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Chronic Pain after Cesarean Section. Influence of Anesthetic/Surgical Technique and Postoperative Analgesia

Brito Cançado, Thais Orrico de; Omais, Maruan; Ashmawi, Hazem Adel; Abramides Torres, Marcelo Luis
Fonte: ELSEVIER SCIENCE INC; NEW YORK Publicador: ELSEVIER SCIENCE INC; NEW YORK
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
66.29%
Cancado TO, Omais M, Ashmawi HA, Torres MLA - Chronic Pain after Cesarean Section. Influence of Anesthetic/Surgical Technique and Postoperative Analgesia. Background and objectives: Brazil ranks second among countries with the highest rates of cesarean section in the world. Little is known about the future consequences of this procedure on maternal health. This study investigated the influence of anesthetic/surgical technique and postoperative analgesia on the onset of chronic pain after three months of cesarean section. Method: This is a prospective randomized study of 443 patients undergoing cesarean section (elective and emergency), with different doses of hyperbaric bupivacaine 0.5% and opioids in spinal anesthesia. Patients were alocated into five groups as follow: G1 received hyperbaric bupivacaine (8 mg), sufentanil (2.5 mu g), and morphine (100 mu g); G2 received hyperbaric bupivacaine (10 mg), sufentanil (2.5 mu g), and morphine (100 mu g); G3 received hyperbaric bupivacaine (12.5 mg) and morphine (100 mu g); G4 received hyperbaric bupivacaine (15 mg) and morphine (100 mu g); G5 received hyperbaric bupivacaine (12.5 mg) and morphine (100 mu g), without perioperative anti-inflammatory. Pain at rest and in movement were evaluated in the immediate postoperative period. Phone contact was made after three months of surgery for identification of patients with chronic pain. Results: The incidence of chronic pain in the groups was G1 = 20%; G2 = 13%; G3 = 7.1%; G4 = 2.2%...

Crença de auto-eficácia e validação da Chronic Pain Self-Efficacy Scale.; Self-efficacy beliefs and Chronic Pain Self-Efficacy Scale validation.

Salvetti, Marina de Góes
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 29/06/2004 PT
Relevância na Pesquisa
66.3%
A crença de auto-eficácia relaciona-se com a percepção da dor e com a funcionalidade física e psíquica dos doentes. Os objetivos deste estudo foram validar para a língua portuguesa a escala Chronic Pain Self-efficacy Scale e analisar as crenças de auto-eficácia de doentes com dor crônica. A amostra foi de 132 pacientes com dor crônica de etiologia variada (54,5% fibromialgia e 24,2% dor neuropática); 87,9% foram mulheres, a idade média foi de 46 anos (DP=12,6) e a escolaridade média de 10,1 anos. A média da intensidade da dor foi de 6,83 (DP=2,3) e o tempo médio de dor foi de 7,4 anos (DP=7,7). A validade da escala em língua portuguesa foi confirmada pela análise fatorial, que manteve os 3 domínios e os 22 itens da escala original; a variância explicada foi de 60,8%. A confiabilidade, analisada pelo alfa de Cronbach, variou entre 0,76 e 0,92 para os domínios e foi de 0,94 para a escala total. A validade convergente, verificada por meio da comparação entre os escores da Escala de Auto-Eficácia para Dor Crônica (AEDC) e os escores do Inventário de Depressão de Beck mostrou correlação negativa e estatisticamente significativa. As crenças de auto-eficácia foram analisadas em relação às variáveis sexo...

Dor crônica em pacientes esquizofrênicos: prevalência e características; Chronic pain in schizophrenics patients: prevalence and characteristics

