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Treatment of chronic pain

Ulrike Hohenfellner
In specialist urology clinics, 50 - 70 % of patients have chronic urological diseases such as recurrent urinary tract infections, a somatoform overactive bladder, adult and infantile enuresis, a chronic pelvic pain syndrome, and the psychosomatic form of post-prostatectomy incontinence. The 12-month prevalence of psychological disorders in the general adult population is 28 % 1. As many as 20 % of children and adolescents are found to have psychological abnormalities 2. These are frequently accompanied by somatoform symptoms, often consisting of a psychosomatic voiding disorder with a consecutive complex pelvic floor dysfunction 3 4 5 6...
February 14, 2019: Aktuelle Urologie
Eric L Garland, Barbara L Fredrickson
The Mindfulness-to-Meaning Theory (MMT) is a temporally dynamic process model of mindful positive emotion regulation that elucidates downstream cognitive-affective mechanisms by which mindfulness promotes health and resilience. Here we review and extend the MMT to explicate how mindfulness fosters self-transcendence by evoking upward spirals of decentering, attentional broadening, reappraisal, and savoring. Savoring is highlighted as a key, potential means of inducing absorptive experiences of oneness between subject and object, amplifying the salience of the object while imbuing the sensory-perceptual field with affective meaning...
January 14, 2019: Current Opinion in Psychology
Kazue Hisaoka-Nakashima, Yoshiaki Tomimura, Toshiki Yoshii, Kazuto Ohata, Naoki Takada, Fang Fang Zhang, Yoki Nakamura, Keyue Liu, Hidenori Wake, Masahiro Nishibori, Yoshihiro Nakata, Norimitsu Morioka
Clinical evidence indicates that major depression is a common comorbidity of chronic pain, including neuropathic pain. However, the cellular basis for chronic pain-mediated major depression remains unclear. High-mobility group box 1 protein (HMGB1) has a key role in innate immune responses and appears to be have a role in mediating diverse disorders, including neuropathic pain and depression. The current study aimed to characterize neuropathic pain-induced changes in affect over time and to determine whether HMGB1 has a role in neuropathic pain-induced changes in affect...
February 11, 2019: Progress in Neuro-psychopharmacology & Biological Psychiatry
Fabio Barra, Giovanni Grandi, Matteo Tantari, Carolina Scala, Fabio Facchinetti, Simone Ferrero
Endometriosis is a chronic benign estrogen dependent disease characterized by the presence of endometriotic glands and stroma outside the uterine cavity. Although combined hormonal contraceptives and progestins, currently available first-line treatments for endometriosis, are efficacious and well tolerated for treating disease-related pain, some women experience partial or no improvement of pain or its recurrence is frequent after discontinuation of the therapies. For these reasons, new drugs are under investigation for the treatment of endometriosis...
February 14, 2019: Expert Opinion on Biological Therapy
Michael Seth Smith, Jairo Olivas, Kristy Smith
Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, comparable with other standard treatments. When compared with oral analgesics, cervical manipulation and/or mobilization appears to provide better short-term pain relief and improved function in patients with neck pain. Manipulative therapies may be as effective as amitriptyline for treating migraine headaches and can reduce the frequency and intensity of pain...
February 15, 2019: American Family Physician
Kwo Wei David Ho, Torge Rempe, Nivedita Jerath, Ajay Antony
OBJECTIVES: Dorsal root ganglion (DRG) stimulation has been demonstrated to be effective in treating painful diabetic polyneuropathy in a small case series. However, diabetic polyneuropathy only accounts for 41% of all polyneuropathies and the efficacy of DRG on other types of polyneuropathy is unclear. The objective of this study is to evaluate the efficacy of DRG stimulation in treating painful hereditary and idiopathic axonal polyneuropathy. MATERIALS AND METHODS: This is a monocentric retrospective case series...
February 14, 2019: Neuromodulation: Journal of the International Neuromodulation Society
Ayşegül Ceylan, İbrahim Aşık, Güngör Enver Özgencil, Burak Erken
Background/aim: We aimed to compare the results of the treatment of the patients with failed back surgery syndrome (FBSS) by mechanical lysis and steroid hylase injection via epiduroscopy due to their stabilization status and to detect the effect of pathological diagnostic markers on prognosis and ongoing treatment protocol. Materials and methods: Eighty-two patients with FBSS symptoms were included. Two groups were composed as group I (stabilized) and group II (nonstabilized)...
