WorldWideScience

Sample records for adult pain sensitivity

  1. Validity, Sensitivity, and Responsiveness of the 11-Face Faces Pain Scale to Postoperative Pain in Adult Orthopedic Surgery Patients.

    Science.gov (United States)

    Van Giang, Nguyen; Chiu, Hsiao-Yean; Thai, Duong Hong; Kuo, Shu-Yu; Tsai, Pei-Shan

    2015-10-01

    Pain is common in patients after orthopedic surgery. The 11-face Faces Pain Scale has not been validated for use in adult patients with postoperative pain. To assess the validity of the 11-face Faces Pain Scale and its ability to detect responses to pain medications, and to determine whether the sensitivity of the 11-face Faces Pain Scale for detecting changes in pain intensity over time is associated with gender differences in adult postorthopedic surgery patients. The 11-face Faces Pain Scale was translated into Vietnamese using forward and back translation. Postoperative pain was assessed using an 11-point numerical rating scale and the 11-face Faces Pain Scale on the day of surgery, and before (Time 1) and every 30 minutes after (Times 2-5) the patients had taken pain medications on the first postoperative day. The 11-face Faces Pain Scale highly correlated with the numerical rating scale (r = 0.78, p pain intensity, but not gender-time interaction effect, over the five time points was significant (F = 182.03, p Pain Scale is appropriate for measuring acute postoperative pain in adults.

  2. Heightened cold pain and pressure pain sensitivity in young female adults with moderate-to-severe menstrual pain.

    Science.gov (United States)

    Slater, Helen; Paananen, Markus; Smith, Anne J; OʼSullivan, Peter; Briggs, Andrew M; Hickey, Martha; Mountain, Jenny; Karppinen, Jaro; Beales, Darren

    2015-12-01

    This study investigated the association between menstrual pain severity and psychophysical measures of cold and pressure pain sensitivity. A cross-sectional design was used with young women (n = 432) from the Western Australian Pregnancy Cohort (Raine) Study. Menstrual pain severity and oral contraception use was obtained from questionnaires at 20 and 22-year follow-ups. A visual analog scale (VAS; range from 0 [none] to 10 [unbearable]) was used to measure menstrual pain severity at both 20 and 22 years over the 3-year period, with 3 groups created: (1) no pain or mild pain (VAS 0-3), (2) at least moderate pain at a minimum of 1 of the 2 time points (hereafter named "mixed)", and (3) severe pain (VAS 8-10). Cold pain sensitivity (dorsal wrist) and pressure pain sensitivity (lumbar spine, upper trapezius, dorsal wrist, and tibialis anterior) were assessed using standardised quantitative sensory testing protocols. Confounding variables included number of musculoskeletal pain sites, oral contraceptive use, smoking, physical activity, body mass index, psychological distress, and sleep. Severe menstrual pain and mixed menstrual pain were positively associated with heightened cold pain sensitivity (distant from menstrual pain referral site) and pressure pain sensitivity (local to menstrual pain referral site). These associations remained significant after adjusting for potential confounding variables including multisite musculoskeletal pain. Our findings suggest peripheral and central neurophysiological mechanisms contributing to heightened pain sensitivity in young women with moderate and severe menstrual pain. These data highlight the need for innovative management approaches to attenuate the negative impact of severe menstrual pain in young women. PMID:26262827

  3. Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy

    OpenAIRE

    Pedro Montoya

    2013-01-01

    Objective. Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods. Adults with cerebral palsy participa...

  4. Reduction of Pain Sensitivity After Somatosensory Therapy in Adults with Cerebral Palsy

    OpenAIRE

    Riquelme, Inmaculada; Zamorano, Anna; Montoya, Pedro

    2013-01-01

    Objective: Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods: Adults with CP participated in th...

  5. Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Inmaculada eRiquelme

    2013-06-01

    Full Text Available Objective. Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP. Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods. Adults with cerebral palsy participated in the study and were randomly assigned to the intervention (n=17 or the control group (n=20. The intervention group received a somatosensory therapy including 4 types of exercises (touch, proprioception, vibration, and stereognosis. All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, propioception, texture recognition and motor parameters (fine motor skills were assessed before, immediately after and three months after the therapy (follow-up. Results. Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after three months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition or fine motor skills. Conclusions. Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with cerebral palsy.

  6. Pressure pain sensitivity

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille;

    2013-01-01

    induce hyperalgesia.The aim of the present study was to evaluate hyperalgesia by pressure pain sensitivity (PPS) in patients with IHD, and compare PPS to questionnaires measuring depressive symptoms, reduced psychological wellbeing, and QOL as markers of stress. Design. A cross-sectional study of 361...... subjects with IHD. Methods. PPS was measured on the sternum, and compared to the questionnaires: Clinical stress symptoms score (CSS), Major Depression Inventory (MDI), WHO-5 Wellbeing Index, and SF-36 QOL score. Results. PPS correlated to CSS (r = 0.20, p <0.001), MDI (r = 0.14, p = 0.02), SF-36 mental...

  7. Measurement Properties of the Non-Communicating Adult Pain Checklist (NCAPC): A Pain Scale for Adults with Intellectual and Developmental Disabilities, Scored in a Clinical Setting

    Science.gov (United States)

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2010-01-01

    The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have…

  8. Endogenous Opioid-Masked Latent Pain Sensitization

    DEFF Research Database (Denmark)

    Pereira, Manuel P; Donahue, Renee R; Dahl, Jørgen B;

    2015-01-01

    UNLABELLED: Following the resolution of a severe inflammatory injury in rodents, administration of mu-opioid receptor inverse agonists leads to reinstatement of pain hypersensitivity. The mechanisms underlying this form of latent pain sensitization (LS) likely contribute to the development...

  9. Post surgical pain treatment - adults

    Science.gov (United States)

    ... Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. ...

  10. The effect of culture on pain sensitivity.

    Science.gov (United States)

    Al-Harthy, M; Ohrbach, R; Michelotti, A; List, T

    2016-02-01

    Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case-control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. Pressure pain threshold (PPT) and tolerance (PPTo) were measured over one hand and two masticatory muscles. Electrical perception threshold and electrical pain threshold (EPT) and tolerance (EPTo) were recorded between the thumb and index fingers. Italian females reported significantly lower PPT in the masseter muscle than other cultures (P cultures (P = 0.017). Italians reported significantly lower PPTo in all muscles than Swedes (P ≤ 0.006) and in the masseter muscle than Saudis (P cultures (P = 0.01). Temporomandibular disorder cases, compared to TMD-free controls, reported lower PPT and PPTo in all the three muscles (P cultural differences between groups in the PPT, PPTo and EPTo. Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test.

  11. Counseling Adult Clients Experiencing Chronic Pain

    Science.gov (United States)

    Burns, Stephanie T.

    2010-01-01

    Chronic pain affects 35% to 57% of the adult population in the United States and results in billions of dollars spent annually in direct health-care costs and lost productivity. Extensive research confirms the considerable role psychological factors play in the experience and expression of chronic pain. The author discusses implications for…

  12. The role of sensitization in musculoskeletal shoulder pain

    OpenAIRE

    John Borstad; Christopher Woeste

    2015-01-01

    Introduction: Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization. Method: This manuscript summarizes six studies that have evaluated those with musculoskeletal shoulder pain for the presence of sensitization. Results: All six manuscripts report evidence of peripheral sensitization, while central sensitization was described in five of the studie...

  13. Genes contributing to pain sensitivity in the normal population

    DEFF Research Database (Denmark)

    Williams, Frances M.K.; Scollen, Serena; Cao, Dandan;

    2012-01-01

    Sensitivity to pain varies considerably between individuals and is known to be heritable. Increased sensitivity to experimental pain is a risk factor for developing chronic pain, a common and debilitating but poorly understood symptom. To understand mechanisms underlying pain sensitivity and to s...

  14. Advances in understanding the mechanisms and management of persistent pain in older adults.

    Science.gov (United States)

    Karp, J F; Shega, J W; Morone, N E; Weiner, D K

    2008-07-01

    Older adults with persistent pain are not simply a chronologically older version of younger pain patients. Pain-related disability in older adults may be driven by pain 'homeostenosis', that is, diminished ability to effectively respond to the stress of persistent pain. Some of the comorbidities of ageing that can contribute to pain homeostenosis include cognitive and physical impairments, increased sensitivity to suprathreshold pain stimuli, medical and psychological comorbidities, altered pharmacokinetics and pharmacodynamics, and social isolation. A key distinction between older and younger individuals with persistent pain is the normal and pathological ageing-associated brain changes. These may alter the expression and experience of pain with impaired descending inhibition and dysfunction of pain gating mechanisms. Cognizance of these brain changes is needed to guide appropriate evaluation and treatment approaches. This paper reviews data that support these ageing-associated phenomena. Specifically, we discuss age-related changes in the brain (both normal and pathological) and in pain physiology; changes in experience and expression of pain that occur with dementia and contribute to pain homeostenosis; and unique aspects of age and pain-associated psychological function and their contribution to disability. We also present data demonstrating changes in brain morphology and neuropsychological performance that accompany persistent non-malignant pain in older adults and the treatment implications of these brain changes. Finally, preliminary data are presented on the efficacy of mindfulness meditation, a treatment that has been examined explicitly in older adults and targets optimizing brain function and descending inhibition.

  15. The effect of disgust on pain sensitivity.

    Science.gov (United States)

    Oaten, Megan J; Stevenson, Richard J; Case, Trevor I

    2015-01-01

    Experiencing the emotion of disgust leads to delayed up-regulation of immune-related functions, increased core-body temperature and reduced appetite. These changes parallel those of the acute phase response, which occurs when a pathogen is detected by the immune system. Here we examined whether a further predicted aspect of the acute phase response is evident following disgust induction, namely increased pain sensitivity. Participants attended a two-session experiment. On one session they experienced an emotion induction (being randomly assigned to either disgust, negative or positive groups) and on the other they received a neutral control induction. Before and after each induction, and at 15 and 30min post-induction, participants engaged in a cold-pressor task, rating pain intensity at 10s intervals for 90s on each occasion. Relative to neutral control and pre-test, average pain intensity decreased then increased across time following the disgust induction, with the reverse pattern in the negative and positive emotion inductions. These findings are the first to suggest that disgust may lead to an increase in pain sensitivity over a time course paralleling changes observed for core-body temperature and immune-related function, although the mechanisms underpinning these effects remain to be identified.

  16. Pain sensitivity and headache: an examination of the central theory.

    Science.gov (United States)

    Marlowe, N I

    1992-01-01

    The central theory of headache was investigated by examining pain sensitivity in headache sufferers and headache-free controls. Headache subjects had lower pain threshold and tolerance levels than controls for electrical stimulation of the finger. Headache subjects also had a lesser tolerance for pain induced by the application of ice to the temporal region, but there was no significant difference between groups on temporal ice pain threshold. Sensitivity to finger pain was not affected by the presence or absence of headache at the time of testing. No significant differences between tension and migraine subjects were observed; neither were headache subjects, reporting unilateral headaches, significantly more sensitive to temporal ice pain on the side affected by headache. It was concluded that headache sufferers may be more sensitive to pain than headache-free persons but, that this heightened sensitivity is not specific to the head, and in itself, seems unable to account for the locus of headache. PMID:1538347

  17. Sex Differences in How Social Networks and Relationship Quality Influence Experimental Pain Sensitivity

    OpenAIRE

    Vigil, Jacob M; Rowell, Lauren N; Simone Chouteau; Alexandre Chavez; Elisa Jaramillo; Michael Neal; David Waid

    2013-01-01

    This is the first study to examine how both structural and functional components of individuals' social networks may moderate the association between biological sex and experimental pain sensitivity. One hundred and fifty-two healthy adults (mean age = 22yrs., 53% males) were measured for cold pressor task (CPT) pain sensitivity (i.e., intensity ratings) and core aspects of social networks (e.g., proportion of friends vs. family, affection, affirmation, and aid). Results showed consistent sex...

  18. Vagus Nerve Stimulation Affects Pain Perception in Depressed Adults

    Directory of Open Access Journals (Sweden)

    Jeffrey J Borckardt

    2005-01-01

    Full Text Available BACKGROUND: Previous research suggests that vagus nerve stimulation (VNS affects pain perception in epilepsy patients, with acute VNS decreasing pain thresholds and chronic VNS treatment increasing pain thresholds. However, no studies have investigated the effects of VNS on pain perception in chronically depressed adults, nor have controlled, systematic investigations been published on the differential effects of certain VNS device parameters on pain perception.

  19. GCH1 variants, tetrahydrobiopterin and their effects on pain sensitivity

    DEFF Research Database (Denmark)

    Nasser, Arafat; Birk Møller, Lisbeth

    2014-01-01

    A great proportion of the variation in pain experience and chronicity is caused by heritable factors. Within the last decades several candidate genes have been discovered either increasing or decreasing pain sensitivity or the risk of chronic pain in humans. One of the most studied genes is the GCH...

  20. Pain sensitivity and tactile spatial acuity are altered in healthy musicians as in chronic pain patients.

    Directory of Open Access Journals (Sweden)

    Anna M. eZamorano

    2015-01-01

    Full Text Available Extensive training of repetitive and highly skilled movements, as it occurs in professional classical musicians, may lead to changes in tactile sensitivity and corresponding cortical reorganization of somatosensory cortices. It is also known that professional musicians frequently experience musculoskeletal pain and pain-related symptoms during their careers. The present study aimed at understanding the complex interaction between chronic pain and music training with respect to somatosensory processing. For this purpose, tactile thresholds (mechanical detection, grating orientation, two-point discrimination and subjective ratings to thermal and pressure pain stimuli were assessed in 17 professional musicians with chronic pain, 30 pain-free musicians, 20 non-musicians with chronic pain, and 18 pain-free non-musicians. We found that pain-free musicians displayed greater touch sensitivity (i.e. lower mechanical detection thresholds, lower tactile spatial acuity (i.e., higher grating orientation thresholds and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. Moreover, we also found that musicians and non-musicians with chronic pain presented lower tactile spatial acuity and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. The significant increment of pain sensitivity together with decreased spatial discrimination in pain-free musicians and the similarity of results found in chronic pain patients, suggests that the extensive training of repetitive and highly skilled movements in classical musicians could be considered as a risk factor for developing chronic pain, probably due to use-dependent plastic changes elicited in somatosensory pathways.

  1. Differential methylation of the TRPA1 promoter in pain sensitivity.

    Science.gov (United States)

    Bell, J T; Loomis, A K; Butcher, L M; Gao, F; Zhang, B; Hyde, C L; Sun, J; Wu, H; Ward, K; Harris, J; Scollen, S; Davies, M N; Schalkwyk, L C; Mill, J; Williams, F M K; Li, N; Deloukas, P; Beck, S; McMahon, S B; Wang, J; John, S L; Spector, T D

    2014-01-01

    Chronic pain is a global public health problem, but the underlying molecular mechanisms are not fully understood. Here we examine genome-wide DNA methylation, first in 50 identical twins discordant for heat pain sensitivity and then in 50 further unrelated individuals. Whole-blood DNA methylation was characterized at 5.2 million loci by MeDIP sequencing and assessed longitudinally to identify differentially methylated regions associated with high or low pain sensitivity (pain DMRs). Nine meta-analysis pain DMRs show robust evidence for association (false discovery rate 5%) with the strongest signal in the pain gene TRPA1 (P=1.2 × 10(-13)). Several pain DMRs show longitudinal stability consistent with susceptibility effects, have similar methylation levels in the brain and altered expression in the skin. Our approach identifies epigenetic changes in both novel and established candidate genes that provide molecular insights into pain and may generalize to other complex traits.

  2. Catastrophizing and anxiety sensitivity mediate the relationship between persistent pain and emotional eating.

    Science.gov (United States)

    Janke, E Amy; Jones, Elizabeth; Hopkins, Christina M; Ruggieri, Madelyn; Hruska, Alesha

    2016-08-01

    Stress-induced or "emotional eating" contributes to increased caloric intake and weight gain, yet models examining psychosocial factors that promote and sustain this behavior are incomplete. There is a need to identify explicit, clinically-relevant mechanisms of emotional eating behavior. Pain is a common stressor associated with increased weight and, potentially, altered eating behaviors. The present study applies the Fear Avoidance Model (FAM) of pain to examine processes that may explain the relationship between pain and increased weight while also providing the opportunity to examine specific mechanisms that may encourage eating during a variety of stressors. Our aim is to better understand the impact of pain on eating behavior and the potential for the FAM to improve our understanding of the psychological mechanisms that promote eating during times of duress. A survey of 312 adults explored the link between pain experience and stress-induced eating, further examining the mediating effects of the psychological aspects of the FAM (e.g., anxiety sensitivity, catastrophizing, and pain-related fear). 24% of respondents reported persistent pain, and had significantly higher BMIs than their pain-free peers. All three FAM components were positively correlated with measures of emotional, external, and restrained eating. Anxiety sensitivity and catastrophizing significantly mediated the relationship between persistent pain and emotional eating behavior, while anxiety sensitivity alone mediated the relationship between persistent pain and external eating. Findings suggest pain may be associated with increased likelihood for emotional eating and that characteristics from FAM, in particular anxiety sensitivity and catastrophizing, may mediate the relationship between the presence of persistent pain and emotional eating behavior. Evidence-based treatments targeting anxiety sensitivity and catastrophizing could be useful to address emotional eating in individuals struggling

  3. Sex differences in anxiety sensitivity among children with chronic pain and non-clinical children

    OpenAIRE

    Tsao, Jennie C. I.; Evans, Subhadra; Meldrum, Marcia; Zeltzer, Lonnie K

    2009-01-01

    Although sex differences in anxiety sensitivity or the specific tendency to fear anxiety-related sensations have been reported in adults with clinical pain, there is a dearth of relevant research among children. This study examined sex differences in anxiety sensitivity across unselected samples of 187 children with chronic pain (71.7% girls; mean age = 14.5) and 202 non-clinical children (52% girls; mean age = 13.6). Girls in the chronic pain and non-clinical samples reported elevated anxiet...

  4. The role of sensitization in musculoskeletal shoulder pain

    Directory of Open Access Journals (Sweden)

    John Borstad

    2015-08-01

    Full Text Available Introduction: Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization.Method:This manuscript summarizes six studies that have evaluated those with musculoskeletal shoulder pain for the presence of sensitization.Results:All six manuscripts report evidence of peripheral sensitization, while central sensitization was described in five of the studies. The chronicity of symptoms in subjects who were included in the studies is probably influencing this finding. The primary somatosensory test used to assess sensitization in these studies was Pressure Pain Threshold, a test for lowered nociceptive thresholds.Discussion:It appears that peripheral sensitization manifests consistently in those with musculoskeletal shoulder pathology, probably due to the inflammatory processes related to tissue injury. Central sensitization, while not universally present, was reported in a majority of the manuscripts. Because central sensitization is thought to be a key step on the pathway to chronic pain, evidence for its presence in those with shoulder pain is significant. Clinicians should expect the presence of sensitization with shoulder pathology and make appropriate choices about interventions so as not to exacerbate pain.

  5. Sex differences in how social networks and relationship quality influence experimental pain sensitivity.

    Science.gov (United States)

    Vigil, Jacob M; Rowell, Lauren N; Chouteau, Simone; Chavez, Alexandre; Jaramillo, Elisa; Neal, Michael; Waid, David

    2013-01-01

    This is the first study to examine how both structural and functional components of individuals' social networks may moderate the association between biological sex and experimental pain sensitivity. One hundred and fifty-two healthy adults (mean age = 22yrs., 53% males) were measured for cold pressor task (CPT) pain sensitivity (i.e., intensity ratings) and core aspects of social networks (e.g., proportion of friends vs. family, affection, affirmation, and aid). Results showed consistent sex differences in how social network structures and intimate relationship functioning modulated pain sensitivity. Females showed higher pain sensitivity when their social networks consisted of a higher proportion of intimate types of relationship partners (e.g., kin vs. non kin), when they had known their network partners for a longer period of time, and when they reported higher levels of logistical support from their significant other (e.g., romantic partner). Conversely, males showed distinct patterns in the opposite direction, including an association between higher levels of logistical support from one's significant other and lower CPT pain intensity. These findings show for the first time that the direction of sex differences in exogenous pain sensitivity is likely dependent on fundamental components of the individual's social environment. The utility of a social-signaling perspective of pain behaviors for examining, comparing, and interpreting individual and group differences in experimental and clinical pain reports is discussed. PMID:24223836

  6. Sex differences in how social networks and relationship quality influence experimental pain sensitivity.

    Directory of Open Access Journals (Sweden)

    Jacob M Vigil

    Full Text Available This is the first study to examine how both structural and functional components of individuals' social networks may moderate the association between biological sex and experimental pain sensitivity. One hundred and fifty-two healthy adults (mean age = 22yrs., 53% males were measured for cold pressor task (CPT pain sensitivity (i.e., intensity ratings and core aspects of social networks (e.g., proportion of friends vs. family, affection, affirmation, and aid. Results showed consistent sex differences in how social network structures and intimate relationship functioning modulated pain sensitivity. Females showed higher pain sensitivity when their social networks consisted of a higher proportion of intimate types of relationship partners (e.g., kin vs. non kin, when they had known their network partners for a longer period of time, and when they reported higher levels of logistical support from their significant other (e.g., romantic partner. Conversely, males showed distinct patterns in the opposite direction, including an association between higher levels of logistical support from one's significant other and lower CPT pain intensity. These findings show for the first time that the direction of sex differences in exogenous pain sensitivity is likely dependent on fundamental components of the individual's social environment. The utility of a social-signaling perspective of pain behaviors for examining, comparing, and interpreting individual and group differences in experimental and clinical pain reports is discussed.

  7. Sex differences in how social networks and relationship quality influence experimental pain sensitivity.

    Science.gov (United States)

    Vigil, Jacob M; Rowell, Lauren N; Chouteau, Simone; Chavez, Alexandre; Jaramillo, Elisa; Neal, Michael; Waid, David

    2013-01-01

    This is the first study to examine how both structural and functional components of individuals' social networks may moderate the association between biological sex and experimental pain sensitivity. One hundred and fifty-two healthy adults (mean age = 22yrs., 53% males) were measured for cold pressor task (CPT) pain sensitivity (i.e., intensity ratings) and core aspects of social networks (e.g., proportion of friends vs. family, affection, affirmation, and aid). Results showed consistent sex differences in how social network structures and intimate relationship functioning modulated pain sensitivity. Females showed higher pain sensitivity when their social networks consisted of a higher proportion of intimate types of relationship partners (e.g., kin vs. non kin), when they had known their network partners for a longer period of time, and when they reported higher levels of logistical support from their significant other (e.g., romantic partner). Conversely, males showed distinct patterns in the opposite direction, including an association between higher levels of logistical support from one's significant other and lower CPT pain intensity. These findings show for the first time that the direction of sex differences in exogenous pain sensitivity is likely dependent on fundamental components of the individual's social environment. The utility of a social-signaling perspective of pain behaviors for examining, comparing, and interpreting individual and group differences in experimental and clinical pain reports is discussed.

  8. Adult-age inflammatory pain experience enhances long-term pain vigilance in rats.

    Directory of Open Access Journals (Sweden)

    Sheng-Guang Li

    Full Text Available BACKGROUND: Previous animal studies have illustrated a modulatory effect of neonatal pain experience on subsequent pain-related behaviors. However, the relationship between chronic pain status in adulthood and future pain perception remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: In the current study, we investigated the effects of inflammatory pain experience on subsequent formalin-evoked pain behaviors and fear conditioning induced by noxious stimulation in adult rats. Our results demonstrated an increase of the second but not the first phase of formalin-induced pain behaviors in animals with a history of inflammatory pain that have recovered. Similarly, rats with persistent pain experience displayed facilitated acquisition and prolonged retention of pain-related conditioning. These effects of prior pain experience on subsequent behavior were prevented by repeated morphine administration at an early stage of inflammatory pain. CONCLUSIONS/SIGNIFICANCE: These results suggest that chronic pain diseases, if not properly and promptly treated, may have a long-lasting impact on processing and perception of environmental threats. This may increase the susceptibility of patients to subsequent pain-related disorders, even when chronic pain develops in adulthood. These data highlight the importance of treatment of chronic pain at an early stage.

  9. Extreme Thermal Sensitivity and Pain-Induced Sensitization in a Fibromyalgia Patient

    Directory of Open Access Journals (Sweden)

    Fong Wong

    2010-01-01

    Full Text Available During the course of a psychophysical study of fibromyalgia syndrome (FMS, one of the subjects with a long history of headache and facial pain displayed an extraordinarily severe thermal allodynia. Her stimulus-response function for ratings of cutaneous heat pain revealed a sensitivity clearly beyond that of normal controls and most FMS subjects. Specially designed psychophysical methods showed that heat sensitivity sometimes increased dramatically within a series of stimuli. Prior exposure to moderate heat pain served as a trigger for allodynic ratings of series of normally neutral thermal stimulation. These observations document a case of breakthrough pain sensitivity with implications for mechanisms of FMS pain.

  10. Hypnosis for pain management in the older adult.

    Science.gov (United States)

    Cuellar, Norma G

    2005-09-01

    Pain is a physical, emotional and psychologic phenomenon that is often ignored in older adults causing depression and poor quality of life. Older adults report the use of complementary and alternative medicine in some form with 80% of these users reporting improvement in their health conditions. Although physical pain in the older adult is usually managed with pharmacologic interventions, methods that may reduce the use of prescription drugs may decrease adverse effects that can compromise the physiologic state of the older adult. Hypnosis has continued to gain acceptance within mainstream medicine as an appropriate treatment and can be integrated safely with conventional medicine as an effective treatment for a variety of conditions in the older adult. It is an intervention that can be used for relaxation and pain control, especially when conventional pharmacologic regimens have failed. The purpose of this article is to review the concepts related to pain in older adults; the use of complementary and alternative medicine in the older adult; hypnosis and the older adult (i.e., background, definition, benefits, research, mechanism of action, hypnotizability, and the process); and the implications of using hypnosis for pain management in the older adult. PMID:16129381

  11. Effects of Smoking Cessation on Pain in Older Adults

    Science.gov (United States)

    Shi, Yu; Hooten, W. Michael

    2011-01-01

    Introduction: Smokers are at increased risk of developing chronic pain and suffering higher pain intensity. However, nicotine has analgesic properties, and smokers may view smoking as a means to cope with pain. Smoking cessation is clearly beneficial to the long-term health of smokers. However, it is not known how abstinence from smoking affects pain. The aim of this study was to determine the association between smoking cessation and changes in pain symptoms by secondary analysis of a large longitudinal dataset of older adults. Methods: Secondary analyses were performed of longitudinal biennial survey data (1992 through 2006) from the nationally representative Health and Retirement Study of United States adults older than 50 years. Multivariate logistic regressions were utilized to determine the relationship between the changes in smoking status and changes in pain symptoms, controlling for demographics, depression, self-rated health, history of arthritis, and body mass index. Results: In multivariate analyses, among the 4,695 smokers who reported no pain or mild pain at enrollment, smoking status was not independently associated with exacerbation of pain (odds ratio [OR]: 0.95, 95% CI: 0.84, 1.08). Among the 1,118 smokers who reported moderate to severe pain at enrollment, smoking status was not independently associated with improvement of pain (OR: 0.87, 95% CI: 0.70, 1.08). Conclusions: Smoking cessation was not independently associated with changes in pain symptoms in older adults. These results suggest that concerns regarding the effects of abstinence from smoking on pain should not pose a barrier to offering tobacco use interventions to smokers with chronic pain. PMID:21571690

  12. Operant conditioning of enhanced pain sensitivity by heat-pain titration.

    Science.gov (United States)

    Becker, Susanne; Kleinböhl, Dieter; Klossika, Iris; Hölzl, Rupert

    2008-11-15

    Operant conditioning mechanisms have been demonstrated to be important in the development of chronic pain. Most experimental studies have investigated the operant modulation of verbal pain reports with extrinsic reinforcement, such as verbal reinforcement. Whether this reflects actual changes in the subjective experience of the nociceptive stimulus remained unclear. This study replicates and extends our previous demonstration that enhanced pain sensitivity to prolonged heat-pain stimulation could be learned in healthy participants through intrinsic reinforcement (contingent changes in nociceptive input) independent of verbal pain reports. In addition, we examine whether different magnitudes of reinforcement differentially enhance pain sensitivity using an operant heat-pain titration paradigm. It is based on the previously developed non-verbal behavioral discrimination task for the assessment of sensitization, which uses discriminative down- or up-regulation of stimulus temperatures in response to changes in subjective intensity. In operant heat-pain titration, this discriminative behavior and not verbal pain report was contingently reinforced or punished by acute decreases or increases in heat-pain intensity. The magnitude of reinforcement was varied between three groups: low (N1=13), medium (N2=11) and high reinforcement (N3=12). Continuous reinforcement was applied to acquire and train the operant behavior, followed by partial reinforcement to analyze the underlying learning mechanisms. Results demonstrated that sensitization to prolonged heat-pain stimulation was enhanced by operant learning within 1h. The extent of sensitization was directly dependent on the received magnitude of reinforcement. Thus, operant learning mechanisms based on intrinsic reinforcement may provide an explanation for the gradual development of sustained hypersensitivity during pain that is becoming chronic. PMID:18774227

  13. Pain Processing after Social Exclusion and Its Relation to Rejection Sensitivity in Borderline Personality Disorder.

    Directory of Open Access Journals (Sweden)

    Melanie Bungert

    Full Text Available There is a general agreement that physical pain serves as an alarm signal for the prevention of and reaction to physical harm. It has recently been hypothesized that "social pain," as induced by social rejection or abandonment, may rely on comparable, phylogenetically old brain structures. As plausible as this theory may sound, scientific evidence for this idea is sparse. This study therefore attempts to link both types of pain directly. We studied patients with borderline personality disorder (BPD because BPD is characterized by opposing alterations in physical and social pain; hyposensitivity to physical pain is associated with hypersensitivity to social pain, as indicated by an enhanced rejection sensitivity.Twenty unmedicated female BPD patients and 20 healthy participants (HC, matched for age and education played a virtual ball-tossing game (cyberball, with the conditions for exclusion, inclusion, and a control condition with predefined game rules. Each cyberball block was followed by a temperature stimulus (with a subjective pain intensity of 60% in half the cases. The cerebral responses were measured by functional magnetic resonance imaging. The Adult Rejection Sensitivity Questionnaire was used to assess rejection sensitivity.Higher temperature heat stimuli had to be applied to BPD patients relative to HCs to reach a comparable subjective experience of painfulness in both groups, which suggested a general hyposensitivity to pain in BPD patients. Social exclusion led to a subjectively reported hypersensitivity to physical pain in both groups that was accompanied by an enhanced activation in the anterior insula and the thalamus. In BPD, physical pain processing after exclusion was additionally linked to enhanced posterior insula activation. After inclusion, BPD patients showed reduced amygdala activation during pain in comparison with HC. In BPD patients, higher rejection sensitivity was associated with lower activation differences during

  14. Assessment of pressure-pain thresholds and central sensitization of pain in lateral epicondylalgia

    DEFF Research Database (Denmark)

    Jespersen, Anders; Amris, Kirstine; Graven-Nielsen, Thomas;

    2013-01-01

    OBJECTIVE.: To assess pain sensitivity and spreading hyperalgesia in lateral epicondylalgia (LE). SUBJECTS.: Twenty-two women with LE, and 38 controls were included. OUTCOME MEASURES.: Computerized cuff pressure algometry was used for assessment of pressure-pain threshold and tolerance. The stimu...

  15. Nonsurgical Management of Knee Pain in Adults.

    Science.gov (United States)

    Jones, Brandon Q; Covey, Carlton J; Sineath, Marvin H

    2015-11-15

    The role of the family physician in managing knee pain is expanding as recent literature supports nonsurgical management for many patients. Effective treatment depends on the etiology of knee pain. Oral analgesics-most commonly nonsteroidal anti-inflammatory drugs and acetaminophen-are used initially in combination with physical therapy to manage the most typical causes of chronic knee pain. The American Academy of Orthopaedic Surgeons recommends against glucosamine/chondroitin supplementation for osteoarthritis. In patients who are not candidates for surgery, opioid analgesics should be used only if conservative pharmacotherapy is ineffective. Exercise-based therapy is the foundation for treating knee osteoarthritis and patellofemoral pain syndrome. Weight loss should be encouraged for all patients with osteoarthritis and a body mass index greater than 25 kg per m2. Aside from stabilizing traumatic knee ligament and tendon tears, the effectiveness of knee braces for chronic knee pain is uncertain, and the use of braces should not replace physical therapy. Foot orthoses can be helpful for anterior knee pain. Corticosteroid injections are effective for short-term pain relief in patients with osteoarthritis. The benefit of hyaluronic acid injections is controversial, and recommendations vary; recent systematic reviews do not support a clinically significant benefit. Small studies suggest that regenerative injections can improve pain and function in patients with chronic knee tendinopathies and osteoarthritis. PMID:26554281

  16. Investigating the effect of anxiety sensitivity, gender and negative interpretative bias on the perception of chest pain.

    Science.gov (United States)

    Keogh, Edmund; Hamid, Rayhana; Hamid, Shahid; Ellery, Deborah

    2004-09-01

    Research suggests that anxiety sensitivity may be an important component in the negative response to pain sensations, especially those with cardiopulmonary origin. Furthermore, there is experimental evidence to suggest that such effects may be stronger in women than men. The primary aim of the current investigation was to determine the relative roles that anxiety sensitivity and gender have on the pain reports of patients referred to a hospital clinic with chest pain. A total of 78 female and 76 male adults were recruited on entry to a Rapid Access Medical Clinic. All patients had been referred with chest pain, and were administered a range of pain and anxiety measures prior to diagnosis. Results indicate that males were more likely to receive a diagnosis of cardiac chest pain, whereas females were more likely to receive a diagnosis of non-cardiac chest pain. Additionally, anxiety sensitivity was related to pain in women but not men. Finally, evidence was found for the mediating effect of negative interpretative bias on the relationship between anxiety sensitivity and pain. However, this mediating effect was only found in women. These results not only confirm that anxiety sensitivity is related to greater negative pain responses in women, but that this may be due to an increased tendency to negatively interpret sensations.

  17. Migraine pain location in adult patients from eastern India

    Directory of Open Access Journals (Sweden)

    Chakravarty Ambar

    2008-01-01

    Full Text Available Background: Sparse literature documenting the location of pain at the onset of migraine attacks and during established headaches is available. Objectives: A prospective study (2003-05 on 800 adult migraine patients (International Classifications of Headache Disorders (ICHD, 2:1.1, 1.2.1 and 1.6.1 was conducted to document (a sites of onset of pain and (b location of pain during established attacks (in> 50% occasions through semistructured interviews. Results: Demography: N = 800; M:F = 144:656 (1:4.56; age, 16-42 years (mean, 26 years; duration of migraine, 1-18 years (mean, 6.8 years. 87% of the subjects were ethnic Bengalis from the eastern Indian state of West Bengal, Calcutta being the capital city. Migraine types (on the basis of> 50% headache spells: N = 800; 1.1:668 (83.5%; 1.2.1:18 (2.25%; 1.6.1:114 (14.25%. Location of pain at onset: Unilateral onset was present in 41.38% of the patients; of these, 53.17% had eye pain; 8.16%, frontal pain and 38.67%, temporal pain. In 32.25% of the patients, bilateral/central location of pain, mostly bitemporal or at vertex was noted. Cervico-occipital pain onset was noted in 26.43% patients (predominantly occipital, 14.68%; predominantly cervical, 11.75%. Location of established headaches: In 47.4% of the patients, with unilateral ocular or temporal onset, pain remained at the same site. Pain became hemicranial in 32.9%. In most patients, unilateral frontal onset pain (55.5% became bilateral or holocranial. Most bilateral ocular (69.4% and temporal onset (69.7% pains remained at the same location. However, most bifrontal (55.6% and vertex onset (56.9% pains subsequently became holocranial. Most occipital pains at onset became holocranial (45.3%, but cervical pains subsequently became either hemicranial (38.3% or holocranial (36.2%. Conclusions: This study documents location of pain at the onset and during established headaches in migraine patients largely from a specific ethnic group. Migraine with

  18. Associations between adult attachment dimensions and attitudes toward pain behaviour

    Science.gov (United States)

    McWilliams, Lachlan A; Murphy, Paul DJ; Bailey, S Jeffrey

    2010-01-01

    BACKGROUND: Despite the important role positive reinforcement of pain behaviour is believed to play in chronic pain, there is a paucity of research regarding factors that influence the provision of such reinforcement. Attachment theory suggests that individuals high in attachment avoidance view the pain behaviour of others in a negative manner and would, therefore, provide little reinforcement of pain behaviour. As an initial step in evaluating this model, relationships between attachment dimensions and attitudes toward pain behaviour were examined. Attachment avoidance was hypothesized to be negatively associated with accepting attitudes toward pain behaviour. METHODS: A sample of undergraduate students (n=160) completed the Relationships Structures Questionnaire, which provides global ratings of adult attachment dimensions (anxiety and avoidance) by assessing attachment across four relationship targets (friend, mother, father and romantic partner). Attitudes regarding the acceptability of pain behaviour were assessed using male and female versions of the Appropriate Pain Behaviour Questionnaire (APBQ). RESULTS: Consistent with the hypothesis, attachment avoidance was negatively correlated with both APBQ-Female and APBQ-Male scores. Multiple regression analyses were used to investigate the relationships between the attachment scales and the APBQ scales while statistically adjusting for sex and testing for interaction effects. The findings revealed complex relationships involving interaction effects that provided further support for the hypothesis. CONCLUSIONS: The findings provided support for the hypothesis that attachment avoidance is associated with less accepting attitudes toward pain behaviour. Additional research regarding the role of attachment and attitudes on responses to pain behaviour is warranted. PMID:21165372

  19. Decreased pain sensitivity among people with schizophrenia: a meta-analysis of experimental pain induction studies.

    Science.gov (United States)

    Stubbs, Brendon; Thompson, Trevor; Acaster, Sarah; Vancampfort, Davy; Gaughran, Fiona; Correll, Christoph U

    2015-11-01

    Patients with schizophrenia report reduced pain sensitivity in clinical studies, but experimental studies are required to establish pain sensitivity as a potential endophenotype. We conducted a systematic review of electronic databases from database inception until April 15, 2015, including experimental studies investigating pain among patients with schizophrenia spectrum disorder vs healthy controls. A random-effect meta-analysis yielding Hedges' g ±95% confidence intervals (CIs) as the effect size (ES) measure was conducted. Primary outcome was a pooled composite of pain threshold and pain tolerance; secondary outcomes included these parameters individually, plus sensory threshold, physiological pain response, and pain intensity or unpleasantness. Across 17 studies, patients with schizophrenia spectrum disorder (n = 387; age, 30.7 ± 6.9 years; females, 31.9%; illness duration, 7.0 ± 5.7 years) were compared with controls (n = 483; age, 29.5 ± 7.4 years; females, 31.0%). Patients had elevated pain threshold/pain tolerance vs controls (ES = 0.583; 95% CI, 0.212-0.954; P = 0.002; studies = 15). Results were similar in antipsychotic-free individuals (ES = 0.599; 95% CI, 0.291-0.907; P pain tolerance (ES = 0.566; 95% CI, 0.235-0.897; P = 0.0001; studies = 6), sensory threshold (ES = 1.16; 95% CI, 0.505-1.727; P pain threshold (ES = 0.696; 95% CI, 0.407-0.986; P pain intensity/unpleasantness ratings (ES = 0.547; 95% CI, 0.146-0.949; P = 0.008). Findings were similarly significant in antipsychotic-free patients with schizophrenia (analysable parameters = 4) and antipsychotic-treated individuals (analysable parameters = 2). Finally, greater psychiatric symptoms moderated increased pain threshold, and younger patient age moderated increased pain tolerance. Decreased pain sensitivity seems to be an endophenotype of schizophrenia spectrum disorders. How this alteration links to other dimensions of schizophrenia and physical comorbidity-related help-seeking behaviour

  20. Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.

    Directory of Open Access Journals (Sweden)

    Roland Staud

    Full Text Available BACKGROUND: In healthy individuals slow temporal summation of pain or wind-up (WU can be evoked by repetitive heat-pulses at frequencies of ≥.33 Hz. Previous WU studies have used various stimulus frequencies and intensities to characterize central sensitization of human subjects including fibromyalgia (FM patients. However, many trials demonstrated considerable WU-variability including zero WU or even wind-down (WD at stimulus intensities sufficient for activating C-nociceptors. Additionally, few WU-protocols have controlled for contributions of individual pain sensitivity to WU-magnitude, which is critical for WU-comparisons. We hypothesized that integration of 3 different WU-trains into a single WU-response function (WU-RF would not only control for individuals' pain sensitivity but also better characterize their central pain responding including WU and WD. METHODS: 33 normal controls (NC and 38 FM patients participated in a study of heat-WU. We systematically varied stimulus intensities of.4 Hz heat-pulse trains applied to the hands. Pain summation was calculated as difference scores of 1st and 5th heat-pulse ratings. WU-difference (WU-Δ scores related to 3 heat-pulse trains (44°C, 46°C, 48°C were integrated into WU-response functions whose slopes were used to assess group differences in central pain sensitivity. WU-aftersensations (WU-AS at 15 s and 30 s were used to predict clinical FM pain intensity. RESULTS: WU-Δ scores linearly accelerated with increasing stimulus intensity (pNC from WD to WU. Slope of WU-RF, which is representative of central pain sensitivity, was significantly steeper in FM patients than NC (p<.003. WU-AS predicted clinical FM pain intensity (Pearson's r = .4; p<.04. CONCLUSIONS: Compared to single WU series, WU-RFs integrate individuals' pain sensitivity as well as WU and WD. Slope of WU-RFs was significantly different between FM patients and NC. Therefore WU-RF may be useful for assessing central

  1. Single dose oral flurbiprofen for acute postoperative pain in adults

    Science.gov (United States)

    Sultan, Asquad; McQuay, Henry J; Moore, R Andrew; Derry, Sheena

    2014-01-01

    Background Flurbiprofen is a non-selective non-steroidal anti-inflammatory drug (NSAID), related to ibuprofen and naproxen, used to treat acute and chronic painful conditions. There is no systematic review of its use in acute postoperative pain. Objectives To assess efficacy, duration of action, and associated adverse events of single dose oral flurbiprofen in acute postoperative pain in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to January 2009. Selection criteria Randomised, double blind, placebo-controlled trials of single dose orally administered flurbiprofen in adults with moderate to severe acute postoperative pain. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk (RR) and number needed to treat to benefit (NNT) were calculated. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals were collected. Main results Eleven studies compared flurbiprofen (699 participants) with placebo (362 participants) in studies lasting 6 to 12 hours. Studies were of adequate reporting quality, and most participants had pain following dental extractions. The dose of flurbiprofen used was 25 mg to 100 mg, with most information for 50 mg and 100 mg. The NNT for at least 50% pain relief over 4 to 6 hours for flurbiprofen 50 mg compared with placebo (692 participants) was 2.7 (2.3 to 3.3) and for 100 mg (416 participants) it was 2.5 (2.0 to 3.1). With flurbiprofen 50 mg and 100 mg 65% to 70% of participants experienced at least 50% pain relief, compared with 25% to 30% with placebo. Rescue medication was used by 25

  2. Mildly negative social encounters reduce physical pain sensitivity.

    Science.gov (United States)

    Borsook, Terry K; MacDonald, Geoff

    2010-11-01

    While previous research has demonstrated a reduction in physical pain sensitivity in response to social exclusion, the manipulations employed have arguably been far removed from typical daily experience. The purpose of this study was to investigate the effects of relatively ordinary social encounters on the perception of pain. Healthy participants rated the intensity and unpleasantness of painful stimuli before and after engaging in a structured interaction with a confederate who was instructed to either be warm and friendly or indifferent. A control group was asked to perform a similar structured activity, but alone. Consistent with predictions, participants who experienced the mildly negative social exchange reported lower pain intensity and unpleasantness after the encounter relative to baseline, whereas those exposed to the positive social exchange did not evidence any change in pain ratings. These results were not mediated by changes in mood or perceived connectedness. If mildly negative social encounters can provoke an analgesic effect, it is possible that social hypoalgesia may be considerably more commonplace than previously realized. Discussion focuses on the role of stress-induced hypoalgesia, and the implications of the results for clinical assessments of pain.

  3. Juvenile Fibromyalgia: Different from the Adult Chronic Pain Syndrome?

    Science.gov (United States)

    Kashikar-Zuck, Susmita; King, Christopher; Ting, Tracy V; Arnold, Lesley M

    2016-04-01

    While a majority of research has focused on adult fibromyalgia (FM), recent evidence has provided insights into the presence and impact of FM in children and adolescents. Commonly referred as juvenile fibromyalgia (JFM), youths, particularly adolescent girls, present with persistent widespread pain and cardinal symptoms observed in adult FM. A majority of youth with JFM continue to experience symptoms into adulthood, which highlights the importance of early recognition and intervention. Some differences are observed between adult and juvenile-onset FM syndrome with regard to comorbidities (e.g., joint hypermobility is common in JFM). Psychological comorbidities are common but less severe in JFM. Compared to adult FM, approved pharmacological treatments for JFM are lacking, but non-pharmacologic approaches (e.g., cognitive-behavioral therapy and exercise) show promise. A number of conceptual issues still remain including (1) directly comparing similarities and differences in symptoms and (2) identifying shared and unique mechanisms underlying FM in adults and youths. PMID:26984803

  4. The effects of total knee replacement and non-surgical treatment on pain sensitization and clinical pain

    DEFF Research Database (Denmark)

    Skou, S. T.; Roos, E. M.; Simonsen, O.;

    2016-01-01

    were randomized to (1) TKR followed by a non-surgical treatment of neuromuscular exercise, education, diet, insoles and pain medication or (2) the non-surgical treatment alone. Outcomes assessed at baseline and after 3 months were as follows: (1) pain sensitization assessed as pressure-pain thresholds...

  5. Recognition of central sensitization in patients with musculoskeletal pain: Application of pain neurophysiology in manual therapy practice.

    NARCIS (Netherlands)

    Nijs, J.; Houdenhove, B. Van; Oostendorp, R.A.B.

    2010-01-01

    Central sensitization plays an important role in the pathophysiology of numerous musculoskeletal pain disorders, yet it remains unclear how manual therapists can recognize this condition. Therefore, mechanism based clinical guidelines for the recognition of central sensitization in patients with mus

  6. Pain modulatory phenotypes differentiate subgroups with different clinical and experimental pain sensitivity

    DEFF Research Database (Denmark)

    Vaegter, Henrik B.; Graven-Nielsen, Thomas

    2016-01-01

    Pain biomarkers are warranted for individualized pain management. Based on different pain modulatory phenotypes the objectives of this study were to explore the existence of subgroups within nonmalignant chronic pain patients and to investigate differences in clinical pain and pain hypersensitivi...... on demographics, disability, pain catastrophizing, and fear of movement. Future research should investigate interventions tailored towards these subgroups....

  7. Ethanol Increases Mechanical Pain Sensitivity in Rats via Activation of GABAA Receptors in Medial Prefrontal Cortex.

    Science.gov (United States)

    Geng, Kai-Wen; He, Ting; Wang, Rui-Rui; Li, Chun-Li; Luo, Wen-Jun; Wu, Fang-Fang; Wang, Yan; Li, Zhen; Lu, Yun-Fei; Guan, Su-Min; Chen, Jun

    2016-10-01

    Ethanol is widely known for its ability to cause dramatic changes in emotion, social cognition, and behavior following systemic administration in humans. Human neuroimaging studies suggest that alcohol dependence and chronic pain may share common mechanisms through amygdala-medial prefrontal cortex (mPFC) interactions. However, whether acute administration of ethanol in the mPFC can modulate pain perception is unknown. Here we showed that bilateral microinjections of ethanol into the prelimbic and infralimbic areas of the mPFC lowered the bilateral mechanical pain threshold for 48 h without influencing thermal pain sensitivity in adult rats. However, bilateral microinjections of artificial cerebrospinal fluid into the mPFC or bilateral microinjections of ethanol into the dorsolateral PFC (also termed as motor cortex area 1 in Paxinos and Watson's atlas of The Rat Brain. Elsevier Academic Press, Amsterdam, 2005) failed to do so, suggesting regional selectivity of the effects of ethanol. Moreover, bilateral microinjections of ethanol did not change the expression of either pro-apoptotic (caspase-3 and Bax) or anti-apoptotic (Bcl-2) proteins, suggesting that the dose was safe and validating the method used in the current study. To determine whether γ-aminobutyric acid A (GABAA) receptors are involved in mediating the ethanol effects, muscimol, a selective GABAA receptor agonist, or bicuculline, a selective GABAA receptor antagonist, was administered alone or co-administered with ethanol through the same route into the bilateral mPFC. The results showed that muscimol mimicked the effects of ethanol while bicuculline completely reversed the effects of ethanol and muscimol. In conclusion, ethanol increases mechanical pain sensitivity through activation of GABAA receptors in the mPFC of rats. PMID:27628528

  8. Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry

    DEFF Research Database (Denmark)

    Graven-Nielsen, Thomas; Vaegter, Henrik Bjarke; Finocchietti, Sara;

    2015-01-01

    , as well as pressure pain threshold (PPT) with handheld pressure algometry were assessed in 136 healthy subjects. In one session cuff pain sensitivity was also assessed before and after the cold-pressor induced CPM. Good to excellent intraclass correlations (ICCs: 0.60 - 0.90) were demonstrated for...... constitutes a user-independent method for assessment of pain. Difference in age-related pain sensitivity between manual and cuff algometry should be further investigated....

  9. Gender differences in pain and secondary hyperalgesia after heat/capsaicin sensitization in healthy volunteers

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Petersen, Karin Lottrup

    2006-01-01

    , but not total pain, during prolonged noxious thermal stimulation was higher in women. There was no gender difference in pain ratings during capsaicin sensitization or in heat pain detection thresholds. The results provided only limited support to the hypothesis that gender differences in clinical pain syndromes....../capsaicin sensitization, and heat pain detection thresholds. There was a trend toward smaller areas of secondary hyperalgesia in women. After adjusting for estimated gender differences in forearm surface area, areas to brush but not von Frey hair stimulation after capsaicin sensitization were larger in women. Peak pain...... can be explained by enhanced central sensitization in women. PERSPECTIVE: Our findings suggest that gender differences in nociceptive transmission and neuronal sensitization are small and provide only limited support to the hypothesis that gender differences in acute and chronic pain syndromes can...

  10. Genes contributing to pain sensitivity in the normal population: an exome sequencing study.

    Directory of Open Access Journals (Sweden)

    Frances M K Williams

    Full Text Available Sensitivity to pain varies considerably between individuals and is known to be heritable. Increased sensitivity to experimental pain is a risk factor for developing chronic pain, a common and debilitating but poorly understood symptom. To understand mechanisms underlying pain sensitivity and to search for rare gene variants (MAF<5% influencing pain sensitivity, we explored the genetic variation in individuals' responses to experimental pain. Quantitative sensory testing to heat pain was performed in 2,500 volunteers from TwinsUK (TUK: exome sequencing to a depth of 70× was carried out on DNA from singletons at the high and low ends of the heat pain sensitivity distribution in two separate subsamples. Thus in TUK1, 101 pain-sensitive and 102 pain-insensitive were examined, while in TUK2 there were 114 and 96 individuals respectively. A combination of methods was used to test the association between rare variants and pain sensitivity, and the function of the genes identified was explored using network analysis. Using causal reasoning analysis on the genes with different patterns of SNVs by pain sensitivity status, we observed a significant enrichment of variants in genes of the angiotensin pathway (Bonferroni corrected p = 3.8×10(-4. This pathway is already implicated in animal models and human studies of pain, supporting the notion that it may provide fruitful new targets in pain management. The approach of sequencing extreme exome variation in normal individuals has provided important insights into gene networks mediating pain sensitivity in humans and will be applicable to other common complex traits.

  11. Genes contributing to pain sensitivity in the normal population: an exome sequencing study.

    Science.gov (United States)

    Williams, Frances M K; Scollen, Serena; Cao, Dandan; Memari, Yasin; Hyde, Craig L; Zhang, Baohong; Sidders, Benjamin; Ziemek, Daniel; Shi, Yujian; Harris, Juliette; Harrow, Ian; Dougherty, Brian; Malarstig, Anders; McEwen, Robert; Stephens, Joel C; Patel, Ketan; Menni, Cristina; Shin, So-Youn; Hodgkiss, Dylan; Surdulescu, Gabriela; He, Wen; Jin, Xin; McMahon, Stephen B; Soranzo, Nicole; John, Sally; Wang, Jun; Spector, Tim D

    2012-01-01

    Sensitivity to pain varies considerably between individuals and is known to be heritable. Increased sensitivity to experimental pain is a risk factor for developing chronic pain, a common and debilitating but poorly understood symptom. To understand mechanisms underlying pain sensitivity and to search for rare gene variants (MAF<5%) influencing pain sensitivity, we explored the genetic variation in individuals' responses to experimental pain. Quantitative sensory testing to heat pain was performed in 2,500 volunteers from TwinsUK (TUK): exome sequencing to a depth of 70× was carried out on DNA from singletons at the high and low ends of the heat pain sensitivity distribution in two separate subsamples. Thus in TUK1, 101 pain-sensitive and 102 pain-insensitive were examined, while in TUK2 there were 114 and 96 individuals respectively. A combination of methods was used to test the association between rare variants and pain sensitivity, and the function of the genes identified was explored using network analysis. Using causal reasoning analysis on the genes with different patterns of SNVs by pain sensitivity status, we observed a significant enrichment of variants in genes of the angiotensin pathway (Bonferroni corrected p = 3.8×10(-4)). This pathway is already implicated in animal models and human studies of pain, supporting the notion that it may provide fruitful new targets in pain management. The approach of sequencing extreme exome variation in normal individuals has provided important insights into gene networks mediating pain sensitivity in humans and will be applicable to other common complex traits.

  12. Is heat pain detection threshold associated with the area of secondary hyperalgesia following brief thermal sensitization?

    DEFF Research Database (Denmark)

    Hansen, Morten Sejer; Wetterslev, Jørn; Pipper, Christian Bressen;

    2016-01-01

    BACKGROUND: Several factors are believed to influence the development and experience of pain. Human clinical pain models are central tools, in the investigation of basic physiologic pain responses, and can be applied in patients as well as in healthy volunteers. Each clinical pain model investiga......BACKGROUND: Several factors are believed to influence the development and experience of pain. Human clinical pain models are central tools, in the investigation of basic physiologic pain responses, and can be applied in patients as well as in healthy volunteers. Each clinical pain model...... investigates different aspects of the human pain response. Brief thermal sensitization induces a mild burn injury, resulting in development of primary hyperalgesia at the site of stimulation, and secondary hyperalgesia surrounding the site of stimulation. Central sensitization is believed to play an important...

  13. Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

    Directory of Open Access Journals (Sweden)

    Marcio José da Silva Campos

    2013-10-01

    Full Text Available INTRODUCTION: Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age. OBJECTIVE: This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment. METHODS: The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years and 10 adults (18-37 years was recorded with the aid of a Visual Analog Scale (VAS, during 14 days - 7 days with bonded brackets only and 7 days with the initial archwire inserted. RESULTS: There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults. CONCLUSIONS: In general, children reported pain less frequently than adults did, though with greater intensity.

  14. Older adults' pain communication during ambulatory medical visits: an exploration of communication accommodation theory.

    Science.gov (United States)

    Hehl, Jennifer; McDonald, Deborah Dillon

    2014-06-01

    The purpose of this descriptive secondary analysis was to explore the use of Communication Accommodation Theory as a framework to examine pain communication strategies used by older adults and their primary care practitioners during medical ambulatory care visits. Ambulatory medical visits for 22 older adults with moderate or greater osteoarthritis pain were audiotaped, transcribed verbatim, and coded by two independent raters for six a priori communication strategies derived from the attuning strategies of Communication Accommodation Theory: (1) patient selecting the pain topic; (2) patient taking a turn; (3) patient maintaining focus on the pain topic; (4) practitioner using an open-ended question without social desirability to start the pain discussion; (5) practitioner encouraging the patient to take a turn by asking open-ended questions; and (6) practitioner interruptions. The majority of practitioners did not start the pain discussion with an open-ended question, but did not interrupt the older adults as they discussed their pain. Five (22.7%) of the older adults did not discuss their osteoarthritis pain during the ambulatory medical visit. The majority of patients took their turn during the pain discussion, but did not maintain focus while describing important osteoarthritis pain information to their practitioner. Practitioners might assist older adults to communicate more information about their pain by initiating the pain discussion with an open-ended pain question. Older adults might provide more pain information to their practitioner by staying on the pain topic until they have completed all of the pain information they wish to discuss with the practitioner.

  15. Older adults' pain communication during ambulatory medical visits: an exploration of communication accommodation theory.

    Science.gov (United States)

    Hehl, Jennifer; McDonald, Deborah Dillon

    2014-06-01

    The purpose of this descriptive secondary analysis was to explore the use of Communication Accommodation Theory as a framework to examine pain communication strategies used by older adults and their primary care practitioners during medical ambulatory care visits. Ambulatory medical visits for 22 older adults with moderate or greater osteoarthritis pain were audiotaped, transcribed verbatim, and coded by two independent raters for six a priori communication strategies derived from the attuning strategies of Communication Accommodation Theory: (1) patient selecting the pain topic; (2) patient taking a turn; (3) patient maintaining focus on the pain topic; (4) practitioner using an open-ended question without social desirability to start the pain discussion; (5) practitioner encouraging the patient to take a turn by asking open-ended questions; and (6) practitioner interruptions. The majority of practitioners did not start the pain discussion with an open-ended question, but did not interrupt the older adults as they discussed their pain. Five (22.7%) of the older adults did not discuss their osteoarthritis pain during the ambulatory medical visit. The majority of patients took their turn during the pain discussion, but did not maintain focus while describing important osteoarthritis pain information to their practitioner. Practitioners might assist older adults to communicate more information about their pain by initiating the pain discussion with an open-ended pain question. Older adults might provide more pain information to their practitioner by staying on the pain topic until they have completed all of the pain information they wish to discuss with the practitioner. PMID:24882026

  16. GCH1-polymorphism and pain sensitivity among women with provoked vestibulodynia

    Directory of Open Access Journals (Sweden)

    Heddini Ulrika

    2012-09-01

    Full Text Available Abstract Background Provoked vestibulodynia (PVD is a pain disorder localized in the vestibular mucosa. It is the most common cause of dyspareunia among young women and it is associated with general pain hypersensitivity and other chronic pain conditions. Polymorphism in the guanosine triphosphate cyclohydrolase (GCH1 gene has been found to influence general pain sensitivity and the risk of developing a longstanding pain condition. The aim of this study was to investigate GCH1-polymorphism in women with PVD and healthy controls, in correlation to pain sensitivity. Results We found no correlation between the previously defined pain-protective GCH1-SNP combination and the diagnosis of PVD. Nor any correlation with pain sensitivity measured as pressure pain thresholds on the arm, leg and in the vestibule, coital pain scored on a visual analog scale and prevalence of other bodily pain conditions among women with PVD (n = 98 and healthy controls (n = 102. However, among patients with current treatment (n = 36, there was a significant interaction effect of GCH1-gene polymorphism and hormonal contraceptive (HC therapy on coital pain (p = 0.04 as well as on pressure pain thresholds on the arm (p = 0.04. PVD patients carrying the specified SNP combination and using HCs had higher pain sensitivity compared to non-carriers. In non-HC-users, carriers had lower pain sensitivity. Conclusions The results of this study gave no support to the hypothesis that polymorphism in the GCH1-gene contributes to the etiology of PVD. However, among patients currently receiving treatment an interaction effect of the defined SNP combination and use of hormonal contraceptives on pain sensitivity was found. This finding offers a possible explanation to the clinically known fact that some PVD patients improve after cessation of hormonal contraceptives, indicating that PVD patients carrying the defined SNP combination of GCH1 would benefit from this

  17. Combined glutamate and glutamine levels in pain-processing brain regions are associated with individual pain sensitivity.

    Science.gov (United States)

    Zunhammer, Matthias; Schweizer, Lauren M; Witte, Vanessa; Harris, Richard E; Bingel, Ulrike; Schmidt-Wilcke, Tobias

    2016-10-01

    The relationship between glutamate and γ-aminobutyric acid (GABA) levels in the living human brain and pain sensitivity is unknown. Combined glutamine/glutamate (Glx), as well as GABA levels can be measured in vivo with single-voxel proton magnetic resonance spectroscopy. In this cross-sectional study, we aimed at determining whether Glx and/or GABA levels in pain-related brain regions are associated with individual differences in pain sensitivity. Experimental heat, cold, and mechanical pain thresholds were obtained from 39 healthy, drug-free individuals (25 men) according to the quantitative sensory testing protocol and summarized into 1 composite measure of pain sensitivity. The Glx levels were measured using point-resolved spectroscopy at 3 T, within a network of pain-associated brain regions comprising the insula, the anterior cingulate cortex, the mid-cingulate cortex, the dorsolateral prefrontal cortex, and the thalamus. GABA levels were measured using GABA-edited spectroscopy (Mescher-Garwood point-resolved spectroscopy) within the insula, the anterior cingulate cortex, and the mid-cingulate cortex. Glx and/or GABA levels correlated positively across all brain regions. Gender, weekly alcohol consumption, and depressive symptoms were significantly associated with Glx and/or GABA levels. A linear regression analysis including all these factors indicated that Glx levels pooled across pain-related brain regions were positively associated with pain sensitivity, whereas no appreciable relationship with GABA was found. In sum, we show that the levels of the excitatory neurotransmitter glutamate and its precursor glutamine across pain-related brain regions are positively correlated with individual pain sensitivity. Future studies will have to determine whether our findings also apply to clinical populations. PMID:27649042

  18. Altered central sensitization and pain modulation in the CNS in chronic joint pain

    DEFF Research Database (Denmark)

    Arendt-Nielsen, Lars; Skou, Søren Thorgaard; Nielsen, Thomas Arendt;

    2015-01-01

    Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral and ...... mechanisms, available tools are important for patent profiling and providing the basic knowledge for development of new drugs and for developing pain management regimes....... of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater understanding of the mechanisms involved in chronic joint pain. As joint pain is a complex interaction between many different pain...

  19. Altered pressure pain thresholds and increased wind-up in adult patients with chronic back pain with a history of childhood maltreatment: a quantitative sensory testing study.

    Science.gov (United States)

    Tesarz, Jonas; Eich, Wolfgang; Treede, Rolf-Detlef; Gerhardt, Andreas

    2016-08-01

    Childhood maltreatment (CM) has been associated with an increased risk of nonspecific chronic low back pain (nsCLBP). However, the mechanisms underlying this association are unclear. Therefore, this study considered whether distinct types of CM are accompanied by specific alterations in somatosensory function. A total of 176 subjects with nsCLBP and 27 pain-free controls (PCs) were included. The Childhood Trauma Questionnaire (CTQ) was used to categorize patients into 2 groups (abused/neglected vs nonabused/nonneglected) for 5 types of CM (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). The standardized quantitative sensory testing protocol of the "German Research Network on Neuropathic Pain" was performed to obtain comprehensive profiles on somatosensory function, including detection and pain thresholds, pain sensitivity, and assessments of temporal summation (wind-up). Between 17.7% and 51.4% of subjects with nsCLBP reported CM, depending on the type of CM. Childhood Trauma Questionnaire subscores for emotional and sexual abuse were significantly higher in subjects with nsCLBP than in PCs. Compared with PCs, subjects with CM showed reduced pressure pain thresholds (PPTs), irrespective of the type of CM. Regarding distinct types of CM, subjects with nsCLBP with emotional abuse reported significantly higher wind-up than those without, and sexual abuse was accompanied by enhanced touch sensitivity. Our findings suggest that CM is nonspecifically associated with a decreased PPT in nsCLBP. Emotional abuse apparently leads to enhanced spinal pain summation, and sexual abuse leads to enhanced touch sensitivity. These results emphasize the importance of emotional abuse in nsCLBP and suggest that CM can induce long-term changes in adult somatosensory function. PMID:27075429

  20. Relationship between mechanical sensitivity and postamputation pain: A prospective study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; IlKjær, Susanne; Jensen, Troels Staehelin

    2000-01-01

    Limb amputation is followed by stump and phantom pain in a large proportion of amputees and postamputation pain may be associated with signs of hyperexcitability such as hyperalgesia to mechanical stimulation. The present study examined the possible relationship between mechanical pain threshold...

