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Persistent chronic pain

Signe B Bentsen, Christine Miaskowski, Bruce A Cooper, Vivi L Christensen, Anne H Henriksen, Are M Holm, Tone Rustøen
Background: Few studies have examined changes in the pain experience of patients with COPD and predictors of pain in these patients. Objectives: The objectives of the study were to examine whether distinct groups of COPD patients could be identified based on changes in the occurrence and severity of pain over 12 months and to evaluate whether these groups differed on demographic, clinical, and pain characteristics, and health-related quality of life (HRQoL). Patients and methods: A longitudinal study of 267 COPD patients with very severe COPD was conducted...
2018: International Journal of Chronic Obstructive Pulmonary Disease
William J Cottam, Sarina J Iwabuchi, Marianne M Drabek, Diane Reckziegel, Dorothee P Auer
Resting-state functional connectivity (FC) has proven a powerful approach to understand the neural underpinnings of chronic pain, reporting altered connectivity in three main networks: the default mode (DMN), central executive (CEN), and the salience network (SN). The interrelation and possible mechanisms of these changes are less well understood in chronic pain. Based on emerging evidence of its role to drive switches between network states, the right anterior insula (rAI, an SN hub) may play a dominant role in network connectivity changes underpinning chronic pain...
March 16, 2018: Pain
Carole Mast, Dominique Dardevet, Isabelle Papet
The optimisation of nutritional support for the growing number of older individuals does not usually take into account medication. Paracetamol (acetaminophen; APAP) is the first intention treatment of chronic pain that is highly prevalent and persistent in the elderly. Detoxification of APAP occurs in the liver and utilises sulfate and glutathione (GSH), both of which are issued from cysteine (Cys), a conditionally indispensable amino acid. The detoxification-induced siphoning of Cys could reduce the availability of Cys for skeletal muscle...
March 20, 2018: Nutrition Research Reviews
Michael Froehner, Steffen Jahn, Verena Plodeck, Michael Laniado, Manfred P Wirth
A 51-year old male patient presented with lower abdominal pain persisting since about one year. Abdominal computed tomography scan showed a solid tumor interpreted as urachal carcinoma with peritoneal carcinomatosis. Histopathological examination revealed urachal abscess. Awareness of clinical signs and imaging findings of this rare but characteristic condition may avoid emotional distress of patients associated with erroneous suspicion of malignancy.
March 15, 2018: Urology
Sharon Reif, Rachel Sayko Adams, Grant A Ritter, Thomas V Williams, Mary Jo Larson
Introduction: Soldiers are at risk for acute and chronic pain due to the mental and physical challenges of military duties and ongoing training for force readiness. With the burden of pain on any individual attributable across pain sources, a broad perspective that goes beyond prior characterizations of pain is important. We aim to further the understanding of pain's effects among non-deployed active duty soldiers and the Military Health System (MHS), by describing prevalence of 10 painful conditions, reported pain levels, duration of pain and impact of pain on military duty limitations...
March 14, 2018: Military Medicine
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Muhammad Shahid, Nicole Gull, Austin Yeon, Eunho Cho, Jooeun Bae, Hyun Seok Yoon, Sungyong You, Hana Yoon, Minjung Kim, Benjamin P Berman, Jayoung Kim
Interstitial cystitis (IC) is a chronic urinary tract disease that is characterized by unpleasant sensations, such as persistent pelvic pain, in the absence of infection or other identifiable causes. We previously performed comprehensive metabolomics profiling of urine samples from IC patients using nuclear magnetic resonance and gas-chromatography/mass spectrometry and found that urinary α-oxoglutarate (α-OG), was significantly elevated. α-OG, a tricarboxylic acid (TCA) cycle intermediate, reportedly functions to suppress the proliferation of immortalized normal human bladder epithelial cells...
