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Persistent chronic pain

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https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#1
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908839/the-transition-of-acute-postoperative-pain-to-chronic-pain-an-integrative-overview-of-research-on-mechanisms
#2
C Richard Chapman, Charles J Vierck
The nature of the transition from acute to chronic pain still eludes explanation, but chronic pain resulting from surgery provides a natural experiment that invites both clinical epidemiological investigation and basic scientific inquiry into the mechanisms of this transition. The primary purpose of this paper is to review current knowledge and hypotheses on the transition from acute to persistent postsurgical pain, summarizing literature on clinical epidemiological studies of persistent postsurgical pain development, as well as basic neurophysiological studies targeting mechanisms in the periphery, spinal cord, and brain...
November 28, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27904908/spreading-of-pain-and-insomnia-in-patients-with-chronic-pain-results-from-a-national-quality-registry-sqrp
#3
Peter Alföldi, Elena Dragioti, Tobias Wiklund, Björn Gerdle
OBJECTIVE: To explore how demographics, pain, psychosocial factors and insomnia relate to the spread of chronic pain. METHODS: The study included 708 patients (68% women; median age 46 years; interquartile range 35-57 years) with chronic pain who were referred to a multidisciplinary pain centre. Spreading of pain was assessed using a questionnaire covering 36 anatomically predefined pain regions. Data were collected on demographics, pain symptoms, psychological distress, and insomnia (Insomnia Severity Index)...
November 30, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27902749/risk-factors-associated-with-renal-involvement-in-childhood-henoch-sch%C3%A3-nlein-purpura-a-meta-analysis
#4
Han Chan, Yan-Ling Tang, Xiao-Hang Lv, Gao-Fu Zhang, Mo Wang, Hai-Ping Yang, Qiu Li
BACKGROUND AND OBJECTIVE: Henoch-Schönlein purpura (HSP) is an important cause of chronic kidney disease in children. This meta-analysis identified risk factors associated with renal involvement in childhood HSP. METHODS: PubMed, Embase, and Web of Science were searched. The quality of all eligible studies was assessed using the Newcastle-Ottawa scale criteria. An analysis of possible risk factors was conducted to report the odds ratio (OR) and weighted mean difference (WMD)...
2016: PloS One
https://www.readbyqxmd.com/read/27895138/urotensin-ii-inhibitor-eases-neuropathic-pain-by-suppressing-the-jnk-nf-%C3%AE%C2%BAb-pathway
#5
Jing Li, Pan-Pan Zhao, Ting Hao, Dan Wang, Yu Wang, Yang-Zi Zhu, Yu-Qing Wu, Cheng-Hua Zhou
Urotensin II (U-II), a cyclic peptide originally isolated from the caudal neurosecretory system of fishes, can produce proinflammatory effects through its specific G protein-coupled receptor, GPR14. Neuropathic pain, a devastating disease, is related to excessive inflammation in the spinal dorsal horn. However, the relationship between U-II and neuropathic pain has not been reported. This study was designed to investigate the effect of U-II antagonist on neuropathic pain and to understand the associated mechanisms...
February 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/27893306/mesh-fixation-with-fibrin-sealant-in-totally-extraperitoneal-hernia-repair
#6
Hank Hirsch, Kei Nagatomo, Jonathan Gefen
INTRODUCTION: Repair of inguinal hernia is a common procedure, but there is a lack of consensus as to the optimal repair technique along with the use of mesh and methods of mesh fixation. The objective of this study was to evaluate the efficacy and safety of fibrin sealant for mesh fixation in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. MATERIALS AND METHODS: A study was conducted of the first 200 patients undergoing TEP hernia repair with mesh fixation using fibrin sealant between March 2012 and January 2014...
November 28, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27885914/chronic-pain-in-older-adults-prevalence-incidence-and-risk-factors
#7
C Larsson, E E Hansson, K Sundquist, U Jakobsson
OBJECTIVES: Chronic pain is common in older adults, yet little is known of its development and the factors that predict its persistence and onset at old age. The aims of this longitudinal cohort study were to examine the prevalence and incidence of chronic pain and to explore possible risk factors for its persistence and onset in a representative sample of older Swedish adults. METHOD: Data were collected through questionnaires and followed up after 12 and 24 months...