  1. Musculoskeletal pain is associated with restless legs syndrome in young adults

    OpenAIRE

    Hoogwout, Stijn J.; Paananen, Markus V.; Smith, Anne J; Beales, Darren J; O’Sullivan, Peter B.; Straker, Leon M; Eastwood, Peter R.; McArdle, Nigel; Champion, David

    2015-01-01

    Background In recent years, there is considerable evidence of a relationship between the sensorimotor disorder restless legs syndrome (RLS) and pain disorders, including migraine and fibromyalgia. An association between multi-site pain and RLS has been reported in adult women. In the current study, we explored the association between musculoskeletal (MSK) pain and RLS in a large cohort of young adults. Methods Twenty two year olds (n = 1072), followed since birth of part of the Western Austra...

  2. Pain tolerance, pain sensitivity, and accessibility of aggression-related schemata in parents at-risk for child physical abuse.

    Science.gov (United States)

    Hiraoka, Regina; Crouch, Julie L; Reo, Gim; Wagner, Michael; Milner, Joel S; Skowronski, John J

    2014-11-01

    This study examined whether parents with varying degrees of child physical abuse (CPA) risk differed in pain tolerance, pain sensitivity, and accessibility of aggression-related schemata. Participants included 91 (51 low CPA risk and 40 high CPA risk) general population parents. Participants were randomly assigned to complete either an easy or a difficult anagram task. Pain tolerance and pain sensitivity were assessed using a cold pressor task. Accessibility of aggression-related schemata was assessed at the outset of the data collection session and at the end of the session using a word completion task. Parents' self-reported negative affect was assessed three times over the course of the study: baseline, after the anagram task, and after the cold pressor task. As expected, high-risk (compared to low-risk) parents reported higher levels of negative affect at each time point. Moreover, after completing the difficult anagram task, high-risk (compared to low-risk) parents exhibited higher pain sensitivity during the cold pressor task. Following completion of the cold pressor task, high-risk (compared to low-risk) parents exhibited greater accessibility of aggression-related schemata. Collectively, these findings indicate that under certain conditions, high-risk parents experience a confluence of aggression-related risk factors (i.e., negative affect, pain sensitivity, and aggression-related information processes) that may predispose them to aggressive behavior.

  3. Cognitive-emotional sensitization contributes to wind-up-like pain in phantom limb pain patients

    DEFF Research Database (Denmark)

    Vase, Lene; Nikolajsen, Lone; Christensen, Bente;

    2011-01-01

    -four upper-limb amputees with various levels of phantom limb pain were included in the study. Patients' level of pain catastrophizing, anxiety and depression was assessed and they went through quantitative sensory testing (QST) of thresholds (mechanical and thermal) and wind-up-like pain (brush and pinprick...

  4. Orofacial pain, jaw function, and temporomandibular disorders in adult women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Bakke, M.; Zak, M.; Jensen, B.L.;

    2001-01-01

    Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis......Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis...

  5. Chronic pain self-management for older adults: a randomized controlled trial [ISRCTN11899548

    Science.gov (United States)

    Ersek, Mary; Turner, Judith A; Cain, Kevin C; Kemp, Carol A

    2004-01-01

    Background Chronic pain is a common and frequently disabling problem in older adults. Clinical guidelines emphasize the need to use multimodal therapies to manage persistent pain in this population. Pain self-management training is a multimodal therapy that has been found to be effective in young to middle-aged adult samples. This training includes education about pain as well as instruction and practice in several management techniques, including relaxation, physical exercise, modification of negative thoughts, and goal setting. Few studies have examined the effectiveness of this therapy in older adult samples. Methods/Design This is a randomized, controlled trial to assess the effectiveness of a pain self-management training group intervention, as compared with an education-only control condition. Participants are recruited from retirement communities in the Pacific Northwest of the United States and must be 65 years or older and experience persistent, noncancer pain that limits their activities. The primary outcome is physical disability, as measured by the Roland-Morris Disability Questionnaire. Secondary outcomes are depression (Geriatric Depression Scale), pain intensity (Brief Pain Inventory), and pain-related interference with activities (Brief Pain Inventory). Randomization occurs by facility to minimize cross-contamination between groups. The target sample size is 273 enrolled, which assuming a 20% attrition rate at 12 months, will provide us with 84% power to detect a moderate effect size of .50 for the primary outcome. Discussion Few studies have investigated the effects of multimodal pain self-management training among older adults. This randomized controlled trial is designed to assess the efficacy of a pain self-management program that incorporates physical and psychosocial pain coping skills among adults in the mid-old to old-old range. PMID:15285783

  6. Associations between Adult Attachment Dimensions And Attitudes Toward Pain Behaviour

    Directory of Open Access Journals (Sweden)

    Lachlan A McWilliams

    2010-01-01

    Full Text Available BACKGROUND: Despite the important role positive reinforcement of pain behaviour is believed to play in chronic pain, there is a paucity of research regarding factors that influence the provision of such reinforcement. Attachment theory suggests that individuals high in attachment avoidance view the pain behaviour of others in a negative manner and would, therefore, provide little reinforcement of pain behaviour. As an initial step in evaluating this model, relationships between attachment dimensions and attitudes toward pain behaviour were examined. Attachment avoidance was hypothesized to be negatively associated with accepting attitudes toward pain behaviour.

  7. Adult Pacific Oyster (Crassostrea gigas May Have Light Sensitivity.

    Directory of Open Access Journals (Sweden)

    Changlu Wu

    Full Text Available Light-sensitivity is an important aspect of mollusk survival as it plays a vital role in reproduction and predator avoidance. In the Pacific oyster Crassostrea gigas light sensitivity has been demonstrated in the larval stage but has not yet been conclusively demonstrated in adult oysters. In this paper we describe an experiment which was undertaken to determine if adult Pacific oysters were sensitive to light. One LED flashlight was used to shine light onto adult oysters while they were filtering seawater through their shell openings. We found that the degree of opening increased gradually during the light period but rapidly decreased when the flashlight was turned off in the treated group but not in the control group. These results suggest that adult Pacific oyster may be sensitive to light.

  8. Parent and child anxiety sensitivity: Relationship to children’s experimental pain responsivity

    OpenAIRE

    Tsao, Jennie C. I.; Lu, Qian; Myers, Cynthia D.; Kim, Su C.; Turk, Norman; Zeltzer, Lonnie K

    2006-01-01

    Anxiety sensitivity (AS) or fear of anxiety sensations has been linked to childhood learning history for somatic symptoms, suggesting that parental AS may impact children’s responses to pain. Using structural equation modeling (SEM), we tested a conceptual model in which parent AS predicted child AS, which in turn predicted a hypothesized latent construct consisting of children’s pain intensity ratings for three laboratory pain tasks (cold pressor, thermal heat and pressure). This conceptual ...

  9. Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.

    Science.gov (United States)

    Hooten, W Michael; Lamer, Tim J; Twyner, Channing

    2015-06-01

    The hyperalgesic effects of long-term opioid use in community-dwelling adults with chronic pain have not been widely reported. Therefore, the primary aim of this study was to determine the associations between opioid use and heat pain (HP) perception in a sample of community-dwelling adults with chronic pain. The study cohort involved 187 adults (85 opioid and 102 nonopioid) with chronic pain consecutively admitted to an outpatient interdisciplinary pain treatment program. Heat pain perception was assessed using a validated quantitative sensory test method of levels. An effect of opioid use was observed for nonstandardized (P = 0.004) and standardized (P = 0.005) values of HP 5-0.5 in which values of the opioid group were lower (more hyperalgesic) compared with those of the nonopioid group. HP 5-0.5 is a measure of the slope of the line connecting HP 0.5 (HP threshold) and HP 5 (intermediate measure of HP tolerance). In univariable (P = 0.019) and multiple variable (P = 0.003) linear regression analyses (adjusted for age, sex, body mass index, work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower (more hyperalgesic) nonstandardized values of HP 5-0.5. Similarly, in univariable (P = 0.004) and multiple variable (P = 0.011) linear regression analyses (adjusted for work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower standardized values of HP 5-0.5. In this sample of community-dwelling adults, these observations suggest that long-term opioid use was associated with hyperalgesia independent of other clinical factors known to influence HP perception.

  10. The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Roos, Ewa M; Simonsen, Ole;

    2016-01-01

    OBJECTIVE: To report the efficacy of a 3-month treatment program consisting of neuromuscular exercise, education, diet, insoles and pain medication (MEDIC-treatment) compared to usual care (two leaflets with information and treatment advice) in reducing pain-related measures and sensitization...

  11. Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas;

    2014-01-01

    , participants were assigned to 12 weeks of supervised exercise therapy (ET; 36 sessions) or a no attention control group (CG). Pressure-pain sensitivity was assessed by cuff pressure algometry on the calf of the most symptomatic leg. The coprimary outcomes were pressure-pain thresholds (PPTs) and cumulated...

  12. Single vs composite measures of pain intensity: relative sensitivity for detecting treatment effects.

    Science.gov (United States)

    Jensen, Mark P; Hu, Xiaojun; Potts, Susan L; Gould, Errol M

    2013-04-01

    Assay sensitivity remains a significant issue in pain clinical trials. One possible method for increasing assay sensitivity for detecting changes in pain intensity is to increase the reliability of pain intensity assessment by increasing the number of intensity ratings obtained, and combining these ratings into composite scores. The current study performed secondary analyses from a published clinical trial to test this possibility. The reliability and assay sensitivity pain intensity scores made up of 1 to 9 24-hour pain intensity recall ratings were compared. Although the reliability of the outcome measures improved as the number of items increased, this increase in reliability was not associated with an increase in assay sensitivity. A single 24-hour recall rating was about as valid (sensitive) for detecting treatment effects as composite scores made up of 2 to 9 different ratings. If this finding replicates in other pain populations, it has significant implications for the design and conduct of pain clinical trials. Specifically, it suggests the possibility that assessment burden (and associated costs and problems related to missing data) might be greatly reduced by specifying a single recall rating as the primary outcome variable. Research is needed to explore this possibility further.

  13. Anger regulation style, anger arousal and acute pain sensitivity: evidence for an endogenous opioid "triggering" model.

    Science.gov (United States)

    Burns, John W; Bruehl, Stephen; Chont, Melissa

    2014-08-01

    Findings suggest that greater tendency to express anger is associated with greater sensitivity to acute pain via endogenous opioid system dysfunction, but past studies have not addressed the role of anger arousal. We used a 2 × 2 factorial design with Drug Condition (placebo or opioid blockade with naltrexone) crossed with Task Order (anger-induction/pain-induction or pain-induction/anger-induction), and with continuous Anger-out Subscale scores. Drug × Task Order × Anger-out Subscale interactions were tested for pain intensity during a 4-min ischemic pain task performed by 146 healthy people. A significant Drug × Task Order × Anger-out Subscale interaction was dissected to reveal different patterns of pain intensity changes during the pain task for high anger-out participants who underwent pain-induction prior to anger-induction compared to those high in anger-out in the opposite order. Namely, when angered prior to pain, high anger-out participants appeared to exhibit low pain intensity under placebo that was not shown by high anger-out participants who received naltrexone. Results hint that people with a pronounced tendency to express anger may suffer from inadequate opioid function under simple pain-induction, but may experience analgesic benefit to some extent from the opioid triggering properties of strong anger arousal.

  14. The visual analogue thermometer and the graphic numeric rating scale: a comparison of self-report instruments for pain measurement in adults with burns.

    Science.gov (United States)

    de Jong, A E E; Bremer, M; Hofland, H W C; Schuurmans, M J; Middelkoop, E; van Loey, N E E

    2015-03-01

    To evaluate the adequacy of pain management in burn care, pain measurement is essential. The visual analogue thermometer (VAT) and graphic numeric rating scale (GNRS) are frequently used self-report instruments for burn pain. To legitimise their interchangeable use in research and practice, we aimed to compare self-reports obtained by the VAT and GNRS, the ability of the scales to differentiate background from procedural pain, and to compare potential cutpoints. Adults with acute burns (N=319) participated in the study (67% male, mean age 40.3 years (SD 16), mean TBSA 9.9% (SD 10.4). Correlation coefficients between VAT and GNRS were 0.64 and 0.55 for, respectively, morning and afternoon background pain and 0.51 for procedural pain (p<0.01). VAT scores were lower than GNRS scores for all pain types (p<0.01). Both scales could differentiate background from procedural pain: procedural pain was higher (p<0.01). The standardized response mean was moderate (0.518 for VAT and 0.571 for GNRS). Self-reported thresholds for 'unacceptable pain' by GNRS were higher than by VAT (p<0.001). ROC analyses showed that the highest sensitivity was reached for pain score 2 for both scales. The results suggest that the instruments cannot be used interchangeably without taking their differences into account.

  15. Co-occurrence of Pain Symptoms and Somatosensory Sensitivity in Burning Mouth Syndrome: A Systematic Review

    Science.gov (United States)

    Moisset, Xavier; Calbacho, Valentina; Torres, Pilar; Gremeau-Richard, Christelle; Dallel, Radhouane

    2016-01-01

    Background Burning mouth syndrome (BMS) is a chronic and spontaneous oral pain with burning quality in the tongue or other oral mucosa without any identifiable oral lesion or laboratory finding. Pathogenesis and etiology of BMS are still unknown. However, BMS has been associated with other chronic pain syndromes including other idiopathic orofacial pain, the dynias group and the family of central sensitivity syndromes. This would imply that BMS shares common mechanisms with other cephalic and/or extracephalic chronic pains. The primary aim of this systematic review was to determine whether BMS is actually associated with other pain syndromes, and to analyze cephalic and extracephalic somatosensory sensitivity in these patients. Methods This report followed the PRISMA Statement. An electronic search was performed until January 2015 in PubMed, Cochrane library, Wiley and ScienceDirect. Searched terms included “burning mouth syndrome OR stomatodynia OR glossodynia OR burning tongue OR oral burning”. Studies were selected according to predefined inclusion criteria (report of an association between BMS and other pain(s) symptoms or of cutaneous cephalic and/or extracephalic quantitative sensory testing in BMS patients), and a descriptive analysis conducted. Results The search retrieved 1512 reports. Out of these, twelve articles met criteria for co-occurring pain symptoms and nine studies for quantitative sensory testing (QST) in BMS patients. The analysis reveals that in BMS patients co-occurring pain symptoms are rare, assessed by only 0.8% (12 of 1512) of the retrieved studies. BMS was associated with headaches, TMD, atypical facial pain, trigeminal neuralgia, post-herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain or vulvodynia. However, the prevalence of pain symptoms in BMS patients is not different from that in the age-matched general population. QST studies reveal no or inconsistent evidence of abnormal cutaneous cephalic

  16. Central Sensitization in Functional Chronic Pain Syndromes: Overview and Clinical Application.

    Science.gov (United States)

    Bettini, Liz; Moore, Ki

    2016-10-01

    The purpose of this review and clinical application article is to offer nurses up-to-date knowledge on peripheral and central sensitization in chronic functional pain syndromes, and to discuss therapies that have shown efficacy in treating various aspects of these disorders. Central sensitization is a result of changes in the peripheral and central nervous system due to noxious stimuli, such as illness or trauma. Once these changes occur, treatment for the associated syndromes requires a multimodal approach that includes behavioral pain psychology, physical therapy, and pharmacological agents that specifically target neuroinflammation, pain modulation, and amplification of pain pathways. More research needs to be conducted on the basis and patient perception of functional pain syndromes to reduce the morbidity and significant disability associated with these illnesses. Nurses have the opportunity to be at the forefront of this research because of their holistic and multidimensional approach to patient care, assessment, and symptom management. PMID:27553129

  17. Differential changes in gingival somatosensory sensitivity after painful electrical tooth stimulation.

    Science.gov (United States)

    Baad-Hansen, Lene; Lu, Shengyi; Kemppainen, Pentti; List, Thomas; Zhang, Zhenting; Svensson, Peter

    2015-04-01

    We aimed to evaluate the effect of painful tooth stimulation on gingival somatosensory sensitivity of healthy volunteers in a randomized, controlled design. Thirteen healthy volunteers (six women, seven men; 28.4 ± 5.0 years) were included for two experimental sessions of electrical tooth stimulation: painful tooth stimulation and tooth stimulation below the sensory threshold (control). Eight of the human subjects participated in a third session without tooth stimulation. In all sessions, the somatosensory sensitivity of the gingiva adjacent to the stimulated tooth was evaluated with a standardized battery of quantitative sensory tests (QST) before, immediately after and 30 min after tooth stimulation. Painful tooth stimulation evoked significant decreases in warmth and heat pain thresholds (P 0.086). No QST changes were detected in the session without tooth stimulation (P > 0.060). In conclusion, modest increased gingival sensitivity to warmth, painful heat and pressure stimuli as well as desensitization to non-painful mechanical stimulation were demonstrated after tooth stimulation. This suggests involvement of competing heterotopic facilitatory and inhibitory mechanisms. Furthermore, stimulation below the sensory threshold induced similar thermal sensitization suggesting the possibility of activation of axon-reflex-like mechanisms even at intensities below the perception threshold. These findings may have implications for interpretation of somatosensory results in patients with chronic intraoral pain.

  18. [Systemic analgesia for postoperative pain management in the adult].

    Science.gov (United States)

    Binhas, M; Marty, J

    2009-02-01

    Severe postsurgical pain contributes to prolonged hospital stay and is also believed to be a risk factor for the development of chronic pain. Locoregional anesthesia, which results in faster patient recovery with fewer side effects, is favored wherever feasible, but is not applicable to every patient. Systemic analgesics are the most widely used method for providing pain relief in the postoperative period. Improvements in postoperative systemic analgesia for pain management should be applied and predictive factors for severe postoperative pain should be anticipated in order to control pain while minimizing opioid side effects. Predictive factors for severe postoperative pain include severity of preoperative pain, prior use of opiates, female gender, non-laparoscopic surgery, and surgeries involving the knee and shoulder. Pre- and intraoperative use of small doses of ketamine has a preventive effect on postoperative pain. Multimodal or balanced analgesia (the combined use of various analgesic agents) such as NSAID/morphine, NSAID/nefopam, morphine/ketamine improves analgesia with morphine-sparing effects. Nausea and vomiting, the principle side effects of morphine, can be predicted using Apfel's simplified score; patients with a high Apfel score risk should receive preemptive antiemetic agents aimed at different receptor sites, such as preoperative dexamethasone and intraoperative droperidol. Droperidol can be combined with morphine for postoperative patient-controlled anesthesia (PCA). When PCA is used, dosage parameters should be adjusted every day based on pain evaluation. Patients with presurgical opioid requirements will require preoperative administration of their daily opioid maintenance dose before induction of anesthesia: PCA offers useful options for effective postsurgical analgesia using a basal rate equivalent to the patient's hourly oral usage plus bolus doses as required.

  19. The relationship of adult attachment dimensions to pain-related fear, hypervigilance, and catastrophizing.

    Science.gov (United States)

    McWilliams, Lachlan A; Asmundson, Gordon J G

    2007-01-01

    Despite the prominence of fear-avoidance models of chronic pain, there is a paucity of research regarding the origins of pain-related fear. Based on the premise that insecure attachment could be a developmentally based origin of elevated fear of pain, associations between adult attachment dimensions and constructs included in fear-avoidance models of chronic pain were investigated. Consistent with Bartholomew and Horowitz's [Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. J Pers Soc Psychol 1991;61:226-44.] model, attachment was conceptualized as being comprised of a model of self dimension (i.e., degree of anxiety regarding rejection based on beliefs of personal unworthiness) and a model of others dimension (i.e., degree of interpersonal mistrust and discomfort with interpersonal closeness). A large university student sample free of chronic pain (N=278) completed a measure of adult romantic attachment (i.e., Experiences in Close Relationships Questionnaire; [Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: an integrative overview. In: Simpson JA, Rholes WS, editors. Attachment theory and close relationships. New York: The Guilford Press, 1998. p. 46-76.]), the Fear of Pain Questionnaire-III [McNeil DW, Rainwater AJ. Development of the fear of pain questionnaire - III. J Behav Med 1998;21:389-410.], the Pain Vigilance and Awareness Questionnaire [McCracken LM. Attention to pain in persons with chronic pain: a behavioural approach. Behav Ther 1997;28:271-84.], and the Pain Catastrophizing Scale [Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995;7:24-532.]. It was hypothesized that insecure attachment would be positively associated with reports of pain-related fear, hypervigilance, and catastrophizing and that the model of self dimension would be the attachment variable most strongly associated with these variables

  20. Interhemispheric Dorsolateral Prefrontal Cortex Connectivity is Associated with Individual Differences in Pain Sensitivity in Healthy Controls.

    Science.gov (United States)

    Sevel, Landrew S; Letzen, Janelle E; Staud, Roland; Robinson, Michael E

    2016-06-01

    The dorsolateral prefrontal cortex (DLPFC) is implicated in pain modulation through multiple psychological processes. Recent noninvasive brain stimulation studies suggest that interhemispheric DLPFC connectivity influences pain tolerance and discomfort by altering interhemispheric inhibition. The structure and role of interhemispheric DLPFC connectivity in pain processing have not been investigated. The present study used dynamic causal modeling (DCM) for fMRI to investigate transcallosal DLPFC connectivity during painful stimulation in healthy volunteers. DCM parameters were used to predict individual differences in sensitivity to noxious heat stimuli. Bayesian model selection results indicated that influences among the right DLPFC (rDLPFC) and left DLPFC (lDLPFC) are modulated during painful stimuli. Regression analyses revealed that greater rDLPFC→lDLPFC couplings were associated with higher suprathreshold pain temperatures. These results highlight the role of interhemispheric connectivity in pain modulation and support the preferential role of the right hemisphere in pain processing. Knowledge of these mechanisms may improve understanding of abnormal pain modulation in chronic pain populations. PMID:26916416

  1. Scaffolding Young Children's Prosocial Responsiveness: Preschoolers' Responses to Adult Sadness, Anger, and Pain.

    Science.gov (United States)

    Denham, Susanne A.; And Others

    Two studies investigated children's responsiveness to an adult's negative emotions (anger, sadness, and pain). The studies also evaluated effects of adult scaffolding (labeling and explaining negative emotions, and requesting help). In the first study, subjects were 55 preschool children between the ages of 33 and 56 months. During individual play…

  2. Enhanced striatal sensitivity to aversive reinforcement in adolescents versus adults.

    Science.gov (United States)

    Galván, Adriana; McGlennen, Kristine M

    2013-02-01

    Neurodevelopmental changes in mesolimbic regions are associated with adolescent risk-taking behavior. Numerous studies have shown exaggerated activation in the striatum in adolescents compared with children and adults during reward processing. However, striatal sensitivity to aversion remains elusive. Given the important role of the striatum in tracking both appetitive and aversive events, addressing this question is critical to understanding adolescent decision-making, as both positive and negative factors contribute to this behavior. In this study, human adult and adolescent participants performed a task in which they received squirts of appetitive or aversive liquid while undergoing fMRI, a novel approach in human adolescents. Compared with adults, adolescents showed greater behavioral and striatal sensitivity to both appetitive and aversive stimuli, an effect that was exaggerated in response to delivery of the aversive stimulus. Collectively, these findings contribute to understanding how neural responses to positive and negative outcomes differ between adolescents and adults and how they may influence adolescent behavior.

  3. Peer volunteers in an integrative pain management program for frail older adults with chronic pain: study protocol for a randomized controlled trial

    OpenAIRE

    Tse, Mimi Mun Yee; Lee, Paul Hong; Ng, Sheung Mei; Tsien-Wong, Bik Kwan; Yeung, Suey Shuk Yu

    2014-01-01

    Background Chronic pain is common among the older population. A literature review on pain management program showed that exercise, yoga, massage therapy, Tai Chi, and music therapy could significantly reduce pain. In spite of the proven benefits of pain management programs, these intervention programs were effective only in the short term, and older adults would resume their old habits. It has been suggested that interventions comprising some type of social support have great potential to inc...

  4. Pain and pain-related interference in adults with lower-limb amputation: Comparison of knee-disarticulation, transtibial, and transfemoral surgical sites

    OpenAIRE

    Behr, James; Friedly, Janna; Molton, Ivan; Morgenroth, David; Jensen, Mark P.; Smith, Douglas G.

    2009-01-01

    Pain and pain-related interference with physical function have not been thoroughly studied in individuals who have undergone knee-disarticulation amputations. The principal aim of this study was to determine whether individuals with knee-disarticulation amputations have worse pain and pain-related interference with physical function than do individuals with transtibial or transfemoral amputations. We analyzed cross-sectional survey data provided by 42 adults with lower-limb amputations. These...

  5. Effects of neonatal peripheral tissue injury on pain-related behaviors in adult rats

    Directory of Open Access Journals (Sweden)

    Meng-meng LI

    2013-09-01

    Full Text Available Objective To observe the effects of peripheraltissueinjury in the developmental stage of newborn rats on pain-related behaviors in adult rats. Methods SD rats 1,4,7,14,21 and 28days after birth were selected in thepresent study(4litters at each time point and 10 rats per litter.Each litter of rats was randomly divided intoinjury group(receiving subcutaneous injection of 20μl bee venomand control group(receiving subcutaneous injection of 20μl normal saline, with20 in each group, and then raised for 2 months to adulthood. The baseline pain threshold was observed by measuring spontaneous paw flinching reflex,paw withdrawal thermal latency(PWTLand paw withdrawal mechanical threshold(PWMT, then 50μl 0.4% bee venom was subcutaneously injected to each rat, and the changesinpa in reaction and pain threshold were determined. Results The baseline thermal pain threshold in adult rats receiving bee venom or normal saline at different time points after birth was similar,but baseline mechanical pain threshold in adult rats receiving bee venom at1,4,7and14 days after birth was decreased significantly compared with the adult rats receiving normal saline at corresponding time points(P0.05.Mechanical hyperalgesia was not induced in rats injected with bee venom but induced in adult ratsinjected with normal saline4-21days after birth.Injection of bee venom 21 and 28 days after birth could obviously enhance the bee venom-induced hyperalgesiain adult rats compared with control group(P<0.01. Conclusions Bee venom stimuli at different time points after birth could affect the baseline PWMT and mechanical pain hypersensitivityin adult rats but not the baseline PWTL and thermal pain hypersensitivity. The 21st day maybe a key time point of nervous system development in rats.

  6. Relationships Between Weight, Physical Activity, and Back Pain in Young Adult Women.

    Science.gov (United States)

    Brady, Sharmayne R E; Hussain, Sultana Monira; Brown, Wendy J; Heritier, Stephane; Billah, Baki; Wang, Yuanyuan; Teede, Helena; Urquhart, Donna M; Cicuttini, Flavia M

    2016-05-01

    Back pain causes enormous financial and disability burden worldwide, which could potentially be reduced by understanding its determinants to develop effective prevention strategies. Our aim was to identify whether modifiable risk factors, weight and physical activity, are predictive of back pain in young adult women.Women born between 1973 and 1978 were randomly selected from the national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, education status, physical activity, and depression were collected in 2000, 2003, 2006, 2009, and 2012. In 2000, 9688 women completed the questionnaire and 83% completed follow-up 12 years later.At baseline, median age was 24.6 years and 41% had self-reported back pain. For every 5 kg higher weight at baseline, there was a 5% (95% confidence interval [CI] 4%-6%) increased risk of back pain over the next 12 years. Higher weight at each survey also predicted back pain risk 3 years later (P < 0.001). The effects of weight on back pain were most significant in those with BMI ≥25 kg/m and were observed at all levels of physical activity. Inadequate physical activity and depression were independent predictors of back pain over the following 12 years (both P < 0.001), after adjusting for age, weight, height, and education status.Back pain is common in community-based young adult women. Higher weight, inadequate levels of physical activity, and depression were all independent predictors of back pain over the following decade. Furthermore, the adverse effects of weight on back pain were not mitigated by physical activity. Our findings highlight the role of both higher weight and physical inactivity in back pain among young women and suggest potential opportunities for future prevention. PMID:27175634

  7. Self-reported pain intensity with the numeric reporting scale in adult dengue.

    Directory of Open Access Journals (Sweden)

    Joshua G X Wong

    Full Text Available BACKGROUND: Pain is a prominent feature of acute dengue as well as a clinical criterion in World Health Organization guidelines in diagnosing dengue. We conducted a prospective cohort study to compare levels of pain during acute dengue between different ethnicities and dengue severity. METHODS: Demographic, clinical and laboratory data were collected. Data on self-reported pain was collected using the 11-point Numerical Rating Scale. Generalized structural equation models were built to predict progression to severe disease. RESULTS: A total of 499 laboratory confirmed dengue patients were recruited in the Prospective Adult Dengue Study at Tan Tock Seng Hospital, Singapore. We found no statistically significant differences between pain score with age, gender, ethnicity or the presence of co-morbidity. Pain score was not predictive of dengue severity but highly correlated to patients' day of illness. Prevalence of abdominal pain in our cohort was 19%. There was no difference in abdominal pain score between grades of dengue severity. CONCLUSION: Dengue is a painful disease. Patients suffer more pain at the earlier phase of illness. However, pain score cannot be used to predict a patient's progression to severe disease.

  8. EFFECT OF MYOFASCIAL RELEASE THERAPY ON PAIN RELATED DISABILITY, QUALITY OF SLEEP AND DEPRESSION IN OLDER ADULTS WITH CHRONIC LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    Dr. B.Arun, MPT, PhD

    2014-02-01

    Full Text Available Low back pain was experienced by 50% of older adults that has threatened to quality of life. The economic cost of low back pain is more in older adults. Various literatures found that there is strong relationships exist between the low back pain and the psychosocial factors like sleep disturbances, depression, mood sway and chronic illness. Studies has found that depression is one of the commonest psychological problem faced by older adults which relates to other factors like pain, sleep disturbances ect.. Physiotherapy has been shown very effective in the management of chronic low back pain. Various approaches in physiotherapy play a major role in rehabilitation of patients with chronic low back pain. This study estimates to find out the effect of myofascial release therapy on pain related disability, quality of sleep and depression in older adults with chronic low back pain. Study is a single group pre test and post test design. 37 Patients with chronic low back pain were selected from a community setup. Selected subjects were undergone 6 weeks of myofascial release therapy along with moist heat therapy. At the end the outcome measured are pain related disability using pain disability index, Quality of sleep using Insomnia severity index and depression using beck depression inventory. The paired ‘t’ test was used to find out the differences between variables. The result showed that there was a significant improvement in the pre test and post test variables. The beck depression inventory was 21.3 (p<0.05%, and the pain disability index was 24.9 (p<0.05%. The study concludes that the myofascial release therapy is very effective in reducing the pain related disability, quality of sleep and depression on older adults with chronic low back pain.

  9. Association between a composite score of pain sensitivity and clinical parameters in low-back pain

    DEFF Research Database (Denmark)

    O'Neill, Søren; Manniche, Claus; Graven-Nielsen, Thomas;

    2014-01-01

    A limited number of quantitative sensory pain tests (QST) were selected on the basis of ease of application and interpretation in a clinical setting. QST results were summarized as a composite score on a scale of zero to four which was deemed to facilitate clinical interpretation. The QST set...

  10. Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization

    OpenAIRE

    Costantini, Raffaele; Affaitati, Giannapia; Massimini, Francesca; Tana, Claudio; Innocenti, Paolo; Giamberardino, Maria Adele

    2016-01-01

    Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1wee...

  11. Distinct cerebral metabolic patterns related to high pain sensitivity in episodic or chronic migraine patients and healthy volunteers

    OpenAIRE

    D'Ostilio, Kevin; Lisicki Martinez, Marco; Schoenen, Jean; Magis, Delphine

    2016-01-01

    Introduction Allodynia, i.e. pain evoked by a non-painful stimulus, is prevalent in chronic pain and in migraine where it augments with disease severity and chronicity [1]. Central sensitization is thought to be the culprit [2]. It is not known, however, which central areas are involved. The aim of the present study was to evaluate whether brain metabolism in subjects that are more sensitive to pain is different between migraine patients and healthy controls. Subjects and methods Qu...

  12. Body Pain Intensity and Interference in Adults (45–53 Years Old): A Cross-Sectional Survey in Chongqing, China

    Science.gov (United States)

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05). Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help

  13. Body Pain Intensity and Interference in Adults (45–53 Years Old): A Cross-Sectional Survey in Chongqing, China

    Science.gov (United States)

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help relieve the stress of pain among adults. PMID:27618073

  14. Body Pain Intensity and Interference in Adults (45-53 Years Old): A Cross-Sectional Survey in Chongqing, China.

    Science.gov (United States)

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help relieve the stress of pain among adults. PMID:27618073

  15. [Imaging indication for low back pain in the adult population].

    Science.gov (United States)

    Mazzola Eusébio, O; Motamed, S

    2013-09-25

    Low back pain is a frequent symptom-related reason for visits to a general physician. In case of acute low back pain, the only situation that requires a radiologic exam is when are present. This article specifies which anamnestic symptoms and past medical events are to be considered as such, and suggests what kind of radiologic exam should be done depending on the situation. It also mentions the psycho-social factors that favour a chronicisation of the problem and that should be identified in order to be taken care of. When low back pain becomes a chronic condition, there is a lack of scientific evidences/evidence based medicine and the actual recommendations whether or not to ask for imaging studies are based upon experts opinions. Medical follow-up is essential. PMID:24163881

  16. Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Luis Rogério Cosme Silva Santos

    2014-10-01

    Full Text Available OBJECTIVE To analyze the factors associated with back pain in adults who live in quilombola territories. METHODS A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750 was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression. RESULTS The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain. CONCLUSIONS The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems.

  17. Foot posture and patellar tendon pain among adult volleyball players

    NARCIS (Netherlands)

    Groot, R. de; Malliaras, P.; Munteanu, S.; Payne, C.; Morrissey, D.; Maffulli, N.

    2012-01-01

    OBJECTIVE: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. DESIGN: Observational study. SETTING: Field-based study among competing athletes. PARTICIPANTS: Volleyball player

  18. Foot Posture and Patellar Tendon Pain Among Adult Volleyball Players

    NARCIS (Netherlands)

    de Groot, Reinier; Malliaras, Peter; Munteanu, Shannon; Payne, Craig; Morrissey, Dylan; Maffulli, Nicola

    2012-01-01

    Objective: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. Design: Observational study. Setting: Field-based study among competing athletes. Participants: Volleyball player

  19. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults.

    Science.gov (United States)

    Atef, Ahmed; Fawaz, Ahmed Aly

    2008-03-01

    Tonsillectomy in adults is associated with significant postoperative pain. Intravenous paracetamol injection (Perfalgan) is marketed for the management of acute pain. This prospective placebo-controlled study was performed to evaluate the analgesic efficacy and safety of intravenous paracetamol in 76 adult patients undergoing elective standard bipolar diathermy tonsillectomy. After tonsillectomy was performed under general anesthesia, the patients were randomized to receive either intravenous paracetamol 1 g (Perfalgan) (n = 38) or 0.9% normal saline as a placebo (n = 38) at 6-h intervals. No other analgesic medication was permitted for postoperative pain during the study. Need for rescue analgesic during the first 24 h after surgery as well as all adverse events were recorded. The intravenous paracetamol group differed significantly from the placebo group regarding pain relief and median time to pethidine rescue. Intravenous paracetamol significantly reduced pethidine consumption over the 24-h period. The worst pain after surgery was also more severe in the placebo group than that in the paracetamol group. There was no significant difference between groups in the incidence of adverse events. Intravenous paracetamol administered regularly in adult patients with moderate to severe pain after tonsillectomy provided rapid and effective analgesia and was well tolerated. PMID:17891409

  20. Methods to measure peripheral and central sensitization using quantitative sensory testing: A focus on individuals with low back pain.

    Science.gov (United States)

    Starkweather, Angela R; Heineman, Amy; Storey, Shannon; Rubia, Gil; Lyon, Debra E; Greenspan, Joel; Dorsey, Susan G

    2016-02-01

    Quantitative sensory testing can be used to assess peripheral and central sensitization; important factors that contribute to the individual's experience of pain and disability. Many studies use quantitative sensory testing in patients with low back pain to detect alterations in pain sensitivity, however, because investigators employ different protocols, interpretation of findings across studies can become problematic. The purpose of this article is to propose a standardized method of testing peripheral and central pain sensitization in patients with low back pain. Video clips are provided to demonstrate correct procedures for measuring the response to experimental pain using mechanical, thermal and pressure modalities. As nurse researchers and clinicians increase utilization of quantitative sensory testing to examine pain phenotypes, it is anticipated that more personalized methods for monitoring the trajectory of low back pain and response to treatment will improve outcomes for this patient population.

  1. The Impact of Pain Management with Opioids among Older Adults Post Orthopedic Trauma.

    Science.gov (United States)

    Resnick, Barbara; Galik, Elizabeth; Wells, Chris L; Boltz, Marie; Renn, Cynthia L; Dorsey, Susan G

    2016-10-01

    Pain has a significant effect on physical and psychological outcomes for older adults post orthopedic trauma. The purpose of this study was to describe the management of pain among older trauma patients and consider differences between those who received 3 or more dosages daily of opioids versus those who did not. This was a secondary data analysis using data from an intervention study testing the effect of Function Focused Care among older orthopedic trauma patients (FFC-AC). The FFC-AC study was done on trauma units in two acute care settings designated as Level I or II trauma centers from September 2014 to September 2015. All participants from the parent FFC-AC study were included. Data collection for the parent study was done within 24 hours of admission and within 24 hours of discharge and included demographics, medications, assessment of function, physical activity, mood, physical resilience, and whether the patient had pain and their pain intensity. Patient records included all 89 individuals from the parent study, 59 (66%) of whom were female and 82 (92%) were white. Records indicated that those who received more than three dosages per day of opioids had a shorter length of stay, were younger, had more intense pain, and were more resilient compared with those who received less than three dosages per day. This secondary data analysis provides support for the importance of considering pain and pain management among older adults post trauma.

  2. Increased insomnia symptoms predict the onset of back pain among employed adults.

    Directory of Open Access Journals (Sweden)

    Maayan Agmon

    Full Text Available BACKGROUND: Back pain is among the most prevalent pain disorders causing chronic disability among adults, and insomnia is a common co-morbidity. However, whether insomnia precedes back pain or vice versa remains unclear. The current study tested the temporal association between insomnia and back pain. METHODS: A longitudinal design was used to investigate whether changes in insomnia over time predict the onset of back pain and vice versa. The study was conducted on a cohort of active healthy working adults (N = 2,131, 34% women at three time points (T1, T2, and T3 over a period of 3.7 years (range = 2.2-5.12 years. Logistic regression analysis was used to test whether increased insomnia symptoms from T1 to T2 predicted the onset of new back pain. Ordinary least squares regression was used to test whether the existence of back pain at T2 predicted an increase in insomnia from T2 to T3. RESULTS: The results indicated that after controlling for socioeconomic variables, self-reported health, lifestyle behaviors, and anthropometrics, a T1-T2 increase in insomnia symptoms was associated with a 1.40-fold increased risk of back pain at T3 (OR = 1.40; 95% CI = 1.10-1.71. No support was found for reverse causation; i.e., that back pain predicts subsequent increase in insomnia. CONCLUSIONS: Insomnia appears to be a risk factor in the development of back pain in healthy individuals. However, no evidence of reverse causation was found.

  3. The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know

    Energy Technology Data Exchange (ETDEWEB)

    Liong, S.Y.; Awad, D. [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Jones, A.M. [Department of Respiratory Medicine, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom); Sukumar, S.A., E-mail: Sathi.Sukumar@uhsm.nhs.u [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom)

    2011-02-15

    As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

  4. The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know

    International Nuclear Information System (INIS)

    As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

  5. Allergic Sensitization, Rhinitis and Tobacco Smoke Exposure in US Adults.

    Directory of Open Access Journals (Sweden)

    Josef Shargorodsky

    Full Text Available Tobacco exposure has been linked with sinonasal pathology and may be associated with allergic sensitization. This study evaluates the association between exposure to active smoking or secondhand smoke (SHS and the prevalence of rhinitis and allergic sensitization in the US adult population.Cross-sectional study in 4,339 adults aged 20-85 in the National Health and Nutrition Examination Survey, 2005-2006. Never smoking was defined as reported lifetime smoking less than 100 cigarettes and serum cotinine levels 10 ng/mL. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific IgE antigens tested.Almost half of the population (43% had detectable levels of IgE specific to at least one inhaled allergen and 32% reported a history of rhinitis. After multivariate adjustment, there was a statistically significant association between the highest serum cotinine tertile and rhinitis in active smokers (OR 1.42; 95%CI 1.00-2.00. The association between active smoking and rhinitis was stronger in individuals without allergic sensitization (OR 2.47; 95%CI 1.44-4.23. There was a statistically significant association between increasing cotinine tertiles and decreased odds of inhaled allergen sensitization (p-trend <.01.Tobacco smoke exposure was associated with increased prevalence of rhinitis symptoms, but not with allergic sensitization. The results indicate that the relationship between tobacco smoke exposure and sinonasal pathology in adults may be independent of allergic sensitization.

  6. Chronic pain and marijuana use among a nationally representative sample of adults.

    Science.gov (United States)

    Zvolensky, Michael J; Cougle, Jesse R; Bonn-Miller, Marcel O; Norberg, Melissa M; Johnson, Kirsten; Kosiba, Jesse; Asmundson, Gordon J G

    2011-01-01

    This study sought to examine the relations between chronic pain and marijuana use in a large nationally representative survey of adults (n = 5,672; 53% female; M(age) = 45.05, SD = 17.9) conducted in the United States. After controlling for sociodemographic variables, lifetime history of depression, and alcohol abuse/dependence, there was a significant association between lifetime chronic pain and lifetime and current marijuana use. Moreover, current chronic pain was significantly associated with lifetime marijuana use. There was no significant association between current chronic pain and current marijuana use, possibly owing to limited statistical power. Results suggest that there are generally consistent statistically significant relations between chronic pain and marijuana use. Future work is needed to explicate the developmental patterning between chronic pain and marijuana use. This paper presents the potential linkage between chronic pain and marijuana use. Results from this study suggest that it may be beneficial for clinicians to assess for marijuana use among patients suffering from chronic pain. Such patients may be using marijuana as a maladaptive coping strategy.

  7. The relationship of adult attachment to emotion, catastrophizing, control, threshold and tolerance, in experimentally-induced pain.

    Science.gov (United States)

    Meredith, Pamela J; Strong, Jenny; Feeney, Judith A

    2006-01-01

    Although insecure attachment has been associated with a range of variables linked with problematic adjustment to chronic pain, the causal direction of these relationships remains unclear. Adult attachment style is, theoretically, developmentally antecedent to cognitions, emotions and behaviours (and might therefore be expected to contribute to maladjustment). It can also be argued, however, that the experience of chronic pain increases attachment insecurity. This project examined this issue by determining associations between adult attachment characteristics, collected prior to an acute (coldpressor) pain experience, and a range of emotional, cognitive, pain tolerance, intensity and threshold variables collected during and after the coldpressor task. A convenience sample of 58 participants with no history of chronic pain was recruited. Results demonstrated that attachment anxiety was associated with lower pain thresholds; more stress, depression, and catastrophizing; diminished perceptions of control over pain; and diminished ability to decrease pain. Conversely, secure attachment was linked with lower levels of depression and catastrophizing, and more control over pain. Of particular interest were findings that attachment style moderated the effects of pain intensity on the tendency to catastrophize, such that insecurely attached individuals were more likely to catastrophize when reporting high pain intensity. This is the first study to link attachment with perceptions of pain in a pain-free sample. These findings cast anxious attachment as a vulnerability factor for chronic pain following acute episodes of pain, while secure attachment may provide more resilience. PMID:16359795

  8. A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients.

    Science.gov (United States)

    White, Hillary D; Robinson, Thomas D

    2015-08-01

    Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, "Gulf War Syndrome", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypothesis that 1) low or deficient testosterone serum levels are linked to a high risk for an inflamed nociceptive nervous system and resultant chronic pain states, and 2) a testosterone transdermal gel applied once a day by fibromyalgia patients can be an effective therapeutic against chronic pain. Here, a short profile of fibromyalgia is provided along with a brief summary of best practices currently recommended by clinical specialists. The link between testosterone and pain is then discussed, with an overview of scientific studies that lay the foundation for testosterone as a possible important additional therapeutic that has the potential to be safely administered and effective but also avoid the adverse effects of other therapeutics. Finally, novel mechanisms by which testosterone therapy is likely to down-modulate pain signaling are proposed.

  9. Descending pain modulation and its interaction with peripheral sensitization following sustained isometric muscle contraction in fibromyalgia

    DEFF Research Database (Denmark)

    Ge, Hong-You; Nie, HongLing; Graven-Nielsen, Thomas;

    2012-01-01

    OBJECTIVE: Sustained isometric muscle contraction (fatiguing contraction) recruits segmental and/or extrasegmental descending inhibition in healthy subjects but not in fibromyalgia (FM). We hypothesized that fatiguing contraction may shift descending pain modulation from inhibition towards......) than healthy control groups (286.2±24.1s) (P0.05). Following the contraction, PPTs were increased significantly and heterogeneously in the upper trapezius over time, but not, in the tibialis anterior muscle in healthy controls. However, PPT were significantly decreased over time in the tibialis...... facilitation and that the effect of descending pain modulation be dependent on peripheral muscle pain sensitivity. METHODS: Pressure pain thresholds (PPT) were measured from 13 points bilaterally in the upper trapezius muscle and from the mid-point bilaterally in the tibialis anterior before-, immediately...

  10. Pressure pain sensitivity maps, self-reported musculoskeletal disorders and sickness absence among cleaners

    DEFF Research Database (Denmark)

    Binderup, Asbjørn Thalund; Holtermann, Andreas; Søgaard, Karen;

    2011-01-01

    BACKGROUND: Pressure pain threshold mapping is a valuable method for the identification of distinct zones of mechanical pain sensitivity. Such approach was applied for the first time in relation to self-reported musculoskeletal disorders and long-term sickness absence (LTSA) within the last 12 mo...... negatively with most PPT measurements. The group of cleaners with LTSA had significantly lower levels of PPT (large effects) in the neck-shoulder region than the cleaners with no LTSA (P ......BACKGROUND: Pressure pain threshold mapping is a valuable method for the identification of distinct zones of mechanical pain sensitivity. Such approach was applied for the first time in relation to self-reported musculoskeletal disorders and long-term sickness absence (LTSA) within the last 12...... back regions (27 points). LTSA was defined as ten or more consecutive workdays with sick leave. RESULTS: The PPT maps revealed the spatial heterogeneity in mechanical sensitivity among cleaners. The level of pain in the neck and dominant shoulder and upper back within the last 7 days correlated...

  11. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    Science.gov (United States)

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

  12. Entropy as a new measure of mechanical pain sensitivity in the masseter muscle

    DEFF Research Database (Denmark)

    Castrillon, Eduardo; Sato, Hitoshi; Tanosoto, Tomohiro;

    ENTROPY AS A NEW MEASURE OF MECHANICAL PAIN SENSITIVITY IN THE MASSETER MUSCLE Author Block: E. E. Castrillon1, H. Sato2,3, T. Tanosoto4, T. Arima4, L. Baad-Hansen1, P. Svensson1, 1Clinical Oral Physiology, Århus Univ., Aarhus, Denmark, 2Dept. of Dentistry & Oral Physiology, Sch. of Med., Keio Univ.......e., entropy). Methods: Twenty healthy and pain-free subjects (10 women 25.2±4.0 and 10 men 26.5±3.2 years old) volunteered for this study. Pain levels were assessed on a 0-10 electronic visual analog scale (VAS) and the sensitivity to mechanical palpation was assessed at 15 sites (3 x 5) marked and equally....... In the glutamate session, there were significant effects of sex, time, force and site on raw NRS scores (P

  13. Obese older adults suffer foot pain and foot-related functional limitation.

    Science.gov (United States)

    Mickle, Karen J; Steele, Julie R

    2015-10-01

    There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI <25). Obese participants were found to have a significantly higher prevalence of foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals. PMID:26260010

  14. Severely disabling chronic pain in young adults: prevalence from a population-based postal survey in North Staffordshire

    Directory of Open Access Journals (Sweden)

    Thomas Elaine

    2005-07-01

    Full Text Available Abstract Background Severely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs, yet its prevalence in young adults is less clear. Methods All adults aged 18–25 years old registered with three general practices in North Staffordshire were invited to complete a postal questionnaire containing questions on pain within the last 6 months, pain location and duration. Severity of chronic pain was assessed by the Chronic Pain Grade. Severely disabling chronic pain was defined as pain within the last six months that had lasted for three months or more and was highly disabling-severely limiting (Grade IV. Results 858 responses from 2,389 were received (adjusted response = 37.0%. The prevalence of any pain within the previous six months was 66.9% (95%CI: 63.7%, 70.1%. Chronic pain was reported by 14.3% (95%CI: 12.0%, 16.8% of respondents with severely disabling chronic pain affecting 3.0% (95%CI: 2.0%, 4.4% of this population. Late responders were very similar to early responders in their prevalence of pain. Cross-checking the practice register against the electoral roll suggested register inaccuracies contributed to non-response. Conclusion Pain is a common phenomenon encountered by young adults, affecting 66.9% of this study population. Previously observed age-related trends in severely disabling chronic pain in older adults extend to younger adults. Although a small minority of younger adults are affected, they are likely to represent a group with particularly high health care needs. High levels of non-response in the present study means that these estimates should be interpreted cautiously although there was no evidence of non-response bias.

  15. Pain and anxiety experiences of South African adult burn injury patients during physiotherapy management

    Directory of Open Access Journals (Sweden)

    L.D. Morris

    2010-02-01

    Full Text Available A dequate management of procedural pain during physiotherapy management plays an important role in building a trusting relationship betweenthe burn victim and the physiotherapist, and in ensuring desirable functional outcomes. However, the burn pain management regimens currently utilized inburn units, primarily consist of traditional pharmacologic analgesics which areassociated with numerous side-effects and alone are often reported as inadequateto alleviate procedural pain, warranting safer and effective adjunct therapies.Prior to the introduction and implementation of adjunct therapies into a developing world, it is imperative that the current situation in a burn unit, in terms of whether or not the pain management regimens in place are adequate, is first assessed, due to cost concerns. The following short report exemplifies the pain and anxiety experiences of a small number of burn injury patients during physiotherapy at the Tygerberg Hospital adult burn unit, South A frica.  It was hypothesized that the results of this study would underpin whether adult burn injury patients in a developing countryrequire adjunct therapies during physiotherapy management to supplement traditional pharmacologic analgesics inmanaging their procedural pain and subsequent anxiety.

  16. Symptoms Specificity of Anxiety Sensitivity Dimensions in Korean Adults

    OpenAIRE

    Young-Jin Lim

    2014-01-01

    Context: Relation of three dimensions of anxiety sensitivity (AS) (physical concerns [PC], cognitive concerns [CC] and social concerns [SC]) with anxiety or depression has been inconsistently reported. One possible explanation on the mixed findings is the lack of reliable measurement that assesses AS dimensions. Aims: This study was aimed to examine the specificity of dimensions of AS to anxiety and depression in a sample of Korean adults. Settings and Design: Participants included 426 Korean...

  17. Evidence of Nervous System Sensitization in Commonly Presenting and Persistent Painful Tendinopathies : A Systematic Review

    NARCIS (Netherlands)

    Plinsinga, Melanie L.; Brink, Michel S.; Vicenzino, Bill; Van Wilgen, C. Paul

    2015-01-01

    STUDY DESIGN: Systematic review. OBJECTIVES: To elucidate if there is sensitization of the nervous system in those with persistent rotator cuff (shoulder), lateral elbow, patellar, and Achilles tendinopathies. BACKGROUND: Tendinopathy can be difficult to treat, and persistent intractable pain and dy

  18. Muscle trigger points and pressure pain sensitivity maps of the feet in women with fibromyalgia syndrome

    DEFF Research Database (Denmark)

    Tornero-Caballero, Maria C.; Salom-Moreno, Jaime; Cigarán-Méndez, Margarita;

    2016-01-01

    OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24...

  19. Anxiety sensitivity as a predictor of anxiety and pain related to third molar removal

    NARCIS (Netherlands)

    A.J. van Wijk; A. de Jongh; J.A. Lindeboom

    2010-01-01

    PURPOSE: Anxiety sensitivity (AS) refers to the fear of anxiety-related symptoms resulting from beliefs that such sensations have negative somatic, social, or psychological consequences. The aim of the present study was to investigate whether AS can predict both anticipated and experienced pain and

  20. Abnormal Pressure Pain, Touch Sensitivity, Proprioception, and Manual Dexterity in Children with Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Inmaculada Riquelme

    2016-01-01

    Full Text Available Children with autism spectrum disorders (ASD often display an abnormal reactivity to tactile stimuli, altered pain perception, and lower motor skills than healthy children. Nevertheless, these motor and sensory deficits have been mostly assessed by using clinical observation and self-report questionnaires. The present study aims to explore somatosensory and motor function in children with ASD by using standardized and objective testing procedures. Methods. Tactile and pressure pain thresholds in hands and lips, stereognosis, proprioception, and fine motor performance of the upper limbs were assessed in high-functioning children with ASD (n=27 and compared with typically developing peers (n=30.  Results. Children with ASD showed increased pain sensitivity, increased touch sensitivity in C-tactile afferents innervated areas, and diminished fine motor performance and proprioception compared to healthy children. No group differences were observed for stereognosis. Conclusion. Increased pain sensitivity and increased touch sensitivity in areas classically related to affective touch (C-tactile afferents innervated areas may explain typical avoiding behaviors associated with hypersensitivity. Both sensory and motor impairments should be assessed and treated in children with ASD.

  1. The evolution of the painful sensitivity in acute and chronic stress.

    Science.gov (United States)

    Cristea, A; Ciobanu, A; Stoenescu, M; Rusei, I

    1994-01-01

    The clinical research was made on two groups of young volunteer students. We considered stress consisting in chronic informational overexposure during the examination session and the acute stress from their emotions before a hard examination. The painful sensitivity was analysed by measuring the retraction time of the finger from water at 55 degrees C. The experimental research was made on a group of 100 male mice. The acute stress was performed by subjecting each mouse to swim (behavioral despair test). Painful sensitivity was determined by the test of the hot plate heated at 50 degrees C. Individuals with hyper (H) and hypo (h) painful sensitivity were selected for the tests. In chronic stress, the results proved increased painful sensitivity (hyperalgia) more important at "h" compared to "H" (p behaviors with opposite mechanisms involved in stress analgesia. This hypothesis is related with studies which demonstrate the involvement in stress analgesia of non-opioid monoaminergic mechanisms together with the opioid mechanisms (Lewis, 1980). PMID:8640371

  2. A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators.

    Science.gov (United States)

    Grant, Joshua A; Courtemanche, Jérôme; Rainville, Pierre

    2011-01-01

    Concepts originating from ancient Eastern texts are now being explored scientifically, leading to new insights into mind/brain function. Meditative practice, often viewed as an emotion regulation strategy, has been associated with pain reduction, low pain sensitivity, chronic pain improvement, and thickness of pain-related cortices. Zen meditation is unlike previously studied emotion regulation techniques; more akin to 'no appraisal' than 'reappraisal'. This implies the cognitive evaluation of pain may be involved in the pain-related effects observed in meditators. Using functional magnetic resonance imaging and a thermal pain paradigm we show that practitioners of Zen, compared to controls, reduce activity in executive, evaluative and emotion areas during pain (prefrontal cortex, amygdala, hippocampus). Meditators with the most experience showed the largest activation reductions. Simultaneously, meditators more robustly activated primary pain processing regions (anterior cingulate cortex, thalamus, insula). Importantly, the lower pain sensitivity in meditators was strongly predicted by reductions in functional connectivity between executive and pain-related cortices. Results suggest a functional decoupling of the cognitive-evaluative and sensory-discriminative dimensions of pain, possibly allowing practitioners to view painful stimuli more neutrally. The activation pattern is remarkably consistent with the mindset described in Zen and the notion of mindfulness. Our findings contrast and challenge current concepts of pain and emotion regulation and cognitive control; commonly thought to manifest through increased activation of frontal executive areas. We suggest it is possible to self-regulate in a more 'passive' manner, by reducing higher-order evaluative processes, as demonstrated here by the disengagement of anterior brain systems in meditators.

  3. Graded exposure for chronic low back pain in older adults : a pilot study

    NARCIS (Netherlands)

    Leonhardt, Corinna; Kuss, Katrin; Becker, Annette; Basler, Heinz-Dieter; de jong, Jeroen; Flatau, Brigitta; Laekeman, Marjan; Mattenklodt, Peter; Schuler, Matthias; Vlaeyen, Johan; Quint, Sabine

    2016-01-01

    BACKGROUND AND PURPOSE: Fear-avoidance beliefs in older adults with chronic low back pain (CLBP) can lead to disability. Graded exposure-based active physical therapy could be an option to enhance physical ability in older patients with CLBP. The purpose of this study was to develop a standardized g

  4. Adult Perceptions of Pain and Hunger Cries: A Synchrony of Arousal.

    Science.gov (United States)

    Zeskind, Philip Sanford; And Others

    1985-01-01

    Male and female nonparent adults rated tape-recordings of initial, middle, and final 10-second segments of pain and hunger cries on four 7-point Likert-type scale items describing how urgent, arousing, aversive, and sick cry segments sounded. Results suggest that different segments of cries resulting from the same stimulus provide different…

  5. Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

    Science.gov (United States)

    Temkit, M’hamed; Ewais, MennatAllah M.; Luckritz, Todd C.; Stearns, Joshua D.; Craner, Ryan C.; Gaitan, Brantley D.; Ramakrishna, Harish; Thunberg, Christopher A.; Weis, Ricardo A.; Myers, Kelly M.; Merritt, Marianne V.; Rosenfeld, David M.

    2016-01-01

    Background Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients’ pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q). Methods Patients undergoing MIRPE (modified Nuss) underwent random assignment to TEA or On-Q group. Both groups received intravenous, patient-controlled opioid analgesia, with concomitant delivery of local anesthetic. Primary outcomes were length of stay (LOS), opioid use, and pain scores. Results Of 85 randomly assigned patients, 68 completed the study [52 men, 76.5%; mean (range) age, 32.2 (20.0–58.0) years; Haller index, 5.9 (range, 3.0-26.7)]. The groups were equally matched for preoperative variables; however, the On-Q arm had more patients (60.3%). No significant differences were found between groups in mean daily pain scores (P=0.52), morphine-equivalent opioid usage (P=0.28), or hospital stay 3.5 vs. 3.3 days (TEA vs. On-Q; P=0.55). Thirteen patients randomized to TEA refused the epidural and withdrew from the study because they perceived greater benefit of the On-Q system. Conclusions Postoperative pain management in adults after MIRPE can be difficult. Both continuous local anesthetic delivery by TEA and On-Q catheters with concomitant, intravenous, patient-controlled anesthesia maintained acceptable analgesia with a reasonable LOS. In our cohort, there was preference for the On-Q system for pain management.

  6. Equivalent pain relief with and without resection of the posterior tibial tendon in adult flatfoot reconstruction.

    Science.gov (United States)

    Demetracopoulos, Constantine A; DeOrio, James K; Easley, Mark E; Nunley, James A

    2014-01-01

    Transfer of the flexor digitorum longus (FDL) is indicated to compensate for the loss of posterior tibial tendon (PTT) function in the treatment of adult acquired flatfoot deformity (AAFD). The aim of this study was to determine the effect of PTT resection on pain relief following surgical treatment of stage II AAFD. A retrospective review of patients who underwent surgical treatment for stage II AAFD was performed. Patients were divided into two groups based on whether the degenerated PTT was resected or left in situ. A visual analog scale (VAS) score for pain was recorded for each patient preoperatively. Concomitant surgical procedures and the incidence of postoperative pain were also reported for each group. Deformity correction was assessed with standard weight-bearing radiographs. Thirty-four patients with a mean follow-up of 14 months were included in the study. There was no difference in preoperative VAS pain scores, and patients in both groups demonstrated excellent pain relief postoperatively. Five patients in the PTT resection group and one patient in the PTT in situ group reported lateral-sided foot pain postoperatively. Resection of the PTT did not significantly affect postoperative pain relief. Future prospective studies are needed to determine whether resection of the degenerated PTT is necessary at the time of surgery for stage II AAFD.

  7. [Etiology and prevalence of chronic pain in adults: a narrative review].

    Science.gov (United States)

    Latina, Roberto; Sansoni, Julita; D'Angelo, Daniela; Di Biagio, Ettore; De Marinis, Maria Grazia; Tarsitani, Gianfranco

    2013-01-01

    The chronic nonmalignant pain is an underestimated epidemiologic health problem. It is a disease in its own right. It is one of the major reasons because patients use health service. The magnitude of chronic pain is in terms of human suffering and costs to society. The aim of this review is to identify the diagnosis and the prevalence of nonmalignant chronic pain in the adults. We have done a review of the literature from 1998 to 2012 using the virtual newspaper libraries starting from data bases (Pub-Med, CINAHL, Cochrane). We have made a narrative review of the articles obtained. Excluding topics of headache, pain for pediatric and geriatric groups, cancer pain and disease-specific items. Studies were classified for year, author sample, methods, age groups and definition of pain. We have obtained 7 articles. These epidemiological studies conducted in different part of the world, reported prevalence rates of chronic pain ranging from 16-53%. They shows a high heterogeneity of results concerning diagnosis and methods. Although limited the number of articles, show the high complexity of the phenomenon. PMID:24083495

  8. Equivalent pain relief with and without resection of the posterior tibial tendon in adult flatfoot reconstruction.

    Science.gov (United States)

    Demetracopoulos, Constantine A; DeOrio, James K; Easley, Mark E; Nunley, James A

    2014-01-01

    Transfer of the flexor digitorum longus (FDL) is indicated to compensate for the loss of posterior tibial tendon (PTT) function in the treatment of adult acquired flatfoot deformity (AAFD). The aim of this study was to determine the effect of PTT resection on pain relief following surgical treatment of stage II AAFD. A retrospective review of patients who underwent surgical treatment for stage II AAFD was performed. Patients were divided into two groups based on whether the degenerated PTT was resected or left in situ. A visual analog scale (VAS) score for pain was recorded for each patient preoperatively. Concomitant surgical procedures and the incidence of postoperative pain were also reported for each group. Deformity correction was assessed with standard weight-bearing radiographs. Thirty-four patients with a mean follow-up of 14 months were included in the study. There was no difference in preoperative VAS pain scores, and patients in both groups demonstrated excellent pain relief postoperatively. Five patients in the PTT resection group and one patient in the PTT in situ group reported lateral-sided foot pain postoperatively. Resection of the PTT did not significantly affect postoperative pain relief. Future prospective studies are needed to determine whether resection of the degenerated PTT is necessary at the time of surgery for stage II AAFD. PMID:25785467

  9. Translation, cross-cultural adaptation, and validity of the Korean version of the pain sensitivity questionnaire in chronic pain patients.

    Science.gov (United States)

    Kim, Ho-Joong; Ruscheweyh, Ruth; Yeo, Ji-Hyun; Cho, Hyeon-Guk; Yi, Je-Min; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

    2014-11-01

    The purpose of this study was to translate pain sensitivity questionnaires (PSQ) into the Korean language, perform a cross-cultural adaption of the PSQ, and validate the Korean version of PSQ in patients with degenerative spinal disease. The PSQ was translated forward and backward, cross-culturally adapted by 2 independent translators, and approved by an expert committee. The final Korean version of the PSQ was tested on 72 patients with degenerative spinal disease. Test-retest reliability was evaluated for 60 patients (83%) who completed the second assessment in an interval of 4 weeks. The mean PSQ-minor, PSQ-moderate, and PSQ-total (standard deviation [SD]) were 5.40 (2.02), 6.46 (1.98), and 5.93 (1.93), respectively. The PSQ-total, PSQ-minor, and PSQ-moderate of the Korean version showed very good internal consistencies determined by the Cronbach's α of 0.926, 0.869, and 0.877, respectively. For convergent validity, the PSQ scores of the Korean version showed significant correlations with pain catastrophizing scale (PCS) (r = 0.377, P = 0.002; r = 0.365, P = 0.003; r = 0.362, P = 0.003 for PSQ-total, PSQ-minor, and PSQ-moderate of the Korean version, respectively). For test-retest reliability, the intraclass correlation coefficients were 0.782 for PSQ-total, 0.752 for PSQ-minor, and 0.793 for PSQ-moderate. In conclusion, the validated Korean version of PSQ is a transculturally equivalent, reliable, and valid tool to assess individual pain sensitivity.

  10. Advances in understanding the mechanisms and management of persistent pain in older adults†

    OpenAIRE

    Karp, J. F.; Shega, J. W.; Morone, N. E.; Weiner, D. K.

    2008-01-01

    Older adults with persistent pain are not simply a chronologically older version of younger pain patients. Pain-related disability in older adults may be driven by pain ‘homeostenosis’, that is, diminished ability to effectively respond to the stress of persistent pain. Some of the comorbidities of ageing that can contribute to pain homeostenosis include cognitive and physical impairments, increased sensitivity to suprathreshold pain stimuli, medical and psychological comorbidities, altered p...

