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Persistent chronic pain

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https://www.readbyqxmd.com/read/29776891/chronic-recurrent-multifocal-osteomyelitis-in-pediatrics-a-diagnostic-challenge
#1
N Roig-Abraham, M Méndez-Hernández, M Martínez-Morillo
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disease that presents with aseptic bone inflammation and can be accompanied by multisystemic symptoms. We present the case of a 14-year-old male with a 2-week history of pain located at the tibial metaphysis and fever. X-ray revealed a lytic lesion in the tibial metaphysis. MRI revealed an intramedullary bone lesion with perilesional bone oedema. CT-guided biopsy discounted malignancy and microbiological cultures were negative. The patient's symptoms and fever worsened after the biopsy; therefore antibiotherapy was commenced for a suspected superinfection...
May 15, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29776874/examining-risk-for-persistent-pain-among-adults-with-overweight-status
#2
REVIEW
Teresa Bigand, Marian Wilson, Ruth Bindler, Kenn Daratha
Obesity and persistent pain are public health concerns with associated high costs. Evidence supports an increased risk for reports of persistent pain among adults who are above the recommended body mass index level. However, data have not been clearly synthesized to report the risk for the two co-occurring conditions. Even less is known about how overweight status that does not reach the level of obesity is related to pain. Thus, the aim driving this review was to calculate the risk and odds ratios of chronic pain among adults with an overweight body mass index...
May 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29776484/corticotropin-releasing-factor-in-the-brain-and-blocking-spinal-descending-signals-induce-hyperalgesia-in-the-latent-sensitization-model-of-chronic-pain
#3
Wenling Chen, Yvette Taché, Juan Carlos Marvizón
Latent sensitization is a model of chronic pain in which an injury triggers a period of hyperalgesia followed by an apparent recovery, but in which pain sensitization persists but is suppressed by opioid and adrenergic receptors. One important characteristic of latent sensitization is that hyperalgesia can be triggered by acute stress. To determine whether the effect of stress is mimicked by the activation of corticotropin-releasing factor (CRF) signaling in the brain, rats with latent sensitization induced by injecting complete Freund's adjuvant (CFA, 50 μl) in one hind paw were given an intracerebroventricular (i...
June 15, 2018: Neuroscience
https://www.readbyqxmd.com/read/29775120/successful-improvement-of-pain-symptomatology-in-a-suspected-case-of-cramp-fasciculation-syndrome-via-interventional-pain-treatment
#4
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
May 18, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29774940/-prognostic-analysis-and-clinicopathological-features-of-20-patients-with-appendiceal-neuroendocrine-neoplasms
#5
Weilin Mao, Yang Lyu, Ning Pu, Jian'ang Li, Baobao Xin, Wenqi Chen, Dayong Jin, Wenhui Lou, Xuefeng Xu
OBJECTIVE: To investigate clinicopathological features and prognostic factors of appendiceal neuroendocrine neoplasms(a-NEN). METHODS: Clinical data of 20 patients diagnosed with a-NEN at Zhongshan Hospital of Fudan University between January 2000 and December 2016 were retrospectively analyzed. Pathological diagnosis was based on the WHO classification criteria of digestive system tumors (2010 edition). Based on the mitotic count and Ki-67 index, a-NENs were divided into grade 1 neuroendocrine tumor (NET G1), grade 2(G2) NET G2) and grade 3 (neuroendocrine carcinoma, NEC)...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29774224/ectopic-pancreas-in-the-gastric-antrum-wall-complicated-by-ectopic-pancreatitis-and-persistent-gastric-abscess
#6
Yaseen Alastal, Basmah Khalil, Surendra Singh, Sameh B Almadani
Ectopic pancreas is an uncommon finding in the stomach. Complications are rare but can lead to significant morbidity and even mortality. We report a 49-year-old man who presented with upper abdominal pain, vomiting, and weight loss and was found to have a gastric wall abscess that developed a few weeks after endoscopic biopsy of a gastric ulcer. After medical treatment failed to resolve his symptoms, he underwent distal gastrectomy with Roux-en-Y gastrojejunostomy. Postoperatively, the gastric wall abscess was determined to have derived from a focus of ectopic pancreatic tissue with evidence of ectopic chronic pancreatitis...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29770528/pain-one-week-after-an-ed-visit-for-acute-low-back-pain-is-associated-with-poor-three-month-outcomes
#7
Benjamin W Friedman, John Conway, Caron Campbell, Polly E Bijur, E John Gallagher
BACKGROUND: Low back pain (LBP) is responsible for more than 2.5 million visits to US emergency departments (EDs) annually. Nearly 30% of patients who present to an ED with acute LBP report functional impairment or pain three months later. These patients are at risk of chronic LBP, a highly debilitating condition. In this study, we assessed whether three variables assessable shortly after symptom onset could independently predict poor three-month outcomes among LBP patients who present to an ED...