November 25, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27885426/prospective-cohort-study-assessing-chronic-pain-in-patients-following-minor-surgery-for-breast-cancer
#8
Régis Fuzier, Floriane Puel, Philippe Izard, Agnès Sommet, Sébastien Pierre
PURPOSE: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27885350/a-case-of-dermatomyositis-and-anti-ej-autoantibody-with-chronic-intestinal-pseudoobstruction-successfully-treated-with-octreotide
#9
Chiho Yamada, Shinji Sato, Noriko Sasaki, Takayoshi Kurabayashi, Sho Sasaki, Yasushi Koyama, Naofumi Chinen, Takayuki Wakabayashi, Yasuo Suzuki
Chronic intestinal pseudoobstruction (CIPO) is a serious complication in patients with connective tissue disease (CTD) and is sometimes life-threatening or fatal despite intensive medical treatment. Here, we report a patient with dermatomyositis (DM) and anti-EJ autoantibody who developed CIPO that was improved by octreotide. Because her abdominal pain and bloatedness were so severe and persistent, we introduced octreotide to relieve symptoms. In this case, continuous intravenous administration as well as long-acting subcutaneous injection of octreotide was effective for treating CIPO...
2016: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/27884934/chronic-neuropathic-pain-severity-is-determined-by-lesion-level-in-aquaporin-4-antibody-positive-myelitis
#10
George Tackley, Domizia Vecchio, Shahd Hamid, Maciej Jurynczyk, Yazhuo Kong, Rosie Gore, Kerry Mutch, Mark Woodhall, Patrick Waters, Angela Vincent, Maria Isabel Leite, Irene Tracey, Anu Jacob, Jacqueline Palace
IMPORTANCE: Chronic, intractable neuropathic pain is a common and debilitating consequence of neuromyelitis optica spectrum disorder (NMOSD) myelitis, with no satisfactory treatment; few studies have yet to explore its aetiology. OBJECTIVE: To establish if myelitis-associated chronic pain in NMOSD is related to the craniocaudal location of spinal cord lesions. METHOD: (1) Retrospective cohort of 76 aquaporin 4-antibody (AQP4-Ab)-positive patients from Oxford and Liverpool's national NMOSD clinics, assessing current pain and craniocaudal location of cord lesion contemporary to pain onset...
November 24, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#11
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27876655/dorsal-root-ganglion-stimulation-attenuates-the-bold-signal-response-to-noxious-sensory-input-in-specific-brain-regions-insights-into-a-possible-mechanism-for-analgesia
#12
Christopher P Pawela, Jeffery M Kramer, Quinn H Hogan
Targeted dorsal root ganglion (DRG) electrical stimulation (i.e. ganglionic field stimulation - GFS) is an emerging therapeutic approach to alleviate chronic pain. Here we describe blood oxygen-level dependent (BOLD) functional magnetic resonance imaging (fMRI) responses to noxious hind-limb stimulation in a rat model that replicates clinical GFS using an electrode implanted adjacent to the DRG. Acute noxious sensory stimulation in the absence of GFS caused robust BOLD fMRI response in brain regions previously associated with sensory and pain-related response, such as primary/secondary somatosensory cortex, retrosplenial granular cortex, thalamus, caudate putamen, nucleus accumbens, globus pallidus, and amygdala...
November 19, 2016: NeuroImage
https://www.readbyqxmd.com/read/27873750/persistent-spontaneous-fungal-peritonitis-secondary-to-candida-albicans-in-a-patient-with-alcoholic-cirrhosis-and-review-of-the-literature
#13
Aneela Majeed, Waqas Ullah, Umar Zahid, Mayar Al Mohajer
Candida albicans is a common human pathogen. Occasionally, it can cause peritonitis in immunocompromised and postsurgical patients. We report a case of a male patient who presented with abdominal pain and distention. He had a history of end-stage liver disease secondary to alcoholism. His peritoneal fluid culture revealed C albicans, and (1-3)-β-d glucan (BDG) level was elevated. His hospital course was complicated by sepsis and renal failure. He was treated with antifungals for spontaneous fungal peritonitis...
