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Context pain

Ian Kodish
Youth admitted to pediatric hospitals face a variety of emotional challenges throughout their stay. In addition to feeling compromised by their acute medical condition, managing the requirements imposed by hospital care can intensify the potential for behavioral dysregulation. Even meeting basic behavioral expectations often requires children to be highly vulnerable, uncomfortable, and in pain, having to trust a parade of people routinely delivering aversive interventions, all in the context of overwhelmed caregivers...
August 1, 2018: Pediatric Annals
Pamela Liao, Kathleen Rossini, Roberts Sauls
Lymphedema is a challenging condition that occurs as a complication to many life-limiting medical conditions. It has a number of associated symptoms including pain, functional impairments, and emotional distress. Majority of treatment interventions have been studied and applied outside of the palliative care context. Subcutaneous drainage is a technique that has been used in some case reports for the lower extremity and sacrum with good results. This report describes an adapted technique of subcutaneous drainage for treating upper extremity lymphedema in the palliative setting...
August 13, 2018: American Journal of Hospice & Palliative Care
Annina Seiler, Kyle W Murdock, Christopher P Fagundes
BACKGROUND: Fatigue is a common symptom in stressed individuals. Bereavement is a major life event that has been associated with impaired mental health. Little research has investigated the prevalence of fatigue and its inflammatory correlates in bereaved individuals. OBJECTIVES: To assess fatigue prevalence and its relationship with mental health outcomes and markers of inflammation, as indexed by C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in bereaved individuals...
September 2018: Journal of Psychosomatic Research
Walter Tschugguel
No abstract text is available yet for this article.
September 2018: Journal of Psychosomatic Research
Badii Hmida, Soumaya Boudokhane, Houda Migaou, Amine Kalai, Anis Jellad, Zohra Ben Salah
RATIONALE: Stress fractures of the sacrum and mechanical sacroiliac joint disease can occur not only during pregnancy but also postpartum. Mechanical sacroiliac joint disease is common in patients with low back pain but often misdiagnosed by practitioners. The association of the 2 conditions has not been studied yet. PATIENT CONCERNS: A 37-year-old woman physiatrist presented with 8-week history of persistent low back and left buttock pain that started in the third trimester of her pregnancy...
August 2018: Medicine (Baltimore)
Darsi N Pitchon, Amir C Dayan, Eric S Schwenk, Jaime L Baratta, Eugene R Viscusi
Pain control after orthopedic surgery is challenging. A multimodal approach provides superior analgesia with fewer side effects compared with opioids alone. This approach is particularly useful in light of the current opioid epidemic in the United States. Several new nonopioid agents have emerged into the market in recent years. New agents included in this review are intravenous acetaminophen, intranasal ketorolac, and newer nonsteroidal anti-inflammatory drugs, and the established medications ketamine and gabapentinoids...
September 2018: Anesthesiology Clinics
Ibrahim Almassri, Mohamed Sekkarie
In mid-March 2015, a mother and her teenage daughter and son from Syria presented to a Syrian American Medical Society (SAMS) refugee clinic in the Beqaa Valley in Lebanon with the chief complaints of hair loss together with weakness and numbness of their lower extremities. They reported that on March 1, a military foe of their relative had given him several boxes of Middle Eastern cookies which were consumed by over 20 members of their families and neighbors. Soon after the consumption, most members of the households developed symptoms including abdominal pain, nausea, vomiting, and constipation...
July 2018: Avicenna Journal of Medicine
G Harris-Bridge, L Young, I Handel, M Farish, C Mason, M A Mitchell, M J Haskell
Lameness in dairy cattle is a persistent problem, indicating pain caused by underlying disease states and is associated with reduced milk yields. Digital dermatitis is a common cause of lameness. Thermal imaging is a technique that may facilitate early detection of this disease and has the potential for use in automated detection systems. Previous studies with thermal imaging have imaged either the heels or the coronary band of the foot and typically only used the maximum temperature (Max) value as the outcome measure...
July 2018: Veterinary Journal
Jo-Hao Ho, Edward L Stahl, Cullen L Schmid, Sarah M Scarry, Jeffrey Aubé, Laura M Bohn
Biased agonists of G protein-coupled receptors may present a means to refine receptor signaling in a way that separates side effects from therapeutic properties. Several studies have shown that agonists that activate the κ-opioid receptor (KOR) in a manner that favors G protein coupling over β-arrestin2 recruitment in cell culture may represent a means to treat pain and itch while avoiding sedation and dysphoria. Although it is attractive to speculate that the bias between G protein signaling and β-arrestin2 recruitment is the reason for these divergent behaviors, little evidence has emerged to show that these signaling pathways diverge in the neuronal environment...
August 7, 2018: Science Signaling
Alexandra B Kimball, Thrasivoulos Tzellos, Brian M Calimlim, Henrique D Teixeira, Ziqian Geng, Martin M Okun
Hidradenitis Suppurativa Clinical Response (HiSCR), is a validated tool that has been used to assess the efficacy of adalimumab among patients with hidradenitis suppurativa. We evaluated the clinical meaning of HiSCR by relating it to patient-reported outcomes to give further context to its achievement in a post hoc analysis of integrated data from two phase 3 clinical trials (PIONEER I and II). Pooling placebo and active treatment arms, 39% of patients (245/629) achieved HiSCR at week 12. Irrespective of treatment, significantly (p < 0...
August 7, 2018: Acta Dermato-venereologica
Karleen F Giannitrapani, R Thomas Day, Azin Azarfar, Sangeeta C Ahluwalia, Steven Dobscha, Karl A Lorenz
Objectives: We aimed to understand providers' experiences and preferences regarding several brief pain screening measures. Methods: We collected two waves of data for this analysis. Wave one: We conducted nine focus groups with multidisciplinary Department of Veterans Affairs (VA) providers. Wave two: To understand an emergent theme in wave one, we conducted 15 telephone interviews with prescribing providers where we used a semistructured guide comparing screening measures currently used in VA practices...