  11. The association between pressure pain sensitivity, and answers to questionnaires estimating psychological stress level in the workplace. A feasibility study

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Petersen, Pernille; Gyntelberg, Finn;

    2012-01-01

    To examine the association between pressure pain sensitivity (PPS) at the sternum as a measure of persistent stress assessed by questionnaires in a working population.......To examine the association between pressure pain sensitivity (PPS) at the sternum as a measure of persistent stress assessed by questionnaires in a working population....

  12. Pressure pain sensitivity as a marker for stress and pressure pain sensitivity-guided stress management in women with primary breast cancer

    DEFF Research Database (Denmark)

    Axelsson, Christen K; Ballegaard, Søren; Karpatschof, Benny;

    2014-01-01

    employees was divided in a High Stress Group (HSG, n = 37) and a Low Stress Group (LSG, n = 128) to evaluate the association between PPS, questionnaire-related Quality of Life (QOL) and self-evaluated stress. (2) A PPS-guided stress management program (n = 40) was compared to a Psychosocial Group......OBJECTIVES: To validate (1) Pressure Pain Sensitivity (PPS) as a marker for stress and (2) a PPS-guided intervention in women with primary Breast Cancer (BC). METHODS: (1) A total of 58 women with BC were examined before and after 6 months of intervention. A control group of 165 women office...... scores: (all p stress scores (all p

  13. Functional outcome in older adults with joint pain and comorbidity: design of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Dekker Joost

    2011-10-01

    Full Text Available Abstract Background Joint pain is a highly prevalent condition in the older population. Only a minority of the older adults consult the general practitioner for joint pain, and during consultation joint pain is often poorly recognized and treated, especially when other co-existing chronic conditions are involved. Therefore, older adults with joint pain and comorbidity may have a higher risk of poor functional outcome and decreased quality of life (QoL, and possibly need more attention in primary care. The main purpose of the study is to explore functioning in older adults with joint pain and comorbidity, in terms of mobility, functional independence and participation and to identify possible predictors of poor functional outcome. The study will also identify predictors of decreased QoL. The results will be used to develop prediction models for the early identification of subgroups at high risk of poor functional outcome and decreased QoL. This may contribute to better targeting of treatment and to more effective health care in this population. Methods/Design The study has been designed as a prospective cohort study, with measurements at baseline and after 6, 12 and 18 months. For the recruitment of 450 patients, 25 general practices will be approached. Patients are eligible for participation if they are 65 years or older, have at least two chronic conditions and report joint pain on most days. Data will be collected using various methods (i.e. questionnaires, physical tests, patient interviews and focus groups. We will measure different aspects of functioning (e.g. mobility, functional independence and participation and QoL. Other measurements concern possible predictors of functioning and QoL (e.g. pain, co-existing chronic conditions, markers for frailty, physical performance, psychological factors, environmental factors and individual factors. Furthermore, health care utilization, health care needs and the meaning and impact of joint pain

  14. Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Klokker, Louise; Bartholdy, Cecilie;

    2016-01-01

    OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100 particip......OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100...... the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a...... analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS. CONCLUSIONS: These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program...

  15. Effects of naltrexone on pain sensitivity and mood in fibromyalgia: no evidence for endogenous opioid pathophysiology.

    Directory of Open Access Journals (Sweden)

    Jarred W Younger

    Full Text Available The pathophysiological mechanisms underlying fibromyalgia are still unknown, although some evidence points to endogenous opioid dysfunction. We examined how endogenous opioid antagonism affects pain and mood for women with and without fibromyalgia. Ten women with fibromyalgia and ten age- and gender-matched, healthy controls each attended two laboratory sessions. Each participant received naltrexone (50mg at one session, and placebo at the other session, in a randomized and double-blind fashion. Participants were tested for changes in sensitivity to heat, cold, and mechanical pain. Additionally, we collected measures of mood and opioid withdrawal symptoms during the laboratory sessions and at home the night following each session. At baseline, the fibromyalgia group exhibited more somatic complaints, greater sensory sensitivity, more opioid withdrawal somatic symptoms, and lower mechanical and cold pain-tolerance than did the healthy control group. Neither group experienced changes in pain sensitivity due to naltrexone administration. Naltrexone did not differentially affect self-reported withdrawal symptoms, or mood, in the fibromyalgia and control groups. Consistent with prior research, there was no evidence found for abnormal endogenous opioid activity in women with fibromyalgia.

  16. Anxiety sensitivity and its impact on pain experiences and conditions: a state of the art.

    Science.gov (United States)

    Stewart, Sherry H; Asmundson, Gordon J G

    2006-01-01

    This paper serves as an introduction to the special issue of Cognitive Behaviour Therapy devoted to the topic of anxiety sensitivity (AS) and its impact on pain experiences and conditions. We provide a historical overview of relevant cognitive behavioural models of chronic pain, summarize recent models incorporating the AS construct, and introduce the papers in the special issue. These papers are organized into two sets--basic laboratory-based investigations and relatively more applied studies. We attempt to highlight some of the most important findings from each of these investigations and studies, in turn. Then, we consider several important conclusions derived from the set of special issue papers and the implications of these for the practice of cognitive-behavioural interventions with pain populations. Finally, we make several suggestions for directions for future investigations in this burgeoning area of cognitive behavioural research and practice.

  17. Pain sensitivity and pericranial tenderness in children with tension-type headache: a controlled study

    Directory of Open Access Journals (Sweden)

    Soee ABL

    2013-06-01

    Full Text Available Ann-Britt L Soee,1 Liselotte Skov,1 Svend Kreiner,4 Birte Tornoe,1,2 Lise L Thomsen3 1Department of Paediatrics, Children's Headache Clinic, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 2Department of Physiotherapy, Medical Department O, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 3Department of Neuropediatrics, Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen Denmark; 4Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark Purpose: To compare tenderness and pain sensitivity in children (aged 7–17 years with tension-type headache (TTH and healthy controls using total tenderness score (TTS, pressure pain threshold (PPT, and pain perceived at suprapressure pain threshold (supraPPT. Patients and methods: Twenty-three children with frequent episodic TTH, 36 with chronic TTH, and 57 healthy controls were included. TTS was measured bilaterally at seven pericranial myofascial structures. PPT and supraPPT were assessed in the finger, m. temporalis, and m. trapezius by a Somedic® algometer. SupraPPT was defined as the pain perceived at a stimulus calculated as the individual site-specific PPT + 50%. Statistics: The effect of group, sex, age, headache frequency, intensity, and years on TTS, PPT, and supraPPT was analyzed by general linear models. Confirmatory factor analysis was analyzed for mutual relations between measurements. Results and conclusion: Tenderness increased uniformly in both frequent episodic TTH (median 14; interquartile range [IQR] 10–18; P < 0.001 and chronic TTH (median 13; IQR 9–20; P < 0.001 compared to controls (median 5, IQR 3–11. However, the children with frequent episodic TTH and chronic TTH did not show significantly increased sensitivity when measured by PPT or supraPPT. Factor analysis confirmed that the site-specific measurements depended on general latent variables. Consequently, the PPT and supraPPT tests can be assumed to measure

  18. Outcome Measure of Pain in Patients with Lumbar Disc Herniation: Validation Study of the Iranian version of Pain Sensitivity Questionnaire

    Science.gov (United States)

    Azhari, Shirzad; Shahzadi, Sohrab; Nayeb Aghaei, Hossain; Mohammadi, Hassan Reza; Montazeri, Ali

    2016-01-01

    Study Design Cross-sectional. Purpose To translate and culturally adapt an Iranian version of the Pain Sensitivity Questionnaire (PSQ) in Iran. Overview of Literature Instruments measuring patient reported outcomes should satisfy certain psychometric properties. Methods The PSQ was translated following cross-cultural adaptation guidelines. A total of 101 patients with lumbar disc herniation (LDH), and 39 healthy cases were included in the study. All participants completed the PSQ and the Pain Catastrophizing Scale (PCS). The internal consistency, test-retest reliability, known group comparison, criterion validity and item-scale correlations were assessed. Results The mean age of participants was 51.7 years. Reliability, validity and correlation of PSQ and PCS showed satisfactory results. Cronbach's alpha coefficients were 0.81 for PSQ-total, 0.82 for PSQ-minor, and 0.82 for PSQ-moderate. The intraclass correlation coefficients value was 0.84 (0.616–0.932) indicating an excellent test-retest reliability. The instrument discriminated well between sub-groups of patients who differed in a standard predictive measure of LDH surgery (the Finneson–Cooper score). Total PSQ were also significantly correlated with the total scores of the PCS, lending support to its good convergent validity. Additionally, the correlation of each item with its hypothesized domain on the PSQ indicated acceptable results, suggesting that the items had a substantial relationship with their own domains. Conclusions The adapted Iranian PSQ is a valid and reliable questionnaire for the assessment of pain in patients with LDH. PMID:27340527

  19. The alteration of pain sensitivity at disease-specific acupuncture points in premenstrual syndrome.

    Science.gov (United States)

    Chae, Younbyoung; Kim, Hee-Young; Lee, Hwa-Jin; Park, Hi-Joon; Hahm, Dae-Hyun; An, Kyungeh; Lee, Hyejung

    2007-04-01

    Acupuncture points (APs) are well known to be small regions of local or referred pain that are more sensitive than surrounding tissue. Based on bibliographical and clinical data, specific conditions are commonly believed to change the pain sensitivity at corresponding APs. The aim of the present study was to investigate whether the pressure pain threshold (PPT) of specific APs is associated with the severity of premenstrual syndrome. The 46 participants were female students attending a middle school. Premenstrual syndrome (PMS) was measured using a structured questionnaire, the menstruation distress questionnaire (MDQ). High PMS (HP) and low PMS (LP) groups were divided based on their MDQ scores. The PPTs at sites in the leg (the APs SP6, GB39, and LR3 and a non-AP 2-cm anterior to SP6) and in the arm (the APs PC6, TE5, and LI4 and a non-AP 2-cm proximal to PC6) were measured using an algometer. The PPT of the HP group at SP6 was significantly lower than that of the LP group (13.50 +/- 0.73 vs. 16.30 +/- 0.66 kilopascals, P < 0.05), but not at other APs or at non-APs. The findings of our study support the hypothesis that the alteration of pain threshold at specific APs is associated with the severity of corresponding diseases. Further studies are needed to determine whether an observation of pain sensitivity at the APs could be used as an adjunctive tool for the diagnosis of a clinical problem. PMID:17378970

  20. Capsaicin-sensitive C- and A-fibre nociceptors control long-term potentiation-like pain amplification in humans.

    Science.gov (United States)

    Henrich, Florian; Magerl, Walter; Klein, Thomas; Greffrath, Wolfgang; Treede, Rolf-Detlef

    2015-09-01

    Long-term potentiation in the spinal dorsal horn requires peptidergic C-fibre activation in animals. Perceptual correlates of long-term potentiation following high-frequency electrical stimulation in humans include increased sensitivity to electrical stimuli at the high frequency stimulation site (homotopic pain-long-term potentiation) and increased sensitivity to pinprick surrounding the high frequency stimulation site (heterotopic pain-long-term potentiation, equivalent to secondary hyperalgaesia). To characterize the peripheral fibre populations involved in induction of pain-long-term potentiation, we performed two selective nerve block experiments in 30 healthy male volunteers. Functional blockade of TRPV1-positive nociceptors by high-concentration capsaicin (verified by loss of heat pain) significantly reduced pain ratings to high frequency stimulation by 47% (P pain-long-term potentiation by 71% (P pain-long-term potentiation by 92% (P pain to pinprick) significantly reduced pain ratings to high frequency stimulation by 37% (P pain-long-term potentiation (-5%). It had a marginal effect on heterotopic pain-long-term potentiation (-35%, P = 0.059), while the area of secondary hyperalgesia remained unchanged (-2%, P = 0.88). In conclusion, all nociceptor subclasses contribute to high frequency stimulation-induced pain (with a relative contribution of C > Aδ fibres, and an equal contribution of TRPV1-positive and TRPV1-negative fibres). TRPV1-positive C-fibres are the main inducers of both homotopic and heterotopic pain-long-term potentiation. TRPV1-positive A-fibres contribute substantially to the induction of heterotopic pain-long-term potentiation. TRPV1-negative C-fibres induce a component of homotopic self-facilitation but not heterotopic pain-long-term potentiation. TRPV1-negative A-fibres are the main afferents mediating pinprick pain and hyperalgesia, however, they do not appear to contribute to the induction of pain-long-term potentiation. These

  1. The effect of virtual reality on pain and range of motion in adults with burn injuries.

    Science.gov (United States)

    Carrougher, Gretchen J; Hoffman, Hunter G; Nakamura, Dana; Lezotte, Dennis; Soltani, Maryam; Leahy, Laura; Engrav, Loren H; Patterson, David R

    2009-01-01

    Few studies have empirically investigated the effects of immersive virtual reality (VR) on postburn physical therapy pain control and range of motion (ROM). We performed a prospective, randomized controlled study of the effects of adding VR to standard therapy in adults receiving active-assisted ROM physical therapy, by assessing pain scores and maximal joint ROM immediately before and after therapy on two consecutive days. Thirty-nine inpatients, aged 21 to 57 years (mean 35 years), with a mean TBSA burn of 18% (range, 3-60%) were studied using a within-subject, crossover design. All patients received their regular pretherapy pharmacologic analgesia regimen. During physical therapy sessions on two consecutive days (VR one day and no VR the other day; order randomized), each patient participated in active-assisted ROM exercises with an occupational or physical therapist. At the conclusion of each session, patients provided 0 to 100 Graphic Rating Scale measurements of pain after each 10-minute treatment condition. On the day with VR, patients wore a head-position-tracked, medical care environment-excluding VR helmet with stereophonic sound and interacted in a virtual environment conducive to burn care. ROM measurements for each joint exercised were recorded before and after each therapy session. Because of nonsignificant carryover and order effects, the data were analyzed using simple paired t-tests. VR reduced all Graphic Rating Scale pain scores (worst pain, time spent thinking about the pain, and pain unpleasantness by 27, 37, and 31% respectively), relative to the no VR condition. Average ROM improvement was slightly greater with the VR condition; however, this difference failed to reach clinical or statistical significance (P = .243). Ninety-seven percent of patients reported zero to mild nausea after the VR session. Immersive VR effectively reduced pain and did not impair ROM during postburn physical therapy. VR is easily used in the hospital setting and

  2. Female Adults with Patellofemoral Pain Are Characterized by Widespread Hyperalgesia, Which Is Not Affected Immediately by Patellofemoral Joint Loading

    DEFF Research Database (Denmark)

    Pazzinatto, Marcella Ferraz; de Oliveira Silva, Danilo; Barton, Christian;

    2016-01-01

    OBJECTIVE: Compare pressure pain thresholds (PPTs) at the knee and a site remote to the knee in female adults with patellofemoral pain (PFP) to pain-free controls before and after a patellofemoral joint (PFJ) loading protocol designed to aggravate symptoms. DESIGN: Cross-sectional study SETTING......: Participants were recruited via advertisements in fitness centers, public places for physical activity and universities. SUBJECTS: Thirty-eight females with patellofemoral pain, and 33 female pain-free controls. METHODS: All participant performed a novel PFJ loading protocol involving stair negotiation with an...

  3. Clinical pharmacy in a multidisciplinar team for chronic pain in adults.

    Science.gov (United States)

    Bauters, T G M; Devulder, J; Robays, H

    2008-01-01

    The aim of this study was to evaluate the role and the impact of a clinical pharmacist as a member of a multidisciplinary pain team. Although physicians have a good knowledge of pharmacotherapy in the field of pain medication, pharmacy interventions were necessary to enhance the quality of prescribing. On a population of 93 patients, a total of 120 interventions were recorded. The different types of interventions included: provision of information (10.0%), clinical intervention (89.2%) and the provision of a specific product (0.8%). Out of the 107 clinical interventions, a total of 95.3 % interventions were accepted by the physicians. The results highlight the clinical importance of the pharmacy in optimizing drug therapy for adult patients with chronic pain. PMID:19048702

  4. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians

    Directory of Open Access Journals (Sweden)

    Kahabuka Febronia

    2008-09-01

    Full Text Available Abstract Background Oral pain has been the major cause of the attendances in the dental clinics in Tanzania. Some patients postpone seeing the dentist for as long as two to five days. This study determines the prevalence of oral pain and barriers to use of emergency oral care in Tanzania. Methods Questionnaire data were collected from 1,759 adult respondents aged 18 years and above. The study area covered six urban and eight rural study clusters, which had been selected using the WHO Pathfinder methodology. Chi-square tests and logistic regression analyses were performed to identify associations. Results Forty two percent of the respondents had utilized the oral health care facilities sometimes in their lifetime. About 59% of the respondents revealed that they had suffered from oral pain and/or discomfort within the twelve months that preceded the study, but only 26.5% of these had sought treatment from oral health care facilities. The reasons for not seeking emergency care were: lack of money to pay for treatment (27.9%; self medication (17.6%; respondents thinking that pain would disappear with time (15.7%; and lack of money to pay for transport to the dental clinic (15.0%. Older adults were more likely to report that they had experienced oral pain during the last 12 months than the younger adults (OR = 1.57, CI 1.07–1.57, P dental clinics far from home (OR = 5.31, CI = 2.09–13.54, P and being treated by traditional healer (OR = 5.31, CI = 2.25–12.49, P as reasons for not seeking emergency care from the oral health care facilities than their counterparts from urban areas. Conclusion Oral pain and discomfort were prevalent among adult Tanzanians. Only a quarter of those who experienced oral pain or discomfort sought emergency oral care from oral health care facilities. Self medication was used as an alternative to using oral care facilities mainly by rural residents. Establishing oral care facilities in rural areas is recommended.

  5. Was it a pain or a sound? Across-species variability in sensory sensitivity

    OpenAIRE

    Hu, L; Xia, X L; Peng, W. W.; Su, W. X.; Luo, F.; Yuan, H.; Chen, A T; Liang, M.; IANNETTI, G.

    2015-01-01

    Abstract Natural selection has shaped the physiological properties of sensory systems across species, yielding large variations in their sensitivity. Here, we used laser stimulation of skin nociceptors, a widely used technique to investigate pain in rats and humans, to provide a vivid example of how ignoring these variations can lead to serious misconceptions in sensory neuroscience. In 6 experiments, we characterized and compared the physiological properties of the electrocortical responses ...

  6. Effects of Environmental Enrichment on Thermal Sensitivity in an Operant Orofacial Pain Assay

    OpenAIRE

    Rossi, Heather L.; Neubert, John K.

    2007-01-01

    Environmental enrichment reduces reactivity to stressor and could also modulate pain perception. In this study we sought to compare the effects of enriched and standard housing on temperature perception. In an operant assay, rats housed in an enriched environment exhibited significantly lower sensitivities to thermal stimuli and displayed less exploratory behavior in a rearing chamber. These findings indicate that environmental enrichment can significantly affect temperature perception, likel...

  7. Dichoptic training improves contrast sensitivity in adults with amblyopia.

    Science.gov (United States)

    Li, Jinrong; Spiegel, Daniel P; Hess, Robert F; Chen, Zidong; Chan, Lily Y L; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2015-09-01

    Dichoptic training is designed to promote binocular vision in patients with amblyopia. Initial studies have found that the training effects transfer to both binocular (stereopsis) and monocular (recognition acuity) visual functions. The aim of this study was to assess whether dichoptic training effects also transfer to contrast sensitivity (CS) in adults with amblyopia. We analyzed CS data from 30 adults who had taken part in one of two previous dichoptic training studies and assessed whether the changes in CS exceeded the 95% confidence intervals for change based on test-retest data from a separate group of observers with amblyopia. CS was measured using Gabor patches (0.5, 3 and 10cpd) before and after 10days of dichoptic training. Training was delivered using a dichoptic video game viewed through video goggles (n=15) or on an iPod touch equipped with a lenticular overlay screen (n=15). In the iPod touch study, training was combined with anodal transcranial direct current stimulation of the visual cortex. We found that dichoptic training significantly improved CS across all spatial frequencies tested for both groups. These results suggest that dichoptic training modifies the sensitivity of the neural systems that underpin monocular CS. PMID:25676883

  8. Elbow pain

    Science.gov (United States)

    Pain - elbow ... Elbow pain can be caused by many problems. A common cause in adults is tendinitis . This is inflammation and ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

  9. Chronic pain: the help-seeking behavior, attitudes, and beliefs of older adults living in the community.

    Science.gov (United States)

    Cornally, Nicola; McCarthy, Geraldine

    2011-12-01

    Psychologic variables such as attitudes and beliefs may account for patients choosing not to seek treatment for pain; however, there is a dearth of empirical research to support this contention. The aim of this study was to explore the help-seeking behavior, individual characteristics, attitudes, and beliefs of older adults with chronic pain in an Irish community setting. A descriptive correlational design was used. A convenience sample of 72 older adults with chronic pain were recruited through two primary care practices. The research instruments used were a demographic questionnaire, the Level of Expressed Need Questionnaire, which measured help-seeking behavior, the Pain Attitudes Questionnaire, and the Pain Beliefs Questionnaire. Results revealed that individual characteristics associated with help-seeking behavior were female gender, increasing age, higher education, living alone, and severe pain. High levels of stoicism were reported, indicating that participants were more likely to believe they had superior pain control and courage in the face of pain and were not willing to disclose their pain to others. These attitudes were significantly associated with lower levels of expressed need for treatment. Participants had moderate age-related beliefs about the origin of pain, but those who believed pain had an organic cause were more likely to seek help. PMID:22117752

  10. Percutaneous Vertebroplasty in Adult Degenerative Scoliosis for Spine Support: Study for Pain Evaluation and Mobility Improvement

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Filippiadis

    2013-01-01

    Full Text Available We evaluate the efficacy-safety of percutaneous vertebroplasty (PV as primary treatment in adult degenerative scoliosis. During the last 4 years, PV was performed in 18 adult patients (68 vertebral bodies with back pain due to degenerative scoliotic spine. Under anaesthesia and fluoroscopy, direct access to most deformed vertebral bodies was obtained by 13G needles, and PMMA for vertebroplasty was injected. Scoliosis’ inner arch was supported. Clinical evaluation included immediate and delayed studies of patient’s general condition and neurological status. An NVS scale helped assessing pain relief, life quality, and mobility improvement. Comparing patients’ scores prior to (mean value 8.06±1.3 NVS units, the morning after (mean value 3.11±1.2 NVS units, at 12 (mean value 1.67±1.5 NVS units, and 24 months after vertebroplasty (mean value 1.67±1.5 NVS units treatment, patients presented a mean decrease of 6.39±1.6 NVS units on terms of life quality improvement and pain relief (P=0.000. Overall mobility improved in 18/18 (100% patients. No complications were observed. During follow-up period (mean value 17.66 months, all patients underwent a mean of 1.3 sessions for facet joint and nerve root infiltrations. Percutaneous vertebroplasty in the inner arch seems to be an effective technique for supporting adult degenerative scoliotic spine.

  11. Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

    Science.gov (United States)

    Parviainen, Mickael; Pihlajamäki, Harri K.

    2008-01-01

    Excision of the accessory bipartite fragment is widely used, but its long-term outcome is not known. We evaluated the outcome after surgical excision of a symptomatic accessory bipartite or multipartite patella fragment in young adult men performing their compulsory military service and determined the incidence of painful bipartite patellae in this group of skeletally mature adults. We followed 25 of 32 patients for a minimum of 10 years (mean, 15 years; range, 10–22 years). The incidence of painful, surgically treated bipartite patella was 9.2 per 100,000 recruits. Patients’ median age at surgery was 20 years. There were 19 superolateral and six lateral bipartite fragments. Other radiographic findings were rare. At followup, the Kujala score mean was 95 points (range, 75–100 points), and osteoarthrotic changes (Kellgren-Lawrence Grade 1) were seen in two knees. No reoperations related to bipartite patella occurred during the followup. Symptomatic bipartite patella is rare and does not seem primarily associated with anatomic deviations, but when incapacitating pain persists despite nonoperative treatment, surgical excision seems to yield reasonable functional outcome and quick recovery with no apparent adverse sequelae. Our data suggest there is no reason to avoid this technically undemanding procedure for treating persistent symptoms of bipartite patella in young adults. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18607662

  12. Cost-effectiveness of high-sensitive troponin assays for the early rule-out or diagnosis of acute myocardial infarction (AMI) in people with acute chest pain : A nice diagnostic assessment

    NARCIS (Netherlands)

    Ramaekers, B.L.T.; Armstrong, N.; Joore, M.A.; Westwood, M.; Whiting, P.; Thokala, P.; Ross, J.; Kleijnen, J.; Severens, J.; Van Asselt, A.

    2014-01-01

    Objectives: To assess cost-effectiveness of high sensitivity troponin (hs-cTn) assays for the management of adults presenting with acute chest pain at the emergency department. Methods: An economic model was constructed to estimate lifetime costs and QALYs of five hs-cTn strategies (differing accord

  13. Spirometry-related pain and distress in adolescents and young adults with cystic fibrosis: The role of acceptance

    OpenAIRE

    Casier, Annabelle; Goubert, Liesbet; Vervoort, Tine; Theunis, Marleen; Huse, Danielle; De Baets, Frans; Matthys, Dirk; Crombez, Geert

    2013-01-01

    OBJECTIVE: To investigate the occurrence of spirometry-related pain and distress in adolescents and young adults with cystic fibrosis (CF), and to investigate the role of acceptance of illness in spirometry-related pain and distress.METHODS: A total of 36 adolescents and young adults with CF (12 to 22 years of age) completed a questionnaire assessing acceptance of illness. Spirometry-related distress was assessed using self-report (ie, anxiety/worry about the procedure) and physiological outc...

  14. Observation of Pain-Sensitive Points along the Meridians in Patients with Gastric Ulcer or Gastritis

    Directory of Open Access Journals (Sweden)

    Hui Ben

    2012-01-01

    Full Text Available This study aims to investigate the sensitization of human skin points along certain meridians related to visceral disease by using the pressure-pain threshold (PPT as an indicator. We detected and compared the PPTs of people with and without gastric ulcer or gastritis on the related acupoints, abdomen area, and back area with von Frey detector and observed the similarities and differences under their respective physiological and pathological states. The results showed that (1 the PPTs of patients with gastric ulcer on related acupoints decreased significantly compared with the control group; (2 there was no significant difference in PPT between the chosen points of the measured meridian and the adjacent nonacupoints; (3 there was an apparent distribution of tender points on the relevant abdomen and back regions of patients with gastric ulcer or gastritis, but none was found on the control group; (4 the pain-sensitive points of gastric ulcer and gastritis patients were BURONG (ST19, LIANGMEN (ST21, and HUAROUMEN (ST24 of the stomach meridian on the abdominal region and PISHU (BL20, WEISHU (BL21, and WEICANG (BL50 on the back, among others The results suggest that the practical significance of acupoints may lie in its role as a relatively sensitive functional area. In a pathological state, the reflex points on the skin which are related to certain visceral organs become sensitive and functionally intensify.

  15. Paediatric Pain Management: Using Complementary and Alternative Medicine

    OpenAIRE

    Evans, Subhadra; Tsao, Jennie C. I.; Zeltzer, Lonnie K

    2008-01-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Altho...

  16. Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: a systematic review

    Directory of Open Access Journals (Sweden)

    Brkovic T

    2016-06-01

    Full Text Available Tonci Brkovic,1 Eliana Burilovic,2 Livia Puljak3 1Department of Internal Medicine, Division of Nephrology, 2Department of Psychiatry, University Hospital Split, 3Department of Anatomy, Histology and Embryology, Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Objectives: Understanding the epidemiology of pain in patients on hemodialysis (HD is crucial for further improvement in managing pain. The aim of this study was to systematically review available evidence on the prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent HD. Materials and methods: We carried out a systematic review of the literature and developed a comprehensive search strategy based on search terms on pain and HD. We searched the databases MEDLINE, Scopus, PsycINFO, and CINAHL from the earliest date of each database to July 24, 2014. Manuscripts in all languages were taken into consideration. Two authors performed each step independently, and all disagreements were resolved after discussion with the third author. The quality of studies was estimated using the STROBE checklist and Cochrane risk-of-bias tool.Results: We included 52 studies with 6,917 participants. The prevalence of acute and chronic pain in HD patients was up to 82% and 92%, respectively. A considerable number of patients suffered from severe pain. Various locations and causes of pain were described, with most of the studies reporting pain in general, pain related to arteriovenous access, headache, and musculoskeletal pain.Conclusion: The findings of this systematic review indicate high prevalence of pain in HD patients and considerable gaps and limitations in the available evidence. Pain in this population should be recognized as a considerable health concern, and the nephrology community should promote pain management in HD patients as a clinical and research priority to improve patients’ quality of life and pain

  17. Changes in pain and pressure pain sensitivity after manual treatment of active trigger points in patients with unilateral shoulder impingement: a case series.

    Science.gov (United States)

    Hidalgo-Lozano, Amparo; Fernández-de-las-Peñas, César; Díaz-Rodríguez, Lourdes; González-Iglesias, Javier; Palacios-Ceña, Domingo; Arroyo-Morales, Manuel

    2011-10-01

    The aim of this case series was to investigate changes in pain and pressure pain sensitivity after manual treatment of active trigger points (TrPs) in the shoulder muscles in individuals with unilateral shoulder impingement. Twelve patients (7 men, 5 women, age: 25 ± 9 years) diagnosed with unilateral shoulder impingement attended 4 sessions for 2 weeks (2 sessions/week). They received TrP pressure release and neuromuscular interventions over each active TrP that was found. The outcome measures were pain during arm elevation (visual analogue scale, VAS) and pressure pain thresholds (PPT) over levator scapulae, supraspinatus infraspinatus, pectoralis major, and tibialis anterior muscles. Pain was captured pre-intervention and at a 1-month follow-up, whereas PPT were assessed pre- and post-treatment, and at a 1-month follow-up. Patients experienced a significant (P  1). In addition, patients also experienced a significant increase in PPT immediate after the treatment (P  1).A significant negative association (r(s) = -0.525; P = 0.049) between the increase in PPT over the supraspinatus muscle and the decrease in pain was found: the greater the decrease in pain, the greater the increase in PPT. This case series has shown that manual treatment of active muscle TrPs can help to reduce shoulder pain and pressure sensitivity in shoulder impingement. Current findings suggest that active TrPs in the shoulder musculature may contribute directly to shoulder complaint and sensitization in patients with shoulder impingement syndrome, although future randomized controlled trials are required.

  18. Gender Differences in Pain-Physical Activity Linkages among Older Adults: Lessons Learned from Daily Life Approaches

    Directory of Open Access Journals (Sweden)

    Amy Ho

    2016-01-01

    Full Text Available Background. Many older adults know about the health benefits of an active lifestyle, but, frequently, pain prevents them from engaging in physical activity. The majority of older adults experience pain, a complex experience that can vary across time and is shaped by sociocultural factors like gender. Objectives. To describe the time-varying associations between daily pain and physical activity and to explore differences in these associations between women and men. Methods. One hundred and twenty-eight community-dwelling older adults aged 65 years and older were asked to report their pain levels three times daily over a 10-day period and wear an accelerometer to objectively capture their daily physical activity (step counts and minutes of moderate to vigorous physical activity. Results. Increased daily step counts and minutes of moderate to vigorous physical activity were associated with increased daily pain, especially among women. Confirming past literature and contrasting findings for daily pain reports, overall pain levels across the study period were negatively associated with minutes of moderate to vigorous physical activity. Conclusions. Findings highlight that pain is significantly associated with physical activity in old age. The nature of this association depends on the time scale that is considered and differs between women and men.

  19. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA)

    DEFF Research Database (Denmark)

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D;

    2013-01-01

    BACKGROUND: Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most...... commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient......-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. METHODS/DESIGN: This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least...

  20. Cannabinoid CB2 receptors regulate central sensitization and pain responses associated with osteoarthritis of the knee joint.

    Science.gov (United States)

    Burston, James J; Sagar, Devi Rani; Shao, Pin; Bai, Mingfeng; King, Emma; Brailsford, Louis; Turner, Jenna M; Hathway, Gareth J; Bennett, Andrew J; Walsh, David A; Kendall, David A; Lichtman, Aron; Chapman, Victoria

    2013-01-01

    Osteoarthritis (OA) of the joint is a prevalent disease accompanied by chronic, debilitating pain. Recent clinical evidence has demonstrated that central sensitization contributes to OA pain. An improved understanding of how OA joint pathology impacts upon the central processing of pain is crucial for the identification of novel analgesic targets/new therapeutic strategies. Inhibitory cannabinoid 2 (CB2) receptors attenuate peripheral immune cell function and modulate central neuro-immune responses in models of neurodegeneration. Systemic administration of the CB2 receptor agonist JWH133 attenuated OA-induced pain behaviour, and the changes in circulating pro- and anti-inflammatory cytokines exhibited in this model. Electrophysiological studies revealed that spinal administration of JWH133 inhibited noxious-evoked responses of spinal neurones in the model of OA pain, but not in control rats, indicating a novel spinal role of this target. We further demonstrate dynamic changes in spinal CB2 receptor mRNA and protein expression in an OA pain model. The expression of CB2 receptor protein by both neurones and microglia in the spinal cord was significantly increased in the model of OA. Hallmarks of central sensitization, significant spinal astrogliosis and increases in activity of metalloproteases MMP-2 and MMP-9 in the spinal cord were evident in the model of OA pain. Systemic administration of JWH133 attenuated these markers of central sensitization, providing a neurobiological basis for analgesic effects of the CB2 receptor in this model of OA pain. Analysis of human spinal cord revealed a negative correlation between spinal cord CB2 receptor mRNA and macroscopic knee chondropathy. These data provide new clinically relevant evidence that joint damage and spinal CB2 receptor expression are correlated combined with converging pre-clinical evidence that activation of CB2 receptors inhibits central sensitization and its contribution to the manifestation of chronic OA

  1. Cannabinoid CB2 receptors regulate central sensitization and pain responses associated with osteoarthritis of the knee joint.

    Directory of Open Access Journals (Sweden)

    James J Burston

    Full Text Available Osteoarthritis (OA of the joint is a prevalent disease accompanied by chronic, debilitating pain. Recent clinical evidence has demonstrated that central sensitization contributes to OA pain. An improved understanding of how OA joint pathology impacts upon the central processing of pain is crucial for the identification of novel analgesic targets/new therapeutic strategies. Inhibitory cannabinoid 2 (CB2 receptors attenuate peripheral immune cell function and modulate central neuro-immune responses in models of neurodegeneration. Systemic administration of the CB2 receptor agonist JWH133 attenuated OA-induced pain behaviour, and the changes in circulating pro- and anti-inflammatory cytokines exhibited in this model. Electrophysiological studies revealed that spinal administration of JWH133 inhibited noxious-evoked responses of spinal neurones in the model of OA pain, but not in control rats, indicating a novel spinal role of this target. We further demonstrate dynamic changes in spinal CB2 receptor mRNA and protein expression in an OA pain model. The expression of CB2 receptor protein by both neurones and microglia in the spinal cord was significantly increased in the model of OA. Hallmarks of central sensitization, significant spinal astrogliosis and increases in activity of metalloproteases MMP-2 and MMP-9 in the spinal cord were evident in the model of OA pain. Systemic administration of JWH133 attenuated these markers of central sensitization, providing a neurobiological basis for analgesic effects of the CB2 receptor in this model of OA pain. Analysis of human spinal cord revealed a negative correlation between spinal cord CB2 receptor mRNA and macroscopic knee chondropathy. These data provide new clinically relevant evidence that joint damage and spinal CB2 receptor expression are correlated combined with converging pre-clinical evidence that activation of CB2 receptors inhibits central sensitization and its contribution to the manifestation

  2. Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation

    Directory of Open Access Journals (Sweden)

    Freeman Michael D

    2009-04-01

    Full Text Available Abstract Objective it has been established that chronic neck pain following whiplash is associated with the phenomenon of central sensitization, in which injured and uninjured parts of the body exhibit lowered pain thresholds due to an alteration in central pain processing. it has furthermore been hypothesized that peripheral sources of nociception in the muscles may perpetuate central sensitization in chronic whiplash. the hypothesis explored in the present study was whether myofascial trigger points serve as a modulator of central sensitization in subjects with chronic neck pain. Design controlled case series. Setting outpatient chronic pain clinic. Subjects seventeen patients with chronic and intractable neck pain and 10 healthy controls without complaints of neck pain. Intervention symptomatic subjects received anesthetic infiltration of myofascial trigger points in the upper trapezius muscles and controls received the anesthetic in the thigh. Outcome measures: pre and post injection cervical range of motion, pressure pain thresholds (ppt over the infraspinatus, wrist extensor, and tibialis anterior muscles. sensitivity to light (photophobia and subjects' perception of pain using a visual analog scale (vas were also evaluated before and after injections. only the ppt was evaluated in the asymptomatic controls. Results immediate (within 1 minute alterations in cervical range of motion and pressure pain thresholds were observed following an average of 3.8 injections with 1–2 cc of 1% lidocaine into carefully identified trigger points. cervical range of motion increased by an average of 49% (p = 0.000 in flexion and 44% (p = 0.001 in extension, 47% (p = 0.000 and 28% (p Conclusion the present data suggest that myofascial trigger points serve to perpetuate lowered pain thresholds in uninjured tissues. additionally, it appears that lowered pain thresholds associated with central sensitization can be immediately reversed, even when associated

  3. Immunohistochemical analyses of a case of extralobar pulmonary sequestration with chest pain in an adult

    Directory of Open Access Journals (Sweden)

    Yuji Ohtsuki

    2013-01-01

    Full Text Available Computed tomography of a Japanese man in his mid-forties with a complaint of right-side chest pain showed a dome-shaped smooth-surfaced mediastinal mass, which was extirpated. The cut surface was highly hemorrhagic and necrotic and not related to the original pulmonary tissues. Although routine sectioning detected bronchial cartilage, immunohistochemical analyses clearly showed the presence of alveolar type II cells; only the alveolar type II cells located at the periphery of this mass showed positive staining for cytokeratins, thyroid transcription factor 1, surfactant protein A, epithelial membrane antigen and Krebs von den Lungen-6. Thus, these analyses are useful for the detection of pulmonary components, even in severely hemorrhagic and necrotic tissues with marked sequestration. The clinical diagnosis was a rare, adult type of extralobar pulmonary sequestration accompanied by chest pain.

  4. Acute chest pain after bench press exercise in a healthy young adult

    Science.gov (United States)

    Smereck, Janet A; Papafilippaki, Argyro; Sudarshan, Sawali

    2016-01-01

    Bench press exercise, which involves repetitive lifting of weights to full arm extension while lying supine on a narrow bench, has been associated with complications ranging in acuity from simple pectoral muscle strain, to aortic and coronary artery dissection. A 39-year-old man, physically fit and previously asymptomatic, presented with acute chest pain following bench press exercise. Diagnostic evaluation led to the discovery of critical multivessel coronary occlusive disease, and subsequently, highly elevated levels of lipoprotein (a). Judicious use of ancillary testing may identify the presence of “high-risk” conditions in a seemingly “low-risk” patient. Emergency department evaluation of the young adult with acute chest pain must take into consideration an extended spectrum of potential etiologies, so as to best guide appropriate management.

  5. Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization.

    Science.gov (United States)

    Costantini, Raffaele; Affaitati, Giannapia; Massimini, Francesca; Tana, Claudio; Innocenti, Paolo; Giamberardino, Maria Adele

    2016-01-01

    Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1week, 1,3,6 and 12months after laparoscopic cholecystectomy in fibromyalgia patients with symptomatic calculosis (n = 31) vs calculosis patients without fibromyalgia (n. 26) and at comparable time points in fibromyalgia patients not undergoing cholecystectomy, with symptomatic (n = 27) and asymptomatic (n = 28) calculosis, and no calculosis (n = 30). At basis, fibromyalgia+symptomatic calculosis patients presented a significant linear correlation between the number of previously experienced biliary colics and fibromyalgia pain (direct) and muscle thresholds (inverse)(pfibromyalgia pain significantly increased and all thresholds significantly decreased at 1week and 1month (1-way ANOVA, pFibromyalgia pain and thresholds returned to preoperative values at 3months, then pain significantly decreased and thresholds significantly increased at 6 and 12months (pfibromyalgia patients undergoing cholecystectomy thresholds did not change; in all other fibromyalgia groups not undergoing cholecystectomy fibromyalgia pain and thresholds remained stable, except in fibromyalgia+symptomatic calculosis at 12months when pain significantly increased and muscle thresholds significantly decreased (pfibromyalgia symptoms and that laparoscopic cholecystectomy produces only a transitory worsening of these symptoms, largely compensated by the long-term improvement/desensitization due to gallbladder removal. This study provides new insights into the role of visceral pain comorbidities and the effects of

  6. Increased sensitivity to thermal pain following a single opiate dose is influenced by the COMT val(158met polymorphism.

    Directory of Open Access Journals (Sweden)

    Karin B Jensen

    Full Text Available Increased pain sensitivity after opioid administration (opioid-induced hyperalgesia and/or repeated painful stimuli is an individually varying and clinically important phenomenon. The functional polymorphism (val(158met of the Catechol-O-methyltransferase (COMT gene regulates the metabolism of dopamine/noradrenaline. Individuals homozygous for the met(158 allele have been reported to have increased pain sensitivity and there are findings of lower micro-opioid system activation during sustained pain. We hypothesized that met/met individuals would exhibit higher pain sensitization and opioid-induced hyperalgesia in response to repeated pain stimuli and an intravenous injection of an opioid drug. Participants were 43 healthy subjects who went through an experiment where five blocks of pain were induced to the hand using a heat probe. After each stimulus subjects rated the pain on a visual analogue scale (VAS from 0 mm (no pain to 100 mm (worst possible pain. Before the second stimulus there was an intravenous injection of a rapid and potent opioid drug. At baseline there was no difference in pain ratings between the COMTval(158met genotypes, F(2, 39<1. However, a repeated measures ANOVA for all five stimuli revealed a main effect for COMTval(158met genotype, F(2, 36 = 4.17, p = 0.024. Met/met individuals reported significantly more pain compared to val/val, p = 0.010. A pairwise comparison of baseline and the opioid intervention demonstrated that analgesia was induced in all groups (p = 0.042 without a separating effect for genotype (n.s. We suggest that the initial response of the descending pain system is not influenced by the COMTval(158met polymorphism but when the system is challenged the difference is revealed. An important clinical implication of this may be that the COMTval(158met related differences may be more expressed in individuals where the inhibitory system is already challenged and sensitive, e.g. chronic pain patients. This has to

  7. Knee extensor strength is associated with pressure pain thresholds in adults with fibromyalgia.

    Directory of Open Access Journals (Sweden)

    W Michael Hooten

    Full Text Available OBJECTIVE: Individuals with fibromyalgia (FM have lower muscle strength and lower pressure pain thresholds (PPT. The primary aim of this study was to determine the associations between muscle strength and PPT in adults with FM to test the hypothesis that greater measures of muscle strength would be associated with greater values of PPT. Secondary aims included determining the effects of pain severity and the peak uptake of oxygen (VO2 on the associations between muscle strength and PPT. METHODS: Knee extensor and flexor strength (N = 69 was measured in the dominant leg using a dynamometer, and PPT was assessed using an electronic algometer. Pain severity was determined using the Multidimensional Pain Inventory, and peak VO2 uptake was quantified using an electronically braked cycle ergometer. RESULTS: Univariable linear regression analysis demonstrated a significant association between PPT (dependent variable and isometric knee extensor (P<.001, isokinetic (60°/s knee extensor (P = .002, and isokinetic (60°/s knee flexor strength (P = .043. In a multiple variable linear regression analysis adjusted for age, sex, pain severity, body mass index and peak VO2 uptake, a significant association was found between PPT and isometric knee extensor strength (P = .008. In a similar multiple variable analysis, a significant association was found between PPT and isokinetic knee extensor strength (P = .044. CONCLUSION: Greater measures of isometric and isokinetic knee extensor strength were significantly associated with greater values of PPT in both univariable and multiple variable linear regression models. TRIAL REGISTRATION: ClinicalTrials.gov NCT01253395.

  8. Assessment of pain sensitivity in patients with deep bite and sex- and age-matched controls

    DEFF Research Database (Denmark)

    Sonnesen, Ane Liselotte; Svensson, Peter

    2011-01-01

    was scored by the subjects ( n = 60) on a 0 to 10 cm visual analog scale. Subjects drew the perceived pain area on a face and arm chart and described the quality of pain on the McGill Pain Questionnaire. Thresholds for cold detection, cold pain, cold tolerance, warmth detection, heat pain, and heat tolerance...

  9. Psychophysical demonstration of bidirectional pain modulation (sensitization and desensitization) by ascending or descending progressions of thermal stimulus intensity.

    Science.gov (United States)

    Vierck, Charles J; Riley, Joseph L; Wong, Fong; King, Christopher D; Mauderli, Andre P

    2010-08-01

    A psychophysical method of response-dependent stimulation presented ascending and descending series of thermal stimulus intensities that maintained an average rating (setpoint) of mild pain (20 on a scale of 0-100) or moderate pain (35). Subjects were presented with alternating series of thermal stimuli that increased until ratings reached or exceeded the setpoint, then decreased until ratings equaled or were less than the setpoint, then increased, etc. Plots of pain intensity ratings differed substantially for series of ascending and descending stimulus intensities. After an ascending series, pain ratings during a descending series were higher than predicted, and after a descending series, pain ratings during an ascending series were lower than predicted. Thus, the nervous system detects and discriminates between ascending and descending trends in stimulus intensity and alters the magnitude of pain sensations in the direction of the trend of increasing or decreasing stimulus intensity. Ascending (sensitizing) trend effects may increase the magnitude of pathological pain in the absence of treatment, and descending (desensitizing) trend effects likely would enhance the efficacy of procedures that reduce pain sensitivity.

  10. The Discriminative validity of "nociceptive," "peripheral neuropathic," and "central sensitization" as mechanisms-based classifications of musculoskeletal pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-02-01

    OBJECTIVES: Empirical evidence of discriminative validity is required to justify the use of mechanisms-based classifications of musculoskeletal pain in clinical practice. The purpose of this study was to evaluate the discriminative validity of mechanisms-based classifications of pain by identifying discriminatory clusters of clinical criteria predictive of "nociceptive," "peripheral neuropathic," and "central sensitization" pain in patients with low back (+\\/- leg) pain disorders. METHODS: This study was a cross-sectional, between-patients design using the extreme-groups method. Four hundred sixty-four patients with low back (+\\/- leg) pain were assessed using a standardized assessment protocol. After each assessment, patients\\' pain was assigned a mechanisms-based classification. Clinicians then completed a clinical criteria checklist indicating the presence\\/absence of various clinical criteria. RESULTS: Multivariate analyses using binary logistic regression with Bayesian model averaging identified a discriminative cluster of 7, 3, and 4 symptoms and signs predictive of a dominance of "nociceptive," "peripheral neuropathic," and "central sensitization" pain, respectively. Each cluster was found to have high levels of classification accuracy (sensitivity, specificity, positive\\/negative predictive values, positive\\/negative likelihood ratios). DISCUSSION: By identifying a discriminatory cluster of symptoms and signs predictive of "nociceptive," "peripheral neuropathic," and "central" pain, this study provides some preliminary discriminative validity evidence for mechanisms-based classifications of musculoskeletal pain. Classification system validation requires the accumulation of validity evidence before their use in clinical practice can be recommended. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.

  11. Association between dental pain and depression in Korean adults using the Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yang, S E; Park, Y G; Han, K; Min, J A; Kim, S Y

    2016-01-01

    The purpose of this study was to evaluate the relationships between the prevalence of depression and dental pain using a well characterised, nationally representative, population-based study. This study analysed data from the 2012 Korea National Health and Nutrition Examination Survey (n = 4886). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Depression was defined as the participant having been diagnosed as depression during the previous year. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI), controlling for a range of covariates. Results demonstrated that participants included in 'root canal treatment is necessary' showed higher prevalence of self-reported dental pain; in particular, participants with depression presented more dental pain than those without depression. After adjusting for sociodemographic factors, self-reported dental pain increased in participants with depression. The AOR (95% CI) for having self-reported dental pain was 1·58 (1·08-2·33) in dentists' diagnosis of no dental pain/depression group, 1·62 (1·32-1·98) in dentists' diagnosis of dental pain/no depression group and 2·84 (1·10-7·37) in dentists' diagnosis of dental pain/depression group. It was concluded that depression was associated with dental pain after adjustment for potential confounders in Korean adults. Thus, dentists should consider the possible presence of psychopathology when treating patients with dental pain. PMID:26337763

  12. Inducing Expectations for Health: Effects of Verbal Suggestion and Imagery on Pain, Itch, and Fatigue as Indicators of Physical Sensitivity.

    Directory of Open Access Journals (Sweden)

    Kaya J Peerdeman

    Full Text Available Research into placebo effects has convincingly shown that inducing positive outcome expectations can reduce pain and other physical sensations. However, the comparative effects of different expectation inductions, such as verbal suggestion or mental imagery, and their generic effects on physical sensitivity, to different sensations such as pain, itch, and fatigue, are still largely unknown. In the current study, we assessed the individual and combined effects of verbal suggestion and imagery on pain, itch, and fatigue as indicators of physical sensitivity in a randomized study design. Healthy participants (n = 116 were given an inert (placebo capsule that was said to be effective for reducing physical sensitivity in either the majority (positive verbal suggestion or the minority (control verbal suggestion of users. Subsequently, they imagined either their best possible health (positive imagery or a typical day (control imagery. Sensitivity to pain, itch, and fatigue was tested using a cold pressor test, histamine iontophoresis, and a bicycle test, respectively. Heart rate and skin conductance were recorded continuously. Results showed that positive verbal suggestion and imagery successfully induced positive expectations, but they did not affect physical sensitivity, as indicated by sensitivity to pain, itch, or fatigue, or concurrent physiological responses. These results could indicate that the specificity and concreteness of expectation inductions might be important for their applicability in the treatment of physical symptoms.Nederlands Trial Register NTR3641.

  13. Autoimmunity contributes to nociceptive sensitization in a mouse model of complex regional pain syndrome.

    Science.gov (United States)

    Li, Wen-Wu; Guo, Tian-Zhi; Shi, Xiaoyou; Czirr, Eva; Stan, Trisha; Sahbaie, Peyman; Wyss-Coray, Tony; Kingery, Wade S; Clark, J David

    2014-11-01

    Complex regional pain syndrome (CRPS) is a painful, disabling, chronic condition whose etiology remains poorly understood. The recent suggestion that immunological mechanisms may underlie CRPS provides an entirely novel framework in which to study the condition and consider new approaches to treatment. Using a murine fracture/cast model of CRPS, we studied the effects of B-cell depletion using anti-CD20 antibodies or by performing experiments in genetically B-cell-deficient (μMT) mice. We observed that mice treated with anti-CD20 developed attenuated vascular and nociceptive CRPS-like changes after tibial fracture and 3 weeks of cast immobilization. In mice with established CRPS-like changes, the depletion of CD-20+ cells slowly reversed nociceptive sensitization. Correspondingly, μMT mice, deficient in producing immunoglobulin M (IgM), failed to fully develop CRPS-like changes after fracture and casting. Depletion of CD20+ cells had no detectable effects on nociceptive sensitization in a model of postoperative incisional pain, however. Immunohistochemical experiments showed that CD20+ cells accumulate near the healing fracture but few such cells collect in skin or sciatic nerves. On the other hand, IgM-containing immune complexes were deposited in skin and sciatic nerve after fracture in wild-type, but not in μMT fracture/cast, mice. Additional experiments demonstrated that complement system activation and deposition of membrane attack complexes were partially blocked by anti-CD20+ treatment. Collectively, our results suggest that CD20-positive B cells produce antibodies that ultimately support the CRPS-like changes in the murine fracture/cast model. Therapies directed at reducing B-cell activity may be of use in treating patients with CRPS. PMID:25218828

  14. Effect of commensals and probiotics on visceral sensitivity and pain in irritable bowel syndrome.

    Science.gov (United States)

    Theodorou, Vassilia; Ait Belgnaoui, Afifa; Agostini, Simona; Eutamene, Helene

    2014-01-01

    The last ten years' wide progress in the gut microbiota phylogenetic and functional characterization has been made evidencing dysbiosis in several gastrointestinal diseases including inflammatory bowel diseases and irritable bowel syndrome (IBS). IBS is a functional gut disease with high prevalence and negative impact on patient's quality of life characterized mainly by visceral pain and/or discomfort, representing a good paradigm of chronic gut hypersensitivity. The IBS features are strongly regulated by bidirectional gut-brain interactions and there is increasing evidence for the involvement of gut bacteria and/or their metabolites in these features, including visceral pain. Further, gut microbiota modulation by antibiotics or probiotics has been promising in IBS. Mechanistic data provided mainly by animal studies highlight that commensals or probiotics may exert a direct action through bacterial metabolites on sensitive nerve endings in the gut mucosa, or indirect pathways targeting the intestinal epithelial barrier, the mucosal and/or systemic immune activation, and subsequent neuronal sensitization and/or activation.

  15. Peripheral effect of NMDA receptor antagonists on adult rats exposed to neonatal colon pain

    Institute of Scientific and Technical Information of China (English)

    ChunLin; ElieD.Al-Chaer

    2004-01-01

    AIM: Previous work done by Al-Chaer' s lab has shown that colon irritation (CI) in neonates can lead to chronic visceral hypersensitivity in adult rats, with characteristics of visceral allodynia and hyperalgesia, associated with central neuronal sensitization in the absence of identifiable peripheral pathology (Al-Chaer et al. 2000) . The pathogenesis of

  16. Communicative responses to the painful self-disclosures of familial and non-familial older adults.

    Science.gov (United States)

    Fowler, Craig; Soliz, Jordan

    2013-01-01

    Data from 365 college students were used to assess young adults' communicative responses to older persons' painful self-disclosures (PSDs). Coupland, Coupland, and Giles (1991) proposed that recipients of PSD may respond to such disclosures via a variety of"next moves." These responses may broadly be considered to reflect forms of pro-social engagement, passive disengagement, and active disengagement. We investigated whether young adults' tendency to use certain responses to PSD were influenced by their affective reactions to PSD, their communicative background and characteristics, and the sociorelational context of the encounter in which PSD occurred. Results are discussed with respect to their implications for intergenerational interaction, and interpreted through the lens of communication accommodation theory. PMID:24340871

  17. An Unusual Presentation of Adult Tethered Cord Syndrome Associated with Severe Chest and Upper Back Pain

    Directory of Open Access Journals (Sweden)

    Shotaro Kanda

    2015-01-01

    Full Text Available Adult tethered cord syndrome (ATCS is a rare entity that usually presents with multiple neurological symptoms, including lower extremity pain, backache, lower extremity muscle weakness, and bowel/bladder disturbances. Prompt surgical treatment is often necessary to avoid permanent sequelae. We report a 63-year-old man with sudden-onset severe right chest and upper back pain, followed by urinary retention. His initial workup included computed tomography of the abdomen and pelvis, which showed a presacral mass. His symptom-driven neurological workup focused on the cervical and thoracic spine, the results of which were normal. Pelvic radiographs and magnetic resonance imaging of the lumbosacral spine showed spina bifida occulta, meningocele, and presacral masses consistent with a teratomatous tumor. His symptoms, except for urinary retention, improved dramatically with surgical treatment. The excised specimen contained a teratomatous lesion plus an organized hematoma. Hematoma formation was suspected as the trigger of his sudden-onset right chest and upper back pain.

  18. Physical, lifestyle, psychological, and social determinants of pain intensity, pain disability, and the number of pain locations in depressed older adults

    NARCIS (Netherlands)

    Hanssen, Denise J. C.; Naarding, Paul; Collard, Rose M.; Comijs, Hannie C.; Oude Voshaar, Richard C.

    2014-01-01

    Late-life depression and pain more often co-occur than can be explained by chance. Determinants of pain in late-life depression are unknown, even though knowledge on possible determinants of pain in depression is important for clinical practice. Therefore, the objectives of the present study were 1)

  19. Mechanical pain sensitivity of deep tissues in children - possible development of myofascial trigger points in children

    Directory of Open Access Journals (Sweden)

    Han Ting-I

    2012-02-01

    Full Text Available Abstract Background It is still unclear when latent myofascial trigger points (MTrPs develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs in school children. Methods Five hundreds and five healthy school children (age 4- 11 years were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site, the mid-point of the muscle belly (site B, assumed to be the MTrP site, and the muscle-tendon junction as a control site (site C. Results The results showed that, for all children in this study, the mean PPT values was significantly lower (p p Conclusions It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to indentify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

  20. Fluctuating Experimental Pain Sensitivities across the Menstrual Cycle Are Contingent on Women’s Romantic Relationship Status

    OpenAIRE

    Jacob M Vigil; Chance Strenth; Tiffany Trujillo; Gangestad, Steven W.

    2014-01-01

    We explored the social-signaling hypothesis that variability in exogenous pain sensitivities across the menstrual cycle is moderated by women’s current romantic relationship status and hence the availability of a solicitous social partner for expressing pain behaviors in regular, isochronal ways. In two studies, we used the menstrual calendars of healthy women to provide a detailed approximation of the women’s probability of conception based on their current cycle-day, along with relationship...

  1. Effects of strength vs aerobic exercise on pain severity in adults with fibromyalgia: a randomized equivalence trial.

    Science.gov (United States)

    Hooten, W Michael; Qu, Wenchun; Townsend, Cynthia O; Judd, Jeffrey W

    2012-04-01

    Strength training and aerobic exercise have beneficial effects on pain in adults with fibromyalgia. However, the equivalence of strengthening and aerobic exercise has not been reported. The primary aim of this randomized equivalence trial involving patients with fibromyalgia admitted to an interdisciplinary pain treatment program was to test the hypothesis that strengthening (n=36) and aerobic (n=36) exercise have equivalent effects (95% confidence interval within an equivalence margin ± 8) on pain, as measured by the pain severity subscale of the Multidimensional Pain Inventory. Secondary aims included determining the effects of strengthening and aerobic exercise on peak Vo(2) uptake, leg strength, and pressure pain thresholds. In an intent-to-treat analysis, the mean (± standard deviation) pain severity scores for the strength and aerobic groups at study completion were 34.4 ± 11.5 and 37.6 ± 11.9, respectively. The group difference was -3.2 (95% confidence interval, -8.7 to 2.3), which was within the equivalence margin of Δ8. Significant improvements in pain severity (Ppain thresholds (Peffects of exercise have important clinical implications that could allow practitioners to target exercise recommendations on the basis of comorbid medical conditions or patient preference for a particular type of exercise. This study found that strength and aerobic exercise had equivalent effects on reducing pain severity among patients with fibromyalgia.

  2. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults

    Directory of Open Access Journals (Sweden)

    Novak SP

    2016-06-01

    Full Text Available Scott P Novak,1 Cristie Glasheen,1 Carl L Roland,2 1Behavioral Health Epidemiology, RTI International, 2Clinical Sciences and Outcomes Evidence, Pfizer Inc., Durham, NC, USA Background: The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, a representative 3-year longitudinal survey (ages 18+ years that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods: We used a two-wave, nationally representative sample of adults (aged 18+ years in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves. Results: Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion: This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of

  3. The local effect of octreotide on mechanical pain sensitivity is more sensitive in DA rats than DA.1U rats.

    Science.gov (United States)

    Yao, Fan-Rong; Wang, Hui-Sheng; Guo, Yuan; Zhao, Yan

    2016-02-01

    A recent study by the authors indicated that major histocompatibility complex (MHC) genes are associated with the differences in basal pain sensitivity and in formalin model between Dark-Agouti (DA) and novel congenic DA.1U rats, which have the same genetic background as DA rats except for the u alleles of MHC. The objective of the present study is to investigate whether there is a difference in the pristane-induced arthritis (PIA) model and local analgesic effect of octreotide (OCT) between DA and DA.1U rats. The hindpaw mechanical withdrawal threshold (MWT) and heat withdrawal latency (HWL) were observed. The C unit firings of the tibial nerve evoked by non-noxious and noxious toe movements were recorded by electrophysiological methods in normal and PIA models in DA and DA.1U rats before and after local OCT administration. The expression of somatostatin receptor 2A (SSTR2A) was observed by immunohistochemistry. The results demonstrate that DA rats have a higher mechanical sensitivity than DA.1U rats after PIA. Local OCT administration significantly elevated MWT in DA rats under normal and PIA sate, but not in DA.1U rats. The electrophysiological experiments showed OCT significantly attenuated the firings of C units evoked by non-noxious and noxious stimulation in DA rats more than those in DA.1U rats both in normal and PIA states. In addition, the expression of SSTR2A in the dorsal horn of the spinal cord was significantly higher in DA than in DA.1U rats. All of the findings suggest a higher local analgesic effect of OCT in DA rats than DA.1U rats, which might be associated with the MHC genes.

  4. The mu opioid receptor A118G gene polymorphism moderates effects of trait anger-out on acute pain sensitivity.

    Science.gov (United States)

    Bruehl, Stephen; Chung, Ok Y; Burns, John W

    2008-10-15

    Both trait anger-in (managing anger through suppression) and anger-out (managing anger through direct expression) are related to pain responsiveness, but only anger-out effects involve opioid mechanisms. Preliminary work suggested that the effects of anger-out on postoperative analgesic requirements were moderated by the A118G single nucleotide polymorphism of the mu opioid receptor gene. This study further explored these potential genotypexphenotype interactions as they impact acute pain sensitivity. Genetic samples and measures of anger-in and anger-out were obtained in 87 subjects (from three studies) who participated in controlled laboratory acute pain tasks (ischemic, finger pressure, thermal). McGill Pain Questionnaire (MPQ) Sensory and Affective ratings for each pain task were standardized within studies, aggregated across pain tasks, and combined for analyses. Significant anger-outxA118G interactions were observed (p'seffects tests for both pain measures revealed that whereas anger-out was nonsignificantly hyperalgesic in subjects homozygous for the wild-type allele, anger-out was significantly hypoalgesic in those with the variant G allele (p'spain sensitivity in high anger-out subjects with the G allele and heightened pain sensitivity in low anger-out subjects with the G allele relative to responses in homozygous wild-type subjects. No genetic moderation was observed for anger-in, although significant main effects on MPQ-Affective ratings were noted (peffects were due to overlap with negative affect, but anger-outxA118G interactions were not, suggesting unique effects of expressive anger regulation. Results support opioid-related genotypexphenotype interactions involving trait anger-out.

  5. Cohort Removal Induces Changes in Body Temperature, Pain Sensitivity, and Anxiety-Like Behavior.

    Science.gov (United States)

    Takao, Keizo; Shoji, Hirotaka; Hattori, Satoko; Miyakawa, Tsuyoshi

    2016-01-01

    Mouse behavior is analyzed to elucidate the effects of various experimental manipulations, including gene mutation and drug administration. When the effect of a factor of interest is assessed, other factors, such as age, sex, temperature, apparatus, and housing, are controlled in experiments by matching, counterbalancing, and/or randomizing. One such factor that has not attracted much attention is the effect of sequential removal of animals from a common cage (cohort removal). Here we evaluated the effects of cohort removal on rectal temperature, pain sensitivity, and anxiety-like behavior by analyzing the combined data of a large number of C57BL/6J mice that we collected using a comprehensive behavioral test battery. Rectal temperature increased in a stepwise manner according to the position of sequential removal from the cage, consistent with previous reports. In the hot plate test, the mice that were removed first from the cage had a significantly longer latency to show the first paw response than the mice removed later. In the elevated plus maze, the mice removed first spent significantly less time on the open arms compared to the mice removed later. The results of the present study demonstrated that cohort removal induces changes in body temperature, pain sensitivity, and anxiety-like behavior in mice. Cohort removal also increased the plasma corticosterone concentration in mice. Thus, the ordinal position in the sequence of removal from the cage should be carefully counterbalanced between groups when the effect of experimental manipulations, including gene manipulation and drug administration, are examined using behavioral tests. PMID:27375443

  6. Cohort removal induces changes in body temperature, pain sensitivity, and anxiety-like behavior

    Directory of Open Access Journals (Sweden)

    Keizo eTakao

    2016-06-01

    Full Text Available Mouse behavior is analyzed to elucidate the effects of various experimental manipulations, including gene mutation and drug administration. When the effect of a factor of interest is assessed, other factors, such as age, sex, temperature, apparatus, and housing, are controlled in experiments by matching, counterbalancing, and/or randomizing. One such factor that has not attracted much attention is the effect of sequential removal of animals from a common cage (cohort removal. Here we evaluated the effects of cohort removal on rectal temperature, pain sensitivity, and anxiety-like behavior by analyzing the combined data of a large number of C57BL/6J mice that we collected using a comprehensive behavioral test battery. Rectal temperature increased in a stepwise manner according to the position of sequential removal from the cage, consistent with previous reports. In the hot plate test, the mice that were removed first from the cage had a significantly longer latency to show the first paw response than the mice removed later. In the elevated plus maze, the mice removed first spent significantly less time on the open arms compared to the mice removed later. The results of the present study demonstrated that cohort removal induces changes in body temperature, pain sensitivity, and anxiety-like behavior in mice. Cohort removal also increased the plasma corticosterone concentration in mice. Thus, the ordinal position in the sequence of removal from the cage should be carefully counterbalanced between groups when the effect of experimental manipulations, including gene manipulation and drug administration, are examined using behavioral tests.

