The Pain Management Clinic of Corpus Christi is now offering over ten effective treatments for chronic back pain. The pain management doctors in Corpus Christi now offer options for both medication...(PRWeb December 10, 2013)Read the full story at http://www.prweb.com/releases/corpuschristipainclinic/backpaindoctors/prweb11395299.htm (Source: PRWeb: Medical Pharmaceuticals)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Detection and successful treatment of depression and anxiety has a potential to lead to improved quality of life in family medicine attendees; family physicians should be alert for the early onset of these conditions, knowing that symptoms of chronic pain, depression and anxiety often overlap in patients. Poorly educated patients and those lacking social support and/or satisfactory household circumstances should be recognised and empowered, and appropriate coping mechanisms should be introduced. (Source: BMC Public Health - Latest articles)
Our findings suggest that exogenous leptin can alleviate the chronic neuropathic pain caused by CCI. The leptin effect may be mediated by attenuated expression of IL-6, TNFalpha, and the P2X2 and P2X3 receptors in the DRG of CCI rats. (Source: Molecular Pain)
We suggest that PPN-induced enhancement of synaptic plasticity in EC - hippocampal pathways and the behavioral effects of PPN are dependent on mTOR-S6K signaling. (Source: BioMed Central)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
ConclusionsThis prospective, multicenter study confirms that PNFS is an effective therapy for the management of cLBP. Significant improvements in many aspects of the pain condition were measured, and complications were minimal. (Source: Neuromodulation)
Muscle tone is the slight tension that is felt in a muscle when it is voluntarily relaxed. It can be assessed by asking the patient to relax and then taking the muscles through a range of motion such as moving the wrists, forearm and upper arm. Muscle strength is the muscle’s force against active resistance. Impaired strength is called weakness or paresis. There are 5 levels of muscle strength.
0 = No muscle contraction detected
1 = Barely detected flicker of contraction
2 = Active movement with gravity eliminated
3 = Active movement against gravity
4 = Active movement against gravity and some resistance
5 = Active movement against full resistance. This is normal muscle strength.
Toe walking is common in toddlers who are learning to walk. It becomes less common as child...
In different countries a set of recommendations for the diagnostics and treatment of chronic pancreatitis (CP) have been published, but to date a unified systematic management has not been developed yet. Because CP is within the interests of physicians of various specialties: surgeons, gastroenterologists, endoscopists and others, approaches to the most effective treatment--conservative therapy, endoscopic or surgical treatment--should be determined on an equal footing on the basis of well-known and well-conducted trials at the minimization of possible interpretations of the terms and tactics. In most cases there is a need for a comprehensive approach, which allows to achieve the main tasks: to cut pain short, maintain the function of the gland and/or compensate ...
ConclusionGONB seems to be an efficacious treatment with reproducible effects in CCH patients. Performed three monthly, GONB may have a useful role in the management of CCH. (Source: European Journal of Neurology)
A mother-of-three who treated her back and leg pain with the alkaline diet after a herniated disc shares her day on a plate (Source: Telegraph Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Chronic widespread pain (CWP), including fibromyalgia, is a highly prevalent condition with a range of disabling symptoms, both physical and psychological. The British Pain Society (BPS) is supporting the treatment of this group of patients through a care pathway and this article describes the rationale and discussion points relevant to the CWP and fibromyalgia pathway. There are several aims in producing this pathway: to reduce variation in the standards of care, to reduce delays at all stages of care, and in particular, to enable clinicians to help patients accept a diagnosis of CWP. This diagnosis should be based on the presence and distribution of symptoms in the absence of another defined pathological process: the features in the history or clinical examination are generally more impo...
ConclusionsIslet transplant solutions are frequently culture‐positive, presumably as a result of prior pancreas intervention. Microbial contamination of islet preparations should not preclude autotransplantation. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)
Few studies have examined health‐related quality of life (HRQoL) with respect to daily living and health factors for relatively healthy elderly individuals. To this end, this study examines 85‐year‐olds' reported HRQoL in relation to social support, perceived health, chronic diseases, healthcare use and instrumental activities of daily living (IADL). Data were collected from 360 participants (55% response rate) between March 2007 and March 2008 using a postal questionnaire and a home visit interview. HRQoL was assessed using the EQ‐5D‐3L. For the items in the EQ‐5D‐3L, more problems were related to lower HRQoL. Restricted mobility and occurrence of pain/discomfort was common. Lower HRQoL was associated with increased risk for depression, increased use of medication, ...
Authors: Miller DR
PMID: 24310421 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Applying an electric current to a particular part of the brain makes people feel a sense of determination, say researchersDoctors in the US have induced feelings of intense determination in two men by stimulating a part of their brains with gentle electric currents.The men were having a routine procedure to locate regions in their brains that caused epileptic seizures when they felt their heart rates rise, a sense of foreboding, and an overwhelming desire to persevere against a looming hardship.The remarkable findings could help researchers develop treatments for depression and other disorders where people are debilitated by a lack of motivation.One patient said the feeling was like driving a car into a raging storm. When his brain was stimulated, he sensed a shaking in his chest and a sur...
Being a woman should never be considered a 'risk factor' for disease. Sadly, the drug culture - created by the pharmaceutical industry - wants every woman to solve their health issues with toxic drugs. In truth, no woman should accept a life filled with chronic pain... (Source: NaturalNews.com)
These results indicate that phosphorylation of T394 plays a critical role in determining the potency of DAMGO-induced analgesia and IK desensitization, but has limited effect on morphine-induced responses. On the other hand, the mutation contributes minimally to both DAMGO- and morphine-induced behavioral tolerance. Furthermore, the study shows that plasmid gene delivery of mutant receptors to DRG neurons is a useful strategy to explore nociceptive behavioral consequences of the mutation. (Source: Molecular Pain)
DiscussionWe outline a patient‐centered ethics to underpin contemporary collaborative, multimodal approaches in the management of chronic pain. We firstly describe an agency‐oriented, neo‐Aristotelian 1st person ethics and then outline a hermeneutic relationship with extant “duty‐based,” 3rd person bioethics. The utility of the ethics model we propose (the ethical reasoning bridge) lies in its capacity for developing a sense of moral agency for both practitioner and patient, resonating with the current emphasis of seeking active engagement of patients in management. (Source: Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
ConclusionsAlthough the results of our study suggest that EMDR may be a safe and promising treatment option in chronic pain conditions, the small number of high‐quality studies leads to insufficient evidence for definite treatment recommendations. (Source: Pain Medicine)
ConclusionsIn patients with chronic low back pain, HF10 SCS resulted in clinically significant and sustained back and leg pain relief, functional and sleep improvements, opioid use reduction, and high patient satisfaction. These results support the long‐term safety and sustained efficacy of HF10 SCS. (Source: Pain Medicine)
Despite the age of nearly 50 years and a training history of over 35 years, the athlete showed no signs of chronic damage or overuse injuries in the joints of his lower limbs. This leads to the conclusion that extensive sports and training does not compulsory lead to damages of the musculoskeletal system. This is a very important finding for all endurance-athletes as well as for their physicians. (Source: BMC Musculoskeletal Disorders)
ConclusionsThe context in which physical therapy interventions are offered has the potential to dramatically improve therapeutic effects. The combination of enhanced TA active IFC appears to lead to clinically meaningful improvements in outcomes when treating patients with chronic LBP.