Almeida, Jouce Gabriela de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 29/05/2009 PT
Relevância na Pesquisa
66.31%
A prevalência de dor crônica entre pacientes com transtornos psiquiátricos é, possivelmente, no mínimo igual à da população geral; no entanto, são poucos os estudos na área. Objetivos: Avaliar a prevalência e as características da dor crônica em pacientes com esquizofrenia e comparar a qualidade de vida dos pacientes com e sem dor crônica. Método: Estudo transversal que envolveu uma amostra probabilística de 205 pacientes adultos, com diagnóstico de esquizofrenia (idade média 37 anos; 65% homens; média de anos de escolaridade 9 anos; 87% sem companheiro(a); 65% residiam com os pais; como ocupação principal, 25% eram trabalhadores dos serviços), atendidos em um ambulatório de hospital público do município de São Paulo, Brasil. Os pacientes foram entrevistados por meio de dois instrumentos caracterização da população e da dor e a Escala de Qualidade de Vida WHOQOL-bref. Resultados: A prevalência de dor em pacientes esquizofrênicos foi de 36,6% (75 pacientes). A dor foi mais presente no abdômen (30,7%), seguida da cabeça, face e boca (24%) e região lombar, sacra e cóccix (14,7%). Com relação à freqüência, 24% dos entrevistados referiram ter dor todos os dias, com duração entre 1 a 6 horas, 33...

Avaliação de dor crônica pós-cesariana. Influência da técnica anestésico-cirúrgica e da analgesia pós-operatória; Chronic pain after cesarean delivery. Influence of anesthetics, surgical techniques and postoperative analgesia

Cançado, Thais Orrico de Brito
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 11/03/2013 PT
Relevância na Pesquisa
66.33%
INTRODUÇÃO: O Brasil ocupa o primeiro lugar entre os países com maiores taxas de cesariana no mundo. Pouco se sabe a respeito das consequências futuras deste procedimento, sobre a saúde materna. Este estudo investigou a influência da técnica anestésico-cirúrgica e analgesia pós-operatória, no aparecimento de dor crônica após a cesariana. Procuramos também identificar os fatores de risco de dor crônica pós-cesariana. MÉTODO: Este estudo prospectivo com distribuição aleatória foi conduzido em 443 pacientes que foram submetidas à cesariana (eletivas e emergenciais), com diferentes doses de bupivacaína 0,5% hiperbárica e opioides na raquianestesia, bem como uso de anti-inflamatórios não esteroidais peri-operatório. Os grupos foram: G8SMA- 8 mg bupivacaína hiperbárica + 2,5 mcg sufentanil + 100 mcg morfina; G10SMA- 10 mg bupivacaína hiperbárica + 2,5 mcg sufentanil + 100 mcg morfina; G12,5MA- 12,5 mg bupivacaína hiperbárica + 100 mcg morfina; G15MA- 15 mg bupivacaína hiperbárica + 100 mcg morfina; G12,5M - 12,5 mg bupivacaína hiperbárica + 100 mcg morfina. Somente as pacientes do grupo G12,5M não receberam AINE no peri-operatório. Dor em repouso e em movimento foram avaliadas no pós-operatório imediato. Fatores peri-operatórios...

Avaliação somatossensorial do sistema trigeminal em condições dolorosas crônicas: testes quantitativos sensoriais e limiar de percepção atual; Trigeminal system somatosensory evaluation in chronic pain patients: quantitative sensory tests and current perception threshold

Sydney, Priscila Brenner Hilgenberg
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 20/05/2013 PT
Relevância na Pesquisa
66.3%
A dor crônica envolve complexos processos de gênese e condução neural e é decorrente da ativação de mecanismos periféricos e centrais de manutenção. Muitos pacientes crônicos são refratários aos diferentes tipos de tratamento propostos, o que gera a suspeita de que de alguma maneira estes não estão sendo totalmente eficazes. O objetivo deste trabalho é avaliar os mecanismos de condução, manutenção e modulação da dor em diferentes condições dolorosas crônicas. Foram avaliadas 92 mulheres, divididas em 5 grupos: Grupo I, 20 pacientes com Dor Miofascial da musculatura mastigatória; Grupo II, 20 pacientes com Fibromialgia; Grupo III, 20 pacientes com Cefaleia Crônica Diária; Grupo IV, 12 pacientes com Neuralgia Trigeminal e Grupo V, 20 pacientes saudáveis assintomáticas. Foram aplicados dois questionários, o IDATE e o OHIP-30, para mensuração do estado ansioso e da qualidade de vida relacionada a condição dolorosa diagnosticada, respectivamente. Todas as pacientes foram submetidas a Testes Quantitativos Sensoriais, como: Limiar de Dor à Pressão, Limiar de Detecção Mecânico, Limiar Doloroso Mecânico, Tolerância à Dor Isquêmica, Sensibilidade Dolorosa ao Frio, Sensação Pós-Estímulo e Controle da Modulação da Dor. Além disso...

