Pain practice : the official journal of World Institute of Pain
-
Case Reports
Introducing Interventional Pain Services in a Large African Teaching Hospital: Challenges and Opportunities.
There is a need for interventional pain management in the developing world; however, there are many barriers to the introduction of interventional pain therapies. This brief report describes one approach to the introduction of interventional pain medicine to a Nigerian teaching hospital. Although many barriers exist, interventional pain medicine can be brought to the developing world, as demonstrated in this case series.
-
There is convincing evidence that inflammation plays a pivotal role in the pathophysiology of complex regional pain syndrome (CRPS). Besides inflammation, central sensitization is also an important phenomenon. ⋯ In the development of a more mechanism-based treatment, influencing the activity of mast cells might be important in the treatment of CRPS. We describe the rationale for using medication that counteracts the effects of mast cells in the treatment of CRPS.
-
Burning mouth syndrome (BMS) is a chronic condition most common in middle-aged and elderly women, with prevalence rates in the general population ranging from 0.5% to 5%. Defined by the International Headache Society as "an intraoral burning sensation for which no medical or dental cause can be found," BMS is considered a form of neuropathic pain. The management of BMS remains unsatisfactory. ⋯ Acupuncture treatment lasted 8 weeks and consisted of 20 sessions. Patients reported a mean reduction in pain of 0.99 points on the VAS (max 2.1-min 0.1), which, although slight, was statistically significant (Wilcoxon test P < 0.009). No significant improvement in the overall score for quality of life was observed, although subjects receiving acupuncture treatment seemed better able cope with their oral symptoms.
-
The mu-opioid receptor (OPRM1) A118G polymorphism has been associated with decreased analgesic effects of opioids and predisposition to addiction. However, its role in specific clinical scenarios and in different ethnicities must be better defined. No studies evaluating the A118G polymorphism in the Brazilian population have yet been published. ⋯ We developed a fast and reliable genotyping method to identify the allele frequency distribution of the OPRM1 A118G polymorphism among patients from Center-West Brazil. Our preliminary results suggest functional consequences of the polymorphism on smoking behavior among Brazilians.