May 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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
#8
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/29756087/from-acute-to-persistent-low-back-pain-a-longitudinal-investigation-of-somatosensory-changes-using-quantitative-sensory-testing-an-exploratory-study
#9
Anna Marcuzzi, Paul J Wrigley, Catherine M Dean, Petra L Graham, Julia M Hush
Introduction: Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. Objectives: This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset...
March 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29754321/chronic-low-back-pain-a-mini-review-on-pharmacological-management-and-pathophysiological-insights-from-clinical-and-pre-clinical-data
#10
REVIEW
Thomas S W Park, Andy Kuo, Maree T Smith
Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population...
May 12, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29753617/patient-factors-associated-with-prolonged-postoperative-opioid-use-after-total-knee-arthroplasty
#11
Robert S Namba, Anshuman Singh, Elizabeth W Paxton, Maria C S Inacio
BACKGROUND: Pain persists in a moderate proportion of patients after total knee arthroplasty (TKA). Identifying patient factors that are associated with persistent pain may lead to improved care. PURPOSE: The purpose of the study was to identify preoperative factors associated with increased opioid prescriptions after TKA. METHODS: A retrospective cohort study of TKAs in an integrated health-care system (January 2008-December 2011) was conducted...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29752280/-drosophila-insulin-receptor-regulates-the-persistence-of-injury-induced-nociceptive-sensitization
#12
Seol Hee Im, Atit A Patel, Daniel N Cox, Michael J Galko
Diabetes-associated nociceptive hypersensitivity affects diabetic patients with hard-to-treat chronic pain. Because multiple tissues are affected by systemic alterations in insulin signaling, the functional locus of insulin signaling in diabetes-associated hypersensitivity remains obscure. Here, we used Drosophila nociception/nociceptive sensitization assays to investigate the role of Insulin receptor (Insulin-like receptor, InR) in nociceptive hypersensitivity. InR mutant larvae exhibited mostly normal baseline thermal nociception (absence of injury) and normal acute thermal hypersensitivity following UV-induced injury...
May 10, 2018: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29742468/native-septic-arthritis-is-not-an-immediate-surgical-emergency
#13
Nicolas Lauper, Marie Davat, Ergys Gjika, Camillo Müller, Wilson Belaieff, Didier Pittet, Benjamin A Lipsky, Didier Hannouche, Ilker Uçkay
Acute native joint septic arthritis is generally considered a surgical emergency, requiring drainage within hours, including during night, weekend or holiday shifts. However, there are few data supporting the need for the disruption caused by this degree of urgency. METHODS: We performed a retrospective review of all adult patients seen in our medical center from 1997-2015 with culture-proven septic arthritis and noted the epidemiology of sequelae, and their possible association with a delay in surgical drainage...
May 6, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#14
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739242/challenges-and-concerns-of-persistent-opioid-use-in-cancer-patients
#15
Laxmaiah Manchikanti, Kavita N Manchikanti, Alan D Kaye, Adam M Kaye, Joshua A Hirsch
As a result of advancements in the diagnosis and treatment of cancer, two-thirds of individuals suffering with cancer survive more than 5 years after diagnosis, resulting in a large proportion of patients with chronic cancer pain alone or associated with chronic noncancer pain. There is a paucity of literature in reference to diagnosis and management of chronic cancer pain, specifically in relation to persistent opioid use, its effectiveness, and adverse consequences. Areas Covered: This review covers the prevalence of chronic cancer pain and its association with multiple comorbidities, persistent opioid use and related consequences, and challenges in managing persistent chronic cancer pain patients...
