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Severe chronic pain

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https://www.readbyqxmd.com/read/28340308/a-preliminary-investigation-on-the-effect-of-extracorporeal-shock-wave-therapy-as-a-treatment-for-neurogenic-heterotopic-ossification-following-traumatic-brain-injury-part-i-effects-on-pain
#1
J E Reznik, E Biros, A C Lamont, Y Sacher, O Kibrik, S Milanese, S Gordon, M P Galea
INTRODUCTION: Neurogenic heterotopic ossification (NHO) is a complication of a neurological injury following traumatic brain injury (TBI) and may be present around major synovial joints. It is often accompanied by severe pain, which may lead to limitation in activities of daily living. Currently, a common intervention for NHO is surgery, which has been reported to carry many additional risks. This study was designed to assess the effect of extracorporeal shock wave therapy (ESWT) on pain in patients with TBI with chronic NHO...
March 24, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28339928/opioid-use-in-chronic-pain-patients-with-chronic-kidney-disease-a-systematic-review
#2
Vittal R Nagar, Pravardhan Birthi, Sara Salles, Paul A Sloan
Objectives. : To investigate the prevalence of chronic pain and opioid management among patients with chronic kidney disease (CKD). Design.:  Systematic review. Methods.:  A systematic search was performed, including citations from 1960 to May 2015. The review highlights methodological quality assessment of the selected studies; prevalence of pain; type, dose, and reason for opioid use; effectiveness of pain control and associated adverse effects of opioids in CKD patients...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339447/chronic-localized-back-pain-due-to-posterior-cutaneous-nerve-entrapment-syndrome-pocnes-a-new-diagnosis
#3
Oliver B Boelens, Robert C Maatman, Marc R Scheltinga, Kees van Laarhoven, Rudi M Roumen
Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339438/the-role-of-autonomic-function-in-exercise-induced-endogenous-analgesia-a-case-control-study-in-myalgic-encephalomyelitis-chronic-fatigue-syndrome-and-healthy-people
#4
Jessica Van Oosterwijck, Uros Marusic, Inge De Wandele, Lorna Paul, Mira Meeus, Greta Moorkens, Luc Lambrecht, Lieven Danneels, Jo Nijs
BACKGROUND: Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are unable to activate brain-orchestrated endogenous analgesia (or descending inhibition) in response to exercise. This physiological impairment is currently regarded as one factor explaining post-exertional malaise in these patients. Autonomic dysfunction is also a feature of ME/CFS. OBJECTIVES: This study aims to examine the role of the autonomic nervous system in exercise-induced analgesia in healthy people and those with ME/CFS, by studying the recovery of autonomic parameters following aerobic exercise and the relation to changes in self-reported pain intensity...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339432/bipolar-versus-unipolar-intraarticular-pulsed-radiofrequency-thermocoagulation-in-chronic-knee-pain-treatment-a-prospective-randomized-trial
#5
Ersel Gulec, Hayri Ozbek, Sinan Pektas, Geylan Isik
BACKGROUND: Chronic knee pain is a major widespread problem causing significant impairment of daily function. Pulsed radiofrequency has been shown to reduce severe chronic joint pain as a non-pharmacological and less invasive treatment method. OBJECTIVE: We aimed to compare the effectiveness of unipolar and bipolar intraarticular pulsed radiofrequency methods in chronic knee pain control. STUDY DESIGN: Prospective, randomized, double-blind study...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#6
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339430/comparative-effectiveness-review-of-cooled-versus-pulsed-radiofrequency-ablation-for-the-treatment-of-knee-osteoarthritis-a-systematic-review
#7
Anita Gupta, Daniel P Huettner, Matthew Dukewich
BACKGROUND: Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. OBJECTIVE: This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339428/does-conservative-treatment-change-the-brain-in-patients-with-chronic-musculoskeletal-pain-a-systematic-review
#8
Jeroen Kregel, Iris Coppieters, Robby DePauw, Anneleen Malfliet, Lieven Danneels, Jo Nijs, Barbara Cagnie, Mira Meeus
BACKGROUND: Chronic musculoskeletal pain is characterized by maladaptive central neuroplastic changes. Many observational studies have demonstrated that chronic pain states are associated with brain alterations regarding structure and/or function. Rehabilitation of patients with chronic musculoskeletal pain may include cognitive, exercise, or multimodal therapies. OBJECTIVE: The current review aims to provide a constructive overview of the existing literature reporting neural correlates, based on brain magnetic resonance imaging (MRI) techniques, following conservative treatment in chronic musculoskeletal pain patients...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339334/a-movement-system-impairment-approach-to-evaluation-and-treatment-of-a-person-with-lumbar-radiculopathy-a-case-report
#9
Eileen Miller, Shirley A Sahrmann, Dale Avers
BACKGROUND AND PURPOSE: There are several systems of classification and treatment of patients with low back pain (LBP) based on assessment of the effect of lumbar postures and movements on symptoms. The efficacy of one of these systems, The Movement System Impairment (MSI) method, has not yet been demonstrated in the literature. The purpose of this case report is to describe the approach of the MSI method for an individual with lumbar radiculopathy. CASE DESCRIPTION: A 79-year-old woman with a history of chronic LBP was referred to PT with a physician's diagnosis of sciatica...
