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Medworm: Chronic Pain - Recent Medical Updates

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Pain Symptoms Associated with Opioid Use amon Vulnerable Persons with HIV: An exploratory study with implications for palliative care and opioid abuse prevention.
Authors: Knowlton AR, Nguyen TQ, Robinson AC, Harrell PT, Mitchell MM Abstract Current or former injection drug users with human immunodeficiency virus (HIV) are at high risk for pain, which adversely affects their quality of life and may increase their risk for illicit drug use or relapse. We explored associations between pain symptoms and substance use among injection-drug-using study participants with HIV who had histories of heroin use. Using generalized estimating equations and controlling for prior substance use, we found that pain in each six-month period was associated with the use of heroin and prescription opioids, but not the use of nonopioid drugs or alcohol. Routine clinical assessment and improved management of pain symptoms may be needed for persons with HIV and a hi...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Australia set to legalize cultivation of medical cannabis
SYDNEY (Reuters) - Australia is expected to legalize the cultivation of cannabis for medical or scientific purposes with a bill introduced to parliament on Wednesday -- the first step towards doctors eventually prescribing it to patients with chronic pain. (Source: Reuters: Health)


New health evidence gives women informed choice in the prolapse surgery debate
New evidence published in the Cochrane Library highlights benefits and harms of using artificial mesh when compared with tissue repair in the surgical treatment of vaginal prolapse. Slightly better repair with mesh needs to be weighed carefully against increased risk of harms.A new Cochrane Review summarizes evidence that addresses a long-standing controversy in the surgical repair of vaginal prolapse. It will help women and surgeons to make better informed choices about surgical treatment, and reinforces the need for careful consideration of the advantages and disadvantages of grafting artificial material compared with using tissue to repair the anatomy of the vagina.A vaginal prolapse occurs when the walls of the vagina become weak and collapse inwards. This can be a distressing disorder...


Peripheral nerve field stimulation for chronic neuropathic pain: a single institution experience
Conclusions PNFS can be considered an effective and safe option to treat carefully selected, drug-resistant and chronic neuropathic pain patients; the reversibility of the procedure and its lack, at least in our hands, of long-term complications may contribute to wider use of this procedure. (Source: Acta Neurochirurgica)


Difficult defecation in constipated patients and its relationship to colonic disorders
Conclusions This study demonstrates that difficult defecation is part of a more generalized colorectal dysfunction in both irritable bowel syndrome and in functional constipation patients with an overlap of symptomatology. It also demonstrates the relative inadequacy of the Rome III criteria to describe the relationship between constipation and difficult defecation. (Source: International Journal of Colorectal Disease)


Intrathecal Ziconotide: Dosing and Administration Strategies in Patients With Refractory Chronic Pain
ConclusionsClinical trials and experience confirm the feasibility and usefulness of IT ziconotide in the management of refractory chronic pain. Emerging evidence suggests that additional IT delivery options may further expand the usefulness and benefits of ziconotide. (Source: 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>


Applying a Part of the Daily Dose as Boli May Improve Intrathecal Opioid Therapy in Patients With Chronic Pain
ConclusionsIntermittent bolus administration may be helpful for increasing the efficacy of intrathecal opioid therapy of chronic pain. (Source: Neuromodulation)


Impact on quality of life of a nursing intervention programme for patients with chronic non‐cancer pain: an open, randomized controlled parallel study protocol
DiscussionIf significant effects were detected, impact on quality of life through a nurse‐led programme would offer a complementary service to existing pain clinics for a group of patients with frequent unmet needs. (Source: Journal of Advanced Nursing)


Posttraumatic Stress Disorder After Sexual Abuse in Adolescent Girls
This article will describe PTSD following sexual abuse and its impact on presenting complaints, such as sexually transmitted infections, contraception, and chronic pain, for the pediatric and adolescent gynecology (PAG) clinician. Treatment approaches, including the use of antidepressants and anxiolytics, as well as evidenced based psychotherapies, will be highlighted. (Source: Journal of Pediatric and Adolescent Gynecology)


Preliminary Treatment of Achilles Tendinopathy Using Low-Intensity Pulsed Ultrasound
Conclusions. LIPUS is an additional noninvasive treatment modality for chronic Achilles tendinopathy that may potentially help improve clinical symptoms and delay and/or prevent the need for surgical intervention. While LIPUS is easy to use, well-tolerated, and has promising early clinical results, further research is needed to determine the long-term benefits, disadvantages, and cost-effectiveness of this alternative treatment for tendinopathy. Levels of Evidence: Therapeutic, Level IV: Case series (Source: Foot and Ankle Specialist)


Symptomatic Bipartite Medial Cuneiform: Report of Five Cases and Review of the Literature
Bipartition of the medial cuneiform is a well-described but rarely seen anatomic variant. The majority of literature focuses on anatomic description and incidents based on studies of archeological collections. Symptomatic cases can be overlooked or misdiagnosed initially given the vague complaint of pain either chronic in nature or following an acute injury that could result in a myriad of foot conditions. Treatment ranges from orthotics, immobilization, injection therapy, and surgery. Presented here is a series of 5 cases treated successfully with conservative and surgical measures. Levels of Evidence: Therapeutic, Level IV (Source: Foot and Ankle Specialist)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ankle Impingement Caused by an Intra-articular Plica: A Report of 2 Cases
We present 2 cases of ankle impingement occurring in the setting of equivocal examination and imaging findings. In both cases, arthroscopy revealed a likely congenital, intra-articular plica. Levels of Evidence: Therapeutic, Level IV: Case Study (Source: Foot and Ankle Specialist)


A Rare Case of Glomus Tumor of the Great Toe: An Analysis of Behavior at This Rare Site
Glomus tumor, originally known as an angioneuromyoma, is a benign neoplasm arising from specialized structures called glomus bodies, involved in thermoregulation. Although it has been reported at a number of sites in the body, this rare tumor is most commonly seen in the subungual areas of the digits of the hand. Only a handful of lesions have been reported in the toes. Because most foot conditions are treated by podiatrists and dermatologists, orthopaedic surgeons are generally unaccustomed to making early diagnoses. The purpose of this case report is to alert the attending surgeon regarding the possibility of glomus tumor as a cause of chronic toe pain. Also it has been observed that the behavior of this tumor varies with the site of occurrence&mdash;whether digital or extradigital. So w...


Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis
The objective of the present study is to evaluate the effectiveness of vitamin D supplementation in the management of CNMP through a systematic review and meta-analysis. According to PRISMA guidelines, PubMed, Embase, Web of Science, Cochrane and Scopus electronic databases were searched for randomised controlled trials comparing vitamin D supplementation to a control or placebo in CNMP patients; the search was not limited by language or date. Meta-analysis was performed using the mean and standardised mean difference which was computed with 95 % confidence intervals, and overall effect size was calculated. Both fixed and random effects models were used in meta-analysis to account for heterogeneity in the studies. The initial search identified 107 studies, of which 10 were potentially rel...


The effectiveness of balneotherapy in chronic neck pain
Abstract The aim of this study was to investigate the effectiveness of balneotherapy (BT), which is applied in addition to physical therapy (PT), in the treatment of chronic neck pain. Sixty patients with chronic neck pain were divided into study (n = 30) and control (n = 30) groups. All of the patients in both groups were treated with a 15-session standard PT program consisting of hot pack, ultrasound, and transcutaneous electrical stimulation. Patients in the study group were also treated with a 15-session BT program lasting 20 min/day in addition to the standard PT program. Visual analogue scale (VAS), modified neck disability index (mNDI), and Nottingham Health Profile (NHP) scores of all patients were evaluated at three different times as pretreatment, posttreatment,...


A Systematic Review of the Treatment for Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES)
Abdominal cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal pain. We aim to outline the current available literature concerning the treatment of patients diagnosed with ACNES. (Source: American Journal of Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Thoracic dysfunction in whiplash-associated disorders: a systematic review and meta-analysis protocol
Discussion This is the first study to bring together evidence of thoracic dysfunction post whiplash and provide new insights into the scope and nature of thoracic dysfunction in WAD. With current management options being largely focused to a primary neck complaint and many patients going to become chronic in their presentations, this review may stimulate research and clinical interest in a largely under investigated, yet anatomically and kinematically related, spinal region. Systematic review registration PROSPERO CRD42015026983. (Source: Systematic Reviews)


Low back pain as seen in orthopedic clinics of a Nigerian Teaching Hospital
Conclusion: Low back pain of mechanical origin (recurrent and chronic in a significant proportion of patients) is predominant in our environment. This pattern calls for prevention as well as the early and appropriate care of the patient with low back pain. (Source: Nigerian Journal of Clinical Practice)


St. Jude launches new OCT system
Cardiac technology developer St. Jude Medical has launched its Optis Mobile...Read more on AuntMinnie.comRelated Reading: St. Jude obtains CE Mark for MRI chronic pain unit FDA approves St. Jude Medical's paddle lead St. Jude commences trial of OCT guidance FDA clears St. Jude's MR-conditional spinal stimulation system St. Jude launches 3D vessel system in Japan (Source: AuntMinnie.com Headlines)


Research finds no easy answers to use of drug screening for pain patients
Doctors who treat patients suffering from chronic pain face a quandary, according to research. Monitoring patients through urine drug screenings, part of the standard protocol to ensure patient safety, is associated with an increase in the odds that the patients won't return for future treatment. (Source: ScienceDaily Headlines)


Quality of Life and Economic Burden in Recessive Dystrophic Epidermolysis Bullosa.
CONCLUSION: RDEB had a profound impact on QoL and economic burden. Compared with other dermatologic diseases, RDEB showed severe symptoms and QoL was seriously impaired. Most patients sustained economic burdens, especially on preparing dressing materials. Younger patients experienced more economic burdens. PMID: 26848213 [PubMed] (Source: Annals of Dermatology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea.
CONCLUSION: The high cost of initiating ITMP infusion therapy is challenging; however, the present results may encourage more patients to consider ITMP therapy. PMID: 26847303 [PubMed - in process] (Source: Yonsei Medical Journal)


Validation of the Korean Version of the DN4 Diagnostic Questionnaire for Neuropathic Pain in Patients with Lumbar or Lumbar-Radicular Pain.
CONCLUSION: The present study demonstrated the good discriminatory power of DN4 between nociceptive pain and neuropathic component pain in patients with lumbar or lumbar-radicular pain. PMID: 26847299 [PubMed - in process] (Source: Yonsei Medical Journal)


Research finds no easy answers to use of drug screening for pain patients
(University of Houston) Doctors who treat patients suffering from chronic pain face a quandary, according to research from the University of Houston and the University of Texas Medical Branch. Monitoring patients through urine drug screenings, part of the standard protocol to ensure patient safety, is associated with an increase in the odds that the patients won't return for future treatment. (Source: EurekAlert! - Social and Behavioral Science)


What Factors Influence Linear Growth After Transplantation?
Discussion Growth is a defining characteristic of children. Children are expected to have normal height, weight and head circumference growth velocities for their specific age. A review of mid-parental height determination and other growth parameters can be found here. For children with chronic illness and organ dysfunction or failure, their bodies cannot be expected to continue to have normal growth and therefore these children often have failure of normal growth for any and all of the growth parameters. For children facing organ failure or high risk or relapsed cancers, organ transplantation can be life-saving, but is not without its own problems including neurocognitive abnormalities, psychosocial dysfunction, endocrine abnormalities, bone abnormalities, primary or secondary malignancy...


The clinical consequences of sucrase-isomaltase deficiency
Abstract Primary sucrase-isomaltase deficiency, originally thought to be a homozygous recessive disorder, has been found to have numerous genetic variants that alone or in combination (compound heterozygosity) express varying degrees of clinical illness, most commonly causing chronic diarrhea, abdominal pain, and bloating. These symptoms are also present with secondary sucrase-isomaltase deficiency. Recent investigations are providing evidence that sucrase-isomaltase deficiency is more prevalent and of greater clinical significance than previously suspected. Further research is required to correlate the specific genotypes and phenotypes with their clinical expressions and to determine the most appropriate treatment algorithm for these patients. (Source: Molecular and Cellular Ped...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Nutrient Insufficiencies/Deficiencies in Children With Sickle Cell Disease and Its Association With Increased Disease Severity
ConclusionsOur findings show that patients with SCD commonly have multiple nutrient insufficiencies/deficiencies and support the growing evidence for the link between low zinc and increased VOC. It also indicates that increased nutrient insufficiencies/deficiencies are associated with increased disease severity in SCD. Prospective studies with larger samples are needed to further elucidate the relationship between nutrient deficiencies and SCD, and to determine whether nutrient supplementation can improve the disease course. (Source: Pediatric Blood and Cancer)


Pain and Cognitive Function Among Older Adults Living in the Community
Conclusions. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. (Source: Journals of Gerontology Series A: Biological Sciences and Medical Sciences)


Oral Palmitoylethanolamide Treatment Is Associated with Reduced Cutaneous Adverse Effects of Interferon-β1a and Circulating Proinflammatory Cytokines in Relapsing–Remitting Multiple Sclerosis
Abstract Palmitoylethanolamide (PEA) is an endogenous lipid mediator known to reduce pain and inflammation. However, only limited clinical studies have evaluated the effects of PEA in neuroinflammatory and neurodegenerative diseases. Multiple sclerosis (MS) is a chronic autoimmune and inflammatory disease of the central nervous system. Although subcutaneous administration of interferon (IFN)-β1a is approved as first-line therapy for the treatment of relapsing–remitting MS (RR-MS), its commonly reported adverse events (AEs) such as pain, myalgia, and erythema at the injection site, deeply affect the quality of life (QoL) of patients with MS. In this randomized, double-blind, placebo-controlled study, we tested the effect of ultramicronized PEA (um-PEA) added to IFN-β1a in the t...


Coping styles and disability in patients with hand osteoarthritis
Conclusion. In patients with hand OA, joint-specific factors and coping styles decreasing activity and pacing were both associated with disability. Our results suggest that interventions should aim at joint-specific complaints as well as changing coping styles to improve functional outcome. (Source: Rheumatology)


Respiratory dysfunction in patients with chronic neck pain: what is the current evidence?
Respiratory function of patients with neck pain has not been given much consideration in usual clinical practice. The problem has however been highlighted occasionally by renown clinical scientists and recently there is a growing interest in the investigation of respiratory function in this clinical population. The aim of this review is to critically present the emerging evidence and discuss the similarities and differences observed. Although the evidence for some respiratory parameters is conflicting, it seems to be generally agreed that others such as maximal voluntary ventilation, strength of respiratory muscles, chest mechanics and partial pressure of arterial carbon dioxide are affected in patients with chronic neck pain. (Source: Journal of Bodywork and Movement Therapies)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Subdural empyema following lumbar facet joint injection: An exceeding rare complication
We report a rare case of a 47-year-old female patient who developed a left L4/5 facet septic arthrosis with an associated subdural empyema and meningitis following facet joint injection. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention. The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated. (Source: Polish Journal of Neurology and Neurosurgery)


Exercise therapy for chronic fatigue syndrome.
CONCLUSIONS: Patients with CFS may generally benefit and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes. A positive effect with respect to sleep, physical function and self-perceived general health has been observed, but no conclusions for the outcomes of pain, quality of life, anxiety, depression, drop-out rate and health service resources were possible. The effectiveness of exercise therapy seems greater than that of pacing but similar to that of CBT. Randomised trials with low risk of bias are needed to investigate the type, duration and intensity of the most beneficial exercise intervention. PMID: 26852189 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Prevalence of Diabetes and Health-Related Quality of Life Among Rural-to-Urban Nong Zhuan Fei Migrants in an Urban Area of Northern China, 2013.
CONCLUSION: The Chinese government hopes to integrate an additional 250 million people into city living by 2025. As the NZF population increases, so may the prevalence of diabetes associated with the change from a rural to an urban lifestyle. Action is needed now by public health professionals to prevent a possible diabetes crisis in NZF communities in the future. PMID: 26843683 [PubMed - in process] (Source: Public Health Reports)


Cognitive Behavioral Therapy Formulation With Chronic Pain
(Source: Journal of Cognitive Psychotherapy)


Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Conclusions The management of headaches associated with neck pain should include exercise. Patients who suffer from chronic tension-type headaches may also benefit from relaxation training with stress coping therapy or multimodal care. Patients with cervicogenic headache may also benefit from a course of manual therapy. (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>


The association between metacognitions and the impact of Fibromyalgia in a German sample
Fibromyalgia is a chronic condition of unknown aetiology, characterised by widespread pain, sleep disturbances, and fatigue. In this paper we examined the relationship metacognitions and the impact of Fibromyalgia in a German sample, detailing the translation and validation of a self-report metacognitive instrument. (Source: Journal of Psychosomatic Research)


Role of Protease-Activated Receptor 2 in the development of lower urinary tract dysfunction
We reported that the mast cell-tryptase-PAR2 axis plays a critical role in the development of chronic pain in experimental autoimmune prostatitis (EAP), a mouse model of CP/CPPS. We therefore examined whether PAR2 activation mediates lower urinary tract dysfunction. (Source: The Journal of Urology)


[Long-term Application of Opioids for Non-Tumor Associated Pain - Impact of the S3 Guidelines for the Field of Orthopaedic Surgery and Trauma Surgery].
Discussion: Opioid analgetics are a treatment option for particular pain syndromes (arthritis, back pain). However, the latest S3 guidelines emphasise patient education and therapy. The indication, effects, side effects and therapeutic objectives should be regularly assessed, both before and during treatment. Once therapeutic goals have been achieved, measures such as physical therapy, physiotherapy or psychotherapy should be continued, whereas opioid dosage should be gradually reduced. PMID: 26844856 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Orthopadie und Unfallchirurgie)


Case complexity in patients with chronic nonspecific musculoskeletal pain: a Delphi and feasibility study
The objective of this study was to explore case complexity and to initiate the development of a case complexity index (CCI). A three-round Delphi study among clinicians involved in multidisciplinary Pain Rehabilitation Programs was performed to identify important factors that are assumed to influence functioning in patients with CMP. The 10 most important factors were used to initiate the development of a CCI, with mean ratings of importance per factor as weights. The feasibility of the CCI was tested in a pilot study on 16 patients with CMP. In the first round, 166 factors were identified; in the second round, the 10 most important factors were selected; in the third round, relative weights of each factor were calculated, ranging from 1.75 (features of complaints) to 3.56 (psychiatric dis...


Simple SpA screening tool works in U.S. population
People under the age of 45 with chronic back pain for more than 3 months can be reliably identified as having axial spondyloarthritis (axSpA) if they have one or more of three SpA disease features,... (Source: Rheumatology 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>


Cure: A Journey Into the Science of Mind Over Body review – can illness be ‘all in your head’?
From placebos and ‘kissing it better’ to hypnosis and Lourdes – a level-headed look at alternatives to prescription drugsThere are certain kinds of illnesses that seem to cause great distress to doctors; and there are certain kinds of patients that medicine seems almost incapable of helping. It can seem to some people that doctors are almost hostile to them. We often read in illness memoirs of doctors who have been dismissive, and patients being told: “it’s all in your head”, “you’re imagining it”, “your symptoms aren’t real” (whatever that means).I have in mind a patient I saw last Monday morning. Mr Hutchens (not his real name) has been depressed for many years, since losing his job because of his chronic back pain, sustained after an apparently minor road acciden...


Helicobacter Pylori Associated Gastritis Increases Risk of Colorectal Polyps: a Hospital Based-Cross-Sectional Study in Nakhon Ratchasima Province, Northeastern Thailand.
CONCLUSIONS: This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer. PMID: 26838234 [PubMed - in process] (Source: Asian Pacific Journal of Cancer Prevention)


Pilot study shows meditation can help US veterans manage chronic pain
(American University) A small pilot study conducted at the Washington, DC Veterans Affairs Medical Center reveals that veterans who practiced meditation reported a 20 percent reduction in pain intensity (how bad pain hurts or feels), as well as pain interference, how pain interferes with everyday aspects of life, such as sleep, mood, and activity level. (Source: EurekAlert! - Medicine and Health)


The Impact of Spinal Cord Stimulation on Sleep Patterns
DiscussionWe demonstrate that insomnia scores on ISI improve with SCS at six‐month follow‐up. Further, we find that improvements in pain correlate with these ISI improvements. (Source: Neuromodulation)


Flow cytometry as an improved method for the titration of Chlamydiaceae and other intracellular bacteria
In this study we compared the use of flow cytometry with microscopy and Fluorospot for the titration of C. suis as a representative of other intracellular bacteria. Titer determination via Fluorospot was unreliable, while titration via microscopy led to a linear read‐out range of 16 − 64 dilutions and moderate reproducibility with acceptable standard deviations within and between investigators. In contrast, flow cytometry had a vast linear read‐out range of 1,024 dilutions and the lowest standard deviations given a basic training in these methods. In addition, flow cytometry was faster and material costs were lower compared to microscopy. Flow cytometry offers a fast, cheap, precise, and reproducible alternative for the titration of intracellular bacteria like C. suis. © 2016 In...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Baroreflex mechanisms in Irritable Bowel Syndrome: Part I. Traditional indices
Conclusions These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS. (Source: Physiology and Behavior)


Development and Evaluation of the Psychometric Properties of the CKD-MBD Knowledge and Behavior Questionnaire (CKD-MBD-KB) for Patients with Chronic Kidney Disease
Chronic kidney disease-mineral and bone disorder (CKD-MBD) is one of the most complicated morbidities among patients with end-stage renal disease. At present, a specific questionnaire assessing relevant knowledge and behavior for patients with CKD-MBD is still unavailable. (Source: Journal of Pain and Symptom Management)


Novel application of high‐dose rate brachytherapy for severe, recalcitrant palmoplantar pustulosis
We present the case of a 36‐year‐old man with severe PPP who had treatment failure with multiple medical therapies but showed marked improvement with high‐dose rate brachytherapy. Brachytherapy has the advantage of providing a conformal dose distribution over complex curved surfaces, such as the foot and ankle. Our observations suggest that brachytherapy may be a well‐tolerated treatment option for patients with severe, refractory PPP. (Source: Clinical And Experimental Dermatology)


Pain self‐management training increases self‐efficacy, self‐management behaviours and pain and depression outcomes
ConclusionA combined intervention increased patient self‐management behaviours and self‐efficacy to manage symptoms among primary care patients with chronic musculoskeletal pain and depression. Receipt of the full dose of the entire PSM programme was related to improvements in pain interference and depression severity. What does this study add?A nurse‐led six‐session PSM programme increased self‐efficacy as well as specific behaviours such as strengthening and stretching exercises, progressive muscle relaxation and visualization.There was a dose–response in that attending a greater proportion of the PSM sessions led to greater improvement in both pain and depression outcomes. (Source: European Journal of Pain)


Medical cannabis: considerations for the anesthesiologist and pain physician
Conclusion The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios. (Source: Canadian Journal of Anesthesia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Anterior sacral meningocele presenting as right adnexal cyst
A 47-year old woman presented with chronic pelvic pain for 6 months. There was no history of trauma or surgical operation. Pelvic ultrasound (US) was performed. Pelvic US revealed an anechoic cyst in the right pelvic areas. The origin of the cyst could not be determined during the US examination. The magnetic resonance (MR) imaging showed a thin-walled cystic lesion in the right adnex. The lesion was not associated with the ovaries. In the posterior, it was communicating with the spinal subarachnoid space (Figure 1A-C). (Source: The Spine Journal)


Forecasting the future pain in hip OA: can we rely on pain trajectories?
Hip osteoarthritis (OA) is a common disorder, with nearly 5 million adults older than 50 years in the United States having both radiographically apparent changes and near-daily hip pain.1 About 20 million additional adults have radiographic changes to their hip but experience no or only intermittent pain. The pain and functional disability caused by symptomatic hip OA can be immense; persons with hip OA report quality of life comparable to those who have rheumatoid arthritis or chronic obstructive pulmonary disease. (Source: Osteoarthritis and Cartilage)


Role of Free Iliac Crest Flap in Foot and Ankle Reconstruction
Conclusions The free iliac crest flap is a feasible option for extensive compound fractures and bone-healing complications in the foot and ankle. It can also be used to achieve ankle arthrodesis when other techniques have failed and in patients at high risk for amputation.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Reconstructive Microsurgery)


A study of the psychometric properties of 12-item World Health Organization Disability Assessment Schedule 2.0 in a large population of people with chronic musculoskeletal pain.
CONCLUSIONS: The present data indicate that the Finnish translation of the 12-item WHODAS 2.0 is a valid instrument for measuring restrictions of activity and participation among patients with chronic musculoskeletal pain. PMID: 26851249 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)


Laparoscopic Appendectomy for Chronic Right Iliac Fossa Pain: Correlating Histology with Outcome.
This study collected prospective data for a single surgeon's series of laparoscopic appendectomy performed for CRIF pain between 2003 and 2014. RESULTS: Forty patients with a median age of 13 years (range 5-19 years) underwent laparoscopic appendectomy for CRIF pain. Twenty-nine patients (73%) had macroscopically normal appendixes, but histological changes were identified in 28 patients (70%). Other findings at laparoscopy included gynecological pathology (ovarian/para-ovarian cysts), unfixed mobile caecum, and a well-defined peritoneal band extending from the caecum to the anterolateral abdominal wall (caeco-peritoneal band). Patients were followed up for a median of 2 months (range 1-15 months). All patients reported resolution of CRIF pain. DISCUSSION: Laparoscopic appendectomy ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 cannabis: considerations for the anesthesiologist and pain physician.
CONCLUSION: The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios. PMID: 26850063 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)


[Pain-related parental behavior : Maternal and paternal responses to chronic pain of their child and modifications following inpatient interdisciplinary pain treatment].
CONCLUSION: Pain-related solicitous behavior can be modified by the interdisciplinary inpatient treatment of chronic pain in children and changes in solicitous behavior seem to be closely related to parental catastrophizing. This association should be considered when dealing with parents of children with chronic pain and also within the framework of future research projects. PMID: 26847081 [PubMed - as supplied by publisher] (Source: Schmerz)


Neuropeptide S modulates the amygdaloidal HCN activities (Ih) in rats: Implication in chronic pain.
We report that NPS inhibits hyperpolarization-activated cyclic nucleotide-gated (HCN) channel current (Ih) in the rat's amygdala through activation of NPSR. This NPS effect is mediated through ERK1/2 phosphorylation in a subset of pyramidal-like neurons located in the medial amygdala. The characters of the recorded Ih suggest a major role for HCN1 activity in this process. Inhibition of Ih by NPS stimulates the glutamatergic drive onto fast spiking intra-amygdalolidal GABAergic interneurons, which in turn facilitates GABA release onto pyramidal-like neurons. Moreover, the HCN1 expression is increased in the amygdala of rats with peripheral nerve injury and intra-amygdaloidal administration of the HCN channel inhibitor ZD7288 attenuates nociceptive behavior in these rats. These results sugg...


Systemic administration of vitamins C and E attenuates nociception induced by chronic constriction injury of the sciatic nerve in rats.
Authors: Riffel AP, de Souza JA, Santos MD, Horst A, Scheid T, Kolberg C, Belló-Klein A, Partata WA Abstract Antioxidants have been tested to treat neuropathic pain, and α-Tocopherol (vitamin E - vit. E) and ascorbic acid (vitaminC - vit. C) are potent antioxidants. We assessed the effect of intraperitoneal administration of vit. C (30mg/kg/day) and vit. E (15mg/kg/day), given alone or in combination, on the mechanical and thermal thresholds and the sciatic functional index (SFI) in rats with chronic constriction injury (CCI) of the sciatic nerve. We also determined the lipid hydroperoxides and total antioxidant capacity (TAC) in the injured sciatic nerve. Further, we assessed the effects of oral administration of vit. C+vit. E (vit. C+E) and of a combination of vit. C+E and gaba...


Better quality of care may reduce risk of death for patients on opioid painkillers
Better quality of care may reduce the risk of death for patients who are prescribed opioid painkillers for chronic pain, say Yale researchers. Their study offers evidence that supports recommendations from clinical practice guidelines encouraging physicians to engage patients with mental health services and substance abuse treatment, as well as to avoid co-prescriptions for sedatives. (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>


Oral ketamine for the treatment of pain and treatment-resistant depression†.
ConclusionsOral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. PMID: 26834167 [PubMed - in process] (Source: The British Journal of Psychiatry for Mental Science)


Chronic Intussusception Caused by Diffuse Large B-Cell Lymphoma in a 6-Year-Old Girl Presenting with Abdominal Pain and Constipation for 2 Months.
Authors: Choi SH, Han SA, Won KY Abstract The classical triad of abdominal pain, vomiting, and bloody stool is absent in chronic intussusception for more than 2 weeks. Here, we report a 6-year-old female with recurrent abdominal pain for 2 months. Ultrasonography of the abdomen revealed an ileocolic-type intussusception. The lesion accompanying the tight fibrous adhesion was treated by resection and ileocolic anastomosis. It was diagnosed as intussusception with diffuse large B-cell lymphoma. A high index of suspicion for abdominal pain in children should result in the correct diagnosis and appropriate management. PMID: 26839490 [PubMed - in process] (Source: Journal of Korean Medical Science)


Predictive Factors of Mortality in Population of Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH): Results from a Korean PNH Registry.
Authors: Jang JH, Kim JS, Yoon SS, Lee JH, Kim YK, Jo DY, Chung J, Sohn SK, Lee JW Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is a progressive, systemic, life-threatening disease, characterized by chronic uncontrolled complement activation. A retrospective analysis of 301 Korean PNH patients who had not received eculizumab was performed to systematically identify the clinical symptoms and signs predictive of mortality. PNH patients with hemolysis (lactate dehydrogenase [LDH] ≥ 1.5 × the upper limit of normal [ULN]) have a 4.8-fold higher mortality rate compared with the age- and sex-matched general population (P &lt; 0.001). In contrast, patients with LDH &lt; 1.5 × ULN have a similar mortality rate as the general population (P = 0.824). Thromboembolism (TE) (odds ratio...


Serum Troponin I Level for Diagnosis of Acute Coronary Syndrome in Patients with Chronic Kidney Disease.
CONCLUSIONS: Serum levels of cardiac troponin I and creatine kinase-myocardial bound were not suitable to diagnose ACS in CKD patients (stages 3 to 5); therefore, we suggest using other diagnostic attempts in similar conditions. More evaluation is needed to confirm these findings. PMID: 26837675 [PubMed - in process] (Source: Iranian Journal of Kidney Diseases)


Functional MRI may help identify new, effective painkillers for chronic pain sufferers
New research may allow new, more effective and safer pain medications to reach patients who suffer from chronic pain sooner. (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>


Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic Lateral Epicondylitis.
Authors: Rodik T, McDermott B Abstract CLINICAL SCENARIO: Lateral epicondylitis (LE) is a relatively common pathology capable of producing chronic debilitation in a variety of patients. A newer treatment for orthopedic conditions is platelet-rich plasma (PrP) local injection. Focused Clinical Question: Is PrP a more appropriate injection therapy for LE than other common injections such as corticosteroid or whole blood? Summary of Key Findings: Four studies were included: 1 randomized controlled trial (RCT), 2 double-blind RCTs, and 1 cohort study. Two studies involved comparisons of PrP injection to corticosteroid injection. One of the studies involved a 2-y follow-up while another involved a 1-y follow-up. Another study involved the comparison of PrP injection with whole-blood inj...


Effects of intracutaneous injections of sterile water in patients with acute low back pain: a randomized, controlled, clinical trial.
Authors: Cui JZ, Geng ZS, Zhang YH, Feng JY, Zhu P, Zhang XB Abstract Intracutaneous sterile water injection (ISWI) is used for relief of low back pain during labor, acute attacks of urolithiasis, chronic neck and shoulder pain following whiplash injuries, and chronic myofascial pain syndrome. We conducted a randomized, double-blinded, placebo-controlled trial to evaluate the effect of ISWI for relief of acute low back pain (aLBP). A total of 68 patients (41 females and 27 males) between 18 and 55 years old experiencing aLBP with moderate to severe pain (scores ≥5 on an 11-point visual analogue scale [VAS]) were recruited and randomly assigned to receive either ISWIs (n=34) or intracutaneous isotonic saline injections (placebo treatment; n=34). The primary outcome was improvement...


Facet orientation and tropism: Associations with asymmetric lumbar paraspinal and psoas muscle parameters in patients with chronic low back pain.
CONCLUSIONS: Muscular asymmetries may develop in the lumbar region of the spine, which are associated with facet asymmetry in patients with chronic low back pain. Longitudinal studies are needed to understand the causal relationship between facet orientation and tropism and muscular asymmetry in future. PMID: 26836843 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Scapulothoracic muscle strength in individuals with neck pain.
CONCLUSIONS: Significant within subject differences were found between sides for the LT and MT while significant between group differences were identified for all three muscles tested. PMID: 26836839 [PubMed - as supplied by publisher] (Source: Journal of Back and Musculoskeletal Rehabilitation)


Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain.
CONCLUSION: The kinesiophobia adversely affect the quality of life limiting the physical activity status of patients with chronic low back pain. PMID: 26836836 [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>


Pediatric obesity: Causes, symptoms, prevention and treatment.
Authors: Xu S, Xue Y Abstract Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21-24% children and adolescents are overweight, and 16-18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults. Obesity in children is a major health concern of the developed world. The National Health and Nutrition Examination Survey has reported that the prevalence of obesity is on ...


The unhappy triad: pain, sleep complaints, and internalizing symptoms - Koffel E, Krebs EE, Arbisi PA, Erbes CR, Polusny MA.
There is limited understanding of the etiology and temporal relations of chronic pain, sleep complaints, and depression/anxiety. Several models have been proposed by which sleep disruption represents a common mechanism for the comorbidity of these symptoms... (Source: SafetyLit)


Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study - Hu J, Bortsov AV, Ballina L, Orrey DC, Swor RA, Peak D, Jones J, Rathlev N, Lee DC, Domeier R, Hendry P, Parry BA, McLean SA.
Motor vehicle collision (MVC) can trigger chronic widespread pain (CWP) development in vulnerable individuals. Whether such CWP typically develops through the evolution of pain from regional to widespread or through the early development of widespread pain... (Source: SafetyLit)


Better quality of care may reduce risk of death for patients on opioid painkillers
(Yale University) Better quality of care may reduce the risk of death for patients who are prescribed opioid painkillers for chronic pain, say Yale researchers. Their study, published Feb. 4 in the Journal of General Internal Medicine, offers evidence that supports recommendations from clinical practice guidelines encouraging physicians to engage patients with mental health services and substance abuse treatment, as well as to avoid co-prescriptions for sedatives. (Source: EurekAlert! - Social and Behavioral Science)


Implications of Sensorineural Hearing Loss With Hydrocodone/Acetaminophen Abuse.
This report describes a patient who experienced hearing loss from hydrocodone/acetaminophen abuse. PMID: 26835162 [PubMed] (Source: The Primary Care Companion for CNS Disorders)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Durability of Benefit From Repeated Intravenous Lidocaine Infusions in Fibromyalgia Patients: A Case Series and Literature Review.
Authors: Marks DM, Newhouse A Abstract Fibromyalgia is a painful disorder with no curative treatments, and available medications typically provide partial relief of pain. Reported here is the effective use of serial intravenous lidocaine infusions for the chronic management of 3 patients with fibromyalgia. The details of the infusion procedure are described, and relevant literature is reviewed. Lidocaine infusions should be considered in fibromyalgia patients who are refractory to other treatments, and a positive response to 1 infusion may justify repeated infusions for chronic management. PMID: 26835161 [PubMed] (Source: The Primary Care Companion for CNS Disorders)


A Validation and Generality Study of the Committed Action Questionnaire in a Swedish Sample with Chronic Pain
Conclusion The development, translation and further validation of the CAQ is an important step forward in evaluating the utility of the psychological flexibility model to the treatment of chronic pain. The CAQ can both assist researchers interested in mediators of chronic pain treatment and further enable research on change processes within the psychological flexibility model. (Source: International Journal of Behavioral Medicine)


Estimating the true global burden of mental illness
Publication date: February 2016 Source:The Lancet Psychiatry, Volume 3, Issue 2 Author(s): Daniel Vigo, Graham Thornicroft, Rifat Atun We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of ye...


Adolescent With Weight Loss and Abdominal Pain
This article briefly reviews the emergency department approach to the differential diagnosis of weight loss, pelvic pain, and adnexal masses in adolescent girls with a concise summary of the clinical manifestations and laboratory testing for human immunodeficiency virus among adolescents. (Source: Clinical Pediatric Emergency Medicine)


Percutaneous endoscopic cecostomy (introducer method) in chronic intestinal pseudo‐obstruction: Report of two cases and literature review
We report on two patients with recurrent episodes of chronic intestinal pseudo‐obstruction (CIPO). A 50‐year‐old woman with severe multiple sclerosis and an 84‐year‐old man with Parkinson's disease and dementia had multiple hospital admissions because of pain and distended abdomen. Radiographic and endoscopic findings showed massive dilation of the colon without any evidence of obstruction. Conservative management resolved symptoms only for a short period of time. As these patients were poor candidates for any surgical treatment we carried out percutaneous endoscopic colostomy by placing a 20‐Fr tube in the cecum with the introducer method. The procedure led to durable symptom relief without complications. We present these two cases and give a review through the existing litera...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue
Conclusions Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist–patient communication. These simple, inexpensive interventions could improve women’s experiences during core-needle breast biopsy. (Source: Journal of the American College of Radiology)


Case Study
This case illustrates the complexity and interrelationship of osseous pathology with peripheral nerve entrapment and neuromata. She had an iatrogenic nerve injury of a branch of the medial dorsal cutaneous nerve causing her painful scar. Secondarily, she developed an injury to her common peroneal nerve from the cast immobilization, resulting in palsy/drop foot. The tarsal tunnel entrapment was likely a sequela of the cast immobilization and chronic swelling. Her postoperative chronic pain was compounded by the failure to use grommets with the polymeric silicon (Silastic) implant at the initial surgery, leading to a breakdown of the implant with subsequent detritic synovitis. (Source: Clinics in Podiatric Medicine and Surgery)


From hospitalist to rapper: The story of ZDoggMD
You may have heard of ZDoggMD—the rapping doctor whose parody music videos on medical topics like electronic health records (EHR), re-admission and sepsis have acquired millions of views. But who is the physician behind the persona? Primary care physician Michael Rakotz, MD, director of chronic disease prevention with the AMA’s Improving Health Outcomes initiative, sat down with Zubin Damania, MD, to talk about burnout, discuss EHRs and find out how he came to be the Youtube rapping sensation ZDoggMD. The burnout story that started it all Dr. Rakotz: “When did you first realize that you were facing burnout?” Dr. Damania: “For me it was really a slow creep. I started my career in hospital medicine …. I had a wonderful hospital job with mentorship with interns, medical st...


Role of Transient Receptor Potential Channels in Paclitaxel- and Oxaliplatin-induced Peripheral Neuropathy.
Authors: Taguchi K Abstract   Peripheral neuropathy is a common adverse effect of paclitaxel and oxaliplatin treatment. The major dose-limiting side effect of these drugs is peripheral sensory neuropathy. The symptoms of paclitaxel-induced neuropathy are mostly sensory and peripheral in nature, consisting of mechanical allodynia/hyperalgesia, tingling, and numbness. Oxaliplatin-induced neurotoxicity manifests as rapid-onset neuropathic symptoms that are exacerbated by cold exposure and as chronic neuropathy that develops after several treatment cycles. Although many basic and clinical researchers have studied anticancer drug-induced peripheral neuropathy, the mechanism is not well understood. In this review, we focus on (1) analysis of transient receptor potential vanilloid 1 (TR...


[Conversion disorder in an internal medicine department: A series of 37 cases].
CONCLUSION: This case series confirms that the DSM-IV-TR criterion of "psychogenicity" (later abandoned in DSM-5) is highly problematic in clinical practice. It suggests a close relationship between conversion disorder and unexplained chronic pain. PMID: 26827119 [PubMed - as supplied by publisher] (Source: L Encephale)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Boston Scientific, Bard escape joint pelvic mesh trial
Boston Scientific (NYSE:BSX) and C.R. Bard (NYSE:BCR) yesterday won the 1st trial in a pelvic mesh lawsuit against 2 companies after a Kansas City jury voted 10-2 that their implants were not defective and didn&#8217;t cause plaintiff Eve Sherrer&#8217;s injuries. Sherrer alleged that Bard’s Align and Boston Scientific’s Solyx products used a polypropylene mesh that reacts to tissue by becoming brittle, and that the companies failed to warn patients about the products’ attendant risks, seeking $28 million in damages. Manufacturers of pelvic mesh products, designed to treat female urinary incontinence and pelvic organ prolapse, face some 70,000 lawsuits spanning 3 multi-district litigations. Only a few have made it to trial, with juries recording 17 wins for plaintiffs and 5 for t...


Managing medical comorbidities in patients with depression to improve prognosis.
Authors: Thase ME Abstract Medical comorbidities contribute to poor antidepressant response, treatment resistance, and poor outcomes in many patients with depression. Depression can co-occur with thyroid conditions, chronic pain conditions, central nervous system disorders, and more. Inflammatory conditions such as diabetes and obesity are also associated with depression, and the connection between inflammation and depression may lead to testing that could better match patients to specific antidepressant treatment. Interventions for patients with depression and a comorbid medical condition include careful selection of antidepressant therapy as well as psychotherapy and adjunctive agents. PMID: 26829434 [PubMed - in process] (Source: Journal of Clinical Psychiatry)


Health Tip: Prevent Heel Pain
Title: Health Tip: Prevent Heel PainCategory: Health NewsCreated: 2/3/2016 12:00:00 AMLast Editorial Review: 2/3/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Outcomes and reflections on a consensus-building workshop for developing a spinal cord injury-related chronic pain research agenda.
Conclusions The consensus workshop provided an initial roadmap for research on SCI-related chronic pain, and supported five pilot projects on the identified priorities. Reflections on the current research landscape in Canada and abroad suggest increased activity towards addressing pain post-SCI but evidence-based approaches are still lacking. PMID: 26828394 [PubMed - as supplied by publisher] (Source: Journal of Spinal Cord Medicine)


Immediate and One Week Effects of Laterally Wedge Insoles on Gait Biomechanics in Healthy Females
Osteoarthritis is a disease associated with significant morbidity and is a leading cause of chronic pain and limited activity in the elderly population [1]. Approximately 12-16% of individuals above 65 years of age are diagnosed with knee osteoarthritis (KOA) [2], and it is estimated that approximately 45% of the U.S. population will develop KOA [3]. KOA also creates significant economic burdens in both direct healthcare costs and indirect costs [4,5]. Epidemiological data indicates a higher prevalence of radiographic KOA in women than in men [6]. (Source: Gait and Posture)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Deep Spine Infection After Acupuncture in the Setting of Spinal Instrumentation
Conclusions Acupuncture is sometimes pursued as part of a multimodality pain management program for back pain, but it is not without risk and can lead to infection. Deep infection from acupuncture may contaminate existing spinal instrumentation and require operative debridement, implant removal, and long-term antibiotic therapy. Accordingly, there is an increased risk for deformity progression in this scenario related to the implant removal. (Source: Spine Deformity)


The Relationship Among Neuromuscular Impairments, Chronic Back Pain, and Mobility in Older Adults
Conclusions The neuromuscular impairment profiles associated with mobility function among older adults with back pain vary compared with older adults without back pain. (Source: PMandR)


Investigation of the effect of traditional Chinese medicine on pain and inflammation in chronic nonbacterial prostatitis in rats
Summary According to traditional Chinese medicine, the symptoms of chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CNP/CPPS) may be treated using a cocktail of herbs that stimulate blood circulation (‘activating blood circulation formula’). We investigated the effect of three doses of this formula on a rat model of CNP/CPPS. Male Wistar rats were injected with a saline extract of male sex accessory glands on days 0 and 30 to induce prostatitis and then treated daily by gavage between days 32 and 60. Treatment with low, medium and high doses of activating blood circulation formula resulted in an almost total rescue of paw withdrawal threshold at day 60, and treatment with the highest dose also significantly decreased prostate inflammation (assessed histopathologically). W...


Frequency and characteristics of healthcare visits associated with chronic pain: results from a population-based Canadian study
Conclusion Interventions aimed at reducing healthcare costs for chronic pain should target individuals living with multiple chronic conditions. Research is needed to develop and test interventions that focus on the needs of these groups. Identifying the risk factors for high healthcare use and improving self-management may reduce healthcare visits. (Source: Canadian Journal of Anesthesia)


Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis.
CONCLUSIONS: Low quality evidence suggested that DPPHR may result in shorter hospital stay than PD. Based on low or very low quality evidence, there is currently no evidence of any difference in the mortality, adverse events, or quality of life between DPPHR and PD. However, the results were imprecise and further RCTs are required on this topic. Future RCTs comparing DPPHR with PD should report the severity as well as the incidence of postoperative complications and their impact on patient recovery. In such trials, participant and observer blinding should be performed and the analysis should be performed on an intention-to-treat basis to decrease the bias. In addition to the short-term benefits and harms such as mortality, surgery-related complications, quality of life, length of hospital ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality
Conclusions Providers should use caution in initiating LtOT in conjunction with benzodiazepines and untreated SUDs. Patients receiving LtOT may benefit from multi-modal treatment that addresses chronic pain and its associated comorbidities across multiple disciplines. (Source: Journal of General Internal Medicine)


Frequency and characteristics of healthcare visits associated with chronic pain: results from a population-based Canadian study.
CONCLUSION: Interventions aimed at reducing healthcare costs for chronic pain should target individuals living with multiple chronic conditions. Research is needed to develop and test interventions that focus on the needs of these groups. Identifying the risk factors for high healthcare use and improving self-management may reduce healthcare visits. PMID: 26846618 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)


Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide
Lichen sclerosus (LS) is an inflammatory and chronic disease that causes itching, pain, dysuria, urinary retention, dyspareunia and sexual dysfunction, in both men and women. The first line pharmacological treatment is based on the use of topical steroids, which have proved their efficacy in 60-70% of cases but with a high rate of relapses in time (50-80% of the patients of both sexes). The purpose of our non-randomised prospective pilot study was to evaluate the efficacy and tolerability of a new loco regional therapy with polydeoxyribonucleotides (PDRN) in the treatment of male genital LS. PDRN is an healing and anti-dystrophic drug with anti-inflammatory effects, through the reduction of cytokine. Twenty one male patients suffering from genital LS were recruited. All the patients were s...


Evaluation of endometriosis-associated pain and influence of conventional treatment: a systematic review
This study aimed to evaluate pain levels in women with endometriosis, focusing on the influence of conventional treatment in controlling this variable. To do so, a literature search was conducted in the Medline/Pubmed databases, with 119 scientific articles found. After applying the inclusion and exclusion criteria, 27 were selected for reading and elaboration of this review. Thus, 9 studies evaluated the contribution of surgery, 17 the use of drugs to reduce pain levels in patients with endometriosis and one assessed surgical and medical treatment. The main results of these searches are presented and discussed in this revision. Surgery and the use of drugs provided reduced pain scores in patients with endometriosis but nevertheless exhibit disadvantages, such as risk of recurrence and sid...


THE INTESTINAL MICROBIOTA AND THE ROLE OF PROBIOTICS IN IRRITABLE BOWEL SYNDROME: a review
Irritable bowel syndrome is a common, chronic relapsing gastrointestinal disorder that affects 7%-22% of the population worldwide. According to Rome III Criteria, the disorder is defined by the coexistence of abdominal discomfort or pain associated with an alteration in bowel habits. Its pathophysiology is not completely understood but, in addition to some important abnormalities, the disturbed intestinal microbiota has also been described supported by several strands of evidence. The treatment of irritable bowel syndrome is based upon several therapeutic approaches but few have been successful or without adverse events and more recently the gut microbiota and the use of probiotics have emerged as a factor to be considered. Probiotics are live micro-organisms which when consumed in adequat...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Painkillers Don't Ease Disability Due to Nerve Damage: Study
Title: Painkillers Don't Ease Disability Due to Nerve Damage: StudyCategory: Health NewsCreated: 2/1/2016 12:00:00 AMLast Editorial Review: 2/2/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Preliminary Evaluation of the Values Tracker: A Two-Item Measure of Engagement in Valued Activities in Those With Chronic Pain
Engagement in valued activities is an important outcome, particularly in treatments that aim to enhance quality of life in those with chronic conditions. The present study describes the initial evaluation of the Values Tracker (VT), a two-item measure of values engagement, in 302 treatment-seeking adults with chronic pain. Hierarchical regression analyses were conducted to examine the utility of the VT in the statistical prediction of pain-related functioning, after controlling for demographic variables, pain intensity, and pain-related distress. Across analyses, pain intensity accounted for significant variance (range R2 = .06-.09) with pain-related distress adding additional unique variance (range R2 = .07-.19). The VT accounted for additional unique variance (range R2 = .02-.17) for all...


Myofascial Triggerpoint Release (MTR) for Treating Chronic Shoulder Pain: A New Approach
This study comprehensively evaluated a myofascial triggerpoint release (MTR) technique for shoulder pain. (Source: Journal of Bodywork and Movement Therapies)


Chronic Exertional Compartment Syndrome
Increased tissue pressure within a fascial compartment may be the result from any increase in volume within its contents, or any decrease in size of the fascial covering or its distensibility. This may lead to symptoms of leg tightness, pain or numbness brought about by exercise. There are multiple differential diagnoses of exercise induced leg pain and the proper diagnoses of chronic exertional compartment syndrome (CECS) is made by a careful history and by exclusion of other maladies and confirmed by compartment syndrome testing as detailed in this text. Surgical fasciotomies for the anterior, lateral, superficial and deep posterior compartments are described in detail along with ancillary procedures for chronic shin splints that should allow the athlete to return to competitive activity...


Effects of Apremilast on Pruritus and Skin Discomfort/Pain Correlate With Improvements in Quality of Life in Patients With Moderate to Severe Plaque Psoriasis.
Authors: Sobell JM, Foley P, Toth D, Mrowietz U, Girolomoni G, Goncalves J, Day RM, Chen R, Yosipovitch G Abstract Pruritus and skin discomfort/pain negatively impact health-related quality of life (HRQoL). The effects of apremilast, an oral phosphodiesterase inhibitor, on pruritus, skin discomfort/pain, and patient global assessment of psoriasis disease activity (PgAPDA) were assessed in moderate/severe chronic plaque psoriasis patients in the phase 3 ESTEEM trials. Significant improvements in pruritus and skin discomfort/pain observed at Week 2 with apremilast versus placebo (both studies, p &lt; 0.0001) were sustained through Week 32. Among apremilast-treated patients, improvements in pruritus visual analog scale (VAS) scores correlated with Dermatology Life Quality Index sc...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Gender Differences in Patients with Fibromyalgia Undergoing Cognitive‐Behavioral Therapy for Insomnia: Preliminary Data
ConclusionsDifferential responses to treatment between men and women were observed in some sleep‐ and pain‐related variables. Outcomes show the needed to design different treatments for men and women with FM is discussed. (Source: Pain Practice)


Peripheral nerve blocks in patients with Ehlers-Danlos syndrome, hypermobility type: a report of 2 cases
Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. (Source: Journal of Clinical Anesthesia)


Efficacy and safety of Myofascial-meridian Release Acupuncture (MMRA) for chronic neck pain: a study protocol for randomized, patient- and assessor-blinded, sham controlled trial
The purpose of this study is to evaluate the efficacy and safety of myofascial-meridian release acupuncture (MMRA) in the treatment of chronic neck pain compared with sham acupuncture. (Source: BMC Complementary and Alternative Medicine)


Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritis.
CONCLUSIONS: LLLT is a safe, non-invasive, efficient and efficacious means to reduce pain and swelling and to increase joint mobility in patients suffering from Heberden's and Bourchard's OA. Further randomized controlled studies are needed to examine medium- to long-term effects as well as the ideal LLLT parameters. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc. PMID: 26833862 [PubMed - as supplied by publisher] (Source: Hand Surgery)


Correction: Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain.
Authors: PMID: 26829916 [PubMed - in process] (Source: Annals of Internal Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Evaluation of Pain, Dyspnea, and Goals of Care Among Adults With Cystic Fibrosis: A Comprehensive Palliative Care Survey.
CONCLUSION: Pain and dyspnea are common among adults with CF. Few had an advance directive in place, but most are open to discussing EOLC issues. Results of this single-center study may not represent the entire population, thus a multicenter investigation should be pursued. PMID: 26843535 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)


Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritis
ConclusionsLLLT is a safe, non‐invasive, efficient and efficacious means to reduce pain and swelling and to increase joint mobility in patients suffering from Heberden's and Bourchard's OA. Further randomized controlled studies are needed to examine medium‐ to long‐term effects as well as the ideal LLLT parameters. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc. (Source: Lasers in Surgery and Medicine)


Systemic inflammatory cytokine analysis to monitor biomaterial augmented tissue healing.
CONCLUSIONS: Analysis of systemic inflammation biomarkers confirmed inflammation elicited by surgeries and meshes irrespective of their composition. However, at an early postoperative endpoint (i.e., 1 week), some biomarkers, namely, IL-18 and RANTES, appeared to discriminate the noncomposite mesh from the composite materials, although in this study all materials successfully repaired the defects without recurrence or external indicators of postoperative chronic pain. PMID: 26847499 [PubMed - as supplied by publisher] (Source: The International Journal of Artificial Organs)


Best Bet For Neck Pain?
I heard that the Alexander Technique and acupuncture are the best treatments for chronic neck pain. Can you tell me about these approaches? Which one would be best? (Source: Dr. Weil Q and A)


Medical News Today: Chronic pain may be linked to genetic changes in the immune system
Chronic pain following injury may involve epigenetic changes, implying a potential future role for medications that target specific genes. (Source: Health News from Medical News Today)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Drug Counselors’ Attitudes Toward Nonpharmacologic Treatments for Chronic Pain
Conclusions: Findings indicate that methadone drug counselors perceive several nonpharmacologic evidence-based pain treatments as efficacious for methadone-maintained patients with chronic pain and counselors would be willing to refer their patients to these therapies if they were available. If some of these nonpharmacologic interventions were shown to be effective in methadone maintenance treatment, they have the potential to address, at least in part, the routine undertreatment of pain in this vulnerable patient population. (Source: Journal of Addiction Medicine)


Perioperative Continuous Ropivacaine Wound Infusion in Laparoscopic Cholecystectomy: A Randomized Controlled Double-blind Trial
Wound infusion with local anesthetics has been used for postoperative pain relief with variable results. This randomized, controlled, double-blind clinical trial examines the effect of ropivacaine infusion on pain after laparoscopic cholecystectomy. A total of 110 patients were randomly assigned to 2 groups. After induction of anesthesia a 75-mm catheter was inserted subcutaneously and connected to an elastomeric pump containing either 0.75% ropivacaine (ropivacaine group) or normal saline (control group) for 24 hours postoperatively. Before skin closure, each hole was infiltrated with 2 mL of 0.75% ropivacaine or normal saline according to randomization. Pain at rest, pain during cough, and analgesic consumption were recorded in the postanesthesia care unit and at 2, 4, 8, 24, and 48 hour...


Why Do Niches Develop in Caesarean Uterine Scars? Hypotheses on the Aetiology of Niche Development
Obstet Gynecol Surv 2016;71(2):83–84 There has been a substantial increase over last few decades in rates of cesarean section (CS) worldwide. Increasing CS rates have heightened awareness of gynecological symptoms after a CS, such as postmenstrual spotting, dysmenorrhea, chronic pelvic pain, and dyspareunia. (Source: Obstetrical and Gynecological Survey)


Bilateral Neuropathy of Primary Sensory Neurons by the Chronic Compression of Multiple Unilateral DRGs.
Authors: Xie YB, Zhao H, Wang Y, Song K, Zhang M, Meng FC, Yang YJ, He YS, Kuang F, You SW, You HJ, Xu H Abstract To mimic multilevel nerve root compression and intervertebral foramina stenosis in human, we established a new animal model of the chronic compression of unilateral multiple lumbar DRGs (mCCD) in the rat. A higher occurrence of signs of spontaneous pain behaviors, such as wet-dog shaking and spontaneous hind paw shrinking behaviors, was firstly observed from day 1 onward. In the meantime, the unilateral mCCD rat exhibited significant bilateral hind paw mechanical and cold allodynia and hyperalgesia, as well as a thermal preference to 30°C plate between 30 and 35°C. The expression of activating transcription factor 3 (ATF3) was significantly increased in the ipsilatera...


Adapting the ABCDEF Bundle to Meet the Needs of Patients Requiring Prolonged Mechanical Ventilation in the Long-Term Acute Care Hospital Setting: Historical Perspectives and Practical Implications.
This article is about such an extrapolation from the intensive care unit (ICU) to the long-term acute care hospital (LTACH) setting. Chronic critical illness is an emerging, disabling, costly, and yet relatively silent epidemic that is central to both of these settings. The number of chronically critically ill patients requiring prolonged mechanical ventilation is expected to reach unprecedented levels over the next decade. Despite the prevalence, numerous distressing symptoms, and exceptionally poor outcomes associated with chronic critical illness, to date there is very limited scientific evidence available to guide the care and management of this exceptionally vulnerable population, particularly in LTACHs. Recent studies conducted in the traditional ICU setting suggest interprofessional...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Oral ketamine for the treatment of pain and treatment-resistant depression [Review articles]
Conclusions Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. (Source: The British Journal of Psychiatry)


Comparative effectiveness of conservative interventions for non-specific chronic spinal pain: Physical, behavioural/psychologically informed or combined? A systematic review and meta-analysis
Non-specific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioural interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy and ergonomics. Behavioural and/or psychologically informed interventions aim to enhance behaviours, cognitions or mood by using methods such as relaxation and cognitive behavioural therapy (CBT). Combined interventions aim to target both physical and behavioural and/or psychological factors contributing to patients’ pain by using methods such as multidisciplinary pain management programmes. (Source: The Journal of Pain)


Increasing Neuroplasticity to Bolster Chronic Pain Treatment: A Role for Intermittent Fasting and Glucose Administration?
Neuroplastic changes in brain structure and function are not only a consequence of chronic pain but are involved in the maintenance of pain symptoms. Thus, promotion of adaptive, treatment-responsive neuroplasticity represents a promising clinical target. Emerging evidence about the human brain's response to an array of behavioral and environmental interventions may assist in identifying targets to facilitate increased neurobiological receptivity, promoting healthy neuroplastic changes. Specifically, strategies to maximize neuroplastic responsiveness to chronic pain treatment could enhance treatment gains by optimization of learning and positive central nervous system adaptation. (Source: The Journal of Pain)


Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa
Abstract Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due to the lack of evidence based treatment guidelines. The purpose of this study was to promote a holistic evidence-based approach which implemented Level of Evidence and Strength of Recommendation for the treatment of HS. Based upon the European Dermatology Forumguidelines for the management of HS, evidence-based approach was explored for the treatment of HS. The diagnosis of HS should be made by a dermatologist or other healthcare professional with expert knowledge in HS. All patie...


Clinical presentations, risk factors, treatment and outcomes in patients with splanchnic vein thrombosis: a single-center experience
Abstract Splanchnic vein thrombosis (SVT) is an uncommon form of venous thrombosis. Management can be challenging due to underlying conditions, increased bleeding risk, and lack of evidence from clinical trials. We sought to characterize the presentation and management of patients with SVT at a large tertiary hospital. A total of 43 patients’ electronic medical records were reviewed. Median age at diagnosis was 43 (18–71). Sixteen patients had isolated portal vein thrombosis (37.2 %), and 16 (37.2 %) had thrombosis involving multiple splanchnic veins. Abdominal pain was the most common clinical presentation (67.4 %). Thrombophilia was present in 18 patients (41.9 %), nine had underlying liver disease (20.9 %) and seven had inflammatory bowel disease (16.3 %). Thirty-nine...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Frequency of dressing changes for central venous access devices on catheter-related infections.
CONCLUSIONS: The best available evidence is currently inconclusive regarding whether longer intervals between CVAD dressing changes are associated with more or less catheter-related infection, mortality or pain than shorter intervals. PMID: 26827714 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Local anesthetic injections with or without steroid for chronic non-cancer pain: a protocol for a systematic review and meta-analysis of randomized controlled trials
Discussion Our review will evaluate both the effectiveness and the adverse events associated with steroid plus LA vs. LA alone for CNCP, evaluate the quality of the evidence using the GRADE approach, and prioritize patient-important outcomes guided by IMMPACT recommendations. Our results will facilitate evidence-based management of patients with chronic non-cancer pain and identify key areas for future research. Trial registration PROSPERO CRD42015020614 (Source: Systematic Reviews)


Fear-Avoidance Beliefs and Chronic Pain.
Authors: Gatchel RJ, Neblett R, Kishino N, Ray CT Abstract Fear-avoidance (FA) beliefs are significantly associated with the experience of pain, especially when the pain becomes chronic in nature. The anticipated threat of intense pain will often result in the constant vigilance and monitoring of pain sensations, which, in turn, can cause even low-intensity sensations of pain to become unbearable for the person. Just the anticipation of increased pain or reinjury can further stimulate avoidance behaviors. A vicious cycle may develop, in which fears of increased pain or reinjury contribute to the avoidance of many activities, leading to inactivity and, ultimately, to greater disability. Anyone who assesses and treats pain-related disability should also be prepared to assess and trea...


Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration
Conclusions Unique factors influence weight management in Veterans. Findings will inform development of a technology-assisted weight management intervention with tailored counseling and goal-setting within primary care at the VHA. (Source: BMC Obesity)


[Efficacy, tolerability and safety of cannabinoids for chronic neuropathic pain : A systematic review of randomized controlled studies].
CONCLUSION: Cannabinoids were marginally superior to placebo in terms of efficacy and inferior in terms of tolerability. Cannabinoids and placebo did not differ in terms of safety during the study period. Short-term and intermediate-term therapy with cannabinoids can be considered in selected patients with chronic neuropathic pain after failure of first-line and second-line therapies. PMID: 26830780 [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>


Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa.
Authors: Gulliver W, Zouboulis CC, Prens E, Jemec GB, Tzellos T Abstract Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due to the lack of evidence based treatment guidelines. The purpose of this study was to promote a holistic evidence-based approach which implemented Level of Evidence and Strength of Recommendation for the treatment of HS. Based upon the European Dermatology Forumguidelines for the management of HS, evidence-based approach was explored for the treatment of HS. The diagnosis of HS should be made by a dermatologist or other...


Prevalence and burden of osteoarthritis amongst older people in Ireland: findings from The Irish LongituDinal Study on Ageing (TILDA)
Conclusions: OA is a common and multifaceted condition, with comparable prevalence of self-reported OA in Ireland with similar populations. Assessment and management should focus on potentially modifiable factors such as BMI, pain, physical limitations, polypharmacy and fear of falling. More research is required to understand the complex inter-relationships between these and other risk-associated variables. (Source: The European Journal of Public Health)


Direct and Indirect Costs of Chronic and Episodic Migraine in the United States: A Web‐Based Survey
ConclusionThe results of this study build on previous results of the AMPP Study, demonstrating that headache‐related direct, indirect, and total costs are significantly greater among individuals with chronic migraine than with episodic migraine in the United States. (Source: Headache: The Journal of Head and Face Pain)


Right fronto-insular white matter tracts link cognitive reserve and pain in migraine patients
Conclusions Long-term chronic migraine patients show abnormalities in anterior white matter tracts, particularly of the right hemisphere, involved in pain modulation emotion, cognition and resilience. Robustness in these areas is associated with a higher cognitive reserve, which in turn might result in a lower tendency to migraine chronification. (Source: The Journal of Headache and Pain)


Advanced Innovations for Pain
Chronic pain represents one of the most important public health problems in terms of both the number of patients afflicted and health care costs. Most patients with chronic pain are treated with medications as the mainstay of therapy, and yet most medically treated patients continue to report ongoing pain. Additionally, adverse effects from pain medications represent a major challenge for clinicians and patients. Spinal cord stimulation and intrathecal drug delivery systems are well-established techniques that have been utilized for over 25 years. (Source: Mayo Clinic Proceedings)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Evaluation of Quality of Life, Functioning, Disability, and Work/School Productivity Following Treatment with an Extended‐Release Hydrocodone Tablet Formulated with Abuse‐Deterrence Technology: A 12‐month Open‐label Study in Patients with Chronic Pain
ConclusionsPatients receiving hydrocodone ER showed early numeric improvements in functioning that continued throughout this 12‐month study. (Source: Pain Practice)


Reports of perceptual distortion of the face are common in patients with different types of chronic oro‐facial pain
This study demonstrates that many chronic oro‐facial pain patients may experience perceptual distortions. Future studies may clarify the mechanisms underlying perceptual distortions, which may point towards new complementary strategies for the management of chronic oro‐facial pain. (Source: Journal of Oral Rehabilitation)


Up-regulation of immunomodulatory effects of mouse bone-marrow derived mesenchymal stem cells by tetrahydrocannabinol pre-treatment involving cannabinoid receptor CB2.
Authors: Xie J, Xiao D, Xu Y, Zhao J, Jiang L, Hu X, Zhang Y, Yu L Abstract Chronic pain is commonly and closely correlated with inflammation. Both cannabinoid signaling and mesenchymal stem cells (MSCs) have been demonstrated to reduce inflammatory pain. Although cannabinoid signaling is essential for mesenchymal stem cell survival and differentiation, little is known about its role in modulatory effect of MSCs on inflammation and pain sensitivity. Here we showed that mouse bone-marrow derived MSCs (BM-MSCs) expressed both cannabinoid receptor type 1 and 2 (CB1 and CB2). CB2 expression level in BM-MSCs increased with their maturation. In addition, we found that tetrahydrocannabinol (THC) activated CB2 receptor and ERK signaling, consequently enhancing the modulation of MSCs on inf...


Psychopharmacology of Chronic Pain: A Focus on Antidepressants and Atypical Antipsychotics.
Authors: Khouzam HR Abstract Chronic pain is considered one of the most prevalent causes of costly and disabling medical conditions. This review will define chronic pain and its categories and then will summarize the effectiveness and side effects associated with the use of various antidepressants, including the tricyclics, the selective serotonin reuptake inhibitors, the serotonin norepinephrine reuptake inhibitors, other miscellaneous antidepressants and the atypical antipsychotics in the treatment of chronic pain. PMID: 26821680 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


Back pain, tendons, Tiger Woods: all grist for the mill for sports medicine clinicians
Sports Doctors Australia is proud to be in its fourth year as one of BJSM's 23 member societies. This issue will touch a chord&mdash;pleasant or unpleasant&mdash;with most primary care practitioners. Clinicians are well aware of the inability to change the course of chronic low back pain in many people. When yet another patient comes in with persisting back pain, it may trigger a heart-sinking response or be seen as a challenge. Back pain&mdash;are we making progress? For a long time, we clinicians have tried to attack this problem through the reductionist model, believing that the more we understand about the cause of the pain, the more likely we were to improve the outcomes. J&oslash;rgen Jevne (see page 198) editorialises where we have gone wrong in our approach to finding a structural ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 biopsychosocial rehabilitation for chronic low back pain (PEDro synthesis)
This section features a recent systematic review that is indexed on PEDro, the Physiotherapy Evidence Database (http://www.pedro.org.au). PEDro is a free, web-based database of evidence relevant to physiotherapy. &nbsp;Kamper SJ, Apeldoorsn AT, Chiarotto A, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ 2015;350:h444. Background Low back pain (LBP) is a highly prevalent health condition, being the leading cause of years lived with disability, around the world.1 2 It is not unusual for people with chronic LBP (symptoms persisting for more than 3&nbsp;months)3 to experience signs of anxiety and depression, with effects on social, recreational and work life.4 Recognition of these potential psychosocial facto...


[Myelopathy secondary to an aneurysmal bone cyst of thoracic spine].
CONCLUSION: Despite their low incidence, aneurysmal bone cysts of the spine must be taken into account in the differential diagnosis of spinal bone tumours as a possible cause of subacute or chronic compressive myelopathy. Full surgical removal of the tumour is considered the preferred treatment, which is often curative and is associated with a good prognosis of the patient in the long term. PMID: 26815849 [PubMed - in process] (Source: Revista de Neurologia)


Management of patients with issues related to opioid safety, efficacy and/or misuse: a case series from an integrated, interdisciplinary clinic.
CONCLUSIONS: The core components of our approach-biopsychosocial assessment and multimodal treatment planning with an emphasis on promoting functional goals and safety using clear communication and a patient-centered stance-should guide providers in the management of similar clinical scenarios. More evidence is needed to definitively guide specific interventions and points of clinical equipoise. PMID: 26818474 [PubMed - in process] (Source: Addiction Science and Clinical Practice)


Dental Hygienist-Led Chronic Disease Management System to Control Early Childhood Caries
Conclusions ECC disease control requires meaningful engagement of patients and parents by the oral health care team in order to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally-based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in rates of new caries, dental pain and referral to the operating room compared to baseline rates. Dental hygienists are the appropriate team members to lead this approach due to their expertise in behavior cha...


Management of acute pain
Publication date: Available online 30 January 2016 Source:Surgery (Oxford) Author(s): Kiran K. Koneti, Martin Jones Acute pain is an important fear for most patients and influences their recovery and overall experience. Poorly treated, it could lead to undesirable effects and patient dissatisfaction. Hence, it is important to understand, assess and treat acute pain effectively. Pain is regarded as the fifth vital sign and should be addressed as important as other vital parameters. Management of pain involves team work, including acute pain services, especially in dealing with complex problems. Management of pain ideally starts at the pre-assessment visit or from first presentation to the clinician. It is important to anticipate and treat acute pain effectively, which may prevent the 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>


Effect of spinal monoaminergic neuronal system dysfunction on pain threshold in rats, and the analgesic effect of serotonin and norepinephrine reuptake inhibitors
Publication date: 26 February 2016 Source:Neuroscience Letters, Volume 615 Author(s): Ryuta Tamano, Mitsuhiro Ishida, Toshiyuki Asaki, Minoru Hasegawa, Shunji Shinohara Dysfunction in the central serotonin (5-HT) and norepinephrine (NE) systems cause depression and pain. Descending spinal pain modulatory pathways are important in the analgesic mechanisms of antidepressants, particularly serotonin and norepinephrine reuptake inhibitors (SNRIs). While many non-clinical studies have demonstrated the roles of central monoaminergic systems in pain, there is little evidence to illuminate the direct contribution of spinal descending pain modulatory systems independently of depressive-like behavior. To examine the effects of dysfunction of spinal monoaminergic systems on pain sensitivity, w...


Infection in Venous Leg Ulcers: Considerations for Optimal Management in the Elderly
Abstract Venous leg ulcers are the most common cause of chronic leg wounds, accounting for up to 70 % of all chronic leg ulcers and carrying with them a significant morbidity, especially for elderly patients. Among people aged 65 years and older, the annual prevalence is 1.7 %. Billions of dollars per year are spent caring for patients with these often difficult-to-heal and sometimes recurrent chronic wounds. Chronic non-healing wounds of the lower extremities are susceptible to microbial invasion and can lead to serious complications, such as delayed healing, cellulitis, enlargement of wound size, debilitating pain, and deeper wound infections causing systemic illness. Recognition and treatment of the infected venous leg ulcer is an essential skill set for any physician caring...


Prescription drug coverage and chronic pain
In this study, I examine whether increased access to prescription drugs due to the introduction of the Medicare Part D program in 2006 led to better management of pain among the elderly. While prior work has identified increases in the utilization of analgesics due to the introduction of Medicare Part D, the extent to which this increase in drug use actually improved the well-being of older adults is not known. Using data from the Health and Retirement Study, I employ a difference-in-differences strategy that compares pre versus post 2006 changes in pain related outcomes between Medicare eligible persons and a younger ineligible group. I find that Medicare Part D significantly reduced pain related activity limitations among a sample of older adults who report being troubled by pain. (Sourc...


Predominant role of spinal P2Y1 receptors in the development of neuropathic pain in rats.
In this study we assessed the role of P2Y1 receptors in several neuropathic pain models in the rat. Furthermore, we analyzed the expression of P2Y1 receptors in the ipsilateral dorsal root ganglia (DRG) and dorsal part of the spinal cord during the development and maintenance of neuropathic pain. We also determined the effect of the P2Y1 receptor antagonist on the expression of P2Y1 receptors. Chronic constriction injury (CCI), spared nerve injury (SNI) or spinal nerve ligation (SNL) produced tactile allodynia from 1 to 14 days after nerve injury. CCI, SNI and SNL enhanced expression of P2Y1 receptors in DRG but not in the dorsal part of the spinal cord at 1-3 days after injury. Intrathecal injection of the selective P2Y1 receptor antagonist MRS2500, but not vehicle, reduced tactile allody...


Chronic Pain in the Ambulatory Palliative Care Setting: A Distinct Entity from Acute Pain? (S744)
Acute pain is common in ambulatory palliative care (APC), and includes pain related to progression of serious illness and at the end of life. Chronic pain is pain lasting > 3 months, beyond the period of normal tissue healing. It has a unique pathophysiology, and I negatively impacts health outcomes. Acute pain management typically involves opioids; treatment of chronic pain often limits opioids and focuses on physical therapy, treatment of comorbid mood disorders, and pain self-management/coping. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Personal Growth, Symptom Burden and Uncertainty in Heart Failure (S725)
Heart failure (HF) is a chronic disease associated with unpredictable trajectories, significant symptom burden, and diminished quality of life (QOL). National guidelines recommend that palliative care (PC) be considered in early stages of life-limiting chronic illnesses, such as HF. Personal growth (PG), which is the ability to perceive positive psychosocial outcomes through significant adversity, is now being examined in addition to QOL in people with serious illnesses, but it has been little studied in HF. (Source: Journal of Pain and Symptom Management)


Measurement of Pain and Health-Related Quality of Life Measures in Adult Males with Hemophilia: Initial Observations of Disease Impact (S724)
Hemophilia is a rare genetic bleeding disorder characterized by acute, painful bleeds as well as chronic arthropathy. No standardized recommendations exist to measure pain and its subsequent impact on health-related quality of life (HRQoL) measures in adult patients with hemophilia (PWH). (Source: Journal of Pain and Symptom Management)


Naloxegol for Treating Opioid-Induced Constipation n Patients with Non-Cancer Pain (S710)
Opioid-induced constipation (OIC) affects 40%–80% of patients receiving opioids to manage chronic non-cancer pain, which can negatively impact quality of life and effective pain management. OIC results when opioid agonist effects at mu-opioid receptors in the enteric nervous system reduce gastrointestinal (GI) transit and secretions. Over-the-counter laxatives are often ineffective. Naloxegol is an approved, orally administered, peripherally acting mu-opioid receptor antagonist (PAMORA) that specifically targets the mechanism of OIC. (Source: Journal of Pain and Symptom Management)


Antithrombotic Therapy upon Discharge to Hospice Care (S763)
Patients transitioning to hospice care face difficult decisions regarding continuation of chronic medications. (Source: Journal of Pain and Symptom Management)


Artists' Perspectives on Encounters with Palliative Inpatients, a Qualitative Study (S758)
In January, 2015, our Palliative Medicine Program teamed up with our cancer center’s Arts and Humanities Program to send artists to perform for palliative inpatients at bedside. Current literature supports the positive impact of music and art on patients with chronic illnesses. However, the encounter between artist and patient is not just one-directional; it is a rich interaction where both individuals are affected. After each encounter with our palliative patients, artists wrote down their thoughts to encourage self-reflection and self-care. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Considering Care: A Descriptive Study of Moral Distress (S747)
Moral distress involves stressful situations in which moral values are challenged. As patient acuity rises, staff will likely face more situations presenting ethical dilemmas that may result in moral distress. Our academic medical center serves a multicultural community that includes a large population of a minority, faith-based group, which influences decisions to utilize life-sustaining therapy (LST). Patients on the respiratory care unit (RCU) have a mean age of 82, have chronic ventilator-dependent respiratory failure, and often utilize additional LST (tube feeding, dialysis, vasopressors). (Source: Journal of Pain and Symptom Management)


Palliative Wound Care (P12)
The concept of palliation for chronic wounds is a relatively new concept within the past ten years. Palliation recognizes and accepts nonhealing endpoints as appropriate care and uses nonhealing strategies to comfort patients and improve quality of life. There is no formal education on palliative wound care at this time, other than scattered individual lectures at various wound care symposiums and the annual palliative wound conference held for the past four years. There are many hospice caregivers who desire more information on specific treatments available and on approaches to management of chronic wounds in terminally ill patient. (Source: Journal of Pain and Symptom Management)


Smooth Sailing in Advanced Illness Transitions of Care: Optimizing Medication Management from Palliative Care to Hospice Care (P05)
Medications play a very large role in the management of chronic illnesses in advanced illness. The purpose of this all-day preconference is to wrestle with optimizing medication management in the most common advanced illnesses at the end of life including metabolic syndrome, heart failure, COPD, dementia, ALS and other disease states. Particular attention will be paid to medication-related issues in transitions of care between palliative care and hospice care, including medication and dosage formulation selection, therapeutic goal setting, monitoring and dosage titration aimed at optimizing symptom control. (Source: Journal of Pain and Symptom Management)


Intervention to Integrate Palliative Care into Transitional Care for Older Adults: Potential Challenges Identified by Clinicians (S798)
Poorly managed symptoms and lack of advance care planning (ACP) for older adults with chronic conditions may lead to unwanted hospital readmissions and eventual death in the hospital. Integration of palliative care into post-hospitalization primary care is a promising strategy to improve care for this population. (Source: Journal of Pain and Symptom Management)


Yes, I Can Live with Less Pain: A Pain Educational Intervention Improving Patient-Centered Care and Attitudes Among Older Adults (S784)
Uncontrolled chronic pain is very common among older adults (OA). Pain is a complex symptom with subjective measurements that is also difficult to manage due to social stigma related to treatment. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Setting the Agenda: What do Academic Hospitalists Want to Learn from Their Palliative Care Colleagues? (TH310B)
Hospitalists are on the front lines of providing care for the increasing numbers of patients with chronic serious illnesses. Given the high clinical volume and intensity of hospitalist practice, it is important to optimize educational interventions to create the most “high-yield” experiences. A survey investigation was intended to explore educational perceived needs in primary palliative care among academic hospitalists. (Source: Journal of Pain and Symptom Management)


In-Hospital Mortality Among California’s Jail and Prison Inmates: The Need for Improved Data on the Causes of Death (TH360A)
California incarcerates nearly 10% of U.S. prisoners. While prisoners experience poor health and early mortality, little is known about the chronic conditions or causes of death of prisoners who die in our community hospitals. (Source: Journal of Pain and Symptom Management)


A Culturally Responsive Approach to Advance Care Planning: A New Communication Framework Tool to Reduce Racial Disparities in End-of-Life Care (TH358)
Our country’s population is growing older, becoming more diverse, and surviving longer with chronic conditions. Healthcare professionals must develop skills to provide culturally sensitive care while practicing in an already overburdened healthcare system. Advance care planning is the process of establishing patient and family-centered goals of care in the event of life-threatening illness, and these sensitive conversations are integral to providing quality end-of-life care. Newer models have demonstrated that through efficient and early advance care planning we can achieve the IHI Triple Aim of improved healthcare quality, improved patient satisfaction, and reduced end-of-life cost within a patient-centered model of care. (Source: Journal of Pain and Symptom Management)


Outpatient Pediatric Palliative Medicine: Complex Lives, Comprehensive Services (FR440D)
Pediatric palliative services nationwide enroll children with life-limiting, but not acutely life threatening chronic illness. Children receiving inpatient palliative services, the most prevalent service delivery model, have a survival rate of nearly 75% at one year. In response to the long survival rate of pediatric palliative care patients and the need for outpatient palliative services, University Health System (UHS) developed a medical home clinic that provides integrated palliative and primary care for children with medical complexity or incurable illness. (Source: Journal of Pain and Symptom Management)


Advance Care Planning and HIV in the Post-Antiretroviral Therapy Era: A Narrative Review (FR481B)
Since the advent of antiretroviral therapy (ART), HIV has transitioned from a rapidly fatal illness to a chronic disease with multi-morbidity, and providers are faced with an emerging population with unique advance care planning (ACP) needs. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Growing Up with Our Kids! Caring for Childhood Diseases You Will See as an Adult HPM Provider (FR455)
Children with chronic, life-limiting illnesses are living longer. As a result of improved technology and a better understanding of disease processes, many of these children are surviving into adulthood and transitioning from the pediatric medical world to adult care. Transitional care for young people with life-limiting illnesses is a complex issue. These young people often experience multiple, concurrent transitions, including a variety of organizational and illness transitions, as well as the adjustment from childhood to adulthood. (Source: Journal of Pain and Symptom Management)


Outcomes of In-Hospital Cardiopulmonary Resuscitation in Patients with Chronic Kidney Disease (SA527D)
Advance care planning including code status discussion is an essential part of the medical care of patients with chronic kidney disease (CKD). There is little information on the outcomes of cardiopulmonary resuscitation (CPR) in these patients. (Source: Journal of Pain and Symptom Management)


“Why Do I Still Hurt?” An Integrated Model of Survivorship and Palliative Care (SA523)
The late- and long-term effects of cancer and its treatment leave an expanding population of cancer survivors struggling with transitions into survivorship. The multidisciplinary palliative care team is ideally positioned to manage and coordinate care for these patients. Cancer survivors in the US today number 13.7 million with 5%-10% experiencing pain severe enough to cause functional impairment. Certain subpopulations of cancer survivors are disproportionately affected. Chronic postmastectomy pain can affect up to 50% of breast cancer survivors with more than 30% of patients reporting above average pain 10 years after treatment. (Source: Journal of Pain and Symptom Management)


Using Film to Foster Empathetic Partnerships Between Care Providers and Family Caregivers (SA521)
Fragmentation in the US healthcare system has frayed the critical relationships among caregivers and healthcare providers. Yet, caregivers are on the frontlines managing complicated chronic illnesses, assisting with day-to-day functioning, and providing direct palliative care to manage symptoms and improve quality of life. While meeting loved one’s needs, caregivers navigate an increasingly complex and confusing health system. Students and providers receive little, if any, training on the vital role caregivers play on the healthcare team and how effective partnering optimizes patient care throughout the illness trajectory and at end-of-life. (Source: Journal of Pain and Symptom Management)


Scrambler Therapy for Chronic Neuropathic Pain (SA514)
Pain remains one of the most common clinical problems and causes of debility, disability, and lost productivity. (Simon L, 2012; Institute of Medicine 2011) Neuropathic pain is particularly vexing as relief is often incomplete and associated with significant medication side effects. Spinal cord stimulation is effective, with pain reductions of 50%-90% reported in well-designed randomized trials (Deer TR, 2014) but is invasive, permanent, and expensive (over $75,000/implant.) Scrambler Therapy (ST) is a new way of relieving pain by giving artificial nerve impulses to simulate “non-pain” information along the damaged pathways to repair damaged nerve pathways, capturing the nerve pathways much like spinal cord stimulation. (Source: Journal of Pain and Symptom Management)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


It's Like Heart Failure: It's Chronic and It Will Kill You: Exploring Hospice and Palliative Care Clinicians' Experiences with Burnout (SA538B)
Clinical palliative care is stressful, with self-reported burnout rates as high as 62% among clinicians. To date, there has been scant qualitative investigation into the causes, ameliorators, and effects of this pervasive phenomenon. Alarming as such statistics may be, quantitative estimates in isolation cannot disentangle the predisposing, situational, and protective factors related to one’s experience of burnout; absent rigorous mixed-methods appraisal of the lived experience of burnout, feasible solutions to address burnout may be out of reach. (Source: Journal of Pain and Symptom Management)


Oversleeping: The Effects and Health Risks of Sleeping Too Much
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)


Adhesions to Mesh after Ventral Hernia Mesh Repair Are Detected by MRI but Are Not a Cause of Long Term Chronic Abdominal Pain.
Conclusion. MRI can detect adhesions between bowel and abdominal wall in a fair reliable way. Adhesions are formed both after open and laparoscopic hernia mesh repair and are not associated with chronic pain. PMID: 26819601 [PubMed] (Source: Gastroenterology Research and Practice)


Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging
Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.Resumo Objetivo: Avaliar a prevalência de achados isolados que causam compressão do primeiro ramo do nervo plantar lateral em pacientes com queixa de dor crônica no calcanhar, cujos exames de ressonância magnética mostraram atrofia gordurosa seletiva completa do músculo abdutor do quinto dedo. Materiais e Métodos: Estudo retrospectivo, analítico e transversal. Selecionamos exames de ressonância magnética do retropé de 90 pacientes que apresentavam atrofia muscular g...


[Editors' Choice] A double-drug approach for chronic pain
Author: Peter Stern (Source: ScienceNOW)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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] A double-drug approach for chronic pain
Chronic pain is a major reason why people visit a doctor. Unfortunately, the underlying causes of chronic pain are still poorly understood. To gain more insight, Ren et al. – [Read More] (Source: Editors' Choice)


Risk for Opioid Misuse Among Emergency Department Cancer Patients
ConclusionsThe risk of opioid misuse among cancer patients is substantial. Screening for opioid misuse in the ED is feasible. (Source: Academic Emergency Medicine)


Is There a Benefit for Liposomal Bupivacaine Compared to a Traditional Peri-Articular Injection in Total Knee Arthroplasty Patients With a History of Chronic Opioid Use?
We examined whether a novel suspended release local anesthetic, liposomal bupivacaine (LB) would improve pain control and decrease opioid consumption after TKA compared to a standard periarticular injection, in opioid dependent patients. (Source: The Journal of Arthroplasty)


Risk for Opioid Misuse Among Emergency Department Cancer Patients.
CONCLUSIONS: The risk of opioid misuse among cancer patients is substantial. Screening for opioid misuse in the ED is feasible. PMID: 26824227 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)


Multiple Crush Concept Applied to Multiple Nerves in Leprous Neuropathy
There is a large reservoir of leprosy patients, no longer contagious, due to multidrug therapy, who are considered cured and are becoming increasingly disabled due to progressive chronic nerve entrapment in the upper and lower extremities. After a review of the history of understanding leprous neuropathy, an approach is outlined based on the approach taken to relieve pain and restore sensation that prevents ulcers and amputations in diabetics with neuropathy and superimposed nerve compressions. The results of the first application of this approach in an indigenous area for leprosy, Guayaquil, Ecuador, is discussed with implications for international care of this neglected patient population. (Source: Clinics in Podiatric Medicine and 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>


Paraspinous lidocaine injection for chronic nonspecific low back pain: A randomized controlled clinical trial
In this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1- LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2- SH-INJ); and analgesics and exercises (group 3- STD-TTR). (Source: The Journal of Pain)


Trends in Opioid Dosing Among of Washington State Medicaid Patients Before and After Opioid Dosing Guideline Implementation
We report here on opioid dosing in the WA Medicaid fee-for-service population for 273,200 adults with a paid claim for an opioid prescription between 4-1-2006 and 12-31-2010. (Source: The Journal of Pain)


Physical activity, psychiatric distress, and interest in exercise group participation among individuals seeking methadone maintenance treatment with and without chronic pain.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Low levels of physical activity and low interest in exercise group participation among patients entering MMT point to the need for and likely challenges of implementing exercise interventions in MMT. (Am J Addict 2016;XX:1-7). PMID: 26824197 [PubMed - as supplied by publisher] (Source: American Journal on Addictions)


[Ankle impingement : Indications and arthroscopic therapy].
Authors: Buchhorn T, Koch M, Weber J, Ziai P Abstract Ankle impingement syndromes are one of the most frequent chronic and posttraumatic pathologies of the ankle joint. Anterior and posterior impingement result from the abutting of anatomical structures leading to pain and limitation in the range of motion of the ankle joint. Ankle impingement can be classified based on the localization or the underlying cause. Besides chronic ankle pain, further symptoms are movement and load-dependent swelling of the ankle joint and limitations in dorsiflexion and plantar flexion. The clinical symptoms and physical examination play an essential role in diagnosing soft tissue impingement, whereas various imaging techniques are important for the diagnostics of bony impingement. From a therapeutic p...


Activation of mGluR1 Contributes to Neuronal Hyperexcitability in the Rat Anterior Cingulate Cortex via Inhibition of HCN Channels.
Authors: Gao SH, Wen HZ, Shen LL, Zhao YD, Ruan HZ Abstract Neuronal hyperexcitability in the anterior cingulate cortex (ACC) is considered as one of the most important pathological changes responsible for the chronification of neuropathic pain. However, the underlying mechanisms remain elusive. In the present study, we investigated the possible mechanisms using a rat model of chronic constriction injury (CCI) to the sciatic nerve. We found a substantial decrease in hyperpolarization-activated/cyclic nucleotide-gated (HCN) currents in layer 5 pyramidal neurons (L5 PNs) in ACC slices, which dramatically increased the excitability of these neurons. This effect could be mimicked in sham slices by activating group 1 metabotropic glutamate receptors, and be blocked in CCI slices by inhi...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Helicobacter pylori infection is high in paediatric non‐ulcer dyspepsia but not associated with specific gastrointestinal symptoms
ConclusionThe prevalence of H. pylori infection was high in Brazilian children with non‐ulcer dyspepsia, but was not associated with specific signs and symptoms, except for nausea.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)


3 Simple Exercises to Eliminate Knee Pain
By Pete Egoscue About 1 in 4 Americans suffers from knee pain, according to a 2011 study published in the Annals of Internal Medicine. Rather than ignore that wincing discomfort until it's unbearable, see if you can ease the ouch with these three simple strengthening exercises from Sonima's pain and anatomy advisor, Pete Egoscue. You may be surprised to find that the pain you feel in your knee is due to weakness and instability in other areas of the body. The exercises demonstrated in this video--sitting knee pillow squeezes, supine foot circles and point flexes, and sitting abductor press--build strength and mobility in the lower body, particularly the ankles, calves, and thighs, to better support the joints' movements and thereby eliminate knee pain. Related: How to Fix Chronic Knee Pain...


[Neurolitic block of the lumbar sympathetic chain improves chronic pain in a patient with critical lower limb ischemia].
CONCLUSION: Neurolitic block of the lumbar sympathetic chain is an effective and safe treatment option for pain control in patients with critical limb ischemia patients in whom the only possible intervention would be limb amputation. PMID: 26809966 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)


New drug could be safer, non-addictive alternative to morphine
A painkiller has been developed that is as strong as morphine but isn't likely to be addictive and with fewer side effects, according to a new study. Opium-based drugs are the leading treatments for severe and chronic pain, but they can be highly addictive. Their abuse results in thousands of overdose deaths in the United States annually. (Source: ScienceDaily Headlines)


Palmitoylethanolamide, a Special Food for Medical Purposes, in the Treatment of Chronic Pain: A Pooled Data Meta-analysis.
CONCLUSION: These results confirm that PEA might represent an exciting, new therapeutic strategy to manage chronic and neuropathic pain associated with neuroinflammation. PMID: 26815246 [PubMed - as supplied by publisher] (Source: Pain Physician)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


In errata.
Authors: Pain Physician Journal J Abstract In Response: The Cause of Fatal Respiratory Depression Is Combination of Clindamycin and Fentanyl, Rather than TramadolHanbin Wu, MM, and Gao Wu, MMDepartment of Clinical Pharmacy150 Jimo RoadShanghai 200120, China.E362CRPS: Early Lumbar Sympathetic Block is Better Compared to Other Interventions"Shikha Awal MD, Rajashree Madabushi MD, Anil Agarwal MD, and Varun Singla MDDepartment of AnaesthesiologySanjay Gandhi Postgraduate Institute of Medical Sciences,Rae Bareilly Road, LucknowE363There was a typo in the names of the authors in Coxib Safety in Patients with Inflammatory Bowel Diseases: A Meta-analysis Pain Physician 2015; 18:599-607. Correct spelling is:Claudio De Angelis, MDSharmila Fagoonee, PhDThere was an error in author affiliatio...


Pulsed Radiofrequency Reduced Neuropathic Pain Behavior in Rats Associated with Upregulation of GDNF Expression.
CONCLUSIONS: The findings suggest that the application of PRF at the impaired SN relieved reduced the CCI-induced NP by through regulating the upregulation of the GDNF expression in the nervous tissues. PMID: 26815249 [PubMed - as supplied by publisher] (Source: Pain Physician)


rTMS in Alleviating Mild TBI Related Headaches - A Case Series.
CONCLUSIONS: rTMS offers a non-invasive treatment option for MTBI-HA. The tested treatment protocol was well tolerated by the patients and can be adopted for future randomized controlled studies in further validating the treatment efficacy. PMID: 26815263 [PubMed - as supplied by publisher] (Source: Pain Physician)


Intrathecal Pump Exposure to Electromagnetic Interference: A Report of Device Interrogation following Multiple ECT Sessions.
CONCLUSION: Communication with multiple entities (patient, family, consulting physicians, and device manufacturer) and maintaining vigilance through device interrogation both before and after EMI exposure are appropriate safeguards to mitigate the risk and detect potential adverse events of EMI with intrathecal drug delivery systems. Given the infrequent reports of device exposure to ECT, best practices may be derived from experience with EMI exposure from magnetic resonance imaging (MRI). Although routine EMI exposure to intrathecal drug delivery systems should be avoided, we describe one patient with repeated exposure to ECT without apparent complication. PMID: 26815262 [PubMed - as supplied by publisher] (Source: Pain Physician)


Percutaneous and Endoscopic Adhesiolysis in Managing Low Back and Lower Extremity Pain: A Systematic Review and Meta-analysis.
CONCLUSION: The evidence is Level I or strong that percutaneous adhesiolysis is efficacious in the treatment of chronic refractory low back and lower extremity pain. Percutaneous adhesiolysis may be considered as a first-line treatment for chronic refractory low back and lower extremity pain. The evidence is Level II to III that spinal endoscopy is effective in the treatment of chronic refractory low back and lower extremity pain. Key words: Spinal pain, chronic low back pain, post lumbar surgery syndrome, epidural scarring, adhesiolysis, endoscopy, radicular pain. PMID: 26815254 [PubMed - as supplied by publisher] (Source: Pain Physician)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Urine Drug Screening on No Shows and Dropouts among Chronic Pain Patients: A Propensity-Matched Cohort Study.
CONCLUSIONS: The results indicate that UDS is associated with increased no-shows and dropout from clinic subject to limitations of observational studies such as selection bias and confound by unobserved variables. These results serve as a call for additional prospective randomized studies to understand the impact of UDS, and where the patients might go when they dropout from the clinic. PMID: 26815253 [PubMed - as supplied by publisher] (Source: Pain Physician)


Widespread Pressure Pain Hyperalgesia in Chronic Nonspecific Neck Pain with Neuropathic Features: A Descriptive Cross-Sectional Study.
CONCLUSIONS: Widespread pressure pain hyperalgesia was detected in patients with CNSNP with NF, but not in patients with CNSNP with No-NF. Patients with CNSNP presented bilateral pressure pain hyperalgesia over the cervical region and a decreased cervical ROM compared to healthy controls. However, no differences were found between the 2 CNSNP groups. These findings suggest differences in the mechanism of pain processing between patients with CNSNP with NF and No-NF. PMID: 26815252 [PubMed - as supplied by publisher] (Source: Pain Physician)


Upregulation of the Purinergic Receptor Subtype P2X3 in the Trigeminal Ganglion Is Involved in Orofacial Pain Induced by Occlusal Interference in Rats.
CONCLUSION: Upregulated P2X3R expression in the TG may contribute to orofacial pain development induced by an occlusal interference. P2X3R may be a therapeutic target for chronic TMJ or masseter muscle pain. PMID: 26817033 [PubMed - as supplied by publisher] (Source: Journal of Orofacial Pain)


Efficacy of Herpes Simplex Virus Vector Encoding the Human Preproenkephalin Gene for Treatment of Facial Pain in Mice.
CONCLUSION: Topically administered KHPE produced a significant antinociceptive effect in the TIC mouse model of chronic facial neuropathic pain. This is the first report in which a gene therapeutic approach reduced trigeminal pain-related behaviors in an established pain state in mice. PMID: 26817032 [PubMed - as supplied by publisher] (Source: Journal of Orofacial Pain)


Inflammatory Cytokines and Sleep Disturbance in Patients with Temporomandibular Disorders.
CONCLUSION: Patients with TMD, especially those with high disability, had elevated plasma cytokine levels and increased ESS and PSQI scores suggestive of sleep disturbance. PMID: 26817030 [PubMed - as supplied by publisher] (Source: Journal of Orofacial Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Explanatory Models of Illness and Treatment Goals in Temporomandibular Disorder Pain Patients Reporting Different Levels of Pain-Related Disability.
CONCLUSION: Illness explanations and goals for treatment differ in patients reporting different levels of TMD pain-related disability. PMID: 26817028 [PubMed - as supplied by publisher] (Source: Journal of Orofacial Pain)


Self-Reported Migraine and Chronic Fatigue Syndrome Are More Prevalent in People with Myofascial vs Nonmyofascial Temporomandibular Disorders.
CONCLUSION: Individuals with myofascial TMD had a higher prevalence of self-reported migraine and chronic fatigue syndrome than those with nonmyofascial TMD. PMID: 26817027 [PubMed - as supplied by publisher] (Source: Journal of Orofacial Pain)


Altered Expression of Cytoskeletal and Axonal Proteins in Oxaliplatin-Induced Neuropathy
Conclusions: These results suggest that changes in the protein levels of the regulatory and structural proteins are due to oxaliplatin-induced neurotoxicity and imply that there is a direct link between structural changes in the central nervous system and chemotherapy-induced neurotoxicity.Pharmacology 2016;97:146-150 (Source: Pharmacology)


Herbal Medicine for Low Back Pain: A Cochrane ReviewHerbal Medicine for Low Back Pain: A Cochrane Review
Are herbal medicines a safe and effective option for sufferers of chronic low back pain? Spine (Source: Medscape Orthopaedics Headlines)


UK-based researchers launch app-based study to examine connection between weather and pain
Researchers from the University of Manchester have launched an app-based study, called Cloudy with a Chance of Pain, that will study the relationship between the weather and chronic pain in the UK.  The initiative was launched in partnership with Arthritis Research UK, health app company uMotif, New York-based Office for Creative Research, and the University’s Health e-Research Centre. (Source: mobihealthnews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Risk factors for depression and fatigue among survivors of hematopoietic cell transplantation
CONCLUSIONSRates of depression and fatigue in this group of survivors suggest a high symptom burden. Better screening, referral, and interventions are needed. Cancer 2016. © 2016 American Cancer Society. (Source: Cancer)


Regional Versus General Anesthesia in Surgical Patients With Chronic Obstructive Pulmonary Disease: Does Avoiding General Anesthesia Reduce the Risk of Postoperative Complications?
No abstract available (Source: Survey of Anesthesiology)


Why are doctors writing opioid prescriptions — even after an overdose?
A group of researchers at Boston Medical Center recently looked at nearly 3,000 patients who had survived an opioid-related overdose between 2000 and 2012. According to their recently published study, over 90% of these patients continued to receive opioid medications from doctors — even after their overdose. Given the soaring numbers of opioid-related overdose deaths and heightened scrutiny on how these medications are being over-prescribed, the study findings are alarming and disturbing. The researchers identified almost 3,000 patients nationwide who had had a nonfatal overdose while being treated with opioid medications for chronic pain. These patients were followed for 300 days, on average, after their overdose. During those 300 days, an additional 7% of the patients overdosed a secon...


Balancing cardiovascular and gastrointestinal risks in nonsteroidal anti-inflammatory drugs use in patients with osteoarthritis: guidelines summary from an international expert group addressing.
Authors: Mosleh W, Farkouh ME Abstract Over the past two decades, extensive research has assessed the use of traditional NSAIDs, and the newer cyclooxygenase-2 (COX-2) inhibitor drugs in the treatment of chronic pain syndromes. Proper NSAID use has been a subject of significant debate, bringing together multidisciplincary researchers and clinicians to discuss the risks and benefits of these therapies. Current guidelines discussing the proper use of NSAIDs do not address the issue of the risks of COX-2 selective NSAIDs and ns-NSAIDs at both the gastrointestinal and cardiovascular systems of either class of drugs with low-dose aspirin. Accordingly, a multidisciplinary expert group organized to review current evidence, with the aim of developing statements devoted guide clinicians in ...


Harnessing the knowledge of animal toxins to generate drugs
Publication date: Available online 27 January 2016 Source:Pharmacological Research Author(s): V.O. Zambelli, K.F.M. Pasqualoto, G. Picolo, A.M. Chudzinski-Tavassi, Y. Cury Animal toxins present high selectivity and specificity for their molecular targets, and have long been considered as prototypes for developing novel drugs, with some successful cases. In this regard, the variety of molecules found in animal venoms, which can be capable of affecting vital physiological systems, have providing the development of studies focusing on turning those molecules (toxins) into therapeutics to treat several diseases, such as chronic pain, hypertension, thrombosis, cancer, and so on. However, some important issues have been responsible for disrupting the toxin-based drug discovery projects. I...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Dextromethorphan: An update on its utility for neurological and neuropsychiatric disorders
Publication date: Available online 28 January 2016 Source:Pharmacology &amp; Therapeutics Author(s): Linda Nguyen, Kelan L. Thomas, Brandon P. Lucke-Wold, John Z. Cavendish, Molly S. Crowe, Rae R. Matsumoto Dextromethorphan (DM) is a commonly used antitussive and is currently the only FDA-approved pharmaceutical treatment for pseudobulbar affect. Its safety profile and diverse pharmacologic actions in the central nervous system have stimulated new interest for repurposing it. Numerous preclinical investigations and many open-label or blinded clinical studies have demonstrated its beneficial effects across a variety of neurological and psychiatric disorders. However, the optimal dose and safety of chronic dosing are not fully known. This review summarizes the preclinical and cli...


Lateral Hypothalamic Stimulation Reduces Hyperalgesia Through Spinally Descending Orexin-A Neurons in Neuropathic Pain
No evidence to date shows that lateral hypothalamic (LH) stimulation produces orexin-A-mediated antinociception in the spinal cord dorsal horn (SCDH) in a model of neuropathic pain. We conducted experiments to examine the effect of orexin-A-mediated LH stimulation in female rats with chronic constriction injury (CCI) on thermal hyperalgesia. Rats receiving carbachol into the LH demonstrated antinociception on both the left CCI and right nonligated paws (p &lt; .05). Rats were given carbachol in the LH followed by intrathecal injection of the orexin-1 (OX1) receptor antagonist SB-334867, which blocked LH-induced antinociception compared with control groups (p &lt; .05) in the left paw, but not in the right paw. These findings support the hypothesis that LH stimulation produces antinocicepti...


Adapting the ABCDEF Bundle to Meet the Needs of Patients Requiring Prolonged Mechanical Ventilation in the Long-Term Acute Care Hospital Setting: Historical Perspectives and Practical Implications
This article is about such an extrapolation from the intensive care unit (ICU) to the long-term acute care hospital (LTACH) setting. Chronic critical illness is an emerging, disabling, costly, and yet relatively silent epidemic that is central to both of these settings. The number of chronically critically ill patients requiring prolonged mechanical ventilation is expected to reach unprecedented levels over the next decade. Despite the prevalence, numerous distressing symptoms, and exceptionally poor outcomes associated with chronic critical illness, to date there is very limited scientific evidence available to guide the care and management of this exceptionally vulnerable population, particularly in LTACHs. Recent studies conducted in the traditional ICU setting suggest interprofessional...


Fibromyalgia: management strategies for primary care providers
ConclusionAlthough there remain several barriers to overcome, implementation of a PCMH would allow patients with FM, like those with other chronic conditions, to be successfully managed in the primary care setting. (Source: International Journal of Clinical Practice)


Elevated TNF-α is associated with pain and physical disability in mucopolysaccharidosis types I, II, and VI
Conclusions Higher TNF-α levels are implicated in the pain and decreased physical function present in individuals with MPS despite treatment with ERT and/or HCT, suggesting that TNF-a inhibition could potentially be a useful adjunctive therapy. Further investigation into the role of TNF-α inhibition in MPS to decrease pain and improve physical function is indicated. (Source: Molecular Genetics and Metabolism)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Three kinds of Ganoderma lucidum polysaccharides attenuate DDC-induced chronic pancreatitis in mice
This study was to characterize chemical structures of GLPS3 and determine their effects on diethyldithiocarbamate (DDC)-induced CP in mice. The total sugar content of GLPS3 from fermentation broth (GLPS3-Ⅰ), cultured mycelia (GLPS3-Ⅱ) and fruiting body (GLPS3-Ⅲ) was 90.4%, 92.2% and 91.8% respectively. GLPS3-Ⅰ, GLPS3-Ⅱ and GLPS3-Ⅲ were composed of Glu:Gal:Ara:Xyl, Glu:Gal:Ara:Xyl:Man:Rha, and Glu:Gal:Xyl:Man:Rha:Fuc, with molar ratio of 2.82: 1.33: 1.26: 0.87, 5.84: 2.23: 0.72:1.38: 1.40: 0.51 and 5.34: 2.72: 1.14: 1.10: 0.33: 0.38, respectively. The antioxidative activity of GLPS3-Ⅱfrom cultured mycelia in vitro is higher than other two polysaccharides. The superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in serum were increased while the malondialdehyde (MDA) ...


Lower Extremity Focused Neurologic Examination
A focused lower extremity neurologic evaluation aids in the diagnosis of lower extremity nerve pathology. Injuries to the peripheral neural infrastructure can result in chronic neuropathic pain and discomfort. The most common etiologies of chronic neuropathic pain are from peripheral distal pathologies. A complete lower extremity neurologic evaluation includes sensory, motor, and deep tendon reflexes. Additional specific attention to the geographic anatomic testing of peripheral sensory and motor nerves is essential in eliciting a correct etiologic diagnosis for peripheral neural pain and dysfunction. (Source: Clinics in Podiatric Medicine and Surgery)


Identification and Management of Chronic Pain in Primary Care: a Review
Abstract Chronic pain is a common, complex, and challenging condition, where understanding the biological, social, physical and psychological contexts is vital to successful outcomes in primary care. In managing chronic pain the focus is often on promoting rehabilitation and maximizing quality of life rather than achieving cure. Recent screening tools and brief intervention techniques can be effective in helping clinicians identify, stratify and manage both patients already living with chronic pain and those who are at risk of developing chronic pain from acute pain. Frequent assessment and re-assessment are key to ensuring treatment is appropriate and safe, as well as minimizing and addressing side effects. Primary care management should be holistic and evidence-based (where pos...


An unusual cause of chronic nausea and abdominal pain
Question: A 65-year-old woman presented for evaluation of postprandial nausea and abdominal pain of 5 years’ duration. The nausea was not associated with vomiting and was controlled with an antiemetic. The abdominal pain was predominantly located in the right upper quadrant; she had undergone a cholecystectomy decades before the onset of these symptoms. Owing to intractable pain, she had been started on daily opioid analgesics. She had a smoking history of >50 pack-years, and did not consume alcohol heavily. (Source: Gastroenterology)


Neuromuscular response amplitude to mechanical stimulation using large-array surface electromyography in participants with and without chronic low back pain
The present study aimed to compare the neuromuscular response under various mechanical stimulations of the lumbar spine in participants with and without chronic low back pain (cLBP). (Source: Journal of Electromyography and Kinesiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 and Return to Activity After Operative Repair of Chronic Latent Syndesmotic Instability
Conclusion: This study presents a treatment method that can be instituted at the time of diagnosis for syndesmotic injuries with greater than 4 mm of diastasis that were treated with debridement and stabilization. The results of this treatment technique are promising, with significant improvements in subjective outcome scores and a high rate of return to running sports. Level of Evidence: Level IV, retrospective case series. (Source: Foot and Ankle International)


Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review.
Authors: Veehof MM, Trompetter HR, Bohlmeijer ET, Schreurs KM Abstract The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were c...


Opioid Prescribing for Chronic Pain — Achieving the Right Balance through Education
New England Journal of Medicine, Volume 374, Issue 4, Page 301-303, January 2016. (Source: New England Journal of Medicine)


Your body’s “other” pulse
When I take a patient’s pulse, I’m really checking to make sure their heart is beating in rhythm and their blood is flowing regularly. It wasn’t until much later that I learned your body has another pulse — your “dural pulse.” In the 1970s, Dr. John Upledger discovered the dural pulse. He was studying dural tubes at the College of Osteopathic Medicine at Michigan State University. The dural tube is a membrane surrounding your spinal cord. It’s filled with cerebral spinal fluid. Dr. Upledger noticed that this spinal fluid moves with a set rhythm. In fact, this dural pulse beats at 6 to 12 cycles per minute. While the dural pulse is still completely ignored by Western medicine, this central nervous system network of tissues, bones and fluids at the core of your body beats like ...


Intranasal abuse potential, pharmacokinetics, and safety of once-daily, single-entity, extended-release hydrocodone (HYD) in recreational opioid users - Harris SC, Cipriano A, Colucci SV, Kapil RP, Geoffroy P, Hopyan T, Levy-Cooperman N.
This study evaluated the intranasal abuse potential an... (Source: SafetyLit)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


A survey of spinal cord stimulator use by chronic pain patients while driving - Simopoulos TT, Rosa H, Wootton J, Eichman DS, Gill JS.
OBJECTIVE: The study aims to assess utilization of spinal cord stimulator (SCS) devices while driving a vehicle and potential association with motor vehicle accidents (MVAs). MATERIALS AND METHODS: A telephone survey study was conducted in two phas... (Source: SafetyLit)


Exercise and cognitive functioning in people with chronic whiplash-associated disorders: a controlled laboratory study - Ickmans K, Meeus M, De Kooning M, de Backer A, Kooremans D, Hubloue I, Schmitz T, Van Loo M, Nijs J.
Study Design Controlled laboratory study. Background Besides their persisting pain, people with chronic WAD commonly deal with cognitive dysfunctions. In healthy individuals aerobic exercise has a positive effect on cognitive performance and preliminary ev... (Source: SafetyLit)


Will the National Pain Strategy Offer an Effective And Balanced Approach to Chronic Pain?
No abstract available (Source: The Back Letter)


NYU/UCLA $2.4 million to study non-psychotropic cannabinoids to suppress chronic cancer pain
(New York University) The purpose of the five-year, $2,494,784 R01 grant from the National Institutes of Health National Cancer Institute is to test PRCBs for oral cancer and chemotherapy-induced peripheral neuropathy pain reduction. (Source: EurekAlert! - Biology)


Orthopaedic Perspective on Barefoot and Minimalist Running.
Authors: Roth J, Neumann J, Tao M Abstract In recent years, there has been a movement toward barefoot and minimalist running. Advocates assert that a lack of cushion and support promotes a forefoot or midfoot strike rather than a rearfoot strike, decreasing the impact transient and stress on the hip and knee. Although the change in gait is theorized to decrease injury risk, this concept has not yet been fully elucidated. However, research has shown diminished symptoms of chronic exertional compartment syndrome and anterior knee pain after a transition to minimalist running. Skeptics are concerned that, because of the effects of the natural environment and the lack of a standardized transition program, barefoot running could lead to additional, unforeseen injuries. Studies have show...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Tungiasis-associated morbidity in pigs and dogs in endemic villages of Uganda
Conclusions: The pattern of clinical manifestations in pigs and dogs were very similar to those reported from affected humans and rats. The important morbidity associated with animal tungiasis makes the disease a serious veterinary health problem in sub-Saharan Africa warranting treatment and control for optimal animal production. (Source: Parasites and Vectors)


Rapid Electrocardiogram Evolution in a Dialysis Patient
A 74-year-old man with a history of chronic kidney disease and diabetes presented to the Emergency Department with 1 day of generalized weakness after reportedly missing dialysis 2 days earlier and subsequently on the day of presentation. He denied any other recent health changes, including fever, chest pain, nausea, or abdominal pain. His initial electrocardiogram (ECG) showed a wide complex tachycardia at 120 beats/min, without distinct p-waves (Figure 1). Intravenous access was immediately secured, and blood was obtained for point-of-care labs as well as formal laboratory testing. (Source: The Journal of Emergency Medicine)


Effect of respiratory exercises on neck pain patients: A pilot study
Conclusions Respiratory exercise contributes to improvement in respiratory muscle endurance and reduces pain who is enduring from CNP. (Source: Polish Annals of Medicine)


Endometriosis and irritable bowel syndrome: a dilemma for the gynaecologist and gastroenterologist
Key content Chronic pelvic pain has a significant impact on health services, accounting for 20% of gynaecological referrals. The overlap between irritable bowel syndrome and endometriosis, two of the leading causes of chronic pelvic pain, should not be overlooked. Visceral sensitivity has been demonstrated in both conditions, further highlighting their similarities. Close communication between gastroenterologists and gynaecologists should help to distinguish the causative condition and improve management. Learning objectives To understand the aetiology, pathology, clinical presentation and current national guidance on endometriosis and irritable bowel syndrome. To increase awareness of visceral hypersensitivity and its significance. To appreciate the importance of good history taki...


Frequency of axial spondyloarthritis diagnosis among patients seen by United States rheumatologists for evaluation of chronic back pain
Conclusion Among patients with chronic back pain for ≥3 months beginning at age &lt;45 years, the presence of ≥1 of 3 SpA features is an effective way to identify patients with possible axSpA. This article is protected by copyright. All rights reserved. (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>


Alterations in Gray Matter Volume are Associated with Reduced Evoked‐Pain Connectivity following Acute Pregabalin Administration
Conclusion. Short‐term PGB treatment alters brain structure and evoked‐pain connectivity, and these decreases were associated with reduced clinical pain. We speculate that these fairly rapid changes in GMV may be related to brain neuroplasticity. It is unknown if these effects are generalizable to other chronic pain states. This article is protected by copyright. All rights reserved. (Source: Arthritis and Rheumatism)


Meshfixation in open and endoscopic inguinal hernia repair
Summary Unfortunately, neither new operation techniques nor advancements in mesh development could change the fact that chronic pain remains the most severe postoperative complication in open and laparoscopic hernia surgery. The main reason seems to be nerve injury due to mesh fixation. New fixation techniques like fibrin sealing, self-fixating meshes and no fixation have replaced conventional traumatic fixation devices. The guidelines by the European Hernia Society and the International Endoscopic Hernia Society represent for the first time a publication of evidence-based data. This review illustrates a practical overview of open and laparoscopic fixation techniques based on these guidelines and up to date studies. (Source: European Surgery)


Epidural Electrical Stimulation for Stroke Rehabilitation: Results of the Prospective, Multicenter, Randomized, Single-Blinded Everest Trial
Conclusions. The primary analysis pertaining to efficacy of EECS during upper limb motor rehabilitation in chronic stroke patients was negative at 4 weeks postrehabilitation. A better treatment response was observed in a subset of patients eliciting stimulation induced upper limb movements during motor threshold assessments performed prior to each rehabilitation session. Post hoc comparisons indicated treatment effect differences at 24 weeks, with the control group showing significant decline in the combined primary outcome measure relative to the investigational group. These results have the potential to inform future chronic stroke rehabilitation trial design. (Source: Neurorehabilitation and Neural Repair)


Epidural Cortical Stimulation as a Treatment for Poststroke Aphasia: A Systematic Review of the Literature and Underlying Neurophysiological Mechanisms
Conclusions. Due to the small number of existing cases in the literature, the strength of the evidence is still low. Two main hypotheses of neurobiological mechanisms have been explored: either using continuous stimulation to modify cortical perilesional inhibition or using intermittent stimulation during the speech and language therapy sessions to explore synaptic plasticity and long-term potentiation or depression. To establish the role of epidural stimulation and the relevant stimulation protocols and parameters, large randomized controlled trials are mandatory. We suggest avenues of investigation. (Source: Neurorehabilitation and Neural Repair)


Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia
ConclusionsBehavioral treatment of comorbid insomnia in individuals with CM produced large reductions in headache frequency, though some improvement in headache occurred with a behavioral intervention not focused on modifying sleep. Among the CBTi group only, both headache frequency and sleep parameters continued to improve after treatment, suggesting the presence of enduring effects over time. Directly treating insomnia using components of stimulus control and sleep restriction holds promise for reducing comorbid migraine. Development of and comparison to a truly inert pseudotherapy control presents unique challenges that future studies should address. (Source: Headache: The Journal of Head and Face Pain)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Botulinum Toxin Type A for Neuropathic Pain in Patients with Spinal Cord Injury
This article is protected by copyright. All rights reserved. (Source: Annals of Neurology)


Three kinds of Ganoderma lucidum polysaccharides attenuate DDC-induced chronic pancreatitis in mice.
This study was to characterize chemical structures of GLPS3 and determine their effects on diethyldithiocarbamate (DDC)-induced CP in mice. The total sugar content of GLPS3 from fermentation broth (GLPS3-Ⅰ), cultured mycelia (GLPS3-Ⅱ) and fruiting body (GLPS3-Ⅲ) was 90.4%, 92.2% and 91.8% respectively. GLPS3-Ⅰ, GLPS3-Ⅱ and GLPS3-Ⅲ were composed of Glu:Gal:Ara:Xyl, Glu:Gal:Ara:Xyl:Man:Rha, and Glu:Gal:Xyl:Man:Rha:Fuc, with molar ratio of 2.82: 1.33: 1.26: 0.87, 5.84: 2.23: 0.72:1.38: 1.40: 0.51 and 5.34: 2.72: 1.14: 1.10: 0.33: 0.38, respectively. The antioxidative activity of GLPS3-Ⅱfrom cultured mycelia in vitro is higher than other two polysaccharides. The superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in serum were increased while the malondialdehyde (MDA) ...


eTect Announces Initiation of a Clinical Study Using Its Novel Ingestion Event Monitoring System to Reliably Track Opioid Use for Pain Management
This study has been designed to evaluate use of the ID-Cap System in monitoring and improving medication adherence. Additional clinical validation studies in partnership with pharmaceutical companies, the NIH, and academic research organizations are planned for 2016. eTect’s technology enables an objective measurement of medication ingestion with real-time reporting of time-stamped dose ingestion events, ensuring that this important information is available to doctors who need it to provide the best care to their patients. The ID-Cap System allows a definitive understanding of medication-taking behavior that has the potential to transform how medications are evaluated by clinical researchers, prescribed by doctors, and used by patients. Medication Adherence Nonadherence to prescribed med...


Terminology of chronic pain
Peppin JF, Schatman ME (Source: Journal of Pain Research)


Calcific tendinitis of the rotator cuff.
Authors: ElShewy MT Abstract Calcific tendinitis within the rotator cuff tendon is a common shoulder disorder that should be differentiated from dystrophic calcification as the pathogenesis and natural history of both is totally different. Calcific tendinitis usually occurs in the fifth and sixth decades of life among sedentary workers. It is classified into formative and resorptive phases. The chronic formative phase results from transient hypoxia that is commonly associated with repeated microtrauma causing calcium deposition into the matrix vesicles within the chondrocytes forming bone foci that later coalesce. This phase may extend from 1 to 6 years, and is usually asymptomatic. The resorptive phase extends from 3 wk up to 6 mo with vascularization at the periphery of the calci...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Opioids Do Not Improve Physical Function In Patients With Neuropathic Pain
While opioids may alleviate pain in some chronic pain patients, their effectiveness when it comes to restoring physical function in patients with neuropathic pain could be considered finite. (Source: Forbes.com Healthcare News)


Many Chronic Pain Sufferers May Overuse Nonprescription Painkillers
Title: Many Chronic Pain Sufferers May Overuse Nonprescription PainkillersCategory: Health NewsCreated: 1/25/2016 12:00:00 AMLast Editorial Review: 1/26/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Rotator Cuff Injury
Title: Rotator Cuff InjuryCategory: Diseases and ConditionsCreated: 1/26/2016 12:00:00 AMLast Editorial Review: 1/26/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Opioid-induced constipation, use of laxatives, and health-related quality of life
Conclusions The results suggest a high degree of moderate to very severe abdominal symptoms, a high degree of self-management of opioid-induced constipation, a low degree of satisfaction with laxative, and low health-related quality of life of patients suffering from chronic pain necessitating long-term opioid treatment, subsequent constipation and laxatives use. Implications Patients suffering from OIC with low quality of life and remaining symptoms despite use of two or more laxatives are a vulnerable patient group in need of optimized healthcare management, who also might benefit from more specific and innovative therapy. (Source: Scandinavian Journal of Pain)


Low-Dose Ketamine in Chronic Critical Illness
We report a case series on the observed effects of low-dose ketamine infusions in 4 critically ill patients with varying complications related to prolonged critical illness. Doses of ketamine infusion ranged from 0.5 to 4 &mu;g/kg/min. A low-dose ketamine infusion was used to reduce agitation in a patient requiring high doses of sedatives and analgesics. In a second patient, ketamine improved depression and anxiety symptoms. In a third patient, ketamine may have facilitated liberation from mechanical ventilation. In a fourth patient, ketamine was used for palliation to avoid lethargy. Ketamine may be considered to help decrease agitation, manage pain, facilitate opioid and benzodiazepine withdrawal, prevent respiratory depression, and potentially manage depression and anxiety in chronicall...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ultrasound-guided pulsed radiofrequency treatment of the pudendal nerve in chronic pelvic pain.
Authors: Ozkan D, Akkaya T, Yildiz S, Comert A Abstract Chronic pelvic pain is a condition that can be caused by pudendal neuralgia, interstitial cystitis, piriformis syndrome and neuropathy of the ilioinguinal, iliohypogastric and genitofemoral nerves. Based on three case reports this article discusses the clinical effectiveness of pulsed high-frequency radiofrequency (PRF) treatment applied to the pudendal nerve under ultrasound guidance in medicinally treated patients with chronic pelvic pain. PMID: 26811947 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)


Chronic Pain Status, Nicotine Withdrawal, and Expectancies for Smoking Cessation Among Lighter Smokers.
CONCLUSIONS: These findings suggest that individuals with chronic pain may constitute an important subgroup of tobacco smokers who tend to experience lower confidence and greater difficulty when attempting to quit. Future research would benefit from replicating these findings among older and more diverse samples of heavier tobacco smokers, and extending this work to the study of prospective relations between chronic pain status and cessation-relevant processes/outcomes over the course of a quit attempt. PMID: 26813264 [PubMed - as supplied by publisher] (Source: Annals of Behavioral Medicine)


Fibromyalgia and bipolar disorder: emerging epidemiological associations and shared pathophysiology.
Authors: Bortolato B, Berk M, Maes M, McIntyre RS, Carvalho AF Abstract Fibromyalgia (FM) is a prevalent disorder defined by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction. Recent studies indicate that bipolar spectrum disorders frequently co-occur in individuals with FM. Furthermore, shared pathophysiological mechanisms anticipate remarkable phenomenological similarities between FM and BD. A comprehensive search of the English literature was carried out in the Pubmed/MEDLINE database through May 10th, 2015 to identify unique references pertaining to the epidemiology and shared pathophysiology between FM and bipolar disorder (BD). Overlapping neural circuits may underpin parallel clinical manifestations of both diso...


