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https://www.readbyqxmd.com/read/29913923/national-guidelines-for-evaluating-pain-patients-legal-right-to-prioritised-health-care-at-multidisciplinary-pain-clinics-in-norway-implemented-2009
#1
Karen Walseth Hara, Petter Borchgrevink
Background All nations are posed with the challenge of deciding how to allocate limited health care resources. A Patients' Rights Law from 1999 gives patients in Norway with a serious health condition, for which there is efficacious and cost-effective treatment, a legal right to receive health care from the National Health Care system. Methods Recently national guidelines have been produced for implementing these legal rights within 32 fields of specialist health care. One of these fields deals with serious chronic pain conditions...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913873/postherpetic-neuralgia-new-hopes-in-prevention-with-adult-vaccination-and-in-treatment-with-a-concentrated-capsaicin-patch
#2
Ewa Gawecka, Oddbjørn Viken
Background and purpose Postherpetic neuralgia (PHN) is a complication of acute herpes zoster (HZ). The evidence base for management of PHN has increased by recent publications. Therefore, we reviewed incidence of HZ, prevalence, risk factors, and mechanism of PHN pain, prevention and treatment of PHN with special interest in studies on adult vaccination and topical application of lidocaine and concentrated capsaicin patch. Methods We searched databases with an English language restriction: MEDLINE 1944-2011, EMBASE 1988-2011, PubMed, and the Cochrane Controlled Trial Register and Cochrane Library (2011)...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29905649/multivariate-pattern-classification-of-brain-white-matter-connectivity-predicts-classic-trigeminal-neuralgia
#3
Jidan Zhong, David Qixiang Chen, Peter S P Hung, Dave J Hayes, Kevin E Liang, Karen D Davis, Mojgan Hodaie
Trigeminal neuralgia (TN) is a severe form of chronic facial neuropathic pain. Increasing interest in the neuroimaging of pain has highlighted changes in the root entry zone in TN, but also group level CNS grey and white matter abnormalities. Group differences in neuroimaging data are frequently evaluated with univariate statistics, however this approach is limited because it is based on single, or clusters of, voxels. In contrast, multivariate pattern analyses consider all the model's neuroanatomical features to capture a specific distributed spatial pattern...
June 13, 2018: Pain
https://www.readbyqxmd.com/read/29904802/an-update-on-repetitive-transcranial-magnetic-stimulation-for-the-treatment-of-co-morbid-pain-and-depressive-symptoms
#4
REVIEW
Jonathan H Hsu, Zafiris J Daskalakis, Daniel M Blumberger
PURPOSE: Review recent meta-analyses and clinical trials investigating the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) for concurrent pain and depressive symptoms. RECENT FINDINGS: Recent meta-analyses have included both pain and depression outcomes in fibromyalgia and chronic pain. Randomized controlled trials have also been conducted in post-herpetic neuralgia, trauma-related headache, and neuropathic pain with attention to both pain and depressive symptoms...
June 14, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29901619/continuous-radiofrequency-thermocoagulation-under-ct-guidance-for-glossopharyngeal-neuralgia-two-case-reports
#5
Qing Zhu, Shulan Wang, Rui Chen, Xianbin Cai, Cuihua Jiang, Baolin Zhong, Tao Sun
RATIONALE: Glosssopharyngeal neuralgia (GPN) is a painful syndrome characterized by paroxysmal neuropathic pain in the pharynx, tonsil, posterior base of tongue, inner ear, and mandibular angle. The traditional therapies of GPN, including medication and surgical operation, are not always effective in pain controlling. Radiofrequency therapy is a minimally interventional technique to provide analgesia in chronic pain. PATIENT CONCERNS: Two patients who were refractory to medical treatment were hospitalized for primary GPN...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29894812/why-are-there-no-drugs-indicated-for-sciatica-the-most-common-chronic-neuropathic-syndrome-of-all
#6
REVIEW
John D Markman, Ralf Baron, Jennifer S Gewandter
Here, we examine the stark contrast between the successes and failures of the clinical development of analgesics for different types of chronic low back pain (CLBP) syndrome over the past three decades. Multiple drugs with differing mechanisms of action have been developed for nonspecific axial-predominant low back syndromes and yet not a single therapy is indicated for any neuropathic low back pain syndrome (e.g., sciatica). Clinician findings have informed the entry criteria for neuropathic low back pain clinical trials, whereas entry criteria of axial CLBP trials have prioritized only patient reports of pain...