February 11, 2019: Turkish Journal of Medical Sciences
A B Zhiborev, A G Martov
INTRODUCTION: Concurrent chronic prostatitis (CP) plays an important role in the pathogenesis and progression of benign prostatic hyperplasia (BPH), increasing the severity of lower urinary tract symptoms (LUTS), lowering the quality of life, and increasing the risk of acute urinary retention. However, in the management of patients with BPH, the role of CP is not always taken into account. AIM: To evaluate the effectiveness of integrated management of patients with CP and patients with co-occurring BPH and CP using a physiotherapeutic device Mavit for the treatment of inflammatory diseases of the prostate...
October 2018: Urologii︠a︡
Doralina L Anghelescu, Jessica Michala Tesney
Neuropathic pain in pediatric oncology can be caused by distinct lesions or disease processes affecting the somatosensory system, including chemotherapy-related neuronal injury, solid tumor-related involvement of neural structures, post-surgical neuropathic pain-including phantom limb pain and pain after limb-sparing surgery-and the complex circumstances of neuropathic pain at the end of life. Treatment algorithms reflect the general treatment principles applied for adult neuropathic pain, but the dose regimens applied in children are modest and rarely escalated to the maximum doses to optimize analgesic efficacy...
February 14, 2019: Paediatric Drugs
Ishanka Weerasekara, Peter Grant Osmotherly, Suzanne Jordan Snodgrass, John Tessier, Darren Anthony Rivett
BACKGROUND: Up to 40% of individuals who sprain their ankle develop chronic ankle instability (CAI). One treatment option for this debilitating condition is joint mobilisation. There is preliminary evidence that Mulligan's Mobilisation With Movement (MWM) is effective for treating patients with CAI, but the mechanisms by which it works are unclear, with Mulligan suggesting a repositioning of the fibula. This randomised controlled trial aims to determine the effects of MWM on anatomical and clinical characteristics of CAI...
February 13, 2019: BMC Musculoskeletal Disorders
Simranpal Dhanju, Sidney H Kennedy, Susan Abbey, Joel Katz, Aliza Weinrib, Hance Clarke, Venkat Bhat, Karim Ladha
Background and aims The co-morbidity between pain and depression is a target of interest for treatment. However most of the published literature on the topic has used clinical cohorts as the population of interest. The goal of this study was to use a nationally representative sample to explore how health outcomes varied across pain and depression status in a cohort sampled from the general US population. Methods This was a cross-sectional analysis of adults ≥18 years in the 2009-2010 National Health and Nutrition Examination Survey...
February 13, 2019: Scandinavian Journal of Pain
Bonnie K Lind, Dennis McCarty, Yifan Gu, Robin Baker, K John McConnell
BACKGROUND: It is important to understand patterns and predictors of initiation and engagement in treatment for Medicaid-covered individuals with substance use disorders because Medicaid is a major source of payment for addiction treatment in the United States. Our analysis examined similarities and differences in predictors between adults and adolescents. METHODS: An analysis of Oregon Medicaid claims data for the time period January 2010 through June 2015 assessed rates of substance use and of treatment initiation and engagement using the Healthcare Effectiveness Data and Information Set (HEDIS) definitions...
February 13, 2019: Substance Abuse
Jorge H Ulloa
Chronic venous disease (CVD) is both prevalent and unavoidable in many people as a result of persistent or unalterable risk factors, the most important of which are advanced age, excess body weight, and family history. Given this inevitability, medical treatment is required to alleviate symptoms and slow disease progression. Venoactive drug therapy is emerging as a valuable treatment option for many CVD patients and micronized purified flavonoid fraction (MPFF) is the most widely prescribed and well-studied venoactive drug available...
February 13, 2019: Advances in Therapy
Alun H Davies
Chronic venous disease (CVD) is a prevalent condition that tends to worsen with age. Patients initially seek treatment to relieve symptoms of leg pain, discomfort, heaviness and swelling, all of which impact their quality of life. As the disease increases in severity to include varicose veins, skin changes, and venous ulcer, the demand for treatment increases while the quality of life further diminishes. The prevalence of CVD is highest in Western countries where it already consumes up to 2% of healthcare budgets...