PMID: 24309616 [PubMed - as supplied by publisher] (Source: Physical Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Authors: Hoeger Bement MK, St Marie BJ, Nordstrom TM, Christensen N, Mongoven JM, Koebner IJ, Fishman SM, Sluka KA
Core competencies in pain management for prelicensure health professional education were recently established and represent minimal capabilities for health science students across four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain. One hundred million adults in America suffer from chronic pain. and costs the U.S. over 600 billion dollars per year in health care costs and lost wages. Under-treatment, inadequate-treatment or mismanagement of pain is common and can delay recovery and result in long-lasting changes to the peripheral and central nervous system. The Institute of Medicine report on ...
ConclusionsThere were significant differences in demographics between individuals with functional bowel disorders. Despite this, the Rome III classification system falls short of describing unique entities. (Source: Alimentary Pharmacology and Therapeutics)
People who suffer with chronic musculoskeletal pain face a daily struggle with their sense of self and find it difficult to prove the legitimacy of their condition.A new study, funded by the National Institute for Health Research Health Services and Delivery Research (HS&DR) Programme, systematically searches for, and makes sense of, the growing body of qualitative research on musculoskeletal pain to help understand the experiences of patients suffering from chronic pain. (Source: Health News from Medical News Today)
ConclusionA significant population of India suffers from chronic pain, and their QoL is affected leading to disability. A proportion of respondents receiving pain treatment were taking nonprescription medications with a majority of respondents on NSAIDs. A very few were consulting pain management specialists. (Source: Pain Practice)
This study will validate the performance of these simple tests for BPS in women with chronic pelvic pain (CPP).
We will conduct a prospective test validation study amongst women with unexplained CPP presenting to gynaecology outpatient clinics. Two index tests will be performed: patient reported bladder filling pain and bladder wall tenderness on internal pelvic bimanual examination. A final diagnosis of BPS will be made by expert consensus panel. We will assess the rates of index tests in women with CPP; evaluate the correlation between index tests and Pelvic Pain Urgency/ Frequency (PUF) questionnaire results; and determine index test sensitivity and specificity using a range of analytical methods. Assuming a 50% prevalence of BPS and an 80% power approximately 152 subjects will...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
CONCLUSION: Our results showed that a long-term multimodal medical therapy (Verapamil associated with Propolis, Blueberry, Vitamin E and local Diclofenac) is statistically effective in treating PD, whereas, lower therapeutic responses were obtained after 6 months treatment (medium-term treatment). Furthermore, this study strongly supports the recommendation that the best approach for treating PD is multimodal therapy.
PMID: 24304332 [PubMed - as supplied by publisher] (Source: Inflammation and Allergy Drug Targets)
CONCLUSIONS: Our findings suggest that patients with persistently high pain scores despite opioid therapy are more likely than those with lower levels of pain to present with characteristics associated with having centralized pain. This study cannot determine whether these characteristics were present before (fibromyalgia-like patient) or after the initiation of opioids (opioid-induced hyperalgesia). Regardless, patients with a centralized pain phenotype are thought to be less responsive to opioids and may merit alternative approaches.
PMID: 24310048 [PubMed - as supplied by publisher] (Source: Pain Physician)
Conclusions NIH-CPSI was adapted to Brazilian spoken Portuguese and its original proprieties were maintained, being a valid instrument for evaluations of symptoms of chronic prostatitis in Brazilian patients. (Source: International Braz J Urol)
A 48-year old woman presented with chronic back pain. Previous examinations had been inconclusive. Gynaecological examination revealed large cystic masses on the fundus uteri and left adnexa. Laparoscopy and histopathology showed unusually extensive cystic endosalpingiosis covering the serosa-coated uterine surface as well as the adnexa on both sides. After uneventful laparoscopic-assisted vaginal hysterectomy the patient quickly recovered and was relieved of her chronic backache.Virtual slides: http://www.diagnosticpathology.diagnomx.eu/vs/1501709091077524. (Source: BioMed Central)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
This study will be the first pragmatic trial to investigate the clinical outcomes and cost-effectiveness of ePT and uPOD in individuals with PHP. The results will serve to inform clinical practice decisions and management guidelines of multiple disciplines.Trial registration: ClinicalTrials.gov: NCT01865734 (Source: Trials)
CONCLUSIONS: Large, high-quality, long-duration studies reporting clinically useful levels of pain relief for individual participants provided no convincing evidence that lamotrigine is effective in treating neuropathic pain and fibromyalgia at doses of about 200 to 400 mg daily. Given the availability of more effective treatments including antiepileptics and antidepressant medicines, lamotrigine does not have a significant place in therapy based on the available evidence. The adverse effect profile of lamotrigine is also of concern.
PMID: 24297457 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
OBJECTIVES:: To examine suicidal ideation in individuals with chronic pain, especially change in suicidal thinking following interdisciplinary treatment. METHODS:: Consecutive patients (n=250) admitted to a 4-week, group-based chronic pain management progr... (Source: SafetyLit: All (Unduplicated))
Help is now available for those suffering from chronic headaches and migraines with Botox Injections at Berkower Pain and Spine. The Broward County pain clinic offers the treatment with a Double Board...(PRWeb December 02, 2013)Read the full story at http://www.prweb.com/releases/painmanagementftlauderdal/botoxforheadaches/prweb11376152.htm (Source: PRWeb: Medical Pharmaceuticals)
Title: Health Tip: Coping With Neck PainCategory: Health NewsCreated: 12/2/2013 7:35:00 AMLast Editorial Review: 12/2/2013 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
(University of Warwick) People who suffer with chronic musculoskeletal pain face a daily struggle with their sense of self and find it difficult to prove the legitimacy of their condition. (Source: EurekAlert! - Social and Behavioral Science)
We propose that, in trigeminal sensory neurons, the CASK/P2X3 complex has a dynamic nature depending on intracellular calcium and related signaling, that are enhanced in a transgenic mouse model of genetic hemiplegic migraine. (Source: Molecular Pain)
Authors: Barawid E, Covarrubias N, Tribuzio B, Liao S
Palliative care requires an interdisciplinary team approach to provide the best care for patients with life-threatening illnesses. Like palliative medicine, rehabilitation also uses an interdisciplinary approach to treating patients with chronic illnesses. This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliat...
