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Chronic intractible pain

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https://www.readbyqxmd.com/read/29652011/quest-for-haller-cells-a-digital-orthopantomography-study
#1
Kavitaa Nedunchezhian, Nalini Aswath, A Amudhan
Aims: Haller Cells refer to the ethmoidal pneumatization and are the extensions of anterior ethmoid sinus into the floor of the orbit and superior aspect of the maxillary sinus, basically an anatomic variation. They may be associated with orofacial pain, sinusitis, nasal obstruction, impaired nasal breathing, headache, chronic cough, and mucocele. The aim of the present study was to identify, determine the prevalence and characteristics of Haller's cells on Digital orthopantomographs in patient's reporting to a dental institution in Chennai...
March 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/29594982/penile-calciphylaxis-in-a-patient-on-combined-peritoneal-dialysis-and-hemodialysis
#2
Takahiro Kasai, Naoki Washida, Hirokazu Muraoka, Kentarou Fujii, Kiyotaka Uchiyama, Keisuke Shinozuka, Kohkichi Morimoto, Hirobumi Tokuyama, Shu Wakino, Hiroshi Itoh
Calciphylaxis presents with painful purpura and intractable skin ulcers on the trunk and particularly the distal extremities, and it mainly occurs in patients on chronic dialysis. A 66-year-old man with renal failure due to diabetic nephropathy was on peritoneal dialysis alone for 1 year, followed by peritoneal dialysis combined with hemodialysis for 3 years. He developed calciphylaxis of the penis, which was diagnosed from the skin biopsy findings and clinical observation. To treat this condition, PD was stopped and HD was performed three times a week...
March 28, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29587798/inhibition-of-peripheral-macrophages-by-nicotinic-acetylcholine-receptor-agonists-suppresses-spinal-microglial-activation-and-neuropathic-pain-in-mice-with-peripheral-nerve-injury
#3
Norikazu Kiguchi, Daichi Kobayashi, Fumihiro Saika, Shinsuke Matsuzaki, Shiroh Kishioka
BACKGROUND: Neuro-immune interaction underlies chronic neuroinflammation and aberrant sensory processing resulting in neuropathic pain. Despite the pathological significance of both neuroinflammation-driven peripheral sensitization and spinal sensitization, the functional relationship between these two distinct events has not been understood. METHODS: In this study, we determined whether inhibition of inflammatory macrophages by administration of α4β2 nicotinic acetylcholine receptor (nAChR) agonists improves neuropathic pain and affects microglial activation in the spinal dorsal horn (SDH) in mice following partial sciatic nerve ligation (PSL)...
March 27, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29587729/comparing-the-efficacy-of-targeted-spinal-cord-stimulation-scs-of-the-dorsal-root-ganglion-with-conventional-medical-management-cmm-in-patients-with-chronic-post-surgical-inguinal-pain-the-smashing-trial
#4
Frederique M U Mol, Rudi M Roumen, Marc R Scheltinga
BACKGROUND: A significant number of patients who undergo a standard inguinal hernia repair or a Pfannenstiel incision develop chronic (> 3 months) post-surgical inguinal pain (PSIP) due to nerve entrapment. If medication or peripheral nerve blocks fail, surgery including neurectomies may offer relief. However, some patients do not respond to any of the currently available remedial treatment modalities. Targeted spinal cord stimulation (SCS) of the dorsal root ganglion (DRG) is a relatively new type of therapy that has a potential to significantly reduce chronic PSIP...
March 27, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29575415/gastrointestinal-dysmotility-a-qualitative-exploration-of-the-journey-from-symptom-onset-to-diagnosis
#5
K Twist, J Ablett, A Wearden, P Paine, D Vasant, S Lal, S Peters
BACKGROUND: Gastrointestinal dysmotility (GID) covers a spectrum of disorders disrupting enteric neuromuscular co-ordination which, when severe, causes intractable gastrointestinal symptoms and malnutrition and is a recognized cause of chronic intestinal failure. To date, no study has provided an in-depth account of the experiences of patients with severe GID and their psychosocial needs. This study aimed to explore patients' experiences from symptom onset and the process of seeking and receiving a diagnosis...
March 25, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29545351/endothelin-type-a-receptors-mediate-pain-in-a-mouse-model-of-sickle-cell-disease
#6
Brianna Marie Lutz, Shaogen Wu, Xiyao Gu, Fidelis E Atianjoh, Zhen Li, Brandon M Fox, David M Pollock, Yuan-Xiang Tao
Sickle cell disease is associated with acute painful episodes and chronic intractable pain. Endothelin-1, a known pain inducer, is elevated in the blood plasma of both sickle cell patients and mouse models of sickle cell disease. We show here that the levels of endothelin-1 and its endothelin type A receptor are increased in the dorsal root ganglia of a mouse model of sickle cell disease. Pharmacologic inhibition or neuron-specific knockdown of endothelin type A receptors in primary sensory neurons of dorsal root ganglion alleviated basal and post-hypoxia evoked pain hypersensitivities in sickle cell mice...