February 13, 2019: Advances in Therapy
Martin Heinrich, Simon Steiner, Christoph Michael Bauer
OBJECTIVES: Visual feedback as an intervention for people suffering from chronic back or chronic neck pain is a novel approach based on the person's perception of the painful body part. Visual feedback is an innovative therapeutic approach whose effects have not yet been systematically reviewed specifically for people with chronic back or chronic neck pain. Therefore, a systematic review was performed on the literature to evaluate the effects of visual feedback on pain intensity in people with chronic back or neck pain...
February 13, 2019: Physiotherapy Theory and Practice
Sufang Tian, Shu-Yuan Xiao, Qiongrong Chen, Huan Liu, Jie Ping
There is a significant overlap between intestinal lymphoproliferative disorders (LPDs) and inflammatory conditions of the intestine, including inflammatory bowel disease (IBD), in clinical, endoscopic, or histologic appearance, leading to diagnostic challenges. We report two cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) that were initially considered to be ulcerative colitis (UC) and lymphocytic colitis, respectively. Both patients presented with diarrhea and abdominal pain. Colonoscopy revealed hyperemia and scattered shallow ulcerations in the colon, without obvious mass...
January 2019: International Journal of Immunopathology and Pharmacology
Sang Wook Kang, Je-Hoon Park, Hosik Seok, Hae Jeong Park, Joo-Ho Chung, Chang-Ju Kim, Young Ock Kim, Young Rok Han, DongWhan Hong, Young Sik Kim, Su Kang Kim
Chronic prostatitis typically occurs in aging men, and its symptoms include frequent and painful urination. In recent study, several studies have shown that Korean red ginseng (KRG) can be used in the prevention and treatment of various diseases. The objective of this study is to investigate whether KRG can play a role in repressing the development of chronic nonbacterial prostatitis (CNP) in male Wistar rats. To induce CNP, rats were castrated and beta-estradiol (0.25 mg/kg) was subcutaneously (s.c.) injected daily...
2019: BioMed Research International
Carine Mekoguem, Cécile Triboulet, Alexandre Gouveia
BACKGROUND: Mycetoma is a neglected infectious disease caused by a fungus (eumycetoma) or bacteria (actinomycetoma); it is characterized by chronic local inflammation with sinus formation and purulent discharge. Its course can be quite devastating because of the difficulty in diagnosing the infection and in eliminating the causative agent. Although endemic in many countries in the tropics and subtropics, the migration of Africans to Europe may increase the presence of this neglected disease in European countries...
February 12, 2019: Journal of Medical Case Reports
Hong-Chun Xiang, Li-Xue Lin, Xue-Fei Hu, He Zhu, Hong-Ping Li, Ru-Yue Zhang, Liang Hu, Wen-Tao Liu, Yi-Lin Zhao, Yang Shu, Hui-Lin Pan, Man Li
BACKGROUND: Chronic pain is a major clinical problem with limited treatment options. Previous studies have demonstrated that activation of adenosine monophosphate-activated protein kinase (AMPK) can attenuate neuropathic pain. Inflammation/immune response at the site of complete Freund's adjuvant (CFA) injection is known to be a critical trigger of the pathological changes that produce inflammatory pain. However, whether activation of AMPK produces an analgesic effect through inhibiting the proinflammatory cytokines, including interleukin-1β (IL-1β), in inflammatory pain remains unknown...
February 12, 2019: Journal of Neuroinflammation
Gaia Favero, Francesca Bonomini, Caterina Franco, Rita Rezzani
Fibromyalgia syndrome (FMS) is considered a musculoskeletal disorder associated to other symptoms including chronic pain. Since the hypothesis of FMS etiogenesis is consistent with mitochondrial dysfunction and oxidative stress, we evaluated the pathophysiological correlation among these factors studying some proteins involved in the mitochondrial homeostasis. We focused our attention on the roles of peroxisome proliferator activated receptor gamma coactivator-1alpha (PGC-1α), mitofusin2 (Mfn2), and coenzyme Q10 (CoQ10) in reserpine-induced myalgic (RIM) rats that manifest fibromyalgia-like chronic pain symptoms...
February 11, 2019: International Journal of Molecular Sciences
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