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Complex Regional Pain Syndrome (CRPS)

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https://www.readbyqxmd.com/read/28716513/update-in-the-treatment-of-chronic-pain-within-pediatric-patients
#1
Jeffrey Rabin, Mackenzie Brown, Sean Alexander
Pediatric chronic pain is a challenging entity to evaluate and treat as it encompasses a wide variety of presentations often with overlapping psychosocial implications. Chronic pain may have significant effects upon a child's involvement in academic, athletic, and social participation. If unrecognized, it may have deleterious effects upon family interactions and stability. The treatment of pediatric chronic pain is focused on not only providing analgesia, but also on assisting the child and family with reintegrating into a more functional lifestyle...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28715350/a-prospective-multisite-international-validation-of-the-complex-regional-pain-syndrome-severity-score
#2
R Norman Harden, Christian Maihofner, Elias Abousaad, Jean-Jacques Vatine, Amy Kirsling, Roberto S G M Perez, Maxine Kuroda, Florian Brunner, Michael Stanton-Hicks, Johan Marinus, Jacobus J van Hilten, Sean Mackey, Frank Birklein, Tanja Schlereth, Angela Mailis-Gagnon, Joe Graciosa, Sara B Connoly, David Dayanim, Michael Massey, Hadas Frank, Anatoly Livshitz, Stephen Bruehl
Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity...
August 2017: Pain
https://www.readbyqxmd.com/read/28713977/analysis-of-gene-expression-profile-microarray-data-in-complex-regional-pain-syndrome
#3
Wulin Tan, Yiyan Song, Chengqiang Mo, Shuangjian Jiang, Zhongxing Wang
The aim of the present study was to predict key genes and proteins associated with complex regional pain syndrome (CRPS) using bioinformatics analysis. The gene expression profiling microarray data, GSE47603, which included peripheral blood samples from 4 patients with CRPS and 5 healthy controls, was obtained from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) in CRPS patients compared with healthy controls were identified using the GEO2R online tool. Functional enrichment analysis was then performed using The Database for Annotation Visualization and Integrated Discovery online tool...
July 12, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28700507/pramipexole-induced-limb-dystonia-and-its-associated-complex-regional-pain-syndrome-in-idiopathic-parkinson-s-disease-a-case-report
#4
Donghwi Park
RATIONALE: This case may be due to basal ganglia dysfunction, which was probably caused by abnormal activation of dopamine 1-like receptor (D1R) boosted by pramipexole binding on dopamine 3-like receptor (D3R) in a situation where D3R was overexpressed by the chronic treatment of L-dopa. PATIENT CONCERNS: Striatal hand and foot deformities. DIAGNOSES: Striatal hand and foot deformities with CRPS. INTERVENTIONS: Steroid treatemnt and withdrawal of the pramipexole...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28692702/impaired-insula-functional-connectivity-associated-with-persistent-pain-perception-in-patients-with-complex-regional-pain-syndrome
#5
Jae-Hun Kim, Soo-Hee Choi, Joon Hwan Jang, Do-Hyeong Lee, Kyung-Jun Lee, Won Joon Lee, Jee Youn Moon, Yong Chul Kim, Do-Hyung Kang
Given that the insula plays a contributory role in the perception of chronic pain, we examined the resting-state functional connectivity between the insular cortex and other brain regions to investigate neural underpinnings of persisting perception of background pain in patients with complex regional pain syndrome (CRPS). A total of 25 patients with CRPS and 25 matched healthy controls underwent functional magnetic resonance imaging at rest. With the anterior and posterior insular cortices as seed regions, we compared the strength of the resting-state functional connectivity between the two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28691512/the-incidence-of-complex-regional-pain-syndrome-in-simultaneous-surgical-treatment-of-carpal-tunnel-syndrome-and-dupuytren-contracture
#6
Mitchell Buller, Steven Schulz, Morton Kasdan, Bradon J Wilhelmi
BACKGROUND: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. METHODS: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28691184/risk-factors-for-post-treatment-complex-regional-pain-syndrome-crps-an-analysis-of-647-cases-of-crps-from-the-danish-patient-compensation-association
#7
Pelle B Petersen, Kim L Mikkelsen, Jes B Lauritzen, Michael R Krogsgaard
OBJECTIVES: Complex regional pain syndrome is a challenging condition including a broad spectrum of sensory, autonomic and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with CRPS following orthopedic treatment. The present study aimed to identify factors associated with post-treatment development of CRPS. METHODS: Using the Danish Patient Compensation Association's (DPCA) database we identified 647 patients claiming post-treatment CRPS, between 1992 and 2015...
July 10, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28670058/management-of-complex-regional-pain-syndrome
#8
Jason Chung-Chieh Lo, Joel Cavazos, Christopher Burnett
Complex regional pain syndrome (CRPS) is a relatively rare, chronic, and debilitating condition that significantly impacts the patient's quality of life. There is an overall paucity of literature addressing the management of CRPS in immunocompromised patients. We define features of CRPS, outline its treatment options, and describe a course of CRPS management for a 35-year-old patient who had heart transplantation requiring immunosuppressive medications.