Analgesic effect of recombinant GABAergic cells in a model of peripheral neuropathic pain.
Authors: Jergova S, Gajavelli S, Varghese MS, Shekane P, Sagen J Abstract Chronic neuropathic pain represents clinically challenging state with poor response to current treatment options. Long-term management of chronic pain is often associated with the development of tolerance, addiction and other side effects, reducing the therapeutic value of treatment. Alternative strategies based on cell therapy and gene manipulation, balancing the inhibitory and excitatory events in the spinal cord, may provide sustained pain relief in the long term. Transplantation of GABAergic cells has been successfully used to enhance inhibition and to restore physiological spinal pain processing. However, since the underlying mechanism of chronic pain development involves changes in several pain signalin...


Many Chronic Pain Sufferers May Overuse OTC Meds
They run risk of stomach bleeds, ulcers, liver damage from meds, doctors say (Source: WebMD 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>


Arizona Pain Specialists Now Offering Peripheral Nerve Stimulation for...
The top Phoenix pain management centers, Arizona Pain Specialists, are now offering peripheral nerve stimulation treatment for over ten chronic pain conditions. The treatments are offered at five...(PRWeb January 25, 2016)Read the full story at http://www.prweb.com/releases/phoenix-pain-management/peripheralnervestimulator/prweb13173351.htm (Source: PRWeb: Medical Pharmaceuticals)


Pacific Medical Care in San Diego is Now Offering Revolutionary...
Pacific Medical Care is now offering a revolutionary effective treatment for chronic neck and back pain. The treatment, radiofrequency ablation, is covered by insurance and offered by the Board...(PRWeb January 25, 2016)Read the full story at http://www.prweb.com/releases/back-pain-sandiego/radiofrequency-ablation/prweb13179450.htm (Source: PRWeb: Medical Pharmaceuticals)


Many Chronic Pain Sufferers May Overuse Nonprescription Painkillers
They run risk of stomach bleeds, ulcers, liver damage from meds, doctors say Source: HealthDay Related MedlinePlus Pages: Chronic Pain, Drug Reactions, Pain Relievers (Source: MedlinePlus Health News)


Solving America’s opioid crisis: Remember the patient
Physicians, medical organizations and public health experts around the nation all have shared reasons why the opioid overdose epidemic must be top of mind in the medical world, and it comes down to one focus—the patient. A panel of experts recently gave recommendations that lead the way to making patient-focused pain management possible. Reducing the stigma of chronic pain One important aspect of the efforts to combat the opioid epidemic is reducing stigma so that patients with chronic pain do not lose access to the care that they need. “What is our role as physicians in this current problem?” asked John A. Renner, MD, president of the American Academy of Addiction Psychiatry and professor of psychiatry at Boston University School of Medicine, speaking to physician leaders at t...


Cerebellar direct current stimulation modulates pain perception in humans.
CONCLUSIONS: tcDCS modulates pain perception and its cortical correlates. Since it is effective on both N1 and N2/P2 components, we speculate that the cerebellum engagement in pain processing modulates the activity of both somatosensory and cingulate cortices. Present findings prompt investigation of the cerebellar direct current polarization as a possible novel and safe therapeutic tool in chronic pain patients. PMID: 25777683 [PubMed - in process] (Source: Restorative Neurology and 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>


Relationships Between Tobacco Abuse and Self-Assessment of Health.
Authors: Gawlikowska-Sroka A, Dzięciołowska-Baran E, Szczurowski J Abstract Smoking cigarettes negatively influences the functioning of the body. Among other effects, it has an important impact on the respiratory system, circulation, and behavior. It leads to morphological and physiological changes in organs and tissues, so it can change mood. The aim of this study was to assess the relationships between tobacco abuse and self-assessment of health. The survey was conducted among Polish (243) and foreign (80) medical students at the Pomeranian Medical University in Szczecin, Poland. The study was based on a survey questionnaire of the authors' own design, comprising open and multi-choice questions. Our questionnaire was based on the international standard questionnaire from the He...


Current Strategies in Anesthesia and Analgesia for Total Knee Arthroplasty.
Authors: Moucha CS, Weiser MC, Levin EJ Abstract Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia-incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperati...


Relieving pain … with light?
Consider this scenario: A patient is home recovering from knee surgery to repair an ACL tear. Her pain medications are wearing off, and the surgical cuts are starting to throb. Reaching over to the table she picks up what’s essentially a souped-up laser pointer, points it at the surgical wound and turns it on. Within seconds, the pain starts to fade. This picture isn’t as far-fetched as you might think. In a pair of simultaneous papers, Boston Children’s Hospital’s Daniel Kohane, MD, PhD, and his laboratory recently reported their efforts to create not one, but two methods for packaging long-lasting local anesthetics in microspheres that could be injected in advance by a surgeon or anesthesiologist and that would release the drugs when zapped with a laser. Both methods have one go...


CANVAS an update: clinical presentation, investigation and management.
CONCLUSIONS: CANVAS is an increasingly recognised cause of late-onset ataxia and disequilibrium, and is likely to be a recessive disorder. PMID: 25564090 [PubMed - indexed for MEDLINE] (Source: Journal of Vestibular Research: Equilibrium and Orientation)


Downregulation of the spinal dorsal horn clock gene Per1 expression leads to mechanical hypersensitivity via c-jun N-terminal kinase and CCL2 production in mice
Publication date: Available online 23 January 2016 Source:Molecular and Cellular Neuroscience Author(s): Norimitsu Morioka, Munenori Saeki, Tatsuhiko Sugimoto, Takuya Higuchi, Fang Fang Zhang, Yoki Nakamura, Kazue Hisaoka-Nakashima, Yoshihiro Nakata Disturbances of circadian rhythm and dysregulation of clock gene expression are involved in the induction of various neurological disorder states, including chronic pain. However, the relationship between the CNS circadian-clock gene system and nociception remains poorly defined. Significant circadian oscillations of Period (Per1, Per2), Bmal1 and Cryptochrome 1 (Cry1) mRNA expression have been observed in the lumbar spinal dorsal horn of naïve mice. The current study examined the expression of clock genes in the lumbar spinal dorsal...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Identification of A3 adenosine receptor agonists as novel non‐narcotic analgesics
Abstract Chronic pain negatively impacts the quality‐of‐life in a variety of patient populations. The current therapeutic repertoire is inadequate in managing patient pain and warrants the development of new therapeutics. Adenosine and its four cognate receptors (A1AR, A2AAR, A2BAR, and A3AR) have important roles in physiological and pathophysiological states, including chronic pain. Preclinical and clinical studies have revealed that while adenosine and agonists of the A1AR and A2AAR have antinociceptive properties, their therapeutic utility is limited by adverse cardiovascular side effects. In contrast, our understanding of the A3AR is only in its infancy, but exciting preclinical observations of A3AR antinociception, which have been bolstered by clinical trials of A3AR agonists in o...


Platelet-rich plasma versus open surgical release in chronic tennis elbow: A retrospective comparative study
Conclusion The PRP seems to be better for pain relief and functionality in the short and mid-term periods. (Source: Journal of Orthopaedics)


When Is Osteonecrosis Not Osteonecrosis?: Adjudication of Reported Serious Adverse Joint Events in the Tanezumab Clinical Development Program
ConclusionDespite initial reports, tanezumab treatment was not associated with an increase in ON but was associated with an increase in RPOA. Higher doses of tanezumab, tanezumab administered with nonsteroidal antiinflammatory drugs, and preexisting subchondral insufficiency fractures were risk factors for RPOA in this cohort. (Source: Arthritis and Rheumatism)


Rest Pain and Movement‐Evoked Pain as Unique Constructs in Hip and Knee Replacements
ConclusionSEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work that explores the mechanisms underlying pain‐on‐movement and pain‐at‐rest. (Source: Arthritis Care and Research)


ormed physiotherapy for chronic pain: patient experiences of treatment and therapeutic process
This study aimed to investigate patients’ beliefs about, and experiences of, this type of treatment, and helpful and unhelpful experiences. (Source: Physiotherapy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


CDC issues draft voluntary guidelines for prescribing opioids for chronic pain
The federal Centers for Disease Control and Prevention (CDC) issued draft guidelines for the prescribing of opioids for pain on December 14 in the Federal Register. The guidelines are meant to reduce overprescribing of opioids, which the CDC says should not be used for chronic pain. They are meant for primary care providers (family physicians or internists) who are treating patients for chronic pain in an outpatient setting. They do not apply to methadone or buprenorphine prescribing for the treatment of opioid use disorders. They also do not apply to chronic pain related to palliative or end‐of‐life care, or to treatment of patients with active cancer. Adherence to the guidelines is voluntary. (Source: The Brown University Child and Adolescent Psychopharmacology Update)


Primary care physicians, acupuncture and chiropractic clinicians, and chronic pain patients: a qualitative analysis of communication and care coordination patterns
A variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment. While there are frequently problems in communication and coordination of care within... (Source: BMC Complementary and Alternative Medicine)


Latent class analysis of the Apathy Scale does not identify subtypes of apathy in general population‐based older persons
ConclusionDifferences between LCA‐derived classes were minimal, suggesting that in a general population‐based cohort the Apathy Scale measures a homogeneous construct. (Source: International Journal of Geriatric Psychiatry)


The impact of regular lifestyle behavior in migraine: a prevalence case–referent study
Abstract Regular lifestyle behaviors (RLBs) of sleep, exercise, mealtime pattern and hydration status independently affect migraine occurrence. We aimed herein to evaluate the differences in migraine occurrence among participants who do and do not maintain the RLB triumvirate. Cases of chronic migraine (CM) and referents of episodic migraine (EM) ≥aged 15 years with charts regularly documenting RLB notes were continuously enrolled from a retrospective case–referent cohort study performed on electronic chart review from January 1, 2014 to January 1, 2015 at the Stanford Headache and Facial Pain Program. Association between RLB prevalence and migraine occurrence was studied. 175 CM and 175 EM patients were enrolled (mean age 44.4 years, 22 % males). Migraine was diagnosed acc...


Knee contact forces are not altered in early knee osteoarthritis
Osteoarthritis (OA) is a chronic degenerative and multifactorial [1,2] joint disease that most frequently affects the knee [3]. Patients complain about pain, reduced range of joint movement, muscle weakness, stiffness and instability, which limits physical activities in daily living [4], results in loss of their independence, reduced quality of life and high health-related costs [5]. (Source: Gait and Posture)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Expectancy Effects on Conditioned Pain Modulation Are Not Influenced by Naloxone or Morphine.
CONCLUSIONS: The present findings confirm that expectancy is an important contributor to conditioned pain modulation effects, and therefore significant caution is needed when interpreting findings that do not account for this individual difference. Opioid mechanisms do not appear to be involved in these expectancy effects. PMID: 26809850 [PubMed - as supplied by publisher] (Source: Annals of Behavioral Medicine)


[Efficacy, tolerability, and safety of cannabinoids in gastroenterology : A systematic review].
CONCLUSIONS: Cannabis may be useful for symptom relief in Crohn's disease such as pain, nausea, and loss of appetite. However, studies with high methodological quality, sufficient sample size, and study duration are mandatory to determine potential therapeutic effects and risks of cannabis in gastroenterology. Currently, use of tetrahydrocannabinol to alleviate symptoms such as pain and appetite loss in Crohn's disease should only be considered in individual patients after failure of established medical therapies and only after careful risk-benefit assessment. PMID: 26809974 [PubMed - as supplied by publisher] (Source: Schmerz)


Targeted Exercise Helps Lower Back Pain
When the short days of winter combine with the wet and blustery weather patterns we've been seeing on the west coast lately - it's not always easy to get out of bed and get on with the day but when you have chronic back pain to deal with - it's an even greater challenge. There is some good news this month from researchers for patients who suffer from chronic back pain and persistent spine issues. A new study released on January 7th, clearly demonstrates that targeting exercises to muscles that support and control the spine may offer a significant strategy to reducing pain and long term disability commonly caused by chronic lower back pain. (Source: Disabled World)


The Real Reason You Get Sick After A Stressful Period Has Ended
Have you ever wondered how you manage to get through a particularly&nbsp;stressful period&nbsp;&ndash; whether it's an intense deadline at work, final exams in school or a spate of holiday houseguests &ndash; only to get sick after the stress has lifted? It's not a fluke. It's a phenomenon that's often referred to as "the let-down effect," a pattern in which people come down with an illness or develop&nbsp;flare-ups of a chronic condition&nbsp;not&nbsp;during&nbsp;a concentrated period of stress but&nbsp;after&nbsp;it dissipates, explains psychologist Marc Schoen, an assistant clinical professor of medicine at the University of California&ndash;Los Angeles and the author of "When Relaxation Is Hazardous to Your Health." Research has linked the let-down of perceived stress with an increase ...


Development Of A Virtual Environment Based On The Perceived Characteristics Of Pain In Patients With Fibromyalgia.
This study aims to develop a new virtual environment for the treatment of FM in order to enhance the therapeutic effects of traditional interventions. The first phase included a sample of 19 patients in order to identify common characteristics of the representation of pain and absence of pain, through drawing. The results showed that patients used different colors and different physical states to depict pain (red, motionless) and the absence of pain (blue, in motion). These features were then included in a 3D representation of the human body. ANOVA analysis showed that the degree of anxiety and depression influenced the perceived characteristic of movement. PMID: 26799899 [PubMed - in process] (Source: Studies in Health Technology and Informatics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ectopic Human Fasciola hepatica Infection by an Adult Worm in the Mesocolon.
We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F. hepatica. Histologically, numerous eggs of F. hepatica were noted with acute and chronic granulomatous inflammations in the subserosa and pericolic adipose tissues. Conclusively, a rare case of ectopic fascioliasis has been confirmed in this s...


Characterization of the Percutaneous Absorption of Ketoprofen Using the Franz Skin Finite Dose Model.
CONCLUSION: Chronic musculoskeletal pain can be a major burden for most patients, affecting their lifestyle and reducing overall quality of life. When compared to PLO, Phospholipid Base has the ability to potentially deliver higher concentrations of ketoprofen to underlying soft tissues and at a more rapid rate. With more ketoprofen at the site of injury, the analgesic and anti-inflammatory effects will likely be enhanced, potentially reducing pain and improving quality of life. PMID: 26788899 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


Microscopic Colitis: What Do We Know About Pathogenesis?
Abstract: Microscopic colitis (MC) is a common cause of chronic diarrhea. The 2 most frequent forms of MC are collagenous colitis and lymphocytic colitis. Over the past years, the incidence and prevalence of microscopic colitis are rising and this is largely attributed to a greater awareness, and concomitantly an increasing number of diagnoses. Patients with microscopic colitis report watery, nonbloody diarrhea of chronic course, abdominal pain, weight loss, and fatigue that may impair patient's health-related quality of life. The underlying mechanisms involved in the pathogenesis of microscopic colitis remain unspecified but is probably multifactorial. Collagenous colitis and lymphocytic colitis may represent specific mucosal responses to different luminal agents in predisposed individual...


Comparative study of efficacy and safety of tapentadol versus etoricoxib in mild to moderate grades of chronic osteorthritis of knee
Conclusions Tapentadol is as effective as etoricoxib in the management of mild to moderate grades of chronic osteoarthritis of knee with lower incidences of adverse effects. (Source: Indian Journal of Rheumatology)


Mechanisms mediating nitroglycerin-induced delayed-onset hyperalgesia in the rat
We reported that hyperalgesia induced by intradermal GTN has a delay to onset of ∼30min in male and ∼45min in female rats. This hyperalgesia was greater in females, was prevented by pretreatment with the anti-migraine drug, sumatriptan, as well as by chronic pretreatment with the mast cell degranulator, compound 48/80. The acute administration of GTN and compound 48/80 both induced hyperalgesia that was prevented by pretreatment with octoxynol-9, which attenuates endothelial function, suggesting that GTN and mast cell-mediated hyperalgesia are endothelial cell-dependent. Furthermore, A-317491, a P2X3 antagonist, which inhibits endothelial cell-dependent hyperalgesia, also prevents GTN and mast cell-mediated hyperalgesia. We conclude that delayed-onset mechanical hyperalgesia induced by...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Do unresponsive wakefulness syndrome patients feel pain? Role of laser-evoked potential-induced gamma-band oscillations in detecting cortical pain processing
In conclusion, RSL-induced GBO power evaluation could be helpful in the differential diagnosis between MCS and UWS patients, besides the clinical assessment, and in identifying covert pain perception in some UWS individuals. (Source: Neuroscience)


Communication between Health Care Professionals and Chronic Pain Patients Time to change the "Pain Game".
Communication between Health Care Professionals and Chronic Pain Patients Time to change the "Pain Game". Acta Orthop Belg. 2015 Dec;81(4):752-577 Authors: Lavand'Homme P Abstract Patient satisfaction is currently used as a comparative measure to evaluate the quality of health care programs. This seems the best way to evaluate results although an important discordance might exist between patient's perception and doctor's opinion regarding satisfactory outcome after surgery, including that after joint replacement. Pain remains a major cause of dissatisfaction for many patients. To understand the meaning of pain, i.e. "why does pain hurt" in some patients but not in other ones, and to decipher -patient's pain expression is a key feature of patient-doctor communication. Q...


Investigation of knee pain in osteoarthritic and neuropathic pain awareness.
In this study, the awareness of both types of chronic pain was investigated among patients and doctors. This prospective study was planned and coordinated by the orthopedic and internal medicine clinics and included 100 patients with a diagnosis of knee OA evaluated with the DN4 questionnaire. Patients with an OA diagnosis included those with NP linked to diabetes and those without NP, and these groups were compared using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritic Index (WOMAC). Data analysis of both groups focused on descriptive statistics of demographic and clinical characteristics. Twenty-four of the patients with type 2 diabetes -mellitus (DM) were diagnosed with NP according to DN4 criteria, and began treatment. Of these patients, 21...


Prepatellar Friction Syndrome : a common cause of knee pain in the elite cyclist.
CONCLUSION: PPFS is a new clinical entity of the -triple-layered prepatellar fascial structures. Correct diagnosis is critical and based on the typical history and clinical findings. Partial prepatellar fasciectomy is the treatment of choice in order to regain the pre-injury performance level. PMID: 26790782 [PubMed - in process] (Source: Acta Orthopaedica Belgica)


Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study.
Authors: Hesse T, Holmes LG, Kennedy-Overfelt V, Kerr LM, Giles LL Abstract Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs) have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10 ± 2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84) of 6 practices per week. Five participants dropped out for reasons not inherent to the gr...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Pilot Study of an Adapted Mindfulness-Based Intervention for Adolescents With Chronic Pain
Chronic pain in children and adolescents is a common condition that results in significant impairments in quality of life. Mindfulness is an approach that takes roots in ancient Buddhist meditative practices. It has been used with promising results in various adult and adolescent populations to address such conditions as depression, anxiety and chronic pain. The primary objective of this study was to determine the feasibility, validity and acceptability of a randomized pilot trial measuring the impact of an adapted mindfulness-based intervention in adolescents with chronic pain. (Source: Journal of Adolescent Health)


The moderator role of family type in the relationship between functional disability and quality of life in patients with chronic low back pain
This study aimed to identify the moderating effect of the “Type of Family” in the relationship between functional disability and quality of life in patients with chronic low back pain. Two hundred and three patients with low back pain for longer than 3 months participated in the study. The instruments used were: Medical Outcome Study (MOS 20); Roland Morris Disability Questionnaire (RMDO; Family Adaptability and Cohesion Evaluation Scales (FACES II). Regression analyses were performed in order to test the moderating effect of the type of family. The results showed that patients with lower levels of disability presented better quality of life in the intermediate and balanced families, and this relationship was even stronger in balanced families. According to the results, intervention pr...


Processos de Alcoolização Indígena no Brasil: perspectivas plurais
This study aimed to identify the moderating effect of the “Type of Family” in the relationship between functional disability and quality of life in patients with chronic low back pain. Two hundred and three patients with low back pain for longer than 3 months participated in the study. The instruments used were: Medical Outcome Study (MOS 20); Roland Morris Disability Questionnaire (RMDO; Family Adaptability and Cohesion Evaluation Scales (FACES II). Regression analyses were performed in order to test the moderating effect of the type of family. The results showed that patients with lower levels of disability presented better quality of life in the intermediate and balanced families, and this relationship was even stronger in balanced families. According to the results, intervention pr...


Adding genetic testing to evidence-based guidelines to determine the safest and most effective chronic pain treatment for injured workers - Meshkin B, Lewis K, Kantorovich S, Anand N, Davila L.
Published guidelines for treating injured workers include the need for personalized treatment to manage chronic pain symptoms and increase functional status. However, they often fail to clarify how to objectively personalize these treatments. Further, cert... (Source: SafetyLit)


Chronic post-thyroidectomy pain: incidence, typology, and risk factors
Publication date: Available online 22 January 2016 Source:Anaesthesia Critical Care &amp; Pain Medicine Author(s): Jean-Michel Wattier, Robert Caïazzo, Grégoire Andrieu, Eric Kipnis, François Pattou, Gilles Lebuffe Chronic postoperative pain exists in varying degrees for every type of surgery. An evaluation of the incidence, the typology and predictive factors of chronic pain was carried out at 3 and 6 months after thyroidectomy. A prospective observational study, having included each of the patients prior to their thyroidectomy, was carried out over 12 months. The patients used an 11-point numerical rating scale (NRS), a neuropathic pain screening questionnaire (DN4), an evaluation scale for anxiety and for the need for information related to anaesthesia and surgery (APAIS)...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Model and Processes of Acceptance and Commitment Therapy (ACT) for Chronic Pain Including a Closer Look at the Self
Abstract Acceptance and commitment therapy (ACT) is one of the so called “third-wave” cognitive behavioral therapies. It has been increasingly applied to chronic pain, and there is accumulating evidence to support its effectiveness. ACT is based on a model of general human functioning called the psychological flexibility (PF) model. Most facets of the PF model have been examined in chronic pain. However, a potential key facet related to “self” appears underappreciated. Indeed, a positive or healthy sense of self seems essential to our well-being, and there have been numerous studies of the self in chronic pain. At the same time, these studies are not currently well organized or easy to summarize. This lack of clarity and integration creates barriers to progress in this ar...


p27(kip1) overexpression regulates IL-1β in the microenvironment of stem cells and eutopic endometriosis co-cultures.
Authors: Gonçalves GA, Invitti AL, Parreira RM, Kopelman A, Schor E, Girão MJ Abstract Endometriosis is a gynecological benign chronic disease defined as the growth of endometrial glands and stroma in extra-uterine sites, most commonly implanted over visceral and peritoneal surfaces within the female pelvis causing inflammatory lesions. It affects around 10% of the female population and is often accompanied by chronic pelvic pain, adhesion formation and infertility. Therefore, endometriosis could be considered a "social disease", since it affects the quality of life, reproductivity and also has a socio-economic impact. The expression of cell cycle and inflammatory proteins is modified in the endometriotic tissues. Immunostaining of glandular and stromal cells in endometrial biops...


Fungi Prevalent in Urine of Women With Chronic Pelvic Pain (CME/CE)
(MedPage Today) -- Fungi may play role in interstitial cystitis flares (Source: MedPage Today Urology)


More than just a pretty face: Inside Revance's efforts to create a Botox alternative for cosmetic, therapeutic uses (Photos)
Revance Therapeutics is developing an injectable alternative to Botox and a topical treatment that requires no needles at all, but the East Bay company aims to treat far more than wrinkles. The company has ambitions to alleviate pain for chronic migraine sufferers or people who get shingles, and to help those who sweat profusely from their underarms or get sweaty palms. It's working to reduce the frequency of injections and increase the duration for its treatments versus competitors already on the… (Source: bizjournals.com Health Care:Biotechnology headlines)


Vitamin D Deficiency, Association With Chronic Low Back Pain Examined
No abstract available (Source: Lippincott’s Bone and Joint Newsletter)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Influence of Education and Depression on Autonomy of Women with Chronic Pelvic Pain: A Cross-sectional Study
Conclusions Our data show that systematic evaluation of patient autonomy can provide clinical relevant information in gynecology. Low educational level, anxiety and depression might reduce the patient autonomy in women with chronic pelvic pain. Objetivo A autonomia da paciente é de grande importância para que o consentimento informado seja válido na prática clínica. Nossos objetivos foram quantificar os domínios da autonomia e avaliar variáveis que modificam a autonomia em mulheres com dor pélvica crônica. Métodos Este é um estudo transversal realizado em um Hospital Universitário terciário. Foram incluídas consecutivamente 52 mulheres com dor pélvica crônica agendadas para videolaparoscopia. Foi utilizada uma escala Likert com 24 afirmativas validadas para quantificar os t...


[Conservative and Surgical Treatment for Distal Ulna Fractures Associated with Distal Radius Fractures].
CONCLUSIONS Distal ulna fractures can be treated conservatively if osteosynthesis of the distal radius in the anatomical position is achieved together with anatomical reduction of bone fragments of the distal ulna. When a distal radius fracture managed by osteosynthesis is not accompanied by anatomical reduction of distal ulna fragments, or the ulna is shorter or longer than the contralateral bone, an open reduction and stabilisation using an angle-stable locking plate, set at an adequate radius-toulna length ratio, is the method of choice. KEY WORDS: fracture, radius, ulna, plate osteosynthesis. PMID: 26787181 [PubMed - in process] (Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca)


Medtech approvals: FDA releases November 2015 PMAs
The FDA today released its list of the pre-market approvals it granted for medical devices in November 2015: Summary of PMA Originals & Supplements Approved Originals: 3 Supplements: 69 Summary of PMA Originals Under Review Total Under Review: 57 Total Active: 30 Total On Hold: 27 Summary of PMA Supplements Under Review Total Under Review: 583 Total Active: 433 Total On Hold: 150 Summary of All PMA Submissions Originals: 4 Supplements: 75 Summary of PMA Supplement PMA Approval/Denial Decision Times Number of Approvals: 69 Number of Denials: 0 Average Days Fr Receipt to Decision (Total Time): 193.4 FDA Time: 103.0 Days MFR Time: 90.4 Days PMA Original Approvals APPLICATION NUMBER / DATE of APPROVAL DEVICE TRADE NAME COMPANY NAME CITY, STATE, & ZIP DEVICE DESCRIPTION /...


DMP chronic back pain: Guideline recommendations cover all important health-care aspects
(Institute for Quality and Efficiency in Health Care) IQWiG conducted a search for clinical practice guidelines and identified recommendations for a potential new disease management program. These recommendations are largely consistent. (Source: EurekAlert! - Medicine and Health)


Local muscle flaps via video-assisted thoracoscopic surgery (VATS) without thoracotomy for dead space obliteration
Abstract The obliteration of intra-thoracic dead space following tumor or empyema extirpation is imperative to successful long-term outcomes. We sought to describe the technique of using a pedicled latissmus dorsi muscle flap for obliteration of a large 14 × 6cm intrathoracic dead space following pleural decortication of chronic empyema, without thoracotomy or rib spreading via video-assisted thoracoscopic surgery (VATS). Specific attention is directed to the technical details of the flap harvest and inset in relation to the modifications required to inset the flap without a thoracotomy or rib spreading. The patient’s history, presenting symptoms, pre-operative imaging, intraoperative details, and post-operative course are delineated with a focus on the length of stay, 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>


Topical sodium metabisulfite for the treatment of calcinosis cutis: A promising new therapy
This article is protected by copyright. All rights reserved. (Source: British Journal of Dermatology)


Prospective, Multicenter, Randomized, Double‐Blinded, Partial Crossover Study to Assess the Safety and Efficacy of the Novel Neuromodulation System in the Treatment of Patients With Chronic Pain of Peripheral Nerve Origin
ConclusionThe novel peripheral nerve stimulation device is a safe and effective treatment strategy to address neuropathic pain of peripheral nerve origin. (Source: Neuromodulation)


The Relationship Between Neuromuscular Impairments, Chronic Back Pain and Mobility in Older Adults
Conclusions The neuromuscular impairment profiles associated with mobility function among older adults with back pain vary as compared to older adults without back pain. (Source: PMandR)


Chronic pain causes a persistent anxiety state leading to increased ethanol intake in CD1 mice
Mood disorders and chronic pain are closely linked, but limited progress has been made in understanding the role of chronic and neuropathic pain in the aetiopathogenesis of depression. To explore the pathological mechanisms that mediate the association between pain and depressive-like behaviours, we studied the time-dependent effect of neuropathic pain on the development of anxiety-like and despair behaviours in CD1 mice. We analysed behavioural data, neuroinflammation reactions and changes in neurotransmitter (glutamate and serotonin) levels in the mouse prefrontal cortex. Sciatic-operated mice displayed long-lasting anxiety-like and despair behaviours, starting 5 and 20 days after partial sciatic nerve ligation, respectively. Glutamatergic neurotransmission and IL-1&beta; cytokine expres...


The interrelations between spiritual well-being, pain interference and depressive symptoms in patients with multiple sclerosis
Abstract Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain in...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Topical sodium metabisulfite for the treatment of calcinosis cutis: A promising new therapy.
This article is protected by copyright. All rights reserved. PMID: 26799451 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)


Analysis of the behavioral, cellular and molecular characteristics of pain in severe rodent spinal cord injury.
Authors: Lee-Kubli CA, Ingves M, Henry KW, Shiao R, Collyer E, Tuszynski MH, Campana WM Abstract Human SCI is frequently associated with chronic pain that is severe and refractory to medical therapy. Most rodent models used to assess pain outcomes in SCI apply moderate injuries to lower thoracic spinal levels, whereas the majority of human lesions are severe in degree and occur at cervical or upper thoracic levels. To better model and understand mechanisms associated with chronic pain after SCI, we subjected adult rats to T3 severe compression or complete transection lesions, and examined pain-related behaviors for three months. Within one week after injury, rats developed consistent forepaw pain-related behaviors including increased spontaneous lifts, tactile allodynia and cold se...


Long term test-retest reliability of oswestry disability index in male office workers.
CONCLUSION: The difference between median score of the days with 1st day was neither statistically nor clinically significant. ODI has long term test re-test reliability in healthy subjects over a 1 month time interval. PMID: 26835862 [PubMed - as supplied by publisher] (Source: Work)


NeuroMetrix wins Chinese regulatory win for DPNcheck
NeuroMetrix (NSDQ:NURO) said today it won regulatory approval in China for its DPNCheck diagnostic test for peripheral neuropathy. DPNCheck is a point-of-care-test designed to detect diabetic peripheral neuropathy at an early stage to allow for appropriate treatment. NeuroMetrix said that DPN is the most common complication of diabetes, and affects more than 50% of people with diabetes. &#8220;Omron skillfully guided DPNCheck through an extended regulatory process. We are now collaborating on marketing plans leading to commercial launch. We believe that DPNCheck addresses an important void in the care of persons with diabetes in China, and have discussed this topic with leading Chinese physicians over the past several years. Working closely with Omron, we believe we can develop a signific...


Paternal depression linked to premature birth
ConclusionThis study has found a link between depression in expectant fathers and an increased risk of preterm birth in their babies. It was based on large, independent sources of data, and the researchers adjusted their figures to take account of many factors that could have skewed the results. However, it's worth noting a few uncertainties.The main measure of depression was whether people took antidepressants. People take antidepressants for many reasons, including anxiety and chronic pain. Also, many people with depression don’t take antidepressants, and men in particular are less likely to come forward for any type of treatment. Some of the men thought to be healthy might have had undiagnosed depression.Depression in men was only linked to prematurity in certain situations. After tak...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Emerging applications of deep brain stimulation.
Authors: Sharma M, Naik V, Deogaonkar M Abstract Deep brain stimulation (DBS) implantation surgery is an established treatment modality for a variety of medical refractory movement disorders such as Parkinson's disease, Essential tremors and Dystonia. Following the success of DBS in these movement disorders with a high rate of safety and efficacy, there is a resurgence of interest in the utility of this modality in other medical refractory disorders. Consequently, neuromodulation has been explored for a variety of refractory conditions such as neuropsychiatric disorders (major depressive disorders, obsessive- compulsive disorders, addictions), eating disorders including obesity, traumatic brain injury, post-traumatic stress disorders (PTSD), dementias and chronic pain. This review ...


Novel Translational Approaches for Improving Drug Discovery Efforts in Chronic Pain.
Authors: Munro G PMID: 26778453 [PubMed - in process] (Source: CNS Neuroscience and Therapeutics)


Federal Way Pain Doctor, Alexey Ryskin MD, Now Offering Spinal Cord...
Top Federal Way pain management doctor, Alexey Ryskin MD, is now offering spinal cord stimulator implants for many chronic pain conditions. The neurostimulators offer exceptional pain relief over 75%...(PRWeb January 20, 2016)Read the full story at http://www.prweb.com/releases/spinal-cord-stimulator/federal-way-seattle/prweb13173279.htm (Source: PRWeb: Medical Pharmaceuticals)


methadone, Dolophine, Methadone HCl Intensol, Methadose, Methadose Sugar-Free
Title: methadone, Dolophine, Methadone HCl Intensol, Methadose, Methadose Sugar-FreeCategory: MedicationsCreated: 3/2/2005 12:00:00 AMLast Editorial Review: 1/21/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Non-invasive Monitoring of Hepatic Oxygenation Using Time-Resolved Spectroscopy.
CONCLUSIONS: Our data suggest that the optical properties of the liver may be measured by the TRS placed on the skin surface, and the hepatic oxygenation may act as a non-invasive monitoring for early detection of intestinal ischemia. PMID: 26782239 [PubMed - in process] (Source: Advances in Experimental Medicine and Biology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Nursing Times article reports on recent Cochrane Review
Low back pain (LBP) is a common condition, widely reported as a major health and socioeconomic problem associated with work absenteeism, disability, and high costs for patients and society. Exercise is a modestly effective treatment for chronic LBP, and a Nursing Times article reports on a recent Cochrane Review assessing low to moderate quality evidence that a specific form of exercise - motor control exercise - has a clinically important effect compared with a minimal intervention for chronic LBP. Thursday, January 21, 2016 (Source: Cochrane News and Events)


Positive emotions and brain reward circuits in chronic pain
This article is protected by copyright. All rights reserved. (Source: The Journal of Comparative Neurology)


A preliminary study on how hypohydration affects pain perception
This study investigated the effect of hypohydration (mild, voluntary dehydration from ∼24 h of limiting fluid intake, mimicking someone drinking less than usual) on a person's pain perception. Seventeen healthy males (age 27 ± 5 years) visited the laboratory on three occasions, once as a familiarization and then twice again while either euhydrated (urine specific gravity: 1.008 ± 0.005) or hypohydrated (urine specific gravity: 1.024 ± 0.003, and −1.4 ± 0.9% body mass). Each visit, they performed a cold pressor test, where their feet were placed in cold water (0–3°C) for a maximum of 4 min. Measures of hydration status, pain sensitivity, pain threshold, and catastrophization were taken. We found that hypohydration predicted increased pain sensitivity (β = 0.4...


The relationship between pelvic vein incompetence and chronic pelvic pain in women: systematic reviews of diagnosis and treatment effectiveness, Health Technology Assessment, Vol:20, Iss:5
Authors: Champaneria R, Shah L, Moss J, Gupta JK, Birch J, Middleton LJ, Daniels JP. (Source: NIHR Journals Library)


High Prevalence of Vitamin D Deficiency and Associated Risk Factors among Employed Women in a Sunny Industrial City.
CONCLUSION: The symptoms of vitamin D deficiency including depression, weakness, fatigue, tingling, leg cramps and body and muscle pain have been observed in more than 90 % after recruitment and treatment. Therefore, for improving the health and productivity of employees, a routine monitoring system for vitamin D and the other factors should be put in place. PMID: 26780391 [PubMed - in process] (Source: International Journal for Vitamin and Nutrition 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>


Mutation in cytochrome b gene of mitochondrial DNA in a family with fibromyalgia is associated with NLRP3-inflammasome activation
Conclusions We propose further studies on mtDNA sequence analysis in patients with FM with evidences for maternal inheritance. The presence of similar symptoms in mitochondrial myopathies could unmask mitochondrial diseases among patients with FM. On the other hand, the inflammasome complex activation by mitochondrial dysfunction could be implicated in the pathophysiology of mitochondrial diseases. (Source: Journal of Medical Genetics)


Multi-level isolated spinous process fractures with delayed deterioration observed radiographically: A case report
We describe a rare case of multi-level isolated spinous process fractures not clearly detected on admission and subsequently diagnosed on radiography 2 months after traumatic injury. Early recognition of a small crack in the spinous process and treatment with rest and immobilization is crucial to prevent chronic back pain or stiffness. (Source: Interdisciplinary Neurosurgery)


The Survey of Pain Attitudes: A revised version of its pediatric form
Conclusions These findings will be helpful to researchers who wish to study the role that pain beliefs play in adjustment to pain in youth. Implications The results provide critical psychometric information about a revised version of one of the most used questionnaires to assess pain beliefs. The evidence presented will be helpful to researchers who want to study the role that pain beliefs play in adjustment to chronic pain in young people. (Source: Scandinavian Journal of Pain)


Social Anxiety, Pain Catastrophizing and Return-To-Work Self-Efficacy in chronic pain: a cross-sectional study
Conclusions In the context of pain and work-related communication, symptoms of social anxiety was identified as being of similar importance to the outcome as pain interference, while pain severity was not associated with the individual's confidence in communicating one's pain-related needs. Implications The results implicate that fears relating to pain-related social situations at work might be central in the process of return-to-work and rehabilitation in chronic pain. (Source: Scandinavian Journal of Pain)


A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience
Conclusions This study represents the largest and longest post-marketing studies of doses comparison with OnabotulinumtoxinA in a real-life clinical setting. Here, we demonstrate the superior efficacy of OnabotulinumtoxinA 195 U compared to 155 U in CM patients with MOH during a 2-year treatment period with similar safety and tolerability profile. (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>


The Relationship Between Neuromuscular Impairments, Chronic Back Pain and Mobility in Older Adults
For older adults with mobility problems, one focus of rehabilitation is treating the underlying neuromuscular impairment(s) that lead to functional decline and disability. Knowing which neuromuscular impairments contribute to basic mobility tasks among older adults with back pain will fill an important knowledge gap and is a critical step towards developing mechanistically-based rehabilitative interventions. (Source: PM and R)


[Arthroscopically assisted treatment of ankle fractures].
Authors: Braunstein M, Baumbach SF, Böcker W, Mutschler W, Polzer H Abstract Acute ankle fractures are one of the most common fractures in adults with an incidence of 0.1-0.2 % per year. Operative treatment by open reduction and internal fixation (ORIF) is the standard method of treatment for unstable or dislocated fractures. The main goal of the operation is the anatomical realignment of the joint and restoration of ankle stability; nevertheless, anatomical reduction does not automatically lead to favorable clinical results. According to several studies the mid-term and in particular the long-term outcome following operative treatment is often poor with residual symptoms including chronic pain, stiffness, recurrent swelling and ankle instability. There is growing evidence that ...


Theory-driven group-based complex intervention to support self-management of osteoarthritis and low back pain in primary care physiotherapy: protocol for a cluster randomised controlled feasibility trial (SOLAS)
Introduction International clinical guidelines consistently endorse the promotion of self-management (SM), including physical activity for patients with chronic low back pain (CLBP) and osteoarthritis (OA). Patients frequently receive individual treatment and advice to self-manage from physiotherapists in primary care, but the successful implementation of a clinical and cost-effective group SM programme is a key priority for health service managers in Ireland to maximise long-term outcomes and efficient use of limited and costly resources. Methods/analysis This protocol describes an assessor-blinded cluster randomised controlled feasibility trial of a group-based education and exercise intervention underpinned by self-determination theory designed to support an increase in SM behaviour in...


Randomised controlled trial of contralateral manual acupuncture for the relief of chronic shoulder pain.
CONCLUSIONS: These results demonstrate beneficial effects of contralateral acupuncture in the treatment of chronic shoulder pain, both in terms of pain and function. Future research is required to compare directly the effects of local and contralateral acupuncture and to quantify the specific and non-specific effects. TRIAL REGISTRATION NUMBER: NCT01733914. PMID: 26795764 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)


Population Pharmacokinetic Modeling of Tapentadol Extended Release (ER) in Healthy Subjects and Patients with Moderate or Severe Chronic Pain
Conclusions A one-compartment disposition model with two input functions and first-order elimination adequately described the pharmacokinetics of tapentadol ER. The dose-dependency in the pharmacokinetics of tapentadol ER is adequately described by the absorption model. None of the covariates were considered as clinically relevant factors that warrant dose adjustments. (Source: Clinical Drug Investigation)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The Relationship Among Neuromuscular Impairments, Chronic Back Pain, and Mobility in Older Adults
For older adults with mobility problems, one focus of rehabilitation is treating the underlying neuromuscular impairment(s) that lead to functional decline and disability. Knowing which neuromuscular impairments contribute to basic mobility tasks among older adults with back pain will fill an important knowledge gap and is a critical step towards developing mechanistically based rehabilitative interventions. (Source: PM and R)


Sacroiliac joint and chronic low back pain
Polly DW, Cher D (Source: ClinicoEconomics and Outcomes Research)


Delivery of siRNA, miRNA, shRNA and Plasmids Guaranteed
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Low health-related quality of life is a predictor of major adverse cardiovascular events in patients with chronic nonischemic heart failure.
CONCLUSIONS: Low values for HRQoL parameters (Bodily Pain and Mental Health), right ventricular end-diastolic diameter, serum concentration of hsCRP and alkaline phosphatase are prognostic factors in NIHF patients. PMID: 26336436 [PubMed] (Source: Polish Journal of Cardio-Thoracic Surgery)


[Porphyrias and haem related disorders].
Authors: Peoc'h K, Martin-Schmitt C, Talbi N, Deybach JC, Gouya L, Puy H Abstract The hereditary porphyrias comprise a group of eight metabolic disorders of the haem biosynthesis pathway characterised by acute neurovisceral symptoms, skin lesions or both. Each porphyria is caused by abnormal function of a separate enzymatic step resulting in a specific accumulation of haem precursors. Seven porphyrias are the consequence of a partial enzyme deficiency while a gain of function mechanism has been recently characterised in a novel porphyria. Acute porphyrias present with severe abdominal pain, nausea, constipation, confusion and seizure, which may be life threatening. Cutaneous porphyrias can be present with either acute painful photosensitivity or skin fragility and blisters. Rare re...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Hip Pain
Title: Hip PainCategory: Diseases and ConditionsCreated: 1/20/2016 12:00:00 AMLast Editorial Review: 1/20/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Selective up‐regulation of functional mu‐opioid receptor splice variants by chronic opioids
Abstract We recently reported (Verzillo, et al. J. Neurochem: 130, 790–796, 2014) that chronic systemic morphine selectively up‐regulates mRNA encoding two C‐terminal μ‐opioid receptor (MOR) splice variants, MOR‐1C1 and MOR‐1B2 (MOR‐1B2/‐1C1). Given the known disconnects between changes in levels of mRNA and corresponding protein, it is essential to directly demonstrate that chronic opioid treatment elevates functional MOR‐1B2/‐1C1 protein prior to inferring relevance of these MOR variants to spinal opioid tolerance mechanisms. Accordingly, we investigated the ability of chronic opioid exposure to up‐regulate MOR protein in Chinese hamster ovary cells stably transfected with rat MOR variants MOR‐1B2, MOR‐1C1, or MOR‐1 (considered to be the predominant MOR). Fi...


Short-term complementary and alternative medicine on quality of life in women with fibromyalgia
Conclusion TCM therapies (AC, EAC and MX) promoted an improvement in the QoL in two areas (vitality and mental health) in FMS women. Further large-scale clinical trials are required to confirm this effect. (Source: Journal of Integrative Medicine)


Skin depigmentation along lymph vessels of the lower leg following local corticosteroid injection for interdigital neuroma
One of the most common causes of forefoot pain is interdigital neuroma. It is also known as Morton's neuroma, named after Thomas George Morton [1]. After it was first described by Civinini in 1835 [2] it was later described by Gauthier as an entrapment syndrome where the nerve is compressed repeatedly between the intermetatarsal ligament and the plantar aspect of the foot during the last part of the stance phase of gait [3]. Although it's exact cause has yet to be elucidated, a possible explanation for the pain found in patients with interdigital neuroma is chronic compression and thickening of the interdigital nerve between the metatarsal heads and the transverse metatarsal ligament [4]. (Source: Foot and Ankle Surgery)


Mitochondrial DNA variants correlate with symptoms in myalgic encephalomyelitis/chronic fatigue syndrome
Conclusions: Analysis of mitochondrial genomes in ME/CFS cases indicates that individuals of a certain haplogroup or carrying specific SNPs are more likely to exhibit certain neurological, inflammatory, and/or gastrointestinal symptoms. No increase in susceptibility to ME/CFS of individuals carrying particular mitochondrial genomes or SNPs was observed. (Source: Journal of Translational 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>


Spinal Cord Stimulation Therapy for the Treatment of Concomitant Phantom Limb Pain and Critical Limb Ischemia
Phantom limb pain (PLP) is a chronic condition experienced by about 80% of patients who have undergone amputation. In most patients, both the frequency and the intensity of pain attacks diminish with time, but severe pain persists in about 5-10%. Probably, factors in both the peripheral and central nervous system play a role in the occurrence and persistence of pain in the amputated lower limb. The classical treatment of PLP can be divided into pharmacological, surgical, anesthetic, and psychological modalities. (Source: Annals of Vascular Surgery)


Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion
This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. (Source: International Journal of Shoulder Surgery)


Loin pain hematuria syndrome
(LPHS), first described in 1967, is a rare pain syndrome, which is not well understood. The syndrome is characterized by severe intermittent or persistent flank pain, either unilateral or bilateral, associated with gross or microscopic hematuria. LPHS is a diagnosis of exclusion as there still is not a consensus of validated diagnostic criteria, though several criteria have been proposed. The wide differential diagnosis would suggest a meticulous yet specific diagnostic work-up depending on the individual clinical features and natural history. Several mechanisms regarding the pathophysiology of LPHS have been proposed but without pinpointing the actual causative etiology, the treatment remains symptomatic. Treatment modalities for LPHS are diverse including simple analgesia, opioid analge...


Are U.S. Physicians Focusing on the Wrong Aspect of Chronic Low Back Pain?
No abstract available (Source: The Back Letter)


Will the National Pain Strategy Offer an Effective And Balanced Approach to Chronic Pain?Pain?
No abstract available (Source: The Back Letter)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Upregulation of Chemokine CXCL12 in the Dorsal Root Ganglia and Spinal Cord Contributes to the Development and Maintenance of Neuropathic Pain Following Spared Nerve Injury in Rats
Abstract Emerging evidence indicates that CXCL12/CXCR4 signaling is involved in chronic pain. However, few studies have systemically assessed its role in direct nerve injury-induced neuropathic pain and the underlying mechanism. Here, we determined that spared nerve injury (SNI) increased the expression of CXCL12 and its cognate receptor CXCR4 in lumbar 5 dorsal root ganglia (DRG) neurons and satellite glial cells. SNI also induced long-lasting upregulation of CXCL12 and CXCR4 in the ipsilateral L4–5 spinal cord dorsal horn, characterized by CXCL12 expression in neurons and microglia, and CXCR4 expression in neurons and astrocytes. Moreover, SNI-induced a sustained increase in TNF-α expression in the DRG and spinal cord. Intraperitoneal injection (i.p.) of the TNF-α synthesis ...


Uterine Leukocyte Function and Dysfunction: A Hypothesis on the Impact of Endometriosis
Endometriosis is a chronic inflammatory disease characterized by the growth of endometrial glands and stroma outside of the uterus. The disease affects approximately 10–15% of women of reproductive age and presents with clinical symptoms of pelvic pain and infertility. Changes in the leukocyte populations within the ectopic tissue and eutopic endometrium have been reported, and data suggest these alterations contribute to the pathology and symptoms of the disease. In this review, we discussed differences when comparing uterine NK cells and regulatory T cells within the eutopic endometrium between patients with endometriosis and healthy patients, and how these differences relate to implantation failure and/or decreased clearance of menstrual tissue in patients with the disease. The data d...


Acute versus chronic phase mechanisms in a rat model of CRPS
Conclusions: These results demonstrate that tibia fracture and immobilization cause peripheral changes in neuropeptide signaling and inflammatory mediator production acutely, but central spinal changes may be more important for the persistent nociceptive changes in this CRPS model. (Source: Journal of Neuroinflammation)


Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice
Conclusions. Almost all patients presenting for a lumbar MRI examination as referred by their GP had abnormal MRI findings. In total, 55% of the patients reported persistent sciatica in which imaging is recommended according to international guidelines. (Source: Family Practice)


Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients
Conclusion. To enhance the functional capacity of primary care patients with co-existing chronic disease and depressive symptoms, health care interventions should be directed at improving the physical aspects of HRQOL, in particular enhancing patients&rsquo; GH perception, role functioning and PF, and to better manage chronic pain. (Source: Family Practice)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Ultrasound measurement of deep and superficial abdominal muscles thickness during standing postural tasks in participants with and without chronic low back pain
Activity of deep abdominal muscles increases the lumbar stability. Majority of previous studies indicated abdominal muscle activity dysfunction during static activity in patients with low back pain (LBP). However, the number of studies that evaluated deep abdominal muscle activity in dynamic standing activities in patients is limited, while this assessment provides better understanding of pain behavior during these activities. (Source: Manual Therapy)


Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial
Conclusions Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus. (Source: Polish Journal of Neurology and Neurosurgery)


Sacral roots stimulation in chronic pelvic pain
Conclusion Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system. (Source: Polish Journal of Neurology and Neurosurgery)


Carnosic acid attenuates neuropathic pain in rat through the activation of spinal sirtuin1 and down-regulation of p66shc expression
Conclusions Carnosic acid is effective in the treatment of the established CCI-induced pain. It may be possible that spinal sirtuin1 activition by carnosic acid attenuates neuropathic pain through a mechanism involving the down-regulation of p66shc expression. (Source: Neurochemistry International)


Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention.
This article presents best practices for antibiotic use in healthy adults (those without chronic lung disease or immunocompromising conditions) presenting with ARTI. Methods: A narrative literature review of evidence about appropriate antibiotic use for ARTI in adults was conducted. The most recent clinical guidelines from professional societies were complemented by meta-analyses, systematic reviews, and randomized clinical trials. To identify evidence-based articles, the Cochrane Library, PubMed, MEDLINE, and EMBASE were searched through September 2015 using the following Medical Subject Headings terms: "acute bronchitis," "respiratory tract infection," "pharyngitis," "rhinosinusitis," and "the common cold." High-Value Care Advice 1: Clinicians should not perform testing or initia...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Where now for UK chronic pain management services?
(Source: British Journal of Anaesthesia)


Treatment of glenohumeral instability in rugby players
Abstract Rugby is a high-impact collision sport, with impact forces. Shoulder injuries are common and result in the longest time off sport for any joint injury in rugby. The most common injuries are to the glenohumeral joint with varying degrees of instability. The degree of instability can guide management. The three main types of instability presentations are: (1) frank dislocation, (2) subluxations and (3) subclinical instability with pain and clicking. Understanding the exact mechanism of injury can guide diagnosis with classical patterns of structural injuries. The standard clinical examination in a large, muscular athlete may be normal, so specific tests and techniques are needed to unearth signs of pathology. Taking these factors into consideration, along with the imaging, ...


Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study.
CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot. PMID: 26786073 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Integrating Mobile health and Physical Activity to reduce the burden of Chronic low back pain Trial (IMPACT): a pilot trial protocol
It is well recognised that low back pain is a significant public health problem and engagement in moderate levels of physical activity is associated with positive outcomes. (Source: BMC Musculoskeletal Disorders)


Musculoskeletal pain characteristics associated with lower balance confidence in community-dwelling older adults - Stubbs B, Schofield P, Patchay S, Leveille S.
OBJECTIVE: 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. DESIGN: Cross-sectional study. SETT... (Source: SafetyLit)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Yoga on Symptoms, Physical Function, and Psychosocial Outcomes in Adults with Osteoarthritis: A Focused Review
ABSTRACT: Osteoarthritis (OA) is a highly prevalent and disabling chronic condition. Because physical activity is a key component in OA management, effective exercise interventions are needed. Yoga is an increasingly popular multimodal mind-body exercise that aims to promote flexibility, strength, endurance, and balance. Its gentle approach is potentially a safe and effective exercise option for managing OA. The purpose of this focused review is to examine the effects of yoga on OA symptoms and physical and psychosocial outcomes. A comprehensive search was conducted using seven electronic databases. Twelve reports met inclusion criteria involving a total of 589 participants with OA-related symptoms. A variety of types, frequencies, and durations of yoga interventions were reported; Hatha a...


Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura.
In this report we describe a case in which discontinuation of steroid therapy improved the condition of a patient with peliosis hepatis. Our patient was a 64-year-old woman with a history of long-term steroid treatment for idiopathic thrombocytopenic purpura . Her symptoms included abdominal pain and weight loss; the only finding of a physical examination was hepatomegaly. We performed computed tomography (CT) and magnetic resonance imaging (MRI) of the liver and a liver biopsy. Based on these findings plus clinical observations, she was diagnosed with peliosis hepatis and her steroid treatment was terminated. The patient recovered completely 3 months after steroid discontinuation, and remained stable over the following 6 months. PMID: 26770928 [PubMed - in process] (Source: Clinical ...


Scientists discover blueprint of body's heat sensor
(Duke University) Researchers at Duke University and Scripps Research Institute have determined the structure of an ion channel on the cell membrane called TRPV2 that is related to the perception of pain and heat. The study is an important step toward new therapies that target pain receptors. More than 100 million Americans suffer from some sort of severe or chronic pain, a condition that is underdiagnosed and poorly treated. (Source: EurekAlert! - Medicine and Health)


Different forms of exercise for chronic low back pain (PEDro synthesis)
This section features a synthesis of a recent systematic review that is indexed on PEDro, the Physiotherapy Evidence Database (http://www.pedro.org.au). PEDro is a free, web-based database of evidence relevant to physiotherapy. &nbsp;Searle A, Spink M, Ho A, et al. Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials. Clin Rehabil 2015;29:1155&ndash;67. Background Low back pain (LBP) is an extremely common health condition and the leading cause of disability worldwide. Exercise for the treatment of chronic LBP is widely recommended in current national and international guidelines,1 however, there is no consensus with regards to the type of exercise, duration or intensity. Aim To investigate the effectivenes...


Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap
ConclusionsThe superficial keratectomy and Gundersen inlay flap may provide a surgical alternative to chronic medical treatment of severe corneal edema in horses. (Source: Veterinary Ophthalmology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Progesterone modulates pro-inflammatory cytokine expression profile after spinal cord injury: Implications for neuropathic pain
In this study we evaluated the effects of progesterone, a neuroactive steroid, on pain development and the spinal expression of IL-1β, its receptors (IL-1RI and IL-1RII) and antagonist (IL-1ra), IL-6 and TNFα, and NR1 subunit of NMDAR. Our results show that progesterone, by modulating the expression of pro-inflammatory cytokines and neuronal IL-1RI/NR1 colocalization, emerges as a promising agent to prevent chronic pain after SCI. (Source: Journal of Neuroimmunology)


Bilateral non-traumatic hip fractures in a heavy smoker COPD patient on inhaled steroids
Conclusion History of COPD with corticosteroid use may be used as a diagnostic tool to identify patients having osteoporosis. Preventive measures can be performed by monitoring high-risk patients with bone mineral densitometry, WHO fracture risk assessment tool (FRAX tool), serum calcium, and vitamin D levels to prevent bone fractures. Treating those patients with the lowest effective dose of corticosteroids should be targeted. (Source: Archives of Orthopaedic and Trauma Surgery)


Limited thoracotomy for segmentectomy: a comparison of postoperative pain with thoracoscopic lobectomy
Conclusion Postoperative pain does not differ significantly between VATS-L and LT-S. LT may be preferable to VATS for segmentectomy to identify the anatomy, dissect the hilar nodes, and establish surgical margins. (Source: Surgery Today)


Health-related quality of life in adults with congenital unilateral upper limb deficiency in Norway. A cross-sectional study.
Conclusions Persons with UULD reported reduced HRQoL on most SF-36 subscales, mostly in the physical health domain. Employment status, occurrence of comorbidity and chronic pain seem to have a negative impact on the HRQoL. Measures that can reduce pain and loss of function should be given particular attention in UULD rehabilitation. Implications for Rehabilitation Persons with congenital unilateral upper limb deficiency (UULD) who experience pain and discomfort should seek professional help for evaluating their everyday coping strategies. Professionals who meet persons with UULD should examine anomalies, comorbidity, pain and employment status before choosing advices and actions. Individually adapted grip-improving devices, environments, physical exercise and pain management programs shoul...


The need to address increasing opioid use in elderly COPD patients.
Authors: Vozoris NT, O'Donnell DE Abstract Opioid drugs may be used among older adults with chronic obstructive pulmonary disease (COPD) for several reasons, including for chronic musculoskeletal pain, insomnia, and respiratory symptoms that are refractory to more traditional pharmacotherapy. Pharmacoepidemiologic studies show that opioids are being used in potentially concerning ways in the older adult COPD population. While there are clinical studies supporting the careful prescription of opioids to help treat refractory respiratory symptoms in advanced COPD, these trials have important limitations. Furthermore, the results of population-based observational studies raise several important safety concerns about the use of opioid drugs among individuals with COPD. Opioid drugs like...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations
Conclusion Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail. (Source: Cephalalgia)


Stress fracture of the scaphoid in an elite junior tennis player: a case report and review of the literature
Conclusions In this case, the scaphoid stress fracture had resulted from repetitive practicing of the attacking backhand high volley, which involved excessive dorsal flexion of the wrist. Although rare, scaphoid stress fractures must be considered in tennis players with chronic wrist pain. (Source: Journal of Medical Case Reports)


Adding Genetic Testing to Evidence-Based Guidelines to Determine the Safest and Most Effective Chronic Pain Treatment for Injured Workers.
Authors: Meshkin B, Lewis K, Kantorovich S, Anand N, Davila L Abstract Published guidelines for treating injured workers include the need for personalized treatment to manage chronic pain symptoms and increase functional status. However, they often fail to clarify how to objectively personalize these treatments. Further, certain patients need analgesic relief beyond the short term. In these cases, it is not sufficient or reasonable to utilize the typical broad protocol-based justifications for reduction of opioids and other medications in a haphazard manner based purely on poor response, without attempting to elucidate possible pharmacogenetic reasons for this. These guidelines acknowledge the problem of substance abuse and set forth methods for treatment and prevention. Although i...


Prevalence of endometriosis at a university hospital in Jeddah, Saudi Arabia.
CONCLUSION: Endometriosis was uncommon in women who had undergone gynecologic laparoscopy. PMID: 26753486 [PubMed - in process] (Source: Clinical and Experimental Obstetrics and Gynecology)


CHRNA7 inhibits cell invasion and metastasis of LoVo human colorectal cancer cells through PI3K/Akt signaling.
Authors: Xiang T, Yu F, Fei R, Qian J, Chen W Abstract The α7 neuronal nicotinic receptor gene (CHRNA7) is widely expressed in both the brain and periphery whereas its encoding protein of α7 neuronal acetylcholine receptor (α7nAChR) belongs to the nicotinic acetylcholine receptor family. Considerable evidence suggests that α7nAChR plays an important role in chronic inflammatory and neuropathic pain signaling and thus has been proposed as a potential target for treating cognitive deficits in patients with schizophrenia, attention deficit hyperactivity disorder (ADHD) and Alzheimer's disease. The aim of the present study was to determine the role of endogenous α7nAChR signaling in human colorectal cancer growth and metastasis. pLVX‑CHRNA7 encoding the full length of CHRNA7 was...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Spanish version of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for fibromyalgia: reliability and validity assessment.
CONCLUSIONS: Our results indicate that the 2010 ACR Preliminary Diagnostic Criteria for FM may be useful to establish a diagnosis of FM in Spanish individuals with chronic pain. PMID: 26752202 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)


Metal Hypersensitivity and Total Knee Arthroplasty.
Authors: Lachiewicz PF, Watters TS, Jacobs JJ Abstract Metal hypersensitivity in patients with a total knee arthroplasty (TKA) is a controversial topic. The diagnosis is difficult, given the lack of robust clinical validation of the utility of cutaneous and in vitro testing. Metal hypersensitivity after TKA is quite rare and should be considered after eliminating other causes of pain and swelling, such as low-grade infection, instability, component loosening or malrotation, referred pain, and chronic regional pain syndrome. Anecdotal observations suggest that two clinical presentations of metal hypersensitivity may occur after TKA: dermatitis or a persistent painful synovitis of the knee. Patients may or may not have a history of intolerance to metal jewelry. Laboratory studies, in...


EUS-guided pancreatic duct drainage by using a novel self-expandable stent in patients with obstructive pancreatic pain: a step in the right direction!
Pancreatic pain is classically described as epigastric or upper abdominal pain that can radiate to the back and tends to be exacerbated by food, especially with food with a high fat content. Multiple etiologies can result in pancreatic pain, including acute or chronic pancreatitis and its sequelae and malignant processes of the pancreas. Pancreatic pain may result in chronic pain syndromes and is associated with a significant decrease in quality of life and the inability to work. (Source: Gastrointestinal Endoscopy)


Phytochemical Screening, Anti-Inflammatory and Analgesic Activities Of Formulation Cream of Silene vulgaris
The present study evaluates the anti-inflammatory and analgesic activities of cream formulation of Silene vulgaris leaves in rats. The anti-inflammatory effect of cream of Silene vulgaris at doses of 10 and 20% applied topically and was evaluated in rats during 6 h using the acute anti-inflammatory model of carrageenan-induced paw edema and during 7 days by chronic anti-inflammatory activity of cotton pellet induced granuloma. The analgesic activity using two in vivo models: acetic acid-induced writhing test and plantar test (Hargreaves method) was also studied. Furthermore, the acute toxicity of topical cream was evaluated in rats. Finally, a phytochemical analysis of Silene vulgaris was performed. The resulted demonstrated a significant reduction of inflammation after carrageenan-induced...