March 14, 2018: Scientific Reports
Agnieszka E Zawada, Małgorzata Moszak, Dorota Skrzypczak, Marian Grzymisławski
Diabetes mellitus is a systemic disease which affects patients of various age. Hyperglycemia induces damage of vascular endothelium, development of chronic inflammation, organic and functional lesions in several systems and organs. The principal gastroenterological complaints linked to the manifestation of the disease include abdominal pain, diarrhea, nausea, flatulence, and vomiting. However, complications in the alimentary system may manifest exclusively by difficulties in reaching normoglycemia and numerous persistent episodes of hypoglycemia...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Guan Yun Frances Wang, Xiang Qun Shi, Wenjia Wu, Maria Gueorguieva, Mu Yang, Ji Zhang
Temporomandibular disorder (TMD) is a set of heterogeneous musculoskeletal conditions involving the temporomandibular joint (TMJ) and/or the masticatory muscles. Up to 33% of the population has had at least one symptom of TMD with 5-10% of them requiring treatment. Common symptoms include limited jaw movement, joint sound, and pain in the orofacial area. Once TMD becomes chronic, it can be debilitating with comorbidities that greatly reduce one's overall quality of life. However, the underlying mechanism of TMD is unclear due to the multicausative nature of the disease...
March 12, 2018: Pain
Meritxell Llorca-Torralba, Juan A Mico, Esther Berrocoso
The persistent activation of N-methyl-d-aspartate acid receptors (NMDARs) seems to be responsible for a series of changes in neurons associated with neuropathic pain, including the failure of opioids that act through mu-opioid receptors (MORs) to provide efficacious pain relief. As the noradrenergic locus coeruleus (LC) forms part of the endogenous analgesic system, we explored how intra-LC administration of morphine, a MORs agonist, alone or in combination with MK-801, a NMDARs antagonist, affects the sensorial and affective dimension of pain in a rat model of neuropathic pain; chronic constriction injury (CCI)...
March 7, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
Yoko Sugiyama, Hiroki Iida, Fumimasa Amaya, Kanako Matsuo, Yutaka Matsuoka, Keiko Kojima, Fumitaka Matsuno, Takayuki Hamaguchi, Masako Iseki, Keisuke Yamaguchi, Yoshika Takahashi, Atsuko Hara, Yusuke Sugasawa, Mikito Kawamata, Satoshi Tanaka, Yoshimi Inagaki, Akihiro Otsuki, Mitsuaki Yamazaki, Hisakatsu Ito
We performed a multicenter observational study to assess the prevalence and risk factors of persistent pain after lung cancer surgery and total knee arthroplasty (TKA) in the Japanese population. After receiving Ethics Committee approval, a retrospective chart review was performed for patients who underwent surgery at seven university hospitals in Japan in 2013. A total of 511 patients who underwent lung cancer surgery and 298 patients who underwent TKA were included. The prevalence of chronic postsurgical pain (CPSP) at 3 and 6 months was 18 and 12% after lung surgery and 49 and 33% after TKA, respectively...
March 9, 2018: Journal of Anesthesia
Abdulhadi A AlAmodi, Mohamad H Farhoud, Najwa Mohammad, Rawan Alatassi, Dana Alolayet, Noor AlQeshtaini, Raghad AlMamlouk, Mohamed Hussein Ahmed, Mahmoud Ashour, Sara S Kayyali, Abdullah AlShammari
BACKGROUND Leiomyomas are benign neoplasms of the smooth muscle. When found in the pulmonary system, a rare occurrence, leiomyomas can result in hypertrophic osteoarthropathy, or significant clubbing, associated with proliferation of long bone periosteum. Bronchopulmonary fistulas, or communications between the bronchial tree and pleural space, are an uncommon postoperative complication of pneumonectomies. Even more infrequent is the presence of a bronchopulmonary fistula that is determined to be sterile. CASE REPORT The patient presented in the current case report is a 40-year-old previously healthy woman who presented with a 5-year history of chronic cough, right-sided chest discomfort, and dyspnea associated with back pain, and lower leg pain...
March 9, 2018: American Journal of Case Reports
Jelena M Janjic, Kiran Vasudeva, Muzamil Saleem, Andrea Stevens, Lu Liu, Sravan Patel, John A Pollock
Neuroinflammation involving macrophages elevates Prostaglandin E2 , associated with neuropathic pain. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) inhibits cyclooxygenase, reducing PGE2 . However, NSAIDs cause physiological complications. We developed nanoemulsions incorporating celecoxib and near infrared dye. Intravenous injected nanoemulsion is incorporated into monocytes that accumulate at the injury; revealed in live animals by fluorescence. A single dose (celecoxib 0.24 mg/kg) provides targeted delivery in chronic constriction injury rats, resulting in significant reduction in the visualized inflammation, infiltration of macrophages, COX-2 and PGE2 ...