  7. Cohort Removal Induces Changes in Body Temperature, Pain Sensitivity, and Anxiety-Like Behavior.

    Science.gov (United States)

    Takao, Keizo; Shoji, Hirotaka; Hattori, Satoko; Miyakawa, Tsuyoshi

    2016-01-01

    Mouse behavior is analyzed to elucidate the effects of various experimental manipulations, including gene mutation and drug administration. When the effect of a factor of interest is assessed, other factors, such as age, sex, temperature, apparatus, and housing, are controlled in experiments by matching, counterbalancing, and/or randomizing. One such factor that has not attracted much attention is the effect of sequential removal of animals from a common cage (cohort removal). Here we evaluated the effects of cohort removal on rectal temperature, pain sensitivity, and anxiety-like behavior by analyzing the combined data of a large number of C57BL/6J mice that we collected using a comprehensive behavioral test battery. Rectal temperature increased in a stepwise manner according to the position of sequential removal from the cage, consistent with previous reports. In the hot plate test, the mice that were removed first from the cage had a significantly longer latency to show the first paw response than the mice removed later. In the elevated plus maze, the mice removed first spent significantly less time on the open arms compared to the mice removed later. The results of the present study demonstrated that cohort removal induces changes in body temperature, pain sensitivity, and anxiety-like behavior in mice. Cohort removal also increased the plasma corticosterone concentration in mice. Thus, the ordinal position in the sequence of removal from the cage should be carefully counterbalanced between groups when the effect of experimental manipulations, including gene manipulation and drug administration, are examined using behavioral tests.

  8. Sensitization of capsaicin and icilin responses in oxaliplatin treated adult rat DRG neurons

    Directory of Open Access Journals (Sweden)

    Anand Praveen

    2010-11-01

    Full Text Available Abstract Background Oxaliplatin chemotherapy induced neuropathy is a dose related cumulative toxicity that manifests as tingling, numbness, and chronic pain, compromising the quality of life and leading to discontinued chemotherapy. Patients report marked hypersensitivity to cold stimuli at early stages of treatment, when sensory testing reveals cold and heat hyperalgesia. This study examined the morphological and functional effects of oxaliplatin treatment in cultured adult rat DRG neurons. Results 48 hour exposure to oxaliplatin resulted in dose related reduction in neurite length, density, and number of neurons compared to vehicle treated controls, using Gap43 immunostaining. Neurons treated acutely with 20 μg/ml oxaliplatin showed significantly higher signal intensity for cyclic AMP immunofluorescence (160.5 ± 13 a.u., n = 3, P Conclusions Oxaliplatin treatment induces TRP sensitization mediated by increased intracellular cAMP, which may cause neuronal damage. These effects may be mitigated by co-treatment with adenylyl cyclase inhibitors, like CB2 agonists, to alleviate the neurotoxic effects of oxaliplatin.

  9. Does format matter for comprehension of a facial affective scale and a numeric scale for pain by adults with Down syndrome?

    NARCIS (Netherlands)

    N.C. de Knegt; H.M. Evenhuis; F. Lobbezoo; C. Schuengel; E.J.A. Scherder

    2013-01-01

    People with intellectual disabilities are at high risk for pain and have communication difficulties. Facial and numeric scales for self-report may aid pain identification. It was examined whether the comprehension of a facial affective scale and a numeric scale for pain in adults with Down syndrome

  10. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2008-05-01

    Full Text Available Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S; levator scapulae region (LS; sternocleidomastoid region (SCM and temporomandibular region (TMJ. For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables using forward stepwise General Linear Model. Results The visual analog scale (0 to 10 had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P Conclusion After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly

  11. An evidence-based guideline on yoga in reducing pain among adult patients with chronic low back pain

    OpenAIRE

    林德; Lam, Tak

    2013-01-01

    Low back pain (LBP) is a common complaint and health problem in Hong Kong, particularly among middle-aged individuals. LBP is the main cause of chronic disability which significantly affects the daily life activities of patients. Pain might result in repeated hospital admissions and subsequently increase the burden on health care providers in Hong Kong. LBP has an enormous effect on quality of life and therefore deserves research attention. Growing evidence shows that yoga may help reduce...

  12. Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

    Directory of Open Access Journals (Sweden)

    Astrid M. A. Eriksen

    2016-10-01

    Full Text Available Background: Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective: The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design: The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5% and 8,963 non-Sami respondents (80.5%. Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results: Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model, and higher pain intensity. Conclusion: Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity.

  13. Activation of CB1 inhibits NGF-induced sensitization of TRPV1 in adult mouse afferent neurons.

    Science.gov (United States)

    Wang, Z-Y; McDowell, T; Wang, P; Alvarez, R; Gomez, T; Bjorling, D E

    2014-09-26

    Transient receptor potential vanilloid 1 (TRPV1)-containing afferent neurons convey nociceptive signals and play an essential role in pain sensation. Exposure to nerve growth factor (NGF) rapidly increases TRPV1 activity (sensitization). In the present study, we investigated whether treatment with the selective cannabinoid receptor 1 (CB1) agonist arachidonyl-2'-chloroethylamide (ACEA) affects NGF-induced sensitization of TRPV1 in adult mouse dorsal root ganglion (DRG) afferent neurons. We found that CB1, NGF receptor tyrosine kinase A (trkA), and TRPV1 are present in cultured adult mouse small- to medium-sized afferent neurons and treatment with NGF (100ng/ml) for 30 min significantly increased the number of neurons that responded to capsaicin (as indicated by increased intracellular Ca(2 +) concentration). Pretreatment with the CB1 agonist ACEA (10nM) inhibited the NGF-induced response, and this effect of ACEA was reversed by a selective CB1 antagonist. Further, pretreatment with ACEA inhibited NGF-induced phosphorylation of AKT. Blocking PI3 kinase activity also attenuated the NGF-induced increase in the number of neurons that responded to capsaicin. Our results indicate that the analgesic effect of CB1 activation may in part be due to inhibition of NGF-induced sensitization of TRPV1 and also that the effect of CB1 activation is at least partly mediated by attenuation of NGF-induced increased PI3 signaling.

  14. Effect of physical training on pain sensitivity and trapezius muscle morphology

    DEFF Research Database (Denmark)

    Nielsen, Pernille Kofoed; Andersen, Lars L; Olsen, Henrik B;

    2010-01-01

    activation. After 10 weeks, increased shoulder torque and PPT of the painful trapezius were observed in SST solely. The PPT of a pain-free reference muscle was increased in response to both SST and GFT, indicating a general effect of physical activity on pain perception. This study shows clinically relevant...

  15. Role of induced negative and positive emotions in sensitivity to itch and pain in women.

    NARCIS (Netherlands)

    Laarhoven, A.I.M. van; Walker, A.L.; Wilder-Smith, O.H.G.; Kroeze, S.; Riel, P.L.C.M. van; Kerkhof, P.C.M. van de; Kraaimaat, F.W.; Evers, A.W.M.

    2012-01-01

    Background Itch and pain are common symptoms in skin disease. It has been suggested that negative emotions may play a role in itch and pain. To date, however, the role of emotions has only been studied for pain in experimental studies, not yet for itch. Objectives To investigate the effects of negat

  16. The Sensitization Model to Explain How Chronic Pain Exists Without Tissue Damage

    NARCIS (Netherlands)

    van Wilgen, C. Paul; Keizer, Doeke

    2012-01-01

    The interaction of nurses with chronic pain patients is often difficult. One of the reasons is that chronic pain is difficult to explain, because no obvious anatomic defect or tissue damage is present. There is now enough evidence available indicating that chronic pain syndromes such as low back pai

  17. Long-Term Effects of Neonatal Morphine Infusion on Pain Sensitivity: Follow-Up of a Randomized Controlled Trial.

    Science.gov (United States)

    Valkenburg, Abraham J; van den Bosch, Gerbrich E; de Graaf, Joke; van Lingen, Richard A; Weisglas-Kuperus, Nynke; van Rosmalen, Joost; Groot Jebbink, Liesbeth J M; Tibboel, Dick; van Dijk, Monique

    2015-09-01

    Short-term and long-term effects of neonatal pain and its analgesic treatment have been topics of translational research over the years. This study aimed to identify the long-term effects of continuous morphine infusion in the neonatal period on thermal pain sensitivity, the incidence of chronic pain, and neurological functioning. Eighty-nine of the 150 participants of a neonatal randomized controlled trial on continuous morphine infusion versus placebo during mechanical ventilation underwent quantitative sensory testing and neurological examination at the age of 8 or 9 years. Forty-three children from the morphine group and 46 children from the placebo group participated in this follow-up study. Thermal detection and pain thresholds were compared with data from 28 healthy controls. Multivariate analyses revealed no statistically significant differences in thermal detection thresholds and pain thresholds between the morphine and placebo groups. The incidence of chronic pain was comparable between both groups. The neurological examination was normal in 29 (76%) of the children in the morphine group and 25 (61%) of the children in the control group (P = .14). We found that neonatal continuous morphine infusion (10 μg/kg/h) has no adverse effects on thermal detection and pain thresholds, the incidence of chronic pain, or overall neurological functioning 8 to 9 years later. Perspective: This unique long-term follow-up study shows that neonatal continuous morphine infusion (10 μg/kg/h) has no long-term adverse effects on thermal detection and pain thresholds or overall neurological functioning. These findings will help clinicians to find the most adequate and safe analgesic dosing regimens for neonates and infants.

  18. Impact of osteopathic treatment on pain in adult patients with cystic fibrosis--a pilot randomized controlled study.

    Directory of Open Access Journals (Sweden)

    Dominique Hubert

    Full Text Available Pain is a common complication in patients with cystic fibrosis (CF and is associated with shorter survival. We evaluated the impact of osteopathic manipulative treatment (OMT on pain in adults with CF.A pilot multicenter randomized controlled trial was conducted with three parallel arms: OMT (group A, 16 patients, sham OMT (sham treatment, group B, 8 patients and no treatment (group C, 8 patients. Medical investigators and patients were double-blind to treatment for groups A and B, who received OMT or sham OMT monthly for 6 months. Pain was rated as a composite of its intensity and duration over the previous month. The evolution of chest/back pain after 6 months was compared between group A and groups B+C combined (control group. The evolution of cervical pain, headache and quality of life (QOL were similarly evaluated.There was no statistically significant difference between the treatment and control groups in the decrease of chest/back pain (difference = -2.20 IC95% [-4.81; 0.42], p = 0.098; also, group A did not differ from group B. However, chest/back pain decreased more in groups A (p = 0.002 and B (p = 0.006 than in group C. Cervical pain, headache and QOL scores did not differ between the treatment and control groups.This pilot study demonstrated the feasibility of evaluating the efficacy of OMT to treat the pain of patients with CF. The lack of difference between the group treated with OMT and the control group may be due to the small number of patients included in this trial, which also precludes any definitive conclusion about the greater decrease of pain in patients receiving OMT or sham OMT than in those with no intervention.ClinicalTrials.gov NCT01293019.

  19. SURGICAL MANAGEMENT OF SYMPTOMATIC LOW BACK PAIN AND MONORADICULAR LEG PAIN IN ADOLESCENT AND YOUNG ADULT PATIENTS

    Directory of Open Access Journals (Sweden)

    Kalevski Svetoslav

    2014-07-01

    Full Text Available Objectives: The purpose of the present retrospective study is to draw attention to symptomatic low back pain in adolescent patients, in order to encourage earlier diagnosis and surgical treatment. The study assessed the radiological, clinical features and surgical outcomes of 13 of this kind of patient. Materials and Methods: Out of a series of 983 consecutive cases (1999–2011 of lumbar disc excisions from our neurosurgical institution, 13–1,32% of the patients were between the ages of 15 and 20 mean 17,84. Fifteen operations, including two reoperations,were performed on this patient group, by a conventional microsurgical procedure. The indications for surgery were failure of conservative treatment, in tractable pain and/or progressive neurological impairment. Results: Low back pain and monoradicular sciatica were the main complaints in 77%, but findings of neurological deficits were rare — 1 case. The surgical findings revealed a protruding disc in eleven cases, one lateral recess stenosis and one lumbar synovial cyst. Initially, all patients were treated conservatively by their physicians more than 3 months without success. On the day of discharge, Kirkaldy-Willis criteria results were excellent or good in 92% of patients. The follow-up period ranged from 6 months to 2 years with an average of 1 year and 2 months. The results were excellent in 10 patients and good in 3 patients. Discussion: We demonstrate that the cause of low back pain and monoradicular leg pain in adolescent patients may not only be a cause of herniated lumbar disc or lateral recess narrowing. Very rarely these symptoms may be caused by lumbar synovial cysts. Conclusion: Surgical treatment of adolescent patients is able to relieve the clinical symptoms quickly. Clinical symptoms such as low back pain and leg pain and the neurologic deficit disappear within 3 months after surgery.

  20. Serum Levels of Proinflammatory Cytokines in Painful Knee Osteoarthritis and Sensitization

    Science.gov (United States)

    Imamura, Marta; Ezquerro, Fernando; Marcon Alfieri, Fábio; Vilas Boas, Lucy; Tozetto-Mendoza, Tania Regina; Chen, Janini; Özçakar, Levent; Arendt-Nielsen, Lars

    2015-01-01

    Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients' functional capacity and pressure pain threshold (PPT) values. PMID:25821631

  1. Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

    Directory of Open Access Journals (Sweden)

    Vacek TP

    2014-09-01

    Full Text Available Thomas P Vacek, Shahnaz Rehman, Shipeng Yu, Ankush Moza, Ragheb Assaly Department of Internal Medicine, The University of Toledo Medical Center, Toledo OH, USAAbstract: Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient's blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause.Keywords: substernal, pleuritic, myocardial infarction, differential

  2. Evidence of heterosynaptic LTD in the human nociceptive system: superficial skin neuromodulation using a matrix electrode reduces deep pain sensitivity.

    Directory of Open Access Journals (Sweden)

    Martin Mücke

    Full Text Available Long term depression (LTD is a neuronal learning mechanism after low frequency stimulation (LFS. This study compares two types of electrodes (concentric vs. matrix and stimulation frequencies (4 and 30 Hz to examine homo- and heterosynaptic effects indirectly depicted from the somatosensory profile of healthy subjects. Both electrodes were compared in a prospective, randomized, controlled cross-over study using 4 Hz as the conditioning LFS compared to 30 Hz (intended sham condition. Quantitative sensory testing (QST was used to examine 13 thermal and mechanical detection and pain thresholds. Sixteen healthy volunteers (10 women, age 31.0 ± 12.7 years were examined. Depending on the electrodes and frequencies used a divergent pattern of sensory minus signs occurred. Using LFS the concentric electrode increased thermal thresholds, while the matrix electrode rather increased mechanical including deep pain thresholds. Findings after cutaneous neuromodulation using LFS and a matrix electrode are consistent with the concept of heterosynaptic LTD in the human nociceptive system, where deep pain sensitivity was reduced after superficial stimulation of intraepidermal nerve fibres. Cutaneous neuromodulation using LFS and a matrix electrode may be a useful tool to influence deep pain sensitivity in a variety of chronic pain syndromes.

  3. Adult Attachment States of Mind: Measurement Invariance across Ethnicity and Associations with Maternal Sensitivity

    Science.gov (United States)

    Haltigan, John D.; Leerkes, Esther M.; Wong, Maria S.; Fortuna, Keren; Roisman, Glenn I.; Supple, Andrew J.; O'Brien, Marion; Calkins, Susan D.; Plamondon, André

    2014-01-01

    This study examined the developmental significance of mothers' adult attachment representations assessed prenatally with the Adult Attachment Interview in relation to observed maternal sensitivity at 6 months postpartum in an ethnically diverse sample (N = 131 African American; N = 128 European American). Multiple-group confirmatory factor…

  4. Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis - treatment effects of neuromuscular exercise and total joint replacement

    DEFF Research Database (Denmark)

    Kosek, E; Roos, Ewa M.; Ageberg, E;

    2013-01-01

    To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters.......To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters....

  5. Self-assessment of pain and discomfort in patients with temporomandibular disorders: a comparison of five different scales with respect to their precision and sensitivity as well as their capacity to register memory of pain and discomfort.

    Science.gov (United States)

    Magnusson, T; List, T; Helkimo, M

    1995-08-01

    Five different scales of self-assessment of pain were tested in patients with temporomandibular disorders. The precision and sensitivity and the capacity to register memory of pain and discomfort were compared for each of the five scales. The behaviour rating scale was found to be superior to the other four scales in respect of precision and sensitivity to pain and discomfort and when recording the memory of these two variables. This scale was also considered by the patients to be the most relevant and the simplest to understand. From these results, the behaviour rating scale can be recommended when measuring pain and discomfort in patients with temporomandibular disorders.

  6. Thresholds and Tolerance of Physical Pain Among Young Adults Who Self-Injure

    Directory of Open Access Journals (Sweden)

    Katrina McCoy

    2010-01-01

    Full Text Available Prevalence rates of nonsuicidal self-injury among college students range from 17% to 38%. Research indicates that individuals with borderline personality disorder who self-injure sometimes report an absence of pain during self-injury. Furthermore, self-injury in the absence of pain has been associated with more frequent suicide attempts. The present study examined pain thresholds and tolerance among 44 college students (11 who engaged in self-injury and 33 who did not. Pain thresholds and tolerance were measured using an algometer pressure device that was used to produce pain in previous laboratory research. Participants who engaged in self-injury had a higher pain tolerance than those who did not. In addition, participants who engaged in self-injury rated the pain as less intense than participants who did not. ANCOVAs revealed that depression was associated with pain rating and pain tolerance.

  7. Quantitative automated microscopy (QuAM elucidates growth factor specific signalling in pain sensitization

    Directory of Open Access Journals (Sweden)

    Levine Jon D

    2010-12-01

    PGE2-induced sensitization. Conclusions QuAM is a suitable if not necessary tool to analyze activation of endogenous signalling in heterogeneous cultures. NGF, GDNF and EGF stimulation of DRG-neurons shows differential Erk1/2 activation responses and a corresponding differential behavioral phenotype. Thus, in addition to expression-markers also signalling-activity can be taken for functional subgroup differentiation and as predictor of behavioral outcome. The anti-nociceptive function of EGF is an intriguing result in the context of tissue damage but also for understanding pain resulting from EGF-receptor block during cancer therapy.

  8. Pain frequency moderates the relationship between pain catastrophizing and pain

    OpenAIRE

    Heidi eKjøgx; Robert eZachariae; Mogens ePfeiffer-Jensen; Helge eKasch; Peter eSvensson; Troels Staehelin Jensen; Lene eVase

    2014-01-01

    Background Pain frequency has been shown to influence sensitization, psychological distress and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale, Beck Depression Inventory and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency Results In...

  9. Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS)

    DEFF Research Database (Denmark)

    Kuzminskyte, Ruta; Kupers, Ronny Clement Florent; Videbech, Poul;

    2010-01-01

    Many patients in a variety of medical settings suffer from persistently painful bodily symptoms that are not explained by known pathophysiological mechanisms. In the most severe cases, these patients complain of multiple functional somatic symptoms (MFS). We tested the hypothesis of reduced pain ...

  10. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    Science.gov (United States)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p pain intensity (NRS: 6.4 versus 2.7; p painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain. PMID:26824670

  11. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    Science.gov (United States)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p pain intensity (NRS: 6.4 versus 2.7; p shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain.

  12. Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Gay CW

    2013-02-01

    Full Text Available Charles W Gay,1 Meryl J Alappattu,1 Rogelio A Coronado,1 Maggie E Horn,1 Mark D Bishop21Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, 2Department of Physical Therapy, University of Florida, Gainesville, FLBackground: Muscle-biased therapies (MBT are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration.Methods: A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type.Results: Reports from 24 randomized controlled trials (23 articles were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain

  13. Effect of TENS on pain in relation to central sensitization in patients with osteoarthritis of the knee: study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Beckwée David

    2012-02-01

    Full Text Available Abstract Background Central sensitization has recently been documented in patients with knee osteoarthritis (OAk. So far, the presence of central sensitization has not been considered as a confounding factor in studies assessing the pain inhibitory effect of tens on osteoarthritis of the knee. The purpose of this study is to explore the pain inhibitory effect of burst tens in OAk patients and to explore the prognostic value of central sensitization on the pain inhibitory effect of tens in OAk patients. Methods Patients with knee pain due to OAk will be recruited through advertisements in local media. Temporal summation, before and after a heterotopic noxious conditioning stimulation, will be measured. In addition, pain on a numeric rating score, WOMAC subscores for pain and function and global perceived effect will be assessed. Patients will be randomly allocated to one of two treatment groups (tens, sham tens. Follow-up measurements will be scheduled after a period of 6 and 12 weeks. Discussion Tens influences pain through the electrical stimulation of low-threshold A-beta cutaneous fibers. The responsiveness of central pain-signaling neurons of centrally sensitized OAk patients may be augmented to the input of these electrical stimuli. This would encompass an adverse therapy effect of tens. To increase treatment effectiveness it might be interesting to identify a subgroup of symptomatic OAk patients, i.e., non-sensitized patients, who are likely to benefit from burst tens. Trial Registration ClinicalTrials.gov: NCT01390285

  14. Psychological distress and emotional pain among adult attendees of a dental clinic: a case-control study

    Directory of Open Access Journals (Sweden)

    Adebayo Rasheed Erinfolami

    2016-05-01

    Full Text Available We set out to carry out a case-control evaluation of psychological distress and emotional pain among adult attendees of a Nigerian dental clinic. A total of 201 subjects, made up of 101 dental patients (test group matched with age and sex with 100 normal subjects (controls, was recruited into the study. All participants completed a designed socio-demographic questionnaire. General Health Question naire and Psyche ache Assessment Schedule were also administered to assess psychological distress based on cut-off scores ≥3 and emotional pain based on cut-off scores ≥28 respectively. The mean ages of study and control group were 33 (±12 and 36 (±13 years respectively, and both study and control groups were not significantly different in all the assessed socio-demographic parameters. Overall, 21.8% (n=22 of the subjects had psychological distress, while only 7% of the control group had psychological distress. This difference was statistically significant (P=0.003. Similarly, there was significant difference in the experience of psyche ache (unbearable psychological pain as over a third of the dental patients (37.6%, n=38 had emotional pain, while only 13% of the controls experienced psych ache (P<0.001. In this study, the burden of psychological distress and emotional pain was many-fold in dental patients when compared with the controls.

  15. Psychological Distress and Emotional Pain Among Adult Attendees of a Dental Clinic: A Case-Control Study.

    Science.gov (United States)

    Erinfolami, Adebayo Rasheed; Olagunju, Andrew Toyin; Oshodi, Yewande Olufunmilayo; Akinbode, Abiola Adelphine; Fadipe, Babatunde; Adeyemo, Wasiu Lanre

    2016-05-18

    We set out to carry out a case-control evaluation of psychological distress and emotional pain among adult attendees of a Nigerian dental clinic. A total of 201 subjects, made up of 101 dental patients (test group) matched with age and sex with 100 normal subjects (controls), was recruited into the study. All participants completed a designed socio-demographic questionnaire. General Health Question naire and Psyche ache Assessment Schedule were also administered to assess psychological distress based on cut-off scores ≥3 and emotional pain based on cut-off scores ≥28 respectively. The mean ages of study and control group were 33 (±12) and 36 (±13) years respectively, and both study and control groups were not significantly different in all the assessed socio-demographic parameters. Overall, 21.8% (n=22) of the subjects had psychological distress, while only 7% of the control group had psychological distress. This difference was statistically significant (P=0.003). Similarly, there was significant difference in the experience of psyche ache (unbearable psychological pain) as over a third of the dental patients (37.6%, n=38) had emotional pain, while only 13% of the controls experienced psych ache (P<0.001). In this study, the burden of psychological distress and emotional pain was many-fold in dental patients when compared with the controls. PMID:27403272

  16. Factors associated with sexual orientation and gender disparities in chronic pain among U.S. adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Sabra L. Katz-Wise

    2015-01-01

    Full Text Available This research investigated factors associated with sexual orientation disparities in chronic pain frequency among youth. Data were analyzed from 4534 female and 3785 male youth from Waves I–IV (1995–2009 of the U.S. National Longitudinal Study of Adolescent to Adult Health. Gender-stratified weighted logistic regression models controlled for sociodemographic characteristics and included sexual orientation (primary predictor and frequency of three types of chronic pain (outcomes. Models with sexual orientation only were compared to models with factors hypothesized to increase or decrease risk of pain. Significant odds ratios (OR for chronic pain frequency (daily/weekly vs. rarely with confidence intervals (CI and associated factors are reported. Compared to same-gender heterosexual females, mostly heterosexuals were more likely to report headaches (OR = 1.40, CI = 1.09, 1.79 and mostly heterosexuals and bisexuals were more likely to report muscle/joint pain (mostly heterosexual OR = 1.69, CI = 1.29, 2.20; bisexual OR = 1.87, CI = 1.03, 3.38. Compared to same-gender heterosexual males, gay males were more likely to report headaches (OR = 2.00, CI = 1.06, 3.82, but less likely to report muscle/joint pain (OR = 0.28, CI = 0.11, 0.74. Significant disparities were attenuated by up to 16% when associated factors were added to the model. Sexual orientation disparities in chronic pain were partially explained by associated factors, but more research is needed to develop intervention and prevention strategies.

  17. Factors associated with sexual orientation and gender disparities in chronic pain among U.S. adolescents and young adults

    Science.gov (United States)

    Katz-Wise, Sabra L.; Everett, Bethany; Scherer, Emily A.; Gooding, Holly; Milliren, Carly E.; Austin, S. Bryn

    2015-01-01

    This research investigated factors associated with sexual orientation disparities in chronic pain frequency among youth. Data were analyzed from 4534 female and 3785 male youth from Waves I–IV (1995–2009) of the U.S. National Longitudinal Study of Adolescent to Adult Health. Gender-stratified weighted logistic regression models controlled for sociodemographic characteristics and included sexual orientation (primary predictor) and frequency of three types of chronic pain (outcomes). Models with sexual orientation only were compared to models with factors hypothesized to increase or decrease risk of pain. Significant odds ratios (OR) for chronic pain frequency (daily/weekly vs. rarely) with confidence intervals (CI) and associated factors are reported. Compared to same-gender heterosexual females, mostly heterosexuals were more likely to report headaches (OR = 1.40, CI = 1.09, 1.79) and mostly heterosexuals and bisexuals were more likely to report muscle/joint pain (mostly heterosexual OR = 1.69, CI = 1.29, 2.20; bisexual OR = 1.87, CI = 1.03, 3.38). Compared to same-gender heterosexual males, gay males were more likely to report headaches (OR = 2.00, CI = 1.06, 3.82), but less likely to report muscle/joint pain (OR = 0.28, CI = 0.11, 0.74). Significant disparities were attenuated by up to 16% when associated factors were added to the model. Sexual orientation disparities in chronic pain were partially explained by associated factors, but more research is needed to develop intervention and prevention strategies. PMID:26557475

  18. Paternal and maternal bonding styles in childhood are associated with the prevalence of chronic pain in a general adult population: the Hisayama Study

    OpenAIRE

    Anno, Kozo; Shibata, Mao; Ninomiya, Toshiharu; Iwaki, Rie; Kawata, Hiroshi; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

    2015-01-01

    Background Previous research has suggested that extraordinary adverse experiences during childhood, such as abuse, are possible risk factors for the development of chronic pain. However, the relationship between the perceived parental bonding style during childhood and chronic pain has been much less studied. Methods In this cross-sectional study, 760 community-dwelling Japanese adults were asked if they had pain that had been present for six months or more. They completed the Parental Bondin...

  19. Early maladaptive schemas in Finnish adult chronic pain patients and a control sample.

    Science.gov (United States)

    Saariaho, Tom Harri; Saariaho, Anita Sylvia; Karila, Irma Anneli; Joukamaa, Matti I

    2011-04-01

    Engel (1959) suggested that negative physical or emotional experiences in childhood predispose to the development of chronic pain. Studies have shown that physical and sexual abuse in early life is connected with chronic pain. Emotional adversities are much less studied causes contributing to the development of chronic pain and disability. Early emotional abuse, neglect, maltreatment and other adversities are deleterious childhood experiences which, according to Young's schema theory (1990), produce early maladaptive schemas (EMSs). The primary goal of this study was to examine whether early adversities were more common in chronic pain patients than in a control group. A total of 271 (53% women) first-visit chronic pain patients and 331 (86% women) control participants took part in the study. Their socio-demographic data, pain variables and pain disability were measured. To estimate EMSs the Young Schema Questionnaire was used. Chronic pain patients scored higher EMSs reflecting incapacity to perform independently, catastrophic beliefs and pessimism. The most severely disabled chronic pain patients showed an increase in all the EMSs in the Disconnection and Rejection schema domain, namely Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, Defectiveness/Shame and Social Isolation/Alienation EMSs. The results of the study suggested that chronic pain patients had suffered early emotional maltreatment. PMID:21054422

  20. Pain measurement as part of primary healthcare of adult patients with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Andreza Aparecida Felix Signorelli

    2013-01-01

    Full Text Available OBJECTIVE: The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare. METHODS: Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle β-thalassemia and others and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis with a level of 5% (p-value < 0.05 being set for the rejection of the null hypothesis. RESULTS: Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7% and female (59.6% and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS. The intensity of pain (Numeric Pain Scale was 5.5 and the quantitative index (McGill was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes. CONCLUSION: According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized and treated at the three levels of healthcare. In primary healthcare, accurate measurement of pain combined with better care may decrease acute painful episodes and consequently minimize tissue damage, thus improving the patient's overall health.

  1. Improved foot sensitivity and pain reduction in patients with peripheral neuropathy after treatment with monochromatic infrared photo energy--MIRE.

    Science.gov (United States)

    Harkless, Lawrence B; DeLellis, Salvatore; Carnegie, Dale H; Burke, Thomas J

    2006-01-01

    The medical records of 2239 patients (mean age=73 years) with established peripheral neuropathy (PN) were examined to determine whether treatment with MIRE was, in fact, associated with increased foot sensitivity to the Semmes Weinstein monofilament (SWM) 5.07 and a reduction in neuropathic pain. The PN in 1395 of these patients (62%) was due to diabetes. Prior to treatment with MIRE, of the 10 tested sites (5 on each foot), 7.1+/-2.9 were insensitive to the SWM 5.07, and 2078 patients (93%) exhibited loss of protective sensation defined by Medicare as a loss of sensation at two or more sites on either foot. After treatment, the number of insensate sites on both feet decreased to 2.4+/-2.6, an improvement of 66%. Of the 2078 (93%) patients initially presenting with loss of protective sensation, 1106 (53%) no longer had loss of protective sensation after treatment (P<.0001); 1563 patients (70%) also exhibited neuropathic pain in addition to sensory impairment. Prior to treatment with MIRE, pain measured on the 11-point visual analogue scale (VAS) was 7.2+/-2.2 points, despite the use of a variety of pain-relieving therapeutic agents. After treatment with MIRE, pain was reduced by 4.8+/-2.4 points, a 67% reduction. Therefore, MIRE appears to be associated with significant clinical improvement in foot sensation and, simultaneously, a reduction in neuropathic pain in a large cohort of primarily Medicare aged, community-dwelling patients, initially diagnosed with PN. The quality of life associated with these two outcomes cannot be underappreciated. PMID:16504836

  2. Abnormal Pressure Pain, Touch Sensitivity, Proprioception, and Manual Dexterity in Children with Autism Spectrum Disorders

    OpenAIRE

    Inmaculada Riquelme; Hatem, Samar M.; Pedro Montoya

    2016-01-01

    Children with autism spectrum disorders (ASD) often display an abnormal reactivity to tactile stimuli, altered pain perception, and lower motor skills than healthy children. Nevertheless, these motor and sensory deficits have been mostly assessed by using clinical observation and self-report questionnaires. The present study aims to explore somatosensory and motor function in children with ASD by using standardized and objective testing procedures. Methods. Tactile and pressure pain threshold...

  3. Sensory-processing sensitivity moderates the association between childhood experiences and adult life satisfaction

    OpenAIRE

    Booth, C; Standage, H; Fox, E

    2015-01-01

    There are few studies testing the differential susceptibility hypothesis (DSH: hypothesizing that some individuals are more responsive to both positive and negative experiences) with adult personality traits. The current study examined the DSH by investigating the moderating effect of sensory-processing sensitivity (SPS) on childhood experiences and life satisfaction. A total of 185 adults completed measures of SPS, positive/negative childhood experiences and life satisfaction. SPS did modera...

  4. Cat sensitization according to cat window of exposure in adult asthmatics

    NARCIS (Netherlands)

    M.P. Oryszczyn; R. Ree; J. Maccario; R. Nadif; F. Kauffmann

    2009-01-01

    P>Background In adults, there is limited information on tolerance to cat, which may be reflected by high IgG(4) without IgE sensitization. Early exposure to cat may play a critical role. Objective The aim was to assess among adults the association of Fel d 1 IgG(4), Fel d 1 IgE, skin prick test (SPT

  5. Cultural Sensitivity in Screening Adults for a History of Childhood Abuse: Evidence from a Community Sample

    OpenAIRE

    Thombs, Brett D.; Bennett, Wendy; Roy C Ziegelstein; Bernstein, David P; Scher, Christine D.; Forde, David R.

    2007-01-01

    Background A number of practice guidelines and recommendations call for the assessment of childhood abuse history among adult medical patients. The cultural sensitivity of screening questions, however, has not been examined. Objective To assess whether questions that inquire about childhood abuse history function differently for black and white patients. Design Cross-sectional telephone surveys in 1997 and 2003. Subjects Randomly sampled adults from Memphis, Tenn (1997, N = 832; 2003, N = 967...

  6. Impairment-targeted exercises for older adults with knee pain: protocol for a proof-of-principle study

    Directory of Open Access Journals (Sweden)

    Thomas Elaine

    2011-01-01

    Full Text Available Abstract Background Exercise therapy for knee pain and osteoarthritis remains a key element of conservative treatment, recommended in clinical guidelines. Yet systematic reviews point to only modest benefits from exercise interventions. One reason for this might be that clinical trials tend to use a one-size-fits-all approach to exercise, effectively disregarding the details of their participants' clinical presentations. This uncontrolled before-after study (TargET-Knee-Pain aims to test the principle that exercises targeted at the specific physical impairments of older adults with knee pain may be able to significantly improve those impairments. It is a first step towards testing the effectiveness of this more individually-tailored approach. Methods/Design We aim to recruit 60 participants from an existing observational cohort of community-dwelling older adults with knee pain. Participants will all have at least one of the three physical impairments of weak quadriceps, a reduced range of knee flexion and poor standing balance. Each participant will be asked to undertake a programme of exercises, targeted at their particular combination and degree of impairment(s, over the course of twelve weeks. The exercises will be taught and progressed by an experienced physiotherapist, with reference to a "menu" of agreed exercises for each of the impairments, over the course of six fortnightly home visits, alternating with six fortnightly telephone calls. Primary outcome measures will be isometric quadriceps strength, knee flexion range of motion, timed single-leg standing balance and the "Four Balance Test Scale" at 12 weeks. Key secondary outcome measures will be self-reported levels of pain, stiffness and difficulties with day-to-day functional tasks (WOMAC. Outcome measures will be taken at three time-points (baseline, six weeks and twelve weeks by a study nurse blinded to the exercise status of the participants. Discussion This study (TargET-Knee-Pain

  7. Anterior knee pain in younger adults as a precursor to subsequent patellofemoral osteoarthritis: a systematic review

    Directory of Open Access Journals (Sweden)

    Thomas Martin J

    2010-09-01

    Full Text Available Abstract Background Patellofemoral osteoarthritis (PFOA is a common form of knee OA in middle and older age, but its relation to PF disorders and symptoms earlier in life is unclear. Our aim was to conduct a systematic review to investigate the strength of evidence for an association between anterior knee pain (AKP in younger adults and subsequent PFOA. Methods The search strategy included electronic databases (Pubmed, EMBASE, AMED, CINAHL, Cochrane, PEDro, SportDiscus: inception to December 2009, reference lists of potentially eligible studies and selected reviews. Full text articles in any language, - identified via English titles and abstracts, were included if they were retrospective or prospective in design and contained quantitative data regarding structural changes indicative of PFOA, incident to original idiopathic AKP. Eligibility criteria were applied to titles, abstracts and full-texts by two independent reviewers. Data extraction included study location, design, date, sampling procedure, sample characteristics, AKP/PFOA definitions, follow-up duration and rate, and main findings. Foreign language articles were translated into English prior to examination. Results Seven articles satisfied eligibility (5 English, 2 German. Only one case-control study directly investigated a link between PFOA and prior AKP, providing level 3b evidence in favour of an association (OR 4.4; 95%CI 1.8, 10.6. Rough estimates of the annual risk of PFOA from the remaining six small, uncontrolled, observational studies (mean follow-up range: 5.7 to 23 years ranged from 0% to 3.4%. This was not the primary aim of these studies, and limitations in design and methodology mean this data should be interpreted with caution. Conclusions There is a paucity of high-quality evidence reporting a link between AKP and PFOA. Further, well-designed cohort studies may be able to fill this evidence gap.

  8. Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa--Pain Is an Issue.

    Directory of Open Access Journals (Sweden)

    Limakatso Lebina

    Full Text Available The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC.Evaluate safety and feasibility of PrePex in South Africa.A multisite prospective cohort PrePex study in adults and adolescents at three MMC clinics. Participants were followed-up 8 times, up to 56 days after PrePex placement.In total, 398 PrePex circumcisions were performed (315 adults and 83 adolescents their median ages were 26 (IQR: 22-30 and 16 years (IQR: 15-17, respectively. The median time for device placement across both groups was 6 minutes (IQR: 5-9 with the leading PrePex sizes being B (30% and C (35% for adults (18-45 years, and A (31% and B (38% for adolescents (14-17 years. Additional sizes (size 12-20 were rarely used, even in the younger age group. Pain of device application was minimal but that of removal was severe. However, described pain abated rapidly and almost no pain was reported 1 hour after removal. The Adverse Events rate were experienced by 2.7% (11/398 of all participants, three of which were serious (2 displacements and 1 self-removal requiring prompt surgery. None of the Adverse Events required hospitalization. The majority of participants returned to work within a day of device placement.Our study shows that PrePex is a safe MMC method, for males 14 years and above. PrePex circumcision had a similar adverse event rate to that reported for surgical MMC, but device removal caused high levels of pain, which subsided rapidly.

  9. Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: an uncontrolled, observational study

    Institute of Scientific and Technical Information of China (English)

    Hidetoshi Mori; Hiroshi Kuge; Tim Hideaki Tanaka; Eiichi Taniwaki; Kazuyo Hanyu; Tateyuki Morisawa

    2013-01-01

    OBJECTIVE:The aim of this study was to examine the changes in natural killer (NK) cell activity,pulse rate,and pain intensity among older adults before and after acupuncture treatment.METHODS:Fifty-six individuals (16 males and 40 females),aged 60 to 82 years (mean age 72.4 ± 5.0),who were experiencing pain in the shoulder,low back,or knee,participated in the study.NK cell activity,leukocyte differentiation (granulocytes and lymphocytes),pulse rate,and blood pressure values were obtained.Pain intensity was evaluated by using the visual analog scale (VAS).The Wilcoxon test was used to analyze NK cell activity,leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio),and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment.RESULTS:NK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups.Further,the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group.Pulse rate decreased for the shoulder-pain,low-backpain,and knee-pain groups after acupuncture treatment.The VAS score decreased after acupuncture treatment for the shoulder-pain,low-back-pain,and knee-pain groups.CONCLUSION:This study showed that in older adults,acupuncture treatment decreases pulse rate,relieves pain in the shoulder,low back,and knee,and reduces NK-cell activity.

  10. Transient inflammation-induced ongoing pain is driven by TRPV1 sensitive afferents

    Directory of Open Access Journals (Sweden)

    Mercado Ramon

    2011-01-01

    Full Text Available Abstract Background Tissue injury elicits both hypersensitivity to evoked stimuli and ongoing, stimulus-independent pain. We previously demonstrated that pain relief elicits reward in nerve-injured rats. This approach was used to evaluate the temporal and mechanistic features of inflammation-induced ongoing pain. Results Intraplantar Complete Freund's Adjuvant (CFA produced thermal hyperalgesia and guarding behavior that was reliably observed within 24 hrs and maintained, albeit diminished, 4 days post-administration. Spinal clonidine produced robust conditioned place preference (CPP in CFA treated rats 1 day, but not 4 days following CFA administration. However, spinal clonidine blocked CFA-induced thermal hyperalgesia at both post-CFA days 1 and 4, indicating different time-courses of ongoing and evoked pain. Peripheral nerve block by lidocaine administration into the popliteal fossa 1 day following intraplantar CFA produced a robust preference for the lidocaine paired chamber, indicating that injury-induced ongoing pain is driven by afferent fibers innervating the site of injury. Pretreatment with resiniferatoxin (RTX, an ultrapotent capsaicin analogue known to produce long-lasting desensitization of TRPV1 positive afferents, fully blocked CFA-induced thermal hypersensitivity and abolished the CPP elicited by administration of popliteal fossa lidocaine 24 hrs post-CFA. In addition, RTX pretreatment blocked guarding behavior observed 1 day following intraplantar CFA. In contrast, administration of the selective TRPV1 receptor antagonist, AMG9810, at a dose that reversed CFA-induced thermal hyperalgesia failed to reduce CFA-induced ongoing pain or guarding behavior. Conclusions These data demonstrate that inflammation induces both ongoing pain and evoked hypersensitivity that can be differentiated on the basis of time course. Ongoing pain (a is transient, (b driven by peripheral input resulting from the injury, (c dependent on TRPV1 positive

  11. Risk Factors and Disability Associated with Low Back Pain in Older Adults in Low- and Middle-Income Countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE.

    Directory of Open Access Journals (Sweden)

    Jennifer Stewart Williams

    Full Text Available Back pain is a common disabling chronic condition that burdens individuals, families and societies. Epidemiological evidence, mainly from high-income countries, shows positive association between back pain prevalence and older age. There is an urgent need for accurate epidemiological data on back pain in adult populations in low- and middle-income countries (LMICs where populations are ageing rapidly. The objectives of this study are to: measure the prevalence of back pain; identify risk factors and determinants associated with back pain, and describe association between back pain and disability in adults aged 50 years and older, in six LMICs from different regions of the world. The findings provide insights into country-level differences in self-reported back pain and disability in a group of socially, culturally, economically and geographically diverse LMICs.Standardized national survey data collected from adults (50 years and older participating in the World Health Organization (WHO Study on global AGEing and adult health (SAGE were analysed. The weighted sample (n = 30, 146 comprised respondents in China, Ghana, India, Mexico, South Africa and the Russian Federation. Multivariable regressions describe factors associated with back pain prevalence and intensity, and back pain as a determinant of disability.Prevalence was highest in the Russian Federation (56% and lowest in China (22%. In the pooled multi-country analyses, female sex, lower education, lower wealth and multiple chronic morbidities were significant in association with past-month back pain (p<0.01. About 8% of respondents reported that they experienced intense back pain in the previous month.Evidence on back pain and its impact on disability is needed in developing countries so that governments can invest in cost-effective education and rehabilitation to reduce the growing social and economic burden imposed by this disabling condition.

  12. The Long Term Role of Anxiety Sensitivity and Experiential Avoidance on Pain Intensity, Mood, and Disability among Individuals in a Specialist Pain Clinic.

    Science.gov (United States)

    Mehta, S; Rice, D; Janzen, S; Serrato, J; Getty, H; Shapiro, A P; Morley-Forster, P; Sequeira, K; Teasell, R W

    2016-01-01

    Background. Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes. Objective. The current study attempted to (1) identify distinct CP subgroups based on their level of EA and AS and (2) compare the subgroups in terms of mood and disability. Methods. Individuals with CP were recruited from an academic pain clinic. Individuals were assessed for demographic, psychosocial, and personality measures at baseline and 1-year follow-up. A cluster analysis was conducted to identify distinct subgroups of patients based on their level of EA and AS. Differences in clinical outcomes were compared using the Repeated Measures MANOVA. Results. From a total of 229 participants, five clusters were formed. Subgroups with lower levels of AS but similar high levels of EA did not differ in outcomes. Mood impairment was significantly greater among those with high levels of EA compared to lower levels (p < 0.05). Significant improvement in disability (p < 0.05) was only seen among those with lower levels of EA and AS. Conclusions. This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP. PMID:27445621

  13. Pain frequency moderates the relationship between pain catastrophizing and pain

    Science.gov (United States)

    Kjøgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene

    2014-01-01

    Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089

  14. Pain frequency moderates the relationship between pain catastrophizing and pain

    Directory of Open Access Journals (Sweden)

    Heidi eKjøgx

    2014-12-01

    Full Text Available Background Pain frequency has been shown to influence sensitization, psychological distress and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method A non-clinical (247 students and a clinical (223 pain patients sample completed the Danish versions of the Pain Catastrophizing Scale, Beck Depression Inventory and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency Results In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed.Conclusions This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations.

  15. Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study

    Directory of Open Access Journals (Sweden)

    George Steven Z

    2006-08-01

    Full Text Available Abstract Background The underlying causes of spinal manipulation hypoalgesia are largely unknown. The beneficial clinical effects were originally theorized to be due to biomechanical changes, but recent research has suggested spinal manipulation may have a direct neurophysiological effect on pain perception through dorsal horn inhibition. This study added to this literature by investigating whether spinal manipulation hypoalgesia was: a local to anatomical areas innervated by the lumbar spine; b correlated with psychological variables; c greater than hypoalgesia from physical activity; and d different for A-delta and C-fiber mediated pain perception. Methods Asymptomatic subjects (n = 60 completed baseline psychological questionnaires and underwent thermal quantitative sensory testing for A-delta and C-fiber mediated pain perception. Subjects were then randomized to ride a stationary bicycle, perform lumbar extension exercise, or receive spinal manipulation. Quantitative sensory testing was repeated 5 minutes after the intervention period. Data were analyzed with repeated measures ANOVA and post-hoc testing was performed with Bonferroni correction, as appropriate. Results Subjects in the three intervention groups did not differ on baseline characteristics. Hypoalgesia from spinal manipulation was observed in lumbar innervated areas, but not control (cervical innervated areas. Hypoalgesic response was not strongly correlated with psychological variables. Spinal manipulation hypoalgesia for A-delta fiber mediated pain perception did not differ from stationary bicycle and lumbar extension (p > 0.05. Spinal manipulation hypoalgesia for C-fiber mediated pain perception was greater than stationary bicycle riding (p = 0.040, but not for lumbar extension (p = 0.105. Conclusion Local dorsal horn mediated inhibition of C-fiber input is a potential hypoalgesic mechanism of spinal manipulation for asymptomatic subjects, but further study is required to

  16. Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

    DEFF Research Database (Denmark)

    Joshi, G P; Rawal, N; Kehlet, H

    2012-01-01

    BACKGROUND: Open inguinal hernia repair is associated with moderate postoperative pain, but optimal analgesia remains controversial. The aim of this systematic review was to evaluate the available literature on the management of pain after open hernia surgery. METHODS: Randomized studies, in Engl......BACKGROUND: Open inguinal hernia repair is associated with moderate postoperative pain, but optimal analgesia remains controversial. The aim of this systematic review was to evaluate the available literature on the management of pain after open hernia surgery. METHODS: Randomized studies...... that the recommendations had clinical validity. RESULTS: Of the 334 randomized studies identified, 79 were included. Quantitative analysis suggested that regional anaesthesia was superior to general anaesthesia for reducing postoperative pain. Spinal anaesthesia was associated with a higher incidence of urinary retention...

  17. Mitogen activated protein kinase phosphatase-1 prevents the development of tactile sensitivity in a rodent model of neuropathic pain

    Directory of Open Access Journals (Sweden)

    Ndong Christian

    2012-04-01

    Full Text Available Abstract Background Neuropathic pain due to nerve injury is one of the most difficult types of pain to treat. Following peripheral nerve injury, neuronal and glial plastic changes contribute to central sensitization and perpetuation of mechanical hypersensitivity in rodents. The mitogen activated protein kinase (MAPK family is pivotal in this spinal cord plasticity. MAPK phosphatases (MKPs limit inflammatory processes by dephosphorylating MAPKs. For example, MKP-1 preferentially dephosphorylates p-p38. Since spinal p-p38 is pivotal for the development of chronic hypersensitivity in rodent models of pain, and p-p38 inhibitors have shown clinical potential in acute and chronic pain patients, we hypothesize that induction of spinal MKP-1 will prevent the development of peripheral nerve-injury-induced hypersensitivity and p-p38 overexpression. Results We cloned rat spinal cord MKP-1 and optimize MKP-1 cDNA in vitro using transfections to BV-2 cells. We observed that in vitro overexpression of MKP-1 blocked lipopolysaccharide-induced phosphorylation of p38 (and other MAPKs as well as release of pro-algesic effectors (i.e., cytokines, chemokines, nitric oxide. Using this cDNA MKP-1 and a non-viral, in vivo nanoparticle transfection approach, we found that spinal cord overexpression of MKP-1 prevented development of peripheral nerve-injury-induced tactile hypersensitivity and reduced pro-inflammatory cytokines and chemokines and the phosphorylated form of p38. Conclusions Our results indicate that MKP-1, the natural regulator of p-p38, mediates resolution of the spinal cord pro-inflammatory milieu induced by peripheral nerve injury, resulting in prevention of chronic mechanical hypersensitivity. We propose that MKP-1 is a potential therapeutic target for pain treatment or prevention.

  18. Women with chronic and episodic migraine exhibit similar widespread pressure pain sensitivity

    DEFF Research Database (Denmark)

    Palacios, Maria; Lima Florencio, Lidiane; Natália Ferracini, Gabriela;

    2016-01-01

    OBJECTIVE: To investigate widespread pressure hyperalgesia in the trigemino-cervical and extra-trigeminal (distant pain-free) regions in women with episodic and chronic migraine. METHODS: Fifty-one women with episodic migraine, 52 women with chronic migraine, and 52 healthy women without headache...

  19. Increased trapezius pain sensitivity is not associated with increased tissue hardness

    DEFF Research Database (Denmark)

    Andersen, Helle; Ge, Hong-You; Arendt-Nielsen, Lars;

    2010-01-01

    thresholds and muscle hardness were examined by computer-controlled pressure algometry at baseline, immediately after static or dynamic exercise, and 20 minutes after static or dynamic exercise. Before recording of pressure pain thresholds, the trapezius muscle was examined for tender points by manual...

  20. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

    DEFF Research Database (Denmark)

    Lyons, K. J.; Salsbury, S. A.; Hondras, M. A.;

    2013-01-01

    Background: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and D...

  1. Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Leboeuf-Yde, Charlotte; Kyvik, Kirsten O

    2006-01-01

    study is to gain a deeper insight into the etiology of low back pain and to possibly develop a tool for early identification of high-risk groups. This is done by investigating whether different types of morbidity in adolescence are associated with LBP in adulthood. METHODS: Almost 10,000 Danish twins......BACKGROUND: It has previously been shown that low back pain (LBP) often presents already in the teenage years and that previous LBP predicts future LBP. It is also well documented that there is a large degree of comorbidity associated with LBP, both in adolescents and adults. The objective of this...... predictor variables used in this study were LBP, headache, asthma and atopic disease at baseline; the outcome variable was persistent LBP (>30 days during the past year) at follow-up. Associations between morbidity in 1994 and LBP in 2002 were investigated. RESULTS: LBP, headache and asthma in adolescence...

  2. The effects of daily mood and couple interactions on the sleep quality of older adults with chronic pain.

    Science.gov (United States)

    Song, Sunmi; Graham-Engeland, Jennifer E; Mogle, Jacqueline; Martire, Lynn M

    2015-12-01

    We examined the effect of daily negative and positive mood on the sleep quality of knee osteoarthritis (OA) patients (N = 152) and whether a partner's daily responses to a patient's pain behaviors moderated these associations. Patients and their partners completed a baseline interview and 22 daily diary assessments. After controlling for demographic characteristics, OA severity, comorbidities, medication use, relationship satisfaction, and depressed mood, multilevel modeling analyses demonstrated main effects of negative and positive mood on sleep quality indicators. Mood and partner responses interacted such that high solicitous and punishing responses strengthened the association between negative mood and worse sleep. Further, high solicitous responses increased the degree of association between low positive mood and poor sleep, and empathic responses combined with positive mood were associated with better sleep. Results demonstrate that daily negative and positive mood fluctuations can interact with partner responses to affect sleep quality among older adults with chronic pain. PMID:26143147

  3. Adult Attachment Style and Stress as Risk Factors for Early Maternal Sensitivity and Negativity.

    Science.gov (United States)

    Mills-Koonce, W Roger; Appleyard, Karen; Barnett, Melissa; Deng, Min; Putallaz, Martha; Cox, Martha

    2011-05-01

    The current study examined the individual and joint effects of self-reported adult attachment style, psychological distress, and parenting stress on maternal caregiving behaviors at 6 and 12 months of child age. We proposed a diathesis-stress model to examine the potential deleterious effects of stress for mothers with insecure adult attachment styles. Data from 137 mothers were gathered by the longitudinal Durham Child Health and Development Study. Mothers provided self-reports using Hazan and Shaver's (1987) Adult Attachment Style measure, the Brief Symptom Inventory, and the Parent Stress Inventory; observations of parenting data were made from 10-minute free play interactions. Consistently avoidant mothers were less sensitive with their infants than consistently secure mothers; however, this effect was limited to avoidant mothers who experienced elevated levels of psychological distress. Results suggest that the association between insecure adult attachment style and insensitive parenting behavior is moderated by concurrent psychosocial stress. Clinical implications for these findings are discussed. PMID:24855326

  4. A Model for Pain Behavior in Individuals with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Meir, Lotan; Strand, Liv Inger; Alice, Kvale

    2012-01-01

    The dearth of information on the pain experience of individuals with intellectual and developmental disabilities (IDD) calls for a more comprehensive understanding of pain in this population. The Non-Communicating Adults Pain Checklist (NCAPC) is an 18-item behavioral scale that was recently found to be reliable, valid, sensitive and clinically…

  5. Postural Responses to a Suddenly Released Pulling Force in Older Adults with Chronic Low Back Pain: An Experimental Study.

    Science.gov (United States)

    Lee, Pei-Yun; Lin, Sang-I; Liao, Yu-Ting; Lin, Ruey-Mo; Hsu, Che-Chia; Huang, Kuo-Yuan; Chen, Yi-Ting; Tsai, Yi-Ju

    2016-01-01

    Chronic low back pain (CLBP), one of the most common musculoskeletal conditions in older adults, might affect balance and functional independence. The purpose of this study was to investigate the postural responses to a suddenly released pulling force in older adults with and without CLBP. Thirty community-dwelling older adults with CLBP and 26 voluntary controls without CLBP were enrolled. Participants were required to stand on a force platform while, with one hand, they pulled a string that was fastened at the other end to a 2-kg or to a 4-kg force in the opposite direction at a random order. The number of times the participants lost their balance and motions of center of pressure (COP) when the string was suddenly released were recorded. The results demonstrated that although the loss of balance rates for each pulling force condition did not differ between groups, older adults with CLBP had poorer postural responses: delayed reaction, larger displacement, higher velocity, longer path length, and greater COP sway area compared to the older controls. Furthermore, both groups showed larger postural responses in the 4-kg pulling force condition. Although aging is generally believed to be associated with declining balance and postural control, these findings highlight the effect of CLBP on reactive balance when responding to an externally generated force in an older population. This study also suggests that, for older adults with CLBP, in addition to treating them for pain and disability, reactive balance evaluation and training, such as reaction and movement strategy training should be included in their interventions. Clinicians and older patients with CLBP need to be made aware of the significance of impaired reactive balance and the increased risk of falls when encountering unexpected perturbations. PMID:27622646

  6. The association between changes in pressure pain sensitivity and changes in cardiovascular physiological factors associated with persistent stress

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Petersen, Pernille B.; Harboe, Gitte S.;

    2014-01-01

    Abstract Objectives. To evaluate the possible association between pressure pain sensitivity of the chest bone (PPS) and cardiovascular physiological factors related to persistent stress in connection with a three-month PPS-guided stress-reducing experimental intervention programme. Methods. Forty...... rate (HR) and work of the heart measured as Pressure-Rate-Product (PRP); Secondary endpoints: Other features of the metabolic syndrome. Results. PPS decreased and changes in PPS after the intervention period were significantly associated with HR, PRP, body mass index (BMI) and visceral fat index (all...... blood pressure, heart rate, work of the heart and serum cholesterols....

  7. Effects of coping statements on experimental pain in chronic pain patients

    Directory of Open Access Journals (Sweden)

    Daniela Roditi

    2009-08-01

    Full Text Available Daniela Roditi, Michael E Robinson, Nola LitwinsDepartment of Clinical and Health Psychology, University of Florida, Gainesville, FL, USAAbstract: The present study measured the effects of catastrophizing self-statements and positive coping self-statements on cold pressor-induced pain. Participants were 58 adult chronic pain patients with current facial pain. It was hypothesized that catastrophizing would lead to a decrease in pain endurance whereas positive coping would lead to an increase in pain endurance. It was also hypothesized that catastrophizing would lead to an increase in peak pain intensity whereas positive coping would lead to a decrease in peak pain intensity. At pretest, participants submerged their nondominant hand in the cold pressor. Pain sensitivity ranges (PSR were subsequently determined by calculating the difference between tolerance and threshold times. Ratings of peak pain intensity were measured using a pressure sensitive bladder/transducer. Participants underwent random assignment to either a catastrophizing group or a positive coping self-statement group. ANCOVA results revealed that on average, participants employing catastrophizing statements as a coping strategy experienced significantly lower PSR (M = 35.53, SD = 39.71 compared to participants employing positive coping self-statements (M = 73.70, SD = 86.14 when controlling for pretest PSR. Group assignment had no significant influence on peak pain intensity ratings. Thus, our results reveal that manipulation of coping causes changes in pain endurance.Keywords: catastrophizing, coping, expectation, pain sensitivity

  8. Association between Gene Polymorphisms and Pain Sensitivity Assessed in a Multi-Modal Multi-Tissue Human Experimental Model - An Explorative Study

    DEFF Research Database (Denmark)

    Nielsen, Lecia Møller; Olesen, Anne Estrup; Sato, Hiroe;

    2016-01-01

    The genetic influence on sensitivity to noxious stimuli (pain sensitivity) remains controversial and needs further investigation. In the present study, the possible influence of polymorphisms in three opioid receptor (OPRM, OPRD and OPRK) genes, and the catechol-O-methyltransferase (COMT) gene...... on pain sensitivity in healthy participants were investigated. Catechol-O-methyltransferase has an indirect effect on the mu opioid receptor by changing its activity through an altered endogenous ligand effect. Blood samples for genetic analysis were withdrawn in a multi-modal and multi......, and mechanical, electrical and thermal visceral stimulations. A cold pressor test was also conducted. DNA was available from 38 participants out of 40. Compared to non-carriers of the COMT rs4680A allele, carriers reported higher bone pressure pain tolerance threshold (i.e., less pain) by up to 23.8% (P

  9. Dentinal sensitivity among a selected group of young adults in Nigeria

    Directory of Open Access Journals (Sweden)

    Clement C Azodo

    2011-01-01

    Full Text Available Background: There is paucity of data on the prevalence of dentinal sensitivity outside the hospital setting and impact of dentinal sensitivity among young adults in Africa. This study aimed to determine the prevalence and impact of dentinal sensitivity among young adults in Nigeria. Materials and Methods: A cross-sectional survey was conducted among the undergraduates of University of Benin in August, 2010. Self-administered questionnaire elicited information on demography, self-reported dentinal sensitivity, the trigger factor, action taken, functional, and psychological impact. Results: The prevalence of dentinal sensitivity was 211 (52.8% among the participants and it was significantly higher in females than males (P=0.027. Participants experienced shocking sensation more on the left-side of the mouth. The most common trigger factor for the dentinal sensitivity was due to cold drink [169 (80.1%]. Among the participants with dentinal sensitivity, majority [139 (65.9%] have not taken any action and only 24 (11.4% have visited the dentist because of the problem. Dentinal sensitivity exhibited psychological impact among the participants as 64 (30.3 reported unhappiness due to the shocking sensation. Eating and talking were disturbed, respectively, in 59 (28.0% and 12 (5.7% of the participants. Conclusion: The prevalence of dentinal sensitivity was high which was significantly higher in females than males. Despite the negative functional and psychological impact among the participants, only a few sought dental professional care. Screening for dentinal sensitivity at community level is required to proffer early treatment and ameliorate its impact on the populace.

  10. Humor Therapy: Relieving Chronic Pain and Enhancing Happiness for Older Adults

    OpenAIRE

    Tse, Mimi M.Y.; Lo, Anna P. K.; Cheng, Tracy L. Y.; Chan, Eva K. K.; Annie H. Y. Chan; Chung, Helena S. W.

    2010-01-01

    The present study examined the effectiveness of a humor therapy program in relieving chronic pain, enhancing happiness and life satisfaction, and reducing loneliness among older persons with chronic pain. It was a quasiexperimental pretest-posttest controlled design. Older persons in a nursing home were invited to join an 8-week humor therapy program (experimental group), while those in another nursing home were treated as a control group and were not offered the program. There were 36 older ...

  11. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults

    OpenAIRE

    Jordan, JL; Holden, MA; Mason, EE; Foster, NE

    2010-01-01

    BACKGROUND: Chronic musculoskeletal pain (CMP) is a major health problem, accounting for approximately one-quarter of general practice (GP) consultations in the United Kingdom (UK). Exercise and physical activity is beneficial for the most common types of CMP, such as back and knee pain. However, poor adherence to exercise and physical activity may limit long-term effectiveness. OBJECTIVES: To assess the effects of interventions to improve adherence to exercise and physical activity for peopl...

  12. Enhanced quantal release of excitatory transmitter in anterior cingulate cortex of adult mice with chronic pain

    Directory of Open Access Journals (Sweden)

    Zhao Ming-Gao

    2009-01-01

    Full Text Available Abstract The anterior cingulate cortex (ACC is a forebrain structure that plays important roles in emotion, learning, memory and persistent pain. Our previous studies have demonstrated that the enhancement of excitatory synaptic transmission was induced by peripheral inflammation and nerve injury in ACC synapses. However, little information is available on their presynaptic mechanisms, since the source of the enhanced synaptic transmission could include the enhanced probability of neurotransmitter release at existing release sites and/or increases in the number of available vesicles. The present study aims to perform quantal analysis of excitatory synapses in the ACC with chronic pain to examine the source of these increases. The quantal analysis revealed that both probability of transmitter release and number of available vesicles were increased in a mouse model of peripheral inflammation, whereas only probability of transmitter release but not number of available vesicles was enhanced in a mouse model of neuropathic pain. In addition, we compared the miniature excitatory postsynaptic potentials (mEPSCs in ACC synapses with those in other pain-related brain areas such as the amygdala and spinal cord. Interestingly, the rate and amplitude of mEPSCs in ACC synapses were significantly lower than those in the amygdala and spinal cord. Our studies provide strong evidences that chronic inflammatory pain increases both probability of transmitter release and number of available vesicles, whereas neuropathic pain increases only probability of transmitter release in the ACC synapses.

  13. Adult Stem Cell as New Advanced Therapy for Experimental Neuropathic Pain Treatment

    Directory of Open Access Journals (Sweden)

    Silvia Franchi

    2014-01-01

    Full Text Available Neuropathic pain (NP is a highly invalidating disease resulting as consequence of a lesion or disease affecting the somatosensory system. All the pharmacological treatments today in use give a long lasting pain relief only in a limited percentage of patients before pain reappears making NP an incurable disease. New approaches are therefore needed and research is testing stem cell usage. Several papers have been written on experimental neuropathic pain treatment using stem cells of different origin and species to treat experimental NP. The original idea was based on the capacity of stem cell to offer a totipotent cellular source for replacing injured neural cells and for delivering trophic factors to lesion site; soon the researchers agreed that the capacity of stem cells to contrast NP was not dependent upon their regenerative effect but was mostly linked to a bidirectional interaction between the stem cell and damaged microenvironment resident cells. In this paper we review the preclinical studies produced in the last years assessing the effects induced by several stem cells in different models of neuropathic pain. The overall positive results obtained on pain remission by using stem cells that are safe, of easy isolation, and which may allow an autologous transplant in patients may be encouraging for moving from bench to bedside, although there are several issues that still need to be solved.