Suction Drain Tip Culture after Spine Surgery: Can It Predict a Surgical Site Infection?
CONCLUSIONS: Suction drain tip culture analysis is a poor predictor of SSI after primary posterior spine surgery. Routine use of a drain tip culture is not supported by the results of this study. PMID: 26713117 [PubMed] (Source: Asian 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>


Rotator cuff tears: An evidence based approach.
Authors: Sambandam SN, Khanna V, Gul A, Mounasamy V Abstract Lesions of the rotator cuff (RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an age-dependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears (PTT) can be bursal-sided or articular-sided tears. Over the course of time, PTT enlarge ...


Chronic Daily Headache: Mechanisms and Principles of Management
Abstract Primary headache is a common malady that is often under-recognized and frequently inadequately managed in spite of the fact that it affects up to 95 % of the population in a lifetime. Many forms of headache, including episodic tension and migraine headaches, if properly diagnosed, are reasonably amenable to treatment, but a smaller, though not insignificant, percent of the population suffer daily from a chronic, intractable form of headache that destroys one’s productivity and quality of life. These patients are frequently seen in neurological practices at a point when treatment options are limited and largely ineffective. In the following review, we will discuss mechanisms drawn from recent studies that address the transition from acute to chronic pain that may apply...


The assessment of immunohistochemical profile of endometriosis implants, a practical method to appreciate the aggressiveness and recurrence risk of endometriosis.
Authors: Brătilă E, Brătilă CP, Comandaşu DE, Bauşic V, Vlădescu CT, MehedinŢu C, Berceanu C, Cîrstoiu MM, Mitroi G, Stănculescu R Abstract UNLABELLED: Endometriosis represents a chronic female genital tract disease characterized by implants outside the endometrial cavity, leading to alteration of pelvic anatomy and having as result chronic pelvic pain and infertility. AIM: From the molecular perspective, the aim of studying endometriosis is identifying a cause and a consequence, that lead to the appearance and perpetual arising of new implants. The description of the immunohistochemical (IHC) profile of ectopic endometrium could represent a new element in the pathogenesis of endometriosis and also a practical method to appreciate the aggressiveness and possibility of...


Chronic Pain – Stories Of Struggle And Hope: Part 10 – Support Systems
BOSTON (CBS) – An accident changed Cindy Steinberg&#8217;s life in ways she couldn&#8217;t have imagined. Excruciating, unrelenting back pain forced her to give up her career &#8211; but it didn&#8217;t steal her spirit. “I was thinking ‘My God, I can’t be the only one living like this,’” Cindy recalls. “And so I just hung a sign at the local library saying if you have pain I’m starting a group. If you’d like to come, show up.” And they did. For 15 years, hundreds of people have been taking part in Steinberg&#8217;s support group which is held at the Arlington Library every month. Related: Boston Chapter of the American Chronic Pain Association Working with lawmakers on Beacon Hill, she&#8217;s been able to get legislation passed. “To require three hours of pain manag...


Eltrombopag : How secure in triple therapy of HCV ?
We described here a patient who developing thrombosis secondary to eltrombopag in receiving triple therapy. PMID: 26712061 [PubMed - in process] (Source: Acta Gastro-Enterologica Belgica)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Biggest Medical Stories You May Have Missed In 2015
SPECIAL FROM Next Avenue By Craig Bowron As we head into the New Year, let&#8217;s take a look back and see what lessons we should have learned from medical science in 2015. The New England Journal of Medicine&#8217;s publication Journal Watch provides physicians and other health care providers with expert analysis of the most recent medical research. Below is a brief synopsis of what the Journal Watch editors felt were the most important stories in general medicine for the year 2015. While you likely heard about a couple, others probably escaped your radar. Getting Aggressive with Strokes We&#8217;re familiar with the idea of a cardiologist performing an angioplasty, where a tiny tube called a catheter is threaded into a coronary artery and a balloon on the end of the catheter is inflate...


Chronic Pain – Stories Of Struggle And Hope: Part 9 – Addiction Misconceptions
BOSTON (CBS) – Many people who take painkillers say they&#8217;re being unfairly targeted in the current war on drugs. The opioid crisis has been grabbing headlines for months. Gov. Charlie Baker has declared the opioid epidemic a public health emergency. Over 1,200 Massachusetts residents have died from opioid overdoses in 2014. Cindy Steinberg is the policy council chair of the Massachusetts pain initiative. “We know that 78 percent of people who are abusing these medications did not get them from a physician,” said Steinberg. “They’re getting them on the street, they’re getting diverted, they’re getting them from friends, they’re buying them. And those probably were stolen from somewhere.” Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series Independ...


Opioid risk addiction in the management of chronic pain in primary care: the addition risk questionnaire.
CONCLUSIONS: Due to the increasing relevance of primary care physicians in chronic pain management, we propose a 28-item questionnaire to validate specifically conceived for GPs' and aimed at the preliminary evaluation of the risk of addiction in patients with chronic pain. PMID: 26744882 [PubMed - in process] (Source: European Review for Medical and Pharmacological Sciences)


A rapid, simple and sensitive method for the determination and bioequivalence study of transdermal fentanyl in human plasma using liquid chromatography-electrospray ionization tandem mass spectrometry.
CONCLUSIONS: Quantification of fentanyl was carried out by multiple reaction monitoring (MRM) of the transitions at m/z 337.1→188.0 for fentanyl and 341.9→187.9 for IS. The lower limit of quantification was 9.75 pg×mL-1, and the test showed a linear range of 9.75 - 10,000 pg×mL-1. The validated method was subsequently applied to a bioequivalence (BE) study in 24 healthy Chinese volunteers by using transdermal fentanyl patches. PMID: 26754304 [PubMed - as supplied by publisher] (Source: International Journal of Clinical Pharmacology and Therapeutics)


[Correspondence] Methadone for prisoners – Authors' reply
Daniel D'Hotman and colleagues make important points that forced withdrawal from methadone causes predictable pain and suffering, is a disproportionate double punishment, and does not cure the addiction, and question why substance dependence is treated differently to other medical disorders. We suggest that addiction is treated differently owing to the stigma associated with the disease and its treatment. Addiction is fundamentally misunderstood to be a moral failing rather than a chronic relapsing brain disease. (Source: LANCET)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Silencing of Id2 Alleviates Chronic Neuropathic Pain Following Chronic Constriction Injury
In this study, we investigated the effect of Id2 on neuropathic pain in a rat chronic constriction injury (CCI) model. Our results demonstrated that Id2 was upregulated in the dorsal root ganglion (DRG) in a CCI rat in a time-dependent manner. Intrathecal short-hairpin RNA (shRNA)-Id2 attenuates mechanical allodynia and thermal hyperalgesia in CCI rats, and inhibits the expression of TNF-α and IL-1β in the DRG in CCI rats. Furthermore, knockdown of Id2 reduces the expression of NF-κB p65 in the DRG of CCI rats. Taken together, our findings suggest that knockdown of Id2 may alleviate neuropathic pain by inhibiting the NF-κB activation to inhibit the production of pro-inflammatory mediators. Therefore, Id2 may provide an important target of neuropathic pain treatment. (Source: Journal of...


Altered fMRI resting‐state connectivity in individuals with fibromyalgia on acute pain stimulation
ConclusionsThese data reporting changes in resting‐state brain activity following a noxious stimulus suggest that the acute painful stimuli may contribute to the alteration of the neural signature of chronic pain. What does this study/add?In this study acute pain application shows an echo in functional connectivity and clinical pain changes in chronic pain. (Source: European Journal of Pain)


P-glycoprotein inhibitors improve effective dose and time of pregabalin to inhibit intermittent cold stress-induced central pain
Publication date: Available online 14 January 2016 Source:Journal of Pharmacological Sciences Author(s): Takehiro Mukae, Wakako Fujita, Hiroshi Ueda Pregabalin (PGB) is a valuable therapeutic drug against chronic pain. Here we attempted to perform the combinatorial drug therapy with P-glycoprotein (P-gp) inhibitors to lower therapeutic dosage of PGB in the intermittent cold stress-induced fibromyalgia (FM)-like pain model. Single intracerebroventricular (i.c.v.) PGB injection exerted long-lasting anti-hyperalgesic effects for 72 h, while the effect of PGB given intraperitoneally (i.p.) disappeared within 3 h. Importantly, the pretreatment with P-gp inhibitors markedly prolonged the PGB (i.p.) effects, which lasted for 72 h. These results suggest that the combinatorial treatment with P...


Kinesiophobia is not associated with disability in elderly women with acute low back pain: Back Complaints in the Elders (BACE) Brazil study results
The study of Low Back Pain (LBP) is complex and the physical and psychological aspects, including kinesiophobia, should be considered. Several studies have investigated the relationship between kinesiophobia and functionality in patients with chronic LBP. However, to the best of the authors' knowledge, no studies have investigated the association between kinesiophobia and self-reported assessments of disability and physical performance in elderly patients with acute LBP. (Source: The Spine Journal)


Ulnar-Sided Wrist Pain due to Long Ulnar Styloid: A Case Report
We present a patient with chronic wrist pain of unknown origin, culminating with arthroscopic findings demonstrating substantial loss of articular cartilage on both the lunate and triquetrum. The patient successfully underwent operative ulnar styloid excision, ultimately resolving chronic wrist pain symptomology.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Wrist 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>


Ulna Rotation Osteotomy in Complete Dislocation of the Distal Radioulnar Joint
We report a procedure in which the rotation of the distal ulna is corrected to restore DRUJ congruity in chronic dislocations. The rotation osteotomy described is useful in gross ligamentous instability following loss of constraint by the TFCC and the DIOM.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Wrist Surgery)


Chronic Pain – Stories Of Struggle And Hope: Part 8 – Challenges
BOSTON (CBS) – Chronic pain affects the mind, body and soul.  As a result, doctors are treating their patients in a myriad of ways. If you suffer from chronic pain, popping a pill isn’t the answer. Dr. Joshua Wootton is the Director of Pain Psychology at the Arnold Warfield Pain Center at Beth Israel Deaconess Medical Center, where patients learn mind-body techniques. “By the time pain has become chronic it’s actually made changes in the structures of the brain, changes in the biochemistry that these techniques actually over time can compensate for,” Wootton said. Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series Meditation, Tai Chi and Qigong are just some of those techniques being used. Laura Kiesel&#8217;s had luck with massage and acupuncture, but it&#8...


Chronic Pain – Stories Of Struggle And Hope: Part 7 – A Personal Story
BOSTON (CBS) – It&#8217;s tough for most 17-year-olds to get up in the morning. For Liam Talbot, it&#8217;s next to impossible. Each day he wakes up with a headache that&#8217;s an 8 out of 10 on the pain scale. And that&#8217;s not all. “The majority of the days I can’t even go downstairs to go and make a meal for myself because my muscles are also affected,” Liam says. Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series Liam&#8217;s weak muscles and the slew of other medical issues he suffers from are blamed on a disease called small fiber poly-neuropathy. It causes nerve damage throughout the body, including the gastrointestinal tract. “Well I’ve had all these symptoms since birth. This is just a normal thing for me at this point,” Liam said. Liam was 1...


Low-Cost Mosquito Mesh Good Alternative for Hernia Repair in Poor Countries: Study
Title: Low-Cost Mosquito Mesh Good Alternative for Hernia Repair in Poor Countries: StudyCategory: Health NewsCreated: 1/13/2016 12:00:00 AMLast Editorial Review: 1/14/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Modified Appleby procedure for borderline resectable/locally advanced distal pancreatic adenocarcinoma: A major procedure for selected patients
Conclusions DP-CAR for borderline resectable/locally advanced distal PDAC is associated with high morbidity and mixed long-term functional results. Neoadjuvant treatment may prevent from unnecessary surgery for patients with progressive disease and may facilitate resection with acceptable long-term survival. (Source: Journal of Visceral 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>


Psychometric properties including reliability, validity and responsiveness of the Majeed pelvic score in patients with chronic sacroiliac joint pain
Conclusion Overall the Majeed scoring system demonstrated acceptable psychometric properties for outcome assessment in chronic sacroiliac joint pain. Thus, its use in this condition is adequate. However, some domains demonstrated suboptimal performance indicating that improvement might be achieved with the development of an outcome measure specific for sacroiliac joint dysfunction and degeneration. (Source: European Spine Journal)


Derivation and Evaluation of a Risk-Scoring Tool to Predict Participant Attrition in a Lifestyle Intervention Project
Abstract Participant attrition in clinical trials and community-based interventions is a serious, common, and costly problem. In order to develop a simple predictive scoring system that can quantify the risk of participant attrition in a lifestyle intervention project, we analyzed data from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention to prevent diabetes in 36 American Indian and Alaska Native communities. SDPI-DP participants were randomly divided into a derivation cohort (n = 1600) and a validation cohort (n = 801). Logistic regressions were used to develop a scoring system from the derivation cohort. The discriminatory power and calibration properties of the system were assessed using the valida...


Comparison of thermal and mechanical quantitative sensory testing in client-owned dogs with chronic naturally occurring pain and normal dogs
In conclusion, whether QST is different between dogs with chronic pain and normal dogs needs further investigation using a larger group of animals and age, weight and sex matched groups. (Source: The Veterinary Journal)


Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis) : A systematic review of randomized controlled trials.
CONCLUSIONS: Currently, there is insufficient evidence for recommendation for any cannabinoid preparations for symptom management in patients with chronic pain associated with rheumatic diseases. PMID: 26767993 [PubMed - as supplied by publisher] (Source: Schmerz)


Medical use of cannabis products : Lessons to be learned from Israel and Canada.
CONCLUSIONS: The use of standardized, synthetic, and plant-based cannabis products should be allowed in Germany for defined medical conditions when high-level evidence of efficacy and safety exists. The costs should be reimbursed by the health insurance companies. Contraindications for the medical use of cannabis should be defined. Growing marijuana by patients for their medical use should not be allowed. PMID: 26767992 [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>


Expression and physiology of opioid receptors in the gastrointestinal tract
Purpose of review: Stimulation of opioid receptors elicits analgesic effect not only in the central nervous system, but also in the gastrointestinal tract, where a high concentration of opioid receptors can be found within the enteric nervous system as well as muscular and immune cells. Along with antinociception, opioid receptors in the stomach and intestine relay signals crucial for secretory and motor gastrointestinal function. Recent findings: The review focuses on the utility of opioid receptor antagonists, which is generally contributing to the management of postoperative ileus and opioid bowel dysfunction in chronic pain patients nonetheless, opioid receptor antagonists can also be useful in the treatment of irritable bowel syndrome and chronic idiopathic constipation. The study al...


Opioid-induced constipation in chronic noncancer pain
Purpose of review: Opioid-based management of noncancer pain has become much more prevalent over the last 2 decades and is responsible for a wide range of side-effects, particularly affecting the intestinal tract causing opioid-induced constipation (OIC). This review will consider results of recent clinical trials that have provided evidence of new pharmacological management options for the treatment of OIC. Recent findings: Supportive use of conventional agents, such as stool softeners, osmotic laxatives, and stimulating laxatives in OIC has limited efficacy. The peripheral μ-opioid receptor antagonist (PAMORA) methylnaltrexone (MNTX) was first FDA approved for OIC in patients with advanced illness and later also for OIC in noncancer pain patients; clinical trial results indicated MNTX ...


Healing Trauma
trau·ma ˈtroumə,ˈtrômə/ 1. 1. a deeply distressing or disturbing experience. ▪ emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes, leads to long-term neurosis. Lets face it, trauma is devastating enough when you're going through it, but what can be even worse is the insidious, long-term affects that can echo throughout one's entire life. I should know, with two of my family members being paranoid schizophrenics, I often felt like I was trying to dodge a bullet as a child. Needless to say, my life became a constant struggle until I made a decision to get some much-needed help. After one of the largest scientific research of it's kind, the ACE Study (Adverse Childhood Experience) a collaboration between the Ce...


Neurometrix gets FDA clearance for smartphone-controlled Quell device
Neurometrix has received FDA clearance for a new smartphone-controlled version of Quell, its wearable for pain relief, the company announced last week. Like its predecessor, the device will use nerve stimulation to treat chronic pain by sending signals to the brain that cause it to release natural opioids. It's worn around the calf. (Source: mobihealthnews)


Chronic Pain – Stories Of Struggle And Hope: Part 6 – Family Impact
BOSTON (CBS) – Anyone who lives with chronic pain will probably tell you they&#8217;ve felt lost, misunderstood, and lonely at times. Those who live with and love those in pain often feel this way, too. One hundred million Americans bear the burden of living with chronic pain. Their family members do, too. Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series Bonnie&#8217;s husband, Allen, has chronic back pain, the result of an accident. Because of that, Bonnie&#8217;s been forced to do many things on her own. This makes her feel frustrated, sometimes even angry, but most of all it pains her. “It saddens me because, I mean, it’s not his fault. He didn’t do anything to make this happen,” Bonnie told WBZ NewsRadio 1030. In another case, Paul and Lisa were a typic...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


5 Tips to Cope with Chronic Pain
Chronic pain can be in your neck, back and anywhere else. It can disrupt your work, your relationships and, by extension, your mental health. This week, Savvy Psychologist Dr. Ellen Hendriksen offers... -- Read more on ScientificAmerican.com (Source: Scientific American)


Chronic Pain – Stories Of Struggle And Hope: Part 5 – Veterans Coping
BOSTON (CBS) &#8211;  Over the last decade the United States has been involved in wars in Iraq and Afghanistan. Roughly 60-percent of returning veterans from there suffer some sort of chronic pain. Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series Dr. Diana Higgins, a pain psychologist at VA Boston, says she sees a correlation between chronic pain and post traumatic stress disorder (PTSD). “Chronic pain for these younger folks is as prevalent if not more so than PTSD, coming back but they co-occur very frequently. And it makes it challenging. Both things really need to be addressed and they’re addressed similarly, but not necessarily by the same people,&#8221; she told WBZ NewsRadio 1030.  &#8220;And that’s maybe one thing that I think we’re working on in ...


Treatment with a carbon monoxide-releasing molecule (CORM-2) inhibits neuropathic pain and enhances opioid effectiveness in rats.
CONCLUSIONS: Our data suggest that P2X4 receptors play a significant role in neuropathic pain development, suggesting that their blockade may have potential therapeutic utility. PMID: 26721375 [PubMed - in process] (Source: Pharmacological Reports)


Endoscopic Resection of the Bicipitoradial Bursa
The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis. It can be treated conservatively with aspiration and steroid injection. Surgical excision of the bursa is indicated in case of infection cause, failed conservative treatment with recurrence of the enlarged bursa and pain after aspiration, the presence of nerve compression with neurological impairment, mechanical limitation to flexion and extension of the elbow or biceps tendon degeneration, and/or functional impairment. Open resection through the anterior approach requires extensive dissection to expose the radial tuberosity and the radial neck, which increases the risk of neurovascular injury. Endoscopic resection is possible through distal biceps tendo...


Assessment of the Therapeutic Effectiveness of Deep Electromagnetic Stimulation in Patients with Chronic Low Back Pain.
CONCLUSIONS: 1. Deep electromagnetic stimulation is an effective treatment in patients with chronic low back pain. 2. The degree of effectiveness of this modality in the longer term depends on the cause and duration of pain. PMID: 26751753 [PubMed - as supplied by publisher] (Source: Ortopedia Traumatologia Rehabilitacja)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Neurobiology of opioid withdrawal: Role of the endothelin system
Publication date: Available online 13 January 2016 Source:Life Sciences Author(s): Shaifali Bhalla, Shridhar V. Andurkar, Anil Gulati Morphine and oxycodone are potent opioid analgesics most commonly used for the management of moderate to severe acute and chronic pain. Their clinical utility is limited by undesired side effects like analgesic tolerance, dependence, and withdrawal. We have previously demonstrated that endothelin-A (ETA) receptor antagonists potentiate opioid analgesia and eliminate analgesic tolerance. Mechanistically, G proteins and regulatory proteins such as β-arrestins have shown to play an important role in mediating opioid tolerance, dependence, and withdrawal. Recently, the involvement of central ET mechanisms in opioid withdrawal was investigated. ETA receptor...


Common Brain Mechanisms of Chronic Pain and Addiction
Publication date: 6 January 2016 Source:Neuron, Volume 89, Issue 1 Author(s): Igor Elman, David Borsook While chronic pain is considered by some to be a CNS disease, little is understood about underlying neurobiological mechanisms. Addiction models have heuristic value in this regard, because both pain and addictive disorders are characterized by impaired hedonic capacity, compulsive drug seeking, and high stress. In drug addiction such symptomatology has been attributed to reward deficiency, impaired inhibitory control, incentive sensitization, aberrant learning, and anti-reward allostatic neuroadaptations. Here we propose that similar neuroadaptations exist in chronic pain patients. Teaser Pain and addictive disorders are characterized by impaired hedonic capacity, preoccupation with...


In vivo characterization of colorectal and cutaneous inputs to lumbosacral dorsal horn neurons in the mouse spinal cord
Publication date: 1 March 2016 Source:Neuroscience, Volume 316 Author(s): K.E. Farrell, M.M. Rank, S. Keely, A.M. Brichta, B.A. Graham, R.J. Callister Chronic abdominal pain is a common symptom of inflammatory bowel disease and often persists in the absence of gut inflammation. Although the mechanisms responsible for ongoing pain are unknown, clinical and preclinical evidence suggests lumbosacral spinal cord dorsal horn neurons contribute to these symptoms. At present, we know little about the intrinsic and synaptic properties of this population of neurons in either normal or inflammed conditions. Therefore, we developed an in vivo preparation to make patch-clamp recordings from superficial dorsal horn (SDH) neurons receiving colonic inputs in naïve male mice. Recordings were made...


The Immunologic Mechanisms of Eosinophilic Esophagitis
Abstract Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease that is triggered by food and/or environmental allergens and is characterized by a clinical and pathologic phenotype of progressive esophageal dysfunction due to tissue inflammation and fibrosis. EoE is suspected in patients with painful swallowing, among other symptoms, and is diagnosed by the presence of 15 or more eosinophils per high-power field in one or more of at least four esophageal biopsy specimens. The prevalence of EoE is increasing and has now reached rates similar to those of other chronic gastrointestinal disorders such as Crohn’s disease. In recent years, our understanding of the immunologic mechanisms underlying this condition has grown considerably. Thanks to new genetic, molecu...


Lifestyle Factors and Migraine in Childhood
Abstract Migraine is one of the most common pain symptoms in children. Indeed, a high percentage of adult migraine patients report to have suffered from recurrent headache during the childhood. In particular, children could experience the so-called childhood periodic syndromes (such as cyclic vomiting, abdominal migraine, and benign paroxysmal vertigo) that have been usually considered precursors of migraine or they could develop overt migraine headaches. However, typical cohort of migraine symptoms could be absent and children could not achieve all clinical features necessary for a migraine attack diagnosis according to classification criteria. Nevertheless, migraine is characterized also in childhood by a significant negative impact on the quality of life and a high risk of dev...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Reappraisal of epileptic pain as a rare symptom of seizures
Conclusion Epileptic pain is a neglected, but important, semiologic symptom with localization and lateralization value in the patients with somatosensorial seizures of parietal as well as temporal lobe origin. It occurs mainly as peripherally localized, cephalic, or abdominal pain and is usually associated with a symptomatic etiology. Awareness of epileptic pain is important to avoid misdiagnosis and delayed treatment. (Source: Epilepsy and Behavior)


Does hemiplegic shoulder pain share clinical and sensory characteristics with central neuropathic pain? A comparative study.
CONCLUSION: The similarities between HSP and SCI-CNP and the altered spinothalamic function and sensitization suggest that HSP has neuropathic components in its mechanism. Nevertheless, the unique features of HSP point towards additional possible mechanisms. CLINICAL REHABILITATION IMPACT: The use of specific therapy options for neuropathic pain should be considered when treating patients with HSP. PMID: 26761563 [PubMed - as supplied by publisher] (Source: European Journal of Physical and Rehabilitation Medicine)


Transumbilical thoracic sympathectomy: a single-centre experience of 148 cases with up to 4 years of follow-up [ORIGINAL ARTICLES]
CONCLUSIONS This preliminary human experience suggested that transumbilical thoracic sympathectomy was a safe and efficacious alternative to the conventional approach. This technique avoided the chronic pain and chest wall paraesthesia that are associated with the chest incision. In addition, this novel procedure afforded maximum cosmetic benefits. (Source: European Journal of Cardio-Thoracic Surgery)


Top San Antonio Pain Clinic, Premier Pain Consultants, Now Offering...
The top San Antonio pain management clinics, Premier Pain Consultants, is now offering first rate intrathecal pain pump management. For patients suffering from chronic, intractable pain, a pain pump...(PRWeb January 12, 2016)Read the full story at http://www.prweb.com/releases/intrathecal-pain-pump/san-antonio-texas/prweb13160614.htm (Source: PRWeb: Medical Pharmaceuticals)


Health-related quality of life among blood donors with hepatitis B and hepatitis C: longitudinal study before and after diagnosis
Conclusion: A decreased quality of life was detected before and after diagnosis in blood donors with hepatitis B and hepatitis C. Contrary to hepatitis B positive donors, the pos- sibility of medical care may have improved the quality of life among hepatitis C positive donors. (Source: Revista Brasileira de Hematologia e Hemoterapia)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Extracorporeal Shock Wave Lithotripsy for Chinese Patients With Pancreatic Stones: A Prospective Study of 214 Cases
Conclusions: Thus, ESWL is a safe and effective method to treat Chinese patients with pancreatic stones. This procedure can significantly improve the success rate of endotherapy. (Source: Pancreas)


Whether Post-Tonsillectomy Medication Should be Liquid Based or Can be Solid? A Randomised, Single-Blinded, Controlled Trial.
CONCLUSION: There was no statistical difference in the pain scores, adverse effects and complications between groups. There is no necessity to restrict patients to liquid medication. PMID: 26742388 [PubMed - in process] (Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet)


Hyperenhancement of the Pericardium on Cardiac Magnetic Resonance Imaging: A Marker of Acute Inflammation and Neovascularization or a Chronic Fibrotic State
We present a case of intense hyperenhancement and marked thickening of the pericardium in a patient with constrictive pericarditis with antecedent chest pain. Surgical resection of the pericardium and microscopy revealed a chronic fibrotic state with no evidence of inflammation or neovascularization, thus clarifying the failure of initial medical/anti-inflammatory treatment. Our case highlights the fact that hyperenhancement of the pericardium post gadolinium is non-specific for histology and does not necessarily imply the reversibility of pericardial constriction.Cardiology 2016;133:239-241 (Source: Cardiology)


This Is By Far The Best Way To Avoid Lower Back Pain
By: Cari Nierenberg Published: 01/11/2016 06:35 PM EST on LiveScience Shoe inserts, back-support belts and other gadgets aimed at preventing low back pain may be a waste of money. Instead, exercise is the best way to ward off this common problem, a new review of studies suggests. The researchers found evidence that an exercise program alone, or exercise along with education about how to prevent&#160;back pain, was effective in averting an episode of low back pain and reducing people's use of sick time at work. Education may include receiving training in proper lifting techniques, learning about correct posture or attending back school, which is a comprehensive program on back health. About 80 percent of U.S. adults will experience an episode of low back pain at some point in their lives, a...


Digital Pain Drawings: Assessing Touch-Screen Technology and 3D Body Schemas
Objectives: To assess the consistency and level of agreement between pain drawings collected on (1) paper and a personal computer tablet; and (2) between a 2-dimensional (2D) line drawing and 3-dimensional (3D) body schema. Materials and Methods: Pain-free participants (N=24) recreated a premarked “pain” area from a 2D line drawing displayed on paper onto paper or tablet, and individuals with chronic neck pain (N=29) expressed their current pain on paper and tablet. A heterogeneous group (N=26) was recruited from cross-disciplinary pain clinic and expressed their pain on a 2D line drawing and a 3D body schema, as displayed on a tablet, and then completed an user-experience questionnaire. Results: Pain drawings showed moderate to high level of consistency and a high level of agreement...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Do Pain-related Beliefs Influence Adherence to Multidisciplinary Rehabilitation?: A Systematic Review
Discussion: The findings suggest that treatment adherence is determined by a combination of pain-related beliefs either supporting or inhibiting chronic pain patients’ ability to adhere to treatment recommendations over time. In the studies reviewed, self-efficacy appears to be the most commonly researched predictor of treatment adherence, its effects also influencing other pain-related beliefs. More refined and standardized methodologies, consistent descriptions of pain-related beliefs, and methods of measurement will improve our understanding of adherence behaviors. (Source: The Clinical Journal of Pain)


Effect of Perioperative Vitamin C Supplementation on Postoperative Pain and the Incidence of Chronic Regional Pain Syndrome: A Systematic Review and Meta-Analysis
The objective was to analyze the effects of perioperative vitamin C supplementation on postoperative pain and the development of complex regional pain syndrome I (CRPS I) in patients undergoing surgical procedures. Materials and Methods: A systematic review of published literature was performed through April 2014. References from relevant studies were scanned for additional studies. Results were screened for relevance independently, and full-text studies were assessed for eligibility. Reporting quality was assessed using a modified Newcastle-Ottawa Scale. Results: The search strategy yielded 710 studies, of which 13 were included: 7 on postoperative pain and 6 on CRPS I. In the final analysis, 1 relevant study found a reduction in postoperative morphine utilization after preoperative vit...


Chronic Opioid Therapy After Lumbar Fusion Surgery for Degenerative Disk Disease in a Workers’ Compensation Patients
No abstract available (Source: The Clinical Journal of Pain)


Conditioned Pain Modulation in Patients With Acute and Chronic Low Back Pain
Discussion: The present study provides evidence for some alterations of endogenous modulation in both acute and chronic LBP. CPM was still detected in both patient groups, indicating that endogenous modulation, although effective for a shorter duration, is partially functioning in patients with LBP. (Source: The Clinical Journal of Pain)


Accuracy of Self-reported Prescribed Analgesic Medication Use: Linkage Between the Quebec Pain Registry and the Quebec Administrative Prescription Claims Databases
The objective of this study was to assess the accuracy of self-reported prescribed analgesic medication use. This was attained by comparing the data collected in the Quebec Pain Registry (QPR) database to those contained in the Quebec administrative prescription claims database (Régie de l’assurance maladie du Québec [RAMQ]). Methods: To achieve the linkage between the QPR and the RAMQ databases, the first 1285 patients who were consecutively enrolled in the QPR between October 31, 2008 and January 27, 2010 were contacted by mail and invited to participate in a study in which they had to provide their unique RAMQ health insurance number. Using RAMQ prescription claims as the reference standard, κ coefficients, sensitivity, specificity, and their respective 95% confidence intervals we...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Pain – Stories Of Struggle And Hope: Part 4 – Migraines
BOSTON (CBS) &#8211; You may be dizzy. Nauseous. Light bothers you. Noise pierces you to the core. You&#8217;re not having a headache &#8211; you&#8217;re having a migraine. Read-Listen: Chronic Pain – Stories Of Struggle And Hope: The Series “When we speak of conditions like migraine most people think of it as a headache disorder. I always think of it as a headache plus disorder,” said Dr. Elizabeth Loder, Chief of the Division of Headache and Pain in the Neurology Department at Brigham and Women&#8217;s Hospital. The Migraine Research Foundation says some 38 million Americans suffer from this syndrome. Health care and lost productivity costs are as high as $36 billion a year. “By and large it tends to be most active during the otherwise healthy productive middle years of peopl...


Pain intensity and interference with functioning and well-being in subgroups of patients with chronic pain treated with once-daily hydrocodone tablets.
CONCLUSION: Regardless of subgroup, patients with CNNP treated with HYD showed clinically meaningful improvements in pain intensity, pain interference, and physical HRQL, although not in mental HRQL or sleep quality. Improvements were generally larger for opioid-naïve patients and patients with severe baseline pain. PMID: 26728649 [PubMed - in process] (Source: Journal of Opioid Management)


Efficacy and safety of a hydrocodone extended-release tablet formulated with abuse-deterrence technology in patients with moderate-to-severe chronic low back pain.
CONCLUSIONS: Hydrocodone ER formulated with ADT was significantly more effective than placebo in alleviating chronic low back pain and demonstrated a safety profile consistent with that of opioids, with a low occurrence of study drug loss and diversion. PMID: 26728648 [PubMed - in process] (Source: Journal of Opioid Management)


Successful interventions in decreasing oxycodone CR prescriptions within an underserved population.
CONCLUSIONS: By implementing criteria for oxycodone CR prescribing in an innovative, comprehensive, and unified patient-centered practice model, the authors saw a significant decrease in the number of oxycodone CR tablets prescribed per month and also a decrease in total prescriptions per month. PMID: 26728645 [PubMed - in process] (Source: Journal of Opioid Management)


Chronic Pain – Stories Of Struggle And Hope: Part 3 – Thinking About Suicide
BOSTON (CBS) &#8211; Atara Schimmel is in the prime of her life and she almost ended it. For two years, Schimmel felt a tearing type of pain in her body. Read-Listen: Chronic Pain &#8211; Stories Of Struggle And Hope: The Series At other times, she says her body felt like it was on fire with no way to put it out. “I was suicidal because the nerve pain was so excruciating. It was terrifying, terrorizing,” she told WBZ NewsRadio 1030. Schimmel is referring to pain caused by the pudendal nerve, which runs through the pelvic region. Doctos told Schimmel the problem was all in her head. But after her suicide attempt, she was finally given a type of anti-depressant that&#8217;s used to treat pain and it&#8217;s been a life-saver. “I don’t cry every night wishing that I could just die o...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Factors Associated With the Development of Chronic Post-Sternotomy Pain: a Case-Control Study
CONCLUSION: The factors associated with chronic poststernotomy pain were: use of the internal thoracic artery; use of antidepressants; hypothyroidism; surgical wound complication, and patients on disability benefits or scheduled for a consultative examination. (Source: Revista Brasileira de Cirurgia Cardiovascular)


Sleep Deprivation and Recovery Sleep Prior to a Noxious Inflammatory Insult Influence Characteristics and Duration of Pain
Conclusion:The data suggest that acute sleep loss preceding an inflammatory insult enhances pain and can contribute to chronic pain. The results encourage studies in a model of surgical pain to test whether enhancing sleep reduces pain levels and duration.Citation:Vanini G. Sleep deprivation and recovery sleep prior to a noxious inflammatory insult influence characteristics and duration of pain. SLEEP 2016;39(1):133&#8211;142. (Source: Sleep)


Exercise Eases Low Back Pain
Title: Exercise Eases Low Back PainCategory: Health NewsCreated: 1/11/2016 12:00:00 AMLast Editorial Review: 1/12/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Headaches, bloating and fatigue? You may have Ehlers-Danlos syndrome (EDS)
For 20 years, GP Kate Barnes now 52, from Buckinghamshire, has lived with chronic headaches and pain. Two years ago she found out she has Ehlers-Danlos syndrome (EDS). (Source: the Mail online | Health)


New research shows that exercise to improve skill and coordination can help reduce lower back pain
A new Cochrane Review shows that targeting exercises to muscles that support and control the spine offers another strategy to reduce pain and disability caused by lower back pain.Lower back pain is one of the most common health conditions worldwide. It can have substantial health and economic costs as people experience disability and general ill health, leading them to need time off work.&nbsp;Motor control exercise is a popular form of exercise that aims to improve coordination of the muscles that control and support the spine. Patients are initially guided by a therapist to practice normal use of the muscles with simple tasks. As the patient's skill increases, the exercises become more complex and include the functional tasks that the person needs to perform during work and/or leisure ac...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Blockade of IL-18 signaling diminished neuropathic pain and enhanced the efficacy of morphine and buprenorphine
Publication date: Available online 5 January 2016 Source:Molecular and Cellular Neuroscience Author(s): Dominika Pilat, Anna Piotrowska, Ewelina Rojewska, Agnieszka Jurga, Joanna Ślusarczyk, Wioletta Makuch, Agnieszka Basta-Kaim, Barbara Przewlocka, Joanna Mika Currently, the low efficacy of antinociceptive drugs for the treatment of neuropathic pain is a major therapeutic problem. Here, we show the potential role of interleukin (IL)-18 signaling in this phenomenon. IL-18 is an important molecule that performs various crucial functions, including the alteration of nociceptive transmission in response to neuropathic pain. We have studied the changes in the mRNA and protein levels (qRT-PCR and Western blot analysis, respectively) of IL-18, IL-18-binding protein (IL-18BP) and the ...


The co-occurrence of chronic pain and psychological distress and its associations with salient socio-demographic characteristics among long-term social assistance recipients in Norway
Conclusions and implications Co-occurrence of chronic pain and psychological distress is common in LTRs and problems in early life are associated with the co-occurrence of chronic pain and psychological distress in adult life. Although this study cannot assign a clear direction or causality to the association between social and demographic characteristics and chronic pain and psychological distress, the findings when examining LTRs’ problems in childhood before the age of 16, indicated that incidents in early life create a probability of chronic pain and psychological distress in the adult life of the individuals. Further studies should use life course studies and longitudinal data in to investigate these important questions in LTRs. (Source: Scandinavian Journal of Pain)


Patient reported outcome measures of pain intensity: Do they tell us what we need to know?
Conclusions (1) Patients tend to report different levels of pain intensity when asked to report their pain over different periods; (2) insofar as it can be said to exist, the relationship between measures of intensity and interference with activities of daily living is minimal; (3) participants tend to report similar levels of pain intensity, irrespective of etiology. Implications (1) Chronic pain patients’ elicited beliefs and strategies concerning how they complete pain intensity questionnaires are sometimes, but not invariably, reflected in their responses to these measures. Thus, purely qualitative methodologies alone cannot provide completely reliable information and point to the need to use a “mixed methods” approach combining both qualitative and quantitative data; (2) the la...


Yokukansan, a Kampo medicine, prevents the development of morphine tolerance through the inhibition of spinal glial cell activation in rats
Conclusion These results suggest that the pre-administration of YKS attenuates the development of antinociceptive morphine tolerance, and the suppression of spinal glial cell activation may be one mechanism underlying this phenomenon. (Source: Integrative Medicine Research)


Anti-nociceptive, anti-hyperalgesic and anti-arthritic activity of amides and extract obtained from Piper amalago in rodents
Conclusion The EEPA was effective for inhibition of pain and arthritic parameters but was not effective against depressive-like behavior; additionally, it did not alter locomotor activity. The amides obtained seemed to be the active component(s) present in the EEPA because they proved to be anti-nociceptive and anti-hyperalgesic in models of acute pain. Considering that few drugs are currently available for the treatment of chronic pain, especially neuropathic pain, the present results may have clinical relevance and open new possibilities for the development of new anti-hyperalgesic and anti-arthritic agents from P. amalago. Graphical abstract (Source: Journal of Ethnopharmacology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Carbon dioxide insufflation or warm-water infusion for unsedated colonoscopy: A randomized controlled trial in patients with chronic constipation in China
Conclusions: Compared with air, the CO 2 or water-aided method reduced real-time maximum pain and cecum-intubated time for chronic constipated patients in unsedated colonoscopy. The CO 2 insufflation or warm-water irrigation may be a simple and inexpensive way to reduce discomfort in unsedated patients with constipation. This study demonstrated an advantage of using CO 2 insufflation and warm-water irrigation during colonoscopy in unsedated constipated patients in China. (Source: The Saudi Journal of Gastroenterology)


Chronic pain in hemodialysis patients: Role of bone mineral metabolism
Conclusion Chronic pain is highly experienced in long-term hemodialysis patients. Malnutrition, high CRP and disturbed bone mineral metabolism are highly correlated with the incident of this pain. (Source: Alexandria Journal of Medicine)


Catastrophizing Mediates the Relationship Between the Personal Belief in a Just World and Pain Outcomes Among Chronic Pain Support Group Attendees
Abstract Health-related research suggests the belief in a just world can act as a personal resource that protects against the adverse effects of pain and illness. However, currently, little is known about how this belief, particularly in relation to one’s own life, might influence pain. Consistent with the suggestions of previous research, the present study undertook a secondary data analysis to investigate pain catastrophizing as a mediator of the relationship between the personal just world belief and chronic pain outcomes in a sample of chronic pain support group attendees. Partially supporting the hypotheses, catastrophizing was negatively correlated with the personal just world belief and mediated the relationship between this belief and pain and disability, but not distres...


Ilioinguinal Nerve Block in Obese Patients: Description of New Technique
Publication date: Available online 30 December 2015 Source:Journal of Medical Ultrasound Author(s): Jonathan Mathers, Chris Haley, Michael Gofeld Ilioinguinal nerve blockade is an effective technique for both perioperative and chronic pain conditions in adult and pediatric practice. Ultrasound guidance can increase the success rate and reduce the complications associated with performing ilioinguinal nerve blockade. Obese patients present a particular challenge with ilioinguinal block as the overlying abdominal pannus impedes the ultrasound view by increasing the depth to target and necessitating an out-of-plane approach. We demonstrate that modification of the technique by placing the patient into the lateral decubitus position reduces the depth to target and allows an in-plane approa...


Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP research network
We describe the neuroimaging methods and procedures used to scan participants, the challenges encountered in obtaining data from multiple sites with different equipment/software, and our efforts to minimize site-to-site variation. (Source: NeuroImage: Clinical)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


An evidence-based information booklet helps reduce fear-avoidance beliefs after first-time discectomy for disc prolapse
Conclusions Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. ClinicalTrials.gov identifier NCT00761111. (Source: Annals of Physical and Rehabilitation Medicine)


Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study
Conclusion Participants who received intradiskal PRP showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over 8 weeks compared with controls. Those who received PRP maintained significant improvements in FRI scores through at least 1 year of follow-up. Although these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiskal treatment and the ideal cellular characteristics of the intradiskal PRP injectate. (Source: PMandR)


A case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with herniation of lung – A very rare entity
Publication date: Available online 11 January 2016 Source:Egyptian Journal of Chest Diseases and Tuberculosis Author(s): Arnab Sit, Surajit Chatterjee, Ira Das, Arundhati Datta, Pulak Kumar Jana, Jineesh K. Joseph, Ritam Chakraborty, Sibkinkar Lala Herein we report a case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with lung herniation in an elderly gentleman with Chronic Obstructive Pulmonary Disease (COPD). Initially he presented with severe cough followed by pain and small fluctuating swelling over the right chest wall. In-patient investigations were suggestive of hemothorax without any chest wall abnormality. Later the swelling gradually increased to a significant size for which he was further evaluated. Detailed imaging studies revealed it...


Evidence for neuropathic processes in chronic cough
Publication date: December 2015 Source:Pulmonary Pharmacology &amp; Therapeutics, Volume 35 Author(s): Akio Niimi, Kian Fan Chung Chronic cough is a very common symptom for which patients seek medical attention but can often be difficult to manage, because associated causes may remain elusive and treatment of any associated causes does not always provide adequate relief. Current antitussives have limited efficacy and undesirable side-effects. Patients with chronic cough typically describe sensory symptoms suggestive of upper airway and laryngeal neural dysfunction. They often report cough triggered by low-level physical and chemical stimuli supporting the recently emerging concept of ‘cough hypersensitivity syndrome’. Chronic cough is a neuropathic condition that could be secon...


Reappraisal of epileptic pain as a rare symptom of seizures.
CONCLUSION: Epileptic pain is a neglected, but important, semiologic symptom with localization and lateralization value in the patients with somatosensorial seizures of parietal as well as temporal lobe origin. It occurs mainly as peripherally localized, cephalic, or abdominal pain and is usually associated with a symptomatic etiology. Awareness of epileptic pain is important to avoid misdiagnosis and delayed treatment. PMID: 26773678 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Downregulation of microRNA-218 relieves neuropathic pain by regulating suppressor of cytokine signaling 3.
Authors: Li L, Zhao G Abstract Neuropathic pain is an incapacitating disease that affects a large number of people worldwide, but effective therapies have not yet been established. microRNAs (miRs) are short non-coding RNAs that participate in several biological processes and states, including neuropathic pain. Nevertheless, the precise role of miRs in regulating neuropathic pain remains largely unknown. In the present study, we investigated the role of miR-218 in neuropathic pain using a rat model of chronic constriction injury (CCI). miR-218 expression was induced and studied in the spinal cord and microglial cells of rats with CCI. We noted that downregulation of miR-218 by a specific miR-218 inhibitor significantly attenuated mechanical allodynia, thermal hyperalgesia, and pr...


Life With Crohn's Disease
Back in my 20s I remember going on a double date with one of my besties. After weeks of planning and almost an hour of waiting in line for movie tickets (this was obviously pre-Fandango), my friend spent most of the date running back-and-forth to the ladies' room, creating a most awkward situation. Though at the time we laughed about it, the episodes continued. Years later she would discover a diagnosis that proved these episodes were no laughing matter. Recently I learned about actor Benjamin King's journey and how it was so similar to my friend's struggles. When Benjamin signed up to play "Dad" on the Disney Channel show "Liv and Maddie," he says understood that his character would most certainly find himself in a multitude of silly, if not awkward and humiliating, scenarios (see episo...


Chronic Pain – Stories Of Struggle And Hope: Part 2 – Back Pain
BOSTON (CBS) &#8211; Back pain is number one when it comes to ranking chronic pain here in the United States. Read-Listen: Chronic Pain &#8211; Stories Of Struggle And Hope: The Series So what causes it? “Spondylolisthesis and spondylosis and radiculopathy. There are a lot of names that are thrown at people in terms of rationale of why they have back pain,” Dr. Dana Zalkind at New England Baptist’s Pain Management Center, told WBZ NewsRadio 1030. Words you hardly ever hear, but Dr. Zalkind says there are causes we all can relate to. But for those who have suffered chronic back pain for years, like Allen, the struggle is relentless. “When the pain is with me it’s impossible. When the pain leaves it’s amazing how resilient people are&#8211; you bounce back pretty quickly. The ...


Knee Pain 101
CNN interviews an orthopedic surgeon at Emory: Mild injury as a child leads to chronic changes as we get older: Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images)


Chronic Pain – Stories Of Struggle And Hope: Part 1 – You’re Not Alone
BOSTON (CBS) &#8211; Millions of people feel they&#8217;re living life in the shadows in their struggle with chronic pain. “There was a gut deep pain that I felt immediately.” “I didn’t belong anywhere anymore. I had no place to go and no way to get there.” “I had no clue that it would become something so disabling and so terrible.” “I was already suicidal because the nerve pain was so excruciating. It was terrifying, terrorizing.&#8221; These are all reactions from people who suffer from chronic pain. It affects more people than cancer, diabetes and heart disease combined. “The figure that many organizations quote now as for the number of Americans who live with chronic pain is about 100 million, if not somewhat more,” Dr. Daniel Carr, the Founding Director of Tufts&...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Successful therapy for protein-losing enteropathy caused by chronic neuronopathic Gaucher disease
We report a male with Chronic Neuronopathic Gaucher disease (GD) (homozygous for c.1448T&gt;C (NM_000157.3) GBA mutation) who at 16years of age developed intractable abdominal pain, diarrhea and weight loss. This was caused by PLE secondary to intestinal lymphangiectasia caused by calcified mesenteric lymphadenopathy despite prior long term enzyme replacement therapy (ERT) and/or substrate reduction therapy (SRT). His older similarly affected sister who had been receiving treatment with ERT and/or SRT remains stable on these treatments with no evidence of mesenteric lymphadenopathy. Medical management with total parenteral nutrition, daily medium chain triglyceride-oil (MCT) supplementation, low dose oral budesonide, continued oral SRT and an increased dose of parenteral ERT has stabil...


Developments in Varicella Zoster Virus Vasculopathy
Abstract Varicella zoster virus (VZV) is a highly neurotropic human herpesvirus. Primary infection usually causes varicella (chicken pox), after which virus becomes latent in ganglionic neurons along the entire neuraxis. VZV reactivation results in zoster (shingles) which is frequently complicated by chronic pain (postherpetic neuralgia). VZV reactivation also causes meningoencephalitis, myelitis, ocular disorders, and vasculopathy, all of which can occur in the absence of rash. This review focuses on the association of VZV and stroke, and on the widening spectrum of disorders produced by VZV vasculopathy in immunocompetent and immunocompromised individuals, including recipients of varicella vaccine. Aside from ischemic stroke, VZV infection of cerebral arteries may lead to devel...


A diagnostic dilemma: chronic sinusitis diagnosed by non‐otolaryngologists
ConclusionMost patients diagnosed with chronic sinusitis by non‐otolaryngologists do not have the condition. Caution should be used in studying chronic sinusitis using administrative data from non‐otolaryngology providers because a large proportion of the patients may not actually have the disease. (Source: International Forum of Allergy and Rhinology)


Randomized, controlled blind study comparing sacroiliac intra-articular steroid injection to radiofrequency denervation for sacroiliac joint pain
Conclusions Radiofrequency ablation at L4 and L5 primary dorsal rami and S1–3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results, and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder. (Source: Egyptian Journal of Anaesthesia)


Social isolation in women with endometriosis and chronic pelvic pain
Conclusion Women with endometriosis develop progressive social isolation after the onset of chronic pelvic pain. This finding is important for the multidisciplinary management of the disease. (Source: International Journal of Gynecology and Obstetrics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Primary shame, mortal wound and tragic circularity: Some new reflections on shame and shame conflicts
Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built‐in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes t...


Light therapy modulates serotonin levels and blood flow in women with headache. A preliminary study
In this study, we looked at the possible effects of low-level laser therapy (LLLT) on blood flow velocity, and serotonin (5-HT) and cholinesterase levels in patients with chronic headache associated with temporomandibular disorders (TMD). LLLT has been clinically applied over the past years with positive results in analgesia and without the report of any side effects. The understanding of biological mechanisms of action may improve clinical results and facilitate its indication. Ten patients presenting headache associated with TMD completed the study. An 830-nm infrared diode laser with power of 100 mW, exposure time of 34 s, and energy of 3.4 J was applied on the tender points of masseter and temporal muscle. Blood flow velocity was determined via ultrasound Doppler velocimetry before and...


Exercise and Cognitive Functioning in People With Chronic Whiplash-Associated Disorders: A Controlled Laboratory Study.
Conclusions In the short-term, post-exercise cognitive functioning, pain and fatigue were not aggravated in people with chronic WAD. However, RCTs are required to study the longer-term and isolated effects of exercise on cognitive functioning. Level of Evidence Therapy, level 3b. J Orthop Sports Phys Ther, Epub 11 Jan 2016. doi:10.2519/jospt.2016.6060. PMID: 26755408 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Patient expectations for a multimodal pain rehabilitation programme: active participation and coping skills. A qualitative study.
CONCLUSIONS: Many patients expressed expectations which may reflect that the information before the programme had started rehabilitation process at the time point for this study. The results could be applied in rehabilitation programmes by acknowledging expectations to interact with professional team members and fellow patients, by early addressing of positive and negative expectations about the future pain and by incorporating and strengthen expectations of learning to cope with pain. Implications for Rehabilitation Patients' expectations to interact with professional team members and fellow patients by participating actively in the pain rehabilitation programme should be acknowledged in each rehabilitation situation. Patients expressed both positive and negative expectations about their ...


Conservative treatment of idiopathic mesenteric phlebosclerosis
We report on a 59-year-old man with periumbilical abdominal pain for 1 week. The pain was dull and persistent. A physical examination revealed a soft, tender abdomen with normoactive bowel sounds and mild rebounding tenderness in the right upper abdomen. The abdominal plain X-ray and abdominal computed-tomography findings were compatible with idiopathic mesenteric phlebosclerosis. The symptoms resolved after only conservative treatment, and the disease did not recur during 5 years of follow-up. Idiopathic mesenteric phlebosclerosis is a rare disease, and its pathogenesis is not yet clearly understood; however, it differs from other rare causes of nonthrombotic mesenteric venous occlusion. Idiopathic mesenteric phlebosclerosis can be diagnosed on the basis of imaging findings, and most sy...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


FMRI of spinal and supra‐spinal correlates of temporal pain summation in fibromyalgia patients
In conclusion, the spinal and brainstem BOLD responses to TSSP are different between NC and FM patients, which may indicate alterations to descending pain control mechanisms suggesting contributions of these mechanisms to central sensitization and pain of FM patients. Hum Brain Mapp, 2016. © 2016 Wiley Periodicals, Inc. (Source: Human Brain Mapping)


Dry Eye & Chronic Pain Syndrome Link
Physician-researchers with Bascom Palmer Eye Institute, part of UHealth - the University of Miami Health System, have found a link between "dry eye" and chronic pain syndromes - a finding that suggests that a new paradigm is needed for diagnosis and treatment to improve patient outcomes. (Source: Disabled World)


Adhesive capsulitis: An age related symptom of metabolic syndrome and chronic low-grade inflammation?
Adhesive capsulitis (AC) is very poorly understood, particularly it’s underlying etiology. Obesity and metabolic syndrome, which are strongly associated with chronic low grade inflammation, are becoming increasingly understood to underlie a raft of morbid states including upper limb pain syndromes, diabetes (DM), cardiovascular disease (CVD), cancer and central nervous system dysfunction and degeneration. Notwithstanding age, two of the strongest established risk factors for AC are DM and CVD. The hypothesis argues that similar to DM & CVD, the inflammation and capsular fibrosis seen in AC is precipitated by metabolic syndrome and chronic low grade inflammation. (Source: Medical Hypotheses)


Postoperative pain control with paravertebral catheters after pediatric total pancreatectomy and islet autotransplantation: a retrospective cohort study.
CONCLUSIONS: Bilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT. PMID: 26749428 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)


Postoperative pain control with paravertebral catheters after pediatric total pancreatectomy and islet autotransplantation: a retrospective cohort study
ConclusionsBilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT. (Source: Pediatric 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>


Pathophysiology of Pruritus in Primary Localised Cutaneous Amyloidosis.
CONCLUSION: Small fibre neuropathy is present in PLCA. Pruritus in PLCA is likely associated with hypersensitivity of cutaneous nerve fibres, which may be related to an increased expression of epidermal IL-31 receptors. Targeting IL-31 receptors is therefore a potential therapeutic approach. This article is protected by copyright. All rights reserved. PMID: 26748444 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)


Pathophysiology of Pruritus in Primary Localised Cutaneous Amyloidosis
ConclusionSmall fibre neuropathy is present in PLCA. Pruritus in PLCA is likely associated with hypersensitivity of cutaneous nerve fibres, which may be related to an increased expression of epidermal IL‐31 receptors. Targeting IL‐31 receptors is therefore a potential therapeutic approach.This article is protected by copyright. All rights reserved. (Source: British Journal of Dermatology)


Patient‐Centered Dialysis Care: Depression, Pain, and Quality of Life
Abstract Remarkable advancements have been made in the provision of chronic dialysis therapy since its inception decades ago. A series of studies inform current dialysis dosing recommendations, while advancements in strategies to treat mineral and bone disease, acid‐base and electrolyte disturbances, and anemia have facilitated the management of these well‐recognized complications of ESRD. The collective result has been a model of chronic dialysis care focused principally on the achievement of metabolic and dialysis‐related targets. In fact, guidelines such as the Kidney Disease Outcomes Quality Initiative put forth by the National Kidney Foundation recommend metrics that characterize successful dialysis care, including the attainment of specific solute clearance targets; maintenance...


Transient receptor potential ankyrin 1 (TRPA1) receptor is involved in chronic arthritis: in vivo study using TRPA1-deficient mice
Conclusions: TRPA1 has an important role in chronic arthritis/osteoarthritis and related pain behaviours in the mouse. Therefore, it might be a promising target for novel analgesic/anti-inflammatory drugs. (Source: Arthritis Research and Therapy)


‘Can we predict those with OA who worsen following a chronic disease management program?'
Conclusion: Participants reporting worsening on the transition scale did not consistently meet the WOMACG definition of worsening symptoms. TJA waitlist status was predictive of the Composite definition of worsening, a trend apparent for the Transition definition. However, variables that predict worsening remain largely unknown, further research is required to direct comprehensive and targeted management of patients with hip and knee OA. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Infectious spondylitis in a patient with chronic kidney disease: identification of Campylobacter fetus subsp. testudinum with 16S ribosomal RNA sequencing.
We report the first case in which spondylitis with bacteremia caused by Campylobacter fetus subsp. testudinum, which was identified by 16S ribosomal ribonucleic acid (rRNA) gene sequencing. An 81 year-old man presented with fever and general weakness. His medical history included end-stage renal disease, hypertension, and type 2 diabetes. Despite empirical antibiotic treatment, fever and back pain persisted. Magnetic resonance imaging with gadolinium enhancement showed a low-signal-intensity lesion in T1-weighted imaging and a high-signal-intensity lesion in T2-weighted imaging at the L3 vertebra body. Campylobacter fetus grew on one pair of blood cultures. C. fetus subsp. testudinum was identified via 16S rRNA sequencing of the cultivated organisms. The patient recovered uneventfully afte...


Effects of intraarticular [32]P colloid in the treatment of hemophilic synovitis of the knee: A short term clinical study
Conclusion: The frequency of joint hemorrhage in patients with hemophilic knee synovitis can be significantly reduced and local symptoms can be improved in the short term by intraarticular injection of [32]P colloid. (Source: Indian Journal of Orthopaedics)


Results of cement augmentation and curettage in aneurysmal bone cyst of spine
Saumyajit Basu, Dharmesh R Patel, Gaurav Dhakal, T SarangiIndian Journal of Orthopaedics 2016 50(1):99-102Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, o...


Efficacy of a workplace relaxation exercise program on muscle tenderness in a working community with headache and neck pain: a longitudinal, controlled study.
CONCLUSIONS: The administration of a workplace relaxation exercise intervention significantly decreased pericranial/cervical muscle tenderness in the working community, in association with head-neck pain benefit. CLINICAL REHABILITATION IMPACT: This relaxation exercise programme was remarkably cost- effective, yielding a relevant benefit on pericranial/cervical muscle tenderness in a working community, at a relatively low cost. PMID: 26745361 [PubMed - as supplied by publisher] (Source: European Journal of Physical and Rehabilitation Medicine)


Patient-Centered Dialysis Care: Depression, Pain, and Quality of Life.
Authors: Weisbord SD Abstract Remarkable advancements have been made in the provision of chronic dialysis therapy since its inception decades ago. A series of studies inform current dialysis dosing recommendations, while advancements in strategies to treat mineral and bone disease, acid-base and electrolyte disturbances, and anemia have facilitated the management of these well-recognized complications of ESRD. The collective result has been a model of chronic dialysis care focused principally on the achievement of metabolic and dialysis-related targets. In fact, guidelines such as the Kidney Disease Outcomes Quality Initiative put forth by the National Kidney Foundation recommend metrics that characterize successful dialysis care, including the attainment of specific solute clearan...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Psychometric Properties of a Brief Instrument to Assess Perceptions of Injustice Associated with Debilitating Health and Mental Health Conditions
Abstract The present study examined the psychometric properties of a shortened and simplified version of the Injustice Experience Questionnaire (IEQ). The instructional set of the original IEQ was modified to make it better suited to the context of debilitating health and mental health conditions that do not necessarily arise as a result of injury. The number of items was reduced from 12 to 5, and the response scale was simplified. The Injustice Experiences Questionnaire – Short Form (IEQ-SF) was administered to individuals diagnosed with a chronic musculoskeletal (MSK) condition (N = 88) or major depressive disorder (MDD) (N = 87). The internal consistency of the IEQ-SF was acceptable. The IEQ-SF was significantly correlated with measures of pain severity, depressive sy...


Motor control exercise for chronic non-specific low-back pain.
CONCLUSIONS: There is very low to moderate quality evidence that MCE has a clinically important effect compared with a minimal intervention for chronic low back pain. There is very low to low quality evidence that MCE has a clinically important effect compared with exercise plus EPA. There is moderate to high quality evidence that MCE provides similar outcomes to manual therapies and low to moderate quality evidence that it provides similar outcomes to other forms of exercises. Given the evidence that MCE is not superior to other forms of exercise, the choice of exercise for chronic LBP should probably depend on patient or therapist preferences, therapist training, costs and safety. PMID: 26742533 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Unilateral giant hypertrophy of the lamina and spinous process of c5 vertebra presenting with chronic cervical pain
A 26-year-old man presented with complaint of cervical pain. His medical history was unremarkable. There was no history of trauma. Physical examination revealed a hard, immobile, palpable mass in the posterior cervical region, which was more prominent after flexion. Plain radiographs of the cervical spine showed overgrowth and elongation of the spinous process of C5 vertebra. Computed tomography scan showed left unilateral marked hypertrophy of the lamina and spinous process of C5 vertebra, with associated schisis of the spinous process at the same level (Fig. (Source: The Spine Journal)


Acute renal infarction: a single center experience.
CONCLUSION: Risk factors associated with the development of chronic kidney disease following renal infarction are unknown. In our subjects, renal function remained stable in all but one patient who developed end stage renal disease. Further studies should focus on etiology and evolution of kidney function in patients with acute renal infarction. PMID: 26743079 [PubMed - as supplied by publisher] (Source: Journal of Nephrology)


The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta‐analysis
ConclusionsAcupuncture has promising efficacy for patients with CP/CPPS. Compared to standard medical treatment, it has better efficacy. Thus, it may also serve as a standard treatment option when available. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc. (Source: Neurourology and Urodynamics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study
Summary Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty‐two female computer workers who were divided into two groups: (i) those with self‐reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self‐reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD,...


