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1

The relationship of experimental pain tolerance to pain threshold  

Microsoft Academic Search

This study examined the effects resulting from an application of the more permissive instructions of Clark and Bindra to the technique of Gelfand et al., and compared the findings to those of Gelfand. The hypotheses tested were: no significant difference between groups for pain threshold; pain tolerance is significantly lower when instructions are more permissive; regardless of instructions, the correlation

Sidney Gelfand

1964-01-01

2

Spontaneous pain, pain threshold, and pain tolerance in Parkinson’s disease  

Microsoft Academic Search

The mechanisms underlying pain in Parkinson’s disease (PD) are unclear. Although a few studies have reported that PD patients\\u000a may have low pain threshold and tolerance, none could accurately assess whether there was a correlation between sensory thresholds\\u000a and demographic\\/clinical features of PD patients. Thus, tactile threshold, pain threshold, and pain tolerance to electrical\\u000a stimuli in the hands and feet

Sandro Zambito Marsala; Michele Tinazzi; Roberta Vitaliani; Serena Recchia; Federico Fabris; Corrado Marchini; Antonio Fiaschi; Giuseppe Moretto; Bruno Giometto; Antonella Macerollo; Giovanni Defazio

2011-01-01

3

Thresholds and tolerance of physical pain among young adults who self-injure  

PubMed Central

Prevalence rates of nonsuicidal self-injury among college students range from 17% to 38%. Research indicates that individuals with borderline personality disorder who self-injure sometimes report an absence of pain during self-injury. Furthermore, self-injury in the absence of pain has been associated with more frequent suicide attempts. The present study examined pain thresholds and tolerance among 44 college students (11 who engaged in self-injury and 33 who did not). Pain thresholds and tolerance were measured using an algometer pressure device that was used to produce pain in previous laboratory research. Participants who engaged in self-injury had a higher pain tolerance than those who did not. In addition, participants who engaged in self-injury rated the pain as less intense than participants who did not. ANCOVAs revealed that depression was associated with pain rating and pain tolerance. PMID:21165371

McCoy, Katrina; Fremouw, William; McNeil, Daniel W

2010-01-01

4

Alone but Feeling No Pain: Effects of Social Exclusion on Physical Pain Tolerance and Pain Threshold, Affective Forecasting, and Interpersonal Empathy  

Microsoft Academic Search

Prior findings of emotional numbness (rather than distress) among socially excluded persons led the authors to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1–4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional

C. Nathan DeWall; Roy F. Baumeister

2006-01-01

5

Effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester.  

PubMed Central

The effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester was evaluated. Subjects (n = 120) were randomly assigned to one of four experimental groups (baseline, placebo, square wave, and postsynaptic wave). Symptom-free right-sided maxillary incisor teeth were tested for anesthesia with an electric pulp tester. Electrostimulation significantly increased the pain perception threshold and pain tolerance level with both the square wave and postsynaptic wave. The postsynaptic wave was more effective than the square wave. Presented at the Satellite Symposium on Advances in the Management of Acute and Chronic Facial Pain associated with the 6th World Congress on Pain, Melbourne, Australia, 1990. Images Figure 1 PMID:1811428

Gerschman, J. A.; Giebartowski, J.

1991-01-01

6

Effects of stress on pain threshold and tolerance in children with recurrent abdominal pain  

Microsoft Academic Search

Models of stress-induced hyperalgesia state that exposure to stress can exaggerate subsequent pain experiences. Studies using both animal and human subjects have shown evidence for hyperalgesia as a function of stress [e.g., Jorum E. Analgesia or hyperalgesia following stress correlates with emotional behavior in rats. Pain 1988;32:341–48; Peckerman A, Hurwitz BE, Saab PG, Llabre MM, McCabe PM, Schneiderman N. Stimulus

Lynette M. Dufton; Brian Konik; Richard Colletti; Catherine Stanger; Margaret Boyer; Sara Morrow; Bruce E. Compas

2008-01-01

7

Effect of GaAs Laser at 904 nm in the Pain Threshold in Tibia and Tolerance in Deltoid Evaluated by Pressure Algometry  

NASA Astrophysics Data System (ADS)

The use of LLLT in pain relief is a controversial issue in Physiotherapy, with the efficacy of LLLT associated to pain relief still requiring significant study. Objective. This work focuses on the evaluation of the effect of low power GaAs laser at 904 nm in pressure pain threshold and tolerance in tibia and deltoid muscle, respectively. A total of 17 subjects were divided in two groups: active and sham laser. Measurements were taken before and after laser irradiation in healthy individuals using a pressure algometry, first verifying the viability of algometry to evaluate the pain threshold and tolerance inter individuals and comparing the differences of right and left sides in the same patients, and finally evaluating the pain threshold and tolerance before and after a single laser application. Laser energy density was of 4.0 J/cm2 with power density of 137 mW/cm2. Comparing algometry values of active laser group and the sham group, the pain tolerance in the deltoid muscle did not change among groups after laser irradiation, while it was also encountered a statistically significant difference in the pain threshold in tibia when comparing the laser active and sham laser (p<0.05). It was found that the active laser was effective in maintaining the pain threshold in tibia. The effective laser action in raising the pain threshold in tibia upon healthy individuals can suggest that the laser could be applied not only as curative but also with preventive purpose.

Soares, Luiz G. P.; Sato, Sidney K.; Silveira, Landulfo; Aimbire, Flávio; Moreira, Leonardo M.; Pinheiro, Antônio L. B.

2011-08-01

8

Use of pain threshold reports to satisfy social needs  

PubMed Central

OBJECTIVE: To examine the hypothesis that experimental threats to social belongingness, interacting with individual differences in attachment security, cause modification of pain threshold reports by individuals who report high pain thresholds at baseline. METHODS: In each of three studies, baseline pain threshold and tolerance were assessed in response to a pain task (cold pressor pain in Studies 1 and 2, finger pressure pain in Study 3). Participants then completed a measure of attachment security and were randomly assigned to a social exclusion or control condition (exclusion from a computer game in Study 1, recalling past rejection experiences in Studies 2 and 3). The pain task was administered again to examine the effects on pain threshold and tolerance. RESULTS: Those with high anxious attachment and high baseline pain thresholds reported higher postmanipulation pain thresholds in the exclusion conditions than in the control conditions. Those with low anxious attachment and high baseline pain thresholds reported lower postmanipulation pain thresholds in the exclusion conditions than in the control conditions. No differences were found for pain tolerance. CONCLUSIONS: Across studies, results suggested that postmanipulation pain threshold reports of individuals with high baseline pain thresholds were particularly responsive to social exclusion. The form of the response was dependent on the level of anxious attachment. The present studies provide evidence that variance in pain threshold reports not accounted for by pain intensity may reflect the use of pain reports to satisfy social needs. This work also suggests that baseline measures of pain thresholds may, in interaction with psychological variables, have predictive power beyond serving as a control variable. PMID:18719713

MacDonald, Geoff

2008-01-01

9

Experimental changes in pain threshold and severe pain threshold for electrically induced pain.  

PubMed

Pain and severe pain thresholds were measured in groups of 15 (Experiment 1) and 20 (Experiment 2) normal volunteers. In Experiment 1, the subjects underwent a series of ten constant level, painful stimuli each of 10 sec duration at an arbitrarily chosen level between the thresholds. This level was recorded. It ranged from 14% to 81% of the difference between thresholds. The thresholds were then remeasured. For the second experiment the experimental stimulus commenced at a non-painful level and increased over a period of 5 sec to a level midway between thresholds for a series of three stimuli and again thresholds were remeasured. An overall effect was demonstrable only in Experiment 2, where the severe pain threshold was significantly reduced (p less than 0.001). There was a marked individual variation with increases and decreases in both thresholds occurring in different individuals at significance levels varying from p less than 0.05 to p less than 0.001. No subject changed the two thresholds in opposite directions. Examination of the responses in Experiment 1 suggested that for any increase in either threshold to occur it was necessary that the repeated painful stimulus should be at a level below the mid-point between the two thresholds, but that this was not a sufficient condition. PMID:2313617

Collier, J L; Mehta, B M; Spear, F G

1990-01-01

10

Pain tolerance in upper limb disorders: findings from a community survey  

PubMed Central

Aims: To test the hypothesis that non-specific upper limb pain arises from altered pain perception with reduced tolerance of sensory stimuli. Methods: Subjects undergoing clinical examination as part of a community based survey of upper limb disorders were invited to return for an assessment of pain tolerance. A standardised algorithm was used to classify the 94 participants according to whether they had specific upper limb disorders (n = 22), non-specific arm pain (n = 15), or no arm pain (n = 57). Pain tolerance was assessed at three anatomical sites in each arm in response to electrocutaneous stimulation with alternating currents up to a maximum of 10 mA at three frequencies (5, 250, and 2000 Hz). A proportional odds model was used to compare pain tolerance thresholds according to sex, age, and diagnosis. Results: Women were less tolerant of pain than men (OR 0.13) and tolerance also declined with age (OR for one year increase in age 0.97). After allowance for sex and age, there was no indication that pain tolerance was lower in subjects with non-specific arm pain than in those with specific upper limb disorders or those who had no arm pain. Conclusions: The study hypothesis was not supported. However, before the hypothesis is dismissed, it should be tested further in patients with more severe and disabling arm pain. PMID:12598671

Mitchell, S; Reading, I; Walker-Bone, K; Palmer, K; Cooper, C; Coggon, D

2003-01-01

11

THE EFFECTS OF SLEEP DEPRIVATION AND SLEEP RECOVERY ON PAIN THRESHOLDS OF RATS WITH CHRONIC PAIN  

Microsoft Academic Search

Background and objective: The aim of this study was to compare the effects of different paradoxical sleep deprivation methods on the pain threshold in rats submitted to inflammatory and neuropathic pain models. We also investigated whether changes in pain threshold could be reverted by sleep recovery period. Methods: Wistar rats were randomly assigned in arthritis-induced by adjuvant (AIA), chronic constrictive

Monica Levy Andersen; Regiane Kawakami; Sergio Tufik

12

Fault-Tolerant Thresholds for Encoded Ancillae with Homogeneous Errors  

E-print Network

I describe a procedure for calculating thresholds for quantum computation as a function of error model given the availability of ancillae prepared in logical states with independent, identically distributed errors. The thresholds are determined via a simple counting argument performed on a single qubit of an infinitely large CSS code. I give concrete examples of thresholds thus achievable for both Steane and Knill style fault-tolerant implementations and investigate their relation to threshold estimates in the literature.

Bryan Eastin

2006-05-22

13

Genetic variance of tolerance and the toxicant threshold model.  

PubMed

A statistical genetics method is presented for estimating the genetic variance (heritability) of tolerance to pollutants on the basis of a standard acute toxicity test conducted on several isofemale lines of cladoceran species. To analyze the genetic variance of tolerance in the case when the response is measured as a few discrete states (quantal endpoints), the authors attempted to apply the threshold character model in quantitative genetics to the threshold model separately developed in ecotoxicology. The integrated threshold model (toxicant threshold model) assumes that the response of a particular individual occurs at a threshold toxicant concentration and that the individual tolerance characterized by the individual's threshold value is determined by genetic and environmental factors. As a case study, the heritability of tolerance to p-nonylphenol in the cladoceran species Daphnia galeata was estimated by using the maximum likelihood method and nested analysis of variance (ANOVA). Broad-sense heritability was estimated to be 0.199?±?0.112 by the maximum likelihood method and 0.184?±?0.089 by ANOVA; both results implied that the species examined had the potential to acquire tolerance to this substance by evolutionary change. PMID:22278917

Tanaka, Yoshinari; Mano, Hiroyuki; Tatsuta, Haruki

2012-04-01

14

Modification of Electrical Pain Threshold by Voluntary Breathing-Controlled Electrical Stimulation (BreEStim) in Healthy Subjects  

PubMed Central

Background Pain has a distinct sensory and affective (i.e., unpleasantness) component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of post-amputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli. Methods Eleven pain-free healthy subjects (7 males, 4 females) participated in the study. All subjects received BreEStim (100 stimuli) and conventional electrical stimulation (EStim, 100 stimuli) to two acupuncture points (Neiguan and Weiguan) of the dominant hand in a random order. The two different treatments were provided at least three days apart. Painful, but tolerable electrical stimuli were delivered randomly during EStim, but were triggered by effortful inhalation during BreEStim. Measurements of tactile sensation threshold, electrical sensation and electrical pain thresholds, thermal (cold sensation, warm sensation, cold pain and heat pain) thresholds were recorded from the thenar eminence of both hands. These measurements were taken pre-intervention and 10?min post-intervention. Results There was no difference in the pre-intervention baseline measurement of all thresholds between BreEStim and EStim. The electrical pain threshold significantly increased after BreEStim (27.5±6.7% for the dominant hand and 28.5±10.8% for the non-dominant hand, respectively). The electrical pain threshold significantly decreased after EStim (9.1±2.8% for the dominant hand and 10.2±4.6% for the non–dominant hand, respectively) (F[1, 10]?=?30.992, p?=?.00024). There was no statistically significant change in other thresholds after BreEStim and EStim. The intensity of electrical stimuli was progressively increased, but no difference was found between BreEStim and EStim. Conclusion Voluntary breathing controlled electrical stimulation selectively increases electrical pain threshold, while conventional electrical stimulation selectively decreases electrical pain threshold. This may translate into improved pain control. PMID:23894632

Li, Shengai; Berliner, Jeffrey C.; Melton, Danielle H.; Li, Sheng

2013-01-01

15

Intrarater Reliability of Pain Intensity, Tissue Blood Flow, Thermal Pain Threshold, Pressure Pain Threshold and Lumbo-Pelvic Stability Tests in Subjects with Low Back Pain  

PubMed Central

Purpose This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain. Methods Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen's Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P>0.05). Results ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level. Conclusions It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error. PMID:22461960

Paungmali, Aatit; Sitilertpisan, Patraporn; Taneyhill, Khanittha; Pirunsan, Ubon; Uthaikhup, Sureeporn

2012-01-01

16

Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation  

Microsoft Academic Search

It is not known whether or not muscle spasm of the back muscles presented in patients with sciatic scoliosis caused by lumbar disc herniation produces muscle pain and\\/or tenderness. Pressure pain thresholds (PPTs) of the lower back and low-back pain were examined in 52 patients (13 of 52 presenting sciatic scoliosis) with lumbar disc herniation who complained of radicular pain

Jiro Hirayama; Masatsune Yamagata; Satoshi Ogata; Koh Shimizu; Yoshikazu Ikeda; Kazuhisa Takahashi

2006-01-01

17

Rowers' high: behavioural synchrony is correlated with elevated pain thresholds  

PubMed Central

Physical exercise is known to stimulate the release of endorphins, creating a mild sense of euphoria that has rewarding properties. Using pain tolerance (a conventional non-invasive assay for endorphin release), we show that synchronized training in a college rowing crew creates a heightened endorphin surge compared with a similar training regime carried out alone. This heightened effect from synchronized activity may explain the sense of euphoria experienced during other social activities (such as laughter, music-making and dancing) that are involved in social bonding in humans and possibly other vertebrates. PMID:19755532

Cohen, Emma E. A.; Ejsmond-Frey, Robin; Knight, Nicola; Dunbar, R. I. M.

2010-01-01

18

Fault-tolerant adaptive FIR filters using variable detection threshold  

NASA Astrophysics Data System (ADS)

Adaptive filters are widely used in many digital signal processing applications, where tap weight of the filters are adjusted by stochastic gradient search methods. Block adaptive filtering techniques, such as block least mean square and block conjugate gradient algorithm, were developed to speed up the convergence as well as improve the tracking capability which are two important factors in designing real-time adaptive filter systems. Even though algorithm-based fault tolerance can be used as a low-cost high level fault-tolerant technique to protect the aforementioned systems from hardware failures with minimal hardware overhead, the issue of choosing a good detection threshold remains a challenging problem. First of all, the systems usually only have limited computational resources, i.e., concurrent error detection and correction is not feasible. Secondly, any prior knowledge of input data is very difficult to get in practical settings. We propose a checksum-based fault detection scheme using two-level variable detection thresholds that is dynamically dependent on the past syndromes. Simulations show that the proposed scheme reduces the possibility of false alarms and has a high degree of fault coverage in adaptive filter systems.

Lin, L. K.; Redinbo, G. R.

1994-10-01

19

Correlations between Brain Cortical Thickness and Cutaneous Pain Thresholds Are Atypical in Adults with Migraine  

PubMed Central

Background/Objective Migraineurs have atypical pain processing, increased expectations for pain, and hypervigilance for pain. Recent studies identified correlations between brain structure and pain sensation in healthy adults. The objective of this study was to compare cortical thickness-to-pain threshold correlations in migraineurs to healthy controls. We hypothesized that migraineurs would have aberrant relationships between the anatomical neurocorrelates of pain processing and pain thresholds. Methods Pain thresholds to cutaneously applied heat were determined for 31 adult migraineurs and 32 healthy controls. Cortical thickness was determined from magnetic resonance imaging T1-weighted sequences. Regional cortical thickness-to-pain threshold correlations were determined for migraineurs and controls separately using a general linear model whole brain vertex-wise analysis. A pain threshold-by-group interaction analysis was then conducted to estimate regions where migraineurs show alterations in the pain threshold-to-cortical thickness correlations relative to healthy controls. Results Controls had negative correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left posterior cingulate/precuneus, right superior temporal, right inferior parietal, and left inferior temporal regions, and a negative correlation (p<0.01 Monte Carlo corrected) with a left superior temporal/inferior parietal region. Migraineurs had positive correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left superior temporal/inferior parietal, right precuneus, right superior temporal/inferior parietal, and left inferior parietal regions. Cortical thickness-to-pain threshold correlations differed between migraine and control groups (p<0.01 uncorrected) for right superior temporal/inferior parietal, right precentral, left posterior cingulate/precuneus, and right inferior parietal regions and (p<0.01 Monte Carlo corrected) for a left superior temporal/inferior parietal region. Conclusions Unlike healthy control subjects who have a significant negative correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds, migraineurs have a non-significant positive correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds. Since this region participates in orienting and attention to painful stimuli, absence of the normal correlation might represent a migraineurs inability to inhibit pain sensation via shifting attention away from the painful stimulus. PMID:24932546

Schwedt, Todd J.; Chong, Catherine D.

2014-01-01

20

Pleasant and unpleasant slides: Their effects on pain tolerance  

Microsoft Academic Search

Pleasant imagery and focusing on pleasant slides have been found to be effective in increasing pain tolerance during noxious stimulation. However, since studies have not systematically varied the affective quality of the imagery or slides, there has been no way of determining whether the affective quality of the techniques is critical to their effectiveness. This study intended to examine the

Sara Maltzman Greenstein

1984-01-01

21

Pain and pressure pain thresholds in adolescents with chronic fatigue syndrome and healthy controls: a cross-sectional study  

PubMed Central

Objectives Although pain is a significant symptom in chronic fatigue syndrome (CFS), pain is poorly understood in adolescents with CFS. The aim of this study was to explore pain distribution and prevalence, pain intensity and its functional interference in everyday life, as well as pressure pain thresholds (PPT) in adolescents with CFS and compare this with a control group of healthy adolescents (HC). Methods This is a case–control, cross-sectional study on pain including 120 adolescents with CFS and 39 HCs, aged 12–18?years. We measured pain frequency, pain severity and pain interference using self-reporting questionnaires. PPT was measured using pressure algometry. Data were collected from March 2010 until October 2012 as part of the Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial. Results Adolescents with CFS had significantly lower PPTs compared with HCs (p<0.001). The Pain Severity Score and the Pain Interference Score were significantly higher in adolescents with CFS compared with HCs (p<0.001). Almost all adolescents with CFS experienced headache, abdominal pain and/or pain in muscles and joints. Moreover, in all sites, the pain intensity levels were significantly higher than in HCs (p<0.001). Conclusions We found a higher prevalence of severe pain among adolescents with CFS and lowered pain thresholds compared with HCs. The mechanisms, however, are still obscure. Large longitudinal population surveys are warranted measuring pain thresholds prior to the onset of CFS. Trial registration number Clinical Trials, NCT01040429; The Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorCAPITAL) http://www.clinicaltrials.gov. PMID:25287104

Winger, Anette; Kvarstein, Gunnvald; Wyller, Vegard Bruun; Sulheim, Dag; Fagermoen, Even; Smastuen, Milada Cvancarova; Helseth, S?lvi

2014-01-01

22

The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder.  

PubMed

This study examined masseter and temporalis pain-pressure thresholds in 29 patients with chronic bilateral myogenous temporomandibular disorder and in 11 controls. Patients with evidence of temporomandibular joint pathosis were omitted. The influence of time, facial side, muscle site, and side of greatest spontaneous pain on pain-pressure thresholds was measured. No significant pain-pressure threshold differences were found between the more and less painful sides, as indicated by the patients, which lends support to theories of centrally mediated pain. Mean pain-pressure thresholds in patients differed over the four sessions, which is consistent with recent reports of fluctuating levels of pain in patients with temporomandibular disorders. Additional findings included significant pain-pressure threshold differences among muscle sites in patients and controls, and lower patient pain-pressure thresholds relative to controls. Within- and between-session reliability was adequate for patients (r = .85 and r = .75, respectively) and controls (r = .90 and r = .75, respectively). PMID:7812223

Reid, K I; Gracely, R H; Dubner, R A

1994-01-01

23

Avoidant coping, verbal-autonomic response dissociation and pain tolerance  

Microsoft Academic Search

Higher autonomic reactivity relative to self-reported discomfort, often found in repressors and avoidant copers might be associated with a diminished perception of bodily symptoms. This study aimed at relating such so-called verbal-autonomic response dissociation to pain tolerance. Eighty-five volunteers underwent a public speaking task and a cold pressor test. Heart rate and negative affect in response to the speech, and

Andreas Schwerdtfeger; Stefan C. Schmukle; Boris Egloff

2006-01-01

24

Pain tolerance in patients presenting to primary care and physiotherapy services with upper limb disorders  

PubMed Central

Background Arm pain is a common cause of incapacity for work and is often attributed to occupational activities, but in many cases the pathogenesis is unclear. Objective To investigate whether arm pain in the absence of identifiable underlying pathology is associated with reduced tolerance of painful sensory stimuli. Methods 133 incident cases of arm pain, recruited from primary care and physiotherapy services, were classified according to a validated diagnostic algorithm. Pain tolerance was measured at three sites in each arm in response to electrocutaneous stimulation. Associations with pain tolerance (the geometric mean of the six measurements at 5?Hz) were assessed by linear regression, and findings were summarised as proportional changes in pain tolerance. Results Pain tolerance was generally lower than in an earlier community survey. Women had a lower tolerance than men. After allowance for sex, age, use of analgesics and anatomical extent of pain, there was no indication of reduced tolerance in patients with non?specific pain relative to those with specific local pathology. Conclusions Pain tolerance may be generally reduced in patients presenting to medical services with arm pain, but those with non?specific pain do not seem to have lower tolerance than those with identifiable local pathology. PMID:17182647

Ryall, Claire; Coggon, David; Peveler, Robert; Reading, Isabel; Palmer, Keith T

2007-01-01

25

Tactile sensory and pain thresholds in the face and tongue of subjects asymptomatic for oro-facial pain and headache.  

PubMed

The aim of this study was to examine the tactile sensory and pain thresholds in the face, tongue, hand and finger of subjects asymptomatic for pain. Sixteen healthy volunteers (eight men and eight women, mean age 35·7 years, range 27-41) participated. Using Semmes-Weinstein monofilaments, the tactile detection threshold (TDT) and the filament-prick pain detection threshold (FPT) were measured at five sites: on the cheek skin (CS), tongue tip (TT), palm side of the thenar skin (TS), dorsum of the hand (DH) and the finger tip (FT). The difference between the tactile sensory and pain threshold (FPT-TDT) was also calculated. Both for the TDT and FPT, TT and DH had the lowest and highest values, respectively. As for the FPT-TDT, there were no significant differences among the measurement sites. As the difference between FPT and TDT (FPT-TDT) is known to be an important consideration in interpreting QST (quantitative sensory testing) data and can be altered by neuropathology, taking the FPT-TDT as a new parameter in addition to the TDT and FPT separately would be useful for case-control studies on oro-facial pain patients with trigeminal neuralgia, atypical facial pain/atypical odontalgia and burning mouth syndrome/glossodynia. PMID:25041286

Okayasu, I; Komiyama, O; Ayuse, T; De Laat, A

2014-12-01

26

Fault-tolerant quantum computation with high threshold in two dimensions  

E-print Network

We present a scheme of fault-tolerant quantum computation for a local architecture in two spatial dimensions. The error threshold is 0.75% for each source in an error model with preparation, gate, storage and measurement errors.

Robert Raussendorf; Jim Harrington

2006-10-11

27

Surgical pain attenuates acute morphine tolerance in rats.  

PubMed

Nociceptive stimuli, such as formalin-induced pain and adjuvant-induced arthritis, attenuate tolerance to morphine antinociception. In this study, we have explored the effect of upper and lower abdominal surgical pain on the prevention of acute tolerance to morphine antinociception in Sprague-Dawley rats. Group I received lower abdominal surgery (LAS) and i.v. morphine infusion; group II received LAS and i.v. saline infusion; group III received upper abdominal surgery (UAS) and i.v. morphine infusion; group IV received UAS and i.v. saline infusion; group V received i.v. morphine infusion; and group VI received i.v. saline infusion. The antinociceptive effects of morphine were measured by an infrared thermal tail flick test. We also measured plasma concentrations of morphine in rats receiving morphine infusions with or without surgical treatment. We found that acute tolerance to morphine antinociception developed after 2 h following i.v. infusion of morphine alone. However, both UAS and LAS significantly slowed the rate of development of acute tolerance to morphine. The area under the time-response curves (AUC) of groups I and III were mean 34,556 (SD 5607) and 32,548 (9783), respectively, which were significantly different from that of group V (18,759 (8225)) (P < 0.01). Also, there were no significant differences between groups I and III. There were no significant differences between groups for plasma morphine concentrations during the 8-h study (e.g. groups I, III and V: 179.9 (22.6), 182.7 (14.4) and 170.9 (15.8) ng ml-1 at 8 h, respectively) and we suggest that the appearance of acute morphine tolerance after morphine infusion is not pharmacokinetic in nature. PMID:10325847

Ho, S T; Wang, J J; Liaw, W J; Lee, H K; Lee, S C

1999-01-01

28

Significant thresholds for the 75-g oral glucose tolerance test in pregnancy  

Microsoft Academic Search

The significant threshold values for the 75-g oral glucose tolerance test (oGTT) during pregnancy have yet to be conclusively determined. This study aimed to identify the risk significance of various set thresholds for the oGTT result. Women undergoing a 75-g oGTT during the third trimester of pregnancy were classified into three groups: mild gestational impaired glucose tolerance (GIGT; 2-h postload

Charles Savona-Ventura; Marcel Chircop

2008-01-01

29

Fault-tolerant thresholds for quantum error correction with the surface code  

NASA Astrophysics Data System (ADS)

The surface code is a promising candidate for fault-tolerant quantum computation, achieving a high threshold error rate with nearest-neighbor gates in two spatial dimensions. Here, through a series of numerical simulations, we investigate how the precise value of the threshold depends on the noise model, measurement circuits, and decoding algorithm. We observe thresholds between 0.502(1)% and 1.140(1)% per gate, values which are generally lower than previous estimates.

Stephens, Ashley M.

2014-02-01

30

Fault-tolerant thresholds for quantum error correction with the surface code  

E-print Network

The surface code is a promising candidate for fault-tolerant quantum computation, achieving a high threshold error rate with nearest-neighbor gates in two spatial dimensions. Here, through a series of numerical simulations, we investigate how the precise value of the threshold depends on the noise model, measurement circuits, and decoding algorithm. We observe thresholds between 0.502(1)% and 1.140(1)% per gate, values which are generally lower than previous estimates.

Ashley M. Stephens

2013-11-20

31

Lubiprostone does not Influence Visceral Pain Thresholds in Patients with Irritable Bowel Syndrome  

PubMed Central

Background In clinical trials, lubiprostone reduced the severity of abdominal pain. Aims The primary aim was to determine whether lubiprostone raises the threshold for abdominal pain induced by intraluminal balloon distention. A secondary aim was to determine whether changes in pain sensitivity influence clinical pain independently of changes in transit time. Methods Sixty-two patients with irritable bowel syndrome with constipation (IBS-C) participated in an 8-week crossover study. All subjects completed a 14-day baseline ending with a barostat test of pain and urge sensory thresholds. Half, randomly selected, then received 48 ug/day of lubiprostone for 14 days ending with a pain sensitivity test and a Sitzmark test of transit time. This was followed by a 14-day washout and then a crossover to 14 days of placebo with tests of pain sensitivity and transit time. The other half of the subjects received placebo before lubiprostone. All kept symptom diaries. Results Stools were significantly softer when taking lubiprostone compared to placebo (Bristol Stool scores 4.20 vs. 3.44, p<0.001). However, thresholds for pain (17.36 vs. 17.83 mmHg, lubiprostone vs. placebo) and urgency to defecate (14.14 vs. 14.53 mmHg) were not affected by lubiprostone. Transit time was not significantly different between lubiprostone and placebo (51.27 vs. 51.81 hours), and neither pain sensitivity nor transit time was a significant predictor of clinical pain. Conclusions Lubiprostone has no effect on visceral sensory thresholds. The reductions in clinical pain that occur while taking lubiprostone appear to be secondary to changes in stool consistency. PMID:21914041

Whitehead, William E.; Palsson, Olafur S.; Gangarosa, Lisa; Turner, Marsha; Tucker, Jane

2011-01-01

32

The fine tuning of pain thresholds: a sophisticated double alarm system.  

PubMed

Two distinctive features characterize the way in which sensations including pain, are evoked by heat: (1) a thermal stimulus is always progressive; (2) a painful stimulus activates two different types of nociceptors, connected to peripheral afferent fibers with medium and slow conduction velocities, namely Adelta- and C-fibers. In the light of a recent study in the rat, our objective was to develop an experimental paradigm in humans, based on the joint analysis of the stimulus and the response of the subject, to measure the thermal thresholds and latencies of pain elicited by Adelta- and C-fibers. For comparison, the same approach was applied to the sensation of warmth elicited by thermoreceptors. A CO(2) laser beam raised the temperature of the skin filmed by an infrared camera. The subject stopped the beam when he/she perceived pain. The thermal images were analyzed to provide four variables: true thresholds and latencies of pain triggered by heat via Adelta- and C-fibers. The psychophysical threshold of pain triggered by Adelta-fibers was always higher (2.5-3 degrees C) than that triggered by C-fibers. The initial skin temperature did not influence these thresholds. The mean conduction velocities of the corresponding fibers were 13 and 0.8 m/s, respectively. The triggering of pain either by C- or by Adelta-fibers was piloted by several factors including the low/high rate of stimulation, the low/high base temperature of the skin, the short/long peripheral nerve path and some pharmacological manipulations (e.g. Capsaicin). Warming a large skin area increased the pain thresholds. Considering the warmth detection gave a different picture: the threshold was strongly influenced by the initial skin temperature and the subjects detected an average variation of 2.7 degrees C, whatever the initial temperature. This is the first time that thresholds and latencies for pain elicited by both Adelta- and C-fibers from a given body region have been measured in the same experimental run. Such an approach illustrates the role of nociception as a "double level" and "double release" alarm system based on level detectors. By contrast, warmth detection was found to be based on difference detectors. It is hypothesized that pain results from a CNS build-up process resulting from population coding and strongly influenced by the background temperatures surrounding at large the stimulation site. We propose an alternative solution to the conventional methods that only measure a single "threshold of pain", without knowing which of the two systems is involved. PMID:20428245

Plaghki, Léon; Decruynaere, Céline; Van Dooren, Paul; Le Bars, Daniel

2010-01-01

33

The Fine Tuning of Pain Thresholds: A Sophisticated Double Alarm System  

PubMed Central

Two distinctive features characterize the way in which sensations including pain, are evoked by heat: (1) a thermal stimulus is always progressive; (2) a painful stimulus activates two different types of nociceptors, connected to peripheral afferent fibers with medium and slow conduction velocities, namely A?- and C-fibers. In the light of a recent study in the rat, our objective was to develop an experimental paradigm in humans, based on the joint analysis of the stimulus and the response of the subject, to measure the thermal thresholds and latencies of pain elicited by A?- and C-fibers. For comparison, the same approach was applied to the sensation of warmth elicited by thermoreceptors. A CO2 laser beam raised the temperature of the skin filmed by an infrared camera. The subject stopped the beam when he/she perceived pain. The thermal images were analyzed to provide four variables: true thresholds and latencies of pain triggered by heat via A?- and C-fibers. The psychophysical threshold of pain triggered by A?-fibers was always higher (2.5–3°C) than that triggered by C-fibers. The initial skin temperature did not influence these thresholds. The mean conduction velocities of the corresponding fibers were 13 and 0.8 m/s, respectively. The triggering of pain either by C- or by A?-fibers was piloted by several factors including the low/high rate of stimulation, the low/high base temperature of the skin, the short/long peripheral nerve path and some pharmacological manipulations (e.g. Capsaicin). Warming a large skin area increased the pain thresholds. Considering the warmth detection gave a different picture: the threshold was strongly influenced by the initial skin temperature and the subjects detected an average variation of 2.7°C, whatever the initial temperature. This is the first time that thresholds and latencies for pain elicited by both A?- and C-fibers from a given body region have been measured in the same experimental run. Such an approach illustrates the role of nociception as a “double level” and “double release” alarm system based on level detectors. By contrast, warmth detection was found to be based on difference detectors. It is hypothesized that pain results from a CNS build-up process resulting from population coding and strongly influenced by the background temperatures surrounding at large the stimulation site. We propose an alternative solution to the conventional methods that only measure a single “threshold of pain”, without knowing which of the two systems is involved. PMID:20428245

Plaghki, Leon; Decruynaere, Celine; Van Dooren, Paul; Le Bars, Daniel

2010-01-01

34

Gender role expectations of pain: relationship to experimental pain perception  

Microsoft Academic Search

The primary purpose of this study was to investigate the influence of an individual's Gender Role Expectations of Pain (GREP) on experimental pain report. One hundred and forty-eight subjects (87 females and 61 males) subjects underwent thermal testing and were asked to report pain threshold, pain tolerance, VAS ratings of pain intensity and unpleasantness, and a computerized visual analogue scales

Emily A Wise; Donald D Price; Cynthia D Myers; Marc W Heft; Michael E Robinson

2002-01-01

35

Effects of Tobacco Smoking on Measures of Cold-Induced Pain.  

National Technical Information Service (NTIS)

Nicotine's effect on human pain perception is uncertain. This study's purpose was to determine whether pain thresholds, pain tolerances, or ratings of pain intensity differ among smokers (S), non-smokers (NS), and abstaining smokers (AS). Twenty-nine male...

E. L. Spillane, R. P. Szewczyk, J. D. McDonald

2005-01-01

36

Is Paradoxical Pain Induced by Sustained Opioid Exposure an Underlying Mechanism of Opioid Antinociceptive Tolerance?  

Microsoft Academic Search

Opiates are the primary treatment for pain management in cancer patients reporting moderate to severe pain, and are being increasingly used for non-cancer chronic pain. However, prolonged administration of opiates is associated with significant problems including the development of antinociceptive tolerance, wherein higher doses of the drug are required over time to elicit the same amount of analgesia. High doses

Tamara King; Michael H. Ossipov; Todd W. Vanderah; Frank Porreca; Josephine Lai

2005-01-01

37

Mechanisms of spontaneous tension-type headaches: an analysis of tenderness, pain thresholds and EMG  

Microsoft Academic Search

Pericranial muscle tenderness, EMG levels and thermal and mechanical pain thresholds were studied in 28 patients with tension-type headache and in 30 healthy controls. Each patient was studied during as well as outside a spontaneous episode of tension-type headache. Outside of headache, muscle tenderness and EMG levels were significantly increased compared to values in controls subjects, while mechanical and thermal

Rigmor Jensen

1996-01-01

38

Test–retest reliability of the nociceptive withdrawal reflex and electrical pain thresholds after single and repeated stimulation in patients with chronic low back pain  

Microsoft Academic Search

Recent studies have shown that the nociceptive withdrawal reflex threshold (NWR-T) and the electrical pain threshold (EP-T)\\u000a are reliable measures in pain-free populations. However, it is necessary to investigate the reliability of these measures\\u000a in patients with chronic pain in order to translate these techniques from laboratory to clinic. The aims of this study were\\u000a to determine the test–retest reliability

José A. Biurrun Manresa; Alban Y. Neziri; Michele Curatolo; Lars Arendt-Nielsen; Ole K. Andersen

2011-01-01

39

Fault-tolerant ancilla preparation and noise threshold lower bounds for the 23-qubit Golay code  

E-print Network

In fault-tolerant quantum computing schemes, the overhead is often dominated by the cost of preparing codewords reliably. This cost generally increases quadratically with the block size of the underlying quantum error-correcting code. In consequence, large codes that are otherwise very efficient have found limited fault-tolerance applications. Fault-tolerant preparation circuits therefore are an important target for optimization. We study the Golay code, a 23-qubit quantum error-correcting code that protects the logical qubit to a distance of seven. In simulations, even using a naive ancilla preparation procedure, the Golay code is competitive with other codes both in terms of overhead and the tolerable noise threshold. We provide two simplified circuits for fault-tolerant preparation of Golay code-encoded ancillas. The new circuits minimize error propagation, reducing the overhead by roughly a factor of four compared to standard encoding circuits. By adapting the malignant set counting technique to depolarizing noise, we further prove a threshold above 1.32 x 10^{-3} noise per gate.

Adam Paetznick; Ben W. Reichardt

2011-06-11

40

Factor analysis of human pain responses: Pain endurance as a specific pain factor  

Microsoft Academic Search

Induced cutaneous and deep somatic pain with chemical, electrical, and thermal noxious stimuli in 60 18-69 yr. Old chronic arthritis patients. Pain threshold, pain tolerance, and pain sensitivity range (psr) were measured psychophysically and correlated within and between techniques. The correlations were subjected to the centroid method of factor analysis and the 1st 4 factors extracted and rotated to a

B. Berthold Wolff

1971-01-01

41

The Effects of Anticipatory Stress on Pain Threshold and Cortisol Responses in Male and Female Athletes  

Microsoft Academic Search

Abstract: Participating in a competitive athletic event, for example a routine practice or game, can produce anticipatory elevations in cortisol and ,pain threshold in male ,and ,female ,college athletes (basketball and soccer players). In an attempt to bridge,the theoretical gap between ,competition-induced analgesia (CIA) and stress-induced analgesia (SIA), the present study investigated the association between subjective and ,physiological ,measures of

Caryn Dolich

42

What Color is My Arm? Changes in Skin Color of an Embodied Virtual Arm Modulates Pain Threshold  

PubMed Central

It has been demonstrated that visual inputs can modulate pain. However, the influence of skin color on pain perception is unknown. Red skin is associated to inflamed, hot and more sensitive skin, while blue is associated to cyanotic, cold skin. We aimed to test whether the color of the skin would alter the heat pain threshold. To this end, we used an immersive virtual environment where we induced embodiment of a virtual arm that was co-located with the real one and seen from a first-person perspective. Virtual reality allowed us to dynamically modify the color of the skin of the virtual arm. In order to test pain threshold, increasing ramps of heat stimulation applied on the participants’ arm were delivered concomitantly with the gradual intensification of different colors on the embodied avatar’s arm. We found that a reddened arm significantly decreased the pain threshold compared with normal and bluish skin. This effect was specific when red was seen on the arm, while seeing red in a spot outside the arm did not decrease pain threshold. These results demonstrate an influence of skin color on pain perception. This top-down modulation of pain through visual input suggests a potential use of embodied virtual bodies for pain therapy. PMID:23914172

Martini, Matteo; Perez-Marcos, D.; Sanchez-Vives, M. V.

2013-01-01

43

Deep pain thresholds in the distal limbs of healthy human subjects.  

