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Context pain

Susan Salmond, Virginia Allread
The United States is in the midst of a nationwide public health emergency: an epidemic of opioid misuse and abuse that has been called the deadliest drug crisis in American history. This article reviews the current status of the opioid epidemic, the trends over the last 30-40 years that may have contributed to the epidemic, and a population health approach to addressing the epidemic. The epidemic is conceptualized from a population health perspective-an upstream and midstream perspective focusing on prevention and a downstream perspective targeting access to evidence-based interventions and maximizing health whether using or abstaining...
February 13, 2019: Orthopaedic Nursing
Ioan Durnescu
Based on an ethnographic study with 58 participants released from a Romanian prison, this study revisits the pains of release and illustrates the complexity of the reentry process. Some of the pains of reentry seem universal while others seem to be context dependent. In the same time, some pains of release are personal, others social, while others are structural. Concepts of intersectionality and the multi-level model of reentry are discussed, and further suggestions for research are advanced.
February 15, 2019: International Journal of Offender Therapy and Comparative Criminology
Vanara F Passos, Mary A S Melo, Jennifer Park, Howard E Strassler
Dental erosion is a multifactorial condition associated with chemical, biological, and behavioral factors whereby a non-bacterial chemical process leads to an irreversible loss of dental structure. Consequences of this erosive process include painful sensitivity, susceptibility to further erosion, mechanical wear, changes in occlusion, exposure of dental pulp, and poor esthetics. Substantial evidence has revealed new insights to diagnosing early stages of dental erosion and enabling novel preventive approaches to control its progression...
February 2019: Compendium of Continuing Education in Dentistry
James D Harrison, Sanjay Reddy, Rhianon Liu, Shelley R Adler, Maria T Chao
OBJECTIVE: To explore an interprofessional group of health care providers' perspectives on the facilitators and barriers to implementation of an inpatient acupuncture service for pain and symptom management. DESIGN: Qualitative. SETTING: An urban, academic, tertiary care health system. SUBJECTS: Key interprofessional health care providers, including physicians, nurses, and administrators. Methods/interventions: We used interviews and focus group with questions guided by the Promoting Action on Research Implementation in Health Services framework to explore three domains of implementation-evidence, context, and facilitation...
February 13, 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
David A Seminowicz, Bethany Remeniuk, Samuel R Krimmel, Michael T Smith, Frederick S Barrett, Andreas B Wulff, Andrew J Furman, Stephan Geuter, Martin A Lindquist, Michael R Irwin, Patrick H Finan
The nucleus accumbens (NAc) has been implicated in sleep, reward, and pain modulation, but the relationship between these functional roles is unclear. This study aimed to determine if NAc function at the onset and offset of a noxious thermal stimulus is enhanced by rewarding music, and if that effect is reversed by experimental sleep disruption. Twenty-one healthy subjects underwent functional MRI (fMRI) scans on two separate days following both uninterrupted sleep and experimental sleep disruption. During fMRI scans, participants experienced noxious stimulation while listening to individualized rewarding or neutral music...
February 8, 2019: Pain
Roberto Casale, Piercarlo Sarzi-Puttini, Rossana Botto, Alessandra Alciati, Alberto Batticciotto, Daniela Marotto, Riccardo Torta
The concept of resilience varies according to the context in which it is used. Resilience is broadly defined as a protective factor that makes people less vulnerable to future adverse life events, in this implying the previous occurrence of an adverse event that has to be confronted before individual equilibrium can be restored. This definition can be applied to fibromyalgia and other chronic pain situations. Resilience is profoundly related to reaction to acute or chronic stress, and is therefore involved in the stress response system...
January 2019: Clinical and Experimental Rheumatology
Rachel G Grashow, Andrea L Roberts, Ross Zafonte, Alvaro Pascual-Leone, Herman Taylor, Aaron Baggish, Lee Nadler, Theodore K Courtney, Ann Connor, Marc G Weisskopf
Studies of professional American football players have shown that football-related activities lead to acute injuries and may have long-term adverse health outcomes including osteoarthritis, neurocognitive impairment, and cardiovascular disease. However, the full complement of what constitutes professional football exposure has yet to be effectively articulated. Most likely, professional football exposure encompasses a multifaceted array of experiences including head impacts and joint stresses, long-term pain medication use, dietary restrictions, and strenuous training regimens...
