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Perioperative Dexamethasone and the Development of Chronic Postmastectomy Pain: A Single-Center Observational Cohort Study
Conclusions: Perioperative dexamethasone is not associated with a reduction in the incidence and/or severity of chronic postmastectomy pain. In addition, we did not detect a dose-response effect of dexamethasone on the incidence of chronic postsurgical pain. (Source: Regional Anesthesia and Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Structural Autonomic Evaluation in Chronic Pelvic Pain Syndromes
Background: Functional abnormalities of the autonomic nervous system (ANS) often occur in chronic pain, including chronic pelvic pain (CPP). Hypothesis: abnormal ANS innervation of the bladder underlies bladder pain syndrome (BPS). We therefore compared ANS testing in pa-tients with 2 types of CPP: BPS and myofascial pelvic pain (MPP), and healthy control subjects (HC). Methods: In this IRB approved protocol, with 39 HC, 36 BPS, 14 MPP and 41 BPS+MPP sub-jects underwent one cardiac parasympathetic test, [deep breathing (DB)], two cardiac and vas-cular autonomic tests [valsalva maneuver and tilt table test (HUT)], and post-ganglionic sudo-motor sympathetic test that evaluated for autonomic neuropathy (AN). (Source: Autonomic Neuroscience: Basic and Clinical)


Neurohumoral and Hemodynamic Profile in Children with Chronic Nausea and Orthostatic Intolerance
Background: Functional gastrointestinal disorders (FGID) are one of the most common and poorly understood causes of debilitating GI symptoms such as pain, nausea and vomiting whose mechanisms are poorly characterized. Children with FGID, whose symptoms are often unexplained by GI diagnostic tests, frequently present with orthostatic intolerance. Upright tilt table testing can detect the presence of an abnormal hemodynamic response to orthostatic challenge. Objective: To better define the clinical phenotype of FGID and dysautonomia through characterization of cardiovascular profiles and changes in specific serum neurohumoral markers. (Source: Autonomic Neuroscience: Basic and Clinical)


The sensory-cardiac interface in heart failure – A therapeutic target
Background: Cardiac sensory nerves that traverse anatomically defined sympathetic pathways (“cardiac sympathetic afferents”) have been traditionally thought to convey the sensation of pain during coronary ischemia. They also have been shown to mediate sympatho-excitation. Previous studies from our laboratory have shown that the afferent discharge and the reflex effects upon stimulation of these afferents with either bradykinin or capsaicin evoke increased responses in the setting of chronic heart failure (CHF). (Source: Autonomic Neuroscience: Basic and Clinical)


​Amgen files for FDA approval for drug to treat dialysis patients
Amgen Inc. said it has filed for approval to sell its drug to treat patients with chronic kidney disease on dialysis. Thousand Oaks-based Amgen(Nasdaq: AMGN) said it submitted a new drug application to the U.S. Food and Drug Administration for etelcalcetide, formerly AMG 416, for the treatment of secondary hyperparathyroidism, a condition that can cause fragile bones, bone pain and organ damage. If approved, etelcalcetide will be the first calcimimetic agent that can be administered intravenously… (Source: bizjournals.com Health Care:Physician Practices headlines)


Contrast-enhanced ultrasound for the evaluation of acute renal infarction
Abstract A 65-year-old male in the dilated phase of hypertrophic cardiomyopathy and with persistent atrial fibrillation was admitted to our hospital because of an episode of ventricular fibrillation following an appropriate shock from an implantable cardiac defibrillator (ICD). At admission, electrocardiography showed a normal sinus rhythm. He had complained of back pain 7 days after the ICD shock. Renal infarction was suspected, although computed tomography and magnetic resonance imaging could not be performed because of chronic renal failure and the presence of his ICD. We, therefore, used contrast-enhanced ultrasonography with a contrast agent to evaluate his acute kidney injury. This showed the left kidney contained a wedge-shaped area that was not enhanced by the contrast ag...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Education positively impacts safe opioid prescribing among clinicians
(Boston University Medical Center) Educating clinicians on how to safely prescribe opioids can help decrease opioid misuse among chronic pain sufferers. These findings, which appear online in the journal Pain Medicine, confirm that education can empower clinicians to make more informed clinical decisions about initiating, continuing, changing or discontinuing opioids for patients suffering from chronic pain based on a careful benefit versus risk/harm assessment. (Source: EurekAlert! - Medicine and Health)


eReply. Is the pre-emptive administration of ketamine able to prevent chronic post-thoracotomy pain?
(Source: Interactive CardioVascular and Thoracic Surgery)


Successful surgical bypass of superior mesenteric and inferior mesenteric artery
Abstract Chronic mesenteric ischemia is a rare but important cause of abdominal pain with high mortality and morbidity rates. The main goal of the treatment is to relieve patient’s symptoms by restoration of intestinal perfusion and to prevent intestinal necrosis. A 40-year-old male was referred to us with complaints of post prandial abdominal pain and weight loss for last 2 years. Computed tomography angiography of abdominal aorta revealed complete occlusion of proximal part of superior mesenteric artery and inferior mesenteric artery. Surgical bypass of superior mesenteric artery was done by retrograde technique from right common iliac artery to ileocolic artery using great saphenous vein. Inferior mesenteric artery bypass was done with great saphenous vein from infrarenal ab...


The prevalence and correlates of chronic pain and suicidality in a nationally representative sample
Conclusions: Health care professionals need to be aware of the risk of suicidality in patients with chronic pain, even in the absence of mental health problems. (Source: Australian and New Zealand Journal of Psychiatry)


Stressful Parental-Bonding Exaggerates the Functional and Emotional Disturbances of Primary Dysmenorrhea
Conclusions Inappropriate parental bonding or chronic traumatic attachment styles have respective relationships with the functional and emotional disturbances experienced by the primary dysmenorrhea patients. (Source: International Journal of Behavioral Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Is levorphanol a better option than methadone?
ConclusionUnlike methadone, levorphanol is a more potent NMDA antagonist, possesses a higher affinity for DOR and KOR, has a shorter plasma half‐life yet longer duration of action, has no CYP450 interactions or QTc prolongation risk, can be a viable option in the elderly, palliative care, and SCI patients, requires little to no need for co‐administration of adjuvant analgesics, and has potentially a lower risk of drug‐related Emergency Department visits compared to other opioids. (Source: Pain Medicine)


Pain by the Numbers
(MedPage Today) -- NIH study: chronic pain afflicts more than 25 million Americans (Source: MedPage Today Psychiatry)


Buddy, Can You Spare a Trillion Dollars? The Cost of Veteran Health Care
"Are you a Vietnam veteran?" I asked "Stan," an auto mechanic I'd met a few minutes earlier in the course of a routine car checkup. He nodded affirmatively. Ten years of working at the Veterans Stress Project have given me a sense of how veterans move, act and think. They can often identify each other in seconds. The signs of psychological traumatization are often apparent, and rarely get better over time. Combat can affect people decades later. That message is reinforced by a study published recently in a prestigious psychiatry journal. The investigators found that the psychological effects of the Vietnam War are still plaguing veterans 40 years on. They estimated that that of the Vietnam veterans still alive, 271,000 have posttraumatic stress disorder (PTSD). The study, performed by Cha...


Mainstay Medical raises $15m
Mainstay Medical (EPA:MSTY) said yesterday it raised $15 million in a debt financing round to help fund its ReActiv8 implantable device for individuals with chronic low back pain. The debt facility came from IPF Partners, according to Dublin, Ireland-based Mainstay. &#8220;We are pleased to have secured this $15 million debt facility. These funds strengthen our financial position, and allow us to continue building momentum towards commercialisation of ReActiv8,&#8221; CEO Peter Crosby said in a press release. The debt will be split into 3 tranches, according to the company, with $4.5 million available up front. The rest of the funds will be available following CE Mark approval process milestones, the company said. Last May, Mainstay&#8217;s initial public offering reeled in about $25 mil...


Buying Time: Long-term Results of Wrist Denervation and Need for Revision Surgery
This study reviews the 20 year long term outcomes of patients treated with partial wrist (anterior and posterior interosseous nerve) denervation focusing on need for and time to salvage procedure. (Source: The Journal of Hand Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Fibromyalgia therapy
Although we do not often consider chronic amplified pain syndromes as important in children, the incidence of these is surprisingly high. As many as 2%-6% of children, for example, may meet the criteria for fibromyalgia. Despite this, there are very few guidelines on the management of fibromyalgia in children. This is unfortunate in that some children may be very seriously involved and compromised by the condition. There is little evidence that medications play a useful role in the management of childhood fibromyalgia. (Source: The Journal of Pediatrics)


Steroid Injections Probably Won't Help Your Lower Back Pain
Title: Steroid Injections Probably Won't Help Your Lower Back PainCategory: Health NewsCreated: 8/24/2015 12:00:00 AMLast Editorial Review: 8/25/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Integration of Cognitive-Behavioral and Interpersonal Therapies in Treating Depression With Concurrent Relational Distress and Chronic Pain
This is a single-case study of a middle-aged man presenting with relationship distress and simultaneous major depressive disorder with chronic back pain and a physical tic. Treatment was informed by cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and psychodynamic principles. Over the course of treatment, a variety of techniques were utilized, including progressive muscle relaxation training, behavioral monitoring, cognitive restructuring, and interpersonal principles to address somatic complaints and underlying feelings of helplessness and inadequacy. Symptoms including general distress, frustration, back pain, worry about his wife&rsquo;s mental illness, and amount of negative thinking were tracked on a daily basis over three assessment periods. In addition, clinic...


SCOPE of Pain: An Evaluation of an Opioid Risk Evaluation and Mitigation Strategy Continuing Education Program
ConclusionsThe SCOPE of Pain program improved knowledge, attitudes, confidence, and self‐reported clinical practice in safe opioid prescribing. This national REMS program holds potential to improve the safe use of opioids for the treatment of chronic pain. (Source: Pain Medicine)


A Case for the Chronic Disease Management and the Integrated Care Model for Pain Medicine: An Affordable Care Act Imperative and Global Trend
(Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Acceptance and Commitment Therapy and Selective Optimization with Compensation for Institutionalized Older People with Chronic Pain
ConclusionsThese results suggest that an ACT intervention combined with training in SOC strategies could help older people with pain to improve their emotional well being and their functional capability. (Source: Pain Medicine)


Obscure Upper Gastrointestinal Bleeding in the Presence of Jaundice and Abdominal Pain
Question: An 84-year-old woman presented with abdominal pain and melena. She had a recent history of an open, low anterior resection and loop ileostomy formation for a diverticular stricture. Physical examination revealed jaundice and right upper quadrant tenderness but no signs of chronic liver disease. Laboratory tests showed a hemoglobin of 55 g/L (normal range, 120-150), elevated liver enzymes (gamma-glutamyl transferase, 1886 IU/L; [normal range, 6-42]; alkaline phosphatase, 1046 IU/L [normal range, 30-110]) and hyperbilirubinemia (148 μmol/L [normal range, (Source: Gastroenterology)


The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability
Conclusion The PFMH scoring system is a simple, reliable, valid and easy screening tool for in the assessment of women with CPP. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)


Treatment of Calcaneal Fracture With Severe Soft Tissue Injury and Osteomyelitis: A Case Report
We present the case of a complex calcaneal fracture complicated by soft tissue injury and osteomyelitis that highlights the importance of shared decision-making between patient and surgeon when considering reconstruction versus amputation. This case exemplifies the need for open communication concerning the risks and benefits of treatment modalities while simultaneously considering the patient's expectations and desired outcomes. (Source: The Journal of Foot and Ankle Surgery)


Symptomatic Osseous Abnormalities at the Posteromedial Tubercle of the Talus: Magnetic Resonance Imaging Features
We present 5 cases of osseous abnormalities at the posteromedial tubercle of the talus depicted on magnetic resonance imaging in subjects with chronic symptoms at this location, with no history of local trauma, who had presented with posteromedial mechanical pain and/or tarsal tunnel syndrome. The symptoms were related to mechanical changes of the bony and soft tissue structures, leading to posterior impingement, and to neurovascular bundle entrapment at the tarsal tunnel, leading to tarsal tunnel syndrome. (Source: The Journal of Foot and Ankle Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Lumbar Intradiscal Platelet Rich Plasma (PRP) Injections: A Prospective, Double-blind, Randomized Controlled Study
Conclusion Participants who received intradiscal PRP showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over eight weeks when compared to controls. Those who received PRP maintained significant improvements in FRI scores through at least one year of follow-up. While these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiscal treatment and the ideal cellular characteristics of the intradiscal PRP injectate. (Source: PMandR)


Non‐steroidal Anti‐inflammatory Drug use Not Associated with Erectile Dysfunction Risk: Results from the Prostate Cancer Prevention Trial
ConclusionsThe modest associations of NSAID use with ED risk in this cohort were likely due to confounding indications of NSAID use. NSAID use was not associated with ED risk.This article is protected by copyright. All rights reserved. (Source: BJU International)


St. Jude Medical wins CE Mark for Prodigy MRI pain device
St. Jude Medical (NYSE:STJ) today said it added MR-conditional labeling to the CE Mark for its Prodigy spinal cord stimulator, which is designed to treat chronic pain. The approval means the company can market the device for patients who need head and extremity MRI scans. Little Canada, Minn.-based St. Jude claimed the Prodigy MRI as the smallest MR-conditional rechargeable implantable pulse generator to hit the market. The company&#8217;s Prodigy device 1st won CE Mark approval in the European Union in March and gained a nod from Health Canada in May. The Prodigy device is designed to stimulate the spinal cord with low-level bursts of electricity to interrupt or mask the transmission of pain signals to the brain, using both tonic and burst stimulation, St. Jude said. The burst techno...


St. Jude obtains CE Mark for MRI chronic pain unit
St. Jude Medical has received the CE Mark for MRI-conditional labeling for...Read more on AuntMinnie.comRelated Reading:FDA approves St. Jude Medical's paddle lead, July 20, 2015St. Jude commences trial of OCT guidance, June 30, 2015FDA clears St. Jude's MR-conditional spinal stimulation system, April 30, 2015St. Jude launches 3D vessel system in Japan, March 13, 2013St. Jude Medical launches MediGuide for fluoro imaging, October 8, 2012 (Source: AuntMinnie.com Headlines)


An Analysis of Rescue Medication Utilization from a 3‐Month, Randomized, Double‐Blind, Placebo‐Controlled Study in Patients with Chronic Low Back Pain Treated with Single‐Entity, Twice‐Daily, Extended‐Release Hydrocodone
ConclusionsEnd‐of‐dose failure was not observed based on the use of rescue medication after administration of single‐entity, twice daily, hydrocodone ER capsules (Zohydro ER). (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effects of chronic dietary exposure to monosodium glutamate on feeding behavior, adiposity, gastrointestinal motility, and cardiovascular function in healthy adult rats
Conclusions & InferencesChronic treatment with MSG in the adult rat increased water intake. This supports its potential to improve acceptance of low‐fat regimens and to increase hydration in the elderly and sportspeople, often at risk of dehydration. Changes in colonic contractility and cardiovascular function could have some long‐term repercussions warranting further research. Regular intake of monosodium glutamate (MSG) in drinking water in adult rats enhanced drinking, but did not alter body weight gain or abdominal fat distribution, suggesting that this food additive is not necessarily involved in the development of obesity and metabolic syndrome. However, it increased colonic contractility in vivo and slightly reduced endothelium‐dependent relaxation in aorta, and therefor...


Acupuncture and chiropractic care: utilization and electronic medical record capture.
CONCLUSIONS: A majority of participants had used acupuncture, chiropractic care, or both. While benefit structure may materially influence utilization patterns, many patients with CMP use acupuncture and chiropractic care without regard to their insurance coverage. A substantial percentage of acupuncture and chiropractic use thus occurs beyond detection of EMR systems, and many patients do not report such care to their HMO clinicians. PMID: 26295269 [PubMed - in process] (Source: The American Journal of Managed Care)


Dietary intervention for osteoarthritis: Clinical trials after the ‘Bone and Joint Decade’
Abstract Osteoarthritis (OA) is a major social and economic burden that continues to grow globally with no effective disease modifying therapies in the pipeline. Current therapeutic strategies to address pain are largely insufficient and joint replacement for end stage disease is unsustainable. Drug development is particularly difficult and expensive due to the complexity of balancing efficacy and toxicity for chronic diseases. The main risk factors for developing OA are increasing age and obesity. Diet has a clear link to the latter, but also impacts strongly on the ageing process. There is no paucity of pre‐clinical data investigating dietary bioactives and their impact on OA disease models. However clinical trials that test these data using relevant trial design and validated outcome ...


Chronic pancreatitis, depression and substance use disorders: A not uncommon combination.
Authors: Jeppe CY, Szabo CP, Smith MD Abstract Chronic pancreatitis (CP) is a progressive and debilitating disease. A potentially important consideration is the relationship between CP, depression and substance use disorders, which seems to be circular and multiplicative. Pain management is a critical component of intervention, and it would seem that in the context of chronic illness this requires a biopsychosocial approach aiming for a tailored intervention that strikes an appropriate therapeutic balance. PMID: 26294819 [PubMed - as supplied by publisher] (Source: South African Medical Journal)


Symptomatic Delayed Aortic Dissection After Superior Mesenteric Artery Stenting for Chronic Mesenteric Ischemia
Chronic mesenteric ischemia (CMI) is an important cause of abdominal pain and most commonly occurs secondary to atherosclerotic disease of the mesenteric arteries. Patients are often >60 years old and can present with postprandial abdominal pain, nausea, diarrhea, and significant weight loss. Symptomatic disease has traditionally been managed with open surgical repair, but endovascular strategies, such as percutaneous angioplasty and stenting, have emerged as the mainstays of therapy. Complications from stenting include plaque embolization, thrombosis, perforation, or dissection, which may require additional salvage procedures. (Source: Journal of Vascular Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Infected Iliac Pseudoaneursym After Girdlestone Pseudoarthroplasty for Recurrent Infection of Hip Prosthesis
We report a massive infected pseudoaneurysm (PSA) of the right external iliac artery (33 × 28 cm) in the setting of Girdlestone pseudoarthrosis (GSA) done for chronic infection. Delay in presentation with severe pain and disability occurred due to attribution of her symptoms to her hip infection and her GSA. The patient underwent ligation of the right external iliac artery and right hip disarticulation. At follow-up, the patient had significant improvement in her ambulation and much improved pain. (Source: Journal of Vascular Surgery)


Find out how to improve your energy, mood and reduce the risk of disease
(NaturalNews) Most people living in the 'modern' world lack sufficient energy; feel emotionally agitated and, in many cases, suffer with chronic disease symptoms like, joint pain, high blood pressure, diabetes and cancer &#8211; to name a few. And, although we often hear that the... (Source: NaturalNews.com)


Autologous Proliferative Therapies in Recalcitrant Lateral Epicondylitis
Conclusions: This study demonstrates the beneficial effects of autologous proliferative therapies in the treatment of lateral epicondylitis. The data show that laser application and ACP therapy lead to a clinical improvement in epicondylopathia. Especially the new treatment with ACP can be highlighted as an alternative and as an easy-to-apply therapy option for clinical practice. (Source: American Journal of Physical Medicine and Rehabilitation)


A cross sectional study between the prevalence of chronic pain and academic pressure in adolescents in China (Shanghai)
Conclusion: Chronic pain is a common condition in Chinese adolescents and is closely related to self-reported academic pressure. (Source: BMC Musculoskeletal Disorders)


Associations between parental chronic pain and self-esteem, social competence, and family cohesion in adolescent girls and boys &#8211; family linkage data from the HUNT study
Conclusions: The findings indicate that the presence of both maternal and paternal chronic pain could be a potential risk factor for lower levels of individual and family resilience factors reported by girls. Further research on the relationship between parental pain and sex-specific offspring characteristics, including positive resilience factors, is warranted. The study demonstrates the importance of targeting the entire family in chronic pain care. (Source: BMC Public Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


“Perforated Meckel's Diverticulum in an adult due to Faecolith: A Case Report and Review of Literature”
Publication date: Available online 22 August 2015 Source:International Journal of Surgery Case Reports Author(s): Sunny Modi, Shant Kanapathipillai, Stefaan DeClercq Meckel's diverticulum (MD) is a persistent remnant of the vitelointestinal duct and is present in 2% of population [1]. It is the most common congenital malformation of the gastrointestinal tract. It can present clinically as haemorrhage, diverticulitis, intussusception, chronic ulceration, intestinal obstruction and perforation. Complicated presentation, especially bleeding, tends to be more common in the paediatric group, whereas intestinal obstruction is more common in adults [2]. Patients with a perforation of Meckel's diverticulum by an enterolith are rare and may present with right iliac fossa pain, which mimics acu...


A Feasibility Study to Determine whether Clinical Contrast-Enhanced MRI can Detect Increased Bladder Permeability in Patients with Interstitial Cystitis
This study established the feasibility of using contrast-enhanced magnetic resonance imaging (CE-MRI) to quantify bladder permeability in IC patients. (Source: The Journal of Urology)


Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome
Conclusion IC/BPS women with dyspareunia have significantly more severe urological pain and a higher PUF scale score than women without dyspareunia. Physicians should consider sexual pain disorder in the management of patients with IC/BPS and use the PUF scale to evaluate not only IC-specific lower urinary tract symptoms, but also sexual pain disorder. (Source: Urological Science)


Chronic pain in Noonan syndrome: A previously unreported but common symptom
Noonan syndrome (NS) is a multiple malformation syndrome characterized by pulmonic stenosis, cardiomyopathy, short stature, lymphatic dysplasia, craniofacial anomalies, cryptorchidism, clotting disorders, and learning disabilities. Eight genes in the RAS/MAPK signaling pathway are implicated in NS. Chronic pain is an uncommon feature. To investigate the prevalence of pain in NS, we distributed a two‐part questionnaire about pain among NS individuals at the Third International Meeting on Genetic Syndromes of the Ras/MAPK Pathway. The first part of the questionnaire queried demographic information among all NS participants. The second part was completed by individuals with chronic pain. Questions included musculoskeletal problems and clinical features of pain. Forty‐five questionnaires w...


I Was Shamed By My Doctor for Being Black
We live in an age of shaming -- shamed for how we look, what we say, who we are. It's so relentless, especially online, you might even say we've become desensitized to it. And yet, when the judgment comes straight from an M.D. -- the one person you trust implicitly with your well-being -- it shocks you to your core. The health consequences can be devastating, even deadly. Enough! With the help of women brave enough to share their stories and be photographed, WH urges you to speak up and join in as we rally for change. Alexandra Moffett-Bateau, 30, was desperate for relief after being admitted to a hospital with crippling stomach cramps. What she got was an epic rant. "There is nothing wrong with you. You are just a drug seeker. People like you make my job harder!" Alexandra had experience...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Systematic review: instruments to assess abdominal pain in irritable bowel syndrome
ConclusionsThe multitude of different instruments to measure chronic abdominal pain in IBS makes it difficult to compare endpoints of published studies. There is need for validated instruments to assess chronic abdominal pain in IBS patients, that overcome the limitations of the currently available methods. (Source: Alimentary Pharmacology and Therapeutics)


NeuroMetrix touts Quell study data
NeuroMetrix (NSDQ:NURO) released preliminary data on Tuesday from a clinical study of its Quell wearable pain relief device for patients with chronic pain. The study found that 81% of the patients reported improvements in chronic pain levels and overall health after 60-days of using the device, Waltham, Mass.-based NeuroMetrix said. &#8220;We are pleased with these results. They represent the 1st formal evaluation of self-administered wearable intensive nerve stimulation. Quell provided substantial pain relief and improvement in quality of life measures. The primary outcome measure was impressive with 81% of subject’s rating Quell therapy as improving their chronic pain and overall health. We were not surprised that ⅔ of the subjects reduced their use of pain medications, as we have...


[Neuroimmunology] For females, a different path to pain
Chronic pain affects more women than men. To better understand why, Sorge et al. compared the mechanisms that underlie neuropathic pain in male and female mice. Previous studies – [Read More] (Source: Editors' Choice)


Characteristic changes of saliva and taste in burning mouth syndrome patients
ConclusionsBMS patients showed lower salivary flow and higher salivary spinnability. These results together with decreased SIgA amount, suggest that BMS may be relevant to the deterioration of salivary condition, which could in turn affect taste function. Furthermore, the lower antioxidant capacity in patient's serum suggests that it can serve as a diagnostic tool for BMS. (Source: Journal of Oral Pathology and Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Fistulation into the Pubic Symphysis following treatment of Prostate Cancer - an important and surgically correctable complication
Chronic pubic pain following the treatment of prostate cancer is often attributed to ‘osteitis pubis’. We have become aware of another complication, namely fistulation into the pubic symphysis, which is more serious and commoner than previously thought. (Source: The Journal of Urology)


Effects of low back pain and of Stabilization or Movement-System-Impairment treatments on induced postural responses: a planned secondary analysis of a randomized controlled trial
Motor retraining for non-specific chronic low back pain (LBP) often focuses on voluntary postural tasks. This training, however, may not transfer to other known postural impairments, such as automatic postural responses to external perturbations. (Source: Manual Therapy)


Complex Decongestive Lymphatic Therapy With or Without Vodder II Manual Lymph Drainage in More Severe Chronic Postmastectomy Upper Limb Lymphedema: A Randomized Non-Inferiority Prospective Study
Complex decongestive lymphatic therapy (CDT) has been the method of choice in conservative management of lymphedema. Although effective, it is time-consuming and manual lymph drainage (MLD) usually requires skilled therapists. (Source: Journal of Pain and Symptom Management)


Chronic Migraineurs Form Carboxyhemefibrinogen and Iron-Bound Fibrinogen.
Authors: Nielsen VG Abstract Chronic migraine (CM) is a disabling painful condition that is associated with dementia and thrombotic disease. It has been proposed that carbon monoxide (CO) and iron may play a role in CM, and CO and iron are products of heme oxygenase system which is widespread within the brain. Further, CO and iron enhance plasmatic coagulation in part via a fibrinogen-dependent mechanism. Thus, our goal was to determine whether patients with CM had experienced carboxyhemefibrinogen formation, iron bound fibrinogen formation and plasmatic hypercoagulability. Nonsmokers with CM were recruited after informed, written consent. Blood was collected, anticoagulated with sodium citrate, and then centrifuged with plasma stored at -80ºC. Carboxyhemefibrinogen formation, iro...


Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach
Conclusions Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented. (Source: BMJ Open)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Dextrose Prolotherapy versus Control Injections in Painful Rotator Cuff Tendinopathy.
CONCLUSIONS: In participants with painful rotator cuff tendinopathy who receive physical therapy, injection of hypertonic dextrose on painful entheses resulted in superior long term pain improvement and patient satisfaction compared with blinded saline injection over painful entheses, with intermediate results for entheses injection with saline. These differences could not be attributed to a regenerative effect. Dextrose prolotherapy may improve upon standard care of painful rotator cuff tendinopathy for certain patients. PMID: 26301385 [PubMed - as supplied by publisher] (Source: Physica Medica)


Violence toward chronic pain care providers: a national survey - David K, Anuj D, Nabil S.
This study measured the following: violence rates against chronic pain care providers (CPCPs), character/context/risk factors for violence and CPCPs' mitigation strategies. METHOD: An e-mail survey was sent to members of the American ... (Source: SafetyLit: All (Unduplicated))


A holistic approach to chronic pain management that involves all stakeholders: change is needed
Current Medical Research & Opinion, Ahead of Print. (Source: Current Medical Research and Opinion)


One-year follow-up of platelet-rich plasma infiltration to treat chronic proximal patellar tendinopathies.
This study confirms that a local injection of PRP coupled with a program of eccentric rehabilitation for treating a chronic jumper's knee, improves pain symptoms and the functionalities of the subjects' knee up to 1 year after injection. PMID: 26280964 [PubMed - in process] (Source: Acta Orthopaedica Belgica)


Intra- and periarticular osteoid osteoma: Percutaneous destruction and alcoholisation.
Authors: El-Mowafi H, El-Hawary A, Hegazi M Abstract Intra- or periarticular osteoid osteoma (00) is uncommon, and therefore a diagnostic challenge. Symptoms are: chronic synovitis, decreased range of motion, joint effusion, and joint contracture. Radiographically, the classical perifocal sclerotic margin is often absent, which leads to a significant delay in diagnosis. The authors retrospectively studied 50 cases of intra- and peri-articular OO, treated with percutaneous destruction and alcoholisation. The mean follow-up period was 8.7 years (range, 1 to 15 years). The diagnosis was only made after +/- 14 months (range, 8 to 18 months), due to atypical symptoms (nightly pain absent in 38%) and uselessness of plain radiographs (in 100%). CT-scan, contrast enhanced MRI and bone scan...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Transcranial Direct Current Stimulation Ineffective for Nonspecific Chronic Back Pain
No abstract available (Source: Lippincott’s Bone and Joint Newsletter)


Evaluation of a disease specific rheumatoid arthritis self-management education program, a single group repeated measures study
Conclusion: Participants in the program recorded significant improvements in depression and mental health post-intervention, which were maintained to 12 months follow up. (Source: BMC Musculoskeletal Disorders)


“Puestow modified procedure in the era of advanced endoscopic interventions for the management of chronic lithiasic pancreatitis. A two cases report”
Conclusion Despite advancement in endoscopic interventions and less invasive therapies for the management of chronic lithiasic pancreatitis we consider that classic surgical management can be appropriate in certain cases. (Source: International Journal of Surgery Case Reports)


Symptom Interference Severity and Health-Related Quality of Life in Pulmonary Arterial Hypertension
While assessing symptom severity is an important component of evaluating symptoms, understanding those symptoms that interfere with patients' lives is also key. Pulmonary arterial hypertension (PAH) is a chronic disease resulting in right heart failure and increased mortality. Patients with PAH experience multiple symptoms but we do not know which symptoms and to what extent their symptoms interfere with daily life. (Source: Journal of Pain and Symptom Management)


Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland
The international cohort of hemodialysis patients is aging and increasing in number. Nephrologists have a therapeutic relationship with their patients that may span decades. Often overlooked components of chronic disease management include symptom control and assessment of health-related quality of life (HRQoL). (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Myotonia-like symptoms in a patient with spinal and bulbar muscular atrophy
• This case with SBMA had difficulty in stretching his extremities without pain after their voluntary contraction.• Muscle biopsy showed neurogenic changes with round fibers of various sizes.• Electromyography showed chronic denervation potentials without myotonic discharge.• Myotonia-like symptoms may occur at an early stage of SBMA. (Source: Neuromuscular Disorders)


Multimodal nociceptive mechanisms underlying chronic pelvic pain
To evaluate candidate mechanisms underlying the pelvic floor dysfunction in women with chronic pelvic pain and/or painful bladder syndrome/interstitial cystitis. Notably, prior studies have not consistently controlled for potential confounding by psychological or anatomical factors. (Source: American Journal of Obstetrics and Gynecology)


Fractal Texture Analysis of the Healing Process after Bone Loss
Healing time of extensive bone deficits in jaws arising after cyst removal and left empty, is prolonged. Very often bone loss areas do not heal completely leading to volume deficit of the alveolar process and subsequent cosmetic defect especially in anterior parts of the oral cavity [1,2]. The filling of postresectal and postcystal areas with connective tissue instead of bone, may result in pain symptoms as well as difficult radiological differential diagnosis of connective tissue scars with chronic periapical granulation tissue and even with root cyst [3–6]. (Source: Computerized Medical Imaging and Graphics)


Supporting chronic pain management across provincial and territorial health systems in Canada: Findings from two stakeholder dialogues.
Authors: Wilson MG, Lavis JN, Ellen M PMID: 26291124 [PubMed - as supplied by publisher] (Source: Pain Research and Management)


[Postoperative pain therapy in Germany : Status quo].
Authors: Pogatzki-Zahn EM, Meissner W Abstract A great deal of progress has been made in the field of postoperative pain therapy in the last 20 years. Beginning from clinical trials on the effectiveness of individual procedures, such as epidural anesthesia and patient-controlled analgesia, a wide range of healthcare services research as well as basic research with human and animal experiments has been established. Whereas health services research in the 1980s and 1990s focused more on the implementation of acute pain services, outcome-oriented research approaches are nowadays the center of attention. Acute pain registries and pain certification projects initiated in Germany have to be mentioned particularly in this respect. Basic research papers from recent years increasingly addr...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Chronic primary pain disorders in children and adolescents].
CONCLUSION: Similar to international trends, research on chronic pediatric pain has also grown and advanced in Germany. Indeed, not only the amount of research has increased but also its scope. Nonetheless, there is clearly a need for more research efforts with regard to the understanding of (pediatric) pain mechanisms, clinical studies and, especially, investigations on health care services. It is particularly important to focus on the implementation, improvement and systematic evaluation of specialized health care services which would be available and accessible for children and adolescents with chronic pain and not be restricted to tertiary care. PMID: 26289393 [PubMed - as supplied by publisher] (Source: Schmerz)


Prescription Opioids and Risk of Dementia or Cognitive Decline: A Prospective Cohort Study
ConclusionPeople with the heaviest opioid or NSAID use had slightly higher dementia risk than people with little or no use. These results may reflect an effect of chronic pain on cognition or residual confounding. Although opioids have other risks, little evidence of long‐term cognitive harm specific to opioids was found. (Source: Journal of the American Geriatrics Society)


Small-molecule nociceptin receptor agonist ameliorates mast cell activation and pain in sickle mice.
Authors: Vang D, Paul JA, Nguyen J, Tran H, Vincent L, Yasuda D, Zaveri NT, Gupta K Abstract Treatment of pain with morphine and its congeners in sickle cell anaemia is sub-optimal, warranting the need for analgesics devoid of side effects, addiction and tolerance liability. Small- molecule nociceptin opioid receptor ligands show analgesic efficacy in acute and chronic pain models. We show that AT-200, a high affinity nociceptin opioid receptor agonist with low efficacy at the mu opioid receptor, ameliorated chronic and hypoxia/reoxygenation-induced mechanical, thermal and deep tissue/musculoskeletal hyperalgesia in HbSS-BERK sickle mice. The antinociceptive effect of AT-200 was antagonized by SB-612111, a nociceptin opioid receptor antagonist, but not naloxone, a non-selective mu ...


Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial.
CONCLUSIONS: This will be the first study to investigate different weekly frequencies of treatment sessions for non-specific LBP. The results of this study will contribute to a better definition of treatment programs for this population. PMID: 26294680 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Myeloid Sarcoma: An Unusual Case of Mediastinal Mass and Malignant Pleural Effusion with Review of Literature
We present an unusual case of myeloid sarcoma in which a mediastinal mass with pleural effusion was the initial presentation. A 27 year old gentleman presented with complaints of fever, chest pain and swelling in the anterior chest wall for 6 months. Examination revealed a lump measuring 5 × 5 cm on the left side of the chest wall. Hematological evaluation showed hemoglobin-14.2 g/dL, platelet count-233 × 109/L, TLC-117 × 106/L with normal differential counts. Contrast enhanced computerised tomography (CECT) confirmed the presence of a soft tissue mass in the superior mediastinum abutting against the chest wall. Core biopsy was suggestive of myeloid sarcoma and immunohistochemistry was positive for myeloperoxidase and negative for CD3, CD 20 and CD 23. Pleural fluid analysis s...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic pain and hypermobility syndrome
Scheper MC, de Vries JE, Verbunt J, Engelbert RHH (Source: Journal of Pain Research)


Overcoming IBD obstacles…and traveling the world
I was diagnosed with ulcerative colitis on December 23, 2009—a day my life changed forever. I went from a healthy and active 14-year-old to a teen with some very concerning symptoms: frequent and sudden onsets of stomach pain, exhaustion and the constant urge to use the bathroom. The diagnosis of a blistered, swollen, large intestine was both a relief and an added stressor. But my diagnosis was just the beginning of my journey. For four years, I was constantly looking for—if not rushing to—the nearest bathroom. Avoiding pizza, spicy foods, certain fruits and vegetables. Swallowing upwards of 15 pills a day. Missing out on school, athletics and memories with friends. Instead of being a real teenage girl, I was a full-time patient. Although ulcerative colitis held me back from living ...


&#8220;You Get Reminded You&#8217;re a Sick Person&#8221;: Personal Data Tracking and Patients With Multiple Chronic Conditions
Conclusions: Developers of consumer health information technologies for data tracking (such as diet and exercise apps or blood glucose logs) often assume patients have unlimited enthusiasm for tracking their own health data via technology. However, our findings potentially explain relatively low adoption of consumer HIT, as they suggest that patients with multiple chronic illnesses consider it work to track their own data, that the data can be emotionally charged, and that they may perceive that providers do not welcome it. Similar themes have been found in some individual chronic diseases but appeared more complex because patients often encountered &#8220;illness work&#8221; connected to multiple diseases simultaneously and frequently faced additional challenges from aging or diff...


Factors related to compliance with oral analgesic treatment of inpatients with chronic pain
In conclusion, the low compliance with oral treatment of analgesics was found in Chinese inpatients with chronic pain and compliance was negatively associated with family income and degree of pain of patients. (Source: Frontiers of Medicine)


Curage axillaire après reconstruction mammaire par lambeau de grand dorsal : principes chirurgicaux et résultats
Conclusion La réalisation d’un CAc est faisable après une procédure de reconstruction mammaire immédiate par lambeau de grand dorsal, et aucune morbidité opératoire surajoutée ne semble être associée comparée à une procédure standard. Objectives We retrospectively reviewed all the cases of axillary lymph node dissection (ALND) performed within a year after an immediate breast reconstruction procedure by a pedicled Latissimus dorsi, which is transferred to the anterior thoracic wall through an axillary funnel. Operative technical steps are described taking account of the new anatomical relationship of the axilla. Methods We assessed postoperative immediate complications and late sequelaes. Results From 1999 to 2013, 21 ALND were performed. Immediate postoperative period w...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Latent Class Analysis of the Short and Long-Form of the Chronic Pain Acceptance Questionnaire- Further Examination of Patient Subgroups
A substantial literature indicates that pain acceptance is a useful behavioral process in chronic pain rehabilitation. Pain acceptance consists of willingness to experience pain and to engage in important activities even in the presence of pain and is often measured using the Chronic Pain Acceptance Questionnaire (CPAQ). Previous traditional cluster analyses of the 20-item CPAQ identified three patient clusters which differed across measures of patient functioning in meaningful ways. The aims of this study were to replicate the prior study in a new sample, using the more robust method of Latent Class Analysis (LCA), and to compare the cluster structure of the CPAQ and the shorter CPAQ-8. (Source: The Journal of Pain)


Cyclodextrin-based delivery systems for arthritic diseases: from development to experimental therapeutics.
Authors: Nascimento MH, Santos Akkari AC, Freitas Mariano KC, Kimus Braz AS, Lobello CB, de Araujo DR Abstract Arthritics diseases, such as rheumatoid arthritis and osteoarthritis are chronic inflammatory and one of the most prevalent health conditions that cause disability (pain and functional limitation of joints). Despite the research advances, the treatment of those pathological conditions remains ineffective, since the pharmacological therapy is palliative, reducing only the symptoms and, in some cases, the chronic progression of the disease. In this context, the development of new formulations for controlled release would be interesting for reducing the number of injections and would also increase the patient compliance. In this article, we present a review of the cyclodextri...


Adverse events experienced by participants in a back pain walking intervention: A descriptive study.
CONCLUSIONS: Individuals with chronic back pain can safely engage in a pedometer-based, unsupervised walking program. However, patients may benefit from focused counseling about musculoskeletal risks with specific attention to injury prevention measures such as gradually incrementing activity levels. PMID: 26289360 [PubMed - as supplied by publisher] (Source: Chronic Illness)


Alcohol intake, reproductive hormones, and menstrual cycle function: a prospective cohort study.
CONCLUSION: Although recent moderate alcohol intake does not appear to have adverse short-term effects on menstrual cycle function, including sporadic anovulation, potential protective and deleterious long-term effects of alterations in reproductive hormones on other chronic diseases warrant additional investigation. PMID: 26289438 [PubMed - as supplied by publisher] (Source: The American Journal of Clinical Nutrition)


A Narrative Review of Evidence-Based Preventive Options for Chronic Migraine
Abstract Chronic migraine is a debilitating disorder that affects 2 % of the global population and imparts a significant societal and economic impact. The cornerstones of chronic migraine management include making an accurate diagnosis, patient education, treatment of comorbid conditions, and selection of an appropriate, evidence-based acute and preventive treatment regimen. Although it is common to treat chronic migraine with preventive medications effective for episodic migraine, a number of treatment options exist with specific evidence for effectiveness in chronic migraine. Currently, onabotulinumtoxinA injections are the only FDA-approved preventive treatment for chronic migraine. A number of non-medication treatment options including occipital nerve and supraorbital nerve ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Consumption of and satisfaction with health care among opioid users with chronic non‐malignant pain
(Source: Acta Anaesthesiologica Scandinavica)


Investors profit by funding surgery for desperate pelvic mesh patients
(Reuters) — In July 2013, California urogynecologist Andrew Cassidenti received an email from an entrepreneur named Otto Fisher, who had a proposition. Fisher was looking for surgeons to perform operations to remove pelvic mesh implants from women. Intrigued, Cassidenti responded. In a phone call, Fisher said he needed doctors to operate at outpatient centers in California and Las Vegas. Fisher said he could guarantee Cassidenti $2,500 for every surgery the doctor performed, &#8220;whether it took 5 minutes or 2 hours,&#8221; or even if the doctor did not remove any mesh, according to the surgeon&#8217;s sworn court statement recounting the conversation. Cassidenti said the conversation made him suspicious. During the call, Fisher referred to litigation that is pitting 10s of thousan...


25 Million U.S. Adults Struggle with Daily Pain
And 14 million experience severe pain, survey finds Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Disabilities, Pain (Source: MedlinePlus Health News)


25 Million U.S. Adults Struggle With Daily Pain
Title: 25 Million U.S. Adults Struggle With Daily PainCategory: Health NewsCreated: 8/18/2015 12:00:00 AMLast Editorial Review: 8/18/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Self-reported pain and pain management strategies among veterans with traumatic brain injury: a pilot study - King PR, Beehler GP, Wade MJ.
Reports of chronic pain such as headache, back and neck pain, and other musculoskeletal conditions are common among veterans with history of traumatic brain injury (TBI). This pilot study investigates self-reported pain and pain management strategies in a ... (Source: SafetyLit: All (Unduplicated))<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Future goals of adolescents and young adults with chronic musculoskeletal pain
ConclusionsDealing with chronic pain in adolescence and early adulthood does not seem to change future goals, but is associated with perceiving barriers to achieving them. The level of depressive symptoms seems to influence this relationship. Some caution is required in generalizing the results due to the relatively low number of male participants. (Source: European Journal of Pain)


Age and pro-inflammatory gene polymorphisms influence adjacent segment disc degeneration more than fusion does in patients treated for chronic low back pain
Conclusions Age was the most significant determinant of adjacent segment disc space height followed by genetic factors, specifically inflammatory genes. Fusion explained a statistically significant but small proportion of the total variance. Much of the variance remained to be explained. (Source: European Spine Journal)


Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a 3 months physical exercise therapy
In this study we investigated resting-state connectivity using functional magnetic resonance imaging (fMRI) before and after a 15 week standardized exercise program supervised by physical therapists. Our aim was to gain an understanding of how physical exercise influence previously shown aberrant patterns of intrinsic brain activity in FM. Fourteen FM patients and eleven healthy controls successfully completed the physical exercise treatment. We investigated post- versus pre-treatment changes of brain connectivity, as well as changes in clinical symptoms in the patient group. FM patients reported improvements in symptom severity. Although several brain regions showed a treatment-related change in connectivity, only the connectivity between the right anterior insula and the left primary sen...


Spontaneous Iliopsoas Tendon Rupture: An Uncommon Cause of Hip Pain in Elderly Patients
Publication date: Available online 29 July 2015 Source:PM&amp;R Author(s): Mohammed Emam, Constantine Farmakidis, Se Won Lee, Stanley F. Wainapel Iliopsoas tendon rupture is a relatively rare cause of hip pain. It has been described in children, in adults with pathologic avulsion secondary to metastatic disease, and in older individuals with multiple chronic illnesses. We are reporting a case of apparently spontaneous iliopsoas tendon rupture that occurred in an elderly patient presenting with severe debilitating hip pain whose etiology initially was unrecognized. Magnetic resonance imaging of the hip confirmed the diagnosis. This case highlights the importance of considering iliopsoas tear in the differential diagnosis of unexplained acute onset hip pain and illustrates that ger...


Exploring patients’ opinions of activity pacing and a new activity pacing questionnaire for chronic pain and/or fatigue: A qualitative study
Despite the frequent recommendation of activity pacing as a coping strategy for patients with chronic pain and/or fatigue, pacing is interpreted in different ways and there is an absence of a widely accepted pacing scale. We have developed a new Activity Pacing Questionnaire (APQ). The aims of this study were to explore patients’ views and beliefs about the concept of pacing, together with the acceptability of the APQ. (Source: Physiotherapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Cutaneous cooling to manage Botulinum Toxin injection-associated pain in facial palsy patients: A randomised controlled trial
Botulinum toxin injections are an effective, well-established treatment to manage synkinesis secondary to chronic facial palsy but necessitate painful injections at multiple sites over the face up to four times per year. Cutaneous cooling has long been recognised to provide an analgesic effect for cutaneous procedures, but evidence to date has been anecdotal or weak. This randomised controlled trial aims to assess the analgesic efficacy of cutaneous cooling using a cold gel pack versus a room temperature Control. (Source: Journal of Plastic, Reconstructive and Aesthetic Surgery)


Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma.
CONCLUSIONS: Catastrophizing behavior patterns and depressive symptoms are associated with more severe pain and worse function after traumatic lower extremity injury. Cognitive and behavioral strategies that have proven effective for chronic pain populations may be beneficial for trauma patients. Future research is needed to determine whether the early identification and treatment of subgroups of at-risk patients based on catastrophizing behavior or depressive symptoms can improve long-term outcomes. LEVEL OF EVIDENCE: Level I, prognostic study. PMID: 26282387 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)


[Axillary lymph node dissection after breast reconstruction by pedicled Latissimus dorsi: Operative steps and outcomes].
CONCLUSION: ALND after immediate breast reconstruction by a pedicled Latissimus dorsi is feasible and safe, without any additional postoperative complication in comparison with a classic ALND. PMID: 26297161 [PubMed - as supplied by publisher] (Source: Gynecologie, Obstetrique et Fertilite)


My 17-Year Quest For The Correct Medical Diagnosis
How many times can you begin again? That's what I asked myself as I entered the Hospital for Special Surgery, just three weeks after my first lumbar spine epidural steroid injection and SI joint procedure. I was late. I spent two hours stuck in traffic during my drive from New Jersey to New York. So I was frazzled and my thoughts were scattered when I arrived. Yet, that question, can I start over again after another procedure rattled around in my head. My entire adulthood has been a long and winding road, at least medically. At 17, a sparse menstrual cycle, joint pain and spontaneous fever left doctors scratching their heads about what was wrong with me. I got progressively worse during my time at Boston College and it's been downhill ever since. Sure, I was tested for every common ailm...


How This Couple Fought Through Illness To Find A New Destiny
I am a caregiver for my partner who has become housebound and bedridden due to an incurable "invisible" disease. I too live with a serious illness, barely getting through each day, mostly housebound myself. Franky and I met, and a spell was cast; we fell madly deeply infatuated with each other, as young love often does to people. We traveled, went to social events and started dreaming of a life together. Within a couple of months, I was diagnosed with an aggressive strain of HIV. Our fast-run fairytale seemed to be cursed and destined for failure. But we persevered. My family's involvement in my life was scarce due to their struggles with me being a gay man. Luckily, Franky took the reins in helping me to fight for my life. Though we had just met, Franky cared for my body, fed me, and cl...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Taking the headache out of migraine
Migraine is a disease that contributes to major disability. Perhaps because migraine attacks are not immediately life-threatening per se and individuals return to a "normal" state between attacks, it is not taken seriously. However, migraine is associated with a number of comorbidities, including psychiatric disease, stroke, and other chronic pain disorders. Current acute treatments for episodic migraine are relatively effective, but preventive treatments for episodic and chronic migraine are far less so. Recent functional imaging studies have shown that the disease affects brain function and structure (either as a result of its genetic predisposition or as a result of repeated attacks). The current evidence in the pain field is that changes observed in brain function and structure may be ...


Opioids for chronic noncancer pain: To prescribe or not to prescribe--What is the question?
The recent American Academy of Neurology position paper by Franklin, "Opioids for chronic noncancer pain," suggests that the benefits of opioid treatment are very likely to be substantially outweighed by the risks and recommends avoidance of doses above 80&ndash;120 mg/day morphine equivalent. However, close reading of the primary literature supports a different conclusion: opioids have been shown in randomized controlled trials (RCTs) to be highly effective in the treatment of chronic nonmalignant pain; long-term follow-up studies have shown that this effectiveness can be maintained; and effectiveness has been limited in many clinical trials by failure to take into account high variability in dose requirements, failure to adequately treat depression, and use of suboptimal outcome measures...


Comment: Prescription opioids--Misused or misunderstood?
Widespread use of opioids for chronic noncancer pain has resulted in an epidemic of misuse; prescribed opioids are currently responsible for more deaths in the United States than heroin and cocaine combined. An American Academy of Neurology (AAN) position paper questions the long-term efficacy of opioids for chronic noncancer pain, calls attention to the poor safety profile of opioids, urges regulatory guidelines in their use, and calls for more research on chronic pain management.1 (Source: Neurology)


Chronic mesenteric ischemia: a rare cause of chronic abdominal pain
Chronic mesenteric ischemia is a rare disease with non-specific clinical symptoms, such as chronic postprandial abdominal pain and weight loss. Diagnostic modalities and revascularization techniques have evolved during the past 20 years. The significance of stenosis in a single splanchnic vessel remains unclear. Our aims were to assess the outcomes of two revascularization techniques and report on the diagnostic modalities of splanchnic vessel stenoses. (Source: The American Journal of Medicine)


AV-Block on Exertion Pulmonary Sarcoidosis with Involvement of the His-Pukinje System
A 67-year-old male patient with systemic hypertension and stage II pulmonary sarcoidosis was referred to our outpatient clinic by his general practitioner secondary to increasing shortness of breath on exertion for several months. The patient reported a maximal walking distance of 150 m. He denied any cough, fevers or chills, lower extremity edema, skin abnormalities, joint pain or any B symptoms. Nor did he report any chest pain. The physical examination was normal, especially signs of chronic hypoxemia or congestive heart failure were absent. (Source: The American Journal of Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Perioperative Treatment of Patients with Rheumatoid Arthritis.
Authors: Saleh KJ, Kurdi AJ, El-Othmani MM, Voss BA, Tzeng TH, Saleh J, Lane JM, Mihalko WM Abstract Rheumatoid arthritis is an autoimmune disease mediated by a widespread chronic systematic inflammatory process that causes joint deterioration, which leads to pain, disability, and poor quality of life. The increased use of disease-modifying antirheumatic drugs has been shown to markedly slow disease progression, which has translated into a decrease in the need for orthopaedic intervention in this population. However, a substantial percentage of patients with the disease fail optimal pharmacologic treatment and still require surgical intervention. A thorough understanding of medical considerations in these patients and improved knowledge of the medical complications caused by the di...


Electrophysiological evidence for voltage-gated calcium channel 2 (Cav2) modulation of mechano- and thermosensitive spinal neuronal responses in a rat model of osteoarthritis
Publication date: 1 October 2015 Source:Neuroscience, Volume 305 Author(s): W. Rahman, R. Patel, A.H. Dickenson Osteoarthritis (OA) remains one of the greatest healthcare burdens in western society, with chronic debilitating pain-dominating clinical presentation yet therapeutic strategies are inadequate in many patients. Development of better analgesics is contingent on improved understanding of the molecular mechanisms mediating OA pain. Voltage-gated calcium channels 2.2 (Cav2.2) play a critical role in spinal nociceptive transmission, therefore blocking Cav2.2 activity represents an attractive opportunity for OA pain treatment, but the only available licensed Cav2.2 antagonist ziconitide (PrilatTM) is of limited use. TROX-1 is an orally available, use dependent and state-selective ...


Strategies to improve bioavailability and in vivo efficacy of the endogenous opioid peptides endomorphin-1 and endomorphin-2.
Authors: De Marco R, Janecka A Abstract Morphine and the other alkaloids found in the opium poppy plant still represent the preferred therapeutic tools to treat severe pain in first aid protocols, as well as chronic pain. The use of the opiate alkaloids is accompanied by several unwanted side effects; additionally, some forms of pain are resistant to standard treatments (e.g. neuropathic pain from cancer). For these reasons, there is currently renewed interest in the design and assay of modified versions of the potent endogenous opioid peptides endomorphin-1 and endomorphin-2. This review presents a selection of the strategies directed at preparing highly stable peptidomimetics of the endomorphins, and of the strategies aimed at improving central nervous system bioavailability, for...


Takayasu Arteritis of the Coronary Arteries Presenting as Sudden Death in a White Teenager
This report discusses the significance of coronary involvement in Takayasu arteritis at autopsy and sudden death. (Source: The American Journal of Forensic Medicine and Pathology)


Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing.
CONCLUSIONS: In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact. PMID: 26270646 [PubMed - as supplied by publisher] (Source: Rural and Remote Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The case of the shrinking testis.
We report the case of a man with idiopathic lymphocytic orchitis (LO) manifested by undifferentiated testicular pain and atrophy. Conventional investigation results were unremarkable. Oral ciprofloxacin only improved the pain temporarily. Scrotal exploration surgery was performed to exclude acute testicular torsion and a biopsy was taken during surgery for histological examination. Histology revealed severe LO with reduced spermatogenesis. A trial of oral steroids was initially effective but the effect was temporary. Due to chronic pain, he eventually underwent unilateral orchidectomy. Histology confirmed the initial diagnosis of LO. He was pain-free postoperatively. Idiopathic LO is a rarely reported cause of testicular atrophy. PMID: 26267036 [PubMed - in process] (Source: Canadian ...


Guideline for prescribing opioids to treat pain in injured workers - Mai J, Franklin G, Tauben D.
Recently, there has been a dramatic increase in the use of opioids to treat chronic noncancer pain. Opioids are also being prescribed in stronger potencies and larger doses for musculoskeletal injuries. In some cases, the use of opioids for work-related in... (Source: SafetyLit: All (Unduplicated))


Plasma pro-inflammatory markers in chronic neuropathic pain: A multivariate, comparative, cross-sectional pilot study
Conclusions This study found an increased level of IL-6 in plasma in patients with neuropathic pain, but not for the other pro-inflammatory substances investigated. There are several possible confounders not registered or controlled for in this and other studies of neuropathic pain. Implications Larger studies that take several possible confounders into consideration are needed to further investigate the levels of plasma cytokines in different pain conditions. (Source: Scandinavian Journal of Pain)


Use of a Hunter Rod for Staged Reconstruction of Peroneal Tendons
We present a 2-stage surgical technique with the use of a Hunter rod as a temporary implant to stimulate generation of a healthy peroneal tendon sheath to host a flexor hallucis longus tendon transfer. This has proved to be a successful treatment option for patients with severe peroneal tendon damage and scarring along the peroneal tendon sheath. We offer a sample case to illustrate a patient with such indications. (Source: The Journal of Foot and Ankle Surgery)


Metastatic breast carcinoma uncovered in an otherwise unremarkable “random colon biopsy”
Publication date: Available online 15 August 2015 Source:Human Pathology: Case Reports Author(s): Mike Black, Ardeshir Hakam, Cynthia Harris, Kun Jiang Breast cancer is one of the most devastating cancers afflicting women, being a main cause of cancer related death. Approximately 50% of these patients have developed regional or distant metastases at the time of diagnosis; hence, an early diagnosis and surgery with indicated neoadjuvant therapy are crucial in eradicating this disease and improving patient survival. A significant percentage of patients, even after initial satisfactory tumor removal, still face the threat of metastatic diseases which could plague a wide spectrum of body sites such as bones, lungs, central nervous system, liver and gastrointestinal tract (mostly upper ga...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


FDA Approval: Ibrutinib for Patients with Previously Treated Mantle Cell Lymphoma and Previously Treated Chronic Lymphocytic Leukemia.
Authors: de Claro RA, McGinn KM, Verdun N, Lee SL, Chiu HJ, Saber H, Brower ME, Chang CJ, Pfuma E, Habtemariam B, Bullock J, Wang Y, Nie L, Chen XH, Lu DR, Al-Hakim A, Kane RC, Kaminskas E, Justice R, Farrell AT, Pazdur R Abstract On November 13, 2013, the FDA granted accelerated approval to ibrutinib (IMBRUVICA capsules; Pharmacyclics, Inc.) for the treatment of patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. On February 12, 2014, the FDA granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy. Ibrutinib is a first-in-class Bruton's tyrosine kinase (BTK) inhibitor that received all four expedited programs of the FDA: Fast-Track designation, Breakthrough Th...


FDA Approves OxyContin For Extremely Sick Kids
The U.S. Food and Drug Association approved the painkiller OxyContin for children ages 11 to 16 with pain "severe enough to require daily, around-the-clock, long-term opioid treatment," according to a statement released on Aug. 14. Some experts expressed concern&#160;that the approval might lead to drug misuse among children or their family members, who may have access to the drugs. But doctors who treat dying children and those in chronic pain say that the move will be a boon to many of their patients.&#160; "Although thankfully uncommon, some children can experience prolonged periods of substantial chronic pain from conditions like cancer," said Dr.&#160;Chris Feudtner, director of the Department of Medical Ethics at the Children's Hospital of Philadelphia, who has no connection to the d...


Tick-ing Time Bomb: Lyme Disease Conquers New Territory
In the summer of 1975 a group of children who often played together developed an unusual flu-like illness with severe joint pain. They were diagnosed with Juvenile Rheumatoid Arthritis (JRA). All of them lived in a small town at the mouth of the Connecticut River called Lyme. The story of their disease contains all the elements of a good novel; mystery, loss, blood, empathy, indifference, conflict, controversy and conspiracy, truth and fiction. Doctors suspect JRA when they see kids with persistent joint pain or swelling, unexplained skin rashes, and fever associated with swelling of lymph nodes or inflammation of internal organs. No single test can be used to make the diagnosis. Both the cause and the cure of JRA, an autoimmune disorder, are unknown. But it is not an infectious disease. P...


Validation of potential candidate biomarkers of drug-induced nephrotoxicity and allodynia in medication-overuse headache
Conclusions In this study, we confirmed previous findings concerning urinary proteins alterations in MOH patients, identified and demonstrated the over-expression of PTGDS, UROM, AMBP, and CYSC, particularly in NSAIDs and mixtures abusers. Over-expression of these proteins have been related to renal dysfunction and probably, PTGDS, to the development of CA. The detection and confirmation of this proteins pattern represent a promising tool for a better understanding of potential nephrotoxicity induced by drugs overuse and may enhance awareness related to the MOH-associated risks, even in absence of clinical symptoms. (Source: The Journal of Headache and Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pediatric Autologous Islet Transplantation
Abstract A total pancreatectomy and islet autotransplant (TPIAT) offers substantial pain relief and improved quality of life for children who are severely affected by chronic or recurrent acute pancreatitis and for whom the usual medical and endoscopic therapies have failed. The pancreas is entirely resected, and the pancreatic islets are isolated from the pancreas and infused back into the patient’s liver. Because this is an autologous transplant, no immunosuppression is required. Over several months, the islets engraft in the liver; the patient is then slowly weaned off insulin therapy. Slightly more than 40 % of patients become and remain insulin independent, yet even among patients who remain on insulin, most have some islet function, permitting easier diabetes control. Th...


Nav1.7 Inhibitors: Potential Effective Therapy for the Treatment of Chronic Pain
ACS Medicinal Chemistry LettersDOI: 10.1021/acsmedchemlett.5b00312 (Source: ACS Medicinal Chemistry Letters)


FDA approves OxyContin for children 11 and older
Stephen FellerWASHINGTON, Aug. 14 (UPI) -- The Food and Drug Administration approved OxyContin for use with children in specific health situations to manage chronic and extreme pain. (Source: Health News - UPI.com)


Slow-Release Oxycodone Eases Chronic Pain in Children
No abstract available (Source: Oncology Times - Current Table Of Contents)


Lung Cancer Patients with Pain before Thoracotomy Likely to have Chronic Pain after
No abstract available (Source: Oncology Times - Current Table Of Contents)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Yeast's New Use: Making Narcotic Painkillers
Title: Yeast's New Use: Making Narcotic PainkillersCategory: Health NewsCreated: 8/13/2015 12:00:00 AMLast Editorial Review: 8/14/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Outcomes of Open Repair of Mycotic Descending Thoracic and Thoracoabdominal Aortic Aneurysms
Conclusions Open repair of mycotic descending thoracic and thoracoabdominal aortic aneurysms remains the gold standard of therapy. Aggressive intraoperative debridement with in situ prosthetic reconstruction permits a high rate of success in this very high risk cohort of patients. Lifelong antibiotic suppression therapy may prevent late prosthetic graft infection. (Source: The Annals of Thoracic Surgery)


Familial Contributions to Self‐Reported Sleep and Pain in Female Twins
ConclusionsThese findings support an association between poor sleep quality and pain and suggest that this relationship may be confounded by shared genetic and environmental factors, which could elucidate biological mechanisms that underlie the development and maintenance of pain and sleep problems. (Source: Pain Medicine)


COMT and OPRM1 genotype associations with daily knee pain variability and activity induced pain
Conclusion This study provides preliminary evidence that patients with certain genotypes for COMT rs4680 and OPRM1 rs1799971 (G-G and A-A, respectively) experience more variability in their day-to-day pain and exacerbation of pain after daily physical activity compared to patients with other genotypes. Our findings should be replicated in larger study populations. Implications Previous clinical research has focused primarily on differences in average level of pain between patients with and without a specific genotype. Assessment of within-person variability through repeated measurements in daily life enhances the reliability, power, and ecological validity of phenotypic measurement. Perspective This study provides preliminary evidence that patients with certain variations in the COMT and...


A Practical Approach to the Management of Radiation-Induced Hemorrhagic Cystitis
Abstract Radiation-induced hemorrhagic cystitis (HC) is a complication of pelvic radiotherapy, mainly for prostate and uterine cancers. In the acute phase, patients feel urinary urgency and bladder pain. This phase is reversible after radiotherapy. In the chronic stage, an irritative syndrome is coupled with hematuria during the 2–10 years following radiotherapy. Cystoscopy shows white and frosted mucosa with telangiectasia. The incidence is estimated at 5 % or less. It is suggested that the radiation oncologist reviews the dosimetry plan to validate that the lesions coincide with significant radiation exposure confirming diagnosis of radiation-induced HC. The treatment for HC is first symptomatic, with bladder lavage, clot evacuation, coagulation via cystoscopy and blood trans...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Distinct Influences of Anxiety and Pain Catastrophizing on Functional Outcomes in Children and Adolescents With Chronic Pain
Conclusions&nbsp;There were age-related differences regarding whether anxiety or pain catastrophizing more strongly predicted specific functional outcomes. Assessment and intervention efforts should emphasize both anxiety and pain catastrophizing. (Source: Journal of Pediatric Psychology)


Local pancreatic head resection: the search for optimal indications through quality of life assessments
Conclusions LPHR is safe and effective for a substantial proportion of patients with chronic pancreatitis. Further refinement in the selection of patients most likely to benefit from this operation is warranted. (Source: The American Journal of Surgery)


Effects of Time Frame on the Recall Reliability of CFS Symptoms
This study serves as an investigation of the reliability of symptom data as reported by individuals with chronic fatigue syndrome (CFS), across three recall time frames (the past week, the past month, and the past 6 months), and at two assessment points (with 1 week in between each assessment). Multilevel model analyses were used to determine the optimal recall time frame, in terms of test -retest reliability, for each of the Fukuda et al. (1994) case defining symptoms. Results suggested that the optimal time frame for reliably reporting CFS symptoms was six months for sore throat, lymph node pain, muscle pain, post-exertional malaise, headaches, memory/concentration difficulties, and unrefreshing sleep. For joint pain, the optimal time frame was one month. Researchers who are interested i...


Evidence for sustained mechanical pain sensitization in women with chronic temporomandibular disorder versus healthy female participants
We examined whether this index accounted for variance in prospective assessments of clinical TMD pain. (Source: The Journal of Pain)


Effects of a guided Internet-delivered self-help intervention for adolescents with chronic pain
Cognitive behavioral therapy (CBT) is effective in reducing the frequency and intensity of chronic pain in adolescents. However, CBT seems not to be considered acceptable by all adolescents. The main aim of our study was therefore to evaluate the effects of a guided Internet-delivered self-help for adolescents with chronic pain. Adolescents (N=69) were assessed on the outcome measures: pain, coping, disability, catastrophizing, rewarding of pain behavior by parents, and quality of life. Measures were taken seven weeks before treatment, pre-treatment, post-treatment, and at three months follow-up. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Impact of an Opioid Prescribing Guideline in the Acute Care Setting
Death from opioid abuse is a major public health issue. The death rate associated with opioid overdose nearly quadrupled from 1999 to 2008. Acute care settings are a major source of opioid prescriptions, often for minor conditions and chronic noncancer pain. (Source: The Journal of Emergency Medicine)


Use of a Hunter Rod for Staged Reconstruction of Peroneal Tendons
Peroneal tendon pathology is a commonly reported cause of lateral ankle pain. The causes include cavovarus foot type, overuse, chronic tendinosis, peroneal subluxation or dislocation, acute traumatic split tears, and traumatic rupture. The purpose of the present report is to describe an alternative approach for surgical reconstruction of the peroneal tendons in patients when repair might no longer be effective. The use of a Hunter rod was originally described by Hunter in 1971 for 2-stage reconstruction of tendons in the hand. (Source: Journal of Foot and Ankle Surgery)


[Multimodal pain therapy : Current situation].
Authors: Kaiser U, Sabatowski R, Azad SC Abstract A multidisciplinary approach for the management of patients with chronic pain is now well-established in many countries, especially in situations involving a complex disease process in the sense of a biopsychosocial model. Both the efficacy and cost-effectiveness of multidisciplinary pain treatment programs and their superiority compared to unimodal therapy has been documented in a number of studies, reviews and meta-analyses, in particular for patients suffering from chronic low back pain. Nevertheless, there are still major shortcomings concerning the definition of multimodal and multidisciplinary treatment and the quality of structures and processes, compared for example to the standards defined by the German Pain Society (Deutsc...


[Visceral pain].
Authors: Elsenbruch S, Häuser W, Jänig W Abstract Chronic visceral pain is an unresolved neurobiological, medical and socioeconomic challenge. Up to 20 % of the adult population suffer from chronic visceral pain and abdominal complaints constitute a prevalent symptom also in children and adolescents. Existing treatment approaches are often unsuccessful and patients typically suffer from multiple somatic and psychological symptoms. This complex situation requires integrative treatment approaches. This review summarizes current basic and clinical research on acute and chronic visceral pain with a focus on research groups in Germany. Despite significant clinical and scientific advances, a number of questions remain open calling for more funding to support research to elucidate the...


