UI - 22502364 PMID- 12616183 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Pain catastrophizing and symptom severity during upper respiratory tract illness. PG - 125-33 AB - OBJECTIVES The present study examined the relation of pain catastrophizing to the severity of upper respiratory tract illness.MATERIALS AND METHODS Participants included 50 adults (35 female subjects, 15 male) who were self-diagnosed with upper respiratory tract illness and who agreed to complete a diary of symptoms for 7 days. Illness symptoms were grouped into three categories: pain-related, constitutional, and respiratory symptoms.RESULTS Results showed that pain catastrophizing was associated with symptom number and symptom severity in all three categories of symptoms. The rumination subscale of the Pain Catastrophizing Scale showed the strongest relations with illness severity. The relation between pain catastrophizing and illness severity remained significant even when controlling for initial symptom severity, duration of the symptoms before the study period, and depression.DISCUSSION The results provide the preliminary evidence that the influence of pain catastrophizing may not be restricted to pain-specific domains. The data also provide some support for the view that the excessive focus on bodily sensations may account for more severe symptoms. FAU - Devoulyte, Kristina AU - Devoulyte K FAU - Sullivan, Michael J L AU - Sullivan MJ LA - eng PT - Journal Article CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):125-33.
UI - 22502363 PMID- 12616182 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Pain on injection of propofol: the effect of granisetron pretreatment. PG - 121-4 AB - OBJECTIVE To assess the effect of granisetron pretreatment in alleviating propofol injection pain.STUDY DESIGN A randomized, controlled, double-blind study, using venous retention with a tourniquet.MATERIALS AND METHODS One hundred fifty adult patients were randomly assigned to one of three groups: group 1 (who received 5 mL of 0.9% saline pretreatment), group 2 (who received 5 mL lidocaine [40 mg in 0.9% saline] pretreatment), and group 3 (who received 5 mL granisetron [2 mg in 0.9% saline] pretreatment). Injections were given in the largest vein on the dorsum of the hand. After 2 minutes, the tourniquet was released and one fourth of the total calculated dose of propofol (2.5 mg/kg body weight) was administered and pain assessment was made.RESULTS Lidocaine and granisetron significantly reduced the incidence and severity of propofol injection pain more than placebo ( < 0.001). The efficacy of granisetron in alleviating the pain on injection of propofol was no different from lidocaine.CONCLUSIONS Granisetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting. FAU - Dubey, Prakash K AU - Dubey PK FAU - Prasad, Sureshwar S AU - Prasad SS LA - eng PT - Journal Article CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):121-4.
UI - 22502360 PMID- 12616179 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Psychologically based occupational rehabilitation: the pain-disability prevention program. PG - 97-104 AB - OBJECTIVES To describe the development, implementation, and preliminary outcome of the Pain-Disability Prevention (PDP) Program. The PDP Program is a 10-week cognitive-behavioral intervention program that aims to increase daily involvement in goal-directed activity and minimize psychological barriers to activity involvement after occupational injury. Workers' Compensation Board claimants with soft tissue injuries to the back, who were still off work 6 weeks after injury and showed evidence of at least one "yellow flag," were offered participation in the PDP Program.DESIGN A single-group, prospective treatment outcome analysis.PARTICIPANTS Data from the first 104 claimants who participated in the PDP Program are summarized.RESULTS Participation in the PDP Program was associated with a 60% success rate, where success was defined as return to work (45%) or readiness to return to work (15%). Initial scores on measures of catastrophizing, fear of movement/reinjury, and depression afforded 92% correct classification of treatment outcome. Early treatment changes in catastrophizing and fear of movement/reinjury were also predictive of treatment outcome.CONCLUSIONS The findings suggest that a psychologically based activity mobilization program can be an effective means of yielding reductions in psychological risk factors for occupational disability. Challenges to program implementation, fidelity to protocol, and issues related to cost efficacy are discussed. FAU - Sullivan, Michael J L AU - Sullivan MJ FAU - Stanish, William D AU - Stanish WD LA - eng PT - Journal Article CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):97-104.
UI - 22502359 PMID- 12616178 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial. PG - 87-96 AB - OBJECTIVES Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status.DESIGN Randomized controlled trial.PATIENTS AND SETTING Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE).OUTCOME MEASURES Days of sick leave and work status. Data were retrieved from occupational health services.RESULTS Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results.CONCLUSIONS The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain. AD - parallel. FAU - Van Den Hout, Johanna H C AU - Van Den Hout JH FAU - Vlaeyen, Johan W S AU - Vlaeyen JW FAU - Heuts, Peter H T G AU - Heuts PH FAU - Zijlema, Johan H L AU - Zijlema JH FAU - Wijnen, Joseph A G AU - Wijnen JA LA - eng PT - Journal Article CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):87-96.
UI - 22502358 PMID- 12616177 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Early identification of patients at risk of developing a persistent back problem: the predictive validity of the orebro musculoskeletal pain questionnaire. PG - 80-6 AB - OBJECTIVE To test the predictive utility of the Orebro Musculoskeletal Pain Screening Questionnaire in identifying patients at risk for developing persistent back pain problems.DESIGN Prospective, where participants completed the questionnaire and their cases were followed for 6 months to assess outcome with regard to pain, function, and absenteeism due to sickness.PARTICIPANTS One hundred seven patients, recruited from seven primary care units.RESULTS Discriminant analyses showed that the items on the questionnaire were significantly related to future problems. For absenteeism due to sickness, 68% of the patients were correctly classified into one of three groups, whereas an even distribution would have produced 33%. The analyses for function correctly classified 81%, and for pain 71%, into one of two groups, compared with a chance level of 50%. A total score analysis demonstrated that a cutoff score of 90 points had a sensitivity of 89% and a specificity of 65% for absenteeism due to sickness, and a sensitivity of 74% and a specificity of 79% for functional ability.CONCLUSIONS The results underscore that psychological variables are related to outcome 6 months later, and they replicate and extend earlier findings indicating that the Orebro Screening Questionnaire is a clinically reliable and valid instrument. The total score was a relatively good predictor of future absenteeism due to sickness as well as function, but not of pain. The results suggest that the instrument could be of value in isolating patients in need of early interventions and may promote the use of appropriate interventions for patients with psychological risk factors. FAU - Linton, Steven J AU - Linton SJ FAU - Boersma, Katja AU - Boersma K LA - eng PT - Journal Article CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):80-6.