March 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#10
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28333778/cochlear-implant-in-severe-impaired-psychiatric-patients-a-case-series
#11
Ioana T Herisanu, Mark Praetorius, Margarete Mattern
OBJECTIVE: Psychotic disorders and intelligence deficiencies are no longer contraindications for cochlear implantation regarding the revised German guidelines from May 2012. This article aims to evaluate the outcome of patients with severe psychiatric comorbidities. Therefore the database of the Cochlear Implant Center of the University Hospital of Heidelberg was investigated. STUDY DESIGN: Retrospective case review. METHODS: We present three patients who received a cochlear implant (CI) despite a serious psychiatric disorder...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28333581/the-social-construction-of-fibromyalgia-as-a-health-problem-from-the-perspective-of-policies-professionals-and-patients
#12
Erica Briones-Vozmediano
BACKGROUND: Fibromyalgia is a painful chronic disease, suffered mainly by women, that consolidates a number of symptoms and skeletal muscle issues which are little understood. OBJECTIVES: To explore the social construction of FM from the perspective of health policies, patients, and health professionals involved in their medical attention. METHODS: I) Policy review of national and regional health plans in a national and international context, the clinical protocols for fibromyalgia in Spain, and the Parliamentary initials in the European and Spanish context; and ii) Qualitative study involving 28 personal interviews with 16 fibromyalgia patients and 12 interviews with health care professionals in Spain...
2017: Global Health Action
https://www.readbyqxmd.com/read/28332731/undiagnosed-pancreatic-exocrine-insufficiency-and-chronic-pancreatitis-in-functional-gi-disorder-patients-with-diarrhea-or-abdominal-pain
#13
N J Talley, G Holtmann, N Q Nguyen, P R Gibson, P Bampton, M Veysey, J Wong, S Philcox, N Koloski, L Bunby, M Jones
BACKGROUND & AIMS: A previous UK study showed that 6.1% of patients with diarrhea-predominant IBS (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEl based on faecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. METHODS: Patients aged over 40 years presenting to hospital outpatient clinics from 6 sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied...
March 23, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28331569/an-unusual-diagnosis-for-persistent%C3%A2-diarrhoea-and-vomiting
#14
James Nott, Asad Khan, Ravi Madhotra, George MacFaul, Kamran Rostami
Identifying the etiology of chronic diarrhoea might be challenging in some patients, and before a diagnosis is made these patients may spend a substantial length of time with unresolved symptoms leading to uncertainty and anxiety that is severely impairing their life quality. A 45-year-old female was referred by her general practitioner with a 5-year history of increasingly frequent episodes of cyclical diarrhoea, vomiting, abdominal pain and intermittent palpitations. Contrast CT Abdomen/Pelvis revealed a 36x33x46 mm mass in the aorto caval region of her retro-peritoneum, just above the bifurcation...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28331358/pain-behavior-mediates-the-relationship-between-perceived-injustice-and-opioid-prescription-for-chronic-pain-a-collaborative-health-outcomes-information-registry-study
#15
Junie S Carriere, Marc-Olivier Martel, Ming-Chih Kao, Michael Jl Sullivan, Beth D Darnall
BACKGROUND AND PURPOSE: Perceived injustice has been defined as an appraisal regarding the severity and irreparability of loss associated with pain, blame and a sense of unfairness. Recent findings have identified perceived injustice as an important risk factor for pain-related outcomes. Studies suggest that perceived injustice is associated with opioid prescription in patients with pain conditions. However, the mechanisms by which perceived injustice is linked to opioid prescription are not well understood...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28331144/totally-extraperitoneal-tep-removal-of-an-infected-mesh-by-laparoscopy-after-open-preperitoneal-repair-initial-case-report
