European journal of pain : EJP
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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.
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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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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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Multicenter Study
Adult attachment variables predict depression before and after treatment for chronic pain.
The complex relationship between chronic pain and depression has long been of clinical and empirical interest. Although attachment theory has been described as a "theory of affect regulation", and has been lauded as a developmental framework for chronic pain, surprisingly little research specifically considers the links between adult attachment variables and pain-related depression. ⋯ Of particular interest was the finding that comfort with closeness was the unique predictor of lower levels of post-treatment depression, usurping pain intensity and pre-treatment depression. These results are discussed in terms of clinical implications, and suggest that adult attachment theory may prove a valuable perspective in pain treatment programs.