The Antinociceptive and Anti-Inflammatory Properties of 3-furan-2-yl-N-p-tolyl-acrylamide, a Positive Allosteric Modulator of α7 Nicotinic Acetylcholine Receptors in Mice.
CONCLUSIONS: These findings suggest that the administration of PAM-2, a new α7-selective type II PAM, reduces the neuropathic and inflammatory pain sensory and affective behaviors in the mouse. Thus, this drug may have therapeutic applications in the treatment and management of chronic pain. PMID: 26280585 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Polymorphism in COMT is associated with IgG 3 subclass level and susceptibility to infection in patients with chronic fatigue syndrome
Conclusion: Our results indicate a relationship of COMT polymorphism rs4680 with immune dysregulation in CFS providing a potential link for the association between stress and infection susceptibility in CFS. (Source: Journal of Translational Medicine)


Antioxidant therapy in acute, chronic and post-endoscopic retrograde cholangiopancreatography pancreatitis: An updated systematic review and meta-analysis.
CONCLUSION: While there is some evidence to support antioxidant therapy in AP, its effect on CP and PEP is still controversial. PMID: 26290647 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)


Music Helps Patients Cope With Surgery, Research Shows
BOSTON (CBS) &#8212; They say music soothes the soul, but it can also soothe pain following surgery. Surgery, by nature, is stressful. Patients are usually nervous before they go under the knife, and then wake up in pain. Surgery in progress. (WBZ-TV) Now, new research suggests music can help in a patient&#8217;s recovery. Researchers reviewed more than 72 studies about the effect of music before, during, and after surgery. They found that listening to music not only reduces anxiety, but also eases pain. Dr. Robert Jamison, a clinical psychologist at Brigham and Women&#8217;s Hospital, treats patients for chronic pain and says he is not surprised. Dr. Robert Jamison. (WBZ-TV) &#8220;Right around the time of surgery, people tend to be very anxious,&#8221; he says. &#8220;Music can help peop...


Zyga wins 510(k) for Simmetry fusion system
Zyga Technology said today it won 510(k) clearance from the FDA for its Simmetry sacroiliac joint fusion system for single or 2-incision indications. Based in Minnetonka, Minn., Zyga develops minimally invasive surgical products for the treatment of lumbar spinal conditions. &#8220;In the operating room, surgeons need as many options as possible to effectively treat each individual. This new Simmetry technique allows me to offer patients a single, 1-inch incision and to adapt the surgery to their individual anatomy and condition,&#8221;Dr. David Greenwald, M.D. of St. Augustine&#8217;s Flagler Brain and Spine Institute said in a press release. Last December, Zyga said it raised $2 million in an equity-and-options round it hopes will eventually bring in $5 million. A year earlier in Decemb...


This Many Million Adults Say They're in Pain Daily
Title: This Many Million Adults Say They're in Pain DailyCategory: Health NewsCreated: 8/13/2015 12:00:00 AMLast Editorial Review: 8/13/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


pCMV-vegf165 Intramuscular Gene Transfer is an Effective Method of Treatment for Patients With Chronic Lower Limb Ischemia
Effective treatment of chronic lower limb ischemia is one of the most challenging issues confronting vascular surgeons. There are a number of choices available to the vascular surgeon. Open or endovascular revascularization is the treatment of choice when applicable. Current pharmacological therapies play an auxiliary role and cannot prevent disease progression. Therefore, new methods of treatment are needed. We conducted a phase 2b/3 multicenter randomized controlled clinical trial of the intramuscular transfer of a plasmid DNA encoding vascular endothelial growth factor (VEGF) 165 with cytomegalovirus promotor (CMV) in patients with atherosclerotic lower limb ischemia. A total of 100 patients were enrolled in the study, that is, 75 patients were randomized into the test group and receive...


Fowler's syndrome of urinary retention: a retrospective study of co-morbidity
Conclusion We found high levels of co-morbidity with patients having some form of pain (50%), a probable functional disorder (24%) or psychological symptoms (31%). There are several potential explanations for this association including the effect of developing an apparently unexplained distressing condition, confounding effect of opiate use or referral bias. The findings suggest a need for prospective systematic study of comorbidity for this disabling condition. (Source: Journal of Neurology, Neurosurgery and Psychiatry)


Per cent of patients with chronic migraine who responded per onabotulinumtoxinA treatment cycle: PREEMPT
Conclusions A meaningful proportion of patients with CM treated with onabotulinumtoxinA who did not respond to the first treatment cycle responded in the second and third cycles of treatment. Trial registration number NCT00156910, NCT00168428. (Source: Journal of Neurology, Neurosurgery and Psychiatry)


Test-retest reliability and minimal detectable change of three-dimensional gait analysis in chronic low back pain patients
Chronic Low back pain (CLBP) is a common health condition in western industrialised countries with an estimated prevalence of 20.1±9.8% [1]. Patients often report difficulties during daily activities, such as gait. Studies have reported that gait coordination is changed in CLBP patients: they walk slower, take shorter steps and have asymmetric step lengths when compared with their healthy peers [2,3]. Chronic low back pain patients also have difficulty in moving from pelvis-trunk in-phase to anti-phase (pelvis and trunk moving in the same or in opposite directions, respectively) as walking speed increases [4] and consequently show lower variability of trunk rotations, possibly adopting a protective movement strategy to diminish pain [5]. (Source: Gait and Posture)


The use of paracetamol (acetaminophen) among a community sample of people with chronic non‐cancer pain prescribed opioids
ConclusionThe majority of people with chronic non‐cancer pain prescribed opioids report using paracetamol appropriately. High income, use of paracetamol/opioid combination analgesics and higher opioid dose were independently associated with paracetamol use above the recommended maximum daily dose. (Source: International Journal of Clinical Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Treatment of elderly with chronic pain in geriatric care and pain therapy facilities in Germany : Survey results].
CONCLUSION: Due to the differences between geriatric and pain management departments shown in all investigated areas, an exchange between these two cross-sectional subjects could help to improve inpatient, outpatient and intersectoral treatment of elderly patients with chronic pain. PMID: 26267819 [PubMed - as supplied by publisher] (Source: Schmerz)


Functional cognitive disorder: what is it and what to do about it?
Authors: Pennington C, Newson M, Hayre A, Coulthard E Abstract To err is human, and it is normal to make minor cognitive errors from time to time. Some people experience persistent subjective cognitive difficulties that cause distress and functional impairment, with no underlying structural, neurodegenerative, toxic or metabolic cause. This is considered a form of functional disorder. In this article, we review functional cognitive disorder and outline its core clinical features. Patients with this are typically of working age and have a source of psychological distress, such as chronic pain, work stress or family difficulties. Its distinction from incipient dementia is difficult and usually requires interval follow-up. Pointers towards possible dementia include abnormal neuroimagi...


Outcomes of Open Repair of Mycotic Descending Thoracic and Thoracoabdominal Aortic Aneurysms.
CONCLUSIONS: Open repair of mycotic descending thoracic and thoracoabdominal aortic aneurysms remains the gold standard of therapy. Aggressive intraoperative debridement with in situ prosthetic reconstruction permits a high rate of success in this very high risk cohort of patients. Lifelong antibiotic suppression therapy may prevent late prosthetic graft infection. PMID: 26277557 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)


SpineData – a Danish chronic back pain clinical registry
Kent P, Kongsted A, Jensen TS, Albert HB, Schiøttz-Christensen B, Manniche C (Source: Clinical Epidemiology)


Hydrocodone bitartrate for chronic pain.
Authors: Manchikanti L, Atluri S, Kaye AM, Kaye AD Abstract Hydrocodone bitartrate is the most commonly used drug for acute and chronic pain in the U.S. with over 135 million prescriptions in 2012. The U.S. is the primary consumer of hydrocodone, using 99% of the global supply for 4.4% of the global population. With its easy availability and abuse patterns, hydrocodone has been touted as a primary driver of opioid-related abuse and misuse. There are no clinical efficacy studies of hydrocodone in short-acting form in combination with acetaminophen or ibuprofen in chronic pain. Hydrocodone has been approved with two long-term formulations since 2014. The FDA has rescheduled hydrocodone from Schedule III to Schedule II which went into effect on October 6, 2014, along with a limit on a...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Palmitoylethanolamide reduces pain-related behaviors and restores glutamatergic synapses homeostasis in the medial prefrontal cortex of neuropathic mice
Conclusions: Given the potential role of the mPFC in pain mechanisms, our findings may provide novel insights into neuropathic pain forebrain processes and indicate PEA as a new pharmacological tool to treat neuropathic pain and the related negative affective states.Graphical AbstractPalmitoylethanolamide: a new pharmacological tool to treat neuropathic pain and the related negative affective states. (Source: Molecular Brain)


Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: Quasi-randomised parallel controlled study
To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). (Source: Physiotherapy)


Informative gene network for chemotherapy-induced peripheral neuropathy
Conclusion: Neurotoxicity is common in cancer patients treated with platinum compounds and anti-microtubule agents and CIPN is one of the debilitating sequela. The bioinformatic approach helped identify genes associated with CIPN in cancer patients. (Source: BioData Mining)


A Highly Mobile Mass in the Anterior Left Ventricular Outflow Tract Immediately Beneath a Heavily Calcified, Stenotic Aortic Valve: Vegetation, Thrombus, or Neoplasm?
AN 87-YEAR-OLD, 124-kg, 170-cm man with a history of coronary artery disease, hypertension, hyperlipidemia, and chronic atrial fibrillation was admitted to the authors’ institution for progressive lower extremity swelling, increasing shortness of breath, and dyspnea on exertion. The patient also reported orthopnea, paroxysmal nocturnal dyspnea, intermittent coughing, fatigue, and recent weight gain but denied fever, chills, palpitations, and chest pain or pressure. He underwent single-vessel coronary artery surgery 14 years before the current admission. (Source: Journal of Cardiothoracic and Vascular Anesthesia)


Assessing the relationship between oral chronic graft-versus-host disease and global measures of quality of life
Chronic graft-versus-host disease (cGVHD) is a frequent complication of allogeneic hematopoietic stem cell transplantation (alloHSCT) and a leading cause of long-term morbidity and non-relapse mortality [1]. Approximately 30–70% of alloHSCT recipients develop some degree of cGVHD, which can manifest in various anatomic locations including the skin, mouth, eyes, and lungs, contributing to varying degrees of morbidity and chronic disability [2–4]. The oral cavity is one of the most frequently affected sites, with manifestations characterized by lichenoid mucosal inflammation with associated pain and sensitivity, difficulty eating, dry mouth and related complications [5–8]. (Source: Oral Oncology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Respective pharmacological features of neuropathic-like pain evoked by intrathecal BDNF versus sciatic nerve ligation in rats
Numerous reported data support the idea that Brain Derived Neurotrophic Factor (BDNF) is critically involved in both depression and comorbid pain. The possible direct effect of BDNF on pain mechanisms was assessed here and compared with behavioral/neurobiological features of neuropathic pain caused by chronic constriction injury to the sciatic nerve (CCI-SN). Sprague-Dawley male rats were either injected intrathecally with BDNF (3.0ng i.t.) or subjected to unilateral CCI-SN. Their respective responses to anti-hyperalgesic drugs were assessed using the Randall-Selitto test and both immunohistochemical and RT-qPCR approaches were used to investigate molecular/cellular mechanisms underlying hyperalgesia in both models. (Source: European Neuropsychopharmacology)


[Pain medicine from intercultural and gender-related perspectives].
Authors: Schiltenwolf M, Pogatzki-Zahn EM Abstract Cultural setting and sex and gender of the patient are important factors affecting the occurrence, severity, clinical course and prognosis of pain and pain-related diseases. Intercultural differences in the perception and verbal expression of symptoms and emotional function are fundamental and it is important to realize these differences in order to understand patients with a migration background. A trusting doctor-patient relationship is generally very sensitive and it is even more difficult to establish when differences in the cultural background impair mutual understanding. Regarding sex and gender there is evidence that females are more susceptible to developing chronic pain conditions, experience more severe pain and respond d...


[Healthcare services research on pain in Germany : A survey].
Authors: Häuser W, Neugebauer E, Petzke F Abstract Within the last ten years healthcare services research has developed into an independent interdisciplinary field of research. A selective search of the literature was conducted in the database Google Scholar and the database on healthcare services research in Germany ( http://versorgungsforschung-deutschland.de ) for healthcare services research projects on pain in Germany. Healthcare services research projects were conducted by pharmaceutical companies, patient self-help organizations, scientific societies, statutory health insurance companies and university departments on acute and chronic pain. Valid data on the epidemiology, grading and treatment of chronic pain are available. There was an overuse of opioids and invasive proce...


An observational evaluation of a new foam adhesive dressing.
This article will describe the findings of an observational evaluation to observe, document and analyse the clinical effectiveness of a new foam adhesive dressing, UrgoTul(®) Absorb Border (Urgo Medical). The main objective of the evaluation was to define the parameters to allow data capture that would demonstrate the clinical effectiveness of the dressing. Parameters studied and analysed included atraumatic pain-free dressing changes; ease of dressing application; comfort and conformability; exudate management; ability of the dressing to stay in place; and peri-wound skin management. A total of 25 patients with wounds suitable to be dressed using the evaluation product were recruited following a full documented wound assessment by the tissue viability nurse. Participants were selected ac...


Nociceptin/orphanin FQ receptor and pain: Feasibility of the fourth opioid family member.
Authors: Di Cesare Mannelli L, Micheli L, Ghelardini C Abstract The pharmacological management of chronic pain is a major therapeutic problem. The need of repeated treatments reduces the usefulness of classical analgesic drugs, like μ opioid receptor (MOP) agonists, characterized by tolerance development, side effects and abuse. Moreover, the pathological persistence of pain modifies nociceptive signals and pain-devoted structure activity weakening MOP agonists and making difficult the research of new active molecules. Nociceptine/orphanin FQ (N/OFQ) and its receptor (NOP) offers a peculiar opioid system able to interact with MOP receptors and made more sensitive by chronic pain conditions. The pain reliever efficacy of NOP agonists against persistent pain, mainly neuropathic pain...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pelvic Apophyseal Avulsion Fractures: A Retrospective Review of 228 Cases
Conclusions: In this series, nearly all pelvic avulsion fractures (97%) were managed successfully with a conservative approach. Contrary to prior studies, AIIS avulsions represented half of the avulsion fractures. AIIS and ischial tuberosity fractures are at increased risk of developing future pain and nonunions, respectively. Patients and families need to be counseled about this possibility because future intervention may be necessary. Level of Evidence: Level IV—therapeutic. (Source: Journal of Pediatric Orthopaedics)


NeuroMetrix inks distro deal with Advantage Consumer Healthcare
NeuroMetrix (NSDQ:NURO) said yesterday it signed a deal with supply chain company Advantage Consumer Healthcare to expand the distribution of its Quell wearable pain relief device. The new deal will position ACH to distribute the pain relief device to the retail sector, including mass merchandisers and chain drug stores, Waltham, Mass.-based NeuroMetrix said. &#8220;We are excited to have Advantage lead our retail launch. Retail expansion is a key component of our strategy, combined with an ongoing relationship with healthcare professionals. Advantage demonstrated a unique understanding of the marketplace and how to create new categories within the major U.S. retailers. Their portfolio is primarily high growth, cutting edge brands such as Quell,&#8221; NeuroMetrix senior veep Frank McGill...


New Analysis Adds to Understanding of Pain in America
In this blog post, NCCIH Director Dr. Josephine Briggs discusses new research findings that 11.2 percent of Americans experience chronic pain and 17.6 percent suffer from severe pain. NCCIH is leading efforts to find nondrug approaches for treating pain and related conditions. (Source: NCCAM Featured Content)


West Africa: Thousands of Ebola Survivors Face Severe Pain, Possible Blindness - Experts
[Vanguard] London -Some global health experts said thousands of West Africans who survived the Ebola virus infection were suffering chronic conditions such as serious joint pain and eye inflammation that could lead to blindness. (Source: AllAfrica News: Health and Medicine)


Persistent pain alters AMPA receptor subunit levels in the nucleus accumbens
Conclusion: Our study shows that while both short-term and persistent pain can trigger depression-like behaviors, GluA1 upregulation in the NAc likely represents a unique adaptive response to minimize depressive symptoms in persistent pain states. (Source: Epidemiologic Perspectives and Innovations)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Preoperative Platelet–Lymphocyte Ratio Augments CA 19-9 as a Predictor of Malignancy in Chronic Calcific Pancreatitis
Conclusion PLR is at least as good as CA 19-9 as a diagnostic marker to differentiate between malignant and inflammatory head mass in CCP. When used together, PLR improves the predictive value of serum CA 19-9. (Source: World Journal of Surgery)


Concussion in Chronic Traumatic Encephalopathy
Abstract Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that occurs in association with repetitive mild traumatic brain injury. It is associated with a variety of clinical symptoms in multiple domains, and there is a distinct pattern of pathological changes. The abnormal tau pathology in CTE occurs uniquely in those regions of the brain that are likely most susceptible to stress concentration during trauma. CTE has been associated with a variety of types of repetitive head trauma, most frequently contact sports. In cases published to date, the mean length of exposure to repetitive head trauma was 15.4 years. The clinical symptoms of the disease began after a mean latency of 14.5 years with a mean age of death of 59.3 years. Most subjects had ...


Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control
This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. (Source: Journal of Holistic Nursing)


Burdensome problems of chronic musculoskeletal pain and future prospects
Abstract According to a recent survey, about 15 % of the Japanese population suffers from moderate-severe chronic musculoskeletal pain persisting for at least 6 months. Social factors and related psychological factors (including depression) thus appear to greatly affect chronic musculoskeletal pain. This suggests the need for measures that take these factors into account. Treatment for musculoskeletal pain at present is generally based on a biomedical model that has been used for many years in this field, and modern medical imaging technologies have been a high priority to support this model and treatment strategy. Under the concept of the biomedical model, nonsteroidal antiinflammatory drugs, channel blockers and opioid analgesics are generally used as pharmacotherapy to allevi...


A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: SHORT-TERM results of a randomised controlled trial
This study assessed the short-term effect of a specific exercise program targeting movement control impairment versus general exercise treatment on disability in patients with LBP and MCI. (Source: Journal of Bodywork and Movement Therapies)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Amelioration of the reduced antinociceptive effect of morphine in the unpredictable chronic mild stress model mice by noradrenalin but not serotonin reuptake inhibitors
Conclusions: We demonstrated that the antinociceptive effect of morphine but not tramadol was reduced in mice that had experienced UCMS. The reduced antinociceptive effect of morphine under the UCMS condition was ameliorated by pretreatment with maprotiline but not escitalopram. These results suggest that the reduced antinociceptive effects of morphine under conditions of chronic stress may be ameliorated by activation of the noradrenergic but not the serotonergic system. (Source: Molecular Pain)


Surgery for chronic inguinodynia following routine herniorrhaphy: beneficial effects on dysejaculation
Conclusion Dysejaculation in men suffering from chronic pain after routine inguinal herniorrhaphy is not uncommon. A tailored neurectomy, funicular release and/or mesh removal offer relief in the majority of these patients. (Source: Hernia)


Symbiotics in irritable bowel syndrome – better than probiotics alone?
Purpose of review: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder associated with significant physical and psychological comorbidity. The etiology of the condition is uncertain but recent research suggests that the gut bacterial composition may play a role in its development. Therefore, manipulation of the intestinal microbiome by using probiotics and symbiotics has the potential to improve patient outcomes in IBS. Recent findings: Numerous randomized controlled trials suggest a benefit of probiotics in the management of IBS, with a significant reduction in the likelihood of symptoms persisting after therapy, and improvements in abdominal pain, bloating and flatulence when probiotics are compared with placebo. Evidence for the effect of probiotics on quality of life ...


Thousands of Ebola Survivors Face Pain, Possible BlindnessThousands of Ebola Survivors Face Pain, Possible Blindness
Thousands of West Africans who were infected with the Ebola virus but survived it are suffering chronic conditions such as serious joint pain and eye inflammation that can lead to blindness, global health experts said. Reuters Health Information (Source: Medscape Medical News Headlines)


Oxycodone/naloxone vs oxycodone vs morphine in chronic low back pain
Ueberall MA, Mueller-Schwefe GHH (Source: Journal of Pain Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ebola Survivors Plagued by Chronic Joint Pain, Eye Problems (FREE)
By Amy Orciari Herman Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH Over 13,000 people have survived the Ebola outbreak in West Africa, and many are now dealing with joint pain, eye problems, and … (Source: Physician's First Watch current issue)


Pathogenetic Mechanisms of Deep Infiltrating Endometriosis
Endometriosis is a benign gynecologic disease, affecting women of reproductive age associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. Ovarian endometrioma (OMA), superficial peritoneal endometriosis (SPE), and deep infiltrating endometriosis (DIE) are, till now, recognized as major phenotypes. The discussion is to know whether they share the same pathogenetic mechanisms. Till today, DIE is recognized as the most severe clinical form of endometriosis and has a complex clinical management. The DIE lesions have been considered in the present article, without distinguishing between the anterior (bladder) or the posterior (vagina, uterosacral ligaments, rectum, and ureter) compartment. The present knowledge indicates that hormonal function (estrogen and progesterone...


Lessons from the Drosophila microbiota
Emma L WaltonBiomedical Journal 2015 38(4):271-274This issue of the Biomedical Journal includes two reviews discussing how studying the gut of the humble fruit fly can reveal important insight about our own microbial communities. In addition, we focus on work showing that acupuncture may not be the best treatment for idiopathic chronic pelvic pain. Finally, we report on several studies that will hopefully help to optimize surgical techniques, from laser treatment for birthmarks to the design of prostheses for radial head fractures. (Source: Biomedical Journal)


Inferior hypogastric plexus blockade versus acupuncture for the management of idiopathic chronic pelvic pain: A randomized clinical trial
Conclusion: The study results showed that inferior hypogastric blockade had a 72.6&#x0025; success rate and showed a significantly higher effect on reducing pain intensity in a short period of time in the management of CPP, compared to acupuncture. (Source: Biomedical Journal)


An unusual case of chronic abdominal pain
(Source: Clinical Gastroenterology and Hepatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The (mis)diagnosis of CIDP: The high price of missing the mark
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated peripheral nervous system disorder classically presenting with progressive, symmetrical limb weakness including the proximal muscles, generalized areflexia, and large fiber sensory loss.1 Electrodiagnostic studies show unequivocal segmental demyelination in multiple motor nerves or nerve roots, and the CSF protein level is usually elevated. In addition to classical CIDP, there are many variant presentations, so-called atypical forms, such as pure motor, pure sensory, regional (restricted to the upper or lower limbs), multifocal (Lewis-Sumner syndrome), and distal patterns.2 The diagnosis of CIDP can be established when patients meet carefully delineated clinical, electrodiagnostic, and laboratory criteria,1,2 bu...


Caught in suffering bodies: a qualitative study of immigrant women on long‐term sick leave in Norway
ConclusionsThe chronic pain made the immigrant women suffer, because they experienced it as a threatening, incomprehensible and unreal force, without meaning or the ability to be controlled. Their own psychological distress exacerbated their pain. Relevance to clinical practiceImmigrant women on long‐term sick leave are likely to need special approaches that are closely adapted to their different backgrounds and their unique personal experiences. We recommend culturally appropriate family counselling and collaboration with employers at the women's workplaces. (Source: Journal of Clinical Nursing)


The H2S-producing enzyme CSE Is dispensable for the processing of inflammatory and neuropathic pain.
Authors: Syhr KM, Boosen M, Hohmann SW, Longen S, Köhler Y, Pfeilschifter J, Beck KF, Geisslinger G, Schmidtko A, Kallenborn-Gerhardt W Abstract Accumulating lines of evidence indicate that hydrogen sulfide (H2S) contributes to the processing of chronic pain. However, the sources of H2S production in the nociceptive system are poorly understood. Here we investigated the expression of the H2S releasing enzyme cystathionine γ-lyase (CSE) in the nociceptive system and characterized its role in chronic pain signaling using CSE deficient mice. We show that paw inflammation and peripheral nerve injury led to upregulation of CSE expression in dorsal root ganglia. However, conditional knockout mice lacking CSE in sensory neurons as well as global CSE knockout mice demonstrated normal pai...


[Acute abdomen with actinomycosis of the colon: A case report].
CONCLUSIONS: Actinomycosis is a disease that must be considered by the surgeon when faced with a clinical picture of subacute onset with intermittent fever, weight loss, abdominal pain, and even anaemia in patients with abdominal and retroperitoneal abscesses or previous history of surgery. PMID: 26272424 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Neurofibromatosis of the lumbosacral plexus and femoral nerve as a cause of chronic lumbal pain syndrome
We present a case of a 26-year old woman whose first symptoms started five years ago as pain in the left knee and the hip. A whitish spot on the back outer side of the left thigh appeared two years ago, subcutaneous nodules arose one year later. The pain was sensitive to weather changes and more intense at night. She was treated with gabapentin, which decreased the pain frequency, but has not reduced the pain intensity.Physical examination showed that left leg circumference was 4cm less than the right and there was a mild weakness of the left leg. (Source: Clinical Neurophysiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Koumine enhances spinal cord 3&#945;-hydroxysteroid oxidoreductase expression and activity in a rat model of neuropathic pain
Conclusion: This study demonstrates that 3α-HSOR is an important molecular target of koumine for alleviating neuropathic pain. Koumine may prove a promising compound for the development of novel analgesic agents effective against intractable neuropathic pain. (Source: Molecular Pain)


Koumine enhances spinal cord 3α-hydroxysteroid oxidoreductase expression and activity in a rat model of neuropathic pain
Conclusion: This study demonstrates that 3α-HSOR is an important molecular target of koumine for alleviating neuropathic pain. Koumine may prove a promising compound for the development of novel analgesic agents effective against intractable neuropathic pain. (Source: BioMed Central)


A Rare Case of Cardiac Tamponade Induced by Chronic Rheumatoid Arthritis.
We present a unique case of a patient with long standing RA who presented with a primary complaint of chest and back pain. Echocardiography revealed borderline normal left ventricular function and a large pericardial effusion with the finding of elevated intrapericardial pressure suspicious for cardiac tamponade. Infectious workup was all found to be negative. The presence and elevation of anti-cyclic citrullinated peptide antibody, rheumatoid factor and C-reactive protein (CRP) confirmed the patient was having an active flare-up of RA. It was determined that this flare-up was the cause of the cardiac tamponade. A pericardiocentesis was performed and 850 mL of bloody fluid was drained. The patient remained stable following the pericardiocentesis. At his follow-up visit, repeat echocardiogr...


Non-allopathic adjuvant management of osteoarthritis by alkalinisation of the diet.
CONCLUSION: A dietary supplement, Multiforce® Alkaline Powder, containing citrate salts which are converted into bicarbonate in vivo, was efficacious and safe as sole therapeutic intervention, significantly attenuating OA-associated signs and symptoms of the hands. PMID: 26245599 [PubMed - in process] (Source: Primary Care)


Evaluation of Health Plan Interventions to Influence Chronic Opioid Therapy Prescribing
Discussion: Following initiatives implemented to alter physician prescribing practices and norms, mean opioid dose prescribed to COT patients declined more in intervention than control practices. Physicians reported more conservative beliefs regarding opioid prescribing immediately after completing an online course in 2011, but the course was not associated with additional reductions in mean daily opioid dose prescribed by physicians completing the course. (Source: The Clinical Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Baseline Variation in Use of VA/DOD Clinical Practice Guideline Recommended Opioid Prescribing Practices Across VA Health Care Systems
Discussion: In 2010, guideline-recommended practices for opioid prescribing were variably used across VA health care systems. Efforts to disseminate practices used at high-performing sites, and increase consistency of use of recommended practices across patients and facilities should be considered to improve pain management and reduce adverse events. (Source: The Clinical Journal of Pain)


R-phenibut binds to the α2–δ subunit of voltage-dependent calcium channels and exerts gabapentin-like anti-nociceptive effects
In conclusion, our results provide experimental evidence for GBP-like, anti-nociceptive properties of R-phenibut, which might be used clinically to treat neuropathic pain disorders. Graphical abstract (Source: Pharmacology Biochemistry and Behavior)


A Brief Mindfulness Meditation Training Increases Pain Threshold and Accelerates Modulation of Response to Tonic Pain in an Experimental Study
ConclusionsA brief MM intervention appears to affect perception of experimental pain both by increasing pain threshold and accelerating modulation of response. Findings may help elucidate mechanisms of MM for chronic pain. (Source: Pain Medicine)


Lower‐extremity ulcers: diagnosis and management
We present a comprehensive yet condensed approach to managing lower‐extremity ulcers, from diagnosis to basic management. (Source: British Journal of Dermatology)


Lower-extremity ulcers: diagnosis and management.
We present a comprehensive yet condensed approach to managing lower-extremity ulcers, from diagnosis to basic management. PMID: 26257052 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ebola Survivors Face Lingering Pain, Fatigue and Depression
About half the survivors seem to have chronic joint pain that is often severe enough to prevent them from working, an expert said. (Source: NYT Health)


Mental defeat is associated with suicide intent in patients with chronic pain - Tang NK, Beckwith P, Ashworth P.
This study examined the role of mental def... (Source: SafetyLit: All (Unduplicated))


Reduced Access to Meds After Crackdown on Illegal Rx Drug TradeReduced Access to Meds After Crackdown on Illegal Rx Drug Trade
An unintended side effect of a crackdown on prescription drug abuse affects chronic pain patients’ access to medication. Kaiser Health News (Source: Medscape Medical News Headlines)


Validation of fibromyalgia survey questionnaire and polysymptomatic distress scale in a Persian population
Abstract The aim of this study was to assess validity of the fibromyalgia survey questionnaire (FSQ) and polysymptomatic distress scale (PSD) in an Iranian population. We also sought to classify the severity levels of fibromyalgia (FM) symptoms according to the PSD scale. Participants were divided into FM and non-FM chronic pain disorder groups according to expert physician diagnosis. Patients in both groups answered to Persian-translated version of FSQ, fibromyalgia impact questionnaire (FIQ) and Short-Form-12 (SF-12). Both 1990 ACR criteria and FSDC were assessed in participates of two groups. Internal consistency and construct validity were evaluated. There was good internal consistency measured by Cronbach’s alpha (0.814 for FSQ). FSQ and its subscales correlated significant...


Effect of a Novel, Orally Active Matrix Metalloproteinase-2 and -9 Inhibitor in Spinal and Trigeminal Rat Models of Neuropathic Pain.
CONCLUSION: The results demonstrated that oral AQU-118 attenuates mechanical allodynia in both neuropathic pain models and with efficacies that mirror gabapentin at the 40 mg/kg dose used in the CCI-IoN model but without effect on basal sensitivity to mechanical stimulation/locomotive activity. These findings support a possible role for MMP-2/-9 in the etiology of neuropathic pain and also suggest that inhibition strategies represent a viable treatment option. PMID: 26244437 [PubMed - in process] (Source: Journal of Orofacial Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Temporomandibular Disorders in a Young Adolescent Brazilian Population: Epidemiologic Characterization and Associated Factors.
CONCLUSION: About 25% of the adolescents evaluated presented painful TMD, and the majority of these comprised muscular and chronic cases. Some factors, such as reports of headache complaints, oral parafunctions, tooth grinding at night, and parents not living together, were associated with this condition among young Brazilian adolescents. Special attention should be given to these factors among adolescents with TMD. PMID: 26244432 [PubMed - in process] (Source: Journal of Orofacial Pain)


Thousands of Ebola survivors face severe pain, possible blindness
LONDON (Reuters) - Thousands of West Africans who were infected with the Ebola virus but survived it are suffering chronic conditions such as serious joint pain and eye inflammation that can lead to blindness, global health experts said on Friday. (Source: Reuters: Health)


A Cross-Sectional Study of Psychological Comparison Processes That May Underlie the Acceptance of Chronic Pain.
In this study, the two subscales of the Chronic Pain Acceptance Questionnaire (Activity Engagement and Pain Willingness) were complemented with a scale of Affective Acceptance. Using linear regression analyses, data from these three acceptance scales were regressed on three scales of temporal comparison processes, four scales of social comparison processes and one scale of counterfactual comparisons. The results showed that the comparison processes explained up to 37% of the variance in acceptance, especially a higher frequency of thinking of one's present condition in relation to a condition in the past, and feeling bad when comparing with others who are doing better, were consistently related to lower acceptance. These explorative results may inspire experimental studies to influence com...


Small Molecule Agonists of Cell Adhesion Molecule L1 Mimic L1 Functions In Vivo
Abstract Lack of permissive mechanisms and abundance of inhibitory molecules in the lesioned central nervous system of adult mammals contribute to the failure of functional recovery after injury, leading to severe disabilities in motor functions and pain. Peripheral nerve injury impairs motor, sensory, and autonomic functions, particularly in cases where nerve gaps are large and chronic nerve injury ensues. Previous studies have indicated that the neural cell adhesion molecule L1 constitutes a viable target to promote regeneration after acute injury. We screened libraries of known drugs for small molecule agonists of L1 and evaluated the effect of hit compounds in cell-based assays in vitro and in mice after femoral nerve and spinal cord injuries in vivo. We identified eight small...


7.0 T high-resolution 1H-MR spectroscopy of metabolic changes induced by chronic codeine phosphate in rat hippocampus
Codeine phosphate is used widely to treat cough and pain. It is actually a sedative, but is known to cause codeine dependence. The exact mechanisms of codeine dependence are not fully understood, but are generally believed to be related to drug-induced neuroadaptation. Metabolites changes can provide information for pathological processes and mechanisms before the shape change. It is very useful for the diagnosis and treatment of drug addiction. We used 1H NMR spectroscopy in vivo to measure the concentrations of cerebral metabolites in the hippocampus of rats subjected to repeated codeine treatment. After 2 months of codeine treatment, the concentration of N-acetylaspartate was significantly decreased in hippocampi, as was that of glutamate, choline, and taurine. Our study highlights the ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Kolkata surgeons find 360 GALLSTONES inside Indian woman
Mousumi Dam, 49, from Kolkata, had been suffering chronic abdominal pain for months. Doctors were amazed to find such a huge cluster of tiny marble-sized stones in her gallbladder. (Source: the Mail online | Health)


Pancreatic pain
Purpose of review: Pain is the most common symptom of chronic pancreatitis, with a profound socioeconomic impact. Historical management paradigms failed, as they did not adequately address the fundamental underlying mechanisms. The present article describes the neurobiology of pain and sensitization in this condition, in an effort to explain prior failings and provide future directions for managing pain in chronic pancreatitis. Recent findings: A number of recent advances have been made in understanding the neurobiology of pain for this condition. This has been coupled with clinical advances in assessing sensitization to pain in these patients, which has been shown to predict response to medical and surgical therapy. Summary: Pain in chronic pancreatitis is complex. Addressing the mechanic...


