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Central pain syndrome

Maciej Salaga, Agata Binienda, Ritesh B Tichkule, Ganesh A Thakur, Alexandros Makriyannis, Martin Storr, Jakub Fichna
The endocannabinoid system (ECS) plays a crucial role in numerous physiological processes in the central and peripheral nervous systems. In the gastrointestinal (GI) tract, selective cannabinoid (CB) receptor agonists exert potent inhibitory actions on motility and pain signalling. In the present study, we used mouse models of diarrhea, hypermotility, and abdominal pain to examine whether a novel synthetic CB1 receptor agonist AM9405 [(2-(2,6-dihydroxy-4-(2-methyloctan-2-yl)phenyl)-1,3-dimethyl-1H-benzo[d]imidazol-3-ium bromide); also known as GAT379] exhibits effects of potential therapeutic relevance...
August 16, 2018: European Journal of Pharmacology
Carlos Alberto Velasco-Benítez, Ricardo Chanís, Edgar Játiva, Roberto Zablah, Milton Mejía, Laura Rodriguez Reynosa, Sofia Araceli Leyva Jimenez
INTRODUCTION: Few pediatric studies classify the irritable bowel syndrome (IBS) subtypes. OBJECTIVE: To describe the characteristics and subtypes of IBS in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico. MATERIAL AND METHODS: Prevalence study performed in children between 8 and 18 years of age with a diagnosis of IBS. The children answered the Questionnaire for Pediatric Gastrointestinal Symptoms Roma III for Schoolchildren and Adolescents (QPGS-III) to identify functional gastrointestinal disorders...
April 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
T Tuna, L Van Obbergh, N Van Cutsem, E Engelman
BACKGROUND: Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS: We compared three populations: healthy (HS, n=280), with acute pain (AP=110 patients), and chronic pain (CP=280 patients) by assessing their pain behaviour with the pain sensitivity questionnaire (PSQ-total and PSQ-minor)...
September 2018: British Journal of Anaesthesia
D Yap, M Ng, N Mbakada
Small bowel obstruction is the most common surgical emergency after a patient has had abdominal surgery. However, Boerhaave syndrome secondary to an ileostomy obstruction has not been reported in current literature. We present a rare case of two concurrent surgical emergencies in a patient with Boerhaave syndrome and small bowel obstruction. A 38-year-old woman presented with sudden onset severe central chest pain associated with breathlessness. She had a history of Crohn's disease, which had been treated with pancolectomy and ileostomy...
August 16, 2018: Annals of the Royal College of Surgeons of England
Amir Awwad, Renan E Ibrahem Adam, Chandni Patel, James D Thomas
Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration. Case presentation: An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms...
2018: Spinal Cord Series and Cases
Seok Mei Lim, Beatrix Wong, Gail Brenda Cross, Reshma Merchant
An 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquaculture pathogen which typically affects elderly and immunocompromised patients...
2018: IDCases
Francesco Brigo, Alberto Vogrig, Arianna Bratti, Veronica Tavernelli, Raffaele Nardone, Eugen Trinka
Epilepsia partialis continua (EPC) is a rare form of focal status epilepticus. We describe a 22-year-old woman with EPC manifesting with isolated toe movements, prevalent over the left side and initially misdiagnosed as psychogenic, clinically almost indistinguishable from those observed in "painful legs and moving toes syndrome". The continuous involuntary movements with EMG correlates of twitches lasting <100 ms, the sharp waves over fronto-central regions on EEG, and the marked asymmetry in somatosensory evoked potentials with higher cortical amplitude over the right side following peripheral stimulation over the left foot confirmed the epileptic nature of the symptoms, leading to the diagnosis of EPC...
August 10, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
Leidiane Mazzardo-Martins, Daiana Cristina Salm, Elisa C Winkelmann-Duarte, Júlia Koerich Ferreira, Daniela Dero Lüdtke, Kamilla Pamplona Frech, Luiz Augusto Oliveira Belmonte, Verônica Vargas Horewicz, Anna Paula Piovezan, Francisco José Cidra-Filho, Ari Ojeda Ocampo Moré, Daniel Fernandes Martins
Complex regional pain syndrome (CRPS) is a disorder that involves abnormal inflammation and nerve dysfunction frequently resistant to a broad range of treatments. Peripheral nerve stimulation with electroacupuncture (EA) has been widely used in different clinical conditions to control pain and inflammation; however, the use of EA in the treatment of CRPS is under investigation. In this study, we explore the effects of EA on hyperalgesia and edema induced in an animal model of chronic post-ischemia pain (CPIP model) and the possible involvement of endothelin receptor type B (ETB ) in this effect...