PubMed

Pressure pain thresholds (PPTs) in distal limbs have been under-investigated despite their potential clinical importance. Therefore, we compared PPTs over nail bed, bony prominences, and muscle in distal parts of upper and lower limbs. We investigated 12 healthy subjects using three handheld devices: a spring-loaded, analogue pressure threshold meter (PTM) with two operating ranges, and an electronic Algometer. PPTs were determined with three series of ascending stimulus intensities with a ramp of about 50 kPa/s. PPTs were normally distributed in logarithmic space. PPTs over different tissues varied significantly (ANOVA, p<0.001): mean thresholds and 95% confidence intervals were 615 kPa (266-1424 kPa) over the nail bed, 581 kPa (271-1245 kPa) over bony prominences, and 520 kPa (246-1100 kPa) over muscles. PPTs on the foot were higher than on the hand (ANOVA, p<0.01), except over muscles. PPTs were significantly lower with the Algometer than with PTMs (ANOVA, p<0.01); again these differences were least when testing over muscle. There was no significant right-left difference (ANOVA, p=0.33). In spite of considerable variability across subjects, reproducibility within subjects was high (correlation coefficients>0.90). For within-subject comparisons, threshold elevations beyond 33-43% would be abnormal (95% confidence intervals), whereas only deviations from the group mean by at least a factor of two would be abnormal with respect to absolute normative values. PPTs over distal muscles were comparable to published values on proximal limb and trunk muscles. These findings suggest that pressure pain testing over distal muscles may be a sensitive test for deep pain sensitivity and that the simple and less expensive devices are sufficient for testing this tissue type. Intra-individual site-to-site comparisons will be more sensitive than absolute normative values. PMID:15629873

Rolke, R; Andrews Campbell, K; Magerl, W; Treede, R-D

2005-02-01

44

Knee Extensor Strength Is Associated with Pressure Pain Thresholds in Adults with Fibromyalgia  

PubMed Central

Objective Individuals with fibromyalgia (FM) have lower muscle strength and lower pressure pain thresholds (PPT). The primary aim of this study was to determine the associations between muscle strength and PPT in adults with FM to test the hypothesis that greater measures of muscle strength would be associated with greater values of PPT. Secondary aims included determining the effects of pain severity and the peak uptake of oxygen (Vo2) on the associations between muscle strength and PPT. Methods Knee extensor and flexor strength (N?=?69) was measured in the dominant leg using a dynamometer, and PPT was assessed using an electronic algometer. Pain severity was determined using the Multidimensional Pain Inventory, and peak Vo2 uptake was quantified using an electronically braked cycle ergometer. Results Univariable linear regression analysis demonstrated a significant association between PPT (dependent variable) and isometric knee extensor (P<.001), isokinetic (60°/s) knee extensor (P?=?.002), and isokinetic (60°/s) knee flexor strength (P?=?.043). In a multiple variable linear regression analysis adjusted for age, sex, pain severity, body mass index and peak Vo2 uptake, a significant association was found between PPT and isometric knee extensor strength (P?=?.008). In a similar multiple variable analysis, a significant association was found between PPT and isokinetic knee extensor strength (P?=?.044). Conclusion Greater measures of isometric and isokinetic knee extensor strength were significantly associated with greater values of PPT in both univariable and multiple variable linear regression models. Trial Registration ClinicalTrials.gov NCT01253395 PMID:23565175

Hooten, W. Michael; Rosenberg, Casandra J.; Eldrige, Jason S.; Qu, Wenchun

2013-01-01

45

Tonic Descending Facilitation from the Rostral Ventromedial Medulla Mediates Opioid-Induced Abnormal Pain and Antinociceptive Tolerance  

Microsoft Academic Search

Many clinical case reports have suggested that sustained opi- oid exposure can elicit unexpected, paradoxical pain. Here, we explore the possibility that (1) opioid-induced pain results from tonic activation of descending pain facilitation arising in the rostral ventromedial medulla (RVM) and (2) the presence of such pain manifests behaviorally as antinociceptive tolerance. Rats implanted subcutaneously with pellets or osmotic minipumps

Todd W. Vanderah; Nova M. H. Suenaga; Michael H. Ossipov; T. Philip; Josephine Lai

2001-01-01

46

Logic gates at the surface code threshold: Superconducting qubits poised for fault-tolerant quantum computing  

E-print Network

A quantum computer can solve hard problems - such as prime factoring, database searching, and quantum simulation - at the cost of needing to protect fragile quantum states from error. Quantum error correction provides this protection, by distributing a logical state among many physical qubits via quantum entanglement. Superconductivity is an appealing platform, as it allows for constructing large quantum circuits, and is compatible with microfabrication. For superconducting qubits the surface code is a natural choice for error correction, as it uses only nearest-neighbour coupling and rapidly-cycled entangling gates. The gate fidelity requirements are modest: The per-step fidelity threshold is only about 99%. Here, we demonstrate a universal set of logic gates in a superconducting multi-qubit processor, achieving an average single-qubit gate fidelity of 99.92% and a two-qubit gate fidelity up to 99.4%. This places Josephson quantum computing at the fault-tolerant threshold for surface code error correction. Our quantum processor is a first step towards the surface code, using five qubits arranged in a linear array with nearest-neighbour coupling. As a further demonstration, we construct a five-qubit Greenberger-Horne-Zeilinger (GHZ) state using the complete circuit and full set of gates. The results demonstrate that Josephson quantum computing is a high-fidelity technology, with a clear path to scaling up to large-scale, fault-tolerant quantum circuits.

R. Barends; J. Kelly; A. Megrant; A. Veitia; D. Sank; E. Jeffrey; T. C. White; J. Mutus; A. G. Fowler; B. Campbell; Y. Chen; Z. Chen; B. Chiaro; A. Dunsworth; C. Neill; P. O`Malley; P. Roushan; A. Vainsencher; J. Wenner; A. N. Korotkov; A. N. Cleland; John M. Martinis

2014-02-19

47

Effects of mood on pain responses and pain tolerance: An experimental study in chronic back pain patients  

Microsoft Academic Search

Although chronic pain and depression commonly co-occur, causal relationships have yet to be established. A reciprocal relationship, with depression increasing pain and vice versa, is most frequently suggested, but experimental evidence is needed to validate such a view. The most straightforward approach would be a demonstration that increasing or decreasing depressed mood predictably modifies pain responses. The current experiment tested

Nicole K. Y. Tang; Paul M. Salkovskis; Amy Hodges; Kelly J. Wright; Magdi Hanna; Joan Hester

2008-01-01

48

The Impact of Demand Characteristics on Brief Acceptance- and Control-Based Interventions for Pain Tolerance  

ERIC Educational Resources Information Center

The present analog study compared the effectiveness of an acceptance- and control-based intervention on pain tolerance using a cold pressor task, and is a partial replication and extension of the Hayes, Bissett et al. (Hayes, S. C., Bissett, R.T., Korn, Z., Zettle, R. D., Rosenfarb, I. S., Cooper, L. D., & Grundt, A. M. (1999). "The impact of…

Roche, Bryan; Forsyth, John P.; Maher, Elaine

2007-01-01

49

Efficacy and tolerability of diclofenac dispersible in painful osteoarthrosis  

Microsoft Academic Search

A multicentre, twelve-week, double-blind, randomized trial was conducted to evaluate the efficacy and tolerability of diclofenac dispersible in patients suffering from osteoarthrosis of the knee and\\/or hip. Symptomatic adult patients (N=129) of either sex were treated with diclofenac dispersible or the conventional enteric-coated tablet of diclofenac sodium 50 mg orally, thrice daily. Both formulations of diclofenac led to comparable and

R. Bakshi; N. Ezzet; L. Frey; D. Lasry; D. Salliere

1993-01-01

50

Dextromethorphan shows efficacy in experimental pain (nociception) and opioid tolerance.  

PubMed

The oral antitussive dextromethorphan is a clinically available N-methyl-D-aspartate receptor antagonist. Dextromethorphan has analgesic efficacy in the experimental formalin test, blocks the nociceptive activation of the immediate-early gene, c-fos proto-oncogene, and prevents and reverses the development of opiate analgesic tolerance in experimental models. These data suggest that dextromethorphan should be evaluated in a controlled clinical trial for analgesic efficacy in zoster-associated neuralgia. PMID:8545027

Elliott, K J; Brodsky, M; Hyanansky, A; Foley, K M; Inturrisi, C E

1995-12-01

51

The Effectiveness of a Hope Intervention in Coping with Cold Pressor Pain  

Microsoft Academic Search

Hope has been correlated with greater pain tolerance and thresholds and less reported pain severity. The present study investigated the effectiveness of a brief hope-based intervention involving guided imagery and skills instruction aimed at enhancing pain coping skills among university students performing the cold pressor task. The intervention resulted in increased hope among females and increased pain tolerance in all

Carla J. Berg; C. R. Snyder; Nancy Hamilton

2008-01-01

52

Pressure Pain Thresholds Increase after Preconditioning 1 Hz Repetitive Transcranial Magnetic Stimulation with Transcranial Direct Current Stimulation  

PubMed Central

Background The primary motor cortex (M1) is an effective target of non-invasive cortical stimulation (NICS) for pain threshold modulation. It has been suggested that the initial level of cortical excitability of M1 plays a key role in the plastic effects of NICS. Objective Here we investigate whether transcranial direct current stimulation (tDCS) primed 1 Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pressure pain thresholds and if this is related to observed alterations in cortical excitability. Method 15 healthy, male participants received 10 min 1 mA anodal, cathodal and sham tDCS to the left M1 before 15 min 1 Hz rTMS in separate sessions over a period of 3 weeks. Motor cortical excitability was recorded at baseline, post-tDCS priming and post-rTMS through recording motor evoked potentials (MEPs) from right FDI muscle. Pressure pain thresholds were determined by quantitative sensory testing (QST) through a computerized algometer, on the palmar thenar of the right hand pre- and post-stimulation. Results Cathodal tDCS-primed 1 Hz-rTMS was found to reverse the expected suppressive effect of 1 Hz rTMS on cortical excitability; leading to an overall increase in activity (p<0.001) with a parallel increase in pressure pain thresholds (p<0.01). In contrast, anodal tDCS-primed 1 Hz-rTMS resulted in a corresponding decrease in cortical excitability (p<0.05), with no significant effect on pressure pain. Conclusion This study demonstrates that priming the M1 before stimulation of 1 Hz-rTMS modulates experimental pressure pain thresholds in a safe and controlled manner, producing a form of analgesia. PMID:24658333

Moloney, Tonya M.; Witney, Alice G.

2014-01-01

53

Human body impedance and threshold currents for perception and pain for contact hazard analysis in the VLF-MF band  

Microsoft Academic Search

The body impedance and threshold currents needed to produce sensations of perception and pain have been measured for 367 human subjects for the frequency range 10 kHz to 3 MHz. A sufficient number of subjects (197 male and 170 female subjects of ages between 18 and 70 years) were utilized in the study to make valid statistical predictions for the

Indira Chatterjee; Ding Wu; Om P. Gandhi

1986-01-01

54

Sleep-related and non-sleep-related migraine: interictal sleep quality, arousals and pain thresholds  

PubMed Central

Background The mechanisms associating sleep and migraine are unknown. No previous polysomnographic (PSG) or pain-threshold (PT) study has compared patients with sleep-related migraine attacks (SM), non-sleep related migraine attacks (NSM) and healthy controls. Methods We have performed a blinded, prospective exploratory study with case–control design. Thirty-four healthy controls, 15 patients with SM and 18 patients with NSM had interictal PSG heat-, cold- and pressure PT (HPT, CPT, PPT) recordings and completed diary- and questionnaire on sleep and headache related aspects. Results NSM patients had more slow-wave sleep (SWS) and more K-bursts than SM patients (K-bursts: p?=?0.023 and SWS: p?=?0.030) and controls (K-bursts: p?=?0.009 and SWS: 0.041). NSM patients also had lower HPT and CPT than controls (p?=?0.026 and p?=?0.021). In addition, SM patients had more awakenings and less D-bursts than controls (p?=?0.025 and p?=?0.041). Conclusion SM- and NSM patients differed in objective-, but not subjective sleep quality. NSM patients had PSG findings indicating foregoing sleep deprivation. As foregoing sleep times were normal, a relative sleep deficit might explain reduced PT among NSM patients. The SM patients had signs of slightly disturbed sleep. PMID:23919583

2013-01-01

55

Acute pain management in opioid-tolerant patients: a growing challenge.  

PubMed

In Australia and New Zealand, in parallel with other developed countries, the number of patients prescribed opioids on a long-term basis has grown rapidly over the last decade. The burden of chronic pain is more widely recognised and there has been an increase in the use of opioids for both cancer and non-cancer indications. While the prevalence of illicit opioid use has remained relatively stable, the diversion and abuse of prescription opioids has escalated, as has the number of individuals receiving methadone or buprenorphine pharmacotherapy for opioid addiction. As a result, the proportion of opioid-tolerant patients requiring acute pain management has increased, often presenting clinicians with greater challenges than those faced when treating the opioid-naïve. Treatment aims include effective relief of acute pain, prevention of drug withdrawal, assistance with any related social, psychiatric and behavioural issues, and ensuring continuity of long-term care. Pharmacological approaches incorporate the continuation of usual medications (or equivalent), short-term use of sometimes much higher than average doses of additional opioid, and prescription of non-opioid and adjuvant drugs, aiming to improve pain relief and attenuate opioid tolerance and/or opioid-induced hyperalgesia. Discharge planning should commence at an early stage and may involve the use of a 'Reverse Pain Ladder' aiming to limit duration of additional opioid use. Legislative requirements may restrict which drugs can be prescribed at the time of hospital discharge. At all stages, there should be appropriate and regular consultation and liaison with the patient, other treating teams and specialist services. PMID:21970125

Huxtable, C A; Roberts, L J; Somogyi, A A; MacIntyre, P E

2011-09-01

56

Sex differences in perceptual and cardiovascular responses to pain: the influence of a perceived ability manipulation  

Microsoft Academic Search

Abstract: Sex differences in responses to experimental pain have been widely reported, with women typically showing lower pain threshold and tolerance than men. One possible explanation for these differences is that traditional gender roles may lead to sex differences in perceived ability to tolerate pain. To address this possibility, the present study evaluated the influence of a sex-related perceived ability

Roger B. Fillingim; Anthony D. Browning; Tykeysha Powell; Rex A. Wright

2002-01-01

57

Human body impedance and threshold currents for perception and pain for contact hazard analysis in the VLF-MF band  

SciTech Connect

The body impedance and threshold currents needed to produce sensations of perception and pain have been measured for 367 human subjects for the frequency range 10 kHz to 3 MHz. A sufficient number of subjects (197 male and 170 female subjects of ages between 18 and 70 years) were utilized in the study to make valid statistical predictions for the general adult population. Various types of contact with metallic electrodes were used to simulate the situation where a human being would be in contact with a large metallic object (car, van, school bus, etc.) in an electromagnetic field in the VLF to MF band. Based on these measurements, it is speculated that the body impedance of a human being is inversely proportional to the body dimensions and the threshold current for perception is directly proportional to the square of the body dimensions. Predictions are made, based on scaling, for the corresponding threshold values for ten-year-old children. The average measured impedance and threshold current values are used to calculate threshold electric fields required to produce sensations of perception and pain in humans in contact with these vehicles. It is concluded from these calculations that many situations can exist in which the present ANSI (American National Standards Institute) recommended standard of 632 V/m for the frequency band 0.3-3 MHz is too high. The usefulness of safety devices like electrical safety shoes and gloves has been evaluated and it is concluded that they offer adequate protection from VLF to MF currents only up to a frequency of 1 MHz and 3 MHz, respectively. The current flowing through the hand of a human in conductive contact with the handle of an ungrounded van is shown to be as high as 879 mA and produces a local SAR in the wrist of about 1045 W/kg.

Chatterjee, I.; Wu, D.; Gandhi, O.P.

1986-05-01

58

Chronic inflammatory pain prevents tolerance to the antinociceptive effect of morphine microinjected into the ventrolateral periaqueductal gray of the rat  

PubMed Central

The ventrolateral periaqueductal gray (vlPAG) contributes to morphine antinociception and tolerance. Chronic inflammatory pain causes changes within the PAG that are expected to enhance morphine tolerance. This hypothesis was tested by assessing antinociception and tolerance following repeated microinjections of morphine into the vlPAG of rats with chronic inflammatory pain. Microinjection of morphine into the vlPAG reversed the allodynia caused by intraplantar administration of Complete Freund's Adjuvant (CFA), and produced antinociception on the hot plate test. Although there was a gradual decrease in morphine antinociception with repeated testing, there was no evidence of tolerance when morphine and saline treated rats with hind paw inflammation were tested with cumulative doses of morphine. In contrast, repeated morphine injections into the vlPAG caused a rightward shift in the morphine dose-response curve in rats without hind paw inflammation, as would be expected with the development of tolerance. The lack of tolerance in CFA treated rats was evident whether rats were exposed to repeated behavioral testing or not (Experiment 2) and whether they were treated with 4 or 8 prior microinjections of morphine into the vlPAG (Experiment 3). These data demonstrate that chronic inflammatory pain does not disrupt the antinociceptive effect of microinjecting morphine into the vlPAG, but it does disrupt the development of tolerance. PMID:24161274

Mehalick, Melissa L.; Ingram, Susan L.; Aicher, Sue; Morgan, Michael M

2013-01-01

59

Efficacy and Tolerability of Intramuscular Dexketoprofen in Postoperative Pain Management following Hernia Repair Surgery.  

PubMed

Objective. To evaluate the safety and efficacy of intramuscular dexketoprofen for postoperative pain in patients undergoing hernia surgery. Methodology. Total 202 patients received single intramuscular injection of dexketoprofen 50?mg or diclofenac 50?mg postoperatively. The pain intensity (PI) was self-evaluated by patients on VAS at baseline 1, 2, 4, 6, and 8 hours. The efficacy parameters were number of responders, difference in PI (PID) at 8?hours, sum of analogue of pain intensity differences (SAPID), and onset and duration of analgesia. Tolerability assessment was done by global evaluation and adverse events in each group. Results. Dexketoprofen showed superior efficacy in terms of number of responders (P = .007), PID at 8?hours (P = .02), and SAPID( 0-8 hours ) (P < .0001). It also showed faster onset of action (42 minutes) and longer duration of action (6.5 hours). The adverse events were comparable in both groups. Conclusion. Single dose of dexketoprofen trometamol 50?mg given intramuscularly provided faster, better, and longer duration of analgesia in postoperative patients of hernia repair surgery than diclofenac 50?mg, with comparable safety. PMID:21716733

Jamdade, P T; Porwal, A; Shinde, J V; Erram, S S; Kamat, V V; Karmarkar, P S; Bhagtani, K; Dhorepatil, S; Irpatgire, R; Bhagat, H; Kolte, S S; Shirure, P A

2011-01-01

60

Efficacy and Tolerability of Intramuscular Dexketoprofen in Postoperative Pain Management following Hernia Repair Surgery  

PubMed Central

Objective. To evaluate the safety and efficacy of intramuscular dexketoprofen for postoperative pain in patients undergoing hernia surgery. Methodology. Total 202 patients received single intramuscular injection of dexketoprofen 50?mg or diclofenac 50?mg postoperatively. The pain intensity (PI) was self-evaluated by patients on VAS at baseline 1, 2, 4, 6, and 8 hours. The efficacy parameters were number of responders, difference in PI (PID) at 8?hours, sum of analogue of pain intensity differences (SAPID), and onset and duration of analgesia. Tolerability assessment was done by global evaluation and adverse events in each group. Results. Dexketoprofen showed superior efficacy in terms of number of responders (P = .007), PID at 8?hours (P = .02), and SAPID 0–8 hours (P < .0001). It also showed faster onset of action (42 minutes) and longer duration of action (6.5 hours). The adverse events were comparable in both groups. Conclusion. Single dose of dexketoprofen trometamol 50?mg given intramuscularly provided faster, better, and longer duration of analgesia in postoperative patients of hernia repair surgery than diclofenac 50?mg, with comparable safety. PMID:21716733

Jamdade, P. T.; Porwal, A.; Shinde, J. V.; Erram, S. S.; Kamat, V. V.; Karmarkar, P. S.; Bhagtani, K.; Dhorepatil, S.; Irpatgire, R.; Bhagat, H.; Kolte, S. S.; Shirure, P. A.

2011-01-01

61

Do Diabetic Patients with Acute Coronary Syndromes Have a Higher Threshold for Ischemic Pain?  

PubMed Central

Background: Data from over 4 decades have reported a higher incidence of silent infarction among patients with diabetes mellitus (DM), but recent publications have shown conflicting results regarding the correlation between DM and presence of pain in patients with acute coronary syndromes (ACS). Objective: Our primary objective was to analyze the association between DM and precordial pain at hospital arrival. Secondary analyses evaluated the association between hyperglycemia and precordial pain at presentation, and the subgroup of patients presenting within 6 hours of symptom onset. Methods: We analyzed a prospectively designed registry of 3,544 patients with ACS admitted to a Coronary Care Unit of a tertiary hospital. We developed multivariable models to adjust for potential confounders. Results: Patients with precordial pain were less likely to have DM (30.3%) than those without pain (34.0%; unadjusted p = 0.029), but this difference was not significant after multivariable adjustment, for the global population (p = 0.84), and for subset of patients that presented within 6 hours from symptom onset (p = 0.51). In contrast, precordial pain was more likely among patients with hyperglycemia (41.2% vs 37.0% without hyperglycemia, p = 0.035) in the overall population and also among those who presented within 6 hours (41.6% vs. 32.3%, p = 0.001). Adjusted models showed an independent association between hyperglycemia and pain at presentation, especially among patients who presented within 6 hours (OR = 1.41, p = 0.008). Conclusion: In this non-selected ACS population, there was no correlation between DM and hospital presentation without precordial pain. Moreover, hyperglycemia correlated significantly with pain at presentation, especially in the population that arrived within 6 hours from symptom onset. PMID:25076180

Nicolau, Jose Carlos; Barbosa, Carlos Jose Dornas Goncalves; Franci, Andre; Baracioli, Luciano Moreira; Franken, Marcelo; Lima, Felipe Gallego; Giraldez, Roberto Rocha; Kalil Filho, Roberto; Ramires, Jose Antonio Franchini; Giugliano, Robert P.

2014-01-01

62

Ferulic acid increases pain threshold and ameliorates depression-like behaviors in reserpine-treated mice: behavioral and neurobiological analyses.  

PubMed

Depression-pain dyad involves a series of pathological changes including the dysfunction of neuroendocrine and immune networks. Depression and pain influence each other, but the mechanisms are still obscure. The present study aimed to investigate the effect of ferulic acid (FA) on reserpine-induced pain and depression-like behaviors in mice. The results showed that reserpine (1 mg/kg for 3 days, i.p.) led to a significant decrease in nociceptive threshold in thermal hyperalgesia and mechanical allodynia, as well as a significant increase in the immobility time in mouse models of despair test. The neurochemical assays suggested the decreased neurotransmitters (dopamine, norepinephrine and serotonin) along with the increased oxidative stress, inflammatory cytokines, and apoptotic parameters in the frontal cortex and hippocampus of the reserpinised mice. Treatment with FA (40 or 80 mg/kg, p.o.) reversed the behavioral abnormalities and decreased norepinephrine, serotonin and dopamine levels in the hippocampus and frontal cortex induced by reserpine. The higher dose of FA effectively antagonized the oxidative and nitrosative stress and inflammation as evidenced by down-regulated nitrite, LPO, IL-1?, TNF-?, and up-regulated GSH and SOD. Furthermore, FA produced a dose dependent decrease in substance P, NF-?? p65 and caspase-3 levels in the frontal cortex and hippocampus of reserpinised mice. The findings suggest that FA exerts the effects on reserpine-induced pain and depression-like behaviors through regulating monoaminergic system, oxidative/antioxidant defense, inflammatory and apoptotic signaling pathways. Understanding the mechanism by which FA ameliorates depression and pain as a multi-targeted compound could open new avenues for the development of innovative treatments for depression coupled with pain. PMID:23584961

Xu, Ying; Zhang, Lu; Shao, Tuo; Ruan, Lina; Wang, Lin; Sun, Jiao; Li, Jianxin; Zhu, Xinbo; O'Donnell, James M; Pan, Jianchun

2013-12-01

63

Pain Sensitivity and Individual Differences in Self-Reported Sexual Behavior  

Microsoft Academic Search

The relationship between sexual behavior and pain sensitivity was assessed in 27 heterosexual men and 20 heterosexual women. Sexual behavior measures included sexual motivation and ratings of subjective sexual arousal to and enjoyment of an auditory stimulus. Pain sensitivity measures were pain threshold and pain tolerance in a cold pressor task. Participants were tested after exposure to a neutral or

Brian E. King; Gerianne M. Alexander

2000-01-01

64

Hypoalgesic effect of EMLA and lidocaine gel applied on human oral mucosa: quantitative evaluation by sensory and pain thresholds to argon laser stimulation.  

PubMed Central

Sensory and pain thresholds to argon laser stimulation were used to evaluate the analgesic efficacy and duration of a eutectic mixture of local anesthetics (EMLA) and a 2% lidocaine gel applied topically on the oral mucosa. Application of EMLA for 2 min on the tongue and gingiva increased the pain thresholds by 92.8% and 63.4% respectively. Corresponding values for lidocaine gel were 53.6% and 21.9%. Standardized variation of the EMLA application period (2, 5, and 15 min) produced significantly different analgesic profiles on the tongue but not on the gingiva. Application of EMLA for 5 and 15 min on the tongue and for 2, 5, and 15 min on the gingiva increased the pain thresholds to a predefined analgesic level (2.15 W) for 2 to 25 min. The present experimental model for assessment of oral mucosa pain is suggested to be well-suited for investigations of intraoral analgesia. PMID:8507024

Svensson, P.; Bjerring, P.; Arendt-Nielsen, L.; Kaaber, S.

1992-01-01

65

Preventive Effects of Forced Exercise against Alcohol-induced Physical Dependency and Reduction of Pain Perception Threshold  

PubMed Central

Background: Treatment of postabstinence syndrome of alcohol is one of the major strategies of alcoholism treatment. Exercise can be modulated major brain pathways such as a reward system and pain perception centers. The aim of this study was to evaluation the effects of forced exercise in the management of alcohol dependence and pain perception alteration which induced by alcoholism. Methods: 72 adult male rats were divided into 2 major groups: (1) 40 of them was divided into groups of positive control (alcohol dependent) negative control and alcohol dependent groups under treatment by forced exercise, diazepam (0.4 mg/kg) and forced exercise in combination with diazepam and alcohol withdrawal signs, and blood cortisols, were measured in this groups. (2) 32 rats were divided into control, alcohol dependent (without treatment), and alcohol-dependent groups under treatment by forced exercise or indometacin (5 mg/kg) and then pain perception was assessed by using writhing test, tail-flick and hot plate test. Results: Forced exercise, diazepam, and their combinations significantly attenuates withdrawal syndrome to 20 ± 2, 22 ± 1.3 and 16 ± 2 and blood cortisol level to 6.8 ± 1.3,7.9 ± 1.2 and 5.8 ± 1.1, respectively, in comparison with the positive control group (P < 0.05 and P < 0.001). In alcohol dependent animal under treatment by forced exercise, pain response significantly inhibited with 37%, 57% and 38% decreases in writhing test, hot plate, and tail-flick test, respectively, in comparison with alcohol dependent (without treatment) group (P < 0.05). Conclusions: This study suggested that forced exercise can be useful as adjunct therapy in alcoholism patient and also can be effective in modulation of pain threshold reduction that was induced by alcohol dependency.

Motaghinejad, Majid; Ghaleni, Majid Asadi; Motaghinejad, Ozra

2014-01-01

66

Perioperative pain management in the opioid-tolerant patient with chronic pain: an evidence-based practice project.  

PubMed

According to the Institute of Medicine (IOM) report on pain, chronic pain affects an estimated 116 million American adults and costs the nation more than $600 billion each year in medical treatment and lost worker productivity. Many individuals with chronic pain undergo surgical procedures. Safe and effective treatment of their postoperative pain can present a significant challenge to the health care team but is essential to their optimal recovery. Administrators in a community hospital in central Pennsylvania identified a need to improve the care of their patients with chronic pain and supported a hospital-wide initiative to address various aspects of this population's hospital experience. This article presents the first phase of an evidence-based practice project that focused on improving the perioperative pain management in patients with chronic pain who receive long-acting opioids for the treatment of chronic pain before admission for surgery. PMID:23164203

Dykstra, Karen M

2012-12-01

67

Olea Europea-derived phenolic products attenuate antinociceptive morphine tolerance: an innovative strategic approach to treat cancer pain.  

PubMed

Morphine and related opioid drugs are currently the major drugs for severe pain. Their clinical utility is limited in the management of severe cancer pain due to the rapid development of tolerance. Restoring opioid efficacy is therefore of great clinical importance. A great body of evidence suggests the key role of free radicals and posttranslational modulation in the development of tolerance to the analgesic activity of morphine. Epidemiological studies have shown a relationship between the Mediterranean diet and a reduced incidence of pathologies such as coronary heart disease and cancer. A central hallmark of this diet is the high consumption of virgin olive oil as the main source of fat which contains antioxidant components in the non-saponifiable fraction, including phenolic compounds absent in seed oils. Here, we show that in a rodent model of opiate tolerance, removal of the free radicals with phenolic compounds of olive oil such as hydroxytyrosol and oleuropein reinstates the analgesic action of morphine. Chronic injection of morphine in mice led to the development of tolerance and this was associated with increased nitrotyrosin and malondialdehyde (MDA) formation together with nitration and deactivation of MnSOD in the spinal cord. Removal of free radicals by hydroxytyrosol and oleuropein blocked morphine tolerance by inhibiting nitration and MDA formation and replacing the MnSOD activity. The phenolic fraction of virgin olive oil exerts antioxidant activities in vivo and free radicals generation occurring during chronic morphine administration play a crucial role in the development of opioid tolerance. Our data suggest novel therapeutic approach in the management of chronic cancer pain, in particular for those patients who require long-term opioid treatment for pain relief without development of tolerance. PMID:24750796

Muscoli, C; Lauro, F; D'Agostino, C; Ilari, S; Giancotti, L A; Gliozzi, M; Costa, N; Carresi, C; Musolino, V; Casale, F; Ventrice, D; Oliverio, E; Palma, E; Nistico', S; Procopio, A; Mollace, V

2014-01-01

68

Habitat selection and ranges of tolerance: how do species differ beyond critical thresholds?  

PubMed

Sensitivity to habitat fragmentation often has been examined in terms of thresholds in landscape composition at which a species is likely to occur. Observed thresholds often have been low or absent, however, leaving much unexplained about habitat selection beyond initial thresholds of occurrence, even for species with strong habitat preferences. We examined responses to varying amounts of tree cover, a widely influential measure of habitat loss, for 40 woodland bird species in a mixed woodland/grassland landscape in eastern North Dakota, USA. We used LOESS smoothing to describe incidence for each species at three scales: within 200, 400, and 1200 m around sample locations. For the 200-m scale, we also calculated the most-preferred range of tree cover (within which at least half of observations were predicted to occur) for each species. Only 10 of 40 species had occurrence thresholds greater than about 10% tree cover. After initial occurrence, species showed three general patterns: some increased monotonically with tree cover; some increased up to an asymptote; some peaked at intermediate amounts of tree cover and then declined. These patterns approximate selection for interior woodlands and for edge-rich environments, but incidence plots provide greater detail in landscape-scale selection than do those categories. For most species, patterns persisted at larger scales, but for some, larger scales had distinctly different patterns than local scales. Preferred ranges of tree cover varied from <20% tree cover (common grackle, Quiscalus quiscula) to >60% (veery, Catharus fuscescens). We conclude that incidence patterns provide more information on habitat selection than do threshold measures for most species: in particular, they differentiate species preferring concentrated woodlands from those preferring mixed landscapes, and they show contrasting degrees of selectiveness. [Correction added on 16 October 2012, after first online publication: the Abstract section has been reworded]. PMID:23170216

Cunningham, Mary Ann; Johnson, Douglas H

2012-11-01

69

Habitat selection and ranges of tolerance: how do species differ beyond critical thresholds?  

PubMed Central

Sensitivity to habitat fragmentation often has been examined in terms of thresholds in landscape composition at which a species is likely to occur. Observed thresholds often have been low or absent, however, leaving much unexplained about habitat selection beyond initial thresholds of occurrence, even for species with strong habitat preferences. We examined responses to varying amounts of tree cover, a widely influential measure of habitat loss, for 40 woodland bird species in a mixed woodland/grassland landscape in eastern North Dakota, USA. We used LOESS smoothing to describe incidence for each species at three scales: within 200, 400, and 1200 m around sample locations. For the 200-m scale, we also calculated the most-preferred range of tree cover (within which at least half of observations were predicted to occur) for each species. Only 10 of 40 species had occurrence thresholds greater than about 10% tree cover. After initial occurrence, species showed three general patterns: some increased monotonically with tree cover; some increased up to an asymptote; some peaked at intermediate amounts of tree cover and then declined. These patterns approximate selection for interior woodlands and for edge-rich environments, but incidence plots provide greater detail in landscape-scale selection than do those categories. For most species, patterns persisted at larger scales, but for some, larger scales had distinctly different patterns than local scales. Preferred ranges of tree cover varied from <20% tree cover (common grackle, Quiscalus quiscula) to >60% (veery, Catharus fuscescens). We conclude that incidence patterns provide more information on habitat selection than do threshold measures for most species: in particular, they differentiate species preferring concentrated woodlands from those preferring mixed landscapes, and they show contrasting degrees of selectiveness. [Correction added on 16 October 2012, after first online publication: the Abstract section has been reworded]. PMID:23170216

Cunningham, Mary Ann; Johnson, Douglas H

2012-01-01

70

Drought Tolerance Thresholds in Cattail ( Typha latifolia ): A Test Using Controlled Hydrologic Treatments  

Microsoft Academic Search

Decades of anthropogenic flooding to create wetlands in spring for breeding waterfowl in the Canadian Prairies have produced\\u000a undesirable successional shifts from open wetlands dominated by endemic Eleocharis palustris L. (spikerush), to habitats dominated by relatively closed communities of Typha latifolia L. (cattail). Using 2 greenhouse experiments, we examined the potential of specific drying regimes to cross moisture thresholds\\u000a and

Stephen A. Asamoah; Edward W. Bork

2010-01-01

71

Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds  

PubMed Central

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ?65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2?36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males <65 years (ATmax = 102 °F; 38.9 °C). Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide. PMID:24658410

Harlan, Sharon L.; Chowell, Gerardo; Yang, Shuo; Petitti, Diana B.; Morales Butler, Emmanuel J.; Ruddell, Benjamin L.; Ruddell, Darren M.

2014-01-01

72

Threshold analysis with fault-tolerant operations for nonbinary quantum error correcting codes  

E-print Network

WITH FAULT-TOLERANT QUAN- TUM COMPUTATION ....................... 25 A.Background .......................... 25 1. Assumptions ....................... 25 2. SyndromeCalculation.................. 27 vii CHAPTER Page 3. ErrorModel ....................... 29 B... quantum error correcting code is most e?cient is based on the above four factors. Optimizing all the four parameters is not possible, but we can select the code based on the requirements of the computation. 2. Syndrome Calculation Error detection...

Kanungo, Aparna

2005-11-01

73

High-Frequency Transcutaneous Peripheral Nerve Stimulation Induces a Higher Increase of Heat Pain Threshold in the Cutaneous Area of the Stimulated Nerve When Confronted to the Neighbouring Areas  

PubMed Central

Background. TENS (transcutaneous electrical nerve stimulation) is probably the most diffused physical therapy used for antalgic purposes. Although it continues to be used by trial and error, correct targeting of paresthesias evoked by the electrical stimulation on the painful area is diffusely considered very important for pain relief. Aim. To investigate if TENS antalgic effect is higher in the cutaneous area of the stimulated nerve when confronted to neighbouring areas. Methods. 10 volunteers (4 males, 6 females) underwent three different sessions: in two, heat pain thresholds (HPTs) were measured on the dorsal hand skin before, during and after electrical stimulation (100?Hz, 0.1?msec) of superficial radial nerve; in the third session HPTs, were measured without any stimulation. Results. Radial nerve stimulation induced an increase of HPT significantly higher in its cutaneous territory when confronted to the neighbouring ulnar nerve territory, and antalgic effect persisted beyond the stimulation time. Conclusions. The location of TENS electrodes is crucial for obtaining the strongest pain relief, and peripheral nerve trunk stimulation is advised whenever possible. Moreover, the present study indicates that continuous stimulation could be unnecessary, suggesting a strategy for avoiding the well-known tolerance-like effect of prolonged TENS application. PMID:24027756

Buonocore, M.; Camuzzini, N.; Cecini, M.; Dalla Toffola, E.

2013-01-01

74

Identifying a temporal threshold of tolerance for silent gaps after requests.  

PubMed

This study addresses whether there is a threshold, some particular length of silent gap between two speakers' turns, at which negative social attributions emerge. The effect of such inter-turn silence was tested by constructing dialogues where responses to requests were identical and affirmative so that study participants' (n = 380) ratings about "willingness" would be colored by lag time, not semantics. 100 ms intervals between 200 and 1200 ms were tested in a between groups design. There was a notable drop-off in ratings at 600 ms and a statistically significant difference in ratings between 700 and 800 ms. PMID:23742442

Roberts, Felicia; Francis, Alexander L

2013-06-01

75

Practical Guide to the Management of Acute and Chronic Pain in the Presence of Drug Tolerance for the Healthcare Practitioner  

PubMed Central

Background Drug tolerance has been on the rise in recent years worldwide, and consequently, pain management in our population has become challenging. Methods Discussed in this review are commonly abused drugs and considerations for treating acute and chronic pain states in patients with substance disorders. Results After marijuana, alcohol, and tobacco, the most widely abused substances are oxycodone (Oxycontin), diazepam (Valium), and methylphenidate (Ritalin). Urine testing can detect metabolites of drugs used by patients and is useful for assessing drug abuse, medication diversion, and drug interactions. The comprehensive treatment of pain in a patient with addictive disorder or tolerance must address 3 issues: the patient's addiction, any associated psychiatric conditions, and the patient's pain. Eliciting a detailed history of drug abuse—illicit drugs as well as prescription drugs—and ascertaining if the patient is currently enrolled in a methadone maintenance program for the treatment of drug addiction is vital. Conclusion Medical observation, supportive care, multidisciplinary pain management, and timely interventions as necessary are the keys to safe outcomes in these patients. PMID:25249810

Vadivelu, Nalini; Singh-Gill, Harman; Kodumudi, Gopal; Kaye, Aaron Joshua; Urman, Richard D.; Kaye, Alan David

2014-01-01

76

Reduction of pain thresholds in fibromyalgia after very low-intensity magnetic stimulation: A double-blinded, randomized placebo-controlled clinical trial  

PubMed Central

BACKGROUND: Exposure to electromagnetic fields has been reported to have analgesic and antinociceptive effects in several organisms. OBJECTIVE: To test the effect of very low-intensity transcranial magnetic stimulation on symptoms associated with fibromyalgia syndrome. METHODS: A double-blinded, placebo-controlled clinical trial was performed in the Sagrado Corazón Hospital, Seville, Spain. Female fibromyalgia patients (22 to 50 years of age) were randomly assigned to either a stimulation group or a sham group. The stimulation group (n=28) was stimulated using 8 Hz pulsed magnetic fields of very low intensity, while the sham group (n=26) underwent the same protocol without stimulation. Pressure pain thresholds before and after stimulation were determined using an algometer during the eight consecutive weekly sessions of the trial. In addition, blood serotonin levels were measured and patients completed questionnaires to monitor symptom evolution. RESULTS: A repeated-measures ANOVA indicated statistically significant improvement in the stimulation group compared with the control group with respect to somatosensory pain thresholds, ability to perform daily activities, perceived chronic pain and sleep quality. While improvement in pain thresholds was apparent after the first stimulation session, improvement in the other three measures occurred after the sixth week. No significant between-group differences were observed in scores of depression, fatigue, severity of headaches or serotonin levels. No adverse side effects were reported in any of the patients. CONCLUSIONS: Very low-intensity magnetic stimulation may represent a safe and effective treatment for chronic pain and other symptoms associated with fibromyalgia. PMID:24308025

Maestu, Ceferino; Blanco, Manuel; Nevado, Angel; Romero, Julia; Rodriguez-Rubio, Patricia; Galindo, Javier; Lorite, Juan Bautista; de las Morenas, Francisco; Fernandez-Arguelles, Pedro

2013-01-01

77

Cognitive strategies, expectancy, and coping style in the control of pain  

Microsoft Academic Search

Measures of tolerance, self-reported pain threshold, and overall discomfort of cold-pressor pain were obtained from 114 male undergraduates in a pretest–training–posttest experiment. Training consisted of brief practice in 1 of 4 cognitive strategies: rational thinking, compatible imagery, incompatible imagery, and task-irrelevant cognition. Analyses of covariance indicated that (a) cognitive-imaginal strategies facilitated endurance of pain and raised self-reported threshold, (b) rational

Thomas M. Beers; Paul Karoly

1979-01-01

78

Transcutaneous spinal direct current stimulation inhibits nociceptive spinal pathway conduction and increases pain tolerance in humans  

Microsoft Academic Search

Despite concerted efforts from pharmacologic research into neuropathic pain, many patients fail to achieve sufficient pain relief with medication alone. For this reason, increasing interest centres on neurostimulation techniques. We assessed whether transcutaneous spinal direct current stimulation (tsDCS) modulates conduction in ascending nociceptive spinal pathways. We measured changes induced by anodal and cathodal tsDCS over the thoracic spinal cord on

A. Truini; M. Vergari; A. Biasiotta; S. La Cesa; M. Gabriele; G. Di Stefano; C. Cambieri; G. Cruccu; M. Inghilleri; A. Priori

2011-01-01

79

Effect of Transcutaneous Electrical Nerve Stimulation on Sensation Thresholds in Patients with Painful Diabetic Neuropathy: An Observational Study  

ERIC Educational Resources Information Center

Transcutaneous electrical nerve stimulation (TENS) is one of the therapies for painful neuropathy. Its analgesic mechanisms probably involve the gate control theory, the physiological block and the endogenous pain inhibitory system. The aim of the study was to determine whether TENS improves small fibre function diminished because of painful

Moharic, Metka

2010-01-01

80

The role of threat-expectancy in acute pain: effects on attentional bias, coping strategy effectiveness and response to pain  

Microsoft Academic Search

The aims of this study were threefold. Firstly, to investigate the effect of increasing threat-expectancy on attentional biases towards pain-related words. Secondly, to determine the interaction between threat-expectancy and the effectiveness of two coping strategies on pain threshold and tolerance. Thirdly, to investigate the relationship between fear of pain and the experimental manipulations. One hundred undergraduate psychology students were randomly

Alison Boston; Louise Sharpe

2005-01-01

81

Effect of a single 30?min UMTS mobile phone-like exposure on the thermal pain threshold of young healthy volunteers.  