March 15, 2018: Haematologica
https://www.readbyqxmd.com/read/29540548/acc-to-dorsal-medial-striatum-inputs-modulate-histaminergic-itch-sensation
#7
Yu-Chen Lu, Yu-Jun Wang, Bin Lu, Ming Chen, Ping Zheng, Jing-Gen Liu
Itch is an unpleasant sensation that initiates scratching behavior. Itch-scratch reaction is a complex phenomenon whose occurrence implicates supraspinal structures required for regulation of sensory, emotional, cognitive, and motivational aspects. However, the central mechanisms underlying the processing of itch and the interplay of the supraspinal regions and spinal cord in regulating itch-scratch processes are poorly understood. Here, we have identified that the neural projections from anterior cingulate cortex (ACC) to dorsal medial striatum (DMS) constitute a critical circuit element for regulating itch-related behaviors in the brain of male C57BL/6J mice...
March 14, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29532593/case-series-intrathecal-baclofen-therapy-in-stiff-person-syndrome
#8
Justin Ralph Abbatemarco, Mary Alissa Willis, Robert G Wilson, Sean J Nagel, Andre G Machado, Francois A Bethoux
OBJECTIVES: Stiff-person syndrome (SPS) is associated with axial rigidity superimposed on sustained muscle spasms. These symptoms commonly interfere with the performance of activities of daily living including ambulation. This retrospective case series evaluates the outcomes of screening tests and chronic infusion of intrathecal baclofen (ITB) in patients diagnosed with SPS treated in our spasticity clinic. MATERIALS AND METHODS: Patients were identified from an institutional review board-approved clinical registry of ITB therapy...
March 13, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29531216/inhibition-of-neuronal-flt3-receptor-tyrosine-kinase-alleviates-peripheral-neuropathic-pain-in-mice
#9
Cyril Rivat, Chamroeun Sar, Ilana Mechaly, Jean-Philippe Leyris, Lucie Diouloufet, Corinne Sonrier, Yann Philipson, Olivier Lucas, Sylvie Mallié, Antoine Jouvenel, Adrien Tassou, Henri Haton, Stéphanie Venteo, Jean-Philippe Pin, Eric Trinquet, Fabienne Charrier-Savournin, Alexandre Mezghrani, Willy Joly, Julie Mion, Martine Schmitt, Alexandre Pattyn, Frédéric Marmigère, Pierre Sokoloff, Patrick Carroll, Didier Rognan, Jean Valmier
Peripheral neuropathic pain (PNP) is a debilitating and intractable chronic disease, for which sensitization of somatosensory neurons present in dorsal root ganglia that project to the dorsal spinal cord is a key physiopathological process. Here, we show that hematopoietic cells present at the nerve injury site express the cytokine FL, the ligand of fms-like tyrosine kinase 3 receptor (FLT3). FLT3 activation by intra-sciatic nerve injection of FL is sufficient to produce pain hypersensitivity, activate PNP-associated gene expression and generate short-term and long-term sensitization of sensory neurons...
March 12, 2018: Nature Communications
https://www.readbyqxmd.com/read/29500312/etiology-and-pharmacology-of-neuropathic-pain
#10
REVIEW
Sascha R A Alles, Peter A Smith
Injury to or disease of the nervous system can invoke chronic and sometimes intractable neuropathic pain. Many parallel, interdependent, and time-dependent processes, including neuroimmune interactions at the peripheral, supraspinal, and spinal levels, contribute to the etiology of this "disease of pain." Recent work emphasizes the roles of colony-stimulating factor 1, ATP, and brain-derived neurotrophic factor. Excitatory processes are enhanced, and inhibitory processes are attenuated in the spinal dorsal horn and throughout the somatosensory system...
April 2018: Pharmacological Reviews
https://www.readbyqxmd.com/read/29475003/neuropathic-pain-models-caused-by-damage-to-central-or-peripheral-nervous-system
#11
REVIEW
Anil Kumar, Harshpreet Kaur, Arti Singh
Neuropathic Pain (NP) is a painful condition which is a direct consequence of a lesion or disease affecting the somatosensory system with symptoms like allodynia, hyperalgesia. It has complex pathogenesis as it involves several molecular signaling pathways, thus numerous reliable animal models are crucial to understand the underlying mechanism of NP and formulate effective management therapy. Some models like spinal cord injury, chronic constriction injury, spinal nerve ligation, chemotherapy induced peripheral neuropathy, diabetes-induced NP and many more are discussed...
April 2018: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29461336/sex-differences-in-antinociceptive-response-to-%C3%AE-9-tetrahydrocannabinol-and-cp-55-940-in-the-mouse-formalin-test
#12
Rebecca A LaFleur, Ronald P Wilson, Daniel J Morgan, Angela N Henderson-Redmond
Cannabinoids have shown promise for the treatment of intractable pain states and may represent an alternative pharmacotherapy for pain management. A growing body of clinical evidence suggests a role for sex in pain perception and in cannabinoid response. We examined cannabinoid sensitivity and tolerance in male and female mice expressing a desensitization-resistant form (S426A/S430A) of the cannabinoid type 1 receptor (CB1R). Mice were assessed for acute and inflammatory nociceptive behaviors in the formalin test following pretreatment with either vehicle or mixed CB1R/CB2R agonists, Δ-9-tetrahydrocannabinol ([INCREMENT]-THC) (1-6 mg/kg) or CP 55,940 (0...
