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Chronic intractible pain

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https://www.readbyqxmd.com/read/27910899/glial-pannexin1-contributes-to-tactile-hypersensitivity-in-a-mouse-model-of-orofacial-pain
#1
Regina Hanstein, Menachem Hanani, Eliana Scemes, David C Spray
Drug studies in animal models have implicated pannexin1 (Panx1) in various types of pain, including trigeminal hypersensitivity, neuropathic pain and migraine. However, the tested drugs have limited specificity and efficacy so that direct evidence for Panx1 contribution to pain has been lacking. We here show that tactile hypersensitivity is markedly attenuated by deletion of Panx1 in a mouse model of chronic orofacial pain; in this model, trigeminal ganglion Panx1 expression and function are markedly enhanced...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27906933/anterior-cingulotomy-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#2
Justin Sharim, Nader Pouratian
BACKGROUND: Anterior cingulotomy for chronic pain aims to modulate patients' attention or emotional reaction to pain rather than to modulate pain intensity. OBJECTIVES: To evaluate the clinical efficacy, both short- and long-term, of anterior cingulotomy in the treatment of chronic pain. STUDY DESIGN: Systematic review. SETTING: This systematic review assessed studies reporting anterior cingulotomy for the treatment of chronic pain...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906080/tonic-and-burst-spinal-cord-stimulation-waveforms-for-the-treatment-of-chronic-intractable-pain-study-protocol-for-a-randomized-controlled-trial
#3
Konstantin V Slavin, Richard B North, Timothy R Deer, Peter Staats, Kristina Davis, Roni Diaz
BACKGROUND: Burst stimulation is a novel form of neurostimulation for the treatment of chronic pain which has demonstrated promise in small uncontrolled studies, but has not yet gained approval for use in the U.S. We report the study methods for an ongoing multicenter, randomized, controlled, cross-over study designed to gain United States Food and Drug Administration (FDA) approval for burst stimulation. METHODS: Participants who are candidates for a currently approved neurostimulation device were enrolled and screened...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27895411/reoperation-in-an-adult-female-with-right-sided-hirschsprung-s-disease-complicated-by-refractory-hypertension-and-cough
#4
Zhi-Jian Wei, Lei Huang, A-Man Xu
Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27884934/chronic-neuropathic-pain-severity-is-determined-by-lesion-level-in-aquaporin-4-antibody-positive-myelitis
#5
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/27843774/long-term-clinical-outcome-of-peripheral-nerve-stimulation-for-chronic-headache-and-complication-prevention
#6
Linqiu Zhou, Avi Ashkenazi, Joseph W Smith, Na Jen, Timothy R Deer, Chen Zhou
BACKGROUND: Subcutaneous peripheral nerve stimulation (PNS) has emerged as a useful tool in the treatment of intractable headaches. However, complications such as skin erosion, infection and lead migration have adversely affected clinical outcome, and occasionally led to treatment cessation. OBJECTIVES: Here we report the results of peripheral nerve stimulator implantation performed on 24 patients with various chronic headaches at our center over a period of 9 years...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27833045/reciprocal-relationship-between-membrane-type-1-matrix-metalloproteinase-and-the-algesic-peptides-of-myelin-basic-protein-contributes-to-chronic-neuropathic-pain
#7
Sanghyun Hong, Albert G Remacle, Sergei A Shiryaev, Wonjun Choi, Swathi Hullugundi, Jennifer Dolkas, Mila Angert, Tasuku Nishihara, Tony L Yaksh, Alex Y Strongin, Veronica I Shubayev
Myelin basic protein (MBP) is an auto-antigen able to induce intractable pain from innocuous mechanical stimulation (mechanical allodynia). The mechanisms provoking this algesic MBP activity remain obscure. Our present study demonstrates that membrane type 1 matrix metalloproteinase (MT1-MMP/MMP-14) releases the algesic MBP peptides from the damaged myelin, which then reciprocally enhance the expression of MT1-MMP in nerve to sustain a state of allodynia. Specifically, MT1-MMP expression and activity in rat sciatic nerve gradually increased starting at day 3 after chronic constriction injury (CCI)...