Prevalência de dor crônica e identificação de fatores associados em um segmento da população da cidade de São Paulo; Chronic pain prevalence and associated factors in a segment of the population of Sao Paulo City

Cabral, Dayane Maia Costa
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 07/05/2014 PT
Relevância na Pesquisa
66.33%
INTRODUÇÃO: A dor crônica é considerada a primeira causa de anos vividos com incapacidade no mundo e uma das razões mais comuns pela qual as pessoas procuram por atendimento médico. Estima-se que pessoas com dor crônica utilizam os serviços de saúde cinco vezes mais do que o restante da população. OBJETIVOS: Estimar a prevalência de dor crônica e identificar fatores associados em uma amostra de pessoas com 15 anos ou mais de idade de um segmento da cidade de São Paulo, Brasil. MÉTODO: Foi realizado um estudo de corte transversal. Do total de 1.108 indivíduos elegíveis, 826 (74.5%) foram selecionados para entrevistas face a face no período entre dezembro de 2011 e fevereiro de 2012. Os instrumentos utilizados para verificar características da dor crônica e problemas psicológicos associados à dor crônica foram: a Escala Graduada de Dor Crônica (EGDC), a Escala Hospitalar de Ansiedade e Depressão (HADS), o teste de Fagerström para dependência de nicotina (FTND), o teste para identificação de problemas relacionados ao uso de álcool (AUDIT) e a Escala EuroQol-5D. RESULTADOS: A prevalência de dor crônica encontrada foi de 42% (intervalo de 95% de confiança 38,6% - 45,4%). Os participantes com dor crônica apresentaram uma média de 5...

Clinical evaluation of amitriptyline for the control of chronic pain caused by temporomandibular joint disorders

Rizzatti-Barbosa, Célia M.; Nogueira, Mariana T. P.; De Andrade, Eduardo D.; Ambrosano, Gláucia M. B.; De Albergaria Barbosa, José R.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 221-225
ENG
Relevância na Pesquisa
66.28%
Temporomandibular disorder (TMD) is characterized by a combination of symptoms affecting the temporomandibular joint and/or chewing muscles. The two most common clinical TMD symptoms are pain and dysfunction. Pain is usually caused by dysfunction, and emergency therapy has focused on controlling it. Recent investigations into TMD have led to the recommendation of antidepressants as a supporting treatment against constant neuralgic pain. The aim of this double-blind study was to verify the efficiency of antidepressants (amitriptyline) as a support in the treatment of chronic TMD pain. Twelve female volunteers presenting chronic TMD pain were divided into two groups and treated for 14 days: Group 1 with 25 mg/day of amitriptyline and Group 2 with a placebo. The intensity of pain and discomfort was evaluated daily, using a visual analog scale (VAS), over a period of seven days preceding the treatment (baseline), during the 14-day treatment, and for seven days after the treatment. The results revealed a significant reduction of pain and discomfort in Group 1 (75%) compared to Group 2 (28%) during the three weeks beginning at baseline (p< 0.01). Amitriptyline proved to be an efficient alternative treatment for chronic pain in TMD patients. Copyright © 2003 by CHROMA...

Dor crônica em residentes das instituições de longa permanência para idosos de uma metrópole da região centro-oeste; Chronic Pain in Residents of nursing home for the Elderly in a Metropolis of the Mid-Western Region

Pessoa, Ana Paula da Costa
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG)
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
66.29%
Chronic pain afflicts people of all ages, however in the elderly, as scholars agree, there are still gaps of knowledge on the standard in which such experience occurs. The main goal of this paper was to assess the prevalence of chronic pain, characteristics, as well as the associated factors in the elderly living in nursing home. This is a cross-sectional study, carried out in seven out of nine nursing home registered in the Municipal Council for the Elderly and in the Municipal Health Office, in Goiânia, Brazil. We included in this study the individuals with highest scores ≥13 in the Mini Mental State Examination (MMSE), with visual, auditory and speech capacity sufficient to participate in the interviews and with age ≥ 60 years , 159 elderly people total. Chronic pain was considered as existing for six months or more. The main pain ( the one most uncomfortable for the elderly) was characterized according to its intensity (through the Verbal Rating Scale, of five points, with the following categories: “none”, “mild”, “moderate”, “severe”, “worst pain ever”) and localization , through body diagrams, with back and front. The variables of exposure included sociodemographic and clinical ones. Self-perception of health was assessed through the following Verbal Rating Scale: “great”...