August 10, 2018: Pflügers Archiv: European Journal of Physiology
Laurent Misery, Henri Duboc, Benoit Coffin, Emilie Brenaut, Flavien Huet, Charles Taieb
BACKGROUND: Irritable bowel and sensitive skin syndromes are common painful conditions that are poorly understood, with alterations of the peripheral (and possibly central) nervous system that lead to a lowering of perception thresholds as the main pathophysiological mechanism. METHODS: A cross-sectional epidemiological study was carried out on a representative sample of French people, according to the quota method using a questionnaire. RESULTS: Among the 5000 respondents, 48...
August 3, 2018: European Journal of Pain: EJP
Ling Yue, Min Chen, Tai-Chun Tang, Tian-Wei She, Yao-Yao Chen, Hui Zheng
BACKGROUND: Several pharmacological treatments are recommended by guidelines with moderate to high evidence for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), but the comparative effectiveness and safety among these treatments are unknown. The review is to assess the comparative effectiveness and safety of pharmacological treatments for IBS-D using network meta-analysis. METHODS: We will search Ovid Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant randomized controlled trials (RCTs) that compare guideline-recommended pharmacological treatments with placebo or one of the treatments...
August 2018: Medicine (Baltimore)
Yu Zhang, Ziqing Li, Fan Han
BACKGROUND: Irritable bowel syndrome (IBS) is a common functional intestinal disease characterized by chronic or recurrent abdominal pain, abdominal distension, constipation and diarrhea. Many IBS sufferers are usually present with poor quality of life for the abdominal discomfort, diarrhea, constipation, and other complaints. At present, the commonly used drug therapy for IBS in the Western clinic, such as antidiarrheal, laxative, gastrointestinal antispasmodic, often cannot get satisfying curative effect...
August 2018: Medicine (Baltimore)
Raphael Twerenbold, Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Mahir Karakas, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Maria Rubini Giménez, Christian Puelacher, Karin Wildi, Nikola Kozhuharov, Dominik Breitenbuecher, Ewelina Biskup, Jeanne du Fay de Lavallaz, Dayana Flores, Desiree Wussler, Òscar Miró, F Javier Martín Sánchez, Beata Morawiec, Jiri Parenica, Nicolas Geigy, Dagmar I Keller, Tanja Zeller, Tobias Reichlin, Stefan Blankenberg, Dirk Westermann, Christian Mueller
BACKGROUND: The safety of the European Society of Cardiology (ESC) 0/1-h algorithm for rapid rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) using high-sensitivity cardiac troponin (hs-cTn) has been questioned. OBJECTIVES: This study aimed to validate the diagnostic performance of the 0/1-h algorithm in a large multicenter study. METHODS: The authors prospectively enrolled unselected patients in 6 countries presenting to the emergency department with symptoms suggestive of NSTEMI...
August 7, 2018: Journal of the American College of Cardiology
Carmen M Galvez-Sánchez, Cristina Muñoz Ladrón de Guevara, Casandra I Montoro, María José Fernández-Serrano, Stefan Duschek, Gustavo A Reyes Del Paso
BACKGROUND: Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread musculoskeletal pain and diffuse tenderness, accompanied by complaints including morning stiffness, fatigue, insomnia and affective symptoms. In addition, affected patients frequently experience cognitive impairments such as concentration difficulties, forgetfulness or problems in planning and decision-making. These deficits are commonly ascribed to interference between nociceptive and cognitive processing...
2018: PloS One
Ugo Bottoni, Stefania Tamburrini, Elisabetta Scali, Stefano Dastoli, Giuseppe Fabrizio Amoruso, Giovanni Paolino, Elisa Moliterni, Teresa Grieco, Guglielmo Pranteda, Stefano Calvieri
Hand eczema is a chronic disease (1), commonly considered the expression of a contact allergic or irritative dermatitis. However, when the prick/patch tests and laboratory investigations are negative, important diagnostic challenges may arise. Peripheral nerve fibers are in fact capable of releasing neuromediators. Thus, an alteration of the central and/or peripheral nervous system can cause the exacerbation as well as the onset of a cutaneous disease (2). From September 1, 2013 to August 31, 2015, we observed 5 female patients between 20 and 40 years old, with particular hand dermatitis lesions on the volar area, unilateral on the right hand in 3 patients and bilateral in 2 patients...