UI - 22502357 PMID- 12616176 DA - 20030304 IS - 0749-8047 VI - 19 IP - 2 DP - 2003 Mar-Apr TI - Introduction: emerging trends in secondary prevention of back pain disability. PG - 77-9 FAU - Sullivan, Michael J L AU - Sullivan MJ LA - eng PT - Editorial CY - United States TA - Clin J Pain JID - 8507389 SB - IM EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Clin J Pain 2003 Mar-Apr;19(2):77-9.
UI - 22509434 PMID- 12622508 DA - 20030307 IS - 0265-0215 VI - 20 IP - 2 DP - 2003 Feb TI - Alternative application site of transdermal nitroglycerin and the reduction of pain on propofol injection. PG - 170-2 FAU - Turan, A AU - Turan A FAU - Karamanlioglu, B AU - Karamanlioglu B FAU - Memis, D AU - Memis D FAU - Pamukcu, Z AU - Pamukcu Z LA - eng PT - Letter CY - England TA - Eur J Anaesthesiol JID - 8411711 SB - IM EDAT- 2003/03/08 04:00 MHDA- 2003/03/08 04:00 PST - ppublish SO - Eur J Anaesthesiol 2003 Feb;20(2):170-2.
UI - 22509428 PMID- 12622502 DA - 20030307 IS - 0265-0215 VI - 20 IP - 2 DP - 2003 Feb TI - Nitrous oxide/oxygen mixture and the prevention of pain during injection of propofol. PG - 158-61 AB - BACKGROUND AND OBJECTIVE: The incidence of pain associated with the injection of propofol still remains a problem. This study sought to examine the analgesic effects of inhaled nitrous oxide in oxygen on the prevention of propofol injection pain. METHODS: Nitrous oxide in oxygen was compared with a lidocaine (20 mg)-propofol mixture and with propofol alone (control) in a prospective, randomized, observer-blinded study. ASA I and II patients (n = 135) scheduled for elective surgical procedures were studied. A standard propofol injection technique and scoring system to measure the pain on injection was used. RESULTS: Demographic variables were similar between the study groups. Without analgesia (control) 26 of 45 patients (58%) reported pain on injection compared with 11 of 45 patients (24%) in both the nitrous oxide (95% CI: 14-52%, P = 0.001) and lidocaine groups (95% CI: 14-52%, P = 0.001). CONCLUSIONS: The inhalation of a nitrous oxide/oxygen mixture significantly reduces the incidence of pain during propofol injection. This therapeutic stratagem was as effective as a lidocaine-propofol mixture. AD - University College Hospital, Department of Anaesthesia, Galway, Ireland. dharmon@indigo.ie FAU - Harmon, D AU - Harmon D FAU - Rozario, C AU - Rozario C FAU - Lowe, D AU - Lowe D LA - eng PT - Journal Article CY - England TA - Eur J Anaesthesiol JID - 8411711 SB - IM EDAT- 2003/03/08 04:00 MHDA- 2003/03/08 04:00 PST - ppublish SO - Eur J Anaesthesiol 2003 Feb;20(2):158-61.
UI - 22228005 PMID- 12243291 DA - 20020923 DCOM- 20030304 IS - 0265-0215 VI - 19 IP - 9 DP - 2002 Sep TI - Epidural morphine injection after combined spinal and epidural anaesthesia. PG - 672-6 AB - BACKGROUND AND OBJECTIVE: Although combined spinal and epidural anaesthesia is efficient and easy to perform, the technique can be a double-edged sword having the potential risk that an increased flux of drugs across the meninges through the hole made in it may lead to severe adverse effects. The aim was to compare the incidence of adverse events when an epidural injection of morphine was given after combined spinal and epidural anaesthesia or after epidural anaesthesia. METHODS: Fifteen patients had an epidural catheter inserted at the L2-3 interspace, and then a spinal block administered via the L3-4 interspace. Another 15 patients only had an epidural catheter inserted. After the onset of spinal or epidural anaesthesia had been confirmed, morphine 2 mg was injected into the epidural space, and a continuous epidural infusion of morphine was started. At the end of the operation and at 4, 8 and 12 h after the administration of epidural morphine and on the next day, the following variables were examined: blood pressure, heart rate, respiratory rate, arterial blood-gas analysis, visual analogue scale pain scores, nausea/vomiting scores, and pruritus scores. RESULTS: In the study population, the epidural injection of morphine was not associated with a significantly higher incidence of adverse events when given after spinal anaesthesia than after epidural anaesthesia. CONCLUSIONS: The adverse effects associated with epidural morphine given after spinal anaesthesia did not increase significantly when a 27-G Whitacre needle was used. Thus, the morphine flux through the meningeal hole into the cerebrospinal fluid was trivial. AD - Gifu University School of Medicine, Department of Anesthesiology & Critical Care Medicine, Gifu City, Japan. FAU - Takenaka-Hamaya, C AU - Takenaka-Hamaya C FAU - Hamaya, Y AU - Hamaya Y FAU - Dohi, S AU - Dohi S LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial CY - England TA - Eur J Anaesthesiol JID - 8411711 RN - 0 (Analgesics, Opioid) RN - 57-27-2 (Morphine) SB - IM MH - Aged MH - Aged, 80 and over MH - Analgesics, Opioid/*adverse effects/therapeutic use MH - *Anesthesia, Epidural MH - *Anesthesia, Spinal MH - Double-Blind Method MH - Female MH - Human MH - Lower Extremity/surgery MH - Middle Age MH - Morphine/*adverse effects/therapeutic use MH - Nausea/etiology MH - Pain Measurement MH - Pain, Postoperative/*prevention & control MH - Prospective Studies MH - Pruritus/etiology MH - Respiratory Insufficiency/etiology MH - Support, Non-U.S. Gov't EDAT- 2002/09/24 06:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Eur J Anaesthesiol 2002 Sep;19(9):672-6.