Subgroups of fibromyalgia patients using the 1990 American College of Rheumatology criteria and the modified 2010 preliminary diagnostic criteria: the al-Ándalus project.
CONCLUSIONS: Our results reinforce the understanding of fibromyalgia as a heterogeneous condition. Subgrouping of fibromyalgia patients is highly recommendable, since these subgroups show diverse clinical pictures and therefore treatment options should be individually tailored to their specific profile. The combination of 1990c and the m-2010c is potentially useful to identify subgroups of fibromyalgia patients. PMID: 26242639 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)


Persistent anal and pelvic floor pain after PPH and STARR: surgical management of the fixed scar staple line
Conclusions The relief of PAP after stapled procedure, in which we recognize a scarred and fixed staple line, depends by the early recognition of this typical finding. The authors suggest the surgical treatment not later than 3–6 months after the onset of symptoms to achieve the best results. (Source: International Journal of Colorectal Disease)


Vitamin D supplementation for the prevention of type 2 diabetes in overweight adults: study protocol for a randomized controlled trial
DiscussionThe trial will provide much needed clinical evidence on the impact of vitamin D supplementation on insulin resistance and secretion and its underlying mechanisms, which are relevant for the prevention and management of type 2 diabetes.Trial registrationClinicaltrials.gov ID: NCT02112721. (Source: Trials)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effectiveness of complementary pain treatment for women with deep endometriosis through transcutaneous electrical nerve stimulation (TENS): randomized controlled trial
Conclusions Both resources (acupuncture-like TENS and self-applied TENS) demonstrated effectiveness as a complementary treatment of pelvic pain and deep dyspareunia, improving quality of life in women with deep endometriosis regardless of the device used for treatment. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)


The Role of Catastrophizing Beliefs in Effective Chronic Pain Treatment
Abstract Chronic pain is a serious and complex health issue. Patients dealing with chronic pain demonstrate multifarious behavioral and cognitive responses to their widely varying individual experiences. How can we, as health professionals, best serve these patients? In this paper, we discuss the place of pain within the historical conceptualization of health and normalcy, and the more current biopsychosocial model. We also review contemporary theories on how cognition plays a vital role in the psychological processing of stimuli, including pain. We focus on the significant interactions between catastrophizing appraisals of pain and the chronic pain experience, including increases in pain perception, pain sensitivity, depression and disability. In light of these significant intera...


Re: Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study
Publication date: Available online 5 August 2015 Source:The American Journal of Surgery Author(s): Amy Gardiner, Robert Drummond, Richard Stevenson, Emma Wright, Erin McIlveen, Adam Couves, Raymond Oliphant (Source: The American Journal of Surgery)


Modulation of morphine antinociceptive tolerance and physical dependence by co-administration of simvastatin
Publication date: Available online 6 August 2015 Source:Pharmacology Biochemistry and Behavior Author(s): Mohammad Taghi Mansouri, Mohammad Javad Khodayar, Amirhossein Tabatabaee, Behnam Ghorbanzadeh, Bahareh Naghizadeh Statins, 3-hydroxy-3-methylglutaryl co-enzyme A (HMG-CoA) reductase inhibitors, are widely used in the management of different diseases beyond their primary indication for lowering cholesterol. Previous studies have demonstrated the neuroprotective effects of simvastatin in different animal models. In the present study, we examined the effects of simvastatin (30, 60, 100 and 300mg/kg, p.o.) on the development and expression of morphine-induced tolerance and dependence in mice. For the induction of morphine tolerance and dependence, mice were twice daily treated with ...


Inhibition of spinal 5-HT3R reverted diabetes-induced mechanical hypersensitivity in a GABAAR-mediated neurotransmission-dependent manner
In this study, we evaluated the contribution of spinal 5-HT3R to pain facilitation and spinal sensitization during DNP, exploiting the role of GABAAR-mediated neurotransmission and glial activation in the effects elicited by intrathecal administration of a 5-HT3R antagonist. Mechanical nociception was evaluated by paw pressure test in streptozotocin (STZ)-diabetic and control rats after intrathecal (i.t.) administration of a 5-HT3R antagonist (Y25130). The spinal activation of extracellular signal-regulated kinases (ERKs) pathway and the expression of 5-HT3R, glial fibrillary acidic protein (GFAP; marker of astroglia activation) and ionized calcium binding adaptor molecule 1 (IBA-1; marker of microglia activation) were evaluated at the peak maximum effect of Y25130. The involvement of GABA...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


How we treat sickle cell patients with leg ulcers
This article is protected by copyright. All rights reserved. (Source: American Journal of Hematology)


Physical activity engagement in early rheumatoid arthritis: A qualitative study to inform intervention development
Physical activity (PA) in patients with rheumatoid arthritis (RA) is lower than in the general population. PA can improve physical function in RA, decrease chronic inflammation and reduce pain, without adversely affecting disease activity. (Source: Physiotherapy)


The role of sensitization in musculoskeletal shoulder pain.
DISCUSSION: It appears that peripheral sensitization manifests consistently in those with musculoskeletal shoulder pathology, probably due to the inflammatory processes related to tissue injury. Central sensitization, while not universally present, was reported in a majority of the manuscripts. Because central sensitization is thought to be a key step on the pathway to chronic pain, evidence for its presence in those with shoulder pain is significant. Clinicians should expect the presence of sensitization with shoulder pathology and make appropriate choices about interventions so as not to exacerbate pain. PMID: 26270721 [PubMed - as supplied by publisher] (Source: Physical Therapy)


P-279 * prognostic factors and scoring system for acute and chronic pain following lobectomy
(Source: Interactive CardioVascular and Thoracic Surgery)


Medtech approvals: FDA releases May 2015 PMAs
The FDA today released its list of the pre-market approvals it granted for medical devices in May 2015: Summary of PMA Originals & Supplements Approved Originals: 5 Supplements: 51 Summary of PMA Originals Under Review Total Under Review: 55 Total Active: 26 Total On Hold: 29 Summary of PMA Supplements Under Review Total Under Review: 547 Total Active: 379 Total On Hold: 168 Summary of All PMA Submissions Originals: 1 Supplements: 62 Summary of PMA Supplement PMA Approval/Denial Decision Times Number of Approvals: 51 Number of Denials: 0 Average Days Fr Receipt to Decision (Total Time): 109.5 FDA Time: 86.4 Days MFR Time: 23.1 Days PMA Original Approvals APPLICATION NUMBER / DATE of APPROVAL DEVICE TRADE NAME COMPANY NAME CITY, STATE, & ZIP DEVICE DESCRIPTION / INDIC...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Modulation of inflammatory mediators in the trigeminal ganglion by botulinum neurotoxin type A: an organ culture study
Conclusion: We hypothesize that chronic migraine might be associated with some degree of inflammation in the TG that could involve both neurons and SGCs. It is clinically well recognized that treatment with corticosteroids will reduce the symptoms of chronic migraine; however this remedy is associated with long-term side effects. Understanding the mechanisms involved in the expressional alterations may suggest novel ways to modify the changes and indicate novel therapeutics. The results of the present work illustrate one way by which BoNT-A may modify these expressional alterations. (Source: Epidemiologic Perspectives and Innovations)


Nociception, Pain, Negative Moods, and Behavior Selection
Publication date: 5 August 2015 Source:Neuron, Volume 87, Issue 3 Author(s): Marwan N. Baliki, A. Vania Apkarian Recent neuroimaging studies suggest that the brain adapts with pain, as well as imparts risk for developing chronic pain. Within this context, we revisit the concepts for nociception, acute and chronic pain, and negative moods relative to behavior selection. We redefine nociception as the mechanism protecting the organism from injury, while acute pain as failure of avoidant behavior, and a mesolimbic threshold process that gates the transformation of nociceptive activity to conscious pain. Adaptations in this threshold process are envisioned to be critical for development of chronic pain. We deconstruct chronic pain into four distinct phases, each with specific mechanisms,...


Treatment of Lateral Epicondylosis Using Allogeneic Adipose‐Derived Mesenchymal Stem Cells: A Pilot Study
Abstract Mesenchymal stem cell therapy is a novel regenerative approach for treating tendinopathy. Here, we evaluated the safety and efficacy of allogeneic adipose‐derived mesenchymal stem cells (allo‐ASC) in treating lateral epicondylosis (LE). Under ultrasound guidance, allo‐ASCs mixed with fibrin glue were injected into the hypoechoic common extensor tendon lesions of 12 participants with chronic LE; 6 subjects each were administered 106 or 107 cells in 1 ml. Safety was evaluated at day 3 and weeks 2, 6, 12, 26, and 52 post‐injection. Efficacy was assessed by measuring patients’ visual analog scale (VAS) score for elbow pain, modified Mayo clinic performance index for the elbow, and by evaluating longitudinal and transverse ultrasound images of tendon defect areas after 6, 12,...


Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis
ConclusionThe role of negative pressure wound therapy with instillation continues to expand and can be used in the management of both acute and chronic wounds in the head and neck. © 2015 Wiley Periodicals, Inc. Head Neck, 2015 (Source: Head and Neck)


Modulation of inflammatory mediators in the trigeminal ganglion by botulinum neurotoxin type A: an organ culture study
Conclusion We hypothesize that chronic migraine might be associated with some degree of inflammation in the TG that could involve both neurons and SGCs. It is clinically well recognized that treatment with corticosteroids will reduce the symptoms of chronic migraine; however this remedy is associated with long-term side effects. Understanding the mechanisms involved in the expressional alterations may suggest novel ways to modify the changes and indicate novel therapeutics. The results of the present work illustrate one way by which BoNT-A may modify these expressional alterations. (Source: The Journal of Headache and Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome—A Case Report
Publication date: Available online 5 August 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Jason Tjeerdsma Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a sing...


Factors Determining Outcome After Surgery for Chronic Groin Pain Following a Lichtenstein Hernia Repair
Conclusions Pain reduction after remedial surgery for chronic groin pain after Lichtenstein repair is more successful if surgery is performed under spinal anaesthesia compared to general anaesthesia. Removal of a meshoma must be considered as success rates are optimized following these measures. Patients using opioids preoperatively have less favourable outcomes. (Source: World Journal of Surgery)


A randomized clinical study on postoperative pain comparing the Polysoft patch to the modified Kugel patch for transinguinal preperitoneal inguinal hernia repair
Conclusions The use of the PP was noninferior to the MK with respect to the severity of postoperative chronic pain scores 12 months after surgery. (Source: Surgery Today)


Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic
Conclusion: Chronic pain and indicators of opioid misuse risk were prevalent. Outpatient palliative care practices should develop policies to address these issues. (Source: American Journal of Hospice and Palliative Medicine)


The Life-Changing Lessons I Learned From Chronic Pain
ASKING FOR HELP IS OPENING THE DOOR FOR LOVE I don't like asking for help. Who does? It brings out all those uncomfortable feelings of vulnerability, loss of independence, of being a burden. It requires a level of honesty and trust I have not mastered before. Haven't yet, truth to be told. But I'm getting there, because pain makes sure I get to practice. It's humbling. I'm not proud like before. I can't keep up appearances like before. I can't do it perfectly -- sometimes I can't do it at all. Not without help, anyway. But you know what? Turns out that the door I need to open in order for others to help me, is the same door that love comes through. Being forced to ask for help has left me flooded at times, lost and bewildered, knee-deep in a love I never dared believe was there before. But...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


“You want to get on with the rest of your life”: a qualitative study of health-related quality of life in gout
The objective of the study is to examine the impact of gout and its treatments on health-related quality of life (HRQOL) using focus group interviews. From the baseline phase of a cohort study of HRQOL in gout, 17 participants (15 males, mean age 71 years) with varying attack frequency and treatment with and without allopurinol participated in one of four focus group interviews. All interviews were audio-recorded and transcribed verbatim. Data was analysed thematically. Physical and psychosocial HRQOL in gout was affected by characteristics of acute gout (particularly the unpredictable nature of attacks, location of joint involved in an attack, pain and modifications in lifestyle), lack of understanding of gout by others (association with unhealthy lifestyle, symptoms ridiculed as non-sev...


Effects of music on pain in patients with fibromyalgia
Abstract Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by diffuse musculoskeletal system pain and painful tender points in certain areas of the body. The aim of the investigation was to determine the effects of music on pain in fibromyalgia patients. This randomized clinical trial was carried out with 37 fibromyalgia outpatients as an experimental group (n = 21) and control group (n = 16) at a University Hospital Internal Medicine and Rheumatology Clinic between 1 June and 1 December 2014. The research instruments used were descriptive characteristics questionnaire, Visual Analogue Scale (VAS), music CD which includes water and wave sounds recommended by the Turkish Psychological Association for psychological relaxation, and pain evaluation form. Accordin...


[Editors' Choice] Why women feel more pain
Gender-specific differences in the immune response to nerve injury contribute to the increased susceptibility of females to chronic pain. (Source: Signal Transduction Knowledge Environment)


The Dermatological Manifestations of Postural Tachycardia Syndrome: A Review with Illustrated Cases
Abstract Postural tachycardia syndrome (POTS) is a syndrome of excessive tachycardia with orthostatic challenge, and relief of such symptoms with recumbence. There are several proposed subtypes of the syndrome, each with unique pathophysiology. Numerous symptoms such as excessive tachycardia, lightheadedness, blurry vision, weakness, fatigue, palpitations, chest pain, and tremulousness are associated with orthostatic intolerance. Other co-morbid conditions associated with POTS are not clearly attributable to orthostatic intolerance. These include chronic headache, fibromyalgia, functional gastrointestinal or bladder disorders, cognitive impairment, and sleep disturbances. Dermatological manifestations of POTS are also common and wide ranging, from livedo reticularis to Raynaud’s...


Managing monoarthritis in children
Publication date: Available online 4 August 2015 Source:Joint Bone Spine Author(s): Valérie Devauchelle-Pensec, Matthias Thepaut, Romain Pecquery, Laetitia Houx Monoarthritis, defined as inflammation of a single joint, requires a thorough physical examination in children, as pain may be lacking in 10% to 30% of cases and joint stiffness may be the only symptom. Joint aspiration is a crucial diagnostic tool that remains markedly underused. Joint aspiration may be unnecessary, however, when the family history or other investigations provide the diagnosis. Radiographs of the involved joint may supply information on the severity of the lesions. In doubtful cases and in patients with arthralgia, B-mode and Doppler ultrasound or magnetic resonance imaging (MRI) may confirm the presence of...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


“It didn’t kill me. It just made me stronger and wiser”: Silver linings for children and adolescents of parents with chronic pain
This study is a secondary analysis of qualitative data, which sought to gain a deeper understanding of the ways in which children and adolescents rebound and grow from experiences living with parents who suffer with CNCP. (Source: Archives of Psychiatric Nursing)


Effectiveness of complementary pain treatment for women with deep endometriosis through transcutaneous electrical nerve stimulation (TENS): randomized controlled trial
Evaluate TENS effectiveness as a complementary treatment of chronic pelvic pain and deep dyspareunia in women with deep endometriosis. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)


Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome—A Case Report
Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a single patient. (Source: Journal of Foot and Ankle Surgery)


Re: Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study
We read with interest the recent paper by Christoffersen et al1 that describes long-term recurrence and chronic pain after repair for small umbilical or epigastric herniae. The authors focus on two significant complications associated with this commonly performed surgical procedure. (Source: American Journal of Surgery)


[Non-opioid pain medication in the elderly].
Authors: Burkhardt H, Wehling M Abstract Non-opioid analgesics are frequently used to control chronic pain in elderly patients; however some of these drugs show high rates of adverse drug reactions. Among these are significant clinical problems which impede an effective and safe pain control. This review provides recent data concerning non-steroidal anti-inflammatory drugs (NSAID), acetaminophen, metamizol and flupirtin. Due to their risk profile NSAIDs are less appropriate due to high incidence rates and drug-related risk patterns. Acetaminophen, metamizol and flupirtin may be recommended instead; however a shortcoming of acetaminophen in comparison to NSAIDs is its weaker action to control pain. Metamizol is still banned in some countries due to rare but potentially severe hemato...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Re: Management of Pain in Autosomal Dominant Polycystic Kidney Disease and Anatomy of Renal Innervation
Autosomal dominant polycystic kidney disease (ADPKD) is well known for its association with renal function decline but cyst formation and cyst associated complications may also lead to renal as well as liver pain. More than 60% of patients with ADPKD experience chronic pain that often is severe, has a physical and social impact on life, and can be difficult to treat.1 (Source: The Journal of Urology)


Moderate alcohol intake could reduce risk of chronic pain.
Authors: Abstract Alcohol consumption of up to 35 units a week is associated with decreasing risk of chronic widespread pain (CWP) and lower levels of disability, suggests a UK study. PMID: 26243094 [PubMed - in process] (Source: Nursing Standard)


Measures and outcomes of chronic pain clinics
Shah S, Ho AC, Kuehler BM, Childs SR, Towlerton G, Goodall ID, Bantel C (Source: Journal of Pain Research)


Pregabalin versus usual care for neuropathic chronic low back pain
Taguchi T, Igarashi A, Watt S, Parsons B, Sadosky A, Nozawa K, Hayakawa K, Yoshiyama T, Ebata N, Fujii K (Source: Journal of Pain Research)


Current Concepts in the Management of Rheumatoid Hand.
Authors: Longo UG, Petrillo S, Denaro V Abstract Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by a T cell-driven autoimmune process, which majorly involves the diarthrodial joints. It affects 1% of the US population, and approximately 70% of patients with RA develop pathologies of the hand, especially of the metacarpophalangeal joints (MCP). Furthermore, also the extensor and flexor tendons of the fingers are frequently involved. The first line of treatment should be conservative. Three general classes of drugs are currently available for RA: nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease modifying antirheumatic drugs (DMARDs). Encouraging results have been obtained using DMARDs. However, when severe deformities occur or when pati...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Additive prognostic value of coronary artery calcium score and renal function in patients with acute chest pain without known coronary artery disease: up to 5-year follow-up
The objective of this study was to examine additive prognostic value of renal function over CACS in patients with acute chest pain suspected of CAD. Renal function and CACS were assessed in patients without known CAD who presented to the emergency department with chest pain from 2005 to 2008. Renal function was assessed using estimated glomerular filtration rate (eGFR), and chronic kidney disease (CKD) was defined as eGFR &lt; 60 mL/min/1.73 m2. A total of 949 patients (804 non-CKD and 145 CKD, age 54 ± 13 years) were included. During the follow-up period of up to 5.3 years, major adverse cardiac events (MACE) occurred in 5.7 % of patients (19 cardiac deaths, 6 myocardial infarction and 29 late coronary revascularization). Annualized MACE rate was higher in patients in higher...


Vulvodynia
This article serves to give the primary gynecologist and practitioner a basic framework with which to identify, diagnose, and begin treatment for such patients as well as understanding for referral if necessary. The initial evaluation and physical examination will be discussed in detail. (Source: Clinical Obstetrics and Gynecology)


PGE2 signaling in endometriosis [Medical Sciences]
Endometriosis is a debilitating, estrogen-dependent, progesterone-resistant, inflammatory gynecological disease of reproductive age women. Two major clinical symptoms of endometriosis are chronic intolerable pelvic pain and subfertility or infertility, which profoundly affect the quality of life in women. Current hormonal therapies to induce a hypoestrogenic state are unsuccessful because of undesirable... (Source: Proceedings of the National Academy of Sciences)


The Role of Methylphenidate in Cancer-Related Fatigue. Commentary on Mitchell et al
Mitchell et al. 1 randomized 43 patients with advanced cancer and cancer-related fatigue to 84 crossover three-day cycles of methylphenidate vs. placebo. Using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) fatigue subscale, they found no significant difference between methylphenidate and placebo. However, they observed that a minority of patients (8) had a clinically important improvement on methylphenidate. (Source: Journal of Pain and Symptom Management)


Neurocognitive evidence for mental imagery-driven hypoalgesic and hyperalgesic pain regulation
Publication date: 15 October 2015 Source:NeuroImage, Volume 120 Author(s): Francesca Fardo, Micah Allen, Else-Marie Elmholdt Jegindø, Alessandro Angrilli, Andreas Roepstorff Mental imagery has the potential to influence perception by directly altering sensory, cognitive, and affective brain activity associated with imagined content. While it is well established that mental imagery can both exacerbate and alleviate acute and chronic pain, it is currently unknown how imagery mechanisms regulate pain perception. For example, studies to date have been unable to determine whether imagery effects depend upon a general redirection of attention away from pain or focused attentional mechanisms. To address these issues, we recorded subjective, behavioral and ERP responses using 64-channel EE...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Zinc involvement in opioid addiction and analgesia &#8211; should zinc supplementation be recommended for opioid-treated persons?
Conclusion: Zinc dietary supplementation in patients treated with opioids for cancer-related chronic pain should be considered, due to the high incidence of zinc deficiency, also well-documented in opioid consumers. The low toxicity of orally-administered zinc also pleads for this idea. The main contra-argument to zinc administration in opioid-treated persons is related to the way zinc influences opioid-induced analgesia. (Source: Substance Abuse Treatment, Prevention, and Policy)


Complex regional pain syndrome (CRPS) or continuous unilateral distal experimental pain stimulation in healthy subjects does not bias visual attention towards one hemifield.
Authors: Filippopulos FM, Grafenstein J, Straube A, Eggert T Abstract In natural life pain automatically draws attention towards the painful body part suggesting that it interacts with different attentional mechanisms such as visual attention. Complex regional pain syndrome (CRPS) patients who typically report on chronic distally located pain of one extremity may suffer from so-called neglect-like symptoms, which have also been linked to attentional mechanisms. The purpose of the study was to further evaluate how continuous pain conditions influence visual attention. Saccade latencies were recorded in two experiments using a common visual attention paradigm whereby orientating saccades to cued or uncued lateral visual targets had to be performed. In the first experiment saccade lat...


[Activating physiotherapy for chronic pain in elderly patients : Recommendations, barriers and resources].
This article offers recommendations for structuring physiotherapy programs based on international guideline recommendations. First examples of pain management concepts for older adults demonstrate the positive results of activating therapy. Additionally, this article provides insights into barriers and resources of affected patients and all actors involved. However, physiotherapeutic treatment for aged chronic pain patients in Germany still shows considerable shortcomings but also offers an exciting challenge for the future. PMID: 26238375 [PubMed - as supplied by publisher] (Source: Schmerz)


[Diagnostics of pain in old age : Perspectives on a multidimensional phenomenon].
Authors: Sirsch E, Gnass I, Fischer T Abstract Old people's experience of pain differs markedly from that of younger people. Old people not only suffer from pain more often but also the pain is predominantly chronic in nature. In many cases older patients experience pain from more than one cause at any time due to multimorbidity. Against this backdrop this article examines the question of how diagnostic procedures of pain have to be specific for older patients and how these requirements are currently met in clinical practice. Diagnostic procedures in older persons need to be rooted in a biopsychosocial understanding of pain that also takes into account that the pain experience is always made up of several pain dimensions. A comprehensive understanding of pain communication also has...


The Role of Methylphenidate in Cancer-Related Fatigue. Commentary on Mitchell et al.
Mitchell et al.1 randomized 43 patients with advanced cancer and cancer-related fatigue to 84 crossover three-day cycles of methylphenidate vs. placebo. Using the functional assessment of chronic illness therapy–fatigue subscale, they found no significant difference between methylphenidate and placebo. However, they observed that a minority of patients (n = 8) had a clinically important improvement on methylphenidate. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The long-term impact of combat exposure on health, interpersonal, and economic domains of functioning.
Authors: Sheffler JL, Rushing NC, Stanley IH, Sachs-Ericsson NJ Abstract PURPOSE: Wartime combat exposure is linked to a broad array of negative outcomes. The current study identified potential differences between middle-to-older aged men exposed to combat and those not exposed for physical health, interpersonal, and economic functioning over 10 years. Post-traumatic stress disorder (PTSD) and social support were examined as moderators between combat exposure and outcomes. METHODS: Data from the National Comorbidity Survey, baseline and 10-year follow-up, were utilized. Only men aged 50-65 at follow-up (N = 727) were included. Group differences between combat and non-combat men were examined. Regression analyses were performed to examine relationships between earlier combat and...


Risk factors for reoperation due to chronic groin postherniorrhaphy pain
Conclusions Risk factors for being reoperated due to CGPP in this cohort included low age, female gender, a direct hernia, a previous Lichtenstein or plug repair, bilateral repair and postoperative complications. Further research on how to avoid CGPP and explore the effectiveness of surgery for CGPP is necessary. (Source: Hernia)


Training with robot-applied resistance in people with motor-incomplete spinal cord injury: Pilot study.
This study provides evidence that Loko-R training is feasible in people with m-iSCI. Furthermore, there is preliminary evidence suggesting that Loko-R may help improve performance in skilled overground walking tasks. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; NCT00610974. "Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study"; https://clinicaltrials.gov/ct2/show/NCT00610974. PMID: 26230667 [PubMed - as supplied by publisher] (Source: J Rehabil Res Dev)


Ibuprofen for acute treatment of episodic tension-type headache in adults.
CONCLUSIONS: Ibuprofen 400 mg provides an important benefit in terms of being pain free at 2 hours for a small number of people with frequent episodic tension-type headache who have an acute headache with moderate or severe initial pain. There is no information about the lesser benefit of no worse than mild pain at 2 hours. PMID: 26230487 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Discovery and clinical application of Nèimádiăn point
Conclusion Acupuncture at Nèimádiăn point can be used for clinical treatment of acute and chronic pain. (Source: World Journal of Acupuncture Moxibustion)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Two hundred and fifty-three cases of headache treated by acupuncture
Conclusion Traditional Chinese Medicine is an efficient method in chronic headaches' treatment. (Source: World Journal of Acupuncture Moxibustion)


The novel PAR2 ligand C391 blocks multiple PAR2 signalling pathways in vitro and in vivo
Conclusions and ImplicationsC391 is the first low MW antagonist to block both PAR2 Ca2+ and MAPK signalling pathways activated by peptidomimetics and/or proteinase activation. C391 represents a new molecular structure for PAR2 antagonism and can serve as a basis for further development for this important therapeutic target. (Source: British Journal of Pharmacology)


New Investigator and Trainee Task Force Survey on the Recruitment and Retention of Headache Specialists
ConclusionsIn this detailed survey on the recruitment and retention of headache specialists, the following themes emerged: mentorship and exposure to a headache center are key foundations in the young investigator/trainee experience. Young headache specialists appear positive about their field of medicine. These specialists like to treat various headache types but not necessarily some of the related comorbidities (sleep disorders, depression, anxiety, back pain, and dizziness). Finally, there was strong agreement that there needs to be improved headache education for physicians of other medical specialties. (Source: Headache: The Journal of Head and Face Pain)


Contribution of chronic diseases to the mild and severe disability burden in Belgium
Conclusions Our results indicate that the assessment of the contribution of chronic diseases on disability is more informative if different levels of disability are taken into consideration. The identification of diseases which are related to different levels of disability – mild and severe – can assist policymakers in the definition and prioritisation of strategies to tackle disability, involving prevention, rehabilitation programs, support services, and training for disabled individuals. (Source: Archives of Public Health)


Prescribing Generic Medication in Chronic Musculoskeletal Pain Patients: An Issue of Representations, Trust, and Experience in a Swiss Cohort
Discussion Economic arguments are not sufficient to justify substitution, and may even raise issues calling upon cognitive dissonance. Even in non-life-threatening diseases, negative cues require attention and need be de-emphasized - in particular lower price as an indication of lower quality, and generic status as contradictory with advocating individualization of medication. (Source: PLoS One)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Lack of cardinal symptoms of meningitis in a hospitalized patient with chronic schizophrenia:Lessons to be learned
There are prior reports describing a diagnostic delay in medical emergencies in patients with schizophrenia. To our knowledge, this is the first case report demonstrating the risk of diagnostic delay of acute meningitis due to reduced pain perception as well as other factors related to schizophrenia and its treatment. (Source: General Hospital Psychiatry)


Chronic Pelvic Pain Caused by Laxity of the Uterosacral Ligaments: Are the Posterior Fornix Syndrome and the Allen–Masters Syndrome Synonyms?
(Source: Pain Medicine)


A Systematic Review and Meta‐Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
ConclusionLimited evidence has been found to show that GA significantly reduces disability in the short and long term when compared with the CG in CNSLBP. There is moderate evidence that GEXP more effectively decreases catastrophizing than GA in the short term. No difference was found between GA and other exercise for any variable. (Source: Pain Medicine)


Evaluation of How Depression and Anxiety Mediate the Relationship between Pain Catastrophizing and Prescription Opioid Misuse in a Chronic Pain Population
ConclusionDue to the partially independent relationship of anxiety and catastrophizing, it is recommended that treatments for chronic pain patients employ techniques addressing both behaviors. The relationship between depression and catastrophizing requires more research since it was observed that their effects were confounded. (Source: Pain Medicine)


TITLE: Effects of a six-week Pilates intervention on the balance and fear of falling of women over 65 years old with chronic low-back pain: A randomized controlled trial.
(Source: Maturitas)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Usefulness of Spinal Cord Stimulation for Chronic Pain Due to Combined Vasospastic Prinzmetal Angina and Diabetic Neuropathic Pain of the Lower Limbs
Conclusion We present a chronic pain syndrome due to combined Prinzmetal angina and diabetic neuropathy of the lower limbs with sustained pain relief utilizing a single SCS lead.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part A: Central European Neurosurgery)


New Investigator and Trainee Task Force Survey on the Recruitment and Retention of Headache Specialists.
CONCLUSIONS: In this detailed survey on the recruitment and retention of headache specialists, the following themes emerged: mentorship and exposure to a headache center are key foundations in the young investigator/trainee experience. Young headache specialists appear positive about their field of medicine. These specialists like to treat various headache types but not necessarily some of the related comorbidities (sleep disorders, depression, anxiety, back pain, and dizziness). Finally, there was strong agreement that there needs to be improved headache education for physicians of other medical specialties. PMID: 26234315 [PubMed - as supplied by publisher] (Source: Headache)


[Hypertensive emergencies and urgencies].
Authors: Phan DG, Dreyfuss-Tubiana C, Blacher J Abstract Hypertension is a common disease, the most common chronic disease. Hypertensive emergency is much less frequent and only affects 1 to 2 % of all hypertensive patients. The true hypertensive emergency is characterized by the serious damage of one hypertensive target organ and requires an urgent intravenous treatment. Isolated blood pressure elevation should not be regarded as a hypertensive emergency if there is no target organ damage, even if the blood pressure is very high. These situations of "false hypertensive emergency", or hypertensive urgencies, often requires an immediate treatment, but oral. Signs of visceral pain of true hypertensive emergency often are a poor general condition, severe headache, decreased visual a...


Effects of a six-week Pilates intervention on balance and fear of falling in women aged over 65 with chronic low-back pain: A randomized controlled trial
The aging process is linked to the deterioration of some physical and psychological aspects such as strength and static and dynamic balance, as it down-regulates activity and increases the risk of falling in older populations [1,2]. A previous history of falls, being female, age, and gait alteration have all been associated with an increased fear of falling (FoF) [3]. The prevalence of FoF varies between 21% and 85% and is defined as “low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living” [4]. (Source: Maturitas)


Self-Reported Pain and Pain Management Strategies Among Veterans With Traumatic Brain Injury: A Pilot Study.
Authors: King PR, Beehler GP, Wade MJ Abstract Reports of chronic pain such as headache, back and neck pain, and other musculoskeletal conditions are common among veterans with history of traumatic brain injury (TBI). This pilot study investigates self-reported pain and pain management strategies in a sample of veterans in postacute recovery from TBI. Participants included 24 outpatients with history of mild-to-moderate TBI who completed a series of self-report measures by mail, including the Pain Outcomes Questionnaire, the Pain Symptom Survey pain scale, and a detailed background survey. Seventy-nine percent of veterans surveyed reported frequent experiences with pain, typically headache, lower back, and joint pain of moderate severity. Two-thirds reported multiple pain locations...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Enthesitis-related arthritis
Abstract Juvenile idiopathic arthritis (JIA) is the most common chronic arthritis of childhood. Currently, it is characterized by seven categories. The enthesitis-related arthritis (ERA) category usually affects boys older than 6 years and presents with lower limb asymmetrical arthritis associated with enthesitis. Later, these children can develop inflammatory lumbosacral pain (IBP). These children are at risk of developing acute anterior uveitis. A recently devised disease activity index, Juvenile Spondyloarthropathy Disease Activity Index (JSpADA), has been validated in retrospective cohorts. The corner stone of treatment is NSAIDs, local corticosteroid injections, and exercise. Methotrexate and sulfasalazine can be used for peripheral arthritis while anti-tumor necrosis factor...


Pediatric Colonic Inflammatory Myofibroblastic Tumor Presenting as Colo-colonic Intussusception: A Case Report and Review of the Literature
We present the second case of colonic IMT presenting as colo-colonic intussusception in a child. The patient is a 12-year-old female who presented with vague abdominal pain for three months. Her workup revealed an intraluminal mass in the descending colon on both CT and colonoscopy. Intraoperatively, the mass was seen causing colo-colonic intussusception. Laparoscopic segmental colon resection was performed, and the patient did well postoperatively. Histology and immunohistochemistry of the mass confirmed IMT. (Source: Journal of Pediatric Surgery Case Reports)


Meta-analysis of randomized trials comparing non-penetrating versus mechanical mesh fixation in laparoscopic inguinal hernia repair
Conclusions Laparoscopic groin hernia repair with bioglue mesh fixation was associated with a reduced incidence of chronic pain compared to mechanical fixation, without increasing morbidity or recurrence. Longer-term data on recurrence are necessary. (CRD42014015374) Teaser Biologic glue has recently emerged as an alternative means of mesh fixation in open and laparoscopic groin hernia repair. Synthesis of data suggests that this method reduces chronic postoperative pain, without increasing morbidity or recurrence, however, longer-term data are needed. (Source: The American Journal of Surgery)


Acute Anterior Uveitis and Spondyloarthritis: More Than Meets the Eye
Abstract Ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA) are associated with some extra-articular features, and the most common symptomatic association is with acute anterior uveitis (AAU). Thus, approximately 40 % of patients with AS will experience a sudden onset of a unilateral anterior uveitis sometime during the course of their disease. Patients with AAU, especially those who are HLA-B27 positive, should be questioned about inflammatory low back pain and also evaluated for other clinical features of SpA. Since a prolonged delay in diagnosis is common among SpA patients and occurrence of AAU may be the reason for their first interaction with medical care, occurrence of AAU presents a unique opportunity for identifying such undiagnosed SpA patients. T...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


TNAP and Pain Control.
Authors: Street SE, Sowa NA Abstract Chronic pain is one of the most debilitating and expensive diseases, yet current therapies are often insufficient in bringing about long-term relief. Further, many treatments for chronic pain also carry significant side effects. The molecule adenosine has long been identified as a potent inhibitor of nociceptive circuits in the spinal cord; however, the widespread expression of adenosine receptors in many organ systems has limited its use as an analgesic. Recently several 5' ectonucleotidases, including tissue non-specific alkaline phosphatase (TNAP), have been characterized for their ability to generate endogenous adenosine in nociceptive circuitry of the dorsal spinal cord. These ectonucleotidases have the ability to hydrolyze the endogenous p...