Sjögren's syndrome, a chronic and progressive autoimmune disorder mainly characterized by xerophthalmia, xerostomia, and parotid enlargement, is primarily managed medically, but some patients will require surgical management. Patients with Sjögren's syndrome have an increased risk of non-Hodgkin lymphoma. Superficial parotidectomy is indicated for diagnostic purposes and can be therapeutic in limited circumstances. Surgical indications for parotidectomy in Sjögren's syndrome include recurrent parotitis refractory to medical management; salivary gland malignancy; and severe, refractory pain. Surgical complications include transient or permanent facial nerve injury, post-operative pain, persistent inflammation of remnant parotid tissue, Frey syndrome, and facial scarring. (Source: Oral an...
Authors: Madero-Visbal R, Milas Z
Sjögren's syndrome, a chronic and progressive autoimmune disorder mainly characterized by xerophthalmia, xerostomia, and parotid enlargement, is primarily managed medically, but some patients will require surgical management. Patients with Sjögren's syndrome have an increased risk of non-Hodgkin lymphoma. Superficial parotidectomy is indicated for diagnostic purposes and can be therapeutic in limited circumstances. Surgical indications for parotidectomy in Sjögren's syndrome include recurrent parotitis refractory to medical management; salivary gland malignancy; and severe, refractory pain. Surgical complications include transient or permanent facial nerve injury, post-operative pain, persistent inflammation of remnant parotid tissue, F...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Nearly four years after the United States Congress heralded a "decade of pain control and research," chronic pain remains a mounting public health concern worldwide. The escalating prevalence of chronic pain in recent years has been paralleled by a rise in prescription opioid availability, misuse, and associated human and social costs. However, national monitoring surveys in the U.S. and Canada currently fail to differentiate between prescription opioid misuse for the purposes of euphoria versus pain or withdrawal management. Furthermore, there is a lack of evidence-based guidelines for pain management among high-risk individuals, and a glaring lack of education for practitioners in the areas of pain and addiction medicine. Herein we propose multiple avenues for intervention and research i...
This study is a single-center, randomized double-blind controlled trial. Eighty patients will be allocated to have ultrasound (US)-guided needling combined with a leukocyte-depleted (that is, pure) PRP or lidocaine each alternate week for a total of two interventions. Outcome data will be collected before intervention, and at 6 weeks, 3, 6, and 12 months after intervention. Main outcome measure: Changes in pain and activity levels, as assessed by Disabilities of the Arm, Shoulder and Hand (DASH-E, Spanish version) score, at 6 months. We will compare the percentage of patients in each group that achieve a successful treatment defined as a reduction of at least 25% in the DASH-E score. Secondary outcome measures include changes in DASH-E at 3 and 12 months, changes in pain as assessed by the...
This study observed physical activity, sleep quality, pain and fatigue in four people hospitalized with severe mental illness.
Significant associations were found between pain and fatigue severity in the morning, but not in the evening. A significant association was found between physical activity and morning and evening pain severity. No association was found between activity and fatigue.
This is a preliminary study that may guide future investigations of the effect of physical activity and exercise on symptoms commonly experienced in people with mental illness.
AbstractGood mental health is imperative to well‐being. Symptoms of fatigue, chronic pain and poor sleep are common in people with mental illness and contribute to substantial loss of functioning. Physical exercise intervention...
Abstract: The differential diagnosis of ankle pain is extensive. Pathology may be classified as intra- or extra-articular. Additionally, ankle pain may be traumatic or non-traumatic. One of the unusual differential diagnoses for pain in the ankle is an accessory muscle. Magnetic resonance imaging is the radiological investigation of choice. However, this is invariably reported as normal unless one specifically looks for an accessory muscle. The purpose of this report is to highlight important features of these muscles and to draw attention to this uncommonly reported condition. (Source: The Foot)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Abstract: Ample evidence suggests that sleep and pain are related. However, many questions remain about the direction of causality in their association, as well as mechanisms that may account for their association. The prevailing view has generally been that they are reciprocally related. The present review critically examines the recent prospective and experimental literature (2005–present) in an attempt to update the field on emergent themes pertaining to the directionality and mechanisms of the association of sleep and pain. A key trend emerging from population-based longitudinal studies is that sleep impairments reliably predict new incidents and exacerbations of chronic pain. Microlongitudinal studies employing deep subjective and objective assessments of pain and sleep support the ...
The objective of this population-based observational study was to evaluate opioid use and dosing before and after guideline implementation. We identified 161,283 workers aged 18 to 64 years with ≥1 opioid prescriptions in Washington Workers' Compensation, April 1, 2004, to December 31, 2010. Prevalence and incidence rates of opioid use were assessed. We compared pre- and postguideline chronic and high-dose use (≥120 mg/d) among incident users. The mean monthly prevalence of opioid use declined by 25.6% between 2004 (14.4%) and 2010 (10.7%). Fewer incident users went on to chronic opioid therapy in the postguideline period (4.7%; 95% confidence interval [CI], 4.5–5.0%) than in the preguideline period (6.3%; 95% CI, 6.1–6.6%). Compared with preguideline incident users, postguidelin...
This study demonstrates anatomical brain alterations associated with both state and trait depression in chronic pain patients. Because our study reveals that trait depression is not correlated to the anatomy of these regions in healthy controls, ongoing pain itself may result in anatomical changes that in turn can alter an individual's personality. (Source: The Journal of Pain)
This study compared the responsiveness of VRS and NRS measuring current pain and investigated the influence of different references (ie, worst, least, average, and current pain or their composite) on the NRSs' responsiveness. Two hundred fifty-four chronic pain patients attended a 10-day pain self-management program and were assessed with two 6-point VRSs (assessing current pain) and four 11-point NRSs (assessing worst, least, average, and current pain) at pre- and posttreatment. A patient-reported rating of pain improvement was used as the criterion for standardized response mean and receiver operating characteristic curve analyses. Results showed that the VRSs and NRSs exhibited small responsiveness in all patients, but the magnitude of responsiveness became moderate to large in patients...
Abstract: If persons at risk of developing chronic pain could be identified early in a pain episode, treatment could be tailored on the basis of risk. Responses to psychophysical tests differ in persons with chronic pain vs pain-free controls and thus appear promising as indicators of susceptibility to chronic pain. In a cohort of 157 patients making their first primary care visit during a back pain episode, we explored the relationships of psychophysical test responses (pressure pain thresholds at low back and thenar sites, cold pressor pain ratings, conditioned pain modulation, and mechanical temporal summation) to baseline measures of pain and psychological distress and assessed whether test responses predicted clinically significant back pain 4 months later. Examiner-standardized pres...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Abstract: Previous studies have reported that the intrathecal (i.t.) administration of transforming growth factor β1 (TGF-β1) prevents and reverses neuropathic pain. However, only limited information is available regarding the possible role and effects of spinal TGF-β1 in neuropathic pain. We aimed to investigate the antinociceptive effects of exogenous TGF-β1 on chronic constriction injury (CCI)-induced neuropathic pain in rats. We demonstrated that sciatic nerve injury caused a downregulation of endogenous TGF-β1 levels on the ipsilateral side of the lumbar spinal dorsal gray matter, and that the i.t. administration of TGF-β1 (.01–10 ng) significantly attenuated CCI-induced thermal hyperalgesia in neuropathic rats. TGF-β1 significantly inhibited CCI-induced spinal neuroinflamma...