PubMed

One of the most frequently investigated effects of radiofrequency electromagnetic fields (RF EMFs) on the behavior of complex biological systems is pain sensitivity. Despite the growing body of evidence of EMF-induced changes in pain sensation, there is no currently accepted experimental protocol for such provocation studies for the healthy human population. In the present study, therefore, we tested the effects of third generation Universal Mobile Telecommunications System (UMTS) RF EMF exposure on the thermal pain threshold (TPT) measured on the surface of the fingers of 20 young adult volunteers. The protocol was initially validated with a topical capsaicin treatment. The exposure time was 30?min and the genuine (or sham) signal was applied to the head through a patch antenna, where RF EMF specific absorption rate (SAR) values were controlled and kept constant at a level of 1.75?W/kg. Data were obtained using randomized, placebo-controlled trials in a double-blind manner. Subjective pain ratings were tested blockwise on a visual analogue rating scale (VAS). Compared to the control and sham conditions, the results provide evidence for intact TPT but a reduced desensitization effect between repeated stimulations within the individual blocks of trials, observable only on the contralateral side for the genuine UMTS exposure. Subjective pain perception (VAS) data indicated marginally decreased overall pain ratings in the genuine exposure condition only. The present results provide pioneering information about human pain sensation in relation to RF EMF exposure and thus may contribute to cover the existing gap between safety research and applied biomedical science targeting the potential biological effects of environmental RF EMFs. PMID:23787775

Vecsei, Zsuzsanna; Csathó, Árpád; Thuróczy, György; Hernádi, István

2013-10-01

82

Enhanced pain modulation among triathletes: a possible explanation for their exceptional capabilities.  

PubMed

Triathletes and ironman triathletes engage in an extremely intense sport that involves hours of considerable pain, as well as physical and psychological stress, every day. The basic pain modulation properties of these athletes has not been established and therefore it is not clear whether they present with unique features that enable them to engage in such efforts. The aim was to investigate the existence of possible alterations in pain perception and modulation of triathletes, as well as possible underlying factors. Participants were 19 triathletes and 17 non-athletes who underwent measurement of pain threshold, pain tolerance, suprathreshold perceived pain intensity, temporal summation of pain, and conditioned pain modulation (CPM). Participants also completed the fear of pain and the pain catastrophizing questionnaires, and rated the amount of perceived stress. Triathletes exhibited higher pain tolerance (P<.0001), lower pain ratings (P<.001), and lower fear of pain values (P<.05) than controls. The magnitude of CPM was significantly greater in triathletes (P<.05), and negatively correlated with fear of pain (P<.05) and with perceived mental stress during training and competition (P<.05). The results suggest that triathletes exhibit greater pain tolerance and more efficient pain modulation than controls, which may underlie their perseverance in extreme physical efforts and pain during training/competitions. This capability may be enhanced or mediated by psychological factors, enabling better coping with fear of pain and mental stress. PMID:23806655

Geva, Nirit; Defrin, Ruth

2013-11-01

83

Pain.  

PubMed

Invasive stimulation of the motor (precentral) cortex using surgically implanted epidural electrodes is indicated for the treatment of neuropathic pain that is refractory to medical treatment. Controlled trials have demonstrated the efficacy of epidural motor cortex stimulation (MCS), but MCS outcome remains variable and validated criteria for selecting good candidates for implantation are lacking. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach that could be used as a preoperative tool to predict MCS outcome and also could serve as a therapeutic procedure in itself to treat pain disorders. This requires repeated rTMS sessions and a maintenance protocol. Other studies have also demonstrated the efficacy of transcranial direct current stimulation (tDCS) in relieving chronic pain syndromes. The most studied target is the precentral cortex, but other targets, such as the prefrontal and parietal cortices, could be of interest. The analgesic effects of cortical stimulation relate to the activation of various circuits modulating neural activities in remote structures, such as the thalamus, limbic cortex, insula, or descending inhibitory controls. In addition to the treatment of refractory neuropathic pain by epidural MCS, new developments of this type of strategy are ongoing, for other types of pain syndrome and stimulation techniques. PMID:24112914

Lefaucheur, Jean-Pascal

2013-01-01

84

Relief of pain by infusion of morphine after operation: does tolerance develop?  

Microsoft Academic Search

To see whether continuous intravenous infusion of opiates provides more effective postoperative relief of pain than conventional intramuscular injection these regimens were compared in a prospective double blind trial. Thirty patients undergoing elective cholecystectomy were allocated randomly to receive an infusion of morphine or an infusion of placebo (control group) for 24 hours. Both groups were allowed supplementary morphine boluses

H Marshall; C Porteous; I McMillan; S G MacPherson; W S Nimmo

1985-01-01

85

Lack of Rapid Development of Opioid Tolerance During Alfentanil and Remifentanil Infusions for Postoperative Pain  

Microsoft Academic Search

Studies in animals and volunteers have suggested the development of acute tolerance to opioid analgesics. In this article, we present data from patients who reg- ulated their own target-controlled infusions of alfen- tanil and remifentanil to provide analgesia in the im- mediate postoperative period. Fifty-one patients received alfentanil for 24 h after cardiac surgery, and 30 patients received remifentanil for

Stefan Schraag; Matthew R. Checketts; Gavin N. C. Kenny

1999-01-01

86

The role of sleep problems in central pain processing in rheumatoid arthritis  

PubMed Central

Objective Among rheumatoid arthritis (RA) patients, pain may exist out of proportion to peripheral inflammation. This observation suggests that central nervous system pain amplification mechanisms, such as diminished conditioned pain modulation (CPM), may play a role in enhancing pain perception among some RA patients. We examined CPM, pressure pain threshold and pressure pain tolerance among RA patients compared to controls. Methods Fifty-eight female RA patients and 54 age-matched controls without chronic pain underwent quantitative sensory testing (QST) to assess CPM, pressure pain threshold and pressure pain tolerance. CPM was induced using a cold water bath, and pain threshold (when patients first felt pain) and tolerance (when pain was too much to bear) were assessed with an algometer. Associations between RA and QST measures were analyzed using linear regression. Sleep problems, mental health and inflammation were assessed as mediators of the relationship between RA and QST measures. Results Median CPM levels were 0.5 kg/cm2 (interquartile range (IQR) ?0.1, 1.6) among RA patients compared to 1.5 kg/cm2 (IQR ?0.1, 2.5) among controls (P = 0.04). Relative to controls, RA patients had lower pain threshold and tolerance at the wrists (P ? 0.05). Compared to controls, RA patients had greater problems with sleep, catastrophizing, depression and anxiety (P < 0.0001). Mediation analyses suggested that low CPM levels may be partially attributable to sleep disturbance (P = 0.04). Conclusion RA patients have impaired CPM relative to pain-free controls. Sleep problems may mediate the association between RA and attenuated CPM. PMID:23124650

Lee, Yvonne C.; Lu, Bing; Edwards, Robert R.; Wasan, Ajay D.; Nassikas, Nicholas J.; Clauw, Daniel J.; Solomon, Daniel H.; Karlson, Elizabeth W.

2012-01-01

87

An open-label, long-term study examining the safety and tolerability of pregabalin in Japanese patients with central neuropathic pain  

PubMed Central

Purpose Studies of pregabalin for the treatment of central neuropathic pain have been limited to double-blind trials of 4–17 weeks in duration. The purpose of this study was to assess the long-term safety and tolerability of pregabalin in Japanese patients with central neuropathic pain. The efficacy of pregabalin was also assessed as a secondary measure. Patients and methods This was a 53-week, multicenter, open-label trial of pregabalin (150–600 mg/day) in Japanese patients with central neuropathic pain due to spinal cord injury, multiple sclerosis, or cerebral stroke. Results A total of 103 patients received pregabalin (post-stroke =60; spinal cord injury =38; and multiple sclerosis =5). A majority of patients (87.4%) experienced one or more treatment-related adverse events, most commonly somnolence, weight gain, dizziness, or peripheral edema. The adverse event profile was similar to that seen in other indications of pregabalin. Most treatment-related adverse events were mild (89.1%) or moderate (9.2%) in intensity. Pregabalin treatment improved total score, sensory pain, affective pain, visual analog scale (VAS), and present pain intensity scores on the Short-Form McGill Pain Questionnaire (SF-MPQ) and ten-item modified Brief Pain Inventory (mBPI-10) total score at endpoint compared with baseline. Improvements in SF-MPQ VAS and mBPI-10 total scores were evident in all patient subpopulations. Mean changes from baseline in SF-MPQ VAS and mBPI-10 scores at endpoint were ?20.1 and ?1.4, respectively. Conclusion These findings demonstrate that pregabalin is generally well tolerated and provides sustained efficacy over a 53-week treatment period in patients with chronic central neuropathic pain. PMID:25114584

Onouchi, Kenji; Koga, Hiroaki; Yokoyama, Kazumasa; Yoshiyama, Tamotsu

2014-01-01

88

Heat pain thresholds and cerebral event-related potentials following painful CO 2 laser stimulation in chronic tension-type headache  

Microsoft Academic Search

Current opinion concerning the pathophysiology of tension-type headache (TTH) and its related pericranial muscle tenderness proposes a primary role of central sensitization at the level of dorsalhorn\\/trigeminal nucleus as well as the supraspinal level. Investigation of these phenomena can be conducted using laser-evoked potentials (LEPs), which are objective and quantitative neurophysiological tools for the assessment of pain perception.In the present

Marina de Tommaso; Giuseppe Libro; Marco Guido; Vittorio Sciruicchio; Luciana Losito; Francomichele Puca

2003-01-01

89

Pressure pain threshold and needle acupuncture in chronic tension-type headache – a double-blind placebo-controlled study  

Microsoft Academic Search

In order to examine the role of muscular mechanisms in chronic tension-type headache a study with needle acupuncture was performed. Needle acupuncture could be of therapeutic value because it has shown some positive effects in myofascial pain syndromes. We performed a double-blind, placebo-controlled study with 39 patients (mean age 49.0 years, SD=14.8) fulfilling the International Headache Society criteria for chronic

Matthias Karst; Jens D Rollnik; Matthias Fink; Michaela Reinhard; Siegfried Piepenbrock

2000-01-01

90

Sex differences and hormonal modulation of deep tissue pain  

PubMed Central

Women disproportionately suffer from many deep tissue pain conditions. Experimental studies show that women have lower pain thresholds, higher pain ratings and less tolerance to a range of painful stimuli. Most clinical and epidemiological reports suggest female gonadal hormones modulate pain for some, but not all, conditions. Similarly, animal studies support greater nociceptive sensitivity in females in many deep tissue pain models. Gonadal hormones modulate responses in primary afferents, dorsal horn neurons and supraspinal sites, but the direction of modulation is variable. This review will examine sex differences in deep tissue pain in humans and animals focusing on the role of gonadal hormones (mainly estradiol) as an underlying component of the modulation of pain sensitivity. PMID:23872333

Traub, Richard J.; Ji, Yaping

2013-01-01

91

Pain Sensitivity Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case Control Study  

PubMed Central

Many studies report that people with temporomandibular disorders (TMD) are more sensitive to experimental pain stimuli than TMD-free controls. Such differences in sensitivity are observed in remote body sites as well as in the orofacial region, suggesting a generalized upregulation of nociceptive processing in TMD cases. This large case-control study of 185 adults with TMD and 1,633 TMD-free controls measured sensitivity to painful pressure, mechanical cutaneous, and heat stimuli, using multiple testing protocols. Based on an unprecedented 36 experimental pain measures, 28 showed statistically significantly greater pain sensitivity in TMD cases than controls. The largest effects were seen for pressure pain thresholds at multiple body sites and cutaneous mechanical pain threshold. The other mechanical cutaneous pain measures and many of the heat pain measures showed significant differences, but with lesser effect sizes. Principal component analysis (PCA) of the pain measures derived from 1,633 controls identified five components labeled: (1) heat pain ratings, (2) heat pain aftersensations and tolerance, (3) mechanical cutaneous pain sensitivity, (4) pressure pain thresholds, and (5) heat pain temporal summation. These results demonstrate that, compared to TMD-free controls, chronic TMD cases are more sensitive to many experimental noxious stimuli at extra-cranial body sites, and provides for the first time the ability to directly compare the case-control effect sizes of a wide range of pain sensitivity measures. PMID:22074753

Greenspan, Joel D.; Slade, Gary D.; Bair, Eric; Dubner, Ronald; Fillingim, Roger B.; Ohrbach, Richard; Knott, Charlie; Mulkey, Flora; Rothwell, Rebecca; Maixner, William

2011-01-01

92

[Difference in tolerance to anti-hyperalgesic effect and its molecular mechanisms between chronic treatment with morphine, fentanyl and oxycodone in a chronic pain-like state].  

PubMed

In the present study, we demonstrated that repeated treatment with fentanyl, but not morphine or oxycodone, causes a rapid desensitization to its ability to block the hyperalgesia associated with the attenuation of mu-opioid receptor resensitization in mice in a chronic pain-like state. In contrast, no such effect was noted in beta-endorphin knockout mice under the chronic pain-like conditions. On the assumption that beta-endorphin might be released within the spinal cord under pain-like conditions, we further examined whether beta-endorphin could be responsible for a desensitization and resensitization of fentanyl under the chronic pain. In cultured cells, unlike morphine, fentanyl and oxycodone induced a robust mu-opioid receptor internalization and, in turn, its resensitization. In the presence of beta-endorphin, the internalized mu-opioid receptor induced by fentanyl, but not oxycodone, remained within the cytosolic component even after washing out. The findings suggest that beta-endorphin could attenuate the resensitization of mu-opioid receptors. This phenomenon may explain the high degree of tolerance to fentanyl that develops with hyperalgesia caused by a chronic pain-like state. PMID:19108502

Satoshi, Imai; Narita, Minoru; Ozeki, Ayumi; Nakamura, Atsushi; Hashimoto, Seiko; Narita, Michiko; Kuzumaki, Naoko; Uezono, Yasuhito; Suzuki, Tsutomu

2008-11-01

93

Psychological aspects of painful medical conditions in children. I. Developmental aspects and assessment.  

PubMed

The assessment and development of pain in children is reviewed in the first part of a two-part series. Assessment of pain in children has relied on self-report measures that have included visual analogue procedures using concrete stimuli for ratings. Behavioral assessment procedures are more sophisticated, but research on behavioral assessment of pediatric pain has begun to emergy only recently. There has been very little research on the developmental aspects of pain tolerance and pain threshold in children. There are preliminary indications that children's thoughts and attitudes about pain may change with age in a manner that contributes to more intense feelings of pain in adolescence than childhood. Children undergoing painful medical procedures show declining emotional outbursts with age and increasing signs of self-control and muscular rigidity. Possibilities for integrating the study of the developmental aspects of pain with social learning theory, cognitive developmental theory, and the psychology of physical symptom perception are discussed. PMID:3540810

Lavigne, J V; Schulein, M J; Hahn, Y S

1986-11-01

94

Effects of coping statements on experimental pain in chronic pain patients  

PubMed Central

The present study measured the effects of catastrophizing self-statements and positive coping self-statements on cold pressor-induced pain. Participants were 58 adult chronic pain patients with current facial pain. It was hypothesized that catastrophizing would lead to a decrease in pain endurance whereas positive coping would lead to an increase in pain endurance. It was also hypothesized that catastrophizing would lead to an increase in peak pain intensity whereas positive coping would lead to a decrease in peak pain intensity. At pretest, participants submerged their nondominant hand in the cold pressor. Pain sensitivity ranges (PSR) were subsequently determined by calculating the difference between tolerance and threshold times. Ratings of peak pain intensity were measured using a pressure sensitive bladder/transducer. Participants underwent random assignment to either a catastrophizing group or a positive coping self-statement group. ANCOVA results revealed that on average, participants employing catastrophizing statements as a coping strategy experienced significantly lower PSR (M = 35.53, SD = 39.71) compared to participants employing positive coping self-statements (M = 73.70, SD = 86.14) when controlling for pretest PSR. Group assignment had no significant influence on peak pain intensity ratings. Thus, our results reveal that manipulation of coping causes changes in pain endurance. PMID:21197299

Roditi, Daniela; Robinson, Michael E; Litwins, Nola

2009-01-01

95

Efficacy, safety, and tolerability of fulranumab, an anti-nerve growth factor antibody, in the treatment of patients with moderate to severe osteoarthritis pain.  

PubMed

Nerve growth factor (NGF) is increased in chronic pain conditions. This study examined analgesic efficacy and safety of fulranumab, a fully human monoclonal anti-NGF antibody, in adults with chronic osteoarthritis pain. Patients (n=466, intent-to-treat) were randomized to receive, in addition to their current pain therapy, subcutaneous injections in 1 of 6 parallel treatment groups: placebo (n=78), fulranumab 1 mg (n=77) or 3 mg (n=79) every 4 weeks (Q4wk), 3 mg (n=76), 6 mg (n=78), or 10 mg (n=78) every 8 weeks (Q8wk). Primary efficacy results showed that fulranumab significantly reduced the average pain intensity score (P < or = 0.030) from baseline to week 12 compared with placebo in the 3mgQ4wk, 6mgQ8wk, and 10mgQ8wk groups. Secondary efficacy outcomes indicated that significant improvement occurred compared with placebo at week 12 on the Western Ontario and McMaster Universities Osteoarthritis Index subscales of pain, stiffness, and physical function (P < 0.040) across all fulranumab groups except 1mgQ4wk, on the Brief Pain Inventory-Short Form subscales of pain intensity (P < or = 0.016) and pain interference (P < or = 0.030) in the 3mgQ4wk and 10mgQ8wk groups, and on the Patient Global Assessment score (P < or = 0.040) in the 3mgQ4wk, 6mgQ8wk, and 10mgQ8wk groups. The most common (> or = 5% of patients) treatment-emergent adverse events in overall fulranumab groups during the first 12weeks included paresthesia (7%), headache (5%), and nasopharyngitis (5%). Most neurologic-related treatment-emergent adverse events were mild or moderate and resolved at the end of week 12. Serious adverse events occurred in 3 patients, but they were not neurologically related and resolved before study completion. Fulranumab treatment resulted in statistically significant efficacy in pain measures and physical function versus placebo and was generally well tolerated. PMID:23748114

Sanga, Panna; Katz, Nathaniel; Polverejan, Elena; Wang, Steven; Kelly, Kathleen M; Haeussler, Juergen; Thipphawong, John

2013-10-01

96

The Measurement of Suprathreshold Pain.  

National Technical Information Service (NTIS)

The study of both subjective and physiological responses to painful stimulation is fraught with a number of difficulties, one of which is the difference in functional relationships between the threshold and suprathreshold of pain, such as surgical pain. B...

J. Voevodsky, L. M. Cooper, A. H. Morgan, E. R. Hilgard

1967-01-01

97

Comparison of analgesic effects and patient tolerability of nabilone and dihydrocodeine for chronic neuropathic pain: randomised, crossover, double blind study  

Microsoft Academic Search

Objective To compare the analgesic efficacy and side effects of the synthetic cannabinoid nabilone with those of the weak opioid dihydrocodeine for chronic neuropathic pain. Design Randomised, double blind, crossover trial of 14 weeks’ duration comparing dihydrocodeine and nabilone.Setting Outpatient units of three hospitals in the United Kingdom.Participants 96 patients with chronic neuropathic pain, aged 23-84 years. Main outcome measures

B Frank; M G Serpell; J Hughes; J N S Matthews; D Kapur

2008-01-01

98

The Effect of Pressure Pain Sensitivity and Patient Factors on Self-Reported Pain-Disability in Patients with Chronic Neck Pain  

PubMed Central

The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p?0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p?0.01). PPS at the 4-selected body locations was able to explain neck disability (R2=25-28%). Comorbidity was the strongest predictor of neck disability (R2 =30%) and pain (R2=25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.

Uddin, Zakir; MacDermid, Joy C.; Woodhouse, Linda J.; Triano, John J.; Galea, Victoria; Gross, Anita R.

2014-01-01

99

Sensitization in patients with painful knee osteoarthritis  

Microsoft Academic Search

Pain is the dominant symptom in osteoarthritis (OA) and sensitization may contribute to the pain severity. This study investigated the role of sensitization in patients with painful knee OA by measuring (1) pressure pain thresholds (PPTs); (2) spreading sensitization; (3) temporal summation to repeated pressure pain stimulation; (4) pain responses after intramuscular hypertonic saline; and (5) pressure pain modulation by

Lars Arendt-Nielsen; Hongling Nie; Mogens B. Laursen; Birgitte S. Laursen; Pascal Madeleine; Ole H. Simonsen; Thomas Graven-Nielsen

2010-01-01

100

Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain  

PubMed Central

Objectives. This study was done to evaluate three bedside tests in discriminating visceral pain from somatic pain among women with chronic pelvic pain. Study Design. The study was an exploratory cross-sectional evaluation of 81 women with chronic pelvic pain of 6 or more months' duration. Tests included abdominal cutaneous allodynia (aCA), perineal cutaneous allodynia (pCA), abdominal and perineal myofascial trigger points (aMFTP) and (pMFTP), and reduced pain thresholds (RPTs). Results. Eighty-one women were recruited, and all women provided informed consent. There were 62 women with apparent visceral pain and 19 with apparent somatic sources of pain. The positive predictive values for pelvic visceral disease were aCA-93%, pCA-91%, aMFTP-93%, pMFTP-81%, and RPT-79%. The likelihood ratio (+) and 95% C.I. for the detection of visceral sources of pain were aCA-4.19 (1.46, 12.0), pCA-2.91 (1.19, 7.11), aMTRP-4.19 (1.46, 12.0), pMFTP-1.35 (0.86, 2.13), and RPT-1.14 (0.85, 1.52), respectively. Conclusions. Tests of cutaneous allodynia, myofascial trigger points, and reduced pain thresholds are easily applied and well tolerated. The tests for cutaneous allodynia appear to have the greatest likelihood of identifying a visceral source of pain compared to somatic sources of pain. PMID:22135736

Jarrell, John; Giamberardino, Maria Adele; Robert, Magali; Nasr-Esfahani, Maryam

2011-01-01

101

Gender expression, sexual orientation and pain sensitivity in women  

PubMed Central

BACKGROUND: Despite a growing body of literature investigating sex differences with regard to pain, surprisingly little research has been conducted on the influence of various aspects of self-identity, including gender expression and sexual orientation, on pain sensitivity within each sex, particularly among women. In men, dispositional femininity is linked to greater clinical pain and trait masculinity is associated with higher pain thresholds. OBJECTIVES: To examine whether gender expression and sexual orientation are associated with within-sex differences in ischemic pain sensitivity in healthy young women. METHODS: A convenience sample of 172 females (mean age 21.4 years; range 18 to 30 years of age; 56.0% white, 89% heterosexual) performed an ischemic pain task in counterbalanced order. Desired levels of dispositional femininity for a preferred romantic partner and self-described levels of personal dispositional femininity were measured. RESULTS: Compared with heterosexual women, lesbian and bisexual women reported lower pain intensity ratings early in the discomfort task. Irrespective of sexual orientation, attraction to more feminine romantic partners and dispositional masculinity were correlated with lower pain intensity, and with higher pain thresholds and tolerance levels. DISCUSSION: These preliminary findings suggest that within-sex differences in sexual orientation and other aspects of identity, irrespective of biological sex, may be important to consider when examining experimental pain performance and clinical pain experiences. CONCLUSION: Larger investigations of the psychophysiological relationships among sexual orientation, gender expression and pain sensitivity are warranted. These findings may have implications for differences in clinical pain sensitivity of lesbian and bisexual women compared with heterosexual women. PMID:24575419

Vigil, Jacob M; Rowell, Lauren N; Lutz, Charlotte

2014-01-01

102

Intrathecal allograft of chromaffin cells for intractable pain treatment: A model for understanding CNS tolerance mechanisms in humans  

Microsoft Academic Search

GRAFTS of adrenal medulla tissue or chromaffin cells have been proposed for the treatment of Parkinson's disease and chronic pain.1,2 It has been shown that transplanted chromaffin cells can release analgesic neuroactive substances, including catecholamines, opioid peptides, metenkephalin, somatostatin, and so on.3,4 The subarachnoid space is a favored site for the allograft since the phenomenon of immunologic privilege is classically

J. Tkaczuk; J. C. Bes; H. de Bouet du Portal; M. Tafani; H. Duplan; M. Abbal; Y. Lazorthes; E. Ohayon

1997-01-01

103

Gender role affects experimental pain responses: a systematic review with meta-analysis.  

PubMed

Gender role refers to the culturally and socially constructed meanings that describe how women and men should behave in certain situations according to feminine and masculine roles learned throughout life. The aim of this meta-analysis was to evaluate the relationship between gender role and experimental pain responses in healthy human participants. We searched computerized databases for studies published between January 1950 and May 2011 that had measured gender role in healthy human adults and pain response to noxious stimuli. Studies were entered into a meta-analysis if they calculated a correlation coefficient (r) for gender role and experimental pain. Searches yielded 4465 'hits' and 13 studies were eligible for review. Sample sizes were 67-235 participants and the proportion of female participants was 45-67%. Eight types of gender role instrument were used. Meta-analysis of six studies (406 men and 539 women) found a significant positive correlation between masculine and feminine personality traits and pain threshold and tolerance, with a small effect size (r = 0.17, p = 0.01). Meta-analysis of four studies (263 men and 297 women) found a significant negative correlation between gender stereotypes specific to pain and pain threshold and tolerance, with a moderate effect size (r = -0.41, p < 0.001). In conclusion, individuals who considered themselves more masculine and less sensitive to pain than the typical man showed higher pain thresholds and tolerances. Gender stereotypes specific to pain scales showed stronger associations with sex differences in pain sensitivity response than masculine and feminine personality trait scales. PMID:22434689

Alabas, O A; Tashani, O A; Tabasam, G; Johnson, M I

2012-10-01

104

Gabapentin improves Cold-pressor Pain Responses in Methadone-maintained Patients  

PubMed Central

Individuals on methadone maintenance for the treatment of addiction (MM) are demonstrated to be hyperalgesic to cold-pressor pain in comparison to matched controls and ex-opioid addicts, a finding described as clinical evidence of opioid-induced hyperalgesia (OIH). Interestingly, opioids induce hyperalgesia via many of the same neuro-inflammatory and central sensitization processes that occur with the development of neuropathic pain. Evaluated in this study was the efficacy of a key pharmacotherapy for neuropathic pain, gabapentin (GPN), to reverse OIH in MM patients. Utilizing a clinical trial design and double blind conditions, changes in cold-pressor pain threshold and tolerance following a five-week trial of GPN (titrated to 2400mg/day) were evaluated at peak and trough methadone plasma levels in a well-characterized MM sample. Drug abstinence was encouraged via an escalating payment schedule, and compliance monitored via pill counts and GPN plasma levels; entered into the analyses were only those subjects compliant and abstinent throughout the study (approx 45%). Utilizing change scores from baseline, significant improvements in cold-pressor pain threshold and pain tolerance were observed at both peak and trough methadone levels (p < 0.05). Notably, drop-out rates due to medication side effects were low (2%) and the medication was well-tolerated. These results support that GPN, as prescribed for the treatment of neuropathic pain, is effective in decreasing OIH in patients who are abstinent and stable in methadone treatment. PMID:20163921

Compton, Peggy; Kehoe, Priscilla; Sinha, Karabi; Torrington, Matt A.; Ling, Walter

2010-01-01

105

Safety, tolerability, pharmacokinetics, and effects on human experimental pain of the selective ionotropic glutamate receptor 5 (iGluR5) antagonist LY545694 in healthy volunteers.  

PubMed

The objective of this study was to establish in healthy volunteers the maximally tolerated multiple dose (MTMD) of the ionotropic glutamate receptor 5 antagonist LY545694 (part A), and to investigate whether that dose had analgesic or antihyperalgesic effects in the brief thermal stimulation (BTS) pain model (Part B). Part A was a double-blind, placebo-controlled study in 3 groups of 10 healthy men. To simulate an extended-release formulation, study drug was administered orally over 6hours (12 equally divided aliquots at 30-minute intervals). Part B was a double-blind, placebo-controlled, double-dummy, 3-way crossover study in 27 healthy men. At each of the 3 study periods, subjects received either LY545694 (MTMD; as determined during part A) as a simulated, twice daily extended-release formulation for 4 doses over 3days, gabapentin (600mg 8hours apart; 6 doses over 3days; positive control), or matching placebo. The BTS model was induced twice with a 1-hour interval on each of the 2 study days, before drug administration and at the time of expected peak analgesia of LY545694. Plasma exposure for LY545694 was approximately linear over the 25- to 75-mg dose range. The MTMD of LY545694 was 25mg twice daily. Areas of secondary hyperalgesia were significantly smaller after administration of LY545694 and gabapentin compared with placebo (P<.0001 and P=.0004, respectively), but there was no difference between areas after administration of gabapentin and LY545694 (P=.400). Neither gabapentin nor LY545694 reduced the painfulness of skin heating during BTS model induction. The most common treatment-emergent adverse event was dizziness. The results of this study suggest that LY545694 should be explored further as a potential treatment for chronic pain involving neuronal sensitization. PMID:24486883

Petersen, Karin L; Iyengar, Smriti; Chappell, Amy S; Lobo, Evelyn D; Reda, Haatem; Prucka, William R; Verfaille, Steven J

2014-05-01

106

Tolerance to the antinociceptive effect of Crotalus durissus terrificus snake venom in mice is mediated by pharmacodynamic mechanisms  

Microsoft Academic Search

Crotalus durissus terrificus venom exerts central and peripheral antinociceptive effect mediated by opioid receptors. The present work investigated the tolerance to the antinociceptive effect of the venom and characterised the mechanisms involved in this phenomenon. The hot plate test, applied in mice, was used for pain threshold determination. The venom (200?g\\/kg) was administered by oral route, daily, for 14 days,

P Brigatte; F. A Hoffmann; M. M Bernardi; R Giorgi; I Fernandes; H. A Takehara; S. B. M Barros; M. G Almeida; Y Cury

2001-01-01

107

Increased Sensitivity to Thermal Pain and Reduced Subcutaneous Lidocaine Efficacy in Redheads  

PubMed Central

Background: Anesthetic requirement in redheads is exaggerated, suggesting that redheads may be especially sensitive to pain. We therefore tested the hypotheses that women with natural red hair are more sensitive to pain, and that redheads are resistant to topical and subcutaneous lidocaine. Methods: We evaluated pain sensitivity in red-haired (n=30) or dark-haired (n=30) women by determining the electrical current perception threshold, pain perception, and maximum pain tolerance with a Neurometer CPT/C (Neurotron, Inc., Baltimore, MD). We evaluated the analogous warm and cold temperature thresholds with the TSA-II Neurosensory Analyzer (Medoc Ltd., Minneapolis, MN). Volunteers were tested with both devices at baseline and with the Neurometer after 1-hour exposure to 4% liposomal lidocaine and after subcutaneous injection of 1% lidocaine. Data are presented as medians [interquartile ranges]. Results: Current perception, pain perception, and pain tolerance thresholds were similar in the red-haired and dark-haired women at 2000, 250, and 5 Hz. In contrast, redheads were more sensitive to cold pain perception (22.6°C [15.1, 26.1] vs. 12.6°C [0, 20], P=0.004), cold pain tolerance (6.0°C [0, 9.7] vs. 0.0°C [0.0, 2.0], P=0.001), and heat pain (46.3°C [45.7, 47.5] vs. 47.7°C [46.6, 48.7], P=0.009). Subcutaneous, lidocaine was significantly less effective in redheads, e.g., pain tolerance threshold at 2000 Hz stimulation in redheads was 11.0 mA [8.5, 16.5] vs. >20.0 mA [14.5, >20] in others, P=0.005). Conclusion: Red hair is the phenotype for mutations of the melanocortin 1 receptor. Our results indicate that redheads are more sensitive to thermal pain and are resistant to the analgesic effects of subcutaneous lidocaine. Mutations of the melanocortin 1 receptor, or a consequence thereof, thus modulate pain sensitivity. PMID:15731586

Liem, Edwin B.; Joiner, Teresa V.; Tsueda, Kentaro; Sessler, Daniel I.

2005-01-01

108

Pain channelopathies  

PubMed Central

Pain remains a major clinical challenge, severely afflicting around 6% of the population at any one time. Channelopathies that underlie monogenic human pain syndromes are of great clinical relevance, as cell surface ion channels are tractable drug targets. The recent discovery that loss-of-function mutations in the sodium channel Nav1.7 underlie a recessive pain-free state in otherwise normal people is particularly significant. Deletion of channel-encoding genes in mice has also provided insights into mammalian pain mechanisms. Ion channels expressed by immune system cells (e.g. P2X7) have been shown to play a pivotal role in changing pain thresholds, whilst channels involved in sensory transduction (e.g. TRPV1), the regulation of neuronal excitability (potassium channels), action potential propagation (sodium channels) and neurotransmitter release (calcium channels) have all been shown to be potentially selective analgesic drug targets in some animal pain models. Migraine and visceral pain have also been associated with voltage-gated ion channel mutations. Insights into such channelopathies thus provide us with a number of potential targets to control pain. PMID:20142270

Cregg, Roman; Momin, Aliakmal; Rugiero, Francois; Wood, John N; Zhao, Jing

2010-01-01

109

Effects of Videogame Distraction using a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Children  

PubMed Central

Objective?To test whether a head-mounted display helmet enhances the effectiveness of videogame distraction for children experiencing cold pressor pain.?Method?Forty-one children, aged 6–14 years, underwent one or two baseline cold pressor trials followed by two distraction trials in which they played the same videogame with and without the helmet in counterbalanced order. Pain threshold (elapsed time until the child reported pain) and pain tolerance (total time the child kept the hand submerged in the cold water) were measured for each cold pressor trial.?Results?Both distraction conditions resulted in improved pain tolerance relative to baseline. Older children appeared to experience additional benefits from using the helmet, whereas younger children benefited equally from both conditions. The findings suggest that virtual reality technology can enhance the effects of distraction for some children. Research is needed to identify the characteristics of children for whom this technology is best suited. PMID:18367495

Weiss, Karen E.; Dillinger Clendaniel, Lindsay; Law, Emily F.; Ackerman, Claire Sonntag; McKenna, Kristine D.

2009-01-01

110

The pain-induced decrease in low-threshold motor unit discharge rate is not associated with the amount of increase in spike-triggered average torque  

Microsoft Academic Search

ObjectiveActivation of nociceptive afferents decreases motor unit discharge rates in static contractions. There is also evidence that during experimental muscle pain the motor unit twitch force increases, which has been hypothesized to compensate for the decrease in discharge rate to maintain constant force. This study examined whether there is an association between the magnitude of change in motor unit discharge

Dario Farina; Lars Arendt-Nielsen; Silvestro Roatta; Thomas Graven-Nielsen

2008-01-01

111

A randomized, double blind, placebo controlled, cross over study to evaluate the analgesic activity of Boswellia serrata in healthy volunteers using mechanical pain model  

PubMed Central

Objective: Experimental pain models in human healthy volunteers are advantageous for early evaluation of analgesics. All efforts to develop nonsteroidal anti-inflammatory drugs (NSAIDs) which are devoid of gastrointestinal and cardiovascular system effects are still far from achieving a breakthrough. Hence we evaluated the analgesic activity of an ayurvedic drug, Boswellia serrata by using validated human pain models which has shown its analgesic activity both in-vitro and preclinical studies to evaluate the analgesic activity of single oral dose (125 mg, 2 capsules) of Boswellia serrata compared to placebo using mechanical pain model in healthy human subjects. Materials and Methods: After taking written informed consent, twelve healthy subjects were randomized (1:1) to receive single oral dose of Boswellia serrata (Shallaki®) 125 mg, 2 capsules or identical placebo in a crossover design. Mechanical pain was assessed using Ugo basile analgesymeter (by Randall Selitto test) at baseline and at 1 hr, 2 hrs and 3 hrs after test drug administration. Pain Threshold force and time and Pain Tolerance force and time were evaluated. Statistical analysis was done by paired t-test. Results: Twelve healthy volunteers have completed the study. Mean percentage change from baseline in Pain Threshold force and time with Boswellia serrata when compared to placebo had significantly increased [Force: 9.7 ± 11.0 vs 2.9 ± 3.4 (P = 0.05) and time: 9.7 ± 10.7 vs 2.8 ± 3.4 (P = 0.04)] at third hr. Mean Percentage change from baseline in Pain Tolerance force and time with Boswellia serrata when compared to placebo had significantly (P ? 0.01) increased at 1 hr, 2 hrs and 3 hrs. Conclusion: In the present study, Boswellia serrata significantly increased the Pain Threshold and Pain Tolerance force and time compared to placebo. Both study medications were well tolerated. Further multiple dose studies may be needed to establish the analgesic efficacy of the drug.

Prabhavathi, K.; Chandra, U. Shobha Jagdish; Soanker, Radhika; Rani, P. Usha

2014-01-01

112

Pain Sensitivity, Sensory Deprivation, and Susceptibility to Satiation  

Microsoft Academic Search

The results reported bear out the hypotheses that (i) pain tolerance is positively related to satiability; (ii) sensory deprivation tolerance is negatively related to satiability. It is inferred that satiability may prove to be in part the mechanism of tolerance and intolerance, and that pain tolerance is inversely related to sensory deprivation tolerance.

Asenath Petrie; Walter Collins; Philip Solomon

1958-01-01

113

Evidence for threshold effects of 25-hydroxyvitamin D on glucose tolerance and insulin resistance in black and white obese postmenopausal women.  

PubMed

We identified normal vs. abnormal 25-hydroxyvitamin D [25(OH)D] concentrations by examining the relation of 25(OH)D to non-bone-related measures (plasma glucose, insulin resistance, lipids, blood pressure, fitness, obesity, and regional adiposity) and asking whether there is a 25(OH)D concentration above and below which the relation between 25(OH)D and outcome changes. We examined the relation between 25(OH)D and outcome by race to see whether race-specific normal ranges are needed, and we examined the role of insulin-like growth factor-1 (IGF-1) in modulating the relation between 25(OH)D and outcome. In a cross-sectional study of 239 overweight and obese, sedentary postmenopausal women without diabetes (83 black, 156 white), outcome measures included plasma lipids, glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), IGF-1, parathyroid hormone (PTH), aerobic fitness, body composition, subcutaneous abdominal and visceral fat, and blood pressure. We identified threshold effects in the association between 25(OH)D and these variables using piecewise linear regressions. We found that 25(OH)D was inversely related to fasting glucose, fasting and 2-h insulin, HOMA-IR, visceral abdominal fat, percentage fat, PTH, and triglycerides. Evidence for a threshold effect of 25(OH)D was found for 2-h glucose, 2-h insulin, fasting insulin, and HOMA-IR. There was no evidence suggesting the need for race-specific normal 25(OH)D concentrations. IGF-1 modulated the relation between 25(OH)D and outcome but only below, and not above, a threshold 25(OH)D concentration. Our findings suggest a threshold effect of 25(OH)D on glucose-insulin metabolism such that 25(OH)D ? ?26 ?g/L (65.0 pmol/L) supports normal glucose homeostasis and that the same cut point defining normal 25(OH)D concentration can be used in black and white women. This study was registered at clinicaltrials.gov as NCT01798030. PMID:24717362

Sorkin, John D; Vasaitis, Tadas Sean; Streeten, Elizabeth; Ryan, Alice S; Goldberg, Andrew P

2014-05-01

114

Post hoc analyses of data from a 90-day clinical trial evaluating the tolerability and efficacy of tapentadol immediate release and oxycodone immediate release for the relief of moderate to severe pain in elderly and nonelderly patients  

PubMed Central

OBJECTIVE: To evaluate the tolerability and efficacy of tapentadol immediate release (IR) and oxycodone IR for relief of moderate to severe pain in elderly and nonelderly patients. METHODS: Post hoc data analyses were conducted on a 90-day randomized, phase 3, double-blind, flexible-dose study (ClinicalTrials.gov: NCT00364546) of adults with moderate to severe lower back pain or osteoarthritis pain who received tapentadol IR 50 mg or 100 mg, or oxycodone HCl IR 10 mg or 15 mg every 4 h to 6 h as needed for pain relief. Treatment-emergent adverse events and study discontinuations were recorded. RESULTS: Data from 849 patients randomly assigned (4:1 ratio) to treatment with a study drug (tapentadol IR [n=679] or oxycodone IR [n=170]) were analyzed according to age (younger than 65 years of age [nonelderly], or 65 years of age or older [elderly]) and treatment group. Among elderly patients, incidences of constipation (19.0% versus 35.6%) and nausea or vomiting (30.4% versus 51.1%) were significantly lower with tapentadol IR versus oxycodone IR (all P<0.05). Initial onsets of nausea and constipation occurred significantly later with tapentadol IR versus oxycodone IR (both P?0.031). Tapentadol IR-treated elderly patients had a lower percentage of days with constipation than oxycodone IR-treated patients (P=0.020). For tapentadol IR- and oxycodone IR-treated elderly patients, respectively, incidences of study discontinuation due to gastrointestinal treatment-emergent adverse events were 15.8% and 24.4% (P=0.190). Tapentadol IR and oxycodone IR provided similar pain relief, with no overall age-dependent efficacy differences (mean pain scores [11-point numerical rating scale] decreased from 7.0 and 7.2 at baseline, to 4.9 and 5.2 at end point, respectively). CONCLUSIONS: Tapentadol IR was safe and effective for the relief of lower back pain and osteoarthritis pain in elderly patients, and was associated with a better gastrointestinal tolerability profile than oxycodone IR. PMID:22059194

Vorsanger, Gary; Xiang, Jim; Biondi, David; Upmalis, David; Delfgaauw, Jacqueline; Allard, René; Moskovitz, Bruce

2011-01-01

115

MorphiDex (morphine sulfate/dextromethorphan hydrobromide combination) in the treatment of chronic pain: three multicenter, randomized, double-blind, controlled clinical trials fail to demonstrate enhanced opioid analgesia or reduction in tolerance.  

