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centralized pain

Gill Norman, Maggie J Westby, Amber D Rithalia, Nikki Stubbs, Marta O Soares, Jo C Dumville
BACKGROUND: Venous leg ulcers are open skin wounds on the lower leg which can be slow to heal, and are both painful and costly. The point prevalence of open venous leg ulcers in the UK is about 3 cases per 10,000 people, and many people experience recurrent episodes of prolonged ulceration. First-line treatment for venous leg ulcers is compression therapy, but a wide range of dressings and topical treatments are also used. This diversity of treatments makes evidence-based decision-making challenging, and a clear and current overview of all the evidence is required...
June 15, 2018: Cochrane Database of Systematic Reviews
Rohan Menon, Aris Karatasakis, Siddharth Patel, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Tayo Addo, Dharam Kumbhani, Samir Kapadia, Michael Luna, Ehtisham Mahmud, Charles Chambers, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: There is great variability in radiation safety practices in cardiac catheterization laboratories around the world. METHODS: We performed an international online survey on radiation safety including interventional cardiologists, electrophysiologists, interventional radiologists, and vascular surgeons. RESULTS: A total of 570 responses were received from various geographic locations, including the United States (77.9%), Asia (7.9%), Europe (6...
June 15, 2018: Journal of Invasive Cardiology
S Korovay
Preterm labor is an urgent medical-social and demographic issue at the present stage. A considerable number of factors affects the course of pregnancy and its outcome, their effect is realized at the level of the central nervous system through numerical metabolic interactions, where monoaminergic systems play an important role. Objective - to study the features of the sympathoadrenal system state by determining the excretion level of DOPHA, dopamine, norepinephrine and epinephrine in women's daily urine with different periods of abortion...
May 2018: Georgian Medical News
Stefania Bianchi Marzoli, Alessandra Criscuoli
Pain occurs with optic neuropathies associated with inflammatory central nervous system diseases (MS and NMO), idiopathic intracranial hypertension and spontaneous hypotension, giant cell arteritis, immunomediated systemic diseases, compressive lesions, or infective disorders. Pain can precede the onset of visual loss in acute optic neuritis, it can be irradiated to the orbital region in giant cell arteritis and parasellar compressive optic neuropathies, or it may be located to the back of the eye with posterior scleritis...
June 2018: Neurological Sciences
Monty A Silverdale, Christopher Kobylecki, Lewis Kass-Iliyya, Pablo Martinez-Martin, Michael Lawton, Sarah Cotterill, K Ray Chaudhuri, Huw Morris, Fahd Baig, Nigel Williams, Leon Hubbard, Michele T Hu, Donald G Grosset
INTRODUCTION: The causes of pain in early/moderate Parkinson's disease (PD) are not well understood. Although peripheral factors such as rigidity, reduced joint movements and poor posture may contribute towards the development of pain, central mechanisms including altered nociceptive processing may also be involved. METHODS: We performed a large clinical study to investigate potential factors contributing towards pain in early/moderate PD. We recruited 1957 PD participants who had detailed assessments of pain, motor and non-motor symptoms...
June 6, 2018: Parkinsonism & related Disorders
Alexis C Thompson, Casey Feeney, Mark B Kristal
Placental Opioid Enhancing Factor (POEF) is found in amniotic fluid (AF) and placenta. When ingested, it enhances opioid-mediated pain relief. Our laboratory has shown that ingestion of AF specifically enhances the hypoalgesia associated with δ-opioid receptor activation in the brain. The specific biochemical compound in AF responsible for the enhancement of δ-opioid activity is of great interest as an analgesic adjunct for pain but is unknown at this time. Research efforts to isolate and characterize this biochemical compound are hampered by the lack of an algesiometric assay that allows repeated measurement of pain threshold and repeated exposure to δ-opioid receptor activation...
June 11, 2018: Brain Research
Christina E McGovern, Corjena Cheung
INTRODUCTION: Primary dysmenorrhea is a prevalent condition causing quality of life (QOL) reduction for many women, resulting from pain as well as parallel social and psychological distress. Yoga reduces pain and sympathetic reactivity, thus promoting QOL. This article reports a systematic review of the evidence for the effectiveness of yoga as a QOL improvement method for women with primary dysmenorrhea. METHODS: The PRISMA guidelines were used in preparation of this review...
June 14, 2018: Journal of Midwifery & Women's Health
Kendall R McEachron, Melena D Bellin
PURPOSE OF REVIEW: We reviewed the current state of total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis and recurrent acute pancreatitis (RAP). RECENT FINDINGS: An increasing number of centers in the United States and internationally are performing TPIAT. In selected cases, TPIAT may be performed partially or entirely laparoscopically. Islet isolation is usually performed at the same center as the total pancreatectomy surgery, but new data suggest that diabetes outcomes may be nearly as good when a remote center is used for islet isolation...
