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Chronic pain

David R Houck, Laurel Sindelar, Carlos R Sanabria, Stephanie H Stanworth, Maggie Krueger, Mary Suh, Torsten M Madsen
NYX-2925, a new chemical entity, acts as a co-agonist to glutamate at the N-methyl-D-aspartate receptor (NMDAR). At low concentrations of endogenous agonists (glycine/D-serine), NYX-2925 partially activates NMDARs, modulating neural pathways relevant for chronic pain. NYX-2925 is being developed for the treatment of chronic pain conditions, including painful diabetic peripheral neuropathy and fibromyalgia. In this first-in-human, Phase 1, single- (50-1200 mg) and multiple-ascending dose (150-900 mg) study, the safety, tolerability, and pharmacokinetics of NYX-2925 were evaluated in 84 healthy adult volunteers...
September 22, 2018: Clinical and Translational Science
Stephen F Murphy, Jonathan F Anker, Daniel J Mazur, Christel Hall, Anthony J Schaeffer, Praveen Thumbikat
INTRODUCTION: Chronic pelvic pain syndrome (CPPS) is a complex disorder that affects a large proportion of all men. A limited understanding of its etiology and pathogenesis is reflected by the absence of effective therapies. Although CPPS is deemed clinically non-infectious with no well-defined etiological role for microbes, bacteria is readily isolated from both healthy and patient prostate secretion and urine samples. Our laboratory has previously demonstrated that a specific gram-negative bacterial isolate can induce CPPS-like symptoms in mice...
September 21, 2018: Prostate
W Häuser, T Schubert, N Scherbaum, T Tölle
BACKGROUND: One major concern of long-term opioid therapy (LTOT) for chronic noncancer pain (CNCP) is the risk of abuse of prescribed opioids. OBJECTIVE: To examine the prevalence and predictors of opioid use-related hospitalizations and potential abuse of prescribed opioids by persons with LTOT for CNCP in a sample representative of the German statutory health insurance companies. METHODS: Retrospective cross-sectional study in 2014. Anonymized German health claims database, including 4,028,618 insured individuals of 69 German statutory health insurances...
September 21, 2018: Der Schmerz
Beverly E Thorn, Lisa C Campbell, Benjamin P Van Dyke, Andrea K Newman, Calia A Torres
No abstract text is available yet for this article.
September 18, 2018: Annals of Internal Medicine
Katherine Rediger, D R Bailey Miles
No abstract text is available yet for this article.
September 18, 2018: Annals of Internal Medicine
Lauren Gorfinkel, Pauline Voon, Evan Wood, Jan Klimas
No abstract text is available yet for this article.
September 21, 2018: BMJ: British Medical Journal
Xianqun Cai, Shengxue Hu, Bangrui Yu, Yilei Cai, Jianmin Yang, Feng Li, Yunquan Zheng, Xianai Shi
Peritoneal adhesion is a general complication following pelvic and abdominal surgery, which may lead to chronic abdominal pain, bowel obstruction, organ injury, and female infertility. Biodegradable polymer membranes have been suggested as physical barriers to prevent peritoneum adhesion. In this work, a transglutaminase (TGase)-catalyzed crosslinked carboxymethyl chitosan/carboxymethyl cellulose/collagen (CMCS/CMCL/COL) composite anti-adhesion membrane with various proportions of CMCS, CMCL, and COL (40/40/20, 35/35/30, 25/25/50) was developed...
December 1, 2018: Carbohydrate Polymers
Tahaniyat Lalani
Prosthetic breast implantation is a common surgical procedure for augmentation and reconstruction after mastectomy. The incidence of implant infection is 1% to 2.5% and is higher for reconstruction following mastectomy compared with augmentation. Most infections are caused by gram-positive pathogens, such as coagulase-negative staphylococci, Cutibacterium species, Staphylococcus aureus, and streptococci. Acute infections are usually associated with fever and breast pain, erythema, and drainage. Subacute infections may present with chronic pain, persistent drainage, failed healing of the incision site, or migration of the implant...