November 7, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27824794/balloon-kyphoplasty-for-managing-intractable-pain-in-pediatric-pathologic-vertebral-fractures
#8
Jane S Hoashi, Stefanie M Thomas, Ryan C Goodwin, David P Gurd, Rabi Hanna, Thomas E Kuivila
BACKGROUND: Vertebral compression fractures are a common result of osteoporosis and osteopenia secondary to steroid use and chemotherapy treatment. Balloon kyphoplasty is a treatment option with good to excellent results well described in adults. Although a few recent studies have been published regarding the use of kyphoplasty in children, no formal indication exists for the pediatric population. The purpose of this study is to describe the outcomes of 3 chronically ill children with intractable pain from vertebral compression fractures, managed with kyphoplasty...
November 7, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27774361/application-of-the-harms-technique-to-treat-undiagnosed-intractable-c1-c2-unilateral-neck-pain-a-case-report
#9
Adnan Bashir Bhatti, Sunny Kim
A 79-year-old female presented with incapacitating chronic neck pain. The patient's pain which was greatest on the left side persisted for 18 months and was described as stabbing in nature (10/10 intensity). In addition to her neck pain, the patient described having frequent headaches. After six weeks of physical therapy and undergoing a rhizotomy procedure, she showed no prolonged improvement. An epidural steroid injection provided only temporary pain relief and was followed by a successful posterior fusion using the Harms technique with iliac crest autogenous bone grafting and placement of polyaxial screws in the C1 lateral masses and C2 pedicles...
September 21, 2016: Curēus
https://www.readbyqxmd.com/read/27770599/high-frequency-spinal-cord-stimulation-in-a-patient-with-an-implanted-cardiac-device
#10
Narayan R Kissoon, Bryan C Hoelzer, David P Martin, Tim J Lamer
BACKGROUND: New advances in spinal cord stimulation have led to improved treatment of patients suffering from chronic pain. While the overall safety of newer stimulation devices has been established, no published reports exist regarding safety considerations when these devices are implanted in patients with a preexisting cardiac device. CASE REPORT: An 83-year-old man with a history of out-of-hospital cardiac arrest secondary to an episode of ventricular fibrillation underwent automated implantable cardiac defibrillator placement...
October 22, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27697258/chronic-postoperative-fungal-endophthalmitis-caused-by-penicillium-citrinum-after-cataract-surgery
#11
Anurag Garg, Alastair Stuart, Mark Fajgenbaum, David Alistair Laidlaw, Miles Stanford
: An 85-year-old man developed chronic postoperative endophthalmitis after complicated cataract surgery. Visual acuity in the affected eye was hand movements. Slitlamp biomicroscopy showed a hypopyon, superonasal iris nodule, and marked vitritis. An anterior chamber washout, iris biopsy, and intravitreal amphotericin injection were performed. Panfungal polymerase chain reaction of anterior chamber and vitreous samples were positive for Penicillium citrinum. The iris biopsy showed hyphae on Grocott staining...
September 2016: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/27684866/transsacrococcygeal-approach-to-ganglion-impar-block-for-treatment-of-chronic-coccygodynia-after-spinal-arachnoid-cyst-removal-a-case-report
#12
Young Deog Cha, Chun Woo Yang, Jung Uk Han, Jang Ho Song, WonJu Na, Sora Oh, Byung-Gun Kim
BACKGROUND: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676681/radiofrequency-ablation-of-the-sphenopalatine-ganglion-using-cone-beam-computed-tomography-for-intractable-cluster-headache
#13
Vivek Loomba, Aman Upadhyay, Hirsh Kaveeshvar
UNLABELLED: Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) has been shown to be an effective modality of treatment for patients with intractable chronic cluster headaches (CHs). While the use of fluoroscopy for RFA of the SPG is common, to our knowledge there are no documented cases of procedures using cone beam computed tomography (CBCT) for image guidance. We present a case report of a patient suffering from chronic intractable CH with complete long-lasting relief after RFA of the SPG using CBCT...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27672683/maybe-it-is-all-in-your-head
#14
EDITORIAL
John Hickner
Recent research provides strong evidence that in some cases of intractable chronic pain, the origin of the pain signal is in the brain--rather than the body.