Systemic inflammation gone awry: PASH syndrome and TMJ ankylosis
The development of new symptoms in a patient with hidradenitis suppurative led to the recognition of a systemic autoinflammatory condition. A long battle with hidradenitis suppurativa and acne became even more difficult for a 24-year-old man who developed increasing pain and malodorous drainage from the chronic subcutaneous nodules on his axillae, groin, and buttocks as well as new rapidly progressive ulcers on his legs. He had first been diagnosed with hidradenitis suppurativa at age 13. His skin lesions had been managed with hygiene, wound care, and topical and oral antibiotics. (Source: The American Journal of Medicine)


Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study)
This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique. Methods and analysis We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption). The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18&nbsp;years, suffering from inguinal pain for at least 3&nbsp;months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by ...


Modeling leukocyte trafficking at the human blood-nerve barrier in vitro and in vivo geared towards targeted molecular therapies for peripheral neuroinflammation
Peripheral neuroinflammation is characterized by hematogenous mononuclear leukocyte infiltration into peripheral nerves. Despite significant clinical knowledge, advancements in molecular biology and progress in developing specific drugs for inflammatory disorders such as rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis, there are currently no specific therapies that modulate pathogenic peripheral nerve inflammation. Modeling leukocyte trafficking at the blood-nerve barrier using a reliable human in vitro model and potential intravital microscopy techniques in representative animal models guided by human observational data should facilitate the targeted modulation of the complex inflammatory cascade needed to develop safe and efficacious therapeutics for immune-media...


Flexion-relaxation ratio in computer workers with and without chronic neck pain
This study evaluated the flexion-relaxation phenomenon (FRP) and flexion-relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20-45 years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4 h/day for other purposes (CG). (Source: Journal of Electromyography and Kinesiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Social isolation in women with endometriosis and chronic pelvic pain
To evaluate the perceptions of women with endometriosis and chronic pelvic pain regarding their social ties. (Source: International Journal of Gynaecology and Obstetrics)


ScaphoLunate Axis Method
Conclusion While chronic scapholunate ligament instability remains an unsolved problem facing wrist surgeons, newer techniques are directed toward restoring the normal relationships of the scaphoid and lunate in both the coronal and sagittal planes. The SLAM technique has demonstrated promise in preliminary clinical studies.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Journal of Wrist Surgery)


The Emerging Role of Spinal Dynorphin in Chronic Pain: A Therapeutic Perspective.
Authors: Podvin S, Yaksh T, Hook V Abstract Notable findings point to the significance of the dynorphin peptide neurotransmitter in chronic pain. Spinal dynorphin neuropeptide levels are elevated during development of chronic pain and sustained during persistent chronic pain. Importantly, knockout of the dynorphin gene prevents development of chronic pain in mice, but acute nociception is unaffected. Intrathecal (IT) administration of opioid and nonopioid dynorphin peptides initiates allodynia through a nonopioid receptor mechanism; furthermore, antidynorphin antibodies administered by the IT route attenuate chronic pain. Thus, this review presents the compelling evidence in the field that supports the role of dynorphin in facilitating the development of a persistent pain state. Th...


Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg
Conclusions: Changes in muscle oxygen saturation during and after an exercise test that elicits leg pain cannot be used to distinguish between patients with CACS and patients with other causes of exercise-induced leg pain. Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: The Journal of Bone and Joint Surgery)


Melatonin relieves neuropathic allodynia through spinal MT2‐enhanced PP2Ac and downstream HDAC4 shuttling‐dependent epigenetic modification of hmgb1 transcription
This article is protected by copyright. All rights reserved. (Source: Journal of Pineal 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>


Risk Assessment for Chronic Pain and Patient Satisfaction After Total Knee Arthroplasty.
Authors: Sakellariou VI, Poultsides LA, Ma Y, Bae J, Liu S, Sculco TP Abstract The estimated prevalence of patients who report minor or no improvement of their symptoms and pain after total knee arthroplasty (TKA) remains high, ranging from 5% to 40%. The authors sought to determine whether chronic pain and functional health are related to specific variations in demographic data, surgical techniques, or radiographic pre- and postoperative findings. They also sought to identify independent risk factors for persistent moderate-to-severe chronic pain after TKA. A total of 273 patients who underwent primary TKA from October 2007 to March 2010 with a minimum follow-up of 1 year were identified from electronic medical records. A questionnaire to identify persistent postoperative pain (36...


Surgery remains the best option for the management of pain in patients with chronic pancreatitis: A systematic review and meta-analysis.
Authors: Jawad ZA, Kyriakides C, Pai M, Wadsworth C, Westaby D, Vlavianos P, Jiao LR Abstract Controversy related to endoscopic or surgical management of pain in patients with chronic pancreatitis remains. Despite improvement in endoscopic treatments, surgery remains the best option for pain management in these patients. PMID: 26778832 [PubMed - as supplied by publisher] (Source: Asian Journal of Surgery)


Flexion–relaxation ratio in computer workers with and without chronic neck pain
This study evaluated the flexion–relaxation phenomenon (FRP) and flexion–relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20–45years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4h/day for other purposes (CG). (Source: Journal of Electromyography and Kinesiology)


Systemic Inflammation Gone Awry: PASH Syndrome and Temporomandibular Joint Ankylosis
The development of new symptoms in a patient with hidradenitis suppurativa led to the recognition of a systemic autoinflammatory condition. A long battle with hidradenitis suppurativa and acne became even more difficult for a 24-year-old man who developed increasing pain and malodorous drainage from the chronic subcutaneous nodules on his axillae, groin, and buttocks, as well as new rapidly progressive ulcers on his legs. He had first been diagnosed with hidradenitis suppurativa at age 13 years. (Source: The American Journal of Medicine)


Inflammation and Symptom Change in Interstitial Cystitis/Bladder Pain Syndrome: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study
To explore inflammatory factors that influence symptom changes in interstitial cystitis/bladder pain syndrome (IC/BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-Like Receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC/BPS and symptom flares over a 48 week period. (Source: Urology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


61-Year-Old Man With Chronic Diarrhea
A 61-year-old man presented with an 18-month history of progressively worsening diarrhea with multiple nonbloody stools of varying volume per day. His medical history included atrial fibrillation with onset at age 40 years, hypothyroidism, hyperlipidemia, and bilateral surgical release for carpal tunnel syndrome. He reported a 14-kg weight loss since the onset of diarrhea, which included intermittent nocturnal stools and occasional urge fecal incontinence. He had no abdominal or anorectal pain, abdominal bloating, nausea, vomiting, fever, chills, or night sweats. (Source: Mayo Clinic Proceedings)


Self‐management abilities and quality of life among frail community‐dwelling individuals: the role of community nurses in the Netherlands
The objective of the study was to determine whether community nurses in the Netherlands improve self‐management abilities and quality of life of frail community‐dwelling people. This longitudinal study was performed in the context of a larger evaluation study of the ‘Zichtbare Schakels’(Visible Link) programme, conducted to determine the quality of care provided by community nurses to community‐dwelling frail people in Rotterdam, the Netherlands. For the current study, clients seen by community workers in Rotterdam between July 2013 and November 2014 participated. Data were gathered via personal interviews by the community nurses as part of care delivery at the start (T0; n = 220) and end of care delivery (T1; n = 111 – the remaining 109 clients were still receiving care) t...


Myocarditis with chest pain, normal heart function and extreme increased troponin
Myocarditis is an inflammatory disease of the myocardium. Patients with myocarditis may present with acute coronary syndrome (ACS)-like symptoms, new-onset heart failure, life threatening arrhythmias and chronic heart failure [1,2]. Myocarditis may lead to sudden cardiac death or dilated cardiomyopathy. Endomyocardial biopsy is currently the gold standard for diagnosis of myocarditis. Cardiac magnetic resonance (CMR) imaging is a non-invasive and valuable clinical tool for diagnosing myocarditis. (Source: International Journal of Cardiology)


Antidepressant Drugs for Postsurgical Pain: Current Status and Future Directions
Abstract Current treatments for postsurgical pain are often inadequate and adverse effects are substantial such that residual pain and/or side effects impair recovery. The recognition of analgesic efficacy with antidepressant drugs for chronic pain suggests the potential for efficacy in acute postsurgical pain. As reviewed here, current evidence suggests that approximately half of previous trials suggest efficacy of various antidepressants for acute postoperative pain. However, most trials are older with deficiencies including: lack of designation of a primary outcome, no assessment of movement-evoked pain, small size and limited safety assessment. Only one of three trials addressing prevention of chronic postsurgical pain suggested any efficacy; however, the evidence base for thi...


Spinal cord oligodendrocyte-derived alarmin IL-33 mediates neuropathic pain [Research Communication]
Neuropathic pain from injury to the peripheral and CNS represents a major health care issue. We have investigated the role of IL-33/IL-33 receptor (ST2) signaling in experimental models of neuropathic pain in mice. Chronic constriction injury (CCI) of the sciatic nerve induced IL-33 production in the spinal cord. IL-33/citrine reporter mice revealed that oligodendrocytes are the main cells expressing IL-33 within the spinal cord together with a minor expression by neurons, microglia. and astrocytes. CCI-induced mechanical hyperalgesia was reduced in IL-33R (ST2)&ndash;/ &ndash; mice compared with wild-type (WT) mice. Intrathecal treatment of WT mice with soluble IL-33 receptor (IL-33 decoy receptor) markedly reduced CCI-induced hyperalgesia. Consistent with these observations, intrathecal ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Validity and everyday clinical applicability of lumbar muscle fatigue assessment methods in patients with chronic non-specific low back pain: a systematic review.
CONCLUSIONS: Future research should address the identification of an advanced method for lower back fatigue assessment in patients with CNSLBP which, eventually, might provide physical therapists with an objective and reliable test usable in everyday clinical practise. Implications for Rehabilitation Despite its limitations, the Biering-Sorensen test is currently the most used, convenient and easily available fatiguing test for lumbar muscles. To increase validity and reliability of the Biering-Sorensen test, concomitant activation of synergistic muscles should be taken into account. Pooled mean frequency and half-width of the spectrum are currently the most valid electromyographic parameters to assess fatigue in chronic non-specific low back pain. Body mass index, grading of pain and leve...


The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain - a literature review.
Conclusions The meaning of the concept of gender in multimodal rehabilitation is undefined and needs to be developed further. The way the concept is used should be defined in the design and evaluation of multimodal rehabilitation in future studies. Implications for rehabilitation Healthcare professionals should reflect on gender relations in encounters with patients, selection of patients into rehabilitation programs and design of programs. In rehabilitation for chronic pain the patients' social circumstances and cultural context should be given the same consideration as biological sex and pain symptoms. PMID: 26730507 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)


Healthcare professional experiences with patients who participate in multimodal pain rehabilitation in primary care - a qualitative study.
CONCLUSIONS: Healthcare professionals perceive MMR as a helpful method for treating chronic pain patients. At the same time, they thought that only including patients who would return to work conflicted with their ethical views on equal healthcare for all patients. Preconceptions can influence selection for, and work with, MMR. Implications for rehabilitation Multimodal pain rehabilitation in primary healthcare is challenging because of the complexity of the patients. Healthcare professionals must deal with conflicting emotions in regard to different commitments from healthcare legislation and the goals of multimodal rehabilitation. Healthcare professionals should be aware that stereotypes regarding gender and immigrants can lead to bias when selecting patients for multimodal rehabilitatio...


[Adherence to a stability exercise program in patients with chronic low back pain].
CONCLUSIONS: At the end of the study all patients had a significant improvement in pain and function. Depressed patients showed higher scores on scales of pain and disability at the beginning and end of the study. However, neither depression, anxiety, nor fear of running activity were predictors of non-adherence to the therapy. PMID: 26769530 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Insider’s guide to care: Doctors and dogs
Olivia and Dayton Olivia Burgess knows every nook and cranny of Boston Children’s Hospital. The 13-year-old and her parents have traveled from their home in Bermuda to Boston since Olivia was three years old for ongoing treatments for systemic onset juvenile rheumatoid (idiopathic) arthritis and pediatric lupus. “The unpredictable and severe nature of Olivia’s condition and the frequent travel required for medical treatment can be stressful at times,” says her mother Traci. Olivia sees providers in multiple departments: cardiology, nephrology, pulmonology, dermatology, neurology, gastroenterology and orthopedic surgery. Drs. Fatma Dedeoglu and Marybeth Son, both in the Boston Children’s Rheumatology Program, are Olivia’s primary providers and serve as home base for her frequent...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 orchialgia: Review of treatments old and new
Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options. (Source: Indian Journal of Urology)


Male chronic pelvic pain: An update
Conclusions: Although no gold-standard treatment exists, a multidisciplinary approach with multimodal therapy gives the UCPPS patient the best chance of symptom relief. (Source: Indian Journal of Urology)


Satisfaction with life in adults with Marfan syndrome (MFS): associations with health-related consequences of MFS, pain, fatigue, and demographic factors
Conclusions The results reflect that MFS influences people’s SWL and that particularly severe fatigue, aortic dissection, and psychological aspects are associated with lower SWL. This is important to take into account in the clinical work with people with MFS. Further investigation is needed, especially on larger sample groups. Studies with combination of qualitative and quantitative approaches are recommended to obtain more comprehensive and accurate knowledge about the consequences of MFS on satisfaction with life. (Source: Quality of Life Research)


The known knowns and known unknowns of chronic pain.
Authors: Peng P PMID: 26728141 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)


[Cerebral metabolic changes and chronic back pain : Study taking into consideration clinical and psychological parameters].
CONCLUSIONS: Despite the uniform diagnosis of nonspecific chronic back pain, we observed a strong variance of neurotransmitters in cerebral pain processing regions. It is necessary to include psychological as well as clinical parameters (e.g., intensity of pain or depression) for a proper interpretation of neurotransmitter turnovers. PMID: 26728488 [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>


The known knowns and known unknowns of chronic pain
(Source: Canadian Journal of Anesthesia)


Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity
Conclusions & InferencesThis experimental study suggests that this noninvasive approach with combined electrical and physiological modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. These findings warrant further investigation in patients with disorders characterized with chronic pain and gastrointestinal dysmotility such as functional dyspepsia and irritable bowel syndrome. The aim was to explore the effect of combined electrical and physiological modulation of vagal tone on musculoskeletal pain thresholds and gastroduodenal motility. Cardiac vagal tone, thresholds to bone pain, frequency of antral contractions, and gastroduodenal motility index all increased during active treatment compared to sham. (Source: Neurogastroenterology and Moti...


iLift: a health behavior change support system for lifting and transfer techniques to prevent lower-back injuries in healthcare.
The Dutch National Compass for Public Health shows data from several studies [1–3]. This points toward lower back problems having a significant impact on insurance funds, and with all likelihood, will continue to do so in the near future. An estimated rate of 40% of reported sick leave is due to lower back problems, and about 2.4 million adults [4] in the Netherlands suffer from chronic lower back pain. This is defined by an employee's absence from work extending for more than 3 months. Between 2000 and 2020, with population growth and ageing this will increase the percentage of people suffering from neck and back problems by 14% [4]. (Source: International Journal of Medical Informatics)


Update on the Pharmacological Treatment of Chronic Migraine
Abstract Chronic migraine (CM) is a common and disabling disorder that remains underdiagnosed and poorly treated. Significant unmet therapeutic needs add to the burden of this disorder; even when CM is recognized, effective treatment options are limited and randomized controlled trials supporting the use of various preventive medications are sparse. In this review, we discuss the available options for CM treatment. Currently the only FDA-approved treatment for CM prevention is onabotulinumtoxinA. Two double-blind studies have demonstrated the efficacy of topiramate for CM prevention, but it is not FDA-approved for this indication. Treatments in development for migraine will also be reviewed. Advancements in the understanding of migraine pathogenesis have identified new targets fo...


Echinocystic acid reduces reserpine-induced pain/depression dyad in mice
Abstract Chronic pain has consistently been correlated with depression. Echinocystic acid (EA), a natural triterpone enriched in various herbs and used for medicinal purpose in many Asian countries, exhibits anti-inflammatory and analgesic activities. However, little is known the effects of EA on the depression. In present study, we investigated the anti-depression activities in the mouse model of reserpine-induced pain-depression dyad. Reserpine (1 mg/kg subcutaneously daily for 3 days) caused significant depression-like behaviors and pain sensation. Subsequent treatment of EA (5 mg/kg intragastrically daily for 5 days) attenuated the reserpine-induced pain/depression dyad as shown by the increase of pain threshold and the behaviors in forced swimming test, tail suspension te...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Noninvasive Tests for Inflammatory Bowel Disease: A Meta-analysis
CONCLUSIONS: In children whose pediatrician is considering an endoscopy, symptoms are not accurate enough to identify low-risk patients in whom an endoscopy can be avoided. FCal, CRP, and albumin findings are potentially of clinical value, given their ability to select children at low risk (negative FCal test result) or high risk (positive CRP or albumin test result) for IBD. (Source: PEDIATRICS)


A qualitative investigation of factors that matter to individuals in the pain management process.
CONCLUSIONS: This study highlighted important factors for healthcare professionals and patients in the management of chronic pain. Participants indicated a desire to understand their condition and learn strategies for self-management to allow them to cope better. As patients found benefit from being involved in the management process, discussions around the options for treatment may enhance management and rehabilitation. It is important we continue to research factors important to individuals with musculoskeletal pain to find an effective, evidence-based framework for understanding and managing this condition. Implications for rehabilitation This study highlights the importance to patients of being given information to help them understand their pain condition and to learn strategies for s...


Similar barriers and facilitators to physical activity across different clinical groups experiencing lower limb spasticity.
Conclusions In this population, participation in physical activity includes activities such as housework which are different than what is typically considered as physical activity. Further, the presence of similar barriers and facilitators across the groups suggests that support and services to promote valued forms of physical activity could be organised and delivered based on limitations in mobility and functioning rather than clinical diagnosis. Implications for rehabilitation Physical activity is of utmost importance in maintaining health and wellness in clinical populations. This research highlights the desired and actual physical activity for these populations can look different than what may traditionally be considered as physical activity (e.g. housework is not typically considered ...


Lessons learned — resolving the enigma of genetic factors in IBS
Nature Reviews Gastroenterology & Hepatology 13, 77 (2016). doi:10.1038/nrgastro.2015.206 Authors: Maria Gazouli, Mira M. Wouters, Lejla Kapur-Pojski&#263;, May-Bente Bengtson, Eitan Friedman, Gordana Nik&#269;evi&#263;, Christiana A. Demetriou, Agata Mulak, Javier Santos & Beate Niesler IBS is the most prevalent functional gastrointestinal disorder and phenotypically characterized by chronic abdominal discomfort, pain and altered defecation patterns. The pathophysiology of IBS is multifactorial, albeit with a substantial genetic component. To date, studies using various methodologies, ranging from family and twin studies to (Source: Nature Reviews Gastroenterology and Hepatology)


Experimental hypervigilance changes the intensity/unpleasantness ratio of pressure sensations: evidence for the generalized hypervigilance hypothesis.
Authors: Hollins M, Walters S Abstract Patients with chronic pain conditions such as fibromyalgia often demonstrate hypervigilance-undue alertness for unpleasant or threatening bodily sensations-as well as enhancement of these sensations. The generalized hypervigilance hypothesis (GHH) of Rollman and colleagues asserts that hypervigilance leads to this perceptual amplification. However, cause-and-effect relationships are difficult to establish in studies using a quasi-experimental design. In the present study, we sought to address this issue by attempting to induce hypervigilance experimentally, in one of two groups to which young, healthy adults had been randomly assigned. Those in the experimental group wrote about the flu and practiced counting their own blinks, breaths, and hea...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Association of Chronic Pain and Community Integration of Returning Veterans With and Without Traumatic Brain Injury
Conclusions: Chronic pain has a negative association with the community integration of returning veterans. Although TBI status was associated with overall community integration ratings, depression had a stronger association with impairments. These findings suggest, above and beyond the treatment of depression, the importance of effectively managing TBI-related pain to foster improved social functioning and to promote the psychological and social well-being of returning veterans. (Source: The Journal of Head Trauma Rehabilitation)


Association of Epidemiologic Factors and Genetic Variants Influencing Hypothalamic-Pituitary-Adrenocortical Axis Function With Postconcussive Symptoms After Minor Motor Vehicle Collision
Conclusions: Postconcussive symptoms after minor MVC are not generally related to the severity of mild brain injury. This study shows that neurobiologic stress systems may play a role in the pathogenesis of postconcussive symptoms. (Source: Psychosomatic Medicine)


Double-Blind Randomized Controlled Trial: Injection of Autologous Blood in the Treatment of Chronic Patella Tendinopathy—A Pilot Study
Conclusions: This study demonstrated that both the ABI and saline groups experienced a significant improvement in symptoms. However, when the results were compared, there was no statistical difference between the 2 groups. Clinical Relevance: This research showed that tendon fenestration is an alternative cost-effective treatment for recalcitrant PT. (Source: Clinical Journal of Sport Medicine)


Herbal Medicine for Low Back Pain: A Cochrane Review
Conclusions. Additional well-designed large trials are needed to test these herbal medicines against standard treatments. In general, the completeness of reporting in these trials was poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions. Level of Evidence: N/A (Source: Spine)


Pain Perception and Stabilometric Parameters in People With Chronic Low Back Pain After a Pilates Exercise Program: A Randomized Controlled Trial
Abstract: Various exercise interventions, such as Pilates exercises and traditional physical therapy methods, are employed to decrease low back pain (LBP). Nonspecific low back pain (NSLBP) is distinct from LBP, however, as the distribution of pain is restricted to the region between the costal margin and the inferior gluteal. The aim of our randomized controlled trial was to evaluate the effects of a program of Pilates exercises on pain perception and stabilometric parameters in patients with NSLBP. Thirty-eight participants were randomly allocated, using a 1:1 scheme, to either the experimental group (EG) or control group (CG). The EG completed a 14-week program of Pilates exercises, performed thrice per week under the supervision of an exercise specialist, while the CG was managed with...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Venous Ulcers of the Lower Extremities
This article provides an overview of the prevalence, pathophysiology, risk factors, and treatment strategies associated with lower extremity venous ulcers. Using a case-based approach, the role of nutrition to promote wound repair and healing is discussed. (Source: Topics in Clinical Nutrition)


Actinobacillus actinomycetemcomitans Keratitis After Glaucoma Infiltration Surgery: A Clinical Report and Literature Review
Abstract: Actinobacillus actinomycetemcomitans infection is a rare and easily misdiagnosed ocular disease. In this article, the authors report a chronic, purulent, and difficult-to-treat case of A actinomycetemcomitans keratitis following a glaucoma infiltration surgery. A 56-year-old man with a long-standing history of open-angle glaucoma in both eyes presented with a 12-week history of ocular pain, redness, and blurred vision in his right eye. He underwent a glaucoma infiltration surgery in his right eye 6 months ago. Three months postoperatively, he developed peripheral corneal stromal opacities associated with a white, thin, cystic bleb, and conjunctival injection. These opacities grew despite topical treatment with topical tobramycin, levofloxacin, natamycin, amikacin, and metronidaz...


Dry Eye Syndrome Risks in Patients With Fibromyalgia: A National Retrospective Cohort Study
Abstract: The coexistence of fibromyalgia (FM) and dry eye syndrome (DES) has been previously reported. However, there are few studies on how patients with FM may develop concomitant DES. Patients with chronic widespread pain, like FM, chronic fatigue syndrome, and irritable bowel syndrome (IBS), was concerned for the rheumatic or psychosomatic disorders which might adequately reflect the long-term risk of DES. We retrieved data on FM patients from the National Health Insurance Research Database of Taiwan covering the years 2000 to 2011. Our FM population consisted of 25,777 patients versus 103,108 patients in the non-FM group: the overall incidence of DES in these populations was 7.37/10,000 and 4.81/10,000, respectively. Male FM patients had a higher incidence of DES, with a 1.39-fold ...


Quality of life in rehabilitation outpatients: normal values and a comparison with the general Dutch population and psychiatric patients
Conclusions WHOQOL-BREF scores of rehabilitation outpatients are lower and differed significantly from normal values of a Dutch population in all four domains. Therefore, the WHOQOL-BREF can be used to measure the subjective impact of their disease or injury. The subjective impact of chronic pain was found to be particularly high. (Source: Quality of Life Research)


Is there a role of pulsed electromagnetic fields in management of patellofemoral pain syndrome? Randomized controlled study at one year follow‐up
Patellofemoral pain syndrome (PFPS) is a common cause of recurrent or chronic knee pain in young adults, generally located in the retropatellar region. Etiology is controversial and includes several factors, such as anatomical defects, muscular imbalance, or joint overuse. Good results have been reported with exercise therapy, including home exercise program (HEP). Joint inflammation with increase of pro‐inflammatory cytokines levels in the synovial fluid might be seen especially when chondromalacia becomes evident. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has shown anti‐inflammatory effects and anabolic chondrocyte activity. The purpose of this randomized controlled study was to evaluate if the combination of HEP with PEMFs was more effective than HEP alone i...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Association of GSTM1, GSTT1, GSTP1-ILE105VAL and ACE I/D polymorphisms with ankylosing spondylitis
Abstract Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin. The aim of this study is to clarify the relationships between susceptibility and severity of AS and GST-mu1 (GSTM1), GST-theta1 (GSTT1), GST-pi1 (GSTP1)-Ile105Val and angiotensin-converting enzyme (ACE) I/D polymorphisms in AS patients. One hundred thirty-eight AS patients and seventy-one healthy controls were enrolled in this study. Erythrocyte sedimentation rate and C-reactive protein (CRP) levels of the AS patients were recorded. The scores of the numeric rating scale (NRS) pain, the Bath Ankylosing Spondylitis Activity Index, the Bath Ankylosing Spondylitis Metrology Index and the Bath Ankylosing Spondylitis Functional Index were calculated. The genotypes distributions and allele frequen...


[Polymyalgia rheumatica update, 2015].
Authors: Schmidt Z, Poór G Abstract Polymyalgia rheumatica is an inflammatory musculoskeletal disorder of people aged 50 years or over, characterised by pain, aching and morning stiffness in the shoulder girdle and often hip girdle and neck. Marked systemic inflammation and rapid response to corticosteroid therapy are characteristic features. Giant cell arteritis is a well-known association of polymyalgia rheumatica. Recent clinical evidence and scientific results in the field have provided new challenges for rheumatologists. Besides the aspecific - although characteristic - proximal syndrome, less well recognizable and more variable distal musculoskeletal manifestations were observed. Magnetic resonance and ultrasound studies showed mild, remitting and non-erosive synovitis, with...


The nuclear molecular imaging of protein brain receptors in chronic pain.
Authors: Su C, Hu R, Gu Y, Han R, Yan X, Liao Q, Huang D Abstract Chronic pain is thought to be a brain disease, but the mechanisms are not well-known. In recent years, brain imaging has become an indispensable tool for pain research. For example, nuclear molecular imaging is a safe and noninvasive technology that allows researchers to probe potential brain regions of interest with suitable biomarkers. These studies help us to understand the central mechanisms of chronic pain states in humans. Brain receptors, such as the opioid receptors, dopamine receptors, NK-1 receptors, 5-HT receptors, NMDA receptors and CGRP receptors, are effector sites of neurotransmission and have prominent roles in pain generation and modulation. With nuclear molecular imaging, density, activity and distr...


The relationship between parental attitudes and behaviours in the context of paediatric chronic pain
ConclusionsParental behaviours in response to their child's pain are significantly related to parental confidence in their child's coping and parental pain‐related catastrophising. Clinical interventions may benefit from addressing parental attitudes, especially their confidence in their child's ability to function. (Source: Child: Care, Health and Development)


Female sexual dysfunction in female genital mutilation.
Authors: Elneil S Abstract Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring.To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Intracranial MR-guided laser-induced thermal therapy: single-center experience with the Visualase thermal therapy system.
CONCLUSIONS MRgLITT, although minimally invasive, must be used with caution. Thermal damage to critical and eloquent structures can occur despite MRI guidance. Once the learning curve is overcome, the overall procedural complication rate is low, and most patients can be discharged within 24 hours, with a relatively low readmission rate. In cases in which they occurred, most neurological deficits were temporary. The therapeutic role of MRgLITT in various intracranial diseases will require larger and more rigorous studies. PMID: 26722845 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)


Efficacy of Duloxetine in Chronic Low Back Pain with a Neuropathic Component A Randomized, Double-blind, Placebo-controlled Crossover Trial
Conclusion In this crossover study, duloxetine proved to be superior to placebo for the treatment of CLBP with a neuropathic leg pain. (Source: Anesthesiology)


Attenuation of Neuropathic Pain by Inhibiting Electrical Synapses in the Anterior Cingulate Cortex
Conclusion The electrical synapses blocker mefloquine could affect gamma oscillations and synaptic plasticity in the anterior cingulate cortex and relieve neuropathic pain. Cx36 may be a new therapeutic target for treating chronic pain. (Source: Anesthesiology)


Acupuncture and Trigger Point Injections for Fibromyalgia: East-West Medicine Case Report.
Authors: Taw LB, Henry E Abstract Fibromyalgia is a clinical syndrome characterized by chronic widespread pain that is often accompanied by ≥1 concomitant symptoms (eg, fatigue, poor sleep, cognitive alterations, and mood disturbances). In 2005, an estimated 5 million people in the United States suffered from fibromyalgia, and its growing effect on health-related quality of life is substantial. An increasingly popular hypothesis proposes that noxious, peripheral sensory input might contribute to the initiation and perpetuation of the diffuse pain seen in patients with fibromyalgia. That theory has led to the evaluation of multiple interventions to stimulate distal areas as a means to modulate the peripheral and central nervous systems. It has been the authors' experiences that th...


Physiotherapy and a Homeopathic Complex for Chronic Low-back Pain Due to Osteoarthritis: A Randomized, Controlled Pilot Study.
Conclusions • The study was too small to be conclusive, but results suggest the homeopathic complex, together with physiotherapy, can significantly improve symptoms associated with CLBP due to OA. PMID: 26773321 [PubMed - as supplied by publisher] (Source: Alternative Therapies in Health and Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Efficacy of Theta Binaural Beats for the Treatment of Chronic Pain.
Conclusions • The results supported the hypothesis that an external audio protocol of TBB was effective in reducing perceived pain severity for participants. PMID: 26773319 [PubMed - as supplied by publisher] (Source: Alternative Therapies in Health and Medicine)


Irritable Bowel Syndrome: A Review for General Pediatricians.
Authors: Kridler J, Kamat D Abstract Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The bothersome and chronic nature of IBS symptoms negatively affects patients' activity level and quality of life, imparting an economic burden on the patient, the family, and the health care system. Research is still trying to elicit a clear pathophysiologic mechanism for IBS, and its clinical presentation and manifestations vary from patient to patient. The importance of a comprehensive history and physical examination cannot be emphasized enough in the diagnosis of IBS, as to date there are no specific laboratory studies that will confirm the diagnosis. There is currently no cure for IBS, and treatmen...


Primary care experiences of people who live with chronic pain and receive opioids to manage pain: A qualitative methodology
ConclusionsParticipants receiving opioids for pain management through primary care feared losing access to opioids, wanted to protect sobriety when they had histories of substance use disorder, experienced stress at their jobs with frequent appointments, identified inconsistencies in health care prolonging their suffering and increasing substance misuse, and identified improvement in coping with pain when they had confidence in healthcare providers. Implications for practiceProviding patient‐centered care while managing patients with pain and unknown risk for prescription opioid misuse is possible. Understanding influences that create prescription opioid risk for misuse can help nurse practitioners improve their delivery of care by providing consistent and convenient healthcare encounter...


Effectiveness of low‐dose pregabalin in three patients with Lewy body disease and central neuropathic pain
Abstract Many patients with Lewy body disease complain of pain, and their pain may be associated with this disease. Recently, pain has become a focus of attention in Parkinson's disease, but there is little information regarding pain in patients who have dementia with Lewy bodies. We used pregabalin to treat three Lewy body disease patients with chronic pain that may have been related to degeneration of central neurons. All three patients responded well to pregabalin at 25–50 mg/day. To our knowledge, there have been no previous reports of pregabalin showing efficacy for central neuropathic pain in Parkinson's disease or Lewy body disease. (Source: Psychogeriatrics)


Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial.
CONCLUSIONS: Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus. PMID: 26851686 [PubMed - as supplied by publisher] (Source: Neurologia i Neurochirurgia Polska)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Pain Reduction Does Not Imply Improved Functional Outcome in Patients Treated With Combined Supraorbital and Occipital Nerve Stimulation for Chronic Migraine
ConclusionThere is a paucity of studies in quality of life, productivity, and psychosocial aspects with peripheral nerve stimulation therapy for headache. Patients with a positive response to SONS and ONS also reported overall improvement in their functional status as reflected by MIDAS and BDI in the perioperative period. Unfortunately, this effect waned over the long‐term follow‐up. (Source: Neuromodulation)


Chronic orchalgia after surgical exploration for acute scrotal pain in children
The aim was to review the pediatric cohort undergoing surgical exploration for acute scrotal pain at our institution and assess the entity of chronic orchalgia post exploration in this cohort. (Source: Journal of Pediatric Urology)


Selective upregulation of functional mu‐opioid receptor splice variants by chronic opioids
This article is protected by copyright. All rights reserved. (Source: Journal of Neurochemistry)


Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand


Nutritional Research May Be Useful in Treating Tendon Injuries
Tendon injures cause a huge amount of disability, pain, and medical costs. However, relatively little is known about tendon biology and healing. Many tendon related surgical procedures are not very successful and leave the patient with essentially a chronic injury. New therapeutic approaches for tendon injury are needed. Preliminary evidence suggests that various nutrients such as protein, amino acids (leucine, arginine, glutamine), vitamins C+D, manganese, copper, zinc, and phytochemicals may be useful to improve tendon growth and healing. (Source: Nutrition)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Endomorphin Analog Analgesics with Reduced Abuse Liability, Respiratory Depression, Motor Impairment, Tolerance, and Glial Activation.
Authors: Zadina JE, Nilges MR, Morgenweck J, Zhang X, Hackler L, Fasold MB Abstract Opioids acting at the mu opioid receptor (MOR) are the most effective analgesics, however adverse side effects severely limit their use. Of particular importance, abuse liability results in major medical, societal, and economic problems, respiratory depression is the cause of fatal overdoses, and tolerance complicates treatment and increases the risk of side effects. Motor and cognitive impairment are especially problematic for older adults. Despite the host of negative side effects, opioids such as morphine are commonly used for acute and chronic pain conditions. Separation of analgesia from unwanted effects has long been an unmet goal of opioid research. Novel MOR agonist structures may prove crit...


Pharmacokinetic Profile and Sustained 24-hour Analgesia of a Once-daily Hydrocodone Bitartrate Extended-release Tablet with Abuse-deterrent Properties.
Authors: Kapil RP, Cipriano A, Wen W, Yu Lynch S, He E, Colucci SV, Harris SC Abstract PURPOSE: The purpose of this study was to evaluate the pharmacokinetics (PK) and 24-hour analgesic effectiveness of once-daily, single-entity, extended-release hydrocodone (HYD) with abuse-deterrent properties. METHODS: Four studies were included. Three open-label PK studies had the following designs: single-dose, 5-treatment, 4-period, crossover, dose-proportionality study; HYD 120 mg for 5 days (steady-state study 1); 2-treatment, 2-period, multiple-dose crossover study assessing the relative bioavailability of HYD 30 mg and hydrocodone 7.5 mg/ibuprofen 200 mg administered every 6 hours (steady-state study 2). A long-term, open-label study assessed the safety and effectiveness of HYD 20 to ...


Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.
Authors: Anderson RU, Wise D, Sawyer T, Nathanson BH, Nevin Smith J Abstract Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women ...


Bladder dysfunction in 2015: Novel findings continue to challenge researchers and clinicians
Nature Reviews Urology 13, 69 (2016). doi:10.1038/nrurol.2015.303 Authors: Rose Khavari & Tim Boone 2015 has seen advances in various bladder conditions. MicroRNAs might become therapeutic targets, the MAPP network characterized central neurological changes in chronic pelvic pain syndrome, and urologists were reminded to consider cognitive effects of long-term anticholinergics use. A study of obstetric vesicovaginal fistula repair shows how evidence-based research might improve public health in poorly resourced countries. (Source: Nature Reviews Urology)


Opioids: What Patients -- and Doctors -- Think
Title: Opioids: What Patients -- and Doctors -- ThinkCategory: Health NewsCreated: 12/30/2015 12:00:00 AMLast Editorial Review: 12/30/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


An exploration of familial associations of two movement pattern-derived subgroups of chronic disabling low back pain; a cross-sectional cohort study
Altered movement patterns with pain have been demonstrated in children, adolescents and adults with chronic disabling low back pain (CDLBP). A previously developed classification system has identified different subgroups including active extension and multidirectional patterns in patients with CDLBP. While familial associations have been identified for certain spinal postures in standing, it is unknown whether a familial relationship might exist between movement pattern-derived subgroups in families with CDLBP. (Source: Manual Therapy)


Clusters of Multiple Complex Chronic Conditions: A Latent Class Analysis of Children at End of Life
Children at end of life often experience multiple complex chronic conditions, with over 50% of children reportedly having two or more conditions. These complex chronic conditions are unlikely to occur in an entirely uniform manner in children at end of life. Previous work has not fully accounted for patterns of multiple conditions when evaluating care among these children. (Source: Journal of Pain and Symptom Management)


Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center
The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes. Upon examination of naloxone administration, we identify potential inappropriate opioid prescription practices such as the use of wrong opioids in hepatic and renal failure and simultaneous use of multiple short-acting opioids. Most importantly, we find that chronic opioid users appear to suffer the most in terms of undertreatment of pain as well as opioid overdose, highlighting the urgent need to target this underserved populati...


Evaluation of Novel EMG Biofeedback for Postural Correction During Computer Use
The objective of this investigation was to evaluate the effectiveness of real-time high-density surface EMG (HDsEMG) biofeedback for postural correction during typing. Twenty healthy participants performed a typing task with two forms of postural feedback: (1) verbal postural coaching and (2) verbal postural coaching plus HDsEMG biofeedback. The interface used activity from two HDsEMG arrays placed over the trapezius designed to shift trapezius muscle activity inferiorly. The center of gravity across both arrays was used to quantify the spatial distribution of trapezius activity. Planar angles taken from upper extremity reflective markers quantified cervicoscapular posture. During the biofeedback condition, trapezius muscle activity was located 12.74 ± 3.73 mm more inferior, the scapul...


Turning pain into cues for goal-directed behavior: Implementation intentions reduce escape-avoidance behavior on a painful task
Pain automatically elicits escape-avoidance behavior to avert bodily harm. In patients with chronic pain long-term escape-avoidance behavior may increase the risk of chronic disability. The aim of the presents study was to examine whether implementation intentions, reduce escape-avoidance behavior during painful tasks in healthy individuals. Implementation intentions are “if-then” self-statements associating situational cues with goal-directed behaviors.Seventy healthy participants performed a painful finger pressing task, preceded by either implementation intention instructions with pain or a non-pain cue as a cue for goal directed behavior, or control instructions. (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>


Congenital insensitivity to pain: Fracturing without apparent skeletal pathobiology caused by an autosomal dominant, second mutation in encoding voltage-gated sodium channel 1.9
Congenital insensitivity to pain (CIP) comprises the rare heritable disorders without peripheral neuropathy that feature inability to feel pain. Fracturing and joint destruction are common complications, but lack detailed studies of mineral and skeletal homeostasis and bone histology. In 2013, discovery of a heterozygous gain-of-function mutation in SCN11A encoding voltage-gated sodium channel 1.9 (Nav1.9) established a distinctive CIP in three unrelated patients who suffered multiple painless fractures, self-inflicted mutilation, chronic diarrhea, and hyperhidrosis. (Source: Bone)


Evaluation of Novel EMG Biofeedback for Postural Correction During Computer Use.
The objective of this investigation was to evaluate the effectiveness of real-time high-density surface EMG (HDsEMG) biofeedback for postural correction during typing. Twenty healthy participants performed a typing task with two forms of postural feedback: (1) verbal postural coaching and (2) verbal postural coaching plus HDsEMG biofeedback. The interface used activity from two HDsEMG arrays placed over the trapezius designed to shift trapezius muscle activity inferiorly. The center of gravity across both arrays was used to quantify the spatial distribution of trapezius activity. Planar angles taken from upper extremity reflective markers quantified cervicoscapular posture. During the biofeedback condition, trapezius muscle activity was located 12.74 ± 3.73 mm more inferior, the scapul...


Healthcare professionals' perceptions of psychological treatment for chronic pain in Singapore: challenges, barriers, and the way forward.
CONCLUSION: Reducing barriers in the access to psychological treatment in settings like Singapore will require a multifaceted approach. Implications for Rehabilitation A multifaceted approach is required to reduce barriers to psychological treatment for chronic pain in settings like Singapore. Educating healthcare professionals on the need for a multidisciplinary approach to chronic pain could help in reducing misconceptions and increase understanding of the benefits of psychological approaches. Utilizing both media and technological platforms as a means to facilitate psychological treatment uptake for chronic pain may be a way forward for a technological savvy generation. PMID: 26714734 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)


Frequency and characteristics of goal attainment following BoNT-A injection for management of spasticity.
CONCLUSIONS: Although active goals are commonly identified by people with spasticity, passive goals were more likely to be achieved following BoNT-A injection. A long duration of spasticity does not preclude patients from achieving mobility and transfer goals. Non-stroke participants were more likely to achieve mobility and transfer goals. Implications for Rehabilitation Patients with chronic spasticity should be considered for BoNT-A as clinically meaningful outcomes can be achieved. When spasticity is present in multiple muscles, the GAS can be an assistive tool to guide clinicians in determining which muscles are a priority for injection, because the client will be more motivated to improve those specific goals. Although carers and patients are more willing to set active goals, these ar...


CE: Fibromyalgia Syndrome: Current Considerations in Symptom Management
This article describes the existing treatment guidelines, discusses pharmacologic and nonpharmacologic approaches (including CAM-based modalities), and outlines nursing approaches aimed at enhancing patient self-management. (Source: AJN)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Leopard Skin–Like Colonic Mucosa: A Novel Endoscopic Finding of Chronic Granulomatous Disease–Associated Colitis
Conclusions: Although nonspecific endoscopic findings of CGD-associated colitis have been reported before, our observation of brownish dots spread across a yellowish edematous mucosa, termed “leopard sign,” could be a unique feature of this condition. (Source: Journal of Pediatric Gastroenterology and Nutrition)


Chronic pre‐operative opioid use and acute pain after fast‐track total knee arthroplasty
ConclusionPre‐operative opioid use increases the risk for post‐operative pain at rest and walk, and increased opioid consumption after TKA. (Source: Acta Anaesthesiologica Scandinavica)


Swing time ratio, a new parameter of gait disturbance, for the evaluation of the severity of neuropathic pain in a rat model of partial sciatic nerve ligation
In this study, we used rats with partial sciatic nerve ligation (PSL) as the neuropathic and chronic pain model. To assess the severity of pain by gait disturbance, we applied automatic analysis on walking function using the GAIT® system. The system employs a novel index of abnormal step cycles, the swing time ratio (STR), of laboratory animals. Data were compared to those obtained with conventional tests, including a von Frey test and a hot plate test. Finally, we analyzed recovery of walking function after single or repeated administration of pregabalin. Results By using rats with PSL, we confirmed that results obtained by the GAIT® system were comparable to those obtained by both von Frey tests and hot plate tests. Single administration of pregabalin transiently improved STR, on the ...


Glomus tumor presenting as complex regional pain syndrome of the left upper limb: a case report
Conclusions Patients with glomus tumors may spend many years in pain and distress because of misdiagnosis. Sensitization and education of both the public and health care workers will help in early diagnosis and treatment of this otherwise potentially disabling pathology for which surgical excision is curative. (Source: Journal of Medical Case Reports)


Activation of corticotropin-releasing factor neurons and microglia in paraventricular nucleus precipitates visceral hypersensitivity induced by colorectal distension in rats
In this study, we examined the mechanism by which microglia and neurons in PVN establish and maintain visceral hypersensitivity and the involvement of TLR4 signaling. Visceral hypersensitivity was precipitated by adult colorectal distension (CRD) only in rats experienced neonatal CRDs. Visceral hypersensitivity was associated with an increase in the expression of c-fos, corticotropin-releasing factor (CRF) protein and mRNA in PVN, which could be prevented by intra-PVN infusion of lidocaine or small interfering RNA targeting the CRF gene. These results suggest PVN CRF neurons modulate visceral hypersensitivity. Adult CRD induced an increase in the expression of Iba-1 (a microglial marker), TLR4 protein, and its downstream effectors MyD88, NF-κB, as well as proinflammatory cytokines tumor n...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Adolescents with chronic pain and associated functional disability: A descriptive analysis
The purpose of this research was to describe the biopsychosocial characteristics of adolescents with chronic pain and functional disability. Data were obtained from a registry of 100 adolescents (mean age = 15.84, SD = 2.72; 21 males) admitted to an interdisciplinary pain rehabilitation program. Clinician ratings were used to categorize coping and personality styles. The most common chief complaint at admission was limb pain (n = 44), followed by headache (n = 21) and abdominal pain (n = 17). Eighteen patients presented with other types of pain. The most frequent triggers to pain were physical trauma, medical condition or disability, and surgery or another medical procedure. Sleep problems, mental health difficulties, and high academic performance were common. Seven previously identified p...


Does physical or psychosocial workload modify the effect of musculoskeletal pain on sickness absence? A prospective study among the Finnish population
Conclusion We did not find evidence for significant modification by physical or psychosocial workload of the relationship between musculoskeletal pain and SA periods lasting ≥10 workdays. (Source: International Archives of Occupational and Environmental Health)


A peripheral messenger for chronic pain
Nature Neuroscience 19, 9 (2016). doi:10.1038/nn.4217 Author: S&#233;bastien Thuault (Source: Nature Neuroscience)


---
Chronic pain and psychiatric disorders such as major depressive disorders and generalized anxiety disorders are two of the most disabling and costly disorders in Western countries, with an expected increase in prevalence over the next decades. While the comorbidity of chronic pain and mood disorders is clinically well established, it has not attracted the interest of the research community since recently. A likely explanation is that the negative experience of chronic pain together with the feelings of helplessness and hopelessness caused by the lack of effective treatments was seen as sufficient to induce the development of anxiety and depression. (Source: Psychoneuroendocrinology)


Hypoxia inducible factor-1α inhibition produced anti-allodynia effect and suppressed inflammatory cytokine production in early stage of mouse complex regional pain syndrome model.
This article is protected by copyright. All rights reserved. PMID: 26711019 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Pharmacology and 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>


Activation of corticotropin-releasing factor neurons and microglia in paraventricular nucleus precipitates visceral hypersensitivity induced by colorectal distension in rats.
In this study, we examined the mechanism by which microglia and neurons in PVN establish and maintain visceral hypersensitivity and the involvement of TLR4 signaling. Visceral hypersensitivity was precipitated by adult colorectal distension (CRD) only in rats experienced neonatal CRDs. Visceral hypersensitivity was associated with an increase in the expression of c-fos, corticotropin-releasing factor (CRF) protein and mRNA in PVN, which could be prevented by intra-PVN infusion of lidocaine or small interfering RNA targeting the CRF gene. These results suggest PVN CRF neurons modulate visceral hypersensitivity. Adult CRD induced an increase in the expression of Iba-1 (a microglial marker), TLR4 protein, and its downstream effectors MyD88, NF-κB, as well as proinflammatory cytokines tumor n...


Systematic review of the influence of spasticity on quality of life in adults with chronic neurological conditions.
CONCLUSIONS: Spasticity is associated with worse health status, however its relationship with overall QOL is not established. The relationship between spasticity and QOL is confounded by other impairments and requires multivariate analysis. Implications for Rehabilitation Effective management of spasticity may result in significant improvements in HRQOL. It is important to address multiple factors in the management of spasticity including pain, bladder problems, fatigue and sleep, as the interplay of these may have significant negative effects on HRQOL. Clinician-administered methods for measuring spasticity, such as the Ashworth scale, may not provide comprehensive assessment of spasticity. Incorporation of patient-reported measures for spasticity is pivotal in the assessment of therapeut...


New Drug Therapy May End Chronic Pain
A brain region controlling whether we feel happy or sad, as well as addiction, is remodeled by chronic pain, reports a new Northwestern Medicine study, published in Nature Neuroscience. (Source: Disabled World)


Should Prescription Drug Monitoring Programs Include Opioid Overdoses?
Clinicians are continuing to prescribe painkillers to chronic pain patients&nbsp;who overdose on highly addictive narcotics, a new study found. (Source: Forbes.com Healthcare News)


Seattle Pain Relief Now Offering Pain Medication Management with Board...
Seattle Pain Relief is now offering pain medication management with a Board Certified provider on a case by case basis. The practice offers treatment for all types of acute and chronic pain conditions...(PRWeb December 28, 2015)Read the full story at http://www.prweb.com/releases/painmedicationmanagement/seattle-tacoma-wa/prweb13144153.htm (Source: PRWeb: Medical Pharmaceuticals)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Mycoplasma hominis–Associated Cystitis, Pyelonephritis, and Bacteremia in an Allogeneic Hematopoietic Stem Cell Transplant Patient
We describe a case of M. hominis infection in a patient receiving oral immunosuppression after allogeneic hematopoietic stem cell transplantation for treatment of acute myeloid leukemia. The patient presented with complaints of chronic cystitis, suprapubic pain, bladder spasms, and an abnormal urinalysis. Mycoplasma hominis was cultured from both the urine and blood and was determined to be the source of infection in this patient. This organism is intrinsically resistant to several classes of antibiotics; however, it is largely susceptible to tetracyclines and clindamycin. Doxycycline is often the agent of choice for treatment of M. hominis infections, because of its favorable pharmacokinetic profile. The patient was treated with a 3-week course of doxycycline and reported resolution of al...


Oral chronic GVHD outcomes and resource utilization: a subanalysis from the chronic GVHD consortium
ConclusionsOral cGVHD consensus assessments corresponding with ancillary therapy use were mouth pain and NIH mouth score, with higher odds of receiving therapy from OM experts. Ancillary care guidelines for oral cGVHD are reflected in academic clinical practice with respect to utilization of recommended prescriptions.This article is protected by copyright. All rights reserved. (Source: Oral Diseases)


Hypoalgesia After Exercise and the Cold Pressor Test is Reduced in Chronic Musculoskeletal Pain Patients With High Pain Sensitivity
Objectives: In chronic pain patients, impaired conditioned pain modulation (CPM) and exercise-induced hypoalgesia (EIH) have been reported. No studies have compared CPM and EIH in chronic musculoskeletal pain patients with high pain sensitivity (HPS) and low pain sensitivity (LPS). Materials and Methods: On 2 days, manual pressure pain thresholds (PPTs) were recorded at the legs, arm, and shoulder in 61 chronic pain patients and they performed the cold pressor test, 2 exercise conditions (bicycling and isometric contraction), and a control condition in a randomized and counterbalanced order. PPTs, pain tolerance, pain tolerance limit, and temporal summation of pain were assessed with cuff algometry before and after the tests. On the basis of a median split of the average PPTs for women and...


Effects of a Tailored Positive Psychology Intervention on Well-Being and Pain in Individuals With Chronic Pain and a Physical Disability: A Feasibility Trial
Conclusions: The results support the feasibility, acceptability, and potential efficacy of a computer-based positive psychology intervention for improving well-being and pain-related outcomes in individuals with physical disabilities and chronic pain, and indicate that a full trial of the intervention is warranted. (Source: The Clinical Journal of Pain)


The Relationship Between Approach to Activity Engagement, Specific Aspects of Physical Function, and Pain Duration in Chronic Pain
Discussion: The results of this study do not support the commonly held notion that avoidance and/or overactivity behavior leads to deconditioning and reduced physical capacity over time. Findings do, however, suggest that a relationship exists between avoidance and/or overactivity behavior and reduced participation in activities. Implications for the clinical management of chronic pain and directions for further research are discussed. (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>


Is Spinal Cord Stimulation Useful and Safe for the Treatment of Chronic Pain of Ischemic Origin? A Review
Discussion: SCS is a minimally invasive and reversible pain intervention. On the basis of the current literature, SCS may be an alternative treatment strategy in refractory angina pectoris and peripheral vascular disease patients, presenting a low surgical risk profile. However, further clinical trials with larger sample sizes and extended follow-up are required to confirm this finding. (Source: The Clinical Journal of Pain)


Interviewing and Urine Drug Toxicology Screening in a Pediatric Pain Management Center: An Analysis of Analgesic Nonadherence and Aberrant Behaviors in Adolescents and Young Adults
Conclusions: These results highlight the challenges of identifying nonadherence to a prescription regimen among adolescents with chronic pain. In addition, this preliminary work suggests that UDT could be used in conjunction with careful clinical interviewing to substantiate patient report and increase the likelihood of detecting analgesic nonadherence and aberrant behaviors. (Source: The Clinical Journal of Pain)


Almost all patients continue to get opioid prescriptions after overdose
(American College of Physicians) More than 90 percent of patients with chronic pain continue to receive prescription opioids after an overdose and are at high risk for experiencing a repeated overdose, according to an article published in Annals of Internal Medicine. (Source: EurekAlert! - Medicine and Health)


Case report: successful treatment of membranous lupus nephritis with belimumab in an African female immigrant
We describe the case of a 26-year-old African female who was treated successfully with belimumab in a case of severe membranous lupus nephritis and retinal vasculitis, resistant to first line therapy. She presented initially with chronic dacryoadenitis and screening showed nephrotic-range proteinuria. Biopsy of the kidney confirmed the diagnosis of membranous lupus nephritis. Clinical features (joint pain, dacryoadenitis, retinal vasculitis and lupus nephritis) in combination with serology (positive anti-double-stranded DNA (ds-DNA) antibodies, hypocomplementemia) confirmed the diagnosis of systemic lupus erythematosus (SLE). Treatment was immediately initiated with glucocorticosteroids (GCS), mycophenolate mofetil (MMF) and hydroxychloroquine sulphate (Plaquenil®). Tacrolimus was associa...


Demyelination/remyelination and expression of interleukin-1β, substance P, nerve growth factor, and glial-derived neurotrophic factor during trigeminal neuropathic pain in rats
Publication date: 26 January 2016 Source:Neuroscience Letters, Volume 612 Author(s): Grazielle Mara Ferreira Costa, Alexandre Penido de Oliveira, Patricia Massara Martinelli, Elizabeth Ribeiro da Silva Camargos, Rosa Maria Esteves Arantes, Camila Megale de Almeida-Leite The etiology of trigeminal neuropathic pain is not clear, but there is evidence that demyelination, expression of cytokines, neuropeptides, and neurotrophic factors are crucial contributors. In order to elucidate mechanisms underlying trigeminal neuropathic pain, we evaluated the time course of morphological changes in myelinated and unmyelinated trigeminal nerve fibers, expression of cytokine IL-1β, neuropeptide substance P (SP), nerve growth factor (NGF), and glial derived neurotrophic factor (GDNF) in peripheral...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


An exploratory study on the effectiveness of “Calmare therapy” in patients with cancer-related neuropathic pain: A pilot study
Calmare therapy (CT) has been suggested as a novel treatment for managing chronic pain. Recently, it was reported to show a positive therapeutic outcome for managing neuropathic pain condition. We performed an exploratory prospective study on the effectiveness of CT in patients with various types of cancer-related neuropathic pain (CNP). (Source: European Journal of Oncology Nursing)


Diagnostic Performance of the Extensor Carpi Ulnaris (ECU) Synergy Test to Detect Sonographic ECU Abnormalities in Chronic Dorsal Ulnar-Sided Wrist Pain
Conclusions&mdash; The results of this prospective study support the hypothesis that the ECU synergy test could be a useful provocative maneuver to detect ECU abnormalities in patients with chronic dorsal ulnar-sided wrist pain. (Source: Journal of Ultrasound in Medicine)


A systematic review and meta-analysis on the safety of newly adjuvanted vaccines among children.
CONCLUSIONS: Our meta-analysis did not show any safety concerns in clinical trials of the newly adjuvanted vaccines in children ≤10 years of age. An unexplained increase of meningitis in one Phase III AS01-adjuvanted malaria trial and the link between narcolepsy and the AS03-adjuvanted pandemic vaccine illustrate that continued safety monitoring is warranted. PMID: 26740250 [PubMed - as supplied by publisher] (Source: Vaccine)


Understanding and Promoting Resiliency in Patients with Chronic Headache
Abstract Even among patients with the same type and severity of headache, there is considerable variability in functional outcomes. Some individuals are resilient, able to thrive despite pain, whereas others find that pain is an overwhelming burden that comes to define their lives. A substantial body of evidence suggests that patients’ cognitive, emotional, and behavioral coping responses to their pain play a significant role in determining their long-term health. Resilient pain responses, which are shaped by both qualities of the individual and his/her social environment, can be learned and thus hold promise as targets for treatment. We draw on recent empirical findings that identify which pain beliefs, appraisals, and behaviors in response to pain are key to resilient and non...


[Questionnaire "Coping Procedures - Goals and Appraisals": Development and First Psychometric Evaluation in Patients with Chronic Back Pain].
Conclusions: The psychometric results were satisfactory. The practical implications of our results are discussed. PMID: 26709464 [PubMed - as supplied by publisher] (Source: Die 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>


Premier Pain Consultants in San Antonio Now Offering Nonoperative Knee...
The top San Antonio pain management clinics, Premier Pain Consultants, is now offering a revolutionary new procedure for chronic knee pain. The procedure, known as radiofrequency ablation, is covered...(PRWeb December 27, 2015)Read the full story at http://www.prweb.com/releases/radiofrequency-ablation/knee-doctor-san-antonio/prweb13144152.htm (Source: PRWeb: Medical Pharmaceuticals)


Huperzine A Alleviates Mechanical Allodynia but Not Spontaneous Pain via Muscarinic Acetylcholine Receptors in Mice.
Authors: Zuo ZX, Wang YJ, Liu L, Wang Y, Mei SH, Feng ZH, Wang M, Li XY Abstract Chronic pain is a major health issue and most patients suffer from spontaneous pain. Previous studies suggest that Huperzine A (Hup A), an alkaloid isolated from the Chinese herb Huperzia serrata, is a potent analgesic with few side effects. However, whether it alleviates spontaneous pain is unclear. We evaluated the effects of Hup A on spontaneous pain in mice using the conditioned place preference (CPP) behavioral assay and found that application of Hup A attenuated the mechanical allodynia induced by peripheral nerve injury or inflammation. This effect was blocked by atropine. However, clonidine but not Hup A induced preference for the drug-paired chamber in CPP. The same effects occurred when Hup A...


for Groin Pain after Inguinal Herniorrhaphy: Does it Really Work?
We retrospectively assessed operative characteristics and outcome of 44 patients undergoing reoperations for post-inguinal hernia repair chronic groin pain. Follow-up in this group of patients was difficult and suboptimal. While the majority of patients with close follow-up gain benefit from reoperation, a minority of patients remain frustrated with ongoing chronic groin pain. (Source: American Journal of Surgery)


Reoperation for groin pain after inguinal herniorrhaphy: does it really work?
Chronic groin pain after inguinal hernia repair (IHR) is a vexing problem. Reoperation for groin pain (R4GP) has varied outcomes. (Source: American Journal of Surgery)


Prevalence of Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae Based on Data Collected by a Network of Clinical Microbiology Laboratories, in Italy.
Authors: Salfa MC, Suligoi B, Italian STI Laboratory-based Surveillance Working Group Abstract Bacterial and protozoal sexually transmitted infections (STIs), such as Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae, may cause acute symptoms, chronic infections and severe long-term complications. The complications of these infections in women include pelvic inflammatory disease, chronic pelvic pain, tubal infertility, ectopic pregnancy, and infertility. Moreover, infection during pregnancy is associated with premature rupture of the membranes, low birth weight and miscarriage.In Italy, Chlamydia trachomatis and Trichomonas vaginalis infections are not subject to mandatory reporting; while Gonorrhoea is subject to mandatory reporting.To extend surveillance to 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>


Arthroplasty of the distal ulna distal in managing patients with post-traumatic disorders of the distal radioulnar joint: measurement of quality of life
Conclusion This concept is subject to the test of time. Implantation of a prosthesis is a very interesting addition to the surgical arsenal for those who are specialists in hand surgery. Arthroplasty of the distal ulna is a safe and effective method with clinical–functional and quality-of-life improvements for patients and presents a low complication rate. (Source: Revista Brasileira de Ortopedia)


Update of Inpatient Treatment for Refractory Chronic Daily Headache
In conclusion, inpatient treatment may be useful for select patients with refractory CDH and should be incorporated in a holistic headache care program. (Source: Current Pain and Headache Reports)


Two heterozygous Cav3.2 channel mutations in a pediatric chronic pain patient: recording condition-dependent biophysical effects.
We report expression system-dependent effects of heterozygous mutations (P769L and A1059S) in the Cav3.2 CACNA1H gene identified in a pediatric patient with chronic pain and absence seizures. The mutations were introduced individually into recombinant channels and then analyzed by means of electrophysiology. When both mutants were co-expressed in tsA-201 cells, we observed a loss of channel function, with significantly smaller current densities across a wide range of voltages (-40 to +20 mV). In addition, when both mutant channels were co-expressed, the channels opened at a more depolarizing potential with a ~5-mV right shift in the half-activation potential, with no changes in half-inactivation potential and the rate of recovery from inactivation. Interestingly, when both mutants were co...


