Articles: hyperalgesia.
-
Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memory-associated plasticity. The authors thereby investigated the potential involvement of NL1-related mechanism in spinal nerve ligation (SNL)-associated allodynia. ⋯ SNL-induced allodynia, which is mediated by the spinal NL1/PSD-95/pNR2B cascade, can be prevented by blockade of transsynaptic Nrx1b-NL1 interactions.
-
Observational Study
Up-regulation of Cathepsin G in the Development of Chronic Postsurgical Pain: An Experimental and Clinical Genetic Study.
Proteases have been shown to modulate pain signaling in the spinal cord and may contribute to the development of chronic postsurgical pain. By using peripheral inflammation in rats as a chronic pain model, the authors identified the deregulation of proteases and their inhibitors as a hallmark of chronic pain development using a genome-wide screening approach. ⋯ This study demonstrated that CTSG is a pronociceptive mediator in both animal model and human study. CTSG represents a new target for pain control and a potential marker to predict patients who are prone to develop chronic pain after surgery.
-
J. Am. Acad. Dermatol. · Oct 2015
ReviewAcute pain management in dermatology: risk assessment and treatment.
Dermatologists perform many procedures that require acute pain control with local anesthesia and, in some cases, management of postoperative pain. Identifying early risk factors before a procedure can better prepare both the patient and provider anticipate acute postsurgical pain needs. Taking a multimodal, algorithmic approach to managing acute postsurgical pain in dermatology practice can effectively attenuate acute postsurgical paint and reduce patient opioid requirements.
-
J. Am. Acad. Dermatol. · Oct 2015
ReviewAcute pain management in dermatology: mechanisms and pathways.
The number of dermatologic surgical procedures performed is increasing each year. The pain associated with these procedures is a major concern for patients and its treatment is part of the increasing emphasis on outcomes and quality of clinical care. ⋯ Having this foundation of knowledge is needed to enhance the clinical treatment of pain. Part II will provide an updated review of available treatments, with an emphasis on their appropriate use for postsurgical pain management.
-
There is little information regarding changes in placebo responsiveness with age, although first predictors of placebo responders such as psychological and physiological processes have been identified. Reviews and meta-analyses indicate that placebo response rates in randomized controlled trials (RCTs) are higher in children and adolescents compared with adults. As these studies cannot control for age-dependent differences in the natural course of the disease, biases might contribute to different placebo rates in RCTs. To avoid these biases, this study investigated age-related differences in placebo responsiveness between children and adults in a well-established experimental model of placebo analgesia combining classic conditioning and expectation. Our data confirm placebo analgesic responses in children, which did not differ in magnitude from those of adults. The influence of previous experience on subsequent treatment outcome was stronger in children than in adults, indicating an increased relevance of learning processes for treatment outcomes in children. Further studies are needed to understand the influence of treatment-related learning processes in children and adolescents, which might critically determine treatment responsiveness during adulthood. ⋯ This study is the first to experimentally explore placebo analgesia and influences of previous experience on placebo responses in children compared with adults. We found comparable placebo responses in both groups and an increased relevance of learning processes for treatment outcomes in children.