July 30, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Magdalena Fresk, Nina Brodin, Wim J Grooten, Conran Joseph, Anna Kiessling
Background: Test Instrument for Profile of Physical Ability (TIPPA) is used in the Swedish sickness certification process for patients with long-term musculoskeletal pain. The aim was to explore the content of TIPPA in the context of work-ability assessments. Methods: The full protocol of TIPPA was linked to the in relation to the International Classification of Functioning, Disability and Health (ICF) and evaluated in relation to the ICF Core Sets for Chronic Widespread Pain (CWP)...
July 30, 2018: European Journal of Public Health
B Emily Esmaili, Kearsley A Stewart, Nestory A Masalu, Kristin M Schroeder
Purpose Palliative care remains an urgent, neglected need in the developing world. Global disparities in end-of-life care for children, such as those with advanced cancers, result from barriers that are complex and largely unstudied. This study describes these barriers at Bugando Medical Center, one of three consultant hospitals in Tanzania, to identify areas for palliative care development suitable to this context. Methods In-depth interviews were conducted with 20 caregivers of pediatric patients with cancer and 14 hospital staff involved in pediatric end-of-life care...
July 2018: Journal of Global Oncology
Mark Salter, Annabel Kenney
Monoamine oxidase inhibitors (MAOIs) are known to cause hypertensive crisis when combined with intake of tyramine, classically found in cheese. We present a case of MAOI-induced hypertensive crisis leading to significant troponin release after soft cheese intake. A 51-year-old lady presented with left-sided chest pain, palpitations and headache in the context of significant hypertension after eating soft cheese. She had a similar episode 2 month prior to this presentation, which resulted in a diagnosis of non-ST elevation myocardial infarction after a troponin of 2768 ng/L (Ref < 17 ng/L) with normal cardiac investigations and CT pulmonary angiogram...
August 6, 2018: Cardiovascular Toxicology
Christoph Thiel, Ines Smit, Vanessa Baier, Henrik Cordes, Brigida Fabry, Lars Mathias Blank, Lars Kuepfer
A quantitative analysis of dose-response relationships is essential in preclinical and clinical drug development in order to optimize drug efficacy and safety, respectively. However, there is a lack of quantitative understanding about the dynamics of pharmacological drug-target interactions in biological systems. In this study, a quantitative systems pharmacology (QSP) approach is applied to quantify the drug efficacy of cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) inhibitors by coupling physiologically based pharmacokinetic models, at the whole-body level, with affected biological networks, at the cellular scale...
2018: NPJ Systems Biology and Applications
Susan S Tavernier, Jia-Wen Guo, Jacqueline Eaton, Jeannine M Brant, Patricia Berry, Susan L Beck
BACKGROUND: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts. AIMS: This paper describes nurse team leaders' perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain. DESIGN: Qualitative descriptive design. SETTING: Interviews took place over the telephone...
August 3, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Frank J P M Huygen, Liong Liem, Harold Nijhuis, William Cusack, Jeffery Kramer
OBJECTIVES: Dorsal root ganglion (DRG) stimulation is a recent neuromodulation option that has delivered safe, effective pain relief for a number of etiologies. This prospective observational study was intended to establish the effectiveness of this treatment in a typical real-world clinical context. MATERIALS AND METHODS: Participants with chronic, intractable pain of the trunk or lower limbs were recruited from multiple pain clinics in the Netherlands. Subjects were trialed and implanted with DRG stimulation systems...
August 5, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Sivashanmugam Raju, Karthikeyan Chinnakkannu, Ashok Selvaraj, Balasubramanian Balakumar, Mohan K Puttaswamy, P V Jayasankar
Background: Total knee arthroplasty (TKA) has been proved to be a successful and cost-effective treatment for improving pain and function in patients with knee arthritis. Total knee arthroplasty (TKA) is one of the most common orthopaedic surgeries performed worldwide and advancement in surgical techniques and prosthetic designs have improved the patient outcomes. However, concerns and priorities of patients and surgeons relating to joint replacement may differ. Materials and Methods: 306 TKAs in 223 patients were evaluated for functional outcome using surgeon reported American Knee Society Knee Score (KS)/Functional Score (FS) and patient-reported Oxford Knee Score (OKS)...
July 2018: Indian Journal of Orthopaedics
Olivier Cottencin
Despite what hospital nomenclature might seem to imply, treatment for alcohol dependence is not weaning; it is more comprehensive and mainly aimed at the overall phenomenon of addiction. Up until now, the objective of treatment has been to obtain total abstinence by any means. However, current treatments and research are aimed at enabling the dependent subject to learn to regain control over a disease defined precisely by the repeated impossibility of controlling behavior that persists notwithstanding his awareness of its deleterious consequences, be they physical, psychological, familial, professional and/or socio-environmental...
August 1, 2018: La Presse Médicale
Martien G S Schrooten, Stefaan Van Damme, Geert Crombez, Hanne Kindermans, Johan W S Vlaeyen
BACKGROUND AND AIMS: Insights into the nature of cognitive bias, including attentional bias to threat signals, are considered pivotal to understanding (chronic) pain and related distress. It has been put forward that attention to pain-related threat is normally dynamic and relates to the motivational state of the individual. In this experiment we aimed (i) to replicate the finding that attentional bias for pain signals in healthy participants can be reduced when a non-pain goal is pursued, and (ii) to extend this finding by taking into account the outcome focus of the non-pain goal...
August 3, 2018: Scandinavian Journal of Pain
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