Meeting the occupational needs of people with chronic pain

Robinson, Catherine T; Harmon, Dominic
Fonte: University of Limerick Publicador: University of Limerick
Tipo: info:eu-repo/semantics/doctoralThesis; all_ul_research; ul_published_reviewed; ul_theses_dissertations
ENG
Relevância na Pesquisa
66.33%
peer-reviewed; This thesis comprises eight papers that aim to explore the relationship between occupation and chronic pain, augment the evidence available to occupational therapists working with people with chronic pain, and to develop occupational therapy services for people with chronic pain in Ireland. The practice of occupational therapists with people with chronic pain appears to reflect the profession wide theory-practice gap. A lack of evidence for occupationbased practice, the use of inappropriate evidence, and the underuse of relevant evidence for occupation-based practice were identified as issues influencing this theory-practice gap. A layered analysis revealed that occupational therapy services for people with chronic pain are influenced by multiple factors, including the biopsychosocial model of health, occupational therapy philosophy and the social construction of people with chronic pain. A participatory action research (PAR) process undertaken with an all-Island group of occupational therapists found that the practice of Irish occupational therapists reflected the identified theory-practice gap and over-reliance on technique based practice. Addressing client’s vocational needs emerged as the greatest challenge faced by participants. The PAR process enabled participants to take multiple actions to address this problem including the development of a handbook to guide vocational rehabilitation. The findings of this study revealed that a participatory process has the potential to translate evidence to practice and enact occupation-based practice. Flow theory is congruent with an occupational perspective of health and an experience sampling methodology study of the flow experiences of people with chronic pain revealed that mean pain scores were lower...

Chronic pain management in non-oncologic patients: multicentric study on adult patients referring to the centers for pain management in the Lazio Region (Italy); LA GESTIONE DEL DOLORE CRONICO NON ONCOLOGICO: STUDIO MULTICENTRICO SULLA POPOLAZIONE ADULTA AFFERENTE AI CENTRI DI TERAPIA DEL DOLORE NELLA REGIONE LAZIO

LATINA, ROBERTO
Fonte: La Sapienza Universidade de Roma Publicador: La Sapienza Universidade de Roma
Tipo: Tese de Doutorado
IT
Relevância na Pesquisa
66.34%
Introduction Chronic pain is a complex phenomenon usually associated with psychological stress, which implies falling back on the National Health Service and reducing work capacities, indeed affecting Activities of Daily Living. Studies based on efficacy have identified the multidisciplinary approach as the most effective means to obtain therapeutic results. These programs can be provided by the Centers for Pain Management (CPMs), where multidisciplinary teams are likely to provide the necessary expertise to outline the best treatments for the diagnosis and management of chronic pain. To date, very little information is available on the kind of assistance and support these centers can provide, as well as on the clinical and socio-demographic characteristics of patients who refer to these facilities. Aims The present investigation has the following objectives: • to describe what kind of assistance the centers for pain management (CPMs) in the Lazio Region are able to provide; • to describe the clinical and socio-demographic characteristics of the population referring to the CPMs; • to describe the type of pharmacologic, complementary and intervention treatments; • to describe the clinical characteristics of patients who turn to the two different levels of available assistance (hub and spoke system). Methods In 2011 a non-profit...

Increased responsiveness of peripheral blood mononuclear cells to in vitro TLR 2, 4 and 7 ligand stimulation in chronic pain patients

