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Medworm: Chronic Pain - Recent Medical Updates

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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 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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-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)


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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&#...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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


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


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


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


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 clinician's quick guide of evidence‐based approaches: Chronic pain
(Source: Clinical Psychologist)


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


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


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


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


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


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


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


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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


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


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


Temporal dynamics of anxiety phenotypes in a dental pulp injury model
Conclusions: Together, these results suggest a temporally progressive causal relationship between orofacial pain and anxiety, calling for more in-depth mechanistic studies on concomitant pain and anxiety disorders. (Source: Molecular Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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, ...


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


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


Study reports mixed findings on medical efficacy of cannabis
A large-scale review that evaluated the medical efficacy of cannabinoids — the active chemical compounds in marijuana — across a range of conditions found there is moderate evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity in patients with multiple sclerosis. The meta-analysis, led by the University of Bristol and published in the Journal of the American Medical Association, analysed the results of 79 different randomised-controlled studies involving more than 6,400 patients to investigate the benefits and side effects of medical cannabinoids. (Source: University of Bristol news)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 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. ...


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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...


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 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)


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 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 ...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Validation of the Danish‐language chronic pain acceptance questionnaire
ConclusionThe psychometric properties of the Danish version of the 20‐item CPAQ were satisfactory, showing that the Danish version of CPAQ is valid and reliable. (Source: Acta Anaesthesiologica Scandinavica)


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


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


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


A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain
Conclusion Office pertubal hysteroscopic-guided diluted bupivacaine infusion could be used to manage endometriosis-associated CPP for at least 3months. AEARCTR-0000573 (Source: International Journal of Gynecology and Obstetrics)


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 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


PTSD and Chronic Pain
Post-traumatic stress disorder (PTSD) mostly is known for its effect on overall mental health. There is research, however, to support the fact that PTSD is increasingly being recognized for its effect on physical wellness as well. Many who suffer with PTSD (veterans in particular) have higher lifetime prevalence of circulatory, digestive, musculoskeletal, nervous system, respiratory and infectious disease. There is also an increased co-occurrence of chronic pain in those who suffer with PTSD. Chronic pain may be defined as pain that persists longer than three months that was initially accompanied with tissue damage or a disease which has already healed. In 1979, the International Association for the Study of Pain (IASP) officially redefined pain as “an unpleasant sensory and emotional ex...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 outcome measures are commonly used for Complex Regional Pain Syndrome clinical trials? A systematic review of the literature
ConclusionsCurrently, CRPS clinical trials use a wide range of outcome measures making the potential to synthesize evidence problematic. There is no internationally agreed core measurement set. This diversity of outcome measures demonstrates a clear need for the development of a core measurement set to be used in CRPS clinical trials. (Source: European Journal of Pain)


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


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


Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency
Conclusions: Immediate PRF application on the proximal nerve injury site provided a significant inhibition of neuropathic pain formation, accompanied by the inhibition of ERK activation. (Source: BMC Anesthesiology)


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....<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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?
Authors: Valkenburg AJ, de Leeuw TG, van Dijk M, Tibboel D Abstract This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. T...


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


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


The effects of extracorporeal shock wave therapy on pain patients.
Authors: Fricova J, Rokyta R Abstract The method of shock wave therapy (ESWT) was used for the treatment of several symptoms of chronic pain. There were especially: cervical syndromes, lumbago, plantar fasciitis, achillodynia, metatarsalgia and humeral epicondylitis. We confirmed the positive effect of shock wave therapy for the pain relief on these syndromes. This method is also effective in other pain syndromes. The effect of this application is very individual and therefore it is necessary to indicate different number of therapeutic applications. We recommend this method as a very useful tool for complete our possibilities for the relief of chronic pain. PMID: 26071587 [PubMed - as supplied by publisher] (Source: Neuroendocrinology Letters)


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...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Empowering Patients with Persistent Pain Using an Internet-based Self-Management Program
New strategies are needed to improve access to cognitive and behavioral therapies for patients with persistent pain. The purpose of this randomized, controlled trial was to determine the effectiveness of the Chronic Pain Management Program, an 8-week online intervention targeting cognitive, emotional, behavioral, and social pain determinants. Program efficacy and engagement was evaluated for 92 individuals with a diagnosis of chronic noncancer pain who had a current opioid prescription. Participants were recruited from primary care practices and Internet sites, then randomly assigned to receive access to the intervention either immediately (treatment group) or after an 8-week delay (wait-list comparison). (Source: Pain Management Nursing)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 closer look: Alternative pain management practices by heart failure patients with chronic pain
To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. (Source: Heart and Lung)


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


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


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


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats.
Authors: Meng F, Ge HY, Wang YH, Yue SW Abstract Myofascial trigger points (MTrPs) are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human) of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P &lt; 0.01), and immunohistochemistry with Neurofilament 200 indicated more myelinated afferents existed in MTrSs (P &lt; 0.01). Spontaneous electrical activity (SEA) recordings at MTrSs showed that specific block of myelinated afferents in sciatic nerve with tetrodotoxin (TTX) led to sign...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Long Term Outcome of The Management of Chronic Neuropathic Pain – A Prospective Observational Study
This prospective observational cohort study addressed the long term clinical effectiveness of the management of chronic neuropathic non-cancer pain at seven Canadian tertiary pain centres. Patients were treated according to standard guidelines and followed at 3, 6, 12, 18 and 24 months. Standard outcome measures for pain, mood, quality of life and overall treatment satisfaction were administered with the primary outcome measure designated as the composite of 30% reduction in average pain intensity and one point drop in the mean Interference Scale Score (0-10) of the Brief Pain Inventory at 12 months relative to baseline. (Source: The Journal of Pain)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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. (Source: Journal of the Formosan Medical Association)


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


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


Adipose-derived stem cells improve the viability of nucleus pulposus cells in degenerated intervertebral discs.
Authors: Song K, Gu T, Shuang F, Tang J, Ren D, Qin J, Hou S Abstract Patients with degenerative disc disease (DDD) experience serious clinical symptoms, including chronic low back pain. A series of therapies have been developed to treat DDD, including physical therapy and surgical treatment. However, the therapeutic effect of such treatments has remained insufficient. Recently, stem cell‑based therapy, in which stem cells are injected into the nucleus pulposus in degenerated intervertebral disc tissue, has appeared to be effective in the treatment of DDD. In the present study, the effect of adipose‑derived stem cells on degenerated nucleus pulposus cells was investigated using a co‑culture system to evaluate the biological activity of degenerated nucleus pulposus cells. Huma...


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Chronic inflammatory pain upregulates expression of P2Y 2 receptor in small-diameter sensory neurons
Abstract Roles of ionotropic purinergic (P2X) receptors in chronic pain have been intensively investigated. However, the contribution of metabotropic purinergic (P2Y) receptors to pathological pain is controversial. In the present study, using single cell RT-PCR (reverse transcription-polymerase chain reaction) and single cell nested-PCR techniques, we examined the expression of P2X2, P2X3, P2Y1 and P2Y2 mRNA transcripts in retrogradely labeled cutaneous sensory neurons from mouse lumber dorsal root ganglia (DRGs) following peripheral inflammation. The percentage of cutaneous sensory neurons expressing P2Y2 mRNA transcripts increased after complete Freund’s adjuvant (CFA) treatment. Particularly, the P2Y2 mRNA transcripts were more frequently detected in small-diameter cutaneous...


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 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


What is the impact of acute and chronic orofacial pain on quality of life?
Conclusion TMD, ADP, TN and PDAP have substantial impact on OHRQoL as measured by the OHIP-49 and the extracted items for the OHIP-14 and 5. Differences among the 4 groups of orofacial pain conditions are likely not to be substantial. (Source: Journal of Dentistry)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Boston Scientific touts positive data from next-gen SCS
Boston Scientific (NYSE:BSX) said yesterday that data from its Precision Spectra spinal cord stimulator study showed 1.5 times better pain relief and 2 times better lower back pain relief than its previous generation SCS. The analysis examined 213 patients treated with the new Precision Spectra and 130 patients treated with the previous generation Precision Plus, as well as 25 patients treated with the Spectra and a different set of leads, the Marlborough, Mass.-based company said. &#8220;The results are exciting because we looked at consecutive patients – some with only low back pain – in a real-world setting. This is strong clinical evidence of the effectiveness of the Precision Spectra system in treating the types of challenging chronic pain patients that physicians see every d...


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 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Assessing patient-centred care for chronic pain: Validation of a new research paradigm.
Authors: Paul-Savoie E, Bourgault P, Gosselin E, Potvin S, Lafrenaye S PMID: 26069896 [PubMed - as supplied by publisher] (Source: Pain Research and Management)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Malawi: Man With Extremely Rare Form of Cancer in Urgent Need of Surgery
[Malawi24] A man in Malawi is living in chronic pain from an extremely rare testicular form of cancer known as congenital granulosa cell tumor. (Source: AllAfrica News: Health and Medicine)


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)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Does Change Occur for the Reasons We Think It Does? A Test of Specific Therapeutic Operations During Cognitive-Behavioral Treatment of Chronic Pain
Discussion: Change with CBT may occur both by theory-specified mechanisms and general mechanisms. However, the results provide the most support for a General Mechanism model in which changes on coping skills have spreading effects on the use of other coping skills. Significant relationships between some skill changes and indexes of patient-therapist working alliance and outcome expectations suggest that nonspecific factors also play a role in treatment-related changes in the use of pain coping strategies. (Source: The Clinical Journal of Pain)


Increased autophagic activity in dorsal root ganglion attenuates neuropathic pain following peripheral nerve injury
Publication date: 10 July 2015 Source:Neuroscience Letters, Volume 599 Author(s): Jian-Shuang Guo , Peng-Bo Jing , Ji-An Wang , Rui Zhang , Bao-Chun Jiang , Yong-Jing Gao , Zhi-Jun Zhang Autophagy is a process of cellular self-cannibalization, and provides an adaptive mechanism to protect cells against diverse pathological settings. Following peripheral nerve injury, autophagic process was changed in Schwann cells and spinal neurons and glial cells, implicating a vital role of autophagy in chronic pain. However, little is known about the role of autophagy in dorsal root ganglion (DRG) in neuropathic pain. In the present study, we investigated the autophagic process in DRG and its effect on neuropathic pain induced by L5 spinal nerve ligation (SNL). The level of microtubule associated pro...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


Pain sensitivity of children with Down syndrome and their siblings: quantitative sensory testing versus parental reports
AimThe aim of this study was to compare thermal detection and pain thresholds in children with Down syndrome with those of their siblings. MethodSensory detection and pain thresholds were assessed in children with Down syndrome and their siblings using quantitative testing methods. Parental questionnaires addressing developmental age, pain coping, pain behaviour, and chronic pain were also utilized. ResultsForty‐two children with Down syndrome (mean age 12y 10mo) and 24 siblings (mean age 15y) participated in this observational study. The different sensory tests proved feasible in 13 to 29 (33–88%) of the children with Down syndrome. These children were less sensitive to cold and warmth than their siblings, but only when measured with a reaction time‐dependent method, and not with a ...


Chronic pain in adults.
Authors: Ostler A Abstract Reading the CPD article helped improve my understanding of the importance of identifying chronic pain. Chronic pain may occur on its own or as a feature of other chronic conditions, and it may be nociceptive or neuropathic, or a combination of the two. PMID: 26058654 [PubMed - in process] (Source: Nursing Standard)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


orphenadrine (Norflex)
Title: orphenadrine (Norflex)Category: MedicationsCreated: 3/2/2005 12:00:00 AMLast Editorial Review: 6/9/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Poor sleep habits amplify knee pain
Patients with knee osteoarthritis with poor sleep habits display greater central sensitisationRelated items from OnMedicaAcupuncture doesn’t improve chronic knee painFirst-line approach to OA should be 10% weight lossCombined diet and exercise effective against knee osteoarthritisPhysios should be first point of contact for musculoskeletal problems (Source: OnMedica Latest News)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


WITHDRAWN: Topical negative pressure for treating chronic wounds.
CONCLUSIONS: Trials comparing TNP with alternative treatments for chronic wounds have methodological flaws and data do demonstrate a beneficial effect of TNP on wound healing however more, better quality research is needed. PMID: 26059170 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Small molecule inhibitors of PSD95-nNOS protein-protein interactions as novel analgesics.
Authors: Lee WH, Xu Z, Ashpole NM, Hudmon A, Kulkarni PM, Thakur GA, Lai YY, Hohmann AG Abstract Aberrant increases in NMDA receptor (NMDAR) signaling contributes to central nervous system sensitization and chronic pain by activating neuronal nitric oxide synthase (nNOS) and generating nitric oxide (NO). Because the scaffolding protein postsynaptic density 95kDA (PSD95) tethers nNOS to NMDARs, the PSD95-nNOS complex represents a therapeutic target. Small molecule inhibitors IC87201 (EC5O: 23.94 μM) and ZL006 (EC50: 12.88 μM) directly inhibited binding of purified PSD95 and nNOS proteins in AlphaScreen without altering binding of PSD95 to ErbB4. Both PSD95-nNOS inhibitors suppressed glutamate-induced cell death with efficacy comparable to MK-801. IC87201 and ZL006 preferentially s...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


N -Palmitoylethanolamine and Neuroinflammation: a Novel Therapeutic Strategy of Resolution
Abstract Inflammation is fundamentally a protective cellular response aimed at removing injurious stimuli and initiating the healing process. However, when prolonged, it can override the bounds of physiological control and becomes destructive. Inflammation is a key element in the pathobiology of chronic pain, neurodegenerative diseases, stroke, spinal cord injury, and neuropsychiatric disorders. Glia, key players in such nervous system disorders, are not only capable of expressing a pro-inflammatory phenotype but respond also to inflammatory signals released from cells of immune origin such as mast cells. Chronic inflammatory processes may be counteracted by a program of resolution that includes the production of lipid mediators endowed with the capacity to switch off inflammation...


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


Incidental diagnosis of bilateral synovial lipomatosis in long standing knee osteoarthritis
Conclusion Though most cases of synovial lipomatosis occur de-novo it may be associated with a degenerative process. Possibly it occurs as a secondary process following a chronic joint disease like osteoarthritis. (Source: Human Pathology: Case Reports)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Education and Hypnosis for Treatment of Functional Gastrointestinal Disorders (FGIDs) in Pediatrics.
Authors: Mahler T Abstract FGIDs in children and adolescents (ROME III classification) have a significant impact on the daily functioning and quality of life. Often it is the pain that is one of the main contributors to the burden of functional dyspepsia, functional abdominal pain (syndrome), and irritable bowel syndrome. Current knowledge confirms that a number of integrated networks at cortical and subcortical sites are responsible for the experience of pain. From the work of Mayer and Tillisch (2011), mainly based on structural and functional magnetic resonance imaging and positron emission tomography, it has become clear that abdominal pain syndromes are disorders of the bi-directional mind-brain-gut interactions. In this multi-factorial bio-psycho-social model we recognize the...


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


It’s All in Your Head review – enduring mystery of psychosomatic illness
Neurologist Suzanne O’Sullivan’s excellent book reveals that medicine remains as much an art as a scienceSuzanne O’Sullivan qualified as a doctor in 1991. She is now a consultant at the National Hospital of Neurology and Neurosurgery in London. This, her first book, is an account of her experience over 20 years of the many conditions that exist in that much disputed no man’s land between psychological and physical illness. The patients she examines in these pages often have dramatic symptoms – blindness, paralysis, seizures, intense pain and chronic fatigue – but they are symptoms related to no identified disease or physical cause. By the time these patients come to O’Sullivan they have generally exhausted every scan and endoscopy the NHS can provide, as well as the patience ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Deep Brain Stimulation for Chronic Pain
Abstract Deep brain stimulation (DBS) is a commonly performed procedure and has been used for the treatment of chronic pain since the early 1970s. A review of the literature was performed utilizing the PubMed database evaluating the use of DBS in the treatment of various pain syndromes. Literature over the last 30 years was included with a focus on those articles in the last 10 years dealing with pain conditions with the highest success as well as the targets utilized for treatment. DBS carries favorable results for the treatment of chronic pain, especially when other methods have not been successful such as medications, conservative measures, and extracranial procedures. Various chronic pain conditions reported in the literature respond to DBS including failed back surgery syn...


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


Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy
Publication date: Available online 6 June 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Xu Yanbin , Chu Haikun , Ji Xiaofeng , Yang Wanshan , Liu Shuangping Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 relationship between subacromial bursa thickness on ultrasound and shoulder pain in open water endurance swimmers over time
Conclusions SAB thickness increases with increasing swimming training. Commonly, this increase is not correlated to pain, suggestive of a painless adaptive process. The significant correlation between pain and SAB thickness soon after an exacerbating event suggests that painful acute SAB thickening is a different entity to chronic, painless adaptive SAB thickening. These two entities can only be differentiated by clinical history and examination. (Source: Journal of Science and Medicine in Sport)


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


Modulation of nociceptive ion channels and receptors via protein-protein interactions- implications for pain relief.
Authors: Rouwette T, Avenali L, Sondermann J, Narayanan P, Gomez-Varela D, Schmidt M Abstract In the last two decades biomedical research has provided great insights into the molecular signatures underlying painful conditions. However, chronic pain still imposes substantial challenges to researchers, clinicians and patients alike. Under pathological conditions, pain therapeutics often lack efficacy and exhibit only minimal safety profiles, which can be largely attributed to the targeting of molecules with key physiological functions throughout the body. In light of these difficulties, the identification of molecules and associated protein complexes specifically involved in chronic pain states is of paramount importance for designing selective interventions. Ion channels and recepto...


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


The treatment of simple elbow dislocation in adults.
CONCLUSION: Early functional treatment is the evidence-based therapeutic standard for simple elbow dislocation. The past few years have seen further developments in surgery for simple elbow dislocation. Further study is needed to determine whether surgery for elbow dislocation with high-grade instability can prevent persistent pain, limitation of motion, and chronic instability. PMID: 26037467 [PubMed - in process] (Source: Deutsches Arzteblatt International)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Meaning-focused coping, pain, and affect: a diary study of hospitalized women with rheumatoid arthritis
Conclusions Findings indicated that meaning-focused coping can be a crucial strategy for keeping daily positive affect in the face of chronic pain and how this effect is modified by interindividual differences. Even if restricted to the specific context, it may inform an intervention for hospitalized women with rheumatoid arthritis. (Source: Quality of Life Research)


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


Action identification and meaning in life in chronic pain
Conclusion Chronic pain patients holding higher levels of action identification report a greater sense of meaning in life. Meaning in life is also associated with the amount of interference of behavioural activity. The anticipated relationship between action identification and interference was not observed. The present evidence suggests that interference and action identification contribute independently to a person's sense of meaning in life. (Source: Scandinavian Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Eurythmy therapy increases specific oscillations of heart rate variability
In this study, the simultaneous effects of two different EYT exercises on cardiac autonomic regulation as assessed by spectral analysis of heart rate variability (HRV) were investigated. Methods: Twenty healthy subjects (age: 29.1 ± 9.3 years, 13 female) performed two different EYT exercises (EYT-A and EYT-B) for 8 min. Each EYT exercise was compared against two matched control exercises: control exercise 1 (CE1-A and CE1-B) consisted of a repetition of the body movements of the EYT exercise but without guided imagery, control exercise 2 consisted of walking on the spot (CE2-A and CE2-B). Spectral power of HRV during each exercise was quantified on the basis of Holter ECG recordings. Results: During EYT-A the frequency of the peak oscillation in the very low frequency (VLF) band mat...


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


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


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


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


Medical evacuation for unrecognized abdominal wall pain: a case series.
CONCLUSION: This case series highlights the need for military physicians to be aware of abdominal wall pain. Early diagnosis of abdominal cutaneous nerve entrapment syndrome by eliciting Carnett's sign will limit symptom chronicity, avoid unnecessary testing, and even prevent medical evacuation. PMID: 25939119 [PubMed - in process] (Source: Military Medicine)


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


Proven Process client Flowonix Medical Inc. achieves FDA PMA Approval of Prometra II infusion device
MANSFIELD, MA – Proven Process Medical Devices, Inc., a global leader in the design, development, validation, and manufacture of Class II and Class III medical devices, announced today that its client Flowonix Medical Inc. has secured PMA-Supplemental approval from the FDA for its next-generation intrathecal infusion device, the Prometra® II system. Approval of this device, created with the assistance of Proven Process&#8217; design and manufacturing services, will enable Flowonix to proceed with product introduction in the coming months. The groundbreaking design for the Prometra II&#8217;s flow-activated valve was made possible in part by Proven Process&#8217; Concept-to-Customer approach which helped Flowonix achieve important milestones and approvals for a successful product introdu...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Intranasal drug delivery in neuropsychiatry: focus on intranasal ketamine for refractory depression.
This article examines the advantages and applications of INDD in neuropsychiatry; provides examples of test, experimental, and approved INDD treatments; and focuses especially on the potential of intranasal ketamine for the acute and maintenance therapy of refractory depression. PMID: 26035196 [PubMed - in process] (Source: Journal of Clinical Psychiatry)


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


Kinesiophobia in relation to physical activity in chronic neck pain.
CONCLUSIONS: Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men. PMID: 25812549 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Do psychological states associate with pain and disability in chronic neck pain patients?
CONCLUSIONS: It can be concluded that anxiety, depression and catastrophizing of patients with chronic neck pain is associated with their self-reported disability, whereas anxiety is also associated with their pain intensity. Anxiety and catastrophizing may be important predicting markers of patients' self-reported disability. PMID: 25736955 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


Effects of visual illusion and transcutaneous electrical nerve stimulation on neuropathic pain in patients with spinal cord injury: A randomised controlled cross-over trial.
CONCLUSION: TENS and VI therapies can be successfully used in clinical practice as an alternative treatment or as a supportive method separetely or together. PMID: 25502348 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Meta-analysis of randomized trials comparing fusion surgery to non-surgical treatment for discogenic chronic low back pain.
CONCLUSIONS: Fusion surgery was not superior to nonsurgical treatment in terms of changes in ODI scores for DLBP. Fusion surgery resulted in surgical complications. Longer follow-up observation is necessary regarding condition-specific disability, pain, and life satisfaction. PMID: 25467996 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


A brief intervention utilising visual feedback reduces pain and enhances tactile acuity in CLBP patients.
CONCLUSIONS: These findings imply that very simple feedback interventions without major technical requirements could be a valuable supplement to standard treatment in CLBP. PMID: 25391329 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Effect of trunk muscles training using a star excursion balance test grid on strength, endurance and disability in persons with chronic low back pain.
CONCLUSION: The results of our study show that core muscles strengthening using a SEBT grid are more effective than conventional programs. We hypothesize SEBT training to have a significant role in skill learning. We recommend SEBT grid training to be incorporated in the treatment planning of persons with CLBP. PMID: 25373742 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


Efficacy of dry needling for treatment of myofascial pain syndrome.
This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems. PMID: 25322743 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Sleep quality in patients with chronic low back pain: A cross-sectional study assesing its relations with pain, functional status and quality of life.
CONCLUSION: The sleep quality of patients with CLBP was worse compared to HCs, and there were positive relations between the sleep quality with pain and functional status. Also, the poor sleep quality had negative effect on the physical component of quality of life. PMID: 25322735 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


Discriminant analysis of neuromuscular variables in chronic low back pain.
CONCLUSION: Based on these findings, the clinical management of low back pain should consist of both resistance and strength training, particularly in the extensor muscles. PMID: 25171336 [PubMed - in process] (Source: Journal of Back and Musculoskeletal Rehabilitation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 comparison of mckenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial.
CONCLUSION: McKenzie therapy reduces pain, and disability, among subjects with chronic LBP. This study revealed that the McKenzie therapy is more effective than EPAs group. PMID: 25159291 [PubMed - in process] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


Effects of intra-articular application of pulsed radiofrequency on pain, functioning and quality of life in patients with advanced knee osteoarthritis.
CONCLUSION: It is possible to state that intra-articular PRF application is effective and safe for the pain treatment of patients with advanced knee OA. Therefore, we think that PRF application will be included in chronic pain treatment guidelines in the future with the increase in the number of future studies. PMID: 25061031 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


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


Health locus of control and self-efficacy predict back pain rehabilitation outcomes.
CONCLUSIONS: In addition to supporting the multiple benefits of multidisciplinary rehabilitation, this study suggests that pain-related self-efficacy and health locus of control may be valuable predictors of treatment benefit for chronic back pain patients. These results provide direction in screening for factors that may maximize the potential to benefit from multidisciplinary intervention for chronic back pain. PMID: 25328476 [PubMed - in process] (Source: Iowa orthopaedic journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


[Radiation synovectomy therapy combined with surgical synovectomy in chronic nonspecific synovitis of the knee joint].
CONCLUSION: Our study results showed that RS procedure combined with the surgical synovectomy is an effective and safe treatment method for the treatment of cases of chronic nonspecific synovitis which recurs despite medical treatment. PMID: 23441736 [PubMed - in process] (Source: Eklem Hastaliklari ve Cerrahisi)


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


Consumer Information on: Senza Spinal Cord Stimulation (SCS) System - P130022
The Senza SCS System (Senza System) is an implanted, rechargeable spinal cord stimulation system for the treatment of chronic pain of the trunk and/or limbs that is difficult to manage (intractable). (Source: Food and Drug Adminstration (FDA): CDRHNew)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


Treatment‐Limiting Complications of Percutaneous Spinal Cord Stimulator Implants: A Review of Eight Years of Experience From an Academic Center Database
ConclusionsSCS is an effective treatment for chronic noncancer pain. It is a minimally invasive procedure, safe, and with good long‐term outcomes. However, the surgical revision and explant rates are relatively high. As the use of SCS continues to grow, research into the causes of and risk factors for SCS‐related complications is paramount to decrease complication rates in the future. (Source: Neuromodulation: Technology at the Neural Interface)


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


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


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


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


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


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


Neuroendocrine and stress-related aspects of endometriosis.
In conclusion, endometriosis is a disease which affects reproductive and neuroendocrine functions with a great impact on women's health and quality of life. PMID: 25789593 [PubMed - as supplied by publisher] (Source: Neuroendocrinology Letters)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 knowledge and future prospects for SAPHO syndrome.
Authors: Kim C Abstract SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a complex disorder characterized by osteoarticular and cutaneous symptoms. Most patients experience bone pain and dermatologic manifestations. Diagnosis of SAPHO syndrome is based on exclusion of infectious arthritis and septic osteomyelitis with findings of hyperostosis or chronic recurrent multifocal osteomyelitis involving axial or peripheral skeleton, with or without skin manifestations. The pathophysiology of SAPHO is unclear, although several hypotheses exist. Some of these hypotheses have led to the ever growing treatment options of medications. Broad varieties of medications have been used, such as nonsteroidal anti-inflammatory drugs and disease-modifying agents. New therapeu...


Bioavailability and pharmacokinetic profile of a newly-developed twice-a-day sustained-release paracetamol formulation.
CONCLUSIONS: The new SR formulation was well absorbed, with more than 90% relative bioavailability as compared to the currently marketed IR and ER products and better sustained-release PK characteristics, which make it suitable for twice-daily paracetamol treatment. PMID: 25500485 [PubMed - in process] (Source: International Journal of Clinical Pharmacology and Therapeutics)


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


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


Chronic Pain in a Biracial Cohort of Young Women.
Authors: Plesh O, Gansky SA, Curtis DA Abstract This is a longitudinal study of a large US biracial community cohort of 732 young women - 50% African-American and 50% Caucasian - specifically investigating incidence, remission, and progression of, as well as factors associated with common chronic pains (back, head, face, chest and abdomen). The results show back, head and abdominal pains were the most common, severe and persistent pains. Facial pain, although less common and severe, was the only pain presenting significant racial differences with Caucasians having higher prevalence, incidence and persistence; incidence per 1000 person-years was 58 for Caucasians and 18 for African-Americans while remission per 1000 person-years was 107 for Caucasians and 247 for African-Americans (...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


The Role of Suggestions in Hypnosis for Chronic Pain: A Review of the Literature.
Authors: Dillworth T, Jensen MP Abstract Several controlled trials have demonstrated that hypnosis is an efficacious treatment for chronic pain. However, less attention has been given to the specific procedures and suggestions used in hypnotic treatments in research. The goal of this review was to address the issue of differences in the content of hypnotic suggestions, including pain management suggestions, non-pain related suggestions, and posthypnotic suggestions, in the context of published clinical trials of hypnosis for chronic pain management. This review focused on the types of suggestions used in twenty five studies comparing hypnosis to active treatments (e.g., relaxation, biofeedback), non-treatment control groups (e.g., standard care/wait-list control, supportive attenti...


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


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


Epigenetic Control of Pannexin-1 Expression in Chronic Pain [Neurobiology]
In this study, we determined the epigenetic mechanism involved in increased Panx1 expression in the DRG after nerve injury. Spinal nerve ligation in rats significantly increased the mRNA and protein levels of Panx1 in the DRG but not in the spinal cord. Immunocytochemical labeling showed that Panx1 was primarily expressed in a subset of medium and large DRG neurons in control rats and that nerve injury markedly increased the number of Panx1-immunoreactive DRG neurons. Nerve injury significantly increased the enrichment of two activating histone marks (H3K4me2 and H3K9ac) and decreased the occupancy of two repressive histone marks (H3K9me2 and H3K27me3) around the promoter region of Panx1 in the DRG. However, nerve injury had no effect on the DNA methylation level around the Panx1 promoter ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study
Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. A posterior approach to these procedures under computed tomography guidance has been reported. Here, we report the clinical outcomes of 42 patients with chronic cervical radicular pain (CCRP) treated with a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. (Source: Journal of Clinical Anesthesia)


The mu opioid receptor: A new target for cancer therapy?
Mu opioids are among the most widely used drugs for patients with cancer with both acute and chronic pain as well as in the perioperative period. Several retrospective studies have suggested that opioid use might promote tumor progression and as a result negatively impact survival in patients with advanced cancer; however, in the absence of appropriate prospective validation, any changes in recommendations for opioid use are not warranted. In this review, the authors present preclinical and clinical data that support their hypothesis that the mu opioid receptor is a potential target for cancer therapy because of its plausible role in tumor progression. The authors also propose the hypothesis that peripheral opioid antagonists such as methylnaltrexone, which reverses the peripheral effects ...


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


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


Chronic opioid induced constipation in patients with nonmalignant pain: challenges and opportunities
With the recent introduction and approval of medications directed at the treatment of opioid induced constipation (OIC) in patients with nonmalignant pain, there is increased interest and understanding of the unmet need and opportunities to enhance patient management. The high incidence of OIC is associated with rapid increase of narcotic analgesic prescriptions for nonmalignant chronic pain. This review addresses briefly the mechanisms of action of opioids that lead to OIC, the differential tolerance of gastrointestinal organs to the effects of opioids, the size and scope of the problem, the definition and outcome measures for OIC, current differential diagnosis and management algorithms, and the pharmacology and efficacy of treatments for OIC in patients with nonmalignant pain. (Source: ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Diagnostic Value of Clinical Cervical Spine Tests in Patients With Cervicogenic Somatic Tinnitus.
CONCLUSIONS: Clinical cervical spine tests can support the diagnostic process of CST. An NBQ score &lt;14 points and the absence of trigger points can help to exclude CST. In contrast, a positive manual rotation and AST can help to include CST. We advise to include these test in a multidisciplinary assessment of patients with suspected CST. PMID: 26045606 [PubMed - as supplied by publisher] (Source: Physical Therapy)


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


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


Recommendations for the management of sickle cell disease in South Africa.
Authors: Alli NA, Patel M, Alli HD, Bassa F, Coetzee MJ, Davidson A, Essop MR, Lakha A, Louw VJ, Novitzky N, Philip V, Poole JE, Wainwright RD Abstract The spectrum of sickle cell disease (SCD) encompasses a heterogeneous group of disorders that include: (I) homozygous SCD (HbSS), also referred to as sickle cell anaemia; (ii) heterozygous SCD (HbAS), also referred to as sickle cell trait; and (iii) compound heterozygous states such as HbSC disease, HbSβ thalassaemia, etc. Homozygous or compound heterozygous SCD patients manifest with clinical disease of varying severity that is influenced by biological and environmental factors, whereas subject with sickle cell trait are largely asymptomatic. SCD is characterized by vaso-occlusive episodes that result in tissue ischaemia and pain ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study.
CONCLUSIONS: psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function. PMID: 26019683 [PubMed - in process] (Source: International Journal of Medical Sciences)


Analysis of efficacy differences between caudal and lumbar interlaminar epidural injections in chronic lumbar axial discogenic pain: local anesthetic alone vs. local combined with steroids.
CONCLUSION: This assessment shows that in patients with axial or discogenic pain in the lumbar spine after excluding facet joint and SI Joint pain, epidural injections of local anesthetic by the caudal or lumbar interlaminar approach may be effective in managing chronic low back pain with a potential superiority for a lumbar interlaminar approach over a caudal approach. PMID: 25678838 [PubMed - in process] (Source: International Journal of Medical Sciences)


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


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


Demyelinating hypertrophic inferior alveolar nerve mimicking a nerve tumor.
Authors: Fujita H, Kokubun N, Sada T, Nagashima T, Komagamine T, Kawabe K, Hirata K Abstract We herein report a patient with demyelinating inferior alveolar nerve hypertrophy, which was initially suspected to have a nerve tumor. A 39-year-old woman with childhood-onset polyneuropathy presented with tooth pain and visited a dental clinic. An X-ray examination of the mandible revealed enlargement of the mandibular canal, and a nerve tumor was suspected. CT scan and MRI showed hypertrophy of the inferior alveolar nerve along its entire length. We diagnosed the patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which was supported by the spontaneous recovery reported in her childhood, the results from a nerve conduction study and MRI data. CIDP should be con...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Cherry juice targets antioxidant potential and pain relief.
This article reviews the antioxidant and anti-inflammatory effects of tart cherries on prevention, treatment, and recovery of soft tissue injury and pain. PMID: 23075558 [PubMed - indexed for MEDLINE] (Source: Medicine and Sport Science)


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


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


Analysis of the effects of micronised purified flavonoid fraction versus placebo on symptoms and quality of life in patients suffering from chronic venous disease: from a prospective randomised trial.
CONCLUSIONS: A 4-month treatment with MPFF significantly reduced leg pain/heaviness and improved QOL when compared to placebo and was well tolerated. PMID: 25972136 [PubMed - as supplied by publisher] (Source: International Angiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Electro-acupuncture for treatment of knee pain from osteoarthritis and the possible endocrinology changes: a study protocol for a randomized controlled trial
This study is a placebo-controlled, randomized, double-blind, parallel design trial. One hundred sixty out-patients who are more than 50 years old and who have osteoarthritis of the knee will be recruited from the island of Mallorca, Spain. Each participant will be randomly placed into one of two groups: (sham) electro-acupuncture non-insertion technique and real electro-acupuncture.Acupuncture treatments will be the Traditional Chinese Medicine type. The patients will be evaluated after a period of 1 month (with two weekly sessions), 3 months (with one monthly session), 6 months (with one session every 45 days), and 1 year later with follow-up sessions at the end of the study (with one session every 2 months).The primary outcomes will be based on the observed changes from the baseline of ...


