Articles: pain-clinics.
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The analysis of the facial expression of pain promises to be one of the most sensitive tools for the detection of pain in patients with moderate to severe forms of dementia, who can no longer self-report pain. Fine-grain analysis using the Facial Action Coding System (FACS) is possible in research but not feasible for clinical use at the moment because it is too time and effort consuming. Studies using the FACS showed either enhanced facial responses or no alterations of facial activity during pain in patients with cognitive impairment. ⋯ Despite this agreement, the content of these face items is very different, ranging from anatomically-based descriptions to inference of internal states. Recent studies let the anatomical orientation appear more promising. Automated video systems for the detection of pain in patients with dementia may lead to ground-breaking improvements of pain care in the future.
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Chronic postsurgical pain impacts most amputees, with more than half experiencing neuralgic residual limb pain. The transition from normal acute postamputation pain to chronic residual limb pain likely involves both peripheral and central inflammatory mechanisms. As part of the Veterans Integrated Pain Evaluation Research study, we investigated links between systemic inflammatory mediator levels and chronic residual limb pain. ⋯ Significant associations between catastrophizing and residual limb pain intensity were partially mediated by TNF-α, TNF- β, SAA, and ICAM-1 levels. Results suggest that chronic postamputation residual limb pain is associated with excessive inflammatory response to injury or to inadequate resolution of the postinjury inflammatory state. Impact of pain catastrophizing on residual limb pain may be because of part to common underlying inflammatory mechanisms.
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Depression is a common feature of chronic pain, but the content of depressed cognitions in groups with chronic pain may be qualitatively different from other depressed groups. Future thinking has been extensively studied in depressed population; however, to our knowledge, this is the first study to investigate future thinking, using a verbal fluency task, in chronic pain. This study investigated the content of cognitions about the future, which are postulated to be a key mechanism in the development of clinical depression, but have not been studied in groups with chronic pain. ⋯ The findings suggest that participants with pain and depression exhibit a cognitive bias specific to negative aspects of health-related future thinking. This focus facilitates understanding of the relationship between depression and pain processing. The implications for therapeutic interventions are discussed.
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Anesthesia and analgesia · Jan 2017
ReviewActive and Passive Optical Imaging Modality for Unobtrusive Cardiorespiratory Monitoring and Facial Expression Assessment.
Because of their obvious advantages, active and passive optoelectronic sensor concepts are being investigated by biomedical research groups worldwide, particularly their camera-based variants. Such methods work noninvasively and contactless, and they provide spatially resolved parameter detection. We present 2 techniques: the active photoplethysmography imaging (PPGI) method for detecting dermal blood perfusion dynamics and the passive infrared thermography imaging (IRTI) method for detecting skin temperature distribution. ⋯ They also offer diagnostic advantages for intensive care patients and for high-risk patients in a homecare/outdoor setting. Selected applications have been validated at our laboratory using optical PPGI and IRTI techniques in a stand-alone or hybrid configuration. Additional research and validation is required before these preliminary results can be introduced for clinical applications.
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This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer. ⋯ Results indicate that persistent breast pain negatively impacts women with a history of breast-conserving cancer surgery compared with women without that history. Strategies to ameliorate persistent breast pain and to improve adjustment among women with persistent breast pain should be explored for incorporation into standard care for breast cancer survivors.