  14. “I felt like a new person.” The effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries

    OpenAIRE

    Morone, Natalia E.; Lynch, Cheryl S.; Greco, Carol M.; Tindle, Hilary A.; Weiner, Debra K.

    2008-01-01

    To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP) we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an eight week mindfulness meditation program. Participants were 27 adults ≥ 65 years with CLBP of at least moderate severity and of at least three months duration. We found several themes reflecting the beneficial effects of mindfulne...

  15. Gabapentin reverses central pain sensitization following a collagenase-induced intrathalamic hemorrhage in rats

    Directory of Open Access Journals (Sweden)

    Castel A

    2013-12-01

    Full Text Available Aude Castel, Pascal VachonFaculty of Veterinary Medicine, Department of Veterinary Biomedicine, University of Montreal, Saint-Hyacinthe, QC, CanadaPurpose: The treatment of central neuropathic pain remains amongst the biggest challenges for pain specialists. The main objective of this study was to assess gabapentin (GBP, amitriptyline (AMI, and carbamazepine (CARBA for the treatment of a rodent central neuropathic pain model.Methods: Male Sprague Dawley rats were trained on the rotarod, Hargreaves, Von Frey and acetone behavioral tests, and baseline values were obtained prior to surgery. A stereotaxic injection of either a collagenase solution or saline was made in the right ventral posterolateral thalamic nucleus. The rats were tested on days 2, 4, 8, and 11 postsurgery. They were retested at regular intervals from day 15 to day 25 postsurgery, after oral administration of either the vehicle (n=7 and n=8 rats with intracerebral injections of collagenase and saline, respectively or the different drugs (GBP [60 mg/kg], AMI [10 mg/kg], CARBA [100 mg/kg]; n=8 rats/drug.Results: A significant decrease in the mechanical thresholds and no change in heat threshold were observed in both hind limbs in the collagenase group, as we had previously shown elsewhere. Reversal of the mechanical hypersensitivity was achieved only with GBP (P<0.05. AMI and CARBA, at the dosages used, failed to show any effect on mechanical thresholds. Transient cold allodynia was observed in some collagenase-injected rats but failed to be statistically significant.Conclusion: Intrathalamic hemorrhaging in the ventrolateral thalamic nucleus induced a bilateral mechanical allodynia, which was reversed by GBP but not AMI or CARBA.Keywords: central pain, thalamus, amitriptyline, carbamazepine

  16. Evidence for a role of NTS2 receptors in the modulation of tonic pain sensitivity

    OpenAIRE

    Martinez Jean; Beaudet Nicolas; Belleville Karine; Ezzoubaa Faouzi; Baudisson Stéphanie; Dansereau Marc-André; Roussy Geneviève; Richelson Elliott; Sarret Philippe

    2009-01-01

    Abstract Background Central neurotensin (NT) administration results in a naloxone-insensitive antinociceptive response in animal models of acute and persistent pain. Both NTS1 and NTS2 receptors were shown to be required for different aspects of NT-induced analgesia. We recently demonstrated that NTS2 receptors were extensively associated with ascending nociceptive pathways, both at the level of the dorsal root ganglia and of the spinal dorsal horn. Then, we found that spinally administered N...

  17. An Examination of Pain Perception and Cerebral Event-Related Potentials following Carbon Dioxide Laser Stimulation in Patients with Alzheimer’s Disease and Age-Matched Control Volunteers

    Directory of Open Access Journals (Sweden)

    Stephen J Gibson

    2001-01-01

    Full Text Available BACKGROUND: Pain perception is known to depend on integrated cognitive processing. Alzheimer's disease affects 5% to 10% of older adults, but the impact of this disease on pain sensitivity and report has yet to be fully investigated.

  18. Does format matter for comprehension of a facial affective scale and a numeric scale for pain by adults with Down syndrome?

    Science.gov (United States)

    de Knegt, N C; Evenhuis, H M; Lobbezoo, F; Schuengel, C; Scherder, E J A

    2013-10-01

    People with intellectual disabilities are at high risk for pain and have communication difficulties. Facial and numeric scales for self-report may aid pain identification. It was examined whether the comprehension of a facial affective scale and a numeric scale for pain in adults with Down syndrome (DS) varies with presentation format. Adults with DS were included (N=106, mild to severe ID, mean age 37 years), both with (N=57) and without (N=49) physical conditions that may cause pain or discomfort. The Facial Affect Scale (FAS) and a numeric rating scale (NRS) were compared. One subgroup of participants (N=50) had to choose the two items within each format to indicate 'least pain' and 'most pain'. The other subgroup of participants (N=56) had to order three faces of the FAS from 'least pain' to 'most pain', and to answer questions about the magnitude of numbers for the NRS. Comprehension percentages were compared between two subgroups. More participants understood the FAS than the NRS, irrespective of the presentation format. The comprehension percentage for the FAS did not differ between the least-most extremities format and the ordering/magnitude format. In contrast, comprehension percentages for the NRS differed significantly between the least-most extremities format (61%) and the ordering/magnitude format (32%). The inclusion of ordering and magnitude in a presentation format is essential to assess thorough comprehension of facial and numeric scales for self-reported pain. The use of this format does not influence the number of adults with DS who pass the comprehension test for the FAS, but reduces the number of adults with DS who pass the comprehension test for the NRS.

  19. Pain evaluation in self and others in autism spectrum disorder

    DEFF Research Database (Denmark)

    Thaler, Hanna; Skewes, Joshua; Gebauer, Line;

    The picture of pain sensation in autism and its relationship with perception of pain in others is currently far from clear. A common observation in case studies is that autistic individuals are more pain insensitive. However, this hypothesis has recently been challenged by experimental evidence...... indicating that physiological sensitivity in autism may even be enhanced. Evaluation of own pain might also relate to one’s ability to evaluate pain in others. There is some experimental evidence indicating that people generally tend to underestimate how much pain another person feels. Our study investigated...... whether this underestimation bias is stronger in individuals with autism and how this evaluation may be associated with one’s individual pain sensitivity. Using electric pain stimulation, we tested whether autistic and non-autistic male adults (n = 16 in each group) rated the intensity and unpleasantness...

  20. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil

    Directory of Open Access Journals (Sweden)

    João Luiz Dornelles Bastos

    2005-10-01

    Full Text Available The aim of this study was to assess dental pain prevalence and its association with dental caries and socioeconomic status in 18-year-old males from Florianópolis, Santa Catarina, Brazil. A cross-sectional study was conducted in a random sample (n = 414 selected from the Brazilian Army conscription list in 2003. Dental pain during the 12 months prior to the interview was recorded as the outcome. Socioeconomic data were obtained through a questionnaire. Dental caries experience was registered according to the DMFT Index. Analyses included simple and multiple non-conditional logistic regression following a hierarchical approach. Response rate was 95.6%. High rates of inter-examiner agreement were achieved (kappa > 0.83. Dental pain prevalence was 21.2% (95%CI: 17.3-25.1. After adjustment, individuals with one or more untreated caries were 3.2 times more likely (95%CI: 1.7-5.8 to have dental pain compared to caries-free subjects. Conscripts with low family income were 1.8 times more likely (95%CI: 1.0-3.3 to have dental pain than those with higher income.

  1. Chest pain and high-sensitivity troponin: What is the evidence?

    Directory of Open Access Journals (Sweden)

    Daniel Ashmore

    2015-03-01

    Full Text Available The number of attendances and admissions of patients with chest pain to hospitals in England and Wales is increasing. Initial assessment may be unrewarding. Consequently, cardiac troponin has become the mainstay of investigation for non-ST-segment-elevation myocardial infarction and unstable angina, although only a small proportion of patients are eventually diagnosed as such. Current National Institute for Healthcare and Clinical Excellence guidance recommends measuring cardiac troponin levels on presentation and 10–12 h after onset of symptoms. A more effective diagnostic tool is needed. The aims are twofold: to increase accuracy of acute coronary syndrome diagnosis thus implementing the most appropriate management at an earlier stage while reducing costs and to provide a more rapid diagnosis to ease the anxieties of patients. Three key issues have been highlighted. The first is that many current studies do not have a ‘normal/reference’ population, making comparison between two studies difficult to interpret. Second, whether newer ‘high-sensitivity’ cardiac troponin tests can be used to rule out a myocardial infarction in a patient with chest pain is discussed. Third, whether a ‘high-sensitivity’ cardiac troponin has great enough specificity to differentiate between the number of other causes of raised troponin in a single test or whether serial testing is needed is assessed. A strategy for such serial testing is discussed. Finally, use of ‘high-sensitivity’ cardiac troponin in risk stratification of other disease processes is highlighted, which is likely to become common practice, changing the way we manage patients with, and without, chest pain.

  2. Humor Therapy: Relieving Chronic Pain and Enhancing Happiness for Older Adults

    Directory of Open Access Journals (Sweden)

    Mimi M. Y. Tse

    2010-01-01

    Full Text Available The present study examined the effectiveness of a humor therapy program in relieving chronic pain, enhancing happiness and life satisfaction, and reducing loneliness among older persons with chronic pain. It was a quasiexperimental pretest-posttest controlled design. Older persons in a nursing home were invited to join an 8-week humor therapy program (experimental group, while those in another nursing home were treated as a control group and were not offered the program. There were 36 older people in the experimental group and 34 in the control group. Upon completion of the humor therapy program, there were significant decreases in pain and perception of loneliness, and significant increases in happiness and life satisfaction for the experimental group, but not for the control group. The use of humor therapy appears to be an effective nonpharmacological intervention. Nurses and other healthcare professionals could incorporate humor in caring for their patients.

  3. Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

    DEFF Research Database (Denmark)

    Loving, Sys; Nordling, Jørgen; Jaszczak, Poul;

    2012-01-01

    dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... of female CPP. Methods Electronic databases, conference proceedings, text books and clinical guidelines were searched for quantitative, observational, and prospective clinical intervention studies of female chronic pelvic pain where physiotherapy was a sole or significant component of the intervention......, interventions, outcome measures and times of follow-up, prevented meta-analysis. Narrative synthesis of the results, based on effect estimates and clinically relevant pain improvement, disclosed some evidence to support an effect of multidisciplinary intervention and Mensendieck somatocognitive therapy...

  4. Efficacy and tolerability of carbamazepine for the treatment of painful diabetic neuropathy in adults: a 12-week, open-label, multicenter study

    Directory of Open Access Journals (Sweden)

    Saeed T

    2014-07-01

    Full Text Available Tariq Saeed,1 Muhammad Nasrullah,2 Adnan Ghafoor,3 Riaz Shahid,4 Nadeem Islam,5 Mohammad Usman Khattak,6 Neeta Maheshwary,7 Ahson Siddiqi,7 Muhammad Athar Khan81Pakistan Telecommunication Company Ltd, Karachi, Pakistan; 2Cavalary Hospital, Gulberg, Lahore, Pakistan; 3Fauji Foundation Hospital, Rawalpindi, Pakistan; 4Dr Riaz Shahid Clinic, Peshawar Cantt, Peshawar, Pakistan; 5Punjab Employs Social Security Institution, Islamabad, Pakistan; 6Medical B Unit, Hayat Abad Medical Complex, Peshawar, Pakistan; 7Novartis Pharma Pakistan, Karachi, Pakistan; 8Department of Medical Education, King Saud bin Abdulaziz University, Riyadh, Kingdom of Saudi ArabiaObjective: Anticonvulsants are increasingly being used in the symptomatic management of several neuropathic pain disorders. The present observational study was designed to evaluate the efficacy, tolerability, and quality of life (QoL of carbamazepine use for 12 weeks in patients with painful diabetic neuropathy, in Pakistan.Methods: This was a 12-week, multicenter, open-label, uncontrolled trial in adult type 2 diabetic patients (aged 18–65 years suffering from clinically confirmed neuropathic pain (Douleur Neuropathique en 4 [DN4] score ≥4. Change in neuropathic pain at week 12 compared with baseline was assessed using the Brief Pain Inventory Scale–Short Form (pain severity score and pain interference score. QoL was determined by the American Chronic Pain Association QoL scale. Safety was assessed based on patient reported adverse events (AEs and serious AEs.Results: Of the total 500 screened patients, 452 enrolled and completed the study. The mean (± standard deviation [SD] pain interference score decreased from 4.5±2.0 at baseline to 3.1±1.9 at week 12 (P<0.001. The mean (± SD pain severity score decreased from 5.8±2.0 at baseline to 3.6±2.2 at week 12 (P<0.001. There was a decrease of ≥30% in the pain severity score between visits. The mean (± SD QoL scale score improved from 5.9±1

  5. Nurses’ knowledge of the principles of acute pain assessment in critically ill adult patients who are able to self-report

    OpenAIRE

    Irene Betty Kizza; Joshua Kanaabi Muliira; Kohi, Thecla W.; Rose Chalo Nabirye

    2016-01-01

    Introduction: Nurses play a critical role in managing and alleviating acute pain among critically ill adult patients (CIAP). The purpose of this study was to determine nurses’ level of knowledge about principles of acute pain assessment in CIAP. Methods: A descriptive cross-sectional study design and questionnaire survey were employed to collect data from 170 nurses caring for CIAP at Uganda’s national hospital. Results: The mean knowledge score of nurses was 71% indicating adequate kno...

  6. Infant attachment, adult attachment, and maternal sensitivity: revisiting the intergenerational transmission gap.

    Science.gov (United States)

    Behrens, Kazuko Y; Haltigan, John D; Bahm, Naomi I Gribneau

    2016-08-01

    This study investigated the intergenerational transmission of attachment, utilizing the Adult Attachment Interview (AAI), the Strange Situation Procedure (SSP), and the Maternal Behavioral Q-Set (MBQS). We revisited fundamental questions in attachment theory and research by examining: (1) the level of intergenerational agreement between maternal attachment representations and infant attachment security, and (2) whether maternal sensitivity serves as an intergenerational mediator between adult and infant attachment security. Significant categorical matches between the AAI and the SSP as well as mean differences for MBQS scores between adult attachment secure-insecure groups were found. Consistent with earlier intergenerational research, maternal sensitivity only partially mediated the AAI-SSP link, indicating the transmission gap remains. Consistent with recent mediation studies, using more contemporary analytical techniques, it was confirmed that maternal sensitivity did mediate the direct pathway between AAI security and SSP security. Thus, the transmission gap appears somewhat different depending on the statistical method used to measure mediation. Post hoc analyses considered mothers' childhood experiences of separation/divorce and this helped make sense of intergenerational mismatches.

  7. Infant attachment, adult attachment, and maternal sensitivity: revisiting the intergenerational transmission gap.

    Science.gov (United States)

    Behrens, Kazuko Y; Haltigan, John D; Bahm, Naomi I Gribneau

    2016-08-01

    This study investigated the intergenerational transmission of attachment, utilizing the Adult Attachment Interview (AAI), the Strange Situation Procedure (SSP), and the Maternal Behavioral Q-Set (MBQS). We revisited fundamental questions in attachment theory and research by examining: (1) the level of intergenerational agreement between maternal attachment representations and infant attachment security, and (2) whether maternal sensitivity serves as an intergenerational mediator between adult and infant attachment security. Significant categorical matches between the AAI and the SSP as well as mean differences for MBQS scores between adult attachment secure-insecure groups were found. Consistent with earlier intergenerational research, maternal sensitivity only partially mediated the AAI-SSP link, indicating the transmission gap remains. Consistent with recent mediation studies, using more contemporary analytical techniques, it was confirmed that maternal sensitivity did mediate the direct pathway between AAI security and SSP security. Thus, the transmission gap appears somewhat different depending on the statistical method used to measure mediation. Post hoc analyses considered mothers' childhood experiences of separation/divorce and this helped make sense of intergenerational mismatches. PMID:27056466

  8. Relationship between frequent knee pain, obesity, and gait speed in older adults: data from the Osteoarthritis Initiative

    Directory of Open Access Journals (Sweden)

    Bindawas SM

    2016-02-01

    Full Text Available Saad M BindawasDepartment of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaBackground: Knee pain (KP causes gait difficulties in older adults and is associated with slow gait speed (GS. Obesity has negative effects on health. GS is an important indicator of health, well-being, and mean life span in older adults and is a strong predictor of future disability and mortality. The relationship between frequent KP, obesity, and GS in older adults remains unclear. Therefore, the present study aimed at examining the relationship between baseline frequent KP and obesity status on GS over time. We hypothesized that frequent KP, obesity, or both would be associated with decreased GS over time.Methods: The data from the Osteoarthritis Initiative were used for this 6-year longitudinal cohort study. We studied 3,118 adults aged between 45 years and 79 years. We grouped the participants into the following four categories according to KP frequency and obesity status at baseline: 1 no KP and nonobese, 2 frequent KP and nonobese, 3 no KP and obese, and 4 frequent KP and obese. GS measurements were based on a 20 m walking test timed using a stopwatch; testing was performed at baseline and over a 6-year follow-up period. Walk pace (m/sec was calculated as the average pace over two trials conducted at clinic visits. General linear mixed models were used to examine the relationships between frequent KP, obesity, and GS.Results: After adjusting for all covariates, at baseline, all the nonobese group with frequent KP (β=-0.06, 95% confidence interval [CI]: -0.07 to -0.04, the obese group with no KP (β=-0.07, 95% CI: -0.1 to -0.04, and the obese group with frequent KP (β=-0.08, 95% CI: -0.1 to -0.05 exhibited decreased GS compared with the nonobese and no KP group. However, the associations between frequent KP, obesity, and GS over time were not statistically significant.Conclusion: Frequent KP alone

  9. Sensitivity to temporal fine structure and hearing-aid outcomes in older adults

    Directory of Open Access Journals (Sweden)

    Elvira ePerez Vallejos

    2014-02-01

    Full Text Available Objective: to investigate the effect of sensitivity to temporal fine structure on subjective measures of hearing aid outcome.Design: Prior to receiving hearing aids, participants completed a test to assess sensitivity to temporal fine structure (TFS, the Glasgow Hearing Aid Benefit Profile (GHABP, and the Speech, Spatial and Qualities of hearing (SSQ-A. Follow-up appointments, comprised the GHABP, the SSQ-B , and the International Outcome Inventory for Hearing Aid Outcomes (IOI-HA.Study sample: 75 adults were recruited from direct referral clinics. Results: Two thirds of participants were found to have good sensitivity to TFS; listeners with good sensitivity to TFS rated their hearing abilities higher at pre-fitting (SSQ-A than those with poor sensitivity to TFS. At follow-up, participants with good sensitivity to TFS showed a small improvement on SSQ-B over listeners with poor sensitivity to TFS. Conclusions: The clinical identification of a patient’s ability to process TFS information at an early stage in the treatment pathway could prove useful in managing expectations about hearing aid outcomes.

  10. Sensibilidad, resistencia y expresión del dolor: relación con la socialización del dolor Sensitivity, resistance and expression of pain: relationship with the socialisation of pain

    Directory of Open Access Journals (Sweden)

    M. Repolles Pro

    2010-10-01

    Full Text Available Objetivos: Este trabajo analiza cómo ciertos rasgos de la personalidad influyen en la percepción del dolor. A través de un cuestionario diferenciamos tres tipos de personalidades (social, aprensivo e igualitario y comparamos estas medidas con los resultados de sensibilidad, resistencia y hábito de expresar el dolor que expresan a través del Gender Role Expectation of Pain. Material y métodos: Se realizaron dos sesiones con un total de 136 sujetos voluntarios que realizaron un cuestionario socio-demográfico y el test, donde se les pregunta sobre la sensibilidad, la resistencia y el hábito de expresar el dolor. Nosotros añadimos tres nuevas preguntas: ¿sientes alivio en el dolor cuanto lo cuentas a otros?, ¿sientes dolor cuando otros te cuentan sus experiencias dolorosas?, ¿saber que a otras personas también les duele igual que a ti te alivia el dolor? A los que responden afirmativamente les llamamos sociales, aprensivos e igualitarios, respectivamente. Resultados: 1 La proporción de sujetos que responde afirmativamente a alguna de nuestras preguntas es alta: solo el 25% de los sujetos responde negativamente a las tres. 2 Los sujetos sociales expresan valores significativamente más altos de sensibilidad al dolor, menor resistencia (-20% y mayor costumbre de expresar dolor (+15%. Conclusiones: Este trabajo muestra que ciertos rasgos personales -que tienen que ver con la socialización del dolor- afectan a la evaluación del mismo. Concretamente, el sentir alivio al contar el dolor a otros resulta ser un factor clave que afecta a la sensibilidad, a la resistencia y a la costumbre de expresarlo.Objectives: This paper explores whether some individual features -due to pain socialisation- may have an effect on subjects' pain perception. Our study focuses on three types of personal traits: social, apprehensive and egalitarian individuals. We analyse the effect of these personal traits on pain sensitivity, pain endurance and willingness to

  11. Lumbar spine spondylolysis in the adult population: using computed tomography to evaluate the possibility of adult onset lumbar spondylosis as a cause of back pain

    International Nuclear Information System (INIS)

    To determine if new onset of low back pain in adults could be secondary to lumbar spondylolysis by establishing the age-related prevalence in the general population by examining patients undergoing computed tomography (CT) for reasons unrelated to back pain. The records of 2,555 patients who had undergone abdominal and pelvic CT in 2008 were reviewed electronically. In order to determine a true representation of the general population, we reviewed all indications for CT, excluding patients with a primary complaint of low back pain as the primary indication for imaging. Equal numbers of patients were separated into age groups by decade to ensure an even distribution of ages for statistical analysis. Patients older than 70 years were grouped together to provide case numbers comparable to those of the other decades. Logistic regression analysis was performed to evaluate the significance of the results. Three board-certified radiologists, including two musculoskeletal fellows and a radiology resident, retrospectively evaluated CT scans for lumbar spondylolysis, including unilateral and bilateral defects. Of the 2,555 cases evaluated, there were 203 positive cases of defects of the lumbar pars interarticularis. This corresponded to an overall prevalence of 8.0%. Prevalence per decade was fairly evenly distributed and ranged from 7.0%(ages 30-39 years) to 9.2% (ages 70 years and above). Prevalence of ages 20-49 years was 7.9%, and that of ages 50 years and older was 8.0%. Male to female ratio was 1.5:1. Logistic regression showed no significant increase in spondylolysis based on age. No significant increase in the prevalence of lumbar spondylolysis was demonstrated in patients older than 20 years. This suggests that the development of symptomatic lumbar pars defects do not occur in this population and should not be considered as a rare but potentially treatable cause of new onset low back pain in adults. This study demonstrated an overall prevalence of pars defects of 8

  12. Lumbar spine spondylolysis in the adult population: using computed tomography to evaluate the possibility of adult onset lumbar spondylosis as a cause of back pain

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, Benjamin K.; Southam, Samuel L.; Mlady, Gary W.; Logan, Jeremy; Rosett, Matthew [University of New Mexico School of Medicine, Department of Radiology, Albuquerque, NM (United States)

    2010-07-15

    To determine if new onset of low back pain in adults could be secondary to lumbar spondylolysis by establishing the age-related prevalence in the general population by examining patients undergoing computed tomography (CT) for reasons unrelated to back pain. The records of 2,555 patients who had undergone abdominal and pelvic CT in 2008 were reviewed electronically. In order to determine a true representation of the general population, we reviewed all indications for CT, excluding patients with a primary complaint of low back pain as the primary indication for imaging. Equal numbers of patients were separated into age groups by decade to ensure an even distribution of ages for statistical analysis. Patients older than 70 years were grouped together to provide case numbers comparable to those of the other decades. Logistic regression analysis was performed to evaluate the significance of the results. Three board-certified radiologists, including two musculoskeletal fellows and a radiology resident, retrospectively evaluated CT scans for lumbar spondylolysis, including unilateral and bilateral defects. Of the 2,555 cases evaluated, there were 203 positive cases of defects of the lumbar pars interarticularis. This corresponded to an overall prevalence of 8.0%. Prevalence per decade was fairly evenly distributed and ranged from 7.0%(ages 30-39 years) to 9.2% (ages 70 years and above). Prevalence of ages 20-49 years was 7.9%, and that of ages 50 years and older was 8.0%. Male to female ratio was 1.5:1. Logistic regression showed no significant increase in spondylolysis based on age. No significant increase in the prevalence of lumbar spondylolysis was demonstrated in patients older than 20 years. This suggests that the development of symptomatic lumbar pars defects do not occur in this population and should not be considered as a rare but potentially treatable cause of new onset low back pain in adults. This study demonstrated an overall prevalence of pars defects of 8

  13. The effect of mindfulness meditation on painful diabetic peripheral neuropathy in adults older than 50 years.

    Science.gov (United States)

    Teixeira, Elizabeth

    2010-01-01

    This pilot study explored the effect of mindfulness meditation for diabetic neuropathy. Twenty participants (10 in each group) completed the study. No significant differences were found between the groups. However, differences between the means were found on 2 constructs: pain quality of life and symptom-related quality of life. Further studies may show efficacy.

  14. Association between Genetic Polymorphisms in Cav2.3 (R-type) Ca2+ Channels and Fentanyl Sensitivity in Patients Undergoing Painful Cosmetic Surgery

    OpenAIRE

    Soichiro Ide; Daisuke Nishizawa; Ken-ichi Fukuda; Shinya Kasai; Junko Hasegawa; Masakazu Hayashida; Masabumi Minami; Kazutaka Ikeda

    2013-01-01

    Individual differences in the sensitivity to fentanyl, a widely used opioid analgesic, lead to different proper doses of fentanyl, which can hamper effective pain treatment. Voltage-activated Ca(2+) channels (VACCs) play a crucial role in the nervous system by controlling membrane excitability and calcium signaling. Ca(v)2.3 (R-type) VACCs have been especially thought to play critical roles in pain pathways and the analgesic effects of opioids. However, unknown is whether single-nucleotide po...

  15. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

    Science.gov (United States)

    Scheinfeld, Meir H; Mahadevia, Soham; Stein, Evan G; Freeman, Katherine; Rozenblit, Alla M

    2010-09-01

    We sought to determine whether laboratory parameters could be found, predictive of a negative abdominal CT scan in young adults with nontraumatic abdominal pain. Following institutional review board approval, we evaluated CT reports of 522 patients, aged 21-35 years old, who presented to the Emergency Department with nontraumatic abdominal pain. Bivariate analyses relating ten laboratory parameters to whether the CT detected a cause for abdominal pain were conducted. A multivariate logistic regression model was then derived, with all variables in the final model significant at p meeting inclusion criteria, 45% had a cause for pain demonstrated by CT. Predictors of a negative CT in men were normal hematocrit and negative urine blood (p = 0.045, p = 0.016, respectively), and in women normal hematocrit, granulocyte percent, and alkaline phosphatase (p = 0.023, p = 0.039, p sufficient to offer reassurance that a CT is not necessary in a young adult patient with nontraumatic abdominal pain. Alternative strategies should be considered to decrease the use of CT, and its associated radiation exposure, in young adults with nontraumatic abdominal pain. PMID:20306104

  16. Age-related sensitive periods influence visual language discrimination in adults.

    Science.gov (United States)

    Weikum, Whitney M; Vouloumanos, Athena; Navarra, Jordi; Soto-Faraco, Salvador; Sebastián-Gallés, Núria; Werker, Janet F

    2013-01-01

    Adults as well as infants have the capacity to discriminate languages based on visual speech alone. Here, we investigated whether adults' ability to discriminate languages based on visual speech cues is influenced by the age of language acquisition. Adult participants who had all learned English (as a first or second language) but did not speak French were shown faces of bilingual (French/English) speakers silently reciting sentences in either language. Using only visual speech information, adults who had learned English from birth or as a second language before the age of 6 could discriminate between French and English significantly better than chance. However, adults who had learned English as a second language after age 6 failed to discriminate these two languages, suggesting that early childhood exposure is crucial for using relevant visual speech information to separate languages visually. These findings raise the possibility that lowered sensitivity to non-native visual speech cues may contribute to the difficulties encountered when learning a new language in adulthood.

  17. Age-related sensitive periods influence visual language discrimination in adults.

    Science.gov (United States)

    Weikum, Whitney M; Vouloumanos, Athena; Navarra, Jordi; Soto-Faraco, Salvador; Sebastián-Gallés, Núria; Werker, Janet F

    2013-01-01

    Adults as well as infants have the capacity to discriminate languages based on visual speech alone. Here, we investigated whether adults' ability to discriminate languages based on visual speech cues is influenced by the age of language acquisition. Adult participants who had all learned English (as a first or second language) but did not speak French were shown faces of bilingual (French/English) speakers silently reciting sentences in either language. Using only visual speech information, adults who had learned English from birth or as a second language before the age of 6 could discriminate between French and English significantly better than chance. However, adults who had learned English as a second language after age 6 failed to discriminate these two languages, suggesting that early childhood exposure is crucial for using relevant visual speech information to separate languages visually. These findings raise the possibility that lowered sensitivity to non-native visual speech cues may contribute to the difficulties encountered when learning a new language in adulthood. PMID:24312020

  18. Efficacy and tolerability of carbamazepine for the treatment of painful diabetic neuropathy in adults: a 12-week, open-label, multicenter study

    Science.gov (United States)

    Saeed, Tariq; Nasrullah, Muhammad; Ghafoor, Adnan; Shahid, Riaz; Islam, Nadeem; Khattak, Mohammad Usman; Maheshwary, Neeta; Siddiqi, Ahson; Khan, Muhammad Athar

    2014-01-01

    Objective Anticonvulsants are increasingly being used in the symptomatic management of several neuropathic pain disorders. The present observational study was designed to evaluate the efficacy, tolerability, and quality of life (QoL) of carbamazepine use for 12 weeks in patients with painful diabetic neuropathy, in Pakistan. Methods This was a 12-week, multicenter, open-label, uncontrolled trial in adult type 2 diabetic patients (aged 18–65 years) suffering from clinically confirmed neuropathic pain (Douleur Neuropathique en 4 [DN4] score ≥4). Change in neuropathic pain at week 12 compared with baseline was assessed using the Brief Pain Inventory Scale–Short Form (pain severity score and pain interference score). QoL was determined by the American Chronic Pain Association QoL scale. Safety was assessed based on patient reported adverse events (AEs) and serious AEs. Results Of the total 500 screened patients, 452 enrolled and completed the study. The mean (± standard deviation [SD]) pain interference score decreased from 4.5±2.0 at baseline to 3.1±1.9 at week 12 (P<0.001). The mean (± SD) pain severity score decreased from 5.8±2.0 at baseline to 3.6±2.2 at week 12 (P<0.001). There was a decrease of ≥30% in the pain severity score between visits. The mean (± SD) QoL scale score improved from 5.9±1.6 at baseline to 8.0±1.7 at week 12. A total of ten (2.2%) patients reported AEs during the study period. No patient discontinued the study due to AEs. Conclusion In this real-life experience study, carbamazepine, when prescribed for 12 weeks to adult diabetic patients suffering from neuropathic pain, showed pain-relief effect, with reduced mean pain severity and mean pain interference scores and with improved QoL and good tolerability profile. PMID:25061334

  19. Nonspecificity of Chronic Soft Tissue Pain Syndromes

    Directory of Open Access Journals (Sweden)

    Eldon Tunks

    1997-01-01

    Full Text Available Persistent (or chronic pain occurs with a prevalence of about 10% in the adult population, and chronic soft tissue pain is especially problematic. Criteria for diagnosis of these soft tissue pain disorders appear to suffer from specificity problems, even though they appear to be sensitive in distinguishing normal from soft tissue pain sufferers. A few decades ago the term 'neuraesthenia' was used as a diagnosis in individuals who now would probably be diagnosed as suffering from fibromyalgia, chronic fatigue and anxiety disorders with fatigue. Soft tissue pain provokes skepticism, especially among third-party payers, and controversy among clinicians. Recent epidemiological studies have demonstrated sex differences in the prevalence of widespread pain and multiple tender points, which are distributed variably throughout the adult population and tend to be correlated with subjective symptoms. Although there is a tendency for these syndromes to persist, follow-up studies show that they tend to vary in extent and sometimes show remissions over longer follow-up, casting doubt about the distinctions between chronic diffuse pains and localized chronic soft tissue pains. Because both accidents and soft tissue pains are relatively prevalent problems, the possibility of chance coincidence of accident and chronic soft tissue pain in an individual creates the need to be cautious in attributing these syndromes to specific accidents in medicolegal situations. At the same time, the available evidence does not support a generally dismissive attitude towards these patients.

  20. Abdominal separation in an adult male patient with acute abdominal pain

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine...

  1. Pain Assessment

    Science.gov (United States)

    Introduction Types of Pain Pain Assessment Pain Treatments Integrative Pain Therapy Pain Management Recommendations References September 04, 2016 Pain Assessment Effective pain management begins with a comprehensive ...

  2. Clinical reasoning in the evaluation and management of undiagnosed chronic hip pain in a young adult.

    Science.gov (United States)

    Zimny, N J

    1998-01-01

    This case report describes the clinical reasoning used to manage chronic left hip pain in a 21-year-old woman who was recreationally active. The patient had a history of possible congenital hip dysplasia (CHD) and known recurrent lateral (external) patellar subluxations on the left side. She complained of experiencing hip pain when walking, sitting, playing soccer, and doing "step aerobics." Hip range of motion (ROM), muscle force, and joint stability problems were assessed. Abnormal movement patterns were observed during gait and step aerobics. Intervention was based on the working hypothesis that periarticular stiffness and muscle weakness from earlier trauma were superimposed on joint instability from CHD. Following intervention, the patient's hip ROM and muscle force improved concurrently with reduction of hip pain, increased ability to participate in recreational activities, and improvement in the movement pattern during step aerobics. An eclectic approach to analysis of the problem was used, combining data unique to the patient with knowledge of CHD and concepts proposed by Cyriax, Maitland, Sahrmann, and others. The clinical reasoning used to establish a basis for treatment and its limitations are discussed.

  3. PHOTOPERIODIC CONTROL OF ADULT DIAPAUSE IN CHRYSOPERLA SINICA (TJEDER) (NEUROPTERA: CHRYSOPIDAE) -I. CRITICAL PHOTOPERIOD AND SENSITIVE STAGES OF ADULT DIAPAUSE INDUCTION

    Institute of Scientific and Technical Information of China (English)

    Yong-yuXu; Ji-yuanMu; CuiHu; Hong-gangWang

    2004-01-01

    Photoperiodic sensitivity for diapause induction of the green lacewing, Chrysoperla sinica (Tjeder) was examined at 22℃. The adult diapause of C. sinica was induced by short-day photoperiods, and the critical photoperiod for its induction was between 12.5L-11.5D and 13L-11D.Adults developed without diapause under long-day conditions, and entered diapause under short-day conditions. The adult stage was the uppermost sensitive stage for adult diapause induction, adults could go into diapause only when the emerging adults were under diapause-inducing short-day photoperiods. The short-day photoperiodic experience by transferring between 15L: 9D and 9L: 15D at preimaginal stages did not result in adult diapause under 15L: 9D photo regime, although some treatments extended the pre-oviposition period in adult stage. The results showed that the 3rd instar larvae and pre-pupae were more sensitive to the photoperiodic change from 15L: 9D to 9L: 15D photo regime than the other preimaginal stages.

  4. Long-Term Changes in Pain Sensitivity in an Animal Model of Social Anxiety

    Directory of Open Access Journals (Sweden)

    Alessandra Berry

    2014-07-01

    Full Text Available Animal models with an eco-ethological relevance can help in identifying novel and reliable stress-related markers. To this end, 3-month-old C57BL/6J male mice were exposed to social defeat (SD stress for 10 days as this stressor shows good face and predictive validity for several models of human affective disorders including depression, social phobia and post-traumatic stress disorder. Social avoidance and pain threshold were assessed 24 h and 4 weeks after the end of SD stress, while corticosterone was assayed at the beginning and at the end of the stressful procedure (days 1 and 10. SD subjects were characterized by increased corticosterone levels (30 min following stress exposure, increased latency to approach the social target in the short-term as well as increased emotionality in the long-term. Moreover, an increase in nociceptive threshold (stress-induced analgesia was found both in the short-term and 4 weeks after the end of stress. These data indicate that the SD paradigm is able to induce emotional changes associated with a stressful/traumatic event. In addition, they indicate that variations in the nociceptive threshold might represent a physiological marker of both short- and long-term effects of stress.

  5. Age-related sensitive periods influence visual language discrimination in adults

    Directory of Open Access Journals (Sweden)

    Whitney M. Weikum

    2013-11-01

    Full Text Available Adults as well as infants have the capacity to discriminate languages based on visual speech alone. Here, we investigated whether adults’ ability to discriminate languages based on visual speech cues is influenced by the age of language acquisition. Adult participants who had all learned English (as a first or second language but did not speak French were shown faces of bilingual (French/English speakers silently reciting sentences in either language. Using only visual speech information, adults who had learned English from birth or as a second language before the age of 6 could discriminate between French and English significantly better than chance. However, adults who had learned English as a second language after age 6 failed to discriminate these two languages, suggesting that early childhood exposure is crucial for using relevant visual speech information to separate languages visually. These findings raise the possibility that lowered sensitivity to non-native visual speech cues may contribute to the difficulties encountered when learning a new language in adulthood.

  6. Differences in the sensitivity of children and adults to carciogenic substances - literature study

    International Nuclear Information System (INIS)

    A literature study was undertaken to investigate whether children are more sensitive to carcinogenic effects than adults. This question is especially important for regulatory decisions for situations with shorter than lifetime exposure. Adequate human data is scare except for ionizing radiation, where there is good evidence for a higher sensitivity of children for breast cancer, leukemia and thyroid cancer from epidemiological studies of japanese atom bomb survivors and tumor patients. For chemical substances main evidence comes from animal studies, which show for several substances (e.g. vinyl chloride, nitrosamines, polycyclic aromatic hydrocarbons, 2-acetylaminofluorene, benzidine, aflatoxin B1, cycasin, urethane) high incidences of tumors in the juvenile organisms whereas under comparable exposure conditions low numbers or no tumors were observed in adult animals. All of the mentioned substances are genotoxic carcinogens and mechanistic studies point towards the importance of high cell division rates in target organs of the juvenile organism which in combination with genotoxic activity leads to tumor development. Concerning nongenotoxic carcinogens there are data for saccharin which show that tumor incidence is higher when exposure periods include the period between birth and weaning. For other substances there is negative evidence under similar conditions. In conclusion there is ample evidence for a high sensitivity of the young towards some genotoxic carcinogens and therefore even less than lifetime exposures of children towards these substances may lead to a high carcinogenic risk. (orig.)

  7. Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Chao Hsing Yeh

    2014-01-01

    Full Text Available This prospective, randomized clinical trial (RCT pilot study was designed to (1 assess the feasibility and tolerability of an easily administered, auricular point acupressure (APA intervention and (2 provide an initial assessment of effect size as compared to a sham treatment. Thirty-seven subjects were randomized to receive either the real or sham APA treatment. All participants were treated once a week for 4 weeks. Self-report measures were obtained at baseline, weekly during treatment, at end-of-intervention (EOI, and at a 1-month follow-up. A dropout rate of 26% in the real APA group and 50% in the sham group was observed. The reduction in worst pain from baseline to EOI was 41% for the real and 5% for the sham group with a Cohen’s effect size of 1.22 P<0.00. Disability scores on the Roland Morris Disability Questionnaire (RMDQ decreased in the real group by 29% and were unchanged in the sham group (+3% P<0.00. Given the high dropout rate, results must be interpreted with caution; nevertheless, our results suggest that APA may provide an inexpensive and effective complementary approach for the management of back pain in older adults, and further study is warranted.

  8. Adolescent alcohol exposure decreased sensitivity to nicotine in adult Wistar rats.

    Science.gov (United States)

    Boutros, Nathalie; Semenova, Svetlana; Markou, Athina

    2016-07-01

    Many adolescents engage in heavy alcohol use. Limited research in humans indicates that adolescent alcohol use predicts adult tobacco use. The present study investigated whether adolescent intermittent ethanol (AIE) exposure alters nicotine sensitivity in adulthood. Adolescent male Wistar rats (postnatal day 28-53) were exposed to AIE exposure that consisted of 5 g/kg of 25 percent ethanol three times per day in a 2 days on/2 days off regimen. Control rats received water with the same exposure regimen. In adulthood, separate groups of rats were tested for nicotine intravenous self-administration (IVSA), drug discrimination and conditioned taste aversion (CTA). The dose-response function for nicotine IVSA under a fixed-ratio schedule of reinforcement was similar in AIE-exposed and control rats. However, AIE-exposed rats self-administered less nicotine at the lowest dose, suggesting that low-dose nicotine was less reinforcing in AIE-exposed, compared with control rats. AIE-exposed rats self-administered less nicotine under a progressive-ratio schedule, suggesting decreased motivation for nicotine after AIE exposure. The discriminative stimulus effects of nicotine were diminished in AIE-exposed rats compared with control rats. No group differences in nicotine CTA were observed, suggesting that AIE exposure had no effect on the aversive properties of nicotine. Altogether, these results demonstrate that AIE exposure decreases sensitivity to the reinforcing, motivational and discriminative properties of nicotine while leaving the aversive properties of nicotine unaltered in adult rats. These findings suggest that drinking during adolescence may result in decreased sensitivity to nicotine in adult humans, which may in turn contribute to the higher rates of tobacco smoking. PMID:25950618

  9. Local and Systemic Changes in Pain Sensitivity After 4 Weeks of Calf Muscle Stretching in a Nonpainful Population: A Randomized Trial

    DEFF Research Database (Denmark)

    Bartholdy, C.; Zangger, Graziella; Hansen, L.;

    2016-01-01

    BACKGROUND: Stretching is often used in clinical practice for a variety of purposes, including pain therapy. The possible mechanism behind the effect of stretching remains to be clarified. AIM: To investigate whether 4 weeks of unilateral stretching of the calf muscles would affect local...... and central pain sensitivity. METHOD: This study was a randomized assessor-blinded clinical study. Healthy participants (age 18 to 40) were included and randomized. Participants in the intervention group were instructed to perform 2 stretching exercises targeting the calf muscles; 3 times 30 seconds, 7 days...... a week for 4 weeks on the dominant leg. Participants in the control group were instructed not to do any stretching for 4 weeks. Pressure pain threshold (PPT) and temporal summation (TS) of pressure pain were measured on the stretched calf, the contra-lateral calf, and contra-lateral lower arm using...

  10. Age-dependent nongenetic influences of birth weight and adult body fat on insulin sensitivity in twins

    DEFF Research Database (Denmark)

    Monrad, Rikke Nygaard; Grunnet, Louise Groth; Rasmussen, Eva Lind;

    2009-01-01

    We hypothesized a nongenetic influence of birth weight (BW) and twin and zygosity status on dual-energy x-ray absorptiometry determined adult total and regional body composition and a quantitative equal, although independent, importance of adult body composition and BW for insulin sensitivity....

  11. Association between Accelerometer-Assessed Physical Activity and Objectively Measured Hearing Sensitivity among U.S. Adults with Diabetes

    Science.gov (United States)

    Loprinzi, Paul D.; Gilham, Ben; Cardinal, Bradley J.

    2014-01-01

    Purpose: The purpose of this study was to examine the association between objectively measured physical activity and hearing sensitivity among a nationally representative sample of U.S. adults with diabetes. Method: Data from the 2003-2006 National Health and Nutrition Examination Survey were used. One hundred eighty-four U.S. adults with diabetes…

  12. Spinal pain

    International Nuclear Information System (INIS)

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  13. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: roberto1766@interfree.it [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: t.popolizio1@gmail.com [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: paoladaprile@yahoo.it [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)

    2015-05-15

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  14. Geographical variation in the prevalence of sensitization to common aeroallergens in adults

    DEFF Research Database (Denmark)

    Newson, R B; van Ree, R; Forsberg, B;

    2014-01-01

    of allergens, and geometric mean serum total immunoglobulin E (IgE), in 3451 participants aged 18-75 years in 13 areas of Europe. Estimated prevalence was standardized to account for study design. We compared prevalence estimates in younger and older subjects and further adjusted for age, gender, smoking...... variation in gender, age, smoking history, farm exposure, family size and BMI. Higher prevalence in younger, compared to older, adults may reflect cohort-associated increases in sensitization or the influence of ageing on immune or tissue responses....

  15. Evaluation of Anxiety Sensitivity among Daily Adult Smokers using Item Response Theory Analysis

    OpenAIRE

    Zvolensky, Michael J.; Strong, David; Bernstein, Amit; Vujanovic, Anka A.; Marshall, Erin C.

    2008-01-01

    The present investigation applied Item Response Theory (IRT) methodology to the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986) for a sample of 475 daily adult smokers (52% women; Mage = 26.9, SD = 11.1, Range = 18 – 65). Using nonparametric item response analysis, all 16 ASI items were evaluated. Evaluation of the Option Characteristic Curves for each item revealed 4 poorly discriminating ASI items (1: “It is important not to appear nervous;” 5: “It is impor...

  16. Effect of Reiki therapy on pain and anxiety in adults: an in-depth literature review of randomized trials with effect size calculations.

    Science.gov (United States)

    Thrane, Susan; Cohen, Susan M

    2014-12-01

    The objective of this study was to calculate the effect of Reiki therapy for pain and anxiety in randomized clinical trials. A systematic search of PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases was conducted using the search terms pain, anxiety, and Reiki. The Center for Reiki Research also was examined for articles. Studies that used randomization and a control or usual care group, used Reiki therapy in one arm of the study, were published in 2000 or later in peer-reviewed journals in English, and measured pain or anxiety were included. After removing duplicates, 49 articles were examined and 12 articles received full review. Seven studies met the inclusion criteria: four articles studied cancer patients, one examined post-surgical patients, and two analyzed community dwelling older adults. Effect sizes were calculated for all studies using Cohen's d statistic. Effect sizes for within group differences ranged from d = 0.24 for decrease in anxiety in women undergoing breast biopsy to d = 2.08 for decreased pain in community dwelling adults. The between group differences ranged from d = 0.32 for decrease of pain in a Reiki versus rest intervention for cancer patients to d = 4.5 for decrease in pain in community dwelling adults. Although the number of studies is limited, based on the size Cohen's d statistics calculated in this review, there is evidence to suggest that Reiki therapy may be effective for pain and anxiety. Continued research using Reiki therapy with larger sample sizes, consistently randomized groups, and standardized treatment protocols is recommended. PMID:24582620

  17. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type

    DEFF Research Database (Denmark)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene;

    2016-01-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey......, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36......). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p pain intensity (NRS: 6.4 versus...

  18. E-learning module on chronic low back pain in older adults: evidence of effect on medical student objective structured clinical examination performance.

    Science.gov (United States)

    Weiner, Debra K; Morone, Natalia E; Spallek, Heiko; Karp, Jordan F; Schneider, Michael; Washburn, Carol; Dziabiak, Michael P; Hennon, John G; Elnicki, D Michael

    2014-06-01

    The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health-designated centers, to teach students important principles for evaluating and managing CLBP in older adults. A team of six experts in education, information technology, pain management, and geriatrics developed the module. Teaching focused on common errors, interactivity, and expert modeling and feedback. The module mimicked a patient encounter using a standardized patient (the older adult with CLBP) and a pain expert (the patient provider). Twenty-eight medical students were not exposed to the module (Group 1) and 27 were exposed (Group 2). Their clinical skills in evaluating CLBP were assessed using an objective structured clinical examination (OSCE). Mean scores were 62.0 ± 8.6 for Group 1 and 79.5 ± 10.4 for Group 2 (P Group 1 students (60.7%) and 26 of 27 Group 2 students (96.3%) passed. The CLBP OSCE was one of 10 OSCE stations in which students were tested at the end of a Combined Ambulatory Medicine and Pediatrics Clerkship. There were no between-group differences in performance on eight of the other nine OSCE stations. This module significantly improved medical student clinical skills in evaluating CLBP. Additional research is needed to ascertain the effect of e-learning modules on more-advanced learners and on improving the care of older adults with CLBP. PMID:24833496

  19. Dopamine and pain sensitivity: neither sulpiride nor acute phenylalanine and tyrosine depletion have effects on thermal pain sensations in healthy volunteers.

    Science.gov (United States)

    Becker, Susanne; Ceko, Marta; Louis-Foster, Mytsumi; Elfassy, Nathaniel M; Leyton, Marco; Shir, Yoram; Schweinhardt, Petra

    2013-01-01

    Based on animal studies and some indirect clinical evidence, dopamine has been suggested to have anti-nociceptive effects. Here, we investigated directly the effects of increased and decreased availability of extracellular dopamine on pain perception in healthy volunteers. In Study 1, participants ingested, in separate sessions, a placebo and a low dose of the centrally acting D2-receptor antagonist sulpiride, intended to increase synaptic dopamine via predominant pre-synaptic blockade. No effects were seen on thermal pain thresholds, tolerance, or temporal summation. Study 2 used the acute phenylalanine and tyrosine depletion (APTD) method to transiently decrease dopamine availability. In one session participants ingested a mixture that depletes the dopamine amino acid precursors, phenylalanine and tyrosine. In the other session they ingested a nutritionally balanced control mixture. APTD led to a small mood-lowering response following aversive thermal stimulation, but had no effects on the perception of cold, warm, or pain stimuli. In both studies the experimental manipulation of dopaminergic neurotransmission was successful as indicated by manipulation checks. The results contradict proposals that dopamine has direct anti-nociceptive effects in acute experimental pain. Based on dopamine's well-known role in reward processing, we hypothesize that also in the context of pain, dopamine acts on stimulus salience and might play a role in the initiation of avoidance behavior rather than having direct antinociceptive effects in acute experimental pain.

  20. [Reliability and validity of the pain assessment tool in confused older adults--IADIC].

    Science.gov (United States)

    Saurin, Gislaine; Crossetti, Maria da Graça Oliveira

    2013-12-01

    This is a methodological study, the objective was to conduct the pre-test and validate the psychometric properties of the Pain Assessment Tool in Confused Elderly (IADIC) in the immediate postoperative period. The sample consisted of 104 patients aged 60 years and over in the immediate postoperative perio4 admitted to the recovery room after surgery in a general hospital of Rio Grande do Sul Brasil. Data were collected from April to August 2012. Patients included in the study were diagnosed as confused after application of the Confusion Assessment Method-CAM and possessed age of 71.51 +/- 8.81 years. In the pre-test did not require modifications of the instrument. Upon validation the psychometric properties and internal consistency showed a Cronbach's alpha of 0.88 and reproducibility assessed by the intmraclass coefficient was 0.838. Internal consistency and reproducibility gave IADIC the validity and reliability for use in Brazil.

  1. Specific proteins of the trapezius muscle correlate with pain intensity and sensitivity – an explorative multivariate proteomic study of the trapezius muscle in women with chronic widespread pain

    Science.gov (United States)

    Olausson, Patrik; Ghafouri, Bijar; Ghafouri, Nazdar; Gerdle, Björn

    2016-01-01

    Chronic widespread pain (CWP) including fibromyalgia syndrome (FMS) has a high prevalence and is associated with prominent negative consequences. CWP/FMS exhibits morphological and functional alterations in the central nervous system. The importance of peripheral factors for maintaining the central alterations are under debate. In this study, the proteins from biopsies of the trapezius muscle from 18 female CWP/FMS patients and 19 healthy female controls were analyzed. Pain intensity and pressure pain thresholds (PPT) over the trapezius muscles were registered. Twelve proteins representing five different groups of proteins were important regressors of pain intensity in CWP/FMS (R2=0.99; P<0.001). In the regression of PPT in CWP/FMS, it was found that 16 proteins representing six groups of proteins were significant regressors (R2=0.95, P<0.05). Many of the important proteins were stress and inflammation proteins, enzymes involved in metabolic pathways, and proteins associated with muscle damage, myopathies, and muscle recovery. The altered expression of these proteins may reflect both direct and indirect nociceptive/inflammatory processes as well as secondary changes. The relative importance of the identified proteins and central alterations in CWP need to be investigated in future research. Data from this and the previous study concerning the same cohorts give support to the suggestion that peripheral factors are of importance for maintaining pain aspects in CWP/FMS. PMID:27330327

  2. Deep pain sensitivity is correlated with oral-health-related quality of life but not with prosthetic factors in complete denture wearers

    Science.gov (United States)

    COSTA, Yuri Martins; PORPORATTI, André Luís; HILGENBERG-SYDNEY, Priscila Brenner; BONJARDIM, Leonardo Rigoldi; CONTI, Paulo César Rodrigues

    2015-01-01

    ABSTRACT Low pressure Pain Threshold (PPT) is considered a risk factor for Temporomandibular Disorders (TMD) and is influenced by psychological variables. Objectives To correlate deep pain sensitivity of masticatory muscles with prosthetic factors and Oral-Health-Related Quality of Life (OHRQoL) in completely edentulous subjects. Material and Methods A total of 29 complete denture wearers were recruited. The variables were: a) Pressure Pain Threshold (PPT) of the masseter and temporalis; b) retention, stability, and tooth wear of dentures; c) Vertical Dimension of Occlusion (VDO); d) Oral Health Impact Profile (OHIP) adapted to orofacial pain. The Kolmogorov-Smirnov test, the Pearson Product-Moment correlation coefficient, the Spearman Rank correlation coefficient, the Point-Biserial correlation coefficient, and the Bonferroni correction (α=1%) were applied to the data. Results The mean age (standard deviation) of the participants was of 70.1 years (9.5) and 82% of them were females. There were no significant correlations with prosthetic factors, but significant negative correlations were found between the OHIP and the PPT of the anterior temporalis (r=-0.50, 95% CI-0.73 to 0.17, p=0.005). Discussion The deep pain sensitivity of masticatory muscles in complete dentures wearers is associated with OHRQoL, but not with prosthetic factors. PMID:26814457

  3. Deep pain sensitivity is correlated with oral-health-related quality of life but not with prosthetic factors in complete denture wearers

    Directory of Open Access Journals (Sweden)

    Yuri Martins COSTA

    2015-12-01

    Full Text Available ABSTRACT Low pressure Pain Threshold (PPT is considered a risk factor for Temporomandibular Disorders (TMD and is influenced by psychological variables. Objectives To correlate deep pain sensitivity of masticatory muscles with prosthetic factors and Oral-Health-Related Quality of Life (OHRQoL in completely edentulous subjects. Material and Methods A total of 29 complete denture wearers were recruited. The variables were: a Pressure Pain Threshold (PPT of the masseter and temporalis; b retention, stability, and tooth wear of dentures; c Vertical Dimension of Occlusion (VDO; d Oral Health Impact Profile (OHIP adapted to orofacial pain. The Kolmogorov-Smirnov test, the Pearson Product-Moment correlation coefficient, the Spearman Rank correlation coefficient, the Point-Biserial correlation coefficient, and the Bonferroni correction (α=1% were applied to the data. Results The mean age (standard deviation of the participants was of 70.1 years (9.5 and 82% of them were females. There were no significant correlations with prosthetic factors, but significant negative correlations were found between the OHIP and the PPT of the anterior temporalis (r=-0.50, 95% CI-0.73 to 0.17, p=0.005. Discussion The deep pain sensitivity of masticatory muscles in complete dentures wearers is associated with OHRQoL, but not with prosthetic factors.

  4. Effect of pulsed electromagnetic field therapy on experimental pain: A double-blind, randomized study in healthy young adults.

    Science.gov (United States)

    Beaulieu, Karen; Beland, Patricia; Pinard, Marilee; Handfield, Guilène; Handfield, Nicole; Goffaux, Philippe; Corriveau, Hélène; Léonard, Guillaume

    2016-01-01

    Previous studies suggested that pulsed electromagnetic field (PEMF) therapy can decrease pain. To date, however, it remains difficult to determine whether the analgesic effect observed in patients are attributable to a direct effect of PEMF on pain or to an indirect effect of PEMF on inflammation and healing. In the present study, we used an experimental pain paradigm to evaluate the direct effect of PEMF on pain intensity, pain unpleasantness, and temporal summation of pain. Twenty-four healthy subjects (mean age 22 ± 2 years; 9 males) participated in the experiment. Both real and sham PEMF were administered to every participant using a randomized, double-blind, cross-over design. For each visit, PEMF was applied for 10 minutes on the right forearm using a portable device. Experimental pain was evoked before (baseline) and after PEMF with a 9 cm(2) Pelletier-type thermode, applied on the right forearm (120 s stimulation; temperature individually adjusted to produce moderate baseline pain). Pain intensity and unpleasantness were evaluated using a 0-100 numerical pain rating scale. Temporal summation was evaluated by comparing pain intensity ratings obtained at the end of tonic nociceptive stimulation (120 s) with pain intensity ratings obtained after 60 s of stimulation. When compared to baseline, there was no change in pain intensity and unpleasantness following the application of real or sham PEMF. PEMF did not affect temporal summation. The present observations suggest that PEMF does not directly influence heat pain perception in healthy individuals. PMID:27014804

  5. Oral nitric-oxide donor glyceryl-trinitrate induces sensitization in spinal cord pain processing in migraineurs: a double-blind, placebo-controlled, cross-over study.

    Science.gov (United States)

    Perrotta, Armando; Serrao, Mariano; Tassorelli, Cristina; Arce-Leal, Natalia; Guaschino, Elena; Sances, Grazia; Rossi, Paolo; Bartolo, Michelangelo; Pierelli, Francesco; Sandrini, Giorgio; Nappi, Giuseppe

    2011-05-01

    Nitric-oxide donor glyceryl-trinitrate (GTN) modulates cerebral and spinal regions that are involved in migraine and pain processing. We hypothesized that in migraineurs, the susceptibility to develop a migraine attack after GTN administration should parallel with an high sensitivity to GTN-induced change in the pain processing at spinal level. We used the temporal summation threshold (TST) of the lower limb nociceptive withdrawal reflex (NWR) and the related pain sensation to study in parallel the time-course of the effect of the GTN administration on the pain processing at spinal level in migraine and healthy subjects. Twenty-eight (21 F; 7M; mean age 34.2 ± 8.2) migraine and 15 (11 F; 4M; mean age 35.9 ± 8.9) healthy subjects were recruited in a double-blind, placebo-controlled, cross-over trial. Neurophysiological examinations were carried out before (baseline) and 30', 60', 120', 180' and 240' after GTN (0.9 mg sublingual) or placebo administration during two different sessions. In migraineurs, GTN administration was associated to a significant facilitation in temporal summation of pain (reduced TST and increased painful sensation) 60', 120' and 180' after drug intake when compared to baseline, to placebo condition and to controls after GTN intake. Furthermore, in migraineurs who developed migraine after GTN, a significant facilitation in temporal summation of pain was detected 60', 120' and 180' after drug intake when compared to patients without clinical response. In migraineurs the susceptibility to develop migraine attack after GTN administration seems to be a specific trait of a subgroup of patients linked to a supersensitivity of the pain system to GTN.

  6. The Danish urban-rural gradient of allergic sensitization and disease in adults

    DEFF Research Database (Denmark)

    Elholm, G; Linneberg, A; Husemoen, L L N;

    2016-01-01

    allergens also decreased with decreasing degree of urbanized upbringing measured by sIgE to 4 common allergens as odds ratio with 95% confidence intervals with city as reference; town 0.60 (0.39-0.92), rural area 0.34 (0.22-0.52) and farm 0.31 (0.21-0.46). Furthermore, it was measured by SPT to 10 common...... allergens; town 0.52 (0.33-0.84), rural area 0.34 (0.21-0.53) and farm 0.29 (0.19-0.45). This urban-rural association was also seen for the risk of sensitization to specific allergens, rhinitis and allergic asthma. CONCLUSION: This is the first study to show an urban-rural gradient of overall allergic......BACKGROUND: The reported prevalence of allergic sensitization among children is lower in rural areas than in urban areas of the world. The aim was to investigate the urban-rural differences of allergic sensitization to inhalant allergens in adults depending on childhood exposure living...

  7. Suicide Risk, Stress Sensitivity, and Self-Esteem among Young Adults Reporting Auditory Hallucinations.

    Science.gov (United States)

    DeVylder, Jordan E; Hilimire, Matthew R

    2015-08-01

    Individuals with subthreshold psychotic experiences are at increased risk for suicidal thoughts and behavior, similar to those with schizophrenia and other psychotic disorders. This may be explained by shared risk factors such as heightened stress sensitivity or low self-esteem. Understanding the nature of this relationship could inform suicide prevention in social work practice. In this study, authors examined the relationship between self-reported auditory hallucinations and suicidal thoughts, plans, and attempts, in a nonclinical sample of young adults, controlling for scores on the Psychological Stress Index and Rosenberg Self-Esteem Scale. Auditory hallucinations were associated with approximately double the odds of suicidal ideation and plans and four times the odds for suicide attempts. This relationship was not explained by stress sensitivity or self-esteem, which were independently related to hallucinations and suicidality, respectively. Subthreshold auditory hallucinations may be a useful indicator of suicide risk. This association may represent a clinically significant relationship that may be addressed through social work interventions intended to alleviate stress sensitivity or improve self-esteem. PMID:26285356

  8. Suicide Risk, Stress Sensitivity, and Self-Esteem among Young Adults Reporting Auditory Hallucinations.

    Science.gov (United States)

    DeVylder, Jordan E; Hilimire, Matthew R

    2015-08-01

    Individuals with subthreshold psychotic experiences are at increased risk for suicidal thoughts and behavior, similar to those with schizophrenia and other psychotic disorders. This may be explained by shared risk factors such as heightened stress sensitivity or low self-esteem. Understanding the nature of this relationship could inform suicide prevention in social work practice. In this study, authors examined the relationship between self-reported auditory hallucinations and suicidal thoughts, plans, and attempts, in a nonclinical sample of young adults, controlling for scores on the Psychological Stress Index and Rosenberg Self-Esteem Scale. Auditory hallucinations were associated with approximately double the odds of suicidal ideation and plans and four times the odds for suicide attempts. This relationship was not explained by stress sensitivity or self-esteem, which were independently related to hallucinations and suicidality, respectively. Subthreshold auditory hallucinations may be a useful indicator of suicide risk. This association may represent a clinically significant relationship that may be addressed through social work interventions intended to alleviate stress sensitivity or improve self-esteem.

  9. Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation

    Science.gov (United States)

    Azimi, Parisa; Benzel, Edward C.

    2016-01-01

    Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ) measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH). This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI) score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC). The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24–35). Post-surgical success was 79.9% (n = 123) at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6), 5.4 (SD = 1.9) and 6.5 (SD = 1.7), respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703–0.926). This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice. PMID:27494617

  10. Chronic pain management in non-oncologic patients: multicentric study on adult patients referring to the centers for pain management in the Lazio Region (Italy)

    OpenAIRE

    LATINA, ROBERTO

    2013-01-01

    Introduction Chronic pain is a complex phenomenon usually associated with psychological stress, which implies falling back on the National Health Service and reducing work capacities, indeed affecting Activities of Daily Living. Studies based on efficacy have identified the multidisciplinary approach as the most effective means to obtain therapeutic results. These programs can be provided by the Centers for Pain Management (CPMs), where multidisciplinary teams are likely to pro...

  11. Occurrence and Characteristics of Chronic Pain in a Community-Based Cohort of Indigent Adults Living With HIV Infection

    OpenAIRE

    Miaskowski, C; Penko, JM; D. Guzman; Mattson, JE; Bangsberg, DR; Kushel, MB

    2011-01-01

    Pain is common among people living with HIV/AIDS (PLWHA), but little is known about chronic pain in socioeconomically disadvantaged HIV-infected populations with high rates of substance abuse in the postantiretroviral era. This cross-sectional study describes the occurrence and characteristics of pain in a community-based cohort of 296 indigent PLWHA. Participants completed questionnaires about sociodemographics, substance use, depression, and pain. Cut-point analysis was used to generate cat...

  12. Older Adults' Trait Impressions of Faces Are Sensitive to Subtle Resemblance to Emotions.

    Science.gov (United States)

    Franklin, Robert G; Zebrowitz, Leslie A

    2013-09-01

    Younger adults (YA) attribute emotion-related traits to people whose neutral facial structure resembles an emotion (emotion overgeneralization). The fact that older adults (OA) show deficits in accurately labeling basic emotions suggests that they may be relatively insensitive to variations in the emotion resemblance of neutral expression faces that underlie emotion overgeneralization effects. On the other hand, the fact that OA, like YA, show a 'pop-out' effect for anger, more quickly locating an angry than a happy face in a neutral array, suggests that both age groups may be equally sensitive to emotion resemblance. We used computer modeling to assess the degree to which neutral faces objectively resembled emotions and assessed whether that resemblance predicted trait impressions. We found that both OA and YA showed anger and surprise overgeneralization in ratings of danger and naiveté, respectively, with no significant differences in the strength of the effects for the two age groups. These findings suggest that well-documented OA deficits on emotion recognition tasks may be more due to processing demands than to an insensitivity to the social affordances of emotion expressions.