UI - 22228004 PMID- 12243290 DA - 20020923 DCOM- 20030304 IS - 0265-0215 VI - 19 IP - 9 DP - 2002 Sep TI - Epidural combination of ropivacaine with sufentanil for postoperative analgesia after total knee replacement: a pilot study. PG - 666-71 AB - BACKGROUND AND OBJECTIVE: We assessed the analgesic efficacy of postoperative epidural infusions of ropivacaine 0.1 and 0.2% combined with sufentanil 1 microg mL(-1) in a prospective, randomized, double-blinded study. METHODS: Twenty-two ASA I-III patients undergoing elective total-knee replacement were included. Lumbar epidural blockade using ropivacaine 0.75% was combined with either propofol sedation or general anaesthesia for surgery. After surgery, the epidural infusion was commenced. Eleven patients in each group received either an epidural infusion of ropivacaine 0.1% with 1 microg mL(-1) sufentanil (Group 1) or ropivacaine 0.2% with 1 microg mL(-1) sufentanil (Group 2) at a rate of 5-9 mL h(-1). All patients had access to intravenous pirinatrimide (piritramide) via a patient-controlled analgesia (PCA) device. RESULTS: Motor block was negligible for the study duration in both groups. There was no significant difference with the 100 mm visual analogue scale (VAS) scores, with the consumption of rescue analgesia or with patient satisfaction. Patients in Group 1 experienced significantly less nausea (P < 0.05) than those in Group 2. Both treatment regimens provided effective postoperative analgesia with only a minimal use of supplemental opioid PCA. CONCLUSIONS: We recommend the use of ropivacaine 0.1% with 1 microg mL(-1) sufentanil for postoperative analgesia after total knee replacement as it provides efficient pain relief with no motor block of the lower limbs. In addition, compared with 0.2% ropivacaine with sufentanil, the mixture reduces local anaesthetic consumption without compromise in patient satisfaction or VAS scores. Patients even experience less nausea. AD - University of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Germany. sandra.kampe@t-online.de FAU - Kampe, S AU - Kampe S FAU - Diefenbach, C AU - Diefenbach C FAU - Kanis, B AU - Kanis B FAU - Auweiler, M AU - Auweiler M FAU - Kiencke, P AU - Kiencke P FAU - Cranfield, K AU - Cranfield K LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial CY - England TA - Eur J Anaesthesiol JID - 8411711 RN - 0 (Amides) RN - 0 (Analgesics, Opioid) RN - 0 (Anesthetics, Combined) RN - 0 (Anesthetics, Intravenous) RN - 0 (Anesthetics, Local) RN - 302-41-0 (Pirinitramide) RN - 56030-54-7 (Sufentanil) RN - 84057-95-4 (ropivacaine) SB - IM MH - Aged MH - Amides/administration & dosage/*therapeutic use MH - Analgesia, Patient-Controlled MH - Analgesics, Opioid/therapeutic use MH - Anesthetics, Combined/*therapeutic use MH - Anesthetics, Intravenous/administration & dosage/*therapeutic use MH - Anesthetics, Local/administration & dosage/*therapeutic use MH - *Arthroplasty, Replacement, Knee MH - Double-Blind Method MH - Female MH - Human MH - Male MH - Middle Age MH - Pain, Postoperative/*drug therapy MH - Pilot Projects MH - Pirinitramide/therapeutic use MH - Sufentanil/administration & dosage/*therapeutic use MH - Treatment Outcome EDAT- 2002/09/24 06:00 MHDA- 2003/03/05 04:00 PST - ppublish SO - Eur J Anaesthesiol 2002 Sep;19(9):666-71.
UI - 22503235 PMID- 12614968 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - For the psychologist treating pain patients. PG - 294-5 FAU - Heil, John AU - Heil J LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402007054 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):294-5.
UI - 22503234 PMID- 12614967 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Pain management in Hong Kong. PG - 293-4 FAU - Spiess, Jeffrey L AU - Spiess JL LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402007066 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):293-4.
UI - 22503233 PMID- 12614966 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Managing pain in the elderly. PG - 292-3 FAU - Ferrell, Betty R AU - Ferrell BR LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S088539240200708X [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):292-3.
UI - 22503228 PMID- 12614961 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Is patient satisfaction a legitimate outcome of pain management? PG - 264-75 AB - Though many studies have measured patient satisfaction with pain management using the American Pain Society (APS) Satisfaction Survey or its variants, little is known about the relationship among the survey items, or whether items relate to satisfaction at all. In an effort to refine the measurement of patient satisfaction, a modified version of the APS survey, which was given to 787 patients as part of a study of postoperative pain management in six community hospitals, was subjected to principal components analysis to determine the survey's empirical structure. Correlations among the five components found were low; a weak relationship (r = -0.24) was discovered between pain intensity and satisfaction. A heuristic model estimated by structural equations analysis yielded additional insights. Though many items thought to influence patient satisfaction were not closely related to patient-reported satisfaction, they indicate important clinical factors relevant to quality of care, and thus, to continuing quality improvement (CQI) efforts. Results suggest that satisfaction was influenced by effectiveness of medication, independent of pain intensity, and by communication. Pain severity ratings near the time satisfaction was measured were more influential than earlier ratings. AD - School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA FAU - Carlson, John AU - Carlson J FAU - Youngblood, Richard AU - Youngblood R FAU - Dalton, Jo Ann AU - Dalton JA FAU - Blau, William AU - Blau W FAU - Lindley, Celeste AU - Lindley C LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402006772 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):264-75.
UI - 22503227 PMID- 12614960 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Ongoing distress from emotional trauma is related to pain, mood, and physical function in a primary care population. PG - 256-63 AB - The relationship of trauma history to physical and emotional functioning in primary care pain patients was examined. Data were drawn from a mailed screening questionnaire for a larger study designed to evaluate an intervention for improving pain management in primary care. Results indicated that 50.4% of the pain patients reported experiencing at least one previous emotionally traumatic event. Further, 31% of patients with trauma history continued to be bothered by that experience. Finally, patients who continued to be significantly bothered by the trauma reported more pain, emotional distress, poorer social functioning, and more difficulty with engaging in their daily activities than did patients with either no trauma history or who had a trauma history but did not have bothersome thoughts of the trauma. These preliminary findings suggest that the experience of trauma alone was not related to additional impairments in physical and psychosocial functioning. However, the report that one continued to be bothered by thoughts of a trauma was associated with greater impairments in functioning. AD - Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA FAU - Seville, Janette L AU - Seville JL FAU - Ahles, Tim A AU - Ahles TA FAU - Wasson, John H AU - Wasson JH FAU - Johnson, Deborah AU - Johnson D FAU - Callahan, Eileen AU - Callahan E FAU - Stukel, Therese AU - Stukel T LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402006462 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):256-63.
