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Long-term maintenance of the analgesic effects of transcranial magnetic stimulation in fibromyalgia

MHALLA, Alaa; BAUDIC, Sophie; ANDRADE, Daniel Ciampi de; GAUTRON, Michele; PERROT, Serge; TEIXEIRA, Manoel Jacobson; ATTAL, Nadine; BOUHASSIRA, Didier
Fonte: ELSEVIER SCIENCE BV Publicador: ELSEVIER SCIENCE BV
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
56.01%
We assessed for the first time the long-term maintenance of repetitive transcranial magnetic stimulation (rTMS)-induced analgesia in patients with chronic widespread pain due to fibromyalgia. Forty consecutive patients were randomly assigned, in a double-blind fashion, to 2 groups: one receiving active rTMS (n = 20) and the other, sham stimulation (n = 20), applied to the left primary motor cortex. The stimulation protocol consisted of 14 sessions: an ""induction phase"" of 5 daily sessions followed by a ""maintenance phase"" of 3 sessions a week apart, 3 sessions a fortnight apart, and 3 sessions a month apart. The primary outcome was average pain intensity over the last 24 hours, measured before each stimulation from day 1 to week 21 and at week 25 (1 month after the last stimulation). Other outcomes measured included quality of life, mood and anxiety, and several parameters of motor cortical excitability. Thirty patients completed the study (14 in the sham stimulation group and 16 in the active stimulation group). Active rTMS significantly reduced pain intensity from day 5 to week 25. These analgesic effects were associated with a long-term improvement in items related to quality of life (including fatigue, morning tiredness, general activity...

Avaliação e mensuração da dor no envelhecimento: instituições de longa permanência; Assessment and measurement of pain in aging: long-term institutions

Pelegrin, Andressa Karina Amaral Plá
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 15/12/2011 PT
Relevância na Pesquisa
66.04%
O envelhecimento é um fenômeno novo e uma tendência mundial. Com ele, há um aumento de doenças e de queixas de dor. Este estudo permitiu que os profissionais de saúde tivessem uma melhor percepção na avaliação da dor no envelhecimento. O objetivo geral foi avaliar os diferentes tipos de dor crônica no envelhecimento. Os objetivos específicos foram mensurar a dor percebida, avaliar os descritores de dor crônica de maior atribuição, identificar diferentes temáticas de dor crônica percebida e avaliar sinais e sintomas de depressão. Foi realizada identificação sócio-demográfica, com perguntas relacionadas ao sexo, à idade, à escolaridade, à religião, ao estado civil, às atividades desenvolvidas na instituição, à situação econômica, ao tempo de institucionalização, ao recebimento de visitas e às doenças diagnosticadas e, posteriormente, foram feitos quatro Experimentos (amostras dependentes). Experimento 1 - Mensurar a dor percebida - a intensidade da dor crônica foi avaliada pelo método psicofísico de estimação de categorias e se percebiam dor no momento da entrevista, para identificar o local, o tempo e o horário. Experimento 2 - Avaliar os descritores de dor crônica de maior atribuição - a intensidade da dor foi avaliada por dois métodos psicofísicos independentes: estimação de categorias e estimação de postos. Experimento 3 - Identificar diferentes temáticas de dor crônica percebida - utilizou-se uma entrevista semiestruturada com sete perguntas relacionadas à dor crônica. Experimento 4 - Avaliar sinais e sintomas de depressão - utilizou-se a Escala de Depressão Geriátrica de 15 pontos. Participaram 46 idosos residentes em duas Instituições de Longa Permanência em Ribeirão Preto...

Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs

Luna, Stelio P.L.; Basílio, Ana C.; Steagall, Paulo V.M.; Machado, Luciana P.; Moutinho, Flávia Q.; Takahira, Regina K.; Brandão, Cláudia V.S.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 258-264
ENG
Relevância na Pesquisa
65.87%
Objective - To evaluate adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. Animals - 36 adult dogs. Procedures - Values for CBC, urinalysis, serum biochemical urinalyses, and occult blood in feces were investigated before and 7, 30, 60, and 90 days after daily oral administration (n = 6 dogs/group) of lactose (1 mg/kg, control treatment), etodolac (15 mg/kg), meloxicam (0.1 mg/kg), carprofen (4 mg/kg), and ketoprofen (2 mg/kg for 4 days, followed by 1 mg/kg daily thereafter) or flunixin (1 mg/kg for 3 days, with 4-day intervals). Gastroscopy was performed before and after the end of treatment. Results - For serum γ-glutamyltransferase activity, values were significantly increased at day 30 in dogs treated with lactose, etodolac, and meloxicam within groups. Bleeding time was significantly increased in dogs treated with carprofen at 30 and 90 days, compared with baseline. At 7 days, bleeding time was significantly longer in dogs treated with meloxicam, ketoprofen, and flunixin, compared with control dogs. Clotting time increased significantly in all groups except those treated with etodolac. At day 90, clotting time was significantly shorter in flunixin-treated dogs...

Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy

Romero, Flávio Ramalho; Vital, Roberto Bezerra; Zanini, Marco Antônio; Ducati, Luis Gustavo; Gabarra, Roberto Colichio
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: 476-479
ENG
Relevância na Pesquisa
66.04%
Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain. Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months. Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC). Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001). Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively. Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.; A Sacroileíte pode ser responsável por até 40% dos casos de dor lombar crônica. Objetivo Análise da eficácia da denervação por radiofrequência na articulação sacro-ilíaca em seis, doze e dezoito meses. Método Trinta e dois pacientes com diagnóstico de sacroileíte foram incluídos em estudo prospectivo. O prognóstico primário foi avaliado pela escala visual analógico (NRS). O prognóstico secundário foi avaliado pela escala de impressão global de mudança pelo paciente (PGIC). Resultados Melhora a curto prazo da dor foi observada...

Pain evaluation and control after routine interventions in cattle

Stilwell, George Thomas
Fonte: Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária Publicador: Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária
Tipo: Tese de Doutorado
Publicado em 21/09/2009 ENG
Relevância na Pesquisa
55.89%
Tese de Doutoramento em Ciências Veterinária; Disbudding and castration are two routine interventions in cattle practice. Both can cause severe pain and cause poor welfare. Through plasma cortisol levels and behaviour evaluation we measured pain caused by different disbudding and castration methods. We also studied the efficacy of several anaesthesia and analgesia protocols. The main conclusions are: - Cortisol together with behaviour assessment is very useful in detecting calves in pain. - Certain behaviours are only shown by very young calves. - Vocalization should not be used as a sign of pain in calves. - Scoop disbudding causes long term pain and local anaesthesia is not efficient. - Hot-iron disbudding causes severe pain during the procedure but does not differ from paste disbudding in the next hours. Local anaesthesia plus analgesia does reduce pain cause by these methods. - Xylazine causes an increase in cortisol even if pain is not induced. - Pain caused by clamp-castration lasts for at least 48 hours and is only controlled by long acting analgesics. - Surgical castration causes intense pain but shorter if two incisions are made instead of just one.; RESUMO - Avaliação e controlo da dor causada por intervenções de rotina em bovinos - A descorna e a castração de bovinos jovens são duas intervenções de rotina nas explorações. Ambas intervenções têm o potencial de causar dor e...

Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation?

Almeida,Daniel Benzecry; Poletto,Paola Hesse; Milano,Jerônimo Buzetti; Leal,André Giacomelli; Ramina,Ricardo
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2007 EN
Relevância na Pesquisa
55.91%
Lumbar disc herniation (LDH) is a common cause of back and sciatic pain. When clinical treatment fails, surgery may be indicated in selected patients. Although surgery is effective in most cases, some of these patients may have a poor outcome. Different factors may influence these results and poor adaptation at work is one well-known cause of treatment failure. This study examines 350 patients on long-term follow-up after surgery for first-time LDH. The relationship was analyzed between occupation before surgery and outcome (maintenance of lumbar and leg pain, satisfaction with the surgical treatment and return to work). The preoperative occupation (employed in public or private services, autonomous, unemployed, housewife, retired or student) and the exertion at work were analyzed as prognostic factors for different clinical outcomes. Although unemployed people had higher numerical analog scale for lumbar pain and retired patients had a higher leg pain, this difference was not statistically significant. Retired people were significantly less satisfied with the surgical result. Higher exertion at work showed a statistically insignificant higher level of pain and lower degree of satisfaction. The authors conclude that preoperative occupation was not a statistically significant factor in this series of patients.