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


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


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


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


A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain
To assess the effectiveness of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain (CPP). (Source: International Journal of Gynaecology and Obstetrics)


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


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


Nerve Growth Factor Controls Development and Persistence of Experimental Pulmonary Hypertension.
CONCLUSIONS: Our study provide evidence for critical roles of NGF in PH. Owing the recent development of anti-NGF blocking antibodies as a possible new pain treatment, such therapeutic strategy of NGF inhibition may be of interest in PH. PMID: 26039706 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 morbidity after multivisceral resection for retroperitoneal sarcoma.
CONCLUSION: Severe chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long-term renal function is not significantly impaired when nephrectomy is performed. PMID: 26041724 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)


The Local and Systemic Actions of Duloxetine in Allodynia and Hyperalgesia Using a Rat Skin Incision Pain Model.
CONCLUSIONS: Our results demonstrate that duloxetine can act as a local anesthetic and an analgesic drug via both local and systemic applications. Because duloxetine inhibits neuronal Na currents with high potency, it may exert its antihyperalgesic effects through inhibition of the spontaneous nerve impulses that result from peripheral injury, encompassing its actions on multiple central nervous system and peripheral targets. PMID: 26049779 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)


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


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


New care measures and their impact on pain medicine: One pain specialist's perspective.
Authors: Pergolizzi JV Abstract Value-based purchasing (VBP) goes into effect this year and it links the quality of care to payments for care. Starting in fiscal year 2013, the Centers for Medicare and Medicaid Services reduces all inpatient prospective payment system reimbursements by 1%. This money then can be returned to hospitals in the form of a bonus through VBP. Value-based purchasing holds hospitals accountable for both cost and quality. With VBP, hospitals get a score that is based on the process of care, the outcomes, and patient-centeredness. This means that reimbursements in health care, which keep hospitals in business, are transitioning from "volume of services" to VBP. Although VBP sounds like a great idea, particularly to politicians in Washington tasked with managi...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 a Medial Collateral Ligament Sprain Using Prolotherapy: A Case Study.
Authors: Ada AM, Yavuz F Abstract Prolotherapy is effective in treating refractory tendinopathies, but inadequate clinical evidence exists to recommend its use as a treatment for acute or chronic, medial collateral ligament (MCL) injuries. The current case study documents an illustrative case of a rugby player who had a grade 2 sprain of the MCL and shows the clinical and radiological outcomes following injections of 15% dextrose combined with 0.2% lidocaine. In his case, the prolotherapy, together with an exercise therapy, lasted 3 wk. At the end of the 3 wk, the patient was pain free, with a full range of motion (ROM), and he was able to perform all rugby-specific movements. The mean duration for recovery with conservative treatment of isolated, complete tears of the MCL is norma...


Internal Hernia After Laparoscopic Antecolic Roux-en-Y Gastric Bypass
Conclusion IH is a serious and potentially fatal complication of RYGB. Presentation can vary from chronic abdominal pain to bowel necrosis. CT is helpful in providing diagnosis; however, careful attention to the specific signs of small bowel volvulus, such as mesenteric swirl sign, should be given. IH should be considered in RYGB patients who present with even vague symptoms. (Source: Obesity Surgery)


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


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


Health Tip: Sleeping With Chronic Pain
Title: Health Tip: Sleeping With Chronic PainCategory: Health NewsCreated: 6/2/2015 12:00:00 AMLast Editorial Review: 6/2/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Distribution of naloxone for overdose prevention to chronic pain patients
Publication date: Available online 27 May 2015 Source:Preventive Medicine Author(s): Marion A. Coe , Sharon L. Walsh In this commentary, we reflect on the growing opioid overdose epidemic and propose that chronic pain patients prescribed opioids are contributing to growing mortality rates. We advocate for expanding naloxone access and overdose prevention training, which has historically been directed when available to injection drug users, to chronic pain patients who may be at high risk for accidental opioid overdose. (Source: Preventive Medicine)


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


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


Assessment of health-related quality of life in end-stage chronic obstructive pulmonary disease and non-small-cell lung cancer patients in Serbia.
Authors: Maric D, Jovanovic D, Nagorni-Obradovic L, Stjepanovic M, Kisic-Tepavcevic D, Pekmezovic T Abstract OBJECTIVE: Under conditions in which palliative care has not yet become part of clinical practice, the differences in palliative care needs between patients with cancer and other life-limiting diseases can yield knowledge that will be very valuable for future planning. The aim of our investigation was to compare health-related quality of life (HRQoL) for patients with end-stage chronic obstructive pulmonary disease (COPD) and those with non-small-cell lung cancer (NSCLC) in Belgrade, Serbia. We also evaluated the influence of demographic, socioeconomic, and clinical factors on HRQoL for both patient groups. METHOD: This cross-sectional study included 100 NSCLC patients (...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


Commercial Driver Medical Examinations: Prevalence of Obesity, Comorbidities, and Certification Outcomes
Conclusions: Obesity is related to multiple medical factors as well as increasing numbers of conditions that limit driving certification. (Source: Journal of Occupational and Environmental Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


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


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


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


A New Integrated Clinical-Biohumoral Model to Predict Functionally Significant Coronary Artery Disease in Patients With Chronic Chest Pain
Conclusions The Genders model has a low accuracy for predicting functionally significant CAD. A new model integrating HDL cholesterol, AST, and hs-CRP levels with common clinical variables has a higher predictive accuracy for functionally significant CAD and allows the reclassification of patients from an intermediate/high to a low pretest likelihood of CAD. (Source: Canadian Journal of Cardiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


The day‐to‐day concurrence of bodily complaints and affect in patients with severe somatoform disorder
Based on the concept of somatization, psychological distress can be experienced as symptoms of physical illness. This suggests a close‐fitting intra‐individual association between bodily complaints and mood in patients with somatoform disorder (SFD). The contemporaneous day‐to‐day complaints‐mood association was investigated in patients with severe chronic SFD using an ecological momentary assessment (EMA) design. Eleven patients, who had recently received specialized tertiary care treatment for severe chronic SFD, kept an online electronic diary for four consecutive weeks. They were prompted at intervals throughout the day to complete questions on their momentary primary symptoms (pain and fatigue), and mood state (negative and positive). For each measure, day‐mean aggregated ...


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


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


Physical Examination of the Wrist: Useful Provocative Maneuvers
Chronic wrist pain resulting from partial interosseous ligament injury remains a diagnostic dilemma for many hand and orthopedic surgeons. Overuse of costly diagnostic studies including magnetic resonance imaging, computed tomography scans, and bone scans can be further frustrating to the clinician because of their inconsistent specificity and reliability in these cases. Physical diagnosis is an effective (and underused) means of establishing a working diagnosis of partial ligament injury to the wrist. (Source: The Journal of Hand Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


44-Year-Old Man With Abdominal Pain, Fever, and Bloody Diarrhea
A 44-year-old man with a history of ulcerative colitis since age 20 years presented with acute-on-chronic epigastric abdominal pain associated with new-onset low-grade fever, chills, and night sweats of 2- to 3-months’ duration. Despite multiple immunosuppressive regimens, including oral prednisone, azathioprine, sulfasalazine, and methotrexate, his ulcerative colitis symptoms had never been fully controlled. Approximately 18 months before the current presentation, infliximab had been prescribed. (Source: Mayo Clinic Proceedings)


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


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


Knee Pain and a Prior Injury Are Associated with Increased Risk of a New Knee Injury: Data from the Osteoarthritis Initiative.
CONCLUSION: Knee pain and a history of injury are associated with new knee injuries. It may be beneficial for individuals with knee pain or a history of injury to participate in injury prevention programs. PMID: 26034152 [PubMed - as supplied by publisher] (Source: J Rheumatol)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


Long‐term morbidity after multivisceral resection for retroperitoneal sarcoma
ConclusionSevere chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long‐term renal function is not significantly impaired when nephrectomy is performed. (Source: British Journal of Surgery)


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


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


The Editors' Choice
Eosinophilic esophagitis is an inflammation of the esophagus. Symptoms of this chronic (lifelong) allergic inflammatory disease include difficulty in swallowing food and abdominal pain. Evaluating treatments currently involves looking at changes in the tissues and cells of the esophagus. However, to improve both clinical outcomes and patients' quality of life, there is a need to objectively measure and consider patients' symptoms and how they feel. Using a questionnaire called the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS v2.0), Martin et al (p 1519) showed that categories of questions assessing related symptoms corresponded with clinical and biologic features of pediatric eosinophilic esophagitis. (Source: Journal of Allergy and Clinical Immunology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


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


The influence of age and gender on venous symptomatology. An epidemiological survey in Belgium and Luxembourg.
CONCLUSION: CVD is a very common progressive disease with age as a major risk factor. Increasing age results in a higher C-classification, more symptoms, and a lower GIS score (quality of life). Female gender interacts significantly with age and results in a more advanced stage of CVD. PMID: 26036248 [PubMed - as supplied by publisher] (Source: Phlebology)


Deep brain stimulation of the dorsal anterior cingulate cortex for the treatment of chronic neuropathic pain.
Authors: Russo JF, Sheth SA Abstract Chronic neuropathic pain is estimated to affect 3%-4.5% of the worldwide population. It is associated with significant loss of productive time, withdrawal from the workforce, development of mood disorders such as depression and anxiety, and disruption of family and social life. Current medical therapeutics often fail to adequately treat chronic neuropathic pain. Deep brain stimulation (DBS) targeting subcortical structures such as the periaqueductal gray, the ventral posterior lateral and medial thalamic nuclei, and the internal capsule has been investigated for the relief of refractory neuropathic pain over the past 3 decades. Recent work has identified the dorsal anterior cingulate cortex (dACC) as a new potential neuromodulation target given ...


IL-1 receptor antagonist improves morphine and buprenorphine efficacy in a rat neuropathic pain model.
Authors: Pilat D, Rojewska E, Jurga AM, Piotrowska A, Makuch W, Przewlocka B, Mika J Abstract An interesting research and therapeutic problem is the reduced beneficial efficacy of opioids in the treatment of neuropathic pain. The present study sought to investigate the potential role of IL-1 family members in this phenomenon. We studied the time course of changes in IL-1alpha, IL-1beta, IL-1 receptor type I and IL-1 receptor antagonist mRNA and protein levels experienced by rats after chronic constriction injury (CCI) of the sciatic nerve using qRT-PCR and Western blot analysis. In CCI-exposed rats, spinal levels of IL-1alpha mRNA were slightly downregulated on the 7(th) day, and protein levels were not changed on the 7(th) and 14(th) days. Levels of IL-1 receptor antagonist and IL...


Characteristics of acupuncture users among internal medicine patients in Germany.
CONCLUSION: Acupuncture was used by more than half of internal medicine patients. Prevalence and rated helpfulness of acupuncture use was associated with the patients' medical condition, sociodemography, and health locus of control. PMID: 26051578 [PubMed - in process] (Source: Complementary Therapies in Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.
CONCLUSIONS: Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. PMID: 26051577 [PubMed - in process] (Source: Complementary Therapies in Medicine)


Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes.
CONCLUSIONS: Prolotherapy resulted in safe, significant, progressive improvement of knee pain, function and stiffness scores among most participants through a mean follow-up of 2.5 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care. PMID: 26051574 [PubMed - in process] (Source: Complementary Therapies in Medicine)


The effect of an acupressure backrest on pain and disability in office workers with chronic low back pain: A randomized, controlled study and patients' preferences.
CONCLUSION: These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect. PMID: 26051569 [PubMed - in process] (Source: Complementary Therapies in Medicine)


Chronic generalized musculoskeletal pain, vitamin D levels, and the association with exocrine pancreatic insufficiency
Introduction: Chronic generalized musculoskeletal pain (CGMP), which includes fibromyalgia, is one of the most frequent reasons patients attend the rehabilitation service. Vitamin D deficiency is a habitual finding in CGMP, and even in fibromyalgia. (Source: Pancreatology)


Chronic pancreatitis. Multicentre prospective data collection and analysis by the Hungarian Pancreatic Study Group
Introduction: Chronic pancreatitis is an inflammatory disease associates with structural and functional damage of the pancreas causing pain, maldigestion and weight loss worsening the quality of life. (Source: Pancreatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 of a patient-reported outcome measure in pancreatic exocrine insufficiency (PEI)
Introduction: Patients with chronic pancreatitis (CP) and cystic fibrosis (CF) often experience symptoms of Pancreatic Exocrine Insufficiency (PEI). PEI increases the risk of malnutrition which is associated with comorbidities and increased mortality. Clinicians recognise steatorrhoea, diarrhoea and abdominal pain as symptoms of PEI, but recognition of other symptoms is poor. A validated Patient-Reported Outcome (PRO) measure for PEI symptoms is lacking. (Source: Pancreatology)


Effectiveness of Tapentadol Prolonged Release (PR) Compared with Oxycodone/Naloxone PR for the Management of Severe Chronic Low Back Pain with a Neuropathic Component: A Randomized, Controlled, Open‐Label, Phase 3b/4 Study
ConclusionsThe study was formally shown to be positive and demonstrated, in the primary effectiveness endpoint, the noninferiority for tapentadol PR vs. oxycodone/naloxone PR. The effectiveness of tapentadol PR was superior to that of oxycodone/naloxone PR by means of clinical relevance and statistical significance (confirmatory evidence of superiority). Tapentadol PR was associated with significantly greater improvements in neuropathic pain‐related symptoms and global health status than oxycodone/naloxone PR and with a significantly better gastrointestinal tolerability profile. Tapentadol PR may be considered a first‐line option for managing severe chronic low back pain with a neuropathic pain component. (Source: Pain Practice)


Characterization of facial pain associated with chronic rhinosinusitis using validated pain evaluation instruments
ConclusionSubjects with CRS have a greater burden of facial pain relative to control subjects across several standardized pain measures. Further, facial pain in CRS significantly correlated to quality of life and CRS‐specific disease severity measures. Study across larger cohorts using standardized pain measures is warranted to clarify the association of facial pain with CRS. (Source: International Forum of Allergy and Rhinology)


Occupational Therapy Interventions in Chronic Pain – A Systematic Review
Abstract The use of interventions based on the best available evidence in occupational therapy is essential, and evaluation of research is part of an evidence‐based practice. The aim of this study was to assess the quality of studies describing and evaluating the effects of occupational therapy interventions on chronic pain. A systematic review of studies with diverse designs was carried out. A quality assessment was conducted, and the level of evidence was defined using the Research Pyramid Model. Of 19 included studies, three received the highest evidence level, and three were considered to be of high quality. The clinical recommendations that can be derived from this study are the following: occupational therapy interventions should start from the identified needs of the person with c...


H19 lncRNA alters stromal cell growth via IGF signaling in the endometrium of women with endometriosis
Abstract Endometriosis affects approximately 15% of reproductive aged women and is associated with chronic pelvic pain and infertility. However, the molecular mechanisms by which endometriosis impacts fertility are poorly understood. The developmentally regulated, imprinted H19 long noncoding RNA (lncRNA) functions to reduce the bioavailability of microRNA let‐7 by acting as a molecular sponge. Here we report that H19 expression is significantly decreased in the eutopic endometrium of women with endometriosis as compared to normal controls. We show that decreased H19 increases let‐7 activity, which in turn inhibits Igf1r expression at the post‐transcriptional level, thereby contributing to reduced proliferation of endometrial stromal cells. We propose that perturbation of this newly ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Editorial Comment
The complex network of etiologic and pathologic factors involving the chronic pelvic pain syndrome makes the diagnosis and treatment of this pathologic condition one of the most difficult challenge in current urologic daily clinical practice. Different conditions such as chronic prostatitis–chronic pelvic pain syndrome category III according the National Institutes of Health classification, interstitial cystitis, and painful bladder syndrome should be included in the list of diseases with multifactorial mechanisms of physiopathology and development, thus exposed to unsuccessful treatments in the absence of multimodal therapies. (Source: Urology)


Widespread Psychosocial Difficulties in Men and Women With Urologic Chronic Pelvic Pain Syndromes: Case-control Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network
To determine the extent, severity, and sex differences of psychosocial deficits in men and women with urologic chronic pelvic pain syndromes (UCPPS), which in the past have been considered separate bladder (interstitial cystitis–painful bladder syndrome) and prostate (chronic prostatitis–chronic pelvic pain syndrome) disorders. Evaluations of men and women separately suggest UCPPS is associated with increased anxiety and depression. However, studies directly testing deficits in broader psychosocial domains such as cognitive processes, intimate relationships, and trauma history, or tests of sex differences in the pattern of difficulties associated with UCPPS have not been performed. (Source: Urology)


Animal Models of Urologic Chronic Pelvic Pain Syndromes: Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network
To describe the approach taken by the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network investigators to advance the utility of urologic chronic pelvic pain syndromes (UCPPS) animal models. (Source: Urology)


Safety and performance evaluation of a next‐generation antimicrobial dressing in patients with chronic venous leg ulcers
The objective of this study was to investigate the safety and performance of AQUACEL™ Ag+ dressing, a wound dressing containing a combination of anti‐biofilm and antimicrobial agents, in the management of chronic wounds. Patients (n = 42) with venous leg ulcers exhibiting signs of clinical infection were treated for 4 weeks with AQUACEL™ Ag+ dressing, followed by management with AQUACEL™ wound dressings for 4 weeks. Wound progression, wound size, ulcer pain and clinical evolution of the wound were assessed for up to 8 weeks. Adverse events were recorded throughout the study. AQUACEL™ Ag+ dressing had an acceptable safety profile, with only one patient discontinuing from the study, because of a non‐treatment‐related adverse event. After 8 weeks, substantial wound improvements ...


Is the Quebec provincial administrative database a valid source for research on chronic non‐cancer pain?
ConclusionsOur study provides evidence supporting the value of the RAMQ administrative database for conducting research on certain types of chronic pain disorders including back and neck pain. Users should, however, be cautious about the limitations of this database for studying other types of chronic pain syndromes such as complex regional pain syndrome, fibromyalgia, and neuropathic pain. Copyright © 2015 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain in HIV‐Infected Patients: Relationship to Depression, Substance Use, and Mental Health and Pain Treatment
ConclusionsDespite pharmacologic treatment, moderate‐severe chronic pain and elevated depression symptoms are common among HIV‐infected patients and frequently co‐occur. (Source: Pain Medicine)


Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.
Authors: Tesher MS Abstract A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the ...


[Work ability in cancer patients: Six years assessment after diagnosis in a cohort of 153 workers].
CONCLUSIONS: Six years after returning to work, one employee out of two is still working in the same company. Far to disappear, the identified difficulties two years after the diagnosis are still present, long time after stopping the treatments. A successfull return to work needs an important support from both the company and the co-workers. PMID: 26118877 [PubMed - in process] (Source: Bulletin du Cancer)


Endometriosis: A Culprit for Chronic Pelvic Pain.
Authors: Seth N PMID: 26126387 [PubMed - in process] (Source: The Alabama Nurse)


Parents can be 'too nice' to their children, neurologist warns
Psychosomatic conditions like chronic pain, seizures or even paralysis are not only triggered by trauma but also can too much love and attention (Source: Telegraph Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Abdominal Syndrome Due to Nervous Compression. Study of 100 Cases and Proposed Diagnostic-Therapeutic Algorithm
Conclusion Thoracic disc protrusion, as well as having a non-negligible incidence, is often associated with a digestive-urologic clinical syndrome, and this factor should be taken into account in all cases of chronic abdominal pain and other digestive-urologic symptoms when standard tests are negative, so that appropriate treatment may be given. (Source: Journal of Gastrointestinal Surgery)


Modified laparoscopic intraperitoneal onlay mesh in complicated inguinal hernia surgery
Conclusions The optimal treatment of these relatively rare and complicated patients is still an issue of debate, but in the light of the present study it seems that the IPOM technique is equal to or has a better profile compared to Lichtenstein in terms of re-recurrence and chronic pain. We believe that the IPOM technique has a place in the treatment of these patients. (Source: Hernia)


Importance and utility of laparoscopic inguinal exploration in cases with chronic groin pain
(Source: Hernia)


Correction
In the article by O'Connor et al, Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis, published in the April issue (Arch Phys Med Rehabil 2015;96:724-34), George D. Baxter's degree was incorrect. The correct degree is DPhil. (Source: Archives of Physical Medicine and Rehabilitation)


Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain
Abstract Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral and central pain mechanisms are not fully understood, and safe and efficient analgesic drugs are not available. The pain associated with joint pain is highly individual, and features from radiological imaging have not demonstrated robust associations with the pain manifestations. In recent years, a variety of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater unders...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Easy to Harm, Hard to Heal: Patient Views About the Back
Conclusion. Negative assumptions about the back made by those with LBP may affect information processing during an episode of pain. This may result in attentional bias toward information indicating that the spine is vulnerable, an injury is serious, or the outcome will be poor. Approaching consultations with this understanding may assist clinicians to have a positive influence on beliefs. Level of Evidence: 3 (Source: Spine)


The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care
Discussion: The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs.Forsch Komplementmed (Source: Research in Complementary Medicine)


Treatment patterns, healthcare utilization, and costs of chronic opioid treatment for non-cancer pain in the United States.
CONCLUSIONS: These results demonstrated that healthcare resource utilization and costs increased during the first 6 months following clinical scenarios that necessitated opioid initiation and subsequently declined, suggesting the need to monitor patients beyond the acute care period. PMID: 26014310 [PubMed - in process] (Source: The American Journal of Managed Care)


A systematic review of the outcomes reported in multimodal pain therapy for chronic pain
ConclusionsThe current lack of standardization of outcome domains in MPT studies hinders to readily compare interventions from different trials and is a barrier towards evidence‐based decision making. Based on these results, the development of a core outcome set of domains for MPT has been initiated. (Source: European Journal of Pain)


Hacking The Nervous System
(Photo: © Job Boot) One nerve connects your vital organs, sensing and shaping your health. If we learn to control it, the future of medicine will be electric.When Maria Vrind, a former gymnast from Volendam in the Netherlands, found that the only way she could put her socks on in the morning was to lie on her back with her feet in the air, she had to accept that things had reached a crisis point. “I had become so stiff I couldn’t stand up,” she says. “It was a great shock because I’m such an active person.”It was 1993. Vrind was in her late 40s and working two jobs, athletics coach and a carer for disabled people, but her condition now began taking over her life. “I had to stop my jobs and look for another one as I became increasingly disabled myself.” By the time she w...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Variations in patient-reported physical health between cardiac and musculoskeletal diseases: systematic review and meta-analysis of population-based studies
We examined a cardiovascular disease spectrum which consisted of hypertension, ischaemic heart disease and heart failure, and a musculoskeletal disease spectrum of lower back pain, osteoarthritis and rheumatoid arthritis. Using Medline, EMBASE and CINAHL databases, articles which had examined these morbidities and used either the SF-12 or SF-36 in general or primary care populations were selected; data was extracted independently by three reviewers. Study characteristics were described and the mean physical component summary scores of the SF-12 or SF-36 was analysed by disease, using random-effects meta-analysis. The association between disease and physical health (mean physical component summary scores) was assessed using multilevel meta-regression analysis, adjusting for age, health sett...


MTOR, a New potential target for chronic pain and Opioid-induced tolerance and hyperalgesia
Chronic pain is a major public health problem with limited treatment options. Opioids remain a routine treatment for chronic pain, but extended exposure to opioid therapy can produce opioid tolerance and hyperalgesia. Although the mechanisms underlying chronic pain, opioid-induced tolerance, and opioid-induced hyperalgesia remain to be uncovered, mammalian target of rapamycin (mTOR) is involved in these disorders. The mTOR complex 1 and its triggered protein translation are required for the initiation and maintenance of chronic pain (including cancer pain) and opioid-induced tolerance/hyperalgesia. Given that mTOR inhibitors are FDA-approved drugs and an mTOR inhibitor is approved for treatment of several cancers, these findings suggest that mTOR inhibitors will likely have multiple clinic...


[Psychological assessment and psychotherapy for chronic pain in the elderly].
Authors: Mattenklodt P, Leonhardt C Abstract Systematic reviews of psychosocial assessment and effectiveness of psychotherapy for chronic pain syndromes in older patients are rare. However, it is of particular importance to consider the psychosocial aspects of elderly people with chronic pain. This narrative review describes recommended German-language assessments of the psychosocial dimensions of pain and summarizes existing studies of psychological therapy approaches for chronic pain in old age. Effective psychometric instruments are available for the assessment of cognitive function, pain-specific attitudes, depression, fear of falling, interpersonal processes and social activities, pain management, pain acceptance, disability, psychological well-being, and quality of life. Furt...


[Chronic myofacial pain : Reduced pain through psychoeducation and physiotherapy].
CONCLUSION: The results show the necessity of early identification of patients with severe pain chronification and the need for psychological pain therapy. PMID: 26024643 [PubMed - as supplied by publisher] (Source: Schmerz)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis.
CONCLUSION: There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required. PMID: 26009534 [PubMed - in process] (Source: The British Journal of General Practice)


Safety and efficacy of oxycodone/naloxone vs. oxycodone vs. morphine for the treatment of chronic low back pain: results of a 12 week prospective, randomized, open-label blinded endpoint streamlined study with prolonged-release preparations
Current Medical Research & Opinion, Ahead of Print. (Source: Current Medical Research and Opinion)


Chronic venous disease and venous leg ulcers: An evidence-based update
Chronic venous disease (CVD) is a complex chronic vascular condition with multifaceted primary and secondary etiologies leading to structural and functional changes in veins and valves and blood flow of the lower legs. As a consequence, a spectrum of clinical manifestations arise, ranging from symptoms of mild leg heaviness and achiness to debilitating pain, and signs of skin changes, such as eczema and hemosiderosis, to nonhealing, heavily draining venous leg ulcers (VLUs). Triggers such as trauma to the skin are responsible for a large majority of VLU recurrences. (Source: Journal of Vascular Nursing)


Unravelling nocebo effect: the mediating effect of anxiety between anticipation and pain at wound dressing change
ConclusionAnticipation of pain triggers anxiety that can lead to increased pain. Relevance to clinical practiceThere is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience. (Source: Journal of Clinical Nursing)


Inflammatory Claims About Inflammation
We all appreciate the elegance of simple solutions to complex problems. But we know too that simplicity can often masquerade as truth, hiding a more nuanced reality. Such is the case with inflammation, where pseudoscience, exaggerated claims, false promises, and dangerous oversimplification have dominated for too long. Here is a typical missive: "Inflammation controls our lives. Have you or a loved one dealt with pain, obesity, ADD/ADHD, peripheral neuropathy, diabetes, heart disease, stroke, migraines, thyroid issues, dental issues, or cancer? If you answered yes to any of these disorders you are dealing with inflammation." Well, no, inflammation does not control our lives. Like many others, this author claims inflammation is responsible for a huge range of maladies, ranging from Alzhei...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prostanoids and NSAIDs in Cardiovascular Biology and Disease
Abstract Prostanoids and related arachidonic acid derivatives are important physiologic modulators in arteries, as well as mediators of inflammation, hemostasis, and cell proliferation. Their participation in atherosclerosis and in acute thrombotic events is complex, as demonstrated by untoward cardiovascular (CV) effects associated with clinical use of inhibitors of prostaglandin synthesis for treatment of chronic pain, inflammatory states, or cancer prophylaxis. Newer understanding of the pathophysiology of atherosclerosis and the pharmacology of prostanoids promises potential resolution of current problems resulting from the hazards of available prostanoid-altering drugs. (Source: Current Atherosclerosis Reports)


The effect of changing movement and posture using motion-sensor biofeedback, versus guidelines-based care, on the clinical outcomes of people with sub-acute or chronic low back pain-a multicentre, cluster-randomised, placebo-controlled, pilot trial
Conclusions: Individualised movement retraining using motion-sensor biofeedback resulted in significant and sustained improvements in pain and activity limitation that persisted after treatment finished. This pilot trial also refined the procedures and sample size requirements for a fully powered RCT.This trial (Australian New Zealand Clinical Trials Registry NCT01572779) was equally funded by dorsaVi P/L and the Victorian State Government. (Source: BMC Musculoskeletal Disorders)


An autopsy case of myocardial infarction due to idiopathic thrombotic thrombocytopenic purpura
This report is a critical teaching case considering that its cause of sudden death may be arrhythmia due to a myocardial infarction including cardiac conduction system disorder by platelet microthrombi.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2113354005156739 (Source: Diagnostic Pathology)


Molecules, Vol. 20, Pages 10047-10064: A 1H-NMR-Based Metabonomic Study on the Anti-Depressive Effect of the Total Alkaloid of Corydalis Rhizoma
In this study, the antidepressive effect of the total alkaloid of YuanHu (YHTA) was investigated in a chronic unpredictable mild stress (CUMS) rat model using 1H-NMR-based metabonomics. Plasma metabolic profiles were analyzed and multivariate data analysis was applied to discover the metabolic biomarkers in CUMS rats. Thirteen biomarkers of CUMS-introduced depression were identified, which are myo-inositol, glycerol, glycine, creatine, glutamine, glutamate, β-glucose, α-glucose, acetoacetate, 3-hydroxybutyrate, leucine and unsaturated lipids (L7, L9). Moreover, a metabolic network of the potential biomarkers in plasma perturbed by CUMS was detected. After YHTA treatment, clear separation between the model group and YHTA-treated group was achieved. The levels of all the abnormal metabolit...


Physiotherapist-led neck-specific exercise improves pain, disability and self-efficacy in chronic whiplash-associated disorders
Publication date: Available online 29 May 2015 Source:Journal of Physiotherapy Author(s): Mark Elkins (Source: Journal of Physiotherapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Living Well with Pain: Development and Preliminary Evaluation of the Valued Living Scale
Conclusions The VLS items can be administered and scored to assess: 1) the importance of as well as 2) confidence in and 3) success in achieving values‐consistent goals. The measure can be used by clinicians to monitor and track changes in patient's perceptions about their goals with treatment. Researchers can use the VLS to test theoretical models of the roles that patient perceptions about goal importance, confidence, and success play in chronic pain treatment outcome. (Source: Pain Medicine)


In vivo luminescent imaging of NF‐κB activity and NF‐κB‐related serum cytokine levels predict pain sensitivities in a rodent model of peripheral neuropathy
ConclusionsUsing in vivo luminescent imaging of NF‐κB activity and serum cytokine measures, this work establishes NF‐κB and NF‐κB‐regulated cytokines as novel multivariate biomarkers of pain‐related sensitivity in this model of neuropathy that may be useful for the rapid screening of novel molecular therapeutics. (Source: European Journal of Pain)


Factors associated with pain and disability reduction following exercise interventions in chronic whiplash
ConclusionFactors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck‐specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck‐specific exercise for individuals with chronic WAD. (Source: European Journal of Pain)


Asymptomatic chronic gastritis decreases metformin tolerance in patients with type 2 diabetes
Summary What is known and ObjectiveDigestive disorders represent the most common metformin side effects for type 2 diabetes. The mechanism of these metformin side effects is unclear. The aim of this study was to assess whether asymptomatic chronic gastritis could influence metformin tolerance in patients with type 2 diabetes. MethodsDemographic, anthropometric, ultrasound and laboratory data were obtained from 144 metformin naïve patients with diabetes. The diagnosis of chronic gastritis was based on endoscopic and histopathological examination, and H. pylori infection was assessed based on 13C urea breath test (UBT). All subjects started metformin at 500 mg/day and increasing progressively to 1500 mg/day over 4 weeks. A score of gastrointestinal side effects (abdominal pain, diarrhoe...


Somatic Symptom Disorders Without Known Physical Causes: One Disease with Many Names?
Patients complaining of pain and/or fatigue in the absence of known physical diseases constitute a high percentage of those seeking general medical care. Depending upon the type of physician/specialist consulted, those individuals may receive disease labels that range from an implied psychological origin such as somatoform or psychosomatic disease, or to a presumed physical disease such as fibromyalgia. Although all these conditions are regularly associated with fatigue, we are now provided with a new label suggesting another disease category, "systemic exertion intolerance disease", which replaces the previous "chronic fatigue syndrome." All these conditions have common, overlapping features that usually consist of both fatigue and pain, and, in the absence of definitive objective confirm...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Multidisciplinary treatment for rheumatic pain
Publication date: Available online 29 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Irina Kudrina , Yoram Shir , Mary-Ann Fitzcharles Chronic pain experienced by patients with rheumatic conditions is recognized to contribute importantly to suffering. Multidisciplinary pain clinics that adhere to the biopsychosocial concept of pain management provide an effective treatment strategy for many with chronic pain. Other than for low back pain and fibromyalgia, little attention has been given to the specific experience of treating those with rheumatic diseases in such a setting. It is, however, reasonable to suggest that many patients with chronic rheumatic pain could benefit from exposure to a multidisciplinary pain treatment programme that incorporates comp...


Chronic Leg Pain in Athletes
Chronic leg pain is commonly treated by orthopaedic surgeons who take care of athletes. The sources are varied and include the more commonly encountered medial tibial stress syndrome, chronic exertional compartment syndrome, stress fracture, popliteal artery entrapment syndrome, nerve entrapment, Achilles tightness, deep vein thrombosis, and complex regional pain syndrome. Owing to overlapping physical examination findings, an assortment of imaging and other diagnostic modalities are employed to distinguish among the diagnoses to guide the appropriate management. Although most of these chronic problems are treated nonsurgically, some patients require operative intervention. For each condition listed above, the pathophysiology, diagnosis, management option, and outcomes are discussed in tur...


Small‐nerve‐fiber pathology in critical illness documented by serial skin biopsies
Conclusion: Serial IENFD measurements confirmed the development of small‐fiber sensory involvement in the acute phase of critical illness. Muscle Nerve, 2015 (Source: Muscle and Nerve)


[Erratum to: Opioids in chronic low back pain : A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration].
Authors: Petzke F, Welsch P, Klose P, Schaefert R, Sommer C, Häuser W PMID: 26022428 [PubMed - as supplied by publisher] (Source: Schmerz)


Atypical Cause of Lateral Hip Pain Due to Proximal Gluteus Medius Muscle Tear: A Report of 2 Cases
We report here 2 cases of traumatic tears of the gluteus medius muscle at its proximal attachment on the iliac crest. (Source: PM and R)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Seroprevalence of HSV-1/2 and correlation with aggravation of oral mucositis in patients with squamous cell carcinoma of the head and neck region submitted to antineoplastic treatment
Conclusion The reactivation of HSV-1/2 was shown to be relatively infrequent and there was no correlation between presence of the virus and aggravation of oral mucositis resulting from antineoplastic treatment. (Source: Supportive Care in Cancer)


When acute pain becomes chronic
(Source: Anaesthesia)


Tattoos last, but for 1 out 10, so does the pain
A new study suggests people suffer infections, itching and chronic complications for their body art. (Source: CNN.com - Health)


Health Tip: Exercising Despite Chronic Fatigue Syndrome
Title: Health Tip: Exercising Despite Chronic Fatigue SyndromeCategory: Health NewsCreated: 5/28/2015 12:00:00 AMLast Editorial Review: 5/28/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Pulsed Radiofrequency Treatment Enhances Dorsal Root Ganglion Expression of Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels in a Rat Model of Neuropathic Pain
In conclusion, PRF can upregulate HCN channel expression in the DRG of rats with sciatic nerve CCI. How this regulation of Ih in nociceptive afferents contributes to the suppression of neuropathic pain by PRF remains to be determined. (Source: Journal of Molecular Neuroscience)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 multilevel path model analysis of the relations between sleep, pain, and pain catastrophizing in chronic pain rehabilitation patients
Conclusion and implications These results call into question previous evidence that pain catastrophizing indirectly affects pain by way of its impact on sleep. Rather, our findings suggest that pain mediates the relationship between sleep and levels of pain catastrophizing. These results therefore underscore importance and value in collecting longitudinal data and potential influence on the conclusions gained with regards to sleep, pain and psychological variables. These findings may be of clinical importance when tailoring interventions for individuals with chronic pain and perhaps even more so for those with comorbid pain and sleep disturbance; prioritizing the treatment of sleep difficulties could result in improvements to pain-related outcomes. (Source: Scandinavian Journal of Pain)


Total knee arthroplasty – the optimal analgesic regime
This article examines and appraises the options for total knee arthroplasty in the current environment which mandates rapid discharge from hospital. Peripheral nerve blockade and multimodal analgesic options are covered in detail, along with newer techniques such as high volume local anaesthetic infiltration and infiltration with liposomal bupivacaine. Recommendations are made for the straightforward patient and the patient with chronic pain or opioid requirements. (Source: Trends in Anaesthesia and Critical Care)


Childbirth Pain and Postpartum Depression
Publication date: Available online 13 May 2015 Source:Trends in Anaesthesia and Critical Care Author(s): S. Kwok , D. Moo , S.T. Sia , A.S. Razak , B.L. Sng Childbirth pain is one of the most painful experiences of a mother’s life. In this review we investigate the association between childbirth pain and post partum depression. It is well documented that postpartum depression is an increasing concern which affects not only the mother but can impact the newborn’s development. Multiple factors seem to contribute to the likelihood of this depression developing such as the mother’s socio-econoimc background, age, education level, history of childhood abuse as well as pain catastrophizing traits. Severe acute pain is linked with an increased risk of chronic pain as well as postpartum de...


Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling
Conclusions: We conclude that the data available in a community practice can be a rich source of biopsychosocial information relevant to the phenotypes of chronic pain. It is anticipated that phenotype linkages to best treatments and outcomes can be constructed from this set of records. (Source: BMC Medical Informatics and Decision Making)


Machine-Based, Self-guided Home Therapy for Individuals With Severe Arm Impairment After Stroke: A Randomized Controlled Trial
This study compared self-guided, high-repetition home therapy with a mechanical device (the resonating arm exerciser [RAE]) to conventional therapy in patients with chronic stroke and explored RAE use for patients with subacute stroke. Methods. A total of 16 participants with severe upper-extremity impairment (mean Fugl-Meyer [FM] score = 21.4 &plusmn; 8.8 out of 66) &gt;6 months poststroke were randomized to 3 weeks of exercise with the RAE or conventional exercises. The primary outcome measure was FM score 1 month posttherapy. Secondary outcome measures included Motor Activity Log, Visual Analog Pain Scale, and Ashworth Spasticity Scale. After a 1-month break, individuals in the conventional group also received a 3-week course of RAE therapy. Results. The change in FM score was significa...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Belgian siblings of children with a chronic illness: Is their quality of life different from their peers?
To assess Belgian siblings&rsquo; self-reported quality of life (QoL) and the impact of illness on four different paediatric illnesses. Healthy siblings (n&nbsp;=&nbsp;131) of children with type 1 diabetes, cancer, congenital heart disease (CHD) and cystic fibrosis (CF) completed the Child Health Questionnaire and the Sibling Perception Questionnaire. Results were compared to those of a matched group of siblings of healthy children. Siblings reported a good QoL, similar to controls, with the exception that siblings reported better on the QoL domain pain (p&nbsp;&lt;&nbsp;.01). QoL was not related to time since diagnosis but the impact of illness was higher nearer to the time of diagnosis (r&nbsp;=&nbsp;&ndash;.39, p&nbsp;&lt;&nbsp;.001). QoL of siblings of children with CHD or cancer was l...


Medical Management of Tumor Lysis Syndrome, Postprocedural Pain, and Venous Thromboembolism Following Interventional Radiology Procedures
Semin intervent Radiol 2015; 32: 209-216DOI: 10.1055/s-0035-1549379The rapid expansion of minimally invasive image-guided procedures has led to their extensive use in the interdisciplinary management of patients with vascular, hepatobiliary, genitourinary, and oncologic diseases. Given the increased availability and breadth of these procedures, it is important for physicians to be aware of common complications and their management. In this article, the authors describe management of select common complications from interventional radiology procedures including tumor lysis syndrome, acute on chronic postprocedural pain, and venous thromboembolism. These complications are discussed in detail and their medical management is outlined according to generally accepted practice and evidence from t...


Assessment of spinal pain
Publication date: Available online 28 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): J. Braun , X. Baraliakos , A. Regel , U. Kiltz Spinal pain or back pain is a very common symptom that can have many reasons. The most studied location is low back pain, and it is considered to be nonspecific in the majority of cases. Only a small proportion of patients have axial inflammation as the major cause of their back complaints with chronic inflammatory back pain (IBP) as the most prominent clinical feature of spondyloarthritis (SpA). The recognition of IBP and patients with axial spondyloarthritis (axSpA) is challenging in primary care, and it is important to further facilitate the early diagnosis of SpA. Proposals for improving the referral of patients with a ...


Sex differences in knee loading in recreational runners
This study aimed to determine whether female recreational runners exhibit distinct knee loading compared to males. Fifteen male and fifteen female recreational runners underwent 3D running analysis at 4.0m.s-1±5%. Sagittal/ coronal joint moments, patellofemoral contact forces (PTF) and pressures (PCP) were compared between sexes. (Source: Journal of Biomechanics)


Clinical Ratings of Pain Sensitivity Correlate With Quantitative Measures in People With Chronic Neck Pain and Healthy Controls: Cross-Sectional Study.
CONCLUSIONS: The ice-pain test may be useful as a clinical correlate with CPT at all sites except the wrist, whilst the pressure-pain test is less convincing as a clinical correlate of PPT. PMID: 26023218 [PubMed - as supplied by publisher] (Source: Physical Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 post-inflammatory visceral pain following acute colitis.
This study aimed at establishing the role of TRPV1 in the peripheral sensitization underlying chronic visceral pain in the context of colitis. Wild-type and TRPV1-deficient mice were separated into three groups (Control, Acute colitis, Recovery) and experimental colitis induced by oral administration of dextran sulfate sodium (DSS). Recovery mice showed increased chemically- and mechanically-evoked visceral hypersensitivity five weeks post-DSS discontinuation, at which point inflammation had completely resolved. Significant changes in non-evoked pain-related behaviours could also be observed in these animals, indicative of persistent discomfort. These behavioural changes correlated with elevated colonic levels of substance P (SP) and TRPV1 in recovery mice, thus leading to the hypothesis t...


Combined contraceptive pills 'increase risk of blood clots'
Conclusion It is already well known that the combined oral contraceptive pill (&quot;the pill&quot;) is associated with increased risk of venous blood clots. It is also already known that risk can differ according to the type of progestogen in the pill. This study adds further evidence helping to quantify these risks. The study has numerous strengths. It has used two large GP databases covering large samples of the UK population, and containing reliable information on medical diagnoses and prescriptions made. The analyses were also adjusted for various confounders known to be associated with risk of blood clots. It demonstrates pill use in the previous year almost tripled risk of venous blood clot, with risk generally higher with the newer pills than the older ones – though there were so...


Novel expression pattern of neuropeptide Y immunoreactivity in the peripheral nervous system in a rat model of neuropathic pain
Conclusions: This is the first study to provide a comprehensive description of changes in NPY expression in the periphery after nerve injury. Novel expression of NPY in the skin comes mostly from sprouted sympathetic fibers. This information is fundamental in order to understand where endogenous NPY is expressed, and how it might be acting to modulate pain in the periphery. (Source: Molecular Pain)


Effect of manual versus mechanically assisted manipulations of the thoracic spine in neck pain patients: study protocol of a randomized controlled trial
The objective of this study is to compare the short- and long-term effects of manual versus mechanically assisted manipulations of the thoracic spine for neck pain patients.Methods/DesignA 6-month, randomized controlled trial consisting of 54 patients with acute or chronic neck pain patients will be conducted. Patients with no signs of major pathology and with little or no interference with daily activities will be recruited. Three treatment sessions with 4-day intervals will be carried out. The patients will be randomly assigned to receive either manually performed manipulations or electromechanical manipulations at the thoracic spine. The primary outcome is pain intensity as measured by the Visual Analogue Pain Rating Scale. The secondary outcome measures are neck physical disability usi...


The effect of decompressive surgery on lumbar paraspinal and biceps brachii muscle function and movement perception in lumbar spinal stenosis: a 2-year follow-up
Conclusion Impaired lumbar proprioception seems to improve shortly after decompressive surgery but tends to deteriorate again with longer follow-up despite the sustaining favorable clinical outcome. The surgery did not affect either the feed-forward or the feed-back muscle function, which indicates that the abnormal muscle activity in LSS is at least partly irreversible. (Source: European Spine Journal)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease
Background: Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem.ObjectiveTo compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the technique of choice. Methods: 120 patients were treated between 2003 and 2010 at king Abdullah university hospital for lumber disc disease. The patients were divided into three groups: Group I (PLF n = 30 [59 levels]); Group II (PLIF n = 40 [70 levels]); and Group III (TLIF n = 50 [96 levels]...


Psychosocial, musculoskeletal and somatoform comorbidity in patients with chronic low back pain: original results from the Dutch Transition Project
Conclusions. General practitioners should consider all the musculoskeletal symptoms when caring for patients with chronic LBP. Rather than systematically screening for specific psychological, social or somatoform disorders, they should consider with the patient how LBP and any type of potential comorbidity interfere with his/her daily functioning. (Source: Family Practice)


Hurt, tired and queasy: Specific variants in the ATPase domain of the TRAP1 mitochondrial chaperone are associated with common, chronic “functional” symptomatology including pain, fatigue and gastrointestinal dysmotility
In this study, provided clinical information and the exon sequence of the TRAP1 mitochondrial chaperone were retrospectively reviewed with a focus on the functional categories of chronic pain, fatigue and gastrointestinal dysmotility. Very-highly conserved TRAP1 variants were identified in 73 of 930 unrelated patients. Functional symptomatology is strongly associated with specific variants in the ATPase binding pocket. In particular, the combined presence of all three functional categories is strongly associated with p.Ile253Val (OR 7.5, P=0.0001) and with two other interacting variants (OR 18, P=0.0005). Considering a 1-2% combined variant prevalence and high odds ratios, these variants may be an important factor in the etiology of functional symptomatology. (Source: Mitochondrion)


[Research Articles] Shaping mycolactone for therapeutic use against inflammatory disorders
Inflammation adversely affects the health of millions of people worldwide, and there is an unmet medical need for better anti-inflammatory drugs. We evaluated the therapeutic interest of mycolactone, a polyketide-derived macrolide produced by Mycobacterium ulcerans. Bacterial production of mycolactone in human skin causes a combination of ulcerative, analgesic, and anti-inflammatory effects. Whereas ulcer formation is mediated by the proapoptotic activity of mycolactone on skin cells via hyperactivation of Wiskott-Aldrich syndrome proteins, analgesia results from neuronal hyperpolarization via signaling through angiotensin II type 2 receptors. Mycolactone also blunts the capacity of immune cells to produce inflammatory mediators by an independent mechanism of protein synthesis blockade. In...


m-Trifluoromethyl-diphenyl diselenide, a multi-target selenium compound, prevented mechanical allodynia and depressive-like behavior in a mouse comorbid pain and depression model
This study evaluated the effect of m-trifluoromethyl diphenyl diselenide [(m-CF3-PhSe)2], an organoselenium compound that has been reported to have both antinociceptive and antidepressant-like actions, in the comorbidity of chronic pain and depression induced by partial sciatic nerve ligation (PSNL) in an inflammatory approach. Mice were submitted to PSNL during 4 weeks and treated with (m-CF3-PhSe)2 acutely (0.1 – 10 mg/kg, i.g.) or subchronically (0.1 mg/kg, i.g., once a day during the 3rd and 4th weeks). Both treatments prevented PSNL-increased pain sensitivity and depressive-like behavior observed in von-frey hair (VFH) and forced swimming (FST) tests, respectively. These effects could be mainly associated with an anti-inflammatory action of (m-CF3-PhSe)2 which reduced the levels of ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ultrasonography Leads to Accurate Diagnosis and Management of Painful Acromioclavicular Joint Cyst
DiscussionMusculoskeletal ultrasound is useful for diagnosis and management of refractory musculoskeletal conditions that are commonly misdiagnosed on physical examination and translucent to radiographic imaging. Musculoskeletal ultrasound allowed us to exclude rotator cuff pathology, identify ACJ cyst as the pain generator, classify it as a type 1 ACJ cyst, and aid in needle guidance for successful aspiration leading to full resolution of our patient's pain. (Source: Pain Practice)


Tapentadol for chronic musculoskeletal pain in adults.
CONCLUSIONS: Tapentadol extended release is associated with a reduction in pain intensity in comparison to placebo and oxycodone. However, the clinical significance of the results is uncertain due to the following reasons: modest difference between interventions in efficacy outcomes, high heterogeneity in some comparisons and outcomes, high withdrawals rates, lack of data for the primary outcome in some studies and impossibility to use BOCF as imputation method. Tapentadol is associated with a more favourable safety profile and tolerability than oxycodone. PMID: 26017279 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


A synthesis of qualitative research exploring the barriers to staying in work with chronic musculoskeletal pain.
CONCLUSIONS: Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic. The papers span 15 years of qualitative research. A significant finding is that these themes continue to pervade the current work environment for those in pain, and this has clear implications for education, social care and policy. Implications for Rehabilitation People with chronic pain face an adversarial struggle to maintain their credibility at work. Strategies to maintain personal credibility can have an adverse effect on working lives. Changes at a systems level are needed to facilitate continuance and return to work. Cultural changes in the way that we view people with pain would help to keep people...


Pharmacoepidemiology of chronic noncancer pain patients requiring chronic opioid therapy: A nationwide population-based study.
CONCLUSION: COT-requiring CNCP patients were easily associated with adverse socioeconomic liabilities and often visited emergency department as well as pain clinics. Morphine was the main opioid used for their chronic pain. Transfer of COT-requiring CNCP patients to appropriate departments is strongly recommended for efficient long-term pharmacotherapy for their chronic pain. PMID: 26026843 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)


Cost of Chronic and Episodic Migraine: a pilot study from a tertiary headache centre in northern Italy
Conclusions CM is a disabling condition with a huge impact on the QoL of sufferers and a significant economic impact on the NHS. The adequate management of CM, reverting it back to EM, will provide a dual benefit: on the individual and on the society. (Source: The Journal of Headache and Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


New findings about mechanisms underlying chronic pain reveal novel therapeutic strategies
A critical role for a class of cells present in the brain and spinal cord, called microglia, has been discovered for those in pain. Researchers have found microglia to neuron signaling to be crucial in the development of pain hypersensitivity after injury, but also for one of the paradoxical effects morphine and other opioids sometimes produce, called hyperalgesia, which is an increase in pain sensitivity. (Source: ScienceDaily Headlines)


[Occipital nerve stimulation for refractory chronic migraine].
CONCLUSIONS: ONS is an effective, well tolerated and safe treatment for the prevention of chronic migraine and could emerge as a useful option for those patients with medically refractory chronic migraine. PMID: 26005075 [PubMed - in process] (Source: Revista de Neurologia)


Effects of intrathecal injection of rapamycin on pain threshold and spinal cord glial activation in rats with neuropathic pain.
CONCLUSIONS: Intrathecal injection of rapamycin may attenuate CCI-induced hyperalgesia and inhibit the activation of astrocyte. PMID: 26004146 [PubMed - as supplied by publisher] (Source: Neurological Research)


Diagnostic criteria in 72 women with erosive vulvovaginal lichen planus
ConclusionsThe most frequent findings in women with EVLP were symptoms of pain or burning, well‐demarcated red shiny areas or erosions at the introitus and scarring with loss of architecture. Our findings support the recently described diagnostic criteria for EVLP. (Source: Australasian Journal of Dermatology)


Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain?
Abstract The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial evaluation, patients were classified into three groups. Group 1, those without any comorbid disease (N = 105), group 2, those having regional non-inflammatory painful disorders (N = 104), and group 3, those with a diagnosis of an inflammatory rheumatic disease (N = 75). Overall, 65 % of the patients fulfilled the 1990 criteria, while 94 % of them fulfilled the 2010 criteria. Almost all of the patients (97 %) with CWP did meet at least one of the criteria set, regardless of w...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Peripartum changes of the sacroiliac joints on MRI: increasing mechanical load correlating with signs of edema and inflammation kindling spondyloarthropathy in the genetically prone
In conclusion, pregnancy and puerperium are associated with a host of acute findings in and around the SIJ, including BME, capsulitis, and enthesitis, reflecting most probably, mechanical load and hormonal changes. While the vast majority of symptoms abate within weeks to several months postpartum, 3.8 % of women go on to develop spondyloarthropathy. Diffuse SIJ BME and the presence of risk factors for spondyloarthropathy are predictive of a chronic course. (Source: Clinical Rheumatology)


Fentanyl Buccal Tablet: A New Breakthrough Pain Medication in Early Management of Severe Vaso‐Occlusive Crisis in Sickle Cell Disease
ConclusionsWe propose that VOCs might require breakthrough pain drug strategy as vaso‐occlusive phenomena and enhanced vasoconstriction promoting acute ischemic pain component exacerbate the continuous pain of VOCs. FBT might be a powerful and feasible tool in early management of acute pain during VOCs in emergency departments. (Source: Pain Practice)


Pain Management in Four‐Limb Amputation: A Case Report
We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four‐limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four‐limb amputation. (Source: Pain Practice)


Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review
ConclusionIt is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required. (Source: Pain Practice)


Calibration of the Dutch‐Flemish PROMIS Pain Behavior item bank in patients with chronic pain
ConclusionsThe Dutch‐Flemish PROMIS Pain Behavior item bank was found to have good cross‐cultural validity, reliability and construct validity. The development of the Dutch‐Flemish PROMIS Pain Behavior item bank will serve as the basis for Dutch‐Flemish PROMIS short forms and computer adaptive testing (CAT). (Source: European Journal of Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Abdominal Pain Caused by Spontaneous Rupture of a Liver Tumor
Question: A 47-year-old man was admitted to our hospital with an 8-hour history of intermittent abdominal pain that had developed suddenly. He had a history of liver cirrhosis and chronic hepatitis B virus infection for 10 years. Physical examination revealed tenderness of the right abdomen. His liver function was abnormal: γ-glutamyltransferase, 110U/L (normal range,10-60), alkaline phosphatase, 135U/L (normal range, 45-125), glutamate dehydrogenase, 22.4U/L (normal range, 0-7.4), prealbumin, 11.7 mg/dL (normal range, 17-40). (Source: Gastroenterology)


A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study
Authors: A E Bunner, C L Wells, J Gonzales, U Agarwal, E Bayat & N D Barnard (Source: Nutrition and Diabetes)


Insulin‐Like Growth Factor II (IGF‐II) Inhibits IL‐1β‐Induced Cartilage Matrix Loss and Promotes Cartilage Integrity in Experimental Osteoarthritis
This article is protected by copyright. All rights reserved (Source: Journal of Cellular Biochemistry)


Diagnostic criteria in 72 women with erosive vulvovaginal lichen planus.
CONCLUSIONS: The most frequent findings in women with EVLP were symptoms of pain or burning, well-demarcated red shiny areas or erosions at the introitus and scarring with loss of architecture. Our findings support the recently described diagnostic criteria for EVLP. PMID: 26010759 [PubMed - as supplied by publisher] (Source: The Australasian Journal of Dermatology)


Cognitive-behavioural treatment for subacute and chronic neck pain.
CONCLUSIONS: With regard to chronic neck pain, CBT was found to be statistically significantly more effective for short-term pain reduction only when compared to no treatment, but these effects could not be considered clinically meaningful. When comparing both CBT to other types of interventions and CBT in addition to another intervention to the other intervention alone, no differences were found. For patients with subacute NP, CBT was significantly better than other types of interventions at reducing pain at short-term follow-up, while no difference was found for disability and kinesiophobia. Further research is recommended to investigate the long-term benefits and risks of CBT including for the different subgroups of subjects with NP. PMID: 26006174 [PubMed - as supplied by publisher...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls
Conclusion Gluteus medius weakness and gluteal muscle tenderness are common symptoms in people with chronic non-specific LBP. Future investigations should validate these findings with quantitative measures as well as investigate the effect of gluteus medius strengthening in people with LBP. (Source: European Spine Journal)


Analgesia enhancement and prevention of tolerance to morphine: beneficial effects of combined therapy with omega‐3 fatty acids
ConclusionThis finding suggests a role for O3 as adjuncts to opioids in pain therapy and might contribute to the reduction of the occurrence of morphine side‐effects. (Source: Journal of Pharmacy and Pharmacology)


Healthcare costs associated with elderly chronic pain patients in primary care
Conclusion Healthcare costs increased rapidly over time, largely due to hospitalization. Prevention strategies to limit hospitalizations in elderly appear to be the most useful in order to achieve cost savings in the future. (Source: European Journal of Clinical Pharmacology)


Transurethral intraprostatic injection of botulinum neurotoxin type A for the treatment of chronic prostatitis/chronic pelvic pain syndrome: results of a prospective pilot double‐blind and randomized placebo‐controlled study
ConclusionsTransurethral intraprostatic BoNT‐A injection maybe an effective therapeutic option in patients with CP/CPPS as it reduces pain and improves QoL. (Source: BJU International)


Acute opioid withdrawal is associated with increased neural activity in reward-processing centers in healthy men: A functional magnetic resonance imaging study
The objective and subjective signs and symptoms of opioid withdrawal are well-documented, and validated scales have been developed for their assessment (Handelsman et al., 1987). (Source: Drug and Alcohol Dependence)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Clinical Reasoning: A case of unilateral facial pain
A 62-year-old man admitted with B cell chronic lymphocytic leukemia (CLL) reported 2 weeks of progressive left-sided jaw and facial pain. He first noticed the pain occurring during prolonged chewing. It was exacerbated by teeth clenching and resolved with jaw rest. The patient described the pain as dull and gnawing without radiation. He also described a "knot" within his left "jaw muscles" at the mandibular angle. He had decreased range of motion, could not fully open his mouth, and felt that his jaw was misaligned. He was therefore placed on a soft mechanical diet. He denied a temporal headache or transient loss of vision. He was on his second day of obinutuzumab chemotherapy but was not on any other new medications. He had no history of trauma to his face, head, or neck. (Source: Neurolo...


Metabolic analysis of knee synovial fluid as a potential diagnostic approach for osteoarthritis
This article is protected by copyright. All rights reserved (Source: Journal of Orthopaedic Research)


Editorial: Voltage‐Gated Calcium 2.2 Channels: Therapeutic Target for Chronic Arthritic Pain?
(Source: Arthritis and Rheumatism)


Suppression of Peripheral Pain by Blockade of Voltage‐Gated Calcium 2.2 Channels in Nociceptors Induces RANKL and Impairs Recovery From Inflammatory Arthritis in a Mouse Model
ConclusionTaken together, our results indicate that alleviation of peripheral pain by blockade of CaV2.2‐ mediated calcium influx and signaling in nociceptor sensory neurons impairs recovery from induced arthritis and point to the potentially devastating effects of using CaV2.2 channel blockers as analgesics during inflammation. (Source: Arthritis and Rheumatism)


Calcitonin Gene‐Related Peptide–Expressing Sensory Neurons and Spinal Microglial Reactivity Contribute to Pain States in Collagen‐Induced Arthritis
ConclusionSensory neuron–derived CGRP sustains mechanical hypersensitivity and spinal microglial reactivity in CIA, suggesting that central mechanisms play critical roles in chronic inflammatory pain. Blockade of these central events may provide pain relief in rheumatoid arthritis patients. (Source: Arthritis and Rheumatism)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Prevalence of Chronic Axial Pain, Inflammatory Back Pain, and Spondyloarthritis in Diagnosed Psoriasis
ConclusionThere is a higher prevalence of lower axial pain, IBP, SpA, and alternating buttock pain associated with a prior diagnosis of psoriasis. These data may influence the way psoriasis patients are approached in primary care and specialty clinics. (Source: Arthritis Care and Research)


Behcet Colitis
Clinics in Colon and Rectal Surgery 2015; 28: 099-102DOI: 10.1055/s-0035-1547336Behcet disease (BD) is a chronic, multisystem, inflammatory disease characterized by variable clinical manifestations involving systemic vasculitis of both the small and large blood vessels. The majority of BD patients present with recurrent oral ulcers in combination with other manifestations of the disease, including genital ulcers, skin lesions, arthritis, uveitis, thrombophlebitis, gastrointestinal or central nervous system involvement. Gastrointestinal BD occurs in 3 to 25% of the BD patients and shares many clinical characteristics with inflammatory bowel disease (IBD). Consequently, the differentiation between IBD and gastrointestinal manifestation of BD is very difficult. Intestinal BD should be conside...


Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been ….
CONCLUSION: The literature suggests that the medicinal use of cannabis may have a therapeutic role for a multitude of diseases, particularly chronic pain disorders including headache. Supporting literature suggests a role for medicinal cannabis and cannabinoids in several types of headache disorders including migraine and cluster headache, although it is primarily limited to case based, anecdotal, or laboratory-based scientific research. Cannabis contains an extensive number of pharmacological and biochemical compounds, of which only a minority are understood, so many potential therapeutic uses likely remain undiscovered. Cannabinoids appear to modulate and interact at many pathways inherent to migraine, triptan mechanisms ofaction, and opiate pathways, suggesting potential synergistic or ...


Transcriptional regulator PRDM12 is essential for human pain perception
Nature Genetics 47, 803 (2015). doi:10.1038/ng.3308 Authors: Ya-Chun Chen, Michaela Auer-Grumbach, Shinya Matsukawa, Manuela Zitzelsberger, Andreas C Themistocleous, Tim M Strom, Chrysanthi Samara, Adrian W Moore, Lily Ting-Yin Cho, Gareth T Young, Caecilia Weiss, Maria Schabh&#252;ttl, Rolf Stucka, Annina B Schmid, Yesim Parman, Luitgard Graul-Neumann, Wolfram Heinritz, Eberhard Passarge, Rosemarie M Watson, Jens Michael Hertz, Ute Moog, Manuela Baumgartner, Enza Maria Valente, Diego Pereira, Carlos M Restrepo, Istvan Katona, Marina Dusl, Claudia Stendel, Thomas Wieland, Fay Stafford, Frank Reimann, Katja von Au, Christian Finke, Patrick J Willems, Michael S Nahorski, Samiha S Shaikh, Of&#233;lia P Carvalho, Adeline K Nicholas, Gulshan Karbani, Maeve A McAleer, Maria Roberta Cilio...


Kaempferol and inflammation: From chemistry to medicine
Publication date: Available online 14 May 2015 Source:Pharmacological Research Author(s): Kasi Pandima Devi , Dicson Sheeja Malar , Seyed Fazel Nabavi , Antoni Sureda , Jianbo Xiao , Seyed Mohammad Nabavi , Maria Daglia Inflammation is an important process of human healing response, wherein the tissues respond to injuries induced by many agents including pathogens. It is characterized by pain, redness and heat in the injured tissues. Chronic inflammation seems to be associated with different types of diseases such as arthritis, allergies, atherosclerosis, and even cancer. In recent years natural product based drugs are considered as the novel therapeutic strategy for prevention and treatment of inflammatory diseases. Among the different types of phyto-constituents present in natural prod...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Benzodiazepines may be worse than opioids: negative medication effects in severe chronic pain - Gauntlett-Gilbert J, Gavriloff D, Brook P.
OBJECTIVES: Opioid prescription for non-malignant pain is increasing in Europe and the US. Research and guidance have focused on the potential for dependency and medical side effects with high doses. In contrast, benzodiazepines have received little attent... (Source: SafetyLit: All (Unduplicated))


Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers
Abstract Although acupuncture is effective for treating pain, its site-specificity is questioned. The aim was to compare the cerebral responses of needling applied to an acupuncture point to the needling of a sham point, using functional magnetic resonance imaging (fMRI). Twenty-one healthy male volunteers were enrolled. Manual stimulation of the acupuncture (ST44) and sham points on the dorsum of the left foot was applied during fMRI in a crossover manner. fMRI data analysis was performed contrasting the ST44 and the sham conditions. Stimulation intensity, subjective discrimination of the needling site and the incidence of “Qi” sensation were additionally recorded. Stimulation of ST44 acupoint, in comparison to the sham procedure, was associated with an increased fMRI-activa...


Sympathetic innervation of human muscle spindles.
Authors: Radovanovic D, Peikert K, Lindström M, Domellöf FP Abstract The aim of the present study was to investigate the presence of sympathetic innervation in human muscle spindles, using antibodies against neuropeptide Y (NPY), NPY receptors and tyrosine hydroxylase (TH). A total of 232 muscle spindles were immunohistochemically examined. NPY and NPY receptors were found on the intrafusal fibers, on the blood vessels supplying muscle spindles and on free nerve endings in the periaxial space. TH-immunoreactivity was present mainly in the spindle nerve and vessel. This is, to our knowledge, the first morphological study concerning the sympathetic innervation of the human muscle spindles. The results provide anatomical evidence for direct sympathetic innervation of the intrafusal ...


EGb761 Ameliorates Neuropathic Pain by Scavenging Reactive Oxygen Species
Conclusion: Taken together, our results suggest that administration of EGb761 can ameliorate neuropathic pain, and further indicate that JNK, which is activated by both exogenous and endogenous ROS, might be the mechanism underlying the effects of EGb761 on CCI neuropathic pain.Pharmacology 2015;95:293-299 (Source: Pharmacology)


How to investigate: Chronic pain
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Matthew Hague , Nicholas Shenker Chronic pain is defined as an unpleasant sensory and emotional experience persisting longer than the normal process of healing, usually longer than 3 months. About a fifth of the world's population is believed to suffer from chronic pain. In Europe, chronic pain accounts for nearly 500 m lost working days, and it costs the European economy &gt;€34 billion (£28 billion) every year. Establishing a reliable diagnosis is the primary challenge in evaluating a patient with chronic pain. Common diagnoses not to miss include seronegative spondyloarthritides, endocrine abnormalities including severe vitamin D deficiency and polymyalgia rh...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Evolving spectrum of HIV-associated rheumatic syndromes
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Christine Fox , Karen Walker-Bone At the end of 2013, 35 million people worldwide were infected with HIV. The prognosis of HIV has been transformed by combination antiretroviral therapy (cART). Providing compliance is good, the use of cART has normalised the life expectancy of HIV-infected people leading to a growing population of people with chronic infection. Management of HIV patients has therefore needed to adapt in order to not only control viral activity but also manage long-term complications of HIV and cART. Rheumatological manifestations of HIV were first described in 1989. Since then, there have been case reports, case series and epidemiological studies descri...


Meta-analyses of pain studies: What we have learned
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Winfried Häuser , Thomas R. Tölle Meta-analysis is a statistical procedure that integrates the results of at least two independent studies. The biggest threats to meta-analysis are publication bias due to missing studies with negative results and low-quality evidence due to methodological limitations imposed by included studies. Tools to improve the quality of meta-analysis have been developed by the Cochrane Collaboration and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analyses of trials have demonstrated that pain responses in patients with chronic pain, following treatment, are not normally distributed but have a bimodal...


Physical exercise as non-pharmacological treatment of chronic pain: Why and when
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Kirsten R. Ambrose , Yvonne M. Golightly Chronic pain broadly encompasses both objectively defined conditions and idiopathic conditions that lack physical findings. Despite variance in origin or pathogenesis, these conditions are similarly characterized by chronic pain, poor physical function, mobility limitations, depression, anxiety, and sleep disturbance, and they are treated alone or in combination by pharmacologic and non-pharmacologic approaches, such as physical activity (aerobic conditioning, muscle strengthening, flexibility training, and movement therapies). Physical activity improves general health, disease risk, and progression of chronic illnesses such as c...


Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s)
Publication date: Available online 23 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Daniel J. Clauw Until recently, most clinicians considered chronic pain to be typically due to ongoing peripheral nociceptive input (i.e., damage or inflammation) in the region of the body where the individual is experiencing pain. Clinicians are generally aware of a few types of pain (e.g., headache and phantom limb pain) where chronic pain is not due to such causes, but most do not realize there is not a single chronic pain state where any radiographic, surgical, or pathological description of peripheral nociceptive damage has been reproducibly shown to be related to the presence or severity of pain. The primary reason for this appears to be that both the peripheral a...


Cognitive behaviour therapy plus aerobic exercise training to increase activity in patients with myotonic dystrophy type 1 (DM1) compared to usual care (OPTIMISTIC): study protocol for randomised controlled trial
DiscussionOPTIMISTIC will not only provide effectiveness data on an intervention that could fill a treatment-gap for DM1 patients but will also improve our understanding of the relevant determinants of the prognosis of DM1.Trial registrationRegistration number: Cinicaltrials.gov NCT02118779; registered 11 April 2014. (Source: Epidemiologic Perspectives and Innovations)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hope for People with IBD and Those at Risk
Marla Dubinsky, MD Chief, Pediatric Gastroenterology and Hepatology, and Co-Director of the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center Icahn School of Medicine at Mount Sinai Hope for People with IBD and Those at Risk Up to 1.3 million Americans have inflammatory bowel disease (IBD), a complex disorder of the immune system that results in uncontrolled inflammation of the gastrointestinal (GI) tract. Crohn's disease and ulcerative colitis are the two most common forms of IBD, causing severe GI symptoms, such as diarrhea, abdominal pain, and rectal bleeding, that can wreak havoc with everyday life. These symptoms can often be controlled with medication, but many people still cycle through periods of remission and flare-ups. Deep, long-term remission is possib...


Improving methodology when analyzing shockwave evidence
A recent publication showed that extracorporeal shockwave therapy (ESWT) was neither effective nor cost-effective for low back pain [1]. This conclusion came after performing a systematic review of shockwave treatments in chronic low back pain using a FairMed device. However, we believe these conclusions must be reviewed because FairMed used for these studies is not a shockwave device. No physical parameter characterizing the pressure curve of the FairMed device has been described. This system does not meet the International Society for Medical Shockwave Treatment standards [2]. (Source: The Spine Journal)


Screening method for major depressive disorders by questionnaire survey in patients with chronic spinal pain
I greatly appreciate the study by Choi et al. [1] on the screening ability of depression in patients with chronic spinal pain. The authors used five screening tests for depression, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) Axis I Disorders (SCID-I) was set as a gold standard of major depressive disorders (MDDs). They mainly used a receiver-operating characteristic (ROC) curve analysis to determine the superiority among screening tests. (Source: The Spine Journal)


Predictors of Chronic Abdominal Pain Affecting the Well-Being of ChildrenPredictors of Chronic Abdominal Pain Affecting the Well-Being of Children
Abdominal pain is frequent among children, and may persist for years. Are there specific patient characteristics at initial evaluation that might predict prognosis one year later? Annals of Family Medicine (Source: Medscape Today Headlines)


Acupuncture-brain interactions as hypothesized by mood scale recordings
Mood expressions encompassing positive scales like “activity, elation, contemplation, calmness” and negative scales like “anger, excitement, depression, fatigue” were applied for introducing a new tool to assess the effects of acupuncture on brain structures. Traditional acupuncture points defined in the literature for their effects on task negative and task positive brain structures were applied to chronic disease patients supposed to have dominant negative mood scales. Burn-out syndrome (n=10) and female chronic pain patients (n=22) showed a significant improvement on positive mood scales and a decline in negative mood scales after 10 acupuncture sessions. (Source: Medical Hypotheses)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances.
CONCLUSIONS: PEG was associated with a lower probability of intervention failure, suggesting the endoscopic procedure may be more effective and safe compared with NGT. There is no significant difference in mortality rates between comparison groups, or in adverse events, including pneumonia related to aspiration. Future studies should include details of participant demographics including underlying disease, age and gender, and the gastrostomy technique. PMID: 25997528 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


[Delayed complications after pancreatic surgery : Pancreatic insufficiency, malabsorption syndrome, pancreoprivic diabetes mellitus and pseudocysts].
CONCLUSION: As the evidence is limited, an interdisciplinary and individually tailored approach for delayed pancreatic morbidity is recommended. PMID: 25997699 [PubMed - as supplied by publisher] (Source: Der Chirurg)


Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.
CONCLUSION: The rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails. PMID: 26002783 [PubMed - as supplied by publisher] (Source: Vascular)


Acupuncture–brain interactions as hypothesized by mood scale recordings
Mood expressions encompassing positive scales like “activity, elation, contemplation, calmness” and negative scales like “anger, excitement, depression, fatigue” were applied for introducing a new tool to assess the effects of acupuncture on brain structures. Traditional acupuncture points defined in the literature for their effects on task negative and task positive brain structures were applied to chronic disease patients supposed to have dominant negative mood scales. Burn-out syndrome (n=10) and female chronic pain patients (n=22) showed a significant improvement on positive mood scales and a decline in negative mood scales after 10 acupuncture sessions. (Source: Medical Hypotheses)


Is chronic postherniorrhaphy pain always chronic
Sandblom G (Source: Journal of Pain Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Subacute combined degeneration of the spinal cord in a patient abusing nitrous oxide and self-medicating with cyanocobalamin.
CONCLUSION: A patient who abused nitrous oxide chronically developed ataxia, paresthesia, and urinary retention while self-medicating with cyanocobalamin. A diagnosis of SCD was supported by MRI findings, symptoms, and the known relationship between nitrous oxide exposure and vitamin B12 deficiency. PMID: 25987690 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)


Clinical implications of patient-provider agreements in opioid prescribing.
Authors: Kraus CN, Baldwin AT, Curro FA, McAllister RG Abstract In June, 2012 the United States Food and Drug Administration (FDA) developed a "blueprint" for prescriber education as a means of directing Certified Medical Education (CME) activities that included content which would meet the regulatory requirements of the class-wide, longacting/ extended-release (LA-ER) opioid Risk Evaluation Mitigation Strategies (REMS). Within the blueprint is the suggested adoption of Patient-Provider Agreements (PPAs) to be used in association with opioid prescribing, but, to our knowledge, there have been no reported evaluations of the role played by opioid-agent PPAs in clinical practice, or of the perceptions of this regulatory mandate by clinicians. Therefore, we conducted a survey regarding...