UI - 22503226 PMID- 12614959 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Pain trajectory of taiwanese with nasopharyngeal carcinoma over the course of radiation therapy. PG - 247-55 AB - The purpose of this study was to describe the characteristics and management of pain among patients with nasopharyngeal carcinoma (NPC) prior to and during the 7-week course of radiation therapy (RT) in Taiwan. Twenty-nine men and 11 women with NPC participated in this prospective, longitudinal study. A modified Brief Pain Inventory was used to assess pain and its interference with daily activities weekly. Medical records were reviewed to abstract pain management and disease data. Findings showed that the pain intensity and pain interference scores escalated prominently at Week 3 and peaked at Week 5, representing the time course of RT complications. Pain prior to RT exacerbated the RT-induced mucositis pain. The pain related to RT for NPC was often severe and undertreated, and affected swallowing and talking more than sleeping or other general activities. We recommend interventions to control pain be instituted prior to Week 3 to minimize the potentiation of subsequent pain. AD - Department of Biobehavioral Nursing and Health System, University of Washington, Seattle, WA, USA FAU - Huang, Hsiu Ying AU - Huang HY FAU - Wilkie, Diana J AU - Wilkie DJ FAU - Chapman, C Richard AU - Chapman CR FAU - Ting, Lai Lei AU - Ting LL LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402006784 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):247-55.
UI - 22503223 PMID- 12614956 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Usability of a Computerized PAINReportIt in the General Public with Pain and People with Cancer Pain. PG - 213-24 AB - We examined usability (completion time, acceptability, and completeness of information) of a computerized format for pain assessment, PAINReportIt. PAINReportIt is the first interactive software extension of the 1970 McGill Pain Questionnaire. Two hundred thirteen patients experiencing pain were recruited for this descriptive, comparative study. Subjects used a Microsoft((R)) Windows 95/98 personal computer with a touch-screen to complete 1) PAINReportIt, 2) demographic, and 3) acceptability questions. Qualitative and quantitative data from the study support PAINReportIt as a feasible method for patients to self-report their pain. Patients completed the tool in less than 18 minutes on average, answered all sections, and scored it high regarding acceptability. Improved directions and practice screens would likely improve patients' independence in completing PAINReportIt, which would free clinicians to focus direct communication on more complex pain issues. AD - School of Nursing, University of Washington, Seattle, WA, USA FAU - Wilkie, Diana J AU - Wilkie DJ FAU - Judge, M Kay M AU - Judge MK FAU - Berry, Donna L AU - Berry DL FAU - Dell, Jean AU - Dell J FAU - Zong, Shiping AU - Zong S FAU - Gilespie, Rudy AU - Gilespie R LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402006383 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):213-24.
UI - 22503222 PMID- 12614955 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Effectiveness of palliative day care in improving pain, symptom control, and quality of life. PG - 202-12 AB - To evaluate the effectiveness of palliative day care in improving pain, symptom control, and quality of life (QOL), 120 consecutive new referrals to five specialist palliative day care centers were recruited into a prospective comparative study. Fifty-three comparison patients were identified as those patients receiving usual palliative care services (home care, inpatient care), but did not attend day care. Patients were assessed at 3 interviews (baseline, 6-8 weeks, and 12-15 weeks) using measures of health-related quality of life: McGill Quality of Life Questionnaire (MQOL) and Palliative Care Outcome Scale (POS). There were two main analyses: 1) patient demographic data were analyzed using chi-square (chi(2)), and 2) QOL data were compared, based on distribution of scores, using the Mann-Whitney test (MQOL and POS), and Wilcoxon Signed Rank for within group differences (POS data only); P < 0.05 was taken as significant. The patients were representative of those attending palliative day care in the UK. At baseline, the day care group were (non-significantly) worse than the comparison group in the MQOL support domain (P = 0.065). The comparison group had marginally more severe pain at baseline (P = 0.053) and more severe symptoms at second assessment (P = 0.025). Both patient groups maintained overall health-related quality of life during the three months of the study. Palliative day care was not found to improve overall health-related quality of life. The limitations of the QOL measures in identifying the effects (patient outcomes) of palliative day care and the differences between the two patient groups (age, employment, unequal sample sizes) were limitations of the study and indicate the need for further research in this area. AD - Department of Palliative Care and Policy, King's College, University of London, London, UK FAU - Goodwin, Danielle M AU - Goodwin DM FAU - Higginson, Irene J AU - Higginson IJ FAU - Myers, Kathy AU - Myers K FAU - Douglas, Hannah Rose AU - Douglas HR FAU - Normand, Charles E AU - Normand CE LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402006887 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):202-12.
UI - 22503220 PMID- 12614953 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Herpes zoster. A previously unrecognized complication of epidural steroids in the treatment of complex regional pain syndrome. PG - 198-9 AD - Pain Management Clinic Rockyview General Hospital, Calgary, Alberta, Canada FAU - Parsons, Simon J AU - Parsons SJ FAU - Hawboldt, Geoffrey S AU - Hawboldt GS LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402007078 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):198-9.
UI - 22503219 PMID- 12614952 DA - 20030304 IS - 0885-3924 VI - 25 IP - 3 DP - 2003 Mar TI - Criteria of pain response to radiotherapy in advanced cancer patients. PG - 197 AD - Department of Oncology Hospital Universitario de Valladolid, Valladolid, Spain FAU - Rey, Pilar AU - Rey P FAU - Vecino, Amaya AU - Vecino A FAU - Rubiales, Alvaro S AU - Rubiales AS FAU - Lopez-Lara, Francisco AU - Lopez-Lara F LA - eng PT - Journal Article CY - United States TA - J Pain Symptom Manage JID - 8605836 SB - IM SB - N EDAT- 2003/03/05 04:00 MHDA- 2003/03/05 04:00 AID - S0885392402007091 [pii] PST - ppublish SO - J Pain Symptom Manage 2003 Mar;25(3):197.