Evaluation and measurement of pain in the aging process

Pelegrin,Andressa K.A.P.; Siqueira,Hilze B.O. Moura; Garbi,Márcia O.S.S.; Saltareli,Simone; Sousa,Fátima Faleiros
Fonte: Pontificia Universidade Católica do Rio de Janeiro; Universidade de Brasília; Universidade de São Paulo Publicador: Pontificia Universidade Católica do Rio de Janeiro; Universidade de Brasília; Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
56.03%
The purpose of the present study was to evaluate pain in the aging process in long-term care institutions. The study included 46 elderly subjects of both genders and with chronic pain. Descriptors of chronic pain were analyzed using psychophysical category estimation methods, and the thematic content of semi-structured interviews was analyzed. Chronic pain was perceived in 33.33% of the elderly subjects. For the descriptors of pain, the results showed higher scores for "painful." In the interview, the thematic units were time, start of symptoms, coping, pain-related causes, current situation, and other perceptions about pain. Pain was related to physical, emotional, and cognitive factors. The present results shed light on "pain" and "aging" phenomena and may contribute to improving the management of pain symptoms in long-term institution residents.

Risk Factors for Long-term Pain After Hernia Surgery

Fränneby, Ulf; Sandblom, Gabriel; Nordin, Pär; Nyrén, Olof; Gunnarsson, Ulf
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/2006 EN
Relevância na Pesquisa
65.9%
Thirty-one percent of 2853 patients, who answered a postal questionnaire 2 to 3 years after inguinal hernia surgery, still had pain in the operated groin. Six percent had pain of such severity that it interfered with daily activities. Young age, preoperative pain level above average, postoperative complications, and anterior approach independently predicted long-term pain.

Long-term control of neuropathic pain in a non-viral gene therapy paradigm

Sloane, EM; Soderquist, RG; Maier, SF; Mahoney, MJ; Watkins, LR; Milligan, ED
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.06%
Traditional approaches to treating chronic neuropathic pain largely focus on manipulations directly altering neuronal activity or neuron-to-neuron communication. Recently, however, it has become clear that glial cells (including microglia and astroglia) play a significant role in pain expression in a variety of neuropathic pain models. Multiple aspects of the inflammatory response of glial cells, commonly observed in neuropathic pain conditions, have been implicated in pain expression. Thus, glial cell inflammation has emerged as a potential therapeutic target in neuropathic pain. Our laboratory has been exploring the use of an anti-inflammatory cytokine, interleukin-10 (IL-10), to control glial inflammatory activation thereby controlling neuropathic pain. IL-10 protein delivery is limited by a short half-life and an inability to cross into the central nervous system from the periphery, making a centrally delivered gene therapy approach attractive. We have recently characterized a non-viral gene therapy approach using two injections of naked DNA to achieve long-term (>3 months) control of neuropathic pain in a peripheral nerve injury model. Timing and dose requirements leading to long-term pain control are discussed in this review...

Bone Marrow Stromal Cells Produce Long-Term Pain Relief in Rat Models of Persistent Pain

Guo, Wei; Wang, Hu; Zou, Shiping; Gu, Ming; Watanabe, Mineo; Wei, Feng; Dubner, Ronald; Huang, George T.-J.; Ren, Ke
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/2011 EN
Relevância na Pesquisa
55.92%
Chronic pain conditions are difficult to treat and are major health problems. Bone marrow stromal cells (BMSCs) have generated considerable interest as a candidate for cell-based therapy. BMSCs are readily accessible and are easy to isolate and expand ex vivo. Clinical studies show that direct injection of BMSCs does not produce unwanted side effects and is well tolerated and safe. Here, we show that a single systemic (intravenous) or local injection (into the lesion site) of rat primary BMSCs reversed pain hypersensitivity in rats after injury and that the effect lasted until the conclusion of the study at 22 weeks. The pain hypersensitivity was rekindled by naloxone hydrochloride, an opioid receptor antagonist that acts peripherally and centrally, when tested at 1–5 weeks after BMSC infusion. In contrast, naloxone methiodide, a peripherally acting opioid receptor antagonist, only rekindled hyperalgesia in the first 3 weeks of BMSC treatment. Focal downregulation of brainstem mu opioid receptors by RNA interference (RNAi) reversed the effect of BMSCs, when RNAi was introduced at 5- but not 1-week after BMSC transplantation. Thus, BMSCs produced long-term relief of pain and this effect involved activation of peripheral and central opioid receptors in distinct time domains. The findings prompt studies to elucidate the cellular mechanisms of the BMSC-induced pain relieving effect and translate these observations into clinical settings.