September 18, 2018: Infectious Disease Clinics of North America
Amit H Sachdev, Frank G Gress
Pain is often associated with chronic pancreatitis and pancreatic cancer. Often times opioids are used to treat pain; however, the use of opioids is frequently difficult. Endoscopic ultrasound-guided celiac plexus block and celiac plexus nuerolysis are safe and effective modalities used to alleviate pain. Celiac plexus block is a transient interruption of the plexus by local anesthetic, while celiac plexus neurolysis is prolonged interruption of the transmission of pain from the celiac plexus using chemical ablation...
October 2018: Gastrointestinal Endoscopy Clinics of North America
Averill Guo, John M Poneros
Patients with recurrent acute pancreatitis (RAP) have few treatment options available to them to manage their symptoms or prevent progression to chronic pancreatitis. At present, endotherapy is typically pursued as a means to achieve symptom remission and reduce rates of recurrence, hospitalization, abdominal pain, narcotic use, and surgical intervention. However, evidence that endotherapy effectively alters the natural history of disease remains limited. This article reviews the recent literature on the efficacy of endoscopic intervention in the treatment RAP with a focus on high-quality prospective randomized controlled studies...
October 2018: Gastrointestinal Endoscopy Clinics of North America
Ciro Manzo
The possibility that polymyalgia rheumatica (PMR) can be diagnosed when both ESR and CRP are normal at the time of diagnosis and before therapy with glucocorticoids, has been often discussed in the literature. We present a case report of a 100-year-old Caucasian man referred to our outpatient clinic, complaining of chronic pain in the shoulder and hip girdle associated with normal values of both ESR (21 mm/1st hour) and CRP (4 mg/dL). In the previous four months, several anti-inflammatory drugs and painkillers associated with physiotherapy treatments gave no significant improvement in pain and self-care...
September 20, 2018: Diseases (Basel)
Ryan Patel, Anthony H Dickenson
Descending brainstem control of spinal nociceptive processing permits a dynamic and adaptive modulation of ascending sensory information. Chronic pain states are frequently associated with enhanced descending excitatory drive mediated predominantly through serotonergic neurones in the rostral ventromedial medulla. In this study, we examine the roles of spinal 5-HT2A and 5-HT3 receptors in modulating ascending sensory output in normal and neuropathic states. In vivo electrophysiology was performed in anaesthetised spinal nerve ligated (SNL) and sham-operated rats to record from wide dynamic range neurones in the ventral posterolateral thalamus...
September 18, 2018: Neuropharmacology
Thibaut Demaneuf, Zoe Aitken, Amalia Karahalios, Teng Ieng Leong, Alysha M De Livera, George A Jelinek, Tracey J Weiland, Claudia H Marck
OBJECTIVE: To systematically review the evidence of the effect of exercise compared to passive control on pain in people with multiple sclerosis. DATA SOURCE AND STUDY SELECTION: Five electronic databases were searched for randomized controlled trials published up to March 2017 that recruited people with multiple sclerosis where exercise was the intervention and pain was an outcome. (PROSPERO registration number CRD42017060489). STATISTICAL ANALYSIS: A random-effects meta-analysis was conducted to estimate the standardized mean difference of the effect of exercise on pain between treatment and control groups...
September 18, 2018: Archives of Physical Medicine and Rehabilitation
Hannah Datz, Dmitry Tumin, Rebecca Miller, Timothy P Smith, Tarun Bhalla, Joseph D Tobias
Background and aims Caring for children with chronic pain incurs burdens of cost and time for families. We aimed to describe variation in caregiver burden among parents of adolescents with chronic pain who responded to a nationally-representative survey. Our secondary aim was to identify child and parent characteristics associated with increased caregiver burden. Methods We used de-identified, publicly-available data from the 2016 National Survey of Children's Health (NSCH), designed to be representative of non-institutionalized children in the United States...