UI - 22508615 PMID- 12621144 DA - 20030306 DCOM- 20030317 IS - 1533-4406 VI - 348 IP - 10 DP - 2003 Mar 6 TI - Analgesics for the treatment of pain in children. PG - 959-60; author 959-60 FAU - Birenbaum, Debra AU - Birenbaum D FAU - Mattison, Donald R AU - Mattison DR LA - eng PT - Comment PT - Letter CY - United States TA - N Engl J Med JID - 0255562 RN - 0 (Analgesics) SB - AIM SB - IM CON - N Engl J Med. 2002 Oct 3;347(14):1094-103. PMID: 12362012 MH - Analgesics/*therapeutic use MH - Child MH - Drug Evaluation/*legislation & jurisprudence MH - Drug Labeling MH - Human MH - Infant MH - Pain/*drug therapy MH - United States MH - United States Food and Drug Administration EDAT- 2003/03/07 04:00 MHDA- 2003/03/18 04:00 AID - 10.1056/NEJM200303063481020 [doi] AID - 348/10/959 [pii] PST - ppublish SO - N Engl J Med 2003 Mar 6;348(10):959-60; author 959-60.
UI - 22508798 PMID- 12620613 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Cannabis use for chronic non-cancer pain: results of a prospective survey. PG - 211-6 AB - There has been a surge in interest in medicinal cannabis in Canada. We conducted a questionnaire survey to determine the current prevalence of medicinal cannabis use among patients with chronic non-cancer pain, to estimate the dose size and frequency of cannabis use, and to describe the main symptoms for which relief was being sought. Over a 6-week period in mid-2001, 209 chronic non-cancer pain patients were recruited in an anonymous cross-sectional survey. Seventy-two (35%) subjects reported ever having used cannabis. Thirty-two (15%) subjects reported having used cannabis for pain relief (pain users), and 20 (10%) subjects were currently using cannabis for pain relief. Thirty-eight subjects denied using cannabis for pain relief (recreational users). Compared to never users, pain users were significantly younger (P=0.001) and were more likely to be tobacco users (P=0.0001). The largest group of patients using cannabis had pain caused by trauma and/or surgery (51%), and the site of pain was predominantly neck/upper body and myofascial (68% and 65%, respectively). The median duration of pain was similar in both pain users and recreational users (8 vs. 7 years; P=0.7). There was a wide range of amounts and frequency of cannabis use. Of the 32 subjects who used cannabis for pain, 17 (53%) used four puffs or less at each dosing interval, eight (25%) smoked a whole cannabis cigarette (joint) and four (12%) smoked more than one joint. Seven (22%) of these subjects used cannabis more than once daily, five (16%) used it daily, eight (25%) used it weekly and nine (28%) used it rarely. Pain, sleep and mood were most frequently reported as improving with cannabis use, and 'high' and dry mouth were the most commonly reported side effects. We conclude that cannabis use is prevalent among the chronic non-cancer pain population, for a wide range of symptoms, with considerable variability in the amounts used. Discussions between patients and health care providers concerning cannabis use may facilitate education and follow up, and would allow side effects and potential interactions with other medications to be monitored. Clinical trials of cannabis for chronic non-cancer pain are warranted. AD - McGill University Health Center, Pain Center, Montreal General Hospital, Room D10.137, 1650 Cedar Avenue, Quebec, H3G 1A4, Montreal, Canada FAU - Ware, Mark A AU - Ware MA FAU - Doyle, Crystal R AU - Doyle CR FAU - Woods, Ryan AU - Woods R FAU - Lynch, Mary E AU - Lynch ME FAU - Clark, Alexander J AU - Clark AJ LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902004001 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):211-6.
UI - 22508795 PMID- 12620610 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Changes in intensity, location, and quality of vaso-occlusive pain in children with sickle cell disease. PG - 187-93 AB - A descriptive, longitudinal design was used to examine changes in current, worst, and least pain intensity during hospitalization for a vaso-occlusive episode in children with sickle cell disease. Other dimensions of the pain experience including location and quality were also evaluated. Children reported severe pain on the day of admission with 50% of the episodes showing a current pain intensity score of >70 and a worst pain intensity score of >80. Although both pain intensity scores demonstrated statistically significant decreases by approximately 5% over the course of the hospitalization, these decreases were not clinically significant based on the recommendations made in the American Pain Society's Guideline for the management of acute and chronic pain in sickle cell disease. In contrast to the pain intensity ratings, which did not decrease in 25% of the episodes, pain location surface area decreased in 100% of the episodes. Children described the quality of vaso-occlusive pain using all categories of word descriptors from the adolescent pediatric pain tool. These findings suggest that pain associated with a vaso-occlusive episode is inadequately assessed and managed during hospitalization. AD - Children's Hospital Oakland, 747, 52nd Street, 94602, Oakland, CA, USA FAU - Jacob, Eufemia AU - Jacob E FAU - Miaskowski, Christine AU - Miaskowski C FAU - Savedra, Marilyn AU - Savedra M FAU - Beyer, Judith E AU - Beyer JE FAU - Treadwell, Marsha AU - Treadwell M FAU - Styles, Lori AU - Styles L LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003743 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):187-93.
UI - 22508793 PMID- 12620608 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. PG - 167-78 AB - The objective of this paper was to present estimates on the prevalence of musculoskeletal pain of five different anatomical areas and ten anatomical sites, and their consequences and risk groups in the general Dutch population. Cross-sectional data from a population-based study of a sex-age stratified sample of Dutch inhabitants of 25 years and older were used. With a postal questionnaire data was assessed on musculoskeletal pain, additional pain characteristics (location, duration, course), its consequences (utilization of health care, sick leave and limitation in daily life) and general socio-demographic characteristics. The top three of self-reported musculoskeletal pain (point prevalence (P(p)) with 95% confidence interval (CI)) was: (1) low back pain, P(p)=26.9% (95% CI 25.5-28.3); (2) shoulder pain, P(p)=20.9% (95% CI 19.6-22.2); and (3) neck pain, P(p)=20.6% (95% CI 19.3-21.9). In most cases the pain was described as continuous or recurrent and mild. In every three out of ten cases the complaints about pain were accompanied by limitations in daily living. Between 33 and 42% of those with complaints consulted their general practitioner about their pain. With the exception of persons who are work disabled, general sociodemographic characteristics cannot be used to identify high risk groups. Musculoskeletal pain is common in all subgroups of the population and has far-reaching consequences for health, work and the use of health care. AD - National Institute of Public Health and the Environment, Center for Chronic Diseases Epidemiology (CZE, pb 101), PO box 1, 3720 BA, Bilthoven, The Netherlands FAU - Picavet, H S J AU - Picavet HS FAU - Schouten, J S A G AU - Schouten JS LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S030439590200372X [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):167-78.