June 8, 2018: Current Opinion in Gastroenterology
Luca Napolitano, Mathew Waku, Gustavo Maggi, Franco Ciarelli
Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan and endoscopy and are usually characterized by the typical pattern of gas bubbles in the wall of the intestine...
March 19, 2018: Annali Italiani di Chirurgia
Dongsheng Xu, Hui Zhao, Han Gao, Huling Zhao, Dandan Liu, Jing Li
BACKGROUND: Neuropathic pain is observed in patients as chemotherapeutic oxaliplatin (OXL) is used to treat metastatic digestive tumors; however, the mechanisms responsible for hyperalgesia are not well understood. Chronic neuroinflammation is one of the hallmarks of pathophysiology of neuropathic pain. Since the midbrain periaqueductal gray (PAG) is an important component of the descending inhibitory pathway controlling on central pain transmission, we examined the role for pro-inflammatory cytokines (PICs) system of the PAG in regulating mechanical hyperalgesia and cold hypersensitivity evoked by OXL...
January 1, 2018: Molecular Pain
Ricardo Galhardoni, Daniel Ciampi de Andrade, Mariana Yt Puerta, Andre R Brunoni, Bruna Lr Varotto, José Tt de Siqueira, Manoel J Teixeira, Silvia Rdt Siqueira
Introduction Persistent idiopathic facial pain is a refractory and disabling condition of unknown mechanism and etiology. It has been suggested that persistent idiopathic facial pain patients have not only peripheral generators of pain, but also central nervous system changes that would contribute to the persistence of symptoms. We hypothesized that persistent idiopathic facial pain would have changes in brain cortical excitability as measured by transcranial magnetic stimulation compared to healthy controls...
January 1, 2018: Cephalalgia: An International Journal of Headache
Shai Efrati, Amir Hadanny, Shir Daphna-Tekoah, Yair Bechor, Kobi Tiberg, Nimrod Pik, Gil Suzin, Rachel Lev-Wiesel
Fibromyalgia Syndrome (FMS) is a condition considered to represent a prototype of central sensitization syndrome, characterized by chronic widespread pain and along with symptoms of fatigue, non-restorative sleep and cognitive difficulties. FMS can be induced by trauma, infection or emotional stress with cumulative evidence that dissociation is relatively frequent in FMS patients. Two randomized controlled trials have shown that hyperbaric oxygen therapy (HBOT) can induce neuroplasticity and be effective in patients suffering from FMS...
2018: Frontiers in Psychology
Viola Spahn, Giovanna Del Vecchio, Antonio Rodriguez-Gaztelumendi, Julia Temp, Dominika Labuz, Michael Kloner, Marco Reidelbach, Halina Machelska, Marcus Weber, Christoph Stein
Novel pain killers without adverse effects are urgently needed. Opioids induce central and intestinal side effects such as respiratory depression, sedation, addiction, and constipation. We have recently shown that a newly designed agonist with a reduced acid dissociation constant (pKa ) abolished pain by selectively activating peripheral μ-opioid receptors (MOR) in inflamed (acidic) tissues without eliciting side effects. Here, we extended this concept in that pKa reduction to 7.22 was achieved by placing a fluorine atom at the ethylidene bridge in the parental molecule fentanyl...
June 12, 2018: Scientific Reports
Kiri A Sandler, Fereidoun Abtin, Robert Suh, Ryan R Cook, Carol Felix, Jay M Lee, Edward B Garon, Jeffrey Wu, Elaine M Luterstein, Nzhde Agazaryan, Stephen E Tenn, Chul Lee, Michael L Steinberg, Percy Lee
PURPOSE: Stereotactic body radiation therapy (SBRT) and heat-based ablation (HBA) are both potentially safe and effective treatments for primary and metastatic lung tumors. Both are suboptimal for centrally located tumors, with SBRT having a higher risk of significant toxicity and HBA having lower efficacy. This study evaluates the safety and efficacy of combination SBRT-HBA to determine whether combined treatment can result in superior outcomes to each treatment alone. METHODS AND MATERIALS: Patients with 1 or 2 primary or metastatic lung tumors ≤ 5 cm in size were enrolled in a prospective phase 2 trial and treated with SBRT in 3 fractions followed by HBA...