Clinical Forms and Animal Models of Hypophosphatasia.
Authors: Salles JP Abstract Hypophosphatasia (HPP) is due to mutations of the tissue non-specific alkaline phosphatase (TNAP) gene expressed in the liver, kidney , and bone. TNAP substrates include inorganic pyrophosphate cleaved into inorganic phosphate (Pi) in bone, pyridoxal-5'-phosphate (PLP), the circulating form of vitamin B6, and phosphoethanolamine (PEA). As an autosomal recessive or dominant disease, HPP results in a range of clinical forms. Its hallmarks are low alkaline phosphatase (AP) and elevated PLP and PEA levels. Perinatal HPP may cause early death with respiratory insufficiency and hypomineralization resulting in deformed limbs and sometimes near-absence of bones and skull. Infantile HPP is diagnosed before 6 months of life. Respiratory failure, rib fractures and...


Even Worse — Risk Factors and Protective Factors for Transition from Chronic Localized Low Back Pain to Chronic Widespread Pain in General Practice: A Cohort Study
Conclusion. The results suggest that CWP is no independent entity but rather a particularly negative occurrence on a continuum of chronic pain. Processes of somatization play a major role in the development of this extreme. Level of Evidence: 2 (Source: Spine)


Chronic Low Back Pain: Perception and Coping With Pain in the Presence of Psychiatric Comorbidity
Abstract: This retrospective study investigated the influence of psychiatric comorbidity on pain perception and coping with pain in tertiary pain clinic patients, 427 treated for chronic low back pain (CLBP) and 629 for other forms of chronic pain (CG). No differences in psychosomatic dimensions were found between the two groups, but Italian Pain Questionnaire dimensions and intensity scores (t = 7.35; p < 0.0001) were higher in CLBP than in CG subjects. According to the Mini-International Neuropsychiatric Interview, CLBP patients also had a higher prevalence of lifetime major depressive episodes (χ2 = 4.96; p < 0.05), dysthymic disorder (χ2 = 4.64; p < 0.05), suicide risk (χ2 = 10.43; p < 0.01), and agoraphobia (χ2 = 6.31; p < 0.05) than CG patients did. The Multidimensional Pain Inve...


Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A Randomized Controlled Trial
Conclusions: Allogeneic MSC therapy may be a valid alternative for the treatment of chronic knee osteoarthritis that is more logistically convenient than autologous MSC treatment. The intervention is simple, does not require surgery, provides pain relief, and significantly improves cartilage quality. (Source: Transplantation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Rethink Chronic Pain: Opioid painkillers can be addictive and are not always appropriate for long-term use. Experts say an alternative is to think about—and treat—pain differently.
No abstract available (Source: Neurology Now)


The Eye and Headache
This article highlights painful conditions involving the eyes that are encountered in practice, emphasizing those that do not have obvious findings on the neurologic examination. Recent Findings: Peripheral and central sensitization are associated with chronic neuropathic ocular pain, and hyperalgesia is associated with dry eyes. The aorta and its branches are involved in 25% of patients with giant cell arteritis. Summary: Eye pain is a common concern and one of the most difficult symptoms for the clinician to evaluate. Eye pain may be a manifestation of a primary headache disorder, as is common in migraine, the trigeminal autonomic cephalalgias, and primary stabbing headache. Secondary headache disorders, such as posterior communicating artery aneurysm, Tolosa-Hunt syndrome, and microvasc...


Increased Postoperative Day One Discharges After Implementation of a Hysterectomy Enhanced Recovery Pathway: A Retrospective Cohort Study
ABSTRACT: Enhanced recovery or “fast-track” programs that optimize perioperative care have been effective in improving outcomes after colorectal and orthopedic surgery. These programs accelerate recovery, reduce morbidity, and shorten the hospital length of stay (LOS). Benefits of enhanced recovery following gynecologic surgery have been less clearly defined. The primary barriers to early discharge from the hospital for open hysterectomy and myomectomy patients include pain, nausea and vomiting, ileus, inability to mobilize, and sedation. The hysterectomy enhanced recovery (HER) pathway is an evidence-based, multidisciplinary, and multifaceted intervention for perioperative care for women with benign disease undergoing elective open surgery. The HER pathway was introduced in 2011 at Ot...


Neural underpinnings of nocebo hyperalgesia in visceral pain: A fMRI study in healthy volunteers
Publication date: 15 October 2015 Source:NeuroImage, Volume 120 Author(s): Julia Schmid, Ulrike Bingel, Christoph Ritter, Sven Benson, Manfred Schedlowski, Carolin Gramsch, Michael Forsting, Sigrid Elsenbruch Despite the clinical relevance of nocebo effects, few studies have addressed their underlying neural mechanisms in clinically-relevant pain models. We aimed to address the contribution of nocebo effects and their underlying neural circuitry to central pain amplification in visceral pain, as it may develop over repeated painful experiences due to negative pain-related expectations. Healthy volunteers received verbal suggestions of pain sensitization (nocebo group, N=28) or neutral instructions (control group, N=16). fMRI was used to investigate changes in neural responses dur...


The expenditure of computer-related worktime using clinical decision support systems in chronic pain therapy
Conclusions: Applying a CDSS to examine a patients drug regimen for potential DDIs causes an average extra expenditure of work time of 2:09 min, which extends patient treatment time by 25 % on average. Nevertheless, the authors believe that the extra expenditure of time employing a CDSS is outweighed by their benefits, including reduced ADR risks and safer clinical drug management. (Source: BMC Anesthesiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Health care professionals' attitudes and beliefs towards older back pain patients : Analysis of the assessment methods and research gaps].
This article summarizes these results and illuminates transferability of existing questionnaires to older patients with back pain. A literature review shows that most studies were conducted with physiotherapists and general practitioners. At present the most thoroughly investigated tool for its psychometric validity is the Pain Attitudes and Beliefs Scale (PABS). The PABS could be a suitable instrument for examinations regarding therapist attitudes towards older pain patients by using more age-neutral wording. Concluding from the literature, an additional methodological assessment tool could be the utilization of case vignettes. However, those case vignettes, which had been used in studies in England, should be translated and culturally adapted before its application in Germany. Overall, i...


The duration and course of opioid therapy in patients with chronic non‐malignant pain
ConclusionThe findings confirm high discontinuation rates in patients receiving opioids for chronic non‐malignant pain. However, a clinically significant number of patients increase their doses over 6 years and many patients combine long‐term opioid treatment with benzodiazepines and z‐hypnotics. (Source: Acta Anaesthesiologica Scandinavica)


Alternative Splicing of G Protein–Coupled Receptors: Relevance to Pain Management
Drugs that target G protein–coupled receptors (GPCRs) represent the primary treatment strategy for patients with acute and chronic pain; however, there is substantial individual variability in both the efficacy and adverse effects associated with these drugs. Variability in drug responses is due, in part, to individuals’ diversity in alternative splicing of pain-relevant GPCRs. G protein–coupled receptor alternative splice variants often exhibit distinct tissue distribution patterns, drug-binding properties, and signaling characteristics that may impact disease pathology as well as the extent and direction of analgesic effects. (Source: Mayo Clinic Proceedings)


Differences in Features and Course of Mucosal Type Eosinophilic Gastroenteritis between Korean Infants and Children.
This study aimed to evaluate the characteristics of EGE in infants and children. A total of 22 patients were diagnosed with histologic EGE (hEGE) or possible EGE (pEGE). Serum specific IgE levels, peripheral eosinophil counts, and endoscopic biopsies were carried out. In the hEGE group (n = 13), initial symptoms included hematemesis, abdominal pain, and vomiting. Three of the subjects had normal endoscopic findings. Eight patients were categorized into the infant group and 5 into the child group. All patients in the infant group showed clinical improvement after switching from cow's milk feeding to special formula or breast feeding. The infant group showed a higher eosinophil count in the gastric mucosal biopsy than the child group. In the pEGE group (n = 9) initial symptoms included hemat...


Harmonizing Pain Outcome Measures: Results of the Pre-OMERACT Meeting on Partnerships for Consensus on Patient-important Pain Outcome Domains Between the Cochrane Musculoskeletal Group and OMERACT.
CONCLUSION: Further work is needed on inclusion of the patient perspective in the development of pain domains as well as Cochrane Collaboration summary of findings tables. PMID: 26233508 [PubMed - as supplied by publisher] (Source: J Rheumatol)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Pain Management Life History Calendar: A Pilot Study
Pain management trajectory data that includes previous pain treatments, timing, changes, and outcomes provide crucial data for patients with chronic pain and their practitioners to use when discussing ways to optimize pain management regimens. The aim of this study was to test the use of the life history calendar method to identify pain treatments, treatment regimens, timing, and outcomes of the pain management trajectory of individuals with chronic pain, and to examine feasibility. A pilot, descriptive, methodological design was used. (Source: Pain Management Nursing)


Yoga attitudes in chronic low back pain: Roles of catastrophizing and fear of movement.
Authors: Combs MA, Thorn BE Abstract Chronic low back pain is a significant public health problem and, although underused, yoga may be an effective complementary treatment. The current study examined associations of pain catastrophizing and fear of movement with attitudes toward yoga in adults with chronic low back pain. Participants completed three quantitative questionnaires assessing specific constructs: beliefs about yoga, fear of movement, and pain catastrophizing. A semi-structured in-person interview was then conducted to obtain specific pain-related information. Hierarchical regression and mediational analyses were used to test hypotheses. Consistent with the fear-avoidance model of chronic pain, catastrophizing and fear of movement were negatively associated with yoga atti...


[In Process Citation].
Authors: Illés ST Abstract The low back pain has become one of the greatest public health problems worldwide. The author based on the current international standards summarizes the knowledge necessary for every day treatment of low back pain. In acute low back pain the author underlines the necessity of the rapid, accurate diagnosis and separation for specific and non-specific low back pain. In specific acute low back pain the treatment should focus on to eliminate the root causes. In non-specific cases pain killing treatment and early active mobilization is the choice for the therapeutic process. Beside analgesia, the primary goal of the treatment is to prevent becoming chronic the symptomatology. Objectives of the management of chronic low back pain are effective pain reduction,...


Bilateral Femoral Neck Fatigue Fracture due to Osteomalacia Secondary to Celiac Disease: Report of Three Cases.
In this report, we present three young female patients with bilateral femoral neck fracture secondary to osteomalacia. The underlying cause of osteomalacia was Celiac disease in all patients. The patients were treated with closed reduction and internal fixation with cannulated lag screws. They were free of pain and full weight bearing was achieved at three months. There were no complications, avascular necrosis and nonunion during the follow up period. In patients with bone pain, non traumatic fractures and muscle weakness, osteomalacia should be kept in mind and proper diagnostic work-up should be performed to identify the underlying cause of osteomalacia such as celiac disease. PMID: 26265523 [PubMed - in process] (Source: Archives of Iranian Medicine)


Prescribing marijuana for chronic pain.
Authors: Ladouceur R PMID: 26273072 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Watching your pain site reduces pain intensity in chronic back pain patients
ConclusionsThese results suggest that online video feedback may be helpful in alleviating chronic pain. (Source: European Journal of Pain)


Walking Program Effective for Chronic Low Back Pain.
Authors: Shaughnessy AF PMID: 26280147 [PubMed - in process] (Source: American Family Physician)


Medial humeral epicondylitis in clinically affected cats
ConclusionsCats with forelimb lameness should be evaluated for MHE. This condition is associated with free joint bodies and neurogenic myopathy. Surgical treatment is associated with excellent outcome in the majority of cats. (Source: Veterinary Surgery)


Attitudes of Primary Care Practitioners in Managing Chronic Pain Patients Prescribed Opioids for Pain: A Prospective Longitudinal Controlled Trial
This study investigated the benefits of interventions designed to track potential opioid misuse and to improve practitioner confidence in managing patients with chronic pain through the use of risk assessment, monthly monitoring of compliance, and specialty support. MethodsFifty‐six PCPs and 253 chronic pain patients were recruited into the study. All patients were assessed for risk and called once a month for 6 months to monitor pain and opioid compliance. Practitioner knowledge about opioids, concerns about analgesic prescriptions, practice behavior, and attitudes of managing chronic pain patients were assessed and questionnaires were repeated after 1 year. Practitioners in the experimental group received monthly patient summary reports that consisted of pain, mood, activity levels, he...


Pretreatment anxiety and pain acceptance are associated with response to trigger point injection therapy for chronic myofascial pain
ConclusionThese results suggest that responses to interventional pain management in chronic myofascial paraspinous pain may be influenced by psychological characteristics, especially pretreatment anxiety. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


3 Key Questions to Ask Yourself Before You Pop That Pill
I still remember the day as if it were just yesterday. I was sitting in my office across from a patient who came in to see me for his intractable pain. I was covering for another physician, so this patient was new to me. He was wearing a heavy winter coat and sat at the edge of his chair. I asked him to sit back and take his coat off. He said he was in a hurry and wanted his prescription. As I wrote the prescription for methadone, a little voice in my head told me that this encounter was not the way medicine should be practiced. I wanted him to prove to me he needed this strong narcotic. Was he following the lifestyle changes I would typically recommend such as yoga and stress management? Had he taken time to even evaluate why he was in pain and the possible meaning behind it? In a flash, ...


Opioid Overdose And Abuse Awareness Campaigns Continue To Grow
With opioid-related deaths continuing to rise, many entities are doing their part to educate both prescribers and patients on the potential dangers of using prescription painkillers for chronic pain. Government officials, presidential candidates and other advocacy groups have publicly made it known that there&rsquo;s a problem -- and something needs to be done to tackle growing concerns. (Source: Forbes.com Healthcare News)


Premature Aging in Fibromyalgia.
Authors: Hassett AL, Clauw DJ, Williams DA Abstract Chronic pain is highly prevalent in older adults, and until recently, was considered to be common but relatively "benign." Mounting evidence, however, suggests that some of the 116 million US adults who suffer from chronic pain are also at an increased risk for developing age-related diseases prematurely, suffering earlier cognitive and physical decline, and experiencing earlier mortality. Given the aging US population and the prevalence of chronic pain along with related healthcare consequences, there is a critical need to better understand the relationship between aging and chronic pain. Herein, we focus on one chronic pain state, fibromyalgia, and provide an overview of the evidence suggesting that individuals with this chronic...


Case 3: Abdominal Pain and Chronic Constipation in a 14-year-old Girl
(Source: Pediatrics in Review)


Evaluation of Sexual Function Before and After Hip Arthroscopic Surgery for Symptomatic Femoroacetabular Impingement
Conclusion: This study demonstrates the prevalence of sexual difficulties among the majority of patients with symptomatic FAI, the significant effect that these difficulties may have on quality of life, and the ability of hip arthroscopic surgery to improve sexual function postoperatively. While further studies are required to elucidate what specific factors are associated with sexual difficulties, the current study suggests that this is an important topic to explore. (Source: The American Journal of Sports Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Anatomic Reconstruction With a Semitendinosus Allograft for Chronic Lateral Ankle Instability
Conclusion: Anatomic lateral ankle ligament reconstruction with a semitendinosus allograft for the treatment of CLAI leads to high patient satisfaction, decreased pain, a stable ankle without arthritic changes, and significantly improved function. (Source: The American Journal of Sports Medicine)


R-phenibut binds to the α2-δ subunit of voltage-dependent calcium channels and exerts gabapentin-like anti-nociceptive effects
In conclusion, our results provide experimental evidence for GBP-like, anti-nociceptive properties of R-phenibut, which might be used clinically to treat neuropathic pain disorders. Graphical abstract (Source: Pharmacology Biochemistry and Behavior)


KCNQ channels in nociceptive cold-sensing trigeminal ganglion neurons as therapeutic targets for treating orofacial cold hyperalgesia
Conclusion: Taken together, these findings indicate that KCNQ channel plays a significant role in controlling cold sensitivity and is a therapeutic target for alleviating trigeminal neuropathic pain that manifests orofacial cold hyperalgesia. (Source: Molecular Pain)


Paternal and maternal bonding styles in childhood are associated with the prevalence of chronic pain in a general adult population: the Hisayama Study
Conclusion: The results demonstrate that the parental bonding style during childhood is associated with the prevalence of chronic pain in adults in the general population and that the association is more robust for paternal bonding than for maternal bonding. (Source: BMC Psychiatry)


The pelvic floor muscle hyperalgesia (pfmh) scoring system: a new classification tool to assess women with chronic pelvic pain: multi centre pilot study of validity and reliability
The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has not been established or validated so far. The aim of this study is to assess the validity and reliability of the PFMH scoring system. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Peroneal Tendon Disorders
Peroneal tendon pathology is often found in patients complaining of lateral ankle pain and instability. Conditions encountered include tendinosis; tendinopathy; tenosynovitis; tears of the peroneus brevis, peroneus longus, and both tendons; subluxation and dislocation; and painful os peroneum syndrome. Injuries can be acute as a result of trauma or present as chronic problems, often in patients with predisposing structural components such as hindfoot varus, lateral ligamentous instability, an enlarged peroneal tubercle, and a symptomatic os peroneum. Treatment begins with nonoperative care, but when surgery is required, reported results and return to sport are in general very good. (Source: Clinics in Sports Medicine)


Meta-analysis of randomized trials comparing non-penetrating versus mechanical mesh fixation in laparoscopic inguinal hernia repair
Biologic glue has recently emerged as an alternative means of mesh fixation in open and laparoscopic groin hernia repair. Synthesis of data suggests that this method reduces chronic postoperative pain, without increasing morbidity or recurrence, however, longer-term data are needed. (Source: American Journal of Surgery)


Using impairment and cognitions to predict walking in osteoarthritis: A series of n-of-1 studies with an individually tailored, data-driven intervention.
CONCLUSION: Despite the lack of evidence for an individually tailored walking intervention, predictive data suggest that interventions for people with osteoarthritis that address cognitions are likely to be more effective than those that address impairment only. Further within-individual investigation, including testing mediational relationships, is warranted. Statement of contribution What is already known on this subject? N-of-1 methods have been used to study within-individual predictors of walking in healthy and chronic pain populations An integrated biomedical and behavioural model of activity and activity limitations recognizes the roles of impairment and psychology (cognitions) Interventions modifying cognitions can increase physical activity in people with mobility limitations What...


[Empowerment by patient education in rheumatology].
Authors: Faller H, Ehlebracht-König I, Reusch A Abstract Due to the chronic course, rheumatic diseases may be associated with both long-lasting pain and movement limitations. Those afflicted by these disorders thus face continuous challenges regarding both adapting to their illness as well as changing their lifestyle habits, for example increasing the physical activity levels. However, patient education may provide patients with the competencies they need to cope with their illness and modify their behavior. Therefore, patient education programs are core elements of rehabilitation in rheumatology. The German Society for Rheumatology has performed pioneering work concerning conceptualization and evaluation of standardized educational programs. In this article some more recent devel...


The May-Husni Procedure: A Reappraisal.
CONCLUSIONS: These results indicate that a highly selected subgroup of patients with severe symptomatic post-thrombotic syndrome secondary to chronic segmental obstruction of the femoral vein do well after the May-Husni procedure. In order to refine the criteria for the selection of patients who may benefit from this operation, there is a need for more studies that use a combination of hemodynamic and validated scales that diagnose and grade the severity of post-thrombotic syndrome. PMID: 26238309 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Concerted Public Health Strategies Should Address the Barriers to Transformative Pain Research
The interdisciplinary approach used by the American Pain Society (APS) to develop a goal-oriented research agenda was greeted with interest.2 Classifying the challenges to advancing pain treatment in the form of 5 broad goals provides baseline scaffolding to which individual disciplines can establish further structure. As an example of their interdisciplinary approach, the use of large epidemiologic study designs was highlighted as a way to identify risk factors for new-onset chronic pain and pain perpetuation, provide power to study subtypes, and elucidate associations for bidirectional translational research—thus ultimately assisting in the prevention, diagnosis, and management of chronic pain. (Source: The Journal of Pain)


Moderate Drinking May Ease Disability from Chronic Pain (CME/CE)
(MedPage Today) -- Greatest benefit reported by those who consumed three to five drinks daily (Source: MedPage Today Psychiatry)


Study Finds Drinking May Ease Fibromyalgia Pain, But Doctors Wary
U.S. specialists say alcohol is the wrong approach Source: HealthDay Related MedlinePlus Pages: Alcohol, Chronic Pain, Fibromyalgia (Source: MedlinePlus Health News)


acetaminophen, Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain
Title: acetaminophen, Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/PainCategory: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 7/30/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


In Rare Cases, Infection May Be at Root of Back Pain
Title: In Rare Cases, Infection May Be at Root of Back PainCategory: Health NewsCreated: 7/30/2015 12:00:00 AMLast Editorial Review: 7/30/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Study Finds Drinking May Ease Fibromyalgia Pain, But Doctors Wary
Title: Study Finds Drinking May Ease Fibromyalgia Pain, But Doctors WaryCategory: Health NewsCreated: 7/30/2015 12:00:00 AMLast Editorial Review: 7/30/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


The dopaminergic response to acute stress in health and psychopathology: A systematic review
Publication date: September 2015 Source:Neuroscience &amp; Biobehavioral Reviews, Volume 56 Author(s): Thomas Vaessen, Dennis Hernaus, Inez Myin-Germeys, Thérèse van Amelsvoort Previous work in animals has shown that dopamine (DA) in cortex and striatum plays an essential role in stress processing. For the first time, we systematically reviewed the in vivo evidence for DAergic stress processing in health and psychopathology in humans. All studies included (n studies=25, n observations=324) utilized DA D2/3 positron emission tomography and measured DAergic activity during an acute stress challenge. The evidence in healthy volunteers (HV) suggests that physiological, but not psychological, stress consistently increases striatal DA release. Instead, increased medial prefrontal cor...


Group 2 innate lymphocytes (ILC2s) are enriched in active eosinophilic esophagitis
Eosinophilic esophagitis (EoE) is a chronic, antigen-mediated disease characterized by esophageal remodeling including epithelial cell hyperplasia with barrier dysfunction, subepithelial fibrosis, and smooth muscle dysmotility leading to food impactions and strictures as well as symptoms of chronic pain, feeding intolerance, and dysphagia.1 EoE pathogenesis is driven by thymic stromal lymphopoeitin (TSLP) produced by activated epithelial cells, and IL-5 and IL-13 produced by inflammatory cells. Production of IL-5 results in esophageal eosinophilia, and IL-13 induces EoE-specific epithelial gene expression and remodeling changes such as angiogenesis. (Source: Journal of Allergy and Clinical Immunology)


Prevalence of Chronic Pain in a Large Integrated Healthcare Delivery System in the U.S.A
ConclusionsIn this comprehensive analysis of 2 years of data from a large, vertically integrated metropolitan health system, chronic pain was identified in 12% of adult patients. Approximately 75% of chronic pain conditions were musculoskeletal. The triad of age ≥ 60 years, BMI ≥ 30, and female sex were the most salient demographic characteristics of patients with chronic pain conditions. These diagnostic and demographic data may be used to inform treatment program development. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Optimizing the pre‐referral workup for gastroenterology and hepatology specialty care: consensus using the Delphi method
ConclusionsConsideration of externally developed referral guidelines using a consensus‐building process leads to significant local tailoring and adaption. Our next steps include implementation and dissemination of these guidelines and evaluating their impact on care efficiency in clinical practice. (Source: Journal of Evaluation in Clinical Practice)


Palindromic rheumatism: an unusual cause of chronic intermittent arthritis
A 53 years old African-American male presented with the complaint of episodic pain and swelling in his shoulder, wrists, metacarpophalangeal, interphalangeal, knees and ankle joints for 16 years. He was diagnosed with scrofuloderma 16 years prior when he completed four drug anti-tuberculosis therapy for 9 months. He subsequently developed multiple joint pain and swelling. He denied joint stiffness or diurnal variation in symptoms. There were no identifiable factors that triggered the symptoms. His symptoms lasted from several hours to a few days and subsided spontaneously. (Source: The American Journal of Medicine)


Chronic Alcoholism and the Danger of Profound Hypomagnesemia
A 57-year-old bartender suddenly lost consciousness while serving drinks at work. She was unconscious for several seconds before spontaneous arousal. Her episode was without preceding chest pain, light-headedness or palpitations and was not accompanied by seizure-like activity. Her medical history included obesity, hypertension, hyperlipidemia, type II diabetes, gastroesophageal reflux, and chronic hypomagnesemia. She had no history of cardiac disease or syncopal events and no family history of sudden death. (Source: The American Journal of Medicine)


Comorbidity Is associated with pain-related activity Limitations in multiple sclerosis
Conclusion Comorbidity is associated with pain in persons with MS. Closer examination of these associations may provide guidance for better management of this disabling symptom in MS. (Source: Multiple Sclerosis and Related Disorders)


Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach
Publication date: Available online 29 July 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Jae Hoon Ahn, Chi-Young Ahn, Chu-Hwan Byun, Yoon-Chung Kim Haglund syndrome is characterized by chronic posterior heel pain associated with a posterosuperior calcaneal prominence. We assessed the clinical and radiologic outcomes after operative treatment of Haglund syndrome using the central tendon-splitting approach. Fifteen feet in 15 patients were investigated retrospectively after surgery. Of the 15 patients, 14 were males (93.3%) and 1 was female (6.7%). Their mean age was 33.1 ± 8.2 (range 20 to 50) years. The mean follow-up duration was 3.5 ± 1.5 years (range 24 to 90 months). The American Orthopaedic Foot and Ankle Society ankle-hindfoot Scale and Victorian Institu...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Immature spinal cord neurons are dynamic regulators of adult nociceptive sensitivity
Abstract Chronic pain is a debilitating condition with unknown mechanism. Nociceptive sensitivity may be regulated by genetic factors, some of which have been separately linked to neuronal progenitor cells and neuronal differentiation. This suggests that genetic factors that interfere with neuronal differentiation may contribute to a chronic increase in nociceptive sensitivity, by extending the immature, hyperexcitable stage of spinal cord neurons. Although adult rodent spinal cord neurogenesis was previously demonstrated, the fate of these progenitor cells is unknown. Here, we show that peripheral nerve injury in adult rats induces extensive spinal cord neurogenesis and a long‐term increase in the number of spinal cord laminae I–II neurons ipsilateral to injury. The production and mat...


Immature spinal cord neurons are dynamic regulators of adult nociceptive sensitivity.
Authors: Rusanescu G, Mao J Abstract Chronic pain is a debilitating condition with unknown mechanism. Nociceptive sensitivity may be regulated by genetic factors, some of which have been separately linked to neuronal progenitor cells and neuronal differentiation. This suggests that genetic factors that interfere with neuronal differentiation may contribute to a chronic increase in nociceptive sensitivity, by extending the immature, hyperexcitable stage of spinal cord neurons. Although adult rodent spinal cord neurogenesis was previously demonstrated, the fate of these progenitor cells is unknown. Here, we show that peripheral nerve injury in adult rats induces extensive spinal cord neurogenesis and a long-term increase in the number of spinal cord laminae I-II neurons ipsilateral t...


Guideline for Prescribing Opioids to Treat Pain in Injured Workers
Recently, there has been a dramatic increase in the use of opioids to treat chronic noncancer pain. Opioids are also being prescribed in stronger potencies and larger doses for musculoskeletal injuries. In some cases, the use of opioids for work-related injuries may actually increase the likelihood of disability. Chronic opioid use is associated with increased risk for overdose morbidity and mortality and other nonfatal adverse outcomes. The risk of dependence and addiction is much more common than previously thought. This guideline provides recommendations for prudent opioid prescribing and addresses issues critical to the care and rehabilitation of injured workers. (Source: Physical Medicine and Rehabilitation Clinics of North America)


Seattle biotech Kineta lands $4M contract to develop immunotherapy for infectious disease
The growing market for immunotherapy treatments isn't just focused on cancer. Seattle biotech Kineta just landed a federal contract from the National Institutes of Health for about $4 million to develop an immunotherapy treatment which would treat a variety of infectious diseases, such as the flu, dengue fever, Ebola and others. Kineta develops drugs for chronic pain, autoimmune and infectious diseases. The funding will be used to bring a specific drug candidate to the pre-clinical stage, with… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)


Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women
Conclusions: Menstrual abnormalities, endometriosis, pelvic pain, hysterectomy, and early/surgical menopause are all associated with CFS. Clinicians should be aware of the association between common gynecologic problems and CFS in women. Further work is warranted to determine whether these conditions contribute to the development and/or perpetuation of CFS in some women. (Source: Menopause)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Breast Cancer Survivors, Aromatase Inhibitors, and Joint PainBreast Cancer Survivors, Aromatase Inhibitors, and Joint Pain
Can an evidence-based walking program developed for arthritis sufferers help breast cancer patients who experience joint symptoms as a side effect of aromatase inhibitor therapy? Preventing Chronic Disease (Source: Medscape Today Headlines)


Medical News Today: High-frequency spinal cord stimulation 'more effective for chronic pain'
A new form of spinal cord stimulation has been shown to be more effective at alleviating chronic pain than the traditional method, without unwanted side effects. (Source: Health News from Medical News Today)


High intensity training helps ease arthritis pains
Arthritis: it’s a disease that sneaks up on you. Fingers and toes slowly but surely become stiff and painful. A nice morning stretch is no longer all it takes to get your body moving. Arthritis is a chronic illness that sinks its claws into your body, and causes inflammation in your joints. It can destroy your joints, which causes weakness and loss of movement. New research suggests that high intensity training can help with the pain that the illness provides. (Source: ScienceDaily Headlines)


Back to school: 6 tips to manage IBD at college
I’m a 20-year-old rising junior at Harvard University and I have inflammatory bowel disease (IBD). Growing up in Orlando, Florida, I participated in typical childhood activities and was what you would consider to be a “normal” kid. But I was dealing with chronic, excruciating abdominal pain, diarrhea and bloody stools. At age 10, doctors diagnosed me with Crohn’s disease. I went from one hospital visit to another and was prescribed various pills, injections and infusions, all of which failed at some point. During high school, I was embarrassed to discuss my disease. Very few of my teachers and friends knew I had Crohn’s. I was afraid I wouldn’t be able to manage school assignments, participate in athletics and still have a social life. Heading to college When it was time to ...


Isolated Gastrocnemius Recession for Treatment of Insertional Achilles Tendinopathy: A Pilot Study
Conclusion. An isolated gastrocnemius recession for chronic insertional Achilles tendinopathy can provide high satisfaction, pain relief, and a faster recovery period with few or no complications. Levels of Evidence: Therapeutic, Level IV: Case series (Source: Foot and Ankle Specialist)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Spontaneous iliopsoas tendon rupture: an uncommon cause of hip pain in the elderly
Publication date: Available online 29 July 2015 Source:PM&amp;R Author(s): Mohammed Emam, Constantine Farmakidis, Se Won Lee, Stanley F. Wainapel Iliopsoas tendon rupture is a relatively rare cause of hip pain. It has been described in children, in adults with pathologic avulsion secondary to metastatic disease, and in older individuals with multiple chronic illnesses. We are reporting a case of apparently spontaneous iliopsoas tendon rupture which occurred in an elderly patient presenting with severe debilitating hip pain whose etiology was initially unrecognized. Magnetic resonance imaging (MRI) of the hip confirmed the diagnosis. This case highlights the importance of considering iliopsoas tear in the differential diagnosis of unexplained acute onset hip pain, and illustrates ...


Weber‐Christian disease present with lung nodules dramatically improved with corticosteroid therapy: one case report and literature review
Abstract Weber–Christian disease (WCD) is a chronic recurrent organ disease characterized by the formation of painful dense nodes in subcutaneous fat tissues, free from suppuration and accompanied by episodic temperature changes, chills and muscular pain. Sometimes it can involve the visceral organs. WCD often relapses during irregular intervals. It is a rare autoimmune inflammatory disorder of subcutaneous adipose tissue. However, lung involvement in WCD is rare. Here we report a man presenting with lung nodules. He was diagnosed as having WCD and successfully treated by corticosteroid and immonosuppressive agents. A 53‐year‐old male presented with a 2.5‐year history of painful subcutaneous nodules on his trunk and limbs, accompanied by fever, night sweats, fatigue and malaise. A ...


Bilateral chronic compartment syndrome of the thenar muscles: A case report.
Authors: Haiun M, Michel F, Lepage D Abstract This case report features a patient with chronic bilateral compartment syndrome of the thenar muscles, which had appeared spontaneously 8 years earlier. The condition was progressive and symptoms recently had become worse. Pressure measurements were performed three times to establish the diagnosis: before, immediately after and 10minutes after hand exertion. Pain relief was achieved by performing a fasciotomy of the right thenar compartment. PMID: 26233717 [PubMed - as supplied by publisher] (Source: Chirurgie de la Main)


Spinal cord stimulation more effective at higher frequency
Stephen FellerCHICAGO, July 28 (UPI) -- High-frequency spinal cord stimulation was twice as effective for chronic back and leg pain patients as traditional low frequency stimulation. (Source: Health News - UPI.com)


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


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


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


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


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


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


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


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


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


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


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


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


Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach
Haglund syndrome is characterized by chronic posterior heel pain associated with a posterosuperior calcaneal prominence. We assessed the clinical and radiologic outcomes after operative treatment of Haglund syndrome using the central tendon-splitting approach. Fifteen feet in 15 patients were investigated retrospectively after surgery. Of the 15 patients, 14 were males (93.3%) and 1 was female (6.7%). Their mean age was 33.1 ± 8.2 (range 20 to 50) years. The mean follow-up duration was 3.5 ± 1.5 years (range 24 to 90 months). (Source: Journal of Foot and Ankle Surgery)


Biological Approaches to Treating Intervertebral Disc Degeneration: Devising stem cell therapies.
Authors: Han I, Ropper AE, Konya D, Kabatas S, Toktas Z, Aljuboori Z, Zeng X, Chi JH, Zafonte R, Teng YD Abstract Intervertebral disc (IVD) degeneration is a common, chronic, and complex degeneration process that frequently leads to back pain and disability, resulting in a major public health issue. In this review we describe biological therapies under preclinical or clinical development with an emphasis on stem cell-based multimodal approaches that target prevention and treatment of IVD degeneration. Systematical review of the basic science and clinical literature was performed to summarize the current status of devising biological approaches to treat IVD degeneration. Since the exact mechanisms underlying IVD degeneration have not yet been fully elucidated and conservative manage...


