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Persistent chronic pain

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https://www.readbyqxmd.com/read/28104503/invasive-candida-krusei-infection-and-candida-vasculitis-of-a-leg-ulcer-in-an-immunocompetent-patient-a-case-report
#1
Jud Philipp, Valentin Thomas, Regauer Sigrid, Gary Thomas, Hackl Gerald, Rief Peter, Brodmann Marianne, Hafner Franz
A 71year old female Caucasian farmer without any known immunosuppression presented with a painful ulcer of her right lower leg after a trauma caused by a wood billet. There was no response to empirical antibacterial treatment. An ulcer biopsy showed an invasive Candida infection of the soft tissue and leucocytoclastic vasculitis. Voriconazole treatment was followed by wound healing. Invasive Candida infection and localized Candida vasculitis represent a rare cause of persisting leg ulcers. The similar clinical picture of chronic venous leg ulcers might blur the true cause and refractory cases should therefore promptly be processed by histopathological diagnostics...
January 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28103661/-asynchronous-bilateral-testicular-infarction-with-suspected-polyarteritis-nodosa-a-case-report
#2
Masayuki Kurokawa, Sei Naito, Osamu Ichiyanagi, Aya Suto, Yuta Kurota, Toshihiko Sakurai, Hayato Nishida, Hisashi Kawazoe, Tomoyuki Kato, Akira Nagaoka, Hiromi Ito, Mitsunori Yamakawa, Norihiko Tsuchiya
This report documents a case of asynchronous bilateral testicular infarction. The patient was a 42- year-old man who presented with left testicular pain and swelling. He had a past history of right idiopathic testicular infarction and underwent a right orchiectomy 6 years ago. He also had received treatment for 5 years for suspected polyarteritis nodosa (PAN). The left scrotal pain persisted for a week and left orchiectomy was performed. Pathological evaluations demonstrated a benign testis with testicular hemorrhage and chronic vasculopathy...
December 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28103165/burn-wound-healing-present-concepts-treatment-strategies-and-future-directions
#3
A Oryan, E Alemzadeh, A Moshiri
Burns are the most extensive forms of soft tissue injuries occasionally resulting in extensive and deep wounds and death. Burns can lead to severe mental and emotional distress, because of excessive scarring and skin contractures. Treatment of burns has always been a difficult medical problem and many different methods have been used to treat such injuries, locally. Biofilms are a collection of microorganisms that delay wound healing. One of the new methods of prevention and treatment of burn wound infections is application of antimicrobials, which act on biofilms and prevent the wound infection...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#4
Sana Ahmad Din, Iman Naimi, Mirza Beg
Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100744/compensatory-activation-of-cannabinoid-cb2-receptor-inhibition-of-gaba-release-in-the-rostral-ventromedial-medulla-in-inflammatory-pain
#5
Ming-Hua Li, Katherine L Suchland, Susan L Ingram
: The rostral ventromedial medulla (RVM) is a relay in the descending pain modulatory system and an important site of endocannabinoid modulation of pain. Endocannabinoids inhibit GABA release in the RVM, but it is not known whether this effect persists in chronic pain states. In the present studies, persistent inflammation induced by complete Freund's adjuvant (CFA) increased GABAergic miniature IPSCs (mIPSCs). Endocannabinoid activation of cannabinoid (CB1) receptors known to inhibit presynaptic GABA release was significantly reduced in the RVM of CFA-treated rats compared with naive rats...
January 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28096256/chronic-symptoms-in-a-representative-sample-of-community-dwelling-older-people-a-cross-sectional-study-in-switzerland
#6
Yves Henchoz, Christophe Büla, Idris Guessous, Nicolas Rodondi, René Goy, Maurice Demont, Brigitte Santos-Eggimann
OBJECTIVES: The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact. DESIGN: A large cross-sectional population-based study. SETTING: Community in 2 regions of French-speaking Switzerland...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092651/long-lasting-antinociceptive-effects-of-green-light-in-acute-and-chronic-pain-in-rats
#7
Mohab M Ibrahim, Amol Patwardhan, Kerry B Gilbraith, Aubin Moutal, Xiaofang Yang, Lindsey A Chew, Tally Largent-Milnes, T Philip Malan, Todd W Vanderah, Frank Porreca, Rajesh Khanna
Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain...