Abstract: Factors contributing to pain following surgery are poorly understood, with previous research largely focused on adults. With approximately 6 million children undergoing surgery each year, there is a need to study pediatric persistent postsurgical pain. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multicentered registry examining postsurgical outcomes. The Scoliosis Research Society Questionnaire–Version 30, which includes pain, activity, mental health, and self-image subscales, was administered to 190 patients prior to surgery and at 1 and 2 years postsurgery. A subset (n = 77) completed 5-year postsurgery data. Pain prevalence at each time point and longitudinal trajectories of pain outc...
ConclusionsThe Portuguese LANSS version pain scale properties lead us to the conclusion that such a cross‐cultural version is a reliable and valid instrument for the differentiation of this type of pain. Its usage is recommended. (Source: Pain Practice)
Nearly four years after the United States Congress heralded a “decade of pain control and research”, chronic pain remains a mounting public health concern worldwide. The escalating prevalence of chronic pain in recent years has been paralleled by a rise in prescription opioid availability, misuse, and associated human and social costs. However, national monitoring surveys in the U.S. and Canada currently fail to differentiate between prescription opioid misuse for the purposes of euphoria versus pain or withdrawal management. Furthermore, there is a lack of evidence-based guidelines for pain management among high-risk individuals, and a glaring lack of education for practitioners in the areas of pain and addiction medicine. Herein we propose multiple avenues for intervention and resear...
Abstract: Chronic pain (CP) in children is a significant medical condition. The exact incidence is difficult to define but we know that historically it has been underdiagnosed and undertreated. Children can present with a variety of pain conditions (e.g. chronic headache, abdominal pain and musculoskeletal/limb pain).The medical pathway of children with chronic pain is a long and stressful one, often involving extensive investigations. A child with chronic pain will show a variety of concomitant symptoms – sleep disturbance, school absence, psychological symptoms such as anxiety, low mood and in extreme cases depression. The impact on the family needs to be taken into consideration, as by the time the child is referred to pain management there is invariably a degree of parental stress an...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Abstract: Chronic pain has now been recognized as a disease entity in its own right. Significant numbers of patients suffer from intractable chronic pain. Neuromodulation has been defined by the International Neuromodulation Society as ‘the therapeutic alteration of activity in the central or peripheral nervous system either electrically or pharmacologically’. It can be achieved either by electrical stimulation of peripheral nerves, spinal cord or brain, or by delivering pharmacological agents directly into the intrathecal, epidural or intracerebroventricular sites. Neuromodulation is expensive, invasive and not without complications. Patients requiring neuromodulation should undergo multidisciplinary assessment for suitability. Clinical effectiveness is possible with appropriate patie...
Abstract: The involvement of the sympathetic nervous system in chronic pain conditions has been well described and recognized for over a century. However, the exact mechanism of the relationship has not been fully explained. In certain chronic pain conditions (e.g. complex regional pain syndrome (CRPS)), the presence of sympathetic signs forms part of the diagnostic criteria.Typical management will involve a multidisciplinary approach, including physical, pharmacological, and psychological therapies. Interventional techniques such as sympathetic blocks can also be used; however evidence of efficacy for many treatments remains poor. (Source: Anaesthesia and intensive care medicine)
Abstract: Neurosurgical treatment for pain can be classified into three categories: treatment of the cause, neuro-ablative techniques and neuromodulation. Treatment of the cause is exemplified by microvascular decompression for trigeminal neuralgia.All of these treatments are now delivered in a multidisciplinary context, with other adjunctive treatments including cognitive techniques and pain management programmes. There is increasing emphasis on outcome measurement in all categories, using both condition-specific and generic assessment tools such as the EuroQuol-5D. (Source: Anaesthesia and intensive care medicine)
Abstract: Adapting to chronic pain is often problematic due to the intensity of emotions that pain provokes. Negative emotions that are associated with pain tend to amplify the severity of the pain experienced. Current treatment strategies that address emotion dysregulation can enhance tolerance and acceptance of pain states. These effects are viewed in the light of current research into the neuroscience of pain and emotion. (Source: Anaesthesia and intensive care medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
To evaluate long-term clinical results of lumbar total disc replacement (TDR) compared with posterior lumbar fusion. This prospective randomized controlled trial comprised 152 patients; 80 were randomized to TDR and 72 to fusion. All patients had chronic low back pain (CLBP) and had not responded to nonsurgical treatment. Primary outcome measure was global assessment of back pain (GA), secondary outcome measures were back and leg pain, Oswestry Disability Index (ODI), EQ5D, and SF-36. All measures were collected from SweSpine (Swedish national register for spinal surgery) at 1, 2, and 5 years. Follow-up rate at 5 years was 99.3 %. (Source: The Spine Journal)
The aim of this study was to compare the salivary cortisol level, pain intensity and psychological factors between patients with chronic and acute oro‐facial pain (OP) and pain‐free subjects. Twenty‐seven females with chronic OP (a diagnosis of myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders with at least 6 months duration), 24 females with acute OP (<10 days duration) and 27 pain‐free females participated. Morning saliva was collected from all participants for analyses of the cortisol level. The pain intensity was assessed on a 0–10 numeric rating scale. The participants were evaluated by the Symptom Checklist 90‐revised for levels of depression and somatisation, and the Perceived Stress Scale. The cortisol levels amon...
Conclusions: Multiple presentations and interactive sessions from leading experts in the management of rheumatic diseases emphasized the interconnection between rheumatology and dermatology. Practical management approaches to both specialties and their sequelae were discussed. Additional content from the conference is available at www.globalacademycme.com and through Rheumatology News at www.rheumatologynews.com. (Source: Seminars in Arthritis and Rheumatism)
CONCLUSIONS: The significant correlation between sAA concentrations and VAS pain scores identified in these preliminary results suggests that this biomarker may be a valuable, noninvasive and sensitive index for the objective assessment of pain intensity in patients with cancer-induced bone pain.
PMID: 24286404 [PubMed - in process] (Source: Chinese Medical Journal)
We describe a series of studies using nociceptive inflammatory and neuropathic pain models to investigate the effects of known pain therapeutics on nociceptive-induced biochemical signaling and present this as a complementary research strategy for assessing antinociceptive activity useful in the preclinical development of novel pain therapeutics.
PMID: 24300134 [PubMed - as supplied by publisher] (Source: Biochemical Pharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Chronic low-back pain is one of the most common and costly health complaints. It can be debilitating, and it remains a tough condition to diagnose, treat, and study. Spinal manipulative therapy is often used to treat a large portion of low-back pain in the United States, and is included in current clinical practice guidelines for treatment of this condition. Yet, recommendations for duration and frequency vary widely and there is no consensus on its efficacy. (Source: NCCAM Featured Content)
Until recently, the Defense Advanced Research Projects Agency (DARPA) kept its plans for its $70 million portion of the Brain Research through Advancing Innovative Neurotechnologies Initiative largely under wraps, generating considerable speculation and a few outlandish rumors. Now, however, DARPA has released two calls for grant applications, with at least one more likely: The first, called SUBNETS (Systems-Based Neurotechnology for Emerging Therapies), asks researchers to develop novel, wireless devices, such as deep brain stimulators, that can cure neurological disorders including posttraumatic stress (PTS), major depression, and chronic pain. The second, RAM (Restoring Active Memory), calls for a separate wireless device that repairs brain damage and restores memory loss. Science sat d...