UI - 22508789 PMID- 12620604 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Transgene-mediated enkephalin release enhances the effect of morphine and evades tolerance to produce a sustained antiallodynic effect in neuropathic pain. PG - 135-42 AB - We examined the pharmacologic characteristics of herpes simplex virus (HSV) vector-mediated expression of proenkephalin in the dorsal root ganglion in a rodent model of neuropathic pain. We found that: (i) vector-mediated enkephalin produced an antiallodynic effect that was reversed by naloxone; (ii) vector-mediated enkephalin production in animals with spinal nerve ligation prevented the induction of c-fos expression in second order sensory neurons in the dorsal horn of spinal cord; (iii) the effect of vector-mediated enkephalin enhanced the effect of morphine, reducing the ED(50) of morphine 10-fold; (iv) animals did not develop tolerance to the continued production of vector-mediated enkephalin over a period of several weeks; and, (v) vector transduction continued to provide an analgesic effect despite the induction of tolerance to morphine. This is the first demonstration of gene transfer to provide an analgesic effect in neuropathic pain. The pharmacologic analysis demonstrates that transgene-mediated expression and local release of opioid peptides produce some effects that are distinct from peptide analogues delivered pharmacologically. AD - Department of Neurology, University of Pittsburgh, 15213, Pittsburgh, PA, USA FAU - Hao, Shuanglin AU - Hao S FAU - Mata, Marina AU - Mata M FAU - Goins, William AU - Goins W FAU - Glorioso, Joseph C AU - Glorioso JC FAU - Fink, David J AU - Fink DJ LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003469 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):135-42.
UI - 22508787 PMID- 12620602 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Self-reports of pain intensity and direct observations of pain behavior: when are they correlated? PG - 109-24 AB - Meta-analytic techniques were utilized to investigate the relationship between self-reports of pain intensity and direct observations of pain behavior. Estimation of the overall effect size from 29 studies and 85 effect sizes yielded a moderately positive association, z=0.26. High variability across studies permitted a random-effects moderator analysis that determined chronicity of pain, the timing of the pain assessment, the use of global measures of pain behavior, and pain site significantly moderate the relationship between self-reports of pain intensity and direct observations of pain behavior. These findings indicate that self-reports of pain intensity and direct observations of pain behavior are more likely to be significantly related to each other when the individual being studied has acute pain (z=0.35), when the self-report of pain intensity data are collected soon after the observation of pain behavior (z=0.40), when global composite measures are used to quantify pain behavior (z=0.37), and when the person being observed suffers from chronic low back pain (z=0.30). Other factors not found to be significant moderators include: extent of observer training, relevance of the pain-inducing task, and pain behavior observation measure used. The implications of the findings for the assessment of pain are discussed. AD - Department of Psychology, Ohio University, Athens, OH 45701, USA FAU - Labus, Jennifer S AU - Labus JS FAU - Keefe, Francis J AU - Keefe FJ FAU - Jensen, Mark P AU - Jensen MP LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003548 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):109-24.
UI - 22508786 PMID- 12620601 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Pain and the defense response: structural equation modeling reveals a coordinated psychophysiological response to increasing painful stimulation. PG - 97-108 AB - The defense response theory implies that individuals should respond to increasing levels of painful stimulation with correlated increases in affectively mediated psychophysiological responses. This paper employs structural equation modeling to infer the latent processes responsible for correlated growth in the pain report, evoked potential amplitudes, pupil dilation, and skin conductance of 92 normal volunteers who experienced 144 trials of three levels of increasingly painful electrical stimulation. The analysis assumed a two-level model of latent growth as a function of stimulus level. The first level of analysis formulated a nonlinear growth model for each response measure, and allowed intercorrelations among the parameters of these models across individuals. The second level of analysis posited latent process factors to account for these intercorrelations. The best-fitting parsimonious model suggests that two latent processes account for the correlations. One of these latent factors, the activation threshold, determines the initial threshold response, while the other, the response gradient, indicates the magnitude of the coherent increase in response with stimulus level. Collectively, these two second-order factors define the defense response, a broad construct comprising both subjective pain evaluation and physiological mechanisms. AD - Pain Research Center, Department of Anesthesiology, University of Utah School of Medicine, 615 Arapeen Drive, 84108, Salt Lake City, UT, USA FAU - Donaldson, Gary W AU - Donaldson GW FAU - Chapman, C Richard AU - Chapman CR FAU - Nakamura, Yoshi AU - Nakamura Y FAU - Bradshaw, David H AU - Bradshaw DH FAU - Jacobson, Robert C AU - Jacobson RC FAU - Chapman, Christopher N AU - Chapman CN LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003512 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):97-108.
UI - 22508785 PMID- 12620600 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. PG - 87-95 AB - Individuals diagnosed with fibromyalgia syndrome (FMS) report chronic pain that is frequently worsened by physical activity and improved by rest. Palpation of muscle and tendinous structures suggests that nociceptors in deep tissues are abnormally sensitive in FMS, but methods of controlled mechanical stimulation of muscles are needed to better characterize the sensitivity of deep tissues. Accordingly, force-controlled mechanical stimulation was applied to the flexor digitorum muscle of the forearm in a series of brief contacts (15 stimuli, each of 1s duration, at 3 or 5s interstimulus intervals). Repetitive stimulation was utilized to determine whether temporal summation of deep muscular pain would occur for normal subjects and would be enhanced for FMS subjects. Moderate temporal summation of deep pain was observed for normal controls (NC), and temporal summation was greatly exaggerated for FMS subjects. Temporal summation for FMS subjects occurred at substantially lower forces and at a lower frequency of stimulation. Furthermore, painful after-sensations were greater in amplitude and more prolonged for FMS subjects. These observations complement a previous demonstration that temporal summation of pain and after-sensations elicited by thermal stimulation of the skin are moderately enhanced for FMS subjects. Abnormal input from muscle nociceptors appears to underlie production of central sensitization in FMS that generalizes to input from cutaneous nociceptors. AD - Department of Medicine, McKnight Brain Institute, University of Florida College of Medicine, 1600 SW Archer Rd, P.O. Box 100221, 32610-0221, Gainesville, FL, USA FAU - Staud, Roland AU - Staud R FAU - Cannon, Richard C AU - Cannon RC FAU - Mauderli, Andre P AU - Mauderli AP FAU - Robinson, Michael E AU - Robinson ME FAU - Price, Donald D AU - Price DD FAU - Vierck, Charles J AU - Vierck CJ LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003445 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):87-95.