Corticomotor control of lumbar multifidus muscles is impaired in chronic low back pain: concurrent evidence from ultrasound imaging and double-pulse transcranial magnetic stimulation.
Authors: Massé-Alarie H, Beaulieu LD, Preuss R, Schneider C Abstract Chronic low back pain (CLBP) is often associated with impaired control of deep trunk muscles and reorganization of the primary motor areas (M1). Precisely, functional changes of the lumbar multifidus muscles (MF) involved in spine stability may be of special interest in rehabilitation. Therefore, we tested MF corticomotor control using double transcranial magnetic stimulation (TMS) paradigms for the first time in this muscle and examined its link with MF volitional activation. Eleven individuals with lateralized CLBP and 13 pain-free participants were recruited. Ultrasound imaging enabled measurement of MF volitional isometric contraction in prone lying. TMS of MF M1 area was used to test hemispheric excitability...


Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: a prospective randomized study comparing three exercise programs - Treleaven J, Peterson G, Ludvigsson ML, Kammerlind AS, Peolsson A.
BACKGROUND: Dizziness and unsteadiness are common symptoms following a whiplash injury. OBJECTIVE: To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizzines... (Source: SafetyLit)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Christmas, Grief, and Moving Forward After an Alzheimer's Diagnosis
The last time my mother and I stood near a Christmas tree together was December 2012. She was in the middle of a long battle with Chronic Lyme Disease and we had recently found out that she also had Alzheimer's. This dynamic cocktail of ailments left her unable to function as she used to -- as an entertainer, caregiver, and a joker. My mother and I were very close, and when she began showing signs of her disease I became extremely protective of her. A little more than 10 years prior my mother was very protective of me as I successfully battled Stage 3 Hodgkin's Disease -- cancer. This created a unique bond that seems to have literally given me the ability to feel her pain, shame and exhaustion. The Christmas season is my favorite time of year. Mainly because of all the amazing memories I ...


Antinociceptive effect of palm date spathe hydroalcoholic extract on acute and chronic pain in mice as compared with analgesic effect of morphine and diclofenac.
CONCLUSION: 200 mg/kg extract of PDS, revealed a significant analgesic effect on chronic pain, but it did not show any analgesic effect on acute pain. PMID: 26693469 [PubMed] (Source: Biomed Res)


Mood and anxiety disorders in patients with chronic low back and neck pain caused by disc herniation.
CONCLUSIONS: Mood and anxiety disorders were more commonly seen in patients with lumbar or cervical disc herniation than in those without herniation. No relationship was detected between pain severity and mood or anxiety disorders. However, mood and anxiety disorders were associated with neurological deficits. PMID: 26524007 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)


Anti-hypersensitive effect of intramuscular administration of αO-conotoxin GeXIVA[1,2] and GeXIVA[1,4] in rats of neuropathic pain
Publication date: 3 April 2016 Source:Progress in Neuro-Psychopharmacology and Biological Psychiatry, Volume 66 Author(s): Xiaodan Li, Yuanyan Hu, Yong Wu, Yi Huang, Shurun Yu, Qing Ding, Dongting Zhangsun, Sulan Luo αO-conotoxin GeXIVA (GeXIVA) is a potent antagonist of α9α10 nicotinic acetylcholine receptors (nAChRs), which has four Cys residues and three disulfide isomers. Among the 3 isomers, both GeXIVA[1,2] (bead isomer) and GeXIVA[1,4] (ribbon isomer) showed potent block on α9α10 nAChRs with close low nanomolar IC50s. Here we report that anti-hypersensitive effects of the bead and ribbon isomers in the chronic constriction injury (CCI) model of neuropathic pain and acute pain model of tail flick test. Treatment was started and continued for 7 or 14days after the devel...


Laparoscopic surgery for severe recto-vaginal endometriosis compromising the bowel. A prospective cohort study
Conclusions Severe recto-vaginal endometriosis compromising the bowel can be treated surgically with experienced combined gynaecological and colorectal input with a low serious complication rate. Surgery by an experienced multidisciplinary team results in significant improvement in pain, sexual function and quality of life up to 1 year post operatively. Pelvic clearance improves outcome and patients should be counselled accordingly. There is no difference in outcome between the types of bowel surgery undertaken as long as all the visible/palpable endometriosis is removed. Teaser Surgical treatment of severe bowel endometriosis utilising a multidisciplinary team and experienced surgeons, results in significant improvement of symptoms and quality of life at 1 year post operatively. (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>


Conservative treatment of idiopathic mesenteric phlebosclerosis: A case report and literature review
We report on a 59-year-old man with periumbilical abdominal pain for 1 week. The pain was dull and persistent. A physical examination revealed a soft, tender abdomen with normoactive bowel sounds and mild rebounding tenderness in the right upper abdomen. The abdominal plain X-ray and abdominal computed-tomography findings were compatible with idiopathic mesenteric phlebosclerosis. The symptoms resolved after only conservative treatment, and the disease did not recur during 5 years of follow-up. Idiopathic mesenteric phlebosclerosis is a rare disease, and its pathogenesis is not yet clearly understood; however, it differs from other rare causes of nonthrombotic mesenteric venous occlusion. Idiopathic mesenteric phlebosclerosis can be diagnosed on the basis of imaging findings, and most sy...


Multiple Looser zones of osteomalacia in Byler disease with associated vitamin D deficiency, phosphaturia, and elevated FGF23
Conclusion Byler disease may result in Looser zones of osteomalacia due to chronic malabsorption. Renal phosphorus wasting as a consequence of unexplained marked elevation in FGF23 is thought to have contributed to the onset of osteomalacia. (Source: International Journal of Surgery Case Reports)


Efficacy of Behavioural Graded Activity Compared with Conventional Exercise Therapy in Chronic Non-Specific Low Back Pain: Implication for Direct Health Care Cost.
CONCLUSION: The results indicate that CET and BGA have similar outcomes in patients with chronic nonspecific LBP with regard to the pain and quality of life. Effective application may however be hampered by the cost-related factors thus suggesting evaluation of health care system in Ghana. PMID: 26693193 [PubMed - in process] (Source: Ghana Medical Journal)


Descending nociceptive inhibition is modulated in a time-dependent manner in a double-hit model of chronic/tonic pain
Publication date: 19 February 2016 Source:Neuroscience, Volume 315 Author(s): A.J. Parent, P. Tétreault, M. Roux, K. Belleville, J.-M. Longpré, N. Beaudet, P. Goffaux, P. Sarret Clinical evidences suggest that an imbalance between descending inhibition and facilitation drives the development of chronic pain. However, potential mechanisms promoting the establishment of a persistent pain state and the increased pain vulnerability remain unknown. This preclinical study was designed to evaluate temporal changes in descending pain modulation at specific experimental endpoints (12, 28, 90 and 168days) using a novel double-hit model of chronic/tonic pain (first hit: chronic constriction injury (CCI) model; second hit: tonic formalin pain in the contralateral hindpaw). Basal activity o...


Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft
Conclusion This specific MPFL reconstruction gives good clinical results and corrects patellar tilt. It did not affect the patellofemoral surfaces at the short term, as shown by the absence of radiological signs of OA in the CT scan. The procedure has been shown to be safe and suitable for the treatment of chronic patellar instability, including in adolescents with open physis. A new effective, inexpensive and easy-to-perform technique is described to reconstruct MPFL in the daily clinical practice. Level of evidence Therapeutic case series, Level IV. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Bidirectional Dislocation of the Distal Radioulnar Joint After Distal Radius Fracture: Case Report
We report a patient with bidirectional dislocation of the distal radioulnar joint after malunited distal radius fracture, in which the ulnar head dislocated dorsally during forearm pronation and palmarly during supination without manual compression of the ulnar head. The patient had chronic ulnar wrist pain and experienced a painful clunk during forearm rotation. The distal radioulnar joint ballottement test was positive in both the dorsal and palmar directions. Her distal radius was malunited with a 20° dorsal angulation and 18° pronation deformity. (Source: The Journal of Hand Surgery)


[Non-randomised trial of an educational intervention based on cognitive-behavioural principles for patients with chronic low back pain attended in Primary Care Physiotherapy].
CONCLUSIONS: These results should be considered in light of possible limits imposed by the study. Its pragmatic nature would allow a potential transfer to usual care. PMID: 26724987 [PubMed - as supplied by publisher] (Source: Atencion Primaria)


Dyspareunia: including this diagnosis in chronic pain reporting
No abstract available (Source: Menopause)


Study Suggests Mental Disorders Increase Risk of Subsequent Chronic Physical Conditions
Findings from a study published today in JAMA Psychiatry suggest that mental disorders increase the odds of later developing a wide range of chronic physical conditions, with chronic pulmonary disease and chronic pain disorders being most prevalent.Researchers from the University of Otago in Australia analyzed retrospective data generated from the World Health Surveys of more than 47,000 adults in 17 countries. Survey participants were asked to report the year of onset of their mental illness diagnosis (based on DSM-IV criteria) as well as any chronic physical condition (e.g., heart disease, cancer, chronic pulmonary disease diabetes mellitus, and arthritis) and the year it was diagnosed.The single physical condition most strongly associated with an earlier diagnosis of a mental disorder w...


Decreased voltage-gated potassium currents in rat dorsal root ganglion neurons after chronic constriction injury
Voltage-gated potassium channels (KV) regulate pain transmission by controlling neuronal excitability. Changes in KV expression patterns may thus contribute toward hyperalgesia following nerve injury. The aim of this study was to characterize KV current density in dorsal root ganglion (DRG) neurons following chronic constriction injury (CCI) of the right sciatic nerve, a robust model of post-traumatic neuropathic pain. The study examined changes in small-diameter potassium ion currents ( (Source: NeuroReport)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Trauma-induced heterotopic bone formation and the role of the immune system: A review
ABSTRACT: Extremity trauma, spinal cord injuries, head injuries, and burn injuries place patients at high risk of pathologic extraskeletal bone formation. This heterotopic bone causes severe pain, deformities, and joint contractures. The immune system has been increasingly implicated in this debilitating condition. This review summarizes the various roles immune cells and inflammation play in the formation of ectopic bone and highlights potential areas of future investigation and treatment. Cell types in both the innate and adaptive immune system such as neutrophils, macrophages, mast cells, B cells, and T cells have all been implicated as having a role in ectopic bone formation through various mechanisms. Many of these cell types are promising areas of therapeutic investigation for potent...


Contemporary Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Conclusions Our current understanding of the pathophysiology underlying CP/CPPS resulting in this highly variable syndrome does not speak in favor of a monotherapy for management. No efficient monotherapeutic option is available. The best evidence-based management of CP/CPPS strongly suggests a multimodal therapeutic approach addressing the individual clinical phenotypic profile. Patient summary Chronic prostatitis/chronic pelvic pain syndrome presents a variable syndrome. Successful management of this condition is challenging. It appears that a tailored treatment strategy addressing individual patient characteristics is more effective than one single therapy. A multifactorial genesis appears to contribute to an individual multifaceted complex of symptoms for every patient diagnosed with ...


Chronic Pelvic Pain Syndrome: Light at the End of the Tunnel?
Publication date: February 2016 Source:European Urology, Volume 69, Issue 2 Author(s): Thomas M. Kessler (Source: European Urology)


Health-related Quality of Life of Patients With Chronic Systolic Heart Failure in Spain: Results of the VIDA-IC Study
Conclusions Patients with heart failure have worse quality of life than the general Spanish population and patients with other chronic diseases. Female sex, being older, comorbidity, advanced symptoms, and recent hospitalization are determinant factors in health-related quality of life in these patients. (Source: Revista Espanola de Cardiologia)


Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial
ConclusionEnlargement of the apical foramen during root canal treatment increased the incidence and intensity of postoperative pain. (Source: International Endodontic 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>


Short answer question: a distracting ECG
Part 1 A 76-year-old man with a past medical history of chronic obstructive pulmonary disease is brought to the emergency department (ED) with suspected sepsis. He is a smoker of 15 cigarettes per day who has an exercise tolerance of approximately 30&nbsp;m. He saw his general practitioner who treated him with antibiotics and steroids. He has rung for an ambulance complaining of increasing shortness of breath and back pain. His initial vital signs were: BP 100/87&nbsp;mm&nbsp;Hg, HR 120&nbsp;bpm, RR 24 breaths per minute, oxygen saturations 100% on room air and normal temperature. He appeared sweaty and clammy, but his heart and chest were normal on examination. An ECG is done (figure 1). Questions What is the differential diagnosis? What is your initial management? &nbsp; The differential...


Development and initial validation of the Activity Patterns Scale in patients with chronic pain
Several self-report measures were used to identify six activity patterns in chronic pain patients: pain avoidance, activity avoidance, task-contingent persistence, excessive persistence, pain-contingent persistence, and pacing. Instruments for assessing pacing should include three pacing behaviours (breaking tasks into smaller tasks, taking frequent short rests, slowing down), each of which relate to a single goal (increasing activity levels, conserving energy for valued activities, and reducing pain). (Source: The Journal of Pain)


Management of pudendal neuralgia using ultrasound-guided pulsed radiofrequency: a report of two cases and discussion of pudendal nerve block techniques
This report describes two cases of pudendal neuralgia that were successfully managed using ultrasound-guided pulsed radiofrequency and presents a literature review of pudendal nerve block techniques. However, in the management of chronic neuropathic pain, physicians should keep in mind that the placebo effect related to invasive approaches must not be neglected. (Source: Journal of Anesthesia)


Glt1 glutamate receptor mediates the establishment and perpetuation of chronic visceral pain in an animal model of stress-induced bladder hyperalgesia.
Authors: Ackerman AL, Jellison FC, Lee UJ, Bradesi S, Rodriguez LV Abstract Psychological stress exacerbates interstitial cystitis/bladder pain syndrome (IC/BPS), a lower urinary tract pain disorder characterized by increased urinary frequency and bladder pain. Glutamate (Glu) is the primary excitatory neurotransmitter modulating nociceptive networks. Glt1, an astrocytic transporter responsible for Glu clearance, is critical in pain signaling termination. We sought to examine the role of Glt1 in stress-induced bladder hyperalgesia and urinary frequency. In a model of stress-induced bladder hyperalgesia with high construct validity to human IC/BPS, female Wistar-Kyoto (WKY) rats were subjected to 10-day water avoidance stress (WAS). Referred hyperalgesia and tactile allodynia were a...


Recent Approaches and Development of Acupuncture on Chronic Daily Headache
Abstract Chronic daily headache (CDH) is a very important part of primary headache disorder, and it causes heavy socioeconomic burden. An increasing number of people are suffering from CDH, and there are many treatment choices for the different subtypes of CDH. However, the definite effect of these treatments, especially the non-pharmacologic treatments, is still unclear and controversial. Acupuncture, a key component of Traditional Chinese Medicine (TCM), has an over 2500-year history in China as an effective non-pharmacologic method for chronic pain, but the researches on CDH are limited. Varying stimulations and the acupoints can be chosen for different acupuncturists, and there are many primary and secondary assessments of the therapeutic effect. Although acupuncture has been...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 epidemiology and risk factors of chronic polyneuropathy
Abstract Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness. Although the disease is often encountered in neurological clinics and is well known by physicians, incidence and prevalence rates are not well known. We searched EMBASE, Medline, Web-of-science, Cochrane, PubMed Publisher, and Google Scholar, for population-based studies investigating the prevalence of polyneuropathy and its risk factors. Out of 5119 papers, we identified 29 eligible studies, consisting of 11 door-to-door survey studies, 7 case–control studies and 11 cohort/database studies. Prevalence of polyneuropathy across these studies varies substantially. This can partly be explained by differenc...


JAB1 is Involved in Neuropathic Pain by Regulating JNK and NF-κB Activation After Chronic Constriction Injury.
This study aimed to investigate the possible involvement of JAB1. Here, employing a neuropathic pain model induced by chronic constriction injury (CCI) on rats, we reported the role of JAB1 in the maintenance of neuropathic pain. By western blot, we found that CCI markedly up-regulated JAB1 expression in the dorsal root ganglion (DRG) and spinal cord. Immunofluorescent assay demonstrated that JAB1 was extensively localized in IB4-, CGRP- and NF200-positive neurons in the injured L5 DRG, and mainly co-localized with NeuN in spinal cord. In addition, we showed that CCI induced phosphorylation of p65 and JNK in vivo. Intrathecal injection of JAB1 siRNA significantly attenuated the CCI-induced JNK and p65 phosphorylation and alleviated both mechanical allodynia and heat hyperalgesia in rats. T...


Urinary biomarkers for the non-invasive diagnosis of endometriosis.
CONCLUSIONS: There was insufficient evidence to recommend any urinary biomarker for use as a replacement or triage test in clinical practice for the diagnosis of endometriosis. Several urinary biomarkers may have diagnostic potential, but require further evaluation before being introduced into routine clinical practice. Laparoscopy remains the gold standard for the diagnosis of endometriosis, and diagnosis of endometriosis using urinary biomarkers should only be undertaken in a research setting. PMID: 26695425 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Central pain processing is altered in people with Achilles tendinopathy.
We report a reduced conditioned pain modulation effect in people with Achilles tendinopathy compared to people without Achilles tendinopathy. A reduced conditioned pain modulation effect reflects altered central pain processing which is believed to contribute to the persistence of pain in other conditions. Altered central pain processing may also be an important factor in persistent tendon pain that has traditionally been regarded to be dominated by peripheral mechanisms. PMID: 26701922 [PubMed - as supplied by publisher] (Source: British Journal of Sports Medicine)


Spinal histamine in attenuation of mechanical hypersensitivity in the spinal nerve ligation-induced model of experimental neuropathy.
Authors: Wei H, Viisanen H, You HJ, Pertovaara A Abstract Here we studied whether and through which mechanisms spinal administration of histamine dihydrochloride (histamine) attenuates pain behavior in neuropathic animals. Experiments were performed in rats with spinal nerve ligation-induced neuropathy and a chronic intrathecal catheter for spinal drug delivery. Mechanical hypersensitivity was assessed with monofilaments while radiant heat was used for assessing nociception. Ongoing neuropathic pain and its attenuation by histamine was assessed using conditioned place-preference test. Following spinal administration, histamine at doses 0.1-10µg produced a dose-related mechanical antihypersensitivity effect. With prolonged treatment (twice daily 10µg for five days), the antihypers...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


The role of PON1 and CYP2D6 Genes in Susceptibility to Organophosphorus Chronic Intoxication in Egyptian Patients.
CONCLUSION: PON1 192RR genotype and CYP2D6 1934A allele were found to be related to the susceptibility to organophosphate chronic toxicity in Egyptians. Larger scale gene-environmental interaction studies are recommended to confirm results and Genotyping is recommended during selection of agricultural pesticide workers to exclude high risk group. PMID: 26723569 [PubMed - as supplied by publisher] (Source: Neurotoxicology)


Autologous mid-urethral sling for stress urinary incontinence: Preliminary results and description of a contemporary technique
Conclusion: In a heterogeneous group of women with primary or recurrent stress urinary incontinence, the aMUS was found to have good subjective short-term cure rates with acceptable patient-reported satisfaction scores. We report a low rate of de novo OAB symptoms, no cases of erosion and no chronic pelvic, groin, or vaginal pain. We believe that aMUS is a good alternative to synthetic mid-urethral sling surgery and could be offered to women contemplating surgery for SUI. (Source: Journal of Clinical Urology)


How To Help A Pregnant Mom Who Needs Baby Products And A Home
This holiday season, Breanna Brame isn't fixated on picking out gifts or decorating a tree. Instead, she's trying to make ends meet and acquire the essentials she needs to provide for her family. In addition to raising a toddler, the 25-year-old mom from Oakland, California has spent over three years taking care of her mother, who has diabetes, experienced kidney failure and was on dialysis for two years before receiving a transplant from Breanna's brother. Unable to afford her own housing, Breanna lives with her mom in Livermore, along with her son, and helps with tasks like cooking, cleaning and personal care as her in-home care provider, she told The Huffington Post.&#160; Through a California government program called In-Home Supportive Services (IHSS), the young mom receives a small a...


Prioritizing Comparative Effectiveness Research Questions for Treatment Options for Chronic Low Back Pain: A Stakeholder Workshop
Registration is open for this webinar, being held on Thursday, January 7, 2016 - 09:30 am to 12:30 pm EST. The public is welcome to listen to the proceedings. (Source: HSR Information Central)


In Reply: A Survey of Chronic Pain Due to Spinal Dural Arteriovenous Fistulae
No abstract available (Source: Neurosurgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Letter: A Survey of Chronic Pain Due to Spinal Dural Arteriovenous Fistulae
No abstract available (Source: Neurosurgery)


Isolated abdominal aortic dissection in a young female patient
A 43-year-old woman presented with acute lower abdominal pain radiating to both sides of the groin. She had no history of smoking, drug abuse, surgeries, trauma, or any chronic diseases. There was no family history of vascular disease. On the admission physical examination, she was normotensive, had normal pulses on four limbs, and presented tenderness and pain on abdominal aortic palpation and in her lower abdomen. Contrast-enhanced abdominal and thoracic computed tomography showed a distal infrarenal abdominal aortic dissection compromising both common iliac arteries (A) and a saccular dilation of the left common iliac dissected artery (B and C). (Source: Journal of Vascular Surgery)


Surgical Approaches to Chronic Pancreatitis.
Authors: Hartmann D, Friess H Abstract Chronic pancreatitis is a progressive inflammatory disease resulting in permanent structural damage of the pancreas. It is mainly characterized by recurring epigastric pain and pancreatic insufficiency. In addition, progression of the disease might lead to additional complications, such as pseudocyst formation or development of pancreatic cancer. The medical and surgical treatment of chronic pancreatitis has changed significantly in the past decades. With regard to surgical management, pancreatic head resection has been shown to be a mainstay in the treatment of severe chronic pancreatitis because the pancreatic head mass is known to trigger the chronic inflammatory process. Over the years, organ-preserving procedures, such as the duodenum-pre...


Utility of diffusion‐weighted MRI for differentiating acute from chronic cholecystitis
ConclusionVisually increased mural signal on high b‐value DWI was highly sensitive and moderately specific for acute cholecystitis, being an independent predictor relative to conventional features for both readers. Although requiring larger studies, DWI (particularly the high b‐value images) may have additive value relative to conventional MRI‐suspected acute cholecystitis. J. Magn. Reson. Imaging 2015. (Source: Journal of Magnetic Resonance Imaging)


Sleep disorders in patients with postural tachycardia syndrome
Conclusions It is unlikely that the sleep-related complaints of POTS patients are the result of a primary sleep disorder unique to POTS. We propose that a combination of factors such as body fatigue, chronic pain, and other somatic symptoms common in POTS patients might be the underlying reason for sleep-related symptoms in POTS. (Source: Clinical Autonomic 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>


Ultrasonographic analysis of dorsal neck muscles thickness changes induced by isometric contraction of shoulder muscles: a comparison between patients with chronic neck pain and healthy controls
Altered pattern of muscle activity is commonly seen with chronic neck pain (CNP). However, limited investigations have been done on dorsal neck muscles’ activity pattern while performing upper limb tasks in patients with CNP. (Source: Manual Therapy)


Large Pleural Effusion and Mediastinal Mass: An Unusual Connection!
Question: A 50-year-old Hispanic man with history of smoking, chronic obstructive pulmonary disease, chronic pancreatitis, congestive heart failure, and recurrent deep vein thrombosis on anticoagulation therapy was admitted with worsening shortness of breath and upper abdominal and chest pain for 3 days. The patient had chronic abdominal pain, occasional productive cough and had lost 50-lb weight over the last 6 months. He denied fever, night sweats, difficulty swallowing, vomiting, or diarrhea. (Source: Gastroenterology)


Interventional pain management for spinal disorders: a review of injection techniques
Summary Chronic spinal pain has a high prevalence and a severe economic, societal and health impact. In the last decades the practice and research of interventional techniques for the diagnosis and treatment of spinal pain has increased sharply. The level of evidence of the most common techniques is well documented. With image-guided precise diagnostic blocks it is possible to identify the source of chronic spinal pain in well over 60% of the cases. Nonsurgical specialties such as PM&R increasingly resort to the possibilities of interventional pain management for musculoskeletal disorders. For many forms of spinal pain there is at least fair evidence for long-term pain relief after a guided therapeutic injection often reducing the intake of analgesic medication or the need for...


Chest X-ray findings in late-onset congenital diaphragmatic hernia, a rare emergency easily misdiagnosed as hydropneumothorax: a case report
Conclusions Gastric and intestinal gas shadow distribution provides an important marker in the diagnosis of late-onset congenital diaphragmatic hernia and should be sought for in every case of suspected congenital diaphragmatic hernia in addition to noting the position of the nasogastric tube in the chest cavity. (Source: Journal of Medical Case Reports)


Psychological Therapy in Adolescents with Chronic Daily Headache
Abstract Chronic daily headache is a serious disease, causing significant problems in terms of reduced quality of life and disability, with pain localized to the head (headache) occurring 15 or more days per month for more than 3 months (&gt;180 days per year). Drugs, both used as preventive medications or as pain-killers, are insufficient for the management of these patients; a more global approach has been advocated. This paper reviews existing data concerning different psychological approaches, with a focus on adolescence. This leads to evidence still unanswered questions but also the importance to include psychological treatments in the management of this potentially disabling condition. (Source: Current Pain and Headache 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>


Outcome of Chronic Daily Headache or Chronic Migraine
Abstract Chronic daily headache (CDH) is a common neurological condition that affects 1–4 % of the general population. Recent epidemiological studies have shown that CDH is mainly represented by chronic migraine (CM). Owing to the frequent headaches, associated symptoms, and comorbid conditions associated with CDH/CM, disability, quality of life (QoL), economic burden, and treatment outcome have become important personal and social issues. There have been several studies assessing the disability, QoL, and economic burden associated with CDH/CM. These studies, conducted in different settings, consistently reported significantly higher disability and economic burden and lower QoL among CDH/CM patients compared to patients with episodic headache (EH) or episodic migraine (EM). Tr...


The threatened self: Considerations of time, place, and uncertainty in advanced illness.
CONCLUSION: Professional relationships that focus solely on the 'person as patient' may be insufficient for patients' needs. Health care professionals should seek to recognize and acknowledge the personal identity that may be critical to their sense of self-worth. Through an ongoing relationship guiding the patient through the uncertainties they face, health care professionals may play an essential role in sustaining the 'patient as person'. Statement of contribution What is already known on this subject? Loss of self or personal identity occurs in a range of serious conditions. The sick self is incorporated in a process of identity reconstruction. Uncertainty is an inherent aspect of serious and advanced illness. Unmanaged uncertainty results in a range of negative psychological consequen...


Psychophysiological Processing of Itch in Patients with Chronic Post-burn Itch: An Exploratory Study.
This study aimed to explore psychophysiological processes of chronic post-burn itch by comparing 15 patients with long-term itch due to burn injury with 15 matched healthy controls. Exploratory results indicated tendencies for higher itch sensitivity in patients than in controls, for mechanical stimuli and histamine, but not for electrical stimulation. Results further suggest that the efficacy of itch modulation by an itch- or pain-conditioning stimulus or directing attention towards itch stimuli do not differ between these patients and controls. Further elucidation of the processes underlying post-burn itch may improve the early identification and treatment of burn patients developing chronic itch. PMID: 26694745 [PubMed - as supplied by publisher] (Source: Acta Dermato-Venereologica)


[Splanchnic venous thrombosis: A monocentric study of 31 cases].
CONCLUSION: SVT often reflects the existence of a disease and/or an underlying prothrombotic state that should be identified to adapt the treatment and to avoid fatal complications. PMID: 26725444 [PubMed - as supplied by publisher] (Source: Journal des Maladies Vasculaires)


Mother who had boobs reduced from 34I TO 34D due to horrific back pain loses 9LB of flesh
Scyra Alexander, 32, from Cardiff, suffered from chronic back and neck pain because of her large breasts - and had to wear shirts double the size of the rest of her body. (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>


“We never thought we’d run again.”
For five years Hope Prockop, a competitive women’s squash player, battled chronic foot pain, while her daughter Lyle struggled with excruciating back pain. “It was really stressful to cope with both conditions,” says Hope. “I wondered if I would ever reach my goals.” Mother and daughter found the care and support they needed at Boston Children’s Hospital, where a team of doctors got the pair running and helped Hope reach the pinnacle of her sport. She represented the U.S. on the Team USA national women’s squash team in 2006, 2008 and 2010 and won two U.S. Masters national titles and the Allam British Open 45+ Squash Championships in 2015. Head-to-toe care In 2010, Hope was questioning her body and her athletic goals. She had chronic foot pain and had consulted podiatrists thr...


Low Level Laser Therapy for chronic knee joint pain patients.
CONCLUSION: The present study demonstrated that 830 nm LLLT was an effective form of treatment for chronic knee pain caused by knee osteoarthritis. Patients were advised to undertake training involving gentle flexion and extension of the knee. PMID: 25705083 [PubMed] (Source: Laser Therapy)


The Proximal Priority Theory: An Updated Technique in Low Level Laser Therapy with an 830 nm GaAlAs Laser.
CONCLUSIONS: PPLT is easy to deliver and offers tangible results in a large range of conditions, enhancing the efficacy of diode laser LLLT. PMID: 24511197 [PubMed] (Source: Laser Therapy)


Low level laser therapy for patients with cervical disk hernia.
CONCLUSION: The present study demonstrates that LLLT was an effective form of treatment for neck and back pain caused by cervical disk hernia, reinforced by postural training. PMID: 24511189 [PubMed] (Source: Laser Therapy)


[Workers with Ehlers-Danlos syndrome: indications for health surveillance and suitable job assignment].
CONCLUSIONS: People with EDS suffer from chronic pain, impaired quality of life and employment difficulties. The hypermobile type seems more compromised in functional areas such as pain and work, while the classic type is more compromised in daily routine and home activities. The employment section was more impaired for EDS subjects who perform tasks with greater physical effort. PMID: 25607285 [PubMed - indexed for MEDLINE] (Source: Medicina del Lavoro)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 of chronic renal patients in peritoneal dialysis and hemodialysis.
CONCLUSION: QOL is similar among patients in DP or in HD, except in terms of pain, that was less severe in PD patients. PMID: 26398639 [PubMed - in process] (Source: Jornal Brasileiro de Nefrologia)


[Nonsteroid anti-inflammatory drugs (NSAID) and risk of cardiovascular events. Literature review and clinical implications].
Authors: Temporelli PL, Zito GB, Pedretti RF, Belisarii FI, Putortí G, Faggiano P, Gruppo Italiano di Cardiologia Preventiva e Riabilitative (GICR-IACPR), Associazioni Regionali Cardiologi Ambulatoriali (ARCA) Abstract Non steroid anti-inflammatory drugs (NSAIDs) are largely used for treatment of acute and chronic pain, even for long periods of time (months or years). While it is known that their use is frequently associated with gastrointestinal damage, including major bleedings from peptic ulcer, the risk of cardiovascular events related to NSAID has received much less attention. However, there is a large body of evidence showing that NSAIDs (both "traditional", such as diclofenac or indobufen, and selective cyclooxygenase inhibitors, COX-2) are associated with a significant inc...


Image-guided facet joint injection.
Authors: Peh W Abstract Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain management tool for facet-related spinal pain that can be effectively administered by a radiologist. This technique is the gold standard for identifying facet joints as the source of spinal pain. The major indications for facet injections include strong clinical suspicion of the facet syndrome, focal tenderness over the facet joints, low back pain with normal radiological findings, post-laminectomy syndrome with no evidence of arachnoiditis or recurrent disc disease, and persistent low back pain after spinal fusion. The contraindications are ...


F-FDG PET/CT as a potential valuable adjunct to MRI in characterising the Brodie's abscess.
Authors: Fathinul F, Nordin A Abstract Chronic osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Early diagnosis of Brodie's abscess is deemed important as the disease has a good curative potential following an appropriate antibiotic treatment. Of late, PET/CT using (18)F-FDG is taking a centre stage in the imaging of bone infection though documentation on its role in characterising the feature of Brodie's abscess is exceedingly scarce. On the other hand, it is well known that MRI imaging plays a very important role in distinguishing abscess loculation from malignancy. The authors present the case of a 13-year-old boy with pain in the right heel for few ...


White House expands opioid addiction response: Treat chronic pain like other chronic conditions, pharmacists say.
Authors: Traynor K PMID: 26683672 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


CDC issues draft opioid prescribing guidelines for chronic pain
(Source: Alcoholism and Drug Abuse Weekly)


An unusual cause of chronic headache in a young man
(Source: Headache: The Journal of Head and Face Pain)


Ocular neuropathic pain
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 these nociceptive pathways are determined by the t...


Laparoscopic Longitudinal Pancreaticojejunostomy Using Barbed Sutures: an Efficient and Secure Solution for Pancreatic Duct Obstructions in Patients with Chronic Pancreatitis
We describe our laparoscopic longitudinal pancreaticojejunostomy (LPJ) technique using barbed sutures to manage a pancreatic duct obstruction. We performed laparoscopic longitudinal anterior pancreaticojejunostomy using barbed sutures (3-0 absorbable wound closure device, V-Loc™, Covidien, Minneapolis, MN, USA) in 11 patients who presented with signs of a pancreas ductal obstruction and chronic pancreatitis. The surgical outcomes and follow-up records at the outpatient department were reviewed, and the effectiveness and feasibility of this method were analyzed. Mean patient age was 54.4 ± 9.5 years, and pancreatic duct stones were removed from all patients without conversion to laparotomy. Overall operative time was 200.7 ± 56.4 min, and estimated blood loss was 42.2 ± 1...


Stress and glucocorticoid receptor transcriptional programming in time and space: Implications for the brain–gut axis
Abstract BackgroundChronic psychological stress is associated with enhanced abdominal pain and altered intestinal barrier function that may result from a perturbation in the hypothalamic–pituitary–adrenal (HPA) axis. The glucocorticoid receptor (GR) exploits diverse mechanisms to activate or suppress congeneric gene expression, with regulatory variation associated with stress‐related disorders in psychiatry and gastroenterology. PurposeDuring acute and chronic stress, corticotropin‐releasing hormone drives secretion of adrenocorticotropic hormone from the pituitary, ultimately leading to the release of cortisol (human) and corticosterone (rodent) from the adrenal glands. Cortisol binds with the GR in the cytosol, translocates to the nucleus, and activates the NR3C1 (nuclear recepto...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Emerging treatments in neurogastroenterology: eluxadoline – a new therapeutic option for diarrhea‐predominant IBS
Abstract BackgroundIrritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder worldwide. The global prevalence of IBS is estimated to be as high as 15%. For many patients, IBS is a chronic disorder which can significantly reduce quality of life. Just as important as the effects on any one individual, IBS also places a significant impact on the population as a whole with its negative effects on the health care system. Irritable bowel syndrome is categorized into one of three main categories: IBS with diarrhea, IBS with constipation, and IBS with mixed bowel habits. Patients with diarrhea‐predominant IBS (IBS‐D) comprise a substantial proportion of the overall IBS population. A number of therapeutic options exist to treat the symptoms of abdominal pain, bloati...


Initial Presentation of a Pancreatic Mass
Question: A 55-year-old African American man with a medical history of chronic pancreatitis, pancreatic mass, alcohol abuse, hypertriglyceridemia, gastroesophageal reflux disease, and essential hypertension presented to the emergency department with severe abdominal pain radiating to his back that was associated with diaphoresis and weight loss. The initial workup demonstrated acute pancreatitis. Prior radiologic studies were reviewed to better characterize the pancreatic mass. More recent computed tomography and MRI scans demonstrated an enlarging, cystic and septated mass within the pancreatic head with marked dilatation of the patient’s pancreatic, and intrahepatic and extrahepatic biliary ducts (MRI; Figure A). (Source: Gastroenterology)


Nerves are more abundant than blood vessels in the degenerate human intervertebral disc
Conclusions: This study addresses the controversial topic of nerve and blood vessel ingrowth into the IVD in a large number of human samples. Our findings demonstrate that nerves are present within a large proportion of NP samples from degenerate IVDs. This study shows a possible link between nerve ingrowth and degeneration of the IVD and suggests that nerves can migrate in the absence of blood vessels. (Source: Arthritis Research and Therapy)


[Maladaptive plasticity in chronic and neuropathic pain].
This article tries to fill the gap between the practicing pain therapist and the researcher in summarizing neurophysiological and imaging results on neuropathic and chronic pain in a clear and simple manner. PMID: 26692212 [PubMed - as supplied by publisher] (Source: Schmerz)


KCNQ potassium channels in sensory system and neural circuits.
Authors: Wang JJ, Li Y Abstract M channels, an important regulator of neural excitability, are composed of four subunits of the Kv7 (KCNQ) K(+) channel family. M channels were named as such because their activity was suppressed by stimulation of muscarinic acetylcholine receptors. These channels are of particular interest because they are activated at the subthreshold membrane potentials. Furthermore, neural KCNQ channels are drug targets for the treatments of epilepsy and a variety of neurological disorders, including chronic and neuropathic pain, deafness, and mental illness. This review will update readers on the roles of KCNQ channels in the sensory system and neural circuits as well as discuss their respective mechanisms and the implications for physiology and medicine. We wil...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 adolescent with sickle cell disease.
Authors: Majumdar S Abstract Most children and adolescents with sickle cell disease are managed by primary care physicians. Sickle cell disease is often considered to be a disorder that is only associated with treatment of acute pain, although it has become evident over the years that the condition is associated with numerous organ complications, many of which begin during adolescence. The purpose of this article is to highlight the various organ complications that may occur in sickle cell disease, with a particular emphasis on adolescence, and how best to detect and screen for such complications. Furthermore, as life expectancy continues to improve, transition to adult health care for patients has become a critical issue. The psychological effect on the adolescent with this chroni...


An adolescent female with abdominal pain and chronic cough.
Authors: Lindley L, Williams S, Gross JE, Greene JP PMID: 23162940 [PubMed - indexed for MEDLINE] (Source: Adolescent Medicine: State of the Art Reviews)


Complete resolution of frozen shoulder syndrome in a woman treated with dextroamphetamine sulfate for chronic urinary urgency.
CONCLUSIONS: Idiopathic frozen shoulder syndrome can be added to the long list of conditions that are related to hypofunction of the sympathetic nervous system and all respond to dextroamphetamine sulfate therapy. They gynecologist is more familial with this syndrome be- cause of it being the main cause of pelvic pain. Thus the gynecologist may become the physician who subsequently treats orthopedic or rheumatological problems or other health issues. PMID: 26524823 [PubMed - in process] (Source: Clinical and Experimental Obstetrics and Gynecology)


Resolution of pelvic pain related to adenomyosis following treatment with dextroamphetamine sulfate.
CONCLUSIONS: Dextroamphetamine sulfate relieved pain from adenomyosis similar to its effect on endometriosis. PMID: 26524821 [PubMed - in process] (Source: Clinical and Experimental Obstetrics and Gynecology)


Failed surgical therapy for chronic back pain and sciatica may be due to hypofunction of the sympathetic nervous system.
CONCLUSIONS: Chronic pelvic pain and sciatica both may be symptoms of hypofunction of the sympathetic nervous system. In addition, with other pain symptoms, this can be effectively treated with sympathomimetic amines. PMID: 26411226 [PubMed - indexed for MEDLINE] (Source: Clinical and Experimental Obstetrics and Gynecology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 comparison of the efficacy of radiofrequency nucleoplasty and targeted disc decompression in lumbar radiculopathy.
Authors: Adakli B, Cakar Turhan KS, Asik I Abstract Chronic low back pain is a common clinical condition causing medical, socioeconomic, and treatment difficulties. In our study, we aimed to compare early and long-term efficacy of lumbar radiofrequency thermocoagulation (RFTC) nucleoplasty and targeted disc decompression (TDD) in patients with lumbar radiculopathy in whom previous conventional therapy had failed. The medical records of 37 patients undergoing TDD and 36 patients undergoing lumbar RFTC nucleoplasty were retrospectively examined and assigned to the Group D and Group N, respectively. In all patients Visual Analogue Scale (VAS) and Functional Rating Index (FRI) were recorded before treatment and after one, six and twelve months after the procedure. The North American Sp...


Sinotomy technique versus surgical excision with primary closure technique in pilonidal sinus disease.
Authors: Emir S, Topuz O, Kanat BH, Bali I Abstract Pilonidal disease is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Many surgical treatment modalities have been suggested, but an ideal and widely accepted treatment has yet to be established. The aim of this study was to compare quality of life of patients treated with the sinotomy technique with quality of life of patients treated with surgical excision plus primary closure technique by means of quality of life questionnaire. The data of patients who had been treated for pilonidal sinus in our clinic from September 2010 to June 2012 were analyzed retrospectively. Forty patients were treated with sinotomy technique and 40 patients were treated with surgical excision plus primary cl...


Carbon-13 urea breath test for Helicobacter pylori infection in patients with uninvestigated ulcer-like dyspepsia: an evidence-based analysis.
CONCLUSIONS: The ¹³C UBT is an accurate test with high sensitivity and specificity. Compared with serology, it has higher specificity. There is a paucity of data on the ¹³C UBT beyond test accuracy. PLAIN LANGUAGE SUMMARY: Breath test for detecting bacteria in patients with ulcer-like symptoms. Dyspepsia is a condition that causes long-term pain or discomfort in the upper abdomen. Symptoms can include heartburn, burping, bloating, nausea, or slow digestion. Dyspepsia can be caused by a bacterium that also causes ulcers and stomach cancer. Half of the world's people are believed to be infected with these bacteria. A test has been developed to detect the bacteria in a breath sample. Our review determined the accuracy of this breath test in adults with ulcer-like symptoms. From 19 stu...


Self-management support interventions for persons with chronic disease: an evidence-based analysis.
CONCLUSIONS: The Stanford CDSMP led to statistically significant, albeit clinically minimal, short-term improvements across a number of health status measures (including some measures of health-related quality of life), healthy behaviours, and self-efficacy compared to usual care. However, there was no evidence to suggest that the CDSMP improved health care utilization. More research is needed to explore longer-term outcomes, the impact of self-management on clinical outcomes, and to better identify responders and non-responders. PLAIN LANGUAGE SUMMARY: Self-management support interventions are becoming more common as a structured way of helping patients learn to better manage their chronic disease. To assess the effects of these support interventions, we looked at the results of 10 st...


Collagen cross-linking using riboflavin and ultraviolet-a for corneal thinning disorders: an evidence-based analysis.
Authors: Pron G, Ieraci L, Kaulback K, Medical Advisory Secretariat, Health Quality Ontario Abstract OBJECTIVE: The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objective for corneal cross-linking is to increase the...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis.
The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost-effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. BACKGROUND: The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). CLINICAL CONDITION: Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior ...


Endovascular laser therapy for varicose veins: an evidence-based analysis.
The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost-effectiveness of endovascular laser therapy (ELT) for the treatment of primary symptomatic varicose veins (VV). BACKGROUND: The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS). CLINICAL CONDITION: VV are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). Th...


How does a biopsy of endoscopically normal terminal ileum contribute to the diagnosis? Which patients should undergo biopsy?
CONCLUSION: In anemia indication or chronic diarrhea together with abdominal pain, the frequency of aphthous ulcers detected by ileoscopy and the frequency of chronic ileitis detected histopathologically despite a normal-appearing ileum were elevated. PMID: 24560378 [PubMed - indexed for MEDLINE] (Source: Libyan Journal of Medicine)


Prevalence of chronic pain in Libya before and after the uprising of 17 February 2011.
Authors: Tashani OA PMID: 23401725 [PubMed - indexed for MEDLINE] (Source: Libyan Journal of Medicine)


Chronic Paraspinal Pain due to Multiple Aortic Aneurysms.
We report a case of a 46 year old smoker who had developed multiple aneurysms of the aorta in both the thoracic and abdominal parts and was incidentally diagnosed on work-up of a chronic back pain associated with venous prominence on left side of chest and left arm. PMID: 26591150 [PubMed - indexed for MEDLINE] (Source: Journal of the Association of Physicians of India)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Plantar Pressure Distribution Pattern during Mid-Stance Phase of the Gait in Patients with Chronic Non-Specific Low Back Pain.
CONCLUSION: At mid-stance phase of walking, the pressures on the plantar surface were unequally distributed in subjects with chronic non-specific low back pain. PMID: 26591401 [PubMed - indexed for MEDLINE] (Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet)


Immediate Effect of Hold-Relax Stretching of Iliopsoas Muscle on Transversus Abdominis Muscle Activation in Chronic Non-Specific Low Back Pain with Lumbar Hyperlordosis.
CONCLUSION: The HR of the iliopsoas muscle reduced pain and lumbar lordosis angle, enhanced TrA activation, and increased length of hip flexor in CNSLBP with lumbar hyperlordosis. PMID: 26387404 [PubMed - indexed for MEDLINE] (Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet)


Effect of painless diabetic neuropathy on pressure pain hypersensitivity (hyperalgesia) after acute foot trauma.
CONCLUSION: Physiological nociception and post-traumatic hyperalgesia to pressure are diminished at the foot with severe painless (diabetic) neuropathy. A degree of post-traumatic hypersensitivity required to 'pull away' from any one, even innocuous, mechanical impact in order to avoid additional damage is, therefore, lacking. PMID: 25397867 [PubMed] (Source: Diabetic Foot and Ankle)


Etiology, pathophysiology and classifications of the diabetic Charcot foot.
Authors: Papanas N, Maltezos E Abstract In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, ...


Excerpt of Spiral Up! Discover the Power of Simple Tools to Relieve Stress & Feel Good Now
A meticulous analysis of national health data has shown startling rises in death rates for middle-aged white Americans. Surprisingly, these deaths are not from infectious or chronic diseases, but from emotional diseases. Clearly, it is time for a focal shift related to our health; it is time for our emotional health needs to take center stage. Luckily, there is a very specific part of our brain that controls our emotional responses. By targeting this emotional center, we can learn to improve our emotional state, decrease our stress levels, and improve our health. The emotional center of our brain dictates how we process the experiences of daily life, and over time it develops habitual responses to stress. If the brain’s response to stress is ineffective, it can lead to stress-related 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>


[Erythropoietic protoporphyria : Clinical manifestations, diagnosis and new therapeutic possibilities].
Authors: Urbanski U, Frank J, Neumann NJ Abstract BACKGROUND: Erythropoietic protoporphyria, the second most common type of the cutaneous porphyrias, is due to an enzymatic deficiency of ferrochelatase, the last enzyme in heme biosynthesis. The enzyme defect leads to an accumulation of protoporphyrin IX in erythrocytes and an elevated excretion of this metabolite in the feces. CLINICAL PRESENTATION: Usually, disease onset is in early infancy, characterized by increased photosensitivity. During or shortly after sunlight exposure, affected individuals suffer from burning, stinging, itching, and pain in sun-exposed skin areas. These symptoms lead to a considerably reduced quality of life and strict avoidance of sunlight exposure. Subacute symptoms include visible changes like ede...


Mindfulness-based Stress Reduction (MBSR) as Treatment for Chronic Back Pain - an Observational Study with Assessment of Thalamocortical Dysrhythmia.
CONCLUSION: MBSR is a feasible intervention for patients with low back pain. They benefit from medium size effects which are comparable to similar behavioral interventions. Randomized controlled trials are needed in order to determine the specificity of these benefits. PMID: 26565981 [PubMed - in process] (Source: Forschende Komplementarmedizin)


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. PMID: 26335279 [PubMed - in process] (Source: Forschende Komplementarmedizin)


[Reimbursement for Acupuncture Treatments in the German Statutory Health Insurance System].
Authors: Trinczek K Abstract Since 2007, acupuncture in Germany is reimbursed by the statutory health insurance. However, this policy is limited to the diagnoses ‘chronic pain in lumbar spine’ and ‘chronic pain in knee joint through gonarthrosis’ and connected to semi-standardized specifications for acupuncture treatment that partly do not correspond with standards in professional acupuncture training. Predominantly, acupuncture is applied in orthopedic practice. High demands in qualification and quality assurance as well as the difficulty to establish an economically attractive framework in acupuncture treatment are issues that curtail the appeal of acupuncture as treatment option to be offered by statutory health insurance. PMID: 26021962 [PubMed - in process] (Source...


[Successful endoscopic neural therapy of a patient with chronic pain syndrome after rectum gunshot injury].
CONCLUSION: This is the first case report describing the successful endoscopic neural therapy of an intraluminal focus causing a chronic pain syndrome refractory to conventional analgetic and anti-inflammatory treatment. PMID: 25427522 [PubMed - indexed for MEDLINE] (Source: Forschende Komplementarmedizin)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Using hospital data and routines to estimate costs and effects of integrative care programmes for chronic pain and stress disorders--a feasibility study.
CONCLUSIONS: It was feasible to use hospital registry data to estimate costs and show positive effects of anthroposophic IC programmes for pain and stress disorders in Sweden. Clinical implications and the need for long-term follow-up are discussed. PMID: 25060155 [PubMed - in process] (Source: Forschende Komplementarmedizin)


Fasting therapy for treating and preventing disease - current state of evidence.
Authors: Michalsen A, Li C Abstract Periods of deliberate fasting with restriction of solid food intake are practiced worldwide, mostly based on traditional, cultural or religious reasons. There is large empirical and observational evidence that medically supervised modified fasting (fasting cure, 200-500 kcal nutritional intake per day) with periods of 7-21 days is efficacious in the treatment of rheumatic diseases, chronic pain syndromes, hypertension, and metabolic syndrome. The beneficial effects of fasting followed by vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials. Further beneficial effects of fasting are supported by observational data and abundant evidence from experimental research which found caloric restriction and intermittent fast...


Fasting therapy - an expert panel update of the 2002 consensus guidelines.
Authors: Wilhelmi de Toledo F, Buchinger A, Burggrabe H, Hölz G, Kuhn C, Lischka E, Lischka N, Lützner H, May W, Ritzmann-Widderich M, Stange R, Wessel A, Boschmann M, Peper E, Michalsen A, Medical Association for Fasting and Nutrition (Ärztegesellschaft für Heilfasten und Ernährung, ÄGHE Abstract Fasting for medical purpose (fasting therapy) has a long tradition in Europe and is established as a defined therapeutic approach in specialized fasting hospitals or within clinical departments for integrative medicine. In 2002, the first guidelines for fasting therapy were published following an expert consensus conference; here we present a revised update elaborated by an expert panel. Historical aspects and definitions, indications, methods, forms, and accompanying procedures of ...


Fibromyalgia Syndrome - a multidisciplinary approach.
Authors: Binkiewicz-Glińska A, Bakuła S, Tomczak H, Landowski J, Ruckemann-Dziurdzińska K, Zaborowska-Sapeta K, Kowalski I, Kiebzak W Abstract According to American College of Rheumatology fibromyalgia syndrome (FMS) is a common health problem characterized by widespread pain and tenderness. The pain and tenderness, although chronic, present a tendency to fluctuate both in intensity and location around the body. Patients with FMS experience fatigue and often have sleep disorders. It is estimated that FMS affects two to four percent of the general population. It is most common in women, though it can also occur in men. FMS most often first occur in the middle adulthood, but it can start as early as in the teen years or in the old age. The causes of FMS are unclear. Various infect...


[Relaxation treatments and biofeedback for anxiety and somatic stress-related disorders].
CONCLUSIONS: TR and BFB are effective for anxiety and somatic stress-related disorders, associated with coping and quality of life improvement and affordable costs; they are minimally invasive but needing an active participation in the treatment process. Some limits are responders' prediction, continuity of practice and limited effectiveness for depression disorders. Finally, it is shown that they are real psychosomatic therapies that are able to produce somatic peripheral changes (neuroendocrine, neurovegetative and muscular systems) generated by the mind and secondary to the involvement of central neurotransmitter circuits. PMID: 25424335 [PubMed - in process] (Source: Rivista di Psichiatria)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medical News Today: Acupuncture 'safe and effective' for chronic pain in children
While studies have shown acupuncture is effective for chronic pain in adults, new research suggests the treatment may also be a feasible treatment for children with the condition. (Source: Health News from Medical News Today)


Long-term Safety and Effectiveness of Once-daily, Single-entity, Extended-release Hydrocodone Over 76 Weeks of an Open-label Study in Patients with Chronic Noncancer and Nonneuropathic Pain.
CONCLUSIONS: HYD was generally well tolerated. No unexpected safety concerns emerged. Pain control was sustained throughout 76 weeks of treatment. PMID: 26681111 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


Decreased Opioid Utilization and Cost at One Year in Chronic Low Back Pain Patients Treated with Transcutaneous Electric Nerve Stimulation (TENS).
DISCUSSION: Treatment of CLBP with TENS demonstrated significantly fewer patients requiring opioids, fewer events where a patient required an opioid prescription, and lower per-patient costs. Since TENS is both non-invasive and a non-narcotic, it may potentially allow physicians to be more aggressive in treating CLBP patients. PMID: 26680409 [PubMed - in process] (Source: Surgical Technology International)


Laparascopic Neurolysis of Deep Endometriosis Infiltrating Left Femoral Nerve: Case Report.
We report an isolated unilateral endometriosis lesion of the left lumbar region infiltrating the femoral nerve in a 38-year-old woman. She described severe dysmenorrhea, dyspareunia, dischezia, and chronic pelvic pain with irradiation to the anterior part of the left thigh. After investigation, it was identified as a 5-centimeter endometriotic nodule involving the femoral nerve and the psoas muscle. The patient was treated by two laparoscopic surgeries with neurolysis of the involved somatic nerve by a multidisciplinary team, with improvement of the symptoms. Laparoscopic neurolysis is the first approach advocated in these cases, leading to relief of neurological symptoms resulting from nerve infiltration by endometriosis. PMID: 26680392 [PubMed - in process] (Source: Surgical Technol...


Pulse-Dose Radiofrequency in Athletic Pubalgia: Preliminary Results.
CONCLUSIONS: Pulse-Dose Radiofrequency is an effective and safe technique in management of chronic pubalgia in athletes. PMID: 26667902 [PubMed - as supplied by publisher] (Source: Journal of Sport 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 SPANK Block: A Selective Sensory, Single-Injection Solution for Posterior Pain After Total Knee Arthroplasty
No abstract available (Source: Regional Anesthesia and Pain Medicine)


Neurologic Evaluation and Management of Perioperative Nerve Injury: Erratum
No abstract available (Source: Regional Anesthesia and Pain Medicine)


Block Performance and Risk Factors for Nerve Injury
No abstract available (Source: Regional Anesthesia and Pain Medicine)


Revising the 2012 American Society of Regional Anesthesia and Pain Medicine Checklist for Local Anesthetic Systemic Toxicity: A Call to Resolve Ambiguity in Clinical Implementation
No abstract available (Source: Regional Anesthesia and Pain Medicine)


Ultrasound-Guided Interventional Procedures in Pain Medicine: A Review of Anatomy, Sonoanatomy, and Procedures: Part VI: Ankle Joint
Abstract: Ultrasound-guided injections in pain medicine are emerging as a popular technique for pain interventions. Ultrasound can be applied for procedures of the ankle joint and surrounding structures. This review describes the anatomy and sonoanatomy of the ankle joint, subtalar joint, and surrounding extra-articular structures relevant for intra-articular injection. Second, it reviews injection techniques and the accuracy and efficacy of these intra-articular ankle injections. (Source: Regional Anesthesia and Pain Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Efficacy and Safety of Methylnaltrexone for Opioid-Induced Constipation in Patients With Chronic Noncancer Pain: A Placebo Crossover Analysis
Conclusions: Findings during placebo treatment further establish the profile of OIC and support that little or no gastrointestinal tolerance develops across time. Findings under open-label conditions established the reproducibility and durability of methylnaltrexone for OIC. (Source: Regional Anesthesia and Pain Medicine)


Epidural Steroid Injections for Radiculopathy and/or Back Pain in Children and Adolescents: A Retrospective Cohort Study With a Prospective Follow-Up
Conclusions: Children and adolescents can receive ESIs under conscious sedation with good safety. Further prospective studies may better define the role for these injections in the comprehensive management of pediatric spinal pain disorders. (Source: Regional Anesthesia and Pain Medicine)


The Development and Validation of a Quality Assessment and Rating of Technique for Injections of the Spine (AQUARIUS)
Conclusions: The instrument in both 17- and 12-item formats demonstrates good reliability and diagnostic accuracy in rating ESI studies. As a complement to other tools that assess bias, the instrument may improve the ability to evaluate evidence for systematic reviews and improve clinical trial design. (Source: Regional Anesthesia and Pain Medicine)


Serum Triamcinolone Levels Following Interlaminar Epidural Injection
Conclusions: The pharmacokinetics of epidural-administered triamcinolone is consistent with previously observed adverse effects of the drug on endocrine function. The pharmacokinetics of other epidural-administered steroids should be determined and incorporated in clinical trials to investigate the potential associations between serum levels, clinical outcomes, and potential adverse endocrine effects. (Source: Regional Anesthesia and Pain Medicine)


Effects of Intrathecal κ-Opioid Receptor Agonist on Morphine-Induced Itch and Antinociception in Mice
Abstract: The μ-opioid receptor (MOR) agonist–induced itch is a significant issue associated with analgesic therapies. Research suggested that systemically administered κ-opioid receptor (KOR) agonists inhibit intrathecal morphine–induced itch in primates. However, serious adverse effects induced by systemically administered KOR agonists may restrict their usefulness in humans. We investigated the effects of intrathecal KOR agonists on intrathecal morphine–mediated itch and antinociception in mice. Mice received intrathecal injections of one of the following drugs: morphine (0.1–1.0 nmol), the selective KOR agonist TRK-820 100 pmol, the combination of morphine 0.3 nmol + TRK-820 (10–100 pmol), and 5 μL of saline. One hour after intraperitoneal administration of the selective K...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 perception of disease in patients with chronic leg ulcer.
This study included 100 patients with chronic wounds/lower leg ulcer (59% of women and 41% of men, aged 31 to 89) treated locally with special wound dressings for moist wound healing. Study results showed no age and sex correlation with the quality of life, and all participants evaluated their quality of life and health satisfaction as neither good nor bad, but it was found that the disease mostly affected social relationships and to a lesser extent patient satisfaction with their physical and mental health, and the environment. Results on the disease perception showed that the participants considered their disease to have a significant effect on their life and would last for a relatively long time, but they also believed they had good control of their disease. Also, they considered the di...


Co-occurrence of chronic head, face and neck pain, and depression in war veterans with post-traumatic stress disorder.
This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either wa...


Chronic nerve injury-induced Mas receptor expression in dorsal root ganglion neurons alleviates neuropathic pain.
In conclusion, this study has provided the first evidence, to the best of our knowledge, that the Mas expression in DRG neurons is time-dependently induced by chronic nerve injury and that the intrathecal activation and inhibition of Mas can improve and aggravate CCI-induced neuropathic pain, respectively. This study has provided novel insights into the pathophysiological process of neuropathic pain and suggests that the Ang-(1-7)/Mas axis could be an effective therapeutic target for neuropathic pain, warranting further study. PMID: 26668645 [PubMed - as supplied by publisher] (Source: Experimental and Therapeutic Medicine)


A Duodenal Ulcer Caused by Pancreatic Ductal Hypertension with Chronic Pancreatitis.
Authors: Imoto A, Masuda D, Okuda A, Takagi W, Onda S, Sano T, Mikami T, Mohamed M, Ogura T, Higuchi K Abstract We herein describe the case of a 67-year-old woman with a duodenal ulcer thought to be caused by elevated pancreatic ductal pressure. The patient complained of continuous upper abdominal pain. Her medical history included idiopathic chronic pancreatitis. Endoscopy revealed a huge duodenal ulcer located on the inferior duodenal angle, which had not been seen on endoscopic retrograde pancreatography two months previously. A combination study using endoscopy and contrast imaging confirmed the relationship between the duodenal ulcer and the pancreatic branch duct. To our knowledge, this is the first case of duodenal ulcer thought to be caused by elevated pancreatic ductal pre...


Prevalence and Predictive Factors of Irritable Bowel Syndrome in a Community-dwelling Population in Japan.
Conclusion We found that an "Alcohol and accompanying" dietary pattern and depression were related to the risk of IBS in a Japanese community population. However, we could not rule out the possibility of some selection bias. Further studies with longitudinal observations are therefore warranted. PMID: 26666595 [PubMed - in process] (Source: Internal Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Activity of botulinum toxin type A in cranial dura: implications for treatment of migraine and other headaches
Conclusions and ImplicationsPericranially injected BoNT/A was taken up by local sensory nerve endings, axonally transported to the trigeminal ganglion and transcytosed to dural afferents. Colocalization of cleaved SNAP‐25 and the migraine mediator CGRP in dura suggests that BoNT/A may prevent DNI by suppressing transmission by CGRP. This might explain the effects of BoNT/A in temporomandibular joint inflammation and in migraine and some other headaches. (Source: British Journal of Pharmacology)


Comparison of the Safety of Adenosine and Regadenoson in Patients Undergoing Outpatient Cardiac Stress Testing
ConclusionAmong patients undergoing an outpatient pharmacologic stress test, the use of adenosine was associated with a lower occurrence of adverse effects and lower rate of a rescue agent use and may provide a potential medication cost savings opportunity compared with regadenoson. (Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy)


The midbrain central gray best suppresses chronic pain with electrical stimulation at very low pulse rates in two human cases.
Authors: Hentall ID, Luca CC, Widerstrom-Noga E, Vitores A, Fisher LD, Martinez-Arizala A, Jagid JR Abstract Deep brain stimulation in the midbrain׳s central gray (CG) can relieve neuropathic pain in man, but for unclear reasons sometimes fails intraoperatively or in early weeks. Here we describe continuous bilateral stimulation in the CG of two subjects with longstanding, severe neuropathic pain from spinal cord injury. Stimulation parameters were recursively adjusted over many weeks to optimize analgesia while minimizing adverse effects. In early weeks, adjustments were made in periodic office visits; subjects later selected ad libitum at home among several blinded choices while rating pain twice daily. Both subjects received significantly better pain relief when stimulus pulse ...