June 9, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29890676/the-role-of-genetic-polymorphisms-in-chronic-pain-patients
#7
REVIEW
Nebojsa Nick Knezevic, Tatiana Tverdohleb, Ivana Knezevic, Kenneth D Candido
It is estimated that the total annual financial cost for pain management in the U.S. exceeds 100 billion dollars. However, when indirect costs are included, such as functional disability and reduction in working hours, the cost can reach more than 300 billion dollars. In chronic pain patients, the role of pharmacogenetics is determined by genetic effects on various pain types, as well as the genetic effect on drug safety and efficacy. In this review article, we discuss genetic polymorphisms present in different types of chronic pain, such as fibromyalgia, low back pain, migraine, painful peripheral diabetic neuropathy and trigeminal neuralgia...
June 8, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29888123/combined-therapy-of-pulsed-radiofrequency-and-nerve-block-in-postherpetic-neuralgia-patients-a-randomized-clinical-trial
#8
Dan Li, Guohua Sun, Hanzhe Sun, Yanjuan Wang, Zhiping Wang, Jianping Yang
Caused by viral infection, postherpetic neuralgia (PHN) is the most common chronic neuropathic pain. Various treatment modalities such as early use of nerve block therapy (NBT) and pulsed radiofrequency (PRF) have been studied in reducing pain, however, no consistent success was achieved in all the patients treated with single regimen. The combined therapy of PRF and NBT with different targeting mechanism are of interest and remains to be determined. Here we investigated the combined effects of pulsed radiofrequency (PRF) with nerve block therapy (NBT) in PHN patients in a prospective randomized clinical trial...
2018: PeerJ
https://www.readbyqxmd.com/read/29860538/the-role-of-mirtazapine-in-patients-with-fibromyalgia-a-systematic-review
#9
REVIEW
Andreina A Ottman, Carly B Warner, Jamie N Brown
Mirtazapine is commonly used to treat major depressive disorder. Due to its effects on multiple neurotransmitters, it has been investigated for possible benefits in patients with fibromyalgia. The objective of this systematic review is to assess the efficacy and safety of mirtazapine in the treatment of patients with fibromyalgia. Pubmed (1946-May 2018), Embase (1947-May 2018), CENTRAL, and ClinicalTrials.gov were queried using the search term combination: fibromyalgia, pain, chronic pain, neuralgia, neuropathic pain, chronic widespread pain, or chronic pain syndrome and mirtazapine...
June 2, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29807711/live-zoster-vaccination-in-an-immunocompromised-patient-leading-to-death-secondary-to-disseminated-varicella-zoster-virus-infection
#10
Kate E Alexander, Philip L Tong, Kristine Macartney, Rohan Beresford, Vicky Sheppeard, Monisha Gupta
In 2016, the live attenuated zoster vaccine (Zostavax, Merck and Co, USA) was introduced into the Australian National Immunisation Program for people aged 70 years who are not significantly immunocompromised. We report the administration of Zostavax in an immunocompromised patient with chronic lymphocytic leukaemia and no evidence of primary varicella zoster virus (VZV) infection. The patient presented with a bilateral vesicular facial rash 22 days after receiving Zostavax and was initially managed as an outpatient with oral acyclovir...
May 25, 2018: Vaccine
https://www.readbyqxmd.com/read/29803784/injectable-nanocomposite-analgesic-delivery-system-for-musculoskeletal-pain-management
#11
Manakamana Khanal, Shalini V Gohil, Emmanuel Kuyinu, Ho-Man Kan, Brittany E Knight, Kyle M Baumbauer, Kevin W-H Lo, Joseph Walker, Cato T Laurencin, Lakshmi S Nair
Musculoskeletal pain is a major health issue which results from surgical procedures (i.e. total knee and/ or hip replacements and rotator cuff repairs), as well as from non-surgical conditions (i.e. sympathetically-mediated pain syndrome and occipital neuralgia). Local anesthetics, opioids or corticosteroids are currently used for the pain management of musculoskeletal conditions. Even though local anesthetics are highly preferred, the need for multiple administration presents significant disadvantages. Development of unique delivery systems that can deliver local anesthetics at the injection site for prolonged time could significantly enhance the therapeutic efficacy and patient comfort...
May 24, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29781961/-from-ear-to-trunk-mri-reveals-referral-of-pain
#12
Julia Forstenpointner, Stephan Wolff, Patrick W Stroman, Olav Jansen, Stefanie Rehm, Ralf Baron, Janne Gierthmühlen
Referred and projecting pain can be observed in acute and chronic pain states. We present the case of a 69-year-old female patient with postherpetic neuralgia (PHN) in dermatome Th2/3 who reported that touching the ipsilateral earlap (dermatome C2) would enhance pain and dynamic mechanical allodynia (DMA) in the affected Th2/3-dermatome. The aim was to investigate possible underlying mechanisms of this phenomenon using the capsaicin experimental pain sensitization model, quantitative sensory testing (QST) and functional spinal and supraspinal MRI (fMRI)...