Mindfulness as Effective as CBT in Pain CatastrophizingMindfulness as Effective as CBT in Pain Catastrophizing
Mindfulness-based stress reduction may be as effective as cognitive-behavior therapy in countering the catastrophizing thought patterns of people with chronic back pain. Medscape Medical News (Source: Medscape Medical News Headlines)


Novus Medical Detox Addresses Opioids for Chronic Pain: The “Silent...
Although little scientific evidence exists to support the safety and efficacy of long-term opioid use and despite deadly results, an estimated 8 million Americans use opioids in lieu of many other...(PRWeb May 21, 2015)Read the full story at http://www.prweb.com/releases/2015/05/prweb12738054.htm (Source: PRWeb: Medical Pharmaceuticals)


Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia
In conclusion, the level of nociception during breast surgery is not significantly affected by preoperative anxiety. (Source: Journal of Anesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial
Publication date: Available online 18 May 2015 Source:The Lancet Author(s): Robert Pickard , Kathryn Starr , Graeme MacLennan , Thomas Lam , Ruth Thomas , Jennifer Burr , Gladys McPherson , Alison McDonald , Kenneth Anson , James N'Dow , Neil Burgess , Terry Clark , Mary Kilonzo , Katie Gillies , Kirsty Shearer , Charles Boachie , Sarah Cameron , John Norrie , Samuel McClinton Background Meta-analyses of previous randomised controlled trials concluded that the smooth muscle relaxant drugs tamsulosin and nifedipine assisted stone passage for people managed expectantly for ureteric colic, but emphasised the need for high-quality trials with wide inclusion criteria. We aimed to fulfil this need by testing effectiveness of these drugs in a standard clinical care setting. Methods For this mu...


Psychological aspects of chronic musculoskeletal pain
Publication date: Available online 21 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Leslie J. Crofford Chronic musculoskeletal pain, by its very nature, is associated with negative emotions and psychological distress. There are individual differences in personality, coping skills, behavioral adaptation, and social support that dramatically alter the psychological outcomes of patients with chronic pain. Patients who have an aspect of central pain amplification associated with mechanical or inflammatory pain and patients with fibromyalgia (FM) are likely to exhibit higher levels of psychological distress and illness behaviors. This manuscript discusses several different constructs for the association between chronic pain, central pain amplification, and ...


“Real-life” treatment of chronic pain: Targets and goals
Publication date: Available online 20 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Jacob N. Ablin , Dan Buskila Treating chronic pain is a complex challenge. While textbooks and medical education classically categorize pain as originating from peripheral (nociceptive), neuropathic, or centralized origins, in real life each and every patient may present a combination of various pain sources, types, and mechanisms. Moreover, individual patients may evolve and develop differing types of pain throughout their clinical follow-up, further emphasizing the necessity to maintain clinical diligence during the evaluation and follow-up of these patients. Rational treatment of patients suffering from chronic pain must attempt at deconstructing complex pain cases, ...


Pain in systemic inflammatory rheumatic diseases
Publication date: Available online 19 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Fabiola Atzeni , Ignazio Francesco Masala , Fausto Salaffi , Manuela Di Franco , Roberto Casale , Piercarlo Sarzi-Puttini The sometimes intense, persistent and disabling pain associated with rheumatoid arthritis (RA) and spondyloarthritis frequently has a multifactorial, simultaneously central and peripheral origin, and it may be due to currently active inflammation or joint damage and tissue destruction caused by a previous inflammatory condition. The symptoms of inflammatory pain symptoms can be partially relieved by non-steroidal anti-inflammatory drugs, but many patients continue to experience moderate pain due to alterations in central pain regulation mechanisms, a...


Oxytocin and the modulation of pain experience: Implications for chronic pain management
Publication date: August 2015 Source:Neuroscience &amp; Biobehavioral Reviews, Volume 55 Author(s): Lincoln M. Tracy , Nellie Georgiou-Karistianis , Stephen J. Gibson , Melita J. Giummarra In an acute environment pain has potential protective benefits. However when pain becomes chronic this protective effect is lost and the pain becomes an encumbrance. Previously unheralded substances are being investigated in an attempt to alleviate the burden of living with chronic pain. Oxytocin, a neuropeptide hormone, is one prospective pharmacotherapeutic agent gaining popularity. Oxytocin has the potential to modulate the pain experience due to its ubiquitous involvement in central and peripheral psychological and physiological processes, and thus offers promise as a therapeutic agent. In this...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders
Chronic pain is a global problem (Blyth et al., 2001; Gureje et al., 1998) and a frequent cause for seeking medical care (Andersson et al., 1999; Kroenke and Mangelsdorff, 1989; Mantyselka et al., 2001). Patients with a history of opioid use disorders appear to be particularly vulnerable to pain (Karasz et al., 2004; Rosenblum et al., 2003; Sheu et al., 2008). The prevalence of chronic pain among persons with opioid use disorders treated with opioid agonist therapy (OAT) ranges from 36 to 61% (Barry et al., 2009, 2013; Jamison et al., 2000; Rosenblum et al., 2003). (Source: Drug and Alcohol Dependence)


Islet Transplantation for Type 1 Diabetes, 2015: What Have We Learned From Alloislet and Autoislet Successes?
The therapeutic potential of pancreatic islet allotransplantation, in which human donor islets are used, as a treatment for type 1 diabetes (T1D) has fascinated diabetes researchers and clinicians for decades. At the same time, the therapeutic potential of total pancreatectomy and islet autotransplantation (TPIAT) (in which one&rsquo;s own islets are used) as a preventive treatment for diabetes in patients who undergo total pancreatectomy for chronic, painful pancreatitis has received relatively less attention. This is ironic, since the latter has been much more effective than the former in terms of successful glucose management and duration of efficacy. The reasons for this disparity can be partially identified. TPIAT receives very little attention in textbooks of internal medicine and ge...


Patient-centered care for chronic pain in the emergency department: a qualitative study
• Patient centered care must be individualized with culturally appropriate assessment.• Individualized care planning may ensure an effective transition of care.• Health care providers must deal ethically and respectfully with patients of all types.• Emergency department nurses can advocate for a model for patient centered care. (Source: International Emergency Nursing)


Muscle Monitoring and Maintenance as an End Point for Patients Treated for Cancer
In the past, people being treated for chronic disease, including cancer, were often advised by their physician to rest and reduce their physical activity. This is suitable advice if movement causes pain, cardiac or respiratory distress. Newer research indicates that exercise is not only safe but also feasible during cancer treatment, improving physical function and quality of life. (Source: Clinical Oncology)


Microsurgical Spermatic Cord Denervation as a Treatment for Chronic Scrotal Content Pain: A Multicenter Open Label Trial
To prospectively evaluate the results of microsurgical spermatic cord denervation in a series of patients with chronic scrotal content pain in a multicenter study, including one center in Germany and three centers in Chile. (Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Cost-effectiveness of stimulation of the sphenopalatine ganglion (SPG) for the treatment of chronic cluster headache: a model-based analysis based on the Pathway CH-1 study
Conclusions Our model-based analysis suggests that SPG stimulation for the treatment of chronic cluster headache, under the assumption of sustained therapy effectiveness, leads to meaningful gains in health-related quality of life and is a cost-effective treatment strategy in the German healthcare system. (Source: The Journal of Headache and Pain)


WITHDRAWN: Botulinum toxin for subacute/chronic neck pain.
CONCLUSIONS: Current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for chronic neck pain associated with or without associated cervicogenic headache. Likewise, there was no benefit seen for disability and quality of life at four week and six months. PMID: 25994306 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


WITHDRAWN: Medicinal and injection therapies for mechanical neck disorders.
CONCLUSIONS: ??? PMID: 25994305 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Sex differences in cerebellar mechanisms involved in pain-related safety learning.
Authors: Labrenz F, Icenhour A, Thürling M, Schlamann M, Forsting M, Timmann D, Elsenbruch S Abstract Recent studies have suggested that the cerebellum contributes to the central processing of pain, including pain-related learning and memory processes. As a complex experience with multiple emotional and cognitive facets, the response to pain and its underlying neural correlates differ between men and women. However, it remains poorly understood whether and to what extent sex differences exist in the cerebellar contribution to pain-related associative learning processes. In the present conditioning study with experimental abdominal pain as unconditioned stimuli (US), we assessed sex-dependent differences in behavioral and neural responses to conditioned warning and safety cues in h...


Treatment of pain in fibromyalgia patients with testosterone gel: Pharmacokinetics and clinical response.
Authors: White HD, Brown LA, Gyurik RJ, Manganiello PD, Robinson TD, Hallock LS, Lewis LD, Yeo KT Abstract To test our hypothesis that testosterone deficiency plays an important role in chronic pain, a Phase I/II pilot study was initiated with 12 fibromyalgia patients to verify that a daily dose for 28days with transdermal testosterone gel would 1) significantly and safely increase mean serum testosterone concentrations from low baseline levels to mid/high-normal levels, and 2) effectively treat the pain and fatigue symptoms of fibromyalgia. Pharmacokinetic data confirmed that serum free testosterone concentrations were raised significantly above baseline levels, by assessment of maximum hormone concentration (Cmax) and area under the curve (AUC) parameters: free testosterone Cmax ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients.
Authors: White HD, Robinson TD Abstract Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, "Gulf War Syndrome", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypot...


Hypogonadism associated with long-term opioid therapy: A systematic review.
CONCLUSIONS: There is lack of high-quality studies to associate chronic opioid pain management with hypogonadism. At present, there is fair evidence to associate hypogonadism with chronic opioid pain management, and only limited evidence for treatment of OPISHD. PMID: 25985810 [PubMed - in process] (Source: Journal of Opioid Management)


Opioid regimens in patients with chronic pain with multiple cytochrome P450 defects.
Authors: Tennant F Abstract There is a subgroup of patients with chronic pain who have multiple cytochrome P450 enzyme defects. These patients tend to use opioids that are not metabolized by the CYP450 system and most apparently require a higher than average dosage. A significant number require nonoral administration. PMID: 25985808 [PubMed - in process] (Source: Journal of Opioid Management)


Functional Fecal Retention Visualized by 111In-DTPA Colon Transit Scintigraphy
We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of 111In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study. (Source: Clinical Nuclear Medicine)


[Editors' Choice] Which receptor underlies chronic pain?
Finding that nicotinic receptors containing the a6 subunit, but not the a4, inhibit chronic pain points to a new set of potential therapeutic drugs. (Source: Signal Transduction Knowledge Environment)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Microsurgical Varicocele Repair on Men with Grade III Lesions and Chronic Dull Scrotal Pain: A Pilot Study
Conclusion: These results indicated that microsurgical varicocele repair may benefit patients with grade III lesions and chronic dull scrotal pain.Curr Urol 2014;8:29-31 (Source: Current Urology)


Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome
Summary There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide sy...


Combination Of Medical Marijuana, Opioids Does Not Increase Substance Abuse Risk, Study Finds
With nearly half of the country&nbsp;having already legalized&nbsp;the use of cannabis for medical purposes, physicians prescribing opioids for pain management have another alternative at their disposal. As medical marijuana laws become more relaxed, practitioners now have the option of treating&nbsp;chronic pain patients with prescription opioids, medical cannabis or both. Among many, however, there's a concern about the adverse effects in patients using both. (Source: Forbes.com Healthcare News)


Is Medicine Ignoring Key Influences on Chronic Pain? And Important Therapeutic Solutions?
No abstract available (Source: The Back Letter)


Steroids No Better for Sciatica Pain Than Placebo, Study Finds
Title: Steroids No Better for Sciatica Pain Than Placebo, Study FindsCategory: Health NewsCreated: 5/19/2015 12:00:00 AMLast Editorial Review: 5/20/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Efficacy of Retigabine in the Monosodium Lodoacetate Rat Model for Osteoarthritis Pain
Conclusion: Retigabine showed antinociceptive effects for OA pain in the MIA model at different times during pain development. Retigabine may be an alternative therapeutic treatment for OA.Pharmacology 2015;95:251-257 (Source: Pharmacology)


Prevalence and Role of a Low-Lying Peroneus Brevis Muscle Belly in Patients With Peroneal Tendon Pathologic Features: A Potential Source of Tendon Subluxation
Publication date: Available online 19 May 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Roya Mirmiran , Chad Squire , Daniel Wassell A peroneus brevis low-lying muscle belly (LLMB) is a rare anomaly. A few published studies have supported the presence of this anomaly as an etiology for a peroneal tendon tear. However, the association between a peroneus brevis LLMB and tendon subluxation has not been well explored. In the present retrospective study, the magnetic resonance imaging (MRI) and intraoperative findings of 50 consecutive patients undergoing primary peroneal tendon surgery during a 5-year period were assessed. The sensitivity and specificity of MRI compared with the intraoperative findings for identifying peroneal tendon disease were investigated. The presence of ...


Lateral Hindfoot Impingement After Nonunion of Fracture of the Lateral Process of the Talus
We present the case of a patient with such an injury. The patient was treated operatively and was followed for 18 months. (Source: The Journal of Foot and Ankle Surgery)


Pulse‐dose radiofrequency can reduce chronic pain in trapezio‐metacarpal osteoarthritis: A mini‐invasive therapeutic approach
ConclusionsThe PDRF may be a safe, repeatable and effective short‐term pain management technique in patients with trapezio‐metacarpal OA. Larger, randomized controlled studies are indicated to better clarify the efficacy and utility of the PDRF. (Source: APLAR Journal of Rheumatology)


Fibromyalgia with chronic rheumatic diseases in South Korea: a comparison of clinical and American College of Rheumatology criteria
ConclusionsWe found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases. (Source: APLAR Journal of Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Telephone interview strategy can be used for screening inflammatory back pain in the community
ConclusionThe results of our study indicate that telephone surveys based on Calin's criteria for IBP has a moderate, almost substantial agreement with face‐to‐face interviews and can be used as an easily applicable, less expensive and time‐saving method in screening subjects for IBP. (Source: APLAR Journal of Rheumatology)


Hypothesis: Human papillomavirus vaccination syndrome—small fiber neuropathy and dysautonomia could be its underlying pathogenesis
This article forwards the hypothesis that small fiber neuropathy and dysautonomia could be the common underlying pathogenesis to the group of rare, but severe reactions that follow HPV vaccination. Clinicians should be aware of the possible association between HPV vaccination and the development of these difficult to diagnose painful dysautonomic syndromes. (Source: Clinical Rheumatology)


Update on the genetics of the fibromyalgia syndrome
Publication date: Available online 18 May 2015 Source:Best Practice &amp; Research Clinical Rheumatology Author(s): Jacob N. Ablin , Dan Buskila Fibromyalgia syndrome (FMS), a condition characterized by chronic widespread pain and tenderness, is a complex condition considered to represent a paradigm of centralized pain. FMS has demonstrated a clear familial aggregation, and hence it is considered to have a genetic background. Multiple candidate-gene studies have been conducted in this field, focusing on target genes that play a role in the transmission and processing of pain. While many of these have focused in the past on markers related to neurotransmitter systems such as catecholamines (catechol-O-methyltransferase (COMT)) and serotonin, novel target genes have recently emerged. I...


Quality of life and sexual satisfaction in women suffering from endometriosis: An Italian preliminary study
Discussion and conclusion Our results showed that the disease has a negative impact on many areas of the overall functioning and sexuality quality of life of women. Nevertheless, the existence of mediatory variables emerged, emphasising how the presence of a partner could be considered a protective value in the experience of pain, therefore stressing the need to adopt a bio-psychosocial perspective to study and fully understand the disease. (Source: Sexologies)


Alcohol and Tobacco Use in Youth With and Without Chronic Pain
Conclusions&nbsp;Chronic pain may not increase risk for tobacco and alcohol use in adolescents. Research is needed to understand use of other substances in this medically vulnerable population. (Source: Journal of Pediatric Psychology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Neuromuscular Ultrasound Imaging in Low Back Pain Patients with Radiculopathy
Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. (Source: Manual Therapy)


Effects of focal muscle vibration on physical functioning in patients with knee osteoarthritis: a randomized controlled trial.
CONCLUSIONS: In this study, focal muscle vibration therapy has proven to be effective and safe in improving functioning of patients affected by mild to moderate chronic knee OA. CLINICAL REHABILITATION IMPACT: The use of focal muscle vibration therapy might be an additional and safe tool in the conservative management of knee OA. PMID: 25990196 [PubMed - as supplied by publisher] (Source: European Journal of Physical and Rehabilitation Medicine)


Evidence for a distinct neuro-immune signature in rats that develop behavioural disability after nerve injury
Conclusions: This study has defined individual differences in the immune response at peripheral and spinal sites following CCI in rats. These changes correlated with the degree of disability. Our data suggest that individual immune signatures play significant roles in the different behavioural trajectories following nerve injury, and in some cases may lead to persistent affective-motivational disturbances. (Source: Journal of Neuroinflammation)


Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration
Conclusion This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration. (Source: The Journal of Headache and Pain)


Neuromuscular ultrasound imaging in low back pain patients with radiculopathy
Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. (Source: Manual Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Depression: An important factor associated with disability among patients with chronic low back pain
Conclusion Depression was the most powerful factor associated with disability of CLBP among depression, anxiety, and somatic symptoms. Depression should be evaluated when investigating disability among patients with CLBP. (Source: International Journal of Psychiatry in Medicine)


Targeting the Affective Component of Chronic Pain: a Case Series of Deep Brain Stimulation of the Anterior Cingulate Cortex: Erratum
No abstract available (Source: Neurosurgery)


Endometriosis – Hope is at Hand
The post Endometriosis – Hope is at Hand appeared first on Hysterectomy Association. ‘Historically, the symptoms of inexplicable chronic pelvic pain have often been attributed to imagined madness, female weakness, promiscuity or hysteria’ Wikipedia on Endometriosis. Fortunately, the tide has turned on this outmoded way of thinking! Modern medicine recognises the painful truth about endometriosis and uterine fibroids to such an extent that Covance, the clinical research unit in Leeds, has an upcoming study which could provide hope for women suffering from these aggressive and often debilitating conditions. Currently, there is no existing drug which combats the full spectrum of endometriosis and fibroids symptoms. I have little doubt that these symptoms will be familiar to loads of you...


Newbridge Spine & Pain Now Offering Revolutionary Procedure for...
The top pain management clinics in Maryland, Newbridge Spine & Pain, are now offering a revolutionary treatment for chronic back and neck pain. The procedure, radiofrequency ablation, offers up to...(PRWeb May 19, 2015)Read the full story at http://www.prweb.com/releases/pain-clinic-md/frederick-dundalk-waldorf/prweb12732693.htm (Source: PRWeb: Medical Pharmaceuticals)


Buprenorphine Buccal Film Reduces Chronic Low Back PainBuprenorphine Buccal Film Reduces Chronic Low Back Pain
A new study has shown that buprenorphine delivered through a buccal film can reduce chronic low back pain with few adverse effects. Medscape Medical News (Source: Medscape Neurology and Neurosurgery Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)
Title: ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 5/19/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Medical Pot-Painkiller Combo Isn't Always Recipe for Abuse
Title: Medical Pot-Painkiller Combo Isn't Always Recipe for AbuseCategory: Health NewsCreated: 5/18/2015 12:00:00 AMLast Editorial Review: 5/19/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Combined endovascular and endoscopic management of thoracic aortic pseudoaneurysm, mediastinal pseudocyst, and pancreatic pleural effusion due to chronic pancreatitis
A 49-year-old man presented to the cardiology unit with sudden-onset chest pain. His electrocardiogram and cardiac troponin levels were within normal limits. The patient had a history of alcohol abuse and had experienced episodes of abdominal pain for the previous 2 years. Contrast-enhanced CT (CECT) of the chest revealed bilateral pleural effusion and a descending thoracic aorta pseudoaneurysm (Fig. 1A). The surrounding mediastinum had a fluid collection that communicated with the abdominal pseudocyst (Fig. 1A, B). (Source: Gastrointestinal Endoscopy)


Erratum to: Relative frequency of chronic postoperative pain in patients operated for chronic otitis media
(Source: European Archives of Oto-Rhino-Laryngology)


Development of a High-Throughput Screening Assay to Identify Inhibitors of the Lipid Kinase PIP5K1C
Phosphatidylinositol 4-phosphate 5-kinases (PIP5Ks) regulate a variety of cellular processes, including signaling through G protein-coupled receptors (GPCRs), endocytosis, exocytosis, and cell migration. These lipid kinases synthesize phosphatidylinositol 4,5-bisphosphate (PIP2) from phosphatidylinositol 4-phosphate [PI(4)P]. Because small-molecule inhibitors of these lipid kinases did not exist, molecular and genetic approaches were predominantly used to study PIP5K1 regulation of these cellular processes. Moreover, standard radioisotope-based lipid kinase assays cannot be easily adapted for high-throughput screening. Here, we report a novel, high-throughput, microfluidic mobility shift assay to identify inhibitors of PIP5K1C. This assay uses fluorescently labeled phosphatidylinositol 4-p...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Comparison of Fluoroscopy and Ultrasound Guidance for Sacroiliac Joint Injection in Patients with Chronic Low Back Pain
ConclusionsUltrasound‐guided SIJ injection with fluoroscopic confirmation has similar accuracy and efficacy to fluoroscopy alone for SIJ injections in patients with chronic low back pain secondary to SIJ arthritis. (Source: Pain Practice)


Hyperbaric Oxygen Therapy: A New Treatment for Chronic Pain?
ConclusionsHBOT has been shown to reduce pain using animal models. Early clinical research indicates HBOT may also be useful in modulating human pain; however, further studies are required to determine whether HBOT is a safe and efficacious treatment modality for chronic pain conditions. (Source: Pain Practice)


Day‐to‐Day Changes of Auricular Point Acupressure to Manage Chronic Low Back Pain: A 29‐day Randomized Controlled Study
ConclusionThis study shows that APA is a promising pain management strategy that is not invasive and can be self‐managed by participants for CLBP. Given the day‐to‐day fluctuation in ratings, the tighter ecologic assessment of pain scores and other treatment parameters are an important pragmatic aspect of the design of chronic pain studies. (Source: Pain Medicine)


An overlooked cause of head- and neck-pain: Chronic canalithiasis, or Benign Paroxysmal Positional Vertigo – BPPV
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): Harald Breivik (Source: Scandinavian Journal of Pain)


Treatment of chronic canalithiasis can be beneficial for patients with vertigo/dizziness and chronic musculoskeletal pain, including whiplash related pain
Publication date: July 2015 Source:Scandinavian Journal of Pain, Volume 8 Author(s): Wenche Iglebekk , Carsten Tjell , Peter Borenstein Background and aim Chronic musculoskeletal pain, e.g. whiplash associated disorders (WAD), fibromyalgia and myalgia, causes significant burden on both the individual and on society as a whole. In a previous study, the authors concluded that there is a likely connection between chronic benign paroxysmal positional vertigo (BPPV)/canalithiasis and headache, neck pain, generalized pain, fatigue, cognitive dysfunctions as well as tinnitus. The balance dysfunction in BPPV/canalithiasis is dynamic and not static. This leads to a perpetual postural mismatch. The vicious cycle of a disturbed equilibrium control system may be the driving force behind the vicious ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Intra- and postoperative intravenous ketamine does not prevent chronic pain: A systematic review and meta-analysis
Conclusions Based on the currently available data, there is currently not sufficient evidence to support a reduction in chronic pain due to perioperative administration of ketamine. Only the analysis of postoperative pain at rest after 1 month resulted in a marginally significant reduction of chronic postoperative pain using ketamine in the perioperative setting. Implications It can be hypothesised, that regional anaesthesia in addition to the administration of perioperative ketamine might have a preventive effect on the development of persistent postsurgical pain. An additional high-quality pain relief intra- and postoperatively as well after discharge could be more effective than any particular analgesic method per se. It is an assumption that a low dose infusion ketamine has to be admi...


Experimental design and reporting standards for improving the internal validity of pre-clinical studies in the field of pain: Consensus of the IMI-Europain consortium
Conclusions More systematic research is needed to analyze how inadequate internal validity and/or experimental bias may impact reproducibility across pre-clinical pain studies. Addressing the potential threats to internal validity and the sources of experimental biases, as well as increasing the transparency in reporting, are likely to improve preclinical research broadly by ensuring relevant progress is made in advancing the knowledge of chronic pain pathophysiology and identifying novel analgesics. Implications We are now disseminating these Europain processes for discussion in the wider pain research community. Any benefit from these guidelines will be dependent on acceptance and disciplined implementation across pre-clinical laboratories, funding agencies and journal editors, but it i...


Single cases are complex Illustrated by Flink et al. ‘Happy despite pain: A pilot study of a positive psychology intervention for patients with chronic pain’
Publication date: April 2015 Source:Scandinavian Journal of Pain, Volume 7 Author(s): Stephen Morley (Source: Scandinavian Journal of Pain)


Happy despite pain: Pilot study of a positive psychology intervention for patients with chronic pain
Conclusions The results of this preliminary study indicate that a positive psychology intervention may have beneficial effects for some chronic pain patients. Although it is not to be expected that a limited positive psychology intervention on its own is sufficient to treat pain-related disability in chronic patients, our findings suggest that for some it may be an advantageous complement to enhance the effects of other interventions. Implications The results of this pilot study about the potential effects of a positive psychology intervention for chronic pain patients may be encouraging, warranting a larger randomized controlled study. Future studies may also concentrate on integrating positive psychology techniques into existing treatments, such as composite CBT-programs for chronic pai...


Osteopathic manipulative treatment for chronic nonspecific neck pain: A systematic review and meta-analysis
The objective of the current review was to assess the effectiveness of osteopathic manipulative treatment (OMT) in the management of chronic nonspecific neck pain regarding pain, functional status, and adverse events. (Source: International Journal of Osteopathic 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>


Lateral Hindfoot Impingement After Nonunion of Fracture of the Lateral Process of the Talus
We present the case of a patient with such an injury. The patient was treated operatively and was followed for 18 months. (Source: Journal of Foot and Ankle Surgery)


Surgical Success in Chronic Pancreatitis: Sequential Endoscopic Retrograde Cholangiopancreatography and Surgical Longitudinal Pancreatojejunostomy (Puestow Procedure)
Conclusion ERCP and stenting provide a therapeutic trial to assess possible benefit of a definitive duct drainage procedure. LPJ—the modified Puestow operation was safe and complication-free with good medium-term relief of symptoms. We were not able to identify a consistent etiology-associated outcome.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: European Journal of Pediatric Surgery)


Quality of life outcomes in women with endometriosis are highly influenced by recruitment strategies
STUDY QUESTION To what extent are outcome measures in endometriosis-related quality of life studies influenced by the setting in which patient recruitment is performed? SUMMARY ANSWER Quality of life outcomes in women with endometriosis are highly influenced by recruitment strategies. WHAT IS KNOWN ALREADY Most studies on quality of life in women with endometriosis are conducted in tertiary care centres or patient associations. It is conceivable that the setting in which patient recruitment is performed influences the quality of life results. This has not been investigated before. STUDY DESIGN, SIZE, DURATION Retrospective questionnaire based cohort study (part of the World Endometriosis Research Foundation (WERF) EndoCost study). The investigated women were recruited in three settings:...


Prevalence, management and burden of episodic and chronic headaches—a cross-sectional multicentre study in eight Austrian headache centres
Conclusion This study provides comprehensive data from eight Austrian headache centres for the first time. We found a substantial number of patients with CH including pMOH and its association with more common utilization of health care facilities and greater burden. The low use of prophylactic medication requires further examination. (Source: The Journal of Headache and Pain)


Treadmill Training Combined with Insulin Suppresses Diabetic Nerve Pain and Cytokines in Rat Sciatic Nerve.
CONCLUSIONS: Treadmill training combined with insulin therapy showed the best improvements in tactile allodynia and thermal hyperalgesia among our 3 treatment groups. The benefits of insulin intervention and treadmill training could be related to chronic inflammation (proinflammatory cytokines) and oxidative stress (MDA). PMID: 25993391 [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>


Building bridges between doctors and patients: the design and pilot evaluation of a training session in argumentation for chronic pain experts
Conclusions: This study enriches the research in the field of medical education. In line with the findings of studies that explore the value of argumentation in different fields, argumentative discussion skills can be applied by doctors to express their views and to account for the views of patients without patronizing the interaction. In this paper, we provide a basis to reflect on the value of argumentation in enhancing patients’ right to autonomy and self-determination in interactions with their doctors. (Source: BMC Medical Education)


Qing-Yi decoction in participants with severe acute pancreatitis: a randomized controlled trial
Conclusions: QYD could restore gastrointestinal motility to normal and reduce the infection rates in the SAP patients who completed a full course of QYD treatment according to per protocol analysis. (Source: Chinese Medicine)


[Acute abdomen due to complicated intramural duodenal hematoma. We report of a case and review in the literature].
CONCLUSIONS: Duodenal intramural hematoma secondary to chronic pancreatitis are rare, although the diagnosis should be made with imaging and, if suspected it, we start conservative treatment and surgery only in complicated cases. PMID: 26001766 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Combining voice therapy and physical therapy: A novel approach to treating muscle tension dysphonia.
CONCLUSIONS: Findings show voice therapy to be an effective approach to treating MTD. Importantly, other treatment modalities incorporating physical therapy had a similar, albeit not significant, improvement in VHI. This preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of MTD patients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. LEARNING OUTCOMES: The reader will describe symptoms associated with muscle tension dysphonia and current treatment. The reader will describe the systematic adjunctive physical therapy approach and understand the rationale to consider incorporation of physical therapy into the current treatment regimen. PMID: 26012419 [PubMed - as suppl...


Could a simple magnet magic away all of your aches and pains?
Faith Eckersall, 50, Sophie Mullins, 32 and Sheila Wenborne, 55, all use magnets to ease a variety of different medical conditions including chronic back pain, arthritis and the menopause. (Source: the Mail online | Health)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Deciding When to Prescribe Opioids in Primary CareDeciding When to Prescribe Opioids in Primary Care
How do primary care physicians approach the challenges of prescribing opioids in the context of chronic noncancer pain management? BMC Family Practice (Source: Medscape Today Headlines)


Candida, chronic inflammation - How to heal and rid the body of pain
(NaturalNews) Inflammation is a natural, healthy response to cellular damage or a natural, healthy immune response to a perceived threat. The idea that inflammation can persist without serving a purpose is a misnomer that allows the cause of disease to go unchecked and ignored.When... (Source: NaturalNews.com)


Mindfulness-based stress reduction (MBSR) as sole intervention for non-somatisation chronic non-cancer pain (CNCP): protocol for a systematic review and meta-analysis of randomised controlled trials
Introduction Chronic non-cancer pain (CNCP) affects up to 50% of the world's population. It impacts negatively on quality of life; entailing high costs on our medical systems, and translates to economic burden due to work loss. Aetiology of CNCP is complex and multifactorial, embracing the somatosensory, cognitive and affective domains. Opioid analgesia and other invasive interventions are often inadequate for clinical management of CNCP. Recently, mindfulness-based stress reduction (MBSR) has become a popular therapy for various medical conditions, including CNCP. However, studies reported varying efficacies, and relevant systematic reviews have included clinical trials with inherent heterogeneity either in study conditions or types of interventions used. Our study aims to provide an upda...


Overlap between fibromyalgia tender points and Charcot's hysterical zones: A historical curiosity
A 50-year-old woman was referred for evaluation of a bizarre gait pattern, defined as a functional movement disorder. Comorbidities included depression, sleep disorder, and chronic generalized pain for more than 1 year. On clinical examination, she had pain upon touching 15 out of the 18 specified tender points (figure, A), suggesting the diagnosis of fibromyalgia. When questioned about pain, she fulfilled the diagnostic criteria for fibromyalgia, with a widespread pain index &gt;7 and a symptom severity scale score &gt;5.1 These fibromyalgia tender points are similar to the ones described by Charcot in 1890, defined as "zones hyst&eacute;rog&egrave;nes"&mdash;hysterical zones (figure, B), overlapping perfectly.2 (Source: Neurology)


Treatment of Secondary Osteonecrosis of the Knee with Local Debridement and Osteoprogenitor Cell Grafting
We report a series of young patients in whom the osteonecrotic lesion was openly debrided, and concentrated bone marrow osteoprogenitor cells (OPC) harvested from the iliac crest were placed in the defect. Twelve patients (fourteen knees) have undergone debridement and grafting of distal femoral osteonecrotic lesions. Age at surgery averaged 23 years. Follow-up averaged 5 years. None of the patients have undergone further surgery, or were taking medications for ipsilateral knee pain. (Source: The Journal of Arthroplasty)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The effectiveness of acupuncture versus clonazepam in patients with burning mouth syndrome.
CONCLUSIONS: Acupuncture and clonazepam are similarly effective for patients with BMS. PMID: 25987645 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)


Eosinophilic Esophagitis as Paraneoplastic Syndrome in a Patient with Ganglioneuroblastoma
Klin Padiatr 2015; 227: 173-175DOI: 10.1055/s-0035-1547307A 16-month-old boy presented with failure to thrive despite sufficient caloric intake, hypersalivation, abdominal pain, chronic diarrhea and blepharitis. An eosinophilic esophagitis (EoE) was diagnosed by esophageal biopsy. Dietary restrictions and topical steroid treatment lead to no improvement. Further diagnostic work-up revealed an intrathoracal, paraspinal ganglioneuroblastoma. After operative extirpation of the tumour, all initial symptoms resolved. An esophageal control biopsy 4 weeks after tumour resection was normal. This is the first report of eosinophilic esophagitis as part of a paraneoplastic syndrome in a patient with a malignant disease other than a carcinoma.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle...


Disease burden of rheumatic diseases in India: COPCORD perspective
Publication date: Available online 16 May 2015 Source:Indian Journal of Rheumatology Author(s): Arvind Chopra The maiden WHO ILAR COPCORD (community oriented program for control of rheumatic diseases) Bhigwan (1996–2014) demonstrated that musculoskeletal (MSK) pain was the commonest self-reported ailment in the community, soft tissue rheumatism, ill-defined MSK symptoms and osteoarthritis (OA) were the predominant disorders and about 10% cases suffered from inflammatory arthritis. The burden of rheumatoid arthritis (RA) was high with point prevalence of 0.7%. Bone and joint decade (BJD) India conducted several standardized and uniform surveys (2004–2010) all over India and collected data from over 55,000 persons at 12 sites. The pooled age sex adjusted (India census population 2001) ...