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28656207/expression-of-granulocyte-colony-stimulating-factor-3-receptor-in-the-spinal-dorsal-horn-following-spinal-nerve-ligation-induced-neuropathic-pain
#9
Enji Zhang, Sunyeul Lee, Min-Hee Yi, Yongshan Nan, Yinshi Xu, Nara Shin, Youngkwon Ko, Young Ho Lee, Wonhyung Lee, Dong Woon Kim
In previous studies that have profiled gene expression in patients with complex regional pain syndrome (CRPS), the expression of granulocyte colony-stimulating factor 3 receptor (G‑CSFR) was elevated, as were a number of pain‑associated genes. The present study determined the expression of G‑CSFR and the mechanisms by which it may affect hypersensitivity, focusing on the signal transducer and activator of transcription 3 (STAT3)/transient receptor potential cation channel subfamily V 1 (TRPV1) signaling pathway in particular, which is an important mediator of pain...
August 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28654557/the-effectiveness-of-transcranial-direct-current-stimulation-as-an-add-on-modality-to-graded-motor-imagery-for-treatment-of-complex-regional-pain-syndrome-a-randomized-proof-of-concept-study
#10
Émilie Lagueux, Michaël Bernier, Patricia Bourgault, Kevin Whittingstall, Catherine Mercier, Guillaume Léonard, Sarah Laroche, Yannick Tousignant-Laflamme
BACKGROUND: The efficacy of graded motor imagery (GMI) for the management of complex regional pain syndrome (CRPS) is supported by evidence, but its treatment effect remains generally modest. Transcranial direct current stimulation (tDCS) has been advocated as an adjunct intervention to enhance the effect of motor imagery approaches in pain populations. OBJECTIVE: The purpose of this study was to investigate the effectiveness of GMI+active tDCS compared to the GMI+sham tDCS in the treatment of CRPS type I...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28638948/does-socioeconomic-status-influence-the-epidemiology-and-outcome-of-distal-radial-fractures-in-adults
#11
N D Clement, A D Duckworth, N R Wickramasinghe, C M Court-Brown, M M McQueen
PURPOSE: The aim of this study in adult patients with a distal radial fracture was to determine whether socioeconomic status influenced the epidemiology, mechanism of injury, fracture severity, or the outcome according to function, radiographic assessment, and rate of associated complications. METHODS: We identified 3983 distal radial fractures over a 7-year period. Socioeconomic status was assigned using the Carstairs score, and the population was divided into quintiles depending on deprivation...
June 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28638296/ultrasound-guided-percutaneous-cervical-and-upper-thoracic-sympathetic-chain-neuromodulation-for-upper-extremity-complex-regional-pain-syndrome
#12
Samer Narouze, Dmitri Souzdalnitski
BACKGROUND: Complex regional pain syndrome (CRPS) comprises a group of conditions characterized by severe, debilitating pain that is disproportionate to any inciting event and is not distributed in a specific nerve distribution or dermatome. CASE REPORT: A 42-year-old female with a 2-year history of right upper extremity CRPS type I refractory to conventional management underwent an ultrasound-guided and fluoroscopy confirmed percutaneous peripheral nerve stimulation trial with a lead extending from the C6 to the T3 level to cover the cervical and upper thoracic sympathetic chain...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28634419/elevated-plasma-levels-of-sil-2r-in-complex-regional-pain-syndrome-a-pathogenic-role-for-t-lymphocytes
#13
Krishna D Bharwani, Maaike Dirckx, Dirk L Stronks, Willem A Dik, Marco W J Schreurs, Frank J P M Huygen
The immune system has long been thought to be involved in the pathophysiology of complex regional pain syndrome (CRPS). However, not much is known about the role of the immune system and specifically T-cells in the onset and maintenance of this disease. In this study, we aimed to evaluate T-cell activity in CRPS by comparing blood soluble interleukin-2 receptor (sIL-2R) levels between CRPS patients and healthy controls. CRPS patients had statistically significant elevated levels of sIL-2R as compared to healthy controls (median sIL-2R levels: 4151 pg/ml (Q3 - Q1 = 5731 pg/ml - 3546 pg/ml) versus 1907 pg/ml (Q3 - Q1: 2206 pg/ml - 1374 pg/ml), p < 0...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28621025/dorsal-root-ganglion-stimulation-as-a-salvage-treatment-for-complex-regional-pain-syndrome-refractory-to-dorsal-column-spinal-cord-stimulation-a-case-series
#14
Ajax Yang, Corey W Hunter
OBJECTIVE: The efficacy of traditional spinal cord stimulation (t-SCS) tends to decay over time in patients with complex regional pain syndrome (CRPS). While it has been shown that dorsal root ganglion (DRG) stimulation is extremely effective in t-SCS-naïve patients with CRPS, its efficacy in patients who had previously failed t-SCS is unknown. Given that DRG-SCS and t-SCS target different spinal pathways, a failure with t-SCS should not automatically preclude a patient from attempting DRG-SCS...