Hyperphosphatemia is a nearly universal complication of end-stage renal disease that is widely recognized as one of the most important and most challenging clinical targets to meet in the care of dialysis patients. Left untreated, it can lead to bone pain, pruritus and worsening secondary hyperparathyroidism. Data from observational studies demonstrate that an elevated serum phosphorus level is an independent risk factor for mortality, and that treatment with phosphate binders is independently associated with improved survival. Experimental studies provide support for the epidemiologic findings: phosphate excess promotes vascular calcification, induces endothelial dysfunction and may contribute to other emerging chronic kidney disease-specific mechanisms of cardiovascular toxicity. On the ...
Nature Reviews Drug Discovery 12, 906 (2013).
Author: Alexandra Flemming
The potassium-chloride co-transporter KCC2 is expressed in neurons of the central nervous system (CNS), where it is responsible for maintaining low Cl− concentrations. Loss of activity of KCC2 is a key mechanism underlying several neurological and psychiatric disorders, including epilepsy, schizophrenia and chronic (Source: Nature Reviews Drug Discovery)
Treatment of chronic pain conditions such as fibromyalgia is challenging due to limitations of drug therapies. An initial exploration into the relationships between self-reported alcohol consumption, symptom severity, and quality of life for individuals with fibromyalgia sheds new light on plausible hypotheses and potential mechanisms of action for future research. Evidence suggests that alcohol consumption may improve social and psychological factors because of activity in the ascending and descending pain pathways in modulating gamma-aminobutyric acid neurotransmission. Further methodologically rigorous studies in this field to improve well-being of individuals with fibromyalgia are warranted. (Source: Arthritis Research and Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physi...
VGF (nonacronymic) is a neuropeptide precursor that plays multiple roles in regulation of energy balance, reproduction, hippocampal synaptic plasticity, and pain. Data from a number of pain models showed significant up-regulation of VGF in sensory neurons. TLQP-21, one of the VGF-derived neuropeptides, has been shown to induce a hyperalgesic response when injected subcutaneously into the hind paw of mice. However, the precise role of VGF-derived neuropeptides in neuropathic pain and the molecular identity of the receptor for VGF-derived peptides are yet to be investigated. Here we identified gC1qR, the globular heads of the C1q receptor, as the receptor for TLQP-21 using chemical cross-linking combined with mass spectrometry analysis. TLQP-21 caused an increase in intracellular Ca2+ levels...
Authors: Chen M, Zhang X, Xu H, Ma X, Jiang W, Xu T
Knockdown of spinal metabotropic glutamate 5 (mGlu5) receptor was shown to inhibit the development of intrathecal morphine antinociceptive tolerance. The present work was designed to evaluate the expression of spinal G-protein during morphine tolerance and knockdown of spinal mGlu5 receptor with antisense oligonucleotide (ODN). Rats were treated with saline, morphine, mGlu5 receptor antisense or mismatch ODN intrathecally. Behavioral tests were employed to test the thermal and mechanical pain thresholds. Five days later, rats were scarified and spinal expression of spinal Gαi, Gαo, Gαq and Gβ were detected. Consistent with previous results, knockdown of spinal mGlu5 receptor could inhibit spinal morphine antinocicepti...
O Acidente Vascular Cerebral (AVC) é a doença neurológica que mais incapacita os adultos. A respiração, a postura e a deglutição possuem uma relação direta nesta doença, necessitando assim de uma intervenção multidisciplinar. O objetivo do presente estudo foi realizar uma avaliação clínica integrada para analisar a relação entres estas disfunções. Trata-se de uma paciente do sexo feminino com 37 anos, com seis anos de diagnóstico de AVC isquêmico com hemiparesia completa à direita de predomínio crural, hipertensão arterial sistêmica, disfagia e disartrofonia. Na anamnese, relatou sintomas referentes à dispnéia, dores na coluna lombar, presença de tosse e engasgos à alimentação e escape anterior de saliva, principalmente durante a fala. A paciente apresenta es...
Abstract: Bone and joint infections (BJI) are serious. They may be life-threatening or, more commonly, associated with long-term disability and reduced quality of life. The spectrum of disease has changed over time and the proportion of iatrogenic disease caused by prosthetic joints is increasing annually.Osteomyelitis is caused when bacteria colonize bone, usually a sterile tissue, via direct inoculation from trauma or operation, haematogenous seeding from bloodstream infection or contiguous spread from another infected site. The pathophysiology of biofilm formation leads to a chronic infection that is not readily accessible to either host immunity or antibiotics. Presentation is with pain, swelling, lack of mobility and systemic symptoms.Diagnosis requires clinical symptoms, appropriate ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
ConclusionsLong‐term intermittent intravesical hyaluronidase could develop a severe chronic cystitis with diffused fibrosis accompanied by altered histology and bladder function. This chronic cystitis rat model can resemble the clinical and histopathological features of human bladder pain syndrome, and might be a potential valuable model for investigation of this troublesome disease. (Source: International Journal of Urology)
Authors: Wang JQ, Guo ML, Jin DZ, Xue B, Fibuch EE, Mao LM
Protein phosphorylation is an important mechanism for regulating ionotropic glutamate receptors (iGluRs). Early studies have established that major iGluR subtypes, including α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors and N-methyl-D-aspartate (NMDA) receptors, are subject to phosphorylation. Multiple serine, threonine, and tyrosine residues predominantly within the C-terminal regions of AMPA receptor and NMDA receptor subunits have been identified as sensitive phosphorylation sites. These distinct sites undergo either constitutive phosphorylation or activity-dependent phosphorylation induced by changing cellular and synaptic inputs as reversible events. An increasing number of synapse-enr...
CONCLUSION: Shugan-decoction can reduce chronic stress-induced visceral hypersensitivity in rats, and the regulatory mechanism may involve mediating the expressions of TRPV1 and SP in colon tissues.
PMID: 24307802 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)
CONCLUSION Within this group, the social profile was that of low income and unemployed with sickle cell disease considered to be a significant impediment to finding a job. Evaluating quality of life as a determining factor of health is essential for the creation of specific policies and measures, appropriate for the specific characteristics and social context of sickle cell disease. (Source: Revista Brasileira de Hematologia e Hemoterapia)
Microscopic colitis is a frequent cause of chronic watery diarrhea, especially in older persons. Common associated symptoms include abdominal pain, arthralgias, and weight loss. The incidence of microscopic colitis had been increasing, although more recent studies have shown a stabilization of incidence rates. The diagnosis is based on characteristic histologic findings in a patient with diarrhea. Microscopic colitis can occur at any age, including in children, but it is primarily seen in the elderly. Several treatment options exist to treat the symptoms of microscopic colitis, although only budesonide has been well studied in randomized clinical trials. (Source: Clinics in Geriatric Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
This large case control study suggested that people who had experienced disease of the heart and blood vessels were more likely to have taken sodium-containing medicines than people without cardiovascular disease. Put in other words this can be interpreted that people who took sodium-containing medicines were at a higher risk of experiencing cardiovascular disease than people who took the same medications in formulations free of sodium. The increased risk appeared to be driven mostly by an increased risk of hypertension and to a lesser extent, non-fatal stroke.
The study has some strengths including its large sample size, reasonable follow up time (over seven years on average), and direct measure of cardiovascular illness (recorded in a medical database).
However, it does cont...
ConclusionThe combined integration of structural and functional measures allowed for a unique characterization of the impact of FM pain on the brain. These data may lead to the identification of early structural and functional brain alterations in response to pain, which could be used to develop markers for predicting the development of FM and other pain disorders. (Source: Arthritis and Rheumatism)
In this study, patients with chronic LE who had previously undergone an unsuccessful full course of nonoperative treatment showed significantly improved clinical function and structural repair at the origin of the common extensor tendon after ATI. This novel treatment is encouraging for the treatment of tendinopathy and warrants further evaluation. (Source: The American Journal of Sports Medicine)
CONCLUSIONS: This study demonstrates that significant others have similar unrealistic and/or unhelpful treatment expectations to those widely reported by individuals with persistent low back pain, and could further reinforce such illness perceptions and serve as wider psychosocial obstacles to recovery and continued work participation.
PMID: 24284682 [PubMed - as supplied by publisher] (Source: Work)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
ConclusionsImplementation of an opioid risk electronic pain assessment program significantly increased the likelihood that a risk assessment would be included in the medical record, which has implications for improvement of quality of care. (Source: Pain Practice)
Conclusions: No significant healing and surgical outcome differences were found between biodegradable and non‐degradable packing. However pain, bleeding, nasal blockage and facial edema were lower with biodegradable packing. (Source: The Laryngoscope)
Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain manag...
Cancer continues to be a key cause of morbidity and mortality worldwide and its overall incidence continues to increase. Anaesthetists are increasingly faced with the challenge of managing cancer patients, for surgical resection to debulk or excise the primary tumour, or for surgical emergencies in patients on chemotherapy or for the analgesic management of disease- or treatment-related chronic pain. Metastatic recurrence is a concern. Surgery and a number of perioperative factors are suspected to accelerate tumour growth and potentially increase the risk of metastatic recurrence. Retrospective analyses have suggested an association between anaesthetic technique and cancer outcomes, and anaesthetists have sought to ameliorate the consequences of surgical trauma and minimise the impact of a...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
Read these useful pearls regarding opioid use and abuse, as well as tips regarding general pain management, from an expert team of chronic pain specialists. The Hospitalist (Source: Medscape Pharmacist Headlines)
Title: Why Am I So Tired? The Many Causes of FatigueCategory: Doctor's & Expert's views on SymptomsCreated: 5/4/2011 2:57:00 PMLast Editorial Review: 11/26/2013 12:00:00 AM (Source: MedicineNet Chronic Pain General)
CONCLUSIONS: A better understanding of how chronic pain develops at a mechanistic level can aid clinicians in treating their patients by showing how the underlying biology of chronic pain contributes to the clinical manifestations of pain. A thorough understanding of how chronic pain develops may also help identify new targets for future analgesic drugs.
PMID: 24277113 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)
CONCLUSIONS: This result suggests that modulation of the DMN by acupuncture is related to its therapeutic effects on cLBP. Imaging of the DMN provides an objective method for assessment of the effects of acupuncture-induced analgesia.
PMID: 24280949 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)
CONCLUSIONS: LA using energy density range (0-4 J/cm(2)) for the treatment of chronic non-specific LBP resulted in clinical improvement unrelated to laser stimulation.
TRIAL REGISTRATION: http://www.anzctr.org.au ACTRN12610000043033.
PMID: 24280948 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)
This is a valuable diagnostic study that demonstrates the potential value of using contrast enhanced ultrasonography (CEUS) to examine liver tumours in children. As the researchers say, the liver would normally be initially examined using standard “grey scale” ultrasound, but as this often does not give enough diagnostic information, this has to be followed by further imaging using CT or MRI. CT involves the use of ionising radiation, which still carries uncertain risk for the child, while MRI can be difficult for the child and require sedation.
Therefore an accurate alternative would be a good advancement. It would not only reduce potential risks or harm to the child, but could also have potential benefits in terms of reducing healthcare costs and use of resources.
PTNS is an effective and safe option to treat OAB patients. Further studies are needed to assess the role of PTNS in the remaining indications and to evaluate the long term durability of the treatment. Further research is needed to address several unanswered questions about PTNS. (Source: BMC Urology - Latest articles)
(Ivanhoe Newswire) –Marijuana, people use it recreationally and medically to treat a variety of conditions, from chronic pain to epilepsy. However, a new study has revealed the molecular pathways responsible for marijuana-induced learning and memory problems, and preventing these side effects could be as easy as taking an over-the-counter painkiller. (Source: Medical Headlines From Ivanhoe.com)
Authors: Tabellini G, Borsani E, Benassi M, Patrizi O, Ricotta D, Caimi L, Lanzi R, Micheli F, Iorno V, Bettaglio R, Rezzani R, Rodella LF, Parolini S
Opioid compounds, such as morphine, induce powerful analgesic effects and are extensively used clinically to treat a wide variety of pain. The aim of our study was to evaluate the impact of opioid therapy on phenotype and function peripheral blood NK cells. The patients were referred to three Italian pain therapy centers (Milan, Pavia, Piacenza) for chronic pain in neuropathic or mixed somatic components. The patients were between 18 and 75years old and were of Caucasian ethnicity. We studied the expression of activating and inhibitory NK receptors to discriminate NK subsets with different CD56 surface expression intensities...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
(University of Washington) Scientists have figured out how cells do the improbable: pick the charged calcium ions out of vast sodium sea to generate electrical signals. The speed and accuracy of this selection is crucial to the beating of the heart and the flow of nerve impulses in the brain. The finding is likely to assist the development of new drugs, such as safer medications for chronic pain. (Source: EurekAlert! - Biology)
Authors: Esparza-Moreno KP, García-Garduño OA, Ballesteros-Zebadúa P, Lárraga-Gutiérrez JM, Moreno-Jiménez S, Celis-Lopez MA
Trigeminal neuralgia (TN) is a chronic, episodic facial pain syndrome that can be extremely intense, and it occurs within the regions of the face that are innervated by the three branches of the trigeminal nerve. Stereotactic radiosurgery (SRS) is the least invasive procedure to treat TN. SRS uses narrow photon beams that require high spatial resolution techniques for their measurement. The use of radiographic or radiochromic films for small-field dosimetry is advantageous because high spatial resolution and two-dimensional dose measurements can be performed. Because these films have different properties, it is expected that the calculated dose...
Osteopathy is frequently claimed to be a patient-centred (PC) and biopsychosocially (BPS) orientated profession.1–3 However, recently the relationship that these two models of healthcare have to modern-day osteopathy has been discussed4,5 and questioned.6 An important aspect of the PC and BPS models is the recognition of the patient-as-a-person and that a patient's pain and dysfunction consists of far more than a purely biological entity (e.g. disc ‘lesion’ or facet joint dysfunction) but also includes psychological (e.g. anxiety, fear-avoidance, illness beliefs) and social factors (e.g. family support, workplace attitudes to disability) which should to be taken into account during diagnosis, treatment and management. (Source: International Journal of Osteopathic Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
After revealing that osteopathic manual treatment (OMT) had more effect on chronic low back pain than did ultrasound therapy,1 Licciardone et al. are about to publish a new analysis of results from the OSTEOPATHIC Trial.2 They investigated whether osteopathic manual treatment (OMT) had effect on people with more severe low back pain compared to those with less severe back pain. To do this they compared the effects of OMT over SHAM on 269 patients with an initial low back pain intensity of less than 50 mm on the visual analogic scale (VAS) to these effects on 186 patients with an initial VAS ≥ 50 mm. They then defined responders as patients whose pain was reduced by 50% or more at 12 weeks. Authors' structured analysis showed OMT to have little or no effect in reducing pain by half on pat...
In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon. The lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement parameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic Achilles tendinosis. (Source: BMC Medical Imaging - Latest articles)
In this study, we revealed a dynamic alteration of GSK3β activities and its role in regulating glial glutamate transporter 1 (GLT-1) protein expression in the spinal dorsal horn and nociceptive behaviors following the nerve injury. Specifically, GSK3β was expressed in both neurons and astrocytes in the spinal dorsal horn. GSK3β activities were suppressed on day 3 but increased on day 10 following the nerve injury. In parallel, protein expression of GLT-1 in the spinal dorsal horn was enhanced on day 3 but reduced on day 10. In contrast to these time-dependent changes, the activation of astrocytes and over-production of IL-1β were found on both day 3 and day 10. Meanwhile, thermal hyperalgesia was observed from day 2 through day 10 and mechanical allodynia from day 4 through day 10. Pre...
CONCLUSIONS: Breathing training, walking aids, NMES and CWV appear to be effective non-pharmacological interventions for relieving breathlessness in advanced stages of disease.
PMID: 24272974 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
CONCLUSIONS: Touch therapies may have a modest effect in pain relief. More studies on HT and Reiki in relieving pain are needed. More studies including children are also required to evaluate the effect of touch on children.
PMID: 24271739 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
CONCLUSIONS: Although there is limited evidence in favour of SCS for Failed Back Surgery Syndrome and Complex Regional Pain Syndrome Type I, more trials are needed to confirm whether SCS is an effective treatment for certain types of chronic pain. In addition, there needs to be a debate about trial designs that will provide the best evidence for assessing this type of intervention.
PMID: 24271738 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Medical marijuana helps treat disorders such as chronic pain, nausea and seizures. Unfortunately, it can also...um...oh yeah, it can also impair memory and learning. But a new study suggests we can prevent this side effect with easily available medication. [More] (Source: Scientific American - Official RSS Feed)
Various pelvic floor conditions, including overactive bladder syndrome and chronic pelvic pain, have been successfully managed with the neuromodulation of sacral nerves. Sacral neuromodulation is a minimally invasive procedure involving the implantation of a programmable pulse generator that delivers low-amplitude electrical current via quadripolar tined leads through the S3 foramen. Durable efficacy has been demonstrated in retrospective studies, but questions regarding ideal patient candidacy and optimal technical considerations remain unanswered. (Source: Neurosurgery Clinics of North America)
Authors: Dehlinger FI, Ries C, Hollinger B
OBJECTIVE: Re-establishment of radial stability within the elbow joint in cases of arthroscopically or clinically confirmed posterolateral rotatory instability.
INDICATIONS: Posttraumatic or chronic degenerative posterolateral rotatory instability at least grade I-II according to O'Driscoll.
CONTRAINDICATIONS: Elbow stiffness or elbow arthritis and lateral epicondylitis, if a posterolateral rotatory instability has been excluded as the reason for the symptoms.
SURGICAL TECHNIQUE: Reconstruction or augmentation of the insufficient lateral ulnar collateral ligament (LUCL) with an autologous triceps tendon graft. A stripe of the triceps tendon is fixed at the epicondylus humeri radialis and at the base of the annular liga...
Migraine prevention can be instrumental in the effective management of the migraine patient but remains underused in treatment of this common, chronic, and often debilitating condition. The development of methysergide as the first migraine preventive agent not only laid the groundwork for our current thinking about migraine prevention, but also created a paradigm shift away from migraine as a psychological issue and toward migraine as a legitimate medical condition.
This short review is intended to help the reader select patients appropriate for prevention and to initiate, monitor, and adjust preventive treatment. Goals in discussing preventive management are to facilitate provider familiarity with and confidence in this therapy leading to improved clinical outcomes and to a reduced burden...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
ConclusionChronic headaches and sexual pain are both conditions that have a significant impact on patients and the health care system, and they do coexist. More research is needed to look at the relationship between these conditions in addition to epidemiology, symptomatology, evaluation, and treatments. (Source: Headache: The Journal of Head and Face Pain)
Commentary on: Vickers AJ, Cronin AM, Maschino AC, et al.. Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012;172:1444–53. Context Acupuncture is controversial. Even if one assumes its overall effectiveness, common explanations for its causal impact are biologically implausible. Hence acupuncture is often dismissed as ‘no more than a placebo’, and this allegation is difficult to disprove as placebo-controlled trials are problematic. ‘Placebo’ needles stimulate sensory nerves and are possibly a less active treatment, ‘sham’ rather than ‘placebo’.1 Small differences between treatments require large sample sizes, as achieved by meta-analysis. Previous meta-a...
Commentary on: Lapi F, Azoulay L, Yin H, et al.. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ 2013;346:e8525. Context Acute kidney injury (AKI) is increasing both in the USA and Europe.1 2 Most people with AKI return to baseline renal function, but AKI predisposes some patients to an increased risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD).3 4 Medications contribute to AKI whether administered in hospital such as aminoglycoside antibiotics, or when prescribed for outpatients, such as non-steroidal anti-inflammatory drugs (NSAIDs) whose adverse effects are seen more often to involve the gastrointestina...
CONCLUSION: Chronic headaches and sexual pain are both conditions that have a significant impact on patients and the health care system, and they do coexist. More research is needed to look at the relationship between these conditions in addition to epidemiology, symptomatology, evaluation, and treatments.