Iyengar yoga may be suitable for inclusion in interdisciplinary chronic pain interventions, but evidence is limited
(Source: Focus on Alternative and Complementary Therapies)


Laparoscopic plug removal for femoral nerve colic pain after mesh & plug hernioplasty
Conclusion: In this study, laparoscopic hernioplasty proved useful for plug removal because laparoscopic instruments can easily grasp perilesional tissue, and laparoscopic approach has the benefit of isolating the plug for removal while preserving the onlay patch, and helpful for restoring peritoneal defects. Laparoscopic plug removal effectively resolved colic pain in the left thigh due to compression of the femoral nerve by a calcified plug. (Source: BMC 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>


Use of Prescription Pain Medications Among Medical Cannabis Patients: Comparisons of Pain Levels, Functioning, and Patterns of Alcohol and Other Drug Use.
CONCLUSIONS: Use of PPM among medical cannabis users was not identified as a correlate for more serious forms of alcohol and other drug involvement. However, longitudinal study designs are needed to better understand the trajectories of alcohol and other drug involvement over time among medical cannabis users. PMID: 25978826 [PubMed - as supplied by publisher] (Source: Journal of Studies on Alcohol and Drugs)


Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia
Conclusion: Knowledge and practice of the nurses regarding prevention of pressure ulcer was found to be inadequate. Having higher educational status, attending formal training and being experienced were positively associated with knowledge; while shortage of facilities and equipments, dissatisfaction with nursing leadership and inadequate staff number showed negative association with practice of nurse’s pressure ulcer prevention. In-service training and upgrading courses are some of the important steps to improve nurses’ knowledge and practice on prevention of ulcer pressure. (Source: BMC Nursing)


Patients with chronic non-specific low back pain who reported reduction in pain and improvement in function also demonstrated an improvement in gait pattern
Conclusions Significant differences exist between patients with CNSLBP and healthy controls in terms of gait pattern and self-assessed health status. The examined HBBT led to significant improvements in gait pattern, reduction in pain, improved function and increased quality of life. However, future studies should validate these results while comparing this treatment to other treatment modalities. (Source: European Spine Journal)


Associations of borderline personality with pain, problems with medications and suicidality in a community sample of chronic non-cancer pain patients prescribed opioids for pain
This article aims to examine the prevalence and associations of BPD in a large community sample of CNCP patients and the association with medication problems and suicidality. (Source: General Hospital Psychiatry)


The Comparative Burden of Chronic Widespread Pain and Fibromyalgia in the United States
ConclusionFibromyalgia subjects were characterized by the greatest disease burden with more comorbidities and pain‐related medications, poorer health status, function, sleep, lower productivity, and higher costs. (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>


Barriers to treating pain
A study by Pain Concern has identified the main barriers to effective treatment of chronic pain are organisational issues, limited treatment options, patient wellbeing and difficulty in talking about the nature of the symptom. Scotsman Pain - A to Z of MS (Source: Multiple Sclerosis Trust)


Does Change in Self-reported Mindfulness Mediate the Clinical Benefits of Mindfulness Training? A Controlled Study Using the French Translation of the Five Facet Mindfulness Questionnaire
Abstract Mindfulness training improves mental health and psychological functioning. Although several questionnaires have been developed to measure mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ) is currently one of the most widely used scales. However, uncertainty remains about whether the effects of mindfulness training can be unambiguously attributed to change in self-reported mindfulness. The present study was designed to answer three major questions: First, relative to a wait-list group, does participation in mindfulness training lead to changes in self-reported mindfulness among a mixed sample of individuals presenting stress-related problems, illness, anxiety, and chronic pain? Second, are changes in mindfulness associated with changes in psychological distress...


Meditation Could Help Alleviate Gut Disorder Symptoms
By: Esha Dey Published: May 13, 2015 07:37am ET on LiveScience.com. If you thought meditation was only good for your emotional well-being, think again. A new study shows that meditation may actually alleviate the symptoms of two gut disorders by altering certain genetic signals. The study looked at people who had either irritable bowel syndrome (IBS) or irritable bowel disease (IBD). It found that doing yoga and meditating regularly for two months eased the symptoms associated with the two gut disorders, the researchers said. This mind-and-body intervention seemed to work by inducing genetic changes in the body, the study authors said. The findings suggest that stress-relieving meditation can suppress the activities of certain genes responsible for causing inflammation and other imm...


Your Mysterious Nerve Pain Could Be Undiagnosed Celiac Disease, According To New Study
People with celiac disease are more than twice as likely to suffer from nerve damage than the general population, according to a recently published study in the medical journal JAMA Neurology. The association is so strong that the study authors suggest people with nerve damage should also be screened for celiac disorder in order to pinpoint potential treatment options, according to lead researcher Jonas Ludvigsson of the Swedish medical university Karolinska Institutet. "The current guidelines suggest that patients with neuropathy [nerve pain] should be screened for type 1 diabetes and certain vitamin deficiencies,” Ludvigsson told The Huffington Post. "I believe that in patients with neuropathy and none of these conditions, celiac screening is appropriate." Celiac disease is an auto...


New Clinical Decision Rule for Health Care Providers To Assess Patients’ Risk of Developing Chronic Pain
NCCIH-supported research develops clinical decision rule to identify people most likely to progress from acute to chronic low-back pain (Source: NCCAM Featured Content)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Researchers discover new ways to shut down signals involved in brain diseases
A research team has found new ways to block a pathway that may be responsible for several brain disorders, which could open the door to developing better treatments. Their work is focused on the protein NOS-1, which generates nitric oxide, a chemical signal that is linked to neurological disorders from neurodegeneration, stroke and chronic pain sensitivity to anxiety and depressive disorders. (Source: ScienceDaily Headlines)


Strong evidence still lacking on medical marijuana for pain
With increasing numbers of chronic pain patients experimenting with marijuana to get relief, physicians need to learn more about the plant and its constituents to counsel patients appropriately about its safety and possible analgesic benefits, according to a leading medical marijuana researcher. (Source: ScienceDaily Headlines)


Yoga and chronic pain have opposite effects on brain gray matter
Chronic pain is known to cause brain anatomy changes and impairments, but yoga can be an important tool for preventing or even reversing the effects of chronic pain on the brain, according to a new study. (Source: ScienceDaily Headlines)


'Catching chlamydia': combining cash incentives and community pharmacy access for increased chlamydia screening, the view of young people.
Authors: Parker RM, Bell A, Currie MJ, Deeks LS, Cooper G, Martin SJ, Del Rosario R, Hocking JS, Bowden FJ Abstract In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide ...


Traumatic brain injury in the US military: epidemiology and key clinical and research programs
Abstract Traumatic brain injury (TBI), and particularly concussion, is a major concern for the U.S. Military because of the associated short term disability, long term cognitive and pain symptoms suffered by some, and risk of prolonged or permanent neurologic injury if the Service member incurs a second TBI before full recovery from the first. Concussions were seen more often during the recent conflicts in Afghanistan and Iraq than in prior conflicts, such as the Vietnam War, because of the use of improvised explosive devices that typically caused non-penetrating closed head injury. Since 2000 more than 300,000 Service members were diagnosed with TBI, of which more than 80 % were concussions. Improved TBI screening tools also have identified a higher than expected incidence of co...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


&#8220;You have to go through it and have your children&#8221;: reproductive experiences among women with vulvodynia
Conclusions: Women described strategies regarding reproduction such as finding a personally acceptable level of pain before planning pregnancy, and a resilience that allowed them to achieve their reproductive goals despite pain and perceived lack of assistance from healthcare providers. Therefore, future research should assess the benefits of increased psychosocial support from partners and professionals who may assist in improving resilience. (Source: BMC Pregnancy and Childbirth)


Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis
Abstract To investigate how autoimmune thyroiditis (ATD) affects the clinical presentation of established rheumatoid arthritis (RA) with particular reference to fibromyalgia and chronic widespread pain (CWP). A cohort of 204 patients with RA for whom the presence or absence of autoimmune thyroid antibodies was documented was examined for the relationships between thyroid autoantibodies and fibromyalgia or CWP. We identified 29 % who tested positive for antithyroid peroxidase antibodies (TPOAb). The anti-thyroglobulin antibody (TgAb) was found in 24 %. Among the thyroid autoantibody-positive patients, 40 % had a diagnosis of fibromyalgia or CWP versus 17 % for antibody negative patients. Logistic regression analyses (adjusted by age, sex, diabetes and BMI) indicated that TPOAb-...


Musculoskeletal pain in schoolchildren across puberty: a 3-year follow-up study
Conclusions: Female gender, BJHS and pubertal stage are important risk factors for persistence of MSP. Further studies are needed to evaluate the natural history of MSP towards adulthood and the role of the pubertal age. (Source: Pediatric Rheumatology)


Therapeutic value of spinal cord stimulation in irritable bowel syndrome: a randomized crossover pilot study
Irritable bowel syndrome (IBS) is characterized by abdominal pain and changed bowel habits. Spinal cord stimulation (SCS) has been used for treatment of chronic pain syndromes. Animal studies have shown SCS to reduce the reaction to colonic balloon distension, known to be increased in IBS patients. To elucidate the potential for SCS as treatment for IBS, a pilot study was performed. Ten IBS patients (age 26&ndash;56 yr) were recruited. A SCS system with a four-polar electrode was implanted at the T5-T8 level. After a 2-wk run-in, a randomized, crossover design SCS during 6 wk was compared with no stimulation, with an ensuing stimulation period for 12 wk; total study period 28 wk. Patients recorded pain level, pain attacks, diarrheas, and global quality of life in a diary. At end of the stu...


Common Questions About Chronic Low Back Pain.
Authors: Herndon CM, Zoberi KS, Gardner BJ Abstract More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back pain is categorized as nonspecific low back pain without radiculopathy, low back pain with radicular symptoms, or secondary low back pain with a spinal cause. Imaging should be reserved for patients with red flags for cauda equina syndrome, recent trauma, risk of infection, or when warranted before treatment (e.g., surgical, interventional). Prompt recognition of cauda equina syndrome is critical. Patient education should be combined with evidence-...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Objective and subjective outcome 3 years after synthetic transobturator nonabsorbable anterior mesh use in symptomatic advanced pelvic organ prolapse surgery
Conclusion The Perigee System gave a favorable result in both anatomical and subjective success rates with a low rate of mesh-related morbidities. The strength of the study reported here is its long-term follow up of a relatively large number of patients and the use of validated questionnaires. Limitations are that it is not a RCT; hence, selection and indication bias is unavoidable. The favorable outcome and low morbidities resulting from mesh use is from a single surgeon's perspective and may not be generalized to others. (Source: Gynecology and Minimally Invasive Therapy)


The effects of movement speed on kinematic variability and dynamic stability of the trunk in healthy individuals and low back pain patients
Our findings suggest that slower pace flexion-extension trunk movements are associated with more motor variation as well as local and orbital stability, implying less potential risk of injury for the trunk. Individuals with and without low back pain consistently recruited a closed-loop control strategy towards achieving trunk stability. Chronic low back pain patients exhibited more stable trunk movements over long-term periods, indicating probable temporary pain relief functional adaption strategies. (Source: Clinical Biomechanics)


Structural and functional brain abnormalities in chronic low back pain: A systematic review
The purpose of this systematic review is to analyze the available literature on structural and functional brain abnormalities in chronic low back pain (CLBP) using several brain magnetic resonance imaging (MRI) techniques. (Source: Seminars in Arthritis and Rheumatism)


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)


Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity.
CONCLUSION: CRMO activity on longterm followup might have been underestimated. Our study demonstrates that clinical remission does not necessarily mean radiological remission. We therefore propose that all patients with CRMO, including patients in clinical remission, require longterm clinical followup and should undergo evaluation with WB-MRI on a regular basis until radiological remission or a steady state of disease is achieved. PMID: 25979713 [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>


Aggressive Therapy Reduces Disease Activity without Skeletal Damage Progression in Chronic Nonbacterial Osteomyelitis.
CONCLUSION: An aggressive treatment regimen in CNO improved clinical and imaging measures of disease activity without progression of skeletal damage. PMID: 25979712 [PubMed - as supplied by publisher] (Source: J Rheumatol)


[Profile of the patient with lumbar failed surgery syndrome at National Institute of Rehabilitation. Comparative analysis].
CONCLUSIONS: This study suggests that the diagnostic and treatment standards are different between healthcare centers, specifically between academic centers vs. private practice. PMID: 25986977 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Phantom Remodeling Effect of Dorsal Root Entry Zone Lesioning in Phantom Limb Pain Caused by Brachial Plexus Avulsion
Conclusions: The phantom arms and hands showed a prompt shortening and reduction in size, rather than a disappearance, following successful DREZ lesioning in patients with chronic phantom limb pain caused by brachial plexus avulsion.Stereotact Funct Neurosurg 2015;93:240-244 (Source: Stereotactic and Functional Neurosurgery)


The Great Pot Experiment
Barcott is a journalist who has contributed to the New York Times, National Geographic and other publications. Scherer is TIME&rsquo;s Washington bureau chief. Portions of this article were adapted from Barcott&rsquo;s new book &ldquo;Weed the People, the Future of Legal Marijuana in America,&rdquo; from TIME Books, is now available wherever books are sold, including Amazon.com, Barnes & Noble and Indiebound. Yasmin Hurd raises rats on the Upper East Side of Manhattan that will blow your mind. Though they look normal, their lives are anything but, and not just because of the pricey real estate they call home on the 10th floor of a research building near Mount Sinai Hospital. For skeptics of the movement to legalize marijuana, the rodents are canaries in the drug-policy coal mine. For d...


Development of monosodium acetate-induced osteoarthritis and inflammatory pain in ageing mice
This study suggests that nocifensive responses to damaging stimuli are altered with advancing age and microglial response to peripheral damage is less robust. (Source: AGE)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The prevalence, impact and cost of chronic non-cancer pain in Irish primary schoolchildren (PRIME-C): protocol for a longitudinal school-based survey
Introduction Previous research has indicated that pain influences children's daily lives, resulting in absence from school, sleep problems, poor school performance and problems with social activities. Our study aims to characterise the nature, extent, impact and cost of chronic pain among Irish children. Methods and analysis Using cluster-systematic random sampling, primary schools will be invited to participate and 6000 5&ndash;12-year-olds asked to complete questionnaires in school classrooms, at time points 1&nbsp;year apart. Questionnaires will use internationally valid psychometric measures to assess a range of quality of life factors and chronic pain indicators among children, with corresponding parental/primary caregiver questions, which will be completed at home. Data will also be...


Zingiberaceae extracts for pain: a systematic review and meta-analysis
Conclusion: Our findings indicated that Zingiberaceae extracts are clinically effective hypoalgesic agents and the available data show a better safety profile than non-steroidal anti-inflammatory drugs. However, both non-steroidal anti-inflammatory drugs and Zingiberaceae have been associated with a heightened bleeding risk, and there have been no comparator trials of this risk. Further clinical studies are recommended to identify the most effective type of Zingiberaceae extract and rigorously compare safety, including bleeding risk. (Source: Nutrition Journal)


Quality of life and its association with direct medical costs for COPD in urban China
Conclusion: Impaired quality of life was significantly linked to increased medical costs for COPD patients and could be an important measure for policy- and decision-making in COPD care. (Source: Health and Quality of Life Outcomes)


Re: Park et al.: The Presence of Chlamydia Is Associated With Increased Leukocyte Counts and Pain Severity in Men With Chronic Pelvic Pain Syndrome (Urology 2015;85:574-579)
It was with great interest that we read the article by Park et al,1 regarding the role of urinary chlamydial infection in patients with chronic prostatitis and/or chronic pelvic pain syndrome. In this stimulating article, the authors highlight that urinary chlamydial infection increased the pain and worsens the quality of life in the patients with chronic prostatitis and/or chronic pelvic pain syndrome.1 Recently, we focused our attention on the sexual dysfunction due to the Chlamydia trachomatis in chronic prostatitis patients. (Source: Urology)


Pain interference in youth with neurofibromatosis type 1 and plexiform neurofibromas and relation to disease severity, social‐emotional functioning, and quality of life
This study investigated the impact of pain in youth with NF1 and plexiform neurofibromas (PNs) and its relationship to disease factors, social‐emotional functioning, and quality of life (QOL) within a biopsychosocial framework. Caregivers of 59 children and adolescents with NF1 and PNs (6–18 years), and 41 of these youth (10–18 years), completed questionnaires assessing social‐emotional functioning and QOL, including an item on pain interference. Measures of disease severity included total PN volume by percent body weight and number of disease complications. Both caregiver (73%) and self‐report (59%) ratings indicated that pain interferes with the child's daily functioning despite 33% taking pain medication. Based on caregivers’ behavior ratings, more symptoms of anxiety and 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>


Involvement of GITRL System in Immune Cells in Chronic Pain [Immunology]
In conclusion, GITRL expressed on macrophages drives cytokine release and T cell activation, resulting in neuropathic pain via GITR-dependent actions. The GITRL-GITR pathway might represent a novel target for the treatment of neuropathic pain. (Source: Journal of Biological Chemistry)


Pain Modulation by Lignans (Phyllanthin and Hypophyllanthin) and Tannin (Corilagin) Rich Extracts of Phyllanthus amarus in Carrageenan‐induced Thermal and Mechanical Chronic Muscle Hyperalgesia
In conclusion, we strongly suggest that the observed antihyperalgesic and antiinflammatory effects of P. amarus in current pain model are mediated via spinal or supraspinal neuronal mechanisms, mainly by inhibition of PGE2. Modulation of chronic muscular inflammation may be due to presence of phytoconstituents like phyllanthin, hypophyllanthin, and corilagin, which offers a promising means for treatment of chronic muscle pain. Copyright © 2015 John Wiley & Sons, Ltd. (Source: Phytotherapy Research)


How can the nursing profession alleviate the burden of chronic pain?
Authors: McCabe C, Deaton C, Baillie L, Lowes L, Norton C, Tod A, Carrick-Sen D, Robb E PMID: 25978289 [PubMed - as supplied by publisher] (Source: British Journal of Nursing)


A Comparative Clinicopathologic Study of Collagenous Gastritis in Children and Adults: The Same Disorder With Associated Immune-mediated Diseases
Collagenous gastritis is a rare condition characterized by surface epithelial damage, subepithelial collagen deposition, and a lamina propria inflammatory infiltrate. Previous studies have proposed 2 clinicopathologic subtypes: (1) children (18 y of age or younger) presenting with severe anemia, nodular gastric mucosa, and isolated gastric disease; and (2) adults with chronic watery diarrhea that is associated with diffuse collagenous involvement of the gastrointestinal tract. However, notable exceptions exist. In fact, broad variability in clinical presentation, etiology, treatment and disease course has been reported. To better define the clinicopathologic features of collagenous gastritis, we have collected 10 pediatric and 21 adult cases and describe their clinical, endoscopic, patholo...


Prescription pain medications and chronic headache in Denmark: implications for preventing medication overuse
Conclusions High prevalence of opioid use among people with CH may be due to inappropriate headache treatment or development of MOH among those treated for other pain conditions. While there were cases of triptan overuse, triptans remain underutilized among those with CH, suggesting that migraine may be under-recognized and inappropriately treated, leading to overuse of other medications. Education of physicians on appropriate headache management is essential for MOH prevention. There is a need to increase universal awareness about MOH as an adverse effect of long-term analgesic use. (Source: European Journal of Clinical Pharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


When You Have Cancer And Can't Sleep
By Anna Medaris Miller for U.S. News Traci Gordon never had a problem falling asleep or staying asleep. In fact, she has a sleep disorder that causes her to sleep too much. “I could sleep through a whole weekend,” Gordon says. That all changed when Gordon, a 47-year-old administrative assistant in New York, began chemotherapy for breast cancer about seven years ago. The treatment threw her body into an artificial state of menopause, which caused unrelenting night sweats. “My memory of it was waking up five, six, seven times a night, absolutely dripping,” Gordon says. Each time, she would change her clothes, stand in front of the air conditioner and wonder how much of her fatigue was caused by the cancer, how much was caused by the treatment and how much was caused by her inabili...


Induction of cytoplasmic pattern in the form of "rods and rings" through the treatment of hepatitis C: a case report
This study attempts to clarify the relationship between this pattern not yet completely understood and the clinical picture of the patient. This pattern is characterized by 3–10 µm rods or rings with 2–5 µm in diameter scattered throughout the cytoplasm of the cell. Therefore, this new standard has been designated as "rods and rings" (RR). The antigenic target of this reaction was identified as inosine-5'-monophosphate dehydrogenase type 2 (IMPDH2) which is a key enzyme in the synthesis of purine nucleotides. The IMPDH2 enzyme aggregated or modified shaped RR in those patients treated with ribavirin may become antigenic and induce an autoimmune response. It is possible that interferon alpha stimulates the occurrence of anti-RR reactivity apparently induced by ribavirin. So far it is ...


Temporomandibular disorders in fibromyalgia syndrome: a short-communication
A síndrome da fibromialgia (SFM) é uma síndrome dolorosa crônica. A coexistência de uma condição dolorosa causada pela disfunção temporomandibular (DTM) e pela SFM tem sido frequentemente descrita por vários estudos. No entanto, a hipótese mais provável é que um conjunto de características da SFM pode levar ao aparecimento de sintomas de DTM e elas não são apenas condições coexistentes. Por isso, o objetivo deste estudo é apresentar uma revisão da literatura sobre a relação entre a fibromialgia e os sinais e sintomas da disfunção temporomandibular. Para este fim, fez-se uma pesquisa bibliográfica que envolveu o período de 1990 a 2013 nas bases de dados Medline, Pubmed, Lilacs e Scielo. Foram usadas as palavras-chave fibromialgia, disfunção temporomandibular e do...


Influence of climacteric on sexual dysfunctions in women with rheumatic diseases
A síndrome da fibromialgia (SFM) é uma síndrome dolorosa crônica. A coexistência de uma condição dolorosa causada pela disfunção temporomandibular (DTM) e pela SFM tem sido frequentemente descrita por vários estudos. No entanto, a hipótese mais provável é que um conjunto de características da SFM pode levar ao aparecimento de sintomas de DTM e elas não são apenas condições coexistentes. Por isso, o objetivo deste estudo é apresentar uma revisão da literatura sobre a relação entre a fibromialgia e os sinais e sintomas da disfunção temporomandibular. Para este fim, fez-se uma pesquisa bibliográfica que envolveu o período de 1990 a 2013 nas bases de dados Medline, Pubmed, Lilacs e Scielo. Foram usadas as palavras-chave fibromialgia, disfunção temporomandibular e do...


A Systematic Review of the Economic and Humanistic Burden of Gout
Conclusions The evidence confirms that gout has a growing overall prevalence and represents a significant burden in terms of both direct healthcare cost and HRQL outcomes. In light of this, effective urate-lowering treatments are likely to be valued if they can be clearly demonstrated to be both clinically effective and cost effective. Published data to support healthcare decision making in non-US countries with regards to treatments for gout are currently limited, which is a key limitation of the current evidence base. More research is also required to extend our understanding of the impact of gout on indirect costs, and a need also exists to develop a more comprehensive set of comparative HRQL utility assessments. (Source: PharmacoEconomics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 gene therapy using viral vectors for chronic pain.
Authors: Guedon JM, Wu S, Zheng X, Churchill CC, Glorioso JC, Liu CH, Liu S, Vulchanova L, Bekker A, Tao YX, Kinchington PR, Goins WF, Fairbanks CA, Hao S Abstract The complexity of chronic pain and the challenges of pharmacotherapy highlight the importance of development of new approaches to pain management. Gene therapy approaches may be complementary to pharmacotherapy for several advantages. Gene therapy strategies may target specific chronic pain mechanisms in a tissue-specific manner. The present collection of articles features distinct gene therapy approaches targeting specific mechanisms identified as important in the specific pain conditions. Dr. Fairbanks group describes commonly used gene therapeutics (herpes simplex viral vector (HSV) and adeno-associated viral vector (...


Efficacy and safety of ultrasound-guided interventional management in chronic pain patients: Cohort follow-up
Conclusions Ultrasound-guided interventional pain management is an effective and safe technique. (Source: Colombian Journal of Anesthesiology)


Disability and disability benefit seeking in chronic low back pain
Conclusions Patient characteristics differ between disability benefit seekers and those established on disability benefit payments. Depression may be a modifiable correlate of disability benefit seeking that if treated may reduce the number of patients who eventually come to depend on disability benefits. Additional data collection involving other pain syndromes is warranted to determine if these results are unique to CLBP or apply to other painful conditions. (Source: Occupational Medicine)


Effects of 6 Weeks of Balance Training on Chronic Ankle Instability in Athletes: A Randomized Controlled Trial
The objective of the present study was to determine the effectiveness of a 6-week balance training program on patients with Chronic Ankle Instability (CAI) in relation to the results obtained in Dynamic Balance, subjective feeling of instability and pain using a single-blind randomized controlled trial. 70 athletes were randomly assigned to control or intervention group. The control group performed their usual training, and the intervention group was administered the same usual activity in addition to a balance program. The paired t-test was performed to evaluate the change scores in each group. The t-test for independent samples was performed to evaluate between-group differences in change scores. Significance level was assigned for p-values less than 0.05 for all analyses. There were sig...


Pelvic fractures
Publication date: Available online 12 May 2015 Source:Surgery (Oxford) Author(s): Faiz S. Shivji , Conal Quah , Daren P. Forward Fractures of the pelvic ring are significant injuries that affect diverse population groups. They range from low-energy, stable fractures to high-energy, unstable injuries with a substantial morbidity and mortality. The osseous and ligamentous relationships involved in maintaining the stability of the pelvis are complex, and knowledge of these is essential to appropriately manage pelvic fractures. The mechanism of injury and force vectors involved may be used to predict pelvic instability, likely additional injuries, and management strategies. Initially, temporary stabilization, blood-based resuscitation, and appropriate imaging are required. Further haemorrha...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Research Articles] The nicotinic {alpha}6 subunit gene determines variability in chronic pain sensitivity via cross-inhibition of P2X2/3 receptors
Chronic pain is a highly prevalent and poorly managed human health problem. We used microarray-based expression genomics in 25 inbred mouse strains to identify dorsal root ganglion (DRG)&ndash;expressed genetic contributors to mechanical allodynia, a prominent symptom of chronic pain. We identified expression levels of Chrna6, which encodes the &alpha;6 subunit of the nicotinic acetylcholine receptor (nAChR), as highly associated with allodynia. We confirmed the importance of &alpha;6* (&alpha;6-containing) nAChRs by analyzing both gain- and loss-of-function mutants. We find that mechanical allodynia associated with neuropathic and inflammatory injuries is significantly altered in &alpha;6* mutants, and that &alpha;6* but not &alpha;4* nicotinic receptors are absolutely required for periph...


Heightened Temporal Summation of Pain in Patients with Functional Gastrointestinal Disorders and History of Trauma.
CONCLUSIONS: Assessing for trauma history in patients with FGIDs could identify a subset at risk for greater central sensitization and pain-related symptoms. PMID: 25967582 [PubMed - as supplied by publisher] (Source: Annals of Behavioral Medicine)


Does Age Affect the Relationship Between Pain and Disability? A Descriptive Study in Individuals Suffering From Chronic Low Back Pain.
CONCLUSION: Although both young and older individuals showed a significant association between pain intensity and disability, the relationship between these 2 variables was more tenuous in older individuals than in young patients. Future research is essential to identify the factors underlying this age-related difference. PMID: 25973569 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Treatment of Dyslipidemia with Statins and Physical Exercises: Recent Findings of Skeletal Muscle Responses
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...


Left Atrial Volume Index as Predictor of Events in Acute Coronary Syndrome
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Case 4/2015 A 48-year-old Male Patient with Coarctation of the Aorta, Bicuspid Aortic Valve and Normal Ascending Aorta
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...


Sickle-cell Anemia and Latent Diastolic Dysfunction: Echocardiographic Alterations
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...


Correct Anatomical Orientation of the Heart and Reflections on the Nomenclature Used in Daily Practice
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...


Incremental Value Of 3D Transesophageal Echocardiography for The Assessment of Mitral Valve Prolapse
This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises...


7 Top Futurists Make Some Pretty Surprising Predictions About What The Next Decade Will Bring
From smartphone apps that can do seemingly everything to driverless cars and eerily humanlike robots, the past decade has seen dramatic advances in science and technology. What amazing advances are we likely to see in the next 10 years? To find out, HuffPost Science reached out to seven top futurists -- and they gave us some pretty surprising predictions. Keep reading to learn more. Dr. Michio Kaku, professor of theoretical physics at the City University of New York and author of "The Future of the Mind:" "In the next 10 years, we will see the gradual transition from an Internet to a brain-net, in which thoughts, emotions, feelings, and memories might be transmitted instantly across the planet. Scientists can now hook the brain to a computer and begin to decode some of our memories 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>


FDA Approves Spinal Cord Stimulation System With Superiority Labeling
The FDA announced the approval the first implantable spinal cord stimulation (SCS) system to treat chronic back pain using high frequency (up to 10,000 Hz) stimulation without causing a common tingling side effect called paresthesia. Experts say Nevro&rsquo;s Senza SCS system represents a significant advance in SCS technology, and it is the only system to be FDA approved with superiority labeling. (Source: Medical Design Online News)


9 Common Symptoms Of Fibromyalgia And What To Do If You're Diagnosed
Today is National Fibromyalgia Awareness Day, which raises awareness for a chronic disorder that impacts an estimated five million adults in the United States, and is characterized by widespread pain and tenderness, often accompanied by fatigue, impaired memory and other physical issues. The condition may occur with other chronic pain conditions, such as osteoarthritis, rheumatoid arthritis and lupus. The exact cause of fibromyalgia is unknown, but researchers believe it could be the result of several factors, including genetics, illness and physical or emotional trauma, which lead to an abnormal processing of pain. In the video above from The Doctors, Maggie says she has suffered from fibromyalgia for over 10 years, but receiving the correct diagnosis was a challenge. “I started getti...


Spinal Stimulation System Relieves Pain Without Tingling
Title: Spinal Stimulation System Relieves Pain Without TinglingCategory: Health NewsCreated: 5/11/2015 12:00:00 AMLast Editorial Review: 5/12/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Physical Activity and Health-Related QoL in Low Back PainPhysical Activity and Health-Related QoL in Low Back Pain
This study explores the connections. BMC Musculoskeletal Disorders (Source: Medscape Today Headlines)


Current gene therapy using viral vectors for chronic pain
The complexity of chronic pain and the challenges of pharmacotherapy highlight the importance of development of new approaches to pain management. Gene therapy approaches may be complementary to pharmacotherapy for several advantages. Gene therapy strategies may target specific chronic pain mechanisms in a tissue-specific manner. The present collection of articles features distinct gene therapy approaches targeting specific mechanisms identified as important in the specific pain conditions. Dr. Fairbanks group describes commonly used gene therapeutics (herpes simplex viral vector (HSV) and adeno-associated viral vector (AAV)), and addresses biodistribution and potential neurotoxicity in pre-clinical models of vector delivery. Dr. Tao group addresses that downregulation of a voltage-gated 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>


Persistence with opioid treatment in Germany in patients suffering from chronic non-malignant or cancer pain
Current Medical Research & Opinion, Ahead of Print. (Source: Current Medical Research and Opinion)


Corticotropin-releasing factor receptor type 1 and type 2 interaction in irritable bowel syndrome
Abstract Irritable bowel syndrome (IBS) displays chronic abdominal pain or discomfort with altered defecation, and stress-induced altered gut motility and visceral sensation play an important role in the pathophysiology. Corticotropin-releasing factor (CRF) is a main mediator of stress responses and mediates these gastrointestinal functional changes. CRF in brain and periphery acts through two subtype receptors such as CRF receptor type 1 (CRF1) and type 2 (CRF2), and activating CRF1 exclusively stimulates colonic motor function and induces visceral hypersensitivity. Meanwhile, several recent studies have demonstrated that CRF2 has a counter regulatory action against CRF1, which may imply that CRF2 inhibits stress response induced by CRF1 in order to prevent it from going into an ...


Advances in NSAID Development: Evolution of Diclofenac Products Using Pharmaceutical Technology
Abstract Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) of the phenylacetic acid class with anti-inflammatory, analgesic, and antipyretic properties. Contrary to the action of many traditional NSAIDs, diclofenac inhibits cyclooxygenase (COX)-2 enzyme with greater potency than it does COX-1. Similar to other NSAIDs, diclofenac is associated with serious dose-dependent gastrointestinal, cardiovascular, and renal adverse effects. Since its introduction in 1973, a number of different diclofenac-containing drug products have been developed with the goal of improving efficacy, tolerability, and patient convenience. Delayed- and extended-release forms of diclofenac sodium were initially developed with the goal of improving the safety profile of diclofenac and providing conve...


Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials
Conclusions Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. (Source: BMJ Open)


Subgroups of US IRAQ and Afghanistan veterans: associations with traumatic brain injury and mental health conditions
The objective of this study was to identify subgroups of Iraq and Afghanistan veterans (IAVs) with distinct compositions of symptoms associated with TBI, PTSD, and depression. Our cross-sectional, observational study included 303,716 IAVs who received care in the Veterans Health Administration in 2010–2011. Symptoms and conditions were defined using International Classification of Diseases, Ninth Revision codes and symptom-clusters were identified using latent class analysis. We identified seven classes with distinct symptom compositions. One class had low probability of any condition and low health care utilization (HCU) (48 %). Other classes were characterized by high probabilities of mental health comorbidities (14 %); chronic pain and sleep disturbance (20 %); headaches and memory...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project
This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5–10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health‐care cost savings. (Source: International Journal of Nursing Practice)


Adverse childhood experiences influence development of pain during pregnancy
ConclusionsAdverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.This article is protected by copyright. All rights reserved. (Source: Acta Obstetricia et Gynecologica Scandinavica)


The societal burden of chronic pain in Japan: an internet survey
Conclusions The results suggest that chronic pain has a significant association in an individual’s health status, work productivity, daily activity impairment, healthcare resource use, and economic burden in Japan. Along with low treatment rates, a multidisciplinary approach may lead to an improved quality of life and reduce the economic burden among patients with chronic pain in Japan. (Source: Journal of Orthopaedic Science)


Rural-Urban Differences in the Prevalence of Chronic Disease in Northeast China
Rural&ndash;urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reduci...


Changing channels in pain and epilepsy: Exploiting ion channel gene therapy for disorders of neuronal hyperexcitability
Chronic pain and epilepsy represent major health concerns, together affecting hundreds of millions of people worldwide at a cost to the global economy of hundreds of billions of dollars [1,2]. In Europe, it is estimated that 0.6-0.7% of the general population suffers from epilepsy [3], and up to 20% will experience chronic pain at some point in their lives [4]. Despite the impressive array of drugs available to treat these disorders, a significant proportion of patients remains resistant to traditional pharmacotherapy; 25% of epilepsies are refractory in nature [5], and as many as two-thirds of chronic pain sufferers are dissatisfied with treatment efficacy [6]. (Source: FEBS Letters)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Altered cortical processing of observed pain in fibromyalgia syndrome patients
Fibromyalgia syndrome (FMS) is characterised by widespread chronic pain, fatigue, sleep disorders and cognitive-emotional disturbance. FMS patients exhibit increased sensitivity to experimental pain and pain-related cues, as well as deficits in emotional regulation. The present study investigated the spatio-temporal patterns of brain activations for observed pain in 19 FMS patients and 18 age-matched, healthy control subjects using event-related potential (ERP) analysis. Fibromyalgia patients attributed greater pain and unpleasantness to pain pictures relative to healthy control participants. (Source: The Journal of Pain)


Central sensitization and changes in conditioned pain modulation in people with chronic nonspecific low back pain: a case-control study.
Authors: Corrêa JB, Costa LO, de Oliveira NT, Sluka KA, Liebano RE Abstract Quantitative sensory testing is widely used in human research to investigate the state of the peripheral and central nervous system contributions in pain processing. It is a valuable tool to help identify central sensitization and may be important in the treatment of low back pain. The aim of this study was to evaluate changes in local and segmental hypersensitivity and endogenous pain inhibition in people with chronic nonspecific low back pain. Thirty patients with chronic low back pain and thirty healthy subjects were studied. Pressure pain thresholds (PPTs) were measured from the lumbar region and over the tibialis anterior muscle (TA). A cold pressor test was used to assess the activation of conditione...