September 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/27651513/comparison-of-the-effects-of-intermittent-boluses-to-simple-continuous-infusion-on-patients-global-perceived-effect-in-intrathecal-therapy-for-pain-a-randomized-double-blind-crossover-study
#15
Sam Eldabe, Rui V Duarte, Grace Madzinga, Alan M Batterham, Morag E Brookes, Ashish P Gulve, Christophe Perruchoud, Jon H Raphael, David Lorenzana, Eric Buchser
OBJECTIVE:  Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. METHODS:  Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration...
September 19, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27642742/-chronic-non-infectious-diarrhea-diagnostics-and-therapy
#16
Korinna Ulbricht, Peter Layer, Viola Andresen
Chronic, non-infectious diarrhea can be caused by a variety of gastrointestinal diseases. In anamnesis, it is important to take accompanying warning symptoms and specific triggers into account. The fecal inflammatory marker calprotectin may help differentiating between organic and functional gastrointestinal disorders, but it is not specific. Among other options, gelling fibres, Loperamide and Cholestyramine as well as probiotics are available for the symptomatic treatment of chronic diarrhea. For long-term treatment of chronic diarrhea with the enkephalinase inhibitor racecadotril, which is approved for acute diarrhea, only limited data are available...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27625495/intractable-sacroiliac-joint-pain-treated-with-peripheral-nerve-field-stimulation
#17
Shushovan Chakrabortty, Sanjeev Kumar, Deepak Gupta, Sruthi Rudraraju
As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27619625/mhc-i-promotes-apoptosis-of-gabaergic-interneurons-in-the-spinal-dorsal-horn-and-contributes-to-cancer-induced-bone-pain
#18
Qiaochu Fu, Dai Shi, Yaqun Zhou, Hua Zheng, Hongbing Xiang, Xuebi Tian, Feng Gao, Anne Manyande, Fei Cao, Yuke Tian, Dawei Ye
Cancer induced bone pain (CIBP) remains one of the most intractable clinical problems due to poor understanding of its underlying mechanisms. Recent studies demonstrate the decline of inhibitory interneurons, especially GABAergic interneurons in the spinal cord, can evoke generation of chronic pain. It has also been reported that neuronal MHC-I expression renders neurons vulnerable to cytotoxic CD8(+) T cells and finally lead to neurons apoptosis in a variety neurological disorders. However, whether MHC-I could induce the apoptosis of GABAergic interneurons in spinal cord and contribute to the development of CIBP remains unknown...
September 13, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27579198/effect-of-spinal-cord-stimulation-on-gait-in-a-patient-with-thalamic-pain
#19
Arito Yozu, Masahiko Sumitani, Masahiro Shin, Kazuhiko Ishi, Michihiro Osumi, Junji Katsuhira, Ryosuke Chiba, Nobuhiko Haga
Thalamic pain is a central neuropathic pain disorder which occurs after stroke. Its severe chronic pain is often intractable to pharmacotherapies and affects the patients' activities of daily living (ADL) and quality of life (QOL). Recently, spinal cord stimulation (SCS) has been reported to be effective in relieving the pain of thalamic pain; however, the effect of SCS on gait performance in patients is unknown. Therefore, we evaluated the gait performance before and after SCS in a case with thalamic pain...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27551978/the-current-state-of-critical-limb-ischemia-a-systematic-review
#20
Alik Farber, Robert T Eberhardt
Importance: Chronic critical limb ischemia, marked by intractable lower extremity ischemic rest pain and tissue loss, is a highly morbid condition that leads to the loss of ambulation and decreased quality of life. It is associated with a high risk of limb loss and mortality and presents a significant economic burden to society. Objective: To review the current state of epidemiology, pathophysiology, diagnosis, and treatment of critical limb ischemia. Evidence Review: An extensive literature search of the subject matter was conducted on material published in English between 1980 and 2016; both landmark and recently published articles were evaluated...
November 1, 2016: JAMA Surgery
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