PubMed

While many pre-clinical and clinical studies have suggested that the addition of N-methyl-D-aspartate (NMDA) receptor antagonists, such as dextromethorphan (DM), to opioid analgesics, such as morphine (MS), may enhance the analgesic effects and prevent the tolerance that may result from chronic opioid administration, others have not. The potential for reduced doses, enhanced opioid analgesia, and decreased analgesic tolerance associated with the MS/DM combination were evaluated in a series of three large, randomized, double-blind, parallel group, phase 3, multicenter trials each of 3 months duration in patients with chronic, non-malignant, non-neuropathic pain. To evaluate these unique endpoints, novel study designs were employed. In Study A, patients received fixed doses of MS or MS/DM, based on the stable dose of MS/DM attained during a Run-in period; changes from baseline in average daily pain intensity were compared. In Studies B and C, patients self-titrated doses of MS or MS/DM, based on stable doses of MS or other opioids attained during Run-in periods, to maintain pain relief; percentage changes from baseline in MS (or MS-equivalent) doses were compared. No statistically significant differences between treatment groups in any primary or secondary efficacy variables were demonstrated in any trial. These results suggest that adding the NMDA antagonist, dextromethorphan, to opioids does not add any clinical benefit. PMID:15911155

Galer, Bradley S; Lee, David; Ma, Tina; Nagle, Barbara; Schlagheck, Thomas G

2005-06-01

116

A comparison of the effect of attention training and relaxation on responses to pain  

Microsoft Academic Search

This study aimed to investigate the efficacy of an attention training technique (ATT) on pain ratings, threshold and tolerance during the cold pressor task. One hundred and three undergraduate students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive either ATT or progressive muscle relaxation (PMR). Hence, the present study

L. Sharpe; K. Nicholson Perry; P. Rogers; B. F. Dear; M. K. Nicholas; K. Refshauge

2010-01-01

117

The effect of attentional re-training and threat expectancy in response to acute pain  

Microsoft Academic Search

This study aimed to investigate the efficacy of implicit attention re-training (AR) on pain ratings, threshold and tolerance during the cold-pressor task and to determine whether the effectiveness of AR was affected by threat expectancy. One hundred and four undergraduate psychology students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to

Naomi McGowan; L. Sharpe; K. Refshauge; M. K. Nicholas

2009-01-01

118

P-38no influence of opioid receptor, mu 1 (oprm1) gene polymorphisms on pain sensitivity among opioid dependent patients on methadone maintenance therapy (mmt) in malaysia.  

PubMed

Heightened pain sensitivity was frequently reported in opioid dependent patients on methadone maintenance therapy (MMT). This study investigated the influence of OPRM1 polymorphisms on pain sensitivity. Subjects were 148 Malay male opioid dependent patients receiving MMT. Their pain threshold (time elapsed when the subject started to perceive pain after immersion of hand), tolerance (time required for hand withdrawal), and intensity (0 - 100 visual analogue scale (VAS)) in response to cold pressor test (CPT) were measured at 0 hour (i.e. the time of the first CPT, and at 2, 4, 8, 12, and 24 hours after that. DNA was extracted from blood and subjected to PCR-genotyping. The differences of CPT responses between the OPRM1 polymorphisms were analysed using repeated measure analysis of variance (RM-ANOVA). There were no significant differences of pain responses (pain threshold, tolerance and intensity) between 118A > G and IVS2 + 691G > C polymorphisms of OPRM1 among opioid depedent subjects using genotype and allelic additive model, genotype dominant and recessive model, haplotypes and diplotypes analysis. The results suggest that the OPRM1 polymorphisms were not associated with differences in pain sensitivity. However, further investigations in larger numbers, other populations and pain models are required to confirm these findings. PMID:25221273

Zahari, Z; Lee, C S; Ibrahim, M A; Musa, N; Yasin, M A M; Tan, S C; Mohamad, N; Ismail, R

2014-09-01

119

Efficacy and tolerance of repeated oral doses of tolperisone hydrochloride in the treatment of painful reflex muscle spasm: results of a prospective placebo-controlled double-blind trial.  

PubMed

The efficacy and safety of oral tolperisone hydrochloride (Mydocalm) in the treatment of painful reflex muscle spasm was assessed in a prospective, randomized, double-blind, placebo-controlled trial. A total of 138 patients, aged between 20 and 75 years, with painful reflex muscle spasm associated with diseases of the spinal column or proximal joints were enrolled in eight rehabilitation centers. Patients were randomized to receive either 300 mg tolperisone hydrochloride or placebo for a period of 21 days. Both treatment groups recovered during the 3 weeks rehabilitation program. However, tolperisone hydrochloride proved to be significantly superior to placebo: the change score of the pressure pain threshold as the primary target parameter significantly increased during therapy with tolperisone hydrochloride (P = 0.03, valid-case-analysis) compared to the results obtained on placebo treatment. The overall assessment of efficacy by the patient also demonstrated significant differences in favor of tolperisone hydrochloride. Best results were seen in patients aged between 40 and 60 years with a history of complaints shorter than 1 year and with concomitant physical therapy. The evaluation of safety data, i.e., adverse events, biochemical and hematological laboratory parameters, demonstrated no differences between tolperisone hydrochloride and placebo. As a conclusion tolperisone hydrochloride represents an effective and safe treatment of painful reflex muscle spasm without the typical side effects of centrally active muscle relaxants. PMID:8951937

Pratzel, H G; Alken, R G; Ramm, S

1996-10-01

120

Correlation of human cold pressor pain responses with 5HT 1A receptor binding in the brain  

Microsoft Academic Search

We determined whether serotonin 5-HT1A receptor availability in the brain is associated with cold pressor pain (CPP) or sympathetic reflex responses. Psychophysical testing was performed in eleven healthy males who had participated in a positron emission tomography study with [carbonyl-11C]WAY-100635 ligand for the assessment of 5-HT1A receptor binding potential (BP). Psychophysical testing consisted of determining CPP threshold, tolerance, intensity, unpleasantness

Ilkka K. Martikainen; Jussi Hirvonen; Jaana Kajander; Nora Hagelberg; Heikki Mansikka; Kjell Någren; Jarmo Hietala; Antti Pertovaara

2007-01-01

121

Experimental pain responses in children with chronic pain and in healthy children: How do they differ?  

PubMed Central

BACKGROUND: Extant research comparing laboratory pain responses of children with chronic pain with healthy controls is mixed, with some studies indicating lower pain responsivity for controls and others showing no differences. Few studies have included different pain modalities or assessment protocols. OBJECTIVES: To compare pain responses among 26 children (18 girls) with chronic pain and matched controls (mean age 14.8 years), to laboratory tasks involving thermal heat, pressure and cold pain. Responses to cold pain were assessed using two different protocols: an initial trial of unspecified duration and a second trial of specified duration. METHODS: Four trials of pressure pain and of thermal heat pain stimuli, all of unspecified duration, were administered, as well as the two cold pain trials. Heart rate and blood pressure were assessed at baseline and after completion of the pain tasks. RESULTS: Pain tolerance and pain intensity did not differ between children with chronic pain and controls for the unspecified trials. For the specified cold pressor trial, 92% of children with chronic pain completed the entire trial compared with only 61.5% of controls. Children with chronic pain exhibited a trend toward higher baseline and postsession heart rate and reported more anxiety and depression symptoms compared with control children. CONCLUSIONS: Contextual factors related to the fixed trial may have exerted a greater influence on pain tolerance in children with chronic pain relative to controls. Children with chronic pain demonstrated a tendency toward increased arousal in anticipation of and following pain induction compared with controls. PMID:22518373

Tsao, Jennie CI; Evans, Subhadra; Seidman, Laura C; Zeltzer, Lonnie K

2012-01-01

122

Flank pain  

MedlinePLUS

Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...

123

Chronic Pain  

MedlinePLUS

... a problem you need to take care of. Chronic pain is different. The pain signals go on for ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis Pain ...

124

Postamputation pain: studies on mechanisms.  

PubMed

Amputation is followed by both painful and non-painful phantom phenomena in a large number of amputees. Non-painful phantom sensations rarely pose any clinical problem, but 60-80% of all amputees also experience painful sensations (i.e. phantom pain) located to the missing limb. The severity of phantom pain usually decreases with time, but severe pain persists in 5-10% of patients. Pain in the residual limb (i.e. stump pain) is another consequence of amputation. Both stump and phantom pain can be very difficult to treat. Treatment guidelines used for other neuropathic pain conditions are probably the best approximation, especially for the treatment of stump pain. The aim of the present doctoral thesis was to explore some of the mechanisms underlying pain after amputation. Ten studies were carried out (I-X). My PhD thesis from 1998 dealt with pain before the amputation and showed that preamputation pain increases the risk of phantom pain after amputation (I). A perioperative epidural blockade, however, did not reduce the incidence of pain or abnormal sensory phenomena after amputation (II, III). The importance of sensitization before amputation for the subsequent development of pain is supported by study IV, in which pressure pain thresholds obtained at the limb before amputation were inversely related to stump and phantom pain after 1 week. Afferent input from the periphery is likely to contribute to postamputation pain as sodium channels were upregulated in human neuromas (VI), although neuroma removal did not always alleviate phantom pain (V). Sensitization of neurons in the spinal cord also seems to be involved in pain after amputation as phantom pain was reduced by ketamine, an NMDA-receptor antagonist. Another NMDA-receptor antagonist, memantine, and gabapentin, a drug working by binding to the ?2?-subunit of voltage-gated calcium channels, had no effect on phantom pain (VII-IX). Supraspinal factors are also important for pain after amputation as catastrophizing was associated with phantom pain (X). In conclusion, the present doctoral thesis confirmed and expanded the findings by others that several mechanisms are involved in the development and maintenance of phantom pain. A better understanding of the underlying mechanisms will hopefully lead to improved treatment of pain after amputation in the future. PMID:23158899

Nikolajsen, Lone

2012-10-01

125

Chronic Pain  

MedlinePLUS

MENU Return to Web version Chronic Pain Overview What is chronic pain? There are 2 types of pain: acute and chronic. Acute pain lets you know that your ... It should go away as your body heals. Chronic pain lasts much longer. Chronic pain may last months ...

126

A Phase 3, Randomized, Double-Blind Comparison of Analgesic Efficacy and Tolerability of Q8003 vs Oxycodone or Morphine for Moderate-to-Severe Postoperative Pain Following Bunionectomy Surgery  

PubMed Central

Objective Compare the efficacy and tolerability of the dual-opioid, Q8003® (morphine/oxycodone combination) 12 mg/8 mg to morphine 12 mg or oxycodone 8 mg in subjects following bunionectomy surgery. Design This was a randomized, double-blind study. Setting Hospitalized patients. Patients Healthy men or women aged ?18 years with moderate or severe pain (score ?2 on a 4-point Likert scale) and ?4 on the 11-point numerical pain rating scale following surgery. Interventions Study medication was initiated after surgery and was given for 48 hours. Outcomes The primary efficacy variable was mean sum of the pain intensity difference (SPID) scores from the postsurgical baseline. Results Five hundred twenty-two subjects were randomized; 31 (5.9%) discontinued, including 19 (3.6%) for adverse events. The mean total morphine equivalent dose (MED) was 182.7 mg from Q8003 12 mg/8 mg, 92.4 mg for morphine 12 mg, and 92.1 mg for oxycodone 8 mg. SPID from baseline over 24 hours and SPID from baseline over 48 hours were significantly (P < 0.02) higher for Q8003 12 mg/8 mg vs morphine 12 mg or oxycodone 8 mg. Significantly (P < 0.015) fewer subjects in the Q8003 group required ibuprofen rescue medication, used lower doses of rescue medication, and had a longer median time to first use of rescue medication. Oxygen desaturation <90% occurred in 5.3% with Q8003, 2.8% with morphine 12 mg, and 2.3% with oxycodone 8 mg, and the cumulative median dose at first desaturation was twofold greater with Q8003. Conclusion Q8003 provided superior efficacy to its individual components at twice the MED with only a modest increase in the incidence of adverse events. PMID:23802706

Richards, Patricia; Riff, Dennis; Kelen, Robin; Stern, Warren

2013-01-01

127

Testing hyperalgesia and hypoalgesia in human pain reactivity using shock and radiant heat  

E-print Network

the elects of an unpredictable shock and the threat of an unpredictable shock on pain thresholds using a radiant heat test (putative spinal mediation). Experiment 2 examined the effects of the same unpredictable shock and its threat on pain thresholds...

Rhudy, Jamie Lynn

2012-06-07

128

Pain sensitivity, cerebral laterality, and negative affect  

Microsoft Academic Search

The right hemisphere is assumed to play a unique role for pain sensitivity and negative affect. Pressure pain thresholds were assessed daily in eight right-handed participants over a 6-week period in order to obtain reliable measures of pain sensitivity unaffected by situational influences. In an additional session, cerebral laterality was assessed with behavioral and an EEG measures. Psychometric measures were

Paul Pauli; Georg Wiedemann; Matthias Nickola

1999-01-01

129

Positive Traits Linked to Less Pain through Lower Pain Catastrophizing  

PubMed Central

The present study examined the association between positive traits, pain catastrophizing, and pain perceptions. We hypothesized that pain catastrophizing would mediate the relationship between positive traits and pain. First, participants (n = 114) completed the Trait Hope Scale, the Life Orientation Test- Revised, and the Pain Catastrophizing Scale. Participants then completed the experimental pain stimulus, a cold pressor task, by submerging their hand in a circulating water bath (0º Celsius) for as long as tolerable. Immediately following the task, participants completed the Short-Form McGill Pain Questionnaire (MPQ-SF). Pearson correlation found associations between hope and pain catastrophizing (r = ?.41, p < .01) and MPQ-SF scores (r = ?.20, p < .05). Optimism was significantly associated with pain catastrophizing (r = ?.44, p < .01) and MPQ-SF scores (r = ?.19, p < .05). Bootstrapping, a non-parametric resampling procedure, tested for mediation and supported our hypothesis that pain catastrophizing mediated the relationship between positive traits and MPQ-SF pain report. To our knowledge, this investigation is the first to establish that the protective link between positive traits and experimental pain operates through lower pain catastrophizing. PMID:22199416

Hood, Anna; Pulvers, Kim; Carrillo, Janet; Merchant, Gina; Thomas, Marie

2011-01-01

130

The role of beta-arrestin2 in the severity of antinociceptive tolerance and physical dependence induced by different opioid pain therapeutics.  

PubMed

Ligands acting at the same receptor can differentially activate distinct signal transduction pathways, which in turn, can have diverse functional consequences. Further, receptors expressed in different tissues may utilize intracellular signaling proteins in response to a ligand differently as well. The mu opioid receptor (MOR), which mediates many of the pharmacological actions of opiate therapeutics, is also subject to differential signaling in response to diverse agonists. To study the effect of diverse agonists on MOR signaling, we examined the effects of chronic opiate treatment on two distinct physiological endpoints, antinociceptive tolerance and physical dependence, in mice lacking the intracellular regulatory molecule, ?arrestin2. While ?arrestin2 knockout (?arr2-KO) mice do not become tolerant to the antinociceptive effects of chronic morphine in a hot plate test, tolerance develops to the same degree in both wild type and ?arr2-KO mice following chronic infusion with methadone, fentanyl, and oxycodone. Studies here also assess the severity of withdrawal signs precipitated by naloxone following chronic infusions at three different doses of each opiate agonist. While there are no differences in withdrawal responses between genotypes at the highest dose of morphine tested (48 mg/kg/day), the ?arr2-KO mice display several less severe withdrawal responses when the infusion dose is lowered (12 or 24 mg/kg/day). Chronic infusion of methadone, fentanyl, and oxycodone all lead to equivalent naloxone-precipitated withdrawal responses in both genotypes at all doses tested. These results lend further evidence that distinct agonists can differentially impact on opioid-mediated responses in vivo in a ?arrestin2-dependent manner. PMID:20713067

Raehal, Kirsten M; Bohn, Laura M

2011-01-01

131

Chronic Pain  

MedlinePLUS

NINDS Chronic Pain Information Page Synonym(s): Pain - Chronic Condensed from Pain: Hope Through Research Table of Contents (click to jump ... Trials Organizations Additional resources from MedlinePlus What is Chronic Pain? While acute pain is a normal sensation triggered ...

132

Foetal pain?  

PubMed

The majority of commentary on foetal pain has looked at the maturation of neural pathways to decide a lower age limit for foetal pain. This approach is sensible because there must be a minimal necessary neural development that makes pain possible. Very broadly, it is generally agreed that the minimal necessary neural pathways for pain are in place by 24 weeks gestation. Arguments remain, however, as to the possibility of foetal pain before or after 24 weeks. Some argue that the foetus can feel pain earlier than 24 weeks because pain can be supported by subcortical structures. Others argue that the foetus cannot feel pain at any stage because it is maintained in a state of sedation in the womb and lacks further neural and conceptual development necessary for pain. Much of this argument rests on the definition of terms such as 'wakefulness' and 'pain'. If a behavioural and neural reaction to a noxious stimulus is considered sufficient for pain, then pain is possible from 24 weeks and probably much earlier. If a conceptual subjectivity is considered necessary for pain, however, then pain is not possible at any gestational age. Regardless of how pain is defined, it is clear that pain for conceptual beings is qualitatively different than pain for non-conceptual beings. It is therefore a mistake to draw an equivalence between foetal pain and pain in the older infant or adult. PMID:20356798

Derbyshire, Stuart W G

2010-10-01

133

Dopamine and Pain Sensitivity: Neither Sulpiride nor Acute Phenylalanine and Tyrosine Depletion Have Effects on Thermal Pain Sensations in Healthy Volunteers  

PubMed Central

Based on animal studies and some indirect clinical evidence, dopamine has been suggested to have anti-nociceptive effects. Here, we investigated directly the effects of increased and decreased availability of extracellular dopamine on pain perception in healthy volunteers. In Study 1, participants ingested, in separate sessions, a placebo and a low dose of the centrally acting D2-receptor antagonist sulpiride, intended to increase synaptic dopamine via predominant pre-synaptic blockade. No effects were seen on thermal pain thresholds, tolerance, or temporal summation. Study 2 used the acute phenylalanine and tyrosine depletion (APTD) method to transiently decrease dopamine availability. In one session participants ingested a mixture that depletes the dopamine amino acid precursors, phenylalanine and tyrosine. In the other session they ingested a nutritionally balanced control mixture. APTD led to a small mood-lowering response following aversive thermal stimulation, but had no effects on the perception of cold, warm, or pain stimuli. In both studies the experimental manipulation of dopaminergic neurotransmission was successful as indicated by manipulation checks. The results contradict proposals that dopamine has direct anti-nociceptive effects in acute experimental pain. Based on dopamine’s well-known role in reward processing, we hypothesize that also in the context of pain, dopamine acts on stimulus salience and might play a role in the initiation of avoidance behavior rather than having direct antinociceptive effects in acute experimental pain. PMID:24236199

Becker, Susanne; Ceko, Marta; Louis-Foster, Mytsumi; Elfassy, Nathaniel M.; Leyton, Marco; Shir, Yoram; Schweinhardt, Petra

2013-01-01

134

Heel pain  

MedlinePLUS

Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

135

Neck Pain  

MedlinePLUS

... Pregnancy and Rheumatic Disease Sex and Arthritis Neck Pain PRINT Download PDF Description Saying, “It’s a pain ... requires expensive or uncomfortable tests. What is neck pain? Acute strain may occur after sleeping in an ...

136

Wrist pain  

MedlinePLUS

Pain - wrist ... Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome . You may feel aching, ... become weak, making it difficult to grasp things. Pain may extend up to your elbow. Carpal tunnel ...

137

Elbow pain  

MedlinePLUS

Pain - elbow ... Elbow pain can be caused by a variety of problems. A common cause in adults is tendinitis , an inflammation ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

138

Pain Relievers  

MedlinePLUS

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...

139

Depression, Pain, and Pain Behavior.  

ERIC Educational Resources Information Center

Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

Keefe, Francis J.; And Others

1986-01-01

140

Electronic gaming as pain distraction.  

PubMed

The current study investigated whether active distraction reduces participants' experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2°C) water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system) and passive (television) distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants' expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control. PMID:21369538

Jameson, Eleanor; Trevena, Judy; Swain, Nic

2011-01-01

141

Synthesis and evaluation of fault-tolerant quantum computer architectures  

E-print Network

Fault-tolerance is the cornerstone of practical, large-scale quantum computing, pushed into its prominent position with heroic theoretical efforts. The fault-tolerance threshold, which is the component failure probability ...

Cross, Andrew W. (Andrew William), 1979-

2005-01-01

142

Fear-Avoidance Beliefs and Temporal Summation of Evoked Thermal Pain Influence Self-Report of Disability in Patients With Chronic Low Back Pain  

Microsoft Academic Search

\\u000a Introduction: Quantitative sensory testing has demonstrated a promising link between experimentally determined pain sensitivity and clinical pain. However, previous studies of quantitative sensory testing have not routinely considered the important influence of psychological factors on clinical pain. This study investigated whether measures of thermal pain sensitivity (temporal summation, first pulse response, and tolerance) contributed to clinical pain reports for patients

Steven Z. George; Virgil T. Wittmer; Roger B. Fillingim; Michael E. Robinson

2006-01-01

143

Shoulder pain  

MedlinePLUS

Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

144

Pelvic Pain  

MedlinePLUS

Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

145

Urge-to-cough and dyspnea conceal perception of pain in healthy adults.  

PubMed

Although dyspnea has been shown to attenuate pain, whether urge-to-cough, a respiratory sensation preceding cough, exerts a similar inhibitory effect on pain has not been clarified. We examined the effects of both urge-to-cough and dyspnea on pain induced by thermal noxious stimuli. Urge-to-cough was induced by citric acid challenge and dyspnea was induced by external inspiratory resistive loads. During inductions of two respiratory sensations, perception of pain was assessed by thermal pain threshold (TPTh) and tolerance (TPTo). TPTh and TPTo were significantly increased accompanied by increases in perception of both urge-to-cough and dyspnea. Fractional change in TPTh during dyspnea was significantly correlated with that during urge-to-cough. Fractional change in TPTo during dyspnea was significantly correlated with that during urge-to-cough. The study suggests that both two distinct respiratory sensations, i.e., urge-to-cough and dyspnea may harbor perception of pain. Further studies investigating interactions among these sensations in clinical settings are warranted. PMID:22465527

Gui, Peijun; Ebihara, Satoru; Ebihara, Takae; Kanezaki, Masashi; Kashiwazaki, Naohiro; Ito, Kumiko; Kohzuki, Masahiro

2012-04-30

146

Basic Mechanisms of Pain  

Microsoft Academic Search

Pain itself occurs in the central nervous system (CNS), while the peripheral nervous system reports on tissue damage via a\\u000a mechanical event, termed nociception, characterized by the discharge of high-threshold primary afferent fibers. Neuronal responses\\u000a in these peripheral fibers drive spinal cord activity and result in signals ascending to the brainstem and thalamus through\\u000a spinal cord tracts. It is from

Frank Willard

147

Voluntary and forced exercises prevent the development of tolerance to analgesic effects of morphine in rats  

PubMed Central

Objective(s): Morphine is widely used to treat chronic pain. However, its utility is hindered by the development of tolerance to its analgesic effects. Despite the renowned beneficial effects of physical exercise on cognitive functions and signs of morphine withdrawal in morphine-dependent rats, little is known about the roles of voluntary and forced exercises in tolerance to analgesic effect of morphine in rats. Materials and Methods: In this study, rats were injected with 10 mg/kg of morphine, once daily, SC over a period of 8 days of either voluntary or treadmill exercise. Following these injections, the percent of maximum possible effect (%MPE) of morphine was measured on the 1st, 4th, and 8th days by hot plate test. Results: Both voluntary and forced exercises significantly increased pain threshold compared to the sedentary group (P<0.05). Voluntary and forced exercises also significantly increased potency of morphine compared to sedentary morphine group (P<0.05). Thus, we concluded that voluntary and forced exercises blocked the development of tolerance during 8 daily simultaneously treatments. When exercising rats were returned to sedentary conditions, sensitivity to the analgesic effects of morphine increased significantly and persisted during sedentary period in the exercising rats. In other words, %MPE of the exercising morphine-group increased significantly compared to saline group (P<0.05). Conclusion: Our results showed that voluntary and forced exercises may be possible methods for treating the development of tolerance to analgesic effect of morphine in rats. PMID:24904720

Shokraviyan, Monireh; Miladi-Gorji, Hossein; Vaezi, Gholam Hassan

2014-01-01

148

Efficacy and side effects of diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius.  

PubMed

Locally administered nonsteroidal anti-inflammatory drugs have been widely used in acute soft-tissue damage and articular musculoskeletal pain. This double-blind, placebo-controlled, randomized study was designed to evaluate the efficacy and safety of a topical diclofenac sodium patch in the relief of pain and inflammation as a result of myofascial pain syndrome (MPS) in the upper trapezius. After sample size calculations indicated that 147 patients would be needed to detect a 25% difference between drug and control, 153 patients with MPS were recruited and randomized to receive either a diclofenac sodium patch or control (menthol) patch. Visual analog scale (VAS), cervical active range of motion, pressure pain threshold of the myofascial trigger point (MTrP), patient global assessment, Neck Disability Index, and the occurrence of adverse events were assessed on Day 0 (baseline), Day 4, and Day 8. Use of the diclofenac sodium patch elicited favorable responses for the VAS, cervical active range of motion, and Neck Disability Index by the end of the treatment course (P<0.05), and was consistently superior to the control patch at all time intervals. No significant differences were observed for the pressure pain threshold of the MTrP for either patch. Tolerability assessment similarly showed the diclofenac patch to be comparatively superior. When assessed at the end of the study, 20 diclofenac patch patients, but only four control patients, considered the tolerability of treatment to be "very good." Significant differences in adverse reactions were observed between the diclofenac and control patches, with the control patch more likely to produce overall skin irritation. This study demonstrate that the diclofenac sodium patch was superior to the control patch in terms of reducing pain and improving functional outcomes, and did not result in significant adverse effects. PMID:19822404

Hsieh, Lin-Fen; Hong, Chang-Zern; Chern, Shiuan-Horng; Chen, Chen-Chiao

2010-01-01

149

Back Pain  

MedlinePLUS

... Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, ... 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...

150

Back Pain  

MedlinePLUS

Back Pain The Centers for Disease Control and Prevention’s 2008 Health Report states that over 27% of the ... States population age 18 and older have active back pain. As many as 80-90% of Americans will ...

151

Breast pain  

MedlinePLUS

Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount of swelling and tenderness just before ...

152

Ribcage pain  

MedlinePLUS

... not cause the pain in those who have pleurisy (swelling of the lining of the lungs) or ... Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis Pleurisy (the pain is worse when breathing deeply)

153

Neck Pain  

MedlinePLUS

... over-the counter medicine, such as acetaminophen or ibuprofen, to relieve pain, and apply heat to the ... an injury. Use anti-inflammatory medicines, such as ibuprofen and aspirin, to relieve pain and discomfort, and ...

154

Neuropathic Pain  

MedlinePLUS

... know that it can erode quality of life. Communication Tools View All Everyday Tools During Your Visit ... tires. Video Download Transcript Pain Matters This Discovery Channel documentary explores what chronic pain is, its individual ...

155

Pain Assessment  

Microsoft Academic Search

In adults, pain is one of the most common physical complaints. For example, a comprehensive review of available epidemiological\\u000a studies yielded a median point prevalence of chronic benign pain of 15% in adults, with individual study values ranging from\\u000a 2–40% (Verhaak, Kerssens, Dekker, Sorbi, & Bensing, 1998). Unfortunately, pain is not limited to the adult years, as estimates\\u000a of pain

Frank Andrasik; Carla Rime

156

Repressive coping style and suppression of pain-related thoughts: Effects on responses to acute pain induction  

Microsoft Academic Search

Repressors have shown short-term tolerance of acute pain but long-term sensitivity to chronic pain. To reconcile this discrepancy, we hypothesised that repressors routinely suppress pain-related thoughts during acute pain, and thus paradoxically incur rebound effects (increased accessibility of the to-be-suppressed material) afterwards. Healthy individuals (n=222) were assigned to suppress or not suppress pain-related thoughts during a cold pressor. Recovery and

Erin Elfant; John W. Burns; Amos Zeichner

2008-01-01

157

Managing Pain  

MedlinePLUS

... pain such as aching, burning, gnawing, grabbing • The effect of the pain on the patient and family (for example, is the family anxious or unsure about how to give the medicines; is the patient becoming irritable from lack of sleep because of the pain) What can be done? ...

158

Can coadministration of oxycodone and morphine produce analgesic synergy in humans? An experimental cold pain study  

PubMed Central

Aims The coadministration of subantinociceptive doses of oxycodone with morphine has recently been shown to result in a synergistic antinociceptive effect in rats. The present study was aimed to investigate the possibility that coadministration of morphine and oxycodone can produce a similar synergistic effect in humans exposed to an experimental model of cold pressor test (CPT). Methods The enriched enrolment design was used to exclude ‘stoic’ and ‘placebo responders’ in a single-blind fashion. ‘Nonstoic’, placebo ‘nonresponder’ female volunteers (n = 30) were randomly assigned to receive 0.5 mg kg?1 oral morphine sulphate, 0.5 mg kg?1 oral oxycodone hydrochloride, and the combination of 0.25 mg kg?1 morphine sulphate with 0.25 mg kg?1 oxycodone hydrochloride, 1 week apart from each other, in a double-blind crossover design. Latency to pain onset (threshold), pain intensity (VAS), and pain tolerance (time until removal of the hand from the water) were measured six times over a 3-h period, subsequent to the administration of each medication, and were used to assess their antinociceptive effect. Results The combination produced a significantly higher effect on latency to pain onset than that of morphine alone [difference in mean postbaseline value 2.2; 95% confidence interval (CI) 0.48, 3.9; P = 0.01] but the effect was nonsignificantly smaller that that of oxycodone alone. Similarly, the effect of the combination on pain tolerance was significantly larger than that of morphine alone (combination difference 8.4; 95% CI 2.5, 14.3; P = 0.007), whereas oxycodone alone caused a nonsignificantly larger effect than that of the combination treatment. Comparisons of pain magnitude failed to show any significant differences between the three treatments. Conclusions These results indicate that at the doses tested, morphine and oxycodone do not produce synergistic antinociceptive effects in healthy humans exposed to the CPT. PMID:15327582

Grach, Michael; Massalha, Wattan; Pud, Dorit; Adler, Rivka; Eisenberg, Elon

2004-01-01

159

Simultaneous recording of late and ultra-late pain evoked potentials in fibromyalgia  

Microsoft Academic Search

Objective: To characterize laser evoked potentials (LEP), pain psychophysics and local tissue response in fibromyalgia patients.Methods: LEP were recorded in 14 women with fibromyalgia in response to bilateral stimulation of tender and control points in upper limbs by 4 blocks of 20 stimuli at each point. Subsequently, heat pain thresholds were measured and supra-threshold magnitude estimations of heat pain stimuli

M Granot; D Buskila; Y Granovsky; E Sprecher; L Neumann; D Yarnitsky

2001-01-01

160

An experimental investigation of the effects of preferred and relaxing music listening on pain perception  

Microsoft Academic Search

This study investigates the effects of music listening on perception and tolerance of experimentally induced cold pressor pain. Fifty-four participants (34 females, 20 males) each underwent 3 cold pressor trials while listening to (a) white noise, (b) specially designed relaxation music, and (c) their own chosen music. Tolerance time, pain intensity on visual analog scale, and the pain rating index

Laura A. Mitchell; Raymond A. R. Macdonald

2006-01-01

161

Pain Genes  

PubMed Central

Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors) signal the existence of tissue damage to the central nervous system (CNS), where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating pain pathways using model organisms have identified the molecular nature of the transducers, regulatory mechanisms involved in changing neuronal activity, as well as the critical role of immune system cells in driving pain pathways. In man, mapping of human pain mutants as well as twin studies and association studies of altered pain behaviour have identified important regulators of the pain system. In turn, new drug targets for chronic pain treatment have been validated in transgenic mouse studies. Thus, genetic studies of pain pathways have complemented the traditional neuroscience approaches of electrophysiology and pharmacology to give us fresh insights into the molecular basis of pain perception. PMID:18654615

Foulkes, Tom; Wood, John N.

2008-01-01

162

Mothers’ modeling influences children's pain during a cold pressor task  

Microsoft Academic Search

We set out to determine whether observing one's mother's reaction during a cold pressor test changes ratings of pain threshold, pain intensity, and observed pain-related facial behavior during a cold pressor test, using a Repeated Measures Mixed Factorial design in the setting of the Psychology Department, Dalhousie University, Halifax, Canada. The participants were: 96 mothers (mean age 41 years,) and

Julie E Goodman; Patrick J McGrath

2003-01-01

163

Threshold Concepts in Biochemistry  

ERIC Educational Resources Information Center

Threshold concepts can be identified for any discipline and provide a framework for linking student learning to curricular design. Threshold concepts represent a transformed understanding of a discipline, without which the learner cannot progress and are therefore pivotal in learning in a discipline. Although threshold concepts have been…

Loertscher, Jennifer

2011-01-01

164

Self-control: Factors enhancing tolerance of noxious stimulation  

Microsoft Academic Search

Conducted 2 studies with 120 female undergraduates examining variables expected to enhance pain tolerance in a Skinnerian self-control paradigm. Exp. I compared the effects of S and E initiation of a controlling response on cold-pressor tolerance. Ss who could advance slides of travel pictures at their own rate tolerated ice water immersion of the hand longer than yoked Ss whose

Frederick H. Kanfer; Meryl L. Seidner

1973-01-01

165

Chronic Pelvic Pain  

MedlinePLUS

... Family > Conditions & Treatments > Pain Disorders > Chronic Pelvic Pain Chronic Pelvic Pain Page Content Pelvic pain is an uncommon but ... and can be injured or weakened causing pain Chronic pain can continue long after tissue injury has healed, ...

166

Low back pain - chronic  

MedlinePLUS

Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... your waist, leads to pain. Many people with chronic back pain have arthritis. Or they may have extra wear ...

167

Chronic Pain  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a Non-cancer-related pain that lasts longer than 3 months is considered chronic pain.\\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a According to the National Institutes of Health, chronic pain is the third largest health problem in the world.\\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a Approximately 25 million Americans are affected by chronic pain.\\u000a \\u000a \\u000a \\u000a 4. \\u000a \\u000a Chronic pain is one of the most common problems seen in primary care clinics. Pain-related problems account

Jim Nuovo

168

Central pain.  

PubMed

ABSTRACT Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed. PMID:25295639

Singh, Supreet

2014-12-01

169

Transdermal opioids for cancer pain.  

PubMed

Patients with moderate to severe malignancy-related pain frequently require the use of opioid pharmacotherapy. Unfortunately, many cancer patients continue to be prescribed subtherapeutic doses of pain medications resulting in undo suffering and diminished quality of life. The choice of analgesic pharmacotherapy should be individualized and based on the intensity and etiology of pain reported by the patient. Health care providers must be able to readily quantify the relative analgesic potency when converting from one opioid to another or from one route of administration to another. Transdermal fentanyl is effective and well tolerated pharmacotherapy for the cancer pain patients. However, clinicians need to be cognizant that the U.S./U.K. manufacturer's recommendations for equilalagesic dosing of transdermal fentanyl may result in initial doses that produce subtherapeutic levels and unrelieved pain in some patients. A more aggressive dosing algorithm for transdermal fentanyl using a 2:1 (mg/day of oral morphine: mcg/hr of transdermal fentanyl) conversion ratio that considers both a review of the literature and clinical experience should help clinicians individualize cancer pain pharmacotherapy. Transdermal buprenorphine is now being prescribed in Europe and Australia for chronic and cancer pain management. Buprenorphine's mixed agonist/antagonist activity, dosage ceiling, and high affinity to the opiate receptor limits its use to those patients who do not already require large daily doses of opioids. Thus, buprenorphine may not be an appropriate medication for some patients with advanced unremitting cancer pain. PMID:16573839

Skaer, Tracy L

2006-01-01

170

Pain insensitivity syndrome misinterpreted as inflicted burns.  

PubMed

We present a case study of a 10-year-old child with severe burns that were misinterpreted as inflicted burns. Because of multiple injuries since early life, the family was under suspicion of child abuse and therefore under supervision of the Child Care Board for 2 years before the boy was burned. Because the boy incurred the burns without feeling pain, we conducted a thorough medical examination and laboratory testing, evaluated detection and pain thresholds, and used MRI to study brain morphology and brain activation patterns during pain between this patient and 3 healthy age- and gender-matched controls. We found elevated detection and pain thresholds and lower brain activation during pain in the patient compared with the healthy controls and reference values. The patient received the diagnosis of hereditary sensory and autonomic neuropathy type IV on the basis of clinical findings and the laboratory testing, complemented with the altered pain and detection thresholds and MRI findings. Hereditary sensory and autonomic neuropathy IV is a very rare congenital pain insensitivity syndrome characterized by the absence of pain and temperature sensation combined with oral mutilation due to unawareness, fractures, and anhidrosis caused by abnormalities in the peripheral nerves. Health care workers should be aware of the potential presence of this disease to prevent false accusations of child abuse. PMID:24733875

van den Bosch, Gerbrich E; Baartmans, Martin G A; Vos, Paul; Dokter, Jan; White, Tonya; Tibboel, Dick

2014-05-01

171

Pain without nociception?  

PubMed

We describe a young woman with complete cervical spinal cord transsection, who developed significant abdominal pain, triggered by gastric distension and deep abdominal palpation. On the basis of the nature of her spinal cord injury, her brain-gut axis was limited to vagal pathways. Studies in mammalian models of human visceral sensation consistently showed that the subdiaphragmatic vagus contains a homogeneous population of afferents that are activated by low-intensity stimuli, which are generally believed to be important in regulating autonomic function and perhaps contributing to visceral sensory experiences triggered by such low-intensity stimuli (e.g. fullness, nausea), but not pain, although many fibers encode stimuli well into the noxious range. In contrast, spinal afferent pathways include fibers with high-activation thresholds that are thought to represent specialized nociceptors. This illustrative case argues against an exclusive role of specialized nociceptive pathways in visceral pain, but supports a concept of intensity coding with the composite of vagal and spinal input contributing to conscious perception and pain. PMID:22266836

Levinthal, David J; Bielefeldt, Klaus

2012-03-01

172

Delayed onset muscle soreness at tendon–bone junction and muscle tissue is associated with facilitated referred pain  

Microsoft Academic Search

Delayed onset muscle soreness (DOMS) involves central and peripheral pain mechanisms. Referred pain patterns following stimulation of DOMS affected tissue have not been fully described. Referred pain may provide information on how central mechanisms are involved in DOMS, as referred pain is a central mechanism. Further, tendon tissue involvement in DOMS is not clear. This study assessed pressure pain threshold

William Gibson; Lars Arendt-Nielsen; Thomas Graven-Nielsen

2006-01-01

173

Pain Genes  

Microsoft Academic Search

Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors) signal the existence of tissue damage to the central nervous system (CNS), where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating

Tom Foulkes; John N. Wood

2008-01-01

174

An attempt to attenuate experimental pain in humans by dextromethorphan, an NMDA receptor antagonist  

Microsoft Academic Search

Dextromethorphan (100 mg, orally), an NMDA receptor antagonist, did not significantly attenuate pain intensity or unpleasantness induced by experimental ischemia or by topical capsaicin in healthy human subjects, nor did it increase the threshold for heat pain or mechanical pain. A dose of 200 mg produced marked side effects. Thus, systemically administered dextromethorphan does not attenuate pain at clinically applicable

Timo Kauppila; Mari Grönroos; Antti Pertovaara

1995-01-01

175

Sensory and Biomechanical Characterization of Two Painful Syndromes in the Heel  

Microsoft Academic Search

This study evaluated sensory and biomechanical assets in 2 heel pain conditions with similar symptoms, entrapment syndrome of the nerve to abductor digiti quinti and myofascial syndrome of abductor hallucis. Thirty-three patients with unilateral heel pain and 20 asymptomatic subjects underwent pressure pain threshold measurement in the painful area in site A (medial process of calcaneal tuberosity, trigger point site

Raoul Saggini; Rosa Grazia Bellomo; Giannapia Affaitati; Domenico Lapenna; Maria Adele Giamberardino

2007-01-01

176

The perils of thresholding  

E-print Network

The thresholding of time series of activity or intensity is frequently used to define and differentiate events. This is either implicit, for example due to resolution limits, or explicit, in order to filter certain small scale physics from the supposed true asymptotic events. Thresholding the birth-death process, however, introduces a scaling region into the event size distribution, which is characterised by an exponent that is unrelated to the actual asymptote and is rather an artefact of thresholding. As a result, numerical fits of simulation data produce a range of exponents, with the true asymptote visible only in the tail of the distribution. This tail is increasingly difficult to sample as the threshold is increased. In the present case, the exponents and the spurious nature of the scaling region can be determined analytically, thus demonstrating the way in which thresholding conceals the true asymptote. The analysis also suggests a procedure for detecting the influence of the threshold by means of a da...

Font-Clos, Francesc; Deluca, Anna; Moloney, Nicholas R

2014-01-01

177

Effects of treatment of peripheral pain generators in fibromyalgia patients.  