February 15, 2018: Neuroreport
https://www.readbyqxmd.com/read/29449944/dexmedetomidine-use-during-epiduroscopy-reduces-fentanyl-use-and-postoperative-nausea-and-vomiting-a-single-center-retrospective-study
#13
Takashi Suzuki, Ryota Inokuchi, Kazuo Hanaoka, Machi Suka, Hiroyuki Yanagisawa
Objectives: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine. Methods: A retrospective study including all patients who underwent epiduroscopy at the JR Tokyo General Hospital from April 2011 to March 2016 was designed...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29395154/botulinum-toxin-injection-for-childhood-constipation-is-safe-and-can-be-effective-regardless-of-anal-sphincter-dynamics
#14
Claire Zar-Kessler, Braden Kuo, Jaime Belkind-Gerson
BACKGROUND: Childhood constipation is common. Previously, internal anal sphincterotomy has been used for hypertensive/non-relaxing sphincters; however, recent benefit has been shown with Botulinum Toxin (BT) injections. The aim is to investigate BT, including response duration, symptom association and effectiveness in relation to sphincter dynamics. METHODS: Retrospective study of 164 children receiving sphincter BT for severe constipation unresponsive to medication management...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29391827/development-and-implementation-of-an-inpatient-multidisciplinary-pain-management-program-for-patients-with-intractable-chronic-musculoskeletal-pain-in-japan-preliminary-report
#15
Naoto Takahashi, Satoshi Kasahara, Shoji Yabuki
Introduction: Multidisciplinary pain management is a useful method to treat chronic musculoskeletal pain. Few facilities in Japan administer a multidisciplinary pain management program, especially an inpatient program. Therefore, we implemented a multidisciplinary pain management program in our hospital based on biopsychosocial factors guided by the recommendations of the International Association for the Study of Pain. The purpose of this study is to describe our inpatient pain management program for Japanese patients, which uses the biopsychosocial method of pain self-management...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29390501/space-time-acupuncture-for-intractable-cough-after-lupus-nephropathy-a-case-report-and-literature-review
#16
Taipin Guo, Zukun Chen, Xiantao Tai, Zili Liu, Miansheng Zhu
RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384450/deep-brain-stimulation-of-the-ventral-striatal-area-for-post-stroke-pain-syndrome-a-magnetoencephalography-study
#17
Raghavan Gopalakrishnan, Richard C Burgess, Donald A Malone, Scott F Lempka, John T Gale, Darlene P Floden, Kenneth B Baker, Andre G Machado
Post-stroke pain syndrome (PSPS) is an intractable disorder characterized by hemiparesis associated with unrelenting chronic pain. While traditional analgesia have largely failed, integrative approaches targeting affective-cognitive spheres have started to show promise. Recently, we demonstrated that deep brain stimulation (DBS) of the ventral striatal area significantly improved the affective sphere of pain (Lempka et al. 2017) in PSPS patients. Here, we examine whether electrophysiological correlates of pain anticipation were modulated by DBS that could serve as signatures of treatment effects...
January 31, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29357330/ultrasound-guided-genicular-nerve-block-for-knee-osteoarthritis-a-double-blind-randomized-controlled-trial-of-local-anesthetic-alone-or-in-combination-with-corticosteroid
#18
Doo-Hwan Kim, Seong-Soo Choi, Syn-Hae Yoon, So-Hee Lee, Dong-Kyun Seo, In-Gyu Lee, Woo-Jong Choi, Jin-Woo Shin
BACKGROUND: Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#19
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29324503/%C3%AE-asarone-alleviated-chronic-constriction-injury-induced-neuropathic-pain-through-inhibition-of-spinal-endoplasmic-reticulum-stress-in-an-liver-x-receptor-dependent-manner
#20
Yulong Gui, Aiyuan Li, Jie Zhang, Guan Li, Xia Ruan, Qulian Guo, Wangyuan Zou
BACKGROUND: Neuropathic pain is an intractable and complex disease. Recent studies have shown a close relationship between endoplasmic reticulum (ER) stress and neuropathic pain. Here, we investigated the effect of α-asarone, an ER stress inhibitor, on chronic constriction injury (CCI)-induced neuropathic pain. METHODS: Two parts were included in this study. In part 1, rats were assigned to 7 groups: the sham group, the sham + α-asarone 20 mg/kg group, the CCI group, the CCI + vehicle group, the CCI + α-asarone 5 mg/kg group, the CCI + α-asarone 10 mg/kg group, and the CCI + α-asarone 20 mg/kg group...
January 9, 2018: Anesthesia and Analgesia
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