UI - 22508782 PMID- 12620597 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Chronic neck pain disability due to an acute whiplash injury. PG - 63-71 AB - Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the upper trapezius muscles in the chronic stage of WAD (grade II). There are, however, no studies that confirm that these muscle reactions are initiated in the acute stage of WAD, nor that these muscle reactions persist in the transition from acute neck pain to chronic neck pain disability.We analyzed the muscle activation patterns of the upper trapezius muscles in a cohort of 92 subjects with acute neck pain due to a motor vehicle accident (MVA). This cohort was followed up in order to evaluate differences in muscular activation patterns between subjects who have recovered and those subjects who have not recovered following an acute WAD and developed chronic neck pain. sEMG parameters were obtained at 1, 4, 8, 12, and 24 weeks after an MVA. The level of muscle reactivity (the difference in pre- and post-exercise EMG levels) and the level of muscle activity during an isometric and a dynamic task were used as EMG parameters.The results revealed no elevated muscle reactivity either in the acute stage, or during the follow-up period. The results of both the isometric and dynamic task, showed statistically significant different EMG levels between four neck pain disability subgroups (analysis of variance reaching P-levels of 0.000), with an inverse relationship between the level of neck pain disability and EMG level. Furthermore, follow-up assessments of the EMG level during these two tasks, did not show a time related change.In conclusion, in subjects with future disability, the acute stage is characterized by a reorganization of the muscular activation of neck and shoulder muscles, possibly aimed at minimizing the use of painful muscles. This change of motor control, is in accordance with both the (neurophysiological) 'pain adaptation model' and (cognitive behavioral) 'fear avoidance model'. AD - Roessingh, Research and Development, Roessinghsbleekweg 33, 7500 AH, Enschede, The Netherlands FAU - Nederhand, Marc J AU - Nederhand MJ FAU - Hermens, Hermie J AU - Hermens HJ FAU - IJzerman, Maarten J AU - IJzerman MJ FAU - Turk, Dennis C AU - Turk DC FAU - Zilvold, Gerrit AU - Zilvold G LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902003408 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):63-71.
UI - 22508778 PMID- 12620593 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Anti-allodynic effect of NW-1029, a novel Na(+) channel blocker, in experimental animal models of inflammatory and neuropathic pain. PG - 17-25 AB - NW-1029, a benzylamino propanamide derivative, was selected among several molecules of this chemical class on the basis of its affinity for the [(3)H]batracotoxin ligand displacement of the Na(+) channel complex and also on the basis of its voltage and use-dependent inhibitory action on the Na(+) currents of the rat DRG (dorsal root ganglia) sensory neuron. This study evaluated the analgesic activity of NW-1029 in animal models of inflammatory and neuropathic pain (formalin test in mice, complete Freund's adjuvant and chronic constriction injury in rats) as well as in acute pain test (hot-plate and tail-flick in rats). Orally administered NW-1029 dose-dependently reduced cumulative licking time in the early and late phase of the formalin test (ED(50)=10.1 mg/kg in the late phase). In the CFA model, NW-1029 reversed mechanical allodynia (von Frey test) after both i.p. and p.o. administration (ED(50)=0.57 and 0.53 mg/kg), respectively. Similarly, NW-1029 reversed mechanical allodynia in the CCI model after both i.p. and p.o. administration yielding an ED(50) of 0.89 and 0.67 mg/kg, respectively. No effects were observed in the hot-plate and tail-flick tests up to 30 mg/kg p.o. The compound orally administered (0.1-10 mg/kg) was well tolerated, without signs of neurological impairment up to high doses (ED(50)=470 and 245 mg/kg in rat and mice Rotarod test, respectively). These results indicate that NW-1029 has anti-nociceptive properties in models of inflammatory and neuropathic pain. AD - Newron Pharmaceuticals S.p.A Research and Development, Gerenzano, Varese, Italy FAU - Veneroni, O AU - Veneroni O FAU - Maj, R AU - Maj R FAU - Calabresi, M AU - Calabresi M FAU - Faravelli, L AU - Faravelli L FAU - Fariello, R G AU - Fariello RG FAU - Salvati, P AU - Salvati P LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S0304395902001835 [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):17-25.
UI - 22508776 PMID- 12620591 DA - 20030306 IS - 0304-3959 VI - 102 IP - 1-2 DP - 2003 Mar TI - Translation of symptoms and signs into mechanisms in neuropathic pain. PG - 1-8 AD - Department of Neurology, Aarhus University, DK 8000, Aarhus C, Denmark FAU - Jensen, Troels S AU - Jensen TS FAU - Baron, Ralf AU - Baron R LA - eng PT - Journal Article CY - Netherlands TA - Pain JID - 7508686 SB - IM EDAT- 2003/03/07 04:00 MHDA- 2003/03/07 04:00 AID - S030439590300006X [pii] PST - ppublish SO - Pain 2003 Mar;102(1-2):1-8.