February 2017: Pain
https://www.readbyqxmd.com/read/28091815/quantitative-validation-of-sensory-mapping-in-persistent-postherniorrhaphy-inguinal-pain-patients-undergoing-triple-neurectomy
#8
M F Bjurström, R Álvarez, A L Nicol, R Olmstead, P K Amid, D C Chen
PURPOSE: Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. METHODS: Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13)...
January 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28089259/prosthetic-replacement-for-coronoid-deficiency-report-of-three-cases
#9
Enrico Bellato, Shawn W O'Driscoll
BACKGROUND: Persistent elbow instability associated with coronoid deficiency is a difficult condition to treat. Several surgical techniques have been described for coronoid reconstruction, but the resulting outcomes have been unpredictable. We hypothesized that a coronoid prosthesis could restore elbow stability. METHODS: A nonanatomically shaped metallic coronoid prosthesis was custom designed for each of 3 patients. Each had a chronic fracture-subluxation with persistent instability, deficiencies of the coronoid, and compromise of the radial head...
January 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28076310/the-serum-concentrations-of-leptin-and-mcp-1-independently-predict-low-back-pain-duration
#10
Giuseppe Lippi, Concetta Dagostino, Ruggero Buonocore, Rosalia Aloe, Chiara Bonaguri, Guido Fanelli, Massimo Allegri
BACKGROUND: Low back pain (LBP) is a very frequent condition, affecting most people at some point throughout their life. This cross-sectional study was aimed to investigate a selected panel of cytokines and inflammatory biomarkers in patients with or without LBP. METHODS: The study population consisted of 104 patients diagnosed with LBP (52 non-persistent and 52 persistent) and 52 healthy subjects with no LBP. Blood samples were collected for assessment of adiponectin, leptin, monocyte chemoattractant protein-1 (MCP-1) and C reactive protein (CRP)...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28075022/the-mechanistic-basis-for-photobiomodulation-therapy-of-neuropathic-pain-by-near-infrared-laser-light
#11
Vanessa Milanesi Holanda, Maria Cristina Chavantes, Xingjia Wu, Juanita J Anders
BACKGROUND AND OBJECTIVE: Various irradiances have been reported to be beneficial for the treatment of neuropathic pain with near infrared light. However, the mechanistic basis for the beneficial outcomes may vary based on the level of irradiance or fluence rate used. Using in vivo and in vitro experimental models, this study determined the mechanistic basis of photobiomodulation therapy (PBMT) for the treatment of neuropathic pain using a high irradiance. STUDY DESIGN/MATERIALS AND METHODS: In vitro experiments: Cultured, rat DRG were randomly assigned to control or laser treatment (LT) groups with different irradiation times (2, 5, 30, 60, or 120 seconds)...
January 11, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28072803/neural-correlates-of-maladaptive-pain-behavior-in-chronic-neck-pain-a-single-case-control-fmri-study
#12
Konstantin Beinert, Audrey Mouthon, Martin Keller, Michael Mouthon, Jean-Marie Annoni, Wolfgang Taube
Chronic neck pain patients display functional impairments like decreased range of motion, decreased strength, and reduced sensorimotor function. In patients without structural damage, the reason for the persistence of pain is not well understood. Therefore, it is assumed that in chronic pain states, memory processes play an important role. We have now detected and tested a patient that might help us to better understand the neural correlates of maladaptive pain expectation/memory. This patient displays chronic neck pain and restricted unilateral motion of the cervical spine to the left...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069928/functional-organization-of-cutaneous-and-muscle-afferent-synapses-onto-immature-spinal-lamina-i-projection-neurons
#13
Jie Li, Mark L Baccei
: It is well-established that sensory afferents innervating muscle are more effective at inducing hyperexcitability within spinal cord circuits compared to skin afferents, which likely contributes to the higher prevalence of chronic musculoskeletal pain compared to pain of cutaneous origin. However, the mechanisms underlying these differences in central nociceptive signaling remain incompletely understood, as nothing is known about how superficial dorsal horn (SDH) neurons process sensory input from muscle vs...
January 9, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28068790/temporomandibular-disorders-old-ideas-and-new-concepts
#14
Thomas List, Rigmor Højland Jensen
Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities, and may affect the quality of life of the patient...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28067693/intraoperative-ketamine-reduces-immediate-postoperative-opioid-consumption-after-spinal-fusion-surgery-in-chronic-pain-patients-with-opioid-dependency-a-randomized-blinded-trial
#15
Rikke Vibeke Nielsen, Jonna Storm Fomsgaard, Hanna Siegel, Robertas Martusevicius, Lone Nikolajsen, Jørgen Berg Dahl, Ole Mathiesen
Perioperative handling of surgical patients with opioid dependency represents an important clinical problem. Animal studies suggest that ketamine attenuates central sensitization and hyperalgesia and thereby reduces postoperative opioid tolerance. We hypothesized that intraoperative ketamine would reduce immediate postoperative opioid consumption compared to placebo in chronic pain patients with opioid dependency undergoing lumbar spinal fusion surgery. Primary outcome was morphine consumption 0-24 h postoperatively...
