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Persistent chronic pain

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https://www.readbyqxmd.com/read/29346515/a-brain-based-pain-facilitation-mechanism-contributes-to-painful-diabetic-polyneuropathy
#1
Andrew R Segerdahl, Andreas C Themistocleous, Dean Fido, David L Bennett, Irene Tracey
The descending pain modulatory system represents one of the oldest and most fundamentally important neurophysiological mechanisms relevant to pain. Extensive work in animals and humans has shown how a functional imbalance between the facilitatory and inhibitory components is linked to exacerbation and maintenance of persistent pain states. Forward translation of these findings into clinical populations is needed to verify the relevance of this imbalance. Diabetic polyneuropathy is one of the most common causes of chronic neuropathic pain; however, the reason why ∼25-30% of patients with diabetes develop pain is not known...
January 15, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29340793/neuroimaging-findings-in-patients-with-medication-overuse-headache
#2
REVIEW
Tzu-Hsien Lai, Shuu-Jiun Wang
Medication overuse headache (MOH) is a secondary headache syndrome defined as the deterioration of the headache associated with the overuse of analgesics. The prevalence of MOH is 1-2% in the general population and even up to 50% in special clinics. Overuse of abortive medications is highly associated with chronic daily headaches and also a known risk factor for headache evolution. Possible mechanisms include neural plasticity changes such as sensitization and defective endogenous pain inhibition. Psychological studies have suggested dependence, even addiction, in patients with MOH...
January 16, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29330742/henoch-sch%C3%A3-nlein-purpura-nephritis-initial-risk-factors-and-outcomes-in-a-latin-american-tertiary-center
#3
Izabel M Buscatti, Beatriz B Casella, Nadia E Aikawa, Andrea Watanabe, Sylvia C L Fahrat, Lucia M A Campos, Clovis Artur Silva
The objective of this study was to evaluate prevalence, initial risk factors, and outcomes in Henoch-Schönlein purpura nephritis (HSPN) patients in Latin America. Two hundred ninety-six patients (validated EULAR/PRINTO/PRES HSP criteria) were assessed by demographic data, clinical/laboratorial involvements, and treatments in the first 3 months after diagnosis. They were followed-up in a Latin American tertiary center and were divided in two groups: with and without nephritis. Persistent non-nephrotic proteinuria, nephrotic proteinuria, and acute/chronic kidney injury were also systematically evaluated at 1, 5, 10, and 15 years after diagnosis...
January 13, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29327128/isolated-avulsion-fracture-of-the-first-metatarsal-base-at-the-peroneus-longus-tendon-attachment-a-case-report
#4
Maxwell W Weinberg, Nicola Krähenbühl, Nathan P Davidson, Christopher J Hanrahan, Alexej Barg
Avulsion fractures of the first metatarsal (MT1) base at the peroneus longus (PL) tendon attachment are rare and may be undiagnosed during an emergency visit. If the injury is not treated properly, chronic pain or persistent impairment for inversion and plantar-flexion of the first ray may occur. This case report presents a 30-year-old woman who presented 10 weeks post trauma to a foot and ankle surgeon due to a swollen right midfoot with diffuse tenderness over the medial Lisfranc joint. Further evaluation showed an isolated avulsion fracture of the first metatarsal, which was undiagnosed during the emergent visit following the accident...
January 11, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29323824/a-case-of-atypical-synovitis-acne-pustulosis-hyperostosis-osteitis-sapho-syndrome-presenting-with-osteomyelitis-of-the-clavicle
#5
Chetan Sharma, Brian Chow
Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is considered after exclusion of infection and arthritis; however, microbial infection may be present in osteoarticular lesions of these patients. Chronic osteomyelitis and associated bacterial infection were detected in a recurrent osteoarticular lesion in an adolescent patient with a history of clavicle pain, who complained of recurrent swelling in the left clavicle. Most pediatric case reports of SAPHO syndrome describe patients with associated skin conditions...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322254/the-effects-of-the-calcium-magnesium-bicarbonate-content-in-thermal-mineral-water-on-chronic-low-back-pain-a-randomized-controlled-follow-up-study
#6
Gáti Tamás, Tefner Ildikó Katalin, Kovács Lajos, Hodosi Katalin, Bender Tamás
The aim of this study was to investigate the effects of balneotherapy on chronic low back pain. This is a minimized, follow-up study evaluated according to the analysis of intention to treat. The subjects included in the study were 105 patients suffering from chronic low back pain. The control group (n = 53) received the traditional musculoskeletal pain killer treatment, while the target group (n = 52) attended thermal mineral water treatment for 3 weeks for 15 occasions on top of the usual musculoskeletal pain killer treatment...
