Pain
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Controlled Clinical Trial
Sucrose-induced analgesia is related to sweet preferences in children but not adults.
The present study tested the hypothesis that the efficacy of sucrose in reducing pain during the Cold Pressor Test (CPT) was related to its hedonic value. To this aim, we determined the most preferred level of sucrose and the analgesic properties of 24% w/v sucrose during the CPT in 242, 5- to 10-year-old children and their mothers. Outcome measures included pain thresholds (the time at which discomfort was first indicated) and pain tolerance (the length of time the hand was kept in the cold water bath). ⋯ That is, children who preferred >or=24%w/v sucrose exhibited an increased latency to report pain and tolerated pain for significantly longer periods of time when sucrose was held in their mouths relative to water. This effect was more pronounced among normal weight when compared to overweight/at risk for overweight children. The role that dietary habits and individual differences contribute to the preferences for sweet taste and its physiological consequences in children is an important area for future research.
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Although more severe acute postoperative pain increases the risk of chronic pain following breast cancer surgery, few studies have examined the characteristics of patients who develop greater acute pain. To identify risk factors for acute pain and its persistence one month following breast cancer surgery, a sample of 114 women scheduled for breast cancer surgery was assessed preoperatively for demographic, clinical, and emotional functioning variables that were hypothesized to be associated with acute pain severity. ⋯ In multiple logistic regression analyses, greater preoperative anxiety was the only variable that made an independent contribution to predicting clinically meaningful acute pain at 2 days after surgery whereas younger age, being unmarried, and preoperative anxiety each made an independent contribution to predicting clinically meaningful acute pain that persisted from 2 to 30 days after surgery. These results increase understanding of neurobiologic mechanisms and psychosocial processes that contribute to the development of acute pain following breast cancer surgery and have implications for the development of interventions to prevent it.
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Clinical Trial
The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study.
Chronic pain in adulthood is one of the most costly conditions in modern western society. However, very little is known about the costs of chronic pain in adolescence. This preliminary study explored methods for collecting economic-related data for this population and estimated the cost-of-illness of adolescent chronic pain in the United Kingdom. ⋯ The adolescents attending a specialised pain management unit, who had predominantly non-inflammatory pain, accrued significantly higher costs, than those attending rheumatology outpatient clinics, who had mostly inflammatory diagnoses. Extrapolating the mean total cost to estimated UK prevalence data of adolescent chronic pain demonstrates a cost-of-illness to UK society of approximately 3,840 million pounds in one year. The implications of the study are discussed.
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Clinical Trial
Categorising the severity of neck pain: establishment of cut-points for use in clinical and epidemiological research.
Grading pain intensity scales into simple categories provides useful information for both clinicians and epidemiologists and methods to classify pain severity for numerical rating scales have been recommended. However, the establishment of cut-points is still in its infancy and little is known as to whether cut-points are affected by age or gender. The objectives of this paper were to establish optimal cut-points in pain severity in individuals with neck pain (NP) and to investigate if the cut-points were influenced by gender, age, and NP duration. ⋯ Only small gender differences in cut-points were seen and no specific trend was noted in either single or double cut-points in different age groups. The cut-points were almost identical for acute, subacute, and chronic NP. This paper has implications for understanding the impact of using different pain intensity scales and provides reference cut-points in NP for use in future clinical and epidemiological research.
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Chronic muscle pain is common and often difficult to treat. In this study, we further characterize a model of chronic muscle pain induced by repeated intramuscular injection of acidic saline. Two injections of acid into muscle separated by 5 days result in secondary mechanical hyperalgesia that lasts for up to 4 weeks. ⋯ The second intramuscular injection evoked a calcium-dependent increase in both spinal glutamate and aspartate concentrations. Glutamate concentrations within the dorsal horn were also increased 1 week after the second acid injection. Our data suggest increased release of spinal EAAs in the dorsal horn contributes to the development and maintenance of hyperalgesia.