February 2019: Orthopaedic Journal of Sports Medicine
C Joubert, S Gazzola, A Sellier, A Dagain
Acute spinal cord compression usually results from trauma, infection, or cancer. Spinal subdural hematoma is an uncommon cause of spinal cord compression that occurs after spine trauma or spinal invasive procedure, especially in context of coagulopathy. In the following reported case, an 82-year-old woman with a history of rapidly progressive paraparesis after a sudden middle back pain, with no previous trauma or coagulopathy, due to an acute spontaneous spinal subdural hematoma. In fact, the main difficulty was to determine, in an emergency situation, the right strategy to identify both the lesion and its cause to adapt therapeutics...
February 8, 2019: Neuro-Chirurgie
Tommaso Ingrassia, Benedetto Lombardo, Vincenzo Nigrelli, Vito Ricotta, Lorenzo Nalbone, Antonio D'Arienzo, Michele D'Arienzo, Giuseppe Porcellini
PURPOSE: Massive rotator cuff tears are common in the aging population. The incidence of failed rotator cuff repairs is still quite high, especially in the treatment of full-thickness tears or revision repairs. In this context, natural and synthetic meshes can be used as augmentation scaffolds or as devices to close the gap between a retracted tendon and the bone. The purpose of this work is to evaluate the ultimate tensile strength of different tendon-patch joints in order to consider their use in the treatment of massive cuff tears...
February 2, 2019: Injury
William L Smith
Omega-6 polyunsaturated fatty acids were identified as essential nutrients in 1930. Their essentiality is largely due to their function as prostaglandin (PG) precursors. I spent most of my career in biochemistry determining how PG biosynthesis is regulated. PGs are lipid mediators formed in response to certain circulating hormones and cytokines. PGs act near their sites of synthesis to signal neighboring cells to coordinate their responses ( e.g. when platelets interact with blood vessels). The committed step in PG synthesis is the conversion of a 20-carbon omega-6 fatty acid called arachidonic acid to prostaglandin endoperoxide H2 (PGH2 )...
February 8, 2019: Journal of Biological Chemistry
Carl Wilmsen, A Butch de Castro, Diane Bush, Marcy J Harrington
OBJECTIVES: Forestry services is a hazardous industry with high job-related injury, illness, and fatality rates. The Northwest workforce is largely Spanish-speaking, Latino, and immigrant, working in poor conditions with insufficient attention paid to safety and health. Institutional racism fundamentally shapes the structural vulnerability of Latino immigrant workers. Given this context, we sought to understand how workplace organizational factors and safety climate affect job-related injuries in this industry...
February 8, 2019: Journal of Agromedicine
Odelia Elkana, Yael Conti, Ofir Heyman, Sami Hamdan, Motty Franko, Jean-Jacques Vatine
We investigated the relations between several aspects of Perceived Pain (PP) and different measurements of Executive Functions (EFs), above the influence of depression, in the context of medical rehabilitation. Eighty-one neurologically intact patients participated in this study in their sub-acute stage of recovery. Different aspects of EFs were assessed using the Wisconsin Card Sorting Test (WCST), the Stop-Signal Test (SST) and the Digit Span Backward subtest of the WAIS-III (Span-B). Different aspects of PP were measured: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS)...
February 8, 2019: Neuropsychological Rehabilitation
Jaroslaw Marczak, Gun Rembeck, Eva-Lisa Petersson, Lena Nordeman
OBJECTIVE: The aim of the study was to elucidate how patients experience living with chronic leg ulcers before consulting a health professional, and to determine the reasons behind the decision to visit a health-care centre. METHOD: A qualitative interview study was carried out. There were 11 participants, five men and six women (age range: 27-83 years old). All participants in the study were patients visiting the public primary medical centre in western Sweden for the first time for a chronic leg ulcer...
January 1, 2019: Journal of Wound Care
A Giannini, M Caretto, E Russo, P Mannella, T Simoncini
Pelvic floor dysfunctions are a complex condition in elderly women; pelvic organ prolapse, urinary or fecal incontinence, constipation, pelvic pain, and sexual dysfunction are common problems. The goal of surgical treatment is functional reconstruction with symptom management and repair of anatomic defects. The recent advancements in surgical treatment of pelvic floor dysfunction allow several good options for choosing the best surgery for each patient. The vaginal procedure is traditionally the gold standard approach for elderly patients, but abdominal surgery is increasing as a mini-invasive approach and the robotic approach is gaining acceptance for treatment of pelvic floor dysfunctions...