November 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27871525/a-retrospective-study-of-open-thoracotomies-versus-thoracoscopic-surgeries-for-persistent-postthoracotomy-pain
#14
Harsha Shanthanna, Dina Aboutouk, Eugenia Poon, Ji Cheng, Christian Finley, James Paul, Lehana Thabane
OBJECTIVE: Persistent thoracotomy pain syndrome (PTPS) is a recognized complication and is considered to be less after video-assisted thoracoscopic surgery (VATS) compared with open thoracic surgery (OTS). The primary objective was to compare the incidence of PTPS at 6 months. Secondary objectives were to compare the incidence of neuropathic pain between VATS and OTS and to report perioperative factors associated with the development of PTPS. METHODS: This historical cohort study involved patient contact by a questionnaire regarding the presence of PTPS and its type...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871011/multiple-concurrent-bilateral-groin-hernias-in-a-single-patient-a-case-report-and-a-review-of-uncommon-groin-hernias-a-possible-source-of-persistent-pain-after-successful-repair
#15
O Y Matsevych, M Z Koto, J H R Becker
INTRODUCTION: The wide use of laparoscopy for groin hernia repair has unveiled "hidden hernias" silently residing in this area. During the open repair of the presenting hernia, the surgeon was often unaware of these occult hernias. These patients postoperatively may present with unexplained chronic groin or pelvic pain. PRESENTATION OF CASE: Rare groin hernias are defined according to their anatomical position. Challenges in the diagnosis and management of occult rare groin hernias are discussed...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27867512/a-service-improvement-project-to-review-prescribing-information-provided-by-general-practitioners-for-new-referrals-to-a-uk-national-health-service-hospital-pain-clinic-potential-implications-of-cyp2d6-enzyme-inhibition
#16
Helen Radford, Pauline Fitzgerald, Stephen Martin, Mark I Johnson
INTRODUCTION: Chronic pain is often managed using co-prescription of analgesics and adjuvants, with concomitant medication prescribed for comorbidities. Patients may have suboptimal response to some analgesics or be at risk of drug interactions or adverse drug reactions (ADRs) due to polypharmacy affecting CYP2D6 enzyme activity. The aim of the service improvement project was to determine the proportion of patients referred to a specialist pain service in the UK National Health Service (NHS) by general practitioners (GPs) who may be at risk of suboptimal analgesic response or ADRs due to CYP2D6 inhibition through polypharmacy...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27867508/a-feasibility-study-to-determine-the-benefits-of-upper-extremity-virtual-rehabilitation-therapy-for-coping-with-chronic-pain-post-cancer-surgery
#17
Gregory House, Grigore Burdea, Namrata Grampurohit, Kevin Polistico, Doru Roll, Frank Damiani, Jasdeep Hundal, Didier Demesmin
BACKGROUND: Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27866180/positive-effects-of-uyakujunkisan-therapy-kampo-medicine-for-postherpetic-neuralgia-with-concomitant-pregabalin-two-case-reports-with-a-literature-review
#18
Toshiaki Kogure, Naoyuki Harada, Kanoko Yamamoto, Takeshi Tatsumi
Context • The hallmark of herpes zoster (HZ) is a painful, blistering rash, but neuropathic pain can persist beyond the clearing of the rash and is diagnosed as postherpetic neuralgia (PHN), a chronic pain syndrome. However, the pain in PHN is often refractory to treatment. Objective • The study investigated the ability of Uyakujunkisan (UJS), or Kampo medicine, a traditional herbal medicine, to treat PHN successfully. Design • The study was observational, with discussion of 2 cases. Setting • The study took place in the Department of Japanese Oriental Medicine at Gunma Central and General Hospital (Maebashi, Gunma, Japan)...
November 2016: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/27864046/acute-colitis-chronically-alters-immune-infiltration-mechanisms-and-sensory-neuro-immune-interactions
#19
Melissa A Campaniello, Chris Mavrangelos, Samuel Eade, Andrea M Harrington, L Ashley Blackshaw, Stuart M Brierley, Scott D Smid, Patrick A Hughes
OBJECTIVE: Little is understood regarding how disease progression alters immune and sensory nerve function in colitis. We investigated how acute colitis chronically alters immune recruitment and the impact this has on re-activated colitis. To understand the impact of disease progress on sensory systems we investigated the mechanisms underlying altered colonic neuro-immune interactions after acute colitis. DESIGN: Inflammation was compared in mouse models of health, acute tri-nitrobenzene sulphonic acid (TNBS) colitis, Remission and Reactivated colitis...
November 15, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27863271/comparison-of-combined-hormonal-vaginal-ring-and-low-dose-combined-oral-hormonal-pill-for-the-treatment-of-idiopathic-chronic-pelvic-pain-a-randomised-trial
#20
Khushboo Priya, Shalini Rajaram, Neerja Goel
OBJECTIVE: To compare the efficacy and acceptability of combined hormonal vaginal ring with combined oral hormonal pill in women with idiopathic chronic pelvic pain. STUDY DESIGN: Randomised prospective interventional trial conducted in 60 women with idiopathic chronic pelvic pain. Women were randomised into two groups of 30 each. In each group, treatment was given for 84 days using either combined vaginal ring or combined oral hormonal pill. Hormonal vaginal ring releases 15mcg of ethinyl estradiol and 120mcg of the etonogestrel per day while the hormonal pill contained 30mcg of ethinyl estradiol and 150mcg of levonorgestrel...
November 8, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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