UI - 22454883 PMID- 12567037 DA - 20030204 DCOM- 20030304 IS - 1528-1159 VI - 28 IP - 3 DP - 2003 Feb 1 TI - The effectiveness of standard care, early intervention, and occupational management in worker's compensation claims. PG - 299-304 AB - STUDY DESIGN: A retrospective and prospective cohort. OBJECTIVES: To compare the effectiveness of occupational intervention, early intervention, and standard care in the management of Worker's Compensation injury claims. SUMMARY OF BACKGROUND DATA: The current management of occupational back pain and work-related upper extremity disorders with either standard care or early intervention appears to be ineffective. METHODS: A retrospective cohort compared injury claim incidence, duration, and costs between one company with access to standard care and another similar company with access to early intervention. A prospective cohort looked at the effect of one company changing from standard care to occupational management in comparison with the control group with early intervention. Survival analysis was used to attempt to explain differences in injury claim duration. RESULTS: Standard care resulted in lower injury claim incidence, duration, and costs than early intervention, whereas occupational management resulted in lower injury claim incidence, duration, and costs than standard care. The covariates of physical therapist involvement, chiropractor involvement, injury severity, and relationship between Worker's Compensation and the employer were associated with delayed time to claim closure in the company with access to early intervention with the most important covariate being physical therapist involvement (hazard rate ratio 19.88, 95% confidence interval 7.95-39.77). Only the covariate of injury severity was associated with delayed time to claim closure in the company with access to occupational management (hazard rate ratio 1.67, 95% confidence interval 1.05-27.20). CONCLUSIONS: It is recommended that an occupational management approach, in comparison with standard care or early intervention, be considered for management of occupational injuries. AD - College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. FAU - Lemstra, Mark AU - Lemstra M FAU - Olszynski, W P AU - Olszynski WP LA - eng PT - Journal Article CY - United States TA - Spine JID - 7610646 SB - IM MH - Accidents, Occupational/economics/statistics & numerical data MH - Back Pain/economics/epidemiology/rehabilitation MH - Cohort Studies MH - Comorbidity MH - Disability Evaluation MH - *Disease Management MH - Human MH - Incidence MH - Industry/statistics & numerical data MH - Manipulation, Chiropractic/economics/utilization MH - Occupational Diseases/economics/epidemiology/*rehabilitation MH - Occupational Health Services/economics/*standards MH - *Outcome Assessment (Health Care) MH - Physical Therapy Techniques/economics/utilization MH - Prospective Studies MH - Retrospective Studies MH - Saskatchewan/epidemiology MH - Survival Analysis MH - Workers' Compensation/economics/*statistics & numerical data EDAT- 2003/02/05 04:00 MHDA- 2003/03/05 04:00 AID - 10.1097/01.BRS.0000042249.21349.22 [doi] PST - ppublish SO - Spine 2003 Feb 1;28(3):299-304.
UI - 22454866 PMID- 12567020 DA - 20030204 DCOM- 20030304 IS - 1528-1159 VI - 28 IP - 3 DP - 2003 Feb 1 TI - Rehabilitation following first-time lumbar disc surgery: a systematic review within the framework of the cochrane collaboration. PG - 209-18 AB - STUDY DESIGN: A systematic review of randomized controlled trials. BACKGROUND: Although several rehabilitation programs, physical fitness programs, or protocols regarding instruction for patients to return to work after lumbar disc surgery have been suggested, little is known about the efficacy of these treatments, and there are still persistent fears of causing reinjury, reherniation, or instability. OBJECTIVES: The objective of this systematic review was to evaluate the effectiveness of active treatments that are used in the rehabilitation after first-time lumbar disc surgery. METHODS: The authors searched the MEDLINE, Embase, and Psyclit databases up to April 2000 and the Cochrane Controlled Trials Register 2001, issue 3. Both randomized and nonrandomized controlled trials on any type of active rehabilitation program after first-time disc surgery were included. Two independent reviewers performed the inclusion of studies, and two other reviewers independently performed the methodologic quality assessment. A rating system that consists of four levels of scientific evidence summarizes the results. RESULTS: Thirteen studies were included, six of which were of high quality. There is no strong evidence for the effectiveness for any treatment starting immediately postsurgery, mainly because of the lack of good quality studies. For treatments that start 4 to 6 weeks postsurgery, there is strong evidence (level 1) that intensive exercise programs are more effective on functional status and faster return to work (short-term follow-up) as compared to mild exercise programs, and there is strong evidence (level 1) that on long-term follow-up there is no difference between intensive exercise programs and mild exercise programs with regard to overall improvement. For all other primary outcome measures for the comparison between intensive and mild exercise programs, there is conflicting evidence (level 3) with regard to long-term follow-up. Furthermore, there is no strong evidence for the effectiveness of supervised training as compared to home exercises. There is also no strong evidence for the effectiveness of multidisciplinary rehabilitation as compared to usual care. There is limited evidence (level 3) that treatments in working populations that aim at return to work are more effective than usual care with regard to return to work. Also, there is limited evidence (level 3) that low-tech and high-tech exercises, started more than 12 months postsurgery, are more effective in improving low-back functional status as compared to physical agents, joint manipulations, or no treatment. Finally, there is no strong evidence for the effectiveness of any specific intervention when added to an exercise program, regardless of whether exercise programs start immediately postsurgery or later. None of the investigated treatments seem harmful with regard to reherniation or reoperation. CONCLUSIONS: There is no evidence that patients need to have their activities restricted after first-time lumbar disc surgery. There is strong evidence for intensive exercise programs (at least if started about 4-6 weeks postoperative) and no evidence they increase the reoperation rate. It is unclear what the exact content of postsurgery rehabilitation should be. Moreover, there are no studies that investigated whether active rehabilitation programs should start immediately postsurgery or possibly 4 to 6 weeks later. AD - Department of Epidemiology, Maastricht University, The Netherlands. r.ostelo.emgo@med.vu.nl FAU - Ostelo, Raymond W J G AU - Ostelo RW FAU - de Vet, Henrica C W AU - de Vet HC FAU - Waddell, Gordon AU - Waddell G FAU - Kerckhoffs, Maria R AU - Kerckhoffs MR FAU - Leffers, Pieter AU - Leffers P FAU - van Tulder, Maurits AU - van Tulder M LA - eng PT - Journal Article PT - Review PT - Review, Academic CY - United States TA - Spine JID - 7610646 SB - IM MH - Comparative Study MH - Controlled Clinical Trials/statistics & numerical data MH - *Exercise MH - Exercise Therapy/methods/*statistics & numerical data MH - Human MH - Intervertebral Disk Displacement/*rehabilitation/*surgery MH - Low Back Pain/etiology/prevention & control/rehabilitation MH - Lumbosacral Region MH - *Outcome and Process Assessment (Health Care)/statistics & numerical data MH - Randomized Controlled Trials/statistics & numerical data RF - 35 EDAT- 2003/02/05 04:00 MHDA- 2003/03/05 04:00 AID - 10.1097/01.BRS.0000042520.62951.28 [doi] PST - ppublish SO - Spine 2003 Feb 1;28(3):209-18.