PubMed

Fibromyalgia syndrome (FS) frequently co-occurs with regional pain disorders. This study evaluated how these disorders contribute to FS, by assessing effects of local active vs placebo treatment of muscle/joint pain sources on FS symptoms. Female patients with (1) FS+myofascial pain syndromes from trigger points (n=68), or (2) FS+joint pain (n=56) underwent evaluation of myofascial/joint symptoms [number/intensity of pain episodes, pressure pain thresholds at trigger/joint site, paracetamol consumption] and FS symptoms [pain intensity, pressure pain thresholds at tender points, pressure and electrical pain thresholds in skin, subcutis and muscle in a non-painful site]. Patients of both protocols were randomly assigned to two groups [34 each for (1); 28 each for (2)] to receive active or placebo local TrP or joint treatment [injection/hydroelectrophoresis] on days 1 and 4. Evaluations were repeated on days 4 and 8. After therapy, in active--but not placebo-treated-- groups: number and intensity of myofascial/joint episodes and paracetamol consumption decreased and pressure thresholds at trigger/joint increased (p<0.001); FS pain intensity decreased and all thresholds increased progressively in tender points and the non-painful site (p<0.0001). At day 8, all placebo-treated patients requested active local therapy (days 8 and 11) vs only three patients under active treatment. At a 3-week follow-up, FS pain was still lower than basis in patients not undergoing further therapy and had decreased in those undergoing active therapy from day 8 (p<0.0001). Localized muscle/joint pains impact significantly on FS, probably through increased central sensitization by the peripheral input; their systematic identification and treatment are recommended in fibromyalgia. PMID:20889359

Affaitati, Giannapia; Costantini, Raffaele; Fabrizio, Alessandra; Lapenna, Domenico; Tafuri, Emmanuele; Giamberardino, Maria Adele

2011-01-01

178

HRS Threshold Adjustment Test  

NASA Astrophysics Data System (ADS)

This test will determine the optimal, non-standard discriminator thresholds for the few anomalous channels on each HRS detector. A 15 second flat field observation followed by a 210 second dark count is performed at each of 10 discriminator threshold values for each detector. The result of the test will be the optimal threshold values to be entered into the PDB. Edited 4/30/91 to add comments to disable/re-enable cross-talk tables.

Skapik, Joe

1991-07-01

179

Improving the quality of pain treatment by a tailored pain education programme for cancer patients in chronic pain.  

PubMed

Educational interventions, aiming to increase patients' knowledge and attitude regarding pain, can affect pain treatment. The purpose of this study was to evaluate the effects of a Pain Education Programme (PEP), on adequacy of pain treatment, and to describe characteristics predicting change in adequacy. The PEP consists of a multi-method approach in which patients are educated about the basic principles regarding pain, instructed how to report pain in a pain diary, how to communicate about pain, and how to contact healthcare providers. The effects of the PEP were evaluated taking into consideration the lack of well-established outcome measures to evaluate adequacy of pain treatment, the lack of long-term follow-up, and the influence of missing data.A prospective, randomized study was utilized in which 313 chronic cancer patients were followed-up until 8 weeks postdischarge. Adequacy of pain treatment was evaluated by means of the Amsterdam Pain Management Index (APMI), consisting of an integrated score of patients' Present Pain Intensity, Average Pain Intensity, and Worst Pain Intensity, corrected for patients' Tolerable Present Pain, with the analgesics used by the patient. At pretest, 60% of the patients in the hospital were treated inadequately for their pain. Postdischarge, the control group patients were significantly more inadequately treated at 2 weeks after discharge (56% vs 41%), at 4 weeks after discharge (62% vs 42%) and at 8 weeks after discharge (57% vs 51%) than the intervention group patients. While the level of inadequacy in the control groups remained relatively stable at all assessment points, a slight increase in the percentage of patients being treated inadequately was found in the intervention group patients over time. A beneficial effect of the PEP was found for patients both with and without district nursing. Variables predicting an improvement in adequacy of pain treatment consisted of the PEP, the APMI score at baseline, patients' level of physical functioning, patients' level of social functioning, the extent of adherence to pain medication, patients' pain knowledge, and the amount of analgesics used. These findings suggest that quality of pain treatment in cancer patients with chronic pain can be enhanced by educating patients about pain and improving active participation in their own pain treatment. The benefit from the PEP, however, decreases slightly over time, pointing at a need for ongoing education. PMID:11558980

de Wit, R; van Dam, F; Loonstra, S; Zandbelt, L; van Buuren, A; van der Heijden, K; Leenhouts, G; Duivenvoorden, H; Huijer Abu-Saad, H

2001-01-01

180

The Amsterdam Pain Management Index compared to eight frequently used outcome measures to evaluate the adequacy of pain treatment in cancer patients with chronic pain.  

PubMed

There is no 'gold standard' to assess the adequacy of pain treatment in cancer patients. The purpose of the study is to explore the Amsterdam Pain Management Index, a newly designed measure to evaluate the adequacy of cancer pain treatment, and to compare it with eight frequently used outcome measures. The Amsterdam Pain Management Index compares patients' Present Pain Intensity, Average Pain Intensity, and Worst Pain Intensity with a composite score of analgesics used, while correcting for what a patient considers as a tolerable level of pain. The eight frequently used outcome measure consisted of three Pain Intensity Markers, the Pain Relief Scale, the Patient Satisfaction Scale, and three Pain Management Indexes. In a randomized controlled trial, 313 cancer patients with a pain duration of at least 1 month were included and followed-up three times until 2 months postdischarge at home. The experimental group received a Pain Education Program, consisting of tailored pain information and instruction. Results showed that, except for the three Pain Management Indexes, the agreement between the measures was very low to moderate. The test of known-groups comparisons and equivalence between groups indicated that the Amsterdam Pain Management Index showed promising results. The Pain Intensity Markers and the Pain Relief Scale were limited in discriminating between groups, while the Patient Satisfaction Scale showed no differences between patient groups. Although it was possible for the Pain Management Indexes to distinguish between patient groups, the differences were not in the expected direction. The ability of the outcome measures to detect changes over time was clearly demonstrated by all outcome measures. Effects of the intervention were only found for the Amsterdam Pain Management Index and patients' Substantial Worst Pain score. Although support was provided for the use of the Amsterdam Pain Management Index, more research is warranted. PMID:11275392

de Wit, R; van Dam, F; Loonstra, S; Zandbelt, L; van Buuren, A; van der Heijden, K; Leenhouts, G; Huijer Abu-Saad, H

2001-04-01

181

Urination - painful  

MedlinePLUS

... atrophic vaginitis ) Herpes infection in the genital area Irritation of the vaginal tissue caused by bubble bath, perfumes, or lotions Vulvovaginitis , such as yeast or other infections of the vulva and vagina Other causes of painful urination include: ...

182

Back Pain  

MedlinePLUS

... The procedure is generally performed on an outpatient basis under a mild anesthetic. 3 Used only if ... some cases it is performed on an outpatient basis. For diskogenic low back pain (degenerative disk disease): ...

183

Abdominal Pain  

MedlinePLUS

... You could also try progressive relaxation or self-hypnosis . For more information about non-drug pain relief ... overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] show great promise ...

184

Threshold Bound States  

E-print Network

Relationships between the coupling constant and the binding energy of threshold bound states are obtained in a simple manner from an iterative algorithm for solving the eigenvalue problem. The absence of threshold bound states in higher dimensions can be easily understood.

W. A. Berger; H. G. Miller; D. Waxman

2007-02-08

185

Bayesian Threshold Estimation  

ERIC Educational Resources Information Center

Bayesian estimation of a threshold time (hereafter simply threshold) for the receipt of impulse signals is accomplished given the following: 1) data, consisting of the number of impulses received in a time interval from zero to one and the time of the largest time impulse; 2) a model, consisting of a uniform probability density of impulse time…

Gustafson, S. C.; Costello, C. S.; Like, E. C.; Pierce, S. J.; Shenoy, K. N.

2009-01-01

186

Neonatal pain  

PubMed Central

Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

Walker, Suellen M

2014-01-01

187

Oxygen toxicity and tolerance.  

PubMed

Normobaric oxygen toxicity is well described in all animal species. However susceptibility to oxygen exposure is highly variable according to age, species and strains. Similarly in humans, prolonged high oxygen exposure is reported to induce cough, shortness of breath, decrease vital capacity and increase alveolo-capillary permeability. The toxic FIO2 threshold (length of exposure and level) is still debated. In patients with previous lung injury, this threshold is even more difficult to delineate as pathologic pulmonary lesions might result from hyperoxia or primary lung insult. Oxygen free-radicals play a key role in the pathophysiology of oxygen toxicity. Oxygen resistance or tolerance is obtained with intraperitoneal, intravenous and intratracheal endotoxin or cytokines administration. Previous exposure to high oxygen concentration is also reported to increase survival rate and decrease pulmonary lesions in animal models. Protection may rely on antioxidant enzymes synthesis, nitric oxide production, neutrophils recruitment and modulation of alveolar macrophages activity. In humans, oxygen tolerance might be suspected through several clinical studies reporting favorable outcome after long term-oxygen exposure. Better knowledge of the risks of prolonged high oxygen exposure is important to re-evaluate the goals of mechanical ventilation (FIO2, SaO2, PEEP) and/or to develop treatments to prevent oxygen toxicity (surfactant, antioxidant enzymes). PMID:10394807

Capellier, G; Maupoil, V; Boussat, S; Laurent, E; Neidhardt, A

1999-06-01

188

Cancer pain (classification and pain syndromes).  

PubMed

Inspite the new informations about the physiology and biochemistry of pain, it remains true that pain is only partially understood. Cancer pain is often experienced as several different types of pain, with combined somatic and neuropathic types the most frequently. If the acute cancer pain does not subside with initial therapy, patients experience pain of more constant nature, the characteristics of wich vary with the cause and the involved sites. Chronic pain related to cancer can be considered as tumor-induced pain, chemotherapy-induced pain, and radiation therapy-induced pain. Certain pain mechanisms are present in cancer patients. These include inflammation due to infection, such as local sepsis or the pain of herpes zoster, and pain due to the obstruction or occlusion of a hollow organ, such as that caused by large bowel in cancer of colon. Pain also is commonly due to destruction of tissue, such as is often seen with bony metastases. Bony metastases also produce pain because of periostal irritation, medullary pressure, and fractures. Pain may be produced by the growth of tumor in a closed area richly supplied with pain receptors (nociceptors). Examples are tumors growing within the capsule of an organ such as the pancreas. Chest pain occurring after tumor of the lung or the mediastinum due to invasion of the pleura. Certain tumors produce characteristic types of pain. For example, back pain is seen with multiple myeloma, and severe shoulder pain and arm pain is seen with Pancoast tumors. PMID:16018403

Slavik, E; Ivanovi?, S; Grujici?, D

2004-01-01

189

Effects of laughter and relaxation on discomfort thresholds  

Microsoft Academic Search

Two experiments were conducted to test the proposal that laughter is a pain antagonist. In Experiment I, thresholds for pressure-induced discomfort of 20 male and 20 female subjects were measured after each subject listened to a 20-min-long laughter-inducing, relaxation-inducing, or dull-narrative audio tape or no tape. Discomfort thresholds were higher for subjects in the laughter- and the relaxation-inducing conditions. In

Rosemary Cogan; Dennis Cogan; William Waltz; Melissa McCue

1987-01-01

190

Reliability of the conditioned pain modulation paradigm to assess endogenous inhibitory pain pathways  

PubMed Central

BACKGROUND: Conditioned pain modulation paradigms are often used to assess the diffuse noxious inhibitory control (DNIC) system. DNICs provide one of the main supraspinal pain inhibitory pathways and are impaired in several chronic pain populations. Only one previous study has examined the psychometric properties of the conditioned pain modulation technique and this study did not evaluate intersession reliability. OBJECTIVES: To evaluate and compare the intra- and intersession reliability of two conditioned pain modulation paradigms using different conditioning stimuli, and to determine the time course of conditioned pain inhibition following stimulus removal. METHODS: An electronic pressure transducer was used to determine the pressure-pain threshold at the knee during painful conditioning of the opposite hand using the ischemic arm test and the cold pressor test. Assessments were completed twice on one day and repeated once approximately three days later. RESULTS: The two conditioning stimuli resulted in a similar increase in the pressure-pain threshold at the knee, reflecting presumed activation of the DNIC system. Intrasession intraclass correlation coefficients for the cold pressor (0.85) and ischemic arm tests (0.75) were excellent. The intersession intraclass correlation coefficient for the cold pressor test was good (0.66) but was poor for the ischemic arm test (?0.4). Inhibition of the pressure-pain threshold remained significant at 10 min following conditioning, but returned to baseline by 15 min. CONCLUSIONS: Within-session reliability of DNIC assessment using conditioned pain modulation paradigms was excellent, but the applicability of assessing pain modulation over multiple sessions was influenced by the conditioning stimulus. The cold pressor test was the superior technique. PMID:22518372

Lewis, Gwyn N; Luke, Heales; Rice, David A; Rome, Keith; McNair, Peter J

2012-01-01

191

Transplantation tolerance.  

PubMed

Although transplantation has been a standard medical practice for decades, marked morbidity from the use of immunosuppressive drugs and poor long-term graft survival remain important limitations in the field. Since the first solid organ transplant between the Herrick twins in 1954, transplantation immunology has sought to move away from harmful, broad-spectrum immunosuppressive regimens that carry with them the long-term risk of potentially life-threatening opportunistic infections, cardiovascular disease, and malignancy, as well as graft toxicity and loss, towards tolerogenic strategies that promote long-term graft survival. Reports of "transplant tolerance" in kidney and liver allograft recipients whose immunosuppressive drugs were discontinued for medical or non-compliant reasons, together with results from experimental models of transplantation, provide the proof-of-principle that achieving tolerance in organ transplantation is fundamentally possible. However, translating the reconstitution of immune tolerance into the clinical setting is a daunting challenge fraught with the complexities of multiple interacting mechanisms overlaid on a background of variation in disease. In this article, we explore the basic science underlying mechanisms of tolerance and review the latest clinical advances in the quest for transplantation tolerance. PMID:24213880

Salisbury, Emma M; Game, David S; Lechler, Robert I

2014-12-01

192

Pain as a reward: changing the meaning of pain from negative to positive co-activates opioid and cannabinoid systems.  

PubMed

Pain is a negative emotional experience that is modulated by a variety of psychological factors through different inhibitory systems. For example, endogenous opioids and cannabinoids have been found to be involved in stress and placebo analgesia. Here we show that when the meaning of the pain experience is changed from negative to positive through verbal suggestions, the opioid and cannabinoid systems are co-activated and these, in turn, increase pain tolerance. We induced ischemic arm pain in healthy volunteers, who had to tolerate the pain as long as possible. One group was informed about the aversive nature of the task, as done in any pain study. Conversely, a second group was told that the ischemia would be beneficial to the muscles, thus emphasizing the usefulness of the pain endurance task. We found that in the second group pain tolerance was significantly higher compared to the first one, and that this effect was partially blocked by the opioid antagonist naltrexone alone and by the cannabinoid antagonist rimonabant alone. However, the combined administration of naltrexone and rimonabant antagonized the increased tolerance completely. Our results indicate that a positive approach to pain reduces the global pain experience through the co-activation of the opioid and cannabinoid systems. These findings may have a profound impact on clinical practice. For example, postoperative pain, which means healing, can be perceived as less unpleasant than cancer pain, which means death. Therefore, the behavioral and/or pharmacological manipulation of the meaning of pain can represent an effective approach to pain management. PMID:23265686

Benedetti, Fabrizio; Thoen, Wilma; Blanchard, Catherine; Vighetti, Sergio; Arduino, Claudia

2013-03-01

193

Threshold voltage extraction circuit  

E-print Network

A novel optimally self-biasing MOSFET threshold-voltage (V[]) extractor circuit is presented. It implements the most popular industrial extraction algorithm of biasing a saturated MOSFET to the linear portion of its [] versus [] characteristic...

Hoon, Siew Kuok

2012-06-07

194

Efficient threshold cryptosystems  

E-print Network

A threshold signature or decryption scheme is a distributed implementation of a cryptosystem, in which the secret key is secret-shared among a group of servers. These servers can then sign or decrypt messages by following ...

Jarecki, Stanisł aw (Stanisł aw Michal), 1971-

2001-01-01

195

Threshold cross section measurements  

E-print Network

Accurate measurements of particles masses, couplings and widths are possible by measuring production cross sections near threshold. We discuss the prospects for performing such measurements at a high luminosity muon collider.

M. S. Berger

1998-02-02

196

Salt Tolerance  

PubMed Central

Studying salt stress is an important means to the understanding of plant ion homeostasis and osmo-balance. Salt stress research also benefits agriculture because soil salinity significantly limits plant productivity on agricultural lands. Decades of physiological and molecular studies have generated a large body of literature regarding potential salt tolerance determinants. Recent advances in applying molecular genetic analysis and genomics tools in the model plant Arabidopsis thaliana are shading light on the molecular nature of salt tolerance effectors and regulatory pathways. PMID:22303210

Xiong, Liming; Zhu, Jian-Kang

2002-01-01

197

Back pain during growth.  

PubMed

It is wrong to believe that back pain only burdens adults: the yearly incidence during growth ranges from 10-20%, continuously increasing from childhood to adolescence. Rapid growth-related muscular dysbalance and insufficiency, poor physical condition in an increasingly sedentary adolescent community or - vice versa - high level sports activities, account for the most prevalent functional pain syndromes. In contrast to adults the correlation of radiographic findings with pain is high: the younger the patient, the higher the probability to establish a rare morphologic cause such as benign or malignant tumours, congenital malformations and infections. In children younger than 5 years old, the likelihood is more than 50%. The following red flags should lower the threshold for a quick in-depth analysis of the problem: Age of the patient <5 years, acute trauma, functional limitation for daily activities, irradiating pain, loss of weight, duration >4 weeks, history of tumour, exposition to tuberculosis, night pain and fever. High level sport equals a biomechanical field test which reveals the biologic individual response of the growing spine to the sports-related forces. Symptomatic or asymptomatic inhibitory or stimulatory growth disturbances like Scheuermann disease, scoliosis or fatigue fractures represent the most frequent pathomorphologies. They usually occur at the disk-growth plate compound: intraspongious disk herniation, diminuition of anterior growth with vertebral wedging and apophyseal ring fractures often occur when the biomechanical impacts exceed the mechanical resistance of the cartilaginous endplates. Spondylolysis is a benign condition which rarely becomes symptomatic and responds well to conservative measures. Associated slippage of L5 on S1 is frequent but rarely progresses. The pubertal spinal growth spurt is the main risk factor for further slippage, whereas sports activity - even at a high level - is not. Therefore, the athlete should only be precluded from training if pain persists or in case of high grade slips. Perturbance of the sagittal profile with increase of lumbar lordosis, flattening of the thoracic spine and retroflexion of the pelvis with hamstrings contractures are strong signs for a grade IV olisthesis or spondyloptosis with subsequent lumbosacral kyphosis. Idiopathic scoliosis is not related to pain unless it is a marked (thoraco-) lumbar curve or if there is an underlying spinal cord pathology. Chronic back pain is an under recognised entity characterised by its duration (>3 months or recurrence within 3 months) and its social impacts such as isolation and absence from school or work. It represents an independent disease, uncoupled from any initial trigger. Multimodal therapeutic strategies are more successful than isolated, somatising orthopaedic treatment. Primary and secondary preventive active measures for the physically passive adolescents, regular sports medical check-up's for the young high level athletes, the awareness for the rare but potentially disastrous pathologies and the recognition of chronic pain syndromes are the cornerstones for successful treatment of back pain during growth. PMID:23299906

Hasler, Carol C

2013-01-01

198

[Social pain].  

PubMed

This chapter focuses on what social pain is and how it should be managed. In order to understand social pain in a cancer patient, it is necessary to recognize the change in the patient's daily life after the diagnosis of cancer. Because the degree of suffering and the relationships with family members and the people he or she worked with differ from patient to patient, it is important to note that the context of social pain is different in each patient. Five points shown below are essential in managing social pain. 1. Economical suffering may be alleviated by utilization of the social security system while taking into account each patient's standard of living. 2. Burdens on family members should be lessened, such as by not having them stay at the patient's bedside every day and letting them go home occasionally. 3. The normal patterns of communication, support, and conflict in the family should be identified, and the extent to which they have been disrupted by the illness should be assessed. 4. It is important to understand the ethnic, cultural, and religious background of the patient and the potential impact of their influence on the individual and the illness. 5. Practical or emotional unfinished business that the patient has needs to be identified, and efforts should be made to support fulfillment. PMID:21950034

Shimoyama, Naohito; Shimoyama, Megumi

2011-09-01

199

Heel Pain  

MedlinePLUS

... or other soft-tissue growth. Prevention A variety of steps can be taken to avoid heel pain and accompanying afflictions: Wear shoes that fit well—front, back, and sides—and have shock-absorbent soles, rigid shanks, and supportive heel counters Wear the proper shoes for each activity Do not wear ...

200

Chest Pain  

MedlinePLUS

Having a pain in your chest can be scary. It does not always mean that you are having a heart attack. There can be many other causes, ... embolism Costochondritis - an inflammation of joints in your chest Some of these problems can be serious. Get ...

201

Fetal pain?  

Microsoft Academic Search

During the last few years a vivid debate, both scientifically and emotionally, has risen in the medical literature as to whether a fetus is able to feel pain during abortion or intrauterine surgery. This debate has mainly been inspired by the demonstration of various hormonal or motor reactions to noxious stimuli at very early stages of fetal development. The aims

Sampsa Vanhatalo; Onno van Nieuwenhuizen

2000-01-01

202

Intolerant tolerance.  

PubMed

The Hyde Amendment and Roman Catholic attempts to put restrictions on Title X funding have been criticized for being intolerant. However, such criticism fails to appreciate that there are two competing notions of tolerance, one focusing on the limits of state force and accepting pluralism as unavoidable, and the other focusing on the limits of knowledge and advancing pluralism as a good. These two types of tolerance, illustrated in the writings of John Locke and J.S. Mill, each involve an intolerance. In a pluralistic context where the free exercise of religion is respected, John Locke's account of tolerance is preferable. However, it (in a reconstructed form) leads to a minimal state. Positive entitlements to benefits like artificial contraception or nontherapeutic abortions can legitimately be resisted, because an intolerance has already been shown with respect to those that consider the benefit immoral, since their resources have been coopted by taxation to advance an end that is contrary to their own. There is a sliding scale from tolerance (viewed as forbearance) to the affirmation of communal integrity, and this scale maps on to the continuum from negative to positive rights. PMID:8051515

Khushf, G

1994-04-01

203

Oral tolerance  

Microsoft Academic Search

The ability of the mucosal immune system to distinguish between harmful and harmless antigens is essential for mounting protective immune responses and preventing the induction of mucosal pathology yet the basis for this remains unclear. As fed antigen can also exert systemic effects understanding oral tolerance and priming will also have important consequences for therapy and vaccination. Here we will

P Garside; A. McI Mowat

2001-01-01

204

Complex Regional Pain Syndrome  

MedlinePLUS

Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

205

Central Pain Syndrome  

MedlinePLUS

NINDS Central Pain Syndrome Information Page Table of Contents (click to jump to sections) What is Central Pain Syndrome? Is there ... being done? Clinical Trials Organizations What is Central Pain Syndrome? Central pain syndrome is a neurological condition ...

206

Pain in Parkinson's Disease  

MedlinePLUS

... ways to manage it. Causes of Pain in Parkinson’s Researchers classify pain based on the separation of ... syndrome involving both nociceptive and neuropathic pain. Your Parkinson’s specialist, working with a pain specialist, may select ...

207

Complex Regional Pain Syndrome  

MedlinePLUS

... Syndrome? Complex regional pain syndrome (CRPS) is a chronic pain condition. The key symptom of CRPS is continuous, ... Institute of Neurological Disorders and Stroke (NINDS). NINDS Chronic Pain Information Page Chronic pain information page compiled by ...

208

Pain Management Programs  

MedlinePLUS

... Resource Guide to Chronic Pain Medications & Treatments The Art of Pain Management What We Have Learned Going to the ER ... Resource Guide to Chronic Pain Medications & Treatments The Art of Pain Management What We Have Learned Going to the ER ...

209

Pain Sensitivity and Observer Perception of Pain in Individuals with Autistic Spectrum Disorder  

PubMed Central

The peer-reviewed literature investigating the relationship between pain expression and perception of pain in individuals with ASD is sparse. The aim of the present systematic PRIMSA review was twofold: first, to see what evidence there is for the widely held belief that individuals with ASD are insensitive to pain or have a high pain threshold in the peer-reviewed literature and, second, to examine whether individuals with ASD react or express pain differently. Fifteen studies investigating pain in individuals with ASD were identified. The case studies all reported pain insensitivity in individuals with ASD. However, the majority of the ten experimental studies reviewed indicate that the idea that individuals with ASD are pain insensitive needs to be challenged. The findings also highlight the strong possibility that not all children with ASD express their physical discomfort in the same way as a neurotypical child would (i.e., cry, moan, seek comfort, etc.) which may lead caregivers and the medical profession to interpret this as pain insensitivity or incorrectly lead them to believe that the child is in no pain. These results have important implications for the assessment and management of pain in children with ASD. PMID:23843740

Allely, C. S.

2013-01-01

210

Transient receptor potential channels: targeting pain at the source  

Microsoft Academic Search

Pain results from the complex processing of neural signals at different levels of the central nervous system, with each signal potentially offering multiple opportunities for pharmacological intervention. A logical strategy for developing novel analgesics is to target the beginning of the pain pathway, and aim potential treatments directly at the nociceptors — the high-threshold primary sensory neurons that detect noxious

Ardem Patapoutian; Simon Tate; Clifford J. Woolf

2009-01-01

211

Estradiol benzoate potentiates neuroactive steroids' effects on pain sensitivity  

Microsoft Academic Search

Progesterone (P), its metabolites, and other neuroactive steroids alter pain thresholds consistent with their efficacies at modulating ?-aminobutyric acid (GABAA) receptor complexes. We investigated whether estradiol benzoate (EB) potentiates low dosages of neuroactive steroids' effects on pain. Subcutaneous EB (10 ?g) or sesame oil vehicle was administered to ovariectomized Long-Evans rats (n = 40) 48 h before intracerebroventricular (ICV) infusion

Cheryl A. Frye; Jennifer E. Duncan

1996-01-01

212

Fault-Tolerant Exact State Transmission  

E-print Network

We show that a category of one-dimensional XY-type models may enable high-fidelity quantum state transmissions, regardless of details of coupling configurations. This observation leads to a fault- tolerant design of a state transmission setup. The setup is fault-tolerant, with specified thresholds, against engineering failures of coupling configurations, fabrication imperfections or defects, and even time-dependent noises. We propose the implementation of the fault-tolerant scheme using hard-core bosons in one-dimensional optical lattices.

Zhao-Ming Wang; Lian-Ao Wu; Michele Modugno; Wang Yao; Bin Shao

2012-05-02

213

Regional Seismic Threshold Monioring  

E-print Network

A database comprising a total of 45 events, selected to provide the best possible ray path coverage of the Barents Sea and adjacent areas, was compiled and reanalyzed in a consistent manner. This resulted in new regional attenuation relations for Pn and Sn, together with a preferred average velocity model to be used for predicting the travel times of regional phases. We have now applied these attenuation relations to investigate a regional threshold monitoring scheme for the Barents Sea area. A grid system with an approximately 100-km grid spacing was deployed for the Barents Sea region, and the observations at the arrays, ARCES, SPITS, FINES and NORES, were then used for calculating threshold magnitudes for each of the grid points. During an interval without seismic signals, the threshold magnitudes showed large variations over the region, and, in particular, in the vicinity of each array. However, for the region around the island of Novaya Zemlya, the variations are modest, varying around a mean of magnitude 2.1-2.2. In order to investigate in more detail the variations in threshold magnitudes for the Novaya Zemlya region, we deployed a dense grid with an areal extent of about 500 x 500 km around the former Novaya Zemlya nuclear test site. For each of the grid nodes, we calculated magnitude thresholds for the two-hour time interval 00:00 - 02:00 on 23 February 2002. At 01:21:12.1 there was an event with a magnitude of about 3, located about 100 km northeast of the former nuclear test site. Regions of different sizes were constructed by selecting grid points within different radii from the former nuclear test site. Average, minimum and maximum threshold magnitudes were calculated for circular regions with radii of 20, 50, 100 and 200 km, respectively. The most importan...

T. Kv& aelig; rna; T. Kvrna; E. Hicks; J. Schweitzer; F. Ringdal

2002-01-01

214

Clinical Assessment of Pain, Tolerability, and Preference of an Autoinjection Pen Versus a Prefilled Syringe for Patient Self-Administration of the Fully Human, Monoclonal Antibody Adalimumab: The TOUCH Trial  

Microsoft Academic Search

Background:Adalimumab is a therapeutic monoclonal antibody for SC administration by 2 single-use injection devices providing bioequivalent amounts of adalimumab: a ready-to-use, prefilled syringe and an integrated, disposable delivery system, the autoinjection Pen. Although pens have been shown to be preferred over syringes by patients requiring long-term SC administration of medications, there are no data on preference and pain in the

Alan Kivitz; Steven Cohen; James Edward Dowd; William Edwards; Suman Thakker; Frank R. Wellborne; Cheryl L. Renz; Oscar G. Segurado

2006-01-01

215

Shoulder pain  

PubMed Central

Introduction Shoulder pain is a common problem with an estimated prevalence of 4% to 26%. About 1% of adults aged over 45 years consult their GP with a new presentation of shoulder pain every year in the UK. The aetiology of shoulder pain is diverse and includes pathology originating from the neck, glenohumeral joint, acromioclavicular joint, rotator cuff, and other soft tissues around the shoulder girdle. The most common source of shoulder pain is the rotator cuff, accounting for over two-thirds of cases. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatment, topical drug treatment, local injections, non-drug treatment, and surgical treatment? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 71 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, arthroscopic subacromial decompression, autologous whole blood injection, corticosteroids (oral, subacromial injection, or intra-articular injection), electrical stimulation, excision of distal clavicle, extracorporeal shock wave therapy, ice, laser treatment, manipulation under anaesthesia, suprascapular nerve block, non-steroidal anti-inflammatory drugs (oral, topical or intra-articular injection), opioid analgesics, paracetamol, physiotherapy (manual treatment, exercises), platelet-rich plasma injection, rotator cuff repair, shoulder arthroplasty, and ultrasound. PMID:21418673

2010-01-01

216

Fentanyl nasal spray (Lazanda) for pain.  

PubMed

The FDA has approved a nasal spray formulation of fentanyl (Lazanda-Archimedes) for management of breakthrough pain in adult cancer patients who are already receiving and are tolerant to opioid therapy. Fentanyl is already available in the US for intravenous, intrathecal, epidural, transdermal and oral transmucosal use. PMID:22173454

2011-12-12

217

Pain Management: Post-Amputation Pain  

MedlinePLUS

Pain Management Post-Amputation Pain Volume 8 · Issue 2 · March/April 1998 Text size Larger text Smaller text Java Required Print ... Yahoo MyWeb by G. Edward Jeffries, MD, FACS Post-Amputation Pain Post-amputation pain is one of ...

218

Nausea Threshold in Apparently Healthy Individuals Who Drink Fluids Containing Graded Concentrations of Copper  

Microsoft Academic Search

Ingestion of drinking water with a high copper content may induce acute gastrointestinal effects, mainly nausea and vomiting, rarely diarrhea and abdominal pain. The objectives of this study were to define nausea threshold in apparently healthy adult volunteers who received graded concentrations of copper and to explore how individual thresholds were modified by delivering copper in an orange-flavored drink. Sixty-one

Manuel Olivares; Magdalena Araya; Fernando Pizarro; Ricardo Uauy

2001-01-01

219

Elaborating on Threshold Concepts  

ERIC Educational Resources Information Center

We propose an expanded definition of Threshold Concepts (TCs) that requires the successful acquisition and internalisation not only of knowledge, but also its practical elaboration in the domains of applied strategies and mental models. This richer definition allows us to clarify the relationship between TCs and Fundamental Ideas, and to account…

Rountree, Janet; Robins, Anthony; Rountree, Nathan

2013-01-01

220

Partners' Empathy Increases Pain Ratings: Effects of Perceived Empathy and Attachment Style on Pain Report and Display  

PubMed Central

Pain can be influenced by its social context. We aimed to examine under controlled experimental conditions how empathy from a partner and personal attachment style affect pain report, tolerance, and facial expressions of pain. Fifty-four participants, divided into secure, anxious, and avoidant attachment style groups, underwent a cold pressor task with their partners present. We manipulated how much empathy the participants perceived that their partners had for them. We observed a significant main effect of perceived empathy on pain report, with greater pain reported in the high perceived empathy condition. No such effects were found for pain tolerance or facial display. We also found a significant interaction of empathy with attachment style group, with the avoidant group reporting and displaying less pain than the secure and the anxious groups in the high perceived empathy condition. No such findings were observed in the low empathy condition. These results suggest that empathy from one's partner may influence pain report beyond behavioral reactions. In addition, the amount of pain report and expression that people show in high empathy conditions depends on their attachment style. Perspective Believing that one's partner feels high empathy for one's pain may lead individuals to rate the intensity of pain as higher. Individual differences in attachment style moderate this empathy effect. PMID:24953886

Hurter, Sarah; Paloyelis, Yannis; de C. Williams, Amanda C.; Fotopoulou, Aikaterini

2014-01-01

221

Barriers to Pain Management in a Community Sample of Chinese American Patients with Cancer  

PubMed Central

Barriers to cancer pain management can contribute to the undertreatment of cancer pain. No studies have documented barriers to cancer pain management in Chinese American patients. The purposes of this study in a community sample of Chinese Americans were to: describe their perceived barriers to cancer pain management; examine the relationships between these barriers and patients’ ratings of pain intensity, pain interference with function, mood disturbances, education, and acculturation level; and determine which factors predicted barriers to cancer pain management. Fifty Chinese Americans with cancer pain completed the following instruments: Brief Pain Inventory (BPI), Karnofsky Performance Status (KPS) scale, Barriers Questionnaire (BQ), Hospital Anxiety and Depression Scale (HADS), Suinn-Lew Asia Self-Identity Acculturation (SL-ASIA), and a demographic questionnaire. The mean total BQ score was in the moderate range. The individual barriers with the highest scores were tolerance to pain medicine, time intervals used for dosage of pain medicine, disease progression, and addiction. Significant correlations were found between the tolerance subscale and least pain (r= 0.380) and the religious fatalism subscale and average pain (r=0.282). These two subscales were positively correlated with anxiety and depression levels: (tolerance: r=0.282, r=0.284, respectively; religious fatalism: r=0.358, r=0.353, respectively). The tolerance subscale was positively correlated with pain interference (r=0.374). Approximately 21% of the variance in the total BQ score was explained by patients’ education level, acculturation score, level of depression, and adequacy of pain treatment. Chinese American cancer patients need to be assessed for pain and perceived barriers to cancer pain management to optimize pain management. PMID:19004613

Edrington, Janet; Dodd, Marylin; Wong, Candice; Padilla, Geraldine; Paul, Steven; Sun, Angela; Miaskowski, Christine

2009-01-01

222

Pain in People with Learning Disabilities in Residential Settings--The Need for Change  

ERIC Educational Resources Information Center

This audit investigated residential staff beliefs around pain thresholds and strategies they adopt to recognise and manage pain in people with learning disabilities across Surrey. A structured interview was constructed to elicit information. Results demonstrated that pain is not being effectively recognised or managed by residential staff in…

Beacroft, Monica; Dodd, Karen

2010-01-01

223

Central sensitization and LTP: do pain and memory share similar mechanisms?  

Microsoft Academic Search

Synaptic plasticity is fundamental to many neurobiological functions, including memory and pain. Central sensitization refers to the increased synaptic efficacy established in somatosensory neurons in the dorsal horn of the spinal cord following intense peripheral noxious stimuli, tissue injury or nerve damage. This heightened synaptic transmission leads to a reduction in pain threshold, an amplification of pain responses and a

Ru-Rong Ji; Tatsuro Kohno; Kimberly A. Moore; Clifford J. Woolf

2003-01-01

224

Risk Factor Assessment for Problematic Use of Opioids for Chronic Pain  

Microsoft Academic Search

Opioid analgesics provide effective treatment for noncancer pain, but many health providers have concerns about cognitive effects, tolerance, dependence, and addiction. Misuse of opioids is prominent in patients with chronic pain and early recognition of misuse risk could help providers offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. Many persons with chronic pain

Robert N. Jamison; Robert R. Edwards

2012-01-01

225

Acceptance- versus Change-Based Pain Management: The Role of Psychological Acceptance  

ERIC Educational Resources Information Center

This study compared two theoretically opposed strategies for acute pain management: an acceptance-based and a change-based approach. These two strategies were compared in a within-subjects design using the cold pressor test as an acute pain induction method. Participants completed a baseline pain tolerance assessment followed by one of the two…

Blacker, Kara J.; Herbert, James D.; Forman, Evan M.; Kounios, John

2012-01-01

226

Neural correlates of interindividual differences in the subjective experience of pain  

Microsoft Academic Search

Some individuals claim that they are very sensitive to pain, whereas others say that they tolerate pain well. Yet, it is difficult to determine whether such subjective reports reflect true interindividual experiential differences. Using psychophysical rat- ings to define pain sensitivity and functional magnetic resonance imaging to assess brain activity, we found that highly sensitive individuals exhibited more frequent and

Robert C. Coghill; John G. McHaffie; Ye-Fen Yen

2003-01-01

227

Threshold ElGamal-based key management scheme for distributed RSUs in VANET  

Microsoft Academic Search

semi­ trusted Road Side Units (RSUs) may be compromised. In this paper, we propose a Threshold EIGamal system based key man­ agement scheme for safeguarding VANET from the compromised RSUs and their collusion with the malicious vehicles. We analyze the packet loss tolerance for security performance demonstration, followed by a discussion on the threshold. After discussion of the feasibility on

Na Ruan; Takashi Nishide; Yoshiaki Hori

2011-01-01

228

Stress-induced pain: a target for the development of novel therapeutics.  

PubMed

Although current therapeutics provide relief from acute pain, drugs used for treatment of chronic pain are typically less efficacious and limited by adverse side effects, including tolerance, addiction, and gastrointestinal upset. Thus, there is a significant need for novel therapies for the treatment of chronic pain. In concert with chronic pain, persistent stress facilitates pain perception and sensitizes pain pathways, leading to a feed-forward cycle promoting chronic pain disorders. Stress exacerbation of chronic pain suggests that centrally acting drugs targeting the pain- and stress-responsive brain regions represent a valid target for the development of novel therapeutics. This review provides an overview of how stress modulates spinal and central pain pathways, identifies key neurotransmitters and receptors within these pathways, and highlights their potential as novel targets for therapeutics to treat chronic pain. PMID:25194019

Johnson, Anthony C; Greenwood-Van Meerveld, Beverley

2014-11-01

229

Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Pain  

PubMed Central

Background Pain is one of the most commonly reported impairments after breast cancer treatment affecting anywhere from 16-73% of breast cancer survivors Despite the high reported incidence of pain from cancer and its treatments, the ability to evaluate cancer pain continues to be difficult due to the complexity of the disease and the subjective experience of pain. The Oncology Section Breast Cancer EDGE Task Force was created to evaluate the evidence behind clinical outcome measures of pain in women diagnosed with breast cancer. Methods The authors systematically reviewed the literature for pain outcome measures published in the research involving women diagnosed with breast cancer. The goal was to examine the reported psychometric properties that are reported in the literature in order to determine clinical utility. Results Visual Analog Scale, Numeric Rating Scale, Pressure Pain Threshold, McGill Pain Questionnaire, McGill Pain Questionnaire – Short Form, Brief Pain Inventory and Brief Pain Inventory – Short Form were highly recommended by the Task Force. The Task Force was unable to recommend two measures for use in the breast cancer population at the present time. Conclusions A variety of outcome measures were used to measure pain in women diagnosed with breast cancer. When assessing pain in women with breast cancer, researchers and clinicians need to determine whether a unidimensional or multidimensional tool is most appropriate as well as whether the tool has strong psychometric properties.

Harrington, Shana; Gilchrist, Laura; Sander, Antoinette

2014-01-01

230

Gabapentin in Pain Management  

Microsoft Academic Search

role of gabapentin in pain treatment will be discussed with an attempt to identify pain symptoms that are likely to be responsive to gabapentin; 2) animal stud- ies of gabapentin on neuropathic pain and other pain behaviors will be evaluated; and 3) possible mecha- nisms of gabapentin actions will be considered in re- lation to mechanisms of neuropathic pain in

Jianren Mao; Lucy L. Chen

2000-01-01

231

Low Back Pain  

MedlinePLUS

... Low Back Pain Overview What is low back pain? Low back pain is a common problem for many people. It can be caused by many ... lift and exercise correctly. Symptoms When is low back pain serious? Call your family doctor if: Pain goes ...

232

The psychology of pain  

Microsoft Academic Search

Discusses the aspect theory of pleasure and pain. Aspect theory regards pain as the highest degree of displeasure, and holds that it is always felt with reference to a tactile or temperature sensation. Several experiences of cutaneous pain were examined in order to test the theory. The neurological facts and theories on the psychology of pain indicate that: (1) pain

C. A. Strong

1895-01-01

233

Sensory characteristics of chronic non-specific low back pain: a subgroup investigation.  