February 25, 2018: Journal of Neuroimmunology
Bart Morlion, Flaminia Coluzzi, Dominic Aldington, Magdalena Kocot-Kepska, Joseph Pergolizzi, Ana Cristina Mangas, Karsten Ahlbeck, Eija Kalso
OBJECTIVE: Pain is one of the most common reasons for an individual to consult their primary care physician, with the majority of chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of `pain chronification'. METHODS: This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification...
March 7, 2018: Current Medical Research and Opinion
Rikke Vibeke Nielsen
Increasing evidence indicate that pain is insufficiently treated following surgical procedures. It is essential that pain treatment is effective with a minimum of side effects in order to promote postoperative rehabilitation. Multimodal analgesia is most likely an important strategy in reducing postoperative pain. Combinations of different analgesics with different mechanisms of action may have an additive analgesic effect with fewer side effects compared to using a single drug. However, there is still a pronounced lack of documentation for the effect and side effects of these multimodal analgesic regimes...
March 2018: Danish Medical Journal
Morten Rune Blichfeldt-Eckhardt
The thesis comprises an overview and four papers, all published or submitted for publication in international peer-reviewed scientific journals.
Chronic pain after surgery is a common and debilitating complication after many types of surgery. The cause and pathology behind is still mainly uncovered, though several risk factors have been proposed. One of the strongest risk factors for persistent postsurgical pain is the intensity of the acute pain response though the mechanisms involved remain unsettled...
March 2018: Danish Medical Journal
Moon-Jong Kim, Hong-Seop Kho
Burning mouth syndrome (BMS) is a chronic pain condition characterised by a persistent burning sensation in clinically normal oral mucosa. BMS most commonly occurs in middleaged and elderly women. Various local and systemic factors can cause oral burning symptoms. When all possible local and systemic factors are excluded, burning mouth symptoms can be diagnosed as BMS. Psychophysical tests and histopathological data suggest the involvement of peripheral and central neuropathic mechanisms in BMS etiopathogenesis...
2018: Chinese Journal of Dental Research
Gilda Giancotti, Michela Cancellieri, Andrea Balboni, Mariateresa Giustiniano, Ettore Novellino, Leen Delang, Johan Neyts, Pieter Leyssen, Andrea Brancale, Marcella Bassetto
Chikungunya virus is a re-emerging arbovirus transmitted to humans by Aedes mosquitoes, responsible for an acute febrile illness associated with painful and debilitating arthralgia, which can persist for several months or become chronic. Over the past few years, infection with this virus has spread worldwide with a previously unknown virulence. No specific antiviral treatments nor vaccines are currently available against this important pathogen. Starting from the structure of a class of selective anti-CHIKV agents previously identified in our research group, different modifications to this scaffold were rationally designed, and 69 novel small-molecule derivatives were synthesised and evaluated for their inhibition of Chikungunya virus replication in Vero cells...
February 23, 2018: European Journal of Medicinal Chemistry
Yaping Ji, Bo Hu, Jiyun Li, Richard J Traub
Chronic stress produces maladaptive pain responses, manifested as alterations in pain processing and exacerbation of chronic pain conditions including irritable bowel syndrome. Female predominance, especially during reproductive years, strongly suggests a role of gonadal hormones. However, gonadal hormone modulation of stress-induced pain hypersensitivity is not well understood. In the present study, we tested the hypothesis that estradiol is pronociceptive and testosterone is antinociceptive in a model of stress-induced visceral hypersensitivity (SIVH) in rats by recording the visceromotor response to colorectal distention following a 3 day forced swim stress (FS) paradigm...
February 26, 2018: Journal of Pain: Official Journal of the American Pain Society
Stephanie Voss, Albrecht Will, Rüdiger Lange, Bernhard Voss
BACKGROUND: Sternal dehiscence after median sternotomy is a challenging problem in cases of frail bone, fractures or complete sternectomy. Plate osteosynthesis offers a promising approach to restore sternal integrity. However, there is only scarce data on mid-term outcome. METHODS: Mid-term data on 34 patients with unstable thorax after open-heart surgery, requiring sternal refixation with the Synthes™ Titanium Sternal Fixation System© (TSFS) between 2005 and 2011 were analyzed...
February 26, 2018: Annals of Thoracic Surgery
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