Update on Urinary Tract Markers in Interstitial Cystitis/Bladder Pain Syndrome
Abstract: Interstitial cystitis (IC)/painful bladder syndrome/bladder pain syndrome (BPS) is a chronic hypersensory condition of unknown etiology. Moreover, the optimal modality for diagnosing IC remains disputed. Several urinary markers have been investigated that may have potential utility in the diagnosis or confirmation of IC/BPS. Thus, inflammatory mediators, proteoglycans, urinary hexosamines, proliferative factors, nitric oxide (NO), BK polyomavirus family, and urothelial proinflammatory gene analysis have been found to correlate with varying degrees with the clinical diagnosis or cystoscopic findings in patients with IC/BPS. The most promising urinary biomarker for IC/BPS is antiproliferative factor, a sialoglycopeptide that has demonstrated inhibitory effects on urothelial cell pr...


Treating co-occurring chronic low back pain & generalized anxiety disorder
No abstract available (Source: The Nurse Practitioner)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 “right” goal when managing pain
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The &#8220;balancing act&#8221; of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person&#8217;s life. Our best pain-relieving drugs have lots of unpleasant side effects. Even non-drug interventions (like physical therapy) and complementary therapies (such as acupuncture) usually don&#8217;t have just one single effect. This means that, if we prior...


Strategies for Coping with Chronic Lower Back Pain in Patients with Long Physiotherapy Wait Time.
CONCLUSIONS Patients in different age groups had various difficulties in pain coping. Most of them required support in self-management of pain in addition to physiotherapy. The basic assessment of pain coping strategies should be consistently taken into account and included in rehabilitation protocols in chronic pain treatment. PMID: 26670743 [PubMed - as supplied by publisher] (Source: Medical Science Monitor)


The Patient With Chronic Headache: Part 2—Causes, Evaluation, and Treatment
No abstract available (Source: Topics in Pain Management)


Plumbing the Pits of Despair with Thoracic Outlet Syndrome
Title: Plumbing the Pits of Despair with Thoracic Outlet SyndromeCategory: Health FactsCreated: 6/4/2007 12:00:00 AMLast Editorial Review: 12/18/2015 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>


The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain
ConclusionsIntravenous lidocaine has analgesic, anti‐inflammatory and antihyperalgesic properties mediated by an inhibitory effect on ion channels and receptors. It attenuates the neuroinflammatory response in perioperative pain and chronic neuropathic pain. (Source: European Journal of Pain)


Processes of change in Acceptance and Commitment Therapy and Applied Relaxation for long‐standing pain
ConclusionsResults add to previous findings illustrating the role of psychological inflexibility as a mediator in ACT. (Source: European Journal of Pain)


Pain-related factors associated with lost work days in nurses with low back pain: A cross-sectional study
Conclusion The findings provide important new information regarding what is (and of equal importance) what is not associated with LWDs in nurses with LBP. Implications To effectively reduce LBP-related work disability, interventions may need to teach nurses how to better manage constant pain and remain active despite pain, rather than focus on pain reduction. Research to examine the potential efficacy of such treatment approaches for nurses with LBP is warranted. (Source: Scandinavian Journal of Pain)


Does an online psychological intervention improve self-efficacy and disability in people also receiving Multimodal Manual Therapy for chronic low back pain compared to Multimodal Manual Therapy alone? Design of a randomized controlled trial
Discussion This paper outlines the design of a randomised controlled trial that investigates the potential benefits of adding a widely available and inexpensive internet-based psychological intervention to standard multimodal manual therapy for the management of chronic low back pain. Trial registration ACTRN12615000269538 (Source: Chiropractic and Manual Therapies)


Drug Repurposing for the Development of Novel Analgesics
Publication date: Available online 17 December 2015 Source:Trends in Pharmacological Sciences Author(s): Marco Sisignano, Michael J. Parnham, Gerd Geisslinger Drug development consumes huge amounts of time and money and the search for novel analgesics, which are urgently required, is particularly difficult, having resulted in many setbacks in the past. Drug repurposing – the identification of new uses for existing drugs – is an alternative approach, which bypasses most of the time- and cost-consuming components of drug development. Recent, unexpected findings suggest a role for several existing drugs, such as minocycline, ceftriaxone, sivelestat, and pioglitazone, as novel analgesics in chronic and neuropathic pain states. Here, we discuss these findings as well as their proposed ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Care of the Elderly CKD Patient: A Practical Guide
Publication date: January 2016 Source:Advances in Chronic Kidney Disease, Volume 23, Issue 1 Author(s): Divya Raghavan, Jean L. Holley Palliative care is a branch of medicine dedicated to the relief of symptoms experienced during the course of illness. Renal palliative medicine or kidney supportive care is an evolving branch of nephrology, which incorporates the principles of palliative care into the care of CKD and ESRD (dialysis, transplant, and conservatively managed) patients. Conservative (non-dialytic) management is a legitimate option for frail, elderly CKD patients in whom dialysis may not lead to an improvement in quality or duration of life. Patients with advanced CKD have a high symptom burden that often worsens before death. Palliative or supportive care by visiting nurses,...


Translational control of nociception via 4E-binding protein 1
Activation of the mechanistic/mammalian target of rapamycin (mTOR) kinase in models of acute and chronic pain is strongly implicated in mediating enhanced translation and hyperalgesia. However, the molecular mechanisms by which mTOR regulates nociception remain unclear. Here we show that deletion of the eukaryotic initiation factor 4E-binding protein 1 (4E-BP1), a major mTOR downstream effector, which represses eIF4E activity and cap-dependent translation, leads to mechanical, but not thermal pain hypersensitivity. Mice lacking 4E-BP1 exhibit enhanced spinal cord expression of neuroligin 1, a cell-adhesion postsynaptic protein regulating excitatory synapse function, and show increased excitatory synaptic input into spinal neurons, and a lowered threshold for induction of synaptic potentiat...


Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
by Sanjay K. Shukla, Dane Cook, Jacob Meyer, Suzanne D. Vernon, Thao Le, Derek Clevidence, Charles E. Robertson, Steven J. Schrodi, Steven Yale, Daniel N. Frank Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease characterized by intense and debilitating fatigue not due to physical activity that has persisted for at least 6 months, post-exertional malaise, unrefreshing sleep, and accompanied by a number of secondary symptoms, including sore throat, memory and concentration impairment, headache, and muscle/joint pain. In patients with post-exertional malaise, significant worsening of symptoms occurs following physical exertion and exercise challenge serves as a useful method for identifying biomarkers for exertion intolerance. Evidence suggests that intestinal dysbiosi...


Exploration of clinical changes following a novel mobilisation technique for treatment of chronic low back pain: A single cohort design
To explore clinical changes following a novel manual mobilisation technique, 24 participants who experienced ‘moderate’ to ‘severe’ chronic low back pain were recruited from new patients attending a suburban osteopathy clinic. The intervention was a previously undescribed side-lying mobilisation technique targeting the lumbosacral spine (median of 6 treatment sessions). After 8 weeks reductions were shown in Oswestry Disability Index of 15 points (95% CI: 9.3, 22.7; p < 0.0001 for overall ANOVA); Quadruple Visual Analog Scale of 2.0 points (95% CI: 1.0, 3.0; p < 0.0001); and Patient Specific Functional Scale of 3.1 points (95% CI: 1.9, 4.3; p < 0.0001). (Source: Journal of Bodywork and Movement Therapies)


Long-term outcomes of intradural cervical dorsal root rhizotomy for refractory occipital neuralgia.
CONCLUSIONS Cervical dorsal root rhizotomy provides an efficacious means for pain relief in patients with medically refractory ON. In the appropriately selected patient, it may lead to optimal outcomes with a relatively low risk of complications. PMID: 26684782 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Exploration of clinical changes following a novel mobilisation technique for treatment of chronic low back pain: A single cohort design
To explore clinical changes following a novel manual mobilisation technique, 24 participants who experienced ‘moderate’ to ‘severe’ chronic low back pain were recruited from new patients attending a suburban osteopathy clinic. The intervention was a previously undescribed side-lying mobilisation technique targeting the lumbosacral spine (median of 6 treatment sessions). After 8 weeks reductions were shown in Oswestry Disability Index of 15 points (95% CI: 9.3, 22.7; p  (Source: Journal of Bodywork and Movement Therapies)


[Surgical treatment of pancreatic pseudocysts].
CONCLUSION: Surgical management is a viable option for the management of pancreatic pseudocyst with a low complication and recurrence rate. PMID: 26707249 [PubMed - as supplied by publisher] (Source: Cirugia y Cirujanos)


Proteomic analysis for the identification of serum diagnostic markers for joint hypermobility syndrome.
Authors: Watanabe A, Satoh K, Maniwa T, Matsumoto KI Abstract Joint hypermobility syndrome (JHS) (also termed Ehlers-Danlos syndrome, hypermobility type) is a heritable connective tissue disorder which is characterized by generalized joint hypermobility, chronic pain, dizziness, fatigue, and minor skin changes. However, it has yet to be determined in patients with JHS whether specific genetic factors are involved in the risk of developing the disorder. Therefore, interventions have been limited to symptomatic treatments, and biomarkers for diagnosis and therapy have not yet been identified. In the present study, to identify potential serum biomarkers for JHS, we examined proteins with differential levels in sera from patients with JHS and in sera from control individuals using iso...


Does an online psychological intervention improve self-efficacy and disability in people also receiving Multimodal Manual Therapy for chronic low back pain compared to Multimodal Manual Therapy alone? Design of a randomized controlled trial
Various interventions are available for the treatment of chronic low back pain (LBP), including Manual Therapy and Cognitive Behavioural Therapy (CBT). The purpose of this study is to evaluate whether the addi... (Source: Chiropractic and Osteopathy)


Palmitoylethanolamide, a Natural Retinoprotectant: Its Putative Relevance for the Treatment of Glaucoma and Diabetic Retinopathy.
Authors: Keppel Hesselink JM, Costagliola C, Fakhry J, Kopsky DJ Abstract Retinopathy is a threat to the eyesight, and glaucoma and diabetes are the main causes for the damage of retinal cells. Recent insights pointed out a common pathogenetic pathway for both disorders, based on chronic inflammation. Palmitoylethanolamide (PEA) is an endogenous cell protective lipid. Since its discovery in 1957 as a biologically active component in foods and in many living organisms, around 500 scientific papers have been published on PEA's anti-inflammatory and neuron-protective properties. PEA has been evaluated for glaucoma, diabetic retinopathy, and uveitis, pathological states based on chronic inflammation, respiratory disorders, and various pain syndromes in a number of clinical trials since...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


One- and two-year follow-up of a randomized trial of neck-specific exercise with or without a behavioural approach compared with prescription of physical activity in chronic whiplash disorder.
CONCLUSION: After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity. PMID: 26660722 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)


Predictors of improvement in observed functional ability in patients with fibromyalgia as an outcome of rehabilitation.
CONCLUSION: The results of this exploratory study suggest that several subgroups of patients, specifically those with a low baseline intake of weak and strong analgesics, and more pronounced clinical signs of central sensitization, may gain most clinical benefit from specialized rehabilitation when the outcome of interest is improvement in observed activity of daily living ability. PMID: 26660148 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)


Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial.
CONCLUSION: Both specific cranio-cervical flexion training and proprioception training had a comparable effect on performance on the cranio-cervical flexion test, a test of the neuromuscular control of the deep cervical flexors. These results indicate that proprioception training may have positive effects on the function of the deep cervical flexors. PMID: 26659920 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)


Isolation of Potent CGRP Neutralizing Antibodies Using Four Simple Assays
Calcitonin gene-related peptide (CGRP) is a small neuropeptide and a potent vasodilator that is widely associated with chronic pain and migraine. An antibody that inhibits CGRP function would be a potential therapeutic for treatment of these disorders. Here we describe the isolation of highly potent antibodies to CGRP from phage and ribosome display libraries and characterization of their epitope, species cross-reactivity, kinetics, and functional activity. Homogenous time-resolved fluorescence (HTRF) binding assays identified antibodies with the desired species cross-reactivity from nai&#x0308;ve libraries, and HTRF epitope competition assays were used to characterize and group scFv by epitope. The functional inhibition of CGRP and species cross-reactivity of purified scFv and antibodies ...


A Surface Plasmon Resonance Spectroscopy Method for Characterizing Small-Molecule Binding to Nerve Growth Factor
This study details for the first time a methodology that can be used to directly characterize the binding event between small-molecule inhibitors and NGF. (Source: Journal of Biomolecular Screening)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank
Conclusions In this cross-sectional analysis, previous fracture is associated with an increased likelihood of chronic widespread bodily pain, particularly with hip fractures in women, and spine fractures in both sexes. If replicated, these findings may help inform the identification of those most at risk of chronic widespread pain post-fracture, allowing preventative measures to be targeted. (Source: Archives of Orthopaedic and Trauma Surgery)


Utility of features of the patient's history in the diagnosis of atraumatic shoulder pain: a systematic review
Whereas physical examination tests for shoulder disorders have numeric values that describe the utility of the test and its effect on the probability of having a diagnosis, this information is lacking for elements of the history. The purpose of this study was to conduct a systematic review of the literature to determine numeric data (sensitivity, specificity, predictive values, and likelihood or odds ratios) for elements of the history with regard to diagnoses in patients with chronic atraumatic shoulder pain. (Source: Journal of Shoulder and Elbow Surgery)


Sclerotherapy of Diffuse and Infiltrative Venous Malformations of the Hand and Distal Forearm
Conclusion Sclerotherapy is a safe and effective therapy for VM of the hand with over 83 % of patients experiencing relief. (Source: CardioVascular and Interventional Radiology)


Cryoneurolysis in Patients with Refractory Chronic Peripheral Neuropathic Pain
To evaluate the safety and efficacy of cryoneurolysis in patients with refractory peripheral neuropathic pain. (Source: Journal of Vascular and Interventional Radiology : JVIR)


WITHDRAWN: Psychosocial interventions for the management of chronic orofacial pain.
CONCLUSIONS: There is weak evidence to support the use of psychosocial interventions for chronic orofacial pain. Although significant effects were observed for outcome measures where pooling was possible, the studies were few in number and had high risk of bias. However, given the non-invasive nature of such interventions they should be used in preference to other invasive and irreversible treatments which also have limited or no efficacy. Further high quality trials are needed to explore the effects of psychosocial interventions on chronic orofacial pain. PMID: 26678041 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Distinguishing Microscopic Colitis From Irritable Bowel Syndrome
Irritable bowel syndrome (IBS), a chronic gastrointestinal disorder affecting up to 1 in 5 people in North America and Western Europe, continues to pose a considerable diagnostic and therapeutic challenge.1 Among the hypotheses that have been advanced to explain some instances of IBS, 2 perhaps related phenomena have attracted particular research interest: the immune response and the gut microbiome.2 It has been suggested that a low-grade mucosal and systemic immune response to a disturbed small intestinal and/or colonic bacterial population leads to activation of pain pathways and the various motor and secretory responses that generate the symptoms so characteristic of IBS. (Source: Clinical Gastroenterology and Hepatology)


Quality of life in primary headache disorders: A review
Conclusion This narrative review suggests that headache, particularly in its chronic form, has a great impact on HRQoL. Clinical practice should not solely focus on pain alleviation but rather adopt routine assessment of HRQoL. Furthermore, identification and management of associated psychological comorbidities, which can significantly influence HRQoL in headache sufferers, are essential for optimal clinical management. (Source: Cephalalgia)


The American chronic pain crisis and the media
Schatman ME (Source: Journal of Pain Research)


Cervical zygapophysial (facet) joint pain: effectiveness of interventional management strategies.
Authors: Manchikanti L, Hirsch JA, Kaye AD, Boswell MV Abstract Diagnostic facet joint nerve blocks have been utilized in the diagnosis of cervical facet joint pain in patients without disk herniation or radicular pain due to a lack of reliable noninvasive diagnostic measures. Therapeutic interventions include intra-articular injections, facet joint nerve blocks and radiofrequency neurotomy. The diagnostic accuracy and effectiveness of facet joint interventions have been assessed in multiple diagnostic accuracy studies, randomized controlled trials (RCTs), and systematic reviews in managing chronic neck pain. This assessment shows there is Level II evidence based on a total of 11 controlled diagnostic accuracy studies for diagnosing cervical facet joint pain in patients without dis...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Analgesic efficacy of bilateral superficial and deep cervical plexus block in patients with secondary hyperparathyroidism due to chronic renal failure.
CONCLUSION: Superficial cervical plexus block or combined superficial and deep cervical plexus block effectively reduces postoperative pain, stress response, and complications in SHPT patients who undergo subtotal parathyroidectomy. PMID: 26665128 [PubMed] (Source: Annals of Surgical Treatment and Research)


microRNA and Pain.
Authors: Sakai A, Suzuki H Abstract Pain is an important protective system that alerts organisms to actual or possible tissue damage. However, a variety of pathologies can lead to chronic pain that is no longer beneficial. Lesions or diseases of the somatosensory nervous system cause intractable neuropathic pain that occasionally lasts even after the original pathology subsides. Chronic inflammatory diseases like arthritis are also associated with severe pain. Because conventional analgesics such as non-steroidal anti-inflammatory drugs and opioids have limited efficacy and/or severe adverse events associated with long-term use, chronic pain remains a major problem in clinical practice. Recently, causal roles of microRNAs in chronic pain and their therapeutic potential have been em...


Boston Scientific's Spinal Cord Stimulator "Gamble" Pays Off
Data from a long-term LUMINA study demonstrated that Boston Scientific&rsquo;s Precision Spectra Spinal Cord Stimulator (SCS) offered a 70 percent improvement in lower back pain relief compared to the previous generation of the device. Investigators reported that the system provided &ldquo;sustained and highly significant reduction in overall pain&rdquo; for a wide range of patients who suffer from chronic pain. (Source: Medical Design Online News)


Seattle Pain Relief Now Offering Top Treatment for Chronic Cancer Pain
Seattle Pain Relief is now offering comprehensive pain management options for those suffering from chronic cancer pain. Options for relief with the Double Board Certified pain physician include both...(PRWeb December 15, 2015)Read the full story at http://www.prweb.com/releases/painmanagementseattle/cancer-treatment/prweb13130944.htm (Source: PRWeb: Medical Pharmaceuticals)


Associative learning mechanisms may trigger increased burden of chronic pain; unlearning and extinguishing learned maladaptive responses should help chronic pain patients
Publication date: April 2016 Source:Scandinavian Journal of Pain, Volume 11 Author(s): Harald Breivik (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>


Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations
Conclusion In this study, the favorable prognostic factors found were: time to surgery less than 3 months (p =0.02), associated acromioclavicular stabilization, and postoperative immobilization with a sling extended to 6 weeks. However, resection of the distal clavicle did not influence the final result. Level of proof Level II prospective non-randomized comparative study. (Source: Orthopaedics and Traumatology: Surgery and Research)


MRI technique for the preoperative evaluation of deep infiltrating endometriosis: current status and protocol recommendation
Endometriosis is a common cause of chronic pelvic pain and infertility. It is defined as the occurrence of endometrial tissue outside the uterine cavity and can manifest as a peritoneal, ovarian or infiltrating form, the latter being referred to as deep infiltrating endometriosis (DIE). Surgery is essential in the treatment of DIE and depending on the severity of the disease, surgery can be difficult and extensive. Beside clinical examination and ultrasound, magnetic resonance imaging (MRI) has proven its value to provide useful information for planning surgery in patients with suspected DIE. (Source: Clinical Radiology)


Conceptualizing a subtype of patients with chronic pain: The necessity of obtaining a history of sexual abuse
Lifetime history of sexual abuse is estimated to range between 15% and 25% in the general female population. Cross-sectional studies have shown that sexual assault survivors frequently report chronic musculoskeletal pain and functional somatic syndromes. Treating chronic pain with opioids went from being largely discouraged to being included in standards of care and titrating doses until patients self-report adequate control has become common practice, with 8% to 30% of patients with chronic noncancer pain receiving opioids. In this clinical review, we will discuss the association between survivors of sexual assault and chronic pain/functional somatic syndromes. We will further review evidence-based treatment strategies for this "pain-prone phenotype." (Source: International Journal of Psy...


Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients on Opioid Therapy in Primary Care
The Opioid Compliance Checklist (OCC) is a self-report measure for chronic pain patients prescribed long-term opioid therapy. The original measure includes yes/no items that reflect the content of a typical opioid therapy agreement. The aim of the study was to assess the efficacy of the OCC for monitoring opioid adherence among chronic noncancer pain patients within primary care. One hundred seventy seven (N=177) chronic pain patients were recruited as part of a larger study from 8 primary care centers. (Source: The Journal of Pain)


A Correlative Relationship between Chronic Pain and Insulin Resistance in Zucker Fatty Rats: Role of Downregulation of Insulin Receptors
Epidemiological studies and meta-analyses report a strong relationship between chronic pain and abnormalities in glucose metabolism, but the exact relationship between chronic pain and insulin resistance in type-2-diabetes (T2D) remains unknown. Using a model of neuropathic thermal and tactile hypersensitivity induced by chronic constriction sciatic nerve injury (CCI) in Zucker diabetic fatty (ZDF) and Zucker lean (ZL) littermates, we compared the recovery period of hypersensitivity and the progression of T2D and studied the possible involvement of insulin receptors (IR) in the comorbidity of these two conditions. (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>


Stomach Cancer and the Homeopathic Remedy
Homoeopathic Links 2015; 28: 252-254DOI: 10.1055/s-0035-1565881Cancer means an uncontrolled cell growth of an animal with neighbouring invasion. The pathological cells go on metastasis. In blood cancer, it does not. The development of the gastric cancer takes place to any part of the stomach. The disease spreads through the affected organ or nearby tissues. Primarily, it does not produce painful symptoms. In later part, it produces abdominal pain, nausea, vomiting, weight loss, blood vomiting and dysphagia. In most cases Helicobacter pylori is the cause of gastric cancer. In homeopathic literature we can read that all types of cancer stem from the effect of chronic miasms. Homeopathic medicines in many cases are able to cure the disease. The percentage of cure is not ignorable. The medicin...


MAGnesium-oral supplementation to reduce PAin in patients with severe PERipheral arterial occlusive disease: the MAG-PAPER randomised clinical trial protocol
We describe the protocol of a single-centre randomised double-blind clinical trial aimed at assessing the efficacy of oral magnesium supplementation in controlling severe pain in patients with advanced PAOD. Methods and analysis Adult patients affected by PAOD at stages III and IV of L&egrave;riche-Fontaine classification, who are opioid-nai&#x0308;ve, and who have been admitted to our Acute Pain Service for intractable pain, will be eligible. Patients will be randomised to the control group, treated with standard therapy (oxycodone and pregabalin) plus placebo for 2&nbsp;weeks, or to the experimental group (standard therapy plus magnesium oxide). Patients will be evaluated on days 0, 2, 4, 6, 8, 12 and 14; the following information will being collected: daily oxycodone dose; average and ...


Correlation between symptoms and objective findings may improve the symptom-based diagnosis of chronic rhinosinusitis for primary care and epidemiological studies
Conclusions Our results show that reduction or loss of smell was the symptom most significantly related to positive nasal endoscopic findings. Therefore, symptom-based diagnosis of CRS can be improved by considering reduction or loss of smell as an important symptom for positive endoscopic findings of CRS. (Source: BMJ Open)


Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership
Conclusions Almost 2000 stakeholders contributed their views regarding anaesthetic and perioperative research priorities. This is the largest example of patient and public involvement in shaping anaesthetic and perioperative research to date. (Source: BMJ Open)


Comparing the Diagnostic Utility of Sacroiliac Spectral CT and MRI in Axial Spondyloarthritis.
CONCLUSION: Spectral CT not only depicts findings of chronic sacroiliitis (i.e. bone erosion and sclerosis), but also can detect and quantify the extent of marrow edema in SpA patients with activity sacroiliitis. The sensitivity of MRI for diagnosis of early synovitis and enthesitis remains superior. The combination of spectral CT and MRI may thus improve diagnostic accuracy in the diagnosis of axial SpA. Advances in knowledge: Spectral CT can measure both calcium and water concentration of the sacroiliac joints. The combination of spectral CT and MRI may thus improve diagnostic accuracy in the diagnosis of axial SpA. PMID: 26670154 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Different forms of exercise for chronic low back pain (PEDro synthesis).
Authors: Peek AL, Stevens ML PMID: 26675086 [PubMed - as supplied by publisher] (Source: British Journal of Sports Medicine)


Pulmonary metastasised extraskeletal osteosarcoma
A 63- year-old Caucasian man who smoked presented with lower back pain, dyspnoea and weight loss. A chest CT showed multiple bilateral cavitating lesions, consolidations and ground glass lesions (figure 1). Because a CT-guided pulmonary biopsy elsewhere revealed chronic inflammation with caseating granulomas, he had initially been treated with tuberculostatics and subsequently antifungal medication without clinical improvement. Since the patient had also developed a lesion in the neck, this was biopsied and revealed an undifferentiated round cell tumour. Subsequently, a video-assisted thoracoscopy was performed. Pathological analysis demonstrated metastasis of an osteosarcoma; therefore, the final diagnosis was metastasised extraskeletal small cell osteosarcoma (figure 2). Despite treatmen...


Mayo Clinic Q and A: Specialists in pain management help patients cope with chronic pain
DEAR MAYO CLINIC: I’ve had persistent headaches for about six months. Medication sometimes helps, but not always, and the pain just keeps coming back. My doctor checked to see if another medical problem could be causing the headaches, but she didn’t find anything. She now recommends I see a pain management specialist. What can they [...] (Source: News from Mayo Clinic)


Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients Receiving Opioid Therapy in Primary Care
The Opioid Compliance Checklist (OCC) is a self-report measure for chronic pain patients prescribed long-term opioid therapy. The original measure includes ‘yes’ or ‘no’ items that reflect the content of a typical opioid therapy agreement. The aim of the study was to assess the efficacy of the OCC for monitoring opioid adherence among chronic noncancer pain patients within primary care. One hundred seventy-seven chronic pain patients were recruited as part of a larger study from 8 primary care centers. (Source: The Journal of Pain)


More Evidence On Insomnia and Chronic Pain
No abstract available (Source: The Back Letter)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Not ordinary growing pains
A recent study shows that acupuncture may be a safe and effective adjunctive integrative medicine treatment for chronic pain in pediatric patients. (Source: ScienceDaily Headlines)


[Multimodal therapeutic approach of vaginismus: an innovative approach through trigger point infiltration and pulsed radiofrequency of the pudendal nerve].
Authors: Carvalho JC, Agualusa LM, Moreira LM, Costa JC Abstract Vaginismus is a poorly understood disorder, characterized by an involuntary muscular spasm of the pelvic floor muscles and outer third of the vagina during intercourse attempt, which results in aversion to penetration. It is reported to affect 1%-7% of women worldwide. With this report the authors aim to describe the case of a young patient with vaginismus in whom techniques usually from the Chronic Pain domain were used as part of her multimodal therapeutic regimen. PMID: 26655345 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)


St. Jude Touts Positive Data From BURST Neurostimulation Trial
St. Jude Medical presented during the 19th Annual Meeting of the North American Neuromodulation Society (NANS) in Las Vegas, Nevada, positive results from a clinical trial of its Burst stimulation technology over traditional spinal cord stimulation (SCS) in reducing chronic pain and paresthesia. (Source: Medical Design Online News)


Primary Care Docs the Leading Prescribers of Narcotic Painkillers: Study
Title: Primary Care Docs the Leading Prescribers of Narcotic Painkillers: StudyCategory: Health NewsCreated: 12/14/2015 12:00:00 AMLast Editorial Review: 12/15/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Not ordinary growing pains
(Rush University Medical Center) A recent study at Rush shows that acupuncture may be a safe and effective adjunctive integrative medicine treatment for chronic pain in pediatric patients. Results of the study were published in the December 2015 issue of Alternative and Complementary Therapies. (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>


The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis
Conclusions: Our findings indicate that LLLT is an effective method for relieving pain in NSCLBP patients. However, there is still a lack of evidence supporting its effect on function. (Source: Arthritis Research and Therapy)


Nigella Sativa Oil alleviates Ultrastructural alterations induced by Tramadol in Rat Motor Cerebral Cortex
In conclusion, NS oil alleviates ultrastructural apoptotic changes induced by tramadol in the rat motor cerebral cortex. (Source: Journal of Microscopy and Ultrastructure)


Use of naloxone for reversal of life-threatening opioid toxicity in cancer-related pain
Conclusion Opioid reversal protocols should be developed by a multi-disciplinary team. Each protocol should differentiate those toxicities which are life-threatening and require complete opioid reversal with toxicities that require small aliquots of naloxone to mitigate the presenting symptoms. (Source: Journal of Oncology Pharmacy Practice)


Retroperitoneal fibrosis due to B-cell non-Hodgkin lymphoma: Responding to rituximab!
We report herein a 66-year-old patient with symptomatic retroperitoneal fibrosis leading to bilateral hydronephrosis and renal failure, in whom, after a complex diagnostic work-up and protracted clinical course, a B-cell non-Hodgkin lymphoma in the retroperitoneal space and several vertebral bodies was identified. The patient was treated with radiation therapy and weekly rituximab infusions, with resolution of hydronephrosis and lower back pain. We include a thorough literature review on etiopathogenesis, diagnosis, therapy, and prognosis of retroperitoneal fibrosis. A meticulous search for malignancy is necessary in this rare condition that, if positive, may have significant therapeutic and prognostic implications. (Source: Journal of Oncology Pharmacy Practice)


Long-Lasting Effect of Transcranial Direct Current Stimulation in the Reversal of Hyperalgesia and Cytokine Alterations Induced by the Neuropathic Pain Model
Conclusions Bicephalic tDCS is effective to promote antinociceptive behavior in neuropathic pain, which can be reflected by a spinal neuroimmunomodulation linked to pro- and anti-inflammatory cytokine levels observed in the long-term. (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>


Optimising palliative and end-of-life care within care home settings
Background The World Health Organization (WHO) has defined palliative care as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.1 Globally, it is estimated that every year over 20 million people will require palliative care at the end of life. Of these 69% are adults over 60&nbsp;years. These older population, who make up the vast majority of residents within care home settings, are more likely to have comorbidities such as cardiovascular diseases, cancer, chronic obstructive pulmonary disease and dementias which will re...


Musculoskeletal manifestations of Fabry disease: A retrospective study
Conclusion The diagnosis of Fabry disease is usually delayed, due to confusion with more common disorders. Musculoskeletal manifestations may constitute the presenting symptoms. Past or present pain in the extremities is typical. Osteoporosis may develop early and become severe. Together with the family history, the presence of musculoskeletal manifestations can lead to the correct diagnosis by prompting alpha-galactosidase assays in males and genetic testing in females. Fabry disease is often responsible for musculoskeletal manifestations, of which the most common are pain in the extremities and osteoporosis. These manifestations can be inaugural and lead to diagnostic wanderings. They require specific treatment strategies. (Source: Joint Bone Spine)


Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients
Conclusions Most MERS corona patients present with fever, cough, dyspnea, sore throat, runny nose and sputum. The presence of abdominal symptoms may indicate bad prognosis. Prolonged duration of symptoms before patients’ hospitalization, prolonged duration of mechanical ventilation and hospital stay, bilateral radiological pulmonary infiltrates, and hypoxemic respiratory failure were found to be strong predictors of mortality in such patients. Also, old age, current smoking, smoking severity, presence of associated co-morbidities like obesity, diabetes mellitus, chronic heart diseases, COPD, malignancy, renal failure, renal transplantation and liver cirrhosis are associated with a poor outcome of ICU admitted MERS corona virus infected patients. (Source: Egyptian Journal of Chest Disease...


Long‐term follow‐up of adhesive small bowel obstruction after laparotomy during infancy
ConclusionThe incidence of adhesive small bowel obstruction after laparotomy in infants is high. (Source: British Journal of Surgery)


Reconstruction of ulnar defect with vascularized rib graft: A case report
This case report describes the reconstruction of a segmental ulnar defect using a vascularized rib graft. A 27‐year‐old man was injured during military service by an improvised explosive device, resulting in bilateral through‐the‐knee amputations, left hand deformity, and a segmental left ulnar defect. After unsuccessful ulnar reconstruction with nonvascularized autologous bone and allograft bone substitutes, he presented to our institution. We removed the residual allograft fragments from the ulnar defect, harvested a vascularized left sixth rib with the intercostal artery and vein, secured the construct with internal hardware, and performed microanastomoses of the intercostal artery and vein to the posterior interosseous artery and vein. Postoperatively, he had a hematoma at the ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Physician Careers in Pain Management
What is pain management? What careers are available in pain management? Pain management is a medical specialty related to anesthesiology. As its name suggests, pain management practitioners treat their patients for chronic debilitating pain, to help them live normal pain-free lives. (Source: About.com Health Careers)


Association of diet and lifestyle with chronic prostatitis/chronic pelvic pain syndrome and pain severity: a case–control study
Association of diet and lifestyle with chronic prostatitis&#47;chronic pelvic pain syndrome and pain severity: a case&#8211;control study Prostate Cancer and Prostatic Diseases advance online publication, December 15 2015. doi:10.1038/pcan.2015.57 Authors: X Chen, C Hu, Y Peng, J Lu, N Q Yang, L Chen, G Q Zhang, L K Tang & J C Dai (Source: Prostate Cancer and Prostatic Diseases)


Abnormal cross-network functional connectivity in chronic pain and its association with clinical symptoms
Abstract Cortical functioning within the default mode network (DMN) and salience network (SN) is altered in chronic pain patients. The mechanisms underlying these alterations are unknown, but a novel unexamined source is cross-network communication. Aberrant functional connectivity (FC) between the DMN and SN, whose activity is normally anticorrelated, reflects disease severity in many brain disorders. Further, stronger FC between the posterior cingulate cortex (PCC) and anterior insula has been reported in chronic pain, pointing to abnormal DMN–SN interactions. Here, we tested the hypothesis that cross-network FC between the DMN and SN is abnormal in chronic pain, and is related to pain and associated symptoms. We used resting state fMRI to examine FC within and between the DMN...


Comprehensively understanding fatigue in patients with myeloproliferative neoplasms
CONCLUSIONSThe management of fatigue should be multifactorial, with a comprehensive assessment and treatment plan to address all modifiable fatigue etiologies. Patients with MPNs likely have a higher prevalence of mood disturbances compared with the general population, suggesting the need to assess and intervene in this domain. Cancer 2015. © 2015 American Cancer Society. (Source: Cancer)


Disability with Persistent Pain Following an Epidemic of Chikungunya in Rural South India.
CONCLUSION: Persistence of pain noted in post-CKG disease resulted in significantly deteriorated functional status of those affected. PMID: 26669921 [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>


Long-term follow-up of adhesive small bowel obstruction after laparotomy during infancy.
CONCLUSION: The incidence of adhesive small bowel obstruction after laparotomy in infants is high. PMID: 26667204 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)


Abnormal cross-network functional connectivity in chronic pain and its association with clinical symptoms.
Authors: Hemington KS, Wu Q, Kucyi A, Inman RD, Davis KD Abstract Cortical functioning within the default mode network (DMN) and salience network (SN) is altered in chronic pain patients. The mechanisms underlying these alterations are unknown, but a novel unexamined source is cross-network communication. Aberrant functional connectivity (FC) between the DMN and SN, whose activity is normally anticorrelated, reflects disease severity in many brain disorders. Further, stronger FC between the posterior cingulate cortex (PCC) and anterior insula has been reported in chronic pain, pointing to abnormal DMN-SN interactions. Here, we tested the hypothesis that cross-network FC between the DMN and SN is abnormal in chronic pain, and is related to pain and associated symptoms. We used resti...


Nonpharmacologic Management of Chronic Insomnia.
Authors: Maness DL, Khan M Abstract Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are difficulty falling asleep, difficulty staying asleep, or early awakening despite the opportunity for sleep; symptoms must be associated with impaired daytime functioning and occur at least three times per week for at least one month. Factors associated with the onset of insomnia include a personal or family history of insomnia, easy arousability, poor self-reported health, and chronic pain. Insomnia is more common in women, especially following menopause and during ...


Adhesive small bowel obstruction after laparotomy during infancy
ConclusionThe incidence of adhesive small bowel obstruction after laparotomy in infants is high. (Source: British Journal of Surgery)


Medtronic, Samsung to develop consumer tech tools for neuromodulation therapies
Samsung and Medtronic are once again teaming up, this time to build mobile tools for patients using neuromodulation therapy, a treatment used in a number of chronic conditions including chronic pain, movement disorders, and incontinence. (Source: mobihealthnews)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medtronic, Samsung Linking Devices And Apps For Chronic Pain Management
Medtronic and Samsung are expanding their partnership to make access to health data between medical and consumer mobile devices seamless for patients. The two companies announced a similar collaboration on diabetes management in June, and this time, they are partnering on chronic pain management and other conditions treated by neuromodulation therapy. (Source: Medical Design Online News)


Is exposure in vivo cost-effective for chronic low back pain? A trial-based economic evaluation
Conclusions: Based on these results, implementing EXP for this group of patients seems to be the best decision.Trial registrationISRCTN88087718 (Source: BMC Health Services Research)


The Cortical Signature of Central Poststroke Pain: Gray Matter Decreases in Somatosensory, Insular, and Prefrontal Cortices
It has been proposed that cortical structural plasticity plays a crucial role in the emergence and maintenance of chronic pain. Various distinct pain syndromes have accordingly been linked to specific patterns of decreases in regional gray matter volume (GMV). However, it is not known whether central poststroke pain (CPSP) is also associated with cortical structural plasticity. To determine this, we employed T1-weighted magnetic resonance imaging at 3 T and voxel-based morphometry in 45 patients suffering from chronic subcortical sensory stroke with (n = 23) and without CPSP (n = 22), and healthy matched controls (n = 31). CPSP patients showed decreases in GMV in comparison to healthy controls, involving secondary somatosensory cortex (S2), anterior as well as posterior insular cortex, ven...


Evidence of small fiber neuropathy in a patient with Ehlers–Danlos syndrome, hypermobility-type
Joint hypermobility syndrome (JHS) and Ehlers-Danlos syndrome hypermobility type (EDS-HT) are two clinically overlapping heritable connective tissue diseases. Their clinical identity has been recently suggested and many researchers are now considering EDS-HT and JHS as one and the same (i.e. JHS/EDS-HT) (Castori et al., 2013). As the molecular basis of JHS/EDS-HT is largely unknown, the diagnosis remains based exclusively on clinical criteria. Generalized joint hypermobility, joint complications and skin hyperextensibility are the major features of JHS/EDS-HT and chronic pain, fatigue, headache and dysautonomia represent the major causes of patient disability (Castori et al., 2013; De Wandele et al., 2014). (Source: Clinical Neurophysiology)


A qualitative study of older adults seeking appropriate treatment to self-manage their chronic pain in rural North-East Thailand
Conclusions: Attempts to increase accessibility, affordability and acceptability of pain treatment can promote pain self-management in older Thais. These findings have important implications for health professionals and government organisations seeking to enhance the self-management of pain and quality of life in this population. (Source: BMC Geriatrics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Muscle Activation Timing and Balance Response in Chronic Lower Back Pain Patients with Associated Radiculopathy
: Patients with low back pain and radiculopathy demonstrated some significant differences from control participants in terms of muscle activation timing, sequencing, and overall balance control. The presence of differences between patients and controls, specifically in the lower limb, indicates that radiculopathy may play a role in altering balance control in these patients. (Source: Clinical Biomechanics)


Randomised controlled trials of chronic pain in children and adolescents: a systematic review
Conclusions This is the first systematic review of RCTs conducted to evaluate pharmacological and non-pharmacological therapies in chronic and recurrent pain in children and adolescents. Although, management of pain in adults has significantly improved over the years due to the evaluation of numerous analgesic therapies, our results highlight the existing knowledge gap with regards to children and adolescents. Therapeutic strategies, in particular pharmacological agents, applied to relieve chronic or recurrent pain in children and adolescents are not evaluated through high quality RCTs. The need to improve analgesic therapy in children and adolescents with chronic pain is still unmet. We discuss possible research constraints and challenges related to this fact as well as adequate methodolo...


Cat scratch disease of the parotid gland
Case report A previously well 10-year-old girl presented to the hospital on three occasions over a 2-week period with worsening right-sided cheek swelling and pain. Examination was unremarkable apart from obvious swelling of the right cheek and cervical lymphadenopathy (figure 1). An initial diagnosis of suppurative parotitis was made, and she was treated with oral flucloxacillin. Over the following week, pain and swelling worsened, and she developed fever, nausea, trismus and dizziness. An MRI revealed parotid enlargement with central necrosis and infiltration into the right masseter (figure 2). A lymph node biopsy showed chronic necrotising granulomatous inflammation suggestive of cat scratch disease (CSD) (figure 3). PCR on lymph node tissue was positive for Bartonella henselae. Further...


Comparison of the Effectiveness of Suprascapular Nerve Block with Physical Therapy, Placebo, and Intra-articular Injection in Management of Chronic Shoulder Pain- a Meta-analysis of Randomized Controlled Trials
To explore the effectiveness of suprascapular nerve block (SSNB) at different timing after administration compared with physical therapy, placebo, and intra-articular injections in patients with chronic shoulder pain. (Source: Archives of Physical Medicine and Rehabilitation)


Therapeutic role of endoscopic ultrasound in pancreaticobiliary disease: A comprehensive review.
Authors: Meng FS, Zhang ZH, Ji F Abstract With the development of technology and accessories, the role of endoscopic ultrasound (EUS) has evolved from diagnostics to therapeutics. In order to characterise the therapeutic role of EUS, we searched Web of Knowledge database and reviewed articles associated with therapeutic EUS. There are two modalities for the therapeutic purpose: drainage and fine-needle injection. EUS-guided drainage is a promising procedure for the treatment of peripancreatic fluid collection and biliary obstruction; EUS-guided fine-needle injections such as celiac plexus neurolysis, for the purpose of pain relief for pancreatic cancer and chronic pancreatitis, has emerged as a promising procedure. The aim of the study was to perform a comprehensive and conscientio...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


HCN channels as therapeutic targets for heart failure and pain.
Authors: Cao Y, Pang J, Zhou P Abstract Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels play important roles both in the control of heart rate and neuronal excitability. HCN channels open on hyperpolarization voltage, permeate to potassium and sodium, and generate an inward current, which is modulated by intracellular cAMP. HCN channels have been reported to involve in various human diseases, including heart failure, pain and epilepsy with datas from mutagenesis, transgenic mice and pharmacological studies. As a result, HCN channels may offer excellent drug development opportunities for novel analgestic, bradycardic and anticonvulsant drugs. Ivabradine is the first HCN channel inhibitor being clinically approved in 2005 for the treatment of chronic stable angina ...


Doppler ultrasound diagnosis of an unusual variant of median arcuate ligament syndrome: concomitant involvement of celiac and superior mesenteric arteries. A case report.
We report a case with complaints of chronic abdominal pain from compression of both the celiac artery and the superior mesenteric artery due to MALS, which was primarily detected by Doppler ultrasound. The diagnosis was confirmed with CT-angiography. PMID: 26649356 [PubMed - in process] (Source: Medical Ultrasonography)


Acute effects of TGFβ1 on neuronal excitability and involvement in the pain of rats with chronic pancreatitis.
Conclusions: These results suggest that TGFβ1 enhances neuronal excitability and increases the concentration of intracellular calcium. TGFβ1 and TGFβ receptors are involved in abdominal hyperalgesia in CP. This and future study might identify a potentially novel target for the treatment of abdominal pain in CP. PMID: 26645248 [PubMed - as supplied by publisher] (Source: Journal of Neurogastroenterology and Motility)


Voltage gated sodium channels as drug discovery targets.
Authors: Bagal SK, Marron BE, Owen RM, Storer RI, Swain NA Abstract Voltage-gated sodium (NaV) channels are a family of transmembrane ion channel proteins. They function by forming a gated, water-filled pore to help establish and control cell membrane potential via control of the flow of ions between the intracellular and the extracellular environments. Blockade of NaVs has been successfully accomplished in the clinic to enable control of pathological firing patterns that occur in a diverse range of conditions such as chronic pain, epilepsy, and cardiac arrhythmias. First generation sodium channel modulator drugs, despite low inherent subtype selectivity, preferentially act on over-excited cells which reduces undesirable side effects in the clinic. However, the limited therapeutic ...


Kawasaki-like disease (KLD) in an adult with congenital HIV infection
Conclusion It is a challenging task to diagnose Kawasaki-like disease in HIV infected adults due to a high likelihood of opportunistic infections or possible hypersensitivity to any one of the plethora of prescribed medications. A high suspicion of KLD is advised in HIV infected adults with severe immunosuppression and unexplained fever lasting&gt;5 days to ensure timely diagnosis and treatment. (Source: HIV and AIDS Review)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement
We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. (Source: Journal of NeuroInterventional Surgery)


Endometriosis - A Chameleon: Patients' Perception of Clinical Symptoms, Treatment Strategies and Their Impact on Symptoms.
Discussion: When deciding on the best treatment strategy for endometriosis, it is important to take account of potential pain and infertility. Women's perception of endometriosis will vary depending on their symptoms, the time of diagnosis and their lifestyle. Offering continuous information on clinical aspects and manifestations of the disease may improve treatment outcomes. Personalized counseling is an essential part of the clinical management of the disease. PMID: 25364034 [PubMed - as supplied by publisher] (Source: Geburtshilfe und Frauenheilkunde)


Endometriosis: Survey of Current Diagnostic and Therapeutic Options and Latest Research Work.
Authors: Juhasz-Böss I, Laschke MW, Müller F, Rosenbaum P, Baum S, Solomayer EF, Ulrich U Abstract Endometriosis is one of the most frequent benign diseases in women of child-bearing age. The main symptoms are chronic upper abdominal pain and infertility. However, the aetiology and pathogenesis of endometriosis are as yet insufficiently clarified. Thus, therapy is mainly symptomatic with laparoscopic surgery being the gold standard. The aim of drug therapy is to achieve a hypo-oestrogenic condition. In cases of severe endometriosis and a desire to have children there is often an indication for assisted reproduction. The present article illustrates almost all current aspects on the diagnosis of and therapy of endometriosis. From the clinical viewpoint, emphasis is placed on the ra...


‘You Can’t Put Ice Over a Migraine,’ a Lurking Malady in the N.F.L.
Jets punt returner Jeremy Kerley left last week’s game against the Giants with a “sharp, shooting, throbbing pain,” and experts wonder if contact sports can contribute to frequent or chronic headaches later in life. (Source: NYT Health)


Epidermoid cyst presenting as isolated trigeminal neuralgia - two case reports.
CONCLUSION: In the first patient, teenage onset, abnormal trigeminal reflex, and early developing background pain struck us directly to symptomatic TN. In the second case, we suspected symptomatic TN with uncertainty before image study. TN could be the isolated initial symptom of CPA epidermoid cysts. In consideration about pretty high prevalence of symptomatic TN, physicians should be more alert and straightforward arrange neuroimage when facing TN patients with atypical presentation. PMID: 24030093 [PubMed - indexed for MEDLINE] (Source: Acta Neurologica Taiwanica)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Near infrared spectroscopy - investigations in neurovascular diseases.
This study showed increased LFOs amplitude only in FHM patients with co-existing common type of migraine, but not in patients with pure FHM phenotype. This suggests that the sensitivity to NO resides within the common migraine phenotypes rather than the FHM phenotype. Stimulation of the sphenopalatine ganglion (SPG) may lead to parasympathetic outflow and cause pain in cluster headache (CH). The fifth study therefore investigated pain and autonomic symptoms in relation to high or low SPG frequency stimulation in chronic CH patients. Cortical changes in oxygenated hemoglobin (HbO) were also recorded with NIRS and showed a moderate HbO increase, which was most pronounced on the ipsilateral CH side following high frequency stimulation. A possible application of NIRS to assess cerebral vascula...


ONSTEP versus laparoscopy for inguinal hernia repair: protocol for a randomised clinical trial.
This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic repair. Patients are recruited from surgical departments in Denmark and follow-up is one year. In total, 188 patients will be included. DISCUSSION: This protocol describes one of the first randomised clinical trials investigating the ONSTEP technique. To our knowledge, it is the first clinical trial comparing the ONSTEP technique with the laparoscopic technique. The results from this study are needed before it can be decided whether the ONSTEP technique should replace the laparoscopic technique in general surgical practice. FUNDING: This study has not received external funding. TRIAL REGISTRATION: NCT01960777 (clinicaltrials.gov). PMI...


Clinical outcomes after elective repair for small umbilical and epigastric hernias.
Authors: Christoffersen MM Abstract Repair for an umbilical or epigastric hernia is one of the most frequently conducted gastrointestinal surgical procedures. Al-though it is a minor procedure, there is no consensus on the optimal repair technique. The readmission rate is surprisingly high due to postoperative pain, wound-related complications, and long-term results in terms of recurrence and chronic pain is not well investigated. The overall objective of this thesis was to improve early and long-term postoperative outcomes after repair for umbilical or epigastric hernias. The present thesis consisted of one RCT, one protocol article for a running RCT, and two register-based cohort studies. An abdominal binder had no analgesic effects or impact on seroma formation. We await early a...


Renal embolism as a primary manifestation of Streptococcus dysgalactiae subspecies equisimilis endocarditis in a patient with chronic aortic dissection.
We report a case of renal embolism as an initial manifestation of Streptococcus dysgalactiae subspecies equisimilis (SDSE) endocarditis in a patient with chronic aortic dissection. A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain. The endocarditis affected the native aortic valve and was complicated by a renal embolism. Blood culture results were positive for SDSE. Intravenous penicillin resulted in satisfactory clinical and echocardiographic recovery. PMID: 26110298 [PubMed - in process] (Source: Infezioni in Medicina)


An incidental case of biliary fascioliasis mimicking cholangiocellular carcinoma.
Authors: Şenateş E, Doğan A, Şenates BE, Bodakçi E, Bekçibasi M Abstract Fascioliasis is a zoonotic infestation caused by Fasciola hepatica that usually attacks mammals, such as goats, sheep and cattle. The parasites can infect humans via freshwater plants contaminated with encysted metacercariae. In the acute phase, which involves hepatic invasion, the disease may present with abdominal pain, mild fever and hepatomegaly. In the chronic phase, the parasites settle into the biliary tracts, and then cause cholangitis and cholestasis. Sometimes, the disease may mimic malignancies, creating a mass appearance. Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and treatment method because it allows simultaneous diagnosis and treatment. Here, we presen...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Analgesic and Antineuroinflammatory Effect of Baicalein in Cancer-Induced Bone Pain.
In this study, we examined the effect of BE on CIBP and the mechanism of this effect. Intrathecal and oral administration of BE at different doses could alleviate the mechanical allodynia in CIBP rats. Intrathecal 100 μg BE could inhibit the production of IL-6 and TNF-α in the spinal cord of CIBP rats. Moreover, intrathecal 100 μg BE could effectively inhibit the activation of p-p38 and p-JNK MAPK signals in CIBP rats. The analgesic effect of BE may be associated with the inhibition of the expression of the inflammatory cytokines IL-6 and TNF-α and through the activation of p-p38 and p-JNK MAPK signals in the spinal cord. These findings suggest that BE is a promising novel analgesic agent for CIBP. PMID: 26649065 [PubMed - as supplied by publisher] (Source: Evidence-based Compl...


Borderline Personality in the Medical Setting.
CONCLUSIONS: Unlike patients with borderline personality disorder in mental health settings, who tend to present with relationship difficulties, mood instability/dysphoria, and overt self-harm behavior, patients with borderline personality disorder in primary care settings tend to present with unsubstantiated chronic pain of various types as well as somatic preoccupation. PMID: 26644960 [PubMed - as supplied by publisher] (Source: The Primary Care Companion for CNS Disorders)


[The prevalence of low back pain in hospital staff and its relationship with chronic fatigue syndrome and occupational factors].
CONCLUSION: To the best of our knowledge, this is the first to show the relationship between low back pain and chronic fatigue syndrome in hospital employees. Shift work and length of time in occupation are risk factors for chronic fatigue syndrome. PMID: 26356104 [PubMed - in process] (Source: Agri Dergisi)


[An evaluation of the psychosocial characteristics of patients admitted to a pain clinic and their relatives].
CONCLUSION: Changes in psychosocial status were observed in pain patients and their relatives when compared to the control group. The study recommends that in addition to evaluating the psychological status of pain patients in order to provide them with psychological and medical support, relatives of these patients should also be evaluated carefully and given psychological and medical support to enable necessary diagnosis and treatment. PMID: 26356103 [PubMed - in process] (Source: Agri Dergisi)


Are fibromyalgia and failed back surgery syndromes actually "functional somatic syndromes" in terms of their symptomatological, familial and psychological characteristics? A comparative study with chronic medical illness and healthy controls.
CONCLUSION: This study is Important Insofar as it simultaneously evaluated FMS and FBSS groups in the presence of a control group. The results suggest that FMS and FBSS, currently treated as two different diagnostic categories in general medical practice, may be evaluated under the single heading of FSS. PMID: 26356100 [PubMed - in process] (Source: Agri Dergisi)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Incidence of chronic pain after ingunial hernia repair].
CONCLUSION: The incidence of chronic pain after inguinal hernia repair was found %18, compatible with similar studies. Compared with other risk factors, preoperative pain, postoperative severe acute pain and reoperations were thought to be the most important risk factors for the development of chronic pain. PMID: 25944136 [PubMed - in process] (Source: Agri Dergisi)


Chronic pain, depression symptoms and daily living independency level among geriatrics in nursing home.
CONCLUSION: Investigation of pain, presence of depression, and independence in activities of daily living is important in determining the necessary measures to be adopted for promoting the health and well-being of the geriatric population. PMID: 25867872 [PubMed - in process] (Source: Agri Dergisi)


[Effects of a thoracic paravertebral block on postoperative analgesia in patients undergoing modified radical mastectomy].
CONCLUSION: A paravertebral block with a single dose of 150 mg levobupivacaine before general anaesthesia in patients undergoing modified radical mastectomy and axillary lymph node dissection decreases postoperative pain values and the need for analgesics during the postoperative 24 hours. PMID: 25551814 [PubMed - in process] (Source: Agri Dergisi)


[Effects of triple shoulder injection accompanied by fluoroscopy on pain experienced by patients with chronic shoulder pain].
CONCLUSION: Triple shoulder injection accompanied by fluoroscopy applied on patients with chronic shoulder pain is effective in short-, mid- and long-term, but its mid- and long-term effectiveness is less than its short-term effectiveness. PMID: 25551812 [PubMed - in process] (Source: Agri Dergisi)


The effectiveness of subcutaneously implanted epidural ports for relief of severe pain in patients with advanced-stage gynecological cancer: a prospective study.
CONCLUSION: Morphine administration via SIEP provided excellent pain relief without creating side effects, increased patient quality of life, and contributed to the patient's ability to enjoy life. PMID: 24481578 [PubMed - in process] (Source: Agri Dergisi)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Results of the assessment of the council of multidisciplinary pain.
CONCLUSION: Evaluation of complex patients by physicians from different disciplines has better diagnostic and treatment outcomes. In addition, multidisciplinary approach offer and perform different therapy options and this has positive effects on treatment efficiency and patient satisfaction. We are in the opinion that instead of standard treatment protocols, determining individualized multidisciplinary treatment protocols should be useful. PMID: 24104534 [PubMed - indexed for MEDLINE] (Source: Agri Dergisi)


[Retrospective evaluation of the patients with chronic pain admitted to the algology polyclinic between 2000-2010].
CONCLUSION: In conclusion, pain treatments with multidisciplinary approach applied by the increasing number of pain clinics provide favorouble results and patients quality of life is also increased. We hope our retrospective study may provide helpful data for future studies on chronic pain with its comprehensive base of patient data which covers an eleven years period. PMID: 24104533 [PubMed - indexed for MEDLINE] (Source: Agri Dergisi)


[Episacral lipoma: a treatable cause of low back pain].
Authors: Erdem HR, Nacır B, Özeri Z, Karagöz A Abstract Episacral lipoma is a small, tender subcutaneous nodule primarily occurring over the posterior iliac crest. Episacral lipoma is a significant and treatable cause of acute and chronic low back pain. Episacral lipoma occurs as a result of tears in the thoracodorsal fascia and subsequent herniation of a portion of the underlying dorsal fat pad through the tear. This clinical entity is common, and recognition is simple. The presence of a painful nodule with disappearance of pain after injection with anaesthetic, is diagnostic. Medication and physical therapy may not be effective. Local injection of the nodule with a solution of anaesthetic and steroid is effective in treating the episacral lipoma. Here we describe 2 patients wi...


[Concomitant use of strong and weak opioids in the management of chronic cancer pain].
CONCLUSION: We found in our study that when TDF and tramadol are used together, TDF need is reduced and the pain management protocol is better tolerated by patients. Based on the results of our study, we suggest concomitant use of strong and weak opioids. PMID: 23588864 [PubMed - indexed for MEDLINE] (Source: Agri Dergisi)


Neuropathic pain after dental treatment.
Authors: Tınastepe N, Oral K Abstract The head and neck regions are the most common sites of the human body to be involved in chronic pain conditions. Neuropathic pain is a chronic pain condition, and refers to all pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral or central nervous system (CNS). Trigeminal neuralgia, atypical odontalgia (phantom tooth pain), burning mouth syndrome, traumatic neuropathies, postherpetic neuralgias and complex regional pain syndrome are neuropathic pain conditions in the orofacial region that can be encountered in pain and dental clinics. The majority of the time this problem is misdiagnosed by the dentist, which can lead to unnecessary treatments. These treatments may include endodontic treatme...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Functional Recovery of Carbon Nanotube/Nafion Nanocomposite in Rat Model of Spinal Cord Injury.
CONCLUSION: These data suggest that the CNT/Nafion nanocomposite may be an effective material to promote axonal repair and regeneration after SCI. PMID: 25861814 [PubMed - as supplied by publisher] (Source: Artificial Cells, Nanomedicine and Biotechnology)


Prescribing Pattern of Non-Steroidal Anti-Inflammatory Drugs at the Outpatient Pharmacy Department of a University Teaching Hospital in Nigeria.
CONCLUSION: Though most of the prescribers complied with WHO standard in their prescriptions vis a vis generic prescription, avoidance of polypharmacy and avoidance of drug interactions and contraindications, there is obvious need for interventional measures or strategies to improve rational prescribing for some of the prescribers tailored towards rational prescription and use of drugs. PMID: 26339081 [PubMed - in process] (Source: Ghana Medical Journal)


Practice-based Evidence for Outpatient, Acceptance & Commitment Therapy for Veterans with Chronic, Non-cancer Pain
Publication date: Available online 12 December 2015 Source:Journal of Contextual Behavioral Science Author(s): David Cosio Past research has shown that Acceptance &amp; Commitment Therapy (ACT) compares favorably with Cognitive-Behavioral Therapy (CBT) in the treatment of chronic pain among different populations. However, practice-based evidence comparing ACT and CBT to treat chronic, non-cancer pain solely among a Veteran population is lacking. The current pilot study used a quasi-experimental, single-site, pre-/post-test design. A sample of 96 Veterans participated in the study at a Midwestern Department of Veterans Affairs Medical Center between November 3, 2009-November 4, 2010. Veterans self-selected to participate in either a manualized ACT or CBT for chronic pain group. All p...


Prevalence of degenerative changes of the spine on magnetic resonance images and radiographs in patients aged 16-45 years with chronic back pain of short duration in the Spondyloarthritis Caught Early (SPACE) cohort
Conclusion. Prevalence of DCs was high in this cohort of young patients with short-term chronic back pain, in accordance with the literature. Prevalence of DCs in no-axSpA patients, poss-axSpA patients and axSpA patients was found to be similar. (Source: Rheumatology)


Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey


Assessment of Inducible Myocardial Ischemia, Quality of Life and Functional Status after Successful Percutaneous Revascularization in Patients with Chronic Total Coronary Occlusion
The benefits of chronic total coronary occlusion (CTO) revascularization are not well-established. In this prospective cohort study, 47 consecutive patients with successful percutaneous recanalization of CTO underwent adenosine stress cardiac magnetic resonance (CMR), 6-minute walk test (6MWT) and the SF-36 Health Survey (SF-36), before and 6 month after the procedure. Successful recanalization of a CTO was followed by significant improvement of a) global physical and mental health status; b) the distance walked in the 6MWT; c) the incidence of chest pain at the end of the 6MWT; and d) the score of a novel CMR ischemic burden index based on the characteristics of adenosine stress perfusion defects (extension, persistence, transmurality, and induced-contractile regional dysfunction). (Sourc...