Neonatal Pain in Very Preterm Infants: Long-Term Effects on Brain, Neurodevelopment and Pain Reactivity

Grunau, Ruth Eckstein
Fonte: Rambam Health Care Campus Publicador: Rambam Health Care Campus
Tipo: Artigo de Revista Científica
Publicado em 29/10/2013 EN
Relevância na Pesquisa
56.05%
Effects of early life psychosocial adversity have received a great deal of attention, such as maternal separation in experimental animal models and abuse/neglect in young humans. More recently, long-term effects of the physical stress of repetitive procedural pain have begun to be addressed in infants hospitalized in neonatal intensive care. Preterm infants are more sensitive to pain and stress, which cannot be distinguished in neonates. The focus of this review is clinical studies of long-term effects of repeated procedural pain-related stress in the neonatal intensive care unit (NICU) in relation to brain development, neurodevelopment, programming of stress systems, and later pain sensitivity in infants born very preterm (24–32 weeks’ gestational age). Neonatal pain exposure has been quantified as the number of invasive and/or skin-breaking procedures during hospitalization in the NICU. Emerging studies provide convincing clinical evidence for an adverse impact of neonatal pain/stress in infants at a time of physiological immaturity, rapidly developing brain microstructure and networks, as well as programming of the hypothalamic-pituitary-adrenal axis. Currently it appears that early pain/stress may influence the developing brain and thereby neurodevelopment and stress-sensitive behaviors...

Pain in long-term breast cancer survivors: The role of body mass index, physical activity, and sedentary behavior

Forsythe, Laura P; Alfano, Catherine M; George, Stephanie M; McTiernan, Anne; Baumgartner, Kathy B; Bernstein, Leslie; Ballard-Barbash, Rachel
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.06%
Although pain is common among post-treatment breast cancer survivors, studies that are longitudinal, identify a case definition of clinically meaningful pain, or examine factors contributing to pain in survivors are limited. This study describes longitudinal patterns of pain in long-term breast cancer survivors, evaluating associations of body mass index [BMI], physical activity, sedentary behavior with mean pain severity and above-average pain. Women newly diagnosed with stages 0–IIIA breast cancer (N=1183) were assessed, on average, 6 months (demographic/clinical characteristics), 30 months (demographics), 40 months (demographics, pain), 5 years (BMI, physical activity, and sedentary behavior) and 10 years (demographics, pain, BMI, physical activity, and sedentary behavior) post-diagnosis. This analysis includes survivors who completed pain assessments 40 months post-diagnosis (N=801), 10 years post-diagnosis (N=563), or both (N=522). Above-average pain was defined by SF-36 bodily pain scores ≥1/2 standard deviation worse than age-specific population norms. We used multiple regression models to test unique associations of BMI, physical activity, and sedentary behavior with pain adjusting for demographic and clinical factors. The proportion of survivors reporting above-average pain was higher at 10 years than at 40 months (32.3% vs. 27.8%...

A 3-month Follow-up Study of the Long-term Effects of Direct Stretching of the Tensor Fasciae Latae Muscle in Patients with Acute Lumbago Using a Single-case Design

Ohtsuki, Keisuke
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
55.88%
[Purpose] A 3-month follow-up study was conducted on a patient diagnosed with acute nonspecfic lumbago. Direct stretching (DS) of the tensor fasciae latae muscle (TFLM) was performed, and an immediate effect was confirmed. [Subjects] The case subject was a 60-year-old woman diagnosed with acute nonspecific lumbago. [Methods] We used a single-case study design and an AB-type study structure, in which the leg was placed in positions that relieved the back pain in period A and DS of the TFLM was performed in period B. The evaluation indices were the visual analog scale (VAS), finger-to-floor distance (FFD), and posterior lumbar flexibility (PLF), which were analyzed using the binomial test. [Results] The VAS, FFD, and PLF in period B showed significant improvement when compared with period A. Additionally, complaints of lower back pain ceased after 2 weeks, and the results of the follow-up study showed no recurrence of back pain during the 3 months. [Conclusion] The results of this study suggest that DS of the TFLM has an immediate effect on acute nonspecific lumbago in addition to long-term pain relief effects.

