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Pediatric chronic pain

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https://www.readbyqxmd.com/read/28103764/multimodal-pediatric-pain-management-part-2
#1
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf speaks to Commissioning Editor Jade Parker: Stefan Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota in Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The pain and palliative care program is devoted to control acute, chronic/complex and procedural pain for inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
January 20, 2017: Pain Management
https://www.readbyqxmd.com/read/28088398/mindfulness-based-stress-reduction-for-adolescents-with-functional-somatic-syndromes-a-pilot-cohort-study
#2
Ather Ali, Theresa R Weiss, Anne Dutton, Douglas McKee, Kim D Jones, Susmita Kashikar-Zuck, Wendy K Silverman, Eugene D Shapiro
OBJECTIVE: To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility. STUDY DESIGN: Three cohorts of subjects completed an 8-week MBSR program. Child- and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale...
January 12, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28033158/a-review-of-adult-and-pediatric-neuropathic-pain-assessment-tools
#3
Kyle Joseph Morgan, Doralina L Anghelescu
An early and thorough assessment of pain is essential to its proper diagnosis and treatment. This assessment is especially important when NP is suspected, given the different treatment modalities available and the serious impact of NP on patients' quality of life. This article summarizes the various screening and assessment tools available to clinicians for evaluating NP. Despite the availability of the 15 tools discussed, a deficiency remains, particularly in the pediatric realm. To date, there is no well-validated NP assessment tool for children younger than 5 years, no pediatric NP screening tool that has been validated outside the domain of chemotherapy-induced peripheral neuropathy, and no consistent recommendation regarding the optimal tool to use with pediatric patients who have chronic pain...
December 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#4
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009822/pain-neuroscience-education-state-of-the-art-and-application-in-pediatrics
#5
REVIEW
Hannah Robins, Victoria Perron, Lauren C Heathcote, Laura E Simons
Chronic pain is a widespread problem in the field of pediatrics. Many interventions to ameliorate pain-related dysfunction have a biobehavioral focus. As treatments for chronic pain (e.g., increased movement) often stand in stark contrast to treatments for an acute injury (e.g., rest), providing a solid rationale for treatment is necessary to gain patient and parent buy-in. Most pain treatment interventions incorporate psychoeducation, or pain neuroscience education (PNE), as an essential component, and in some cases, as a stand-alone approach...
December 21, 2016: Children
https://www.readbyqxmd.com/read/28009630/sex-differences-in-the-efficacy-of-psychological-therapies-for-the-management-of-chronic-and-recurrent-pain-in-children-and-adolescents-a-systematic-review-and-meta-analysis
#6
Katelynn E Boerner, Christopher Eccleston, Christine T Chambers, Edmund Keogh
Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents...
December 15, 2016: Pain
https://www.readbyqxmd.com/read/27989331/juvenile-fibromyalgia-a-primary-pain-or-pain-processing-disorder
#7
REVIEW
Lawrence Zemel, Peter R Blier
Juvenile fibromyalgia (JFM), a chronic disorder of widespread musculoskeletal pain in combination with autonomic, sensory, and cognitive dysfunction, is responsible for considerable morbidity and impaired quality of life in affected patients and their families. Historically, fibromyalgia has been incorrectly characterized as a psychosomatic or psychogenic disorder, but new understanding of the science of pain has demonstrated unambiguously that it is an organic disorder of the pain processing system itself...
August 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27989329/nonpharmacologic-treatment-of-pain
#8
REVIEW
Anna Monica Agoston, Christine B Sieberg
Pain is a complex biopsychosocial experience that is influenced by neurological processes and psychosocial factors. Systematic reviews and meta-analyses of randomized controlled trials of psychological interventions have demonstrated evidence for psychological approaches in treating procedural pain and multiple types of chronic pain, including headaches, abdominal pain, and musculoskeletal pain. This article is directed toward clinicians and would provide an overview of cognitive-behavioral therapy, including specific cognitive-behavioral techniques for pediatric pain...
August 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27989326/pediatric-pain-measurement-assessment-and-evaluation
#9
REVIEW
Renee C B Manworren, Jennifer Stinson
Assessment provides the foundation for diagnosis, selection of treatments, and evaluation of treatment effectiveness for pediatric patients with acute, recurrent, and chronic pain. Extensive research has resulted in the availability of a number of valid, reliable, and recommended tools for assessing children's pain. Yet, evidence suggests children's pain is still not optimally measured or treated. In this article, we provide an overview of pain evaluation for premature neonates to adolescents. The difference between pain assessment and measurement is highlighted; and the key steps to follow are identified...
August 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27984491/sex-differences-in-the-efficacy-of-psychological-therapies-for-the-management-of-chronic-and-recurrent-pain-in-children-and-adolescents-a-systematic-review-and-meta-analysis
#10
Katelynn E Boerner, Christopher Eccleston, Christine T Chambers, Edmund Keogh
Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents...
December 15, 2016: Pain
https://www.readbyqxmd.com/read/27979583/abdominal-pain-associated-functional-gastrointestinal-disorder-prevalence-in-children-and-adolescents-with-celiac-disease-on-gluten-free-diet-a-multinational-study
#11
Miguel Saps, Naire Sansotta, Sean Bingham, Giuseppe Magazzu, Caterina Grosso, Simone Romano, Cenk Pusatcioglu, Stefano Guandalini
OBJECTIVE: To test the hypothesis that children with celiac disease (CD) on gluten-free diet are at increased risk of abdominal pain (AP) associated-functional gastrointestinal disorders (FGIDs). STUDY DESIGN: This was a multinational cross-sectional study performed from 2014 to 2015. Patients 4-18 years of age with CD on gluten-free diet for longer than 6 months were recruited from pediatric CD clinics in US and Italy. Control groups included siblings of children with CD (with normal tissue transglutaminase levels) and unrelated controls...