Pain: Chronic back pain linked to reduced dopamine function in the striatum
Nature Reviews Neurology 11, 428 (2015). doi:10.1038/nrneurol.2015.135 The vast majority of people will experience back pain at some point in their lives. In up to 40% of adults, back pain becomes chronic or recurrent; however, the underpinnings of pain chronification are poorly understood. Now, a new PET study evaluating dopamine and opioid (Source: Nature Reviews Neurology)


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


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


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


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


Determinants of Patient Satisfaction in an Academic Rheumatology Practice
Conclusions: Factors contributing to satisfaction scores differed for median satisfaction level and lower satisfaction level. Most of the factors identified as influencing patient satisfaction were unrelated to the physician or the skills of that physician. (Source: JCR: Journal of Clinical Rheumatology)


The effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps strength and pain in individuals with knee synovitis: a prospective observational study
IntroductionSubstantial weakness of the quadriceps muscles is typically observed in patients with arthritis. This is partly due to ongoing neural inhibition that prevents the quadriceps from being fully activated. Evidence from animal studies suggests enhanced flexion reflex excitability may contribute to this weakness. This prospective observational study examined the effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps muscle strength and knee pain in individuals with knee synovitis. Methods: Sixteen patients with chronic arthritis and clinically active synovitis of the knee participated in this study. Knee pain flexion reflex threshold, and quadriceps peak torque were measured at baseline, immediately after knee joint aspira...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Calibration and Validation of the Dutch-Flemish PROMIS Pain Interference Item Bank in Patients with Chronic Pain
by Martine H. P. Crins, Leo D. Roorda, Niels Smits, Henrica C. W. de Vet, Rene Westhovens, David Cella, Karon F. Cook, Dennis Revicki, Jaap van Leeuwen, Maarten Boers, Joost Dekker, Caroline B. Terwee The Dutch-Flemish PROMIS Group translated the adult PROMIS Pain Interference item bank into Dutch-Flemish. The aims of the current study were to calibrate the parameters of these items using an item response theory (IRT) model, to evaluate the cross-cultural validity of the Dutch-Flemish translations compared to the original English items, and to evaluate their reliability and construct validity. The 40 items in the bank were completed by 1085 Dutch chronic pain patients. Before calibrating the items, IRT model assumptions were evaluated using confirmatory factor analysis (CFA). Items were c...


Pain Catastrophizing Predicts Menstrual Pain Ratings in Adolescent Girls with Chronic Pain
ConclusionResults demonstrate differences in relationships among menstrual pain, acute laboratory pain, and psychological variables in girls with no pain compared with girls with chronic pain. In addition, pain catastrophizing may be a particularly salient factor associated with menstrual pain in girls with chronic pain that warrants further investigation. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Neuropathic pain depends upon d-serine co-activation of spinal NMDA receptors in rats
Publication date: 31 August 2015 Source:Neuroscience Letters, Volume 603 Author(s): Yan Lefèvre, Aurélie Amadio, Peggy Vincent, Amélie Descheemaeker, Stéphane H.R. Oliet, Radhouane Dallel, Daniel L. Voisin Activation of N-methyl-d-aspartate (NMDA) receptors is critical for hypersensitivity in chronic neuropathic pain. Since astroglia can regulate NMDA receptor activation by releasing the NMDA receptor co-agonist d-serine, we investigated the role of NMDA receptor and d-serine in neuropathic chronic pain. Male Wistar rats underwent right L5–L6 spinal nerve ligation or sham surgery and were tested for mechanical allodynia and hyperalgesia after 14 days. Acute intrathecal administration of the NMDA receptor antagonist d-AP5 as well as chronic administration of the glia metaboli...


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


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


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


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


Comparison of calcium alginate and carboxymethyl cellulose for nasal packing after endoscopic sinus surgery: a prospective, randomised, controlled single‐blinded trial
ConclusionsCalcium alginate nasal packing is associated with reduced severity of oedema and adhesions after endoscopic sinus surgery.This article is protected by copyright. All rights reserved. (Source: Clinical Otolaryngology)


Porphyrias: A 2015 update
Publication date: Available online 2 July 2015 Source:Clinics and Research in Hepatology and Gastroenterology Author(s): Zoubida Karim, Said Lyoumi, Gael Nicolas, Jean-Charles Deybach, Laurent Gouya, Hervé Puy The hereditary porphyrias comprise a group of eight metabolic disorders of the heme biosynthesis pathway. Each porphyria is caused by abnormal function at a separate enzymatic step resulting in a specific accumulation of heme precursors. Porphyrias are classified as hepatic or erythropoietic, based on the organ system in which heme precursors (δ-aminolevulinic acid [ALA], porphobilinogen and porphyrins) are overproduced. Clinically, porphyrias are characterized by acute neurovisceral symptoms, skin lesions or both. However, most if not all the porphyrias impair hepatic or g...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


The New Science on the Health Benefits of Yoga
This article originally appeared on Sonima.com -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)


Delayed pseudoaneurysm after below-knee amputation
A 50-year-old man presented to our outpatient department with a 5-week history of worsening pain and a pulsatile lump within his right below-knee amputation stump. The patient had a previous work-related crush injury to the leg, with 10 operations and eventual below-knee amputation 18 years earlier. Chronic pain in his stump, ascribed to painful neuroma, required three hospital admissions in the previous 2 years under the chronic pain team to titrate opioid, neuromodulatory, and antidepressant medications. (Source: Journal of Vascular Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Coupled cell networks are target cells of inflammation, which can spread between different body organs and develop into systemic chronic inflammation
Several organs in the body comprise cells coupled into networks. These cells have in common that they are excitable but do not express action potentials. Furthermore, they are equipped with Ca 2+ signaling systems, which can be intercellular and/or extracellular. The transport of small molecules between the cells occurs through gap junctions comprising connexin 43. Examples of cells coupled into networks include astrocytes, keratinocytes, chondrocytes, synovial fibroblasts, osteoblasts, connective tissue cells, cardiac and corneal fibroblasts, myofibroblasts, hepatocytes, and different types of glandular cells. These cells are targets for inflammation, which can be initiated after injury or in disease. If the inflammation reaches the CNS, it develops into neuroinflammati...


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


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


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


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


A review on quality of life in systemic sclerosis
Publication date: Available online 23 July 2015 Source:Autoimmunity Reviews Author(s): Cristiana Almeida, Isabel Almeida, Carlos Vasconcelos Systemic sclerosis (SSc) is a chronic multi-system autoimmune disease associated with disability and reduced quality of life. There is no effective treatment or cure to SSc, so it is important improve global health of these patients and reduce morbidity and mortality associated with SSc. It was made a literature review about quality of life in patients with SSc, regarding the several factors that should be considered and evaluated when attending to SSc patients. It was also considered the validated scales and questionnaires used to measure outcomes in patients with SSc. We concluded that it is important to have an interdisciplinary approach to SS...


The revised FLACC score: Reliability and validation for pain assessment in children with cerebral palsy
Conclusion and implications This study benefits from a systematical approach to the validation and reliability parameters by using the COSMIN checklist as a guideline. It is evident that the r-FLACC pain score maintains its psychometric properties after translation. In conclusion, the r-FLACC pain score is valid and reliable in assessing postoperative pain in children with CP not able to self-report pain. With the r-FLACC pain score clinicians have a valid tool for assessing postoperative pain, hence increasing the quality of pain management in children with CP. In addition the validated r-FLACC score has the potential for use in interventional research regarding pain management in this vulnerable group of patients. Future perspectives include validation of the r-FLACC score for procedural...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


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


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


Reassessing cortical reorganization in the primary sensorimotor cortex following arm amputation
The role of cortical activity in generating and abolishing chronic pain is increasingly emphasized in the clinical community. Perhaps the most striking example of this is the maladaptive plasticity theory, according to which phantom pain arises from remapping of cortically neighbouring representations (lower face) into the territory of the missing hand following amputation. This theory has been extended to a wide range of chronic pain conditions, such as complex regional pain syndrome. Yet, despite its growing popularity, the evidence to support the maladaptive plasticity theory is largely based on correlations between pain ratings and oftentimes crude measurements of cortical reorganization, with little consideration of potential contributions of other clinical factors, such as adaptive b...


Distress improves after mindfulness training for progressive MS: A pilot randomised trial
Conclusions: A mindfulness intervention delivered through Skype video conferences appears accessible, feasible and potentially effective and cost-effective for people with progressive MS. (Source: Multiple Sclerosis)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


A technical report on ultrasound-guided scapulocostal syndrome injection
Conclusion Serratus posterior superior injection can confirm a diagnosis of scapulocostal syndrome and be therapeutically beneficial. (Source: Irish Journal of Medical Science)


Treatment of Lateral Epicondylosis by Using Allogeneic Adipose‐Derived Mesenchymal Stem Cells: A Pilot Study
This article is protected by copyright. All rights reserved. (Source: Stem Cells)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Insidious: Takayasu arteritis
Hypertensive crisis in a 39-year-old Haitian woman with a history of hypertension proved secondary to an underlying chronic disease. Having arrived in the emergency department for evaluation of a severe headache and shortness of breath, she added that for several months, she had been experiencing chest pain, both at rest and with exertion. Episodes lasted for 10-15 minutes and were substernal and squeezing in nature, often reaching 10/10 in severity. These were intermittently associated with shortness of breath and nausea. (Source: The American Journal of Medicine)


French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads
Abstract Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), mode...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


G protein-gated inwardly rectifying potassium channel subunits 1 and 2 are down-regulated in rat dorsal root ganglion neurons and spinal cord after peripheral axotomy
Background: Increased nociceptive neuronal excitability underlies chronic pain conditions. Various ion channels, including sodium, calcium and potassium channels have pivotal roles in the control of neuronal excitability. The members of the family of G protein-gated inwardly rectifying potassium (GIRK) channels, GIRK1–4, have been implicated in modulating excitability. Here, we investigated the expression and distribution of GIRK1 and GIRK2 in normal and injured dorsal root ganglia (DRGs) and spinal cord of rats. Results: We found that ~70% of the DRG neurons expressed GIRK1, while only (Source: Epidemiologic Perspectives and Innovations)


Why Science Doesn't Need Mice
A recent editorial called "Why Science Needs Female Mice" by the New York Times Editorial Review Board relies on a new study published in Nature Neuroscience by Robert Sorge and his colleagues titled "Different immune cells mediate mechanical pain hypersensitivity in male and female mice." The abstract for this essay reads: "A large and rapidly increasing body of evidence indicates that microglia-to-neuron signaling is essential for chronic pain hypersensitivity. Using multiple approaches, we found that microglia are not required for mechanical pain hypersensitivity in female mice; female mice achieved similar levels of pain hypersensitivity using adaptive immune cells, likely T lymphocytes. This sexual dimorphism suggests that male mice cannot be used as proxies for females in pain resea...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Acupuncture impacts same biologic pathways in rats that pain drugs target in humans
In animal models, acupuncture appears to impact the same biologic pathways ramped up by pain and stress, analogous to what drugs do in humans. The researchers say their animal study provides the strongest evidence to date on the mechanism of this ancient Chinese therapy in chronic stress. (Source: ScienceDaily Headlines)


Rats help scientists get closer to solving the mystery of acupuncture
Study finds that form of therapy which uses electric current blunted activity in rats’ hormonal pathway linked to stress, chronic pain and mood A biological mechanism explaining part of the mystery of acupuncture has been pinpointed by scientists studying rats. Stimulation with electroacupuncture – a form of the therapy in which a small electric current is passed between a pair of needles – blunted activity in a key hormonal pathway linked to stress, chronic pain and mood, the researchers found. Continue reading... (Source: Guardian Unlimited Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


St. Jude Medical Announces FDA Approval for Industry's Only MR-Conditional 5-Column Paddle Lead for the Management of Chronic Pain
St. Jude Medical, Inc. has announced FDA approval of MR-conditional labeling for the company&rsquo;sPenta 5-column paddle leadfor spinal cord stimulation (SCS) therapy to manage chronic pain. The Penta lead is the only five-column paddle lead on the market that allows patients to safely undergo head and extremity MRI scans. (Source: Medical Design Online News)


Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report
Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient’s abdominal symptoms. Since hydrostatic reduction was unsuccessful, la...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Use of long-acting, vs short-acting, opioids for chronic pain was linked to unintentional overdose.
Authors: Holbrook A PMID: 26192579 [PubMed - in process] (Source: Annals of Internal Medicine)


Long-Term Opioid Therapy for Chronic Pain.
Authors: Chou R PMID: 26192568 [PubMed - in process] (Source: Annals of Internal Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Pain perception in major depressive disorder: A neurophysiological case-control study
Depression and pain may sometimes be related conditions. Occasionally, depression may be associated with physical symptoms, such as back pain and headache. Moreover, depression may impair the subjective response to pain and is likely to influence the pain feeling. Conversely, chronic pain may represent an emotional condition as well as physical sensation, and can influence both the mood and behaviour. (Source: Journal of the Neurological Sciences)


Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases
We describe three cases of MS patients who have had moderate to severe complaints of bruxism in the two weeks following their relevant MS attacks. None of the three patients had a diagnosis of bruxism prior to her attack. The diagnosis was confirmed in one out of three by a polysomnography. One patient did not have any complaints related to bruxism previous to her attack, whereas two had mild and infrequent complaints. The symptoms of the relevant attacks were left hemihypesthesia in all and hemiparesis in two. None of the patients had spasticity that could result in severe teeth clenching. All three patients presented with morning headaches and jaw pain or tightness and were treated successfully with botulinum toxin (Btx) injections applied to their masseter and temporalis muscles. The ca...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases.
CONCLUSIONS: The clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear-cut clinical pictures with excellent consistency both inter- and intra-individually. PMID: 26198298 [PubMed - as supplied by publisher] (Source: Headache)


Healthcare providers’ accuracy in assessing patients’ pain: A systematic review
Uncontrolled acute and chronic pain is a major healthcare challenge and public health problem [1]. Estimates suggest that more than one-third of American adults and one-fifth of European adults suffer from some type of chronic pain [1,2]. Although the majority of pain sufferers seek medical attention for their pain [3], pain is often undertreated. Considerable undertreatment of pain has been documented in patients with cancer [4], AIDS and HIV [5,6], emergency department patients [7], children [8], and older adults and dementia patients [9]. (Source: Patient Education and Counseling)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Pain perception in major depressive disorder: A neurophysiological case–control study
Depression and pain may sometimes be related conditions. Occasionally, depression may be associated with physical symptoms, such as back pain and headache. Moreover, depression may impair the subjective response to pain and is likely to influence the pain feeling. Conversely, chronic pain may represent an emotional condition as well as physical sensation, and can influence both the mood and behaviour. (Source: Journal of the Neurological Sciences)


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


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


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


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


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


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


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


Synergistic effect of pain and deficits in ADL towards general practitioner visits
Conclusion. There is a strong synergistic effect of CP and deficits in ADL in patients &ge;65 years on visiting the GP. Prevention, screening, treatment and rehabilitation in this population should focus on both CP and ADL deficits. (Source: Family Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Rest pain and movement‐evoked pain as unique constructs in hip and knee replacement
Conclusions SEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work which explore the mechanisms underlying pain‐on‐movement and pain‐at‐rest. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)


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


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


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


Health-Related Quality of Life and Pain Intensity Among Ethnically Diverse Community-Dwelling Older Adults
This study compared HRQoL, including physical health and mental health, in persons of differing ethnicities, and identified factors associated with pain intensity and HRQoL in ethnically diverse older adults. Older adults with chronic pain from four ethnic groups (African Americans, Afro-Caribbeans, Hispanics, and European Americans) were recruited from the Florida Atlantic University Healthy Aging Research Initiative (HARI) registry. (Source: Pain Management Nursing)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation.
CONCLUSIONS: There is some very low quality evidence that goal setting may improve some outcomes for adults receiving rehabilitation for acquired disability. The best of this evidence appears to favour positive effects for psychosocial outcomes (i.e. health-related quality of life, emotional status, and self-efficacy) rather than physical ones. Due to study limitations, there is considerable uncertainty regarding these effects however, and further research is highly likely to change reported estimates of effect. PMID: 26189709 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


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


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


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


Antiallodynic and antihyperalgesic effects of zerumbone on a mouse model of chronic constriction injury-induced neuropathic pain.
In this study, we investigated the antiallodynic and antihyperalgesic effects of zerumbone, a bioactive sesquiterpene from Zingiber zerumbet in chronic constriction injury (CCI)-induced neuropathic pain animal model. Our findings showed that single and repeated dose of intra-peritoneal administration of zerumbone (5, 10, 50, 100mg/kg) significantly attenuated the CCI-induced neuropathic pain when evaluated using the electronic von Frey anesthesiometer, cold plate, Randall Selitto analgesiometer and the Hargreaves plantar test. Zerumbone significantly alleviated tactile and cold allodynia as well as mechanical and thermal hyperalgesia. Our findings are in comparison to the positive control drugs used gabapentin (20mg/kgi.p.) and morphine (1mg/kgi.p.). Together, these results showed that the...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Rasch analysis of the Neck Bournemouth Questionnaire to measure disability related to chronic neck pain.
CONCLUSION: The Neck Bournemouth Questionnaire with the purposed modification may provide useful clinical profiles and change scores of subjects with chronic neck pain for research purposes. PMID: 26182201 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Dynamic view of postoperative pain and quality of life evolution after total knee arthroplasty - a prospective observational study.
CONCLUSION: The trajectories of the different types of pain after TKA show their nonlinear evolution, highlighting the need of a better pain control at precise moments. Sleep disturbances and alterations of quality of life are still present one year after the surgery. PMID: 26184701 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)


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


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


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


Ultrasound-guided versus palpation-guided local corticosteroid injection therapy for treatment of plantar fasciitis
Conclusions Ultrasound-guided and palpation-guided local corticosteroid injections were effective and successful in treatment of PF. Both techniques improved PF clinically and ultrasonographically without statistically significant superior results for the ultrasound-guided injection. (Source: The Egyptian Rheumatologist)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The association between psychosis and severe pain in community-dwelling adults: Findings from 44 low- and middle-income countries
This study assessed the association between psychosis and severe pain among community-dwelling adults in 44 low- and middle-income countries (LMICs) where no data exists. Data on 235,370 adults aged &gt;18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past 12-month psychotic symptoms was established using four questions from the Composite International Diagnostic Interview. Participants were categorized into four mutually exclusive groups based on whether they had at least one psychotic symptom and/or a lifetime psychosis or schizophrenia diagnosis. Multivariable logistic regression was used to estimate the association between psychosis and past-30 day severe pain. The prevalence of severe pain among those with 0, 1, 2, &gt;3 psychotic symptoms w...


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


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


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


Statin Use Is Associated with Bladder Pain Syndrome/Interstitial Cystitis: A Population-Based Case-Control Study
Conclusion: We concluded that there was an association between statin use and BPS/IC.Urol Int (Source: Urologia Internationalis)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Duplex ultrasonography findings are not related to menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease
ConclusionsReflux was not specific to a particular phase of menstrual cycle in women with early symptoms of chronic venous disease. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound, 2015; (Source: Journal of Clinical Ultrasound)


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


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


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


The Anti-Inflammatory Actions of Auricular Point Acupressure for Chronic Low Back Pain.
Conclusion. These findings suggest that APA treatment affects pain intensity through modulation of the immune system, as reflected by APA-induced changes in serum inflammatory cytokine and neuropeptide levels. PMID: 26170869 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Regulation of Neurotrophin-3 and Interleukin-1β and Inhibition of Spinal Glial Activation Contribute to the Analgesic Effect of Electroacupuncture in Chronic Neuropathic Pain States of Rats.
In this study, the mechanical withdrawal threshold and thermal withdrawal latency were recorded. We used immunofluorescence and western blots methods to investigate the effect of EA on the expression of NT-3 and IL-1β in DRG and spinal cord of CCI rats; we also examined the expression of spinal GFAP and OX-42 in spinal cord. In present study, the MWT and TWL of CCI group rats were lower than those in the Sham CCI group rats, but EA treatment increased the pain thresholds. Furtherly, we found that EA upregulates the expression of NT-3 in DRG and spinal cord of CCI rats, while EA downregulates the expression of IL-1β. Additionally, immunofluorescence exhibited that CCI-induced activation of microglia and astrocytes was inhibited significantly by EA treatment. These results demonstrated tha...


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


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


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


Pain Catastrophising Affects Cortical Responses to Viewing Pain in Others
by Nicholas Fallon, Xiaoyun Li, Andrej Stancak Pain catastrophising is an exaggerated cognitive attitude implemented during pain or when thinking about pain. Catastrophising was previously associated with increased pain severity, emotional distress and disability in chronic pain patients, and is also a contributing factor in the development of neuropathic pain. To investigate the neural basis of how pain catastrophising affects pain observed in others, we acquired EEG data in groups of participants with high (High-Cat) or low (Low-Cat) pain catastrophising scores during viewing of pain scenes and graphically matched pictures not depicting imminent pain. The High-Cat group attributed greater pain to both pain and non-pain pictures. Source dipole analysis of event-related potentials during ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Immunoglobulin G4-related ophthalmic disease presenting as uveitis
This report documents a 47-year-old man who presented with back pain, uveitis and an elevated Westergren sedimentation rate. On biopsy, a paraspinal lesion showed a nonspecific chronic inflammatory cell infiltrate. The eye symptoms, after initially responding to immunosuppressive therapy, worsened and progressed to pain, resulting in an extirpation of the right eye. The histopathology of the excised eye showed an inflammatory pseudotumor marked by a lymphoplasmacytic infiltrate, areas of fibrosis, rare evidence of obliterative phlebitis and, focally, over 20 Immunoglobulin G4 (IgG4)-positive staining cells per high power microscopic field. IgG4-related ophthalmic disease is a relatively rare inflammatory lesion involving the eye and periorbital region. It is defined by a marked lymphoplasm...


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


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


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


Recurrence of migraine with aura after a 24-year free period following rTMS treatment for fibromyalgia pain
We report the case of recurrence of migraine with aura following rTMS treatment for fibromyalgia pain in a patient with history of migraines. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Effect of coenzyme Q plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome - A randomized, controlled, double-blind trial
Chronic Fatigue Syndrome (CFS) is a complex condition, characterized by severe disabling fatigue with no known cause, no established diagnostic tests, and no universally effective treatment. Several studies have proposed symptomatic treatment with coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) supplementation. The primary endpoint was to assess the effect of CoQ10 plus NADH supplementation on age-predicted maximum heart rate (max HR) during a cycle ergometer test. Secondary measures included fatigue, pain and sleep. (Source: Clinical Nutrition)


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


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


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


Differences in Neural Mechanosensitivity Between Patients with Chronic Nonspecific Neck Pain With and Without Neuropathic Features. A Descriptive Cross‐Sectional Study
ConclusionsThe findings of this study suggest that chronic nonspecific neck pain patients with NF have greater neural mechanosensitivity, pain intensity, and neck disability than those with No‐NF. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Does the gastroprotective action of a medicinal plant ensure healing effects? An integrative study of the biological effects of Serjania marginata Casar. (Sapindaceae) in rats
Conclusions Despite the anti-H. pylori and gastroprotective actions of S. marginata in experimental models, the gastric injuries aggravation induced after chronic treatment with the HESM argues against the use of this plant species in folk medicine. Graphical abstract (Source: Journal of Ethnopharmacology)


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


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


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


Uveitis in adults: What do rheumatologists need to know?
Publication date: Available online 14 July 2015 Source:Joint Bone Spine Author(s): Pascal Sève, Laurent Kodjikian, Léopold Adélaïde, Yvan Jamilloux Rheumatologists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. To date, no diagnostic strategy for uveitis has been validated by prospective studies. Investigations are selected based on the clinical features and on the anatomic location of the ocular abnormalities. Infections such as syphilis, Lyme disease, tuberculosis, and Whipple's disease may cause uveitis, with concomitant joint inflammation in a few cases. In patients with a known history of chronic inflammatory joint disease, causes of uveitis include bisphosphonate therapy and immunodepression-related infections (...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Early-developed hand osteoarthritis in treated HIV-positive patients: Four cases
We describe four cases of hand osteoarthritis in patients with HIV infection under antiretroviral treatment. A 36-year-old HIV-infected man came for consultation in 2007 with hand osteoarthritis. He was diagnosed HIV positive by sexual transmission in 1997. A 52-year-old HIV-infected woman came for consultation with hand osteoarthritis started in 2006. She was diagnosed HIV positive in 1986 by sexual transmission. A 57-year-old man presented hand osteoarthritis. This former IV drug user was diagnosed HIV positive in 1989. A 61-year-old HIV-infected man presented with hand osteoarthritis started in 2010. He had been contaminated with HIV in 1990 by sexual transmission. For all patients, there were neither clinical nor biological manifestations suggesting inflammatory arthritis. X-rays showe...


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


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


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


Many opioid overdoses linked to lower prescribed doses, intermittent use
Overdoses of opioid pain medications frequently occur in people who aren't chronic users with high prescribed opioid doses -- the groups targeted by current opioid prescribing guidelines, reports a new study. (Source: ScienceDaily Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Men, fire, and burns: Stories of fighting, healing, and emotions
Recovery from burn is often a long and arduous process comprised of painful procedures, lengthy hospital stays, physical and cosmetic disfigurement, and numerous psychosocial issues [1]. Most burn survivors encounter pain, disability, and psychological difficulties which can have a chronic impact on their lives [2]. In the past, research dedicated to understanding the psychological outcomes of burn survivors was often overshadowed by an emphasis on the physical damage caused by these injuries. This is despite data which suggested that burn severity may not be the best predictor of psychosocial functioning or psychological distress [3,4]. (Source: Burns : Journal of the International Society for Burn Injuries)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


TRPV1 sensitization mediates postinflammatory visceral pain following acute colitis
This study aimed at establishing the role of TRPV1 in the peripheral sensitization underlying chronic visceral pain in the context of colitis. Wild-type and TRPV1-deficient mice were separated into three groups (control, acute colitis, and recovery), and experimental colitis was induced by oral administration of dextran sulfate sodium (DSS). Recovery mice showed increased chemically and mechanically evoked visceral hypersensitivity 5 wk post-DSS discontinuation, at which point inflammation had completely resolved. Significant changes in nonevoked pain-related behaviors could also be observed in these animals, indicative of persistent discomfort. These behavioral changes correlated with elevated colonic levels of substance P (SP) and TRPV1 in recovery mice, thus leading to the hypothesis th...


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


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


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


Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan ® instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis
Conclusion Intravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients. (Source: Clinical Drug Investigation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Inhibition of spinal microglia and astrocytes contributes to the anti-allodynic effect of electroacupuncture in neuropathic pain induced by spinal nerve ligation.
CONCLUSIONS: EA stimulation alleviates SNL-induced neuropathic pain, at least in part through inhibition of spinal glial activation. Moreover, inhibition of spinal microglia and astrocyte activation may contribute to the immediate effects and maintenance of EA analgesia, respectively. PMID: 26177687 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)


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


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


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


High-pressure oxygen can effectively treat fibromyalgia
Women with fibromyalgia, a chronic pain syndrome, were able to drastically reduce, or even eliminate, their use of pain medication following hyperbaric oxygen treatment, according to new research.. The researchers also believe they have identified the primary factor causing fibromyalgia: the disruption of the brain mechanism for processing pain. (Source: ScienceDaily Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Antinociceptive activity of astragaloside IV in the animal model of chronic constriction injury
In conclusion, in our animal model, AG effectively inhibited the neuropathic pain induced by chronic constriction injury. (Source: Behavioural Pharmacology)


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


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


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


Intrathecal bone marrow stromal cells inhibit neuropathic pain via TGF-β secretion
Neuropathic pain remains a pressing clinical problem. Here, we demonstrate that a local, intrathecal (i.t.) injection of bone marrow stromal cells (BMSCs) following lumbar puncture alleviates early- and late-phase neuropathic pain symptoms, such as allodynia and hyperalgesia, for several weeks in murine chronic constriction injury (CCI) and spared nerve injury models. Moreover, i.t. BMSCs reduced CCI-induced spontaneous pain and axonal injury of dorsal root ganglion (DRG) neurons and inhibited CCI-evoked neuroinflammation in DRGs and spinal cord tissues. BMSCs secreted TGF-β1 into the cerebrospinal fluid, and neutralization of TGF-β1, but not IL-10, reversed the analgesic effect of BMSCs. Conversely, i.t. administration of TGF-β1 potently inhibited neuropathic pain. TGF-β1 acted as a p...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


High-pressure oxygen can effectively treat fibromyalgia
(American Friends of Tel Aviv University) A new study by Tel Aviv University researchers found that women with fibromyalgia, a chronic pain syndrome, were able to drastically reduce, or even eliminate, their use of pain medication following hyperbaric oxygen treatment. The researchers also believe they have identified the primary factor causing fibromyalgia: the disruption of the brain mechanism for processing pain. (Source: EurekAlert! - Medicine and Health)


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


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


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


Working with severely traumatized, chronically depressed analysands
Surprisingly often in the psychoanalyses of chronically depressed patients, depression represents an unconscious attempt to psychically cope with unbearable psychic pain following severe traumatisation: dissociative states, a chronified psychic state of shock, a disappearance of emotions, an emptying of the self and the object relationships, as well as a disappearance of the psyche in the body are among the possible consequences. The treatment of these difficult groups of analysands can also frequently bring analysts to the limits of the endurable. Often related to this is the repeated danger of denying the trauma, and a re‐traumatisation of the analysand in the analytic situation. The lecture discusses the fact that in comparison with other therapeutic approaches, psychoanalysis has a h...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Fibromyalgia: epidemiology and risk factors, a population‐based case‐control study in Lebanon
ConclusionThis was the first study to address the epidemiology of FM in Lebanon and the region. The chronic nature of FM that is characterized by frequent bouts of intense disabling pain and symptoms constitutes a significant health and economic burden. Clustering of cases in coastal areas was partially explained by other factors such as body mass index, distress level, smoking and work status. The high burden of FM found in our study calls for further investigation of potential risk factors of this condition. (Source: APLAR Journal of Rheumatology)


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


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


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


The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA‐lesioned rats
This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6‐hydroxydopamine‐lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low‐frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint. Thermal and mechanical sensory thresholds are reduced in 6‐hydroxydopamine lesioned parkinsonian rats compared to sham controls. Subthalamic deep brain stimulation at both 150 and 50 Hz improves thermal and mechanical thresholds in parkinsonian rats. Our results suggest that low frequency stimulation could be considered a treatment option for patients with Parkinson's disease with chronic pain as a predominant complaint. (Source: European Journal of Neu...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: a cluster randomized controlled trial protocol
Prescription opioid misuse is a significant public health problem as well as a patient safety concern. Primary care providers (PCPs) are the leading prescribers of opioids for chronic pain, yet few PCPs follow standard practice guidelines regarding assessment and monitoring. This cluster randomized controlled trial will determine whether four implementation strategies; nurse care management, use of a patient registry, academic detailing, and electronic tools, will increase PCP adherence to chronic opioid therapy guidelines and reduce opioid misuse among patients, relative to electronic tools alone. (Source: Journal of Substance Abuse Treatment)


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


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


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


Correlation of 99mTc‐DPD SPECT/CT Scan Findings and Diagnostic Blockades of Lumbar Medial Branches in Patients with Unspecific Low Back Pain in a Randomized‐Controlled Trial
ConclusionCompared with diagnostic infiltrations SPECT/CT scans showed only a moderate sensitivity and specificity and, therefore, may not be recommended as a first line diagnostic tool prior to diagnostic infiltrations. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Emergency Department Staff Attitudes Toward People Presenting in Chronic Pain: A Qualitative Study
ConclusionsED staff found people presenting at ED with chronic pain to be a challenging and frustrating population to treat. Staff was constrained by the fast‐paced nature of their jobs as well as the need to prioritise emergency cases, and so were unable to spend the time needed by chronic pain patients. This was seen as being bad for staff, and for the patient experience. Staff suggested that care could be improved by appropriate information, signposting and with time invested in communication with the patient. (Source: Pain Medicine)


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


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


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


Interventions for bronchiectasis: an overview of Cochrane systematic reviews.
CONCLUSIONS: This overview clearly points to significant opportunities for further research aimed at improving outcomes for people with bronchiectasis. We have highlighted important endpoints for studies (particularly exacerbations, quality of life and lung function), and areas of clinical practice that are in most urgent need of evidence-based support (including long-term antibiotics, ICSs and mucolytics).As the evidence is confined to small trials of short duration, it is not currently possible to assess the balance between the benefits and potential harms of treatments for bronchiectasis. PMID: 26171905 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Applying refinement to the use of mice and rats in rheumatoid arthritis research
Abstract Rheumatoid arthritis (RA) is a painful, chronic disorder and there is currently an unmet need for effective therapies that will benefit a wide range of patients. The research and development process for therapies and treatments currently involves in vivo studies, which have the potential to cause discomfort, pain or distress. This Working Group report focuses on identifying causes of suffering within commonly used mouse and rat ‘models’ of RA, describing practical refinements to help reduce suffering and improve welfare without compromising the scientific objectives. The report also discusses other, relevant topics including identifying and minimising sources of variation within in vivo RA studies, the potential to provide pain relief including analgesia, welfare ...