Osmophobia and allodynia are critical factors for suicidality in patients with migraine
Conclusions Osmophobia and allodynia are critical factors for suicidality in patients with migraine, after controlling for depression, anxiety, and CM. (Source: The Journal of Headache and Pain)


Altered Cortical Processing of Observed Pain in Patients With Fibromyalgia Syndrome
Fibromyalgia syndrome (FMS) is characterized by widespread chronic pain, fatigue, sleep disorders, and cognitive-emotional disturbance. Patients with FMS exhibit increased sensitivity to experimental pain and pain-related cues, as well as deficits in emotional regulation. The present study investigated the spatiotemporal patterns of brain activations for observed pain in 19 patients with FMS and 18 age-matched, healthy control individuals using event-related potential analysis. Patients with FMS attributed greater pain and unpleasantness to pain pictures relative to healthy control participants. (Source: The Journal of Pain)


TCF4 Mediates the Maintenance of Neuropathic Pain Through Wnt/β-Catenin Signaling Following Peripheral Nerve Injury in Rats
Abstract Neuropathic pain is elicited after a serious disorder of the nervous system and is along with the neural damage. It is usually chronic and challenging to treat. Transcription factor 4 (TCF4) is a key transcription factor of Wnt signaling system. Recent studies have shown that TCF4 interacts with β-catenin in the Wnt signaling pathway and coactivates downstream target genes in diverse systems. However, it is not well elucidated in the pathogenesis of neuropathic pain. In the present study, we investigated the role of TCF4 in the maintenance of neuropathic pain after chronic constriction injury (CCI) in rats. CCI induced persistent TCF4 upregulation in the dorsal root ganglion and spinal cord. Interestingly, TCF4 was mainly colocalized with neurons in the injured dorsal 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>


Things I Wish I'd Known When I Was Younger
I am 64 years old. There, I admit it. Women don't always want to admit their age, but there is one really good thing about seeing the decades roll by: I finally appreciate that "women's health" means different things at different times. For this year's National Women's Health Week, we're focusing on what steps women can take at different ages and stages to live a healthier life. And now that I am older, I'd like to share some of my thoughts on things I wish someone had told me when I was younger. In my 20s Fall in love with working out. Sometimes when you're young, you think you don't need to exercise. You can run, jump, and play with no problem and no weight gain, so why work out? But trust me: not making exercise a habit in your 20s makes it much harder to pick it up later in life. M...


Disabled woman finds insulting note on car
A woman with a chronic pain condition who parked in a handicapped-accessible parking spot found a note on her car that implied she wasn&#8217;t really handicapped and insulted her appearance. (Source: WDSU.com - Health)


Pregabalin for chronic pain: does one medication fit all?
Current Medical Research & Opinion, Ahead of Print. (Source: Current Medical Research and Opinion)


FDA Approves New Spinal Cord Stimulator for Chronic Pain (FREE)
By Kristin J. Kelley Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH The FDA has approved an implantable spinal cord stimulation system (marketed as Senza) to help manage … (Source: Physician's First Watch current issue)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Psychometric Evaluation of a German Version of the PROMIS(R) Item Banks for Satisfaction With Participation
The Patient Reported Outcomes Measurement Information System (PROMIS) initiative aims to provide reliable and precise item banks measuring patient-reported outcomes in different health domains. The aim of the present work was to provide a German translation of the PROMIS item banks for satisfaction with participation and to psychometrically test these German versions. Cognitive interviews followed a forward&ndash;backward translation. Distribution characteristics, unidimensionality, Rasch model fit, reliability, construct validity, and internal responsiveness were tested in 262 patients with chronic low back pain undergoing rehabilitation. Results for the final 13- and 10-item German static scales (Satisfaction with Participation in Social Roles&ndash;German version [PSR-G] and Satisfactio...


Clinical Reasoning: A patient with rapidly progressive sensory loss and imbalance
A 52-year-old man presented with sudden onset of acral paresthesia and imbalance. The patient did not have any recent illness, sick contacts, or travel abroad. He denied weakness, pain, bowel or bladder incontinence, dysphagia, dysarthria, or shortness of breath. On neurologic examination, 1 month into his symptoms, he had reduced muscle strength in his finger spread, extension, and flexion on both sides graded on Medical Research Council scale 4&ndash;/5 and in toe extensors &ndash;4/&ndash;4 and toe flexors &ndash;4/4. The rest of his muscle strength was normal. Reflexes were absent throughout. He had reduced sensation to all modalities in a length-dependent pattern up to his midshin and wrists on both sides. He was severely unsteady when walking and he could not tandem. Romberg was posi...


Short-term peripheral nerve stimulation ameliorates axonal dysfunction after spinal cord injury
There is accumulating evidence that peripheral motor axons deteriorate following spinal cord injury (SCI). Secondary axonal dysfunction can exacerbate muscle atrophy, contribute to peripheral neuropathies and neuropathic pain, and lead to further functional impairment. In an attempt to ameliorate the adverse downstream effects that developed following SCI, we investigated the effects of a short-term peripheral nerve stimulation (PNS) program on motor axonal excitability in 22 SCI patients. Axonal excitability studies were undertaken in the median and common peroneal nerves (CPN) bilaterally before and after a 6-wk unilateral PNS program. PNS was delivered percutaneously over the median nerve at the wrist and CPN around the fibular head, and the compound muscle action potential (CMAP) from ...


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


SCOPE: A Novel Scope-of-Practice-Based Paradigm for Empowering Family Physicians to Manage Chronic Nonmalignant Pain (F. Stuart Leeds MD)
PowerPoint version of Spring poster presentation - "final version" has improved readability, and is an exact representation of the physical poster that appeared during sessions at the Spring meeting. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Non‐thermal extremely low frequency magnetic field effects on opioid related behaviors: Snails to humans, mechanisms to therapy
In 1984, it was initially discovered in mice that an extremely low frequency magnetic field (ELF‐MF) could attenuate opiate induced analgesia. In the past 30 years, we defined some of ELF‐MF exposure and subject state conditions that can both increase and decrease nociception in snails and mice and can induce analgesia in humans. In our search for mechanisms and our desire to translate our findings to the treatment of chronic pain in humans, we pioneered the use of electroencephalography and magnetic resonance imaging to monitor effects during exposure. We have contributed to an understanding of the phenomena but a considerable amount remains to be done by us and those who have undertaken corroboratory and complimentary work. As the recipient of the 2013 d'Arsonval Award, I was invited...


Psychosocial experiences of chronic illness in individuals with an intellectual disability: A systematic review of the literature
Conclusions: There are unmet needs within this population, including a lack of assistance in understanding their illness. A substantial gap in the literature should be addressed through further empirical work. (Source: Journal of Intellectual Disabilities)


Pneumonia and Inflammatory Arthritis Caused by Unusual Occupational Exposure or a Life-Threatening Infection Resulting From a More Commonly Encountered Mechanism?
A 44-YEAR-OLD RENOVATION CONTRACTOR with a history of chronic low back pain developed symptoms consistent with an upper respiratory infection approximately 3 days after removing carpeting on which a decomposing human body recently had been discovered. The contractor was not wearing a respirator when he performed the work. He initially ignored his symptoms, but he eventually sought medical attention at a local community hospital complaining of a persistent fever, chills, night sweats, weight loss, a productive cough, dyspnea, orthopnea, and chest “heaviness” that was exacerbated with activity and partially relieved with rest. (Source: Journal of Cardiothoracic and Vascular Anesthesia)


Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy.
CONCLUSIONS: The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther) and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy. PMID: 26094538 [PubMed - as supplied by publisher] (Source: Annals of Agricultural and Environmental Medicine : AAEM)


Persistent Postmastectomy Pain and Pain-Related Physical and Emotional Functioning With and Without a Continuous Paravertebral Nerve Block: A Prospective 1-Year Follow-Up Assessment of a Randomized, Triple-Masked, Placebo-Controlled Study
Conclusions Adding a multiple-day, continuous ropivacaine infusion to a single-injection ropivacaine paravertebral nerve block may result in a lower incidence of pain as well as pain-related physical and emotional dysfunction 1 year after mastectomy. (Source: Annals of Surgical 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>


Outcomes after surgical treatment of missed Monteggia fractures in children
We present a large series of patients treated in our Institution. Materials and methods The outcome of 22 children treated surgically between 1988 and 2011 for post-traumatic chronic radial head dislocation is reported. There were 12 girls and 10 boys with a mean age at surgery of 7.2 years (4.1–13.6). The mean interval between injury and treatment was 15.7 months (1–128). Nine patients underwent open reduction with removal of interposed tissue and repair (7) or Bell-Tawse reconstruction (2) of the annular ligament. Ten patients underwent osteotomy, gradual lengthening and angulation of the ulna by external fixation. Two patients underwent angular osteotomy of the proximal ulna with open wedge, open reduction in the radial head and reconstructi...


FDA Okays Senza SCS System Without Tingling for Chronic PainFDA Okays Senza SCS System Without Tingling for Chronic Pain
The FDA has approved the Senza spinal cord stimulation system, the first such system to relieve pain without paresthesia. FDA Approvals (Source: Medscape Neurology and Neurosurgery Headlines)


The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs
It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. (Source: Pain Management Nursing)


Can a Single-legged Squat Provide Insight into Movement Control and Loading During Dynamic Sporting Actions in Athletic Groin Pain Patients?
CONCLUSION: For AGP patients, a SLS did not provide a meaningful insight into hip and pelvis control or loading during sporting movements that are associated with injury development. The usefulness of a SLS test in the assessment of movement control and loading in AGP patients is thus limited. The SLS provided a moderate insight into knee control while landing and therefore may be of use in the examination of knee injury risk. PMID: 25946707 [PubMed - as supplied by publisher] (Source: Journal of Sport Rehabilitation)


An algorithm for assessment and treatment of postherniorrhaphy pain
Conclusions In the present study, we implemented a diagnostic workup for patients with postherniorrhaphy inguinal pain to select those with neuropathic pain. Eighty-three percent of the patients with neuropathic groin pain obtained significant improvement of their pain scores after our protocolled treatment. The effect was achieved by nerve infiltrations and in some cases by an implanted PNS when the former was unsuccessful. (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>


Is articular pain in rheumatoid arthritis correlated with ultrasound power Doppler findings?
Conclusion Intra-articular PD was not correlated with pain symptom in this study. (Source: Clinical Rheumatology)


FDA approves spinal cord stimulation system that treats pain without tingling sensation
Today the U.S. Food and Drug Administration approved the Senza spinal cord stimulation (SCS) system (Senza System) as an aid in the management of chronic intractable pain of the trunk and/or limbs, including pain associated with failed back surgery syndrome, low back pain and leg pain. The Senza System can reduce pain without producing a tingling sensation called paresthesia by providing high frequency stimulation (at 10 KHz) and low stimulation amplitudes. (Source: Food and Drug Administration)


Clinical Depression Is a Strong Predictor of Poor Lumbar Fusion Outcomes Among Workers' Compensation Subjects
Conclusion. Overall, RTW rates after fusion were low, which was especially true for those with pre-existing depression. Depression was a strong negative predictor of postoperative RTW status. Psychological screening and treatment may be beneficial in these subjects. The poor outcomes in this study may highlight a more limited role for fusion among WC subjects with chronic low back pain where RTW is the treatment goal. Level of Evidence: 3 (Source: Spine)


Cost-Utility of Cognitive Behavioral Therapy for Low Back Pain From the Commercial Payer Perspective
Conclusion. CBT is a cost-effective approach to manage chronic LBP among commercial health plans members. Cost-effectiveness is demonstrated for multiple plan designs. Level of Evidence: 2 (Source: Spine)


Can We Convert Between Outcome Measures of Disability for Chronic Low Back Pain?
Conclusion. The lack of agreement between different outcome measures means that pooling of data on these different disability measurements in a meta-analysis is not recommended. Level of Evidence: 2 (Source: Spine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Randomized, Double-blind, Placebo-Controlled Crossover Trial of Oxymorphone Hydrochloride and Propoxyphene/Acetaminophen Combination for the Treatment of Neurogenic Claudication Associated With Lumbar Spinal Stenosis
Conclusion: This trial failed to demonstrate a benefit of OH or PA in patients experiencing neurogenic claudication. Considering the potential negative side effects of chronic opioid use, additional research is necessary to evaluate the efficacy of sustained opioid treatment specifically for neurogenic claudication. Level of Evidence: 2 (Source: Spine)


Individual patient data meta-analysis of older adults suffering from chronic pain
Publication date: May 2015 Source:Integrative Medicine Research, Volume 4, Issue 1, Supplement Author(s): Claudia Witt , Rainer Luedtke , Klaus Linde , Friederike Martins , Andrew Vickers , Emily Vertosick (Source: Integrative Medicine Research)


Acupuncture differential effect on chronic and acute low back pain using fMRI
Publication date: May 2015 Source:Integrative Medicine Research, Volume 4, Issue 1, Supplement Author(s): Meena M. Makary , Jeungchan Lee , Jun-Hwan Lee , Eunyoung Lee , Jae-Young Shin , Vitaly Napadow , Geonho Jahng , Kyungmo Park (Source: Integrative Medicine Research)


Efficacy of action potential simulation and interferential therapy in the rehabilitation of patients with knee osteoarthritis
Conclusion: Short-term treatment with both APS and IFT could significantly reduce pain and improve physical function in patients with knee OA. (Source: Therapeutic Advances in Musculoskeletal Disease)


Endoscopic Thyroid Lobectomy using Bilateral Axillo‐Breast Approach: Surgical Techniques and Outcomes
ConclusionBilateral axillo‐breast approach is a feasible and cosmetically excellent technique in performing endoscopic thyroid lobectomy. It should be recommended for eligible patients who have strong emphasis on cosmetic outcomes. (Source: Surgical 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>


Complications with office-based venoplasties and stenting and its clinical correlation
Conclusions The correction of iliac vein outflow obstruction in office-based settings results in a low incidence of complications, such as thrombosis (2%), and average pain score of 2 of 10 on the Likert scale. The procedure is minimally invasive with minimal complications. (Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders)


Venous angioplasty and stenting improve pelvic congestion syndrome caused by venous outflow obstruction
Conclusions Nonthrombotic obstruction of the left CIV or IVC is an underappreciated cause of PCS. Venous angioplasty and stenting provide excellent short-term results for such patients, with resolution of chronic pelvic pain and dyspareunia. Venous obstruction should be considered and carefully evaluated in patients presenting with pelvic congestion, and treatment of obstruction alone may solve the patient's symptoms. (Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders)


Management of perforator vein aneurysms in the lower extremities
Conclusions PVAs are rare without causing significant symptoms locally. Diagnosis is made with duplex ultrasound because the affected vein is located below the deep fascia. As only one case in our series of 19 involved the deep veins, we believe that PVAs originate from superficial veins. The condition is relatively benign, and the treatment outcomes are very good with limited complications experienced. However, selective treatment of PVAs may not be needed for most of them as treatment of the superficial veins connecting with the PVA may be sufficient. (Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders)


Utility of iliac vein stenting in elderly population older than 80 years
Conclusions Iliac vein stenting appears to offer a safe and effective option in octogenarians and nonagenarians when compression fails, is difficult, or is impossible. (Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders)


Serum level of vascular endothelial growth factor decreased in chronic ketamine abusers
Ketamine, a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist was used widely in medicine, pain management and anesthesia. Its use as a recreational drug of abuse has become widespread after its hallucinogenic effects were discovered in 1970's. Ketamine provokes distinctive pathopsychological symptoms similar to schizophrenia, as well as cognitive impairments in humans and rodents (Becker et al., 2003; Aalto et al., 2005). A single intravenous dose of ketamine given to healthy volunteers produced acute psychotic symptoms, as well as impairment of memory (Krystal et al., 1994; Morgan et al., 2004). (Source: Drug and Alcohol Dependence)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain and Decreased Opioid Efficacy: An Inflammatory Link
This article describes chronic pain as a disease process that has ineffective treatment modalities, explores the mechanisms of glial cell activation and inflammatory responses that lead to chronic pain and decreased opioid treatment efficacy, and hypothesizes novel chronic pain treatment modalities based on the glial cell inactivation and anti-inflammatory pathways. (Source: Pain Management Nursing)


A Comprehensive Review of Central Post-Stroke Pain
Although central post-stroke pain is widely recognized as a severe chronic neuropathic pain condition, its consolidated definition, clinical characteristics, and diagnostic criteria have not been defined due to its clinically diverse features. The present study was undertaken to comprehensively review current literature and provide a more complete picture of central post-stroke pain with respect to its definition, prevalence, pathophysiology, clinical characteristics, and diagnostic problems, and to describe the range of therapies currently available. (Source: Pain Management Nursing)


Staged treatment of a chronic patellar sleeve fracture using the Taylor spatial frame
We report a novel treatment using a Taylor spatial frame as part of a staged reconstruction to regain length of the extensor mechanism and maintain knee motion prior to performing primary repair of the avulsed patellar sleeve fragment. In our case, an 11-year-old male presented to our institution six months after sustaining a patellar sleeve fracture. (Source: The Knee)


Spinescope
The clinical entity known as discogenic back pain remains controversial. Four randomized trials have attempted to compare efficacy of surgical and non-surgical treatment with one trial showing improved results with surgery and the others showing comparable results. Mirza et al. performed a prospective observational cohort study to compare outcomes of community-based surgical and nonsurgerical treatments for patients with chronic back pain attributed to degeneration at one or two lumbar discs. (Source: Seminars in Spine Surgery)


Effects of Chronic Pelvic Pain on Heart Rate Variability in Women
Interstitial cystitis/bladder pain syndrome (IC/BPS) and myofascial pelvic pain (MPP) are frequently comorbid chronic pelvic pain disorders. Differences in bladder function between IC/BPS and MPP suggest that efferent autonomic function may differentiate these syndromes. Heart rate variability (HRV), defined as the difference in duration of successive heartbeats, serves as an index of autonomic function by measuring its ability to modify heart rate in response to neurophysiological changes. High frequency HRV (HF-HRV) was used as a reflection of more rapid vagally mediated (parasympathetic) changes, while low frequency HRV (LF-HRV) signified slower fluctuations related to baroreflex and sympathetic outflow. (Source: The Journal of Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial.
CONCLUSIONS: The present trial indicates that BAT led to greater improvements than ET for the patients with chronic WAD. Implications for Rehabilation Chronic whiplash-associated disorders are disabling and incur great costs to society often through inability to work. Exercise therapy (ET) may alleviate symptoms of chronic WAD. Basic body awareness therapy (BAT) is often a component of multimodal pain rehabilitation programs. In this randomized comparative trial, BAT increased physical functioning and led to greater pain reduction and social functioning 3 months after the end of treatment. PMID: 25955823 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)


Craniovertebral junction instability as an extension of cocaine-induced midline destructive lesions: case report.
Authors: Brembilla C, Lanterna LA, Risso A, Bombana E, Gritti P, Trezzi R, Bonaldi G, Biroli F Abstract With the increasingly widespread illicit use of cocaine, a broad spectrum of clinical pathologies related to this form of drug abuse is emerging. The most frequently used method of administration of powdered cocaine is intranasal inhalation, or "snorting." Consequently, adverse effects of cocaine on the nasal tract are common. Habitual nasal insufflations of cocaine can cause mucosal lesions. If cocaine use becomes chronic and compulsive, progressive damage of the mucosa and perichondrium leads to ischemic necrosis of the septal cartilage and perforation of the nasal septum. Occasionally, cocaine-induced lesions cause extensive destruction of the osteocartilaginous structures of ...


Potential new painkiller provides longer lasting effects
Medications have long been used to treat pain caused by injury or chronic conditions. Unfortunately, most are short-term fixes or cause side effects that limit their use. Researchers have discovered a new compound that offers longer lasting painkilling effects, and shows promise as an alternative to current anesthetics. (Source: ScienceDaily Headlines)


MicroRNA-146a-5p attenuates neuropathic pain via suppressing TRAF6 signaling in the spinal cord
In this study, we found that in cultured astrocytes, TNF-α, IL-1β, or lipopolysaccharides (LPSs) induced rapid TRAF6 upregulation and delayed miR-146a-5p upregulation. In addition, miR-146a-5p mimic blocked LPS-induced TRAF6 upregulation, as well as LPS-induced c-Jun N-terminal kinase (JNK) activation and chemokine CCL2 expression in astrocytes. Notably, LPS incubation with astrocytes enhanced the DNA binding activity of AP-1 to the promoters of mir-146a and ccl2. TRAF6 siRNA or JNK inhibitor SP600125 significantly reduced LPS-induced miR-146a-5p increase in astrocytes. In vivo, intrathecal injection of TNF-α or LPS increased spinal TRAF6 expression. Pretreatment with miR-146a-5p mimic alleviated TNF-α- or LPS-induced mechanical allodynia and reduced TRAF6 expression. Finally, SNL indu...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 37-Year-Old Man with Chronic Low Back Pain and Substance Abuse
Publication date: May 2015 Source:Journal of Emergency Nursing, Volume 41, Issue 3 Author(s): Daryl Ann Plotzker (Source: Journal of Emergency Nursing)


Musculoskeletal pain characteristics associated with lower balance confidence in community-dwelling older adults
To determine whether musculoskeletal pain (pain severity and number of chronic pain sites; single or multisite) is associated with balance confidence over and above previously established risk factors. (Source: Physiotherapy)


Electroacupuncture analgesia is associated with increased serum brain-derived neurotrophic factor in chronic tension-type headache: a randomized, sham controlled, crossover trial
Background: Chronic tension-type headache (CTTH) is characterized by almost daily headaches and central sensitization, for which electroacupuncture (EA) might be effective. The central nervous system (CNS) plasticity can be tracked in serum using the brain-derived neurotrophic factor (BDNF), a neuroplasticity mediator. Thus, we tested the hypothesis that EA analgesia in CTTH is related to neuroplasticity indexed by serum BDNF. Methods: We enrolled females aged 18–60 years with CTTH in a randomized, blinded, placebo-controlled crossover trial, comparing ten EA sessions applied for 30 minutes (2–10 Hz, intensity by tolerance) in cervical areas twice per week vs. a sham intervention. Treatment periods were separated by two washout weeks. Pain on the 10-cm visual analog scale (VAS) and s...


Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine
This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to partic...


Evaluation of psychosomatic distress and its influence in the outcomes of lumbar fusion procedures for degenerative disorders of the spine
This study emphasizes the need for objective psychological screening on chronic low back pain patients and that although patients with abnormal DRAM scores benefit from surgery, they report inferior outcomes and satisfaction in comparison with the normal DRAM group. (Source: European Journal of Orthopaedic Surgery and Traumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Physical inactivity is associated with narrower lumbar intervertebral discs, high fat content of paraspinal muscles and low back pain and disability
Conclusions: Physical inactivity is associated with narrower intervertebral discs, high fat content of the multifidus and high-intensity low back pain and disability in a dose-dependent manner among community-based adults. Longitudinal studies will help to determine the cause and effect nature of these associations. (Source: Arthritis Research and Therapy)


Screening and referral for axial spondyloarthritis—need of the hour
Abstract Although axial spondyloarthritis (axSpA) is as prevalent as rheumatoid arthritis, it is commonly under recognized due to variety of reasons. AxSpA contributes to significant loss of function and disability among young adults. With the availability of newer assessment methods and effective therapeutic agents, early diagnosis and appropriate treatment are possible. As mechanical back pain is widely prevalent in general population, selection of patients with high likelihood of having axSpA and referral to rheumatologists is very important to allow prompt diagnosis and management of axSpA yet avoid improper utilization of resources. Various referral strategies have been developed for this purpose which have included patients with chronic back pain for &gt;3 months with age ...


The incremental burden of pain in patients with depression: results of a Japanese survey
The objective of this study was to quantify the incremental burden of physical pain among individuals in Japan diagnosed with depression. Methods: Data for individuals age 18 and older who reported a physician diagnosis of depression were obtained from the Japan National Health and Wellness Survey (NHWS). Respondents who also reported physical pain were matched to respondents who did not report pain using propensity scores and compared using bivariate statistics. Measures included Patient Health Questionnaire (PHQ-9) for depression severity, Medical Outcomes Study 12-Item Short Form Survey Instrument (SF-12v2) for health-related quality of life, the Work Productivity and Activity Impairment (WPAI) for work and activity impairment, and 6-month report of health care use. Results: Individuals...


Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders.
Authors: Pelletier R, Higgins J, Bourbonnais D Abstract Present interventions utilized in musculoskeletal rehabilitation are in large part guided by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are however neurophysiological changes across different areas of the peripheral and central nervous system including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas and in the meso-limbic and prefrontal areas associated with chronic musculoskeletal disorders including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear to be not only a consequence of peripheral structural injury but play a part in the pathophysiology of chronic muscul...


Aetiological factors of Budd-Chiari syndrome in Algeria.
CONCLUSION: The main aetiologic factor of BCS in Algeria is MPD. The frequency of celiac disease justifies its consideration when BCS is diagnosed in our region. PMID: 25937867 [PubMed] (Source: World Journal of 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>


Assessing pharmacologic and nonpharmacologic risks in candidates for kidney transplantation.
CONCLUSION: Consensus opinions of practitioners in transplantation pharmacy regarding the pharmacologic and nonpharmacologic factors that should be considered in assessing candidates for kidney transplantation are presented. PMID: 25941253 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)


Integrating Virtual Reality With Activity Management for the Treatment of Fibromyalgia: Acceptability and Preliminary Efficacy
This study focuses on exploring the use of Virtual Reality (VR) as an adjunct to the activity management component. The aim of this study is to present the results of a small-sized randomized controlled trial to test the preliminary efficacy and acceptability of this component. Materials and Methods: The final sample was composed of 61 women diagnosed with FMS according to the American College of Rheumatology. The sample was randomly allocated to 2 conditions: VR treatment and treatment as usual. Results: Participants in the VR condition achieved significant improvements in the primary outcome: disability measured with the FIQ. The improvement was also significant in secondary outcomes, such as perceived quality of life and some of the coping strategies included in the Chronic Pain Coping ...


Using Health Information Technology to Improve Adherence to Opioid Prescribing Guidelines in Primary Care
Discussion: Implementation of an opioid dashboard led to increased adherence to certain opioid practice guidelines and a decline in COT. This may be attributable to more efficient team-based pain management facilitated by the dashboard and increased transparency of opioid prescription practices. Health Information Technology solutions such as clinical dashboards can increase adherence to practice guidelines. (Source: The Clinical Journal of Pain)


Piloting a Text Message–based Social Support Intervention for Patients With Chronic Pain: Establishing Feasibility and Preliminary Efficacy
Discussion: These findings establish the feasibility of collecting daily pain data using a mobile tracking App and provide significant implications and insight into a nuanced approach to reducing the daily experience of pain through mobile technology, especially because of its accessibility. (Source: The Clinical Journal of Pain)


Comparison of an Online Mindfulness-based Cognitive Therapy Intervention With Online Pain Management Psychoeducation: A Randomized Controlled Study
Conclusions: The results of the study provide evidence that although there were equivalent changes across outcomes of interest for participants in both conditions over time, the MIA program showed a number of unique benefits. However, the level of participant attrition in the study highlighted a need for further attention to participant engagement with online chronic pain programs. (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>


Impact of an Acceptance Facilitating Intervention on Patients’ Acceptance of Internet-based Pain Interventions: A Randomized Controlled Trial
Conclusions: Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video. (Source: The Clinical Journal of Pain)


Individualized Guided Internet-delivered Cognitive-Behavior Therapy for Chronic Pain Patients With Comorbid Depression and Anxiety: A Randomized Controlled Trial
Discussion: One-year follow-up showed maintenance of improvements. We conclude that an individualized guided internet-delivered treatment based on cognitive-behavior therapy can be effective for persons with chronic pain comorbid emotional distress. (Source: The Clinical Journal of Pain)


A Systematic Review of Technology-assisted Self-Management Interventions for Chronic Pain: Looking Across Treatment Modalities
This article is a systematic review of technology-assisted self-management interventions for chronic nonheadache, noncancer pain in adults. We examined 3 treatment modalities: telephone, interactive voice response, and Internet. Electronic searches of OVID MEDLINE, OVID PsychINFO, and the Cochrane Database of Systematic Reviews were conducted. Forty-four articles including 9890 participants were reviewed. Results: Across modalities, the existing evidence suggests that technology-assisted psychological interventions are efficacious for improving self-management of chronic pain in adults. All modalities have been shown to provide benefit and no clearly superior modality has emerged. The primary gaps in the literature are lack of in-person comparison groups, lack of direct comparison among te...


Eli Lilly to open new innovation center with a focus on drug delivery devices
Indianapolis-based pharma giant Eli Lilly is opening a new drug delivery and innovation center in Kendall Square in Cambridge, Massachusetts. Construction will begin immediately, with the center opening by the end of the year for a planned staff of 30 scientists and engineers. Eli Lilly Senior Director of Global Corporate Communications Edward Sagebiel said one Eli [&#8230;] (Source: mobihealthnews)


Acute and chronic pseudo‐obstruction: a current update
Abstract Acute colonic pseudo‐obstruction (ACPO) and chronic intestinal pseudo‐obstruction (CIPO) are distinct clinical entities in which patients present similarly with symptoms of a mechanical obstruction without an occlusive lesion. Unfortunately, they also share the issues related to a delay in diagnosis, including inappropriate management and poor outcomes. Advancements have been made in our understanding of the aetiologies of both conditions. Several predisposing factors linked to critical illness have been implicated in ACPO. CIPO is a functional motility disorder, historically misdiagnosed, with unnecessary surgery being performed in many patients with dire consequences. This review discusses the pathophysiology, clinical and diagnostic features, and treatment of each. For ACPO...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Subcutaneous Stimulation as an Additional Therapy to Spinal Cord Stimulation for the Treatment of Low Back Pain and Leg Pain in Failed Back Surgery Syndrome: Four‐Year Follow‐Up
ConclusionSCS combined with SubQ can be considered an effective long term treatment for low back pain in patients with FBSS for whom SCS alone is insufficient in alleviating their pain symptoms. (Source: Neuromodulation: Technology at the Neural Interface)


Clinically Relevant Effectiveness of Focused Extracorporeal Shock Wave Therapy in the Treatment of Chronic Plantar Fasciitis: A Randomized, Controlled Multicenter Study
Conclusions: The results of the present study provide proof of the clinically relevant effect size of focused extracorporeal shock wave therapy without local anesthesia in the treatment of recalcitrant plantar fasciitis, with success rates between 50% and 65%. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. (Source: The Journal of Bone and Joint Surgery)


Effect of a kneeling chair on lumbar curvature in patients with low back pain and healthy controls: A pilot study
Conclusions Although healthy subjects showed more reduction in lordosis between standing and sitting, the chair effect was found in both CLBP patients and healthy subjects. (Source: Annals of Physical and Rehabilitation Medicine)


Diet-induced changes in n-3 and n-6 derived endocannabinoids and reductions in headache pain and psychological distress
Omega-3 and omega-6 fatty acids are biosynthetic precursors to endocannabinoids with antinociceptive, anxiolytic, and neurogenic properties. We recently reported that targeted dietary manipulation—increasing omega-3 fatty acids while reducing omega-6 linoleic acid (the H3-L6 intervention)—reduced headache pain and psychological distress among chronic headache patients. It is not yet known whether these clinical improvements were due to changes in endocannabinoids and related mediators derived from omega-3 and omega-6 fatty acids. (Source: The Journal of Pain)


Psychometric Properties of the Centrality of Pain Scale
The Centrality of Pain Scale (COPS) is a recently developed, patient-centered, 10-item self-report measure designed to assess how central, or dominating, individuals with chronic pain perceive pain in their life. The COPS previously underwent initial development and validation, and preliminary results suggested that the measure had excellent psychometric properties and COPS scores were associated with important clinical factors. The purpose of the present study is to examine the psychometric properties of the COPS in a sample of individuals with mixed chronic pain diagnoses (n=178) being treated at a US Veterans Affairs Medical Center. (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>


Conservative laparoscopic electrocoagulation adenomyolysis for the management of symptomatic adenomyosis
The objective of the study was to assess the safety and efficacy of conservative laparoscopic electrocoagulation adenomyolysis (CLEA) in the management of women with symptomatic adenomyosis. The study design is prospective observational study. The setting was Department of Obstetrics and Gynecology, Mansoura University Hospital. Thirty-nine premenopausal women, complaining of chronic pelvic pain and/or menorrhagia, were diagnosed to have adenomyosis by transvaginal ultrasonography (TVS) and/or magnetic resonance imaging (MRI), between June 2008 and June 2011. They were subjected to laparoscopic multiple uterine unipolar electrocoagulation diathermy punctures aiming at adenomyolysis. Women were evaluated before and at 3, 6, and 12 months after the procedure. Main outcome is the magnitude o...


Effects of intermedin on dorsal root ganglia in the transmission of neuropathic pain in CCI rats.
This article is protected by copyright. All rights reserved. PMID: 25951228 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Pharmacology and Physiology)


Vitamin D for the treatment of chronic painful conditions in adults.
CONCLUSIONS: The evidence addressing the use of vitamin D for chronic pain now contains more than twice as many studies and participants than were included in the original version of this review. Based on this evidence, a large beneficial effect of vitamin D across different chronic painful conditions is unlikely. Whether vitamin D can have beneficial effects in specific chronic painful conditions needs further investigation. PMID: 25946084 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Postoperative hemicrania continua-like headache - a case series
Conclusion The biology of hemicrania continua may be activated post-craniotomy just as can be seen with other primary headache disorders. (Source: The Journal of Headache and Pain)


Diet-Induced Changes in n-3- and n-6-Derived Endocannabinoids and Reductions in Headache Pain and Psychological Distress
Omega-3 and omega-6 fatty acids are biosynthetic precursors to endocannabinoids with antinociceptive, anxiolytic, and neurogenic properties. We recently reported that targeted dietary manipulation—increasing omega-3 fatty acids while reducing omega-6 linoleic acid (the H3-L6 intervention)—reduced headache pain and psychological distress among chronic headache patients. It is not yet known whether these clinical improvements were due to changes in endocannabinoids and related mediators derived from omega-3 and omega-6 fatty acids. (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>


What Hillary Clinton Could Do About the Opioid Crisis
During a recent campaign stop, presidential candidate Hillary Clinton promised to make the "quiet epidemic" involving heroin and prescription opioids an important part of her presidential campaign -- and, presumably, of her presidency, should she be elected. She mentioned the issue of substance misuse again in her highly publicized speech on criminal justice reform last week. As someone intimately familiar with the devastating impact of this public health crisis on individuals, families and communities, I was very pleased to hear this, and thought of several ways she could make good on her pledge. Here are five simple steps Clinton could take, as candidate or President, that could significantly shape the course of opioid addiction in the United States. 1. Define the problem in the ri...