January 10, 2018: International Journal of Biometeorology
https://www.readbyqxmd.com/read/29319390/an-exploration-of-pain-experiences-and-their-meaning-in-people-with-chronic-obstructive-pulmonary-disease
#7
Annemarie L Lee, Samantha L Harrison, Roger S Goldstein, Dina Brooks
BACKGROUND: Pain is a common symptom in people with chronic obstructive pulmonary disease (COPD) which negatively influences quality of life and psychological well-being. However, our understanding of how those with COPD interpret the experience of pain is very limited. OBJECTIVES: To explore how individuals with moderate to severe COPD experience pain. METHODS: Eight patients diagnosed with COPD who reported experiencing pain for greater than three months participated in in-depth interviews...
January 10, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29318865/-advances-in-acupuncture-mechanism-research-on-the-changes-of-synaptic-plasticity-pain-memory-for-chronic-pain
#8
Yi-Ling Yang, Jian-Peng Huang, Li Jiang, Jian-Hua Liu
Previous studies have shown that there are many common structures between the neural network of pain and memory, and the main structure in the pain network is also part of the memory network. Chronic pain is characterized by recurrent attacks and is associated with persistent ectopic impulse, which causes changes in synaptic structure and function based on nerve activity. These changes may induce long-term potentiation of synaptic transmission, and ultimately lead to changes in the central nervous system to produce "pain memory"...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29317848/traumatic-osteoarthritis-induced-persistent-mechanical-hyperalgesia-in-a-rat-model-of-anterior-cruciate-ligament-transection-plus-a-medial-meniscectomy
#9
Hsiao-Chien Tsai, Ta-Liang Chen, Yu-Pin Chen, Ruei-Ming Chen
Background: Osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage degeneration, subchondral bone changes, osteophyte formation, and synovitis. A major symptom is pain that is triggered by peripheral and central changes within the pain pathways. Some surgery-induced joint instability rat models of OA were described to mimic traumatic OA. Several behavioral tests were developed to access OA-induced pain. However, follow-up in most studies usually only occurred for about 4 weeks...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29317049/autoimmunity-against-a-glycolytic-enzyme-as-a-possible-cause-for-persistent-symptoms-in-lyme-disease
#10
Paolo Maccallini, Serena Bonin, Giusto Trevisan
Some patients with a history of Borrelia burgdorferi infection develop a chronic symptomatology characterized by cognitive deficits, fatigue, and pain, despite antibiotic treatment. The pathogenic mechanism that underlines this condition, referred to as post-treatment Lyme disease syndrome (PTLDS), is currently unknown. A debate exists about whether PTLDS is due to persistent infection or to post-infectious damages in the immune system and the nervous system. We present the case of a patient with evidence of exposure to Borrelia burgdorferi sl and a long history of debilitating fatigue, cognitive abnormalities and autonomic nervous system issues...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29313113/epidemiology-and-contemporary-management-of-abdominal-aortic-aneurysms
#11
Brant W Ullery, Richard L Hallett, Dominik Fleischmann
Abdominal aortic aneurysm (AAA) is most commonly defined as a maximal diameter of the abdominal aorta in excess of 3 cm in either anterior-posterior or transverse planes or, alternatively, as a focal dilation ≥ 1.5 times the diameter of the normal adjacent arterial segment. Risk factors for the development of AAA include age > 60, tobacco use, male gender, Caucasian race, and family history of AAA. Aneurysm growth and rupture risk appear to be associated with persistent tobacco use, female gender, and chronic pulmonary disease...
January 9, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29310646/fatigue-and-disturbances-of-sleep-in-patients-with-osteogenesis-imperfecta-a-cross-sectional-questionnaire-study
#12
Heidi Arponen, Janna Waltimo-Sirén, Helena Valta, Outi Mäkitie
BACKGROUND: Persisting fatigue has been reported to be a common complaint by individuals with connective tissue disorders, including Osteogenesis imperfecta (OI). This controlled study evaluated in an adult OI population the subjective experience of fatigue, affecting daily life. Sleep disturbances and chronic pain were examined as hypothesized underlying factors. METHODS: This cross-sectional study analyzed the answers of 56 OI patients and 56 matched healthy controls to a questionnaire, designed to evaluate levels of experienced fatigue and bodily pain, as well as the presence or absence of symptoms related to sleep disturbances or sleep apnea...
January 8, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29302146/helicobacter-pylori-in-dyspepsia-phenotypic-and-genotypic-methods-of-diagnosis
#13
Vignesh Shetty, Mamatha Ballal, Girisha Balaraju, Shiran Shetty, Ganesh C Pai, Ramachandra Lingadakai
Background: Helicobacter pylori affects almost half of the world's population and therefore is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with chronic gastritis, ulcer disease (gastric and duodenal), mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Several diagnostic methods exist to detect infection and the option of one method or another depends on various genes, such as availability, advantages and disadvantages of each method, monetary value, and the age of patients...