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


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


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


An update on complex regional pain syndromes in children and adolescents
Purpose of review: Complex regional pain syndrome (CRPS) is a chronic pain condition typically involving a limb, which is characterized by neuropathic pain, sensory abnormalities and neurovascular findings. The exact cause of CRPS is unknown; however, proposed theories include alterations in the sympathetic and central nervous system (CNS), small fibre changes in the peripheral nervous system and psychological factors. Although this condition was previously considered rare among children and adolescents, it has been increasingly recognized in paediatric patients and can result in significant disability. Recent findings: The diagnosis of paediatric CRPS is based upon clinical criteria obtained from a thorough history and physical examination. Other possible causes, such as orthopaedic, infe...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic pain and obesity
Okifuji A, Hare BD (Source: Journal of Pain Research)


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


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


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


Gastroparesis: A Review of Current Diagnosis and Treatment Options
Gastroparesis (GP) is a chronic neuromuscular disorder of the upper gastrointestinal tract. The incidence of GP is not well described; however, the number of individuals affected by symptoms of GP in the United States is estimated to be over 4 million. The etiology of GP is diverse. Approximately 25% of cases are associated with diabetes, whereas nearly 50% are classified as idiopathic; many of these latter cases likely represent a postinfectious process. Connective tissue disorders, autoimmune disorders, prior gastric surgery, ischemia, and medications make up the vast majority of the remaining cases. The pathophysiology of GP is also diverse. Abnormalities in fundic tone, antroduodenal dyscoordination, a weak antral pump, gastric dysrhythmias, and abnormal duodenal feedback all contribut...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Pregabalin and pain after total knee arthroplasty: a double-blind, randomized, placebo-controlled, multidose trial
Conclusions Pregabalin had no beneficial effects, but increased sedation and decreased patient satisfaction. This study does not support routine perioperative pregabalin for total knee arthroplasty patients. Clinical trial registration. ClinicalTrials.gov: http://www.clinicaltrials.gov/ct2/show/study/NCT01333956. (Source: British Journal of Anaesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Trust and the Ethics of Chronic Pain Management in HIV
The American Nurses Association has designated 2015 as the Year of Ethics, and accordingly has published a revised code of nursing ethics (Willard, 2015). This code explicitly identifies promoting social justice and reducing health care disparities as ethical imperatives. These themes will resonate strongly with health care providers devoted to HIV care, given the disproportionate effects of HIV on predominantly minority, socioeconomically disadvantaged communities. One area in which HIV care providers must be particularly alert to the potential for health care disparities and injustice is chronic pain. (Source: Journal of the Association of Nurses in AIDS Care)


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


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


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


Proctor Chiropractic Seeks to Raise Awareness About Chronic Pain
(Source: Medical News (via PRIMEZONE))<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Immediate changes in electroencephalography activity in individuals with nonspecific chronic low back pain after cranial osteopathic manipulative treatment: study protocol of a randomized, controlled crossover trial
DiscussionThe investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation.Trial registrationNCT02111382 (Source: BioMed Central)


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


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


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


The trues behind TRUS in the setting of chronic prostatitis/chronic pelvic pain syndrome
Conclusion The findings of TRUS studies in patients with suspected CP/CPPS are not pathognomonic for this entity, and TRUS is therefore considered as having very little yield in this setting. (Source: Urological Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report.
Authors: Lee HY, Park JH, Kim SG Abstract Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroeso...


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


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


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


National Dissemination of Cognitive-Behavioral Therapy for Chronic Pain in Veterans: Therapist and Patient-level Outcomes
Discussion: Training in and implementation of CBT-CP in the VA health care system were associated with significant increases in therapist competencies to deliver CBT-CP and improvements in several domains for Veteran patients. Results support the feasibility and effectiveness of broad dissemination of CBT-CP in routine, nonpain specialty settings. (Source: The Clinical Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Natural Variation in Testosterone is Associated With Hypoalgesia in Healthy Women
Discussion: Although future research is needed to replicate and extend these findings to clinical populations (ie, chronic pain, premenstrual dysphoric disorder), results from the present study indicate that menstrual phase-related changes in sex hormones have minimal influence on experimental pain. However, individual differences in testosterone may play a protective role against pain in healthy women. (Source: The Clinical Journal of Pain)


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


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


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


Modulatory effects by CB1 receptors on rat spinal locomotor networks after sustained application of agonists or antagonists
Publication date: 10 September 2015 Source:Neuroscience, Volume 303 Author(s): P. Veeraraghavan , A. Nistri Sustained administration of cannabinoid agonists acting on neuronal CB1 receptors (CB1Rs) are proposed for treating spasticity and chronic pain. The impact of CB1Rs on mammalian locomotor networks remains, however, incompletely understood. To clarify how CB1Rs may control synaptic activity and locomotor network function, we used the rat spinal cord in vitro which is an advantageous model to investigate locomotor circuit mechanisms produced by the local central pattern generator. Neither the CB1 agonist anandamide (AEA) nor the CB1R antagonist AM-251 evoked early (&lt;3h) changes in mono or polysynaptic reflexes or in locomotor rhythms. Application of AEA (24h) significantly dec...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Thalidomide reduces mechanical hyperalgesia and depressive-like behavior induced by peripheral nerve crush in mice
Conclusions: The sciatic nerve crush model represents a good model to study to mechanisms underlying both pain and depressive-like behaviors. Furthermore, inhibitors of TNF-α synthesis, like thalidomide, have a potential to treat depressive disorders associated with neuropathic pain. Graphical abstract (Source: Neuroscience)


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


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


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


Completion pancreatectomy and islet cell autotransplantation as salvage therapy for patients failing previous operative interventions for chronic pancreatitis
Traditional decompressive and/or pancreatic resection procedures have been the cornerstone of operative therapy for refractory abdominal pain secondary to chronic pancreatitis. Management of patients that fail these traditional interventions represents a clinical dilemma. Salvage therapy with completion pancreatectomy and islet cell autotransplantation (CPIAT) is an emerging treatment option for this patient population; however, outcomes after this procedure have not been well-studied. (Source: Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Headaches after Concussion in Pediatrics: a Review
Abstract Concussion and mild traumatic brain injury (TBI) are common pediatric injuries. Headaches are one of the most common and disabling complaints following concussion in the acute phase and are pervasive in those who have prolonged symptoms following concussion. The body of evidence regarding the epidemiology of and risk factors for pediatric concussion and post-traumatic headache is growing rapidly, but there still is a distinct lack of strong scientific evidence to support the best treatment strategies for post-traumatic headaches in either children or adults. In this article, we will review the current evidence regarding the epidemiology of acute and chronic headaches following concussion in the pediatric population, as well as current recommendations for the management o...


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


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


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


FDA Strengthens Heart Attack, Stroke Warning for Popular Painkillers
Title: FDA Strengthens Heart Attack, Stroke Warning for Popular PainkillersCategory: Health NewsCreated: 7/10/2015 12:00:00 AMLast Editorial Review: 7/10/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A single thalamic target for deep brain stimulation to treat hemi-body pain syndrome
Conclusion To our knowledge this was the first time this pattern of pain was treated by a single thalamic DBS electrode, suggesting stimulation in this region may be a feasible target for achieving relief from chronic severe hemi-body pain. (Source: Acta Neurochirurgica)


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


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


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


Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study
Conclusions Chronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain. (Source: BMJ Open)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Spinal sensory projection neuron responses to spinal cord stimulation are mediated by circuits beyond gate control
Spinal cord stimulation (SCS) is a therapy used to treat intractable pain with a putative mechanism of action based on the Gate Control Theory. We hypothesized that sensory projection neuron responses to SCS would follow a single stereotyped response curve as a function of SCS frequency, as predicted by the Gate Control circuit. We recorded the responses of antidromically identified sensory projection neurons in the lumbar spinal cord during 1- to 150-Hz SCS in both healthy rats and neuropathic rats following chronic constriction injury (CCI). The relationship between SCS frequency and projection neuron activity predicted by the Gate Control circuit accounted for a subset of neuronal responses to SCS but could not account for the full range of observed responses. Heterogeneous responses we...


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


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


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


Paradoxical Pain Perception in Posttraumatic Stress Disorder: The Unique Role of Anxiety and Dissociation
Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, patients with PTSD with chronic pain were found to demonstrate a unique paradoxical pain profile: hyperresponsiveness together with hyposensitivity to pain. Our aim was to examine whether 2 seemingly paradoxical facets of PTSD (anxiety and dissociation) underlie this paradoxical profile. Patients with PTSD (n = 32) and healthy control individuals (n = 43) underwent psychophysical testing and completed questionnaires. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


On the Horizon: Virtual Reality Therapy That Treats Chronic Pain
Retraining the brain can restore mobility for people with injuries or difficulty moving -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)


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


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


The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?
Learning objectives To recognise the causes and natural history of non-cardiac chest pain. To recognise features in the history and examination which differentiate cardiac pain from non-cardiac chest pain. To explore and treat the psychological factors initiating and maintaining non-cardiac chest pain. CURRICULUM TOPIC: Chronic ischaemic heart disease Introduction Chest pain is common and usually non-cardiac in origin. The lifetime population prevalence of non-cardiac chest pain (NCCP) is approximately 20&ndash;33%1&ndash;7 compared with approximately 6&ndash;7% for angina.3 8 The incidence of NCCP depends on the clinical setting. It is 70&ndash;80% for patients presenting to a general practitioner or a rapid access chest pain clinic9&ndash;11 and around 50% attending emergency department...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Disaccharidase Deficiencies in Children With Chronic Abdominal Pain.
CONCLUSIONS: A large proportion of patients with CAP have deficiencies in disaccharidases. Bowel frequency, vomiting, or location of pain was no different between groups, suggesting that these clinical features cannot be used to predict disaccharidase deficiencies. PMID: 26160252 [PubMed - as supplied by publisher] (Source: JPEN Journal Of Parenteral And Enteral Nutrition)


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


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


Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis
The aim of this work was to develop a consensual recommendation under the auspices of the Assessment of SpondyloArthritis international Society (ASAS) for early referral of patients with a suspicion of axial spondyloarthritis by non-rheumatologists. The development of a referral recommendation consisted of four phases: (1) systematic literature review, (2) the first Delphi round aiming at identification of unmet needs and development of a candidate list of referral parameters, (3) the second Delphi round aiming at identification of the most useful combination of referral parameters and (4) final discussion and formal endorsement by ASAS membership. The following consensus on a referral recommendation was achieved as a result of the Delphi processes and final voting: "Patients with chronic ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Gait Retraining for Injured and Healthy Runners Using Augmented Feedback: A Systematic Literature Review.
Conclusion In conjunction with traditional therapeutic interventions, real-time auditory and visual feedback should be considered in treating injured runners or addressing potentially injurious running mechanics in a healthy population. J Orthop Sports Phys Ther, Epub 9 Jul 2015. doi:10.2519/jospt.2015.5823. PMID: 26158882 [PubMed - as supplied by publisher] (Source: Physical Therapy)


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


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


JAMA Meta-analysis Finds Mixed Results for Medical Marijuana Use
A meta-analysis published in JAMA: the Journal of the American Medical Association found there was moderate-quality evidence to support the use of cannabinoids for treating chronic pain but only low-quality evidence for a number of other indications. (Source: AAFP News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Online tools may help patients manage chronic pain
Patients can manage chronic pain and reduce their reliance on opioids through an internet-based programme that teaches non-medical alternatives, according to US nurse researchers. (Source: Nursing Times Breaking News)


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


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


Recall Bias in Patients with Chronic Low Back Pain: Individual Pain Response Patterns Are More Important Than Pain Itself!
Conclusion Recall biases in CLBP patients are not only a result of experiencing pain but also effected by patients’ pain response pattern with respect to fear-avoidance versus endurance. (Source: International Journal of Behavioral Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Spontaneous burrowing behavior as an outcome measure of the global impact of chronic pain in preclinical models of arthritis
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): A. Delaney , J. Su , T. Gao , N. Agalave , C.I. Svensson (Source: Scandinavian Journal of Pain)


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


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


Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): T. Jonsdottir , S. Gunnarsdottir , H. Jonsdottir (Source: Scandinavian Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Re: Effectiveness of Acupuncture on Chronic Prostatitis-Chronic Pelvic Pain Syndrome Category IIIB Patients: A Prospective, Randomized, Nonblinded, Clinical Trial
E. V. Küçük, F. Y. Suçeken, A. Bindayı, U. Boylu, F. F. Onol and E. Gümüş (Source: The Journal of Urology)


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


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


Key mechanism that causes neuropathic pain found
A biological process called endoplasmic reticulum stress appears to play a key role in causing neuropathic pain, according to a new study. The discovery could eventually lead to new therapeutics for controlling chronic pain associated with trauma, diabetes, shingles, multiple sclerosis or other conditions that cause nerve damage. (Source: ScienceDaily Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Perspectives on Canadian core fellowship training in pediatric anesthesia: a survey of graduate fellows
Conclusions This survey reports perceived deficiencies in domains of pediatric anesthesia fellowship training. These findings should help guide the future development of core and advanced fellowship training programs in pediatric anesthesia. (Source: Canadian Journal of Anesthesia)


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


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


Management of Pain and Quality of Life in Patients with Chronic Kidney Disease Undergoing Hemodialysis
An important dimension that influences the quality of life of hemodialysis patients is the pain they experience. Quality of life and self-efficacy in pain can play an important role in chronic kidney disease and treatment outcomes. The purpose of the study was to examine self-efficacy in pain and quality of life among patients with end stage renal disease undergoing hemodialysis. Between April 2013 and June 2013, 224 hemodialysis patients completed the Missoula-VITAS Quality of Life Index-15 and the Pain Self-Efficacy Questionnaire. (Source: Pain Management Nursing)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects
Abstract Rheumatoid arthritis (RA), a chronic progressive inflammatory autoimmune disorder characterized by chronic pain and swelling primarily, affects the peripheral joints. RA had attained global concern in the last few decades, affecting more than 1.5 % of the world’s population with higher female percentage than male. In the advanced stage, the disease is associated with the destruction of cartilage and bone along with a variety of systemic manifestations leading to functional disability. Inadequate early/preliminary diagnosis and non-specific therapeutics are the major challenges in the management of RA. Till date, the exact cause(s) of the disease remain(s) obscure, and several genetic, hormonal, and environmental factors are associated with the beginning and the pro...


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


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


Antinociceptive properties of selective MT2 melatonin receptor partial agonists.
Authors: López-Canul M, Comai S, Domínguez-López S, Granados-Soto V, Gobbi G Abstract Melatonin is a neurohormone involved in the regulation of both acute and chronic pain whose mechanism is still not completely understood. We have recently demonstrated that selective MT2 melatonin receptor partial agonists have antiallodynic properties in animal models of chronic neuropathic pain by modulating ON/OFF cells of the descending antinociceptive system. Here, we examined the antinociceptive properties of the selective MT2 melatonin receptor partial agonists N-{2-[(3-methoxyphenyl)phenylamino]ethyl}acetamide (UCM765) and N-{2-[(3-bromophenyl)-(4-fluorophenyl)amino]ethyl}acetamide (UCM924) in two animal models of acute and inflammatory pain: the hot-plate and formalin tests. UCM765 and...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Sleep problems and working memory in chronic pain
Elvemo NA, Landrø NI, Borchgrevink PC, Håberg AK (Source: Journal of Pain Research)


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


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


Muscles and their role in episodic tension‐type headache: implications for treatment
ConclusionMuscular factors play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice. (Source: European Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Milnacipran for neuropathic pain in adults.
CONCLUSIONS: There was no evidence to support the use of milnacipran to treat neuropathic pain conditions. PMID: 26148202 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


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


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


Potential application of miRNAs as diagnostic and therapeutic tools in chronic pancreatitis.
Authors: Hu LH, Ji JT, Li ZS Abstract Chronic pancreatitis (CP) is a progressive inflammatory disease typified by end-stage fibrosis. This disease can also increase the risk of pancreatic cancer. The associated diagnosis, pain and other complications further add to the burden of disease management. In recent years, significant progress has been achieved in identifying miRNAs and their physiological functions, including mRNA repression and protein expression control. Given the extensive effort made on miRNA research, a close correlation has been discovered between certain types of miRNAs and disease progression, particularly for tissue fibrosis. Designing miRNA-related tools for disease diagnosis and therapeutic treatments presents a novel and potential research frontier. In the cur...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Herbs for Low-Back Pain, Acupuncture for Psychological Distress, Osteopathic Manipulative Therapy for Chronic Migraine, Honey Dressings for Burns, Vegetarian Diet and Risk of Colorectal Cancer
Level 2 (mid-level) evidence (Source: Explore)


V31. Learned control over spinal nociception in chronic back pain patients
The descending pain inhibition is a top-down system exerting powerful endogenous pain inhibition. It originates in the brainstem and sends serotonergic and noradrenergic pathways to the spinal dorsal horn, where they inhibit spinal nociceptive transmission and therefore reduce nociceptive input to the brain. The brainstem centers at the origin of descending inhibition are targeted by cortical regions like the prefrontal cortex and the anterior cingulate cortex, and are susceptible to cognitive-emotional modulation (Bingel and Tracey, 2008). (Source: Clinical Neurophysiology)


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


P160. Transcranial magnetic stimulation in chronic neuropathic pain – A prospective study of 45 patients
Chronic neuropathic disorders remain difficult to treat. Analgesic medication often achieve only an insufficient effect, therefore other non-pharmacological treatment has to be considered. One option for management of intractable pain is stimulation of the motor cortex by implantation of an epidural electrode. This effect of invasive stimulation could be replaced by transcranial magnetic stimulation. (Source: Clinical Neurophysiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Two-port totally extraperitoneal inguinal hernia repair: a 10-year experience
Conclusion Two-port TEP appears to be a feasible, safe, and effective method for laparoscopic inguinal hernia repair and should be considered a viable, less invasive alternative to conventional three-port techniques. (Source: Hernia)


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


TRPC3: A New Target for Therapeutic Strategies in Chronic Pain-DAG-mediated Activation of Non-selective Cation Currents and Chronic Pain (Mol Pain 2014;10:43).
Authors: Xia M, Liu D, Yao C PMID: 26130641 [PubMed] (Source: Journal of Neurogastroenterology and Motility)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Sedation methods for intra-articular corticosteroid injections in Juvenile Idiopathic Arthritis: a review
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. Intra-articular corticosteroid injection (IASI), one of the cornerstones of treatment for this disease, is usually associated with anxiety and pain. IASI in JIA may be performed under general anesthesia, conscious sedation, or local anesthesia alone. Currently, there is no widely accepted standard of care regarding the sedation method for IASI. This review discusses the different methods of anesthesia and sedation in this procedure, emphasizing the advantages and shortcomings of each method. (Source: Pediatric Rheumatology)


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


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


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


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


Analgesic management of acute pain in the opioid-tolerant patient
Purpose of review: The management of acute pain in the opioid-tolerant patient is an area in perioperative medicine that is growing, as the use of opioids for chronic noncancer pain has been tolerated in the USA. Adding to this population is an increase in opioid abusers, addicts and those in recovery and maintenance programmes. These patients will continue to present for surgery and with acute pain that anaesthesiologists and other members of the healthcare team must become more adept at managing. Recent findings: This review covers some of the strategies that may be used by practitioners in the management of acute pain in the opioid-tolerant patient. It is important to collect a detailed history of opioid and drugs of abuse, including the timing of the last dose in order to avoid precipi...


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


Spontaneous cervical haemorrhage of a parathyroid adenoma.
This report describes a previously fit and well 54-year-old woman who presented with acute neck swelling and pain with an overlying ecchymosis. Admission laboratory tests revealed a raised parathyroid hormone and hypercalcaemia. A computed tomography (CT) scan showed widespread anterior cervical haemorrhage and a lesion at the inferior pole of the left thyroid gland. A working diagnosis of spontaneous haemorrhage from a parathyroid adenoma was made. As she was haemodynamically stable, she was treated conservatively with a period of observation in hospital to monitor for signs of neck organ compression. Follow-up imaging with CT, ultrasound and sestamibi confirmed the likely source of haemorrhage as a parathyroid nodule with significant vascularity. The diagnosis was confirmed on histopatho...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Treatment of Patellar Tendinopathy Refractory to Surgical Management Using Percutaneous Ultrasonic Tenotomy and Platelet-Rich Plasma Injection: A Case Presentation
We present a case of a collegiate athlete with chronic proximal patellar tendinopathy who was effectively treated with percutaneous ultrasonic tenotomy after failing to improve with extensive non-operative treatment, surgical debridement, and platelet rich plasma injections. Percutaneous ultrasonic tenotomy can be considered as a treatment option in patients presenting with refractory proximal patellar tendinopathy, including those failing prior operative intervention. (Source: PMandR)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


[Drug interactions in pain therapy].
CONCLUSION: Many drug interactions can be avoided by careful and continuous evaluation of pharmacotherapy and if necessary its adaptation; however, a sound knowledge of the underlying pharmacological mechanisms and the properties of currently used analgesics is necessary. PMID: 26137862 [PubMed - as supplied by publisher] (Source: Schmerz)


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


Efficacy and safety profile of prolonged release oxycodone in combination with naloxone (OXN PR) in Parkinson’s disease patients with chronic pain
Abstract Pain is a relevant and often underestimated non-motor symptom affecting the quality of life of patients with Parkinson’s disease (PD). Although some pain symptoms can be effectively treated by dopaminergic medication, a correct diagnosis of the different types and distribution of pain in PD is challenging, and accordingly, its treatment remains troublesome. We evaluated the efficacy and the safety of a prolonged release oral formulation of oxycodone hydrochloride combined with naloxone hydrochloride dehydrate, in a fixed ratio of 2:1 (OXN PR). A total of 16 PD patients with history of pain with a minimum intensity of four on numerical rating scale (NRS) received low-dose OXN PR (5/2.5 mg twice daily) and were observed for a period of 8 weeks. The primary efficacy meas...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Transfer of Opiorphin Through a Blood-Brain Barrier Culture Model
Opioid peptides are potent analgesics with therapeutic potential in the treatment of acute and chronic pain. Their efficacy is limited by peptidases (enkephalinases). Opiorphin pentapeptide (QRFSR) is the first characterized human endogenous inhibitor of enkephalinases. The peptide is able to increase the binding and affinity of endogenous opiates to mu opioid receptors; thus, the mechanism of opiorphin may provide a new therapeutic approach in pain management. The analgesic effect of opiorphin was proven in several earlier published in vitro and in vivo studies. (Source: Archives of Medical Research)


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


Does adding cognitive-behavioural physiotherapy to exercise improve outcome in patients with chronic neck pain? A randomised controlled trial
To determine whether adding a physiotherapist-led cognitive-behavioural intervention to an exercise programme improved outcome in patients with chronic neck pain (CNP). (Source: Physiotherapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Professional knowledge among Swedish and Saudi healthcare practitioners regarding oro‐facial pain in children and adolescents
This study shows that professional knowledge regarding OFP/TMD in children and adolescents is limited among Swedish and Saudi Arabian dental and medical professionals compared to Swedish OFP/TMD specialists. In Swedish groups, the professional knowledge is more accurate than in the corresponding Saudi Arabian. With these results in mind, and the frequent prevalence of OFP/TMD in children and adolescents, one can draw the conclusion that there is a need for modern medical education regarding OFP/TMD among both physicians and dentists, especially in Saudi Arabia. (Source: Journal of Oral Rehabilitation)


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


Dyspnea-related cues engage the prefrontal cortex: Evidence from functional brain imaging in COPD.
Conclusions: Our findings suggest that engagement of the brain's emotional circuitry is important for interpretation of dyspnea-related cues in COPD, and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and our findings suggest such mechanisms may be relevant in COPD. PMID: 26134891 [PubMed - as supplied by publisher] (Source: Chest)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention
Conclusions The low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure. (Source: International Journal of Behavioral Medicine)


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


Zydus gets USFDA nod for morphine sulfate tablets
Zydus Group today announced receipt of approval to sell chronic pain reliever morphine sulfate tablets from the US Food and Drug Administration. (Source: The Economic Times Healthcare and Biotech News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


An Overview of Treatments for Endometriosis
Endometriosis is a chronic disease affecting up to 10% of women in the general population and up to 40% in subfertile women. The most common symptom is pain, which can recur even after treatment. Fertility problems are common among women of reproductive age with this disease. There is no cure. The main goal of treatment is to relieve pain and improve fertility. The primary aim of this overview was to summarize data on treatments associated with improved outcomes in women with endometriosis. Data were analyzed in studies published from 1979 to 2012 from 140 randomized clinical trials (included in 18 Cochrane systematic reviews). Primary treatment outcomes evaluated were self-reported pain relief for dysmenorrhea and live birth rate. Secondary outcomes examined included clinical improvement ...


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


Plasmacytoma of Liver Mimicking Hepatocellular Carcinoma at Multiphasic Computed Tomography Evaluation
Abstract: Plasmacytoma of liver is a rare hepatic tumor more often seen at autopsy than described in the literature; it is also more likely diagnosed in the setting of multiple myeloma than as isolated extramedullary plasmacytoma. However, when found in the setting of multiple myeloma, it is associated with worse clinical outcome. The authors describe a case of an elderly man presenting with nonspecific chronic abdominal pain and a new 4-cm hepatic mass. At multiphasic computed tomography, the mass demonstrated an enhancement pattern identical to that expected of hepatocellular carcinoma; however, thorough history failed to uncover necessary risk factors for hepatic cirrhosis. Ultrasound-guided core biopsy of the mass, as well as additional clinical and radiologic assessment, subsequently ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Sacroiliac joint luxation after pedicle subtraction osteotomy: report of two cases and analysis of failure mechanism
Conclusion Patients with high PI might seek for further compensation at their SIJ when lacking LL after PSO. Chronic anterior imbalance might lead to progressive weakening of sacroiliac ligaments. Initial circumferential lumbosacral fusion and accurate iliac screw fixation might reduce stress on implants, risk for pseudarthrosis, implant failure and finally SIJ deterioration. Bone mineral density should further be investigated preoperatively. (Source: European Spine Journal)


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


The 'Best Practice Guide to Conservative Management of Patellofemoral Pain': incorporating level 1 evidence with expert clinical reasoning
Conclusions and relevance Effective management of PFP requires consideration of a number of proven conservative interventions. An individually tailored multimodal intervention programme including gluteal and quadriceps strengthening, patellar taping and an emphasis on education and activity modification should be prescribed for patients with PFP. We provide a &lsquo;Best Practice Guide to Conservative Management of Patellofemoral Pain&rsquo; outlining key considerations. (Source: British Journal of Sports Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Open surgical management of sialolithiasis
This article highlights the open surgical interventions that are frequently used in sialolithiasis management, when sialoendoscopy is not the most appropriate option, has failed, or is not available. They range from minimally invasive to open techniques. Mastering the anatomy of the salivary ducts and surrounding structures is of exquisite importance. The management of sialolithiasis should aim for gland sparing procedures before considering gland excision. (Source: Operative Techniques in Otolaryngology Head and Neck Surgery)


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


A clinician's quick guide of evidence‐based approaches: Chronic pain
(Source: Clinical Psychologist)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Pathogenesis of Endometriosis: Roles of Retinoids and Inflammatory Pathways
Semin Reprod Med 2015; 33: 246-256DOI: 10.1055/s-0035-1554920Endometriosis is a nonmalignant, but potentially metastatic, gynecological condition manifested by the extrauterine growth of inflammatory endometrial implants. Ten percent of reproductive-age women are affected and commonly suffer pelvic pain and/or infertility. The theories of endometriosis histogenesis remain controversial, but retrograde menstruation and metaplasia each infer mechanisms that explain the immune cell responses observed around the ectopic lesions. Recent findings from our laboratories and others suggest that retinoic acid metabolism and action are fundamentally flawed in endometriotic tissues and even generically in women with endometriosis. The focus of our ongoing research is to develop medical therapies as ad...


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


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


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


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


Atrophy, inducible satellite cell activation and possible denervation of supraspinatus muscle in injured human rotator-cuff muscle.
Authors: Gigliotti D, Leiter JR, Macek B, Davidson MJ, MacDonald PB, Anderson JE Abstract The high frequency of poor outcome and chronic pain after surgical repair of shoulder rotator-cuff injury (RCI) prompted this study to explore the potential to amplify muscle regeneration using nitric oxide- (NO-) based treatment. After pre-operative magnetic resonance imaging (MRI), biopsies of supraspinatus and ipsilateral deltoid (as a control) were collected during reparative surgery for RCI. Muscle fiber diameter, the pattern of neuromuscular junctions observed with alpha-bungarotoxin staining, and the γ:ε subunit ratio of acetylcholine receptors in western blots were examined in tandem with experiments to determine the in vitro responsiveness of muscle satellite cells to activation (in...


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


Assessment of feasibility and efficacy of Class IV laser therapy for postoperative pain relief in off-pump coronary artery bypass surgery patients: A pilot study.
CONCLUSION: Class IV laser can be an effective technique for postoperative analgesia following OPCABG surgery through sternotomy when included as a component of MMA technique. PMID: 26139735 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Distress in patients with bleeding disorders: a single institutional cross‐sectional study
ConclusionDistress among patients with congenital bleeding disorders followed at a comprehensive HTC was high and similar to that reported among patients with cancer. Future research should determine whether distress impacts clinical outcomes in patients with bleeding disorders as demonstrated in other chronic disorders. (Source: Haemophilia)


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


Influence of Defensiveness on Disability in a Chronic Musculoskeletal Pain Population
ConclusionsThe interaction between defensiveness and anxiety plays an important role in patients' perceptions of, and outcomes from, chronic pain. Differentiating the defensive high‐anxious group revealed different patterns of relationship between a range of cognitive factors and disability. This highlights the necessity of assessing personality characteristics that include defensiveness in order to identify those individuals who may be more vulnerable to cognitive factors influencing their perceptions of disability. If personality type is identified as a predictor of poor adjustment, interventions could be customized to the unique needs of this group (eg. high defensive and anxious individuals). (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Prevalence and Characteristics of Discogenic Pain in Tertiary Practice: 223 Consecutive Cases Utilizing Lumbar Discography
ConclusionThe prevalence of discogenic pain in this community practice is below the range, but within confidence intervals, previously reported. Prevalence is considerably elevated, however, among well‐selected patients and discography enabled a firm diagnosis in most such cases. These findings are broadly in keeping with those reached in key publications and support the clinical utility of discography. (Source: Pain Medicine)


Problems in Functioning in Patients with Chronic Musculoskeletal Pain Admitted for Multidisciplinary Rehabilitation
ConclusionA 15‐week multidisciplinary treatment program showed that most problems were seen within chapters Mobility and Community life of the ICF. The program led to significant improvements of patient reported problems, the magnitude of which was similar for all different problem areas. (Source: Pain Practice)


The Fear‐avoidance Components Scale (FACS): Development and Psychometric Evaluation of a New Measure of Pain‐related Fear Avoidance
Abstract Pain‐related fear avoidance (FA), a common problem for patients with painful medical conditions, involves pain‐related catastrophizing cognitions, hypervigilance, and avoidance behaviors, which can ultimately lead to decreased functioning, depression, and disability. Several patient‐reported instruments have been developed to measure FA, but they have been criticized for limited construct validity, inadequate item specificity, lack of cutoff scores, and missing important FA components. The Fear‐Avoidance Components Scale (FACS) is a new patient‐reported measure designed to comprehensively evaluate FA in patients with painful medical conditions. It combines important components of FA found in prior FA scales, while trying to correct some of their deficiencies, within a fr...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Use of a Risk‐Stratification Tool in Identification of Potential Adrenal Suppression Preceding Steroid Injection Therapy in Chronic Pain Patients
ConclusionsOur results suggest that patients receive steroids from many sources and may be at risk for HPA axis suppression. Further testing is necessary to determine if these patients indeed have biochemical evidence of adrenal suppression. Utilization of a screening questionnaire might help identify patients who should be considered for HPA axis testing prior to steroid injections. (Source: Pain Medicine)


A Cross‐Sectional Study of Psychological Comparison Processes That May Underlie the Acceptance of Chronic Pain
In this study, the two subscales of the Chronic Pain Acceptance Questionnaire (Activity Engagement and Pain Willingness) were complemented with a scale of Affective Acceptance. Using linear regression analyses, data from these three acceptance scales were regressed on three scales of temporal comparison processes, four scales of social comparison processes and one scale of counterfactual comparisons. The results showed that the comparison processes explained up to 37% of the variance in acceptance, especially a higher frequency of thinking of one's present condition in relation to a condition in the past, and feeling bad when comparing with others who are doing better, were consistently related to lower acceptance. These explorative results may inspire experimental studies to influence com...


Concurrent Validity of the Defense and Veterans Pain Rating Scale in VA Outpatients
ConclusionsThese findings provide preliminary evidence for the concurrent validity of the DVPRS as a brief, multidimensional measure of pain interference that make it a practical tool for use in primary care settings to assess the impact of pain on daily functioning and monitor chronic pain over time. (Source: Pain Medicine)


Can social support work virtually? Evaluation of rheumatoid arthritis patients' experiences with an interactive online tool.
CONCLUSIONS: Overall, online learning and interaction can do much to help patients with the everyday stresses of their disease; however, its potential for more durable positive impact depends on various individual characteristics such as personality traits, existing social networks, and the severity and longevity of the disease. PMID: 26252664 [PubMed - in process] (Source: Pain Research and Management)


Deconstructing Chronic Low Back Pain in the Older Adult—Step by Step Evidence and Expert‐Based Recommendations for Evaluation and Treatment Part III: Fibromyalgia Syndrome
ConclusionsRecognition of FMS as a common contributor to CLBP in older adults and initiating treatment targeting both FMS and CLBP will lead to improved outcomes in pain and disability. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Primary pulmonary leiomyosarcoma of lung: An unusual entity with brief review.
Authors: Nath D, Arava S, Joshi P, Madan K, Mathur S Abstract Primary pulmonary leiomyosarcomas are rare and diagnostically challenging group of neoplasms approximately constituting 0.2-0.5% of all primary lung malignancies. They originate from the smooth muscle cells of the bronchial wall, blood vessels or from the pulmonary interstitium. Here we present a case of 45 year old male with history of chronic cough, breathlessness and chest pain for few months. Clinical and radiological workup showed a left upper lobe lung mass. Endobronchial ultrasound guided (EUS) needle biopsy of the mass on histopathology confirmed leiomyosarcoma. Further through evaluation ruled out the possibility of metastasis. A final diagnosis of primary leiomyosarcoma of lung was made and patient was planned ...


