Pain
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Randomized Controlled Trial Comparative Study
Spinal cord stimulation normalizes abnormal cortical pain processing in patients with cardiac syndrome X.
Cardiac syndrome X (CSX) is characterized by effort angina, ST-segment depression during stress tests and normal coronary arteries. Abnormal nociception was suggested in these patients by studies showing a reduced cardiac pain threshold; furthermore, we recently found a lack of habituation to pain stimuli using recording of laser evoked potentials (LEPs). In CSX patients with severe angina, spinal cord stimulation (SCS) was shown to improve symptoms. ⋯ Similar results were observed during right-hand stimulation. Our study shows that in CSX patients SCS is able to restore habituation to peripheral pain stimuli. This effect might contribute to restore the ability of CSX patients to better tolerate cardiac pain.
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Comparative Study
Predictors of low back pain hospitalization--a prospective follow-up of 57,408 adolescents.
Low back pain (LBP) is common among adolescents and it has been estimated that one-fifth of adolescents suffer from recurrent severe LBP. However, longitudinal studies describing the risk factors of LBP are scarce. The purpose of this study was to investigate whether health, physical activity and other health behaviors, socio-demographic background and school success predict LBP hospitalization until early middle age. ⋯ The associations between the risk factors and LBP hospitalization persisted into adulthood. Efforts to reduce adolescent smoking may decrease LBP-related morbidity in males. Coaches should pay special attention to the nature of physical training and personal exercises in females, and physiotherapists and sports physicians to the prevention of LBP hospitalization.
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The length of the reporting period specified for items assessing pain and fatigue varies among instruments. How the length of recall impacts the accuracy of symptom reporting is largely unknown. This study investigated the accuracy of ratings for reporting periods ranging from 1 day to 28 days for several items from widely used pain and fatigue measures (SF36v2, Brief Pain Inventory, McGill Pain Questionnaire, Brief Fatigue Inventory). ⋯ An additional 7 day-by-day recall task suggested that patients have increasing difficulty actually remembering symptom levels beyond the past several days. These data were collected while patients were receiving usual care and may not generalize to conditions where new interventions are being introduced and outcomes evaluated. Reporting periods can influence the accuracy of retrospective symptom reports and should be a consideration in study design.
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Randomized Controlled Trial Comparative Study
Evaluation of analgesic effect of skin-to-skin contact compared to oral glucose in preterm neonates.
Nonpharmacological interventions are important alternatives for pain relief during minor procedures in preterm neonates. Skin-to-skin contact or kangaroo mother care is a human and efficient way of caring for low-weight preterm neonates. The aim of the present study was to assess the analgesic effect of kangaroo care compared to oral glucose on the response of healthy preterm neonates to a low-intensity acute painful stimulus. ⋯ In group 3 (glucose, n=31), the neonate was in the prone position in the isolette and received oral glucose (1 ml, 25%) 2 min before heel lancing. A smaller variation in heart rate (p=0.0001) and oxygen saturation (p=0.0012), a shorter duration of facial activity (brow bulge, eye squeeze and nasolabial furrowing) (p=0.0001), and a lower PIPP (Premature Infant Pain Profile) score (p=0.0001) were observed in group 2. In conclusion, skin-to-skin contact produced an analgesic effect in preterm newborns during heel lancing.
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Comparative Study
Psychological predictors of pain expression and activity intolerance in chronic pain patients.
Recent research suggests that communicative and protective pain behaviors represent functionally distinct subsystems of behavior associated with pain. The present research examined whether components of pain experience such as pain severity, catastrophizing and fear of pain were differentially associated with communicative and protective pain behaviors. It was predicted that pain severity would be associated with decreased physical tolerance and heightened expression of pain behavior. ⋯ This study provides additional evidence for the functional distinctiveness of different types of pain expression and provides preliminary evidence for the functional distinctiveness of pain expression and activity intolerance. Discussion addresses the processes by which psychological factors might influence the display of different types of pain behaviors. Discussion also addresses how different types of interventions might be required to specifically target the sensory and behavioral dimensions of the pain system.