July 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Damian R Griffin, Edward J Dickenson, Peter D H Wall, Felix Achana, Jenny L Donovan, James Griffin, Rachel Hobson, Charles E Hutchinson, Marcus Jepson, Nick R Parsons, Stavros Petrou, Alba Realpe, Joanna Smith, Nadine E Foster
BACKGROUND: Femoroacetabular impingement syndrome is an important cause of hip pain in young adults. It can be treated by arthroscopic hip surgery, including reshaping the hip, or with physiotherapist-led conservative care. We aimed to compare the clinical effectiveness of hip arthroscopy with best conservative care. METHODS: UK FASHIoN is a pragmatic, multicentre, assessor-blinded randomised controlled trial, done at 23 National Health Service hospitals in the UK...
June 2, 2018: Lancet
Sheera F Lerman, Claudia M Campbell, Luis F Buenaver, Mary Medak, Jane Phillips, Michelle Polley, Michael T Smith, Jennifer A Haythornthwaite
Negative cognitions are central to the perpetuation of chronic pain and sleep disturbances. Patients with temporomandibular joint disorder (TMJD), a chronic pain condition characterized by pain and limitation in the jaw area, have a high comorbidity of sleep disturbances that possibly exacerbate their condition. Ethnic group differences are documented in pain, sleep and coping, yet the mechanisms driving these differences are still unclear, especially in clinical pain populations. 156 women (79% white, 21% African American (AA)) diagnosed with TMJD were recruited as part of a randomized controlled trial evaluating the effectiveness of interventions targeting sleep and pain catastrophizing on pain in TMJD...
June 8, 2018: Journal of Pain: Official Journal of the American Pain Society
Christos Anthoulakis, Eirini Iordanidou, Anastasia Vatopolou
STUDY OBJECTIVE: Intrauterine devices (IUDs) still remain underused in adolescents. Pain during insertion may prevent adolescents to opt for a levonorgestrel (LNG) - releasing IUD. This study aimed to conduct a systematic review, following the PRISMA guidelines, and critically appraise published data with respect to the efficacy of various substances (analgesics or not) in preventing pain during LNG-IUD insertion in nulliparous women as a proxy for adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A comprehensive computerized systematic literature search of all English language studies between 2006 and 2016 was performed in PubMed, EMBASE, Scopus, Evidence Based Medicine Reviews (Cochrane Database and Cochrane Central Register of Controlled Trials), and Google Scholar...
June 8, 2018: Journal of Pediatric and Adolescent Gynecology
Shakil Ahmed Nagori, Sanjay Kumar Roy Chowdhury, Himanshu Thukral, Anson Jose, Ajoy Roychoudhury
OBJECTIVE: The aim of this systematic review was to investigate the current evidence in order to assess the efficacy of single puncture arthrocentesis versus standard double needle arthrocentesis in the management of temporomandibular joint(TMJ) disorders. METHODS: An electronic search of the PubMed, Scopus, Cochrane CENTRAL and Google scholar databases was performed to identify English studies published up until October 2017. Eligible studies were selected based on inclusion criteria and included randomized controlled trials(RCTs) comparing single puncture arthrocentesis and standard double needle arthrocentesis for the management TMJ disorders...
June 11, 2018: Journal of Oral Rehabilitation
Ben Cooper, Paul Bachoo
BACKGROUND: Leg ulcers are chronic wounds of the lower leg, caused by poor blood flow, that can take a long time to heal. The pooling of blood in the veins can damage the skin and surrounding tissues, causing an ulcer to form. Venous leg ulcers are associated with impaired quality of life, reduced mobility, pain, stress and loss of dignity. The standard treatment for venous leg ulcers is compression bandages or stockings. Shock wave therapy may aid the healing of these wounds through the promotion of angiogenesis (the formation and development of blood vessels) and reduction of inflammation, though this process is poorly understood at present...
June 11, 2018: Cochrane Database of Systematic Reviews
N J Collier, A K Haylett, T H Wong, C A Morton, S H Ibbotson, K E McKenna, R Mallipeddi, H Moseley, D Seukeran, K A Ward, M F Mohd Mustapa, L S Exton, A C Green, L E Rhodes
BACKGROUND: Topical photodynamic therapy (PDT) is an established treatment option for low-risk basal cell carcinoma (BCC). OBJECTIVES: Compare efficacy, cosmesis and tolerability of PDT for BCC with alternative treatments. METHODS: MEDLINE/PubMed/EMBASE/CENTRAL databases were searched from inception until 1 September 2017. Included studies were randomised controlled trials (RCTs) of PDT for nodular (n) and superficial (s) BCC reporting at least one of the outcomes: clearance at 3 months, and sustained at 1 or 5 years; recurrence at ≥1 year; cosmesis; adverse events; tolerability...
June 11, 2018: British Journal of Dermatology
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