September 21, 2018: Scandinavian Journal of Pain
Petri Karkkola, Sanna Sinikallio, Niko Flink, Kirsi Honkalampi, Matti Kuittinen
Background and aims Pain is a common condition. However, only a minority of people experiencing pain develop a chronic pain problem. Factors such as somatization, pain self-efficacy and lack of psychological well-being affect the risk of pain chronicity and pain-related disability. However, research on protective pain-related psychological factors in populations without chronic pain is scarce. We aim to examine if pain self-efficacy attenuates the associations between pain and both anxiety and somatization in a community sample...
September 21, 2018: Scandinavian Journal of Pain
Jonas Keiler, Marko Schulze, Horst Claassen, Andreas Wree
The femoral vein (FV) is a clinically important vessel. Failure of its valves can lead to chronic venous insufficiency (CVI) with severe manifestations such as painful ulcers. Although they are crucial for identifying suitable implant sites for therapeutic valves, studies on the topography of FV tributaries and valves are rare. Moreover, the femoral vein diameter (FVD) must be known to assess the morphometric requirements for valve implants. To reassess the anatomical requirements for valve implants, 155 FVs from 82 human corpses were examined...
September 21, 2018: Clinical Anatomy
Abigail J Rolbiecki, Michelle Teti, Benjamin Crenshaw, Joseph W LeMaster, Jeff Ordway, David R Mehr
Objective: To understand how patients' use of photo-elicitation and online social networks (Facebook) enhances their understanding of what it means to live with pain. Design: Qualitative substudy of the intervention arm of a randomized trial. Setting/Subjects: Primary care patients living with pain drawn from nine family practices with at least two pain visits in the last six months. Methods: The private Facebook group was co-facilitated by a moderator and a patient-investigator who lives with chronic pain...
September 18, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Senthil Packiasabapathy, Nicole Horn, Senthilkumar Sadhasivam
PURPOSE OF REVIEW: The current review will discuss the current literature on genetics of pain and analgesia, with special emphasis on perioperative setting. We will also discuss pharmacogenetics-based management guidelines, current clinical status and future perspectives. RECENT FINDINGS: Recent literature suggests that the interindividual variability in pain and postoperative analgesic response is at least in part because of one's genetic make-up. Some of the well characterized polymorphisms that are associated with surgical pain and opioid-related postoperative adverse outcomes are described in catechol-O-methyl transferase, CYP2D6 and μ-opioid receptor (OPRM1), ATP-binding cassette subfamily B member 1, ABCC3, organic cation transporter 1 genes...
September 18, 2018: Current Opinion in Anaesthesiology
Smiljana Spasic, Iva Brcic, Rochelle Freire, Monica T Garcia-Buitrago, Andrew E Rosenberg
BACKGROUND: Epithelioid hemangioendothelioma (EHE) is an uncommon malignant endothelial neoplasm that most commonly arises in soft tissue, bone, lung, and liver. Crohn's disease (CD) is an inflammatory bowel disease of unknown etiology that is frequently associated with complications including strictures, fistulas/fissures, and neoplasms. CASE DESCRIPTION: A 43-year-old woman with a 6-year history of severe CD presented with anal pain and bleeding. She had prior partial colectomy for a stricture and a diverting ileostomy for perianal fissures and stricture...
September 21, 2018: International Journal of Surgical Pathology
Teodor Goroszeniuk
OBJECTIVE: To report a retrospective review of the longer-term results of peripheral neuromodulation in 12 patients with significant chronic sacroiliac joint pain who had previously failed multiple conservative and interventional pain therapies. METHODS: To allow for the assessment of meaningful longer-term outcome, implants for all 12 patients had been in place for a minimum of 18 months to a maximum of 36 months prior to the formal review. RESULTS: Compared to the preimplantation baseline, the longer-term follow-up revealed a significant and sustained reduction in visual analog scale pain scores from 8...
September 20, 2018: Neuromodulation: Journal of the International Neuromodulation Society
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