Kwok, Y.; Hutchinson, M.; Gentgall, M.; Rolan, P.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
66.3%
Glial activation via Toll-like receptor (TLR) signaling has been shown in animals to play an important role in the initiation and establishment of chronic pain. However, our ability to assess this central immune reactivity in clinical pain populations is currently lacking. Peripheral blood mononuclear cells (PBMCs) are an accessible source of TLR expressing cells that may mirror similarities in TLR responsiveness of the central nervous system. The aim of this study was to characterize the IL-1β response to various TLR agonists in isolated PBMCs from chronic pain sufferers (on and not on opioids) and pain-free controls. Venous blood was collected from 11 chronic pain sufferers on opioids (≥ 20 mg of morphine / day), 8 chronic pain sufferers not on opioids and 11 pain-free controls. PBMCs were isolated and stimulated in vitro with a TLR2 (Pam3CSK4), TLR4 (LPS) or TLR7 (imiquimod) agonist. IL-1β released into the supernatant was measured with ELISA. Significantly increased IL-1β expression was found in PBMCs from chronic pain sufferers (on and not on opioids) compared with pain-free controls for TLR2 (F (6, 277) = 15, P<0.0001), TLR4 (F (8, 263) = 3, P = 0.002) and TLR7 (F (2,201) = 5, P = 0.005) agonists. These data demonstrate that PBMCs from chronic pain sufferers were more responsive to TLR agonists compared with controls...

TLR 2 and 4 responsiveness from isolated peripheral blood mononuclear cells from rats and humans as potential chronic pain biomarkers

Kwok, Y.; Tuke, S.; Nicotra, L.; Grace, P.; Rolan, P.; Hutchinson, M.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.32%
Background: Chronic pain patients have increased peripheral blood mononuclear cell Interkeukin-1β production following TLR2 and TLR4 simulation. Here we have used a human-to-rat and rat-to-human approach to further investigate whether peripheral blood immune responses to TLR agonists might be suitable for development as possible systems biomarkers of chronic pain in humans. Methods and Results: Study 1: using a graded model of chronic constriction injury in rats, behavioral allodynia was assessed followed by in vitro quantification of TLR2 and TLR4 agonist-induced stimulation of IL-1β release by PBMCs and spinal cord tissues (n = 42; 6 rats per group). Statistical models were subsequently developed using the IL-1β responses, which distinguished the pain/no pain states and predicted the degree of allodynia. Study 2: the rat-derived statistical models were tested to assess their predictive utility in determining the pain status of a published human cohort that consists of a heterogeneous clinical pain population (n = 19) and a pain-free population (n = 11). The predictive ability of one of the rat models was able to distinguish pain patients from controls with a ROC AUC of 0.94. The rat model was used to predict the presence of pain in a new chronic pain cohort and was able to accurately predict the presence of pain in 28 out of the 34 chronic pain participants. Conclusions: These clinical findings confirm our previous discoveries of the involvement of the peripheral immune system in chronic pain. Given that these findings are reflected in the prospective graded rat data...

Reduced response to the thermal grill illusion in chronic pain patients

Sumracki, N.; Buisman-Pijlman, F.; Hutchinson, M.; Gentgall, M.; Rolan, P.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
66.3%
OBJECTIVE Sensory illusions may reveal fundamental features of the nervous system. The thermal grill illusion is such a pain illusion, where interlaced warm and cool temperature bars (thermal grill) produce a paradoxical burning sensation. Previous studies have only systematically investigated the thermal grill illusion in pain-free volunteers. The objective of this study was to investigate whether the response to the thermal grill illusion was tolerable in patients with chronic pain and whether the response differed between patients with chronic pain and pain-free volunteers. SUBJECTS Sixteen pain-free participants and 18 chronic pain patients (seven not receiving opioids and 11 receiving opioids). METHODS The thermal grill response was investigated using a custom-built thermal grill. Heat and cold pain thresholds were also determined. RESULTS Chronic pain patients reported less intense pain, heat, and unpleasantness to the thermal grill compared with pain-free participants; in particular, there was an overall main effect for significantly less heat from the thermal grill compared with pain-free participants (P = 0.016). At the 22/38°C combination, although the majority of pain-free participants experienced the illusion to some degree...

Neuro-endocrine function in older men with chronic pain : effects of chronic opioid usage.

Haylock, Clare Louise
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2013
Relevância na Pesquisa
66.3%
Background: There is increasing concern regarding adverse effects of long-term opioid medication use in non-cancer pain. Chronic opioid use has been shown to affect both the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. Hormonal deficiency due to chronic opioid use might contribute to altered pain sensitivity and functional decline. This may be more pronounced in the geriatric population who has poor functional reserve. Methods: A cross sectional study was performed looking at men over the age of 65 years, who have chronic non-malignant pain. Active arm subjects were taking continuous opioid treatment (≥ 4 weeks; dose equivalence ≥ 10mg oral morphine/day); control subjects were not receiving opioid treatment. Assessments included androgen studies (dehdroepiandrosterone sulphate (DHEA-S), testosterone, sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH)), waking salivary cortisol, low dose Synacthen test, neuropsychology testing, experimental cold pressor testing, cortisol testing during cold pressor testing, functional assessments (Instrumental Activities of Daily Living (IADL) Questionnaire, grip strength, and Timed Up and Go), Geriatric Depression Scale (GDS)...

Potential peripheral biomarkers for chronic pain.

Kwok, Yuen Hei
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
66.34%
Chronic pain biomarkers can assist clinicians to diagnose patients, identify underlying mechanisms of disease, reduce the time and cost to reach a decision in early clinical trials and guide personalized pain treatments. Unfortunately, to date, there is no validated biomarker for chronic pain due to the difficulty in accessing the central nervous system. However, emerging literature has consistently provided evidence for the involvement of the immune system to play a substantial role in the modulation of chronic pain. Thus, this thesis examines components of the immune system such as Toll like receptor (TLR) signalling, peripheral immune cells and pro-inflammatory cytokine as an accessible source which may mirror similarities in brain immune cells and capture the changes in chronic pain state. Therefore, the purpose of this thesis was to examine the use of peripheral immune cell reactivity as a potential biomarker for chronic pain. The first study was conducted in heterogeneous chronic pain and pain-free cohorts. Peripheral blood mononuclear cells (PBMCs) were isolated and stimulated with various TLR agonists to generate a pro-inflammatory cytokine interleukin-1β (IL-1β) concentration response curve. Chronic pain patients displayed significantly enhanced expression of IL-1β compared with the pain-free cohort hence the TLR responsiveness demonstrated face validity as a chronic pain biomarker. The second study demonstrated the translatability of the importance of TLR responsiveness in a preclinical neuropathic pain model. IL-1β levels were quantified from basal and TLR2/4 agonist stimulated isolated rat PBMCs and spinal cord tissues...

THE EPIDEMIOLOGY OF CHRONIC PAIN IN CANADA BETWEEN 1994 AND 2008: RESULTS FROM THE NATIONAL POPULATION HEALTH SURVEY AND THE CANADIAN COMMUNITY HEALTH SURVEY

Reitsma, Michelle
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
66.36%
Background: Chronic pain is prevalent worldwide and is estimated to range from 2% to 55% in the general population. There is a limited understanding of the prevalence and incidence of chronic pain in Canada. Furthermore, our understanding of the sociodemographic predictors of chronic pain is limited; thus we are poorly positioned to identify potential populations at risk. Objectives: The primary objectives for this study included: 1) to determine the prevalence and incidence of chronic pain and pain-related interference in Canada over time and, 2) to determine the influence of sociodemographic predictors on the development of chronic pain by sex in the Canadian adult population over 12 years. Methods: Using data from the cross-sectional components of the National Population Health Survey (NPHS) (1994/95, 1996/97, 1998/99) and the Canadian Community Health Survey (2000/01, 2003, 2005, 2007/08), we examined the prevalence and interference of chronic pain. The longitudinal component of the NPHS was used to determine the incidence and sociodemographic predictors of chronic pain. Chronic pain was defined as the presence of “usual pain”. Results: The prevalence in the cross-sectional samples ranged from 15.1% to 18.9%. In the longitudinal sample...

Self-Management of Chronic Pain: Interventions, Strategies, Barriers, and Facilitators

Mann, Elizabeth Gayle
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
66.33%
Background & Purpose: Chronic pain is a prevalent chronic condition for which the best management options rarely provide complete relief. Individuals with chronic pain with neuropathic characteristics (NC) report more severe pain and experience less relief from interventions. Little is known about current self-management practices. The purpose of this dissertation was to inform self-management of chronic pain with and without NC at the individual, health system, and policy levels using the Innovative Care for Chronic Conditions Framework. Methods: The study included a systematic search and review and cross-sectional survey. The review evaluated the evidence for chronic pain self-management interventions and explored the role of health care providers in supporting self-management. The survey was mailed to 8,000 randomly selected Canadians in November 2011, and non-respondents were followed-up in May 2012. Screening questions were included for both chronic pain and NC. The questionnaire captured pain descriptions, self-management strategies, and self-management barriers, and facilitators. Results: Findings of the review suggested that self-management interventions are effective in improving pain and health outcomes. Health care professionals provided self-management advice and referred individuals to self-management interventions. The questionnaire was completed by 1...