  13. Construct Validity and Reliability of the Adult Rejection Sensitivity Questionnaire: A Comparison of Three Factor Models

    Directory of Open Access Journals (Sweden)

    Marco Innamorati

    2014-01-01

    Full Text Available Objectives and Methods. The aim of the study was to investigate the construct validity of the ARSQ. Methods. The ARSQ and self-report measures of depression, anxiety, and hopelessness were administered to 774 Italian adults, aged 18 to 64 years. Results. Structural equation modeling indicated that the factor structure of the ARSQ can be represented by a bifactor model: a general rejection sensitivity factor and two group factors, expectancy of rejection and rejection anxiety. Reliability of observed scores was not satisfactory: only 44% of variance in observed total scores was due to the common factors. The analyses also indicated different correlates for the general factor and the group factors. Limitations. We administered an Italian version of the ARSQ to a nonclinical sample of adults, so that studies which use clinical populations or the original version of the ARSQ could obtain different results from those presented here. Conclusion. Our results suggest that the construct validity of the ARSQ is disputable and that rejection anxiety and expectancy could bias individuals to readily perceive and strongly react to cues of rejection in different ways.

  14. Paediatric Pain Management: Using Complementary and Alternative Medicine.

    Science.gov (United States)

    Evans, Subhadra; Tsao, Jennie C I; Zeltzer, Lonnie K

    2008-09-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Although research is limited for paediatric pain, CAM interventions receiving the most empirical attention include hypnotherapy, acupuncture and music therapy. Evidence also exists for the therapeutic benefits of yoga, massage, humor therapy and the use of certain biological based therapies. PMID:26525515

  15. Botulinum toxin assessment, intervention and aftercare for paediatric and adult niche indications including pain: international consensus statement.

    Science.gov (United States)

    Rawicki, B; Sheean, G; Fung, V S C; Goldsmith, S; Morgan, C; Novak, I

    2010-08-01

    Evidence is emerging for the use of botulinum neurotoxin type-A (BoNT-A) for niche indications including pain independent of spasticity. Pain indications such as chronic nociceptive back pain, piriformis syndrome, chronic myofascial pain, pelvic pain, complex regional pain syndrome, facial pain and neuropathic pain are outlined in this paper. Of these, class I evidence is available for the treatment of chronic nociceptive low back pain, piriformis syndrome, myofascial pain, facial pain, neuropathic pain and plantar fasciitis. Peri-operative use of BoNT-A is emerging, with indications including planning for surgery and facilitating surgery, as well as healing and improving analgesia post-operatively. Evidence is limited, although there are some reports that clinicians are successfully using BoNT-A peri-operatively. There is class I evidence showing pre-operative use of BoNT-A has a beneficial effect on outcomes following adductor-release surgery. The use of BoNT for treatment of tremor, other than neck tremor in the setting of cervical dystonia, including evidence for upper limb tremor, cranial tremor and non-dystonic neck tremor is reviewed. The evidence is variable at this stage, and further study is required to develop definitive recommendations for the clinical utility of BoNT-A for these indications.

  16. Race effects on temporal summation to heat pain in youth.

    Science.gov (United States)

    Morris, Matthew C; Walker, Lynn; Bruehl, Stephen; Hellman, Natalie; Sherman, Amanda L; Rao, Uma

    2015-05-01

    Racial differences in pain responsiveness have been demonstrated in adults. However, it is unclear whether racial differences are also present in youth and whether they extend to experimental pain indices assessing temporal summation of second pain (TSSP). Temporal summation of second pain provides an index of pain sensitivity and may be especially relevant in determining risk for chronic pain. This study assessed pain tolerance and TSSP to evoked thermal pain in 78 healthy youth (age range, 10-17), 51% of whom were African American and 49% were non-Hispanic white. Multilevel models revealed within-individual increases in pain ratings during the temporal summation task in non-Hispanic white youth that were consistent with TSSP. Pain ratings did not change significantly during the temporal summation task in African-American youth. Baseline evoked pain ratings were significantly higher in African-American compared with non-Hispanic white youth. These findings suggest that enhanced responsiveness to evoked thermal pain in African Americans is present in adolescence but is unlikely to be related to elevated TSSP. These results may have implications for understanding racial differences in chronic pain experience in adulthood.

  17. Complementary and Alternative Medicine Use in the US Adult Low Back Pain Population.

    Science.gov (United States)

    Ghildayal, Neha; Johnson, Pamela Jo; Evans, Roni L; Kreitzer, Mary Jo

    2016-01-01

    背景:许多有腰背痛 (Low Back Pain, LBP) 的人都发现常规药物治疗不足以管理其腰背痛,并越来越多地转向补充和替代医学 (Complementary and Alternative Medicine, CAM) 来疼痛缓解。需要全面描绘 CAM 在 LBP 人群中的使用情况,包括所有最常用的方式。研究目标:通过限制性与非限制性 LBP 考察在美国 LBP 人群中使用 CAM 的普遍性和感知利益,同时评估去年在 LBP 人群中使用 CAM 的几率。方法:数据来自于 2012 年国家健康访谈调查,替代健康补充。我们考察了美国成人 LBP 患者的全国代表性样本(N=9665,未加权)。使用多次逻辑回归估计去年使用 CAM的几率。结果:总体而言,41.2% 的 LBP 人群去年使用了 CAM,其中在限制性 LBP 患者中报告的使用率较高。LBP人群中使用最多的疗法包括草药补充剂、整脊疗法和按摩。多数 LBP人群使用了专用于治疗背痛的 CAM,在使用 CAM 治疗背痛者中,58.1% 感觉受益匪浅。结论:结果表明,CAM 正成为 LBP病患护理越来越重要的组成部分。进一步了解 CAM 在 LBP 人群中的使用方式将帮助卫生保健专业人员作出更加知情的护理决定,并指导研究者发展未来的背痛相关 CAM 研究。.

  18. No effect of bicarbonate treatment on insulin sensitivity and glucose control in non-diabetic older adults

    OpenAIRE

    Harris, Susan S.; Dawson-Hughes, Bess

    2010-01-01

    Chronic mild metabolic acidosis is common among older adults, and limited evidence suggests that it may contribute to insulin resistance and type-2 diabetes. This analysis was conducted to determine whether bicarbonate supplementation, an alkalinizing treatment, improves insulin sensitivity or glucose control in non-diabetic older adults. Fasting blood glucose and insulin were measured in stored samples from subjects who had completed a 3-month clinical trial of bicarbonate supplementation to...

  19. The impact of emotion-related autonomic nervous system responsiveness on pain sensitivity in female patients with fibromyalgia

    NARCIS (Netherlands)

    Middendorp, H. van; Lumley, M.A.; Houtveen, J.H.; Jacobs, J.W.G.; Bijlsma, J.W.J.; Geenen, R.

    2013-01-01

    OBJECTIVE: Patients with fibromyalgia have shown hyporeactive autonomic nervous system (ANS) responses to physical stressors, augmented pain to ANS changes, and heightened negative emotions, which can increase pain. This study examined ANS reactivity to negative emotions and its association with pai

  20. Beyond pleasure and pain: Facial expression ambiguity in adults and children during intense situations.

    Science.gov (United States)

    Wenzler, Sofia; Levine, Sarah; van Dick, Rolf; Oertel-Knöchel, Viola; Aviezer, Hillel

    2016-09-01

    According to psychological models as well as common intuition, intense positive and negative situations evoke highly distinct emotional expressions. Nevertheless, recent work has shown that when judging isolated faces, the affective valence of winning and losing professional tennis players is hard to differentiate. However, expressions produced by professional athletes during publicly broadcasted sports events may be strategically controlled. To shed light on this matter we examined if ordinary people's spontaneous facial expressions evoked during highly intense situations are diagnostic for the situational valence. In Experiment 1 we compared reactions with highly intense positive situations (surprise soldier reunions) versus highly intense negative situations (terror attacks). In Experiment 2, we turned to children and compared facial reactions with highly positive situations (e.g., a child receiving a surprise trip to Disneyland) versus highly negative situations (e.g., a child discovering her parents ate up all her Halloween candy). The results demonstrate that facial expressions of both adults and children are often not diagnostic for the valence of the situation. These findings demonstrate the ambiguity of extreme facial expressions and highlight the importance of context in everyday emotion perception. (PsycINFO Database Record

  1. Beyond pleasure and pain: Facial expression ambiguity in adults and children during intense situations.

    Science.gov (United States)

    Wenzler, Sofia; Levine, Sarah; van Dick, Rolf; Oertel-Knöchel, Viola; Aviezer, Hillel

    2016-09-01

    According to psychological models as well as common intuition, intense positive and negative situations evoke highly distinct emotional expressions. Nevertheless, recent work has shown that when judging isolated faces, the affective valence of winning and losing professional tennis players is hard to differentiate. However, expressions produced by professional athletes during publicly broadcasted sports events may be strategically controlled. To shed light on this matter we examined if ordinary people's spontaneous facial expressions evoked during highly intense situations are diagnostic for the situational valence. In Experiment 1 we compared reactions with highly intense positive situations (surprise soldier reunions) versus highly intense negative situations (terror attacks). In Experiment 2, we turned to children and compared facial reactions with highly positive situations (e.g., a child receiving a surprise trip to Disneyland) versus highly negative situations (e.g., a child discovering her parents ate up all her Halloween candy). The results demonstrate that facial expressions of both adults and children are often not diagnostic for the valence of the situation. These findings demonstrate the ambiguity of extreme facial expressions and highlight the importance of context in everyday emotion perception. (PsycINFO Database Record PMID:27337681

  2. Prevalence of self-reported pain, joint complaints and knee or hip complaints in adults aged ≥ 40 years: a cross-sectional survey in Herne, Germany.

    Directory of Open Access Journals (Sweden)

    Ulrich Thiem

    high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany.

  3. Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part VII: Insomnia.

    Science.gov (United States)

    Bramoweth, Adam D; Renqvist, Jenna G; Germain, Anne; Buysse, Daniel J; Gentili, Angela; Kochersberger, Gary; Rodriguez, Eric; Rossi, Michelle I; Weiner, Debra K

    2016-05-01

    OBJECTIVE : To present the seventh in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on insomnia and presents a treatment algorithm for managing insomnia in older adults, along with a representative clinical case. METHODS : A modified Delphi process was used to develop the algorithm and supportive materials. A multidisciplinary expert panel representing expertise in health psychology and sleep medicine developed the algorithm and supporting documents that were subsequently refined through an iterative process of input from a primary care provider panel. RESULTS : We present an illustrative clinical case and an algorithm to help guide the care of older adults with insomnia, an important contributor to CLBP and disability. Multicomponent cognitive behavioral therapy for insomnia (CBTI) and similar treatments (e.g., brief behavioral treatment for insomnia [BBTI]) are the recommended first-line treatment. Medications should be considered only if BBTI/CBTI is suboptimal or not effective and should be prescribed at the lowest effective dose for short periods of time (older adults and should be routinely evaluated and treated because it is an important contributor to pain and disability. The algorithm presented was structured to assist primary care providers in planning treatment for older adults with CLBP and insomnia. PMID:27173512

  4. IgE Sensitization Profiles Differ between Adult Patients with Severe and Moderate Atopic Dermatitis.

    Directory of Open Access Journals (Sweden)

    Irene Mittermann

    Full Text Available Atopic dermatitis (AD is a complex chronic inflammatory disease where allergens can act as specific triggering factors.To characterize the specificities of IgE-reactivity in patients with AD to a broad panel of exogenous allergens including microbial and human antigens.Adult patients with AD were grouped according to the SCORAD index, into severe (n = 53 and moderate AD (n = 126. As controls 43 patients were included with seborrhoeic eczema and 97 individuals without history of allergy or skin diseases. Specific IgE reactivity was assessed in plasma using Phadiatop®, ImmunoCap™, micro-arrayed allergens, dot-blotted recombinant Malassezia sympodialis allergens, and immune-blotted microbial and human proteins.IgE reactivity was detected in 92% of patients with severe and 83% of patients with moderate AD. Sensitization to cat allergens occurred most frequently, followed by sensitization to birch pollen, grass pollen, and to the skin commensal yeast M. sympodialis. Patients with severe AD showed a significantly higher frequency of IgE reactivity to allergens like cat (rFel d 1 and house dust mite (rDer p 4 and 10, to Staphylococcus aureus, M. sympodialis, and to human antigens. In contrast, there were no significant differences in the frequencies of IgE reactivity to the grass pollen allergens rPhl p 1, 2, 5b, and 6 between the two AD groups. Furthermore the IgE reactivity profile of patients with severe AD was more spread towards several different allergen molecules as compared to patients with moderate AD.We have revealed a hitherto unknown difference regarding the molecular sensitization profile in patients with severe and moderate AD. Molecular profiling towards allergen components may provide a basis for future investigations aiming to explore the environmental, genetic and epigenetic factors which could be responsible for the different appearance and severity of disease phenotypes in AD.

  5. Postnatal manganese exposure does not alter dopamine autoreceptor sensitivity in adult and adolescent male rats.

    Science.gov (United States)

    McDougall, Sanders A; Mohd-Yusof, Alena; Kaplan, Graham J; Abdulla, Zuhair I; Lee, Ryan J; Crawford, Cynthia A

    2013-04-15

    Administering manganese chloride (Mn) to rats on postnatal day (PD) 1-21 causes long-term reductions in dopamine transporter levels in the dorsal striatum, as well as a persistent increase in D1 and D2 receptor concentrations. Whether dopamine autoreceptors change in number or sensitivity is uncertain, although D2S receptors, which may be presynaptic in origin, are elevated in Mn-exposed rats. The purpose of this study was to determine if early Mn exposure causes long-term changes in dopamine autoreceptor sensitivity that persist into adolescence and adulthood. To this end, male rats were exposed to Mn on PD 1-21 and autoreceptor functioning was tested 7 or 70 days later by measuring (a) dopamine synthesis (i.e., DOPA accumulation) in the dorsal striatum after quinpirole or haloperidol treatment and (b) behavioral responsiveness after low-dose apomorphine treatment. Results showed that low doses (i.e., "autoreceptor" doses) of apomorphine (0.06 and 0.12 mg/kg) decreased the locomotor activity of adolescent and adult rats, while higher doses increased locomotion. The dopamine synthesis experiment also produced classic autoreceptor effects, because quinpirole decreased dorsal striatal DOPA accumulation; whereas, haloperidol increased DOPA levels in control rats, but not in rats given the nerve impulse inhibitor γ-butyrolactone. Importantly, early Mn exposure did not alter autoreceptor sensitivity when assessed in early adolescence or adulthood. The lack of Mn-induced effects was evident in both the dopamine synthesis and behavioral experiments. When considered together with past studies, it is clear that early Mn exposure alters the functioning of various dopaminergic presynaptic mechanisms, while dopamine autoreceptors remain unimpaired. PMID:23458069

  6. Deconstructing Chronic Low Back Pain in the Older Adult – Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part III: Fibromyalgia Syndrome

    Science.gov (United States)

    Fatemi, Gita; Fang, Meika A.; Breuer, Paula; Cherniak, Paul E.; Gentili, Angela; Hanlon, Joseph T.; Karp, Jordan F.; Morone, Natalia E.; Rodriguez, Eric; Rossi, Michelle I.; Schmader, Kenneth; Weiner, Debra K.

    2016-01-01

    Objective To present the third in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of twelve important contributors to pain and disability in older adults with CLBP. This article focuses on fibromyalgia syndrome (FMS). Methods A modified Delphi approach was used to create the evaluation and treatment algorithm, the table discussing the rationale behind each of the algorithm components, and the stepped-care drug recommendations. The team involved in the creation of these materials consisted of a principal investigator, a 5-member content expert panel, and a 9-member primary care panel. The evaluation and treatment recommendations were based on availability of medications and other resources within the Veterans Health Administration (VHA) facilities. However, non-VHA panelists were also involved in the development of these materials, which can be applied to both VA and civilian settings. The illustrative clinical case was taken from the clinical practice of the principal investigator. Results Following expert consultations and a review of the literature, we developed an evaluation and treatment algorithm with supporting materials to aid in the care of older adults with CLBP who have concomitant FMS. A case is presented that demonstrates the complexity of pain evaluation and management in older patients with CLBP and concomitant FMS Conclusions Recognition of FMS as a common contributor to CLBP in older adults and initiating treatment targeting both FMS and CLBP will lead to improved outcomes in pain and disability. PMID:26272644

  7. Neuropathic pain

    Directory of Open Access Journals (Sweden)

    Giuseppe Re

    2009-02-01

    Full Text Available Neuropathic pain is the expression of a dysfunction or primary lesion of a nerve in the peripheral or central nervous system, or both, rather than the biological signal transmitted by the nerve following peripheral nociceptor activation. It represents about 20% of all painful syndromes, with an estimated prevalence of 1.5%, however is actual incidence is hard to pinpoint due to the difficulties encountered in distinguishing it from chronic pain, of which it represents a significant percentage, on account of the not infrequent concurrence of conditions. It is crucial to recognise the variety of symptoms with which it can present: these can be negative and positive and, in turn, motor, sensitive and autonomic. In public health terms, it is important to emphasise that the diagnosis of neuropathic pain does not in most cases require sophisticated procedures and does not therefore weigh on health expenditure. In clinical practice, a validated scale (the LANSS is mentioned is useful for identifying patients presenting neuropathic pain symptoms. Therapy is based on three categories of medication: tricyclic antidepressants, anti-epileptics and opioids at high doses: neuropathic pain has a bad reputation for often resisting common therapeutic approaches and responding less well that nociceptor pain to monotherapy. Therapeutic strategies are all the more adequate the more they are based on symptoms and therefore on the pain generation mechanisms, although the recommendations are dictated more by expert opinions that double-blind randomised trials.

  8. The effect of spinally administered WIN 55,212-2, a cannabinoid agonist, on thermal pain sensitivity in diabetic rats

    Directory of Open Access Journals (Sweden)

    Samane Jahanabadi

    2016-04-01

    Conclusion: These data show that cannabinoids have potent antinociceptive effects through direct actions in the spinal dorsal horn of nociceptive pathway. This suggests that intrathecally administered cannabinoids may offer hopeful strategies for the treatment of diabetic neuropathic pain.

  9. Personality traits, subjective health complaints, experimental pain sensitivity, and psychophysiological responding in female temporomandibular disorder (TMD) patients

    OpenAIRE

    2008-01-01

    Temporomandibular disorders (TMD) comprise a category of chronic complaints of pain and/or mobility dysfunction of the orofacial region. The main symptoms are pain from the temporomandibular joint and/or in the masticatory structures – sometimes radiating to the temples, head, and neck - clicking sounds from the temporomandibular joint, and restricted movement of the jaw. Psychological characteristics of TMD patients are mainly elevated levels of psychological distress, a relatively low corre...

  10. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review

    Directory of Open Access Journals (Sweden)

    Straker Leon M

    2009-06-01

    Full Text Available Abstract Background Thoracic spine pain (TSP is experienced across the lifespan by healthy individuals and is a common presentation in primary healthcare clinical practice. However, the epidemiological characteristics of TSP are not well documented compared to neck and low back pain. A rigorous evaluation of the prevalence, incidence, correlates and risk factors needs to be undertaken in order for epidemiologic data to be meaningfully used to develop evidence-based prevention and treatment recommendations for TSP. Methods A systematic review method was followed to report the evidence describing prevalence, incidence, associated factors and risk factors for TSP among the general population. Nine electronic databases were systematically searched to identify studies that reported either prevalence, incidence, associated factors (cross-sectional study or risk factors (prospective study for TSP in healthy children, adolescents or adults. Studies were evaluated for level of evidence and method quality. Results Of the 1389 studies identified in the literature, 33 met the inclusion criteria for this systematic review. The mean (SD quality score (out of 15 for the included studies was 10.5 (2.0. TSP prevalence data ranged from 4.0–72.0% (point, 0.5–51.4% (7-day, 1.4–34.8% (1-month, 4.8–7.0% (3-month, 3.5–34.8% (1-year and 15.6–19.5% (lifetime. TSP prevalence varied according to the operational definition of TSP. Prevalence for any TSP ranged from 0.5–23.0%, 15.8–34.8%, 15.0–27.5% and 12.0–31.2% for 7-day, 1-month, 1-year and lifetime periods, respectively. TSP associated with backpack use varied from 6.0–72.0% and 22.9–51.4% for point and 7-day periods, respectively. TSP interfering with school or leisure ranged from 3.5–9.7% for 1-year prevalence. Generally, studies reported a higher prevalence for TSP in child and adolescent populations, and particularly for females. The 1 month, 6 month, 1 year and 25 year incidences were 0

  11. Pain and the ethics of pain management.

    Science.gov (United States)

    Edwards, R B

    1984-01-01

    In this article I clarify the concepts of 'pain', 'suffering', 'pains of body', 'pains of soul'. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis, treatment and research. Next, there is the duty to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfilling these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if any, should override the right to refuse treatment where pain relief is of paramount concern.

  12. No effect of bicarbonate treatment on insulin sensitivity and glucose control in non-diabetic older adults

    Science.gov (United States)

    Chronic mild metabolic acidosis is common among older adults, and limited evidence suggests that it may contribute to insulin resistance and type 2 diabetes. This analysis was conducted to determine whether bicarbonate supplementation, an alkalinizing treatment, improves insulin sensitivity or gluco...

  13. [Pharmacodynamic and pharmacokinetic characteristics of pain therapy in neonates: Austrian interdisciplinary recommendations on pediatric perioperative pain management].

    Science.gov (United States)

    Jaksch, W; Messerer, B; Keck, B; Lischka, A; Urlesberger, B

    2014-02-01

    The false assumption that neonates are less sensitive to pain than adults led to a long delay in the introduction of a reasonable pain therapy for children. Even if the basic principles of the development, transmission and perception of pain in premature infants and neonates are not completely understood, the results of studies have clearly shown that pain can be perceived from 22 weeks of gestation onwards. This knowledge results in the necessity to also administer an adequate pain therapy to premature and newly born infants. However, for the use of pharmaceuticals in neonates and infants the pharmacodynamic and pharmacokinetic characteristics must also be considered. The immaturity of the organs liver and kidneys limits the metabolism and also excretion processes. The different physical proportions also modify the dosing of pharmaceuticals. Children in the first year of life differ substantially from adults in physiology, pharmacodynamics and pharmacokinetics. The care of neonates and infants requires specialist knowledge which is described in this article. PMID:24550024

  14. Relative sensitivity of developmental and immune parameters in juvenile versus adult male rats after exposure to di(2-ethylhexyl) phthalate

    Energy Technology Data Exchange (ETDEWEB)

    Tonk, Elisa C.M., E-mail: ilse.tonk@rivm.nl [Department of Toxicogenomics, Maastricht University, Maastricht (Netherlands); Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Verhoef, Aart; Gremmer, Eric R. [Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Loveren, Henk van [Department of Toxicogenomics, Maastricht University, Maastricht (Netherlands); Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Piersma, Aldert H. [Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Institute for Risk Assessment Sciences, Veterinary Faculty, Utrecht University, Utrecht (Netherlands)

    2012-04-01

    The developing immune system displays a relatively high sensitivity as compared to both general toxicity parameters and to the adult immune system. In this study we have performed such comparisons using di(2-ethylhexyl) phthalate (DEHP) as a model compound. DEHP is the most abundant phthalate in the environment and perinatal exposure to DEHP has been shown to disrupt male sexual differentiation. In addition, phthalate exposure has been associated with immune dysfunction as evidenced by effects on the expression of allergy. Male wistar rats were dosed with corn oil or DEHP by gavage from postnatal day (PND) 10–50 or PND 50–90 at doses between 1 and 1000 mg/kg/day. Androgen-dependent organ weights showed effects at lower dose levels in juvenile versus adult animals. Immune parameters affected included TDAR parameters in both age groups, NK activity in juvenile animals and TNF-α production by adherent splenocytes in adult animals. Immune parameters were affected at lower dose levels compared to developmental parameters. Overall, more immune parameters were affected in juvenile animals compared to adult animals and effects were observed at lower dose levels. The results of this study show a relatively higher sensitivity of juvenile versus adult rats. Furthermore, they illustrate the relative sensitivity of the developing immune system in juvenile animals as compared to general toxicity and developmental parameters. This study therefore provides further argumentation for performing dedicated developmental immune toxicity testing as a default in regulatory toxicology. -- Highlights: ► In this study we evaluate the relative sensitivities for DEHP induced effects. ► Results of this study demonstrate the age-dependency of DEHP toxicity. ► Functional immune parameters were more sensitive than structural immune parameters. ► Immune parameters were affected at lower dose levels than developmental parameters. ► Findings demonstrate the susceptibility of the

  15. Relative sensitivity of developmental and immune parameters in juvenile versus adult male rats after exposure to di(2-ethylhexyl) phthalate

    International Nuclear Information System (INIS)

    The developing immune system displays a relatively high sensitivity as compared to both general toxicity parameters and to the adult immune system. In this study we have performed such comparisons using di(2-ethylhexyl) phthalate (DEHP) as a model compound. DEHP is the most abundant phthalate in the environment and perinatal exposure to DEHP has been shown to disrupt male sexual differentiation. In addition, phthalate exposure has been associated with immune dysfunction as evidenced by effects on the expression of allergy. Male wistar rats were dosed with corn oil or DEHP by gavage from postnatal day (PND) 10–50 or PND 50–90 at doses between 1 and 1000 mg/kg/day. Androgen-dependent organ weights showed effects at lower dose levels in juvenile versus adult animals. Immune parameters affected included TDAR parameters in both age groups, NK activity in juvenile animals and TNF-α production by adherent splenocytes in adult animals. Immune parameters were affected at lower dose levels compared to developmental parameters. Overall, more immune parameters were affected in juvenile animals compared to adult animals and effects were observed at lower dose levels. The results of this study show a relatively higher sensitivity of juvenile versus adult rats. Furthermore, they illustrate the relative sensitivity of the developing immune system in juvenile animals as compared to general toxicity and developmental parameters. This study therefore provides further argumentation for performing dedicated developmental immune toxicity testing as a default in regulatory toxicology. -- Highlights: ► In this study we evaluate the relative sensitivities for DEHP induced effects. ► Results of this study demonstrate the age-dependency of DEHP toxicity. ► Functional immune parameters were more sensitive than structural immune parameters. ► Immune parameters were affected at lower dose levels than developmental parameters. ► Findings demonstrate the susceptibility of the

  16. Anxiety Sensitivity Uniquely Predicts Exercise Behaviors in Young Adults Seeking to Increase Physical Activity.

    Science.gov (United States)

    Moshier, Samantha J; Szuhany, Kristin L; Hearon, Bridget A; Smits, Jasper A J; Otto, Michael W

    2016-01-01

    Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive emotional or physical states, and therefore may have greater difficulty achieving healthy behavioral change. This may be particularly true for exercise, which produces many of the somatic sensations within the domain of AS concerns. Cross-sectional studies show a negative association between AS and exercise. However, little is known about how AS may prospectively affect attempts at behavior change in individuals who are motivated to increase their exercise. We recruited 145 young adults who self-identified as having a desire to increase their exercise behavior. Participants completed a web survey assessing AS and additional variables identified as important for behavior change-impulsivity, grit, perceived behavioral control, and action planning-and set a specific goal for exercising in the next week. One week later, a second survey assessed participants' success in meeting their exercise goals. We hypothesized that individuals with higher AS would choose lower exercise goals and would complete less exercise at the second survey. AS was not significantly associated with exercise goal level, but significantly and negatively predicted exercise at Time 2 and was the only variable to offer significant prediction beyond consideration of baseline exercise levels. These results underscore the importance of considering AS in relation to health behavior intentions. This is particularly apt given the absence of prediction offered by other traditional predictors of behavior change. PMID:26342011

  17. High-sensitive C-reactive protein is associated with reduced lung function in young adults

    DEFF Research Database (Denmark)

    Rasmussen, F; Mikkelsen, D; Hancox, R J;

    2009-01-01

    Systemic inflammation has been associated with reduced lung function. However, data on the interrelationships between lung function and inflammation are sparse, and it is not clear if low-grade inflammation leads to reduced lung function. Associations between high-sensitive C-reactive protein (CR...... inflammation in young adulthood may lead to impaired lung function independently of the effects of smoking, obesity, cardiorespiratory fitness, asthma and eosinophilic inflammation....... decline was 6.2 mL.yr(-1) in the highest CRP quintile versus an increase of 1.8 mL.yr(-1) in the lowest CRP quintile. In a multiple regression analysis adjusted for sex, body mass index, cardiorespiratory fitness, smoking, asthma, airway hyperresponsiveness and serum eosinophil cationic protein, higher...... levels of CRP at age 20 yrs were associated with a greater reduction in both FEV(1) and forced vital capacity between ages 20 and 29 yrs. The findings show that higher levels of C-reactive protein in young adults are associated with subsequent decline in lung function, suggesting that low-grade systemic...

  18. Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults.

    Science.gov (United States)

    Beaudette, Shawn M; Larson, Katelyn J; Larson, Dennis J; Brown, Stephen H M

    2016-08-01

    The purpose of the current work was to (1) determine whether low back cutaneous sensitivity could be reduced through the use of a topical lidocaine-prilocaine anesthetic (EMLA(®)) to mirror reductions reported in chronic lower back pain (CLBP) patients, as well as to (2) identify whether reductions in cutaneous sensitivity resulted in decreased lumbar spine proprioception, neuromuscular control and dynamic stability. Twenty-eight healthy participants were divided equally into matched EMLA and PLACEBO treatment groups. Groups completed cutaneous minimum monofilament and two-point discrimination (TPD) threshold tests, as well as tests of sagittal and axial lumbar spine active repositioning error, seated balance and repeated lifting dynamic stability. These tests were administered both before and after the application of an EMLA or PLACEBO treatment. Results show that low back minimum monofilament and TPD thresholds were significantly increased within the EMLA group. Skin sensitivity remained unchanged in the PLACEBO group. In the EMLA group, decreases in low back cutaneous sensitivity had minimal effect on low back proprioception (active sagittal and axial repositioning) and dynamic stability (seated balance and repeated lifting). These findings demonstrate that treating the skin of the low back with an EMLA anesthetic can effectively decrease the cutaneous sensitivity of low back region. Further, these decreases in peripheral cutaneous sensitivity are similar in magnitude to those reported in CLBP patients. Within this healthy population, decreased cutaneous sensitivity of the low back region has minimal influence on active lumbar spine proprioception, neuromuscular control and dynamic stability. PMID:27010722

  19. Pain Sensitivity to Intraoral Anesthetic Injections among Children.%儿童口内麻醉注射不同部位对疼痛的敏感性

    Institute of Scientific and Technical Information of China (English)

    叶宁; 钱虹; 黄群

    2011-01-01

    目的:调查儿童口内麻醉注射不同部位对疼痛的敏感性.方法:160名5~6岁儿童作为调查对象,调查他们对口内上下颌浸润和阻滞麻醉注射的疼痛反应,并将这些反应用声音、眼睛和身体运动(SEM)几方面来定量.结果:疼痛反应无性别差异;鼻腭神经阻滞引起最大疼痛(SEM评分为10分),上牙槽后神经上牙槽后神经上牙槽后神经阻滞和下牙槽神经阻滞产生疼痛最少(SEM分别为3和4);上颌局部麻醉比下颌注射更痛(约7:5).结论:注射的解剖位置是儿童疼痛反应最重要的决定因素之一,优先考虑疼痛反应有助于在年幼儿童的牙科治疗过程中获得最理想的儿童配合.%Objective: To investigate the pain sensitivity to intraoral anesthetic injections among children. Methods: A total of 160 children aged 5-6 years were investigated for their pain reactions to intraoral maxillary and mandibular anesthetic injections, and the responses were quantified using the sound, eye and motor (SEM) scale. Results:There was no significant gender- specific difference in pain reactions. Administration of nasopalatine nerve block produced maximum pain (SEM score: 10) while that of posterior superior alveolar nerve block and inferior alveolar nerve block produced minimum pain (3 and 4, respectively). Administration of local anesthesia in maxilla was more painful than injections into the mandible (approximately 7: 5). Conclusion: Anatomical location of an injection is one of the most important determinants of pediatric pain reaction, and prior consideration for pain reaction may help to achieve optimal behavioral control during dental treatment in young children.

  20. Prevalence and Red Flags Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice

    NARCIS (Netherlands)

    Enthoven, Wendy T M; Geuze, Judith; Scheele, Jantine; Bierma-Zeinstra, Sita M A; Bueving, Herman J; Bohnen, Arthur M; Peul, Wilco C; van Tulder, Maurits W; Berger, Marjolein Y; Koes, Bart W; Luijsterburg, Pim A J

    2015-01-01

    BACKGROUND: In a small proportion of patients experiencing unspecified back pain a specified underlying pathology is present. OBJECTIVE: To identify the prevalence of physician-specified causes of back pain and to assess associations between red flags and vertebral fractures, as diagnosed by the pat

  1. Effect of Co-Morbid Conditions on Persistent Neuropathic Pain after Brachial Plexus Injury in Adult Patients

    Science.gov (United States)

    Chaudakshetrin, Pongparadee; Chotisukarat, Haruthai; Mandee, Sahatsa

    2016-01-01

    Background and Purpose Neuropathic pain (NeuP) associated with traumatic brachial plexus injury (BPI) can be severe, persistent, and resistant to treatment. Moreover, comorbidity associated with NeuP may worsen the pain and quality of life. This study compared persistent NeuP after BPI between patients with and without co-morbid conditions (psychiatric dysfunction and other painful conditions) and tramadol usage as a second-line agent in combination with an antiepileptic and/or antidepressant during a 2-year follow-up. Methods The medical records of patients diagnosed with BPI referred to a pain center between 2006 and 2010 were reviewed for 2 years retrospectively. Data regarding patient demographics, injury and surgical profiles, characteristics of NeuP and its severity, and treatment received were compared between patients with and without manifesting co-morbid conditions. The NeuP and pain intensity assessments were based on the DN4 questionnaire and a numerical rating scale, respectively. Results Of the 45 patients studied, 24 patients presented with one of the following co-morbid conditions: myofascial pain (21%), psychiatric disorder (17%), phantom limb pain (4%), complex regional pain syndrome (21%), and insomnia (37%). Tramadol was required by 20 patients with co-morbidity and, 9 patients without co-morbidity (ppain score after 2 years was higher in patients with co-morbidity than in those without co-morbidity (ppain following BPI was more common in patients manifesting other painful conditions or psychiatric co-morbidity. A higher proportion of the patients in the co-morbid group required tramadol as a second-line of agent for pain relief.

  2. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire sensitivity to change in low back pain: influence of shifts in priorities.

    Directory of Open Access Journals (Sweden)

    Katherine Sanchez

    Full Text Available OBJECTIVE: To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR in chronic low back pain (CLBP and shifts in patients' priorities of disabling activities over time. METHODS: A prospective longitudinal survey of 100 patients (38 males with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC, Hospital Anxiety and Depression scale (HAD, Fear-Avoidance Beliefs Questionnaire (FABQ, Coping Strategies Questionnaire (CSQ, and pain and handicap visual analogue scales (VASs. Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES and Standardized response mean (SRM and effect size (ES were used to evaluate sensitivity to change of the MACTAR. RESULTS: The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37 were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF, most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients; community, social and civic life (22.7%; and domestic life (22.4%. At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. CONCLUSIONS: Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.

  3. Cultural adaptation and reproducibility validation of the Brazilian Portuguese version of the Pain Assessment in Advanced Dementia (PAINAD-Brazil) scale in non-verbal adult patients

    Science.gov (United States)

    Pinto, Marcia Carla Morete; Minson, Fabiola Peixoto; Lopes, Ana Carolina Biagioni; Laselva, Claudia Regina

    2015-01-01

    Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement). Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain. Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibility. Conclusion The scale has proved to be useful in daily routine care of hospitalized adult and elderly patients in a variety of clinical settings. Short application time, ease of use, clear instructions and the simplicity of training required for application were emphasized. However, interpretation of facial expression and consolability should be given special attention during pain assessment training. PMID:25993063

  4. Efficacy of an intrathecal multidrug infusion for pain control in older adults and in end-stage malignancies: A report of three cases.

    Science.gov (United States)

    Abdolmohammadi, Sadegh; Hétu, Pierre-Olivier; Néron, Andrée; Blaise, Gilbert

    2015-01-01

    The aim of the present study was to explore the effectiveness of an alternative method to manage pain based on a time-limited intrathecal (IT) infusion of an analgesic medication mixture. Three patients (69, 64 and 94 years of age) with intractable and poorly controlled pain due to bed sores, pelvic metastatic mass, and thoracic vertebra and rib fractures, respectively, were treated. Daily doses of opioids could not be increased due to side effects. An IT catheter (20 G) was placed by percutaneous approach in the lumbar area while advancing toward the thoracic region, and was then tunnelled and fixed subcutaneously. It was connected to an external infusion pump with a mixture of bupivacaine 1 mg⁄mL, naloxone 0.02 ng⁄mL, ketamine 100 µg⁄mL, morphine 0.01 mg⁄mL and clonidine 0.75 µg⁄mL. The starting rate was 1 mL⁄h. The pain was mostly controlled at a rate of sphincter dysfunction, and cognitive or mood deterioration, were not observed with this approach. One patient experienced a urinary tract infection followed by sepsis and meningitis, which was cured by antibiotics. The catheter was removed in this patient. IT infusion with a low-concentration multidrug mixture could be considered as an alternative modality for intractable pain relief in older adults or in malignancies. PMID:25996762

  5. Inability to perform because of pain/injury in elite adult Irish dance: A prospective investigation of contributing factors.

    Science.gov (United States)

    Cahalan, R; O'Sullivan, P; Purtill, H; Bargary, N; Ni Bhriain, O; O'Sullivan, K

    2016-06-01

    Previous research in Irish dancing (ID) has recorded high levels of pain/injury. Screening protocols in other genres have been developed to identify at-risk dancers. The aims of the study were to examine the factors that relate to absence from dancing because of musculo-skeletal pain/injury in ID, and to inform guidelines for the development of an evidence-based screening protocol. Baseline subjective data (n = 85) and physical data (n = 84) were gathered. Subjects completed a monthly online questionnaire for 1 year providing data on general physical and psychological health and rates of pain/injury. Subjects were allocated to a "More Time Absent (MTA)" or "Less Time Absent (LTA)" category depending on their duration of absence from performance over the year. Eighty-four subjects completed the year-long follow-up (MTA: n = 32; LTA: n = 52). Two hundred seventy-eight complaints of pain/injury were recorded. Factors significantly associated with membership of the MTA group included greater anger-hostility (P = 0.003), more subjective health complaints (P = 0.026), more severe previous pain/injury (P = 0.017), more general everyday pain (P = 0.020), more body parts affected by pain/injury (P = 0.028), always/often dancing in pain (P = 0.028), and insufficient sleep (P = 0.043). Several biopsychosocial factors appear to be associated with absence from ID because of pain/injury. Biopsychosocial screening protocols and prevention strategies may best identify at-risk dancers. PMID:26040202

  6. Evaluation of elastic bands for lower extremity resistance training in adults with and without musculo-skeletal pain

    DEFF Research Database (Denmark)

    Sundstrup, E; Jakobsen, M D; Andersen, C H;

    2014-01-01

    these findings. However, pain in the lower back decreased muscular activity of the gluteus maximus and vastus medialis (P back. Importantly, the efficiency of these exercises...... was equally high regardless of gender, age, and pain in the knees and hip, whereas pain in the lower back led to altered activation strategies.......Therapists commonly use elastic bands in resistance exercises during rehabilitation of smaller muscles, such as in the shoulder. However, the effectiveness has not yet been investigated for larger muscle groups. This study investigates muscle activity during lower extremity exercises...

  7. Comparative sensitivity of juvenile and adult Potamopyrgus antipodarum (Mollusca: Hydrobiidae) under chronic exposure to cadmium and tributyltin.

    Science.gov (United States)

    Ruppert, Katharina; Geiß, Cornelia; Ostermann, Sina; Theis, Christina; Oehlmann, Jörg

    2016-07-28

    To investigate a potential extension of a partial life cycle test protocol to a full life cycle test design, a comparative sensitivity analysis with juvenile and adult Potamopyrgus antipodarum was performed. Neonates and adult snails were exposed to the metal cadmium (Cd) and the endocrine disruptor tributyltin (TBT) at nominal concentrations ranging from 1.56 to 50 μg Cd/L and from 25 to 1,000 ng TBT-Sn/L. The experiments were performed over 28 days at 16°C in a semi-static test design. Mortality was assessed for both life stages. Juvenile snails' specific growth rate and reproduction of adults were investigated as main endpoints. We determined effects on snails' survival, juvenile growth and embryo numbers in the brood pouch of adult snails under exposure to both chemicals. Juvenile control mortality was between 25% and 30% and significantly higher than in the control groups with adult snails. A higher sensitivity of juvenile snails compared to adults was observed for the endpoint mortality. Calculated LC50 in Cd exposed snails was 38.2 μg/L for adults and 15.0 μg/L for juvenile snails. Significant effects on mortality in TBT exposed adult snails occurred at the highest test concentration only with a LC50 of 535 ng Sn/L. Juvenile survival was significantly affected at 50.8 ng Sn/L and higher concentrations. Effect concentrations for the main endpoints reproduction and juvenile growth show comparable sensitivities. For Cd exposed groups, EC50 values were 11.3 μg/L for the endpoint reproduction in adult snails and 3.82 μg/L for juvenile growth with overlapping confidence intervals. TBT also significantly affected juvenile snails' growth (EC50: 178 ng Sn /L). EC50 for embryo numbers was 125 ng TBT-Sn/L. Results indicate the manageability of a FLC test starting with newly hatched snails. Precautions have to be taken to guarantee a sufficient number of surviving snails until adulthood so that reproduction can be assessed. For final decision for the

  8. Comparative sensitivity of juvenile and adult Potamopyrgus antipodarum (Mollusca: Hydrobiidae) under chronic exposure to cadmium and tributyltin.

    Science.gov (United States)

    Ruppert, Katharina; Geiß, Cornelia; Ostermann, Sina; Theis, Christina; Oehlmann, Jörg

    2016-07-28

    To investigate a potential extension of a partial life cycle test protocol to a full life cycle test design, a comparative sensitivity analysis with juvenile and adult Potamopyrgus antipodarum was performed. Neonates and adult snails were exposed to the metal cadmium (Cd) and the endocrine disruptor tributyltin (TBT) at nominal concentrations ranging from 1.56 to 50 μg Cd/L and from 25 to 1,000 ng TBT-Sn/L. The experiments were performed over 28 days at 16°C in a semi-static test design. Mortality was assessed for both life stages. Juvenile snails' specific growth rate and reproduction of adults were investigated as main endpoints. We determined effects on snails' survival, juvenile growth and embryo numbers in the brood pouch of adult snails under exposure to both chemicals. Juvenile control mortality was between 25% and 30% and significantly higher than in the control groups with adult snails. A higher sensitivity of juvenile snails compared to adults was observed for the endpoint mortality. Calculated LC50 in Cd exposed snails was 38.2 μg/L for adults and 15.0 μg/L for juvenile snails. Significant effects on mortality in TBT exposed adult snails occurred at the highest test concentration only with a LC50 of 535 ng Sn/L. Juvenile survival was significantly affected at 50.8 ng Sn/L and higher concentrations. Effect concentrations for the main endpoints reproduction and juvenile growth show comparable sensitivities. For Cd exposed groups, EC50 values were 11.3 μg/L for the endpoint reproduction in adult snails and 3.82 μg/L for juvenile growth with overlapping confidence intervals. TBT also significantly affected juvenile snails' growth (EC50: 178 ng Sn /L). EC50 for embryo numbers was 125 ng TBT-Sn/L. Results indicate the manageability of a FLC test starting with newly hatched snails. Precautions have to be taken to guarantee a sufficient number of surviving snails until adulthood so that reproduction can be assessed. For final decision for the

  9. Inducing Expectations for Health: Effects of Verbal Suggestion and Imagery on Pain, Itch, and Fatigue as Indicators of Physical Sensitivity.

    NARCIS (Netherlands)

    Peerdeman, K.J.; Laarhoven, A.I. van; Donders, A.R.T.; Hopman, M.T.E.; Peters, M.L.; Evers, A.W.

    2015-01-01

    Research into placebo effects has convincingly shown that inducing positive outcome expectations can reduce pain and other physical sensations. However, the comparative effects of different expectation inductions, such as verbal suggestion or mental imagery, and their generic effects on physical sen

  10. WITHDRAWN : Exercise therapy for patellofemoral pain syndrome

    NARCIS (Netherlands)

    Heintjes, Edith M; Berger, Marjolein; Bierma-Zeinstra, Sita Ma; Bernsen, Roos Md; Verhaar, Jan An; Koes, Bart W

    2015-01-01

    BACKGROUND: Patellofemoral pain syndrome (PFPS) is a common problem among adolescents and young adults, characterised by retropatellar pain (behind the kneecap) or peripatellar pain (around the kneecap) when ascending or descending stairs, squatting or sitting with flexed knees. Etiology, structures

  11. Reduced Sensitivity to Immediate Reward during Decision-Making in Older than Younger Adults

    OpenAIRE

    Ben Eppinger; Nystrom, Leigh E.; Cohen, Jonathan D.

    2012-01-01

    We examined whether older adults differ from younger adults in the degree to which they favor immediate over delayed rewards during decision-making. To examine the neural correlates of age-related differences in delay discounting we acquired functional MR images while participants made decisions between smaller but sooner and larger but later monetary rewards. The behavioral results show age-related reductions in delay discounting. Less impulsive decision-making in older adults was associated...

  12. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2013-02-01

    Full Text Available Alesia Sadosky,1 Caroline Schaefer,2 Rachael Mann,3 Felicia Bergstrom,2 Rebecca Baik,2 Bruce Parsons,1 Srinivas Nalamachu,4 Edward Nieshoff,5 Brett R Stacey,6 Alan Anschel,7 Michael Tuchman81Pfizer Inc, New York, NY, 2Covance Market Access Services Inc, Gaithersburg, MD, 3Covance Market Access Services Inc, San Diego, CA, 4International Clinical Research Institute, Overland Park, KS, 5Rehabilitation Institute of Michigan/Wayne State University, Detroit, MI, 6Oregon Health and Science University, Portland, OR, 7Rehabilitation Institute of Chicago, Chicago, IL, 8Palm Beach Neurological Center, Palm Beach Gardens, FL, USABackground: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN seeking treatment in the US.Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%, depressive symptoms (41.1%, and anxiety (35.7%. The mean pain severity score was 5.2 (0–10 scale, and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale overall, with 2.0 among mild, 5.1 among moderate, and 7

  13. A randomized trial of hypnosis for relief of pain and anxiety in adult cancer patients undergoing bone marrow procedures.

    Science.gov (United States)

    Snow, Alison; Dorfman, David; Warbet, Rachel; Cammarata, Meredith; Eisenman, Stephanie; Zilberfein, Felice; Isola, Luis; Navada, Shyamala

    2012-01-01

    Pain and anxiety are closely associated with bone marrow aspirates and biopsies. To determine whether hypnosis administered concurrently with the procedure can ameliorate these morbidities, the authors randomly assigned 80 cancer patients undergoing bone marrow aspirates and biopsies to either hypnosis or standard of care. The hypnosis intervention reduced the anxiety associated with procedure, but the difference in pain scores between the two groups was not statistically significant. The authors conclude that brief hypnosis concurrently administered reduces patient anxiety during bone marrow aspirates and biopsies but may not adequately control pain. The authors explain this latter finding as indicating that the sensory component of a patient's pain experience may be of lesser importance than the affective component. The authors describe future studies to clarify their results and address the limitations of this study. PMID:22571244

  14. Music in Reducing Anxiety and Pain in Adult Patients Undergoing Bone Marrow Biopsy for Hematologic Cancers or Other Diseases

    Science.gov (United States)

    2012-07-12

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Lymphoproliferative Disorder; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Pain; Precancerous Condition; Psychosocial Effects of Cancer and Its Treatment

  15. Neonatal Pain in Very Preterm Infants: Long-Term Effects on Brain, Neurodevelopment and Pain Reactivity

    Directory of Open Access Journals (Sweden)

    Ruth Eckstein Grunau

    2013-10-01

    Full Text Available Effects of early life psychosocial adversity have received a great deal of attention, such as maternal separation in experimental animal models and abuse/neglect in young humans. More recently, long-term effects of the physical stress of repetitive procedural pain have begun to be addressed in infants hospitalized in neonatal intensive care. Preterm infants are more sensitive to pain and stress, which cannot be distinguished in neonates. The focus of this review is clinical studies of long-term effects of repeated procedural pain-related stress in the neonatal intensive care unit (NICU in relation to brain development, neurodevelopment, programming of stress systems, and later pain sensitivity in infants born very preterm (24–32 weeks’ gestational age. Neonatal pain exposure has been quantified as the number of invasive and/or skin-breaking procedures during hospitalization in the NICU. Emerging studies provide convincing clinical evidence for an adverse impact of neonatal pain/stress in infants at a time of physiological immaturity, rapidly developing brain microstructure and networks, as well as programming of the hypothalamic-pituitary-adrenal axis. Currently it appears that early pain/stress may influence the developing brain and thereby neurodevelopment and stress-sensitive behaviors, particularly in the most immature neonates. However, there is no evidence for greater prevalence of pain syndromes compared to children and adults born healthy at full term. In addressing associations between pain/stress and outcomes, careful consideration of confounding clinical factors related to prematurity is essential. The need for pain management for humanitarian care is widely advocated. Non-pharmacological interventions to help parents reduce their infant’s stress may be brain-protective.

  16. Using a Powered Bone Marrow Biopsy System Results in Shorter Procedures, Causes Less Residual Pain to Adult Patients, and Yields Larger Specimens

    Directory of Open Access Journals (Sweden)

    Croopnick Jonathan

    2011-03-01

    Full Text Available Abstract Background In recent years, a battery-powered bone marrow biopsy system was developed and cleared by the U.S. Food and Drug Administration to allow health care providers to access the bone marrow space quickly and efficiently. A multicenter randomized clinical trial was designed for adult patients to determine if the powered device had advantages over traditional manually-inserted needles in regard to length of procedure, patient pain, complications, user satisfaction, and pathological analysis of the specimens. Methods Adult patients requiring marrow sampling procedures were randomized for a Manual or Powered device. Visual Analog Scale (VAS pain scores were captured immediately following the procedure and 1 and 7 days later. Procedure time was measured and core specimens were submitted to pathology for grading. Results Ten sites enrolled 102 patients into the study (Powered, n = 52; Manual, n = 50. Mean VAS scores for overall procedural pain were not significantly different between the arms (3.8 ± 2.8 for Powered, 3.5 ± 2.3 for Manual [p = 0.623]. A day later, more patients who underwent the Powered procedure were pain-free (67% than those patients in the Manual group (33%; p = 0.003. One week later, there was no difference (83% for Powered patients; 76% for Manual patients. Mean procedure time was 102.1 ± 86.4 seconds for the Powered group and 203.1 ± 149.5 seconds for the Manual group (p 3; Manual: 20.4 ± 9.0 mm3; p = 0.039. Two non-serious complications were experienced during Powered procedures (4%; but none during Manual procedures (p = 0.495. Conclusions The results of this first trial provide evidence that the Powered device delivers larger-volume bone marrow specimens for pathology evaluation. In addition, bone marrow specimens were secured more rapidly and subjects experienced less intermediate term pain when the Powered device was employed. Further study is needed to determine if clinicians more experienced with the

  17. Randomized Trial of Hypnosis as a Pain and Symptom Management Strategy in Adults with Sickle Cell Disease

    OpenAIRE

    Wallen, Gwenyth R.; Middleton, Kimberly R; Nancy Ames; Brooks, Alyssa T; Daniel Handel

    2014-01-01

    Sickle cell disease (SCD) is the most common genetic disease in African-Americans, characterized by recurrent painful vaso-occlusive crises. Medical therapies for controlling or preventing crises are limited because of efficacy and/or toxicity. This is a randomized, controlled, single-crossover protocol of hypnosis for managing pain in SCD patients. Participants receive hypnosis from a trained hypnosis therapist followed by six weeks of self-hypnosis using digital media. Those in the control ...

  18. The effect of age on the onset of pain interference in a general population of older adults: prospective findings from the North Staffordshire Osteoarthritis Project (NorStOP).

    Science.gov (United States)

    Thomas, Elaine; Mottram, Sara; Peat, George; Wilkie, Ross; Croft, Peter

    2007-05-01

    Pain that interferes with daily life appears to be strongly age-related in cross-sectional studies, although the nature of this relationship over time has not been established. We have investigated the onset and persistence of pain and pain interference over a 3-year period to determine their association with age in older people. A 3-year follow-up postal survey was conducted of adults aged 50 years and over (n=5366) who had previously been recruited as part of the North Staffordshire Osteoarthritis Project. Four thousand two-hundred and thirty-four completed questionnaires were received (adjusted response 84.7%). The occurrence of pain interference at 3 years was 19.7% in persons free of such pain at baseline, higher in females than males (6.0% difference; 95% CI: 2.6%, 9.3%), and showed a clear age-related trend with a more than twofold increase from 50 to 59 years (16.0%) to the 80+ years (35%). Any pain at follow-up was reported by 48% of those pain-free at recruitment, and this figure was similar for males and females, and across 10-year age-groups. Persistence of pain interference (72.1%) at 3 years was high. In adults aged 50 years and over, the onset of pain that interferes with life shows a clear gender difference and a consistent rise with age into the oldest age-group. This was in strong contrast to the onset of pain which showed no gender or age-related trends. The implications for public health, as for the treatment of the individual, are twofold, relating to efforts to prevent disabling pain from occurring and to understand the factors that accelerate the impact which pain has on everyday life when people reach the oldest ages.

  19. IgE Sensitization Patterns to Commonly Consumed Foods Determined by Skin Prick Test in Korean Adults.

    Science.gov (United States)

    Kim, Sung Ryeol; Park, Hye Jung; Park, Kyung Hee; Lee, Jae-Hyun; Park, Jung-Won

    2016-08-01

    Offending food allergens can vary with regional preferences in food consumption. In this study, we analysed sensitization rates to commonly consumed foods in Korean adults suspected of having food allergy. One hundred and thirty four subjects underwent a skin prick test (SPT) with 55 food allergens, of which 13 were made by our laboratory and the rest were commercially purchased. Of the 134 patients, 73 (54.5%) were sensitized to one or more food allergens. Sensitization to chrysalis was detected most frequently, at a rate of 25.4%. Sensitization rates to other food allergens were as follows: maize grain (13.4%), shrimp (11.9%), almond (11.1%), wheat flour (8.2%), lobster (8.2%), buckwheat (8.2%), mackerel (5.2%), pollack (5.2%), halibut (4.5%), peanut (4.5%), anchovy (4.4%), squid (3.7%), saury (3.0%), common eel (3.0%), yellow corvina (3.0%), hairtail (2.2%), octopus (2.2%), and others. In addition to well-known food allergens, sensitivity to mackerel, chrysalis, pollack, and halibut, which are popular foods in Korea, was observed at high rates in Korean adults. We suggest that the SPT panel for food allergy in Korea should include these allergens. PMID:27478328

  20. IgE Sensitization Patterns to Commonly Consumed Foods Determined by Skin Prick Test in Korean Adults

    Science.gov (United States)

    2016-01-01

    Offending food allergens can vary with regional preferences in food consumption. In this study, we analysed sensitization rates to commonly consumed foods in Korean adults suspected of having food allergy. One hundred and thirty four subjects underwent a skin prick test (SPT) with 55 food allergens, of which 13 were made by our laboratory and the rest were commercially purchased. Of the 134 patients, 73 (54.5%) were sensitized to one or more food allergens. Sensitization to chrysalis was detected most frequently, at a rate of 25.4%. Sensitization rates to other food allergens were as follows: maize grain (13.4%), shrimp (11.9%), almond (11.1%), wheat flour (8.2%), lobster (8.2%), buckwheat (8.2%), mackerel (5.2%), pollack (5.2%), halibut (4.5%), peanut (4.5%), anchovy (4.4%), squid (3.7%), saury (3.0%), common eel (3.0%), yellow corvina (3.0%), hairtail (2.2%), octopus (2.2%), and others. In addition to well-known food allergens, sensitivity to mackerel, chrysalis, pollack, and halibut, which are popular foods in Korea, was observed at high rates in Korean adults. We suggest that the SPT panel for food allergy in Korea should include these allergens. PMID:27478328

  1. Imaging of painful scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Davies, Alun; Saifuddin, Asif [Royal National Orthopaedic Hospital Trust, Department of Radiology, London (United Kingdom)

    2009-03-15

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  2. Contribution of Pro-Inflammatory Cytokine Signaling within Midbrain Periaqueductal Gray to Pain Sensitivity in Parkinson's disease via GABAergic Pathway

    Directory of Open Access Journals (Sweden)

    Xianbo Zhuang

    2016-07-01

    Full Text Available Background/Aims: Hypersensitive pain response is often observed in patients with Parkinson's disease (PD; however, the mechanisms responsible for hyperalgesia are not well understood. Chronic neuroinflammation is one of the hallmarks of PD pathophysiology. Since the midbrain periaqueductal gray (PAG is an important component of the descending inhibitory pathway controlling on central pain transmission, we examined the role for pro-inflammatory cytokines (PICs system of PAG in regulating exaggerated pain evoked by PD. Methods: We used a rat model of PD to perform the experimental protocols. PD was induced by microinjection of 6-hydroxydopamine to lesion the left medial forebrain bundle. Pain responses to mechanical and thermal stimulation were first examined in control rats and PD rats. Then, ELISA and Western Blot analysis were used to determine PIC levels and their receptors expression. Results: Protein expression of IL-1β, IL-6 and TNF-α receptors (namely, IL-1R, IL-6R and TNFR subtype TNFR1 in the plasma membrane PAG of PD rats was upregulated, whereas the total expression of PIC receptors was not significantly altered. The ratio of membrane protein and total protein (IL-1R, IL-6R and TNFR1 was 1.48±0.15, 1.59±0.18 and 1.67±0.16 in PAG of PD rats (P < 0.05 vs. their respective controls. This was accompanied with increases of PICs of PAG, and decreases of GABA (623±21 ng/mg in control rats and 418±18 ng/mg in PD rats; P < 0.05 vs. control rats and withdrawal thresholds to mechanical and thermal stimuli. Our data further showed that the concentrations of GABA and withdrawal thresholds were largely restored by blocking those PIC receptors in PAG of PD rats. Stimulation of GABA receptors in PAG of PD rats also blunted a decrease in withdrawal thresholds. Conclusions: Our data suggest that upregulation of the membrane PIC receptor in the PAG of PD rats is likely to impair the descending inhibitory pathways in regulating pain transmission

  3. Perceptual Sensitivity and Conceptual Coordination in Children and Younger and Older Adults.

    Science.gov (United States)

    West, Robin L.; And Others

    1978-01-01

    Studies the effects of perceptual salience on performance in problems requiring the coordination of information. Subjects were groups of children, younger adults, and older adults. For each of the age groups, those problems containing the most salient information were solved faster and more accurately than problems containing the least salient…

  4. Sensitive Tumorigenic Potential Evaluation of Adult Human Multipotent Neural Cells Immortalized by hTERT Gene Transduction

    Science.gov (United States)

    Jeong, Da Eun; Kim, Sung Soo; Song, Hye Jin; Pyeon, Hee Jang; Kang, Kyeongjin; Hong, Seung-Cheol; Nam, Do-Hyun; Joo, Kyeung Min

    2016-01-01

    Stem cells and therapeutic genes are emerging as a new therapeutic approach to treat various neurodegenerative diseases with few effective treatment options. However, potential formation of tumors by stem cells has hampered their clinical application. Moreover, adequate preclinical platforms to precisely test tumorigenic potential of stem cells are controversial. In this study, we compared the sensitivity of various animal models for in vivo stem cell tumorigenicity testing to identify the most sensitive platform. Then, tumorigenic potential of adult human multipotent neural cells (ahMNCs) immortalized by the human telomerase reverse transcriptase (hTERT) gene was examined as a stem cell model with therapeutic genes. When human glioblastoma (GBM) cells were injected into adult (4–6-week-old) Balb/c-nu, adult NOD/SCID, adult NOG, or neonate (1–2-week-old) NOG mice, the neonate NOG mice showed significantly faster tumorigenesis than that of the other groups regardless of intracranial or subcutaneous injection route. Two kinds of ahMNCs (682TL and 779TL) were primary cultured from surgical samples of patients with temporal lobe epilepsy. Although the ahMNCs were immortalized by lentiviral hTERT gene delivery (hTERT-682TL and hTERT-779TL), they did not form any detectable masses, even in the most sensitive neonate NOG mouse platform. Moreover, the hTERT-ahMNCs had no gross chromosomal abnormalities on a karyotype analysis. Taken together, our data suggest that neonate NOG mice could be a sensitive animal platform to test tumorigenic potential of stem cell therapeutics and that ahMNCs could be a genetically stable stem cell source with little tumorigenic activity to develop regenerative treatments for neurodegenerative diseases. PMID:27391353

  5. Sensitive Tumorigenic Potential Evaluation of Adult Human Multipotent Neural Cells Immortalized by hTERT Gene Transduction.

    Directory of Open Access Journals (Sweden)

    Kee Hang Lee

    Full Text Available Stem cells and therapeutic genes are emerging as a new therapeutic approach to treat various neurodegenerative diseases with few effective treatment options. However, potential formation of tumors by stem cells has hampered their clinical application. Moreover, adequate preclinical platforms to precisely test tumorigenic potential of stem cells are controversial. In this study, we compared the sensitivity of various animal models for in vivo stem cell tumorigenicity testing to identify the most sensitive platform. Then, tumorigenic potential of adult human multipotent neural cells (ahMNCs immortalized by the human telomerase reverse transcriptase (hTERT gene was examined as a stem cell model with therapeutic genes. When human glioblastoma (GBM cells were injected into adult (4-6-week-old Balb/c-nu, adult NOD/SCID, adult NOG, or neonate (1-2-week-old NOG mice, the neonate NOG mice showed significantly faster tumorigenesis than that of the other groups regardless of intracranial or subcutaneous injection route. Two kinds of ahMNCs (682TL and 779TL were primary cultured from surgical samples of patients with temporal lobe epilepsy. Although the ahMNCs were immortalized by lentiviral hTERT gene delivery (hTERT-682TL and hTERT-779TL, they did not form any detectable masses, even in the most sensitive neonate NOG mouse platform. Moreover, the hTERT-ahMNCs had no gross chromosomal abnormalities on a karyotype analysis. Taken together, our data suggest that neonate NOG mice could be a sensitive animal platform to test tumorigenic potential of stem cell therapeutics and that ahMNCs could be a genetically stable stem cell source with little tumorigenic activity to develop regenerative treatments for neurodegenerative diseases.

  6. In vivo sensitivity of the embryonic and adult neural stem cell compartments to low-dose radiation.

    Science.gov (United States)

    Barazzuol, Lara; Jeggo, Penny A

    2016-08-01

    The embryonic brain is radiation-sensitive, with cognitive deficits being observed after exposure to low radiation doses. Exposure of neonates to radiation can cause intracranial carcinogenesis. To gain insight into the basis underlying these outcomes, we examined the response of the embryonic, neonatal and adult brain to low-dose radiation, focusing on the neural stem cell compartments. This review summarizes our recent findings. At E13.5-14.5 the embryonic neocortex encompasses rapidly proliferating stem and progenitor cells. Exploiting mice with a hypomorphic mutation in DNA ligase IV (Lig4(Y288C) ), we found a high level of DNA double-strand breaks (DSBs) at E14.5, which we attribute to the rapid proliferation. We observed endogenous apoptosis in Lig4(Y288C) embryos and in WT embryos following exposure to low radiation doses. An examination of DSB levels and apoptosis in adult neural stem cell compartments, the subventricular zone (SVZ) and the subgranular zone (SGZ) revealed low DSB levels in Lig4(Y288C) mice, comparable with the levels in differentiated neuronal tissues. We conclude that the adult SVZ does not incur high levels of DNA breakage, but sensitively activates apoptosis; apoptosis was less sensitively activated in the SGZ, and differentiated neuronal tissues did not activate apoptosis. P5/P15 mice showed intermediate DSB levels, suggesting that DSBs generated in the embryo can be transmitted to neonates and undergo slow repair. Interestingly, this analysis revealed a stage of high endogenous apoptosis in the neonatal SVZ. Collectively, these studies reveal that the adult neural stem cell compartment, like the embryonic counterpart, can sensitively activate apoptosis. PMID:27125639

  7. Development of a sensitive method to extract and detect low numbers of Cryptosporidium oocysts from adult cattle faecal samples.

    Science.gov (United States)

    Wells, B; Thomson, S; Ensor, H; Innes, E A; Katzer, F

    2016-08-30

    Cryptosporidium transmission studies to date have concluded that adult cattle are not a significant source of oocysts contributing to clinical cryptosporidiosis in calves on farm. However current methods of sample processing have been optimised for calf faecal samples and may be less sensitive when used on adult samples due to lower numbers of oocysts and larger size of samples. A modified and novel method of oocyst extraction and concentration was developed and applied in an experiment involving spiking adult cattle faecal samples with known concentrations of Cryptosporidium oocysts. The results showed an increased sensitivity of detection from 100oocysts/g of faecal sample using conventional protocols to 5oocysts/g using the newly developed method. As it is important to be able to accurately assess the contribution of adult ruminants to the transmission of Cryptosporidium, both on farm and in the environment, the development of the techniques described here is likely to make an important contribution to Cryptosporidium transmission studies in future and in subsequent control strategies aimed at the reduction of Cryptosporidium infection in calves on farm. PMID:27523933

  8. Postnatal day 2 to 11 constitutes a 5-HT-sensitive period impacting adult mPFC function.

    Science.gov (United States)

    Rebello, Tahilia J; Yu, Qinghui; Goodfellow, Nathalie M; Caffrey Cagliostro, Martha K; Teissier, Anne; Morelli, Emanuela; Demireva, Elena Y; Chemiakine, Alexei; Rosoklija, Gorazd B; Dwork, Andrew J; Lambe, Evelyn K; Gingrich, Jay A; Ansorge, Mark S

    2014-09-10

    Early-life serotonin [5-hydroxytryptamine (5-HT)] signaling modulates brain development, which impacts adult behavior, but 5-HT-sensitive periods, neural substrates, and behavioral consequences remain poorly understood. Here we identify the period ranging from postnatal day 2 (P2) to P11 as 5-HT sensitive, with 5-HT transporter (5-HTT) blockade increasing anxiety- and depression-like behavior, and impairing fear extinction learning and memory in adult mice. Concomitantly, P2-P11 5-HTT blockade causes dendritic hypotrophy and reduced excitability of infralimbic (IL) cortex pyramidal neurons that normally promote fear extinction. By contrast, the neighboring prelimbic (PL) pyramidal neurons, which normally inhibit fear extinction, become more excitable. Excitotoxic IL but not PL lesions in adult control mice reproduce the anxiety-related phenotypes. These findings suggest that increased 5-HT signaling during P2-P11 alters adult mPFC function to increase anxiety and impair fear extinction, and imply a differential role for IL and PL neurons in regulating affective behaviors. Together, our results support a developmental mechanism for the etiology and pathophysiology of affective disorders and fear-related behaviors.

  9. Associations of Adiponectin with Adiposity, Insulin Sensitivity, and Diet in Young, Healthy, Mexican Americans and Non-Latino White Adults

    Directory of Open Access Journals (Sweden)

    Rocio I. Pereira

    2015-12-01

    Full Text Available Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA compared to non-Latino whites (NLW. Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we explored associations between adiponectin and diet. This was an observational, cross-sectional study of healthy MA and NLW adults living in Colorado (U.S.A.. We measured plasma total adiponectin, adiposity (BMI, and visceral adipose tissue, insulin sensitivity (IVGTT, and self-reported dietary intake in 43 MA and NLW adults. Mean adiponectin levels were 40% lower among MA than NLW (5.8 ± 3.3 vs. 10.7 ± 4.2 µg/mL, p = 0.0003, and this difference persisted after controlling for age, sex, BMI, and visceral adiposity. Lower adiponectin in MA was associated with lower insulin sensitivity (R2 = 0.42, p < 0.01. Lower adiponectin was also associated with higher dietary glycemic index, lower intake of vegetables, higher intake of trans fat, and higher intake of grains. Our findings confirm that ethnic differences in adiponectin reflect differences in insulin sensitivity, but suggest that these are not due to differences in adiposity. Observed associations between adiponectin and diet support the need for future studies exploring the regulation of adiponectin by diet and other environmental factors.

  10. Are lifestyle-factors in adolescence predictors for adult low back pain? A cross-sectional and prospective study of young twins

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Leboeuf-Yde, Charlotte; Kyvik, Kirsten Ohm

    2006-01-01

    INTRODUCTION: With more than half of the population experiencing low back pain (LBP) before the age of 20, research must focus on young populations. Lifestyle-factors might be important elements of prevention, since they are modifiable in nature. Therefore, the objective of the present study...... is to investigate the association between smoking, alcohol consumption and overweight in adolescence and 1) present LBP (cross-sectionally) and 2) the risk of future LBP (longitudinally). METHODS: Data from 9,600 twins, aged 12-22, were analysed cross-sectionally with respect to associations between the above...... of temporality (smoking preceding LBP). Adult LBP was negatively associated with adolescent alcohol consumption. We found no evidence of a dose-response relationship or temporality. There were no associations detected between adolescent overweight and adult LBP. In the twin-control study, the directions...

  11. Association between genetic polymorphisms in Ca(v2.3 (R-type Ca2+ channels and fentanyl sensitivity in patients undergoing painful cosmetic surgery.

    Directory of Open Access Journals (Sweden)

    Soichiro Ide

    Full Text Available Individual differences in the sensitivity to fentanyl, a widely used opioid analgesic, lead to different proper doses of fentanyl, which can hamper effective pain treatment. Voltage-activated Ca(2+ channels (VACCs play a crucial role in the nervous system by controlling membrane excitability and calcium signaling. Ca(v2.3 (R-type VACCs have been especially thought to play critical roles in pain pathways and the analgesic effects of opioids. However, unknown is whether single-nucleotide polymorphisms (SNPs of the human CACNA1E (calcium channel, voltage-dependent, R type, alpha 1E subunit gene that encodes Cav2.3 VACCs influence the analgesic effects of opioids. Thus, the present study examined associations between fentanyl sensitivity and SNPs in the human CACNA1E gene in 355 Japanese patients who underwent painful orofacial cosmetic surgery, including bone dissection. We first conducted linkage disequilibrium (LD analyses of 223 SNPs in a region that contains the CACNA1E gene using genomic samples from 100 patients, and a total of 13 LD blocks with 42 Tag SNPs were observed within and around the CACNA1E gene region. In the preliminary study using the same 100 genomic samples, only the rs3845446 A/G SNP was significantly associated with perioperative fentanyl use among these 42 Tag SNPs. In a confirmatory study using the other 255 genomic samples, this SNP was also significantly associated with perioperative fentanyl use. Thus, we further analyzed associations between genotypes of this SNP and all of the clinical data using a total of 355 samples. The rs3845446 A/G SNP was associated with intraoperative fentanyl use, 24 h postoperative fentanyl requirements, and perioperative fentanyl use. Subjects who carried the minor G allele required significantly less fentanyl for pain control compared with subjects who did not carry this allele. Although further validation is needed, the present findings show the possibility of the involvement of CACNA1E

  12. Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain: a multicentre, quasi-experimental study.

    Directory of Open Access Journals (Sweden)

    Jana Semrau

    Full Text Available Improvement of the long-term effectiveness of multidisciplinary ortho-paedic rehabilitation (MOR in the management of chronic non-specific low back pain (CLBP remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named "PASTOR" to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR.A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group, were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group. It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome using the Hannover Functional Ability Questionnaire (FFbH-R and vari-ous secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions.In total 536 participants were consecutively assigned to PASTOR (n=266 or MOR (n=270. At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78 using complete data and 3.56 (95% CI 0.45 to 6.67 using available da-ta, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001 and d=0.10 (p=0.025 in favour of PASTOR. Further improvements in secondary out-comes were also observed in favour of PASTOR.The interprofessional and interdisciplinary, biopsychosocial rehabilita-tion program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults

  13. Correlation of non-traumatic neck pain with cervical angle and shoulder retractor power in adult clerical population

    Directory of Open Access Journals (Sweden)

    Isha Avadhut Godbole

    2015-04-01

    Full Text Available Background: A forward head posture (or chin poking is perhaps the most common abnormality associated with NP and is commonly defined as the protrusion of the head in the sagittal plane so that the head is placed anterior to the trunk. Forward head posture can occur because of an anterior translation of the head, lower cervical flexion, or both, and it is claimed to be associated with an increase in upper-cervical extension. It is suggested that forward head posture leads to an increase in the compressive forces on the cervical apophyseal joints and posterior part of the vertebra and to changes in connective tissue length and strength (because of stretching of the anterior structures of the neck and shortening of the posterior muscles resulting in pain. The objective of the study was to correlate neck pain with cervical angle and shoulder retractor power in non-traumatic neck pain patients. Methods: 50 clerical workers having non traumatic neck pain were included. Neck pain was measured on VAS, cervical angle was measured using photometric method and shoulder retractor power was measured. Results: VAS showed moderate positive correlation with cervical angles (0.63 and 0.72 and moderate negative correlation with shoulder retractor power (-0.59 and -0.71. A moderate positive correlation of craniocervical angle to VAS seen (0.66 whereas there was negative correlation with shoulder retractors I and II (-0.59 and -0.61 A positive correlation was seen between VAS and craniocervical angle but is moderately negative with shoulder retractors I (Rhomboids and II (Middle trapezius (0.78, 0.04, -0.69 and -0.64. Conclusion: A moderate increase in cranio vertebral and craniocervical angle showed plausible weakness in lower Trapezius and rhomboids among clerks` having Non-traumatic neck pain. [Int J Res Med Sci 2015; 3(4.000: 859-862

  14. Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

    Institute of Scientific and Technical Information of China (English)

    Fabio Pace; Giovanna Zuin; Stefania Di Giacomo; Paola Molteni; Valentina Casini; Massimo Fontana; Gabriele Bianchi Porro

    2006-01-01

    AIM: To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS).METHODS: A group of 67 children with RAP referred to the department from January 1986 to December 1995was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview.We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint.RESULTS: Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%)whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test).Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances.CONCLUSION: The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms,possibly through the learning of a specific illness behavior.

  15. "Well, it's nobody's responsibility but my own". A qualitative study to explore views about the determinants of health and prevention of knee pain in older adults.

    LENUS (Irish Health Repository)

    Jinks, Clare

    2010-03-22

    Abstract Background Dahlgren and Whitehead\\'s \\'rainbow\\' outlines key determinants of health and has been widely adopted within public health policy and research. Public understanding regarding the determinants of health is, however, relatively unknown, particularly in relation to common chronic joint problems like knee pain. We aimed to explore individual attitudes to the prevention of knee pain, and assess how people make sense of their lives by using the rainbow model to explore social determinants of health. Methods Twenty-eight semi-structured interviews were undertaken with older adults living in the community. The format of the interview enabled individuals to first tell their story, then the rainbow picture was used to further prompt discussion. Interviews were digitally recorded and transcripts were fully transcribed. Qualitative computer software package NVivo 2 was used to manage the data. Thematic analysis was undertaken. Results Individual responsibility for health was a dominant theme although the role of health and statutory services was also recognised. Barriers to uptake of prevention activities included cultural perceptions, attitudes towards work and perceived costs of prevention activities. Participants used the rainbow for locating their personal life within a wider social, economic and policy context. Conclusions People view individual responsibility as key to maintaining health and draw upon the past, present and future expectations when considering social determinants of their health. The rainbow picture does have relevance at the individual level and can help to formulate more dynamic and contextualised approaches to the prevention of health conditions in community living adults.

  16. "Well, it's nobody's responsibility but my own." A qualitative study to explore views about the determinants of health and prevention of knee pain in older adults

    Directory of Open Access Journals (Sweden)

    O'Neill Tracey

    2010-03-01

    Full Text Available Abstract Background Dahlgren and Whitehead's 'rainbow' outlines key determinants of health and has been widely adopted within public health policy and research. Public understanding regarding the determinants of health is, however, relatively unknown, particularly in relation to common chronic joint problems like knee pain. We aimed to explore individual attitudes to the prevention of knee pain, and assess how people make sense of their lives by using the rainbow model to explore social determinants of health. Methods Twenty-eight semi-structured interviews were undertaken with older adults living in the community. The format of the interview enabled individuals to first tell their story, then the rainbow picture was used to further prompt discussion. Interviews were digitally recorded and transcripts were fully transcribed. Qualitative computer software package NVivo 2 was used to manage the data. Thematic analysis was undertaken. Results Individual responsibility for health was a dominant theme although the role of health and statutory services was also recognised. Barriers to uptake of prevention activities included cultural perceptions, attitudes towards work and perceived costs of prevention activities. Participants used the rainbow for locating their personal life within a wider social, economic and policy context. Conclusions People view individual responsibility as key to maintaining health and draw upon the past, present and future expectations when considering social determinants of their health. The rainbow picture does have relevance at the individual level and can help to formulate more dynamic and contextualised approaches to the prevention of health conditions in community living adults.

  17. Primary study on pain sensitivity of palatal maxillary mucosal%上颌口腔腭侧黏膜疼痛敏感度的初步研究

    Institute of Scientific and Technical Information of China (English)

    白忠诚; 施生根; 李莉莉; 张艳茹; 刘彦; 刘艮兰

    2012-01-01

    目的:研究不同部位口腔上颌腭侧黏膜疼痛敏感度,发现相对敏感区域并提出相应对策,以减轻患者注射麻药时的疼痛感及全身并发证的发生.方法:对需拔除的上颌患牙进行局部浸润麻醉,采用碧兰麻及相对应的0.3mm×21mm细针头,注射部位距离腭侧牙龈缘约5mm,后记录注射部位的疼痛程度,所记录的疼痛程度是注射针刺入黏膜时的疼痛.疼痛分级采用国际通用方法,但加以改良,使之更详细.采用χ2检验分析各牙位的中重度和重度疼痛患者构成比.结果:800例患者中,无痛到中度疼痛患者646例,占总数的80.75%;中重度和重度疼痛患者154例,占19.25%.中重度和重度疼痛患者在中切牙组占47%,侧切牙组占39%,尖牙组占27%,第一前磨牙组占12%,第二前磨牙组占9%,第一磨牙和第二磨牙组均占8%,上颌结节区占4%.与前磨牙、磨牙和上颌结节区相比,中切牙、侧切牙和尖牙组的中重度和重度疼痛患者比例明显增加,差异有统计学意义( χ2检验,P <0.01).结论:中切牙、侧切牙和尖牙腭侧黏膜疼痛敏感度较高,先表面麻醉后再注射麻药,以减少患者的疼痛感,同时减少患者的恐惧感和全身并发症的发生.%Objective: To evaluate pain sensitivity of palatal side of maxillary alveolar mucosal and investigate the sensitive areas, so as to propose countermeasures to decrease pain of injection and prevent systemic complications at the injection of local anesthetic. Methods: Eight hundred patients were recruited in this study. Injections for local infiltration anesthesia were preformed on the maxillary teeth which need to be extracted. Primacaine was injected with a fine needle of 0.3mm diameter. Pain score at the moment of needling was recorded according to patients' description. Pain score was divided into six levels according to a modified international classification. Chi-square test was used to analyze the constituent ratio of the

  18. Role of capsaicin-sensitive C-fiber afferents in neuropathic pain-induced synaptic potentiation in the nociceptive amygdala

    Directory of Open Access Journals (Sweden)

    Nakao Ayano

    2012-07-01

    Full Text Available Abstract Background Neurons in the capsular part of the central nucleus of the amygdala (CeC, a region also called "nociceptive amygdala," receive nociceptive information from the dorsal horn via afferent pathways relayed from the lateral parabrachial nucleus (LPB. As the central amygdala is known to be involved in the acquisition and expression of emotion, this pathway is thought to play central roles in the generation of affective responses to nociceptive inputs. Excitatory synaptic transmission between afferents arising from the LPB and these CeC neurons is potentiated in arthritic, visceral, neuropathic, inflammatory and muscle pain models. In neuropathic pain models following spinal nerve ligation (SNL, in which we previously showed a robust LPB-CeC potentiation, the principal behavioral symptom is tactile allodynia triggered by non-C-fiber low-threshold mechanoreceptor afferents. Conversely, recent anatomical studies have revealed that most of the spinal neurons projecting to the LPB receive C-fiber afferent inputs. Here, we examined the hypothesis that these C-fiber-mediated inputs are necessary for the full establishment of robust synaptic potentiation of LPB-CeC transmission in the rats with neuropathic pain. Results Postnatal capsaicin treatment, which has been shown to denervate the C-fibers expressing transient receptor potential vanilloid type-1 (TRPV1 channels, completely abolished eye-wiping responses to capsaicin eye instillation in rats, but this treatment did not affect mechanical allodynia in the nerve-ligated animals. However, the postnatal capsaicin treatment prevented LPB-CeC synaptic potentiation after SNL, unlike in the vehicle-treated rats, primarily due to the decreased incidence of potentiated transmission by elimination of TRPV1-expressing C-fiber afferents. Conclusions C-fiber-mediated afferents in the nerve-ligated animals may be a required facilitator of the establishment of nerve injury-evoked synaptic

  19. Efficacy of an Intrathecal Multidrug Infusion for Pain Control in Older Adults and in End-Stage Malignancies: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Sadegh Abdolmohammadi

    2015-01-01

    Full Text Available The aim of the present study was to explore the effectiveness of an alternative method to manage pain based on a time-limited intrathecal (IT infusion of an analgesic medication mixture. Three patients (69, 64 and 94 years of age with intractable and poorly controlled pain due to bed sores, pelvic metastatic mass, and thoracic vertebra and rib fractures, respectively, were treated. Daily doses of opioids could not be increased due to side effects. An IT catheter (20 G was placed by percutaneous approach in the lumbar area while advancing toward the thoracic region, and was then tunnelled and fixed subcutaneously. It was connected to an external infusion pump with a mixture of bupivacaine 1 mg/mL, naloxone 0.02 ng/mL, ketamine 100 μg/mL, morphine 0.01 mg/mL and clonidine 0.75 μg/mL. The starting rate was 1 mL/h. The pain was mostly controlled at a rate of <1 mL/h. Opioid consumption was reduced dramatically. The catheter was kept in place for one month in the first and third patients, and for six months in the second patient, until his death. Major side effects, such as hypotension, constipation, muscle weakness, sphincter dysfunction, and cognitive or mood deterioration, were not observed with this approach. One patient experienced a urinary tract infection followed by sepsis and meningitis, which was cured by antibiotics. The catheter was removed in this patient. IT infusion with a low-concentration multidrug mixture could be considered as an alternative modality for intractable pain relief in older adults or in malignancies.

  20. Phospholipase D-mediated hypersensitivity at central synapses is associated with abnormal behaviours and pain sensitivity in rats exposed to prenatal stress.

    Science.gov (United States)

    Sun, Liting; Gooding, Hayley L; Brunton, Paula J; Russell, John A; Mitchell, Rory; Fleetwood-Walker, Sue

    2013-11-01

    Adverse events at critical stages of development can lead to lasting dysfunction in the central nervous system (CNS). To seek potential underlying changes in synaptic function, we used a newly developed protocol to measure alterations in receptor-mediated Ca(2+) fluorescence responses of synaptoneurosomes, freshly isolated from selected regions of the CNS concerned with emotionality and pain processing. We compared adult male controls and offspring of rats exposed to social stress in late pregnancy (prenatal stress, PS), which showed programmed behavioural changes indicating anxiety, anhedonia and pain hypersensitivity. We found corresponding increases, in PS rats compared with normal controls, in responsiveness of synaptoneurosomes from frontal cortex to a glutamate receptor (GluR) agonist, and from spinal cord to activators of nociceptive afferents. Through a combined pharmacological and biochemical strategy, we found evidence for a role of phospholipase D1 (PLD1)-mediated signalling, that may involve 5-HT2A receptor (5-HT2AR) activation, at both levels of the nervous system. These changes might participate in underpinning the enduring alterations in behaviour induced by PS. PMID:23932932

  1. 'Hip' pain.

    Science.gov (United States)

    Zacher, Josef; Gursche, Angelika

    2003-02-01

    'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders. PMID:12659822

  2. Relationships of Depression to Child and Adult Abuse and Bodily Pain among Women Who Have Experienced Intimate Partner Violence

    Science.gov (United States)

    Koopman, Cheryl; Ismailji, Tasneem; Palesh, Oxana; Gore-Felton, Cheryl; Narayanan, Amrita; Saltzman, Kasey M.; Holmes, Danielle; McGarvey, Elizabeth L.

    2007-01-01

    This study investigates whether depression in women who experienced intimate partner violence is associated with having also experienced childhood sexual and physical abuse, psychological abuse by an intimate partner, recent involvement with the abusive partner, and bodily pain. Fifty-seven women who had left a violent relationship with an…

  3. Over-the-Counter Relief From Pains and Pleasures Alike: Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli.

    Science.gov (United States)

    Durso, Geoffrey R O; Luttrell, Andrew; Way, Baldwin M

    2015-06-01

    Acetaminophen, an effective and popular over-the-counter pain reliever (e.g., the active ingredient in Tylenol), has recently been shown to blunt individuals' reactivity to a range of negative stimuli in addition to physical pain. Because accumulating research has shown that individuals' reactivity to both negative and positive stimuli can be influenced by a single factor (an idea known as differential susceptibility), we conducted two experiments testing whether acetaminophen blunted individuals' evaluations of and emotional reactions to both negative and positive images from the International Affective Picture System. Participants who took acetaminophen evaluated unpleasant stimuli less negatively and pleasant stimuli less positively, compared with participants who took a placebo. Participants in the acetaminophen condition also rated both negative and positive stimuli as less emotionally arousing than did participants in the placebo condition (Studies 1 and 2), whereas nonevaluative ratings (extent of color saturation in each image; Study 2) were not affected by drug condition. These findings suggest that acetaminophen has a general blunting effect on individuals' evaluative and emotional processing, irrespective of negative or positive valence. PMID:25862546

  4. Development of Guidelines for Adults on How to Communicate With Adolescents About Mental Health Problems and Other Sensitive Topics

    Directory of Open Access Journals (Sweden)

    Julie A. Fischer

    2013-12-01

    Full Text Available There is little evidence-based information available to guide adults in the general community on communicating effectively with adolescents about mental health problems or other sensitive topics. The Delphi methodology was used to develop guidelines to fill this evidence gap. An online questionnaire containing potential guideline statements was developed following a literature search and input from two focus groups. Two expert panels (Youth Mental Health First Aid instructors and young consumer advocates rated the questionnaire over three rounds, according to whether or not they believed that the statements should be included in the guidelines. Results were analyzed by comparing endorsement rates between the panels. Of the 175 statements presented, 80 were rated as essential or important by ≥90% of both panels and were included in the guidelines. The Delphi process has offered an effective way to achieve consensus between expert panels on useful tips to help adults communicate with adolescents.

  5. Flowering time of butterfly nectar food plants is more sensitive to temperature than the timing of butterfly adult flight.

    Science.gov (United States)

    Kharouba, Heather M; Vellend, Mark

    2015-09-01

    1. Variation among species in their phenological responses to temperature change suggests that shifts in the relative timing of key life cycle events between interacting species are likely to occur under climate warming. However, it remains difficult to predict the prevalence and magnitude of these shifts given that there have been few comparisons of phenological sensitivities to temperature across interacting species. 2. Here, we used a broad-scale approach utilizing collection records to compare the temperature sensitivity of the timing of adult flight in butterflies vs. flowering of their potential nectar food plants (days per °C) across space and time in British Columbia, Canada. 3. On average, the phenology of both butterflies and plants advanced in response to warmer temperatures. However, the two taxa were differentially sensitive to temperature across space vs. across time, indicating the additional importance of nontemperature cues and/or local adaptation for many species. 4. Across butterfly-plant associations, flowering time was significantly more sensitive to temperature than the timing of butterfly flight and these sensitivities were not correlated. 5. Our results indicate that warming-driven shifts in the relative timing of life cycle events between butterflies and plants are likely to be prevalent, but that predicting the magnitude and direction of such changes in particular cases is going to require detailed, fine-scale data.

  6. Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations

    Science.gov (United States)

    Finnerup, Nanna B; Attal, Nadine; Haroutounian, Simon; McNicol, Ewan; Baron, Ralf; Dworkin, Robert H; Gilron, Ian; Haanpaa, Maija; Hansson, Per; Jensen, Troels S; Kamerman, Peter R; Lund, Karen; Moore, Andrew; Raja, Srinivasa N; Rice, Andrew SC; Rowbotham, Michael; Sena, Emily; Siddall, Philip; Smith, Blair H; Wallace, Mark

    2015-01-01

    Summary Background Neuropathic pain is difficult to treat. New treatments, clinical trials and standards of quality for assessing evidence justify an update of evidence-based recommendations for its pharmacological treatment. Methods The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain conducted a systematic review of randomised double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including unpublished trials (retrieved from clinicaltrials.gov and pharmaceutical websites). Meta-analysis used Numbers Needed to Treat (NNT) for 50 % pain relief as primary measure and assessed publication bias. Recommendations used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Findings In total 229 studies were included. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-review journals reported greater effects than online studies (R2=9·3%, p<0·01). Trial outcomes were generally modest even for effective drugs : in particular NNTs were 3·6 (95 % CI 3·0–4·4) for tricyclic antidepressants (TCAs), 6·4 (95 % CI 5·2–8·4) for serotonin- noradrenaline reuptake inbibitor (SNRI) antidepressants duloxetine and venlafaxine, 7·7 (95 % CI 6·5–9·4) for pregabalin and 6·3 (95 % CI 5·0–8·3) for gabapentin. NNTs were higher for gabapentin ER/enacarbil and capsaicin high concentration patches, lower for opioids and botulinum toxin A (BTX-A) and undetermined for lidocaine patches. Final quality of evidence was lower for lidocaine patches and BTX-A. Tolerability/safety and values/preferences were high for lidocaine patches and lower for opioids and TCAs. This permitted a strong GRADE recommendation for use and proposal as first line for TCAs, SNRIs, pregabalin, gabapentin and gabapentin ER/enacarbil in neuropathic pain, a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin

  7. Prenatal Choline Availability Alters the Context Sensitivity of Pavlovian Conditioning in Adult Rats

    Science.gov (United States)

    Lamoureux, Jeffrey A.; Meck, Warren H.; Williams, Christina L.

    2008-01-01

    The effects of prenatal choline availability on Pavlovian conditioning were assessed in adult male rats (3-4 mo). Neither supplementation nor deprivation of prenatal choline affected the acquisition and extinction of simple Pavlovian conditioned excitation, or the acquisition and retardation of conditioned inhibition. However, prenatal choline…

  8. Nicotine-induced behavioral sensitization in an adult rat model of attention deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Watterson, Elizabeth; Spitzer, Alexander; Watterson, Lucas R; Brackney, Ryan J; Zavala, Arturo R; Olive, M Foster; Sanabria, Federico

    2016-10-01

    Attention deficit hyperactivity disorder (ADHD) is associated with increased risk of tobacco dependence. Nicotine, the main psychoactive component of tobacco, appears to be implicated in ADHD-related tobacco dependence. However, the behavioral responsiveness to nicotine of the prevalent animal model of ADHD, the spontaneously hypertensive rat (SHR), is currently underinvestigated. The present study examined the activational effects of acute and chronic nicotine on the behavior of adult male SHRs, relative to Wistar Kyoto (WKY) controls. Experiment 1 verified baseline strain differences in open-field locomotor activity. Experiment 2 tested for baseline strain differences in rotational behavior using a Rotorat apparatus. Adult SHR and WKY rats were then exposed to a 7-day regimen of 0.6mg/kg/d s.c. nicotine, or saline, prior to each assessment. A separate group of SHRs underwent similar training, but was pre-treated with mecamylamine, a cholinergic antagonist. Nicotine sensitization, context conditioning, and mecamylamine effects were then tested. Baseline strain differences were observed in open-field performance and in the number of full rotations in the Rotorat apparatus, but not in the number of 90° rotations or direction changes. In these latter measures, SHRs displayed weaker nicotine-induced rotational suppression than WKYs. Both strains expressed nicotine-induced sensitization of rotational activity, but evidence for strain differences in sensitization was ambiguous; context conditioning was not observed. Mecamylamine reversed the effects of nicotine on SHR performance. These findings are consistent with the hypothesis that a reduced aversion to nicotine (expressed in rats as robust locomotion) may facilitate smoking among adults with ADHD. PMID:27363925

  9. Sensitivity to the photoperiod and potential migratory features of neuroblasts in the adult sheep hypothalamus.

    Science.gov (United States)

    Batailler, Martine; Derouet, Laura; Butruille, Lucile; Migaud, Martine

    2016-07-01

    Adult neurogenesis, a process that consists in the generation of new neurons from adult neural stem cells, represents a remarkable illustration of the brain structural plasticity abilities. The hypothalamus, a brain region that plays a key role in the neuroendocrine regulations including reproduction, metabolism or food intake, houses neural stem cells located within a hypothalamic neurogenic niche. In adult sheep, a seasonal mammalian species, previous recent studies have revealed photoperiod-dependent changes in the hypothalamic cell proliferation rate. In addition, doublecortin (DCX), a microtubule-associated protein expressed in immature migrating neurons, is highly present in the vicinity of the hypothalamic neurogenic niche. With the aim to further explore the mechanism underlying adult sheep hypothalamic neurogenesis, we first show that new neuron production is also seasonally regulated since the density of DCX-positive cells changes according to the photoperiodic conditions at various time points of the year. We then demonstrate that cyclin-dependant kinase-5 (Cdk5) and p35, two proteins involved in DCX phosphorylation and known to be critically involved in migration processes, are co-expressed with DCX in young hypothalamic neurons and are capable of in vivo interaction. Finally, to examine the migratory potential of these adult-born neurons, we reveal the rostro-caudal extent of DCX labeling on hypothalamic sagittal planes. DCX-positive cells are found in the most rostral nuclei of the hypothalamus, including the preoptic area many of which co-expressed estrogen receptor-α. Thus, beyond the confirmation of the high level of neuron production during short photoperiod in sheep, our results bring new and compelling elements in support of the existence of a hypothalamic migratory path that is responsive to seasonal stimuli. PMID:26336953

  10. Prevalência de dor crônica em adultos Prevalencia de dolor cronico en adultos Prevalence of chronic pain in adult workers

    Directory of Open Access Journals (Sweden)

    Maria Clara Giorio Dutra Kreling

    2006-08-01

    Full Text Available A dor crônica é um problema de saúde pública que acarreta prejuízos pessoais e sociais. Estudos epidemiológicos de dor crônica no Brasil e no resto do mundo são escassos, principalmente em se tratando de dores não específicas e em populações não vinculadas a serviços de saúde. Foram objetivos desse estudo: identificar a prevalência de dor crônica em adultos trabalhadores; analisar a prevalência de dor crônica conforme o sexo; e analisar a prevalência de dor conforme locais do corpo. Esta pesquisa foi realizada com uma amostra de 505 funcionários da Universidade Estadual de Londrina (Paraná, Brasil, considerando-se uma prevalência esperada de 50%, margem de erro de 4% na estimativa e nível de confiança de 95%. Estabeleceram-se como significativos os valores de pEl dolor crónico es un problema de salud pública que puede acarrear prejuicios personales y sociales. Estudios epidemiológicos del dolor crónico en Brasil y en el resto del mundo son escasos, máxime cuando se trata de los dolores no específicos y en poblaciones que no se vinculam a los servícios de salud. Esse estudio tuvo como objetivos: identificar la prevalencia del dolor crónico em adultos trabajadores; analizar la prevalencia del dolor conforme regiones del cuerpo. Esa investigación fue realizada con una muestra de 505 funcionarios de la Universidad Estadual de Londrina, considerándose una prevalencia esperada de 50%, margen de error de 4% em la estimativa y nivel de confianza de 95%. Se estableció como significativo los valores de pChronic pain is a public health problem which causes personal and social losses. There are few epidemiological studies of chronic pain in Brazil and elsewhere in the world, especially those dealing with non-specific pain, in general population. The objectives of this study were: to identify the prevalence of chronic pain in adult workers; to analyze the prevalence of chronic pain according to gender, and local of pain

  11. The Effect of Daily Self-Measurement of Pressure Pain Sensitivity Followed by Acupressure on Depression and Quality of Life versus Treatment as Usual in Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Bech, Per;

    2014-01-01

    Pressure Pain Sensitivity (PPS) on the sternum. AIM: To evaluate if stress focus by self-measurement of PPS, followed by stress reducing actions including acupressure, can decrease depressive symptoms and increase psychological well-being in people with stable IHD. DESIGN: Observer blinded randomized......-measurement of PPS twice daily followed by acupressure as mandatory action, aiming at a reduction in PPS. Primary endpoint: change in depressive symptoms as measured by Major depression inventory (MDI). Other endpoints: changes in PPS, Well-being (WHO-5) and mental and physical QOL (SF-36). RESULTS: At 3 months......: PPS measurements followed by acupressure reduce PPS, depressive symptoms and increase QOL in patients with stable IHD. TRIAL REGISTRATION: ClinicalTrials.gov NCT01513824....

  12. Endpoints in pediatric pain studies

    NARCIS (Netherlands)

    M. van Dijk (Monique); I. Ceelie (Ilse); D. Tibboel (Dick)

    2010-01-01

    textabstractAssessing pain intensity in (preverbal) children is more difficult than in adults. Tools to measure pain are being used as primary endpoints [e.g., pain intensity, time to first (rescue) analgesia, total analgesic consumption, adverse effects, and long-term effects] in studies on the eff

  13. Age differences in striatal delay sensitivity during intertemporal choice in healthy adults

    OpenAIRE

    Samanez-Larkin, Gregory R.; Rui eMata; Peter T Radu; Ballard, Ian C.; Carstensen, Laura L.; McClure, Samuel M.

    2011-01-01

    Intertemporal choices are a ubiquitous class of decisions that involve selecting between outcomes available at different times in the future. We investigated the neural systems supporting intertemporal decisions in healthy younger and older adults. Using functional neuroimaging, we find that aging is associated with a shift in the brain areas that respond to delayed rewards. Although we replicate findings that brain regions associated with the mesolimbic dopamine system respond preferentially...

  14. Age Differences in Striatal Delay Sensitivity during Intertemporal Choice in Healthy Adults

    OpenAIRE

    Samanez-Larkin, Gregory R.; Mata, Rui; Peter T Radu; Ballard, Ian C.; Carstensen, Laura L.; McClure, Samuel M.

    2011-01-01

    Intertemporal choices are a ubiquitous class of decisions that involve selecting between outcomes available at different times in the future. We investigated the neural systems supporting intertemporal decisions in healthy younger and older adults. Using functional neuroimaging, we find that aging is associated with a shift in the brain areas that respond to delayed rewards. Although we replicate findings that brain regions associated with the mesolimbic dopamine system respond preferentially...

  15. Age differences in striatal delay sensitivity during intertemporal choice in healthy adults

    Directory of Open Access Journals (Sweden)

    Gregory R Samanez-Larkin

    2011-11-01

    Full Text Available Intertemporal choices are a ubiquitous class of decisions that involve selecting between outcomes available at different times in the future. We investigated the neural systems supporting intertemporal decisions in healthy younger and older adults. Using functional neuroimaging, we find that aging is associated with a shift in the brain areas that respond to delayed rewards. Although we replicate findings that brain regions associated with the mesolimbic dopamine system respond preferentially to immediate rewards, we find a separate region in the ventral striatum with very modest time dependence in older adults. Activation in this striatal region was relatively insensitive to delay in older but not younger adults. Since the dopamine system is believed to support associative learning about future rewards over time, our observed transfer of function may be due to greater experience with delayed rewards as people age. Identifying differences in the neural systems underlying these decisions may contribute to a more comprehensive model of age-related change in intertemporal choice.

  16. Measurement of Trigeminal Neuralgia Pain: Penn Facial Pain Scale.

    Science.gov (United States)

    Lee, John Y K

    2016-07-01

    Pain is a subjective experience that cannot be directly measured. Therefore, patient-reported outcome is one of the currently accepted methods to capture pain intensity and its impact on activities of daily living. This article focuses on five patient-reported outcomes that have been used to measure trigeminal neuralgia pain-Visual Analog Scale, numeric rating scale, Barrow Neurological Institute Pain Intensity Score, McGill Pain Questionnaire, and Penn Facial Pain Scale. Each scale is evaluated for its practicality, applicability, comprehensiveness, reliability, validity, and sensitivity to measuring trigeminal neuralgia pain. PMID:27324999

  17. Systematic pain assessment in horses.

    Science.gov (United States)

    de Grauw, J C; van Loon, J P A M

    2016-03-01

    Accurate recognition and quantification of pain in horses is imperative for adequate pain management. The past decade has seen a much needed surge in formal development of systematic pain assessment tools for the objective monitoring of pain in equine patients. This narrative review describes parameters that can be used to detect pain in horses, provides an overview of the various pain scales developed (visual analogue scales, simple descriptive scales, numerical rating scales, time budget analysis, composite pain scales and grimace scales), and highlights their strengths and weaknesses for potential clinical implementation. The available literature on the use of each pain assessment tool in specific equine pain states (laminitis, lameness, acute synovitis, post-castration, acute colic and post-abdominal surgery) is discussed, including any problems with sensitivity, reliability or scale validation as well as translation of results to other clinical pain states. The review considers future development and further refinement of currently available equine pain scoring systems. PMID:26831169

  18. Borderline Personality and the Pain Paradox

    OpenAIRE

    Sansone, Randy A.; Sansone, Lori A.

    2007-01-01

    Clinical observations and empirical studies indicate that patients with borderline personality are both sensitive and insensitive to pain. This dichotomy may be explained by the context of the pain. For acute self-induced pain, borderline patients seem to experience attenuated pain responses. For chronic endogenous pain, borderline patients appear pain intolerant. In this paper, we explain this unusual paradox. We then discuss the psychiatric assessment of chronic pain, emphasizing the import...

  19. Sensitivity to communicative and non-communicative gestures in adolescents and adults with autism spectrum disorder: saccadic and pupillary responses.

    Science.gov (United States)

    Aldaqre, Iyad; Schuwerk, Tobias; Daum, Moritz M; Sodian, Beate; Paulus, Markus

    2016-09-01

    Nonverbal communication using social cues, like gestures, governs a great part of our daily interactions. It has been proposed that people with autism spectrum disorder (ASD) show a deviant processing of social cues throughout their social cognitive development. However, social cues do not always convey an intention to communicate. Hence, the aim of this study was to test the sensitivity of adolescents and adults with ASD and neurotypical controls to social cues of high communicative (pointing) and low communicative values (grasping). For this purpose, we employed a spatial cueing paradigm with both Cue Types and compared saccadic reaction times (SRTs) between conditions in which the target appeared at a location which was congruent versus incongruent with the direction of the cue. Results showed that both adolescents and adults with ASD had slower SRTs for the incongruent relative to the congruent condition for both Cue Types, reflecting sensitivity to these cues. Additionally, mental effort during the processing of these social cues was assessed by means of pupil dilation. This analysis revealed that, while individuals with and without ASD required more mental effort to process incongruent compared to the congruent cues, cues with higher communicative value posed more processing load for the ASD group. These findings suggest that the perception of social gestures is intact in ASD but requires additional mental effort for gestures with higher communicative value. PMID:27119361

  20. Complex multilocus effects of catechol-O-methyltransferase haplotypes predict pain and pain interference 6 weeks after motor vehicle collision.

    Science.gov (United States)

    Bortsov, Andrey V; Diatchenko, Luda; McLean, Samuel A

    2014-03-01

    Catechol-O-methyltransferase, encoded by COMT gene, is the primary enzyme that metabolizes catecholamines. COMT haplotypes have been associated with vulnerability to persistent non-traumatic pain. In this prospective observational study, we investigated the influence of COMT on persistent pain and pain interference with life functions after motor vehicle collision (MVC) in 859 European American adults for whom overall pain (0-10 numeric rating scale) and pain interference (Brief Pain Inventory) were assessed at week 6 after MVC. Ten single nucleotide polymorphisms spanning the COMT gene were successfully genotyped, and nine were present in three haploblocks: block 1 (rs2020917, rs737865, rs1544325), block 2 (rs4633, rs4818, rs4680, rs165774), and block 3 (rs174697, rs165599). After adjustment for multiple comparisons, haplotype TCG from block 1 predicted decreased pain interference (p = 0.004). The pain-protective effect of the low pain sensitivity (CGGG) haplotype from block 2 was only observed if at least one TCG haplotype was present in block 1 (haplotype × haplotype interaction p = 0.002 and <0.0001 for pain and pain interference, respectively). Haplotype AG from block 3 was associated with pain and interference in males only (sex × haplotype interaction p = 0.005 and 0.0005, respectively). These results suggest that genetic variants in the distal promoter are important contributors to the development of persistent pain after MVC, directly and via the interaction with haplotypes in the coding region of the gene. PMID:23963787

  1. Plasma high sensitivity troponin T levels in adult survivors of childhood leukaemias: determinants and associations with cardiac function.

    Directory of Open Access Journals (Sweden)

    Yiu-fai Cheung

    Full Text Available BACKGROUND: We sought to quantify plasma high sensitivity cardiac troponin (hs-cTnT levels, their determinants, and their associations with left ventricular (LV myocardial deformation in adult survivors of childhood acute leukaemias. METHODS AND RESULTS: One hundred adult survivors (57 males of childhood acute leukaemias, aged 24.1 ± 4.2 years, and 42 age-matched controls (26 males were studied. Plasma cTnT was determined using a highly sensitive assay. Genotyping of NAD(PH oxidase and multidrug resistance protein polymorphisms was performed. Left ventricular function was assessed by conventional, three-dimensional, and speckle tracking echocardiography. The medians (interquartile range of hs-cTnT in male and female survivors were 4.9 (4.2 to 7.2 ng/L and 1.0 (1.0 to 3.5 ng/L, respectively. Nineteen survivors (13 males, 6 females (19% had elevated hs-cTnT (>95(th centile of controls. Compared to those without elevated hs-TnT levels, these subjects had received larger cumulative anthracycline dose and were more likely to have leukaemic relapse, stem cell transplant, and cardiac irradiation. Their LV systolic and early diastolic myocardial velocities, isovolumic acceleration, and systolic longitudinal strain rate were significantly lower. Survivors having CT/TT at CYBA rs4673 had higher hs-cTnT levels than those with CC genotype. Functionally, increased hs-cTnT levels were associated with worse LV longitudinal systolic strain and systolic and diastolic strain rates. CONCLUSIONS: Increased hs-cTnT levels occur in a significant proportion of adult survivors of childhood acute leukaemias and are associated with larger cumulative anthracycline dose received, history of leukaemic relapse, stem cell transplant, and cardiac irradiation, genetic variants in free radical metabolism, and worse LV myocardial deformation.

  2. Patellofemoral pain.

    Science.gov (United States)

    Crossley, Kay M; Callaghan, Michael J; van Linschoten, Robbart

    2016-02-01

    Patellofemoral pain refers to pain behind or around the patella (also known as patellofemoral pain syndrome, anterior knee pain, runner's knee, and, formerly, chondromalacia patellae). Patellofemoral pain is common, accounting for 11-17% of all knee pain presentations to general practice.(1 2) While it typically occurs in physically active people aged Patellofemoral pain can be diagnosed in the clinic, and evidence based treatments can reduce pain and improve function, allowing patients to maintain a physically active lifestyle. PMID:26834209

  3. Neural mechanisms of sensitivity to peer information in young adult cannabis users.

    Science.gov (United States)

    Gilman, Jodi M; Schuster, Randi M; Curran, Max T; Calderon, Vanessa; van der Kouwe, Andre; Evins, A Eden

    2016-08-01

    Though social influence is a critical factor in the initiation and maintenance of marijuana use, the neural correlates of influence in those who use marijuana are unknown. In this study, marijuana-using young adults (MJ; n = 20) and controls (CON; n = 23) performed a decision-making task in which they made a perceptual choice after viewing the choices of unknown peers via photographs, while they underwent functional magnetic resonance imaging scans. The MJ and CON groups did not show differences in the overall number of choices that agreed with versus opposed group influence, but only the MJ group showed reaction time slowing when deciding against group choices. Longer reaction times were associated with greater activation of frontal regions. The MJ goup, compared to CON, showed significantly greater activation in the caudate when presented with peer information. Across groups, caudate activation was associated with self-reported susceptibility to influence. These findings indicate that young adults who use MJ may exhibit increased effort when confronted with opposing peer influence, as well as exhibit greater responsivity of the caudate to social information. These results not only better define the neural basis of social decisions, but also suggest that marijuana use is associated with exaggerated neural activity during decision making that involves social information. PMID:27068178

  4. Exploring the Relationship between Noise Sensitivity, Annoyance and Health-Related Quality of Life in a Sample of Adults Exposed to Environmental Noise

    OpenAIRE

    Daniel Shepherd; David Welch; Renata Mathews; Dirks, Kim N.

    2010-01-01

    The relationship between environmental noise and health is poorly understood but of fundamental importance to public health. This study estimated the relationship between noise sensitivity, noise annoyance and health-related quality of life in a sample of adults residing close to the Auckland International Airport, New Zealand. A small sample (n = 105) completed surveys measuring noise sensitivity, noise annoyance, and quality of life. Noise sensitivity was associated with health-related qual...

  5. [Gender differences in weather sensitivity of normal adult people registered on the rheoencephalogram and electroencephalogram].

    Science.gov (United States)

    Vodolazhskaya, M G; Vodolazhskiy, G I

    2014-01-01

    In the real-life environment the subjectively unperceived reactivity of rheoencephalogram (REG) and electroencephalogram (EEG) to ordinary geophysical factors (i.e. wind, atmospheric pressure, relative humidity and temperature) is gender-dependent. Correlations between REG and EEG values and weather fluctuations are more frequent and stronger in men. Dependence of EEG rhythms on weather factors increases as the rhythmic activity within the delta-theta-beta range becomes more rapid. This pattern is particularly evident in men but not women. Reactivity of neurodynamic parameters in female REG and EEG is responsive to the ovarian-menstrual cycle. Almost all cases of cerebral weather sensitivity of women were objectified in the post-ovulatory period, whereas in the preovulatory period episodes of weather sensitivity were only singular. PMID:26035996

  6. The association between alcohol consumption and contact sensitization in Danish adults: the Glostrup Allergy Study

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Nielsen, N.H.; Linneberg, A.

    2008-01-01

    Background Population-based epidemiological studies have indicated that alcohol consumption is associated with IgE-mediated immune diseases (i.e. allergic rhinitis, asthma and urticaria). These studies have been strongly supported by several immunological studies. Furthermore, an inhibitory effect...... of alcohol consumption on the development of delayed-type hypersensitivity has been shown in healthy controls. However, a possible association between contact sensitization and alcohol consumption in a general population has never been reported. Objectives To investigate whether alcohol consumption...... is associated with contact sensitization in a general population. Methods In 1990, self-reported consumption of alcohol and patch testing results were assessed in 1112 subjects, aged 15-69 years, participating in a population-based cross-sectional study in Glostrup, Denmark. In 1998, they were invited...

  7. Asymptomatic skin sensitization to birch predicts later development of birch pollen allergy in adults

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Poulsen, Lars K; Malling, Hans-Jørgen

    2003-01-01

    birch skin prick test weal diameter of > or =4 mm, a positive conjunctival provocation test result, and specific IgE of > or =CAP class 2, as well as with the presence of other allergies. Specific IgE of > or =CAP class 2 was 87.5% predictive for allergy development, whereas a negative conjunctival...... risk is any subject with target organ sensitivity, an elevated specific IgE level, and/or a skin prick test weal diameter of >4 mm....

  8. The periodontal pain paradox: Difficulty on pain assesment in dental patients (The periodontal pain paradox hypothesis

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2006-12-01

    Full Text Available In daily dental practice, the majority of patients’ main complaints are related to pain. Most patients assume that all pains inside the oral cavity originated from the tooth. One particular case is thermal sensitivity; sometimes patients were being able to point the site of pain, although there is neither visible caries nor secondary caries in dental radiograph. In this case, gingival recession and dentin hypersensitivity are first to be treated to eliminate the pain. If these treatments failed, pain may misdiagnose as pulpal inflammation and lead to unnecessary root canal treatment. Study in pain during periodontal instrumentation of plaque-related periodontitis revealed that the majority of patients feel pain and discomfort during probing and scaling. It seems obvious because an inflammation, either acute or chronic is related to a lowered pain threshold. However, in contrast, in this case report, patient suffered from chronic gingivitis and thermal sensitivity experienced a relative pain-free sensation during probing and scaling. Lowered pain threshold which accompanied by a blunted pain perception upon periodontal instrumentation is proposed to be termed as the periodontal pain paradox. The objective of this study is to reveal the possibility of certain factors in periodontal inflammation which may involved in the periodontal pain paradox hypothesis. Patient with thermal hypersensitivity who was conducted probing and scaling, after the relative pain-free instrumentation, thermal hypersensitivity rapidly disappeared. Based on the successful periodontal treatment, it is concluded that chronic gingivitis may modulate periodontal pain perception which termed as periodontal pain paradox

  9. Managing chronic pain in older people.

    Science.gov (United States)

    Schofield, Patricia

    This article presents the results of a collaborative project between the British Pain Society and British Geriatric Society to produce guidelines on the management of pain in older adults. The guidelines are the first of their kind in the UK and aim to provide best practice for the management of pain to all health professionals working with older adults in any care setting.

  10. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Naomi Brooks, Jennifer E. Layne, Patricia L. Gordon , Ronenn Roubenoff , Miriam E. Nelson , Carmen Castaneda-Sceppa

    2007-01-01

    Full Text Available Hispanics are at increased risk of morbidity and mortality due to their high prevalence of diabetes and poor glycemic control. Strength training is the most effective lifestyle intervention to increase muscle mass but limited data is available in older adults with diabetes. We determined the influence of strength training on muscle quality (strength per unit of muscle mass, skeletal muscle fiber hypertrophy, and metabolic control including insulin resistance (Homeostasis Model Assessment –HOMA-IR, C-Reactive Protein (CRP, adiponectin and Free Fatty Acid (FFA levels in Hispanic older adults. Sixty-two community-dwelling Hispanics (>55 y with type 2 diabetes were randomized to 16 weeks of strength training plus standard care (ST group or standard care alone (CON group. Skeletal muscle biopsies and biochemical measures were taken at baseline and 16 weeks. The ST group show improved muscle quality (mean±SE: 28±3 vs CON (-4±2, p2 and type II fiber cross-sectional area (720±285µm2 compared to CON (type I: -164±290µm2, p=0.04; and type II: -130±336µm2, p=0.04. This was accompanied by reduced insulin resistance [ST: median (interquartile range -0.7(3.6 vs CON: 0.8(3.8, p=0.05]; FFA (ST: -84±30µmol/L vs CON: 149±48µmol/L, p=0.02; and CRP [ST: -1.3(2.9mg/L vs CON: 0.4(2.3mg/L, p=0.05]. Serum adiponectin increased with ST [1.0(1.8µg/mL] compared to CON [-1.2(2.2µg/mL, p

  11. Prevalence of acute post-operative pain in patients in adult age-group undergoing inpatient abdominal surgery and correlation of intensity of pain and satisfaction with analgesic management: A cross-sectional single institute-based study

    Science.gov (United States)

    Singh, Prashant Kumar; Saikia, Priyam; Lahakar, Mangala

    2016-01-01

    Background and Aims: Considering the paucity of regional data, this study was designed to investigate the prevalence of post-operative pain and determine if there exists any correlation between the intensity of post-operative pain and patient's level of satisfaction with their pain management after inpatient abdominal surgery at an academic tertiary care government centre. Methods: Pain intensity was measured in 120 patients with numeric rating scale at the fifth post-operative hour, second and third post-operative day. A questionnaire was used to measure the level of satisfaction with nurse's and doctor's response to their pain and overall pain management. Results: The prevalence of post-operative pain was 84.17%, 92.5% and 96.66% at the fifth post-operative hour, second and third post-operative day, respectively. Less number of patients experienced severe intensity pain on the third post-operative day (P = 0.00046), whereas the number of patients experiencing mild pain increased (P management was − 0.0218 (P = 0.8107), 0.1307 (P = 0.1553) and 0.0743 (P = 0.4195), respectively. Conclusion: There is a high prevalence of acute post-operative pain in patients undergoing inpatient abdominal surgery at our institute. There is a weak correlation between the intensity of pain and level of satisfaction with pain management.

  12. Social learning contributions to the etiology and treatment of functional abdominal pain and inflammatory bowel disease in children and adults

    Institute of Scientific and Technical Information of China (English)

    Rona L Levy; Shelby L Langer; William E Whitehead

    2007-01-01

    This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular emphasis is placed on randomized controlled trials,the majority of which are multi-modal in orientation,incorporating elements of cognitive behavioral therapy,social learning, and relaxation. Based on this review,we offer methodological and clinical suggestions: (1)Research investigations should include adequate sample sizes, long-term follow-up assessments, and a credible,active control group. (2) Standard gastrointestinal practice should include, when appropriate, learning opportunities for patients and family members, for example, instruction regarding the encouragement of wellness behavior.

  13. NCCN Adult Cancer Pain Practice Guidelines%NCCN成人癌性疼痛治疗临床指引(2006.1版)

    Institute of Scientific and Technical Information of China (English)

    邱红; 于世英

    2006-01-01

    @@ 1 目录 综合筛查及评估(PAIN-1) 急性疼痛处理(PAIN-2) 急性疼痛的后续处理(PAIN-3) 疼痛控制后的随访工作(PAIN-4) 短效类阿片类药物对中重度疼痛的疗效(PAIN-5)

  14. Smoking Cessation and Chronic Pain: Patient and Pain Medicine Physician Attitudes

    OpenAIRE

    Hooten, W. Michael; Vickers, Kristin S.; Shi, Yu; Ebnet, Kaye L.; Townsend, Cynthia O.; Patten, Christi A.; Warner, David O.

    2011-01-01

    Although previous studies suggest that the clinical setting of an interdisciplinary pain treatment program may provide an optimal environment to promote smoking cessation, currently available smoking cessation interventions may be less effective for adults with chronic pain due, in part, to unrecognized clinical factors related to chronic pain. The specific aim of this qualitative study was to solicit information from adult smokers with chronic pain participating in an interdisciplinary pain ...

  15. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults

    Energy Technology Data Exchange (ETDEWEB)

    Potts, J.F.; Rona, R.J.; Oyarzun, M.J.; Amigo, H.; Bustos, P. [Kings College London, London (United Kingdom). Dept. for Public Health Science

    2008-04-15

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semi-rural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  16. Sensitivity of Larvae and Adult and the Immunologic Characteristics of Litopenaeus vannamei under the Acute Hypoxia

    Directory of Open Access Journals (Sweden)

    Hailong Zhou

    2014-01-01

    Full Text Available Litopenaeus vannamei is one of the most commercially important species of shrimp in the world. In this study, we performed acute hypoxia tests with Litopenaeus vannamei to estimate 12 h median lethal concentration (LC50 values at different life stages. The results indicated that the 12 h LC50 values were significantly different in different life stages of shrimp (P<0.05. The maximum value of 12 h LC50 was 2.113 mg L−1 for mysis III, and the minimum value was 0.535 mg L−1 for adult shrimp with an average total length of 6 cm. The study also determined the hemocyanin concentration (HC and the total hemocyte counts (THC in the conditions of hypoxia and reoxygenation. These results showed that the THC decreased and the HC increased under hypoxia, and the THC increased and the HC decreased in the condition of reoxygenation. These results can provide fundamental information for shrimp farming and seedling and also can guide the breeding selection, as well as being very helpful to better understand the hypoxia stress mechanism of shrimp.

  17. Tough adults, frail babies: an analysis of stress sensitivity across early life-history stages of widely introduced marine invertebrates.

    Directory of Open Access Journals (Sweden)

    M Carmen Pineda

    Full Text Available All ontogenetic stages of a life cycle are exposed to environmental conditions so that population persistence depends on the performance of both adults and offspring. Most studies analysing the influence of abiotic conditions on species performance have focussed on adults, while studies covering early life-history stages remain rare. We investigated the responses of early stages of two widely introduced ascidians, Styela plicata and Microcosmus squamiger, to different abiotic conditions. Stressors mimicked conditions in the habitats where both species can be found in their distributional ranges and responses were related to the selection potential of their populations by analysing their genetic diversity. Four developmental stages (egg fertilisation, larval development, settlement, metamorphosis were studied after exposure to high temperature (30°C, low salinities (26 and 22‰ and high copper concentrations (25, 50 and 100 µg/L. Although most stressors effectively led to failure of complete development (fertilisation through metamorphosis, fertilisation and larval development were the most sensitive stages. All the studied stressors affected the development of both species, though responses differed with stage and stressor. S. plicata was overall more resistant to copper, and some stages of M. squamiger to low salinities. No relationship was found between parental genetic composition and responses to stressors. We conclude that successful development can be prevented at several life-history stages, and therefore, it is essential to consider multiple stages when assessing species' abilities to tolerate stress. Moreover, we found that early development of these species cannot be completed under conditions prevailing where adults live. These populations must therefore recruit from elsewhere or reproduce during temporal windows of more benign conditions. Alternatively, novel strategies or behaviours that increase overall reproductive success

  18. Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study

    Directory of Open Access Journals (Sweden)

    Isao Saito

    2015-09-01

    Full Text Available Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009–2012, the Toon Health Study recruited 1899 individuals aged 30–79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR and Gutt’s insulin sensitivity index (ISI. Pulse was recorded for 5 min, and time-domain heart rate variability (HRV indices were calculated: the standard deviation of normal-to-normal intervals (SDNN and the root mean square of successive difference (RMSSD. Power spectral analysis provided frequency domain measures of HRV: high frequency (HF power, low frequency (LF power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in non-overweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41–3.10. Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

  19. Exploring the Relationship between Noise Sensitivity, Annoyance and Health-Related Quality of Life in a Sample of Adults Exposed to Environmental Noise

    Directory of Open Access Journals (Sweden)

    Daniel Shepherd

    2010-10-01

    Full Text Available The relationship between environmental noise and health is poorly understood but of fundamental importance to public health. This study estimated the relationship between noise sensitivity, noise annoyance and health-related quality of life in a sample of adults residing close to the Auckland International Airport, New Zealand. A small sample (n = 105 completed surveys measuring noise sensitivity, noise annoyance, and quality of life. Noise sensitivity was associated with health-related quality of life; annoyance and sleep disturbance mediated the effects of noise sensitivity on health.

  20. Adult-onset obesity reveals prenatal programming of glucose-insulin sensitivity in male sheep nutrient restricted during late gestation.

    Directory of Open Access Journals (Sweden)

    Philip Rhodes

    Full Text Available BACKGROUND: Obesity invokes a range of metabolic disturbances, but the transition from a poor to excessive nutritional environment may exacerbate adult metabolic dysfunction. The current study investigated global maternal nutrient restriction during early or late gestation on glucose tolerance and insulin sensitivity in the adult offspring when lean and obese. METHODS/PRINCIPAL FINDINGS: Pregnant sheep received adequate (1.0M; CE, n = 6 or energy restricted (0.7M diet during early (1-65 days; LEE, n = 6 or late (65-128 days; LEL, n = 7 gestation (term approximately 147 days. Subsequent offspring remained on pasture until 1.5 years when all received glucose and insulin tolerance tests (GTT & ITT and body composition determination by dual energy x-ray absorptiometry (DXA. All animals were then exposed to an obesogenic environment for 6-7 months and all protocols repeated. Prenatal dietary treatment had no effect on birth weight or on metabolic endpoints when animals were 'lean' (1.5 years. Obesity revealed generalised metabolic 'inflexibility' and insulin resistance; characterised by blunted excursions of plasma NEFA and increased insulin(AUC (from 133 to 341 [s.e.d. 26] ng.ml(-1.120 mins during a GTT, respectively. For LEL vs. CE, the peak in plasma insulin when obese was greater (7.8 vs. 4.7 [s.e.d. 1.1] ng.ml(-1 and was exacerbated by offspring sex (i.e. 9.8 vs. 4.4 [s.e.d. 1.16] ng.ml(-1; LEL male vs. CE male, respectively. Acquisition of obesity also significantly influenced the plasma lipid and protein profile to suggest, overall, greater net lipogenesis and reduced protein metabolism. CONCLUSIONS: This study indicates generalised metabolic dysfunction with adult-onset obesity which also exacerbates and 'reveals' programming of glucose-insulin sensitivity in male offspring prenatally exposed to maternal undernutrition during late gestation. Taken together, the data suggest that metabolic function appears little compromised in young

  1. Mild obstructive sleep apnea does not modulate baroreflex sensitivity in adult patients

    Directory of Open Access Journals (Sweden)

    Blomster H

    2015-06-01

    Full Text Available Henry Blomster,1 Tomi P Laitinen,2 Juha EK Hartikainen,3,6 Tiina M Laitinen,2 Esko Vanninen,2 Helena Gylling,4,8 Johanna Sahlman,1 Jouko Kokkarinen,5 Jukka Randell,5 Juha Seppä,1 Henri Tuomilehto4,7 1Department of Otorhinolaryngology, Institute of Clinical Medicine, 2Department of Clinical Physiology and Nuclear Medicine, 3Department of Internal Medicine, 4Department of Clinical Nutrition, School of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 5Department of Respiratory Medicine, 6Heart Center, Kuopio University Hospital, 7Oivauni Sleep Clinic, Kuopio, 8Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland Background: Obstructive sleep apnea (OSA is a chronic and progressive disease. OSA is associated with increased cardiovascular morbidity and mortality, the risk being more frequently encountered with severe degrees of OSA. Increased sympathetic activation and impaired cardiac autonomic control as reflected by depressed baroreceptor reflex sensitivity (BRS are possible mechanisms involved in the cardiovascular complications of OSA. However, it is not known at what stage of OSA that changes in BRS appear. The aim of this study was to evaluate BRS in patients with mild OSA. Methods: The study population consisted of 81 overweight patients with mild OSA and 46 body weight-matched non-OSA subjects. BRS, apnea-hypopnea index, body mass index, and metabolic parameters were assessed. The phenylephrine test was used to measure BRS. Results: Patients in the OSA group were slightly but significantly older than the non-OSA population (50.3±9.3 years vs 45.7±11.1 years, P=0.02. Body mass index, percentage body fat, blood pressure, fasting glucose, insulin, and lipid levels did not differ between the OSA patients and non-OSA subjects. Absolute BRS values in patients with mild OSA and non-OSA subjects (9.97±6.70 ms/mmHg vs 10.51±7.16 ms/mmHg, P=0.67 and BRS values proportional

  2. Social participation in older adults with joint pain and comorbidity; testing the measurement properties of the Dutch Keele Assessment of Participation

    Science.gov (United States)

    Hermsen, Lotte A H; Terwee, Caroline B; Leone, Stephanie S; van der Zwaard, Babette; Smalbrugge, Martin; Dekker, Joost; van der Horst, Henriëtte E; Wilkie, Ross

    2013-01-01

    Objective The Keele Assessment of Participation (KAP) questionnaire measures person-perceived participation in 11 aspects of life. Participation allows fulfilment of valued life activities and social roles, which are important to older adults. Since we aimed to use the KAP in a larger Dutch cohort, we examined the measurement properties of KAP in a Dutch sample of older adults with joint pain and comorbidity. Design Cohort study. Setting A community-based sample in Amsterdam, the Netherlands and North Staffordshire, UK. Participants Participants were aged 65 years and over, had at least two chronic diseases (identified through general practice consultation) and reported joint pain on most days (questionnaire). The Dutch cohort provided baseline data (n=407), follow-up data at 6 months (n=364) and test–retest data 2 weeks after 6 months (n=122). The UK cohort provided comparable data (n=404). Outcome measures The primary outcome was person-perceived participation, as measured with the KAP. The measurement properties examined were the following: structural validity (factor analysis), internal consistency (Cronbach's α), reliability (intraclass correlation coefficients; ICC), construct validity (hypothesis testing), responsiveness (hypothesis testing and area under the curve) and cross-cultural validity (differential item functioning; DIF). Results Factor analysis revealed two domains: KAPd1: ‘participation in basic activities’ and KAPd2: ‘participation in complex activities’, with Cronbach's α of 0.74 and 0.57 and moderate test–retest reliability: ICC of 0.63 and 0.57, respectively. Further analyses of KAPd1 showed poor construct validity and responsiveness. Despite the uniform DIF in item ‘interpersonal relations’, the total KAPd1 score seemed comparable between the Dutch and UK sample. Conclusions Only KAP domain ‘participation in basic activities’ showed good internal consistency and sufficient reliability. KAPd2 lacks sufficient

  3. Physiotherapy for pain

    DEFF Research Database (Denmark)

    Ginnerup-Nielsen, Elisabeth; Christensen, Robin; Thorborg, Kristian;

    2016-01-01

    OBJECTIVES: To empirically assess the clinical effects of physiotherapy on pain in adults. DESIGN: Using meta-epidemiology, we report on the effects of a 'physiotherapy' intervention on self-reported pain in adults. For each trial, the group difference in the outcome 'pain intensity' was assessed...... 'no intervention' or of a sham-controlled design were selected. Only articles written in English were eligible. RESULTS: An overall moderate effect of physiotherapy on pain corresponding to 0.65 SD-units (95% CI 0.57 to 0.73) was found based on a moderate inconsistency (I(2)=51%). Stratified...... exploration showed that therapeutic exercise for musculoskeletal diseases tended to be more beneficial than multimodal interventions (difference 0.30 95% CI 0.03 to 0.57; p=0.03). Trials with a 'no intervention' comparator tended to have a higher overall effect size than trials with a sham comparator...

  4. The scars of childhood adversity: minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients.

    Directory of Open Access Journals (Sweden)

    Gemma Kok

    Full Text Available Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients.Daily stress was assessed in recurrently depressed adult patients, enrolled into two randomized trials while remitted. The reported intensity and frequency of dependent and independent daily stress was assessed at baseline. Independent stress is externally generated, for example an accident happening to a friend, while dependent stress is internally generated, for example getting into a fight with a neighbor. Hierarchical regression analyses were performed with childhood adversity, independent and dependent daily stress as predictor variables of prospectively measured depressive symptoms after three months of follow-up (n = 138.We found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress. The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at follow-up (unadjusted models respectively: B = 0.47, t = 2.05, p = 0.041, 95% CI = 0.02-0.92; B = 0.29, t = 2.20, p = 0.028, 95% CI = 0.03-0.55. No associations were found between childhood adversity and depressive symptoms at follow-up.No evidence was found supporting stress sensitization due to the experience of childhood adversity in this recurrently depressed but remitted patient group. Nevertheless, our research indicates that daily stress might be a target for preventive treatment.Trial A: Nederlands Trial Register NTR1907 Trial B: Nederlands Trial Register NTR2503.

  5. Neural mechanisms of pain and alcohol dependence☆

    OpenAIRE

    Apkarian, A. Vania; Neugebauer, Volker; Koob, George; Edwards, Scott; Levine, Jon D.; Ferrari, Luiz; Egli, Mark; Regunathan, Soundar

    2013-01-01

    An association between chronic pain conditions and alcohol dependence has been revealed in numerous studies with episodes of alcohol abuse antedating chronic pain in some people and alcohol dependence emerging after the onset of chronic pain in others. Alcohol dependence and chronic pain share common neural circuits giving rise to the possibility that chronic pain states could significantly affect alcohol use patterns and that alcohol dependence could influence pain sensitivity. The reward an...

  6. Nurses’ knowledge of the principles of acute pain assessment in critically ill adult patients who are able to self-report

    Directory of Open Access Journals (Sweden)

    Irene Betty Kizza

    2016-01-01

    Conclusion: The nurses had adequate general knowledge about the principles of acute pain assessment in CIAP. However, some knowledge gaps exist about key concepts in pain assessment and these can curtail the efforts to ensure quality pain assessment and management in CIAP. The findings entrench the need for focused professional training and continuing professional education about best practices for pain assessment and management in CIAP.

  7. Groin pain

    Science.gov (United States)

    ... groin pain in men. The terms "groin" and "testicle" are sometimes used interchangeably. But what causes pain ... hernia. It may also involve pain in the testicles. Hernia : This problem occurs when there is a ...

  8. Eye pain

    Science.gov (United States)

    Ophthalmalgia; Pain - eye ... Pain in the eye can be an important symptom of a health problem. Make sure you tell your health care provider if you have eye pain that does not go away. Tired eyes or ...

  9. Wrist pain

    Science.gov (United States)

    Pain - wrist; Pain - carpal tunnel; Injury - wrist; Arthritis - wrist; Gout - wrist; Pseudogout - wrist ... Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome . You may feel aching, ...

  10. Heel pain

    Science.gov (United States)

    Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

  11. Depression, Pain, and Pain Behavior.

    Science.gov (United States)

    Keefe, Francis J.; And Others

    1986-01-01

    Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

  12. The visual analogue thermometer and the graphic numeric rating scale : A comparison of self-report instruments for pain measurement in adults with burns

    NARCIS (Netherlands)

    De Jong, A. E E; Bremer, M.; Hofland, H. W C; Schuurmans, M. J.; Middelkoop, E.; Van Loey, N. E E

    2015-01-01

    To evaluate the adequacy of pain management in burn care, pain measurement is essential. The visual analogue thermometer (VAT) and graphic numeric rating scale (GNRS) are frequently used self-report instruments for burn pain. To legitimise their interchangeable use in research and practice, we aimed

  13. Identification of Anxiety Sensitivity Classes and Clinical Cut-Scores in a Sample of Adult Smokers: Results from a Factor Mixture Model

    OpenAIRE

    Allan, Nicholas P.; Raines, Amanda M.; Capron, Daniel W.; Norr, Aaron M.; Zvolensky, Michael J.; Schmidt, Norman B.

    2014-01-01

    Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age = 36.87 years, SD = 13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-...

  14. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  15. Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2015-01-01

    Full Text Available This study aimed to examine the effects of kinesiology taping (KT and different TRX suspension workouts on the amplitude of electromyographic (EMG activity in the core muscles among people with chronic low back pain (LBP. Each participant (total n=21 was exposed to two KT conditions: no taping and taping, while performing four TRX suspension exercises: (1 hamstring curl, (2 hip abduction in plank, (3 chest press, and (4 45-degree row. Right transversus abdominis/internal oblique (TrAIO, rectus abdominis (RA, external oblique (EO, and superficial lumbar multifidus (LMF activity was recorded with surface EMG and expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. Hip abduction in plank increased TrAIO, RA, and LMF EMG amplitude compared with other TRX positions (P0.05. Hip abduction in plank most effectively activated abdominal muscles, whereas the hamstring curl most effectively activated the paraspinal muscles. Applying KT conferred no immediate benefits in improving the core muscle activation during TRX training in adults with chronic LBP.

  16. Neuropathic pain and psychological morbidity in patients with treated leprosy: a cross-sectional prevalence study in Mumbai.

    Directory of Open Access Journals (Sweden)

    Estrella Lasry-Levy

    Full Text Available BACKGROUND: Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated. METHODOLOGY/PRINCIPAL FINDINGS: Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity. CONCLUSIONS/SIGNIFICANCE: One hundred and one patients were recruited, and 22 (21.8% had neuropathic pain. The main sensory symptoms were numbness (86.4%, tingling (68.2%, hypoesthesia to touch (81.2% and pinprick (72.7%. Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity.

  17. Specific proteins of the trapezius muscle correlate with pain intensity and sensitivity – an explorative multivariate proteomic study of the trapezius muscle in women with chronic widespread pain

    Directory of Open Access Journals (Sweden)

    Olausson P

    2016-06-01

    Full Text Available Patrik Olausson, Bijar Ghafouri, Nazdar Ghafouri, Björn Gerdle Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Abstract: Chronic widespread pain (CWP including fibromyalgia syndrome (FMS has a high prevalence and is associated with prominent negative consequences. CWP/FMS exhibits morphological and functional alterations in the central nervous system. The importance of peripheral factors for maintaining the central alterations are under debate. In this study, the proteins from biopsies of the trapezius muscle from 18 female CWP/FMS patients and 19 healthy female controls were analyzed. Pain intensity and pressure pain thresholds (PPT over the trapezius muscles were registered. Twelve proteins representing five different groups of proteins were important regressors of pain intensity in CWP/FMS (R2=0.99; P<0.001. In the regression of PPT in CWP/FMS, it was found that 16 proteins representing six groups of proteins were significant regressors (R2=0.95, P<0.05. Many of the important proteins were stress and inflammation proteins, enzymes involved in metabolic pathways, and proteins associated with muscle damage, myopathies, and muscle recovery. The altered expression of these proteins may reflect both direct and indirect nociceptive/inflammatory processes as well as secondary changes. The relative importance of the identified proteins and central alterations in CWP need to be investigated in future research. Data from this and the previous study concerning the same cohorts give support to the suggestion that peripheral factors are of importance for maintaining pain aspects in CWP/FMS. Keywords: chronic widespread pain, proteomics, biomarkers, multivariate data analysis, pain threshold, numeric rating scale

  18. [Treatment of pain in children burns].

    Science.gov (United States)

    Latarjet, J; Pommier, C; Robert, A; Comparin, J P; Foyatier, J L

    1997-03-01

    Burn injury is considered by children as one of the most painful traumas (just after bone factures). Burn pain in children can and must be controlled as well as for adult patients, with almost identical techniques. Continuous pain from injury and intermittent pain caused by therapeutic procedures must be evaluated and treated separately. Due to very high levels of nociception, satisfactory management of procedural pain requires the use of opioid therapy. Non pharmacological methods are meaningless if pharmacological treatment is not optimal.

  19. Roles of Voltage-Gated Tetrodotoxin-Sensitive Sodium Channels NaV1.3 and NaV1.7 in Diabetes and Painful Diabetic Neuropathy.

    Science.gov (United States)

    Yang, Linlin; Li, Quanmin; Liu, Xinming; Liu, Shiguang

    2016-01-01

    Diabetes mellitus (DM) is a common chronic medical problem worldwide; one of its complications is painful peripheral neuropathy, which can substantially erode quality of life and increase the cost of management. Despite its clinical importance, the pathogenesis of painful diabetic neuropathy (PDN) is complex and incompletely understood. Voltage-gated sodium channels (VGSCs) link many physiological processes to electrical activity by controlling action potentials in all types of excitable cells. Two isoforms of VGSCs, NaV1.3 and NaV1.7, which are encoded by the sodium voltage-gated channel alpha subunit 3 and 9 (Scn3A and Scn9A) genes, respectively, have been identified in both peripheral nociceptive neurons of dorsal root ganglion (DRG) and pancreatic islet cells. Recent advances in our understanding of tetrodotoxin-sensitive (TTX-S) sodium channels NaV1.3 and NaV1.7 lead to the rational doubt about the cause-effect relation between diabetes and painful neuropathy. In this review, we summarize the roles of NaV1.3 and NaV1.7 in islet cells and DRG neurons, discuss the link between DM and painful neuropathy, and present a model, which may provide a starting point for further studies aimed at identifying the mechanisms underlying diabetes and painful neuropathy. PMID:27608006

  20. Roles of Voltage-Gated Tetrodotoxin-Sensitive Sodium Channels NaV1.3 and NaV1.7 in Diabetes and Painful Diabetic Neuropathy

    Science.gov (United States)

    Yang, Linlin; Li, Quanmin; Liu, Xinming; Liu, Shiguang

    2016-01-01

    Diabetes mellitus (DM) is a common chronic medical problem worldwide; one of its complications is painful peripheral neuropathy, which can substantially erode quality of life and increase the cost of management. Despite its clinical importance, the pathogenesis of painful diabetic neuropathy (PDN) is complex and incompletely understood. Voltage-gated sodium channels (VGSCs) link many physiological processes to electrical activity by controlling action potentials in all types of excitable cells. Two isoforms of VGSCs, NaV1.3 and NaV1.7, which are encoded by the sodium voltage-gated channel alpha subunit 3 and 9 (Scn3A and Scn9A) genes, respectively, have been identified in both peripheral nociceptive neurons of dorsal root ganglion (DRG) and pancreatic islet cells. Recent advances in our understanding of tetrodotoxin-sensitive (TTX-S) sodium channels NaV1.3 and NaV1.7 lead to the rational doubt about the cause–effect relation between diabetes and painful neuropathy. In this review, we summarize the roles of NaV1.3 and NaV1.7 in islet cells and DRG neurons, discuss the link between DM and painful neuropathy, and present a model, which may provide a starting point for further studies aimed at identifying the mechanisms underlying diabetes and painful neuropathy. PMID:27608006

  1. Roles of Voltage-Gated Tetrodotoxin-Sensitive Sodium Channels NaV1.3 and NaV1.7 in Diabetes and Painful Diabetic Neuropathy

    Directory of Open Access Journals (Sweden)

    Linlin Yang

    2016-09-01

    Full Text Available Diabetes mellitus (DM is a common chronic medical problem worldwide; one of its complications is painful peripheral neuropathy, which can substantially erode quality of life and increase the cost of management. Despite its clinical importance, the pathogenesis of painful diabetic neuropathy (PDN is complex and incompletely understood. Voltage-gated sodium channels (VGSCs link many physiological processes to electrical activity by controlling action potentials in all types of excitable cells. Two isoforms of VGSCs, NaV1.3 and NaV1.7, which are encoded by the sodium voltage-gated channel alpha subunit 3 and 9 (Scn3A and Scn9A genes, respectively, have been identified in both peripheral nociceptive neurons of dorsal root ganglion (DRG and pancreatic islet cells. Recent advances in our understanding of tetrodotoxin-sensitive (TTX-S sodium channels NaV1.3 and NaV1.7 lead to the rational doubt about the cause–effect relation between diabetes and painful neuropathy. In this review, we summarize the roles of NaV1.3 and NaV1.7 in islet cells and DRG neurons, discuss the link between DM and painful neuropathy, and present a model, which may provide a starting point for further studies aimed at identifying the mechanisms underlying diabetes and painful neuropathy.

  2. Sixteen-item Anxiety Sensitivity Index - Confirmatory factor analytic evidence, internal consistency, and construct validity in a young adult sample from the Netherlands

    NARCIS (Netherlands)

    Vujanovic, Anka A.; Arrindell, Willem A.; Bernstein, Amit; Norton, Peter J.; Zvolensky, Michael J.

    2007-01-01

    The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420)from the Netherlands. Confirmatory factor analysis was used to comparatively e

  3. Chronic pain after childhood groin hernia repair

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Kehlet, Henrik

    2007-01-01

    BACKGROUND: In contrast to the well-described 10% risk of chronic pain affecting daily activities after adult groin hernia repair, chronic pain after childhood groin hernia repair has never been investigated. Studies of other childhood surgery before the age of 3 months suggest a risk of increased...... pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown. METHODS: This was a nationwide detailed questionnaire study of chronic groin pain in adults having surgery for a groin hernia repair before the age of 5 years (n = 1075). RESULTS: The response...... the age of 3 months (n = 122) did not report groin pain more often or with higher intensity than other patients did. CONCLUSIONS: Groin pain in adult patients operated on for a groin hernia in childhood is uncommon and usually mild and occurs in relation to physical activity. Operation before the age...

  4. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  5. The differential mediating effects of pain and depression on the physical and mental dimension of quality of life in Hong Kong Chinese adults

    Directory of Open Access Journals (Sweden)

    Fung Vivian BK

    2010-01-01

    Full Text Available Abstract Objective The impact of pain and depression on health-related quality of life (QoL is widely investigated, yet the pain-depression interactions on QoL remain unclear. This study aims to examine the pain-depression-QoL mediation link. Methods Pain severity were assessed in a sample of Chinese professional teachers (n = 385. The subjects were also assessed on depressive symptoms and QoL. Regression models were fitted to evaluate the pain-depression-QoL relationships. Results About 44% of the sample had 3-5 painful areas in the past 3 months. Shoulder pain (60% and headache (53% were common painful areas. The results of regression analyses showed that pain mediated the effects of depression on the mental aspect of QoL (standardized β = -0.111; Sobel test: z = -3.124, p β = -0.026; Sobel test: z = -4.045, p Conclusions Our study offered tentative evidence that pain and depression impacted differently on the mental and physical aspect of QoL. As these findings were based on a Chinese teacher sample, future studies should employ more representative samples across cultures to verify the present data.

  6. Pelvic Pain

    Science.gov (United States)

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  7. Shoulder pain

    Science.gov (United States)

    Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

  8. 低频电针对脊神经结扎大鼠痛敏化的干预作用%Effect of Electroacupuncture with Low Frequency on Pain Sensitization of Rats Suffered from Spinal Nerve Ligation

    Institute of Scientific and Technical Information of China (English)

    蒋永亮; 尹小虎; 沈亚芳; 赵晓芸; 何晓芬; 方剑乔

    2014-01-01

    Objective To investigate the effect of electroacupuncture with low frequency on pain sensitization of neuropathic pain rats, and the possible mechanism of regulating peripheral pain sensitization. Methods Rat neuropathic pain model was established with the right L5 spinal nerve ligation. Zusanli (ST36) and Kunlun (BL60) were selected for electroacupuncture intervention. Mechanical allodynia, and the levels of stransient receptor potential vanilloid type 1 (TRPV1) and substance P (SP) in ipsilateral L5 and L4 dorsal root ganglion (DRG) were tested. A further validation experiment with TRPV1 agonist 6'-IRTX was carried out. Results Rats suffered from L5 spinal nerve liga-tion showed obvious pain sensitization. The levels of TRPV1 in ipsilateral L4 DRG and SP in ipsilateral L5 DRG were significantly elevated. Electroacupuncture with low frequency significantly relieved pain sensitization, and suppressed TRPV1 and SP increase. 6'-IRTX intraperito-neally administered significantly counteracted the anti-pain sensitization action of electroacupuncture with low frequency. Conclusion Elec-troacupuncture with low frequency is effective on neuropathic pain by intervening pain sensitization, which may be related to the regulation of DRG TRPV1 and SP.%目的:观察低频电针对脊神经结扎神经病理痛大鼠模型痛敏化的干预作用,探讨其可能的外周痛敏化调节机制。方法建立大鼠L5脊神经结扎模型,电针足三里和昆仑穴,观察大鼠痛觉超敏反应,运用Western blotting法检测L4、L5背根神经节(DRG)辣椒素受体(TRPV1)与P物质(SP)水平,采用TRPV1激动剂6'-IRTX进行验证。结果脊神经结扎大鼠出现明显的痛敏化反应,术侧L4 DRG TRPV1和L5 DRG SP水平升高(P<0.05);低频电针能减轻模型大鼠的痛敏反应,抑制TRPV1、SP水平上升(P<0.05)。6'-IRTX腹腔注射能拮抗低频电针的抗痛敏化作用。结论低频电针可减轻痛敏化,发挥对

  9. Development of and recovery from long-term pain. A 6-year follow-up study of a cross-section of the adult Danish population

    DEFF Research Database (Denmark)

    Eriksen, Jørgen; Ekholm, Ola; Sjøgren, Per;

    2004-01-01

    survey also included a question on duration of pain (>6 months). Using this as the 'gold standard', a validation study was performed, which identified the highest accuracy (85%) at the VRS cut-off level: no pain, very mild, or mild pain (control group) versus moderate, severe, or very severe pain (pain.......2-2.0], short education (OR 1.5, CI 1.0-2.2), poor self-rated health (OR 3.3, CI 2.4-4.7), and having at least one long-standing disease (OR 2.6, CI 2.0-3.4). Significant predictors for pain recovery were male gender, younger age, cohabitation status, good self-rated health, good mental health, having no long...

  10. Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data.

    Science.gov (United States)

    Hogan, Mary-Ellen; Taddio, Anna; Katz, Joel; Shah, Vibhuti; Krahn, Murray

    2016-08-01

    Little is known about the economic burden of chronic pain and how chronic pain affects health care utilization. We aimed to estimate the annual per-person incremental medical cost and health care utilization for chronic pain in the Ontario population from the perspective of the public payer. We performed a retrospective cohort study using Ontario health care databases and the electronically linked Canadian Community Health Survey (CCHS) from 2000 to 2011. We identified subjects aged ≥12 years from the CCHS with chronic pain and closely matched them to individuals without pain using propensity score matching methods. We used linked data to determine mean 1-year per-person health care costs and utilization for each group and mean incremental cost for chronic pain. All costs are reported in 2014 Canadian dollars. After matching, we had 19,138 pairs of CCHS respondents with and without chronic pain. The average age was 55 years (SD = 18) and 61% were female. The incremental cost to manage chronic pain was $1742 per person (95% confidence interval [CI], $1488-$2020), 51% more than the control group. The largest contributor to the incremental cost was hospitalization ($514; 95% CI, $364-$683). Incremental costs were the highest in those with severe pain ($3960; 95% CI, $3186-$4680) and in those with most activity limitation ($4365; 95% CI, $3631-$5147). The per-person cost to manage chronic pain is substantial and more than 50% higher than a comparable patient without chronic pain. Costs are higher in people with more severe pain and activity limitations. PMID:26989805

  11. Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers.

    Science.gov (United States)

    Howell, Ashley N; Leyro, Teresa M; Hogan, Julianna; Buckner, Julia D; Zvolensky, Michael J

    2010-12-01

    Anxiety sensitivity, distress tolerance, and discomfort intolerance have been identified as important factors related to alcohol use motives and alcohol-related problems. Yet, these variables are highly correlated and little work has delineated whether these psychological vulnerability factors are differentially related to alcohol use motives and problems. To fill this gap in the existing literature, the present study evaluated whether anxiety sensitivity, distress tolerance, and discomfort intolerance were differentially related to high-risk alcohol use motives (i.e., coping and conformity motives) and alcohol use problems among 224 young adult, current drinkers (52.3% women; M(age)=21.18, SD=7.08). Results indicated that distress tolerance, but not anxiety sensitivity or discomfort intolerance, was significantly related to coping motives for alcohol use. Additionally, anxiety sensitivity, but not distress tolerance or discomfort intolerance, was significantly related to conformity motives for drinking. For both sets of analyses, the observed significant effects were evident above and beyond the variance accounted for by alcohol consumption level, smoking rate, negative affectivity, and non-criterion alcohol use motives. Additionally, discomfort intolerance and anxiety sensitivity each predicted alcohol use problems; effects were not attributable to negative affectivity, cigarettes smoked per day, or shared variance with distress tolerance. Findings are discussed in relation to the role of emotional sensitivity and intolerance in terms of the motivational bases for alcohol use and alcohol use problems among young adult drinkers.

  12. 心理恐惧对止血带加压性疼痛刺激的预测%Prediction of the psychological fear on pain sensitivity

    Institute of Scientific and Technical Information of China (English)

    许敏; 王坤; 陈昭燃

    2014-01-01

    目的:研究止血带加压性疼痛对心率(heart rate,HR)、血压(blood pressure,BP)的影响以及实验前受试者心理状况对疼痛反应的预测性。方法受试者为15名健康年轻成年男性。实验前让受试者填写知情同意书,填写6项心理学量表,以便衡量受试者的心理状况。记录其实验前心率与血压。然后进行3次左上臂(非利手边)止血带加压,连续记录受试者疼痛程度(pain intensity,PI)和不适程度( pain distress,PD),加压速度为10 mmHg/ s(1 mmHg =0.133 kPa)。同时记录各次加压前的疼痛阈值(pain threshold,PT)及每次加压刺激后的心率和血压。结果1)受试者实验前的恐惧量表测量的结果在正常范围内,与其对应的各次加压性疼痛的疼痛阈值变化之间呈负相关(r1=-0.58,P=0.02)。2)疼痛刺激时,心率会随之增加(P<0.03)。3)受试者经每次止血带加压性疼痛刺激,疼痛程度和不适程度都会逐渐升高。结论1)恐惧评分可以预测止血带加压性的疼痛阈值。2)疼痛刺激能增加心率。%Objective To investigate the prediction of the subject’s psychological level on behavioral pain threshold to cuff-pressure tonic pain test and its effect to physical signs of heart rate(HR) and blood pressure(BP). Methods Fifteen healthy young male subjects (age:18-29 years) participated in the study. They were asked to fill in the informed consent and 6 psychological questionnaires, which were used to estimate their psychological level. They all were taken the BP and HR before and after the experiment. Then cuff-pressure pain was induced at their left upper(non-dominated) arms. The pain intensities and the pain distresses were recorded when the stimulus was going at the speed of 10 mmHg/ s. Meanwhile, we recorded the pressure-pain thresholds before the stimulus and the HR as well as BP after each cuff-pressure stimulus. Results ① The results of the psychometrics were all in normal limits and the fear level

  13. Acute pain induces insulin resistance in humans

    DEFF Research Database (Denmark)

    Greisen, J.; Juhl, C.B.; Grøfte, Thorbjørn;

    2001-01-01

    Background: Painful trauma results in a disturbed metabolic state with impaired insulin sensitivity, which is related to the magnitude of the trauma. The authors explored whether pain per se influences hepatic and extrahepatic actions of insulin. Methods: Ten healthy male volunteers underwent two......, circulating concentrations of glucagon and growth hormone tended to increase during pain. Conclusions: Acute severe pain decreases insulin sensitivity, primarily by affecting nonoxidative glucose metabolism. It is conceivable that the counterregulatory hormonal response plays an important role. This may...

  14. Custom-Made Foot Orthoses Decrease Medial Foot Loading During Drop Jump in Individuals With Patellofemoral Pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer;

    2016-01-01

    with 12 weeks of follow-up. SETTING: Hospital setting. PARTICIPANTS: 23 adults with PFP. INTERVENTIONS: Custom-made foot orthoses. MAIN OUTCOME MEASURES: Foot loading (plantar pressure) was collected from the most painful side during drop jump and single leg squat using pressure sensitive Pedar insoles...

  15. UP3005, a Botanical Composition Containing Two Standardized Extracts of Uncaria gambir and Morus alba, Improves Pain Sensitivity and Cartilage Degradations in Monosodium Iodoacetate-Induced Rat OA Disease Model

    Directory of Open Access Journals (Sweden)

    Mesfin Yimam

    2015-01-01

    Full Text Available Osteoarthritis (OA is a multifactorial disease primarily noted by cartilage degradation in association with inflammation that causes significant morbidity, joint pain, stiffness, and limited mobility. Present-day management of OA is inadequate due to the lack of principal therapies proven to be effective in hindering disease progression where symptomatic therapy focused approach masks the actual etiology leading to irreversible damage. Here, we describe the effect of UP3005, a composition containing a proprietary blend of two standardized extracts from the leaf of Uncaria gambir and the root bark of Morus alba, in maintaining joint structural integrity and alleviating OA associated symptoms in monosodium-iodoacetate- (MIA- induced rat OA disease model. Pain sensitivity, micro-CT, histopathology, and glycosaminoglycans (GAGs level analysis were conducted. Diclofenac at 10 mg/kg was used as a reference compound. UP3005 resulted in almost a complete inhibition in proteoglycans degradation, reductions of 16.6% (week 4, 40.5% (week 5, and 22.0% (week 6 in pain sensitivity, statistically significant improvements in articular cartilage matrix integrity, minimal visual subchondral bone damage, and statistically significant increase in bone mineral density when compared to the vehicle control with MIA. Therefore, UP3005 could potentially be considered as an alternative therapy from natural sources for the treatment of OA and/or its associated symptoms.

  16. UP3005, a Botanical Composition Containing Two Standardized Extracts of Uncaria gambir and Morus alba, Improves Pain Sensitivity and Cartilage Degradations in Monosodium Iodoacetate-Induced Rat OA Disease Model.

    Science.gov (United States)

    Yimam, Mesfin; Lee, Young-Chul; Kim, Tae-Woo; Moore, Breanna; Jiao, Ping; Hong, Mei; Kim, Hyun-Jin; Nam, Jeong-Bum; Kim, Mi-Ran; Oh, Jin-Sun; Cleveland, Sabrina; Hyun, Eu-Jin; Chu, Min; Jia, Qi

    2015-01-01

    Osteoarthritis (OA) is a multifactorial disease primarily noted by cartilage degradation in association with inflammation that causes significant morbidity, joint pain, stiffness, and limited mobility. Present-day management of OA is inadequate due to the lack of principal therapies proven to be effective in hindering disease progression where symptomatic therapy focused approach masks the actual etiology leading to irreversible damage. Here, we describe the effect of UP3005, a composition containing a proprietary blend of two standardized extracts from the leaf of Uncaria gambir and the root bark of Morus alba, in maintaining joint structural integrity and alleviating OA associated symptoms in monosodium-iodoacetate- (MIA-) induced rat OA disease model. Pain sensitivity, micro-CT, histopathology, and glycosaminoglycans (GAGs) level analysis were conducted. Diclofenac at 10 mg/kg was used as a reference compound. UP3005 resulted in almost a complete inhibition in proteoglycans degradation, reductions of 16.6% (week 4), 40.5% (week 5), and 22.0% (week 6) in pain sensitivity, statistically significant improvements in articular cartilage matrix integrity, minimal visual subchondral bone damage, and statistically significant increase in bone mineral density when compared to the vehicle control with MIA. Therefore, UP3005 could potentially be considered as an alternative therapy from natural sources for the treatment of OA and/or its associated symptoms. PMID:25802546

  17. Autism Spectrum Disorder and Amplified Pain.

    LENUS (Irish Health Repository)

    Clarke, Ciaran

    2015-05-01

    Among the core features of ASD, altered sensitivities in all modalities have been accorded increasing importance. Heightened sensitivity to pain and unusual expressions of and reaction to pain have not hitherto been widely recognised as a presenting feature of ASD in general paediatrics. Failure to recognise ASD as a common cause of pain can lead to late diagnosis, inappropriate treatment, distress, and further disability. Two cases are presented which illustrate the late presentation of Autism Spectrum Disorder (Asperger\\'s Syndrome subtype) with chronic unusual pain. Conclusion. Pain in autism can be atypical in its experience and expression and for this reason may go unrecognised by physicians treating chronic pain disorders.

  18. The influence of experimental pain intensity in the local and referred pain area on somatosensory perception in the area of referred pain.

    Science.gov (United States)

    Kosek, Eva; Hansson, Per

    2002-01-01

    The aim of this study was to investigate the influence of experimental pain intensity in the local and referred pain area on somatosensory perception thresholds in the area of referred pain. Pain was induced by intramuscular electrical stimulation of the left infraspinatus muscle in 12 healthy individuals. The stimulation corresponded to the local pain threshold ("mild local pain"), the referred pain threshold ("mild referred pain"), and a pain intensity corresponding to 2 on a 10-point category scale in the referred pain area ("moderate referred pain"). Quantitative sensory testing was performed to assess perception thresholds in the referred pain area and the homologous contralateral area before and during stimulation. Perception thresholds to light touch (LTTs), pressure pain (PPTs), and to innocuous as well as noxious warmth and cold were assessed. During stimulation the LTTs increased in the referred pain area compared to baseline, uninfluenced by pain intensity. Perception thresholds to innocuous cold and warmth increased bilaterally during the stimulation, without relation to pain intensity. Heat pain thresholds were not affected. Compared to baseline, PPTs increased bilaterally during stimulation corresponding to "mild local pain" and "mild referred pain", respectively, and a further increase was seen during "moderate referred pain". The decreased sensitivity to innocuous cold, warmth, and pressure pain was bilateral, indicating activation of endogenous net inhibitory mechanisms interacting bilaterally. We found no influence of pain intensity on somatosensory thresholds restricted to the referred pain area and light touch was the only affected modality in the referred pain area only.

  19. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A validation study.

    Science.gov (United States)

    VanDierendonck, Machteld C; van Loon, Johannes P A M

    2016-10-01

    This study presents the validation of two recently described pain scales, the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP), in horses with acute colic. A follow-up cohort study of 46 adult horses (n = 23 with acute colic; n = 23 healthy control horses) was performed for validation and refinement of the constructed scales. Both pain scales showed statistically significant differences between horses with colic and healthy control horses, and between horses with colic that could be treated conservatively and those that required surgical treatment or were euthanased. Sensitivity and specificity were good for both EQUUS-COMPASS (87% and 71%, respectively) and EQUUS-FAP (77% and 100%, respectively) and were not substantially influenced by applying weighting factors to the individual parameters. PMID:27687948

  20. Myofascial Pain: Mechanisms to Management.

    Science.gov (United States)

    Fricton, James

    2016-08-01

    More than 100 million adults in the United States have chronic pain conditions, costing more than $500 billion annually in medical care and lost productivity. They are the most common reason for seeking health care, for disability and addiction, and the highest driver of health care costs. Myofascial pain is the most common condition causing chronic pain and can be diagnosed through identifying clinical characteristics and muscle palpation. Management is focused on integrating patient training in changing lifestyle risk factors with evidence-based treatment. Understanding the cause, diagnosis, and management of myopain conditions will help prevent the impact of chronic pain.

  1. Pain Management

    Science.gov (United States)

    ... opiates such as morphine could relieve pain and chemist Felix Hoffmann developed aspirin from a substance in ... sensory and emotional experience associated with actual or potential tissue damage.” TODAY Pain affects more Americans than ...

  2. [Oral pain].

    Science.gov (United States)

    Benslama, Lotfi

    2002-02-15

    Pain, a major symptom of stomatological disease, usually leads to a specialist consultation. Most commonly it is caused by dental caries and differs in nature and in intensity according to the stage of disease: dentinitis, pulpitis, desmodontitis and dental abscess. Added to this is peridental pain and the pre- and post-operative pains related to these diseases. Almost all oral-maxillary pathology is painful, be it boney such as in osteomyelitis and fractures, mucosal in gingivo-stomatitis and aphthous ulcers, or tumourous. However, besides the "multidisciplinary" facial pains such as facial neuralgia and vascular pain, two pain syndromes are specific to stomatology: pain of the tempero-mandibular joint associated with problems of the bite and glossodynia, a very common somatic expression of psychological problems.

  3. Habituating pain

    DEFF Research Database (Denmark)

    Ajslev, Jeppe Zielinski Nguyen; Lund, Henrik Lambrecht; Møller, Jeppe Lykke;

    2013-01-01

    the industry reproduce physical strain and the habituation of pain as unquestioned conditions in construction work. The understanding of this mutual reinforcement of the necessity of physically straining, painful, high-paced construction work provides fruitful perspectives on the overrepresentation...

  4. Testicle pain

    Science.gov (United States)

    ... pain include: Injury Infection or swelling of the sperm ducts ( epididymitis ) or testicles ( orchitis ) Twisting of the ... Cyst in the epididymis that often contains dead sperm cells ( spermatocele ) Fluid surrounding the testicle ( hydrocele ) Pain ...

  5. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  6. Exercise training augments the peripheral insulin-sensitizing effects of pioglitazone in HIV-infected adults with insulin resistance and central adiposity

    OpenAIRE

    Yarasheski, Kevin E.; Cade, W. Todd; Overton, E Turner; Mondy, Kristin E.; HUBERT, Sara; Laciny, Erin; Bopp, Coco; Lassa-Claxton, Sherry; Reeds, Dominic N.

    2010-01-01

    The prevalence and incidence of insulin resistance and type 2 diabetes mellitus (DM) are higher in people treated for human immunodeficiency virus-1 (HIV) infection than in the general population. Identifying safe and effective interventions is a high priority. We evaluated whether the peroxisome proliferator-activated receptor-γ agonist pioglitazone with exercise training improves central and peripheral insulin sensitivity more than pioglitazone alone in HIV-infected adults with insulin resi...

  7. Are age-related differences between young and older adults in an affective working memory test sensitive to the music effects?

    OpenAIRE

    Erika eBorella; Barbara eCarretti; Massimo eGrassi; Massimo eNucci; Roberta eSciore

    2014-01-01

    There are evidences showing that music can affect cognitive performance by improving our emotional state. The aim of the current study was to analyze whether age-related differences between young and older adults in a Working Memory (WM) Span test in which the stimuli to be recalled have a different valence (i.e., neutral, positive, or negative words), are sensitive to exposure to music. Because some previous studies showed that emotional words can sustain older adults’ performance in WM, we ...

  8. Stress-Induced Locomotor Sensitization to Amphetamine in Adult, but not in Adolescent Rats, Is Associated with Increased Expression of ΔFosB in the Nucleus Accumbens

    Science.gov (United States)

    Carneiro de Oliveira, Paulo E.; Leão, Rodrigo M.; Bianchi, Paula C.; Marin, Marcelo T.; Planeta, Cleopatra da Silva; Cruz, Fábio C.

    2016-01-01

    While clinical and pre-clinical evidence suggests that adolescence is a risk period for the development of addiction, the underlying neural mechanisms are largely unknown. Stress during adolescence has a huge influence on drug addiction. However, little is known about the mechanisms related to the interaction among stress, adolescence and addiction. Studies point to ΔFosB as a possible target for this phenomenon. In the present study, adolescent and adult rats (postnatal day 28 and 60, respectively) were restrained for 2 h once a day for 7 days. Three days after their last exposure to stress, the animals were challenged with saline or amphetamine (1.0 mg/kg i.p.) and amphetamine-induced locomotion was recorded. Immediately after the behavioral tests, rats were decapitated and the nucleus accumbens was dissected to measure ΔFosB protein levels. We found that repeated restraint stress increased amphetamine-induced locomotion in both the adult and adolescent rats. Furthermore, in adult rats, stress-induced locomotor sensitization was associated with increased expression of ΔFosB in the nucleus accumbens. Our data suggest that ΔFosB may be involved in some of the neuronal plasticity changes associated with stress induced-cross sensitization with amphetamine in adult rats. PMID:27672362

  9. Pain: a distributed brain information network?

    Directory of Open Access Journals (Sweden)

    Hiroaki Mano

    2015-01-01

    Full Text Available Understanding how pain is processed in the brain has been an enduring puzzle, because there doesn't appear to be a single "pain cortex" that directly codes the subjective perception of pain. An emerging concept is that, instead, pain might emerge from the coordinated activity of an integrated brain network. In support of this view, Woo and colleagues present evidence that distinct brain networks support the subjective changes in pain that result from nociceptive input and self-directed cognitive modulation. This evidence for the sensitivity of distinct neural subsystems to different aspects of pain opens up the way to more formal computational network theories of pain.

  10. Urination Pain

    Science.gov (United States)

    ... more often bad-smelling, bloody, or discolored urine (pee) fever or chills decreased appetite or activity irritability nausea or vomiting lower back pain or abdominal (belly) pain wetting accidents (in potty-trained kids) What to Do Call the doctor if your child has pain while urinating or can't ...

  11. Abdominal Pain

    Science.gov (United States)

    ... relaxation. Guided imagery for abdominal pain About self-hypnosis and kids See YourChild : Pain and Your Child or Teen for more detail ... how to help your baby cope with the pain of medical procedures, circumcision, and teething. ... Helping Kids YourChild : A Look at Biofeedback YourChild : ...

  12. The nicotinic α6 subunit gene determines variability in chronic pain sensitivity via cross-inhibition of P2X2/3 receptors

    DEFF Research Database (Denmark)

    Wieskopf, Jeffrey S; Mathur, Jayanti; Limapichat, Walrati;

    2015-01-01

    Chronic pain is a highly prevalent and poorly managed human health problem. We used microarray-based expression genomics in 25 inbred mouse strains to identify dorsal root ganglion (DRG)-expressed genetic contributors to mechanical allodynia, a prominent symptom of chronic pain. We identified...... expression levels of Chrna6, which encodes the α6 subunit of the nicotinic acetylcholine receptor (nAChR), as highly associated with allodynia. We confirmed the importance of α6* (α6-containing) nAChRs by analyzing both gain- and loss-of-function mutants. We find that mechanical allodynia associated with...

  13. Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults

    Science.gov (United States)

    Nansel, Tonja R.; Lipsky, Leah M.; Eisenberg, Miriam H.; Haynie, Denise L.; Liu, Danping; Simons-Morton, Bruce

    2016-01-01

    Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods. PMID:27588287

  14. Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults.

    Science.gov (United States)

    Nansel, Tonja R; Lipsky, Leah M; Eisenberg, Miriam H; Haynie, Denise L; Liu, Danping; Simons-Morton, Bruce

    2016-01-01

    Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p fruit or juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods. PMID:27588287

  15. Neuropathic pain in children.

    Science.gov (United States)

    Howard, Richard F; Wiener, Suzanne; Walker, Suellen M

    2014-01-01

    Neuropathic pain (NP), due to a lesion or disease of the somatosensory nervous system, is not well documented or researched in children. NP is a clinical diagnosis that can be difficult, especially in younger children. Nevertheless, it is important to recognise NP, as pain mechanisms and consequently management and prognosis differ from other types of long-term pain. NP is common in adult pain clinics but many of the underlying disease states in which it occurs are infrequently or never encountered in paediatric practice. However, NP in childhood has been reported, even in the very young in certain clinical situations. Causes of NP include traumatic injury, complex regional pain syndrome type II, cancer and chemotherapy, chronic infection, neurological and metabolic disease, and inherited sensory nerve dysfunction. The clinical and laboratory study of traumatic peripheral nerve injury has revealed important age-related differences in clinical presentation and prognosis. It is clear that mechanisms operating during development can profoundly modify the consequences of nerve damage and NP. Clinically, diagnosis, assessment and treatment of NP are based on methods and evidence derived from data in adults. Improvements in the understanding and management of NP are likely to come from developmentally appropriate improvements in the clarity and consistency of diagnosis and systematic, well-researched approaches to treatment.

  16. Exercise Based- Pain Relief Program

    DEFF Research Database (Denmark)

    Zadeh, Mahdi Hossein

    to cause localized pressure pain and hyperalgesia. A prior bout of ECC has been repeatedly reported to produce a protective adaptation known as repeated bout effect (RBE). One of the main scopes of the current project was to investigate the adaptations by which the RBE can be resulted from. The approach...... in the current study was to use exercise induced- muscle damage followed by ECC as an acute pain model and observe its effects on the sensitivity of the nociceptive system and blood supply in healthy subjects. Then, the effect of a repeated bout of the same exercise as a healthy pain relief strategy......Exercise-based pain management programs are suggested for relieving from musculoskeletal pain; however the pain experienced after unaccustomed, especially eccentric exercise (ECC) alters people´s ability to participate in therapeutic exercises. Subsequent muscle pain after ECC has been shown...

  17. Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy

    Directory of Open Access Journals (Sweden)

    Forastiere Francesco

    2009-12-01

    Full Text Available Abstract Background A relationship between quality of primary health care and preventable hospitalizations has been described in the US, especially among the elderly. In Europe, there has been a recent increase in the evaluation of Ambulatory Care Sensitive Conditions (ACSC as an indicator of health care quality, but evidence is still limited. The aim of this study was to determine whether income level is associated with higher hospitalization rates for ACSC in adults in a country with universal health care coverage. Methods From the hospital registries in four Italian cities (Turin, Milan, Bologna, Rome, we identified 9384 hospital admissions for six chronic conditions (diabetes, hypertension, congestive heart failure, angina pectoris, chronic obstructive pulmonary disease, and asthma among 20-64 year-olds in 2000. Case definition was based on the ICD-9-CM coding algorithm suggested by the Agency for Health Research and Quality - Prevention Quality Indicators. An area-based (census block income index was used for each individual. All hospitalization rates were directly standardised for gender and age using the Italian population. Poisson regression analysis was performed to assess the relationship between income level (quintiles and hospitalization rates (RR, 95% CI separately for the selected conditions controlling for age, gender and city of residence. Results Overall, the ACSC age-standardized rate was 26.1 per 10.000 inhabitants. All conditions showed a statistically significant socioeconomic gradient, with low income people being more likely to be hospitalized than their well off counterparts. The association was particularly strong for chronic obstructive pulmonary disease (level V low income vs. level I high income RR = 4.23 95%CI 3.37-5.31 and for congestive heart failure (RR = 3.78, 95% CI = 3.09-4.62. With the exception of asthma, males were more vulnerable to ACSC hospitalizations than females. The risks were higher among 45-64 year

  18. Temporomandibular pain.

    Science.gov (United States)

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, H R; Kalavathi, S D

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  19. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Christensen, Robin Daniel Kjersgaard; Thomsen, Bente;

    2011-01-01

    ABSTRACT: BACKGROUND: Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective...... is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients...... with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. METHODS: The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited...

  20. Self-reported pain and disability outcomes from an endogenous model of muscular back pain

    Directory of Open Access Journals (Sweden)

    George Steven Z

    2011-02-01

    Full Text Available Abstract Background Our purpose was to develop an induced musculoskeletal pain model of acute low back pain and examine the relationship among pain, disability and fear in this model. Methods Delayed onset muscle soreness was induced in 52 healthy volunteers (23 women, 17 men; average age 22.4 years; average BMI 24.3 using fatiguing trunk extension exercise. Measures of pain intensity, unpleasantness, and location, and disability, were tracked for one week after exercise. Results Pain intensity ranged from 0 to 68 with 57.5% of participants reporting peak pain at 24 hours and 32.5% reporting this at 48 hours. The majority of participants reported pain in the low back with 33% also reporting pain in the legs. The ratio of unpleasantness to intensity indicated that the sensation was considered more unpleasant than intense. Statistical differences were noted in levels of reported disability between participants with and without leg pain. Pain intensity at 24 hours was correlated with pain unpleasantness, pain area and disability. Also, fear of pain was associated with pain intensity and unpleasantness. Disability was predicted by sex, presence of leg pain, and pain intensity; however, the largest amount of variance was explained by pain intensity (27% of a total 40%. The second model, predicting pain intensity only included fear of pain and explained less than 10% of the variance in pain intensity. Conclusions Our results demonstrate a significant association between pain and disability in this model in young adults. However, the model is most applicable to patients with lower levels of pain and disability. Future work should include older adults to improve the external validity of this model.

  1. The Nicotinic α6 Subunit Gene Determines Variability in Chronic Pain Sensitivity via Cross-inhibition of P2X2/3 Receptors

    Science.gov (United States)

    Wieskopf, Jeffrey S.; Mathur, Jayanti; Limapichat, Walrati; Post, Michael R.; Al-Qazzaz, Mona; Sorge, Robert E.; Martin, Loren J.; Zaykin, Dmitri V.; Smith, Shad B.; Freitas, Kelen; Austin, Jean-Sebastien; Dai, Feng; Zhang, Jie; Marcovitz, Jaclyn; Tuttle, Alexander H.; Slepian, Peter M.; Clarke, Sarah; Drenan, Ryan M.; Janes, Jeff; Sharari, Shakir Al; Segall, Samantha K.; Aasvang, Eske K.; Lai, Weike; Bittner, Reinhard; Richards, Christopher I.; Slade, Gary D.; Kehlet, Henrik; Walker, John; Maskos, Uwe; Changeux, Jean-Pierre; Devor, Marshall; Maixner, William; Diatchenko, Luda; Belfer, Inna; Dougherty, Dennis A.; Su, Andrew I.; Lummis, Sarah C.R.; Damaj, M. Imad; Lester, Henry A.; Patapoutian, Ardem; Mogil, Jeffrey S.

    2016-01-01

    Chronic pain is a highly prevalent and poorly managed human health problem. We used microarray-based expression genomics in 25 inbred mouse strains to identify dorsal root ganglion (DRG)-expressed genetic contributors to mechanical allodynia, a prominent symptom of chronic pain. We identified expression levels of Chrna6, which encodes the α6 subunit of the nicotinic acetylcholine receptor (nAChR), as highly associated with allodynia. We confirmed the importance of α6* (i.e., α6-containing) nAChRs by analyzing both gain- and loss-of-function mutants. We find that mechanical allodynia associated with neuropathic and inflammatory injuries is significantly altered in α6* mutants, and that α6* but not α4* nicotinic receptors are absolutely required for peripheral and/or spinal nicotine analgesia. Furthermore, we show that Chrna6’s role in analgesia is at least partially due to direct interaction and cross-inhibition of α6* nAChRs with P2X2/3 receptors in DRG nociceptors. Finally, we establish relevance of our results to humans by the observation of genetic association in patients suffering from chronic postsurgical pain and temporomandibular pain. PMID:25972004

  2. Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ≥ 40 Years: A Cross-Sectional Survey in Herne, Germany

    OpenAIRE

    Ulrich Thiem; Rainer Lamsfuß; Sven Günther; Jochen Schumacher; Christian Bäker; Endres, Heinz G.; Josef Zacher; Burmester, Gerd R.; Ludger Pientka

    2013-01-01

    BACKGROUND: Pain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce. METHODS: A cross-sectional survey of a random sample of citizens of Herne, Germany, aged ≥ 40 years was performed. A detailed self-complete postal questionnaire was used, followed by a short reminder questionnaire and telephone contacts...

  3. A GCH1 haplotype confers sex-specific susceptibility to pain crises and altered endothelial function in adults with sickle cell anemia.

    Science.gov (United States)

    Belfer, Inna; Youngblood, Victoria; Darbari, Deepika S; Wang, Zhengyuan; Diaw, Lena; Freeman, Lita; Desai, Krupa; Dizon, Michael; Allen, Darlene; Cunnington, Colin; Channon, Keith M; Milton, Jacqueline; Hartley, Stephen W; Nolan, Vikki; Kato, Gregory J; Steinberg, Martin H; Goldman, David; Taylor, James G

    2014-02-01

    GTP cyclohydrolase (GCH1) is rate limiting for tetrahydrobiopterin (BH4) synthesis, where BH4 is a cofactor for nitric oxide (NO) synthases and aromatic hydroxylases. GCH1 polymorphisms are implicated in the pathophysiology of pain, but have not been investigated in African populations. We examined GCH1 and pain in sickle cell anemia where GCH1 rs8007267 was a risk factor for pain crises in discovery (n = 228; odds ratio [OR] 2.26; P = 0.009) and replication (n = 513; OR 2.23; P = 0.004) cohorts. In vitro, cells from sickle cell anemia subjects homozygous for the risk allele produced higher BH4. In vivo physiological studies of traits likely to be modulated by GCH1 showed rs8007267 is associated with altered endothelial dependent blood flow in females with SCA (8.42% of variation; P = 0.002). The GCH1 pain association is attributable to an African haplotype with where its sickle cell anemia pain association is limited to females (OR 2.69; 95% CI 1.21-5.94; P = 0.01) and has the opposite directional association described in Europeans independent of global admixture. The presence of a GCH1 haplotype with high BH4 in populations of African ancestry could explain the association of rs8007267 with sickle cell anemia pain crises. The vascular effects of GCH1 and BH4 may also have broader implications for cardiovascular disease in populations of African ancestry. PMID:24136375

  4. Are age-related differences between young and older adults in an affective working memory test sensitive to the music effects?

    Science.gov (United States)

    Borella, Erika; Carretti, Barbara; Grassi, Massimo; Nucci, Massimo; Sciore, Roberta

    2014-01-01

    There are evidences showing that music can affect cognitive performance by improving our emotional state. The aim of the current study was to analyze whether age-related differences between young and older adults in a Working Memory (WM) Span test in which the stimuli to be recalled have a different valence (i.e., neutral, positive, or negative words), are sensitive to exposure to music. Because some previous studies showed that emotional words can sustain older adults' performance in WM, we examined whether listening to music could enhance the benefit of emotional material, with respect to neutral words, on WM performance decreasing the age-related difference between younger and older adults. In particular, the effect of two types of music (Mozart vs. Albinoni), which differ in tempo, arousal and mood induction, on age-related differences in an affective version of the Operation WM Span task was analyzed. Results showed no effect of music on the WM test regardless of the emotional content of the music (Mozart vs. Albinoni). However, a valence effect for the words in the WM task was found with a higher number of negative words recalled with respect to positive and neutral ones in both younger and older adults. When individual differences in terms of accuracy in the processing phase of the Operation Span task were considered, only younger low-performing participants were affected by the type music, with the Albinoni condition that lowered their performance with respect to the Mozart condition. Such a result suggests that individual differences in WM performance, at least when young adults are considered, could be affected by the type of music. Altogether, these findings suggest that complex span tasks, such as WM tasks, along with age-related differences are not sensitive to music effects.

  5. Are age-related differences between young and older adults in an affective working memory test sensitive to the music effects?

    Science.gov (United States)

    Borella, Erika; Carretti, Barbara; Grassi, Massimo; Nucci, Massimo; Sciore, Roberta

    2014-01-01

    There are evidences showing that music can affect cognitive performance by improving our emotional state. The aim of the current study was to analyze whether age-related differences between young and older adults in a Working Memory (WM) Span test in which the stimuli to be recalled have a different valence (i.e., neutral, positive, or negative words), are sensitive to exposure to music. Because some previous studies showed that emotional words can sustain older adults' performance in WM, we examined whether listening to music could enhance the benefit of emotional material, with respect to neutral words, on WM performance decreasing the age-related difference between younger and older adults. In particular, the effect of two types of music (Mozart vs. Albinoni), which differ in tempo, arousal and mood induction, on age-related differences in an affective version of the Operation WM Span task was analyzed. Results showed no effect of music on the WM test regardless of the emotional content of the music (Mozart vs. Albinoni). However, a valence effect for the words in the WM task was found with a higher number of negative words recalled with respect to positive and neutral ones in both younger and older adults. When individual differences in terms of accuracy in the processing phase of the Operation Span task were considered, only younger low-performing participants were affected by the type music, with the Albinoni condition that lowered their performance with respect to the Mozart condition. Such a result suggests that individual differences in WM performance, at least when young adults are considered, could be affected by the type of music. Altogether, these findings suggest that complex span tasks, such as WM tasks, along with age-related differences are not sensitive to music effects. PMID:25426064

  6. Pharmacological pain management in the elderly patient

    Directory of Open Access Journals (Sweden)

    Gary McCleane

    2007-01-01

    Full Text Available Gary McCleaneRampark Pain Centre, Lurgan, Northern Ireland, United KingdomAbstract: With the increasing number of elderly patients the issue of pain management for older people is of increasing relevance. The alterations with aging of the neurobiology of pain have impacts of pain threshold, tolerance and treatment. In this review the available evidence from animal and human experimentation is discussed to highlight the differences between young and older subjects along with consideration of how these changes have practical effect on drug treatment of pain. Cognitive impairment, physical disability and social isolation can also impact on the accessibility of treatment and have to be considered along with the biological changes with ageing. Conventional pain therapies, while verified in younger adults cannot be automatically applied to the elderly without consideration of all these factors and in no other group of patients is a holistic approach to treatment more important.Keywords: pain, analgesia, pain threshold, pain tolerance

  7. Pain genes.

    Directory of Open Access Journals (Sweden)

    Tom Foulkes

    2008-07-01

    Full Text Available Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors signal the existence of tissue damage to the central nervous system (CNS, where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating pain pathways using model organisms have identified the molecular nature of the transducers, regulatory mechanisms involved in changing neuronal activity, as well as the critical role of immune system cells in driving pain pathways. In man, mapping of human pain mutants as well as twin studies and association studies of altered pain behaviour have identified important regulators of the pain system. In turn, new drug targets for chronic pain treatment have been validated in transgenic mouse studies. Thus, genetic studies of pain pathways have complemented the traditional neuroscience approaches of electrophysiology and pharmacology to give us fresh insights into the molecular basis of pain perception.

  8. Musculoskeletal Pain as a Marker of Health Quality. Findings from the Epidemiological Sleep Study among the Adult Population of Sao Paulo City.

    Directory of Open Access Journals (Sweden)

    Suely Roizenblatt

    Full Text Available We are witnessing the growth of urban populations, particularly in the developing world. São Paulo, the largest city in South America, continues to grow, and this growth is dramatically effecting the environment and human health. The aim of this study was to estimate the point prevalence of chronic pain in São Paulo city dwellers and to explore the influence of aspects related to urbanicity.A two-stage cluster randomized sample included 1100 individuals of the city of Sao Paulo, representing the population proportionally in terms of gender, age and social classes in 2007. For this observational cross-sectional study, the household sample was interviewed using validated questionnaires for sociodemographic aspects, the Beck inventories for anxiety and depression, the WHOQoL-REF for quality of life, the Chalder Fatigue Scale. Musculoskeletal pain was defined as diffuse pain or pain located in the back, joints or limbs. Data regarding sleep complaints and polysomnography were obtained from the Epidemiologic Sleep Study conducted in São Paulo city in 2007.The prevalence estimate of chronic musculoskeletal pain was approximately 27%, with a female/male ratio of approximately 2.6/1. The predictors were being in the age-range of 30-39 years, low socioeconomic and schooling levels, obesity, sedentarism, fatigue, non-restorative sleep, daytime sleepiness, poor sleep quality, poor life quality, anxiety and depression symptoms. Psychological wellbeing was the main discriminator between responders with chronic musculoskeletal pain and the controls, followed by depression for the participants with poor psychological wellbeing, and fatigue, for the remaining ones. Insomnia syndrome was the third-level discriminator for those with fatigue, whereas sleep quality for those without fatigue.Musculoskeletal pain was frequently reported by São Paulo city dwellers and its correlates with psychological and sleep aspects are suggestive of a response to urbanicity

  9. Reliability and concurrent validity of visual analogue scale and modified verbal rating scale of pain assessment in adult patients with knee osteoathritis in Nigeria

    Directory of Open Access Journals (Sweden)

    M. O.B Olaogun

    2003-02-01

    Full Text Available The objective of this study was to determine the reliability and concurrent validity of two pain rating scales - Visual Analogue Scale (VAS and Verbal Rating Scale (VRS. The verbal rating scale was modified by translating the English description of subjective pain experience into vernacular (Yoruba equivalents and rating the knee pain when the patient was  standing with the knee  flexed . Twenty seven patients who were clinically and radiologically diagnosed with osteoarthritis (OA and with knee pain were purposively selected for the study. Two testers (physiotherapists independently rated the pain experienced by patients, when bearing full weight while standing on the affected leg with slight knee flexion, over a period of several days. For each patient pain was rated with the VAS and the modified VRS (MVRS. There were significant correlations between VAS and MVRS by the same tester (tester 1 and tester2 (r=0.92, p<0.01; r = 0.89,            p<0.01respectively, and between VAS and MVRS between tester 1 and tester 2 (r=0.91,p<0.01. There were no significant differences between VAS for tester 1 and VAS for tester 2, and between MVRS for tester 1and MVRS for tester 2 (p> 0.01.  According to this study, the two pain rating scales for knee OA are reliable. Our use of VAS and MVRS togetherwith the procedure involving the flexed knee posture is, therefore, recommended for wider clinical trials.

  10. Effects of neonatal peripheral tissue injury on pain-related behaviors in adult rats%生后发育期外周组织损伤对大鼠成年后痛行为的影响

    Institute of Scientific and Technical Information of China (English)

    李萌萌; 唐家广; 刘瑛辉; 解葵; 郝建华; 陈军

    2013-01-01

    Objective To observe the effects of peripheral tissue injury in the developmental stage of newborn rats on pain-related behaviors in adult rats.Methods SD rats 1,4,7,14,21 and 28 days after birth were selected in the present study (4 litters at each time point and 10 rats per litter).Each litter of rats was randomly divided into injury group (receiving subcutaneous injection of 20μl bee venom) and control group (receiving subcutaneous injection of 20μl normal saline),with 20 in each group,and then raised for 2 months to adulthood.The baseline pain threshold was observed by measuring spontaneous paw flinching reflex,paw withdrawal thermal latency (PWTL) and paw withdrawal mechanical threshold (PWMT),then 50μl 0.4% bee venom was subcutaneously injected to each rat,and the changes in pain reaction and pain threshold were determined.Results The baseline thermal pain threshold in adult rats receiving bee venom or normal saline at different time points after birth was similar,but baseline mechanical pain threshold in adult rats receiving bee venom at 1,4,7 and 14 days after birth was decreased significantly compared with the adult rats receiving normal saline at corresponding time points(P<0.01).The persistent spontaneous pain response of adult rats in injury group was increased compared with that in control group (P<0.01).No obvious difference in heat hyperalgesia was found between the two groups (P>0.05).Mechanical hyperalgesia was not induced in rats injected with bee venom but induced in adult rats injected with normal saline 4-21 days after birth.Injection of bee venom 21 and 28 days after birth could obviously enhance the bee venom-induced hyperalgesia in adult rats compared with control group (P<0.01).Conclusions Bee venom stimuli at different time points after birth could affect the baseline PWMT and mechanical pain hypersensitivity in adult rats but not the baseline PWTL and thermal pain hypersensitivity.The 21st day maybe a key time point of

  11. The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi.

    Directory of Open Access Journals (Sweden)

    Marriott Nliwasa

    Full Text Available Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence.To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy.Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard, and costs were estimated.Of 273 adults recruited, 44.3% (121/273 were HIV-positive and 19.4% (53/273 had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4% with 100% (95% CI: 98.0% to 100% specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2% was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8% was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98; this was lower than Xpert® MTB/RIF (US$ 13.38 but higher than fluorescence smear microscopy (US$ 0.65.The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis.

  12. The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi

    Science.gov (United States)

    Nliwasa, Marriott; MacPherson, Peter; Chisala, Palesa; Kamdolozi, Mercy; Khundi, McEwen; Kaswaswa, Kruger; Mwapasa, Mphatso; Msefula, Chisomo; Sohn, Hojoon; Flach, Clare; Corbett, Elizabeth L.

    2016-01-01

    Background Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence. Objective To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy. Methods Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated. Results Of 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65). Conclusion The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis. PMID:27171380

  13. Chronic widespread pain in the spectrum of rheumatological diseases.

    Science.gov (United States)

    Bliddal, Henning; Danneskiold-Samsøe, Bente

    2007-06-01

    Chronic pain is very common in all European countries, with musculoskeletal problems predominating. About 1% of the adult population develops a syndrome of chronic muscle pain, fibromyalgia (FMS), characterized by multiple tender points, back or neck pain, and a number of associated problems from other organs, including a high frequency of fatigue. Evidence points to central sensitization as an important neurophysiological aberration in the development of FMS. Importantly, these neurological changes may result from inadequately treated chronic focal pain problems such as osteoarthritis or myofascial pain. It is important for health professionals to be aware of this syndrome and to diagnose the patients to avoid a steady increase in diagnostic tests. On the other hand, patients with chronic widespread pain have an increased risk of developing malignancies, and new or changed symptoms should be diagnosed even in FMS. In rheumatology practice it is especially important to be aware of the existence of FMS in association with immune inflammatory diseases, most commonly lupus and rheumatoid arthritis. Differential diagnoses are other causes of chronic pain, e.g. thyroid disease. The costs of this syndrome are substantial due to loss of working capability and direct expenses of medication and health-system usage. Fibromyalgia patients need recognition of their pain syndrome if they are to comply with treatment. Lack of empathy and understanding by healthcare professionals often leads to patient frustration and inappropriate illness behavior, often associated with some exaggeration of symptoms in an effort to gain some legitimacy for their problem. FMS is multifaceted, and treatment consists of both medical interventions, with emphasis on agents acting on the central nervous system, and physical exercises.

  14. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hansen Inge

    2011-12-01

    Full Text Available Abstract Background Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. Methods/Design The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control group or a combined pain management and training (interventiongroup. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36, Physical Component Summary (PCS. Secondary outcomes will be Global Perceived Effect (-5 to +5, Neck Disability Index (0-50, Patient Specific Functioning Scale (0-10, numeric rating scale for pain bothersomeness (0-10, SF-36 Mental Component Summary (MCS, TAMPA scale of Kinesiophobia (17-68, Impact of Event Scale (0-45, EuroQol (0

  15. The sensitization of a broad spectrum of sensory nerve fibers in a rat model of acute postoperative pain and its response to intrathecal pharmacotherapy

    OpenAIRE

    Nagakura, Yukinori; Jones, Toni L.; Malkmus, Shelle A.; Sorkin, Linda; Yaksh, Tony L.

    2008-01-01

    Further understanding of pathophysiology of postoperative acute pain is necessary for its better management. The methodology of current threshold (CT) determination by using sine-wave stimuli at 3 frequencies has been used to selectively and quantitatively analyze the function of the subsets of fibers (i.e., frequency of 5, 250, and 2000 Hz recruits C-, Aδ-, and Aβ-fibers, respectively). The present study investigated how surgical incision would affect the CTs, and then assessed the efficacy ...

  16. Low back pain - chronic

    Science.gov (United States)

    Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... Low back pain is common. Almost everyone has back pain at some time in their life. Often, the exact cause ...

  17. The scars of childhood adversity : minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients

    NARCIS (Netherlands)

    Kok, Gemma; van Rijsbergen, Gerard; Burger, Huibert; Elgersma, Hermien; Riper, Heleen; Cuijpers, Pim; Dekker, Jack; Smit, Filip; Bockting, Claudi

    2014-01-01

    BACKGROUND: Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily) stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stre

  18. Autoantibody pain.

    Science.gov (United States)

    Goebel, Andreas

    2016-06-01

    As autoantibodies bind to target tissues, Fc-region dependent inflammation can induce pain via mediators exciting nociceptors. But recently another possibility has emerged, where autoantibody binding to nociceptors can directly cause pain, without inflammation. This is thought to occur as a result of Fab-region mediated modification of nerve transduction, transmission, or neuropeptide release. In