritis patients. (Source: Nursing Times Breaking News)


Muscle pain increases heart disease risk
A link between chronic muscle pain and heart disease has been uncovered by researchers at Teesside University. (Source: Nursing Times Breaking News)


Hormones Might Offer Relief From Chronic Pain, Small Study Suggests
Title: Hormones Might Offer Relief From Chronic Pain, Small Study SuggestsCategory: Health NewsCreated: 3/8/2014 9:35:00 AMLast Editorial Review: 3/10/2014 12:00:00 AM (Source: MedicineNet Chronic Pain General)


What Are Complications of Fractures?
Discussion Fifth metatarsal fractures are a common fracture of the foot and are the most common metatarsal fracture in children &gt; 5 years of age and adults. There is a peak age distribution in the second and fifth decades of life. Teenage boys in organized sports are one of the most common groups affected. In acute fractures, acute pain and inability to walk are common presentations, whereas in a stress fracture an increase in activity, or chronic repetitive forces are at play. Fifth metatarsal fractures have various classifications. Fracture locations from proximal to distal include avulsion fractures (a common acute fracture because of torque forces in the proximal diaphysis), Jones fracture, metaphyseal fractures (common location for stress fractures) and neck and head fractures. The...


Multivariate Classification of Structural MRI Data Detects Chronic Low Back Pain
Chronic low back pain (cLBP) has a tremendous personal and socioeconomic impact, yet the underlying pathology remains a mystery in the majority of cases. An objective measure of this condition, that augments self-report of pain, could have profound implications for diagnostic characterization and therapeutic development. Contemporary research indicates that cLBP is associated with abnormal brain structure and function. Multivariate analyses have shown potential to detect a number of neurological diseases based on structural neuroimaging. Therefore, we aimed to empirically evaluate such an approach in the detection of cLBP, with a goal to also explore the relevant neuroanatomy. We extracted brain gray matter (GM) density from magnetic resonance imaging scans of 47 patients with cLBP and 47 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes
ConclusionsBetter understanding of the medical profile of pediatric patients with non‐CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended. (Source: Pediatric Anesthesia)


Mathematical Model of Nerve Fiber Activation During Low Back Peripheral Nerve Field Stimulation: Analysis of Electrode Implant Depth
ConclusionsThe present mathematical model predicts an optimal implantation depth of 10 to 15 mm below the skin surface to achieve activation of the greatest area of Aβ fibers and the smallest area of Aδ fibers. This finding may act as a guide for peripheral nerve field stimulation implant depth to treat low back pain. (Source: Neuromodulation)


Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes.
CONCLUSIONS: Better understanding of the medical profile of pediatric patients with non-CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended. PMID: 24612208 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)


A case study on acupuncture in the treatment of schizophrenia.
This report describes the use of acupuncture as an add on treatment for a patient with chronic schizophrenia. The 63-year-old woman suffered from persistent hallucinations and even physical pain as a result of the hallucination of a black bird that kept pecking her back. The patient received 12 weekly acupuncture treatments. A clinical diagnostic interview and psychological testing (on sleep quality, depression, and on positive and negative symptoms) were conducted before, immediately after and 3 months after the acupuncture treatment. The results of the diagnostic interview gave important insights into the treatment effects. The patient experienced improved daily functioning and noticed a change in hallucinations. Although the hallucinations still occurred, she felt less disturbed by them...


[Mesenteric cysts in children.]
CONCLUSIONS: MC in children are mostly Lymphatic Malformations of mesentery or omentum origin, and clinical presentation varies from chronic abdominal pain to sudden-onset peritonitis or volvulus. About 50-60% require intestinal resection and anastomosis. PMID: 24635977 [PubMed - as supplied by publisher] (Source: Anales de Pediatria)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Electrophysiological evaluation of pathophysiological and pharmacological characteristics of chronic pain.
Authors: Tanabe M Abstract   Recent studies have revealed considerable evidence for our understanding of the mechanisms underlying the development and maintenance of chronic pain including neuropathic and inflammatory pain. It is considered that plastic changes in the spinal dorsal horn contribute to the amplification of pain signaling. Moreover, persistent pain affects brain function and also the endogenous descending pain regulatory system. To characterize these pathophysiological changes and pharmacological properties in chronic pain conditions at the synaptic level, we have employed in vitro electrophysiology in slices of the spinal cord and supraspinal regions such as brainstem and hippocampus of adult mice and in vivo electrophysiology in anesthetized rats. In particular, w...