December 2017: Acta Dermatovenerologica Croatica: ADC
B Pradier, H B Shin, D S Kim, R St Laurent, D Lipscombe, J A Kauer
The peripheral trigeminovascular pathway mediates oro- and craniofacial pain and projects centrally to the brainstem trigeminal nucleus caudalis (TNc). Sensitization of this pathway is involved in many pain conditions, but little is known about synaptic plasticity at its first central synapse. We have taken advantage of optogenetics to investigate plasticity selectively evoked at synapses of nociceptive primary afferents onto TNc neurons. Based on immuno-labeling in the trigeminal ganglia, TRPV1-lineage neurons comprise primarily peptidergic and non-peptidergic nociceptors...
July 27, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
B Delpont, C Blanc, G V Osseby, M Hervieu-Bègue, M Giroud, Y Béjot
Pain after stroke (PAS) is a common clinical problem that is both underdiagnosed and undertreated. Yet, it induces depression and cognitive troubles, and impairs quality of life. To provide tools for practitioners, this report describes the most common PAS syndromes, including central post-stroke pain, spasticity and contractures, shoulder pain and complex regional pain syndromes, as well as headache and chondrocalcinosis, along with their risk factors, their prevention and their specific treatments. In addition, to ensure that the compulsory post-stroke clinical assessment in France is optimal, it is recommended that clinicians be trained in how to diagnose and treat PAS, and even to prevent it by early identification of at-risk patients, with the aim to improve patients' motor and cognitive functions and quality of life...
July 24, 2018: Revue Neurologique
Shi-Cheng Zheng, Hui Gong, Yi-Ping Wang, Qiang Zhang, Li-Li Wang, Xue-Fen Liao, Dai-Wen He, Jing Wu
BACKGROUND: Stress is a common contributing factor for irritable bowel syndrome (IBS). This study was to evaluate the efficacy of the centralized health education program in improving the quality of life (QOL) of middle school students with IBS who experienced the Wenchuan earthquake on May 12, 2008. METHODS: A multi-center, randomized and open evaluation study design was adopted. A total of 584 students who met the Rome III criteria for IBS in four middle schools were identified...
July 27, 2018: BMC Gastroenterology
Joanna Dionne, Alexander C Ford, Yuhong Yuan, William D Chey, Brian E Lacy, Yuri A Saito, Eamonn M M Quigley, Paul Moayyedi
OBJECTIVE: Dietary triggers such as gluten and highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP)-containing foods have been associated with worsening irritable bowel syndrome (IBS) symptoms. However, the true impact of dietary restriction on IBS symptoms has remained unclear. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the efficacy of exclusion diets (we focused on low FODMAP and gluten-free diets (GFD)) in IBS...
July 26, 2018: American Journal of Gastroenterology
Olivier T Lam, Jean-Pierre Dumas, Corey B Simon, Yannick Tousignant-Laflamme
Background: Mechanical diagnosis and therapy (MDT) aims to assess and classify patients into theoretically mutually exclusive subgroups, in order to direct treatment. However, the latest evidence for biopsychosocial influence-central sensitization (CS) and psychological distress-have not been assessed in conjunction with MDT. Objectives: (1) Determine the percentage of patients categorized into the MDT subgroups; (2) characterize the biopsychosocial clinical profile (presence of CS and psychological distress); and (3) identify associations between pain, disability, and biopsychosocial influences among this cohort...
July 2018: Journal of Manual & Manipulative Therapy
Young Hak Roh, Sangwoo Kim, Hyun Sik Gong, Goo Hyun Baek
Patients with carpal tunnel syndrome (CTS) often show bilaterally increased pain sensitivity and widespread symptoms. We evaluated the influence of centrally mediated symptoms on functional outcomes of carpal tunnel release (CTR). A total of 120 patients with surgically treated CTS were enrolled. Centrally mediated symptoms were preoperatively measured by administering a self-reported central sensitization inventory (CSI) questionnaire and peripheral sensitization was measured by assessing patient's pressure pain thresholds (PPT) in the forearm...
July 24, 2018: Scientific Reports
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