June 16, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28616655/-cognitive-perceptive-approaches-in-the-treatment-of-chronic-pain
#15
REVIEW
C Storz, H Schulte-Göcking, M Azqueta, C Wania, M Neugebauer, A Reiners, S Azad, E Kraft
In the treatment of difficult chronic pain conditions, cognitive-perceptive approaches offer an alternative to conventional therapies. Especially phantom limb pain and complex regional pain syndrome (CRPS) are frequently treated with these promising modalities. This article provides an overview of the most important cognitive-perceptive therapies and the research results concerning their clinical efficacy. In addition, we discuss their neurobiological foundation and clinical perspectives.
June 14, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28610824/safety-and-perception-what-are-the-greatest-enemies-of-hpv-vaccination-programmes
#16
Paolo Bonanni, Beatrice Zanella, Francesca Santomauro, Chiara Lorini, Angela Bechini, Sara Boccalini
Vaccines stimulate a person's immune system to produce an adequate reaction against a specific infectious agent; i.e. the person is protected from that disease without having to get it first. As vaccines are administrated to healthy subjects, they are held to the highest standards of safety. Regarding human papillomavirus (HPV) vaccines, at present three prophylactic vaccines are licensed (bivalent HPV 16/18, quadrivalent HPV 6/11/16/18 and the nonovalent HPV 6/11/16/18/31/33/45/52/58 vaccine). Pre- and post-licensure studies (i...
June 10, 2017: Vaccine
https://www.readbyqxmd.com/read/28594885/effect-of-a-new-formulation-of-micronized-and-ultramicronized-n-palmitoylethanolamine-in-a-tibia-fracture-mouse-model-of-complex-regional-pain-syndrome
#17
Roberta Fusco, Enrico Gugliandolo, Michela Campolo, Maurizio Evangelista, Rosanna Di Paola, Salvatore Cuzzocrea
Complex regional pain syndrome type 1 (CRPS-I) is a disabling and frequently chronic condition. It involves the extremities and is a frequent consequence of distal tibia and radius fractures. The inflamed appearance of the affected CRPS-I limb suggests that local production of inflammatory mediators may be implicated in the ensuing etiology. A rodent tibia fracture model, characterized by inflammation, chronic unilateral hindlimb warmth, edema, protein extravasation, allodynia and hyperalgesia resembles the clinical features of patients with acute CRPS-I...
2017: PloS One
https://www.readbyqxmd.com/read/28573699/painful-swelling-after-a-noxious-event-and-the-development-of-complex-regional-pain-syndrome-1-a-one-year-prospective-study
#18
F Brunner, L M Bachmann, R S G M Perez, J Marinus, M M Wertli
BACKGROUND: The timing of diagnosis of complex regional pain syndrome (CRPS) 1 remains a challenge due to the large heterogeneity of clinical presentations. We describe the distribution and differences in outcomes and clinical manifestations between time points and patient groups with and without CRPS 1 following an initiating event. METHODS: Prospective cohort study with a consecutive registration of patients presenting with painful swelling of the affected extremity after an initiating event and follow-up visits after 3, 6 and 12 months...
June 2, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28552760/denervation-of-the-wrist%C3%A2-with-two-surgical-incisions-is-it-effective-a-review-of-33-patients-with-an-average-of-41months-follow-up
#19
S Delclaux, F Elia, C Bouvet, C Aprédoaei, M Rongières, P Mansat
The goal of wrist denervation is to decrease pain at the wrist, whether caused by an intra- or extra-articular problem or even when the reason for the pain is unknown. It is an alternative to partial or total arthrodesis and proximal row carpectomy. Our hypothesis was that wrist denervation with a two-incision technique was a reliable and efficient way to treat painful degenerative wrists. Thirty-three patients, 48years old on average, were included in this study. Indications were scapholunate advanced collapse (SLAC) in 18 cases, scaphoid nonunion advanced collapse (SNAC) in 10, distal radius fracture sequelae with advanced radiocarpal osteoarthritis in 4, and post-traumatic ulnocarpal impingement in 1 case...
May 25, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28540568/-tibial-pilon-fractures-advoidance-and-therapy-of-complications
#20
REVIEW
Ralph Gaulke, Christian Krettek
Because of the complex fracture morphology and vulnerable soft tissue coverage, fractures of the tibial pilon are difficult to treat. Complications are more common than in bi- or trimalleolar fractures. The surgeon has to know about the special risks of these injuries to avoid complications. Early complications are soft tissue necrosis, persisting fragment dislocations after surgery, loss of reposition and deep wound infection. The surgeon has to be aware of early signs of compartment-syndrome and chronic regional pain syndrome (CRPS)...
May 24, 2017: Der Unfallchirurg
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