December 13, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27973405/chronic-pain-in-children-and-adolescents-diagnosis-and-treatment-of-primary-pain-disorders-in-head-abdomen-muscles-and-joints
#12
REVIEW
Stefan J Friedrichsdorf, James Giordano, Kavita Desai Dakoji, Andrew Warmuth, Cyndee Daughtry, Craig A Schulz
Primary pain disorders (formerly "functional pain syndromes") are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain...
December 10, 2016: Children
https://www.readbyqxmd.com/read/27941082/parental-perceptions-of-pediatric-pain-and-pots-related-disability
#13
Elizabeth M Keating, Ryan M Antiel, Karen E Weiss, Dustin Wallace, Seth J Antiel, Philip R Fischer, Ashley N Junghans-Rutelonis, Cynthia Harbeck-Weber
Adolescents with postural orthostatic tachycardia syndrome (POTS) often have pain and functional impairment. This study evaluated how parental attributions of children's symptoms relate to child functional impairment. Adolescents with chronic pain and clinical symptoms suggestive of autonomic dysfunction (fatigue, dizziness, nausea) that attended a multidisciplinary chronic pain clinic completed measures of depression, anxiety, and functioning (n = 141). Parents of 114 of these patients completed the Parent Pain Attribution Questionnaire (PPAQ), a measure indicating the extent they believe physical and psychosocial factors account for their child's health condition...
December 8, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27940762/pediatric-chronic-pain-biopsychosocial-assessment-and-formulation
#14
REVIEW
Christina Liossi, Richard F Howard
Chronic pain in children is an increasingly recognized clinical problem with alarmingly high prevalence rates found in some populations. Although it is not understood why some children experience high levels of pain, the subjective experience of chronic pain (including its site, intensity, quality, unpleasantness, and associated suffering) has long been believed to result from interactions between multiple contributors, including nociceptive, affective, sociocultural, behavioral, and cognitive. Regardless of whether the antecedent of chronic pain is known or unknown, similar patterns of symptoms, behaviors, and disability are often seen...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27940011/pediatric-intracranial-hypertension
#15
REVIEW
Shawn C Aylward, Rachel E Reem
Primary (idiopathic) intracranial hypertension has been considered to be a rare entity, but with no precise estimates of the pediatric incidence in the United States. There have been attempts to revise the criteria over the years and adapt the adult criteria for use in pediatrics. The clinical presentation varies with age, and symptoms tending to be less obvious in younger individuals. In the prepubertal population, incidentally discovered optic disc edema is relatively common. By far the most consistent symptom is headache; other symptoms include nausea, vomiting tinnitus, and diplopia...
January 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/27929419/psychological-neuromodulatory-treatments-for-young-people-with-chronic-pain
#16
REVIEW
Jordi Miró, Elena Castarlenas, Rocío de la Vega, Rubén Roy, Ester Solé, Catarina Tomé-Pires, Mark P Jensen
The treatment of young people with chronic pain is a complex endeavor. Many of these youth do not obtain adequate relief from available interventions. Psychological neuromodulatory treatments have been shown to have potential benefit for adults with chronic pain. Here, we review and summarize the available information about the efficacy of three promising psychological neuromodulatory treatments-neurofeedback, meditation and hypnosis-when provided to young people with chronic pain. A total of 16 articles were identified and reviewed...
December 6, 2016: Children
https://www.readbyqxmd.com/read/27924146/mindfulness-based-intervention-for-female-adolescents-with-chronic-pain-a-pilot-randomized-trial
#17
Nicholas Chadi, Audrey McMahon, Majorie Vadnais, Catherine Malboeuf-Hurtubise, Anissa Djemli, Patricia L Dobkin, Jacques Lacroix, Thuy Mai Luu, Nancy Haley
OBJECTIVE: To test the feasibility of a randomized-controlled trial measuring the impact of an adapted mindfulness-based intervention (MBI) in female adolescents with chronic pain. METHODS: This was a single center, single-blind, prospective, experimental, longitudinal trial conducted in a pediatric tertiary care center. Participants had a history of chronic pain during at least three months. They were randomized into an intervention group or a wait-list control group...
2016: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/27922842/what-s-in-a-name-healthcare-providers-perceptions-of-pediatric-pain-patients-based-on-diagnostic-labels
#18
Taylor A Betsch, Ayala Y Gorodzinsky, G Allen Finley, Michael Sangster, Jill Chorney
OBJECTIVES: Diagnostic labels can help patients better understand their symptoms and can influence providers' treatment planning and patient interactions. Recurrent pain is common in childhood; however, there are various diagnostic labels used. The objective of this study was to evaluate the influence of diagnostic labels on pediatric healthcare providers' perceptions of pediatric chronic pain patients. METHODS: Using an online survey, providers were randomly assigned to one of two vignette conditions (differing only in diagnostic label provided) and completed questionnaires about their perceptions of the vignette patient...
December 5, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#19
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27918444/mental-health-comorbidities-in-pediatric-chronic-pain-a-narrative-review-of-epidemiology-models-neurobiological-mechanisms-and-treatment
#20
REVIEW
Jillian Vinall, Maria Pavlova, Gordon J G Asmundson, Nivez Rasic, Melanie Noel
Chronic pain during childhood and adolescence can lead to persistent pain problems and mental health disorders into adulthood. Posttraumatic stress disorders and depressive and anxiety disorders are mental health conditions that co-occur at high rates in both adolescent and adult samples, and are linked to heightened impairment and disability. Comorbid chronic pain and psychopathology has been explained by the presence of shared neurobiology and mutually maintaining cognitive-affective and behavioral factors that lead to the development and/or maintenance of both conditions...
December 2, 2016: Children
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