PubMed

It has been proposed that patients with chronic non-specific low back pain (CNSLBP) can be broadly classified based on clinical features that represent either predominantly a mechanical pain (MP) or non-mechanical pain (NMP) profile. The aim of this study was to establish if patients with CNSLBP who report features of NMP demonstrate differences in pain thresholds compared to those who report MP characteristics and pain-free controls. This study was a cross-sectional design investigating whether pressure pain threshold (PPT) and/or cold pain threshold (CPT) at three anatomical locations differed between patients with mechanical CNSLBP (n = 17) versus non-mechanical CNSLBP (n = 19 and healthy controls (n = 19) whilst controlling for confounders. The results of this study provide evidence of increased CPT at the wrist in the NMP profile group compared to both the MP profile and control subjects, when controlling for gender, sleep and depression (NMP versus MP group Odds Ratio (OR): 18.4, 95% confidence interval (CI): 2.5-133.1, p = 0.004). There was no evidence of lowered PPT at any site after adjustment for confounding factors. Those with an MP profile had similar pain thresholds to pain-free controls, whereas the NMP profile group demonstrated elevated CPT's consistent with central amplification of pain. These findings may represent different pain mechanisms associated with these patient profiles and may have implications for targeted management. PMID:24731602

O'Sullivan, Peter; Waller, Robert; Wright, Anthony; Gardner, Joseph; Johnston, Richard; Payne, Carly; Shannon, Aedin; Ware, Brendan; Smith, Anne

2014-08-01

234

Intensity Thresholds for Aerobic Exercise-Induced Hypoalgesia  

PubMed Central

Despite many studies investigating exercise-induced hypoalgesia, there is limited understanding of the optimal intensity of aerobic exercise in producing hypoalgesic effects across different types of pain stimuli. Given that not all individuals are willing or capable of engaging in high intensity aerobic exercise, whether moderate intensity aerobic exercise is associated with a hypoalgesic response and whether this response generalizes to multiple pain induction techniques needs to be substantiated. Purpose This study’s purpose is to test for differences in the magnitude of pressure and heat pain modulation induced by moderate (MAE) and vigorous (VAE) intensity aerobic exercise. Methods Twelve healthy young males and 15 females completed one training session and three testing sessions consisting of 25 minutes of either 1) stationary cycling at 70% heart rate reserve (HRR), 2) stationary cycling at 50% HRR, or 3) quiet rest (control). Pain testing was conducted on both forearms prior to and immediately following each condition and included the following tests: pressure pain thresholds (PPT), suprathreshold pressure pain test, static continuous heat test, and repetitive pulse heat pain test. Repeated measures ANOVAs were conducted on each pain measure. Results VAE and MAE reduced pain ratings during static continuous heat stimuli and repetitive heat pulse stimuli, with VAE producing larger effects. VAE also increased PPTs, while neither exercise influenced suprathreshold pressure pain ratings. Conclusion These results suggest that MAE is capable of producing a hypoalgesic effect using continuous and repetitive pulse heat stimuli. However, a dose-response effect was evident as VAE produced larger effects than MAE. PMID:24002342

Naugle, Kelly M.; Naugle, Keith E.; Fillingim, Roger B.; Samuels, Brian; Riley, Joseph L.

2014-01-01

235

Tolerance chart optimization  

Microsoft Academic Search

A tolerance chart is a graphical representation of a process plan and a manual procedure for controlling tolerance stackup when the machining of a component involves interdependent tolerance chains. This heuristic, experience-based method of allocating tolerances to individual cuts of a process plan can be embodied in a computer-based module. This paper introduces a graph theoretic representation for the tolerance

S. A. IRANI; R. O. MITTAL; E. A. LEHTIHET

1989-01-01

236

Morphine Tolerance as Habituation  

Microsoft Academic Search

We propose that the development of drug tolerance is congruent with the behavioral characteristics of habituation. Specifically, we show that morphine tolerance development conforms to Wagner's priming model of habituation. Tolerance develops through both associational and nonassociational routes; We attribute associational tolerance development to retrieval-generated priming of memory, whereas nonassociational tolerance we attribute to self-generating priming. This model accounts for

Timothy B. Baker; Stephen T. Tiffany

1985-01-01

237

Bone pain or tenderness  

MedlinePLUS

... cause of the pain, your doctor may prescribe: Antibiotics Anti-inflammatory medicines Hormones Laxatives (if you develop constipation during prolonged bed rest) Pain relievers If pain is related to thinning bones, you may need treatment for osteoporosis .

238

Medications for back pain  

MedlinePLUS

Your back pain may not go away completely, or it may get more painful at times. Learning to take care ... home and how to prevent repeat episodes of back pain may help you avoid surgery. Different medications can ...

239

Complex regional pain syndrome  

MedlinePLUS

Complex regional pain syndrome (CRPS) is a chronic pain condition that can affect any area of the ... Bailey A, Audette JF. Complex regional pain syndrome. In: Frontera ... of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, ...

240

What Is Back Pain?  

MedlinePLUS

... some types of treatments for chronic back pain. Hot or Cold Packs (or Both) Hot or cold packs can soothe sore, stiff backs. ... helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this ...

241

Somatoform pain disorder  

MedlinePLUS

The main symptom of somatoform pain disorder is chronic pain that lasts for several months and limits a ... effects, and may carry the risk for abuse. Chronic pain syndromes of all types can often be treated ...

242

Pain and your emotions  

MedlinePLUS

Chronic pain can limit your everyday activities and make it hard to work. It can also affect how ... Depression is very common among people who have chronic pain. Pain can cause depression or make existing depression ...

243

Managing Chronic Pain  

MedlinePLUS

... perform household chores. What can a person with chronic pain do? ? Develop and practice a lifestyle based on ... mind and reduce tensions that aggravate pain. Managing Chronic Pain ® Tips for Living Occupational Therapy: Skills for the ...

244

Chronic Pain and Adherence  

Microsoft Academic Search

\\u000a Chronic pain of non-malignant etiology is a significant problem. Chronic non-malignant pain is typically defined as pain that\\u000a persists for 3 months or longer and that is non-life threatening [1, 2]. Among the most common chronic pain conditions are\\u000a chronic back pain, migraine headaches, and tension headaches. Chronic pain is very common. In the United States, 17% of patients\\u000a seen

Rebecca A. Shelby; Francis J. Keefe

245

Pain drawings and sickle cell disease pain.  

PubMed

This study examined the relationship of pain drawings to somatization in patients with sickle cell disease (SCD). Sixty-nine adult patients with SCD completed a pain drawing in which they shaded in areas of the body in which they experienced pain and also completed the symptom checklist (SCL) 90-R as an index of psychological distress. Analysis of variance indicated that patients who were categorized as having pain drawings with sites inconsistent with expected SCD pain patterns had somatization scores in the clinically significant range. The results suggest that health care professionals who treat SCD patients need to consider pain patterns. In individuals with pain patterns atypical for SCD, the psychological status of the patient may need to be evaluated to facilitate optimal pain management. PMID:2135002

Gil, K M; Phillips, G; Abrams, M R; Williams, D A

1990-06-01

246

Pain management in Jordan: nursing students' knowledge and attitude.  

PubMed

Pain management requires knowledgeable and trained nurses. Because nursing students are the nurses of the future, it is important to ensure that students receive adequate education about pain management in nursing schools. The purpose of this study is to evaluate nursing students' knowledge and attitudes regarding pain management. A cross-sectional survey was used. The sample comprised 144 students from three nursing colleges in Jordan. Sixty-one percent were female and the average age was 21.6 years (SD 1.7). The students' Knowledge and Attitudes Survey Regarding Pain was used. The rate of correct answers ranged from 11.1% to 64%. Students showed a low level of knowledge regarding pain management-the average score was just 16 (SD 5.11) out of 40. Students were weak in their knowledge of pain medications pharmacology (actions and side effects). Less than half of students (47.9%) recognised that pain may be present, even when vital signs are normal and facial expressions relaxed. Finally, students showed negative attitudes towards pain management, believing that patients should tolerate pain as much as they can before receiving opioids; almost half (48%) of students agreed that patients' pain could be managed with placebo rather than medication. In conclusion, Jordanian nursing students showed lower levels of pain knowledge compared with other nursing students around the world. This study underlines the need to include pain-management courses throughout undergraduate nursing curricula in Jordan. PMID:24280924

Al Khalaileh, Murad; Al Qadire, Mohammad

247

Gas threshold Cerenkov counters  

NASA Technical Reports Server (NTRS)

The report describes two designs are reported of gas threshold Cerenkov counters for recording electrons of primary cosmic rays without recording protons. Also presented are design and technological measures which ensure maximum light collection of the Cerenkov radiation originating on the photocathode of the photomultiplier inside the radiator. The dependence of the reflection factor on the length of the light wave for different coatings is shown as well as for the throughput of the different optical materials employed. A range of methods for determining the efficiency of the counters during the recording of cosmic ray nucons and ways of increasing it further are given.

Logachev, V. I.; Sinitsyna, V. G.; Chukin, V. S.

1975-01-01

248

Carbamazepine potentiates morphine analgesia on postoperative pain in morphine-dependent rats.  

PubMed

Postoperative pain and its control remain one of the most important issues in the field of surgery and health care systems. Morphine is a potent and effective analgesic, but substance abuse patients can manifest cross-tolerance to it, making it difficult to satisfy their analgesic/anesthetic requirements. As carbamazepine has shown antinociceptive properties in a variety of experimental and clinical settings, in the present study, we evaluated its potential antiallodynic effects on postoperative pain in naïve and morphine-dependent rats. Male rats were assigned to morphine-dependent and naïve groups and received intraperitoneally drug vehicles as control group, 3mg/kg morphine, 5, 10 or 15 mg/kg carbamazepine or 5mg/kg carbamazepine plus 3mg/kg morphine as a combination therapy 2 and 24h after surgery. Morphine-dependency was induced with multiple doses of morphine administered i.p. and plantar incision was made on the hind paw to simulate the postoperative pain. Paw withdrawal threshold (PWT) was obtained by von Frey filaments every 30 min after drug injection for up to 180 min. Morphine at 3mg/kg exerted antiallodynic effects in naïve rats and a decreased antinociception was observed in morphine-dependent rats. In contrast, 5mg/kg carbamazepine did not significantly alter PWT in naives but it was effective in dependent rats. 10 and 15 mg/kg carbamazepine attenuated allodynia following surgery in both groups. Co-administration of 5mg/kg carbamazepine with 3mg/kg morphine produced higher analgesia in morphine-dependent incised rats and prolonged antinociception as compared to morphine alone (P<0.05). Thus carbamazepine may potentiate the analgesic effect of chronically administered morphine on postoperative pain model in morphine-dependent rats. PMID:22061686

Naseri, Kobra; Sabetkasaei, Masoumeh; Moini Zanjani, Taraneh; Saghaei, Elham

2012-01-15

249

fMRI pain activation in the periaqueductal gray in healthy volunteers during the cold pressor test.  

PubMed

The periaqueductal gray (PAG), a brain area belonging to the descending pain modulatory system, plays a crucial role in pain perception. Little information is available on the relationship between PAG activation and perceived pain intensity. In this study, we acquired functional magnetic resonance imaging (fMRI) scans from the PAG during the cold pressor test, a model for tonic pain, in 12 healthy volunteers. fMRI data were acquired with a 12-channel head-coil and a 3-Tesla scanner and analyzed with Statistical Parametric Mapping (SPM8) software. During the cold pressor test, fMRI showed significant activation clusters in pain-related brain areas: bilateral middle and superior frontal gyrus, anterior cingulate cortex and thalamus, left insula, right inferior frontal gyrus, left inferior temporal gyrus and in the bilateral PAG (cluster level corrected threshold p<0.05). PAG activation correlated directly with the pain threshold and inversely with the participant's perceived pain intensity (cluster level corrected threshold (p<0.05). The cold pressor test consistently activated the PAG as well as other pain-related areas in the brain. Our study, showing that the greater the PAG activation the higher the pain threshold and the weaker the pain intensity perceived, highlights the key role of the PAG in inhibiting the pain afferent pathway function. Our findings might be useful for neuroimaging studies investigating PAG activation in patients with chronic idiopathic pain conditions possibly related to dysfunction in the descending pain modulatory system. PMID:24468081

La Cesa, S; Tinelli, E; Toschi, N; Di Stefano, G; Collorone, S; Aceti, A; Francia, A; Cruccu, G; Truini, A; Caramia, F

2014-04-01

250

Coloring geographical threshold graphs  

SciTech Connect

We propose a coloring algorithm for sparse random graphs generated by the geographical threshold graph (GTG) model, a generalization of random geometric graphs (RGG). In a GTG, nodes are distributed in a Euclidean space, and edges are assigned according to a threshold function involving the distance between nodes as well as randomly chosen node weights. The motivation for analyzing this model is that many real networks (e.g., wireless networks, the Internet, etc.) need to be studied by using a 'richer' stochastic model (which in this case includes both a distance between nodes and weights on the nodes). Here, we analyze the GTG coloring algorithm together with the graph's clique number, showing formally that in spite of the differences in structure between GTG and RGG, the asymptotic behavior of the chromatic number is identical: {chi}1n 1n n / 1n n (1 + {omicron}(1)). Finally, we consider the leading corrections to this expression, again using the coloring algorithm and clique number to provide bounds on the chromatic number. We show that the gap between the lower and upper bound is within C 1n n / (1n 1n n){sup 2}, and specify the constant C.

Bradonjic, Milan [Los Alamos National Laboratory; Percus, Allon [Los Alamos National Laboratory; Muller, Tobias [EINDHOVEN UNIV. OF TECH

2008-01-01

251

Qubit coherence decay down to threshold: influence of substrate dimensions  

E-print Network

Keeping single-qubit quantum coherence above some threshold value not far below unity is a prerequisite for fault-tolerant quantum error correction (QEC). We study the initial dephasing of solid-state qubits in the independent-boson model, which describes well recent experiments on quantum dot (QD) excitons both in bulk and in substrates of reduced geometry such as nanotubes. Using explicit expressions for the exact coherence dynamics, a minimal QEC rate is identified in terms of the error threshold, temperature, and qubit-environment coupling strength. This allows us to systematically study the benefit of a current trend towards substrates with reduced dimensions.

Roland Doll; Peter Hanggi; Sigmund Kohler; Martijn Wubs

2008-07-16

252

Effect of experimental chewing on masticatory muscle pain onset  

PubMed Central

Objectives To evaluate the effect of a chewing exercise on pain intensity and pressurepain threshold in patients with myofascial pain. Methods Twenty-nine consecutive women diagnosed with myofascial pain (MFP) according to the Research Diagnostic Criteria comprised the experimental group and 15 healthy age-matched female were used as controls. Subjects were asked to chew a gum stick for 9 min and to stay at rest for another 9 min afterwards. Pain intensity was rated on a visual analog scale (VAS) every 3 min. At 0, 9 and 18 min, the pressure-pain threshold (PPT) was measured bilaterally on the masseter and the anterior, medium, and posterior temporalis muscles. Results Patients with myofascial pain reported increase (76%) and no change (24%) on the pain intensity measured with the VAS. A reduction of the PPT at all muscular sites after the exercise and a non-significant recovery after rest were also observed. Conclusion The following conclusions can be drawn: 1. there are at least two subtypes of patients with myofascial pain that respond differently to experimental chewing; 2. the chewing protocol had an adequate discriminative ability in distinguishing patients with myofascial pain from healthy controls. PMID:21437467

CONTI, Paulo César Rodrigues; SILVA, Rafael dos Santos; de ARAUJO, Carlos dos Reis Pereira; ROSSETI, Leylha Maria N.; YASSUDA, Shigueharu; da SILVA, Renato Oliveira Ferreira; PEGORARO, Luiz Fernando

2011-01-01

253

Peripheral Pain Mechanisms in Chronic Widespread Pain  

PubMed Central

Clinical symptoms of chronic widespread pain (CWP) conditions including fibromyalgia (FM), include pain, stiffness, subjective weakness, and muscle fatigue. Muscle pain in CWP is usually described as fluctuating and often associated with local or generalized tenderness (hyperalgesia and/or allodynia). This tenderness related to muscle pain depends on increased peripheral and/or central nervous system responsiveness to peripheral stimuli which can be either noxious (hyperalgesia) or non-noxious (allodynia). For example, patients with muscle hyperalgesia will rate painful muscle stimuli higher than normal controls, whereas patients with allodynia may perceive light touch as painful, something that a “normal” individual will never describe as painful. The pathogenesis of such peripheral and/or central nervous system changes in CWP is unclear, but peripheral soft tissue changes have been implicated. Indirect evidence from interventions that attenuate tonic peripheral nociceptive impulses in patients with CWP syndromes like FM suggest that overall FM pain is dependent on peripheral input. More importantly, allodynia and hyperalgesia can be improved or abolished by removal of peripheral impulse input. Another potential mechanism for CWP pain is central disinhibition. However, this pain mechanism also depends on tonic impulse input, even if only inadequately inhibited. Thus a promising approach to understanding CWP is to determine whether abnormal activity of receptors in deep tissues is fundamental to the development and maintenance of this chronic pain disorder. Conclusions Most CWP patients present with focal tissue abnormalities including myofascial trigger points, ligamentous trigger points, or osteoarthritis of the joints and spine. While not predictive for the development of CWP these changes nevertheless represent important pain generators that may initiate or perpetuate chronic pain. Local chemical mediators, including lactic acid, ATP, and cytokines seem to play an important role in sensitizing deep tissue nociceptors of CWP patients. Thus the combination of peripheral impulse input and increased central pain sensitivity may be responsible for wide-spread chronic pain disorders including FM. PMID:22094192

Staud, Roland

2011-01-01

254

Pain management for neonatal circumcision.  

PubMed

Circumcision is the most common surgical procedure performed in the neonatal period in North America. If untreated, the pain of circumcision causes both short and long term changes in infant behaviours. The most widely studied pharmacological intervention for pain management during circumcision is dorsal penile nerve block (DPNB) by injected lidocaine (lignocaine). Randomised controlled trials have demonstrated its efficacy; infants premedicated with lidocaine have significantly smaller changes in physiological and pain-related behaviours compared with infants who are not given analgesics. A meta-analysis of injection-related adverse effects (bruising/haematoma) yielded a risk of 6.7% (95% confidence interval, 0.5 to 12.9%). Systemic toxicity from injected local anaesthesia has not been reported. Less effective modalities include topical anaesthesia with lidocaine-prilocaine cream [Eutectic Mixture of Local Anaesthetics (EMLA)], lidocaine cream and oral administration of sucrose. The good tolerability of lidocaine-prilocaine cream has been demonstrated by a lack of clinically significant methaemoglobinaemia when used appropriately. Nonpharmacological interventions (pacifier, specially designed restraint chair) reduce distress during the procedure, and paracetamol (acetaminophen) may provide postoperative analgesia. No single agent has been demonstrated to ameliorate pain for all infants undergoing circumcision. A multimodal approach of pharmacotherapy is currently recommended. Studies evaluating the efficacy of combined analgesia have demonstrated significant benefits for combinations of 2 or more forms of treatment (such as DPNB and sucrose-dipped pacifier) compared with single interventions. The instrument used to perform the circumcision is also important. The Mogen clamp has been shown to be associated with a shorter procedure time and less pain compared with the Gomco clamp. If circumcision is to be performed on infants, it is, therefore, recommended that combined analgesia and the Mogen clamp technique are used, and nonpharmacological stress reducing interventions such as pacifiers and comfortable restraining chairs should also be employed. PMID:11269637

Taddio, A

2001-01-01

255

Taking narcotics for back pain  

MedlinePLUS

... Narcotics can provide short-term relief of severe back pain. This can allow you to return to your ... Nonspecific back pain - narcotics; Backache - chronic - narcotics; Lumbar pain - chronic - narcotics; Pain - back - chronic - narcotics; Chronic back pain - low - narcotics

256

Pain: You Can Get Help  

MedlinePLUS

... face that shows how you feel. Acute And Chronic Pain There are two kinds of pain. Acute pain ... or years is called chronic (or persistent) pain. Chronic pain may last long after the body has healed. ...

257

A Systematic Comparison Between Subjects with No Pain and Pain Associated with Active Myofascial Trigger Points  

PubMed Central

Objective To determine whether standard evaluations of pain distinguish subjects with no pain from those with myofascial pain syndromes (MPS) and active trigger points (MTrPs); and to assess whether self-reports of mood, function and health-related quality of life differ between these groups. Design Prospective, descriptive study. Setting University Patients Adults with and without neck pain Methods We evaluated adults with MPS and active (painful) MTrPs and those without pain. Subjects in the “Active” (‘A’) group had at least one active MTrP with spontaneous pain which was persistent, lasted more than 3 months and had characteristic pain on palpation. Subjects in the “No pain” (‘Np’) group had no spontaneous pain. However, some had discomfort on MTrP palpation (latent MTrP) while others in the Np group had no discomfort on palpation of nodules or had no nodules. Outcome Measures Each participant underwent range of motion (ROM) measurement, 10-point manual muscle test, and manual and algometric palpation. The latter determined the pain/pressure threshold using an algometer of 4 pre-determined anatomical sites along the upper trapezius. Participants rated pain using a verbal analogue scale (0–10); completed the Brief Pain Inventory and Oswestry Disability Scale (ODS), which included a sleep sub-scale; Short Form 36(SF36) and the Profile of Mood States (POMS). Results here were 24 in the ‘A’ group (mean 36 yrs, 16 women) and 26 in the ‘Np’ group (mean 26 yrs, 12 women). Subjects in group ‘A’ differed from ‘Np’ in number of latent MTrPs (p=.0062); asymmetrical cervical ROM (p=.01 side bending and p=.002 rotation); in all pain reports (p<.0001); algometry (p<.03); POMS (p<.038); SF36 (p<.01) and ODS (p<.0001). Conclusion A systematic musculoskeletal evaluation of people with MPS reliably distinguishes them from subjects with no pain. The two groups are significantly different in their physical findings and self-reports of pain, sleep disturbance, disability, health status and mood. These findings support the view that a “local” pain syndrome has significant associations with mood, health-related quality of life and function.. PMID:23810811

Gerber, Lynn H.; Sikdar, Siddhartha; Armstrong, Katee; Diao, Guoqing; Heimur, Juliana; Kopecky, John; Turo, Diego; Otto, Paul; Gebreab, Tadesse; Shah, Jay

2013-01-01

258

Tips for Chronic Pain  

MedlinePLUS

Chronic pain is defined as “persistent pain” and is a common complaint in Sjögren’s syndrome. For example, Sjögren’s ... mental well-being. Some tips for dealing with chronic pain: Continue caring for the condition causing your pain. • ...

259

Thai perspectives on pain.  

PubMed

This qualitative research aimed to study the meaning, the characteristics, and the dimensions of pain from a Thai point of view. It was conducted under the research project on the development of the quality of pain management for people in the hospital. The subjects were 62 patients, experiencing pain and receiving treatment in 4 hospitals in northeast Thailand. Data were analyzed through content analysis. The findings included: 1) concept from experience of pain, perceived pain as suffering physically and psychologically, 2) different characteristics between acute and chronic pain, 3) four levels of pain intensity: mild, moderate, high and severe, 4) pain effects on four dimensions: physical, psychological, behavioral and societal (family-social-economy), 5) two factors related to pain: alleviating factor and predisposing factor, and 6) pain management relies on beliefs, culture and religion i.e. good deeds in Buddhism affected six dimensions: physical, psychological, social, spiritual, treatment seeking and asking health personnel for help. The results of the present study revealed the influence of culture beliefs on the meaning of pain, pain characteristics, and the effects of pain as well as pain management in terms of cultural contexts. The findings may be implemented for the development of pain assessment and the model development of pain management more appropriately according to cultural contexts. PMID:24386747

Mongkhonthawornchai, Siriporn; Sangchart, Bumpenchit; Sornboon, Ariya; Chantarasiri, Jongkolnee

2013-09-01

260

Palliation of Soft Tissue Cancer Pain With Radiofrequency Ablation  

PubMed Central

The purpose of this study was to analyze the feasibility, safety, and efficacy of radiofrequency ablation (RFA) to treat pain from soft tissue neoplasms. RFA was performed on 15 painful soft tissue tumors in 14 patients. Tumors varied in histology and location and ranged in size from 2 to 20 cm. Patient pain was assessed using the Brief Pain Inventory (BPI) at baseline and 1 day, 1 week, 1 month, and 3 months post RFA. All patients had unresectable tumors or were poor operative candidates whose pain was poorly controlled by conventional treatment methods. BPI scores were divided into two categories: pain severity and interference of pain. Although not all scores were statistically significant, all mean scores trended down with increased time post ablation. Based on these outcomes, RFA appears to be a low-risk and well-tolerated procedure for pain palliation in patients with unresectable, painful soft tissue neoplasms. RFA is effective for short-term local pain control and may provide another option for failed chemotherapy or radiation therapy in patients with cancer. However, pain may transiently worsen, and relief is often temporary. PMID:15524075

Locklin, Julia K.; Mannes, Andrew; Berger, Ann; Wood, Bradford J.

2008-01-01

261

Growing pains in children  

PubMed Central

We review the clinical manifestations of "growing pains", the most common form of episodic childhood musculoskeletal pain. Physicians should be careful to adhere to clear clinical criteria as described in this review before diagnosing a child with growing pain. We expand on current theories on possible causes of growing pains and describe the management of these pains and the generally good outcome in nearly all children. PMID:17550631

Uziel, Yosef; Hashkes, Philip J

2007-01-01

262

Evidence of Increased Non-Verbal Behavioral Signs of Pain in Adults with Neurodevelopmental Disorders and Chronic Self-Injury  

ERIC Educational Resources Information Center

The role of pain in relation to self-injurious behavior (SIB) among individuals with intellectual disabilities is not well understood. Some models of SIB are based on altered endogenous opioid system activity which could result in elevated pain thresholds. In this study, non-verbal behavioral signs indicative of pain as measured by the…

Symons, Frank J.; Harper, Vicki N.; McGrath, Patrick J.; Breau, Lynn M.; Bodfish, James W.

2009-01-01

263

Sex, gender, coping, and self-efficacy: Mediation of sex differences in pain perception in children and adolescents  

Microsoft Academic Search

Sex differences in pain perception have been reported in an expanding literature based on adult samples in epidemiological as well as laboratory studies. Especially with respect to the latter, studies with children and adolescents do not consistently show that females report higher pain ratings and display lower pain tolerance than males. The first aim of the presented studies is to

Marc Vierhaus; Arnold Lohaus; Anne-Katharina Schmitz

2011-01-01

264

Pain and Associated Substance Use among Opioid Dependent Individuals Seeking Office-Based Treatment with Buprenorphine-Naloxone: A Needs Assessment Study  

PubMed Central

Background and Objectives A paucity of studies has examined the pain experiences of opioid dependent individuals seeking office-based buprenorphine-naloxone treatment (BNT). We set out to examine, among those seeking BNT: (a) the prevalence of pain types (i.e., recent pain, chronic pain), (b) the characteristics of pain (intensity, frequency, duration, interference, location, and genesis), and (c) substance use to alleviate pain. Methods We surveyed 244 consecutive individuals seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence about physical pain and associated substance use. Results Thirty-six percent of respondents reported chronic pain (CP) (i.e., pain lasting at least 3 months) and 36% reported “some pain” (SP) (i.e., past week pain not meeting the threshold for CP). In comparison to SP respondents, those with CP were, on average, older; reported greater current pain intensity, pain frequency, typical pain duration, typical pain intensity, and typical pain interference; were more likely to report shoulder or pelvis and less likely to report stomach or arms as their most bothersome pain location; and were more likely to report accident or nerve damage and less likely to report opioid withdrawal as the genesis of their pain. Both pain subgroups reported similarly high rates of past-week substance use to alleviate pain. Conclusions and Scientific Significance The high rates of pain and self-reported substance use to manage pain suggest the importance of assessing and addressing pain in BNT patients. PMID:23617861

Barry, Declan T.; Savant, Jonathan D.; Beitel, Mark; Cutter, Christopher J.; Moore, Brent A.; Schottenfeld, Richard S.; Fiellin, David A.

2012-01-01

265

Breakthrough pain: characteristics and impact in patients with cancer pain  

Microsoft Academic Search

Few surveys have been performed to define the characteristics and impact of breakthrough pain in the cancer population. In this cross-sectional survey of inpatients with cancer, patients responded to a structured interview (the Breakthrough Pain Questionnaire) designed to characterize breakthrough pain, and also completed measures of pain and mood (Memorial Pain Assessment Card (MPAC)), pain-related interference in function (Brief Pain

Russell K Portenoy; David Payne; Paul Jacobsen

1999-01-01

266

Earnings Management to Exceed Thresholds  

Microsoft Academic Search

Earnings provide important information for investment decisions. Thus, executives--who are monitored by investors, directors, customers, and suppliers--acting in self-interest and at times for shareholders, have strong incentives to manage earnings. The authors introduce behavioral thresholds for earnings management. A model shows how thresholds induce specific types of earnings management. Empirical explorations identify earnings management to exceed each of three thresholds:

Francois Degeorge; Jayendu Patel; Richard Zeckhauser

1999-01-01

267

The multitarget opioid ligand LP1's effects in persistent pain and in primary cell neuronal cultures.  

PubMed

Persistent pain states, such as those caused by nerve injury or inflammation, are associated with altered sensations, allodynia and hyperalgesia, that are resistant to traditional analgesics. A contribution to development and maintenance in altered pain perception comes from nociceptive processing and descending modulation from supraspinal sites. A multitarget ligand seems to be useful for pain relief with a decreased risk of adverse events and a considerable analgesic efficacy. The multitarget MOR agonist-DOR antagonist LP1, (3-[(2R,6R,11R)-8-hydroxy-6,11-dimethyl-1,4,5,6-tetrahydro-2,6-methano-3-benazocin-3(2H)-yl]-N-phenylpropanamide, is a central acting antinociceptive agent with low potential to induce tolerance. LP1 was tested in models of neuropathic pain - induced by chronic constriction injury (CCI) of the left sciatic nerve - and inflammatory pain - produced by intraplantar injection of carrageenan. In CCI rats, subcutaneous (s.c.) LP1 (3 mg/kg) showed a significant antiallodynic effect, measured with von Frey filaments, and antihyperalgesic effect, evoked in response to a radiant heat stimulus with plantar test. Analogously, LP1 significantly reduced allodynic and hyperalgesic thresholds in a model of inflammatory pain induced by carrageenan. To evaluate the contribution of opioid receptor subtypes in LP1 antinociceptive effects, the multitarget LP1 profile was assessed using selective opioid antagonists. Moreover, functional electrophysiological in vitro assays, using primary cortical and spinal cord networks, allowed to define the "pharmacological fingerprint" of LP1. The EC?? values in this functional screening seem to confirm LP1 as a potent opioid ligand (EC?? = 0.35 fM and EC?? = 44 pM in spinal cord and frontal cortex, respectively). Using a NeuroProof data-base of well characterised reference compounds, a similarity profile of LP1 to opioid and non-opioid drugs involved in pain modulation was detected. Our studies seem to support that multitarget ligand approach should be useful for persistent pain conditions in which mechanical allodynia and thermal hyperalgesia are significant components of the nociceptive response. PMID:23541722

Parenti, Carmela; Turnaturi, Rita; Aricò, Giuseppina; Gramowski-Voss, Alexandra; Schroeder, Olaf H-U; Marrazzo, Agostino; Prezzavento, Orazio; Ronsisvalle, Simone; Scoto, Giovanna M; Ronsisvalle, Giuseppe; Pasquinucci, Lorella

2013-08-01

268

Lower-Order Pain-Related Constructs are More Predictive of Cold Pressor Pain Ratings than Higher-Order Personality Traits  

PubMed Central

Pain is a debilitating condition affecting millions each year, yet what predisposes certain individuals to be more sensitive to pain remains relatively unknown. Several psychological factors have been associated with pain perception, but the structural relations between multiple higher- and lower-order constructs and pain are not well understood. Thus, we aimed to examine the associations between pain perception using the cold pressor task (CPT), higher-order personality traits (neuroticism, negative affectivity, trait anxiety, extraversion, positive affectivity, psychoticism), and lower-order pain-related psychological constructs (pain catastrophizing [pre- and post], fear of pain, anxiety sensitivity, somatosensory amplification, hypochondriasis) in 66 pain-free adults. Factor analysis revealed three latent psychological variables: pain- or body-sensitivity, negative affect/neuroticism, and positive affect/extraversion. Similarly, pain responses factored into three domains: intensity, quality, and tolerance. Regression and correlation analyses demonstrated 1) all the lower-order pain constructs (fear, catastrophizing, and hypochondriasis) are related through a single underlying latent factor, that is partially related to the higher-order negative-valence personality traits; 2) pain- or body-sensitivity was more strongly predictive of pain quality than higher-order traits; and 3) the form of pain assessment is important – only qualitative pain ratings were significantly predicted by the psychological factors. Perspective: Consistent with the biopsychosocial model, these results suggest multiple pain-related psychological measures likely assess a common underlying factor, which is more predictive of qualitative than intensity pain ratings. This information may be useful for the development and advancement of pain assessments and treatments while considering the multidimensional nature of pain. PMID:20356801

Lee, Jennifer E; Watson, David; Frey Law, Laura A

2010-01-01

269

The problem of pain.  

PubMed

Pain problems, especially posttraumatic headache, are very common following head trauma. Pain may be the most significant problem, more disabling than any brain or other injuries, and interfering with aspects of cognition or other function. However, posttraumatic headache and most other chronic posttraumatic pain problems remain poorly understood. This article reviews fundamental issues that should be considered in understanding the nature of chronic pain including the distinction between acute and chronic pain; neurobiological distinctions between the lateral and medial pain system; nociceptive versus neuropathic or other central pain; sensitization effects; the widely accepted view of chronic pain as a multidimensional subjective experience involving sensory, motivational-affective and cognitive-behavioral components; the problem of mind-body dualism; the role of psychosocial factors in the onset, maintenance, exacerbation or severity of pain; plus issues of response bias and malingering. PMID:14732827

Nicholson, Keith; Martelli, Michael F

2004-01-01

270

[The pain from burns].  

PubMed

The painful events associated with the treatment of a severe burn can, because of their long-lasting and repetitive characteristics, be one of the most excruciating experiences in clinical practice. Moreover, burn pain has been shown to be detrimental to burn patients. Although nociception and peripheral hyperalgesia are considered the major causes of burn pain, the study of more hypothetical mechanisms like central hyperalgesia and neuropathic pain may lead to a better understanding of burn pain symptoms and to new therapeutic approaches. Continuous pain and intermittent pain due to therapeutic procedures are two distinct components of burn pain. They have to be evaluated and managed separately. Although continuous pain is by far less severe than intermittent pain, the treatment is, in both cases, essentially pharmacological relying basically on opioids. Because of wide intra- and inter-individual variations, protocols will have to leave large possibilities of adaptation for each case, systematic pain evaluation being mandatory to achieve the best risk/benefit ratio. Surprisingly, the dose of medication decreases only slowly with time, a burn often remaining painful for long periods after healing. Non pharmacological treatments are often useful and sometimes indispensable adjuncts; but their rationale and their feasibility depends entirely on previous optimal pharmacological control of burn pain. Several recent studies show that burn pain management is inadequate in most burn centres. PMID:11933833

Latarjet, J

2002-03-01

271

Intrathecal injection of anti-CX3CR1 neutralizing antibody delayed and attenuated pain facilitation in rat tibial bone cancer pain model.  

PubMed

This study was designed to investigate the effect of intrathecal injection of anti-CX3CR1 neutralizing antibody on pain behaviors in the rat tibial bone cancer pain model. Syngeneic Walker 256 mammary gland carcinoma cells were injected into the tibia medullary cavity to establish the rat model of bone cancer pain. Ambulatory pain, mechanical hindpaw withdrawal threshold, and latency of paw withdrawal to a thermal stimulus were observed. Haematoxylin/eosin staining was used to observe the bone damage on day 21. Intrathecal injection of anti-CX3CR1 neutralizing antibody both delayed the development of ambulatory pain and hyperalgesia and attenuated established pain facilitation, but had no effects on destruction of bone. Our results suggest that intrathecal injection of anti-CX3CR1 neutralizing antibody delayed and attenuated pain facilitation in the rat tibial bone cancer pain model. PMID:20736819

Yin, Qin; Cheng, Wei; Cheng, Ming-Yue; Fan, Su-Zhen; Shen, Wen

2010-10-01

272

Pain as a channelopathy  

PubMed Central

Mendelian heritable pain disorders have provided insights into human pain mechanisms and suggested new analgesic drug targets. Interestingly, many of the heritable monogenic pain disorders have been mapped to mutations in genes encoding ion channels. Studies in transgenic mice have also implicated many ion channels in damage sensing and pain modulation. It seems likely that aberrant peripheral or central ion channel activity underlies or initiates many pathological pain conditions. Understanding the mechanistic basis of ion channel malfunction in terms of trafficking, localization, biophysics, and consequences for neurotransmission is a potential route to new pain therapies. PMID:21041956

Raouf, Ramin; Quick, Kathryn; Wood, John N.

2010-01-01

273

The Nature of Psychological Thresholds  

ERIC Educational Resources Information Center

Following G. T. Fechner (1966), thresholds have been conceptualized as the amount of intensity needed to transition between mental states, such as between a states of unconsciousness and consciousness. With the advent of the theory of signal detection, however, discrete-state theory and the corresponding notion of threshold have been discounted.…

Rouder, Jeffrey N.; Morey, Richard D.

2009-01-01

274

Threshold Hypothesis: Fact or Artifact?  

ERIC Educational Resources Information Center

The threshold hypothesis (TH) assumes the existence of complex relations between creative abilities and intelligence: linear associations below 120 points of IQ and weaker or lack of associations above the threshold. However, diverse results have been obtained over the last six decades--some confirmed the hypothesis and some rejected it. In this…

Karwowski, Maciej; Gralewski, Jacek

2013-01-01

275

Associations between serotonin transporter gene polymorphisms and heat pain perception in adults with chronic pain  

PubMed Central

Background The triallelic serotonin transporter gene linked polymorphic region (5-HTTLPR) has been associated with alterations in thermal pain perception. The primary aim of this study was to investigate the associations between heat pain (HP) perception and the triallelic 5-HTTLPR in a large cohort of adults with chronic pain. Methods The cohort included 277 adults with chronic pain who met inclusion criteria, and were consecutively admitted to an outpatient pain rehabilitation program from March 2009 through March 2010. Individuals were genotyped for the triallelic 5-HTTLPR (including rs25531) and categorized as high, intermediate, or low expressors of the serotonin transporter. Standardized measures of HP perception were obtained using a validated quantitative sensory test method of levels. Results The distribution of the high, intermediate, and low expressing genotypes was 61 (22%), 149 (54%) and 67 (24%), respectively. The Hardy-Weinberg P-value was 0.204 which indicated no departure from equilibrium. A significant effect of genotype was observed for values of HP threshold (P?=?0.029). Individual group comparisons showed that values of HP threshold were significantly greater in the intermediate compared to the high expressing group (P?=?0.009) but not the low expressing group (P?>?0.1). In a multiple variable linear regression model, the intermediate group (P?=?0.034) and male sex (P?=?0.021) were associated with significantly greater values of HP 0.5, but no significant genotype-by-sex interaction effect was observed. Conclusions In this study that involved adults with chronic pain, the intermediate triallelic 5-HTTLPR expressing group, but not the low expressing group, was associated with greater HP thresholds compared to the high expressing group. PMID:23895108

2013-01-01

276

Life below the threshold.  

PubMed

This article explains that malnutrition, poor health, and limited educational opportunities plague Philippine children -- especially female children -- from families living below the poverty threshold. Nearly 70% of households in the Philippines do not meet the required daily level of nutritional intake. Because it is often -- and incorrectly -- assumed that women's nutritional requirements are lower than men's, women suffer higher rates of malnutrition and poor health. A 1987 study revealed that 11.7% of all elementary students were underweight and 13.9% had stunted growths. Among elementary-school girls, 17% were malnourished and 40% suffered from anemia (among lactating mothers, more than 1/2 are anemic). A 1988 Program for Decentralized Educational Development study showed that grade VI students learn only about 1/2 of what they are supposed to learn. 30% of the children enrolled in grade school drop out before they reach their senior year. The Department of Education, Culture and Sports estimates that some 2.56 million students dropped out of school in l989. That same year, some 3.7 million children were counted as part of the labor force. In Manila alone, some 60,000 children work the streets, whether doing odd jobs or begging, or turning to crime or prostitution. the article tells the story of a 12 year-old girl named Ging, a 4th grader at a public school and the oldest child in a poor family of 6 children. The undernourished Ging dreams of a good future for her family and sees education as a way out of poverty; unfortunately, her time after school is spend working in the streets or looking after her family. She considers herself luckier than many of the other children working in the streets, since she at least has a family. PMID:12285009

Castro, C

1991-01-01

277

Effects of the CORE Exercise Program on Pain and Active Range of Motion in Patients with Chronic Low Back Pain  

PubMed Central

[Purpose] This study aimed to identify the effects of the CORE exercise program on pain and active range of motion (AROM) in patients with chronic low back pain. [Subjects and Methods] Thirty subjects with chronic low back pain were randomly allocated to two groups: the CORE group (n = 15) and the control group (n = 15). The CORE group performed the CORE exercise program for 30 minutes a day, 3 times a week, for 4 weeks, while the control group did not perform any exercise. The visual analog scale (VAS) and an algometer were used to measure pain, and pain-free AROM in the trunk was measured before and after the intervention. [Results] The CORE group showed significantly decreased VAS scores at rest and during movement and had a significantly increased pressure pain threshold in the quadratus lumborum and AROM in the trunk compared with those in the control group. [Conclusion] This study demonstrated that the CORE exercise program is effective in decreasing pain and increasing AROM in patients with chronic low back pain. Thus, the CORE exercise program can be used to manage pain and AROM in patients with chronic low back pain. PMID:25202188

Cho, Hwi-young; Kim, Eun-hye; Kim, Junesun

2014-01-01

278

Managing pain during labor  

MedlinePLUS

... a childbirth class. Childbirth classes teach breathing and relaxation techniques. The techniques can help you relieve pain ... to childbirth classes and learn about breathing and relaxation techniques, even if you plan to get pain ...

279

American Chronic Pain Association  

MedlinePLUS

... of their pain. To raise awareness among the health care community, policy makers, and the public at large about issues of living with chronic pain. Recent News View All News OTC ... Verify here Certified by: Independent Charities of ...

280

Abdominal Pain Syndrome  

MedlinePLUS

... most helpful information that a doctor uses to determine the cause of abdominal pain. The characteristics of the pain (sharp, dull, cramping, burning, twisting, tearing, penetrating), its location and relation to eating or to having a bowel movement are important ...

