European journal of pain : EJP
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The etiology of complex regional pain syndrome (CRPS) is unclear yet. Recently autoantibodies and antecedent viral infections have been discussed to be involved in the pathogenesis of CRPS. ⋯ All CRPS 2 patients were positive. 10.2% of the CRPS patients and 10.0% of the controls had AECA (n.s.) and AECA were not associated with parvovirus B19 seropositivity. Our findings suggest the involvement of parvovirus B19, but not autoantibody-mediated endothelial cell damage, in the pathogenesis of CRPS.
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We previously found that for both men and women odors influence mood, which in turn influences pain unpleasantness perception. Others showed that the steroid androstadienone modulates mood differently in men and women, improving mood in women and worsening it or leaving it unchanged in men. Based on its dissociable effect on mood, we hypothesized that women exposed to androstadienone would report lower pain unpleasantness than when exposed to the vehicle, while men would show no change or the reverse pattern. Because of the expected beneficial effect of pleasant odors on mood in both men and women, all subjects should report lower pain unpleasantness when exposed to the pleasant odor compared to the unscented air. ⋯ Planned comparisons confirmed that, in the absence of pain, androstadienone improved mood only in women, while the pleasant odorants improved mood for all subjects. However, these positive mood changes did not persist with the introduction of pain. Consistent with the absence of positive mood changes, pain unpleasantness was not modulated. Unexpectedly, the presence of androstadienone increased perceived pain intensity especially in women, suggesting an effect of androstadienone on pain perception, independent of mood changes. Heightened attentional state may be responsible.
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Comparative Study
Can a sexually dimorphic index of prenatal hormonal exposure be used to examine cold pressor pain perception in men and women?
There is considerable evidence to suggest that important differences exist between men and women in their experience of pain. Research has now turned to determine what the mechanisms of such differences actually are. One potential explanation is the effect of sex hormones, especially those typically found in greater concentration within women, e.g., estrogen, progesterone. ⋯ Although some significant relationships were found between digit ratio/digit length and cold pressor pain reports they were relatively inconsistent. Furthermore, the main finding, that pain thresholds were positively related to digit ratio in women but not men, is somewhat inconsistent with predictions. The results are discussed in light of methods for investigating the effect of prenatal hormonal exposure on pain sensitivity in men and women.
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Pain is the most debilitating symptom in osteoarthritis of the knee (OAK). ⋯ Clinical effects from pharmacological interventions in OAK are small and limited to the first 2-3 weeks after start of treatment. The pain-relieving effects over placebo in OAK are smaller than the patient-reported thresholds for relevant improvement.
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Neonates in a neonatal intensive care unit are exposed to a high number of painful procedures. Since repeated and sustained pain can have consequences for the neurological and behaviour-oriented development of the newborn, the greatest attention needs to be paid to systematic pain management in neonatology. Non-pharmacological treatment methods are being increasingly discussed with regard to pain prevention and relief either alone or in combination with pharmacological treatment. ⋯ Some of the non-pharmacological interventions have an evident favourable effect on pulse rate, respiration and oxygen saturation, on the reduction of motor activity, and on the excitation states after invasive measures. However, unambiguous evidence of this still remains to be presented. Further research should emphasise the use of validated pain assessment instruments for the evaluation of the pain-alleviating effect of non-pharmacological interventions.