January 6, 2017: Pain
https://www.readbyqxmd.com/read/28065792/the-analgesic-effects-of-oxytocin-in-the-peripheral-and-central-nervous-system
#16
Qing Xin, Bo Bai, Wenyan Liu
Pain is a ubiquitously unpleasant feeling among humans as well as many animal species often caused by actual and potential tissue damage. However, it is absolutely crucial for our survival in many ways. Acute pain can signal the presence of danger or life-threatenting events, which help escape noxious stimuli. By contrast, when pain becomes chronic or persistent, it becomes an encumbrance and exerts deleterious effects to the body and mind, often co-occured with anxiety and depression. Additionaly, chronic pain is more or less an economic burden for the patients because it requires immediate medical treatments and seriously hinders pepople in their work...
January 5, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28063959/activity-pattern-profiles-relationship-with-affect-daily-functioning-impairment-and-variables-related-to-life-goals
#17
Rosa Esteve, Alicia E López-Martínez, Madelon L Peters, Elena R Serrano-Ibáñez, Gema T Ruíz-Párraga, Henar González-Gómez, Carmen Ramírez-Maestre
: The aim of this cross-sectional study was to identify subgroups of patients based on their activity patterns and to investigate their relationship with life goals, optimism, affect, and functioning. The sample comprised 276 patients with chronic musculoskeletal pain. Hierarchical cluster analysis was performed on the activity pattern variables and the resulting clusters were compared using 1-way ANOVA. The 4-cluster was the optimal solution. The four clusters comprised: a) Avoiders: patients with high levels of avoidance and low levels of persistence, who use pacing to reduce pain; b) Doers: patients with high levels of persistence and low levels of pacing and avoidance; c) Extreme Cyclers: patients with high levels of avoidance and persistence and low levels of pacing; and d) Medium Cyclers: patients with moderately high levels of avoidance and persistence and high levels of pacing...
January 4, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28060783/mindfulness-is-associated-with-increased-hedonic-capacity-among-chronic-pain-patients-receiving-extended-opioid-pharmacotherapy
#18
Elizabeth A Thomas, Eric L Garland
OBJECTIVES: Chronic pain and long-term opioid use may lead to a persistent deficit in hedonic capacity, characterized by increased sensitivity to aversive states and insensitivity to natural rewards. Dispositional mindfulness has been linked with improved emotion regulation and pain coping. The aim of the current study was to examine associations between dispositional mindfulness, hedonic capacity, and pain-related interference in an opioid-using chronic pain sample. METHODS: Data were obtained from a sample of 115 chronic pain patients on long-term opioid therapy (68% females, M age=48...
February 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28059868/a-novel-inhibitor-of-active-protein-kinase-g-attenuates-chronic-inflammatory-and-osteoarthritic-pain
#19
Ying-Ju Sung, Nelson Sofoluke, Mary Nkamany, Shixian Deng, Yuli Xie, Jeremy Greenwood, Ramy Farid, Donald W Landry, Richard T Ambron
Activating Protein kinase-1α (PKG-1α) induces a long-term hyperexcitability (LTH) in nociceptive neurons. Since the LTH correlates directly with chronic pain in many animal models we tested the hypothesis that inhibiting PKG-1α would attenuate LTH-mediated pain. We first synthesized and characterized compound N46 (propoxybenzoyl)benzamidopyrrolidin-3-yl)-1H-indazole-5-carboxamide). N46 inhibits PKG-1α with an IC50 of 7.5nmol, was highly selective when tested against a panel of 274 kinases, and tissue distribution studies indicate that it does not enter the CNS...
December 30, 2016: Pain
https://www.readbyqxmd.com/read/28059708/impact-of-mr-neurography-in-patients-with-chronic-cauda-equina-syndrome-presenting-as-chronic-pelvic-pain-and-dysfunction
#20
J R Petrasic, A Chhabra, K M Scott
BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome...
November 10, 2016: AJNR. American Journal of Neuroradiology
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