February 2019: Climacteric: the Journal of the International Menopause Society
Elodie Picard, Frederic Antonio Carvalho, Francina Agosti, Emmanuel Bourinet, Denis Ardid, Alain Eschalier, Laurence Daulhac, Christophe Mallet
BACKGROUND AND PURPOSE: Abdominal pain associated with low-grade inflammation is frequently encountered in irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) during the remission phase. Current treatments are generally weakly effective. Therefore, new therapeutic approaches are needed. The role of Cav3.2 voltage-dependent calcium channels, which have been shown to be important in other chronic pain contexts, was investigated in a murine model of colonic hypersensitivity (CHS) associated with low-grade inflammation...
February 4, 2019: British Journal of Pharmacology
F Anger, R Legré, M K Nguyen
The comminuted distal radius fractures among elderly people are usually linked to osteoporosis, and repairing them in this context is a therapeutical challenge. Several teams have reported good results of radius resurfacing. The goal of our study was to evaluate the usability of the wrist in a new series of patients after surgery. We performed a monocentric retrospective study on the data of the medical files. All the included patients were older than 65 years and received a wrist hemiarthroplasty according to the criteria that have been established by the in charge medical team...
January 31, 2019: Hand Surgery and Rehabilitation
Ersilia Lucenteforte, Alfredo Vannacci, Giada Crescioli, Niccolò Lombardi, Laura Vagnoli, Laura Giunti, Valentina Cetica, Maria Luisa Coniglio, Alessandra Pugi, Roberto Bonaiuti, Maurizio Aricò, Sabrina Giglio, Andrea Messeri, Roberto Barale, Lisa Giovannelli, Alessandro Mugelli, Valentina Maggini
BACKGROUND: Genetic polymorphisms in genes involved in pain modulation have been reported to be associated to opioid efficacy and safety in different clinical settings. METHODS: The association between COMT Val158Met polymorphism (rs4680) and the inter-individual differences in the response to opioid analgesic therapy was investigated in a cohort of 87 Italian paediatric patients receiving opioids for cancer pain (STOP Pain study). Furthermore, a systematic review of the association between opioid response in cancer patients and the COMT polymorphism was performed in accordance with the Cochrane Handbook and the Prisma Statement...
January 31, 2019: BMC Cancer
Sara Macdonald, Elaine Conway, Annemieke Bikker, Susan Browne, Kathryn Robb, Christine Campbell, Robert Jc Steele, David Weller, Una Macleod
Though new or altered bodily sensations are a common occurrence they rarely transition to biomedically defined symptoms. When they do, sensations are subject to an appraisal process that can culminate in help-seeking. The transition has particular relevance for cancer diagnoses. Studies of 'symptom appraisal' in cancer patients typically conclude that failure to regard sensations as serious or 'symptom misattribution' results in lengthier help-seeking intervals. Though multiple influences on appraisal processes are acknowledged, including the socio-cultural context, detailed description and analyses of how socio-cultural factors shape appraisal is lacking...
January 10, 2019: Social Science & Medicine
Lindsey A Chew, Shreya S Bellampalli, Erik T Dustrude, Rajesh Khanna
The peripherally expressed voltage-gated sodium NaV 1.7 (gene SCN9A) channel boosts small stimuli to initiate firing of pain-signaling dorsal root ganglia (DRG) neurons and facilitates neurotransmitter release at the first synapse within the spinal cord. Mutations in SCN9A produce distinct human pain syndromes. Widely acknowledged as a "gatekeeper" of pain, NaV 1.7 has been the focus of intense investigation but, to date, no NaV 1.7-selective drugs have reached the clinic. Elegant crystallographic studies have demonstrated the potential of designing highly potent and selective NaV 1...
January 27, 2019: Biochemical Pharmacology
Sigune Kaske, Rolf Lefering, Bertil Bouillon, Marc Maegele
BACKGROUND: Trauma registries provide knowledge about the pathophysiological events that follow severe injuries but only little is known about outpatient care and socioeconomic consequences at later stages in case of survival. We introduce a novel questionnaire to specifically assess the quality of post-discharge outpatient care and socioeconomic burden up to two years after severe multiple injury. DESIGN: Observational Study. SETTING: Post-discharge outpatient treatment and socioeconomic burden within two years after severe trauma...
January 28, 2019: European Journal of Physical and Rehabilitation Medicine
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