Contribution of the sensitization of supraspinal nociceptive transmission in chronic pain.
Authors: Ohsawa M, Yamamoto S, Ono H Abstract   Central sensitization in the spinal cord is well known to be involved in chronic pain. Recent investigations indicated that the protein expressions involving the synaptic plasticity are changed in several brain areas under a chronic pain condition. These changes in supraspinal neural function might cause the emotional and memory dysfunction. It is also possible that these changes are involved in the chronic pain. Indeed, since the improvement of spinal and peripheral sensitization showed limited relief in the neuropathic pain, the sensitization of supraspinal nociceptive transmission might be involved in the expression of chronic pain. We recently found that intra-thalamic treatment with excitatory neurotransmitter glutamate caused ...


Study on Novel Mechanism Underlying Analgesia Targeting TRPV1.
Authors: Maeda T, Ozaki M Abstract   Transient receptor potential protein (TRP) channels are distributed in pain pathways including primary afferent neurons and function as transduction of various noxious stimuli to innocuous stimuli. TRP channels are considered as molecular basis of chronic pain. Targeting TRPs may lead to novel class of analgesics, and so drug-discovery efforts are focused on TRP agonists and its antagonists. Few products have, however, been placed on the market, because most of candidates have adverse effects. A lesion or disease of the somatosensory nervous system causes neuropathic pain, a type of chronic pain. Neuropathic pain is intolerable and obstinate and therefore, debilitates the affected patients. A great deal of effort has been made to develop medic...


Elucidation of the pathogenesis of chronic and intractable pain and its drug discovery.
Authors: Tokuyama S, Maeda T PMID: 24584017 [PubMed - in process] (Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan)


Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study.
CONCLUSIONS: We hypothesize that TTH and NSM patients on the average need more sleep than healthy controls. SM patients seem more susceptible to sleep disturbances. Inadequate rest might be an attack-precipitating- and hyperalgesia-inducing factor. PMID: 24588507 [PubMed - in process] (Source: Acta Neurologica Scandinavica. Supplementum)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best <a href="http://www.thejanuarysales.com/">Christmas Sales</a>, <a href="http://www.thejanuarysales.com/">Boxing Day Sales</a> and <a href="http://www.thejanuarysales.com/">January Sales</a> <a href="http://www.thejanuarysales.com/">here</a>.</p></div>


Hormones Might Offer Relief From Chronic Pain, Small Study Suggests
Early research found 7 of 9 patients benefited from treatment with the 'love' hormone (Source: WebMD Health)


Hormones Might Offer Relief from Chronic Pain, Small Study Suggests
Early research found 7 of 9 patients benefited from treatment with the 'love' hormone Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Hormones (Source: MedlinePlus Health News)


The active identification and management of chronic refractory breathlessness is a human right
Chronic refractory breathlessness is defined as breathlessness at rest or on minimal exertion that will persist chronically despite optimal treatment of the underlying cause(s). At any time, 1% of the population report a modified Medical Research Council dyspnoea score of &ge;3 chronically. Despite the prevalence, severity and chronicity of this symptom and an evidence base of affordable and safe interventions, chronic refractory breathlessness remains grossly undertreated. Many patients and clinicians accept the presence of the chronic refractory breathlessness as an inevitable part of an illness, with no thought of treating the symptom despite an evidence base for its safe treatment. Consensus statements from major respiratory clinician organisations now endorse such a clinical course. F...


Talking-therapy treatments to manage osteoarthritis pain
Abnormalities in the way the brain experiences pain may be to blame for the chronic pain suffered by osteoarthritis patients, scientists have shown for the first time. As a results, the researchers suggest that new therapies should target brain mechanisms to enable the brain to cope more effectively with chronic pain, including mindfulness-based talking therapies. (Source: ScienceDaily Headlines)