Safety and Tolerability of Biphasic Immediate‐Release/Extended‐Release Oxycodone/Acetaminophen Tablets: Analysis of 11 Clinical Trials
ConclusionsSafety and tolerability of IR/ER OC/APAP are similar to other low‐dose opioid/APAP analgesics. (Source: Pain Practice)


A Prospective, Randomized, Single‐Blinded, Head‐to‐Head Long‐Term Outcome Study, Comparing Intrathecal (IT) Boluses With Continuous Infusion Trialing Techniques Prior to Implantation of Drug Delivery Systems (DDS) for the Treatment of Severe Intractable Chronic Nonmalignant Pain
ConclusionLow‐dose IT opioids via DDS can provide significant and long‐lasting reduction in pain, and improvement in function (physical and behavioral) for patients with chronic nonmalignant pain. The two trialing techniques tested, intermittent boluses, and continuous infusion delivered intrathecally showed no clinical significance difference in terms of predicting trial success or long‐term outcomes. (Source: Neuromodulation: Technology at the Neural Interface)


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


Daily vitamin D supplement may prolong remission from Crohn's disease
(NaturalNews) Crohn's disease is a difficult digestive condition marked by chronic inflammation, abdominal pain and bouts of diarrhea. According to the Centers for Disease Control, this disease effects around 200 out of every 10,000 adults here in America and can lead to serious,... (Source: NaturalNews.com)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Evidences of Reduced Antioxidant Activity in Patients With Chronic Migraine and Medication‐Overuse Headache
ConclusionsThe data from the present study suggest that antioxidant capacity is lower in chronic migraine patients and medication‐overuse headache compared to healthy headache‐free subjects, with no differences between patients with triptan or nonsteroidal anti‐inflammatory drug overuse. Further investigation is certainly necessary in order to define the causal or consequential role of an imbalance between pro‐oxidants and antioxidant defenses in migraine pathogenesis and “chronification” and the possible therapeutic implications in clinical practice. (Source: Headache: The Journal of Head and Face Pain)


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


Management of Pain After Spinal Cord Injury
Abstract Chronic pain affects most people with spinal cord injury (SCI). It often impedes performance of activities of daily living and negatively impacts quality of life. Pain after SCI can be classified into subtypes through use of the International SCI Pain Classification with key attributes of the pain necessary for effective monitoring and treatment collected within the International SCI Pain Basic Data Set. Many nociceptive causes of pain seen after SCI are potentially treatable and preventable through the implementation of strategies for preventing overuse injuries. Neuropathic pain, in contrast, has been historically difficult to treat. Options for the treatment of neuropathic pain types which have demonstrated some effectiveness include various adjuvant pharmacological ag...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial
Conclusion: The results of this study show that both traditional ECC and HSR yield positive, equally good, lasting clinical results in patients with Achilles tendinopathy and that the latter tends to be associated with greater patient satisfaction after 12 weeks but not after 52 weeks. (Source: The American Journal of Sports Medicine)


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


Evidence for the Durability of Autologous Tenocyte Injection for Treatment of Chronic Resistant Lateral Epicondylitis: Mean 4.5-Year Clinical Follow-up
Conclusion: ATI significantly improved clinical function and MRI tendinopathy scores for up to 5 years in patients with chronic resistant LE who had previously undergone unsuccessful nonsurgical treatment. This study provides evidence for the midterm durability of ATI for treatment of LE tendinopathy. (Source: The American Journal of Sports Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Gut feelings 2. Mind, mood and gut in inflammatory bowel disease: approaches to psychiatric care.
CONCLUSIONS: IBD is a chronic, debilitating and potentially body integrity altering condition with significant morbidity and a slight increase in mortality. Co-morbidity with anxiety and depression is common. Onset in the younger years can disturb development. Psychotherapy may be most useful for addressing fatigue, pain and assisting with coping. There is a lack of evidence to guide treatment of depression in this population. PMID: 26133813 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)


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


Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1.
CONCLUSIONS: Venous disorders show significant associations with several leg symptoms. Itching, feeling of heaviness, or tightness seem to be more closely related than other symptoms. The associations between C classes and symptoms seem to be restricted to classes C2 or higher. PMID: 26141786 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Closed Sagittal Band Injury of the Metacarpophalangeal Joint.
Authors: Kleinhenz BP, Adams BD Abstract Although it is an uncommon injury, traumatic rupture of the sagittal band often results in subluxation or dislocation of the extensor digitorum communis tendon. The radial sagittal band prevents ulnar subluxation of the extensor tendon at the metacarpophalangeal joint. Injury may result from a direct blow to the hand or from relatively low-energy mechanisms. Symptoms range from metacarpophalangeal joint pain and edema to dislocation of the extensor tendon. Associated injuries include collateral ligament sprains, capsular injury, and osteochondral fractures. Many acute injuries can be managed nonsurgically with extension splints. Optimal management of subacute or chronic injuries remains undefined. Surgical management consists of repair or re...


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


Self‐management support for chronic pain in primary care: a cross‐sectional study of patient experiences and nursing roles
ConclusionThere are several opportunities for primary care practices to facilitate self‐management of chronic pain, including the optimization of the primary care nursing role. (Source: Journal of Advanced Nursing)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


A Randomized Controlled Trial of the Effects of Isolated Lumbar Extension Exercise on Lumbar Kinematic Pattern Variability during Gait in Chronic Low Back Pain
Conclusions Considering the role of the lumbar extensors in gait, and their common deconditioning in CLBP, an isolated lumbar extension resistance exercise intervention may reduce gait variability. These results suggest isolated lumbar extension exercise may specifically reduce sagittal plane variability, indicating improved motor pattern replication through this movement plane, perhaps due to the plane of movement utilized during the exercise. (Source: PMandR)


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


Defining the treatment targets and active ingredients of rehabilitation: Implications for rehabilitation psychology.
Conclusions/implications: This type of systematic approach to defining and, ultimately, measuring the quality and quantity (dose) of specific treatments stands to enhance research, practice, and training in rehabilitation as well as communication across the treatment team and other stakeholders in the process and outcomes of rehabilitation. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (Source: Rehabilitation Psychology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland-Prevalence and Correlates.
CONCLUSIONS: Physical pain is a prevalent and potentially impairing experience in adults seeking treatment for alcohol dependence. Therapeutic interventions aimed at reducing pain in alcohol-dependent individuals should be studied to evaluate their impact on improving overall treatment outcomes. PMID: 26098037 [PubMed - in process] (Source: Journal of Studies on Alcohol and Drugs)


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


History of Abuse in Women With Vulvar Pruritus, Vulvodynia, and Asymptomatic Controls
Conclusions: Patients with vulvar pruritus and vulvodynia report similar rates of sexual and physical abuse. (Source: Journal of Lower Genital Tract Disease)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Clinical Implications of Tapering Chronic Opioids in a Veteran Population
ConclusionsPatients in the population studied can be successfully tapered to lower opioid doses and may not necessarily experience more pain. (Source: Pain Medicine)


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


Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients
Conclusions: The good long-term results of the targeted therapeutic local anesthesia (NT) in the most problematic group of chronic pain patients (unresponsive to all evidence based conventional treatment options) indicate that a vicious circle has been broken. The specific contribution of the intervention to these results cannot be determined. The low costs of local anesthetics, the small number of consultations needed, the reduced intake of analgesics, and the lack of adverse effects also suggest the practicality and cost-effectiveness of this kind of treatment. Controlled trials to evaluate the true effect of NT are needed. (Source: BMC Complementary and Alternative Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Brewing a great doctor-patient relationship
“I love working with Brooke and her mom. They are a great pair, and Brooke has grown into a wonderful, independent young woman who can advocate for herself. She went from being a sweet kid who couldn’t walk five steps without pain to this vibrant college student who treks over here from Northeastern University, bringing me a latte, ready to conquer the world,” says Dr. Kate Ackerman, medical director of Boston Children’s Hospital’s Female Athlete Program. Brooke Lombardi, her mother Shari and Ackerman have a pretty special relationship. Brooke, who grew up in Miami, started seeing Ackerman in 2010 when she was 15. Today, Ackerman helps Brooke, a college student who continues to have minor medical issues, navigate the health care system, helping to provide a safety net for a young...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


The SCOPE Protocol for Primary Care-Based Chronic Pain Management (Frederic Stuart Leeds MD)
(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)


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


Repeated forced swim stress prior to complete Freund’s adjuvant injection enhances mechanical hyperalgesia and attenuates the expression of pCREB and ΔFosB and the acetylation of histone H3 in the insular cortex of rat
Publication date: 20 August 2015 Source:Neuroscience, Volume 301 Author(s): H. Imbe , A. Kimura Exposure to stressors causes substantial effects on the perception and response to pain. In several animal models, chronic stress produces hyperalgesia. The insular (IC) and anterior cingulate cortices (ACC) are the regions exhibiting most reliable pain-related activity. And the IC and ACC play an important role in pain modulation via descending pain modulatory system. In the present study we examined the expression of phospho-cAMP response element-binding protein (pCREB) and ΔFosB and the acetylation of histone H3 in the IC and ACC after forced swim stress (FS) and complete Freund’s adjuvant (CFA) injection to clarify changes in the cerebral cortices that affect the activity of the descend...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Use of a high‐sensitivity troponin T assay in the assessment and disposition of patients attending a tertiary Australian emergency department: A cross‐sectional pilot study
ConclusionsDespite high‐sensitivity TnT assay having a high sensitivity and specificity for myocardial necrosis, the majority of unselected consecutive patients attending ED in whom TnT levels were elevated did not have an acute coronary syndrome. Our pilot study suggests that a larger study is needed to provide evidence to modify management algorithms. (Source: Emergency Medicine Australasia)


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


‘’Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases. ‘’
We describe three cases of MS patients who have had moderate to severe complaints of bruxism in the two weeks following their relevant MS attacks. None of the three patients had a diagnosis of bruxism prior to her attack. The diagnosis was confirmed in one out of three by a polysomnography. One patient did not have any complaints related to bruxism previous to her attack, whereas two had mild and infrequent complaints. The symptoms of the relevant attacks were left hemihypesthesia in all and hemiparesis in two. None of the patients had spasticity that could result in severe teeth clenching. All three patients presented with morning headaches and jaw pain or tightness and were treated successfully with botulinum toxin (Btx) injections applied to their masseter and temporalis muscles. The ca...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Endometriosis with an acute colon obstruction: a case report
Conclusions Infiltrating endometriosis is an invalidating disease that can be misdiagnosed for a wide range of other diseases. Emergency room physicians and surgeons should be aware that it can present as an acute obstruction and should be considered in diagnosing women of childbearing age. After initial colonoscopy, emergency surgery is the best therapeutic approach if there is a complete obstruction. (Source: Journal of Medical Case Reports)


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


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


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


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


Neuroimaging of chronic pain
Publication date: Available online 19 June 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Tobias Schmidt-Wilcke Chronic pain is an important public health problem, and there is a need to understand the mechanisms that lead to pain chronification. From a neurobiological perspective, the mechanisms contributing to the transition from acute to subacute and chronic pain are heterogeneous and are thought to take place at various levels of the peripheral and central nervous system. In the past decade, brain imaging studies have shed light on neural correlates of pain perception and pain modulation, but they have also begun to disentangle neural mechanisms that underlie chronic pain. This review summarizes important and recent findings in pain research using magne...


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


Long-term effects of neonatal morphine infusion on pain sensitivity: Follow-up of a randomized controlled trial
This study aimed to identify long-term effects of continuous morphine infusion on thermal pain sensitivity in the neonatal period, incidence of chronic pain and neurological functioning.Eighty-nine of the 150 participants of a neonatal RCT on continuous morphine infusion versus placebo during mechanical ventilation underwent quantitative sensory testing and neurological examination at the age of 8 or 9 years. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Efficacy of Tailored Physical Activity or Chronic Pain Self-Management Programme on return to work for sick-listed citizens: A 3-month randomised controlled trial.
CONCLUSIONS: The results suggest that TPA is a promising intervention to facilitate return to work and reduce pain among sick-listed citizens with pain related to the back or upper body compared to REF. PMID: 26113171 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Public Health)


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


Exchange protein directly activated by cAMP encoded by the mammalian rapgef3 gene: Structure, function and therapeutics.
Authors: Banerjee U, Cheng X Abstract Mammalian exchange protein directly activated by cAMP isoform 1 (EPAC1), encoded by the RAPGEF3 gene, is one of the two-member family of cAMP sensors that mediate the intracellular functions of cAMP by acting as guanine nucleotide exchange factors for the Ras-like Rap small GTPases. Extensive studies have revealed that EPAC1-mediated cAMP signaling is highly coordinated spatiotemporally through the formation of dynamic signalosomes by interacting with a diverse array of cellular partners. Recently functional analyses of genetically engineered mouse models further suggest that EPAC1 functions as an important stress response switch and is involved in pathophysiological conditions of cardiac stresses, chronic pain, cancer and infectious diseases. ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


5 Findings From The First Major Analysis Of Medical Pot Benefits
CHICAGO (AP) — Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette's syndrome and the authors recommend more research. The analysis is among several medical marijuana articles published Tuesday in the Journal of the American Medical Association. They include a small study suggesting that many brand labels for edible marijuana products list inaccurate amounts of active ingredients. More ...


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


Alcohol, Tobacco Use in Youth With and Without Chronic PainAlcohol, Tobacco Use in Youth With and Without Chronic Pain
Health risk behaviors including alcohol and tobacco use are often established during adolescence. Does having chronic pain contribute to the risk of alcohol or tobacco use in this age group? Journal of Pediatric Psychology (Source: Medscape Today Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Epidemiology of Functional Gastrointestinal Disorders in Japan and in the World.
Authors: Oshima T, Miwa H Abstract Functional gastrointestinal disorders (FGIDs), represented by functional dyspepsia (FD) and irritable bowel syndrome (IBS), are a group of disorders that include variable combinations of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. FGIDs account for a significant percentage of patients seen in primary care settings with abdominal symptoms. Although the definition of FGIDs can easily affect the prevalence, the prevalences of dyspepsia/FD and IBS diagnosed by the Rome III criteria in the general population are 5.3-20.4% and 1.1-29.2%, respectively. Recent reports of FD and IBS defined by the Rome III criteria indicated a female predominance. Regarding the subtype prevalence of FD, postprand...


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


Open synovectomy of the ankle joint in young haemophiliacs: mid‐term to long‐ term results of a single‐centre series of 32 procedures
ConclusionOur long‐term results support that clinical scores are improved even if radiological scores progress. Open synovectomy retards the progression of the arthropathy, but not stops it. Bleeding and pain are controlled and even if recurrence of bleedings is frequent, it is less severe, less painful and requiring less factors replacement. (Source: Haemophilia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Confronting Chronic Pain- A Pain Doctor's Guide to Relief Richeimer Steven H with Steligo Kathy Confronting Chronic Pain- A Pain Doctor's Guide to Relief 256pp £12.83 Johns Hopkins University Press 978 1 4214 1253 5 1421412535 [Formula: see text].
Authors: Abstract Written by a Californian pain doctor and a medical author with an easy writing style, this book is packed with helpful tables, illustrations and case histories. PMID: 26103858 [PubMed - in process] (Source: Nursing Standard)


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


An open multicenter comparative randomized clinical study on chitosan
In conclusion this open multicenter comparative prospective randomized clinical study has provided compelling evidence that the next generation chitosan wound dressing can enhance wound progression towards healing by facilitating wound reepithelialization and reducing the patients pain level. Furthermore the dressing was shown to be clinically safe and effective in the management of chronic wounds. (Source: Wound Repair and Regeneration)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Pathway-Focused Genetic Evaluation of Immune and Inflammation Related Genes with Chronic Fatigue Syndrome.
This study was done to explore the association of functionally important genetic variants in inflammation and immune pathways with CFS. Peripheral blood DNA was isolated from 50 CFS and 121 non-fatigued (NF) control participants in a population-based study. Genotyping was performed with the Affymetrix Immune and Inflammation Chip that covers 11K single nucleotide polymorphisms (SNP) following the manufacturer's protocol. Genotyping accuracy for specific genes was validated by pyrosequencing. Golden Helix SVS software was used for genetic analysis. SNP functional annotation was done using SPOT and GenomePipe programs. CFS was associated with 32 functionally important SNPs: 11 missense variants, 4 synonymous variants, 11 untranslated regulatory region (UTR) variants and 6 intronic variants. ...


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


MicroRNA expression profiles differentiate chronic pain condition subtypes.
Authors: Ciszek BP, Khan AA, Dang H, Slade GD, Smith S, Bair E, Maixner W, Zolnoun D, Nackley AG Abstract Chronic pain is a significant health care problem, ineffectively treated because of its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs (miRNAs) regulate the expression of pain-relevant genes, yet little is known about their role in chronic pain. Here, we evaluate the relationship among pain, psychological characteristics, plasma cytokines, and whole blood miRNAs in 22 healthy controls (HCs); 33 subjects with chronic pelvic pain (vestibulodynia, VBD); and 23 subjects with VBD and irritable bowel syndrome (VBD + IBS). VBD subjects were similar to HCs in self-reported pain, psychological profiles, and remote bodily pain. V...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Gastrointestinal problems in modern wars: clinical features and possible mechanisms
Abstract Gastrointestinal problems are common during wars, and they have exerted significant adverse effects on the health of service members involved in warfare. The spectrum of digestive diseases has varied during wars of different eras. At the end of the 20th century, new frontiers of military medical research emerged due to the occurrence of high-tech wars such as the Gulf War and the Kosovo War, in which ground combat was no longer the primary method of field operations. The risk to the military personnel who face trauma has been greatly reduced, but disease and non-battle injuries (DNBIs) such as neuropsychological disorders and digestive diseases seemed to be increased. Data revealed that gastrointestinal symptoms such as constipation, diarrhea, dyspepsia, and noncardiac c...


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


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


Evidence Supports Marijuana as Medical Treatment for Some Conditions, Not All
Researchers found moderate support for using marijuana to treat chronic pain and muscle spasms and involuntary movements -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)


Medical marijuana unproven to help many illnesses it's used for, studies find
Evidence was weak that marijuana helps anxiety and sleep disordersMany edible products list inaccurate amounts of active ingredientsMedical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits.The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette’s syndrome and the authors recommend more research. Continue reading... (Source: Guardian Unlimited Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Spontaneous Chronic Pain After Experimental Thoractomy Revealed by Conditioned Place Preference:
Chronic pain following surgery limits social activity, interferes with work and causes emotional suffering. A major component of such pain is is reported as “resting” or spontaneous pain with no apparent external stimulus. Although experimental animal models can simulate the stimulus-evoked chronic pain that occurs after surgery, there have been no studies of spontaneous chronic pain in such models. Here the Conditioned Place Preference (CPP) paradigm was used to reveal resting pain after experimental thoracotomy. (Source: The Journal of Pain)


Cannabinoids for Medical Use
This meta-analysis summarizes the effectiveness of cannabis and cannabinoids for managing medical and psychotic disorders, including chemotherapy-induced nausea and vomiting, chronic pain, and mood and sleep disorders. (Source: JAMA)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


MicroRNA expression profiles differentiate chronic pain condition subtypes
Chronic pain is a significant healthcare problem, ineffectively treated due to its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs regulate the expression of pain-relevant genes, yet little is known about their role in chronic pain. Here, we evaluate the relationship between pain, psychological characteristics, plasma cytokines and whole blood microRNAs in 22 healthy controls (HC); 33 subjects with chronic pelvic pain (vestibulodynia: VBD); and 23 subjects with VBD and irritable bowel syndrome (VBD+IBS). (Source: Translational Research)


[Efficacy of epidural steroid injections for chronic lumbar pain syndromes without neurological deficits : A randomized, double blind study as part of a multimodal treatment concept].
DISCUSSION: After the epidural injection the decrease in pain and increase in treatability was statistically significant. The mechanism of the improvement is not clear and should be examined further. The epidural injection of a steroid in this subgroup of patients did not lead to a clinical improvement in the outcome. PMID: 26099752 [PubMed - as supplied by publisher] (Source: Schmerz)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Spontaneous Chronic Pain After Experimental Thoracotomy Revealed By Conditioned Place Preference: Morphine Differentiates Tactile Evoked Pain From Spontaneous Pain
Chronic pain after surgery limits social activity, interferes with work, and causes emotional suffering. A major component of such pain is reported as resting or spontaneous pain with no apparent external stimulus. Although experimental animal models can simulate the stimulus-evoked chronic pain that occurs after surgery, there have been no studies of spontaneous chronic pain in such models. Here the conditioned place preference (CPP) paradigm was used to reveal resting pain after experimental thoracotomy. (Source: The Journal of Pain)


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation
Conclusions: The innervation of the anterior capsule of the knee joint seems to follow a constant pattern making at least 3 of these nerves accessible to percutaneous ablation. To optimize clinical outcome, well-aligned radiographs are critical to guide lesion placement. (Source: Regional Anesthesia and Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Validation of the Danish‐language chronic pain acceptance questionnaire
ConclusionThe psychometric properties of the Danish version of the 20‐item CPAQ were satisfactory, showing that the Danish version of CPAQ is valid and reliable. (Source: Acta Anaesthesiologica Scandinavica)


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


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


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


Effects of low dose oral contraceptive pill containing drospirenone/ethinylestradiol in patients with endometrioma
Conclusion Low dose DRSP/EE therapy is a promising treatment not only to reduce the size of endometrioma but also for dysmenorrhea. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain
Conclusion Office pertubal hysteroscopic-guided diluted bupivacaine infusion could be used to manage endometriosis-associated CPP for at least 3months. AEARCTR-0000573 (Source: International Journal of Gynecology and Obstetrics)


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


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


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


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


PTSD and Chronic Pain
Post-traumatic stress disorder (PTSD) mostly is known for its effect on overall mental health. There is research, however, to support the fact that PTSD is increasingly being recognized for its effect on physical wellness as well. Many who suffer with PTSD (veterans in particular) have higher lifetime prevalence of circulatory, digestive, musculoskeletal, nervous system, respiratory and infectious disease. There is also an increased co-occurrence of chronic pain in those who suffer with PTSD. Chronic pain may be defined as pain that persists longer than three months that was initially accompanied with tissue damage or a disease which has already healed. In 1979, the International Association for the Study of Pain (IASP) officially redefined pain as “an unpleasant sensory and emotional ex...


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


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


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


The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA lesioned rats
This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6‐hydroxydopamine lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint. This article is protected by copyright. All rights reserved. (Source: European Journal of Neuroscience)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency
Conclusions: Immediate PRF application on the proximal nerve injury site provided a significant inhibition of neuropathic pain formation, accompanied by the inhibition of ERK activation. (Source: BMC Anesthesiology)


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


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


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


Effects of low dose oral contraceptive pill containing drospirenone/ethinylestradiol in patients with endometrioma
Low dose oral contraceptive pills (OCPs) that contain synthetic estrogen and progestin are often used to relieve chronic pelvic pain associated with endometriosis. We sought to evaluate the efficacy of drospirenone/ethinylestradiol (DRSP/EE) with low-dose estrogen in treating endometrioma. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


In a secondary care setting, differences between neck pain subgroups classified using the Quebec task force classification system were typically small – a longitudinal study
Conclusions: This study found baseline and outcome differences between neck pain subgroups classified using the Quebec Task Force Classification System. However, differences in outcome were typically small in size and mostly differentiated the local NP subgroup from the other subgroups. A caveat to these results is that they were obtained in a cohort of chronic neck pain patients who only displayed small improvements over time and the results may not apply to other cohorts, such as people at earlier stages of their clinical course and in other clinical settings. (Source: BioMed Central)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effects of extracorporeal shock wave therapy on pain patients.
Authors: Fricova J, Rokyta R Abstract The method of shock wave therapy (ESWT) was used for the treatment of several symptoms of chronic pain. There were especially: cervical syndromes, lumbago, plantar fasciitis, achillodynia, metatarsalgia and humeral epicondylitis. We confirmed the positive effect of shock wave therapy for the pain relief on these syndromes. This method is also effective in other pain syndromes. The effect of this application is very individual and therefore it is necessary to indicate different number of therapeutic applications. We recommend this method as a very useful tool for complete our possibilities for the relief of chronic pain. PMID: 26071587 [PubMed - as supplied by publisher] (Source: Neuroendocrinology Letters)


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


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


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


Integrative Review of Co‐Occurring Symptoms Across Etiologies of Chronic Liver Disease and Implications for Symptom Management Research and Practice
ConclusionsThe symptom of fatigue was commonly reported across chronic liver disease populations and was often found to co‐occur with other distressing symptoms, including depression, sleep disturbance, pain, cognitive impairment, and dizziness associated with autonomic dysfunction. Due to the high prevalence and persistence of these “core” symptoms, the use of core symptom measures integrated longitudinally across populations would inform the development and delivery of symptom management interventions as well as enhance the ability of nurses to incorporate population‐level symptom management programs. Clinical RelevanceNurses play an important role in symptom assessment and may use the findings from the integrative review to incorporate core symptom measures across chronic liver ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Empowering Patients with Persistent Pain Using an Internet-based Self-Management Program
New strategies are needed to improve access to cognitive and behavioral therapies for patients with persistent pain. The purpose of this randomized, controlled trial was to determine the effectiveness of the Chronic Pain Management Program, an 8-week online intervention targeting cognitive, emotional, behavioral, and social pain determinants. Program efficacy and engagement was evaluated for 92 individuals with a diagnosis of chronic noncancer pain who had a current opioid prescription. Participants were recruited from primary care practices and Internet sites, then randomly assigned to receive access to the intervention either immediately (treatment group) or after an 8-week delay (wait-list comparison). (Source: Pain Management Nursing)


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


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


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


Chronic wounds should be one of Australia's National Health Priority Areas.
Authors: Kapp S, Santamaria N Abstract Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A$2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Areas, and to establish a profile of chronic wounds as a chronic disease of national significance in its own right. This approach has the potenti...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.
Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability. PMID: 26064172 [PubMed] (Source: Evidence-based Complementary and Alternative Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats.
Authors: Meng F, Ge HY, Wang YH, Yue SW Abstract Myofascial trigger points (MTrPs) are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human) of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P &lt; 0.01), and immunohistochemistry with Neurofilament 200 indicated more myelinated afferents existed in MTrSs (P &lt; 0.01). Spontaneous electrical activity (SEA) recordings at MTrSs showed that specific block of myelinated afferents in sciatic nerve with tetrodotoxin (TTX) led to sign...


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


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


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


Pubic symphysitis after transurethral resection of the prostate
Conclusion PS remains a rare complication after TUR-P. We could not identify a single cause for developing PS. In our study, suprapubic trocar placement (11/12), chronic prostatic inflammation (9/12), previous UTI (3/12) and extended resection (2/12) were overrepresented. Inflammatory, thermic and/or surgical damage of the capsule may be causative. Patients require antibiotic and symptomatic medication. However, prognosis for remission is excellent. (Source: World Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Long Term Outcome of The Management of Chronic Neuropathic Pain – A Prospective Observational Study
This prospective observational cohort study addressed the long term clinical effectiveness of the management of chronic neuropathic non-cancer pain at seven Canadian tertiary pain centres. Patients were treated according to standard guidelines and followed at 3, 6, 12, 18 and 24 months. Standard outcome measures for pain, mood, quality of life and overall treatment satisfaction were administered with the primary outcome measure designated as the composite of 30% reduction in average pain intensity and one point drop in the mean Interference Scale Score (0-10) of the Brief Pain Inventory at 12 months relative to baseline. (Source: The Journal of Pain)


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


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


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


Long-Term Outcome of the Management of Chronic Neuropathic Pain: A Prospective Observational Study
This prospective observational cohort study addressed the long-term clinical effectiveness of the management of chronic neuropathic noncancer pain at 7 Canadian tertiary pain centers. Patients were treated according to standard guidelines and followed at 3, 6, 12, 18, and 24 months. Standard outcome measures for pain, mood, quality of life, and overall treatment satisfaction were administered, with the primary outcome measure designated as the composite of 30% reduction in average pain intensity and 1-point decrease in the mean Interference Scale Score (0–10) of the Brief Pain Inventory at 12 months relative to baseline. (Source: The Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Adipose-derived stem cells improve the viability of nucleus pulposus cells in degenerated intervertebral discs.
Authors: Song K, Gu T, Shuang F, Tang J, Ren D, Qin J, Hou S Abstract Patients with degenerative disc disease (DDD) experience serious clinical symptoms, including chronic low back pain. A series of therapies have been developed to treat DDD, including physical therapy and surgical treatment. However, the therapeutic effect of such treatments has remained insufficient. Recently, stem cell‑based therapy, in which stem cells are injected into the nucleus pulposus in degenerated intervertebral disc tissue, has appeared to be effective in the treatment of DDD. In the present study, the effect of adipose‑derived stem cells on degenerated nucleus pulposus cells was investigated using a co‑culture system to evaluate the biological activity of degenerated nucleus pulposus cells. Huma...


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


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


St. Jude Study: Axium Neurostimulator Outperforms Traditional Spinal Cord Stimulators
St. Jude Medical is touting positive results of a clinical trial that demonstrated the effectiveness of its Axium Neurostimulator System over traditional spinal cord stimulators (SCS) to relieve the chronic lower limb pain associated with complex regional pain syndrome (CRPS) or peripheral causalgia (nerve damage). The Axium system stimulates the dorsal root ganglion (DRG) for more selective targeting of pain areas that are hard to reach, like the groin, lower leg, and foot. (Source: Medical Design Online News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Chronic inflammatory pain upregulates expression of P2Y 2 receptor in small-diameter sensory neurons
Abstract Roles of ionotropic purinergic (P2X) receptors in chronic pain have been intensively investigated. However, the contribution of metabotropic purinergic (P2Y) receptors to pathological pain is controversial. In the present study, using single cell RT-PCR (reverse transcription-polymerase chain reaction) and single cell nested-PCR techniques, we examined the expression of P2X2, P2X3, P2Y1 and P2Y2 mRNA transcripts in retrogradely labeled cutaneous sensory neurons from mouse lumber dorsal root ganglia (DRGs) following peripheral inflammation. The percentage of cutaneous sensory neurons expressing P2Y2 mRNA transcripts increased after complete Freund’s adjuvant (CFA) treatment. Particularly, the P2Y2 mRNA transcripts were more frequently detected in small-diameter cutaneous...


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


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


A novel method of anal fissure laser surgery: a pilot study
This study revealed that this new laser-based surgery is a simple, safe, and effective procedure to treat the anal fissure that can be performed with local anesthesia in an outpatient clinic with minimal postoperative morbidity. (Source: Lasers in Medical Science)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


What is the impact of acute and chronic orofacial pain on quality of life?
Conclusion TMD, ADP, TN and PDAP have substantial impact on OHRQoL as measured by the OHIP-49 and the extracted items for the OHIP-14 and 5. Differences among the 4 groups of orofacial pain conditions are likely not to be substantial. (Source: Journal of Dentistry)


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


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


Menstrual cycle characteristics in women with persistent schizophrenia.
CONCLUSION: Regular menses are associated with higher oestradiol levels and higher rates of cyclical mood symptoms but are not associated with Positive and Negative Syndrome Scale scores. Understanding the effect the menstrual cycle can have on psychiatric illness, such as premenstrual exacerbations, is important for the holistic care of women with schizophrenia. PMID: 26070315 [PubMed - as supplied by publisher] (Source: The Australian and New Zealand Journal of Psychiatry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Boston Scientific touts positive data from next-gen SCS
Boston Scientific (NYSE:BSX) said yesterday that data from its Precision Spectra spinal cord stimulator study showed 1.5 times better pain relief and 2 times better lower back pain relief than its previous generation SCS. The analysis examined 213 patients treated with the new Precision Spectra and 130 patients treated with the previous generation Precision Plus, as well as 25 patients treated with the Spectra and a different set of leads, the Marlborough, Mass.-based company said. &#8220;The results are exciting because we looked at consecutive patients – some with only low back pain – in a real-world setting. This is strong clinical evidence of the effectiveness of the Precision Spectra system in treating the types of challenging chronic pain patients that physicians see every d...


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


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


Spinal pain—good sleep matters: a secondary analysis of a randomized controlled trial
Conclusion Patients with non-specific neck and/or back pain and self-reported good sleep are more likely to experience a minimal clinically important difference in pain and disability compared to patients with impaired sleep with daytime consequence. (Source: European Spine Journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Assessing patient-centred care for chronic pain: Validation of a new research paradigm.
Authors: Paul-Savoie E, Bourgault P, Gosselin E, Potvin S, Lafrenaye S PMID: 26069896 [PubMed - as supplied by publisher] (Source: Pain Research and Management)


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


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


St. Jude Medical touts early results for Axium neurostim device
St. Jude Medical (NYSE:STJ) said Monday that a study of its Axium dorsal root ganglion neurostimulator showed superior pain relief compared to traditional spinal cord stimulation in treating chronic lower limb pain associated with complex regional pain syndrome. The the 152-patient Accurate study reported that 81.2% of patients treated with the Axium system achieved significant pain relief, compared to 55.7% treated with traditional SCS, St. Paul, Minn.-based St. Jude said. Patients also reported less posture-based paresthesia intensity with DRG, and were less likely to report stimulation outside the area of pain, the company added. &#8220;Data from the Accurate study are exciting because they demonstrate that DRG stimulation can offer meaningful improvement over traditional spinal cord s...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Malawi: Man With Extremely Rare Form of Cancer in Urgent Need of Surgery
[Malawi24] A man in Malawi is living in chronic pain from an extremely rare testicular form of cancer known as congenital granulosa cell tumor. (Source: AllAfrica News: Health and Medicine)


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


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