The Clinical journal of pain
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The aim of this study was to determine the theoretical repeatability coefficient of a 100 mm visual analog scale (VAS) in children in different circumstances. ⋯ The conditions of the assessments influence the repeatability coefficient of the VAS. Depending on different circumstances, the repeatability coefficient in children aged 8 to 17 years varies from 6 to 12 mm on a 100 mm VAS.
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Fibromyalgia (FM) syndrome is characterized by widespread pain that is exacerbated by cold and stress but relieved by warmth. We review the points along thermal and pain pathways where temperature may influence pain. We also present evidence addressing the possibility that brown adipose tissue activity is linked to the pain of FM given that cold initiates thermogenesis in brown adipose tissue through adrenergic activity, whereas warmth suspends thermogenesis. ⋯ This results in lower body temperatures, lower metabolic rates, and lower circulating cortisol/corticosterone in response to stress--characteristics of FM. In the periphery, sympathetic nerves to brown adipose also project to surrounding tissues, including tender points characterizing FM. As a result, the musculoskeletal hyperalgesia associated with conditions such as FM may result from referred pain in the adjacent muscle and skin.
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The main aim of the study was to generate initial convergent validity evidence for the Pain and Discomfort Scale (PADS) for use with nonverbal adults with intellectual disabilities. ⋯ FACS is an objective coding platform for facial expression. It requires intensive training and resources for scoring. As such it may be limited for clinical application. PADS was designed for clinical application. PADS scores were comparable with FACS scores under controlled evaluation conditions providing partial convergent validity evidence for its use.
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Existing research has reported the correlation between patients' psychological flexibility, of which mindfulness is a component, and their perceptions of the spouses' support provision. It is quite likely that spouses' mindfulness, in particular certain aspects of mindfulness, is also related to the support they provide to patients. The current study examined this issue. ⋯ Spouses' mindfulness, especially as it pertains to acting with awareness, was most consistently associated with patient perceptions of spousal support. These findings suggest that acting with awareness should be examined further including the possible contributions this type of mindfulness may make to healthy relationship behaviors in the context of pain.
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Observational Study
Breakthrough Pain in Patients with Abdominal Cancer Pain.
Characterization of breakthrough cancer pain (BTcP) in patients with abdominal cancer is lacking. The aim of this study was to assess the characteristics of BTcP in patients with abdominal cancer pain. ⋯ This preliminary study provides new insights on the characteristics of BTcP in a subclass of patients with abdominal disease. It has been estimated that about 55% of patients with well-controlled background pain will develop BTcP episodes. This percentage was higher (about 90%) in patients who presented with uncontrolled background pain, underlying the need to better characterize patients with BTcP, only after a careful optimization of basal pain, as considered by the definition of BTcP.