October 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/29291254/supportive-periodontal-therapy-spt-for-maintaining-the-dentition-in-adults-treated-for-periodontitis
#14
REVIEW
Carolina Manresa, Elena C Sanz-Miralles, Joshua Twigg, Manuel Bravo
BACKGROUND: Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re-infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases...
January 1, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29289751/patient-selection-for-total-pancreatectomy-with-islet-autotransplantation-in-the-surgical-management-of-chronic-pancreatitis
#15
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. METHODS: A prospectively maintained database of patients undergoing TPIAT is reviewed. Islet function is inferred from daily insulin requirement. Pain relief is evaluated by healthcare utilization and narcotic use. Quality of life (QOL) is measured with SF-12...
December 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29287308/chikungunya-virus-arthritis-implications-of-acute-and-chronic-inflammation-mechanisms-on-patient-management
#16
REVIEW
Ali Zaid, Patrick Gérardin, Adam Taylor, Helen Mostafavi, Denis Malvy, Suresh Mahalingam
In the past decade, arboviruses - arthropod-borne viruses - have been the focus of public health institutions worldwide following a spate of devastating outbreaks. Chikungunya virus (CHIKV), an arbovirus that belongs to the alphavirus genus, is a re-emerging arthritogenic virus that has caused explosive outbreaks since 2006, notably in the Reunion Island, and more recently in the Caribbean, South America, India and South-East Asia. The severity of arthritic disease caused by CHIKV has prompted public health authorities of affected countries to develop specific guidelines to tackle this pathogen...
December 29, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29285444/optimal-levothyroxine-replacement-adequately-improves-symptoms-of-hypothyroidism-residual-symptoms-need-further-evaluation-for-other-than-hypothyroidism-causation
#17
Rekha Singh, Ashwani Tandon, Sushil Kumar Gupta, K Saroja
Objectives: Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of primary hypothyroidism and compare with controls with other chronic conditions. Methods: This prospective case-control follow-up study enrolled patients from July 2014 to May 2015 in an endocrine outpatient clinic of a tertiary hospital...
November 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29284194/chronic-calf-pain-caused-by-fibroma-induced-chronic-inflammation-around-the-tibial-and-peroneal-nerves-that-was-misdiagnosed-as-centralized-neuropathic-pain-a-case-report
#18
Park Jiyoung, Ok Seong-Ho, Han Jeong Yeol, Park Miyeong, Seo Eun Hui, Kim Yeon A
INTRODUCTION: The etiology of calf pain varies widely; therefore, it is difficult to diagnose and requires careful history taking and physical examination by primary care unit physicians. Because ultrasonography is easy to perform, cheap, and readily available with physicians during a routine consultation, it is the first choice of modality for the evaluation of calf pain. However, simple inflammation around the nerve should also be considered as a possible etiology. Here we describe a 35-year-old man with chronic pain in the right calf that was actually caused by fibroma-induced chronic inflammation around the tibial and peroneal nerves but misdiagnosed as centralized neuropathic pain...
December 28, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29282702/treatment-of-dizziness-an-interdisciplinary-update
#19
Rainer Spiegel, Heiko Rust, Thomas Baumann, Hergen Friedrich, Raoul Sutter, Martina Göldlin, Christiane Rosin, René Müri, Georgios Mantokoudis, Roland Bingisser, Michael Strupp, Roger Kalla
This review provides an update on interdisciplinary treatment for dizziness. Dizziness can have various causes and the treatment offered should depend on the cause. After reading this article, the clinician will have an overview of current treatment recommendations. Recommendations are made for the most prevalent causes of dizziness including acute and chronic vestibular syndromes, vestibular neuritis, benign paroxysmal positional vertigo, endolymphatic hydrops and Menière's disease, vestibular paroxysmia and vestibular migraine, cardiac causes, transient ischaemic attacks and strokes, episodic ataxia type 2, persistent postural-perceptual dizziness, bilateral vestibulopathy, degenerative, autoimmune and neoplastic diseases, upbeat- and downbeat nystagmus...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29280092/classifying-clinical-notes-with-pain-assessment-using-machine-learning
#20
Samah Jamal Fodeh, Dezon Finch, Lina Bouayad, Stephen L Luther, Han Ling, Robert D Kerns, Cynthia Brandt
Pain is a significant public health problem, affecting millions of people in the USA. Evidence has highlighted that patients with chronic pain often suffer from deficits in pain care quality (PCQ) including pain assessment, treatment, and reassessment. Currently, there is no intelligent and reliable approach to identify PCQ indicators inelectronic health records (EHR). Hereby, we used unstructured text narratives in the EHR to derive pain assessment in clinical notes for patients with chronic pain. Our dataset includes patients with documented pain intensity rating ratings > = 4 and initial musculoskeletal diagnoses (MSD) captured by (ICD-9-CM codes) in fiscal year 2011 and a minimal 1 year of follow-up (follow-up period is 3-yr maximum); with complete data on key demographic variables...
December 26, 2017: Medical & Biological Engineering & Computing
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