281

Treatments for Managing Pain  

MedlinePLUS

... pain by stimulating nerve fibers through the skin. Acupuncture - This ancient Chinese practice uses very thin needles ... skin to treat disease and pain. Practitioners of acupuncture undergo specialized training in these techniques and may ...

282

What's wrong with pain?  

E-print Network

are quickly confronted with difficult questions. This thesis, through an examination of a particular feature of moral language and a description of recent research on pain, provides an analysis of how pain fits into ethical theory. It is argued...

Shriver, Adam Joseph

2006-10-30

283

Communicating about Cancer Pain  

Cancer.gov

Patients with cancer may be reluctant to discuss their pain with their doctors for a variety of reasons. NCI sponsors research that examines the barriers that prevent patients from talking about pain.

284

Fighting Chronic Pain  

MedlinePLUS

... Navigation Bar Home Current Issue Past Issues Fighting Chronic Pain Past Issues / Fall 2007 Table of Contents For ... diagnose, health care professionals and scientists know that chronic pain is very complex. Below are some of the ...

285

Posttonsillectomy pain in children.  

PubMed

Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence. PMID:24445532

Sutters, Kimberly A; Isaacson, Glenn

2014-02-01

286

Neuropathic low back pain  

Microsoft Academic Search

In this discussion, we hope to advance a clinical approach to low back pain that is more in line with our modern understanding\\u000a of neuropathic pain. We review the current understanding of normal and pathologic neuroanatomy of the lumbar spine and then\\u000a outline how pathology in the different structures can lead to neuropathic pain and cause common pain patterns seen

Joseph F. Audette; Emmanuel Emenike; Alec L. Meleger

2005-01-01

287

Managing Chemotherapy Side Effects: Pain  

MedlinePLUS

... services national institutes of health Managing Chemotherapy Side Effects Pain “I was worried about getting addicted to ... to pay for pain medicine. Managing Chemotherapy Side Effects: Pain Keep track of the pain. Each day, ...

288

Psychology and chronic pain  

Microsoft Academic Search

This article will explore some specific psychological responses to pain and outline the historical developments that have led to current treatments. The recognition and treatment of maladaptive psychological responses to pain can lessen distress and the progression of chronic pain states.

Jennifer K. Dietrich

2011-01-01

289

Pediatric Procedural Pain  

ERIC Educational Resources Information Center

This article reviews the various settings in which infants, children, and adolescents experience pain during acute medical procedures and issues related to referral of children to pain management teams. In addition, self-report, reports by others, physiological monitoring, and direct observation methods of assessment of pain and related constructs…

Blount, Ronald L.; Piira, Tiina; Cohen, Lindsey L.; Cheng, Patricia S.

2006-01-01

290

Lactose tolerance tests  

MedlinePLUS

Hydrogen breath test for lactose tolerance ... Two common methods include: Lactose tolerance blood test Hydrogen breath test The hydrogen breath test is the preferred method. It measures the amount of hydrogen in the air you breathe out. ...

291

Persistent Peripheral Inflammation Attenuates Morphine-induced Periaqueductal Gray Glial Cell Activation and Analgesic Tolerance in the Male Rat  

PubMed Central

Morphine is among the most prevalent analgesics prescribed for chronic pain. However, prolonged morphine treatment results in the development of analgesic tolerance. An abundance of evidence has accumulated indicating that CNS glial cell activity facilitates pain transmission and opposes morphine analgesia. While the midbrain ventrolateral periaqueductal gray (vlPAG) is an important neural substrate mediating pain modulation and the development of morphine tolerance, no studies have directly assessed the role of PAG-glia. Here we test the hypothesis that morphine-induced increases in vlPAG glial cell activity contribute to the development of morphine tolerance. As morphine is primarily consumed for the alleviation of severe pain, the influence of persistent inflammatory pain was also assessed. Administration of morphine, in the absence of persistent inflammatory pain, resulted in the rapid development of morphine tolerance and was accompanied by a significant increase in vlPAG glial activation. In contrast, persistent inflammatory hyperalgesia, induced by intraplantar administration of Complete Freund’s Adjuvant (CFA), significantly attenuated the development of morphine tolerance. No significant differences were noted in vlPAG glial cell activation for CFA-treated animals versus controls. These results indicate that vlPAG glia are modulated by a persistent pain state, and implicate vlPAG glial cells as possible regulators of morphine tolerance. Perspective The development of morphine tolerance represents a significant impediment to its use in the management of chronic pain. We report that morphine tolerance is accompanied by increased glial cell activation within the vlPAG, and that the presence of a persistent pain state prevented vlPAG glial activation and attenuated morphine tolerance. PMID:23395474

Eidson, Lori N.; Murphy, Anne Z.

2014-01-01

292

Surgical Treatment for Chronic Pelvic Pain  

PubMed Central

The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal - neurological, gastrointestinal, or myofascial. A psychological component almost always is a factor, whether as an antecedent event or presenting as depression as result of the pain. Surgical interventions for chronic pelvic pain include: 1) resection or vaporization of vulvar/vestibular tissue for human papillion virus (HPV) induced or chronic vulvodynia/vestibulitis; 2) cervical dilation for cervix stenosis; 3) hysteroscopic resection for intracavitary or submucous myomas or intracavitary polyps; 4) myomectomy or myolysis for symptomatic intramural, subserosal or pedunculated myomas; 5) adhesiolysis for peritubular and periovarian adhesions, and enterolysis for bowel adhesions, adhesiolysis for all thick adhesions in areas of pain as well as thin ahesions affecting critical structures such as ovaries and tubes; 6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx; 7) ovarian treatment for symptomatic ovarian pain; 8) uterosacral nerve vaporization for dysmenorrhea; 9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder origin; 10) resection of endometriosis from all surfaces including removal from bladder and bowel as well as from the rectovaginal septal space. Complete resection of all disease in a debulking operation is essential; 11) appendectomy for symptoms of chronic appendicitis, and chronic right lower quadrant pain; 12) uterine suspension for symptoms of collision dyspareunia, pelvic congestion, severe dysmenorrhea, cul-desac endometriosis; 13) repair of all hernia defects whether sciatic, inguinal, femoral, Spigelian, ventral or incisional; 14) hysterectomy if relief has not been achieved by organ-preserving surgery such as resection of all endometriosis and presacral neurectomy, or the central pain continues to be disabling. Before such a radical step is taken, MRI of the uterus to confirm presence of adenomyosis may be helpful; 15) trigger point injection therapy for myofascial pain and dysfunction in pelvic and abdominal muscles. With application of all currently available laparoscopic modalities, 80% of women with chronic pelvic pain will report a decrease of pain to tolerable levels, a significant average reduction which is maintained in 3-year follow-up. Individual factors contributing to pain cannot be determined, although the frequency of endometriosis dictates that its complete treatment be attempted. The beneficial effect of uterosacral nerve ablation may be as much due to treatment of occult endometriosis in the uterosacral ligaments as to transection of the nerve fibers themselves. The benefit of the presacral neurectomy appears to be definite but strictly limited to midline pain. Appendectomy, herniorraphy, and even hysterectomy are all appropriate therapies for patients with chronic pelvic pain. Even with all laparoscopic procedures employed, fully 20% of patients experience unsatisfactory results. In addition, these patients are often depressed. Whether the pain contributes to the depression or the depression to the pain is irrelevant to them. Selected referrals to an integrated pain center with psychologic assistance together with judicious prescription of antidepressant drugs will likely benefit both women who respond to surgical intervention and those who do not. A maximum surgical effort must be expended to resect all endometriosis, restore normal pelvic anatomy, resect nerve fibers, and treat surgically accessible disease. In addition, it is important to provide patients with chronic pelvic pain sufficient psychologic support to overcome the effects of the condition, and to assist them with underlying psychologic disorders. PMID:9876726

1998-01-01

293

Efficacy and safety of cimicoxib in the control of perioperative pain in dogs  

PubMed Central

Objectives To determine the efficacy and safety of cimicoxib (Cimalgex®; Vétoquinol SA) for the control of perioperative pain in dogs. Methods A double-blind, randomized, controlled multi-centre field study was conducted in 237 dogs undergoing orthopaedic or soft tissue surgery. Pain was monitored by the attending veterinarian over the 7 days following the surgical procedure using two pain-scoring systems and a visual analogue scale. An enhanced monitoring protocol for postoperative pain was utilized during the first 24 hours after surgery. The dog owner's assessment of perceived analgesia during this time period was also recorded. Results Cimicoxib demonstrated statistically significant non-inferiority compared to carprofen. These findings were confirmed by owners’ assessments and by the evolution of the pain scores. Both drugs were well tolerated throughout the study. Clinical Significance Cimicoxib had non-inferior efficacy and tolerability when compared to carprofen for the control of perioperative pain in dogs undergoing orthopaedic or soft tissue surgery. PMID:23710692

Grandemange, E; Fournel, S; Woehrle, F

2013-01-01

294

Abnormal brain processing of cutaneous pain in migraine patients during the attack  

Microsoft Academic Search

We examined cutaneous pain thresholds using CO2 laser stimuli during migraine attacks, and defined the evoked cortical potential characteristics. Ten patients without aura were studied during attacks and for at least 72 h subsequently. Pain stimuli were generated on the dorsum of both hands and the right and left supraorbital zones, using pulses from a CO2 laser. Absolute latencies of

Marina de Tommaso; Marco Guido; Giuseppe Libro; Luciana Losito; Vittorio Sciruicchio; Carlo Monetti; Francomichele Puca

2002-01-01

295

Citalopram Treatment of Pediatric Recurrent Abdominal Pain and Comorbid Internalizing Disorders: An Exploratory Study  

ERIC Educational Resources Information Center

Objective: To assess the potential efficacy, tolerability, and safety of citalopram in the treatment of functional pediatric recurrent abdominal pain and comorbid internalizing disorders. Method: Twenty-five clinically referred children and adolescents with recurrent abdominal pain aged 7 to 18 years, inclusive, participated in a 12-week,…

Campo, John V.; Perel, James; Lucas, Amanda; Bridge, Jeff; Ehmann, Mary; Kalas, Catherine; Monk, Kelly; Axelson, David; Birmaher, Boris; Ryan, Neal; Di Lorenzo, Carlo; Brent, David A.

2004-01-01

296

Effects of combining opioids and clinically available NMDA receptor antagonists in the treatment of pain  

Microsoft Academic Search

This thesis concerns the effects of combining opioids with clinically available NMDA receptor antagonists in the treatment of acute and chronic pain. There are a number of problems with the use of opioids, such as, the development of tolerance\\/hyperalgesia, the reduced effectiveness in (central) neuropathic pain, and troublesome adverse effects. These problems might be resolved by the combined use of

D. G. Snijdelaar

2005-01-01

297

Rapid tolerance and cross-tolerance as predictors of chronic tolerance and cross-tolerance.  

PubMed

Hypothermia and motor impairment (tilt-plane) tests were used to assess the phenomenon of rapid tolerance to ethanol and cross-tolerance to various alcohols, benzodiazepines, and barbiturates that differ in lipid:water partition coefficients. The hypothermic and motor impairment responses to ethanol were significantly reduced on day 2 in rats receiving ethanol (2 doses of 2 g/kg each for the hypothermia test and 2.3 and 1.7 g/kg for the tilt-plane test) 24 and 22 h earlier compared to the control group pretreated with saline. Ethanol pretreatment resulted in rapid cross-tolerance, on both tests, to the various alcohols (n-propanol, n-butanol, and t-butanol) and the benzodiazepines (chlordiazepoxide, diazepam, oxazepam, and flurazepam) tested. Ethanol pretreatment also conferred clear rapid cross-tolerance to barbital and phenobarbital, but did not result in rapid cross-tolerance to pentobarbital, secobarbital, amobarbital, or thiopental. The results on rapid cross-tolerance on both tests seen in these studies parallel the results obtained in chronic tolerance and cross-tolerance studies reported recently. These results suggest that rapid tolerance and cross-tolerance can be used as predictors of chronic tolerance and cross-tolerance. PMID:1574525

Khanna, J M; Kalant, H; Weiner, J; Shah, G

1992-02-01

298

Ethnic differences in pain and pain management.  

PubMed

Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers' treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes. PMID:23687518

Campbell, Claudia M; Edwards, Robert R

2012-05-01

299

Dancing in pain: pain appraisal and coping in dancers.  

PubMed

This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury. PMID:19618573

Anderson, Ruth; Hanrahan, Stephanie J

2008-01-01

300

An Introduction Significance of Pain  

E-print Network

An Introduction to: Pain #12;Significance of Pain !!Pain is adaptive !!Alerts us to danger !!Motivates escape and avoidance learning !!Motivates recuperation !!Congenital insensitivity to pain !!Pain was killing his buddies all around him. When a shell burst nearby, he felt an excruciating pain

Meagher, Mary

301

Thoughts provoked by pain.  

PubMed

Despite the growing interest in the cognitive component of chronic pain, little information has been collected on the variety of thoughts provoked by pain experience. A new assessment instrument (the Cognitive Evaluative Questionnaire--CEQ) has been utilized with 127 chronic pain patients and their cognitions classified into seven discrete clusters. The results confirm the heterogeneity of pain cognitions, the majority of which are likely to play a role in enhancing or perpetuating chronic pain. The relationship of these cognitions to chronic avoidance behavior is discussed. PMID:2775158

Philips, H C

1989-01-01

302

Definition and measurement of dust aeolian thresholds  

Microsoft Academic Search

Dust suspension and particle “saltation threshold” speeds were measured in an environmental boundary layer wind tunnel located at the University of California, Davis. The results indicate that dust suspension threshold speeds occur at substantially lower friction speeds than “saltation threshold” speeds. Many of the dust suspension threshold values are half of the “saltation threshold” values. For example, surface soils from

Jason A. Roney; Bruce R. White

2004-01-01

303

Prescription Pain Reliever Abuse and Dependence among Adolescents: A Nationally Representative Study  

ERIC Educational Resources Information Center

The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…

Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.

2008-01-01

304

Extradural cortical stimulation for central pain.  

PubMed

Central pain results from a central nervous system injury and represents a challenge for the pain therapist. Human studies have shown that motor cortex stimulation (MCS), i.e. the placement of a stimulating plate on the dura overlying the motor cortex can relieve brain central pain. Studies suggest that MCS directly affects activity in the first and second order somatosensory areas, thalamic nuclei and also inhibits spinal primary afferents and spinothalamic tract neurons. The following factors have been found to predict analgesia by MCS: intact or almost intact corticospinal motor function, mild or negligible sensory loss, absence of thermal sensory threshold alteration within the painful area, positive response to the barbiturate and/or ketamine test, positive response to the propofol test, positive response to transcranial magnetic stimulation (TMS). The targeting of the cortical area is made by anatomical localization by computed tomography (CT), magnetic resonance imaging (MRI), neuronavigation, intraoperative neurophysiological recordings, functional MRI (fMRI), and intraoperative clinical assessment. We perform the procedure under local anaesthesia. We describe in detail our surgical technique and stimulation protocol. Furthermore, we review the most important studies with respect to their results, the observed side effects and complications. The future prospects and likely developments of MCS for central pain are also discussed. PMID:17691286

Canavero, S; Bonicalzi, V

2007-01-01

305

Fault-tolerant quantum computation  

E-print Network

The discovery of quantum error correction has greatly improved the long-term prospects for quantum computing technology. Encoded quantum information can be protected from errors that arise due to uncontrolled interactions with the environment, or due to imperfect implementations of quantum logical operations. Recovery from errors can work effectively even if occasional mistakes occur during the recovery procedure. Furthermore, encoded quantum information can be processed without serious propagation of errors. In principle, an arbitrarily long quantum computation can be performed reliably, provided that the average probability of error per gate is less than a certain critical value, the accuracy threshold. It may be possible to incorporate intrinsic fault tolerance into the design of quantum computing hardware, perhaps by invoking topological Aharonov-Bohm interactions to process quantum information.

John Preskill

1997-12-19

306

Endogenous Inhibition of Somatic Pain is Impaired in Girls with Irritable Bowel Syndrome Compared with Healthy Girls  

PubMed Central

Endogenous pain-inhibition is often deficient in adults with chronic pain conditions including irritable bowel syndrome (IBS). It is unclear whether deficiencies in pain-inhibition are present in young children with IBS. The present study compared endogenous pain-inhibition, somatic pain threshold, and psychosocial distress in young girls with IBS versus controls. Girls with IBS did not show significant endogenous pain-inhibition of heat pain-threshold during a cold-pressor task in contrast to controls who had significant pain-inhibition. Girls with IBS did not differ from peers on measures of somatic pain but had more symptoms of depression, somatization, and anxiety than controls. When psychological variables were included as covariates the difference in pain-inhibition was no longer significant, although poor achieved power limits interpretation of these results. Higher-order cognitive processes including psychological variables may be contributing to observed pain-inhibition. In girls with IBS, pain-inhibition was positively related to the number of days without a bowel movement. To our knowledge, this is the first study to demonstrate deficiencies of endogenous pain-inhibition in young children with IBS. Findings have implications for better understanding of onset and maintenance of IBS and other chronic pain conditions. PMID:23685184

Williams, Amy E.; Heitkemper, Margaret; Self, Mariella M.; Czyzewski, Danita I.; Shulman, Robert J.

2013-01-01

307

Specific features of analgesic effect of docosahexaenoic acid in rats with neuropathic pain syndrome.  

PubMed

Experiments on white rats showed that sciatic nerve ligation induced the development of neuropathic pain syndrome: thermal pain threshold decreased, significant reduction in weight bearing of the injured limb, and degenerative changes in the foot tissues. Administration of docosahexaenoic acid reduces activity and duration neuropathic pain syndrome, promoted reversion of weight bearing asymmetry, and prevented the development of degenerative changes in the foot tissues. PMID:24770761

Dyuizen, I V; Manzhulo, I V; Ogurtsova, O S; Lamash, N E; Latyshev, N A; Kas'yanov, S V

2014-03-01

308

Summing tree graphs at threshold  

NASA Astrophysics Data System (ADS)

The solution of the classical field equation generates the sum of all tree graphs. We show that the classical equation reduces to an easily solved ordinary differential equation for certain multiparticle threshold amplitudes and compute these amplitudes.

Brown, Lowell S.

1992-11-01

309

Image thresholding using standard deviation  

NASA Astrophysics Data System (ADS)

Threshold selection using the within-class variance in Otsu's method is generally moderate, yet inappropriate for expressing class statistical distributions. Otsu uses a variance to represent the dispersion of each class based on the distance square from the mean to any data. However, since the optimal threshold is biased toward the larger variance among two class variances, variances cannot be used to denote the real class statistical distributions. Therefore, to express more accurate class statistical distributions, this paper proposes the within-class standard deviation as a criterion for threshold selection, and the optimal threshold is then determined by minimizing the within-class standard deviation. Experimental results confirm that the proposed method produced a better performance than existing algorithms.

Sung, Jung-Min; Kim, Dae-Chul; Choi, Bong-Yeol; Ha, Yeong-Ho

2014-03-01

310

Structural Threshold Regression Andros Kourtellos  

E-print Network

Structural Threshold Regression Andros Kourtellos University of Cyprus Thanasis Stengos University, and 23rd (EC)2 conference. Department of Economics, P.O. Box 537, CY 1678 Nicosia, Cyprus,email: andros

Nesterov, Yurii

311

Common medical pains  

PubMed Central

Pain in infancy and childhood is extremely common. Sources of pain include illness, injury, and medical and dental procedures. Over the past two decades, tremendous progress has been made in the assessment, prevention and treatment of pain. It is important for the paediatric health care provider to be aware of the implications and consequences of pain in childhood. A multitude of interventions are available to reduce or alleviate pain in children of all ages, including neonates. These include behavioural and psychological methods, as well as a host of pharmacological preparations, which are safe and effective when used as indicated. Many complementary and alternative treatments appear to be promising in treating and relieving pain, although further research is required. The present article reviews the most common sources of pain in childhood and infancy, as well as current treatment strategies and options. PMID:19030348

Jacobson, Sheila

2007-01-01

312

Pain syndromes in children.  

PubMed

The pediatric rheumatologist cares for children who may have a wide variety of causes of musculoskeletal pain. These include such diverse conditions as arthritis, low-back pain, hypermobility, metabolic bone pain, and amplified pain syndromes such as complex regional pain syndrome and fibromyalgia. This review examines the recent literature on these and other conditions causing musculoskeletal pain in children and adolescents. Overall, headway is being made, but differentiating soma from psyche remains a problem. This is perhaps due to the marked and unique effect pain brings to each of us. Children are different from adults in causes, presentations, and outcome. Vigilance in history, physical examination, and judicious use of laboratory investigations are usually sufficient in establishing a diagnosis, as well as an appreciation for the variety of presentations each condition can manifest. PMID:11123080

Sherry, D D

2000-08-01

313

Decreased perceptual learning ability in complex regional pain syndrome  

Microsoft Academic Search

Recently, several functional imaging studies have shown that sensorimotor cortical representations may be changed in complex regional pain syndromes (CRPS). Therefore, we investigated tactile performance and tactile learning as indirect markers of cortical changes in patients with CRPS type I and controls. Patients had significant higher spatial discrimination thresholds at CRPS-affected extremities compared to both unaffected sides and control subjects.

Christian Maihöfner; Roberto DeCol

2007-01-01

314

Postsurgical pain outcome assessment.  

PubMed

Reliable and valid measures of pain are essential for conducting clinical trials of pain treatments. Perhaps the most important aspect of a pain measure's validity is its sensitivity, or ability to detect changes in pain over time and due to treatment. Several factors may affect a measure's sensitivity, including the complexity of the rating task for the measure, the number of pain intensity levels assessed by the measure, the dimension of pain assessed (e.g. pain intensity vs. pain relief), and the number of individual ratings (e.g. single rating vs. composite score) used to create the measure. The purpose of this study was to compare the relative sensitivity of three measures of outcome and a composite made up of all three measures for detecting analgesic effects in two samples of persons participating in a randomized controlled trial. One hundred and twenty-three patients who had undergone knee surgery and 124 women who had undergone a laparotomy were given one of three medications in the day after their surgery: morphine, ketorolac, or placebo. Two measures of pain intensity (a visual analog scale (VAS) and a 4-point verbal rating scale (VRS)) were administered at baseline, and these measures plus a 5-point VRS of pain relief were administered at 16 additional time points up to 24 h following surgery. As predicted, we found variability in the sensitivity of the outcome measures used in these studies, with the 4-point VRS showing less sensitivity than the VAS or relief ratings. However, contrary to our prediction, a composite measure of outcome made up of all three measures was not consistently superior to the individual measures for detecting treatment effects. Finally, we found that pain relief ratings were related to, but also distinct from, change in pain intensity as measured by changes in pain intensity ratings from baseline to each postmedication assessment point. These findings have important implications for the assessment of pain in clinical trials. PMID:12237188

Jensen, Mark P; Chen, Connie; Brugger, Andrew M

2002-09-01

315

Threshold models in radiation carcinogenesis.  

PubMed

Cancer incidence and mortality data from the atomic bomb survivors cohort has been analyzed to allow for the possibility of a threshold dose response. The same dose-response models as used in the original papers were fit to the data. The estimated cancer incidence from the fitted models over-predicted the observed cancer incidence in the lowest exposure group. This is consistent with a threshold or non-linear dose-response at low-doses. Thresholds were added to the dose-response models and the range of possible thresholds is shown for both solid tumor cancers as well as the different leukemia types. This analysis suggests that the A-bomb cancer incidence data agree more with a threshold or non-linear dose-response model than a purely linear model although the linear model is statistically equivalent. This observation is not found with the mortality data. For both the incidence data and the mortality data the addition of a threshold term significantly improves the fit to the linear or linear-quadratic dose response for both total leukemias and also for the leukemia subtypes of ALL, AML, and CML. PMID:9721832

Hoel, D G; Li, P

1998-09-01

316

Threshold models in radiation carcinogenesis  

SciTech Connect

Cancer incidence and mortality data from the atomic bomb survivors cohort has been analyzed to allow for the possibility of a threshold dose response. The same dose-response models as used in the original papers were fit to the data. The estimated cancer incidence from the fitted models over-predicted the observed cancer incidence in the lowest exposure group. This is consistent with a threshold or nonlinear dose-response at low-doses. Thresholds were added to the dose-response models and the range of possible thresholds is shown for both solid tumor cancers as well as the different leukemia types. This analysis suggests that the A-bomb cancer incidence data agree more with a threshold or nonlinear dose-response model than a purely linear model although the linear model is statistically equivalent. This observation is not found with the mortality data. For both the incidence data and the mortality data the addition of a threshold term significantly improves the fit to the linear or linear-quadratic dose response for both total leukemias and also for the leukemia subtypes of ALL, AML, and CML.

Hoel, D.G.; Li, P. [Medical Univ. of South Carolina, Charleston, SC (United States). Dept. of Biometry and Epidemiology

1998-09-01

317

Accepting Pain Management or Seeking Pain Cure: An Exploration of Patients’ Attitudes to Chronic Pain  

Microsoft Academic Search

This article explores the differing attitudes of patients toward chronic pain. Because pain is a subjective experience, individuals react to living with chronic pain in varying ways. Some patients successfully manage their chronic pain, whereas others continue to seek a pain cure. A convenience sample (n = 8) was generated from a district general hospital’s nurse-led pain clinic. The sample

Kathryn A. Clarke; Ron Iphofen

2007-01-01

318

Decoding the perception of pain from fMRI using multivariate pattern analysis  

PubMed Central

Pain is known to comprise sensory, cognitive, and affective aspects. Despite numerous previous fMRI studies, however, it remains open which spatial distribution of activity is sufficient to encode whether a stimulus is perceived as painful or not. In this study, we analyzed fMRI data from a perceptual decision-making task in which participants were exposed to near-threshold laser pulses. Using multivariate analyses on different spatial scales, we investigated the predictive capacity of fMRI data for decoding whether a stimulus had been perceived as painful. Our analysis yielded a rank order of brain regions: during pain anticipation, activity in the periaqueductal gray (PAG) and orbitofrontal cortex (OFC) afforded the most accurate trial-by-trial discrimination between painful and non-painful experiences; whereas during the actual stimulation, primary and secondary somatosensory cortex, anterior insula, dorsolateral and ventrolateral prefrontal cortex, and OFC were most discriminative. The most accurate prediction of pain perception from the stimulation period, however, was enabled by the combined activity in pain regions commonly referred to as the ‘pain matrix’. Our results demonstrate that the neural representation of (near-threshold) pain is spatially distributed and can be best described at an intermediate spatial scale. In addition to its utility in establishing structure-function mappings, our approach affords trial-by-trial predictions and thus represents a step towards the goal of establishing an objective neuronal marker of pain perception. PMID:22922369

Brodersen, Kay H.; Wiech, Katja; Lomakina, Ekaterina I.; Lin, Chia-shu; Buhmann, Joachim M.; Bingel, Ulrike; Ploner, Markus; Stephan, Klaas Enno; Tracey, Irene

2012-01-01

319

Pain Control After Surgery: Pain Medicines  

MedlinePLUS

... pain medicine given? Medicines can be given by mouth (liquid or pill), through the rectum (suppository) or injected ... Aspirin, ibuprofen or codeine can be taken by mouth. Pills and liquids cause less discomfort than shots into a muscle ...

320

[Osteoporosis and pain or is osteoporosis painful?].  

PubMed

Osteoporosis as a disease is characterized by skeletal quantitative and qualitative abnormalities, leading to an increased fragility. Classically the disease is painless. The complications of the disease, that is bone fractures, cause a well-known acute symptomatology. Subsequent chronic pain is the consequence of skeletal deformities, joint incongruences and tensions on musculo-tendineous structures. Pain management includes pharmacological, physio- and ergo-therapeutical measures and stabilisation maneuvers. PMID:16117031

Uebelhart, B; Rizzoli, R

2005-06-22

321

The genetics of pain and pain inhibition.  

PubMed Central

The present review summarizes the current state of knowledge about the genetics of pain-related phenomena and illustrates the scope and power of genetic approaches to the study of pain. We focus on work performed in our laboratories in Jastrzebiec, Poland; Portland, OR; and Los Angeles, which we feel demonstrates the continuing usefulness of classical genetic approaches, especially when used in combination with newly available molecular genetic techniques. PMID:8610166

Mogil, J S; Sternberg, W F; Marek, P; Sadowski, B; Belknap, J K; Liebeskind, J C

1996-01-01

322

Small fibre impairment predicts neuropathic pain in Guillain-Barré syndrome.  

PubMed

The mechanisms of neuropathic pain (NP) in Guillain Barré syndrome (GBS) are currently unknown. It has recently been shown that acute neuropathy of GBS not only affects large myelinated fibres but also small nociceptive fibres. In this prospective longitudinal 18 months study, we investigated the role of small fibre impairment in NP in GBS (n=30). Small fibres were assessed by quantifying cold and warm detection and pain thresholds and responses to suprathreshold painful thermal and mechanical stimuli. Nerve conduction velocities and mechanical detection thresholds assessed large myelinated fibres. Detection thresholds particularly at the lower limbs were significantly impaired in patients with GBS compared to 15 healthy controls. GBS patients with NP (n=13) had more severe impairment of cold detection thresholds (p=0.04), heat pain thresholds (p=0.03) and responses to suprathreshold heat stimuli (p=0.017) in the foot compared with those without pain or with non-neuropathic pain (n=17). Large fibre dysfunction and motor disability were similar between groups. Small fibre sensory impairment at the acute stage was correlated with the intensity of burning pain (Rho: -0.72; p=0.01 for cold detection; Rho: 0.72; p=0.02 for heat pain) and predicted residual NP (odds 4.1 p=0.04 for heat pain). These findings emphasize the importance of nociceptive fibre impairment in NP in GBS at both acute and chronic stages and suggest similarities between the mechanisms of NP in GBS and those of small fibre painful sensory polyneuropathies. PMID:20696121

Martinez, Valéria; Fletcher, Dominique; Martin, Frédéric; Orlikowski, David; Sharshar, Tarek; Chauvin, Marcel; Bouhassira, Didier; Attal, Nadine

2010-10-01

323

Advancements in pain research.  

PubMed

After the publication of the First Edition of this book in the series of Methods in Molecular Medicine (volume 99 in the series) in 2004, pain research continues its rapid acceleration until 2009, during which it experienced a plateau of growth that likely resulted from the economic downturn started in 2008 (Fig. 1.1). This rapid growth in pain research could be the driving force for an impressive 66% increase in new randomized, double-blind, placebo-control trials for neuropathic pain medications in the past 5 years compared with the last four decades. Unfortunately, little improvement in pain medications has been obtained [1] due to primarily our limited understanding of mechanisms mediating different pain states, especially that for chronic pain. It is highly possible that the growth in pain research will continue for decades to come due to three main reasons. First, there is an urgent need for more efficacious and safer pain medications that are necessary for better and individualized pain management. The increase in life expectancy of the general population and patients due to improvements in quality of health care and medicine is likely to increase the demand for better pain medications for improving the quality of daily life of those living with pain. It is estimated that the continuous increase in percentage of patients suffering from chronic pain (pain conditions lasting more than 6 months) arranges from 11 to 47% between 40 and 75 years of age [2], which will inevitably and continually increase the demand for better pain medications. Second, the cost of pain conditions to our society is high, estimated $55 billion per year in loss of productivity from full-time workers alone [3], so better pain management can significantly help economic growth and stability. Third, the swift advancement in technologies and our better understanding of sensory circuitries and pain pathways serves as a driving force for timely drug discovery research and development at an unprecedented pace to meet the demand for better pain medications. PMID:22351079

Luo, Z David

2012-01-01

324

Increased colonic pain sensitivity in irritable bowel syndrome is the result of an increased tendency to report pain rather than increased neurosensory sensitivity  

PubMed Central

Objective The aim was to determine whether lower visceral pain thresholds in irritable bowel syndrome (IBS) primarily reflect physiological or psychological factors. Methods Firstly, 121 IBS patients and 28 controls underwent balloon distensions in the descending colon using the ascending methods of limits (AML) to assess pain and urge thresholds. Secondly, sensory decision theory analysis was used to separate physiological from psychological components of perception: neurosensory sensitivity (p(A)) was measured by the ability to discriminate between 30?mm?Hg vs 34?mm?Hg distensions; psychological influences were measured by the report criterion—that is, the overall tendency to report pain, indexed by the median intensity rating for all distensions, independent of intensity. Psychological symptoms were assessed using the Brief Symptom Inventory (BSI). Results IBS patients had lower AML pain thresholds (median: 28?mm?Hg vs 40?mm Hg; p<0.001), but similar neurosensory sensitivity (median p(A): 0.5 vs 0.5; p?=?0.69; 42.6% vs 42.9% were able to discriminate between the stimuli better than chance) and a greater tendency to report pain (median report criterion: 4.0 (“mild” pain) vs 5.2 (“weak” pain); p?=?0.003). AML pain thresholds were not correlated with neurosensory sensitivity (r?=??0.13; p?=?0.14), but were strongly correlated with report criterion (r?=?0.67; p<0.0001). Report criterion was inversely correlated with BSI somatisation (r?=??0.26; p?=?0.001) and BSI global score (r?=??0.18; p?=?0.035). Similar results were seen for the non?painful sensation of urgency. Conclusion Increased colonic sensitivity in IBS is strongly influenced by a psychological tendency to report pain and urge rather than increased neurosensory sensitivity. PMID:17483191

Dorn, Spencer D; Palsson, Olafur S; Thiwan, Syed I M; Kanazawa, Motoyori; Clark, W Crawford; van Tilburg, Miranda A L; Drossman, Douglas A; Scarlett, Yolanda; Levy, Rona L; Ringel, Yehuda; Crowell, Michael D; Olden, Kevin W; Whitehead, William E

2007-01-01

325

Pain in cancer survivors.  

PubMed

Pain is a common problem in cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain that interferes with functioning. The prevalence is much higher in certain subpopulations, such as breast cancer survivors. All cancer treatment modalities have the potential to cause pain. Currently, the approach to managing pain in cancer survivors is similar to that for chronic cancer-related pain, pharmacotherapy being the principal treatment modality. Although it may be appropriate to continue strong opioids in survivors with moderate to severe pain, most pain problems in cancer survivors will not require them. Moreover, because more than 40% of cancer survivors now live longer than 10 years, there is growing concern about the long-term adverse effects of opioids and the risks of misuse, abuse, and overdose in the nonpatient population. As with chronic nonmalignant pain, multimodal interventions that incorporate nonpharmacologic therapies should be part of the treatment strategy for pain in cancer survivors, prescribed with the aim of restoring functionality, not just providing comfort. For patients with complex pain issues, multidisciplinary programs should be used, if available. New or worsening pain in a cancer survivor must be evaluated to determine whether the cause is recurrent disease or a second malignancy. This article focuses on patients with a history of cancer who are beyond the acute diagnosis and treatment phase and on common treatment-related pain etiologies. The benefits and harms of the various pharmacologic and nonpharmacologic options for pain management in this setting are reviewed. PMID:24799477

Glare, Paul A; Davies, Pamela S; Finlay, Esmé; Gulati, Amitabh; Lemanne, Dawn; Moryl, Natalie; Oeffinger, Kevin C; Paice, Judith A; Stubblefield, Michael D; Syrjala, Karen L

2014-06-01

326

Importance of glial activation in neuropathic pain.  

PubMed

Glia plays a crucial role in the maintenance of neuronal homeostasis in the central nervous system. The microglial production of immune factors is believed to play an important role in nociceptive transmission. Pain may now be considered a neuro-immune disorder, since it is known that the activation of immune and immune-like glial cells in the dorsal root ganglia and spinal cord results in the release of both pro- and anti-inflammatory cytokines, as well as algesic and analgesic mediators. In this review we presented an important role of cytokines (IL-1alfa, IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-15, IL-18, TNFalpha, IFNgamma, TGF-beta 1, fractalkine and CCL2); complement components (C1q, C3, C5); metaloproteinases (MMP-2,-9) and many other factors, which become activated on spinal cord and DRG level under neuropathic pain. We discussed the role of the immune system in modulating chronic pain. At present, unsatisfactory treatment of neuropathic pain will seek alternative targets for new drugs and it is possible that anti-inflammatory factors like IL-10, IL-4, IL-1alpha, TGF-beta 1 would fulfill this role. Another novel approach for controlling neuropathic pain can be pharmacological attenuation of glial and immune cell activation. It has been found that propentofylline, pentoxifylline, minocycline and fluorocitrate suppress the development of neuropathic pain. The other way of pain control can be the decrease of pro-nociceptive agents like transcription factor synthesis (NF-kappaB, AP-1); kinase synthesis (MEK, p38MAPK, JNK) and protease activation (cathepsin S, MMP9, MMP2). Additionally, since it is known that the opioid-induced glial activation opposes opioid analgesia, some glial inhibitors, which are safe and clinically well tolerated, are proposed as potential useful ko-analgesic agents for opioid treatment of neuropathic pain. This review pointed to some important mechanisms underlying the development of neuropathic pain, which led to identify some possible new approaches to the treatment of neuropathic pain, based on the more comprehensive knowledge of the interaction between the nervous system and glial and immune cells. PMID:23500198

Mika, Joanna; Zychowska, Magdalena; Popiolek-Barczyk, Katarzyna; Rojewska, Ewelina; Przewlocka, Barbara

2013-09-15

327

Thermal Nociceptive Threshold Testing Detects Altered Sensory Processing in Broiler Chickens with Spontaneous Lameness  

PubMed Central

Lameness is common in commercially reared broiler chickens but relationships between lameness and pain (and thus bird welfare) have proved complex, partly because lameness is often partially confounded with factors such as bodyweight, sex and pathology. Thermal nociceptive threshold (TNT) testing explores the neural processing of noxious stimuli, and so can contribute to our understanding of pain. Using an acute model of experimentally induced articular pain, we recently demonstrated that TNT was reduced in lame broiler chickens, and was subsequently attenuated by administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). This study extended these findings to a large sample of commercial broilers. It examined factors affecting thermal threshold (Part 1) and the effect of an NSAID drug (meloxicam, 5 mg/kg) and of an opioid (butorphanol; 4 mg/kg) (Part 2). Spontaneously lame and matched non-lame birds (n?=?167) from commercial farms were exposed to ramped thermal stimulations via a probe attached to the lateral aspect of the tarsometatarsus. Baseline skin temperature and temperature at which a behavioural avoidance response occurred (threshold) were recorded. In Part 1 bird characteristics influencing threshold were modelled; In Part 2 the effect of subcutaneous administration of meloxicam or butorphanol was investigated. Unexpectedly, after accounting for other influences, lameness increased threshold significantly (Part 1). In Part 2, meloxicam affected threshold differentially: it increased further in lame birds and decreased in non-lame birds. No effect of butorphanol was detected. Baseline skin temperature was also consistently a significant predictor of threshold. Overall, lameness significantly influenced threshold after other bird characteristics were taken into account. This, and a differential effect of meloxicam on lame birds, suggests that nociceptive processing may be altered in lame birds, though mechanisms for this require further investigation. PMID:24847799

Hothersall, Becky; Caplen, Gina; Parker, Richard M. A.; Nicol, Christine J.; Waterman-Pearson, Avril E.; Weeks, Claire A.; Murrell, Joanna C.

2014-01-01

328

Management of Pain in the Cancer Patient.  

National Technical Information Service (NTIS)

Contents: Cancer pain management--diagnosis and evaluation; Cancer pain management--multidisciplinary pain clinics; Cancer pain management--psychologic technics; Cancer pain management--pharmacologic technics; Cancer pain management--neurosurgical technic...

1984-01-01

329

Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life  

Microsoft Academic Search

A prospective survey study was performed in patients with painful diabetic polyneuropathy (PDN) to assess the nature and scope of their pain. Pain associated with diabetic neuropathy is commonly encountered in clinical practice. Yet, little is known regarding the pain experience and impact on quality of life in persons with painful diabetic neuropathy. These 105 patients noted an average of

Bradley S. Galer; Ann Gianas; Mark P. Jensen

2000-01-01

330

Fault Tolerant Quantum Computation with Constant Error  

E-print Network

Recently Shor showed how to perform fault tolerant quantum computation when the error probability is logarithmically small. We improve this bound and describe fault tolerant quantum computation when the error probability is smaller than some constant threshold. The cost is polylogarithmic in time and space, and no measurements are used during the quantum computation. The result holds also for quantum circuits which operate on nearest neighbors only. To achieve this noise resistance, we use concatenated quantum error correcting codes. The scheme presented is general, and works with all quantum codes that satisfy some restrictions, namely that the code is ``proper''. We present two explicit classes of proper quantum codes. The first example of proper quantum codes generalizes classical secret sharing with polynomials. The second uses a known class of quantum codes and converts it to a proper code. This class is defined over a field with p elements, so the elementary quantum particle is not a qubit but a ``qupit''. With our codes, the threshold is about 10^(-6). Hopefully, this paper motivates a search for proper quantum codes with higher thresholds, at which point quantum computation becomes practical.

Dorit Aharonov; Michael Ben-Or

1996-11-14

331

Chronic spinal infusion of loperamide alleviates postsurgical pain in rats.  