ER Doctors Cautious When Prescribing Narcotic Painkillers: Study
Title: ER Doctors Cautious When Prescribing Narcotic Painkillers: StudyCategory: Health NewsCreated: 5/4/2015 12:00:00 AMLast Editorial Review: 5/5/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Acupuncture relieves symptoms in chronic prostatitis/chronic pelvic pain syndrome: a randomized, sham-controlled trial
Acupuncture relieves symptoms in chronic prostatitis&#47;chronic pelvic pain syndrome: a randomized, sham-controlled trial Prostate Cancer and Prostatic Diseases advance online publication, May 5 2015. doi:10.1038/pcan.2015.13 Authors: S Sahin, M Bicer, G A Eren, S Tas, V Tugcu, A I Tasci & M Cek (Source: Prostate Cancer and Prostatic Diseases)


Oxytocin and the modulation of pain experience: A review
Publication date: Available online 5 May 2015 Source:Neuroscience &amp; Biobehavioral Reviews Author(s): Lincoln M. Tracy , Nellie Georgiou-Karistianis , Stephen J. Gibson , Melita J. Giummarra TRACY, L.M., N. Georgiou-Karistianis, S.J. Gibson and M.J. Giummarra. Oxytocin and the modulation of pain experience: A review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2015. In an acute environment pain has potential protective benefits. However when pain becomes chronic this protective effect is lost and the pain becomes an encumbrance. Previously unheralded substances are being investigated in an attempt to alleviate the burden of living with chronic pain. Oxytocin, a neuropeptide hormone, is one prospective pharmacotherapeutic agent gaining popularity. Oxytocin has the potential to modulate th...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Randomized, Placebo-Controlled Trial of Lubiprostone for Opioid-Induced Constipation in Chronic Noncancer Pain
Authors: M Mazen Jamal, Atoya B Adams, Jan-Peter Jansen & Lynn R Webster (Source: The American Journal of Gastroenterology)


Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis
Abstract With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for a bad outcome has never been greater. The genetic basis of ankylosing spondylitis has been considerably advanced, and HLA-B27 testing has a role in the diagnosis. Knowledge is still incomplete of the rest of the genetic contribution to disease susceptibility, and it is likely premature to use extensive genetic testing (other than HLA-B27) for diagnosis. Serum and plasma biomarkers have been examined extensively in assessing disease activity, treatment respon...


Ocular neuropathic pain.
Authors: Rosenthal P, Borsook D Abstract As the biological alarm of impending or actual tissue damage, pain is essential for our survival. However, when it is initiated and/or sustained by dysfunctional elements in the nociceptive system, it is itself a disease known as neuropathic pain. While the critical nociceptive system provides a number of protective functions, it is unique in its central role of monitoring, preserving and restoring the optical tear film in the face of evaporative attrition without which our vision would be non-functional. Meeting this existential need resulted in the evolution of the highly complex, powerful and sensitive dry eye alarm system integrated in the peripheral and central trigeminal sensory network. The clinical consequences of corneal damage to t...


MicroRNA-146a-5p attenuates neuropathic pain via suppressing TRAF6 signaling in the spinal cord.
In this study, we found that in cultured astrocytes, TNF-α, IL-1β, or lipopolysaccharides (LPSs) induced rapid TRAF6 upregulation and delayed miR-146a-5p upregulation. In addition, miR-146a-5p mimic blocked LPS-induced TRAF6 upregulation, as well as LPS-induced c-Jun N-terminal kinase (JNK) activation and chemokine CCL2 expression in astrocytes. Notably, LPS incubation with astrocytes enhanced the DNA binding activity of AP-1 to the promoters of mir-146a and ccl2. TRAF6 siRNA or JNK inhibitor SP600125 significantly reduced LPS-induced miR-146a-5p increase in astrocytes. In vivo, intrathecal injection of TNF-α or LPS increased spinal TRAF6 expression. Pretreatment with miR-146a-5p mimic alleviated TNF-α- or LPS-induced mechanical allodynia and reduced TRAF6 expression. Finally, SNL indu...


Experimental new vaccine may help in the fight against shingles
If you had chickenpox as a child, the virus that caused it can re-emerge later in life — out of the blue — to cause shingles. This condition, also known as herpes zoster, consists of a rash on one side of the body, often accompanied by excruciating pain. The rash typically goes away in about a month, but in some people, the pain lingers for weeks, months, or even years. This chronic pain is called post-herpetic neuralgia. The virus that causes chickenpox, known as varicella-zoster, doesn&#8217;t necessarily disappear from the body after the chickenpox rash fades away. Instead, the virus can go into hiding, taking up residence in the nerve roots coming off the spinal cord. As the immune system becomes weaker with age, varicella-zoster may &#8220;wake up,&#8221; start to grow in a 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>


A Review of Surgical and Nonsurgical Outcomes of Medial Knee Injuries
Medial-sided knee injuries can result in pain, instability, and loss of function. Many clinical studies have been written on the treatment of medial-sided knee injuries; however, the vast majority are isolated case series of surgical or nonoperative treatment regimens, and only a few randomized prospective clinical trials can be found in the literature that compare different treatment modalities. Comparison of these treatments is challenging due to the variety of medial-sided structures that can be involved, the multiple different approaches to treatment, and the variability of how objective and subjective clinical outcomes are reported. In this paper we report on the injuries by extent and type of anatomic structures damaged including partial medial-sided injuries, completed isolated medi...


A genetic model for chronic widespread pain: Clinical comorbidities and psychological correlates
Background: The aim was to investigate the etiological structure underlying chronic widespread pain (CWP) by disentangling the covariation between CWP and previously reported comorbidities (i.e., depression) and psycho-affective correlates (i.e., anxiety, emotional stability and emotional intelligence) into genetic and environmental components. (Source: Journal of Psychosomatic Research)


Mood spectrum disorders in chronic pain patients
Background: Chronic pain is a complex syndrome that affects thinking, mood and behaviour (Nekovarova et al., 2014). It is strongly associated with major depressive disorders (30–40%) but few studies have investigated the prevalence of bipolar disorders in chronic pain patients (Holmes et al., 2012; Nicholl et al., 2014). (Source: Journal of Psychosomatic Research)


Pathogenetic psychosomatic mechanisms in chronic pain: Gender differences among syndromes
Background: Abnormal Illness Behaviour (AIB) and Somatosensory Amplification Scale (SSAS) are two of the main conditions underlying medically unexplained symptoms. (Source: Journal of Psychosomatic Research)


Somatoform pain patients during psychosomatic inpatient treatment — A clinical observation study
We examined whether there were systematic differences between young and old pain patients. (Source: Journal of Psychosomatic 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>


Mindfulness and chronic pain. What is next step?
Background: Several meta-analyses have been performed comprising less specific “mindfulness-derived” interventions. There is a lack of randomized, controlled clinical trials investigating the effects of the full MBSR mindfulness meditation program on chronic pain. (Source: Journal of Psychosomatic Research)


St. Jude Medical Completes Acquisition of Spinal Modulation, Inc.
Now complete, the acquisition of Spinal Modulation adds DRG stimulation technology to the St. Jude Medical chronic pain portfolio ST. PAUL, Minn.--(Healthcare Sales & Marketing Network)--St. Jude Medical, Inc. (STJ), a global medical device company, tod... Devices, Neurology, Mergers & AcquisitionsSt. Jude Medical, Spinal Modulation, Axium, Neurostimulator, neuromodulation (Source: HSMN NewsFeed)


Serotonin Syndrome in a Patient on Trazodone and Duloxetine Who Received Fentanyl following a Percutaneous Liver Biopsy
Serotonin syndrome is a rare but potentially life-threatening adverse drug reaction resulting from the use or overuse of serotonergic medications alone or in combination. Mild symptoms, overlapping features with similar conditions and clinician lack of awareness are the major reasons for an often missed diagnosis. Not surprisingly, this condition is significantly underreported as a potential complication of endoscopy if serotonergic medications are used periprocedurally for sedation and analgesia. Here we report the case of a patient with relapsed chronic hepatitis C on antidepressant medications who developed signs and symptoms of serotonin syndrome after a percutaneous liver biopsy. Review of the patient's medication list suggested a possible interaction between her home antidepressants ...


Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain: A randomized controlled trial
Discussions Based on the findings, a stretching program using the GPR method showed effective at improving pain, function, some quality of life aspects (emotional, limitations in physical functioning, vitality and mental health) and had no effect on depressive symptoms in patients with chronic low back pain. (Source: Joint Bone Spine)


Psychometric assessment of the Japanese version of the Revised Fibromyalgia Impact Questionnaire: reliability and validity
ConclusionThe current psychometric assessment of the JFIQR demonstrated that it is a reliable and valid questionnaire in Japanese patients with FM. Usefulness of the JFIQR in clinical studies and medical practice for Japanese‐speaking populations is expected. (Source: APLAR Journal of Rheumatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Spinal and Nucleus Caudalis Dorsal Root Entry Zone Lesioning for Chronic Pain: Efficacy and Outcomes
Conclusion Spinal and NC DREZ lesioning can provide effective relief in well selected patients with intractable chronic pain conditions arising from trigeminal pain, spinal cord injury, brachial plexus avulsions, post-herpetic neuralgia and phantom limb pain. (Source: World Neurosurgery)


Juvenile idiopathic arthritis and physical activity: Possible inflammatory and immune modulation and tracks for interventions in young populations
Publication date: Available online 29 April 2015 Source:Autoimmunity Reviews Author(s): Emmanuelle Rochette , Pascale Duché , Etienne Merlin Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by persistent joint inflammation that manifests as joint pain and swelling and limited range of joint motion. In healthy subjects, the literature reports that physical activity has an anti-inflammatory effect. In JIA patients, exercise could be used as a therapeutic tool to counteract disease-related inflammation and thereby improve clinical symptoms, although transient flare of pain could be the price to pay. Indeed, in patients with a chronic inflammatory disease, physical activity is prone to exacerbate underlying inflammatory stress. Physical activity improves q...


Antiallodynic effects of alpha lipoic acid in an optimized RR‐EAE mouse model of MS‐neuropathic pain are accompanied by attenuation of upregulated BDNF‐TrkB‐ERK signaling in the dorsal horn of the spinal cord
Abstract Neuropathic pain may affect patients with multiple sclerosis (MS) even in early disease. In an experimental autoimmune encephalomyelitis (EAE)‐mouse model of MS, chronic alpha lipoic acid (ALA) treatment reduced clinical disease severity, but MS‐neuropathic pain was not assessed. Hence, we investigated the pain‐relieving efficacy and mode of action of ALA using our optimized relapsing‐remitting (RR)‐EAE mouse model of MS‐associated neuropathic pain. C57BL/6 mice were immunized with MOG35‐55 and adjuvants (Quil A and pertussis toxin) to induce RR‐EAE; sham‐mice received adjuvants only. RR‐EAE mice received subcutaneous ALA (3 or 10 mg kg−1 day−1) or vehicle for 21 days (15–35 d.p.i.; [days postimmunization]); sham‐mice received vehicle. Hindpaw hype...


Change in T2* Relaxation Time of Hoffa Fat Pad Correlates With Histologic Change in a Rat Anterior Cruciate Ligament Transection Model
This article is protected by copyright. All rights reserved (Source: Journal of Orthopaedic Research)


A systematic review of personality disorders and health outcomes.
Personality disorders (PDs) have been associated with a wide swath of adverse health outcomes and correspondingly high costs to health care systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with PDs. The primary aim of this article is to review research documenting the associations between PDs and health conditions. A systematic review of the literature revealed 78 unique empirical English-language, peer-reviewed articles examining the association of PDs and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of PDs with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Dry Endoscopic-Assisted Mini-Open Approach With Neuromonitoring for Chronic Hamstring Avulsions and Ischial Tunnel Syndrome
Publication date: Available online 4 May 2015 Source:Arthroscopy Techniques Author(s): Juan Gómez-Hoyos , Manoj Reddy , Hal D. Martin Chronic hamstring origin avulsions and ischial tunnel syndrome are common causes of posterior hip pain. Although physical therapy has shown benefits in some cases, recent evidence has reported better outcomes with surgical treatment in appropriately selected patients. The full-open approach has been the classic procedure to address this problem. However, the complications related to extensive tissue exposure and the proximity of the incision to the perianal zone have led to the description of full-endoscopic techniques. Achieving an accurate hamstring repair could be technically demanding with a full-endoscopic procedure. Accurate reattachment is crucial ...


Association of Physical Fitness with Pain in Women with Fibromyalgia: The al‐Ándalus project
Conclusions: Our results suggest that higher physical fitness is associated with lower levels of pain, lower pain‐related catastrophizing, and higher chronic pain self‐efficacy in women with FM. These results might have implications for future intervention studies in this population. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)


Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort.
CONCLUSIONS: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition). PMID: 26098326 [PubMed - as supplied by publisher] (Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases)


Obturator Neuralgia: A Rare Complication of Tension-free Vaginal Tape Sling—Complete Resolution After Laparoscopic Tension-free Vaginal Tape Removal
Conclusion In patients suffering from obturator neuralgia after a retropubic sling, surgeons should include the sling as a potential causative factor in the differential diagnosis. Surgeons should consider removing the sling based on the patient's symptoms. If the patient suffers from only vaginal pain and dyspareunia, then the surgeon should consider only the removal of the vaginal portion of the sling. In patients with obturator neuralgia, retropubic, and/or lower abdominal pain, one should consider a combined transvaginal and laparoscopic approach in an attempt to remove the majority of the sling and release tension between 2 points of fixation. (Source: Journal of Minimally Invasive Gynecology)


Periclitoral Endometriosis: The Dilemma of a Chronic Disease Invading a Rare Location
We present a unique case of periclitoral endometriosis, which to the best of our knowledge is the first in the literature. It is a 29-year-old nulligravida female with a painful fluctuant right periclitoral mass that had been growing with no response to antibiotic therapy. At the initial removal, pathology reported the lesion as endometriosis. The patient was placed on oral contraceptives, and she was noted to have monthly swelling and shrinking of the site with her menstrual cycles. When she went off hormonal contraception, she represented with the growing lesion 3.5 weeks after her last menses; she underwent re-excision. Because of the extension of the lesion medially and its adherence to the clitoral body, the decision was made to evacuate only as much of the capsule that could be safel...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension
Prone hip extension (PHE) is commonly used in the evaluation of the stability of the lumbopelvic region. There is little evidence of difference in muscle activity onset timing between healthy individuals and individuals with chronic low back pain (CLBP) during PHE. The purpose of this study was to determine if individuals with and without CLBP differ in the onset time of the trunk and hip extensor muscles activity during PHE. The participants were 20 patients with CLBP and 20 healthy individuals. (Source: Journal of Electromyography and Kinesiology)


Upregulation of α2δ-1 Calcium Channel Subunit in the Spinal Cord Contributes to Pelvic Organ Cross-Sensitization in a Rat Model of Experimentally-Induced Endometriosis.
We examined if the dysregulation of spinal Cavα2δ-1 subunit may play an important role in the development of ectopic growths-to-colon cross-sensitization in a rat model of experimentally-induced endometriosis. Our findings suggest that there was an increased Cavα2δ-1 expression in the dorsal horn and an ectopic growths-to-colon cross-sensitization in female rats with established endometriosis. Intrathecal administration of gabapentin (300 μg) remarkably reduced the ectopic growths-to-colon cross-sensitization in rats with established endometriosis. Furthermore, intrathecal injection of Cavα2δ-1 antisense oligodeoxynucleotides reversed the ectopic growths-to-colon cross-sensitization and also normalized the upregulation of spinal Cavα2δ-1 expression in endometriosis rats. The curr...


Continuous wound infusion of ropivacaine for the control of pain after thoracolumbar spinal surgery: a randomized clinical trial
Conclusions Our results showed that local infusion of ropivacaine achieved similar analgesic effects to intravenous delivery of analgesic drugs, but significantly reduced incidence of nausea, vomiting and chronic pain. (Source: European Spine Journal)


Frailty among elderly adults in a rural area of Turkey.
CONCLUSIONS It is believed that this study will contribute considerably to understanding the health status and needs of elderly adults in Turkey and the health problems of this population as well as to planning the development of public health and geriatric services based on regional needs. PMID: 25925800 [PubMed - in process] (Source: Medical Science Monitor)


The hypnotic induction profile and absorption.
This study examined the relationship between scores on the Hypnotic Induction Profile (HIP) and the trait of absorption in three different clinical groups: Smokers (n = 226), Phobics (n = 95), and patients with Chronic Pain (n = 65). Two hypotheses were investigated. The first predicted that both the Eye-Roll sign (ERS) and Induction Score (IND) of the HIP would correlate similarly (r = .30) with scores on the Tellegen Absorption Scale (TAS), as has been previously reported with other measures of hypnotic responsivity in student samples. The second was that using a combination of both ERS and IND scores to predict TAS scores would result in a significant increase in forecasting accuracy over using either HIP measure alone. Both hypotheses were supported in all three clinical groups. Correl...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 construct validity of the Short Form-36 Health Survey for patients with nonspecific chronic neck pain
This study investigates construct validity of the SF-36 in these patients using 16 a-priori formulated hypotheses. Ninety-one patients admitted for rehabilitation completed the SF-36 before the rehabilitation program. SF-36 domain scores of patients with CNP were compared with general population reference values and standardized differences were calculated. For both the SF-36 physical and the mental component summary (PCS and MCS), differences between primary and tertiary care setting, men and women, age groups, litigants and nonlitigants, patients with and without compensation, and with ≥3 versus≤2 concomitant complaints were analyzed using independent t-tests. Differences between PCS and MCS scores were analyzed using a paired t-test. Twelve hypotheses were not rejected and four were...


Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients
This study confirmed that therapeutic Tai Chi influences the balance, gait, and life quality of stroke patients. Therefore, therapeutic Tai Chi can be used as an effective exercise in combination with general physical therapy to improve the balance, gait, and quality of life in stroke patients. (Source: International Journal of Rehabilitation Research)


Peripheral nerve pathology in patients with severely affected complex regional pain syndrome type I
Complex regional pain syndrome type I (CRPS-I) is a chronic pain syndrome with no clinical evidence of nerve injury; however, recently, changes in muscle tissue have been found in case of CRPS-I. Our aim was to search for histological changes in peripheral nerves of amputated limbs from patients with therapy-resistant CRPS-I that could justify muscle tissue changes. Fifteen patients with CRPS-I (duration >1 year) were included. Multiple nerve samples were taken from upper (n=4) and lower (n=11) amputated limbs. Histological changes (signs of nerve fiber loss and regeneration), fiber diameters, fiber diameter distribution, and fiber density were studied through microscopy and morphometry. Samples from three healthy sural nerves were used as control data as well as data from the literature. ...


Prevalence of use of non-prescription analgesics in the Norwegian HUNT3 population: Impact of gender, age, exercise and prescription of opioids
Conclusions: Use of OTC analgesics is prevalent, related to chronic pain, female gender and physical inactivity. (Source: BMC Public Health)


Effect of the Duration of Chronic Pancreatitis on Pancreas Islet Yield and Metabolic Outcome Following Islet Autotransplantation
Conclusions The duration of CP could affect islet yield and metabolic outcomes. The time since the diagnosis of CP should be considered when selecting patients for islet autotransplantation. (Source: Journal of Gastrointestinal Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Minocycline does not affect long-term potentiation in the anterior cingulate cortex of normal adult mice
It has been reported that activated microglia plays important roles in chronic pain-related sensory signaling at the spinal cord dorsal horn. Less is known about the possible contribution of microglia to cortical plasticity that has been found to be important for chronic pain. In the present study, we used a 64-channel multi-electrode array recording system to investigate the role of microglia in cortical plasticity of the anterior cingulate cortex (ACC) in normal adult mice. We found that bath application of minocycline, an inhibitor of microglial activation, had no effect on postsynaptic LTP (post-LTP) induced by theta burst stimulation in the ACC. Furthermore, presynaptic LTP (pre-LTP) induced by the combination of low-frequency stimulation with a GluK1-containing kainate receptor agoni...


A Novel Anxiety and Affective Spectrum Disorder of Mind and Body-The ALPIM (Anxiety-Laxity-Pain-Immune-Mood) Syndrome: A Preliminary Report.
This study examined 76 consecutive outpatients with an anxiety disorder plus at least one somatic condition from three domains. More than 80% of the patients had panic attacks, fibromyalgia, and major depressive episodes. Associations were found between joint laxity and bipolar III, headache with bipolar II, and bipolar II with chronic fatigue syndrome. Significant relationships were demonstrated within and between domains, validating ALPIM as a syndrome. PMID: 25923849 [PubMed - in process] (Source: Journal of Neuropsychiatry and Clinical Neurosciences)


Pulmonary embolism as the initial clinical presentation of Kimura disease: case report and literature review
We reported a 47-year-old male case presenting with pleural pain and dyspnoea and was found to have pulmonary embolism. After successful management of pulmonary embolism, he was noticed to have eosinophilia and lymphadenopathy. Pathologic examination of a resected lymph node has confirmed the diagnosis of Kimura disease. The patient was treated with corticosteroid and cyclosporine A, with a significant improvement of the symptoms and signs of Kimura disease and no recurrence of any thromboembolism. Associated literatures were reviewed to explore the pathogenesis underlying the thrombotic event in Kimura disease cases. It is suggested that hypereosinophilia may play a key role in thrombosis formation. The control of hypereosinophilia may contribute to the prevention of thrombosis and its re...


New-onset panic, depression with suicidal thoughts, and somatic symptoms in a patient with a history of lyme disease.
We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient's panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected "chronic Lyme Disease" (CLD) despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptom...


Joint Pain a Major Issue in Chronic HCV Infection (CME/CE)
(MedPage Today) -- Smoking increases risk of arthralgias in hepatitis C. (Source: MedPage Today Gastroenterology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain Follows Adverse Life Events
(MedPage Today) -- But biological stress markers don't show relation to chronic pain risk. (Source: MedPage Today Primary Care)


Could targeting epigenetic processes relieve chronic pain states?
This article will review the evidence obtained from animal studies indicating that epigenetic processes might regulate long-term pain states and then discuss the possibility that targeting epigenetic mechanisms might be useful for the management of chronic pain. Recent findings: Recent animal studies have reported injury-induced changes in epigenetic processes in the central nervous system. The picture that has emerged is that of very complex epigenetic programs that depend on the injury. However, some studies have reported the successful use of nonspecific epigenetic tools to improve the hypersensitivity that develops in animal models of long-term pain states. Summary: The field of epigenetics and pain is rapidly emerging but further investigation is needed to fully comprehend the contrib...


Emerging potassium channel targets for the treatment of pain
Purpose of review: Poor management of chronic pain remains a significant cause of misery with huge socioeconomic costs. Accumulating research in potassium (K+) channel physiology has uncovered several promising leads for the development of novel analgesics. Recent findings: We now recognize that certain K+ channel subunits are directly gated to pain-relevant stimuli (Kv1.1, K2P) whereas others are specifically modulated by inflammatory processes (Kv7, BKCA, K2P). Genetic analyses illustrate that K+ channel gene variation can predict pain sensitivity (KCNS1, GIRKs), risk for persistent pain (KCNS1, GIRKs, TRESK) and analgesic effectiveness (GIRK2). Importantly, preclinical studies confirm that K+ channel dysfunction can be a pain trigger in traumatic neuropathies (Kv9.1/Kv2.1, Kv7, Kv1.2) a...


Emerging targets and therapeutic approaches for the treatment of osteoarthritis pain
Purpose of review: Osteoarthritis is a complex and often painful disease that is inadequately controlled with current analgesics. This review discusses emerging targets and therapeutic approaches that may lead to the development of better analgesics. Recent findings: Aberrant excitability in peripheral and central pain pathways drives osteoarthritis pain, reversing this via modulation of nerve growth factor, voltage-gated sodium channel, voltage-gated calcium channel and transient receptor potential vanilloid one activity, and increasing inhibitory mechanisms through modulation of cannabinoid and descending modulatory systems hold promise for osteoarthritis pain therapy. Somatosensory phenotyping of chronic pain patients, as a surrogate of putative pain generating mechanisms, may predict p...


Opioid-induced hyperalgesia: where are we now?
Purpose of review: Patients receiving chronic opioid treatment who develop paradoxical pain sensations, as well as worsening existing pain, can be diagnosed as suffering from opioid-induced hyperalgesia (OIH). As the worldwide population expands so too does the proportion of patients who experience pain that requires a strong opioid. Recognizing the symptoms of OIH and optimizing the use of morphine in the hospital setting is imperative. This review focuses on clinical data relating to evidence of OIH at the bedside and the novel techniques employed by healthcare providers in order to improve the heightened pain sensations experienced by susceptible patients. Recent findings: An increasing number of randomized prospective controlled trials report worsening patient pain following high-dose ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Holding Grudges Is Bad for Our Health
It might be hard to imagine, but somewhere between 50 and 80 percent of people will experience a trauma at some point in their lives. To make matters worse, most traumas are perpetrated directly by other people -- sometimes even acquaintances, friends, and family members. Given these depressing statistics, it may be tempting to become angry or resentful, to view people as threats and little more. That's what some victims of trauma do, of course. They may hold grudges, harbor life-long resentment, and even seek retribution. Who could blame them? Perhaps this is why some mental health professionals teach that forgiveness is an important step in moving beyond such trauma. It seems obvious that unforgiveness is bad for mental health -- it's highly unpleasant to harbor anger or hurt for prolon...


Health Tip: Spotting Signs of Urinary Tract Infection
Title: Health Tip: Spotting Signs of Urinary Tract InfectionCategory: Health NewsCreated: 5/1/2015 12:00:00 AMLast Editorial Review: 5/1/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Pyoderma Gangrenosum: A Difficult Diagnosis Best Managed in a Burn Treatment Center
Pyoderma gangrenosum (PG) is a rare immunological disorder with inexplicable white blood cell infiltration into the epidermis with necrosis and excruciating pain. Diagnosis is by exclusion which delays proper treatment. Surgical intervention often exacerbates wounds. Between 2004 and 2010, seven patients with PG were admitted to our burn treatment center (BTC). Multiple treatment modalities were used on these patients. An institutional review board–approved retrospective study investigated seven PG BTC admissions. Demographic information, symptom onset, time to diagnosis, admission or transfer, length of stay (LOS), use of corticosteroids, and prior surgery were collected. The average time to PG diagnosis was 18.7 days and the average wound surface area was 3.9%. The average patient age ...


Transdermal Buprenorphine, Opioid Rotation to Sublingual Buprenorphine, and the Avoidance of Precipitated Withdrawal: A Review of the Literature and Demonstration in Three Chronic Pain Patients Treated With Butrans
We present a case series of a novel method of sublingual buprenorphine introduction without an induction period, using the recently Food and Drug Administration-approved low-dose transdermal buprenorphine (Butrans; Purdue Pharma L.P.) as a bridge medication. In these cases, buprenorphine was started in opioid-dependent chronic noncancer pain patients who had taken short-acting opioid medications within hours of the initiation of the rotation. This method avoids the painful abstinence period and did not result in precipitated withdrawal or other significant adverse effects. (Source: American Journal of Therapeutics)


Retrospective Study on the Analgesic Activity of a Topical (TT-CTAC) Cream in Patients With Diabetic Neuropathy and Other Chronic Pain Conditions
The objective of this retrospective study was to evaluate the efficacy of a compounded topical cream (Transdermal Therapeutics). Two versions of TT-CTAC cream were evaluated: cream 6B and cream 7B. Both creams contain ketamine (10%), baclofen (2%), gabapentin (6%), amitriptyline (4%), bupivacaine (2%), and clonidine (0.2%). Additionally, one cream (7B) contains nifedipine (2%). The primary efficacy outcome was the change in numeric pain intensity score from pretreatment to posttreatment. Secondary outcomes were qualitative grading (excellent, good, poor, or no effect), reduction in oral medication, and avoiding referral to a pain specialist. Information on 283 patients was evaluated, 205 received the 7B and 78 received 6B creams. The pain score decreased by 2.4 ± 2.4 (35%) with the 6B cre...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Intralesional pentoxifylline in the treatment of lepromatous ulcers
Conclusion: Intralesional PTX has good efficacy and a high success rate in the treatment of lepromatous ulcers. (Source: Journal of the Egyptian Women’s Dermatologic Society)


Temporomandibular Joint Disorders Treated With Articular Injection: The Effectiveness of Plasma Rich in Growth Factors-Endoret
The objective of this study was to evaluate the effectiveness of the temporomandibular joint (TMJ) osteoarthritis treatment through articular injections of plasma rich in growth factors (PGRF)-Endoret. Thirteen patients (median age, 47.64 y; SD, 7.51; range, 40–64 y; male-female ratio, 2:11) with osteoarthritis of TMJ associated to chronic pain have been selected. They were treated with articular injections of PRGF-Endoret, measuring the maximum mouth opening and pain level before the first injection (t0), 30 days after just before the second (t1), and after 6 months (t2). Data were analyzed using the paired Student's t-test data. The visual analogue scale score at t0 is 7.69 (range, 4–10; SD, 1.9), whereas that at t1 is 1.54 (range, 0–5; SD, 1.74) and that at t2 is 0.23 (range, ...


L-menthone confers antidepressant-like effects in an unpredictable chronic mild stress mouse model via NLRP3 inflammasome-mediated inflammatory cytokines and central neurotransmitters
Publication date: Available online 29 April 2015 Source:Pharmacology Biochemistry and Behavior Author(s): Jinsong Xue , Hongyan Li , Xueyang Deng , Zhanqiang Ma , Qiang Fu , Shiping Ma L-menthone (MTN) is an Chinese old remedy extracted from the genus Mentha. It has been widely used as a cooling agent and a counterirritant for pain relief, although its antidepressant-like effects have not yet been reported. The present study was designed to investigate whether MTN confers an antidepressant-like effect in mice exposed to unpredictable chronic mild stress (UCMS) and to explore its potential mechanisms. The effects of MTN on mouse behavioral changes were investigated in our study. We determined the levels of the nucleotide binding, oligomerization domain-like receptor family pyrin domain-co...


Small constrained SP1–7 analogs bind to a unique site and promote anti-allodynic effects following systemic injection in mice
Publication date: 9 July 2015 Source:Neuroscience, Volume 298 Author(s): A. Jonsson , R. Fransson , Y. Haramaki , A. Skogh , E. Brolin , H. Watanabe , G. Nordvall , M. Hallberg , A. Sandström , F. Nyberg Previous results have shown that the substance P (SP) N-terminal fragment SP1–7 may attenuate hyperalgesia and produce anti-allodynia in animals using various experimental models for neuropathic pain. The heptapeptide was found to induce its effects through binding to and activating specific sites apart from any known neurokinin or opioid receptor. Furthermore, we have applied a medicinal chemistry program to develop lead compounds mimicking the effect of SP1–7. The present study was designed to evaluate the pharmacological effect of these compounds using the mouse spared nerve inju...


Making Friends with Chronic Pain 9/06/99
Making friends with pain can help you cope - from your About.com Guide (Source: About.com Mental 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>


99mTc-NTP 15-5 Imaging for Cartilage Involvement in Experimental Rheumatoid Arthritis: Comparison with Routinely Used Molecular Imaging Methods and Sensitivity to Chronic Nonsteroidal Antiinflammatory Drug Treatment
Conclusion: These experimental results bring data in favor of the 99mTc-NTP 15-5 radiotracer for assessing, in vivo, cartilage remodeling in RA that could be used to monitor therapy. (Source: Journal of Nuclear Medicine)


Integrative medicine Patients have High stress, pain, and psychological Symptoms
Publication date: Available online 30 April 2015 Source:EXPLORE: The Journal of Science and Healing Author(s): Ruth Q. Wolever , Nikita S. Goel , Rhonda S. Roberts , Karen Caldwell , Benjamin Kligler , Jeffery A. Dusek , Adam Perlman , Rowena Dolor , Donald A. Abrams Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, as well as depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous physiological conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Re...


The effects of topical application of metronidazole for treatment of chronic anal fissure: A randomized, controlled pilot study
Conclusion Topical antimicrobial treatment can be effective in patients with CAF provided the relevant microorganisms are correctly identified. (Source: Indian Journal of Gastroenterology)


Chronic Pain
Much has happened in the field of chronic pain in the past few decades. Things continue to change, even in the way chronic pain is characterized, as well as in treatment strategies. In the field of chronic pain, the University of Washington has a longstanding history of excellence in both research and clinical care. Among the leaders here include my good friend and colleague, Dr Jim Robinson. Dr Robinson came immediately to mind when thinking of who could edit a Physical Medicine and Rehabilitation Clinics of North America issue on chronic pain. (Source: Physical Medicine and Rehabilitation Clinics of North America)


Nonopioid Medications for Pain
Evidence of nonopioid analgesic effectiveness exceeds that for long-term opioids in chronic noncancer pain (CNCP), most with lower risk. Non-drug therapies such as cognitive behavioral therapy and physical activation are safer and also effective. Nonsteroidal antiinflammatory drugs are useful for inflammatory and nociceptive pain, share renal and variable gastrointestinal, bleeding and cardiovascular side effects. Antidepressants with noradrenergic activity (such as tricyclics and seroton-norepinephrine reuptake inhibitors) and neuromodulating anticonvulsant drugs (gabapentinoids and sodium-channel blockers) are proven to be effective for neuropathic and centralized pain. Ketamine and cannabinoids are other studied analgesics but have a less well-proven role in CNCP. (Source: Physical Medi...


Injections for Chronic Pain
Although interventional procedures should be used cautiously in the setting of chronic pain, there is a role for a variety of injections to facilitate a patient’s overall rehabilitation program. There are many resources available, including a prior issue of Physical Medicine and Rehabilitation Clinics of North America, which discuss the more conventional spinal injections. The focus of this article is on lesser-known injection options for treating chronic pain. The authors separately discuss trigger point injections, regenerative injections (prolotherapy), and injections using botulin toxins. (Source: Physical Medicine and Rehabilitation Clinics of North America)


Complementary Medicine in Chronic Pain Treatment
This article discusses several issues related to therapies that are considered “complementary” or “alternative” to conventional medicine. A definition of “complementary and alternative medicine” (CAM) is considered in the context of the evolving health care field of complementary medicine. A rationale for pain physicians and clinicians to understand these treatments of chronic pain is presented. The challenges of an evidence-based approach to incorporating CAM therapies are explored. Finally, a brief survey of the evidence that supports several widely available and commonly used complementary therapies for chronic pain is provided. (Source: Physical Medicine and Rehabilitation Clinics of North America)


Psychiatric and Psychological Perspectives on Chronic Pain
This article describes psychiatric disorders that are highly prevalent among pain patients and also describes psychological processes that contribute to poor coping by the patients. Finally, it discusses factors that a physiatrist should consider in deciding whether to refer patients to psychiatrists versus psychologists. (Source: Physical Medicine and Rehabilitation Clinics of North America)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Radial shock wave treatment alone is less efficient than radial shock wave treatment combined with tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain
Whether shock wave therapy or shock wave therapy combined with plantar fascia-specific stretching is more efficient in treating chronic plantar heel pain remains unclear. The aim of the study was to test the null hypothesis of no difference of these two forms of management for patients who had unilateral plantar fasciopathy for a minimum duration of twelve months and which had failed at least three other forms of treatment. (Source: International Journal of Surgery)


Chronic Pruritus: Histamine Is Not Always the Answer!
The experience of chronic pruritus can be tortuous. The management of chronic pruritus is notoriously difficult and the symptom is often met by therapeutic nihilism. Historically, that difficulty was heightened by an incomplete understanding of the pathophysiology of pruritus generally and certain pruritus syndromes specifically. Treatment was largely empirical. Frequently, the published trials of proposed treatment strategies concentrate on the efficacy of the treatment itself with cursory regard to the underlying pathophysiological mechanisms. (Source: Journal of Pain and Symptom Management)


Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults.
CONCLUSIONS: Since the last version of this review, the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine (a SNRI) as preventive drugs for tension-type headache. Over two months of treatment, SSRIs or venlafaxine are no more effective than placebo or amitriptyline in reducing headache frequency in patients with chronic tension-type headache. SSRIs seem to be less effective than tricyclic antidepressants in terms of intake of analgesic medications. Tricyclic antidepressants are associated with more adverse events; however, this did not cause a greater number of withdrawals. No reliable information is available at longer follow-up. Our conclusion is that the use of SSRIs and venlafaxine for the prevention of chronic tension-type headache is ...