May 16, 2018: Pain
https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#13
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29708930/management-of-chronic-complications-associated-with-herpes-zoster-ophthalmicus
#14
Saujanya Vadoothker, Bennie H Jeng
PURPOSE OF REVIEW: Herpes zoster ophthalmicus (HZO) has the potential to cause significant visual morbidity and functional disability in patients with recalcitrant disease, keratitis, and postherpetic neuralgia. This article will review the current methods of prevention and treatment of anterior segment-related chronic complications of HZO. RECENT FINDINGS: HZO-related anterior segment ocular complications can range to include conjunctivitis, keratitis, and uveitis that can all be difficult to manage...
April 27, 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29702268/vascular-entrapment-of-both-the-sciatic-and-pudendal-nerves-causing-persistent-sciatica-and-pudendal-neuralgia
#15
Ahmet Kale, Gulfem Basol, Taner Usta, Isa Cam
STUDY OBJECTIVE: To demonstrate the laparoscopic approach to malformed branches of the vessels entrapping the nerves of the sacral plexus. DESIGN: A step-by-step explanation of the surgery using video (educative video) (Canadian Task force classification II). The university's Ethics Committee ruled that approval was not required for this video. SETTING: Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey. PATIENT: A 26-year-old patient who had failed medical therapy and presented with complaints of numbness and burning pain on the right side of her vagina and pain radiating to her lower limbs for a period of approximately 36 months...
April 24, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29682056/occipital-neuralgia-from-c2-cavernous-malformation
#16
Sang-Woo Ha, Jin-Gyu Choi, Byung-Chul Son
A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29662445/dysregulation-of-pain-and-emotion-related-networks-in-trigeminal-neuralgia
#17
Yanyang Zhang, Zhiqi Mao, Longsheng Pan, Zhipei Ling, Xinyun Liu, Jun Zhang, Xinguang Yu
Classical trigeminal neuralgia (TN) is a severe neuropathic facial pain disorder associated with increased risks of anxiety and depression. Converging evidence suggests that chronic pain pathophysiology involves dysfunctional pain-related and emotion-related networks. However, whether these systems are also among the culprit networks for TN remains unclear. Here, we aimed to assess TN-related anatomical and functional brain anomalies in pain-related and emotion-related networks. We investigated differences in gray matter (GM) volume and the related resting-state functional connectivity (rsFC) between 29 classical TN patients and 34 matched healthy controls...
2018: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29656511/neuropathic-pain-a-patient-centred-approach-to-measuring-outcomes
#18
Steve Hwang, Floortje van Nooten, Ted Wells, Aisling Ryan, Bruce Crawford, Christopher Evans, Marci English
BACKGROUND: Neuropathic pain (NP) is a complex, chronic pain state initiated by a primary lesion or dysfunction of the nervous system and presents as a variety of symptoms across multiple disease states. OBJECTIVE: To develop a patient-centred conceptual model of symptoms and impacts in subjects with diabetic peripheral neuropathy (DPN) or post-herpetic neuralgia (PHN) that can inform the measurement strategy in clinical trials. METHOD: Thirty subjects with DPN or PHN participated in in-person interviews which were performed until saturation was achieved...
April 15, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29597081/a-comparison-of-the-assay-sensitivity-of-average-and-worst-pain-intensity-in-pharmacologic-trials-an-acttion-systematic-review-and-meta-analysis
#19
REVIEW
Shannon M Smith, Mark P Jensen, Hua He, Rachel Kitt, James Koch, Andrew Pan, Laurie B Burke, John T Farrar, Michael P McDermott, Dennis C Turk, Robert H Dworkin
Identifying methods to improve assay sensitivity in randomized clinical trials (RCTs) may facilitate the discovery of efficacious pain treatments. RCTs evaluating pain treatments typically use average pain intensity (API) or worst pain intensity (WPI) as the primary efficacy outcome. However, little evidence is available comparing the assay sensitivity of these 2 measures. In this systematic review and meta-analysis, we comprehensively reviewed all low back pain, osteoarthritis pain, fibromyalgia, diabetic peripheral neuropathy pain, and postherpetic neuralgia RCTs that used a parallel group design...
March 26, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29574434/herpes-zoster-ophthalmicus-evolving-into-headache-characterised-as-hemicrania-continua
#20
Sanjay Prakash, Ankit Dave, Hemant Joshi
Postherpetic neuralgia (PHN) is the most common chronic complication of herpes zoster infection. However, a few patients may develop different types of pain after herpetic lesions. We are reporting two patients who developed postherpetic hemicrania continua (HC). Case 1: a 54-year-old woman had a 10-month history of continuous left-sided pain with superimposed exacerbations. The pain started with the onset of herpetic lesions in the ophthalmic division. The lesions subsided in a few weeks. However, the pain persisted and it responded exclusively to indomethacin...
March 23, 2018: BMJ Case Reports
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