PubMed

Plantar incision in rat generates spontaneous pain behaviour. The opioid drug, morphine used to treat postsurgical pain produces tolerance after long-term administration. Loperamide, a potent mu-opioid agonist, has documented analgesic action in various pain conditions. However, loperamide analgesia and associated tolerance following continuous spinal administration in postsurgical pain has not been reported. Chronic spinal infusion of drugs was achieved using intrathecal catheters connected to osmotic minipump. Coinciding with the onset of spinal infusion of loperamide or morphine, rats were subjected to plantar incision. Pain-related behaviour was assessed by Hargreaves apparatus (thermal hyperalgesia) and von Frey filaments (mechanical allodynia). Morphine and loperamide (0.5, 1 and 2 microL/h) induced analgesia was observed until 7th day post-plantar incision in Sprague-Dawley rats. Morphine and loperamide produced dose-dependent analgesia. Loperamide, in the highest dose, produced analgesia till 7th day. However, the highest dose of morphine produced inhibition of thermal hyperalgesia till 5th day and mechanical allodynia only till 3rd day post-plantar incision. Morphine and loperamide produced analgesia in postsurgical pain, which may be mediated through different mechanisms. Longer duration of analgesia with loperamide could probably be due sustained blockade of calcium channels. PMID:24772934

Kumar, Rakesh; Reeta, K H; Ray, Subrata Basu

2014-04-01

332

Factors associated with the modulation of pain by visual distortion of body size  

PubMed Central

Modulation of pain using visual distortion of body size (VDBS) has been the subject of various reports. However, the mechanism underlying the effect of VDBS on pain has been less often studied. In the present study, factors associated with modulation of pain threshold by VDBS were investigated. Visual feedback in the form of a magnified image of the hand was provided to 44 healthy adults to examine changes in pain. In participants with a higher pain threshold when visual feedback of a magnified image of the hand was provided, the two-point discrimination threshold decreased. In contrast, participants with a lower pain threshold with visual feedback of a magnified image of the hand experienced unpleasant emotions toward the magnified image of the hand. Interestingly, this emotional reaction was strongly associated with negative body consciousness in several subjects. These data suggested an analgesic effect of visual feedback in the form of a magnified image of the hand is only when tactile perception is vivid and the emotional reaction toward the magnified image is moderate. The results also suggested that negative body consciousness is important for the modulation of pain using VDBS. PMID:24688463

Osumi, Michihiro; Imai, Ryota; Ueta, Kozo; Nakano, Hideki; Nobusako, Satoshi; Morioka, Shu

2014-01-01

333

Painful Peripheral Neuropathies  

PubMed Central

Peripheral neuropathies are a heterogeneous group of diseases affecting peripheral nerves. The causes are multiple: hereditary, metabolic, infectious, inflammatory, toxic, traumatic. The temporal profile includes acute, subacute and chronic conditions. The majority of peripheral neuropathies cause mainly muscle weakness and sensory loss, positive sensory symptoms and sometimes pain. When pain is present, however, it is usually extremely intense and among the most disabling symptoms for the patients. In addition, the neurological origin of the pain is often missed and patients receive inadequate or delayed specific treatment. Independently of the disease causing the peripheral nerve injury, pain originating from axonal pathology or ganglionopathy privileges neuropathies affecting smaller fibres, a clinical observation that points towards abnormal activity within nociceptive afferents as a main generator of pain. Natural activation of blood vessels or perineurial nociceptive network by pathology also causes intense pain. Pain of this kind, i.e. nerve trunk pain, is among the heralding symptoms of inflammatory or ischemic mononeuropathy and for its intensity represents itself a medical emergency. Neuropathic pain quality rekindles the psychophysical experience of peripheral nerves intraneural microstimulation i.e. a combination of large and small fibres sensation temporally distorted compared to physiological perception evoked by natural stimuli. Pins and needles, burning, cramping mixed with numbness, and tingling are the wording most used by patients. Nociceptive pain instead is most often described as aching, deep and dull. Good command of peripheral nerve anatomy and pathophysiology allows timely recognition of the different pain components and targeted treatment, selected according to intensity, type and temporal profile of the pain. PMID:18615140

Marchettini, P; Lacerenza, M; Mauri, E; Marangoni, C

2006-01-01

334

Pain of urogenital origin  

Microsoft Academic Search

Chronic nonmalignant pain syndromes (longer than 6 months duration) of urogenital origin are well described but poorly understood\\u000a focal pain syndromes. Pain in these areas of the body is usually very embarrassing for the male and female patient, who may\\u000a be afraid to discuss his or her symptoms with family members, friends, and health care providers. Except in those cases

Ursula Wesselmann; Peter P. Czakanski

1999-01-01

335

Postpartum Lower Abdominal Pain  

Microsoft Academic Search

Pains after labor can be as severe as those experienced during labor, particularly the commonly occurring lower abdominal\\u000a “after-pains” that are associated with prolonged uterine contractions during breast feeding. Other causes of lower abdominal\\u000a pain may not be physiologically based but are either direct complications of parturition, such as genital infection, or fortuitous,\\u000a such as appendicitis. Although the focus of

Anita Holdcroft

1999-01-01

336

Acceptance of chronic pain  

Microsoft Academic Search

The experience of chronic pain can be associated with significant distress and disability; however, this is not always the\\u000a case. Although attempts to control or reduce pain can be helpful for many pain sufferers, on some occasions this is not an\\u000a effective option and a different response is required. This different response can include a fiexible mix of control and

Lance M. McCracken; Kevin E. Vowles

2006-01-01

337

Effects of Laughter on Discomfort Thresholds.  

ERIC Educational Resources Information Center

Pain is affected by a variety of motivational and affective variables, such as relaxation, social modeling, and social support. Norman Cousins has proposed that laughter is a particularly effective pain antagonist. To compare the effects of laughter on pain sensitivity with the effects of relaxation (a variable known to reduce pain sensitivty),…

Cogan, Rosemary; Waltz, William

338

The effects of sex and gender role on responses to pressure pain  

PubMed Central

Background: Several studies on experimental mechanical pain suggested a strong influence of sex demonstrating females to be more sensitive. We examined the hypothesis that not only sex but also gender role affects pain responsiveness and looked for mediators of this effect. Method: As indicators of pain the threshold the intensity and the unpleasantness of pressure stimuli were measured, as well as sensory and affective quality of pain. The gender role of 74 students was assessed by the Bem Sex Role Inventory (BSRI). Furthermore several psychological variables assumed to be potential mediators (catastrophising, fear of pain, depressive symptoms, pain coping) were obtained. Results: ANOVA revealed significant main effects of sex in all pain variables except affective quality of pain. Contrary to our hypothesis gender role had no influence on pain responses, neither was there an interaction of sex and gender. Fear of pain just missed the significance level identifying it as mediator of the sex effect on affective pain. Conclusions: In summary, our study corroborated previous findings that women are more responsive to mechanical pain stimuli with effect sizes being medium to large, whereas gender role did not predict any of the assessed pain parameters. No convincing evidence was found that the influence of sex is predominantly mediated by psychological characteristics of the individual. PMID:22400065

Kroner-Herwig, Birgit; Gassmann, Jennifer; Tromsdorf, Marie; Zahrend, Elfi

2012-01-01

339

Fault-Tolerant Measurement-Based Quantum Computing with Continuous-Variable Cluster States  

NASA Astrophysics Data System (ADS)

A long-standing open question about Gaussian continuous-variable cluster states is whether they enable fault-tolerant measurement-based quantum computation. The answer is yes. Initial squeezing in the cluster above a threshold value of 20.5 dB ensures that errors from finite squeezing acting on encoded qubits are below the fault-tolerance threshold of known qubit-based error-correcting codes. By concatenating with one of these codes and using ancilla-based error correction, fault-tolerant measurement-based quantum computation of theoretically indefinite length is possible with finitely squeezed cluster states.

Menicucci, Nicolas C.

2014-03-01

340

Fault-Tolerant Measurement-Based Quantum Computing with Continuous-Variable Cluster States  

E-print Network

A long-standing open question about Gaussian continuous-variable cluster states is whether they enable fault-tolerant measurement-based quantum computation. The answer is yes. Initial squeezing in the cluster above a threshold value of 20.5 dB ensures that errors from finite squeezing acting on encoded qubits are below the fault-tolerance threshold of known qubit-based error-correcting codes. By concatenating with one of these codes and using ancilla-based error correction, fault-tolerant measurement-based quantum computation of theoretically indefinite length is possible with finitely squeezed cluster states.

Nicolas C. Menicucci

2013-10-28

341

Tolerance.org  

NSDL National Science Digital Library

While some groups only give lip service to spreading the good word about the importance of tolerance, the Southern Poverty Law Center has created this fine website to disseminate valuable materials for people interested in dismantling bigotry and creating communities that welcome and value diversity. The site has much to offer, including daily news updates about groups and individuals working for tolerance and fighting hate, guidebooks for adult and youth activists, and educational games for young children. The site is thematically divided into areas for teachers, teens, children, and parents. The parents section has some great resources, including a feature titled "10 Ways to Nurture Tolerance" and a list of helpful books on the theme of tolerance for parents that is quite handy. Educators will find the "Teaching Tolerance" area a welcome find, as it contains a number of classroom activities and the current edition (along with an archive) of their Teaching Tolerance magazine.

342

Personalized treatment of pain.  

PubMed

Despite advances made in its understanding and treatment, chronic pain remains an unsolved and all too common problem. One of the main obstacles to successful management of pain is the high variability of many patients regarding both response to treatment and susceptibility to adverse effects, which curtails the utility of therapeutic intervention. Understanding the causes of this variability is an important challenge which may lead to a new era in rational pain management. As described in this review, however, there currently seems to be more than one possible explanation of this variability. Rational personalized pain management must take into consideration both ever-increasing knowledge of pharmacogenetics and pharmacokinetics and a broad, clinically based attitude incorporating co-morbidities, both physical and psychiatric, and concomitant medications. Novel models for testing in-vivo pain processing, for example assessment of conditioned pain modulation (CPM), are also promising approaches to use of rational data for empirical treatment of pain. Last, listening to the patient and understanding the context in which pain has affected his or her life is an important part of maintaining the personal nature of therapeutic interaction with patients suffering from pain. PMID:23292814

Ablin, Jacob N; Buskila, Dan

2013-01-01

343

NECK AND SHOULDER PAIN  

PubMed Central

Neck and shoulder pains are presenting or incidental symptoms in a large variety of conditions. There may be similarities in the anatomicophysiological mechanism of pain production and in the clinical picture in many of these conditions. Many of the vague and refractory cases of neck and shoulder pain and of migraine may be due to cervical disc disease. Scalenus anticus syndrome and cardiac disease can be diagnosed or differentiated from cervical disc syndrome only by thorough investigation. Proper treatment of neck and shoulder pain is dependent upon correct diagnosis through complete history, physical examination and laboratory tests, as described in this presentation. PMID:18131684

Fields, Albert; Hoesley, John

1949-01-01

344

Alternative medicine - pain relief  

MedlinePLUS

... for: After surgery or labor Arthritis Cancer Fibromyalgia Irritable bowel syndrome Migraine headache Tension headache Both acupuncture and hypnosis are often offered by pain management centers in ...

345

Cannabinoids in the management of difficult to treat pain  

PubMed Central

This article reviews recent research on cannabinoid analgesia via the endocannabinoid system and non-receptor mechanisms, as well as randomized clinical trials employing cannabinoids in pain treatment. Tetrahydrocannabinol (THC, Marinol®) and nabilone (Cesamet®) are currently approved in the United States and other countries, but not for pain indications. Other synthetic cannabinoids, such as ajulemic acid, are in development. Crude herbal cannabis remains illegal in most jurisdictions but is also under investigation. Sativex®, a cannabis derived oromucosal spray containing equal proportions of THC (partial CB1 receptor agonist ) and cannabidiol (CBD, a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects) was approved in Canada in 2005 for treatment of central neuropathic pain in multiple sclerosis, and in 2007 for intractable cancer pain. Numerous randomized clinical trials have demonstrated safety and efficacy for Sativex in central and peripheral neuropathic pain, rheumatoid arthritis and cancer pain. An Investigational New Drug application to conduct advanced clinical trials for cancer pain was approved by the US FDA in January 2006. Cannabinoid analgesics have generally been well tolerated in clinical trials with acceptable adverse event profiles. Their adjunctive addition to the pharmacological armamentarium for treatment of pain shows great promise. PMID:18728714

Russo, Ethan B

2008-01-01

346

Clinical Approach to the Treatment of Painful Diabetic Neuropathy  

PubMed Central

Painful neuropathy is a common and often progressive complication of diabetes. Patients frequently report symptoms of tingling, burning, lancinating pain, hyperesthesia, and allodynia. The natural history of the disease may vary from intermittent mild symptoms to severe chronic daily pain; the latter is often associated with diminished quality of life. There are a variety of pharmaceutical agents from different medicinal categories available for the symptomatic treatment of painful diabetic neuropathy, however selecting an agent is often challenging given the breadth of choices and lack of consistent guidelines. As a result, many patients remain untreated or undertreated. This article presents a practical clinical approach to the treatment of pain in diabetic neuropathy. Recommendations for first-, second-, and third-line medications are based on specific evidence for the treatment of painful diabetic neuropathy as well as safety, tolerability, drug interactions, and cost. Additional topics of discussion include breakthrough pain, opioid use, and topical therapies. This review does not comprehensively discuss all possible treatments for painful neuropathy, but provides a systematic approach designed to guide clinicians in tailoring therapies to the individual patient. PMID:21709806

Hovaguimian, Alexandra; Gibbons, Christopher H.

2011-01-01

347

New Dynamic Model-Based Fault Detection Thresholds for Robot Manipulators  

Microsoft Academic Search

Autonomous robotic fault detection is becoming increasingly important as robots are used in more inaccessible and hazardous environments. Detection algorithms, however, are adversely effected by the model simplification, parameter uncertainty, and computational inaccuracy inherent in robotic control, leading to an unacceptable number of false alarms and overzealous fault tolerance. The algorithms must use thresholds to mask out these errors. Typically,

M. L. Visinsky; Ian D. Walker; Joseph R. Cavallaro

1994-01-01

348

Cutaneous pain effects induced by Nd:YAG and CO2 laser stimuli  

NASA Astrophysics Data System (ADS)

The near infrared laser technique can activate cutaneous nociceptors with high specificity and reproducibility and be used in anti-riot equipment. This study aimed to explore cutaneous pain effect and determine the threshold induced by Nd:YAG and CO2 laser stimuli. The corresponding wavelength was 1.32?m and 10.6?m. The pain effect was assessed in three healthy subjects (1 woman and 2 men) on the skin of dorsum of both hands. The energy of each pulse and whether the subjects felt a painful sensation after each stimulus were recorded. A simplified Bliss Method was used to calculate the pain threshold which were determined under three pulse durations for Nd:YAG laser and one pulse duration for CO2 laser. As a result the pain thresholds were determined to be 5.6J/cm2, 5.4J/cm2 and 5.0J/cm2 respectively when using Nd:YAG laser, 4.0mm beam diameter, 8ms, 0.1s and 1s pulse duration. The pain threshold was 1.0J/cm2 when using CO2 laser, 4.0mm beam diameter and 0.1s pulse duration. We concluded that the threshold of cutaneous pain elicited by 1.32?m laser was independent upon the pulse duration when the exposure time ranged from 8ms to 1s. Under the same exposure condition, the threshold of cutaneous pain elicited by 1.32?m laser was higher than that elicited by 10.6?m laser.

Wang, Jia-Rui; Yu, Guang-Yuan; Yang, Zai-Fu; Chen, Hong-Xia; Hu, Dong-Dong; Zou, Xian-Biao

2012-12-01

349

Inflammation and transplantation tolerance  

Microsoft Academic Search

Although our understanding of the immunological mechanisms of transplant tolerance induction has greatly improved, how the\\u000a innate immune system impacts transplant tolerance has only been recently appreciated. In this review, the involvement of the\\u000a innate immune receptors, Toll-like receptors (TLRs), in both experimental models of acute allograft rejection and transplant\\u000a tolerance induction in addition to clinical studies of organ transplantation

Daniel R. Goldstein

2011-01-01

350

Threshold of hierarchical percolating systems  

NASA Astrophysics Data System (ADS)

Many modern nanostructured materials and doped polymers are morphologically too complex to be interpreted by classical percolation theory. Here, we develop the concept of a hierarchical percolating (percolation-within-percolation) system to describe such complex materials and illustrate how to generalize the conventional percolation to double-level percolation. Based on Monte Carlo simulations, we find that the double-level percolation threshold is close to, but definitely larger than, the product of the local percolation thresholds for the two enclosed single-level systems. The deviation may offer alternative insights into physics concerning infinite clusters and open up new research directions for percolation theory.

Li, Jiantong; Ray, Biswajit; Alam, Muhammad A.; Östling, Mikael

2012-02-01

351

T Cell Activation Thresholds are Affected by Gravitational  

NASA Technical Reports Server (NTRS)

T cells stimulated in space flight by various mitogenic signals show a dramatic reduction in proliferation and expression of early activation markers. Similar results are also obtained in a ground based model of microgravity, clinorotation, which provides a vector-averaged reduction of the apparent gravity on cells without significant shear force. Here we demonstrate that T cell inhibition is due to an increase in the required threshold for activation. Dose response curves indicate that cells activated during clinorotation require higher stimulation to achieve the same level of activation, as measured by CD69 expression. Interleukin 2 receptor expression, and DNA synthesis. The amount of stimulation necessary for 50% activation is 5 fold in the clinostat relative to static. Correlation of TCR internalization with activation also exhibit a dramatic right shift in clinorotation, demonstrating unequivocally that signal transduction mechanism independent of TCR triggering account for the increased activation threshold. Previous results from space flight experiments are consistent with the dose response curves obtained for clinorotation. Activation thresholds are important aspects of T cell memory, autoimmunity and tolerance Clinorotation is a useful, noninvasive tool for the study of cellular and biochemical event regulating T cell activation threshold and the effects of gravitation forces on these systems.

Adams, Charley; Gonzalez, M.; Nelman-Gonzalez, M.

1999-01-01

352

Sulfur tolerant anode materials  

SciTech Connect

The goal of this program is the development of a molten carbonate fuel cell (MCFC) anode which is more tolerant of sulfur contaminants in the fuel than the current state-of-the-art nickel-based anode structures. This program addresses two different but related aspects of the sulfur contamination problem. The primary aspect is concerned with the development of a sulfur tolerant electrocatalyst for the fuel oxidation reaction. A secondary issue is the development of a sulfur tolerant water-gas-shift reaction catalyst and an investigation of potential steam reforming catalysts which also have some sulfur tolerant capabilities. These two aspects are being addressed as two separate tasks.

Not Available

1988-05-01

353

Sulfur tolerant anode materials  

SciTech Connect

The goal of this program is the development of a molten carbonate fuel cell (MCFC) anode which is more tolerant of sulfur contaminants in the fuel than the current state-of-the-art nickel-based anode structures. This program addresses two different but related aspects of the sulfur contamination problem. The primary aspect is concerned with the development of a sulfur tolerant electrocatalyst for the fuel oxidation reaction. A secondary issue is the development of a sulfur tolerant water-gas-shift reaction catalyst and an investigation of potential steam reforming catalysts which also have some sulfur tolerant capabilities. These two aspects are being addressed as two separate tasks.

Not Available

1988-02-01

354

Pain and stress responses in farmed fish.  

PubMed

Farming fish for human consumption continues to expand as an industry and, with this increasing interaction with captive fish populations, there is now a growing interest in determining how to create good welfare for the fish we farm. This article summarises recent advances in our understanding of pain and stress responses in fish and how these relate to farmed fish welfare. Over the last decade several studies have examined whether or not fish feel pain, how aversive the experience is, and how such experiences may be mitigated through the use of analgesics. The basic neural mechanisms that enable the detection of tissue damage, i.e. nociceptive mechanisms, appear to be broadly conserved from fish through to birds and mammals, however, there is debate about the extent of the negative feelings associated with pain and whether these are truly experienced by fish. The stress response that helps fish to cope with various challenges also appears to be largely conserved across vertebrates, and the physiological changes that occur in response to acute and chronic stress in fish are similar to those described for mammals. Therefore, fish appear to have the innate ability to experience negative states such as pain and stress in a way analogous to that experienced by other vertebrates. There are multiple situations in which farmed fish may experience pain and stress and there is now a growing recognition that, to deliver appropriate welfare, on-farm practices and procedures will have to change. It is also the case that the welfare requirements of the different fish species that we farm vary, with some species coping better in captive rearing environments than others. The topic of fish welfare is relatively new and more research on stress responses, allostasis, pain thresholds and analgesics is required to help promote good fish welfare. PMID:25000797

Braithwaite, V A; Ebbesson, L O E

2014-04-01

355

Gray Level Thresholding in Badly Illuminated Images  

Microsoft Academic Search

The thresholding method involves first locating objects in an image by using the intensity gradient, then noting the levels that correspond to the objects in various areas of the image, and finally using these levels as initial guesses at a threshold. This method is capable of thresholding images that have been produced in the context of variable illumination. The thresholding

J. R. Parker

1991-01-01

356

Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study  

Microsoft Academic Search

ObjectiveTo address the role of anxiety and depression symptoms in altered pain processing in irritable bowel syndrome (IBS).DesignIn this functional magnetic resonance imaging study, the blood oxygen level-dependent (BOLD) response to rectal distensions delivered at previously determined individual discomfort thresholds was assessed.Patients15 female patients with irritable bowel syndrome (IBS) and with normal rectal pain thresholds, and 12 healthy women.MeasuresThe correlation

S Elsenbruch; C Rosenberger; P Enck; M Forsting; M Schedlowski; E R Gizewski

2009-01-01

357

New states above charm threshold  

SciTech Connect

We revise and extend expectations for the properties of charmonium states that lie above charm threshold, in light of new experimental information. We refine the Cornell coupled-channel model for the coupling of c{bar c} levels to two-meson states, defining resonance masses and widths by pole positions in the complex energy plane, and suggest new targets for experiment.

Eichten, Estia J.; /Fermilab; Lane, Kenneth; /Boston U.; Quigg, Chris; /Fermilab

2005-11-01

358

Crossing Thresholds in Academic Reading  

ERIC Educational Resources Information Center

This paper looks at the conceptual thresholds in relation to academic reading which might be crossed by undergraduate English Literature students. It is part of a wider study following 16 students through three years of undergraduate study. It uses theoretical ideas from Bakhtin and Foucault to analyse interviews with English lecturers. It…

Abbott, Rob

2013-01-01

359

MACHINE MONITORING USING PROBABILITY THRESHOLDS  

E-print Network

MACHINE MONITORING USING PROBABILITY THRESHOLDS AND SYSTEM OPERATING CHARACTERISTICS Stephen M a discrete-part production machine, with the objective of effectively determining when to shut the machine analysis: a) There is an underlying time interval that characterizes the operation of the machine, most

Pollock, Stephen

360

Fractal Superconductivity near Localization Threshold  

E-print Network

Fractal Superconductivity near Localization Threshold Mikhail Feigel'man Landau Institute, Moscow-electron states are extended but fractal and populate small fraction of the whole volume How BCS theory should be modified to account for eigenstates fractality ? #12;Mean-Field Eq. for Tc #12;#12;3D Anderson model: = 0

Fominov, Yakov

361

Athletes' leg pains  

Microsoft Academic Search

The frequency and nature of exertion pains of the leg in athletes were studied in 2,750 cases of overuse injuries treated at the Sports Clinic of the Deaconess Institute of Oulu, Finland, during the years 1972-1977. 465 cases of exertion pain (18%) were located in the shin. The medial tibial syndrome was the most common overuse injury among these athletes,

S. Orava; J. Puranen

1979-01-01

362

[A pain assessment logbook].  

PubMed

Fighting pain is one of nurses' duties. At Dreux general hospital, the medical and nursing staff of the physical medicine and rehabilitation department has gradually put in place since 2004 an information and treatment logbook. It constitutes a way of recording and assessing each patient's pain and consequently facilitates its treatment. PMID:22256529

Poindessous, Jean-Luc; Pineau, Christophe; Brambrink, Monica; Menegoz, Jean-Daniel; Coz, Joëlle; Siloret, Baptiste; Papillon, Virginie

2011-12-01

363

Opioids in pain management  

Microsoft Academic Search

Dose titration and differences between clinical and laboratory pharmacology The clinical use of opioids shows a difference between their clinical pharmacology and their laboratory pharmacology. What happens when opioids are given to someone in pain is different from what happens when they are given to someone not in pain. The respiratory depression that results from the acute use of opioids

Henry McQuay

1999-01-01

364

Painful and painless channelopathies.  

PubMed

The discovery of genetic variants that substantially alter an individual's perception of pain has led to a step-change in our understanding of molecular events underlying the detection and transmission of noxious stimuli by the peripheral nervous system. For example, the voltage-gated sodium ion channel Nav1.7 is expressed selectively in sensory and autonomic neurons; inactivating mutations in SCN9A, which encodes Nav1.7, result in congenital insensitivity to pain, whereas gain-of-function mutations in this gene produce distinct pain syndromes such as inherited erythromelalgia, paroxysmal extreme pain disorder, and small-fibre neuropathy. Heterozygous mutations in TRPA1, which encodes the transient receptor potential cation channel, can cause familial episodic pain syndromes, and variants of genes coding for the voltage-gated sodium channels Nav1.8 (SCN10A) and Nav1.9 (SCN11A) lead to small-fibre neuropathy and congenital insensitivity to pain, respectively. Furthermore, other genetic polymorphisms have been identified that contribute to risk or severity of more complex pain phenotypes. Novel models of sensory disorders are in development-eg, using human sensory neurons differentiated from human induced pluripotent stem cells. Understanding rare heritable pain disorders not only improves diagnosis and treatment of patients but may also reveal new targets for analgesic drug development. PMID:24813307

Bennett, David L H; Woods, C Geoffrey

2014-06-01

365

[Pain management in urology].  

PubMed

This article reviews aspects of postoperative and chronic pain management in urology patients. Continuous epidural techniques are recommended for extensive retroperitoneal und transperitoneal surgery due to its excellent analgesia and facilitation of enhanced recovery. In patients without regional analgesia techniques, intravenous or oral non-opioid analgesics should be combined with titration of fast acting opioids on an as-needed basis. Oral slow-release opioids are increasingly being used as part of systemic pain management although little evidence exists. Local wound infiltration and transcutaneous electrical nerve stimulation (TENS) treatment are simple and effective supplements for postoperative pain management. In 70-90% of urological cancer patients pain can be adequately relieved by consistent adherence to the WHO cancer pain recommendations. Additional pain relief approaches, such as radiation as well as psychosocial and spiritual needs of these patients have to be considered. In long-term treatment of non-cancer pain, effective use of opioids is not evidence-based. These patients often benefit from multimodal, interdisciplinary pain management comprising psychological and educational approaches as well as activating physiotherapy. PMID:23529794

Zimmer, A; Greul, F; Meißner, W

2013-04-01

366

No DREAM, No Pain  

Microsoft Academic Search

Pain transmission in the spinal cord is regulated by a balance of facilitatory and inhibitory influences operating on the neural circuits of the somatosensory system. The transcriptional repressor DREAM acts constitutively to suppress prodynorphin expression in spinal cord neurons. Knocking out DREAM results in sufficient dynorphin expression to produce a strong reduction in generalized pain behavior, highlighting the role that

Michael Costigan; Clifford J. Woolf

2002-01-01

367

Psychology and chronic pain  

Microsoft Academic Search

Unfortunately for many sufferers, medical management alone is often not successful in alleviating chronic pain or in improving the emotional impacts and disability that come with it. The patients’ psychological experience of pain, the behaviour patterns they adopt, and the emotional, social, and cognitive influences on those behaviour patterns are critical in the management of many, if not most, cases.

Lance M. McCracken

2008-01-01

368

Advances in Cancer Pain  

Microsoft Academic Search

dvances in cancer pain research and management are an example of the advances that have occurred within the field of neuro-oncology, the medical discipline that includes the diagnosis and treatment of primary central nervous system neoplasms, metastatic and nonmetastatic neurological complications of cancer originating outside the ner- vous system, and pain associated with cancer. Progress in the diagnosis and treatment

Kathleen M. Foley

1999-01-01

369

Back pain in children  

Microsoft Academic Search

SUMMARY Pay attention to back pain reported by children. Half will have a specific or serious cause, the presenting symptoms of serious conditions may be misleadingly mild, and the spectrum of causes and mode of presentation differ from adults. Warning features include onset aged < 4 yr, symptoms persisting beyond 4 weeks, interference with function, systemic features, worsening pain, neurological

P. HOLLINGWORTH

1996-01-01

370

Pediatric heel pain.  

PubMed

Heel pain is a common complaint among young children and adolescents. It has many causes, including trauma, overuse injuries, and tumors, and therefore a thorough clinical examination is warranted. This article outlines some common causes of pediatric heel pain. PMID:24075133

Joseph, Alison M; Labib, Irene K

2013-10-01

371

Hypnosis and Clinical Pain  

Microsoft Academic Search

Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute

David R. Patterson; Mark P. Jensen

2003-01-01

372

Complex regional pain syndrome  

Microsoft Academic Search

Complex regional pain syndrome (CRPS) may develop after limb trauma and is characterized by pain, sensory-motor and autonomic symptoms. Most important for the understanding of the pathophysiology of CRPS are recent results of neurophysiological research. Major mechanism for CRPS symptoms, which might be present subsequently or in parallel during the course of CRPS, are trauma-related cytokine release, exaggerated neurogenic inflammation,

Frank Birklein; Neurologische Klinik

2005-01-01

373

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

PubMed Central

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. PMID:21630378

Guo, Wei; Wang, Hu; Zou, Shiping; Gu, Ming; Watanabe, Mineo; Wei, Feng; Dubner, Ronald; Huang, George T.-J.; Ren, Ke

2012-01-01

374

Pain and symptom control in paediatric palliative care.  

PubMed

Important differences become evident in a comparison of cancer pain between children and adults. Management of pain in children is commonly multidisciplinary, is less dependent on invasive measures and relies more on systemic therapy. Children are not little adults: their immaturity, developing cognition and dependence all influence their experience and interpretation of pain. Much progress has been made in altering practices such as under-prescribing and underdosing that have adversely affected adequate control of pain in children. The challenge for paediatric health care providers in the mid 1990s is not only to be informed of current practices in pain and symptom control in paediatric palliative care, but also to remember to establish those practices in day to day management. Even though pain and its effects in children are now better understood, it is often still not managed optimally. Good management of pain in children depends on accurate assessment. In the past 10 years, assessment of pain in children has advanced considerably. However, assessment of pain in the preverbal child is still inadequate and in need of attention. Sedation, tolerance and involuntary movements may occur as side effects of opioids in children and may cause significant problems in management of the dying child. Psychostimulants can diminish sedation to some extent, but there is little information as yet on the value of these drugs in children. Tolerance to opioids may develop quickly, leading to poor control of pain and distress for the child. Strategies to improve management of tolerance include use of regional anaesthetic techniques such as the epidural/intrathecal route for opioid administration. Involuntary movements induced by opioids are uncommon but have the potential to cause significant distress. The mechanisms underlying these side effects of opioids need to be established. Strategies are needed for the effective treatment and prevention of these side effects. Neuropathic pain can be severe, distressing and difficult to treat. Experience of its treatment in terminally ill children is limited. Effective use of tricyclic antidepressants and systemically administered local anaesthetics is still to be determined. Regional anaesthetic techniques may be of great benefit when neuropathic pain cannot be controlled with systemic therapy. Procedural pain is more common than pain related to disease in the management of paediatric cancer. Further research is needed to identify the best approach to its management. We have found nitrous oxide to be of great benefit in management of procedural pain in children. Non-pharmacological methods of treatment of pain in children, such as transcutaneous electrical nerve stimulation or acupuncture, may also be useful and should receive continuing evaluation. There are significant and current issues in paediatric palliative care besides management of pain. There are difficulties in the provision of home nursing care for children with cancer in the terminal phase of their illness, including lack of community nursing services at night and on weekends and lack of adequate home help for parents. Attitudes of staff involved in the care of the child and family and their commitment to working as a multidisciplinary team strongly influence the quality and success of care given. Pain control and palliative medicine are evaluable by measures of quality assurance or outcome, and adoption of such evaluations should improve standards of care. Euthanasia in children is even more difficult as an ethical dilemma than in adults. Optimum symptom control with current techniques should almost always obviate its consideration. We are opposed to euthanasia. Psychosocial and cultural issues all influence the family's experience of palliative care. Further research is necessary in all of these areas.(ABSTRACT TRUNCATED) PMID:8564995

Stevens, M M; Dalla Pozza, L; Cavalletto, B; Cooper, M G; Kilham, H A

1994-01-01

375

Back Pain and Emotional Distress  

MedlinePLUS

North American Spine Society Public Education Series Back Pain and Emotional Distress Common Reactions to Back Pain Four out of five adults will experience an episode of significant back pain sometime during ...

376

Musculoskeletal chest wall pain  

PubMed Central

The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

Fam, Adel G.; Smythe, Hugh A.

1985-01-01

377

[Groin pain in athletes].  

PubMed

Groin pain in young athletes is a common problem, accounting for significant downtime in sports participation. It can be difficult to make the correct diagnosis as groin pain has a wide differential diagnosis, which encompasses acute as well as chronic causative factors. In this article this is illustrated by presenting three cases of patients who attended our hospital. In all three cases the main complaint was sports-related groin pain, and the patients presented with very similar symptoms. However, after further investigation the patients were diagnosed with three very different types of injury: sportsman's hernia; hip labral tear; and pubic osteitis. This emphasises the need for every general practitioner and medical specialist to understand that there is a wide differential diagnosis for groin pain in athletes, in order to be able to implement specific therapy targeting the actual cause of groin pain. PMID:25315329

Sanders, R J M; Kokshoorn, A P J; Kolkman, K A; van der Wal, W A; van Loon, C J M

2014-01-01

378

An archaeology of pain  

NASA Astrophysics Data System (ADS)

Pain is a discursive construct of science and medicine. Through the discourses of biopower and technoscience pain is used to construct and maintain the social body. Biopower and technoscience are discursive practices that are enveloped within the disciplines of Western society. Specifically, the disciplines of education, science, and medicine use biopower and technoscience to normalize the body and construct binaries which create the abnormal. The cyborg is a discursive practice used to implode the binaries of the disciplines which maintain the social body. Through the implosion of binaries, the binary of mind/body is no longer plausible in the explanation of pain. Neuropathic chronic pain and phantom limb pain become cyborg discourses which operate to deconstruct the pedagogies of science and medicine.

Gruber, Dennis Michael

379

Catechol-O-methyltransferase polymorphisms do not play a significant role in pain perception in male Chinese Han population.  

PubMed

Polymorphisms in the human catechol-O-methyltransferase (COMT) gene have been widely studied for their role in pain and analgesia. In this study, sensitivity to potassium iontophoresis, visual analog scale measurements for fixed twofold pain threshold stimulation and pain threshold changes induced by transcutaneous electrical acupoint stimulation (TEAS) were assessed in a population of healthy Chinese males. These results were correlated with the alleles of six single nucleotide polymorphisms (SNP) or diplotypes of common haplotypes designated as low pain sensitive, average pain sensitive, and high pain sensitive in the COMT gene of these subjects. Our results reveal that the alleles of each SNP are not significantly correlated with pain perception except for the rs4633 allele in the 2 Hz TEAS session (P < 0.05). In addition, the six diplotypes of COMT haplotypes, which cover 92.5% of the Chinese population, are also not correlated with pain perception. Moreover, there were no significant differences in pain threshold changes induced by 2 and 100 Hz TEAS among the diplotypes of each SNP or the various haplotypes. These results suggest that COMT activity do not play a significant role in pain perception and TEAS-induced analgesia in the Chinese Han male population. PMID:22253202

Xiang, Xiaohui; Jiang, Yin; Ni, Yanjun; Fan, Min; Shen, Fang; Wang, Xuewei; Han, Jisheng; Cui, Cailian

2012-03-01

380

A Lesson in Tolerance  

ERIC Educational Resources Information Center

This article describes one classroom's experience integrating a three-part lesson that focused on tolerance. In the lesson, students examined works by American folk-art painter Edward Hicks, researched quotes about tolerance in society, and applied calligraphy skills to an original composition.

Johnt, Marlene

2004-01-01

381

SFT: scalable fault tolerance  

Microsoft Academic Search

In this paper we will present a new technology that we are currently developing within the SFT: Scalable Fault Tolerance FastOS project which seeks to implement fault tolerance at the operating system level. Major design goals include dynamic reallocation of resources to allow continuing execution in the presence of hardware failures, very high scalability, high efficiency (low overhead), and transparency---requiring

Fabrizio Petrini; Jarek Nieplocha; Vinod Tipparaju

2006-01-01

382

Moving Beyond Tolerance.  

ERIC Educational Resources Information Center

Operating under the umbrella of the Santa Barbara County Education Office, the Beyond Tolerance Educational Center serves as a resource for educators. It provides county schools with information and programs that promote social awareness and tolerance while teaching kids the dangers of hatred and discrimination. (MLH)

Cirone, Bill

2001-01-01

383

Back to Central Tolerance  

Microsoft Academic Search

The establishment and maintenance of immunological tolerance entails both central and peripheral mechanisms. The latter have been highlighted in the past several years, mostly because of great interest in the activities of regulatory T cells. However, an important role for central tolerance mechanisms has been reemphasized by recent results on human autoimmune diseases, including APECED and type 1 diabetes.

Diane Mathis; Christophe Benoist

2004-01-01

384

Practical Byzantine Fault Tolerance  

Microsoft Academic Search

This paper describes a new replication algorithm that is able to tolerate Byzantine faults. We believe that Byzantine- fault-tolerant algorithms will be increasingly important in the future because malicious attacks and software errors are increasingly common and can cause faulty nodes to exhibit arbitrary behavior. Whereas previous algorithms assumed a synchronous system or were too slow to be used in

Miguel Castro; Barbara Liskov

1999-01-01

385

Fault tolerant quantum computation with nondeterministic gates.  

PubMed

In certain approaches to quantum computing the operations between qubits are nondeterministic and likely to fail. For example, a distributed quantum processor would achieve scalability by networking together many small components; operations between components should be assumed to be failure prone. In the ultimate limit of this architecture each component contains only one qubit. Here we derive thresholds for fault-tolerant quantum computation under this extreme paradigm. We find that computation is supported for remarkably high failure rates (exceeding 90%) providing that failures are heralded; meanwhile the rate of unknown errors should not exceed 2 in 10(4) operations. PMID:21231569

Li, Ying; Barrett, Sean D; Stace, Thomas M; Benjamin, Simon C

2010-12-17

386

Tolerance to cocaine in brain stimulation reward following continuous cocaine infusions.  

PubMed

This study examined tolerance to cocaine's threshold-lowering effect in brain stimulation reward (BSR) following continuous cocaine infusions and secondly, used the nitric oxide synthase inhibitor N?-nitro-L-arginine methyl ester (L-NAME) to determine NO's involvement in the development of cocaine tolerance. Animals were continuously infused with saline or cocaine (30 mg/kg per day) via osmotic minipump for 14 days and injected daily with saline or L-NAME (30 mg/kg, i.p.) following BSR testing. Saline-treated animals continuously infused with saline showed stable BSR thresholds across the 14-day infusion period. Saline-treated animals continuously infused with cocaine showed markedly lowered BSR thresholds on Day 1 followed by a progressive increase in BSR thresholds across the infusion period - indicating the development of tolerance. L-NAME-treated animals continuously infused with cocaine showed stimulation thresholds that were not significantly different from saline-treated animals continuously infused with cocaine. A cocaine challenge injection (10 mg/kg, i.p.) administered 3 and again at 10 days following minipump removal revealed that saline-treated animals continuously infused with saline showed lowered BSR thresholds. Saline-treated animals continuously infused with cocaine displayed lowered BSR thresholds that were not significantly different from saline-infused animals. L-NAME treated animals continuously infused with cocaine showed higher BSR thresholds to a challenge 3 days following pump removal. However, stimulation thresholds for this group failed to reach statistical significance on both days (i.e., Days 3 and 10) following pump removal. Results showed that animals continuously infused with cocaine develop robust tolerance to cocaine's threshold-lowering effect during the 14-day infusion period. Tolerance to cocaine's threshold-lowering effect was short-lived and dissipated soon after minipump removal. L-NAME treatment failed to significantly alter the development of tolerance to cocaine's threshold-lowering suggesting that NO does not have a primary role in the development of cocaine tolerance. PMID:24768900

Pudiak, Cindy M; KuoLee, Rhonda; Bozarth, Michael A

2014-07-01

387

Teaching Tolerance Magazine  

NSDL National Science Digital Library

The Teaching Tolerance magazine, which is put out by the Southern Poverty Law Center to accompany its free Teaching Tolerance educational program, is available online via the website dedicated to the Teaching Tolerance program. The magazine is loaded with wonderful information and creative ways to teach tolerance. Visitors can view the magazine's archives and read the articles online for free. If the thoughtful content and depth with which the Southern Poverty Law Center supports their Teaching Tolerance program isn't enough to convince visitors that it's a superb program, check out this quote from their "About Us" section: "Scientific surveys demonstrate that our programs help students learn respect for differences and bolster teacher practice."

388

Tapentadol extended-release for treatment of chronic pain: a review  

PubMed Central

Tapentadol is a centrally acting analgesic with a dual mechanism of action of mu receptor agonism and norepinephrine reuptake inhibition. Tapentadol immediate-release is approved by the US Food and Drug Administration for the management of moderate-to-severe acute pain. It was developed to decrease the intolerability issue associated with opioids. Tapentadol extended-release has a 12-hour duration of effect, and has recently been evaluated for pain in patients with chronic osteoarthritis, low back pain, and pain associated with diabetic peripheral neuropathy. Tapentadol extended-release was found to provide safe and highly effective analgesia for the treatment of chronic pain conditions, including moderate-to-severe chronic osteoarthritis pain and low back pain. Initial trials demonstrating efficacy in neuropathic pain suggest that tapentadol has comparable analgesic effectiveness and better gastrointestinal tolerability than opioid comparators, and demonstrates effectiveness in settings of inflammatory, somatic, and neuropathic pain. Gastrointestinal intolerance and central nervous system effects were the major adverse events noted. Tapentadol will need to be rigorously tested in chronic neuropathic pain, cancer-related pain, and cancer-related neuropathic pain. PMID:21887118

Vadivelu, Nalini; Timchenko, Alexander; Huang, Yili; