UI - 22557367 PMID- 12671520 OWN - nlm STAT- in-process DA - 20030402 IS - 0009-921X IP - 409 DP - 2003 Apr TI - Left arm pain in a 2-year 7-month old girl. PG - 342-9 AD - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. FAU - Rihn, Jeffrey A AU - Rihn JA FAU - Carpentieri, David F AU - Carpentieri DF FAU - Dormans, John P AU - Dormans JP LA - eng PT - Journal Article PL - United States TA - Clin Orthop JID - 0075674 SB - AIM SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - 10.1097/01.blo.0000060440.40507.77 [doi] PST - ppublish SO - Clin Orthop 2003 Apr;(409):342-9.
UI - 22557366 PMID- 12671519 OWN - nlm STAT- in-process DA - 20030402 IS - 0009-921X IP - 409 DP - 2003 Apr TI - Hip pain in a 13-year old boy with a pelvic mass. PG - 332-41 AD - Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA. FAU - Khan, Mustafa AU - Khan M FAU - Pawel, Bruce AU - Pawel B FAU - Meyer, James AU - Meyer J FAU - Dormans, John AU - Dormans J LA - eng PT - Journal Article PL - United States TA - Clin Orthop JID - 0075674 SB - AIM SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - 10.1097/01.blo.0000043068.62337.30 [doi] PST - ppublish SO - Clin Orthop 2003 Apr;(409):332-41.
UI - 22524311 PMID- 12636467 OWN - nlm STAT- completed DA - 20030314 DCOM- 20030403 IS - 0098-7484 VI - 289 IP - 11 DP - 2003 Mar 19 TI - Headache assessment and management. PG - 1430-3 AD - The Headache Center, Department of Neurology, University of Pittsburgh, 120 Lytton Ave, Suite 300, Pittsburgh, Pa 15213, USA. kanieckirg@msx.upmc.edu FAU - Kaniecki, Robert AU - Kaniecki R LA - eng PT - Journal Article PL - United States TA - JAMA JID - 7501160 SB - AIM SB - IM MH - *Headache/diagnosis/etiology/therapy MH - *Headache Disorders/diagnosis/etiology/therapy MH - Human MH - Support, Non-U.S. Gov't EDAT- 2003/03/15 04:00 MHDA- 2003/04/04 05:00 AID - jct20023 [pii] PST - ppublish SO - JAMA 2003 Mar 19;289(11):1430-3.
UI - 22558360 PMID- 12670673 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Comment on Zeitz, K.P., et al., Reduced development of tolerance to the analgesic effects of morphine and clonidine in PKC mutant mice, PAIN 94 (2002) 245-253. PG - 309-10 AD - Pain Research Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 02115, Boston, MA, USA FAU - Yukhananov, R Y AU - Yukhananov RY FAU - Kissin, I AU - Kissin I LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395903000198 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):309-10.
UI - 22558359 PMID- 12670672 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study. PG - 297-307 AB - To compare the effects of two free radical scavengers, dimethylsulfoxide 50% (DMSO) and N-acetylcysteine (NAC), for treatment of complex regional pain syndrome I (CRPS I), a randomized, double-dummy controlled, double-blind trial was conducted. Two outpatient clinics of two university hospitals in The Netherlands participated in the study and 146 patients, were included over a period of 24 months. Patients were randomized into two treatment groups, one was instructed to apply DMSO 50% five times daily to the affected extremity, the second was treated with NAC 600mg effervescent tablets three times daily, both combined with placebo. Interventions were accompanied by pain medication, occupational therapy for upper extremity CRPS I and physical therapy for lower extremity CRPS I in specific circumstances. Treatment was given for 17 weeks, with a possibility to continue or switch medication after this period, up to 1 year following the onset of treatment. An impairment level sum score was the primary outcome measure. Upper and lower extremity skills and functions, and general health status were also evaluated. Overall, no significant differences were found between NAC and DMSO after 17 and 52 weeks on impairment level and general health status. Significant differences were found for subscores of lower extremity function, in favor of DMSO-treatment. Subgroup analysis showed more favorable results for DMSO for warm CRPS I and significantly better performance of NAC for patients with a cold CRPS I. Results tended to be negatively influenced if the duration of the complaint was longer. Treatment with DMSO and NAC are generally equally effective in treatment of CRPS I. Strong indications exist for differences in effects for subgroups of patients with warm or cold CRPS I: for warm CRPS I, DMSO-treatment appears more favorable, while for cold CRPS I, NAC-treatment appears to be more effective. AD - Department of Anesthesiology, Vrije Universiteit Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands FAU - Perez, R S G M AU - Perez RS FAU - Zuurmond, W W A AU - Zuurmond WW FAU - Bezemer, P D AU - Bezemer PD FAU - Kuik, D J AU - Kuik DJ FAU - van Loenen, A C AU - van Loenen AC FAU - de Lange, J J AU - de Lange JJ FAU - Zuidhof, A J AU - Zuidhof AJ LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004141 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):297-307.
UI - 22558358 PMID- 12670671 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Pain rating by patients and physicians: evidence of systematic pain miscalibration. PG - 289-96 AB - This study is an investigation of the existence and potential causes of systematic differences between patients and physicians in their assessments of the intensity of patients' pain. In an emergency department in France, patients (N=200) and their physicians (N=48) rated the patients' pain using a visual analog scale, both on arrival and at discharge. Results showed, in confirmation of previous studies, that physicians gave significantly lower ratings than did patients of the patients' pain both on arrival (mean difference -1.33, standard error (SE)=0.17, on a scale of 0-10, P<0.001) and at exit (-1.38, SE=0.15, P<0.001). The extent of 'miscalibration' was greater with expert than novice physicians and depended on interactions among physician gender, patient gender, and the obviousness of the cause of pain. Thus physicians' pain ratings may have been affected by non-medical factors. AD - LTC, UMR 5551 CNRS, Universite Toulouse-II, 31058 Cedex 1, Toulouse, France FAU - Marquie, Laetitia AU - Marquie L FAU - Raufaste, Eric AU - Raufaste E FAU - Lauque, Dominique AU - Lauque D FAU - Marine, Claudette AU - Marine C FAU - Ecoiffier, Marie AU - Ecoiffier M FAU - Sorum, Paul AU - Sorum P LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004025 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):289-96.
UI - 22558356 PMID- 12670669 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders. PG - 273-81 AB - The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated disorders (WAD). The aim of this study was to assess the validity of the NDI and NPQ as measures of outcome in WAD by comparing them to a patient preference questionnaire, the problem elicitation technique (PET), which identifies problems that are of most importance to the individual patient. A cross-sectional study of 71 patients with varying severity and duration of WAD were recruited from a private physiotherapy practice. All patients completed a standardized self-administered questionnaire that included demographic and clinical details as well as self-perceived pain and severity of symptoms, NDI and NPQ. A trained interviewer administered the PET. Construct validity of the disability measures was examined by determining their correlation with each other and with pain and severity of symptoms by calculating Pearson's correlation coefficients. Content validity of the NDI and NPQ was assessed by comparing the items of both questionnaires to the problems identified by the PET. Participants' mean age was 40.1 years (SD=14.3) and 59 were women (83.1%). Most patients were in WAD category I (n=23, 32.1%), or II (n=42, 59.2%). Mean NDI, NPQ, and PET scores were 40.7 (SD=17.0), 38.7 (SD=15.8), and 160.2 (SD=92.0, range 6.0-509.5), respectively. Correlations between the NDI and PET, NPQ and PET, and NDI and NPQ were r=0.57, 0.56 and 0.88, respectively. The PET identified an average of 7.7 problems per patient (SD=4.2, range 1-17 problems). Problems most commonly identified were work for wages (52.1%), fatigued during the day (50.7%), participation in sports (47.9%), depression (43.7%), drive a car (43.7%), socialize with friends (33.8%), sleep through the night (31.0%), frustration (31.0%), and anger (28.2%). Only three of these problems are included in the NDI (work, driving, and sleeping) and only four are included in the NPQ (work, driving, sleeping, and social activities). While both the NDI and NPQ include some problems that are common in patients with WAD, frequently identified problems, such as emotional and social items are absent. In contrast to the PET, neither instrument captures the full spectrum of disabilities judged to be important by the patient. AD - Department of Clinical Epidemiology, Cabrini Hospital, Suite 41, Cabrini Medical Centre, 183 Wattletree Road, Victoria 3144, Malvern, Australia FAU - Hoving, Jan Lucas AU - Hoving JL FAU - O'Leary, Elizabeth F AU - O'Leary EF FAU - Niere, Ken R AU - Niere KR FAU - Green, Sally AU - Green S FAU - Buchbinder, Rachelle AU - Buchbinder R LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004062 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):273-81.
UI - 22558355 PMID- 12670668 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Caudal cingulate cortex involvement in pain processing: an inter-individual laser evoked potential source localisation study using realistic head models. PG - 265-71 AB - Electrophysiological studies have revealed a source of laser pain evoked potentials (LEPs) in cingulate cortex. However, few studies have used realistically shaped head models in the source analysis, which account for individual differences in anatomy and allow detailed anatomical localisation of sources. The aim of the current study was to accurately localise the cingulate source of LEPs in a group of healthy volunteers, using realistic head models, and to assess the inter-individual variability in anatomical location.LEPs, elicited by painful CO(2) laser stimulation of the right forearm, were recorded from 62 electrodes in five healthy subjects. Dipole source localisation (CURRY 4.0) was performed on the most prominent (P2) peak of each LEP data set, using head models derived from each subject's structural magnetic resonance image (MRI).For all subjects, the P2 LEP peak was best explained by a dipole whose origin was in cingulate cortex (mean residual variance was 3.9+/-2.4 %). For four out of five subjects, it was located at the border of the caudal division of left anterior cingulate cortex (area 24/32') with left posterior cingulate cortex (area 23/31). For the fifth subject the dipole was centred in right posterior cingulate cortex (area 31).This study demonstrates that the location of the cingulate source of LEPs is highly consistent across subjects, when analysed in this way, and supports the involvement of caudal cingulate regions in pain processing. AD - Human Pain Research Group, University of Manchester Rheumatic Diseases Centre, Clinical Sciences Building, Hope Hospital, M6 8HD, Salford, UK FAU - Bentley, Deborah E AU - Bentley DE FAU - Derbyshire, Stuart W G AU - Derbyshire SW FAU - Youell, Paula D AU - Youell PD FAU - Jones, Anthony K P AU - Jones AK LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004050 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):265-71.
UI - 22558354 PMID- 12670667 OWN - nlm STAT- in-process DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain. PG - 257-63 AB - Widespread pain has been found to be a risk factor for onset and persistence of temporomandibular disorder (TMD) pain. The aim of this cohort study was to determine if widespread pain is associated with interference and disability related to TMD pain. Three hundred and ninety-seven TMD patients were interviewed at 1 and 2 years following enrollment. Dysfunctional TMD pain was defined as grades IV, III and II with any disability points on the graded chronic pain scale (GCPS). Widespread pain was defined by the number of pain sites (0-4: head, back, stomach, chest) outside the masticatory system. Multivariable logistic regression analysis, controlling for the effects of age, education, depression, baseline GCPS, and time since study enrollment, was used to examine the relationship between widespread pain and risk of onset or maintenance of dysfunctional TMD pain during follow-up. Among women without dysfunctional TMD pain at baseline, widespread pain was a risk factor for development of dysfunctional TMD pain (odds ratio (OR): 1.9, 95% confidence interval (CI): 1.2-2.8, P=0.003). However, there was no association between widespread pain and onset of dysfunctional TMD pain among men (OR: 1.0, 95% CI: 0.4-2.8, P=0.95) or maintenance of dysfunctional TMD among either women (OR: 1.0, 95% CI: 0.8-1.4, P=0.85) or men (OR: 0.4, 95% CI: 0.1-3.2, P=0.40). Widespread pain was independently and highly associated with risk of developing pain-related disability among women who did not have pain dysfunction at baseline, but was not predictive of risk of onset of dysfunctional TMD pain among men or maintenance of dysfunctional pain among either women or men. AD - Department of Prosthodontics, Martin Luther University, Halle-Wittenberg, Grosse Steinstr. 19, 06097, Halle/Saale, Germany FAU - John, Mike Torsten AU - John MT FAU - Miglioretti, Diana L AU - Miglioretti DL FAU - LeResche, Linda AU - LeResche L FAU - Von Korff, Michael AU - Von Korff M FAU - Critchlow, Cathy W AU - Critchlow CW LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004049 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):257-63.
UI - 0 PMID- 12670666 OWN - nlm STAT- pubmed-not-medline DA - 20030402 IS - 0304-3959 VI - 102 IP - 3 DP - 2003 Apr TI - Cystatin C as a cerebrospinal fluid biomarker for pain in humans. PG - 251-256 AB - Through a process of subtraction cloning and differential hybridization, we previously identified several new genes whose expression was induced by peripheral inflammation. One of these coded for cystatin C, a secreted cysteine protease inhibitor in the cystatin superfamily. We hypothesized that, concurrent with increased expression in dorsal horn, increased secretion would elevate the cystatin C content in cerebrospinal fluid (CSF) during active pain states. Alterations were assessed by immunoassay and by surface enhanced laser desorption ionization (SELDI) mass spectrometry with either reverse phase or immobilized anti-cystatin C antibody surfaces using CSF from ten age-matched obstetrical patients at term. Five control subjects were scheduled for an elective caesarian section and were not in pain. Another five subjects were in labor for 8.9+/-1h and were in severe pain as assessed with a visual analog scale and the McGill short form questionnaire. The level of cystatin C as measured by immunoassay in the non-pain patients was 2.77+/-0.75&mgr;g/ml and in the pain patients 5.36+/-0.92&mgr;g/ml (P<0.02). The elevation occurred without significant change in total CSF protein or beta-endorphin content. The cystatin C increase also was detectable by SELDI with either raw CSF or after antibody capture. These data are consistent with our previous animal study and the idea that persistent pain induces the synthesis and release of cystatin C in dorsal spinal cord, the surplus of which overflows into the CSF. AD - Pain and Neurosensory Mechanisms Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, 20892, Bethesda MD, USA AU - Mannes AJ AU - Martin BM AU - Yang HY AU - Keller JM AU - Lewin S AU - Gaiser RR AU - Iadarola MJ LA - ENG PT - JOURNAL ARTICLE TA - Pain JID - 7508686 EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - S0304395902004037 [pii] PST - ppublish SO - Pain 2003 Apr;102(3):251-256.
UI - 22396436 PMID- 12507716 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - The combination of low dose of naloxone and morphine in patient-controlled (PCA) does not decrease opioid requirements in the postoperative period. PG - 209-11; author reply 211-2 FAU - Mehlisch, Donald R AU - Mehlisch DR LA - eng PT - Comment PT - Letter PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Analgesics, Opioid) RN - 0 (Narcotic Antagonists) RN - 465-65-6 (Naloxone) RN - 57-27-2 (Morphine) SB - IM CON - Pain. 2002 Mar;96(1-2):73-9. PMID: 11932063 MH - *Analgesia, Patient-Controlled MH - Analgesics, Opioid/*administration & dosage MH - Drug Therapy, Combination MH - Human MH - Morphine/*administration & dosage MH - Naloxone/*administration & dosage MH - Narcotic Antagonists/*administration & dosage MH - Pain, Postoperative/*drug therapy EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003524 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):209-11; author reply 211-2.
UI - 22396434 PMID- 12507714 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Immediate- or sustained-release morphine for dose finding during start of morphine to cancer patients: a randomized, double-blind trial. PG - 193-8 AB - A titration procedure using immediate-release morphine given 4-hourly is recommended during start of oral morphine for cancer pain. This recommendation is not based on evidence from controlled studies, and many physicians start morphine treatment with controlled-release morphine. We included 40 patients with malignant disease and pain despite treatment with opioids for mild to moderate pain in a randomized, double-blind, double-dummy, parallel-group study comparing titration with immediate-release morphine given 4-hourly with titration with sustained-release morphine given once daily. The primary end point was the time needed to achieve adequate pain relief Secondary end points were other symptoms (nausea, tiredness, lack of sleep, vertigo, appetite and constipation), health related quality of life and patient satisfaction. The mean times needed for titration were 2.1 (95% CI; 1.4-2.7) days using immediate-release morphine and 1.7 (95% CI; 1.1-2.3) days using sustained-release morphine. Patients titrated with immediate-release reported statistically significant more tiredness at the end of titration. We observed no other differences in adverse effects or health related quality of life functions between the two treatments. Similar global satisfactions with the morphine treatments were reported. In conclusion, a simplified titration using sustained-release morphine once daily is equally effective as immediate-release morphine given 4-hourly. AD - Department of Anesthesiology, University Hospital of Trondheim, N-7006, Trondheim, Norway. pal.klepstad@medisin.ntnu.no FAU - Klepstad, P AU - Klepstad P FAU - Kaasa, Stein AU - Kaasa S FAU - Jystad, Ase AU - Jystad A FAU - Hval, Bjorn AU - Hval B FAU - Borchgrevink, Petter C AU - Borchgrevink PC LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Analgesics, Opioid) RN - 0 (Delayed-Action Preparations) RN - 57-27-2 (Morphine) SB - IM MH - Aged MH - Analgesics, Opioid/*administration & dosage/adverse effects MH - Delayed-Action Preparations MH - Double-Blind Method MH - Female MH - Human MH - Male MH - Middle Age MH - Morphine/*administration & dosage/adverse effects MH - Neoplasms/*complications MH - Pain/*drug therapy/etiology MH - Patient Satisfaction MH - Quality of Life MH - Support, Non-U.S. Gov't MH - Treatment Outcome EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003287 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):193-8.
UI - 22396427 PMID- 12507707 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Characterization of the analgesic actions of adenosine: comparison of adenosine and remifentanil infusions in patients undergoing major surgical procedures. PG - 129-38 AB - Perioperative pain is still a major problem, and new pharmacological means should be explored to mitigate such pain. Adenosine is an ubiquitous endogenous substance; when exogenously administered, it provides a number of salutary effects including neuromodulation, antinociception, and cytoprotective actions. The aim of this study was to characterize the perioperative antinociceptive-analgesic effects of intraoperative adenosine infusion and determine the duration of actions in the postoperative period, and compare them to those of remifentanil in patients undergoing major surgical procedures in a double-blind study.Sixty-two patients were randomly assigned to one of the two treatments. After standard induction of anesthesia, the lungs were mechanically ventilated. Anesthesia was maintained with a constant alveolar concentration of inhaled anesthetics (3% desflurane and 65% nitrous oxide in oxygen). A variable-rate of intravenous infusion of adenosine (50-500 microg kg(-1) x min(-1)) or remifentanil (0.05-0.5 microg kg(-1) x min(-1)) was initiated 5 min before the skin incision and was titrated to maintain systolic blood pressure and heart rate within 20% of baseline values during surgery. Postoperative evaluations included the level of sedation, degree of pain severity, opioid analgesic (fentanyl, morphine) consumption, and cardiorespiratory variables for 48 h.Intraoperative inhibition of the cardiovascular responses to surgical stimulation could be equally achieved by adenosine or remifentanil, and both could maintain excellent hemodynamic stability. Postoperatively, however, there were striking differences: (1). initial pain score was reduced by 60% (P<0.001) in the adenosine group compared to the remifentanil group and it remained lower throughout the 48 h recovery period; (2). postoperative morphine requirements during the first 0.25, 2 and 48 h were consistently lower in the adenosine group as compared to the remifentanil group (78, 71 and 42%, P<0.001, respectively); (3). adenosine patients remained significantly less sedated at all evaluations; (4) the end-tidal and arterial carbon dioxide values in the remifentanil group were significantly higher when patients were admitted to the postanesthesia care unit. No adverse effect of adenosine was observed at any time.Intraoperative adenosine infusion provided a salutary recovery from anesthesia associated with a pronounced and sustained postoperative pain relief. Compared to remifentanil, adenosine significantly reduced the opioid requirements and minimized the side effects including protracted sedation, cardiorespiratory instability, nausea, and vomiting in the postoperative recovery period. AD - Harbor-UCLA Medical Center, Department of Anesthesiology, 1000 West Carson Street, Torrance, CA 90509, USA. ab.fukunaga@verizon.net FAU - Fukunaga, Atsuo F AU - Fukunaga AF FAU - Alexander, George E AU - Alexander GE FAU - Stark, Charles W AU - Stark CW LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Analgesics) RN - 0 (Analgesics, Opioid) RN - 0 (Piperidines) RN - 132875-61-7 (remifentanil) RN - 58-61-7 (Adenosine) SB - IM MH - Adenosine/*administration & dosage/adverse effects MH - Adult MH - Analgesics/*administration & dosage/adverse effects MH - Analgesics, Opioid/*administration & dosage/adverse effects MH - Anesthesia, Inhalation MH - Comparative Study MH - Double-Blind Method MH - Female MH - Human MH - Male MH - Middle Age MH - Pain, Postoperative/*drug therapy MH - Piperidines/*administration & dosage/adverse effects MH - Treatment Outcome EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003214 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):129-38.
UI - 22396426 PMID- 12507706 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Functional plasticity in the human primary somatosensory cortex following acute lesion of the anterior lateral spinal cord: neurophysiological evidence of short-term cross-modal plasticity. PG - 117-27 AB - The primary somatosensory cortex (S1) in adult animals and humans is capable of rapid modification after deafferentation. These plastic changes may account for a loss of tonic control by nociceptive inputs over inhibitory mechanisms within structures of the dorsal column-medial lemniscal system. Most studies, however, have been performed under conditions where deafferentation of C and A delta fibres coexists with large-diameter fibres deafferentation.In this study the effect of the acute lesion of one ascending anterior lateral column on neuronal activity within the dorsal column-medial lemniscal system was assessed by recording somatosensory evoked potentials (SEPs) in seven patients who underwent unilateral percutaneous cervical cordotomy (PCC) as treatment for drug-resistant malignant pain.Spinal, brainstem and cortical SEPs were recorded 2h before and 3h after PCC by stimulating the posterior tibial nerve at both ankles. Amplitudes of cortical potentials obtained by stimulation of the leg contralateral to PCC were significantly increased after PCC. No significant changes in spinal or brainstem potentials were observed. PCC did not affect SEP components obtained by stimulation of the leg ipsilateral to PCC.Our results suggest that nociceptive deafferentation may induce a rapid modulation of cortical neuronal activity along the lemniscal pathway, thus providing the first evidence in humans of short-term cortical plasticity across the spinothalamic and lemniscal systems. AD - Dipartimento di Scienze Neurologiche e della Visione, Sezione di Neurologia Riabilitativa, Universita di Verona, Policlinico 'G B Rossi', P le A L Scuro, 37134, Verona, Italy. FAU - Rosso, Tiziana AU - Rosso T FAU - Aglioti, Salvatore Maria AU - Aglioti SM FAU - Zanette, Giampietro AU - Zanette G FAU - Ischia, Stefano AU - Ischia S FAU - Finco, Gabriele AU - Finco G FAU - Farina, Simona AU - Farina S FAU - Fiaschi, Antonio AU - Fiaschi A FAU - Tinazzi, Michele AU - Tinazzi M LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 SB - IM MH - Aged MH - Aged, 80 and over MH - Cordotomy MH - Evoked Potentials, Somatosensory MH - Female MH - Heat MH - Human MH - Laterality MH - Male MH - Middle Age MH - Neoplasms/complications MH - *Neuronal Plasticity MH - Pain/etiology/*physiopathology/*surgery MH - Pyramidal Tracts/physiology MH - Somatosensory Cortex/*physiology MH - Spinal Cord/*surgery MH - Spinothalamic Tracts/physiology MH - Tibial Nerve/physiology MH - Touch EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003044 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):117-27.
UI - 22396425 PMID- 12507705 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Powerful antinociceptive effects of the cone snail venom-derived subtype-selective NMDA receptor antagonists conantokins G and T. PG - 109-16 AB - Subunit non-selective N-methyl-D-aspartate (NMDA) receptor antagonists reduce injury-induced pain behavior, but generally produce unacceptable side effects. In this study, we examined the antinociceptive and motor effects of cone snail venom-derived peptides, conantokins G and T (conG and conT), which are selective inhibitors of the NR2B or NR2A and NR2B subtypes of the NMDA receptor, respectively. We tested the effects of conG and conT in models of tissue (formalin test), nerve injury (partial sciatic nerve ligation) and inflammation-induced (intraplantar Complete Freund's Adjuvant; CFA) pain in mice. In the formalin test, intrathecal (i.t.) conG or conT suppressed the ongoing pain behavior (ED(50) and 95% confidence intervals (CI), 11 (7-19) and 19 (11-33), respectively) at doses that were 17-27 times lower than those required to impair motor function (accelerating rotarod treadmill test: ED(50) and 95% CI, 300 (120-730) and 320 (190-540) pmol, respectively). By comparison, SNX-111, an N-type voltage-sensitive calcium channel antagonist that is also derived from cone snail venom, produced significant motor impairment at a dose (3.0 pmol, i.t.) that was only partially efficacious in the formalin test. Furthermore, conG reversed the allodynia produced by nerve injury, with greater potency on thermal (ED50 and 95% CI, 24 (10-55) pmol) than on mechanical allodynia (59 (33-105) pmol). Finally, a single dose of conG (100 pmol, i.t.) also reduced CFA-evoked thermal and mechanical allodynia. Taken together, these results demonstrate that conantokins exhibit potent antinociceptive effects in several models of injury-induced pain. The study supports the notion that drugs directed against subtypes of the NMDA receptor, by virtue of their reduced side-effect profile, hold promise as novel therapeutic agents for the control of pain. AD - Department of Anatomy 0452, University of California, San Francisco, San Francisco, CA 94143-0452, USA. FAU - Malmberg, Annika B AU - Malmberg AB FAU - Gilbert, Heather AU - Gilbert H FAU - McCabe, R Tyler AU - McCabe RT FAU - Basbaum, Allan I AU - Basbaum AI LA - eng GR - DA08377/DA/NIDA GR - NS211445/NS/NINDS PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Conotoxins) RN - 0 (Excitatory Amino Acid Antagonists) RN - 0 (Mollusk Venoms) RN - 0 (Peptides) RN - 0 (Receptors, N-Methyl-D-Aspartate) RN - 127476-26-0 (conantokin-T) RN - 93438-65-4 (conotoxin GV) SB - IM MH - Animal MH - Behavior, Animal/drug effects MH - Conotoxins/*pharmacology MH - Excitatory Amino Acid Antagonists/*pharmacology MH - Ligation MH - Male MH - Mice MH - Mice, Inbred C57BL MH - Mollusk Venoms/pharmacology MH - Motor Activity/drug effects MH - Neuritis/drug therapy MH - Nociceptors/*drug effects MH - Pain Measurement MH - Peptides/pharmacology MH - Receptors, N-Methyl-D-Aspartate/*antagonists & inhibitors MH - Sciatica/*drug therapy MH - Support, Non-U.S. Gov't MH - Support, U.S. Gov't, P.H.S. EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003032 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):109-16.
UI - 22396423 PMID- 12507703 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Analgesia from a peripherally active kappa-opioid receptor agonist in patients with chronic pancreatitis. PG - 89-95 AB - Preclinical studies suggest that visceral afferents constitutively express kappa-opioid receptors (KORs) and that noxious visceral stimuli can be inhibited at a peripheral site by KOR activation. To test the relevance of these observations to humans, we infused, in a randomized, double blind manner, a peripherally selective KOR agonist (ADL 10-0101) or placebo into six patients with chronic pancreatitis and ongoing abdominal pain despite mu-opioid agonist therapy. Pain was assessed using a pain magnitude estimate, an open ended scale of each patient's choosing and compared to their rating of pain from a 1.6 cm(2) thermode applied to the skin and heated to 49 degrees C for 5s. Normalizing pain scores to this rating as 100, pain prior to study drug treatment was 4070, and was unaffected by placebo infusion in the two individuals receiving this therapy. In contrast, ADL 10-0101 infusion reduced pain score from 63+/-7.6 (mean+/-SE) prior to infusion to 23+/-15 4h after infusion (P<0.05 vs. baseline). One patient receiving placebo and one receiving ADL 10-0101 experienced a mild headache during the study. One patient receiving ADL 10-0101 experienced restlessness and another had assymptomatic transient dysrhythmia upon standing after the 4h study. Neither of the treatments affected blood pressure, heart rate, respiratory rate, or oxyhemoglobin saturation, and no patient experienced nausea during the study. These limited data support the hypothesis that human visceral afferents express KOR and that peripherally restricted KOR agonists produce analgesia in patients with chronic visceral pain. AD - Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. eisenach@wfubmc.edu FAU - Eisenach, James C AU - Eisenach JC FAU - Carpenter, Randall AU - Carpenter R FAU - Curry, Regina AU - Curry R LA - eng GR - M01 RR07122/RR/NCRR GR - P01 NS41386/NS/NINDS PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Analgesics, Opioid) RN - 0 (Receptors, Opioid, kappa) SB - IM MH - Adult MH - Analgesics, Opioid/*administration & dosage MH - Chronic Disease MH - Female MH - Human MH - Injections, Intravenous MH - Male MH - Middle Age MH - Pain/*drug therapy/etiology MH - Pancreatitis/*complications MH - Patient Satisfaction MH - Receptors, Opioid, kappa/*agonists MH - Support, Non-U.S. Gov't MH - Support, U.S. Gov't, P.H.S. MH - Visceral Afferents/drug effects EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902002592 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):89-95.
UI - 22396415 PMID- 12507695 OWN - nlm STAT- completed DA - 20021231 DCOM- 20030331 IS - 0304-3959 VI - 101 IP - 1-2 DP - 2003 Jan TI - Vagus nerve stimulation in awake rats reduces formalin-induced nociceptive behaviour and fos-immunoreactivity in trigeminal nucleus caudalis. PG - 3-12 AB - Besides its well-established efficacy in epilepsy, vagus nerve stimulation (VNS) may be of potential interest in pain treatment. It has, however, not yet been assessed in animal pain models with the devices and stimulation protocols used in humans. We have therefore studied in awake rats the effects of left cervical VNS on trigeminal nociception using an implantable electrode and stimulator (NCP-Cyberonics). VNS was applied for 24h at 2 mA intensity, 20 Hz frequency, 0.5 ms pulse width and a duty cycle of 20s ON/18s OFF. As a nociceptive stimulus, we injected formalin into the left mystacial vibrissae, assessed behaviour for 45 min and sacrificed the animals 45 min later. Fos-immunoreactive (Fos-Ir) neurons were counted in laminae I-II of trigeminal nucleus caudalis (TNC) on both sides. We used three groups of control animals: VNS without formalin, formalin without VNS and sham VNS (implanted without stimulation or formalin). Whereas sham VNS had no significant effect, VNS alone increased Fos expression in ipsilateral TNC in addition to the expected increase in nucleus tractus solitarius. It also significantly attenuated the increase of Fos-Ir neurons observed in ipsilateral TNC laminae I-II after formalin injection. If the proper VNS effect on Fos-expression was subtracted, the reduction of formalin-induced nociceptor activation was 55%. VNS also reduced nociceptive behaviour on average by 96.1% during the early phase (0-6 min) and by 60.7% during the late phase (6-45 min) after the formalin injection. These results suggest that VNS applied with a device used in human therapy may have in awake rats a significant antinociceptive effect in a model of trigeminal pain. AD - Department of Neuroanatomy, 20, rue de Pitteurs, B-4020, Liege, Belgium. FAU - Bohotin, C AU - Bohotin C FAU - Scholsem, M AU - Scholsem M FAU - Multon, S AU - Multon S FAU - Martin, D AU - Martin D FAU - Bohotin, V AU - Bohotin V FAU - Schoenen, J AU - Schoenen J LA - eng PT - Journal Article PL - Netherlands TA - Pain JID - 7508686 RN - 0 (Proto-Oncogene Proteins c-fos) SB - IM MH - Animal MH - Behavior, Animal MH - Cell Count MH - Electric Stimulation Therapy/*methods MH - Facial Pain/*physiopathology/therapy MH - Male MH - Neurons/chemistry/physiology MH - Nociceptors/drug effects/*physiology MH - Pain Measurement MH - Proto-Oncogene Proteins c-fos/analysis MH - Rats MH - Rats, Wistar MH - Support, Non-U.S. Gov't MH - Trigeminal Caudal Nucleus/chemistry/cytology/*physiology MH - Vagus Nerve/*physiology MH - Vibrissae MH - Wakefulness/physiology EDAT- 2003/01/01 04:00 MHDA- 2003/04/01 05:00 AID - S0304395902003019 [pii] PST - ppublish SO - Pain 2003 Jan;101(1-2):3-12.