Magnetic Fields and Intrathecal Pump Malfunction
Medical technology has impacted the overall life-expectancy. Many conditions traditionally considered fatal are now curable. Surviving chronic diseases and aging of the population have increased the number of people with chronic pain. Many devices are also available to manage severe refractory pain. As such, implantable drug-delivery system (IDDS) is a small battery-powered, programmable pump implanted under the subcutaneous tissue of the abdomen and connected to a small catheter tunneled into the spine. (Source: The American Journal of Emergency Medicine)


Large impacted pancreatic stone removed with single-operator pancreatoscopy and electrohydraulic lithotripsy
A 59-year-old man had chronic calcific pancreatitis secondary to alcohol and smoking. He had acute flares of pain and elevation of serum pancreatic enzymes. A CT scan revealed features of chronic pancreatitis, including large pancreatic duct calculi in the dilated main duct. On previous ERCP examination 2 months prior, removal of a 15-mm impacted pancreatic stone near the genu was not attempted because of its large size and a relatively narrow downstream duct. After a failed attempt to advance a 3-4-5F catheter dilator beyond the stone, a 5F Soehendra stent retriever (Cook Medical, Winston-Salem, NC) was advanced into the pancreatic duct upstream to the stone, and a pancreatic duct stent was placed. (Source: Gastrointestinal Endoscopy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


ESCAPE in Veterans
This randomized clinical trial of a stepped-care intervention for chronic pain resulted in statistically significant reductions in pain-related disability, pain interference, and pain severity in veterans with chronic musculoskeletal pain. (Source: JAMA Internal Medicine)


A 37-Year-Old Man with Chronic Low Back Pain and Substance Abuse
A 37-year-old man presented to an urgent care clinic with a report of chronic low back pain and a 1-day history of a pruritic rash on his chest, back, and extremities. The patient denied chest pain, fever, weakness, and any sensory, bowel, or bladder changes. He disclosed a history of tobacco consumption, but disavowed current or past alcohol, intravenous drug, or other substance abuse. The man was homeless, uninsured, had been incarcerated on 4 different occasions, and lacked a primary care or mental health provider. (Source: Journal of Emergency Nursing: JEN)


Estimation of Medical Expenditure Associated with Opioids usage in Chronic Non-Cancer Pain: a cross-sectional study based on Medical Expenditure Survey and Panel data
Chronic or long-term pain disturbs numerous lives, which is one of the most prevalent reasons for doctor visits and reduces people’s quality of life. A common treatment for long-term non-cancer pain (CNCP) is long-term opioid therapy. However, the effectiveness of opioids for CNCP is still controversy and associated medical expenditure is vague. We investigated the impact of opioid treatment on the total medical expenditures for U.S. general population. (Source: Value in Health)


Hydrocodone: a review of the Literature
An estimated 100 million adults suffer from chronic pain in the US. The total cost of pain ranges from $560 to $635 billion in 2010, exceeding that of heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion). The 2011 IOM report on pain states that effective pain management is “a moral imperative” for health care providers. Many pharmaceutical options are available to prescribers, most notably prescription opioids. Prescription opioids are analgesics which can be effective for the treatment of pain when monitored appropriately. (Source: Value in Health)


Correlation between Pain Catastrophizing scale and disease characteristics in Chronic Low Back Pain Patients
Psychosocial and environmental factors might have a potential causal relationship with chronic pain and the related disability. Psychosocial and environmental factors, socioeconomic status (SES) mediate the relationship among pain, disability, and can cause the morbidity and mortality among various conditions. Factor analyses of the Pain catastrophizing Scale (PCS) have shown that catastrophizing can be viewed as a multidimensional construct comprising elements of rumination, magnification and helplessness. (Source: Value in 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>


Cost-utility analysis of Pain Medications used to treat Adult Patients with Chronic Back Pain in the United States
Chronic back pain is a common health problem which is associated with considerable costs in United States. The largest categories for pain therapy costs include NSAID analgesics and opioids. However there has been limited evidence outlining the effectiveness in terms of quality of life of patients taking these pain medications for treating chronic back pain.Objective of this study is to perform a cost-utility analysis of chronic back pain patients using NSAIDS versus those using opioids alone and/ or combination opioid analgesics. (Source: Value in Health)


Cost minimization analysis of Equipotent Opioid Analgesics: Nationwide analysis of medicare Part D stand-alone prescription Drug Plans
Nearly 54 million Medicare beneficiaries, the overwhelming majority of whom are 65 plus years of age, reside in the US. Many beneficiaries suffer from chronic pain and need to use opioid analgesics for treatment. Medicare Part D is the outpatient prescription drug benefit available to beneficiaries through private insurance companies. Plan offerings differ across the country and each plan can have a different cost-sharing structure and formulary. We sought to examine the cost differences between therapeutically equivalent doses of opioid analgesics across all Medicare Part D Stand-alone prescription drug plans (PDPs). (Source: Value in Health)


Use of Hydrocodone/Acetaminophen: prevalence and estimating Emergency Department visits
The objective of this study was to estimate the impact of HC/APAP use in Texas on ED visits, based on the prevalence of HC/APAP prescriptions within the state. (Source: Value in Health)


Evaluating trends in Chronic Pain prevalence in the United States veterans Health Administration Population
The current study examined chronic pain prevalence in the U.S. Veterans Health Administration (VHA) population. (Source: Value in Health)


Conceptual Framework In Interstitial Cystitis / Bladder Pain Syndrome
This study aimed to build a conceptual framework in patients with IC/PBS which is a chronic debilitating condition characterized by pelvic pain, urinary urgency, and urinary frequency. It affects around 0.7-1 million people in the US and mostly middle aged women. Diagnostic criteria developed for research are not efficient and missing 60% of all cases. Uncertainty surrounds definition, etiology, diagnosis, natural history, true prevalence, and most effective treatment(s). (Source: Value in 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>


Impact of overweight/obesity on Arthritis–Attributable Burden And Health–Related Quality of Life Among Adults With Arthritis
This study aimed to determine the additional influence of overweight/obesity on arthritis–attributable burden (joint limitation, work limitation, social activity limitation, and joint pain) and HRQOL (general health status, physical HRQOL, mental HRQOL, activity limitations) among a representative national sample of adults with arthritis in the United States (US). (Source: Value in Health)


Does oral cholecalciferol supplementation improves pain intensity and disability in patients with chronic low back pain?
In the past decade many studies established relationship between vitamin D deficiency and chronic musculoskeletal pain including low back pain. Present study aimed to examine the effect of vitamin D3 supplementation in patients with chronic low back pain with low level of vitamin D. (Source: Value in Health)


Costs Description of Rheumatoid Arthritis Treatment In Chile For Patients Who Have Failed To Conventional Synthetic Dmards
Rheumatoid Arthritis (RA) is a chronic inflammatory disease which destroys synovial joints and generates pain; RA could disable patients and could be the cause of premature death. Its prevalence for Chile has been estimated in 0.46% (IC 95% 0.24-0.8). Available drugs for treatment include conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs), biological therapies and a new oral janus kinase inhibitor drug approved for treatment after failure of csDMARDs: tofacitinib. The aim of this study is to determine the direct costs associated with available therapies after csDMARDs failure. (Source: Value in Health)


Patient Reported outcome Profiles of Adults receiving medical care at Specialty Clinics for chronic pain and diabetes
To identify and compare the health outcomes profiles of adults receiving medical care at specialty clinics for symptomatic (chronic pain) and largely asymptomatic (diabetes) chronic conditions. (Source: Value in Health)


Comparison of the IASP grading system and S-LANSS in identification of Neuropathic pain in patients with Chronic Low Back Pain
Prevalence of neuropathic pain in patients with chronic low back pain is high. Screening for neuropathic pain is important because pharmacological management differs from nociceptive pain. There are various methods to assess the neuropathic pain. However these methods have shown different sensitivity and specificity in identifying the neuropathic pain. Present study compared the IASP grading system and S-LANSS in identification of neuropathic pain in patients with chronic low back pain. (Source: Value in 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>


Feasibility Of Using The Sf-36 Health Survey To Screen For Risk Of Major Depressive Disorder
To assess the feasibility of the SF-36v2 Mental Health (MH) domain and Mental Component Summary (MCS) scores in the classification of risk for major depressive disorder (MDD), and determine the cutoff scores in a US sample and chronic pain subpopulations. (Source: Value in Health)


Renal function and symptoms/adverse effects in opioid‐treated patients with cancer
ConclusionOnly severe constipation and loss of appetite were associated with low GFR in patients treated with morphine. Oxycodone and fentanyl, in relation to the symptoms studied, seem to be safe as used and titrated in routine cancer pain care. (Source: Acta Anaesthesiologica Scandinavica)


A 44-year-old man with abdominal pain, lung nodules, and hemoperitoneum.
Authors: Mostafavi M, Kamangar N Abstract A 44-year-old man presented with a 1-day history of sudden-onset abdominal pain. The pain was characterized as severe, diffuse, sharp, and nonradiating. Associated symptoms included nausea, vomiting, diarrhea, and subjective fevers. He was originally from El Salvador, but had not traveled in &gt; 10 years. Review of systems was positive for 2 weeks of dry cough with associated mild, bilateral, pleuritic chest pain and subjective weight loss. His medical history was notable for gout and end-stage renal disease secondary to chronic nonsteroidal antiinflammatory drug use, for which he attended hemodialysis sessions three times weekly. Surgical history consisted of a currently nonfunctioning left upper extremity fistula, a longstanding ri...


Chronic multisite pain in adolescent girls and boys with emotional and behavioral problems: the Young-HUNT study
Abstract The aim of this study was to assess the prevalence of chronic multisite pain with high disability in relation to emotional or behavioral problems and resilience factors in adolescence. A second aim was to investigate if resilience factors could attenuate the associations between psychiatric symptoms and chronic multisite pain. The study was based on a large cross-sectional study carried out in Norway between 2006 and 2008 and included 7,070 adolescents aged 13–19 years. Chronic multisite pain was defined as pain at least once a week during the last 3 months, scoring high on a disability index, and occurring in three or more locations. Chronic multisite pain was prevalent among adolescents with high scores (&gt;85 %) for anxiety/depression, social anxiety, conduct or...


Altered viscerotopic cortical innervation in patients with irritable bowel syndrome
Conclusions & InferencesThese preliminary findings illustrate how a chronic visceral pain syndrome and brain structure are related in the cohort examined, and because of their indication that IBS diagnosis is associated with anatomic neuropathology of potential neurological relevance in this patient sample. Visual representation of WM connections innervating S1 in a representative study patient. Depicted is a frontal view of the left and right postcentral gyri (red) together with the WM connections innervating S1. WM tracts connecting the postcentral gyri to the corticospinal tracts are drawn in bright green and highlighted by green arrows. (Source: 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>


Evaluation of accelerated corneal collagen cross‐linking for the treatment of bullous keratopathy in eight dogs (10 eyes)
ConclusionsCXL is a useful treatment option for BK in dogs, despite the short‐lasting effects on corneal thickness. Patient comfort improved rapidly after a single procedure, although CXL did not achieve resolution of corneal edema. Treatment protocols may be refined to produce more durable effects on corneal edema. (Source: Veterinary Ophthalmology)


Injections for Chronic Pain.
Authors: Singh V, Trescot A, Nishio I Abstract Although interventional procedures should be used cautiously in the setting of chronic pain, there is a role for a variety of injections to facilitate a patient's overall rehabilitation program. There are many resources available, including a prior issue of Physical Medicine and Rehabilitation Clinics of North America, which discuss the more conventional spinal injections. The focus of this article is on lesser-known injection options for treating chronic pain. The authors separately discuss trigger point injections, regenerative injections (prolotherapy), and injections using botulin toxins. PMID: 25952063 [PubMed - as supplied by publisher] (Source: The Medical Clinics of North America)


Subthalamic Nucleus Deep Brain Stimulation
Parkinson disease (PD) is known to affect multiple neurotransmitter systems, resulting in both motor and nonmotor symptoms. Pain is an underrecognized but important nonmotor symptom of PD that may be very disabling and is known to impair quality of life. While significant progress has been made in ameliorating motor symptoms using pharmacological, rehabilitative, and surgical treatments, the treatment of pain in this context has not received sufficient attention. A literature review noted a reported prevalence of pain in PD of 40% to 85%, yet only about half of patients with PD who felt pain took analgesics. Classifying PD-related pain into its subtypes is important for rational treatment, and the most common subtypes of pain in PD are musculoskeletal and dystonic, with central neuropathic...


Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: a review
This article is protected by copyright. All rights reserved. (Source: Oral Diseases)


Elective hand surgery after axillary lymph node dissection for cancer.
Authors: Lee RJ, LaPorte DM, Brooks JT, Schubert CD, Deune EG Abstract After axillary lymph node dissection (ALND), patients are cautioned against ipsilateral interventional procedures to avoid the theoretical increased risk of postoperative complications, particularly lymphedema. The authors' goal was to evaluate the complications of elective hand surgery after ALND. The authors reviewed patients presenting to their hand clinic from 1998 to 2011, selecting those with a diagnosis of breast cancer or melanoma and a history of previous ALND; the authors excluded those treated nonoperatively and those treated with elective surgery in the contralateral hand. Average age of the 22 patients meeting the criteria (20 with a history of breast cancer, 6 with preexisting lymphedema) was 53.9 ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Microglia in the spinal cord and neuropathic pain
This article is protected by copyright. All rights reserved. (Source: Journal of Diabetes Investigation)


Frequency of Migraine Headaches in Patients With Fibromyalgia
ConclusionThe results of this study suggest that migraine headaches are common in patients with fibromyalgia. Clinicians who care for either population must be aware that these conditions commonly overlap and can significantly increase a patient's cumulative disease burden. (Source: Headache: The Journal of Head and Face Pain)


Efficacy and Safety of White Willow Bark (Salix alba) Extracts
Willow bark extract has been used for thousands of years as an anti‐inflammatory, antipyretic, and analgesic. In spite of its long history of use, relatively few human and animal studies have been published that confirm anecdotal observations. A small number of clinical studies have been conducted that support the use of willow bark extracts in chronic lower back and joint pain and osteoarthritis. Willow bark extracts also are widely used in sports performance and weight loss products presumably because of anti‐inflammatory and analgesic activities, although no human studies have been published that specifically and directly document beneficial effects. In recent years, various in vitro and animal studies have demonstrated that the anti‐inflammatory activity of willow bark extract is...


Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort
ConclusionsIn this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems. (Source: Pain Medicine)


Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been …
ConclusionThe literature suggests that the medicinal use of cannabis may have a therapeutic role for a multitude of diseases, particularly chronic pain disorders including headache. Supporting literature suggests a role for medicinal cannabis and cannabinoids in several types of headache disorders including migraine and cluster headache, although it is primarily limited to case based, anecdotal, or laboratory‐based scientific research. Cannabis contains an extensive number of pharmacological and biochemical compounds, of which only a minority are understood, so many potential therapeutic uses likely remain undiscovered. Cannabinoids appear to modulate and interact at many pathways inherent to migraine, triptan mechanisms ofaction, and opiate pathways, suggesting potential synergistic or ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 and Emerging Treatments for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: Focus on Prosecretory Agents
Irritable bowel syndrome with constipation (IBS‐C) and chronic idiopathic constipation (CIC) are two common functional gastrointestinal disorders that impair quality of life and pose a significant economic burden to the health care system. Current therapeutic options include lifestyle modifications, over‐the‐counter (OTC) agents, antispasmodics, serotonin agonists, and lubiprostone and linaclotide, two prosecretory prescription drugs approved for the treatment of IBS‐C and CIC. This review discusses the efficacy and safety of current treatments and emerging therapies for the treatment of IBS‐C and CIC, with a focus on the prosecretory agents. A search of the PubMed database (1966–November 2014) was performed to identify relevant articles; clinical trials on emerging agents were...


RADIOLOGY REPORT: 2 cases to test your skills.
Authors: Gibson GN, Dunn DP Abstract A 28-year-old G0P0 woman with a history of chronic pelvic fullness presented with acute lower abdominal/pelvic pain. A pelvic exam showed mild cervical motion tenderness without vaginal discharge or palpable adnexal mass. Initial blood work was drawn and the patient was sent for a pelvic ultrasound with differential considerations including pelvic inflammatory disease, ovarian torsion, and intrauterine or ectopic pregnancy. PMID: 26009739 [PubMed - in process] (Source: The Journal of Family Practice)


Oleic acid surfactant in polycaprolactone/hydroxyapatite‐composites for bone tissue engineering
In this study, poly(ε‐caprolactone) (PCL), oleic acid (OA) and hydroxyapatite (HAp) were used to obtain films whose properties were investigated by contact angle, scanning electron microscopy, atomic force microscopy, tensile mechanical tests, and in vitro tests with U2OS human osteosarcoma cells by direct contact. Our results indicate that by using OA as surfactant/dispersant, it was possible to obtain a homogenous film with HAp. The PCL/OA/Hap sample had twice the roughness of the control (PCL) and a lower contact angle, indicating increased hydrophilicity of the film. Furthermore, mechanical testing showed that the addition of HAp decreased the load at yield point and tensile strength and increased tensile modulus, indicating a more brittle composition vs. PCL matrix. Preliminary cel...


Symptoms and side effects in chronic non‐cancer pain patients: clinical implications and development of new assessment tools
ConclusionsThis new and shorter screening tool QSSE‐33 may substitute the original QSSE‐41 and in clinical use, contribute substantially to a more comprehensive and detailed understanding of symptoms/side effects and may consequently lead to improved therapies. (Source: Acta Anaesthesiologica Scandinavica)


Violence toward chronic pain care providers: A national survey
ConclusionCPCPs were at high risk for violence. Risk factors were older age, male, working part time, and anesthesiology. Risk was highest in the context of opioid management and disability. Discharging patient was the most common risk mitigation. A significant number of physicians carried firearms. (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>


Sleep, pain catastrophizing and central sensitization in knee osteoarthritis patients with and without insomnia
Conclusions: These findings highlight the importance of assessing sleep efficiency, CS and catastrophizing in chronic pain patients and have important clinical implications for treatment planning. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)


Lymphocytic colitis complicated by a mass in the terminal ileum.
In conclusion, an untreated lymphocytic colitis may result in the formation of an inflammatory mass lesion. PMID: 26034326 [PubMed - in process] (Source: Singapore Medical Journal)


Adult rectosigmoid junction intussusception presenting with rectal prolapse.
Authors: Du JZ, Teo LT, Chiu MT Abstract Most cases of intussusception in adults present with chronic and nonspecifi c symptoms, and can sometimes be challenging to diagnose. We herein report on a patient w ith the rare symptom of colonic intussusceptions presenting with rectal prolapse and review the existing literature of similar case reports to discuss how to reach an accurate diagnosis. A 75-year-old woman with dementia presented with per rectal bleeding, rectal prolapse and lower abdominal pain. An operation was scheduled and a large sigmoid intussusception with a polyp as a leading point was found intraoperatively. She subsequently recovered well and was discharged. As large sigmoid intussusceptions may present as rectal prolapse, intussusception should be considered as a dif...


A Survey of Ultrasound Training in U.S. and Canadian Chronic Pain Fellowship Programs
ConclusionsChronic pain fellowships were teaching ultrasound‐guided procedures to their fellows. The majority of the fellowships offered ultrasound training throughout the fellowship year. A majority of training was accomplished via hands‐on experience with patients. Chronic pain fellows were receiving a majority of ultrasound training for peripheral nerve blocks, followed by nonaxial musculoskeletal blocks, with few axial nerve blocks being taught. (Source: Pain Medicine)


The Rate of Magnetic Resonance Imaging in Patients With Spinal Cord Stimulation
Conclusion. There is a high need for MRI in this chronic back and leg pain SCS population, with a significant portion being completed on locations outside of the spine. This analysis highlights a need for MRI-conditional SCS devices that grant access of patients with SCS to this imaging modality. Level of Evidence: 3 (Source: Spine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Integrative medicine has positive impact on patient activation, chronic pain, depression
(GYMR) The use of integrative medicine interventions leads to significant improvements in patient activation and patient-reported outcomes in the treatment of chronic pain, depression, and stress, according to a new report released by The Bravewell Collaborative. The findings are based on data collected by the Patients Receiving Integrative Medicine Interventions Effectiveness Registry, the first-ever patient registry on integrative medicine. (Source: EurekAlert! - Medicine and Health)


Record $374B Spent on Drugs: The Pain Medicine News Report
(MedPage Today) -- What Jennifer Aniston teaches us about chronic pain. (Source: MedPage Today Psychiatry)


Assessment of chronic pain: A practice update
Publication date: Available online 7 April 2015 Source:International Journal of Orthopaedic and Trauma Nursing Author(s): Beverley Wellington , Sandra Flynn , Wendy Duperouzel , Sylvia Treloar (Source: International Journal of Orthopaedic and Trauma Nursing)


Fibrocalculous pancreatic diabetes: a case report
Conclusion: This case report demonstrates a rare form of secondary diabetes in a middle aged female, without a childhood history of abdominal pain suggestive of pancreatitis, indicating late onset disease. Therefore a high index of suspicion is necessary even though the diagnostic criteria indicates the presence of childhood onset of disease. (Source: BMC Research Notes)


Management of chronic recurrent /pubic bone stress in a Premier League footballer: evaluating the evidence base and application of a nine-point management strategy
The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent chronic groin pain and evaluate the evidence of the interventions. (Source: Physical Therapy in Sport)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 lateral prefrontal cortex mediates the hyperalgesic effects of negative cognitions in chronic pain patients
While high levels of negative affect and cognitions have been associated in chronic pain conditions with greater pain sensitivity, the neural mechanisms mediating the hyperalgesic effect of psychological factors in patients with pain disorders are largely unknown. In this cross-sectional study, we hypothesized that 1) catastrophizing modulates brain responses to pain anticipation, and that 2) anticipatory brain activity mediates the hyperalgesic effect of different levels of catastrophizing, in fibromyalgia (FM) patients. (Source: The Journal of Pain)


Trauma, Social Support, Family Conflict, and Chronic Pain in Recent Service Veterans: Does Gender Matter?
ConclusionsResults underscore the potential importance of developing and testing gender specific models of chronic pain that consider the relative roles of trauma, social support, and family conflict. (Source: Pain Medicine)


When Is Helping your Partner with Chronic Pain a Burden? The Relation Between Helping Motivation and Personal and Relational Functioning
ConclusionsApplying SDT in a context of pain provides new insights into why chronic pain affects partners and how partners impact patient outcome. Directions for future research are outlined. (Source: Pain Medicine)


Chronic Pain Patients' Impressions of an Emergency Department Opioid Prescribing Guideline Poster
ConclusionsThe vast majority of patients with chronic pain in this cohort believes that a pain guideline poster is reasonable and should be posted in the ED. However, a small percentage of patients reported that they would feel intimidated by such a poster and that it would prevent them from staying to get care, a result meant to inform hospitals and policy‐makers deciding if such posters should be displayed. (Source: Pain Medicine)


Attitudes and Beliefs of Working and Work‐Disabled People with Chronic Pain Prescribed Long‐Term Opioids
ConclusionThe results of this study suggest several tentative hypotheses about why patients on chronic opioid therapy value opioids, and identified several areas for systematic investigation in the future. (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>


Menstrual‐Cycle and Menstruation Disorders in Episodic vs Chronic Migraine: An Exploratory Study
ConclusionWe conclude that chronic migraine is possibly more often than episodic migraine associated with menstrual‐cycle disorders in general and dysmenorrhea, without impact on menstruation sensitivity of the headaches. (Source: Pain Medicine)


Erythema Ab Igne
A 23-year-old woman, with a history of esophageal atresia status postsurgical correction and chronic abdominal pain on high-dose fentanyl, presented with increasing abdominal pain and a dark, net-like rash on her back. She reported that her pain was usually controlled with opioids, marijuana (one joint per day), and hot showers, but had recently worsened. She noted that the rash appeared 1 year prior and had faded and resurfaced during that period. She also reported occasionally using a heated towel in the area to relieve abdominal pain radiating to her back. (Source: The Journal of Emergency Medicine)


Integrative medicine Patients have High stress, pain, and psychological Symptoms
Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, as well as depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous physiological conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN). (Source: Explore)


Inhibition of microglial activity alters spinal wide dynamic range neuron discharge and reduces microglial Toll-like receptor 4 expression in neuropathic rats.
This study aimed to evaluate the role of microglial activation on the hyper-responsiveness of wide dynamic range neurons (WDR) and Toll-like receptor 4 (TLR4) expressions in a chronic constriction injury (CCI) model of neuropathic pain in rats. Adult male Wistar rats (230 ± 30 g) underwent surgery for induction of CCI neuropathy. Six days after surgery, administration of minocycline (10, 20, and 40 mg/kg, i.p.) was initiated and continued until day 14. After administration of the last dose of minocycline or saline, a behavioral test was conducted, then animals were sacrificed and lumbar segments of the spinal cord were collected for Western blot analysis of TLR4 expression. The electrophysiological properties of WDR neurons were investigated by single unit recordings in separate groups. T...


A painful inheritance--patient perspectives on living with polycystic kidney disease: thematic synthesis of qualitative research
Conclusions The erratic onset of pain contributes to the substantial unpredictability of daily living and prevents patients from establishing long-term life goals. Decisions about family planning, genetic testing of children and disclosure involves making profoundly difficult judgments about ethical parental responsibility. Patient engagement in pain management, strategies for self-care, counselling to reduce the burden of &lsquo;genetic guilt&rsquo; and specific family planning decision support tools may be priorities for care to improve patient-centred outcomes in ADPKD. (Source: Nephrology Dialysis 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>


Abstract CS1-2: Contralateral prophylactic mastectomy: Patient preferences and risk perceptions
Recent studies have revealed increasing rates of contralateral prophylactic mastectomy (CPM) among women with unilateral early stage breast cancer. Bilateral mastectomy at diagnosis of unilateral breast cancer is particularly common among young women, with younger age consistently identified as a predictor of CPM. This trend for more surgery rather than less has raised concerns, given the lack of evidence for a survival benefit from CPM and the relatively low risk of contralateral breast cancer for most women in this setting. Although mastectomy is a safe procedure and major complications are rare, there are potential negative consequences including cosmetic concerns and clinically significant potential long-term sequelae such as numbness of the chest skin and chronic pain and decreased fu...


Pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy.
CONCLUSION: Pain is a frequent problem in adolescents with spinal muscular atrophy and dystrophinopathy. The assessments used enable an understanding both of the nature and scope of pain and of the impact of pain in everyday life. The study highlights the importance of assessing pain in a systematic manner and offering an individual approach to interventions designed to reduce pain in this population. PMID: 25978940 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)


Look beyond Catechol-O-Methyltransferase genotype for cathecolamines derangement in migraine: the BioBIM rs4818 and rs4680 polymorphisms study
Conclusions COMT genotype does not influence migraine susceptibility or phenotype, even considering rs4818 polymorphism and peculiar clinical subtypes. This finding prompts to go over COMT to explain catecholamine derangement in migraine, exploring enzymes involved in catecholamines synthesis and catabolism, such as monoamine-oxidase, dopamine beta-hydroxylase, tyrosine-hydroxylase or tyrosine-decarboxylase, among others. (Source: The Journal of Headache and Pain)


The Lateral Prefrontal Cortex Mediates the Hyperalgesic Effects of Negative Cognitions in Chronic Pain Patients
Although high levels of negative affect and cognitions have been associated with greater pain sensitivity in chronic pain conditions, the neural mechanisms mediating the hyperalgesic effect of psychological factors in patients with pain disorders are largely unknown. In this cross-sectional study, we hypothesized that 1) catastrophizing modulates brain responses to pain anticipation and 2) anticipatory brain activity mediates the hyperalgesic effect of different levels of catastrophizing in fibromyalgia (FM) patients. (Source: The Journal of Pain)


Priority interventions in chronic non cancer pain
Lalonde L, Choinière M, Martin E, Lévesque L, Hudon E, Bélanger D, Perreault S, Lacasse A, Laliberté MC (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>


Low-dose SoluMatrix diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.
CONCLUSION: SoluMatrix diclofenac treatment for up to 1 year was generally well tolerated in patients with OA pain and associated with improvement in quality of life measures. TRIAL REGISTRATION: www.clinicaltrials.gov identifier: NCT01510912. PMID: 25913498 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


Few Sickle Cell Patients Receiving Beneficial Drug, Study Finds
Title: Few Sickle Cell Patients Receiving Beneficial Drug, Study FindsCategory: Health NewsCreated: 4/28/2015 12:00:00 AMLast Editorial Review: 4/29/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Calf Muscle Pump Stimulation as a Means to Reduce Symptoms of Fibromyalgia Syndrome
Fibromyalgia (FM) is a debilitating chronic condition that often affects women in midlife with widespread pain that interrupts attempts to exercise. The purpose of this pilot study was to test the efficacy of calf muscle pump (CMP) stimulation as an adjuvant therapy for FM by (1) assessing the correlation of the level of symptoms, as measured by the revised Fibromyalgia Impact Questionnaire (FIQR), and blood pressure (BP), (2) measuring change in mean FIQR scores for subjects who use a CMP-stimulation device for 12 weeks, and (3) measuring the correlation of total device usage and the level of symptoms as measured by the FIQR. The 29 male and female participants (mean age = 47.3 years) were screened using the Widespread Pain Index (WPI), Symptom Severity (SS) score, and the FIQR. Participa...


Increased prevalence of two mitochondrial DNA polymorphisms in functional disease: Are we describing different parts of an energy-depleted elephant?
Publication date: Available online 29 April 2015 Source:Mitochondrion Author(s): Richard G. Boles , Essam A. Zaki , Jonathan R. Kerr , Kingshuk Das , Sawona Biswas , Ann Gardner About 20% of the population suffers from “functional syndromes”. Since these syndromes overlap greatly in terms of co-morbidity, pathophysiology (including aberrant autonomic activity) and treatment responses, common predisposing genetic factors have been postulated. We had previously showed that two common mitochondrial DNA (mtDNA) polymorphisms at positions 16519 and 3010 are statistically associated with the functional syndromes of migraine, cyclic vomiting syndrome and non-specific abdominal pain. Herein, among individuals with mtDNA haplogroup H (HgH), the presence of these two mtDNA polymorphisms were a...


Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States
Conclusion There remains a growing body of both clinical and laboratory evidence pointing to a potential relationship between low levels of 25-hydroxy vitamin D and a variety of chronic pain states. More focused research involving large RCTs is necessary. (Source: Pain and Therapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A Plunging Case of Intermittent Dysphagia
Question: A 71-year-old woman with a history of gastroesophageal reflux disease and chronic intermittent dysphagia presented with progressively worsening dysphagia for solid foods over the past three days. The patient also complained of reflux, without weight loss, and has never had food impaction requiring bolus removal. Upon presentation, the patient denied any nausea, vomiting, abdominal pain. Laboratory results were unremarkable. (Source: Gastroenterology)


Palmitoylethanolamide relieves pain an2d preserves pancreatic islet cells in a murine model of diabetes.
Authors: Donvito G, Bettoni I, Comelli F, Colombo A, Costa B Abstract We previously demonstrated that the intraperitoneal administration of palmitoylethanolamide (PEA) in mice with chronic constriction injury of the sciatic nerve evoked a relief of both thermal hyperalgesia and mechanical allodynia in neuropathic mice. Since diabetic neuropathy is one of the most common long-term complications of diabetes, we explored the ability of PEA to also relief this kind of chronic pain, employing the well-established streptozotocin-induced animal model of type 1 diabetes. Our findings demonstrated that PEA relieves mechanical allodynia, counteracts nerve growth factor deficit, improves insulin level, preserves Langherans islet morphology reducing the development of insulitis in diabetic mic...


Drug targets of migraine and neuropathy: treatment of hyperexcitability.
Authors: L V, Z M, A B, J T Abstract Migraine and neuropathic pain are common causes of chronic pain. The exact pathomechanism has not been fully clarified for either disorder, but their pathophysiological backgrounds involve several similar mechanisms. Peripheral sensitization occurs in the neuronal elements of the dorsal root ganglion or the trigeminal ganglion, while central sensitization appears in the second-order neurons in the dorsal horn of the spinal cord or the trigeminal nucleus caudalis. Central neuronal hyperexcitability has been implicated in both disorders, and the emerging evidence suggests alterations in the glutamatergic neurotransmission and N-methyl-D-aspartate-receptor activation. Migraine and neuropathic pain additionally share certain clinical features, such ...


Role of pituitary adenylate-cyclase-activating polypeptide in nociception and migraine Running title: PACAP: nociception and migraine.
Authors: Tajti J, Tuka B, Botz B, Helyes Z, Vecsei L Abstract Pituitary adenylate cyclase-cctivating polypeptide (PACAP) and its receptors are widely distributed at different levels of the pain-processing pathway. Its action at the peripheral sensory nerve terminals has been found to be divergent; it can exert both pro- and anti-nociceptive effects, depending on the mode of administration (local or systemic) and the mechanism of the pain process (acute or chronic, inflammatory or neuropathic). In the central nervous system it exerts mainly neuronal excitation, leading to increased nociceptive signalling. Since the clinical data strongly suggest the involvement of PACAP in the pathophysiology of migraine, special emphasis is placed on examinations of its role and the mechanisms of a...


Abstract 241: Evaluation of the Parameters of the Euro Qol- 5 D Questionnaire Among Patients With Ischemic Heart Disease With Normal and Elevated BMI [Session Title: Poster Session II]
Conclusion: Our study revealed that Ischemic heart disease patients with obesity had impaired QoL in terms of health, mobility, usual activity, discomfort and anxiety. Hence non-obese ischemic heart disease patients had a better sense of overall wellbeing. (Source: Circulation: Cardiovascular Quality and Outcomes)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Abstract 312: A Tablet Computer-based System to Incorporate Patient-reported Outcomes Into Routine Care for Patients Presenting for Coronary Angiography [Session Title: Poster Session III]
Conclusions: Our program demonstrates that the integration of patient-reported outcomes measurement is technically feasible in a real-world care environment. We share our experiences to provide others with a model for similar programs, and to accelerate implementation nationwide by helping others avoid pitfalls. We believe expansion of similar programs nationally may lead to more robust quality measurement infrastructure and higher-value care for patients. (Source: Circulation: Cardiovascular Quality and Outcomes)


Circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, multicenter trial
Conclusions Our findings show that circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for CP/CPPS patients resulted in improved NIH-CPSI scores compared with medication therapy only. (Source: World Journal of Urology)


Relationships between severity of signs and symptoms and quality of life in patients with chronic venous disease
CONCLUSIONS: There were positive correlations between CEAP and both VAPS and VCSS. Chronic Venous Insufficiency progressively affects quality of life (SF-36). Physical and emotional aspects are more severe at later stages of CVD. Vitality, Mental Health and Role Social can be negatively impacted from the early stages of the disease. CONTEXTO: A doença venosa crônica (DVC) é a causa mais frequente dos sintomas vasculares que acometem os membros inferiores. É pouco estudada a relação entre seus sinais clínicos, a intensidade dos sintomas, e a qualidade de vida do indivíduo acometido. OBJETIVOS: Verificar se existe uma relação positiva entre a progressão da doença e a gravidade dos sintomas e a piora na qualidade de vida. MÉTODOS: Avaliamos 91 membros com classificação clínica...


Gene Expression Profiling Analysis of Patients With Ankylosing Spondylitis: Retracted.
Conclusion: MYH9, BCL11B, PTPRC, CD3G, CD247, CD4, IL7R, and PRF1 might have a correlation with AS. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved. (Source: Journal of Spinal Disorders and Techniques)