The Long-Term Safety and Efficacy of Intrathecal Therapy Using Sufentanil in Chronic Intractable Non-Malignant Pain

Monsivais, Jose Jesus; Monsivais, Diane Burn
Fonte: The Korean Pain Society Publicador: The Korean Pain Society
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
55.93%
This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety?

Kissin, Igor
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
56.01%
Background: For the past 30 years, opioids have been used to treat chronic nonmalignant pain. This study tests the following hypotheses: (1) there is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective; and (2) the main problem associated with the safety of such treatment – assessment of the risk of addiction – has been neglected. Methods: Scientometric analysis of the articles representing clinical research in this area was performed to assess (1) the quality of presented evidence (type of study); and (2) the duration of the treatment phase. The sufficiency of representation of addiction was assessed by counting the number of articles that represent (1) editorials; (2) articles in the top specialty journals; and (3) articles with titles clearly indicating that the addiction-related safety is involved (topic-in-title articles). Results: Not a single randomized controlled trial with opioid treatment lasting >3 months was found. All studies with a duration of opioid treatment ≥6 months (n = 16) were conducted without a proper control group. Such studies cannot provide the consistent good-quality evidence necessary for a strong clinical recommendation. There were profound differences in the number of addiction articles related specifically to chronic nonmalignant pain patients and to opioid addiction in general. An inadequate number of chronic pain-related publications were observed with all three types of counted articles: editorials...

Autoavaliação de saúde, capacidade funcional e perfil demográfico, socioeconômico e clínico entre residentes em Instituições de Longa Permanência para Idosos; Self-assessed health, functional capacity and demographic, socioeconomic and clinical profile of residents in Long-Term Care Institutions for the Elderly

Alves, Denise Pinheiro Marques
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
66.04%
Elderly living in Long-Term Care Institutions for the Elderly (LTCI) live with chronic illnesses and pain, which start/intensify disabilities, hamper the maintenance of daily activities and generative negative perceived health conditions. The study objectives were to analyze the demographic, socioeconomic and health conditions profile of elderly living in LTCI; to estimate the prevalence of disability in basic activities of daily living (BADL) and negative self-assessed health and associated factors. Cross-sectional, analytic study, undertaken between May and August 2012, involving 159 elderly living in LTCI, in the house-home and comprehensive care modalities. The target population in this study included elderly without a severe cognitive deficit (scores ≥13 on the Folstein Mini-Mental State Examination, Folstein Mchugh (1975), who lived in the seven participating LTCI (n=246), three of which were of the house-home and four of the comprehensive care type. The outcome variables were functional disability (assessed through the Katz Index) and negative self-assessed health (bad/vary bad). Depression symptoms were assessed by means of the thirty-point Geriatric Depression Scale and pain intensity through the verbal descriptors scale. The prevalence rates were presented with the respective confidence interval (95%CI). For analysis...

Pleasure into pain: the consequences of long-term opioid use

White, J.
Fonte: Pergamon-Elsevier Science Ltd Publicador: Pergamon-Elsevier Science Ltd
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
55.94%
One consequence of repeated drug administration is the development of adaptations in the nervous system, sometimes termed ‘drug-opposite’ responses. During administration, the effects of the drug are diminished by these adaptations (tolerance), while cessation of drug use results in the emergence of these drug-opposite responses as the withdrawal syndrome. Recent evidence on pain responses challenges this simple notion of withdrawal and suggests that aversive drug-opposite states may play a more important role in drug dependence than previously thought. While opioids such as heroin produce analgesia, people with a history of opioid self-administration are hypersensitive to certain kinds of pain during the time they are under the influence of the analgesic drug. This suggests that in pain systems, the drug-opposite response exceeds the pain inhibiting effect of the drug itself. This hyperalgesia is evident in people with a history of heroin use and is not modified by methadone or buprenorphine treatment but is reduced by long-term abstinence from opioids. This same pattern of the drug-opposite response exceeding the drug effect may also occur for mood. While opioids cause elevation of mood, commonly described as euphoria and reduction of emotional distress...

Langzeitergebnisse nach Harrington-Operation. Funktionelle und radiometrische Untersuchung.; Long-term results after Harrington instrumentation - a functional und radiometric analysis.