May 9, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29738803/standard-analgesics-reverse-burrowing-deficits-in-a-rat-cci-model-of-neuropathic-pain-but-not-in-models-of-type-1-and-type-2-diabetes-induced-neuropathic-pain
#16
Kris Rutten, Stacey A Gould, Luke Bryden, Henri Doods, Thomas Christoph, Anton Pekcec
BACKGROUND: Burrowing is a rodent behavior validated as a robust and reproducible outcome measure to infer the global effect of pain in several inflammatory pain models. However, less is known about the effect of analgesics on burrowing in neuropathic pain models and no studies have determined burrowing performance in models of diabetes-associated neuropathic pain. OBJECTIVE: To compare the sensitivity of the burrowing assay in different neuropathic pain models: mononeuropathic pain and diabetic polyneuropathy...
May 5, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29738328/persistent-postsurgical-pain-pathophysiology-and-preventative-pharmacologic-considerations
#17
Philippe Richebé, Xavier Capdevila, Cyril Rivat
The development of chronic pain is considered a major complication after surgery. Basic science research in animal models helps us understand the transition from acute to chronic pain by identifying the numerous molecular and cellular changes that occur in the peripheral and central nervous systems. It is now well recognized that inflammation and nerve injury lead to long-term synaptic plasticity that amplifies and also maintains pain signaling, a phenomenon referred to as pain sensitization. In the context of surgery in humans, pain sensitization is both responsible for an increase in postoperative pain via the expression of wound hyperalgesia and considered a critical factor for the development of persistent postsurgical pain...
May 7, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29736198/optimism-positive-and-negative-affect-and-goal-adjustment-strategies-their-relationship-to-activity-patterns-in-patients-with-chronic-musculoskeletal-pain
#18
Rosa Esteve, Alicia E López-Martínez, Madelon L Peters, Elena R Serrano-Ibáñez, Gema T Ruiz-Párraga, Carmen Ramírez-Maestre
Objective: Activity patterns are the product of pain and of the self-regulation of current goals in the context of pain. The aim of this study was to investigate the association between goal management strategies and activity patterns while taking into account the role of optimism/pessimism and positive/negative affect. Methods: Two hundred and thirty-seven patients with chronic musculoskeletal pain filled out questionnaires on optimism, positive and negative affect, pain intensity, and the activity patterns they employed in dealing with their pain...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29731244/engagement-in-online-pain-self-management-improves-pain-in-adults-on-medication-assisted-behavioral-treatment-for-opioid-use-disorders
#19
Marian Wilson, Myles Finlay, Michael Orr, Celestina Barbosa-Leiker, Naghmana Sherazi, Mary Lee A Roberts, Matthew Layton, John M Roll
INTRODUCTION: Persistent pain has been recognized as an important motivator that can lead individuals to misuse opioids. New approaches are needed to test pain treatments that can improve outcomes for people with persistent pain in medication-assisted behavioral treatment for opioid use disorder. This study piloted an online pain self-management program to explore acceptability and treatment effects. METHODS: A sample of 60 adults diagnosed with chronic non-cancer pain and receiving medication-assisted behavioral treatment at one of two clinics were randomized into either treatment group with access to an online pain management program or waitlist attention control...
April 27, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29730970/spinal-glial-adaptations-occur-in-a-minimally-invasive-mouse-model-of-endometriosis-potential-implications-for-lesion-etiology-and-persistent-pelvic-pain
#20
Kelsi N Dodds, Elizabeth A H Beckett, Susan F Evans, Mark R Hutchinson
Glial adaptations within the central nervous system are well known to modulate central sensitization and pain. Recently, it has been suggested that activity of glial-related proinflammatory cytokines may potentiate peripheral inflammation, via central neurogenic processes. However, a role for altered glial function has not yet been investigated in the context of endometriosis, a chronic inflammatory condition in women associated with peripheral lesions, often manifesting with persistent pelvic pain. Using a minimally invasive mouse model of endometriosis, we investigated associations between peripheral endometriosis-like lesions and adaptations in central glial reactivity...
January 1, 2018: Reproductive Sciences
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