UI - 22558399 PMID- 12671119 OWN - nlm STAT- completed DA - 20030402 DCOM- 20030418 IS - 1098-4275 VI - 111 IP - 4 Pt 1 DP - 2003 Apr TI - Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. PG - 822-8 AB - OBJECTIVE: To determine the onset of low back pain (LBP) in schoolchildren and to investigate the role of mechanical and psychosocial factors as risk factors for its onset. METHODS: A prospective population-based cohort study was conducted of 1046 schoolchildren, aged 11 to 14 years at baseline, identified as being free of LBP, from 39 secondary schools in Northwest England. New onset of LBP at 1-year follow-up was measured. RESULTS: Children who reported high levels of psychosocial difficulties were more likely to develop LBP than their peers (relative risk: 1.6; 95% confidence interval: 1.1-2.3). An excess risk was, in particular, associated with conduct problems (2.5; 1.7-3.7). Similarly, children who reported high numbers of somatic symptoms at baseline were at greater risk of developing LBP: abdominal pain (1.8; 1.1-3.0), headaches (1.6; 0.97-2.8), and sore throats (1.5; 0.8-2.6). In contrast, we have been unable to demonstrate a strong association between daily mechanical load (schoolbag weight) and the short-term risk of new-onset LBP (highest versus lowest quintile: 1.2; 0.7-2.1). CONCLUSIONS: In children who were initially free of LBP, adverse psychosocial factors and the presence of other preexisting somatic pain symptoms were predictive of future LBP, reflecting findings in adults. In contrast, there was little evidence of an increase in short-term risk associated with mechanical load across the range of weights commonly carried by children to school. AD - Arthritis Research Campaign Epidemiology Unit, School of Epidemiology and Health Sciences, University of Manchester, United Kingdom. gareth.jones@man.ac.uk FAU - Jones, Gareth T AU - Jones GT FAU - Watson, Kath D AU - Watson KD FAU - Silman, Alan J AU - Silman AJ FAU - Symmons, Deborah P M AU - Symmons DP FAU - Macfarlane, Gary J AU - Macfarlane GJ LA - eng PT - Journal Article PL - United States TA - Pediatrics JID - 0376422 SB - AIM SB - IM MH - Abdominal Pain/psychology MH - Adolescent MH - Age Factors MH - Body Composition MH - Child MH - Cohort Studies MH - Cross-Sectional Studies MH - Female MH - Follow-Up Studies MH - Great Britain/epidemiology MH - Headache/psychology MH - Human MH - Life Style MH - Low Back Pain/*epidemiology/psychology MH - Male MH - Pharyngitis/psychology MH - Population Surveillance/*methods MH - Predictive Value of Tests MH - Prevalence MH - Prospective Studies MH - Questionnaires MH - Sex Distribution MH - Stress, Mechanical MH - Stress, Psychological/complications/psychology MH - Support, Non-U.S. Gov't EDAT- 2003/04/03 05:00 MHDA- 2003/04/19 05:00 PST - ppublish SO - Pediatrics 2003 Apr;111(4 Pt 1):822-8.
UI - 22558840 PMID- 12671363 OWN - nlm STAT- in-process DA - 20030402 IS - 1528-1159 VI - 28 IP - 7 DP - 2003 Apr 1 TI - Work restrictions and outcome of nonspecific low back pain. PG - 722-8 AB - STUDY DESIGNRetrospective cohort study was conducted.OBJECTIVETo evaluate the association of prescribed work restrictions with work absenteeism and recurrence in cases of nonspecific low back pain.SUMMARY OF BACKGROUND DATAThe efficacy of commonly prescribed work restrictions in limiting sickness-related absence because of back pain has not been evaluated.METHODSEmployees who had back pain-related sickness absence were identified from medical records of a utility company. The workers were grouped into those who had received a work restriction for their back pain and those who had not. The duration of work disability was compared between the two groups. Employees who returned back to regular, full duty within 1 year of onset were followed for one additional year to determine rates of recurrence. The Cox Proportional Hazards model was used to generate hazard ratios adjusted for age, gender, and job category.RESULTSRestrictions were given to 43% of the workers. Sickness absence duration did not differ between those who had received restrictions and those who had not (adjusted hazard ratio, 1.12; P = 0.41). The median duration of restricted duty was 32.5 days. For 22% of the workers, restricted duty was never lifted. Recurrence appeared less likely to occur among those who had work restrictions in their initial episode. However, this difference was not statistically significant (adjusted hazard ratio, 0.77; P = 0.48).CONCLUSIONSNo evidence of an association between a prescription of work restriction and early return to work was found. More research is needed to clarify the utility of restricted duty in promoting a positive outcome for work-related low back pain. AD - *Hospital for Joint Diseases Orthopaedic Institute, New York University School of Medicine, New York, New York. FAU - Hiebert, Rudi AU - Hiebert R FAU - Skovron, Mary Louise AU - Skovron ML FAU - Nordin, Margareta AU - Nordin M FAU - Crane, Michael AU - Crane M LA - eng PT - Journal Article PL - United States TA - Spine JID - 7610646 SB - IM EDAT- 2003/04/03 05:00 MHDA- 2003/04/03 05:00 AID - 10.1097/01.BRS.0000051909.18567.F8 [doi] PST - ppublish SO - Spine 2003 Apr 1;28(7):722-8.