Dor crônica em idosos: estudo populacional em uma metrópole da região centro-oeste do Brasil; Chronic pain in the elderly: a study population in a metropolis of the west central region of Brazil

Vasconcelos, Patrícia Pereira de
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG)
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
66.32%
Chronic pain is an unpleasant experience that reaches much of the world's population; however, population studies with the elderly are rare. The aim of this study was to assess chronic pain and self-rated health among community elders. Study population-based cross-sectional, in Goiania, Goias, December/2009 between April 2010 and. For this cut, we excluded those who reached  13 on the MEEM scores, and needed help for the answers. The random sample consisted of 872 participants. Chronic pain was considered as existing for six months or more. Pain intensity was measured by using a numeric scale (0-10: zero=no pain, 1,2,3,4=mild, 5.6=moderate, and strong=7,8,9, and 10=worst pain possible) the location investigated through body diagrams, and self-rated health assessed by the scale of verbal descriptors ("very good", "good," "regular," "bad," "worst"). The project was approved by the CEP/UFG (Protocol 050/2009) and seniors signed the Informed Consent. The data were analyzed using Stata version 8.0 and operated by means of absolute and relative frequency and Confidence Interval (95%). Of the 872 elderly, 460 (52.7%: 95% CI: 49.4% -56.1%) reported chronic pain. By age, the prevalence was 52.4, 53.1 and 53.0%, respectively...

Analyses of the motivation for hydrotherapy in users with chronic pain

Murta, Helena Guerreiro
Fonte: Repositório Científico Lusófona Publicador: Repositório Científico Lusófona
Tipo: Dissertação de Mestrado
ENG
Relevância na Pesquisa
66.29%
A dor crónica (DC) é uma das principais causas de incapacidade. A hidroterapia (HT) e exercício apresentam-se efectivos na diminuição da DC, contudo continuamos a assistir a uma fraca adesão e manutenção aos mesmos. Este trabalho teve como objectivo analisar a associação entre motivação para HT e a DC, função e qualidade de vida, em adultos e idosos, com base na teoria da autodeterminação, efectuando uma revisão sistemática da literatura (RSL) e avaliando a dinâmica motivacional, durante 13 semanas de implementação de um programa de HT. Realizou-se uma RSL, sobre a evidência da HT na DC, com base em estudos do tipo “randomized controlled trials” (RCT`s) e de artigos sobre motivação e / ou adesão para HT, com diversas abordagens metodológicas quantitativas. Posteriormente foi realizado um estudo longitudinal quasi experimental, dum programa de HT, onde participaram 124 adultos e idosos, de ambos os géneros, com DC. A dor, função, qualidade de vida e a motivação para a HT foram auto-reportados, através de questionários, no início e no fim do programa e realizadas entrevistas individuais para avaliar o nível de dor. Na RSL encontrou-se evidência de que a HT e o exercício têm efeitos estatisticamente significativos sobre o alívio da DC e que o exercício e a motivação intrínseca para o exercício são efectivos no alívio da dor...

Supporting chronic pain management across provincial and territorial health systems in Canada: Findings from two stakeholder dialogues

Wilson, Michael G; Lavis, John N; Ellen, Moriah E
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
66.29%
BACKGROUND: Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of health care services by individuals living with it. OBJECTIVE: To summarize the research evidence and elicit health system policymakers’, stakeholders’ and researchers’ tacit knowledge and views about improving chronic pain management in Canada and engaging provincial and territorial health system decision makers in supporting comprehensive chronic pain management in Canada. METHODS: For these two topics, the global and local research evidence regarding each of the two problems were synthesized in evidence briefs. Three options were generated for addressing each problem, and implementation considerations were assessed. A stakeholder dialogue regarding each topic was convened (with 29 participants in total) and the deliberations were synthesized. RESULTS: To inform the first stakeholder dialogue, the authors found that systematic reviews supported the use of evidence-based tools for strengthening chronic pain management, including patient education, self-management supports, interventions to implement guidelines and multidisciplinary approaches to pain management. While research evidence about patient registries/treatment-monitoring systems is limited...