Involvement of CC Chemokine Receptor 1 and CCL3 in Acute and Chronic Inflammatory Pain in Mice
This article is protected by copyright. All rights reserved. (Source: Basic and Clinical Pharmacology and Toxicology)


Assessment of Inducible Myocardial Ischemia, Quality of Life, and Functional Status After Successful Percutaneous Revascularization in Patients With Chronic Total Coronary Occlusion
The benefits of chronic total coronary occlusion (CTO) revascularization are not well established. In this prospective cohort study, 47 consecutive patients with successful percutaneous recanalization of CTO underwent adenosine stress cardiac magnetic resonance (CMR), 6-minute walk test (6MWT), and the Short Form-36 Health Survey before and 6 months after the procedure. Successful recanalization of a CTO was followed by significant improvement of (1) global physical and mental health status; (2) the distance walked in the 6MWT; (3) the incidence of chest pain at the end of the 6MWT; and (4) the score of a novel CMR ischemic burden index on the basis of the characteristics of adenosine stress perfusion defects (extension, persistence, transmurality, and induced contractile regional dysfunc...


FDA OKs StimRelieve chronic migraine trial
StimRelieve said today it won FDA investigational device exemption to launch a trial of its percutaneously implantable Halo CFNS device for treating chronic migraines. Ft. Lauderdale, Fla.-based StimRelieve said its Halo CFNS device, using wirelessly-powered, nanotech neurostimulators, is 95% smaller than other implantable treatment options. The wireless device, powered by an external transmitter in the ear, is implanted with a standard-gauge needle, the company said. &#8220;To date, treatments for chronic migraines have had limited and inconsistent results. Chronic migraine headache pain is a crippling condition, disabling millions of Americans every year. If determined safe and effective, StimRelieve’s wireless neuromodulation device offers a promising option for alleviating and cont...


St. Jude touts Burst SCS study
St. Jude Medical (NYSE:STJ) today released data from the Sunburst study examining its Burst spinal cord stimulation neuromodulation therapy, touting its chronic-pain relieving ability compared to traditional tonic spinal cord stimulation. The results were presented at the North American Neuromodulation Society’s annual meeting in Las Vegas this weekend, the company said. St. Jude said the results of the 100-patient, 20 center U.S. Sunburst trial will be used to support the FDA approval of the Burst therapy feature in its Prodigy and Protege rechargeable SCS devices and Proclaim non-rechargeable systems. &#8220;We are excited to report the positive results of the Sunburst study, which shows Burst stimulation can provide patients additional options to effectively manage their chronic 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>


Traumatic Inhalation due to Merapi Volcanic Ash.
Authors: Trisnawati I, Budiono E, Sumardi, Setiadi A Abstract Pneumonoultramicroscopicsilicovolcanoconiosis is fibrotic lung diseases of the pulmonary parenchyma following chronic inhalation of inorganic dusts containing crystalline silicon dioxide. The acute manifestations observed after heavy ashfalls include attacks of asthma and bronchitis, with an increased reporting of cough, breathlessness, chest tightness, and wheezing due to irritation of the lining of the airways. The chronic health condition of most concern is silicosis, a diffuse nodular fibrosis of the lungs, develops slowly, usually appearing 10 to 30 years after first exposure. A 35 years old male was admitted to Sardjito Hospital, Yogyakarta with complaints of progressive dyspnoea, right side chest pain since last 3...


Pulmonary papillomatosis: a rare case of recurrent respiratory papillomatosis presenting with multiple nodular and cavitary lesions.
Authors: Martina D, Kurniawan A, Pitoyo CW Abstract Pulmonary papillomatosis is an extremely rare variant of recurrent respiratory papillomatosis which is hard to treat, causes prolonged morbidity, and may transform into malignant disorder in several cases. Since the symptoms and radiologic findings are not specific, pulmonary papillomatosis is often being misdiagnosed. Although considered benign, pulmonary papillomatosis carries the most significant mortality. This is a case report of a 26 year old man who complained recurrent chronic cough, slight hemoptoe, occasional pleuritic pain, and several episodes of fever. He also had laryngeal papillomatosis and undergone serial endoscopic resection since his childhood. Multiple nodular and cavitary lesions, some with air fluid level, we...


[Heterotopic pancreas as a cause of intussusception: first case reported in Peru].
We report the case of a one year old male patient with a chronic history of anorexia, irritability, abdominal pain, accompanied by intermittent episodes of "currant jelly" stools that evolved to rectal bleeding. The patient presented a concomitant diagnosis of allergic colitis, which prolonged the effective surgical treatment at an external health center. In the abdominal CT scan, the classic "target" sign was found. In the exploratory laparotomy an ileoileal intussusception was confirmed, a mass was found that the histopathology laboratory confirmed as HP. To our knowledge, it is the first case of pediatric intussusception by HP reported in Peru. PMID: 26580946 [PubMed - in process] (Source: Revista Peruana de Medicina de Experimental y Salud Publica)


Long term outcome after lichtenstein hernia repair using general, locoregional or local anaesthesia.
CONCLUSIONS: After Lichtenstein inguinal hernia repair, LA results in beneficial effects beyond the immediate postoperative period. PMID: 26021947 [PubMed - indexed for MEDLINE] (Source: Acta Chirurgica Belgica)


Boston Scientific touts improved back pain relief in Spectra SCS trial
Boston Scientific (NYSE:BSX) today released data from the Lumina trial of its Precision Spectra spinal cord stimulator, touting a 70% improvement in back pain relief over its previous generation Precision Plus SCS. Data from the Lumina study is being presented at the North American Neuromodulation Society&#8217;s annual meeting in Las Vegas this weekend, the company said. &#8220;As the Lumina data show, the Boston Scientific Illumina 3D Algorithm allows me to treat low back pain more consistently and effectively than before. These data are impressive because they demonstrate sustained long term pain relief in an all-comers population; we did not exclude the type of challenging patients that physicians see every day,&#8221; Dr. James North of the Carolinas Pain Institute said in prepared...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Medtronic expands Samsung deal into neuromod
Medtronic (NYSE:MDT) said it expanded its strategic partnership with Samsung Electronics (LON:BC94) into the neuromodulation arena, looking to treat chronic pain, movement disorders, incontinence and other conditions. The announcement was made today at the North American Neuromodulation Soceity&#8217;s scientific session in Las Vegas. The combination will position Samsung to develop tools on Google&#8216;s (NSDQ:GOOG) Android tablet and smartphone platform that can communicate with Medtronic&#8217;s neuromodulation systems. &#8220;Medtronic is committed to solving healthcare challenges, and through this alliance we intend to create efficiencies by developing digital solutions that connect patients and healthcare providers in real time. Medtronic has a track record of developing meaningful...


Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis.
CONCLUSIONS: Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability. PMID: 26640627 [PubMed - in process] (Source: Clinics in Orthopedic Surgery)


Dynamics of quality of life improvement after floppy Nissen fundoplication for gastroesophageal reflux disease.
CONCLUSIONS: Gastroesophageal reflux disease is a chronic disease of long duration, leading to impairment of quality of life. Patients, apart from typical symptoms of GERD, suffer from pain of significant severity. QOL improves significantly after surgery. Surgical treatment results in relief of GERD symptoms, which leads to gradual improvement of QOL. PMID: 26649085 [PubMed - as supplied by publisher] (Source: Videosurgery and Other Miniinvasive Techniques)


Reduction of chronic post-herniotomy pain and recurrence rate. Use of the anatomical self-gripping ProGrip laparoscopic mesh in TAPP hernia repair. Preliminary results of a prospective study.
CONCLUSIONS: Laparoscopic inguinal hernia repair using the transabdominal preperitoneal technique with implantation of the ProGrip laparoscopic mesh is a fast, effective and reliable method in experienced hands, which according to our results reduces the occurrence of chronic post-operative inguinal pain with simultaneously a low recurrence rate. PMID: 26649083 [PubMed - as supplied by publisher] (Source: Videosurgery and Other Miniinvasive Techniques)


Meta-analysis of randomized trials comparing nonpenetrating vs mechanical mesh fixation in laparoscopic inguinal hernia repair
Conclusions Laparoscopic groin hernia repair with bioglue mesh fixation was associated with a reduced incidence of chronic pain compared with mechanical fixation, without increasing morbidity or recurrence. Longer term data on recurrence are necessary. (Source: The American Journal of Surgery)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Does muscle morphology change in chronic neck pain patients? – A systematic review
Neck pain is a common disabling worldwide health problem with a high socio-economic burden. Changes underlying the transition to, or the maintenance of a chronic state are still barely understood. Increasing evidence suggests that morphological muscle changes, including changes in cross-sectional area (CSA) or fatty infiltration, play a role in chronic neck pain. However, a structured overview of the current evidence of morphological changes is lacking. (Source: Manual Therapy)


Pioglitazone inhibits the development of hyperalgesia and sensitization of spinal nociresponsive neurons in type 2 diabetes
Thiazolidinedione drugs (TZDs) such as pioglitazone are FDA-approved for the treatment of insulin resistance in type 2 diabetes. However, whether TZDs reduce painful diabetic neuropathy (PDN) remains unknown. Therefore we tested the hypothesis that chronic administration of pioglitazone would reduce PDN in Zucker Diabetic Fatty (ZDFfa/fa) rats. Compared to Zucker Lean (ZLfa/+) controls, ZDF developed: (1) elevated blood glucose, HbA1c, methylglyoxal and insulin; (2) mechanical and thermal hyperalgesia at the hindpaw; (3) increased avoidance of noxious mechanical probes in a mechanical conflict avoidance behavioral assay, the first report of a measure of affective-motivational pain-like behavior in ZDF; and (4) exaggerated lumbar dorsal horn immunohistochemical expression of pressure-evoked...


Response to intravenous fentanyl infusion predicts subsequent response to transdermal fentanyl
Conclusions The analgesic and side effects after intravenous fentanyl infusion can be used to predict the response to short-term transdermal treatment with fentanyl. (Source: Journal of Anesthesia)


A Comparative Study of Trigger Point Therapy with Local Anaesthetic (0.5 % Bupivacaine) Versus Combined Trigger Point Injection Therapy and Levosulpiride in the Management of Myofascial Pain Syndrome in the Orofacial Region
Conclusion The combined therapy with trigger point injection and levosulpiride as antidepressant significantly reduces pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region. (Source: Journal of Maxillofacial and Oral Surgery)


Spike propagation through the dorsal root ganglia in an unmyelinated sensory neuron: a modeling study
In this study we used biophysical computer modeling to investigate the influence of axon morphology within the DRG and various membrane conductances on the reliability of spike propagation. As expected, calculated input impedance and the amplitude of propagating action potentials were both lowest at the T-junction. Propagation reliability for single spikes was highly sensitive to the diameter of the stem axon and the density of voltage-gated Na+ channels. A model containing only fast voltage-gated Na+ and delayed-rectifier K+ channels conducted trains of spikes up to frequencies of 110 Hz. The addition of slowly activating KCNQ channels (i.e., KV7 or M-channels) to the model reduced the following frequency to 30 Hz. Hyperpolarization produced by addition of a much slower conductance, such ...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 Mixed-Methods Pilot Study of Mindfulness Based Stress Reduction for HIV-Associated Chronic Pain.
Authors: George MC, Wongmek A, Kaku M, Nmashie A, Robinson-Papp J Abstract Treatment guidelines for chronic pain recommend non-pharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of non-pharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no ef...


CE: Fibromyalgia Syndrome: Current Considerations in Symptom Management.
This article describes the existing treatment guidelines, discusses pharmacologic and nonpharmacologic approaches (including CAM-based modalities), and outlines nursing approaches aimed at enhancing patient self-management. PMID: 26669843 [PubMed - as supplied by publisher] (Source: The American Journal of Nursing)


Medicinal Chemistry of Adenosine, P2Y and P2X Receptors.
We present a selection of the most commonly used agents to study purines in the nervous system. Some of these compounds, including A1 and A3 AR agonists, P2Y1R and P2Y12R antagonists, and P2X3, P2X4 and P2X7 antagonists, are potentially of clinical use in treatment of disorders of the nervous system, such as chronic pain, neurodegeneration and brain injury. Agonists of the A2AAR and P2Y2R are already used clinically, P2Y12R antagonists are widely used antithrombotics and an antagonist of the A2AAR is approved in Japan for treating Parkinson's disease. The selectivity defined for some of the previously introduced compounds has been revised with updated pharmacological characterization, for example, various AR agonists and antagonists were deemed A1AR or A3AR selective based on human data, b...


Factors Associated With the Development of Chronic Post-Sternotomy Pain: a Case-Control Study
(Source: Brazilian Journal of Cardiovascular Surgery)


Opioids for Chronic Pain: Yes or No? Opioids for Chronic Pain: Yes or No?
From San Francisco, a neurologist and a rheumatologist debate whether or not opioids belong in the management of chronic, noncancer pain. Medscape Rheumatology (Source: Medscape Psychiatry 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>


Piriformis Syndrome
Title: Piriformis SyndromeCategory: Diseases and ConditionsCreated: 12/10/2015 12:00:00 AMLast Editorial Review: 12/10/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


The five key things you need to know to manage adult patients with sickle cell disease.
Authors: Lanzkron S, Haywood C Abstract The lack of a strong evidence base to guide the management of adults with sickle cell disease (SCD) makes it difficult for patients to receive high quality care outside of specialty centers. As there is a dearth of providers with sickle cell expertise, the purpose of this article is to identify some of the key things every provider who manages the care of adults with SCD should know. Managing adults with SCD requires excellent clinical skills, as it can affect every organ and cause life-threatening complications but it also requires a willingness to manage patients who often have psychosocial issues that are complex and impact care and care delivery in very significant ways. We have chosen topics for which there is a limited evidence base but...


Urticaria as initial finding of a patient with carcinoid tumor
Conclusion This patient, whose principal symptoms were anemia, urticaria and angioedema, was found to have atypical carcinoid syndrome, with tumors located in the stomach. Allergists, immunologists, internists and primary care physicians should consider the possibility of neuroendocrine malignancies, specifically type I carcinoid tumors, when evaluating patients with urticaria, and consider screening patients with chronic urticaria for elevated anti-parietal cell antibody levels. (Source: World Allergy Organization Journal)


Hyaluronan synthases and hyaluronidases in nasal polyps
Abstract Nasal polyps (NPs) are benign lesions of nasal and paranasal sinuses mucosa affecting 1–4 % of all adults. Nasal polyposis affects the quality of patient’s life as it causes nasal obstruction, postnasal drainage, purulent nasal discharge, hyposmia or anosmia, chronic sinusitis, facial pain and snoring. Without treatment, the disease can alter the craniofacial skeleton in cases of extended growth of polyps. The development of NPs is caused by the hyperplasia of nasal or paranasal sinuses mucosa, and edema of extracellular matrix. This is usually the result of high concentration of high molecular mass hyaluronan (HA) which is either overproduced or accumulated from blood supply. The size of HA presents high diversity and, especially in pathologic conditions, chains of ...


The Effects of a Novel Psychological Attribution and Emotional Awareness and Expression Therapy for Chronic Musculoskeletal Pain: A Preliminary, Uncontrolled Trial
Current psychological and behavioral therapies for chronic musculoskeletal pain only modestly reduce pain, disability, and distress. These limited effects may be due to the failure of current therapies: a) to help patients learn that their pain is influenced primarily by central nervous system psychological processes; and b) to enhance awareness and expression of emotions related to psychological trauma or conflict.Methods: We developed and conducted a preliminary, uncontrolled test of novel psychological attribution and emotional awareness and expression therapy that involves an initial individual consultation followed by 4 group sessions. (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>


Reduced physical activity in children and adolescents with Juvenile Idiopathic Arthritis despite satisfactory control of inflammation
Conclusion: Children and adolescents with JIA are less physically active than their healthy peers and less active than recommended for general health by the Danish Health Authorities. This is not explained by pain or objective signs of inflammation. When inflammation has been curbed, restoration of an active healthy lifestyle should be highly prioritized. (Source: Pediatric Rheumatology)


Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis
Discussion The systematic review outlined in this protocol aims to summarise current knowledge regarding descending pain modulation in IBS. Systematic review registration PROSPERO CRD42015024284 (Source: Systematic Reviews)


Development, Validation and Psychometric properties of a diagnostic/prognostic tool for Breakthrough Pain in mixed chronic-pain patients.
Breakthrough pain (BTP) definition[1] does not limit its occurrence to cancer patients. Prevalence of BTP varies in different clinical contexts and may reach as much as 93% among cancer patients and 74% among non-cancer patients.[2–9] BTP has been reported as an independent predictor for poor pain outcomes and to have negative impact on patients’ quality of life (QoL) with physical, psychological and economic burden for both patients and caregivers.[3,6,10–13] Detection of BTP in either chronic-pain (CP) populations is fundamental for adequate pain management. (Source: Clinical Neurology and Neurosurgery)


Bacteremic kidney cyst infection caused by Helicobacter cinaedi
Abstract Cyst infection is one of the major complications in patients with autosomal dominant polycystic kidney disease (ADPKD). The causative pathogen in kidney cyst infection frequently goes undetected. Although only one case report of kidney cyst infection caused by Helicobacter cinaedi (H. cinaedi) is published in English literature, it may be an important pathogen in kidney cyst infection. Kidney cyst infection and H. cinaedi infection share the common characteristic of tendency to relapse and chronic kidney disease is a major risk factor for H. cinaedi infection. Moreover, a long period is required to detect H. cinaedi in blood cultures, potentially causing false-negative results. After the identification of H. cinaedi, we must carefully select antibiotics and the antibiotic...


NS383 Selectively Inhibits Acid-Sensing Ion Channels Containing 1a and 3 Subunits to Reverse Inflammatory and Neuropathic Hyperalgesia in Rats.
CONCLUSIONS: NS383 is a potent and uniquely selective inhibitor of rat ASICs containing 1a and/or 3 subunits. It is well tolerated and capable of reversing pathological painlike behaviors, presumably via peripheral actions, but possibly also via actions within central pain circuits. PMID: 26663905 [PubMed - as supplied by publisher] (Source: CNS Neuroscience and Therapeutics)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Preclinical Assessment of Inflammatory Pain.
Authors: Muley MM, Krustev E, McDougall JJ Abstract While acute inflammation is a natural physiological response to tissue injury or infection, chronic inflammation is maladaptive and engenders a considerable amount of adverse pain. The chemical mediators responsible for tissue inflammation act on nociceptive nerve endings to lower neuronal excitation threshold and sensitize afferent firing rate leading to the development of allodynia and hyperalgesia, respectively. Animal models have aided in our understanding of the pathophysiological mechanisms responsible for the generation of chronic inflammatory pain and allowed us to identify and validate numerous analgesic drug candidates. Here we review some of the commonly used models of skin, joint, and gut inflammatory pain along with t...


Stress and the Microbiota-Gut-Brain Axis in Visceral Pain: Relevance to Irritable Bowel Syndrome.
Authors: Moloney RD, Johnson AC, O'Mahony SM, Dinan TG, Greenwood-Van Meerveld B, Cryan JF Abstract Visceral pain is a global term used to describe pain originating from the internal organs of the body, which affects a significant proportion of the population and is a common feature of functional gastrointestinal disorders (FGIDs) such as irritable bowel syndrome (IBS). While IBS is multifactorial, with no single etiology to completely explain the disorder, many patients also experience comorbid behavioral disorders, such as anxiety or depression; thus, IBS is described as a disorder of the gut-brain axis. Stress is implicated in the development and exacerbation of visceral pain disorders. Chronic stress can modify central pain circuitry, as well as change motility and permeability...


Stimwave wins FDA 510(k) for SCS device
Stimwave Technologies said it won FDA 510(k) clearance for its Stimwave Freedom-8A 8-electrode wireless neuromodulation spinal cord stimulation device for relieving chronic back and leg pain. The Fort Lauderdale, Fla.-based company said it is the 1st wireless, fully programmable SCS neuromodulation device available. Stimwave said it has begun commercialization of the device and began implantation of the device in its 1st patients earlier this quarter. Stimwave said it plans full nationwide commercialization of the device during early 2016. &#8220;Patients utilizing the Stimwave Freedom-8A and Freedom-4A products not only have the option of a wireless device, but the recent advancements in this technology’s platform also provide the majority of the programming and placement features avai...


Kv Channels and Pain Transmissiom
i-Fect TMis a Proven Tool for Gene Manipulation in Studying All Types of PainI previously posted on use of our i-Fect&nbsp;Transfection Kit&nbsp;to silence Kv Channels Receptors. This has enabled researchers to study the role of these receptors in vitro and in vivo (see:i-Fect™ Delivers Your siRNA Payload).Sample DataFigure: Figures. siRNA-mediated knockdown of Kv1.1 expression in thoracic DRG significantly increased gastric sensitivity in naive adult rats. (A) Western blots showed a significant decrease in Kv1.1 protein in thoracic DRG (T8–T12) after intrathecal treatment with Kv1.1 siRNA but not with control siRNA. siRNA treatment did not alter TrpV1 expression (n = 5 rats each; *P &lt; .01 vs control siRNA). (B) Naive rats treated with Kv1.1 siRNA showed a significant increase in VM...


Effect of vitamin D on the recurrence rate of rheumatoid arthritis.
In conclusion, a decreased level of Vit D is a risk factor for the recurrence of RA. PMID: 26640554 [PubMed - as supplied by publisher] (Source: Experimental and Therapeutic 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>


Can public health registry data improve Emergency Medical Dispatch?
ConclusionIncreasing age, male sex, and hospitalization history was associated with increased risk of death on day 1 for FHQ 112 callers. Additional efforts are warranted to clarify the role for risk prediction tools in emergency medical dispatch. (Source: Acta Anaesthesiologica Scandinavica)


Sickle Cell Drug Doesn't Relieve Pain Crises: Study
Title: Sickle Cell Drug Doesn't Relieve Pain Crises: StudyCategory: Health NewsCreated: 12/8/2015 12:00:00 AMLast Editorial Review: 12/9/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


How bad does it hurt? New research helps children suffering from chronic pain conditions
(University of Cincinnati) Interdisciplinary research ultimately aims to help the medical profession better gauge and treat chronic pain such as arthritis in children. (Source: EurekAlert! - Medicine and Health)


Sodium butyrate and its synthetic amide derivative modulate nociceptive behaviors in mice
In conclusion, we describe the role of butyrate-based drugs in pain, identifying different and converging non-genomic and genomic mechanisms of action, which cooperate in nociception maintenance. Graphical abstract (Source: Pharmacological Research)


Chronic pain after TEP inguinal hernia repair, does MRI reveal a cause?
Conclusion For patients with post-TEP hernia groin pain, MRI is useful to confirm a correct flat mesh position and to identify possible not operation-related causes of groin pain. It is of little help to identify a specific cause of groin repair-related pain. (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>


Revascularization of the superior mesenteric artery alone for treatment of chronic mesenteric ischemia.
CONCLUSIONS: Surgery for CMI can be safely performed with retrograde approach and single vessel anastomosis. Mortality rates and long-term survival compare favorably with other surgical approaches to treatment of CMI. PMID: 26649404 [PubMed - as supplied by publisher] (Source: Wiener Klinische Wochenschrift)


Surgery for Dupuytren's contracture of the fingers.
CONCLUSIONS: Currently, insufficient evidence is available to show the relative superiority of different surgical procedures (needle fasciotomy vs fasciectomy, or interposition firebreak skin grafting vs z-plasty closure of fasciectomy). Low-quality evidence suggests that postoperative splinting may not improve outcomes and may impair outcomes by reducing active flexion. Further trials on this topic are urgently required. PMID: 26648251 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)


Trunk coordination in healthy and chronic nonspecific low back pain subjects during repetitive flexion-extension tasks: Effects of movement asymmetry, velocity and load.
In conclusion, coordination pattern and variability could be influenced by trunk flexion-extension conditions. CNSLBP subjects demonstrated less adaptability of movement pattern to the demands of the flexion-extension task. PMID: 26684726 [PubMed - as supplied by publisher] (Source: Human Movement Science)


$10 million gift to UCLA from Wendy and Leonard Goldberg is largest ever to support migraine research
UCLA Health Sciences has received a $10 million gift, most of which will support multidisciplinary research on migraine, a debilitating neurological disorder that affects 36 million people in the U.S. The gift was made by philanthropists Wendy and Leonard Goldberg. Wendy Goldberg is an editor and author; her husband, Leonard, is an award-winning film and television producer and executive. More than 90 percent of sufferers are unable to work during their migraine attacks, costing employers $13 billion a year in lost work days; and every 10 seconds, someone in the U.S. goes to an emergency room with a migraine-related complaint. “The Goldbergs’ visionary gift, which names and endows the UCLA Goldberg Migraine Program, is the largest from individuals to support migraine research and treat...


Low-level Laser Application for Masticatory Muscle PainLow-level Laser Application for Masticatory Muscle Pain
Could low level laser application at the points of greatest pain bring relief to patients with chronic temporomandibular disorders? BMC Oral Health (Source: Medscape Today Headlines)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study.
Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group. PMID: 26640708 [PubMed - as supplied by publisher] (Source: Pain Research and Treatment)


A Study on the Effects of Sympathetic Skin Response Parameters in Diagnosis of Fibromyalgia Using Artificial Neural Networks
This study analyzes the effect of sympathetic skin response (SSR) parameters on the auxiliary tests used in FMS diagnosis, the laboratory tests and physiological tests. The study was conducted in Suleyman Demirel University, Faculty of Medicine, Physical Medicine and Rehabilitation Clinic in Turkey with 60 patients diagnosed with FMS for the first time and a control group of 30 healthy individuals. In the study all participants underwent laboratory tests (blood tests), certain physiological tests (pulsation, skin temperature, respiration) and SSR measurements. The test data and SSR parameters obtained were classified using artificial neural network (ANN). Finally, in the ANN framework, where only laboratory and physiological test results were used as input, a simulation result of 96.51 % ...


Cerebral reactivity in migraine patients measured with functional near-infrared spectroscopy
Conclusion NIRS showed the potential to be a useful tool in the clinical setting for monitoring the vascular reactivity of individual patients to various migraine and headache medications. (Source: European Journal of Medical Research)


CD11b+Ly6G- myeloid cells mediate mechanical pain [Neuroscience]
Pain hypersensitivity at the site of inflammation as a result of chronic immune diseases, pathogenic infection, and tissue injury is a common medical condition. However, the specific contributions of the innate and adaptive immune system to the generation of pain during inflammation have not been systematically elucidated. We therefore set... (Source: Proceedings of the National Academy of Sciences)


Chronic Abdominal Pain from Inferior Venacava Filter Strut Perforation- A Case Report
A 49 year old female presented to our hospital with a one month history of progressive epigastric and right upper quadrant abdominal pain, nausea, anorexia, non-bloody vomiting, and loose stools. The pain was sharp, worsening over the week prior to presentation, and not improving with over the counter pain medications. (Source: The American Journal of Medicine)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Chronic Abdominal Pain from Inferior Vena Cava Filter Strut Perforation: A Case Report
A 49-year-old woman presented to our hospital with a 1-month history of progressive epigastric and right upper quadrant abdominal pain, nausea, anorexia, non-bloody vomiting, and loose stools. The pain was sharp, worsening over the week before presentation, and not improving with over-the-counter pain medications. (Source: The American Journal of Medicine)


Why oral opioids may not be effective in a subset of chronic pain patients.
CONCLUSIONS: There is a group of intractable pain patients who do not effectively metabolize oral opioids. Although gastrointestinal disease and cytochrome P450 enzymatic defects appeared to be dominant causes of oral opioid ineffectiveness, there were other possible contributing factors such as, abdominal, pelvic, and spine surgeries, head and neck trauma, and autoimmune disease. Pain patients who report poor oral opioid effectiveness should be evaluated for the presence of underlying pathologic conditions which may interfere with oral opioid metabolism and, if found, be considered for non-oral opioid treatment. PMID: 26635137 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


Efficacy and Tolerability of Buccal Buprenorphine in Opioid-Naive Patients With Moderate to Severe Chronic Low Back Pain.
CONCLUSIONS: These findings demonstrate the efficacy and tolerability of BBUP among opioid-naive patients requiring around-the-clock opioid treatment for CLBP. PMID: 26634956 [PubMed - as supplied by publisher] (Source: Postgraduate Medicine)


A Need for Personalized Chronic Opioid TherapyA Need for Personalized Chronic Opioid Therapy
Dr Argoff argues that a patient-centered approach must be taken when treating chronic pain with chronic opioid therapy. Medscape Neurology (Source: Medscape Neurology and Neurosurgery Headlines)


Researchers investigate the 'pathways of pain'
ConclusionThis study builds on the knowledge that people born with particular mutations in the SCN9A gene do not have functioning Nav1.7 sodium channels in their sensory nerve cells and do not feel pain. The researchers have further explored the possible reasons behind this. They found that it seems to be – at least for the most part – because absence of this channel leads to increased activity of the body's naturally occurring opioid painkillers.The theory is that if drugs were developed to block these sodium channels, they could replicate some of the painkilling attributes seen in people with the SCN9A mutation. The researchers suggest these could be used in the treatment of a variety of chronic pain conditions – although will probably need to be boosted with other opioid drugs.How...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Electrical Stimulation May Ease Low Back Pain for Some
Title: Electrical Stimulation May Ease Low Back Pain for SomeCategory: Health NewsCreated: 12/4/2015 12:00:00 AMLast Editorial Review: 12/7/2015 12:00:00 AM (Source: MedicineNet Chronic Pain General)


Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study
Conclusions This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation. (Source: Chiropractic and Manual Therapies)


CT enterography in the evaluation of Crohn's disease
Conclusion This study showed that CT enterography presents a good assessment of intestinal involvement by CD. (Source: Journal of Coloproctology)


Hydroxycarbamide versus chronic transfusion for maintenance of transcranial doppler flow velocities in children with sickle cell anaemia—TCD With Transfusions Changing to Hydroxyurea (TWiTCH): a multicentre, open-label, phase 3, non-inferiority trial
This study is registered with ClinicalTrials.gov, number NCT01425307. Findings Between Sept 20, 2011, and April 17, 2013, 159 patients consented and enrolled in TWiTCH. 121 participants passed screening and were then randomly assigned to treatment (61 to transfusions and 60 to hydroxycarbamide). At the first scheduled interim analysis, non-inferiority was shown and the sponsor terminated the study. Final model-based TCD velocities were 143 cm/s (95% CI 140–146) in children who received standard transfusions and 138 cm/s (135–142) in those who received hydroxycarbamide, with a difference of 4·54 (0·10–8·98). Non-inferiority (p=8·82 × 10−16) and post-hoc superiority (p=0·023) were met. Of 29 new neurological events adjudicated centrally by masked reviewers, no strokes were...


Reported concepts for the treatment modalities and pain management of temporomandibular disorders
Conclusions The authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered. (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>


Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease
No studies to date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to (1) describe the prevalence of insomnia symptoms and (2) identify biopsychosocial predictors in community-dwelling adults with SCD. Cross-sectional analysis of baseline data from 263 African American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. (Source: Pain Management Nursing)


Adverse Event Recording and Reporting in Clinical Trials Comparing Lumbar Disk Replacement with Lumbar Fusion: A Systematic Review
Conclusions Based on the currently available literature, lumbar TDR appears to be comparable in safety to lumbar fusion. However, due to lack of consistency in reporting of AEs, it is difficult to make conclusions regarding the true safety profile of lumbar TDR. Standardization in AE reporting will significantly improve the reliability of the current literature.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  open access Full text (Source: Global Spine Journal)


Symptomatic Triple-Region Spinal Stenosis Treated with Simultaneous Surgery: Case Report and Review of the Literature
Conclusions This report is the first of symptomatic TRSS treated with simultaneous surgery in three different regions of the spine. Simultaneous triple region stenosis surgery appears to be an effective treatment option for this rare condition, but may be associated with prolonged hospital stay after surgery.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  open access Full text (Source: Global Spine Journal)


The 10 Best Exercises You Can Do For The Rest Of Your Life
From boot camps to SoulCycle to&#160;early morning dance parties, there&#8217;s no shortage of fitness trends with a devoted, young, fit following. But when it comes to exercises that even the oldest and most out of shape can (and should) add to their workout repertoires, most fitness professionals advise keeping it simple. Here are their votes for the 10 best exercises you can start doing today &#8211; and stop doing, well, never. 1. Walking The votes are in, and the consensus is clear: Nothing quite beats walking. The exercise is functional (you can do it to get places), accessible (no gym needed) and &#8220;suitable for all ages and abilities,&#8221; says Michelle Walters-Edwards, chair of the Department of Health and Human Performance at Marymount University. Best of all? Walking can r...


Pelvic congestion syndrome – Diagnosis and treatment
Publication date: Available online 5 December 2015 Source:Journal of Indian College of Cardiology Author(s): Saroj Das Pelvic Congestion Syndrome is a cause of chronic pelvic pain in 30-40% of young women. This is a complex problem due to ovarian vein reflux and may be associated with reflux in the internal iliac vein tributaries causing pudendal varicosities. Effective treatment for this condition involves a multi disciplinary approach including gynaecologist, vascular surgeon and interventional radiologist supported by appropriate investigations. Investigations may include Ultrasound examination, Transvaginal Ultrasound, CT venogram, MRI venogram and Pelvic Venography. Successful treatment of this condition may involve embolisation of ovarian veins, internal iliac vein tributaries, fo...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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-articular lipoma arborescence of the knee – A rare clinical entity
Conclusions LA should be included in the differential diagnosis of cases with persistent, refractory, chronic knee joint swelling and pain. (Source: Journal of Arthroscopy and Joint Surgery)


Headache Rounds: Sudden Onset Chronic Daily Headache.
Authors: Wrobel Goldberg S, Young W Abstract The following article is a Thomas Jefferson Headache Center headache rounds presentation. A 37-year-old woman, who reports a history of chronic sinusitis, developed sudden onset headache 1 1/2 years prior to her initial presentation at the Jefferson Headache Center. At that time she noted acute severe pressure-like pain bilaterally in her neck, which radiated to her forehead above her eyebrows. She denied fever, rashes, or nasal discharge at the time. The pain was much more intense than her usual "sinus headaches" and associated with a positional component, occurring only upon standing, reaching a peak intensity of 10/10 that would only last seconds and remaining as a dull milder continuous frontal pain for up to 12 hours. She had nausea...


The complementary medicine (CAM) for the treatment of chronic pain: scientific evidence regarding the effects of healing touch massage.
CONCLUSIONS: The way to full recognition by both the institutional and the scientific community seems to promise fairly well, although it should be noted that the achievement of this goal will require further research avoiding the limitations of previous studies. PMID: 26629667 [PubMed - in process] (Source: Acta Bio-Medica : Atenei Parmensis)


Treatment of Cancer Pain and Medical Narcotics.
Authors: Suzuki T Abstract   The World Health Organization has reported that when morphine is used to control pain in cancer patients, psychological dependence is not a major concern. Our studies were undertaken to ascertain the modulation of psychological dependence on morphine under a chronic pain-like state in rats. Morphine induced a dose-dependent place preference. We found that inflammatory and neuropathic pain-like states significantly suppressed the morphine-induced rewarding effect. In an inflammatory pain-like state, the suppressive effect was significantly recovered by treatment with a κ-opioid receptor antagonist. In addition, in vivo microdialysis studies clearly showed that the morphine-induced increase in the extracellular levels of dopamine (DA) in the nucleus ac...


Addiction and Chronic Pain: Training Addiction Psychiatrists.
CONCLUSION: Educators in addiction psychiatry should clarify their role in the management of chronic pain and prioritize training in this area. PMID: 26626792 [PubMed - as supplied by publisher] (Source: The Journal of American Association of Directors of Psychiatric Residency Training)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Trigonalgia: An overlooked cause of bladder pain
Publication date: Available online 4 December 2015 Source:African Journal of Urology Author(s): S. Aminu Bladder pain is a cause of chronic pelvic pain, which constitutes a common presentation in urology out-patient consultation, especially among females. Some endoscopic features of the trigone observed during cystoscopy was correlated with mild to moderately bothersome bladder pain, termed trigonalgia. This is due to peculiarity of the trigonal anatomy from the rest of bladder, especially with the highest concentration of afferent nerves. Research focused on the trigone is worthwhile. (Source: African Journal of Urology)


41 Successful management of chronic scrotal pain syndrome by laparoscopic testicular denervation
Publication date: November 2015 Source:European Urology Supplements, Volume 14, Issue 8 Author(s): A.I. Hinev, K.T. Dikranian (Source: European Urology Supplements)


In search of the person in pain: A systematic review of conceptualization, assessment methods, and evidence for self and identity in chronic pain
Publication date: October 2015 Source:Journal of Contextual Behavioral Science, Volume 4, Issue 4 Author(s): Lin Yu, Sam Norton, Anthony Harrison, Lance M. McCracken One way to develop psychological approaches to chronic pain is to improve our understanding of psychological processes that both underlie the impacts of pain and can be addressed in treatment. A set of processes that deserves further attention in this regard is those related to self or personal identity. The aim of this systematic review was to examine the conceptualizations of processes related to the self in studies of people with chronic pain, approaches to assess these processes, and the evidence for their role in relation to key measures of daily functioning. Fifteen distinct self-related processes were identified f...


Fever and multilobular mass of the right lung in a young adult with asthma
We report a case of a 37-year-old mild asthmatic male presenting with fever, productive cough and chest pain. The chest x-ray showed a multilobular perihilar shadow of the right lung with a mass-like appearance, confirmed by the CT-scan. He was diagnosed with allergic bronchopulmonary aspergillosis (ABPA). ABPA usually manifests as chronic asthma, recurrent pulmonary infiltrates and bronchiectasis. However, it can rarely be seen in patients with mild asthma and with an unusual radiological presentation of a solid mass. (Source: Medical Mycology Case Reports)


Early event related fields during visually evoked pain anticipation.
CONCLUSIONS: The findings indicate that early ERFs are relevant neural substrates of pain anticipatory phenomena and could be potentially serve as biomarkers. SIGNIFICANCE: These measures could assist in the development of neurostimulation approaches aimed at curbing the negative effects of pain anticipation during rehabilitation. PMID: 26733321 [PubMed - as supplied by publisher] (Source: Clinical Neurophysiology)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Researchers find key to treating human pain
Stephen FellerLONDON, Dec. 4 (UPI) -- Researchers used mice to confirm how a rare genetic mutation prevents people from feeling pain, which may lead to new methods of treating chronic pain patients. (Source: Health News - UPI.com)


From Navy SEAL to a Lifetime Dedicated to Teaching the Importance of Proper Exercise: Meet Fred Stellabotte!
The exercise itself will never hurt you-- it's improper form that will injure you. Fred Stellabotte, a veteran of the US Navy's Underwater Demolition Team (forerunner to the present-day Navy SEALs), is an expert in physical fitness and strength. He has focused particularly on bodybuilding and has been preaching the importance of proper exercise and weight training for over 50 years. Weight training is Stellabotte's forte. He has trained champion bodybuilders, as well as professional athletes, triathletes, and members of the general public. According to Stellabotte, weight training is the only way to sculpt your body. Captivated by the Human Body as a US Navy Seal Stellabotte's fascination with the human body began while he was a US Navy SEAL on leave in China. He spent time with monks who...


FDA Nod for Algovita Spinal Cord Stimulator in Chronic PainFDA Nod for Algovita Spinal Cord Stimulator in Chronic Pain
The FDA has approved the Algovita spinal cord stimulation system for patients with chronic, intractable pain. FDA Approvals (Source: Medscape Neurology and Neurosurgery Headlines)


Experts explain how to end opioid overdose epidemic
The nation has seen a four-fold increase in opioid deaths in the last decade, according to the Centers for Disease Control and Prevention (CDC)—and physicians stand on the front lines of this national health crisis. During the 2015 AMA Interim Meeting, physician experts recently discussed actions you can take now to help combat the opioid epidemic and improve patient care. Rethinking prescribing practices, effectively using PDMPs CDC Director Thomas Frieden, MD, was among a panel of experts who offered actionable solutions to help curb the nation’s high rate of opioid overdoses. He noted that the rise in opioid-related deaths and abuse directly correlates with an increase in the prescribing of opioids. Unless physicians adopt improved practices for prescribing for pain, he said th...


Immediate Effects of Core-Stability Exercises and Clinical Massage on Dynamic-Balance Performance of Patients With Chronic Specific Low Back Pain.
CONCLUSION: CS exercises immediately increase the PPT of active MTrPs in physically active adults with clinical instability of the lumbar spine and chronic myofascial pain syndrome. When MTrP therapy is added, side-to-side asymmetries in DB are minimized. PMID: 26633587 [PubMed - as supplied by publisher] (Source: Journal of Sport 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>


Kinesio Taping® is not better than placebo in reducing pain and disability in patients with chronic non-specific low back pain: a randomized controlled trial
Conclusions: The Kinesio Taping® is not better than placebo (Micropore®) in patients with chronic low back pain. (Source: Revista Brasileira de Fisioterapia)


Bard, Boston Scientific in 1st trial against 2 pelvic mesh makers
A trial is under way in Kansas City in a product liability lawsuit against Boston Scientific (NYSE:BSX) and C.R. Bard (NYSE:BCR), marking the 1st time a pelvic mesh lawsuit against 2 companies has gone before a jury, Courtroom View Network reported. Plaintiff Eve Sherrer alleges that Bard&#8217;s Align and Boston Scientific&#8217;s Solyx used a polypropylene mesh that reacts to tissue by becoming brittle and that the companies failed to warn patients about the products&#8217; attendant risks, according to the website. Manufacturers of pelvic mesh products, designed to treat female urinary incontinence and pelvic organ prolapse, face some 70,000 lawsuits spanning 3 multi-district litigations. Only a few have made it to trial, with juries recording 16 wins for plaintiffs and 5 for th...


High-frequency Electrical Stimulation to Spinal Cord Eases Chronic Pain
A researcher at Case Western Reserve University has been awarded a four-year, $2.4 million federal grant to uncover how high-frequency electrical stimulation to the spinal cord reduces or eliminates chronic pain. (Source: Disabled World)


Exertional Leg Pain.
Authors: Rajasekaran S, Finnoff JT Abstract Exertional leg pain is a common condition seen in runners and the general population. Given the broad differential diagnosis of this complaint, this article focuses on the incidence, anatomy, pathophysiology, clinical presentation, diagnostic evaluation, and management of common causes that include medial tibial stress syndrome, tibial bone stress injury, chronic exertional compartment syndrome, arterial endofibrosis, popliteal artery entrapment syndrome, and entrapment of the common peroneal, superficial peroneal, and saphenous nerves. Successful diagnosis of these conditions hinges on performing a thorough history and physical examination followed by proper diagnostic testing and appropriate management. PMID: 26616179 [PubMed - in ...


A Systematic Review of the Association Between Psychiatric Disturbances and Endometriosis.
CONCLUSION: The limited research suggests that women presenting with endometriosis are at risk for psychosocial disturbances or psychiatric distress. Whether such disruptions are a consequence of endometriosis, the associated chronic gynaecological pain, or another factor such as inflammation remains to be delineated. In the interim, women presenting with symptoms of endometriosis should also be screened for psychosocial and psychiatric disturbances. PMID: 26629721 [PubMed - in process] (Source: Journal of Obstetrics and Gynaecology Canada : JOGC)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Provoked Vestibulodynia and the Health Care Implications of Comorbid Pain Conditions.
CONCLUSION: Taken together, these findings suggest that physicians caring for women with PVD and concurrent chronic pain must be alert to the potentially greater health needs among this subsample of women. PMID: 26629720 [PubMed - in process] (Source: Journal of Obstetrics and Gynaecology Canada : JOGC)


Chronic pain in type 2 diabetic patients: a cross-sectional study in primary care setting.
CONCLUSION: The impact of neuropathic pain in DM patients is much more significant than nociceptive pain and affects their quality of life and daily function to a greater degree. PMID: 24645789 [PubMed - indexed for MEDLINE] (Source: European Journal of General Practice)


Vitamin D supplementation for diffuse musculoskeletal pain: results of a before-and-after study.
CONCLUSION: In this small before-and-after study, vitamin D supplementation decreased pain scores in adult patients with diffuse musculoskeletal pain and vitamin D deficiency. These results must be confirmed by further studies. PMID: 24576123 [PubMed - indexed for MEDLINE] (Source: European Journal of General Practice)


Prehension Combined With Gait in Individuals With Chronic Low Back Pain.
Authors: Manciopi PA, Rinaldi NM, Moraes R Abstract Low back pain (LBP) can affect performance in the combined task (CT) of gait and prehension, since it increases muscle activity amplitude during voluntary movements, impairs the anticipatory postural adjustments and reduces gait speed. We analyzed and compared the effect of adding the prehension movement towards a dowel located at three different heights (80, 100 and 120% of the lower limb length) on gait of individuals with and without LBP. The CT caused anticipatory adjustments, showing that gait changes started during the approach phase and continued on the step corresponding to grasping, especially for the lowest dowel height. Furthermore, individuals with LBP reduced walking speed, increased the width of the base of support, ...


The therapeutic use of endoscopic ultrasonography in pediatric patients is safe: A case series
Conclusion: The therapeutic use of endoscopic ultrasound in the pediatric population is safe and has a high success rate. (Source: The Saudi Journal of 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>


Feasibility and Safety of an Operative Tool for Anterior Chronic Exertional Compartment Syndrome Treatment
Conclusion: This fasciotome was simple to use and allowed for a safe fasciotomy in patients with leg ant-CECS. A randomized controlled trial comparing the present device with a widely used fasciotome was under way at the time of writing of this study. Level of evidence: Level IV, case series (Source: Foot and Ankle International)


Multidisciplinary Biopsychosocial Rehabilitation for Nonspecific Chronic Low Back Pain.
This article focuses on the effectiveness of multidisciplinary biopsychosocial rehabilitation for non-specific chronic low back pain. PMID: 26637649 [PubMed - as supplied by publisher] (Source: Physical Therapy)


Bioelectrodynamics: A New Patient Care Strategy for Nursing, Health, and Wellness
Bioelectrodynamics is an interdisciplinary subject that offers a pathway for nursing to develop a new patient care strategy in health care. The application of bioenergy to living organisms has the potential to advance medical science in the areas of prevention, cancer, wound care, pain, and many other chronic diseases. (Source: Holistic Nursing Practice)


NeuroMetrix shares slump after clearing 1-for-4 split
NeuroMetrix (NSDQ:NURO) said today it consummated its 1 for 4 reverse split of its common stock, trading at a split-adjusted basis yesterday. Stocks rose on Tuesday to open at $3.01, but dropped to close at $2.65. Today, shares of NURO opened at $2.70 and fell over 6% to close at $2.43, down roughly 19% from its opening price on Tuesday. The move was initially announced Monday, primarily enacted to increase per share trading price to satisfy the NASDAQ Capital Market’s $1.00 minimum bid price requirement, NeuroMetrix said. As a result, every 4 shares of the Waltham, Mass.-based company’s stock was consolidated into 1 issued and outstanding share, and no fractional shares will be issued. Shareholders who would be entitled to receive a fractional share will receive a cash payment in...


Zika virus infection – Paraguay
On 27 November 2015, the National IHR Focal Point of Paraguay notified PAHO/WHO of 6 laboratory-confirmed autochthonous cases of Zika virus infection in the city of Pedro Caballero, which is located in the northeast of the country and shares borders with Brazil. The diagnoses were made by the national reference laboratory, the Central Public Health Laboratory of the Ministry of Health, through reverse transcription polymerase chain reaction (RT-PCR) technique. Cases were identified from clusters of febrile patients whose samples tested negative for dengue and chikungunya. They presented with fever, headache, myalgia, arthralgia, retroocular pain and nausea. Their age ranges from 14 to 45 years old, and half of them are female. Cases have been managed on an outpatient basis in different he...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://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 integrating standardized patient-reported outcomes in orthopedic care.
CONCLUSIONS: Lessons learned for future adoption of questionnaire systems elsewhere include the need for baseline assessment of clinic work flows to identify the optimal point of administration and the need for IT support. This study demonstrates the feasibility of routinely collecting patient-reported data as part of standard care, which will become increasingly important as the nationwide emphasis on tracking quality and cost-effectiveness of treatments in orthopedics grows. PMID: 26618231 [PubMed - in process] (Source: The American Journal of Managed Care)


Cervical non-invasive vagus nerve stimulation (nVNS) for preventive and acute treatment of episodic and chronic migraine and migraine-associated sleep disturbance: a prospective observational cohort study
Conclusion In this study, treatment with nVNS was safe and provided clinically meaningful decreases in the frequency, intensity, and duration of migraine attacks in patients with treatment-refractory migraine. Improvements in migraine-associated disability, depression, and sleep quality were also noted. (Source: The Journal of Headache and Pain)


Health-related quality of life is inversely correlated with C-reactive protein and age in Mycobacterium avium complex lung disease: a cross-sectional analysis of 235 patients
Conclusions: HRQL, especially the physical component, was impaired in patients with MAC lung diseases; this appears to be related with current treatment status, positive sputum smear or culture within the previous year, and particularly CRP and age. Further studies including qualitative assessments are needed to investigate the efficacy of CRP as a marker for progression or treatment response in MAC lung disease.Trial registrationClinical trial registered with UMIN (UMIN000007964). (Source: Respiratory Research)


Determinants of patient preferences for total knee replacement: African-Americans and whites
The objectives of this study were to identify the determinants of knee osteoarthritis (OA) patients’ preferences regarding TKR by race and to identify the variables that may mediate racial differences in willingness to undergo TKR. Methods: Five hundred fourteen White (WH) and 285 African-American (AA) patients with chronic knee pain and radiographic evidence of OA participated in the study. Participants were recruited from the community, an academic medical center, and a Veterans Affairs hospital. Structured interviews were conducted to collect socio-demographics, disease severity, socio-cultural determinants, and treatment preferences. Logistic regression was performed, stratified by race, to identify determinants of preferences. Clinical and socio-cultural factors were entered simulta...


Enhancing clinical decisions about care through a pre-consultation sheet that captures patients’ views on their health conditions and treatments: A qualitative study in the field of chronic pain
(Source: Patient Education and Counseling)<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Delayed diagnosis and worsening of pain following orthopedic surgery in patients with complex regional pain syndrome (CRPS)
Conclusions and implications A mean time delay of 3.9 years before diagnosis of CRPS is unacceptable. A lack of attention to more subtle signs of autonomic dysfunction may be an important contributing factor for the missing CRPS diagnosis, in particular serious in patients reporting worsening of pain following subsequent orthopedic surgery. It is strongly recommended to consider the diagnosis of CRPS in all patients with a long-lasting pain condition. We emphasize that the present report is not meant as criticism to orthopedic surgical practice, but as a discussion for a hopefully increased awareness and understanding of this disabling pain condition. (Source: Scandinavian Journal of Pain)


Treatment of subchondral cysts in patients with haemophilia
ConclusionThe treatment of subchondral cyst in PWH by aspiration and filling with hydroxyapatite coralline allows bone restoration and delays deterioration of the joint treated. (Source: Haemophilia)


Repeated tender point injections of granisetron alleviate chronic myofascial pain - a randomized, controlled, double-blinded trial
Conclusions Repeated intramuscular tender-point injections with granisetron provide a new pharmacological treatment possibility for myofascial pain patients with repeated intramuscular tender-point injections with the serotonin type 3 antagonist granisetron. It showed a clinically relevant pain reducing effect in the temporomandibular region, both in a short- and long-term aspect. Trial registration European Clinical Trials Database 2005-006042-41 as well as at Clinical Trials NCT02230371. (Source: The Journal of Headache and Pain)


Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey
Conclusions Our study with a large population-based nation-wide sample, using ICHD-II criteria, with structured headache interviews as well as blinded re-validation of the questionnaire diagnoses showed a 2.38 % incidence rate of migraine in Turkey, higher than most of the other previous reports; a finding which could be related to genetic factors and also to the methodological differences in the study designs. Moreover the incidence of CM was found to be 0.066 %. (Source: The Journal of Headache and Pain)


Supplement to Nov-Dec 2015 Issue: Abstracts of Poster Presentations: CNS Summit 2015
Conclusions: Therapeutic and supra-therapeutic doses of flibanserin had no negative effect on measures of next-day simulated driving performance and cognitive testing. &nbsp; Effect of as-needed use of intranasal PH94B on social and performance anxiety in individuals with social anxiety disorder Presenters: Liebowitz M, Hanover R, Draine A, Lemming R, Careri J, Monti L Affiliations: The Medical Research Network, LLC Background: There are no medications approved for use on an as-needed basis for feared social or performance situations for individuals with social anxiety disorder. Objective: In the present study, PH94B, a novel synthetic neurosteroidal molecule that is administered intranasally in microgram doses, was used as needed during everyday stressful social events. Methods: Twenty-tw...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


[Saccharomyces cerevisiae fungemia in an elderly patient following probiotic treatment].
Authors: Eren Z, Gurol Y, Sonmezoglu M, Eren HS, Celik G, Kantarci G Abstract Saccharomyces cerevisiae, known as baker's yeast, is also used as a probiotic agent to treat gastroenteritis by modulating the endogenous flora and immune system. However, since there have been increasing reports of fungemia due to S.cerevisiae and its subspecies S.boulardii, it is recommended that probiotics should be cautiously used in immunosuppressed patients, people with underlying diseases and low-birth weight babies. To emphasize this phenomenon, in this report, a case of S.cerevisiae fungemia developed in a patient given probiotic treatment for antibiotic-associated diarrhea, was presented. An 88-year-old female patient was admitted to our hospital with left hip pain, hypotension, and confusion. H...


How I Choose Happiness
For the longest, I didn't see the light. I only saw the dark, the shadows. I was lost in the forest. I struggled with chronic headaches, depression, self-hate, chronic muscle pains, eating disorders, trauma from being abused growing up, and so on. I desperately wanted to heal. I just wanted to be happy, healthy and free. I wanted happiness, health and freedom so badly that I forgot to think about what these words meant. I imagined happiness, health and freedom as a destination, where I arrive and I will have nothing else to do, but to soak on the sun and hang my feet by the ocean. I imagined it as a permanent destination that something will take me to: I would get fixed and I would be there. I was looking at my problems as separate issues. My original prescription was ibuprofen for my h...


FDA OKs trial for StimRelieve’s facial pain device
StimRelieve said today that it won an investigational device exemption for a clinical trial of its neurostimulation treatment for treating refractory craniofacial neuropathic pain. Ft. Lauderdale, Fla.-based StimRelieve said its Halo CFNS device, using wirelessly-powered, nanotech neurostimulators, is 95% smaller than other implantable treatment options. The wireless device, powered by an external transmitter in the ear, is implanted with a standard-gauge needle, the company said. The trial is designed to evaluate the Halo CFNS device&#8217;s safety and effectiveness in comparison with no active treatment, the company said. The endpoint is sustained pain reduction at 3 months of more than 50%, as measured by visual analog pain scale measurement, with no increase in medication. &#8220;...


Zimmer Biomet wins expanded FDA safety claim for Gel-One knee injection
Zimmer Biomet (NYSE:ZBH) said today that the FDA granted an expanded safety claim for its Gel-One cross-linked hyaluronate knee injection indicating that the treatment is safe to use more than once. Gel-One is used to treat knee osteoarthritis that hasn&#8217;t responded to non-drug therapy, non-steroidal anti-inflammatory drugs or simple analgesics, Warsaw, Ind.-based Zimmer Biomet said. It&#8217;s designed to help lubricate the knee joint, the company said. &#8220;Our expanded FDA safety claim for Gel-One hyaluronate is an exciting development for our growing portfolio of joint preservation treatments, as well as the millions of patients who can benefit from this simple, in-office solution for chronic knee pain,&#8221; biologics, extremities, sports medicine, surgical, trauma and f...


Re-branding cannabis: the next generation of chronic pain medicine? - Carter GT, Javaher SP, Nguyen MHV, Garret S, Carlini BH.
The field of pain medicine is at a crossroads given the epidemic of addiction and overdose deaths from prescription opioids. Cannabis and its active ingredients, cannabinoids, are a much safer therapeutic option. Despite being slowed by legal restrictions ... (Source: SafetyLit: All (Unduplicated))<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Posterolateral diaphragmatic hernia with small-bowel incarceration in an adult.
Authors: Wenzel-Smith G Abstract Bochdalek hernia (BH), a closing defect of the peripheral posterior aspect of the diaphragm, is the commonest of the congenital diaphragmatic hernias and is usually diagnosed in neonates. Symptomatic presentation of a right-sided diaphragmatic hernia in an adult is unusual. Owing to their rarity and varied presentation, they can pose a diagnostic challenge. A right-sided BH in a 40-year-old woman who presented with respiratory distress associated with abdominal pain and symptoms of small-bowel obstruction is reported. Midline laparotomy revealed necrotic small bowel and faecothorax of the pleural cavity. Diaphragmatic hernias should be included in the differential diagnosis of patients with acute or chronic gastrointestinal, or less frequently respi...


Outcome of laparoscopic inguinal hernia repair in a South African private practice setting.
CONCLUSIONS: The recurrence and complication rates for laparoscopic TEP inguinal hernia repair in this practice are low and comparable to the best reported series. There is a low incidence of persistent postoperative pain with the laparoscopic technique, and it is the technique preferred by patients who previously underwent an open repair. PMID: 23217551 [PubMed - indexed for MEDLINE] (Source: South African Journal of Surgery)


Epidemiology and incidence of acute and chronic Post-Surgical pain.
CONCLUSIONS: The incidence of CPSP 12 months after surgery must be improved in the next future. Preoperative pain and the percentage of time with severe pain during the first 24 hours after surgery seem to be CPSP predictors. KEY WORDS: Chronic pain, Opioids, Postoperative pain, Postsurgical pain, Surgery. PMID: 26343897 [PubMed - in process] (Source: Annali Italiani di Chirurgia)


Should we treat white line hernias by laparoscopy? About a prospective study of 42 cases.
In conclusion, the laparoscopic approach should be reserved for cases of large hernias and for recurrent and incisional hernias. KEY WORDS: Epigastric hernia, Laparoscopy, Mesh, Umbilical hernia. PMID: 26343505 [PubMed - in process] (Source: Annali Italiani di Chirurgia)


The role of laparoscopy in recurrent right lower quadrant pain in children.
Authors: Caiazzo P, Esposito M, Del Vecchio G, Papparella A, Cavaiuolo S, Tramutoli PR, Parmeggiani P Abstract According to scientific literature, laparoscopy as aid in diagnosis and therapy for chronic pain in the right iliac quadrant shows a undeniable advantage thanks to its mini-invasiveness, the possibility of a methodical and thorough exploration of the entire abdominal cavity in those cases of recurrent pain, emotionally and socially debilitating, that do not find an answer in the usual etiological diagnostic clinical-instrumental. In those cases in which any significant organic pathology that justifies the recurring pain in the right iliac fossa is found during laparoscopic exploration, it has been seen that it is useful to perform appendectomy anyway, that leads to the dis...<div id="medworm"><p><b><i>MedWorm Sponsor Message:</i></b> Directory of the best <a href="http://www.thejanuarysales.com/">January Sales</a> in the UK. Find the best <a href="http://www.thejanuarysales.com/">Christmas presents</a> too.</p></div>


Future directions for the management of pain in osteoarthritis.
Authors: Sofat N, Kuttapitiya A Abstract Osteoarthritis (OA) is the predominant form of arthritis worldwide, resulting in a high degree of functional impairment and reduced quality of life owing to chronic pain. To date, there are no treatments that are known to modify disease progression of OA in the long term. Current treatments are largely based on the modulation of pain, including NSAIDs, opiates and, more recently, centrally acting pharmacotherapies to avert pain. This review will focus on the rationale for new avenues in pain modulation, including inhibition with anti-NGF antibodies and centrally acting analgesics. The authors also consider the potential for structure modification in cartilage/bone using growth factors and stem cell therapies. The possible mismatch between st...


The important role of CNS facilitation and inhibition for chronic pain.
Authors: Staud R Abstract Multiple studies have demonstrated that the pain experience among individuals is highly variable. Even under circumstances where the tissue injuries are similar, individual pain experiences may vary drastically. However, this individual difference in pain sensitivity is not only related to sensitivity of peripheral pain receptors, but also to variability in CNS pain processing. Peripheral impulses derived from tissue receptors undergo modification in dorsal horn neurons that can either result in inhibition or facilitation of pain. Such influences are particularly apparent in inflammation where not only peripheral, but also central, pain modulatory mechanisms can significantly increase nociceptive pain. Emotional state, level of anxiety, attention and distr...


Fatigue in systemic lupus erythematosus.
Authors: Ahn GE, Ramsey-Goldman R Abstract Systemic lupus erythematosus is a chronic inflammatory autoimmune disease often characterized by fatigue, with significant effects on physical functioning and wellbeing. The definition, prevalence and factors associated with fatigue, including physical activity, obesity, sleep, depression, anxiety, mood, cognitive dysfunction, vitamin D deficiency/insufficiency, pain, effects of medications and comorbidities, as well as potential therapeutic options of fatigue in the systemic lupus erythematosus population are reviewed. Due to variability in the reliability and validity of various fatigue measures used in clinical studies, clinical trial data have been challenging to interpret. Further investigation into the relationships between these ris...


Mucinous cystadenocarcinoma arising in an ectopic kidney simulating a retroperitoneal dermoid cyst: a rare tumour presenting as a diagnostic dilemma.
We report this case for the rarity of the lesion and the associated clinical and radiological diagnostic dilemma. PMID: 23817401 [PubMed - indexed for MEDLINE] (Source: Malaysian Journal of Pathology)