Articles: chronic.
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J Pain Palliat Care Pharmacother · Sep 2014
Comparative StudyClinicians' perspective on the use of immunoassay versus definitive laboratory quantitation methodologies for medication monitoring.
Treating chronic pain is complicated. Primary care doctors and others are called on to treat the vast majority of patients with pain, to do so in brief visits and to do it safely. This is a tall order, but it is possible to do it well when the proper tools are employed to aid the clinician in diagnosing and monitoring the patient. ⋯ When medically necessary, it makes sense to seek definitive testing from the laboratory to confirm results of immunoassay tests with chromatographic testing and/or when there is the possibility of a false negative in the office. These "false negatives" are extremely common, with patients using nonprescribed opioids and illicit medications often go undetected if one were to stop at the office-based result. These patients are in danger of addiction and overdose, and this added information is crucial in efforts to treat pain and avoid these complications.
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Lung cancer is the leading cause of cancer-related mortality. Surgical removal of the tumor at an early stage can be curative. However, lung cancer diagnosis at an early stage remains challenging. There is evidence that free fatty acids play a role in cancer development. ⋯ Serum fatty acids and their metabolites demonstrate good sensitivity and specificity for the identification of adenocarcinoma of the lung.
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Fibromyalgia syndrome (FMS) is a common and intriguing condition, manifest by chronic pain and fatigue. Although the pathogenesis of FMS is not yet completely understood, predicting the future development of FMS and chronic pain is a major challenge with great potential advantages, both from an individual as well as an epidemiological standpoint. Current knowledge indicates a genetic underpinning for FMS, and as increasing data are accumulated regarding the genetics involved, the prospect of utilizing these data for prediction becomes ever more attractive. ⋯ Functional neuroimaging may help to elucidate the neural processes involved in central sensitization, and may ultimately also evolve into markers of predictive value. Last but not least, obesity and disturbed sleep are clinical (inter-related) features relevant for this spectrum. Future efforts will aim at integrating genetic, clinical and physiological data in the prediction of FMS and chronic pain.
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Inhibition of Src-family protein tyrosine kinases (SFKs) in spinal dorsal horn has been established as an effective strategy for the alleviation of chronic pathological pain. As one of the important SFKs members, Fyn kinase is critical for synaptic plasticity and many pathophysiological processes. However, whether Fyn is involved in spinal sensitization is far from being elucidated. ⋯ Fyn played a key role in the sustained sensitization of nociceptive behaviours by up-regulating the functions of ionotropic glutamate receptors in spinal dorsal horn.