#16
Naoto Chihara, Keisuke Mishima, Hideyuki Suzuki, Masanori Watanabe, Tetsutaka Toyoda, Eiji Uchida
Prosthetic mesh infection after open or laparoscopic hernia repair is a rare complication. Superficial wound infection can be resolved by treatment with a combination of antibiotics and wound drainage, whereas deep-seated mesh infection, which can lead to chronic groin sepsis, usually requires removal of the mesh. A 56-year-old Japanese man was admitted to our hospital for the treatment of deep-seated mesh infection. The patient had undergone inguinal hernia repair at another hospital 18 months earlier. The operation was prosthetic mesh repair via an anterior approach...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28331010/presynaptic-and-extrasynaptic-regulation-of-posterior-nucleus-of-thalamus
#17
Anthony Park, Ying Li, Radi Masri, Asaf Keller
The posterior nucleus of thalamus (PO) is a higher-order nucleus involved in sensorimotor processing, including nociception. An important characteristic of PO is its wide range of activity profiles that vary across states of arousal, thought to underlie differences in somatosensory perception subject to attention and degree of consciousness. Further, PO loses the ability to down-regulate its activity level in some forms of chronic pain, suggesting that regulatory mechanisms underlying the normal modulation of PO activity may be pathologically altered...
March 22, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28330877/k-channel-modulatory-subunits-kchip-and-dpp-participate-in-kv4-mediated-mechanical-pain-control
#18
Yen-Ling Kuo, Jen-Kun Cheng, Wen-Hsien Hou, Yu-Cheng Chang, Po-Hao Du, Jhao-Jun Jian, Ruey-Horng Rau, Jung-Hui Yang, Cheng-Chang Lien, Meei-Ling Tsaur
The K(+) channel pore-forming subunit Kv4.3 is expressed in a subset of non-peptidergic nociceptors within the dorsal root ganglion (DRG), and knockdown of Kv4.3 selectively induces mechanical hypersensitivity, a major symptom of neuropathic pain. K(+) channel modulatory subunits KChIP1, KChIP2 and DPP10 are coexpressed in Kv4.3(+) DRG neurons, but whether they participate in Kv4.3-mediated pain control is unknown. Here, we show the existence of a Kv4.3/KChIP1/KChIP2/DPP10 complex (abbreviated as the Kv4 complex) in the endoplasmic reticulum and cell surface of DRG neurons...
March 22, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28330489/profiling-intraoral-neuropathic-disturbances-following-lingual-nerve-injury-and-in-burning-mouth-syndrome
#19
Amely Hartmann, Robin Seeberger, Malte Bittner, Roman Rolke, Claudia Welte-Jzyk, Monika Daubländer
BACKGROUND: The aim of the study was to analyse intraoral neurophysiological changes in patients with unilateral lingual nerve lesions as well as patients with Burning Mouth Syndrome (BMS) by applying a standardized Quantitative Sensory Testing (QST) protocol. METHODS: The study included patients suffering from a peripheral lesion of the lingual nerve (n = 4), from BMS (n = 5) and healthy controls (n = 8). Neurophysiological tests were performed in the innervation areas of the tongue bilaterally...
March 23, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28328697/the-fear-avoidance-components-scale-facs-responsiveness-to-functional-restoration-treatment-in-a-chronic-musculoskeletal-pain-disorder-cmpd-population
#20
Randy Neblett, Tom G Mayer, Mark J Williams, Sali Asih, Antonio I Cuesta-Vargas, Meredith M Hartzell, Robert J Gatchel
OBJECTIVES: To assess the clinical validity and factor structure of the Fear-Avoidance Components Scale (FACS), a new fear-avoidance (FA) measure. METHODS: In this study, 426 chronic musculoskeletal pain disorder (CMPD) patients were admitted to a functional restoration program (FRP). They were categorized into five FACS severity levels, from Subclinical to Extreme, at admission, and again at discharge. Associations with objective lifting performance and other patient-reported psychosocial measures were determined at admission and discharge, and objective work outcomes for this predominantly disabled cohort, were assessed one-year later...
March 21, 2017: Clinical Journal of Pain
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