Grieb, Sarah Friederike
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
66.09%
37 nach Harrington operierte Patienten mit idiopathischer Skoliose wurden in einer retrospektiven Studie mit einem Nachbeobachtungszeitraum von durchschnittlich 22,6 Jahren (11-30 Jahre) auf Rückenschmerzen, Zufriedenheit mit dem Operationsergebnis und radiometrische Veränderungen nachuntersucht. 6 Patienten waren männlichen und 31 weiblichen Geschlechts. Es erfolgte eine funktionelle Auswertung des Operationsergebnisses anhand von drei standardisierten Fragebögen (Visuelle Analog-Skala (VAS), Oswestry-Score (ODS); Roland-Morris Questionnaire (RMQ)), sowie anhand eines klinikeigenen Fragebogens zur Erfassung der Zufriedenheit und der Beurteilung der Operation aus heutiger Sicht durch die Patienten. Zusätzlich erfolgte neben der klinischen Untersuchung die radiometrische Analyse der Wirbelsäulen-Ganzaufnahmen. Auf der Visuellen Analog-Skala gaben die Patienten für das aktuelle Ausmaß ihrer Schmerzen als durchschnittlichen Wert 1,7 an (0-5). Beim Oswestry-Score ergab sich ein durchschnittlichen Ergebnis von 11,2% (0-48%). Am häufigsten zeigten sich Beeinträchtigungen bei den Kategorien Gewichte heben (bei 59% der Patienten), Stehen (51%) und soziale Stellung (43%). Im Roland-Morris-Questionnaire zeigte sich ein mittlerer Wert von 3...

Funktionelle Langzeitergebnisse von Beckenringfrakturen unter besonderer Berücksichtigung der Instabilität des hinteren Beckenrings; Behandlungsmethoden und Ergebnisse der Jahrgänge 1990-2002; Functional long-term outcome of pelvic ring fractures with special consideration of instability of the posterior pelvic ring; Methods of treatment and outcome from 1990 to 2002

Landaverde Mendizabal, Elena
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
65.98%
In der vorliegenden Studie wurden mittel- bis langfristige klinische sowie radiologische Ergebnisse nach instabilen Beckenringfrakturen erfasst. Hierzu wurden umfassende Daten von 123 Patienten erhoben, die sich im Zeitraum zwischen 1990 und 2002 mit Beckenringfrakturen vom Typ B oder C in der BG-Unfallklinik in Tübingen in Behandlung befunden hatten. Der klinisch-radiologische Langzeitverlauf konnte bei einem repräsentativen Kollektiv von insgesamt 71 (58%) dieser Patienten analysiert werden. Die Mindestnachbeobachtungszeit betrug dabei 5 Jahre. Das Durchschnittsalter unseres Patientenkollektivs zum Unfallzeitpunkt lag bei 37 Jahren, wobei 66% der Patienten männlich waren. Unfallursache war meist der Verkehrsunfall. Daher traten die betrachteten Beckenringfrakturen in der Mehrzahl der Fälle (87%) im Rahmen von Mehrfach- oder Polytraumata auf. Die Gesamtletalität lag bei 5%. Mit 77% am häufigsten lagen Typ C Frakturen vor, während Typ B Frakturen nur 23% ausmachten. Die Therapie war meist (56%) operativ. Am häufigsten kam in der später nachuntersuchten Patientengruppe hierbei am vorderen wie auch am hinteren Beckenring die Plattenosteosynthese zum Einsatz. Postoperativ wurden dann bei 71% unserer Patienten exzellente bzw. gute Repositionsergebnisse nach Matta und Tornetta verzeichnet. Dieser Anteil stieg im Langzeitverlauf auf 87% an. Die Beurteilung des Gesundheitszustands sowie der Lebensqualität unserer Patienten im Langzeitverlauf erfolgte mit Hilfe diverser Fragebögen und der klinischen Nachuntersuchung. Verbleibende Schmerzen im Bereich des Beckens gaben hierbei 55% unserer Patienten an. Dieser wurde von 30% als stark...

Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy

Romero,Flávio Ramalho; Vital,Roberto Bezerra; Zanini,Marco Antônio; Ducati,Luis Gustavo; Gabarra,Roberto Colichio
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
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66.04%
Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain.Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months.Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC).Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001). Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively.Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.