PMID: 24261411 [PubMed - as supplied by publisher] (Source: Headache)
This article is protected by copyright. All rights reserved. (Source: Journal of Neurochemistry)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
It is difficult to achieve minimum standards using routine consultant-led care for children referred by their GP with constipation. Nurse-led early intervention is feasible and has produced promising results in a service evaluation. An exploratory trial is planned to develop a teaching module, robust outcomes including costs and benefits, and methodology for a definitive trial recommended by NICE. (Source: BMC Pediatrics - Latest articles)
ConclusionFew people with chronic non‐cancer pain divert their opioids to others. Media reports of elderly patients selling their opioids to supplement their income may be reflective of exceptional cases. Future studies may investigate the extent to which other patient groups divert prescription opioids to the illicit marketplace. [Belcher J, Nielsen S, Campbell G, Bruno R, Hoban B, Larance B, Lintzeris N, Degenhardt L. Diversion of prescribed opioids by people living with chronic pain: Results from an Australian community sample. Drug Alcohol Rev 2013] (Source: Drug and Alcohol Review)
Authors: Henneghan AM, Schnyer RN
Terminally ill patients experience negative symptoms at end of life (EOL) that hinder well-being and quality of life (QOL). Current intervention strategies are not always effective or feasible. A focused literature review to evaluate the use of biofield therapies (ie, Therapeutic Touch, Healing Touch, and Reiki) to manage the symptoms in EOL revealed no studies on the use these therapies, specifically in this population. Evidence from studies on relevant populations (patients with cancer, elderly patients, and patients experiencing chronic pain), which addressed the outcomes relevant to palliative and EOL care (EOLC; pain levels, changes in psychological symptoms, well-being, and QOL), supports the use of biofield therapies in relieving pa...
We describe anatomical structures and neurotransmitters of the descending inhibitory pain pathways that are activated in response to nociceptive pain and altered in response to sustained and persistent pain which leads to chronic pain in various pathological conditions. (Source: Pain Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> <b><i>WANTED!</i></b> 10 people to support MedWorm and trial MedWorm Search <b><a href="http://www.medworm.com/rss/sponsoredsearch.php" target ="_self">Find out more here...</a></b></p></div>
This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia.
A double‐blind, multicenter randomized controlled clinical trial with 6‐month follow‐up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire wer...
We report 5-HT1BR expression in many TRPM8-containing afferents and direct interaction of these proteins in a novel multi-protein signalling complex, which includes phospholipase D1 (PLD1). We provide evidence that the 5-HT1BR activates PLD1 to subsequently activate PIP 5-kinase and generate PIP2, an allosteric enhancer of TRPM8, achieving a several-fold increase in potency of TRPM8 activation. The enhanced activation responses of synaptoneurosomes prepared from spinal cord and cortical regions of animals with a chronic inflammatory pain state are inhibited by TRPM8 activators that were applied in vivo topically to the skin, an effect potentiated by co-administered 5-HT1BR agonists and attenuated by 5-HT1BR antagonists, while 5-HT1BR agents alone had no detectable effect. Corresponding re...
Conclusions: The results of this study suggest that pregabalin works in part by reducing insular glutamatergic activity, leading to a reduction of the increased functional connectivity seen between brain regions in chronic pain states. The study also supports a role for human brain imaging in the development, assessment, and personalized use of central-acting analgesics. (Source: Anesthesiology)
Authors: Unal N, Güney AK, Bilgin K, Yavuz Y, Hökelek M, Günaydın M
Isospora belli is a coccidian protozoon that can cause serious diarrhea especially in immunocompromised patients. The laboratory diagnosis depends primarily on the identification of oocysts in stool specimens by direct microscopic examination with iodine or special stains. This case is presented in order to draw attention to isosporiasis among the diarrheas that can be seen in elderly patients with several chronic diseases. A 81 year-old debilitated male, who had a history of hypertension, Alzheimer's disease, previous cerebrovascular accident and right hemiplegia, was admitted to our hospital complaining of malaise, anorexia, chills, abdominal pain, dysuria, cough, sputum and diarrhea of ten days dura...
In this study, new thienyl (TCP, II), as well as benzothiophen (BTCP, III) derivatives (IV-VII) were synthesized. The acute and chronic pain activities of these drugs were studied using the tail immersion and formalin tests on mice and the results were compared with PCP, TCP and control groups at dosage of 10 mg/kg. The results indicated that the drug VII produced more analgesic effects on acute chemical pain in formalin test compared with other drugs. In addition, this analgesic effect was remarkably seen for drugs II, VI and VII in chronic pain in the mentioned test in comparison with other drugs. Also, the results showed that acute thermal pain could be diminished by drugs VI, II and I compared with other drugs in tail immersion test. It can be concluded that more analgesic effects of n...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Find the best Christmas presents and <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK with this simple shopping directory.</p></div>
Authors: Rostaing-Rigattieri S, Guerin J
Pain prevalence increases during cancer course disease. Cancer incidence is increasing in France, but thanks to therapeutic advances in the specific treatment, cancer has become a chronic disease, often associated with persistent pain. Cancer pain evaluation should be multidimensional. Pain mechanism (nociceptive, neuropathic or mixed pain) should be recognised in order to prescribe appropriate analgesic treatment. Cancer pain characteristics should be defined (baseline and breakthrough pain). Today, a wide range of pain medications, including strong opioids, are available. The use of analgesic combinations is strongly recommended for cancer pain management. Medication characteristics knowledge (pharmacodynamics and pharmacokinetics...
Findings from the largest and most rigorous, randomized dose-response study of spinal manipulative therapy (SMT) for chronic low-back pain suggest that 12 sessions (SMT) may be the best “dose” for people with chronic low-back pain. The study, published in The Spine Journal, was funded by NCCAM. (Source: NCCAM Featured Content)
Conclusion: There is a high prevalence of psychiatric illness in chronic pain patients of any aetiology. Psychiatric morbidity is associated with increased pain perception, impairment in activity and poor functional status. (Source: Indian Journal of Palliative Care)
CONCLUSIONS: The BODE index and the ADO index showed a significant association with HRQOL. Exacerbations and dyspnea were the best individual factors related to HRQoL.
PMID: 24262284 [PubMed - as supplied by publisher] (Source: Atencion Primaria)
ConclusionPersian HIT‐6 is a valid and reliable questionnaire for the evaluation of headache. However, it cannot differentiate between chronic migraine, episodic migraine, and TTH in Iranian population. (Source: Pain Practice)
This book represents an important effort by the American Academy of Pain Medicine to prepare a single text that provides a comprehensive overview of the field of pain medicine. The focus of the textbook is on the treatment of chronic non-cancer pain, so there is little discussion of acute pain or palliative care. The book aims to provide the reader with a detailed discussion of interventional therapy, medication management, rehabilitation, and psychological therapy for the treatment of pain. Another aim is to provide an illuminating discussion of the suffering the patient with chronic pain may experience, a topic often missing in other textbooks. (Source: Journal of Pain and Symptom Management)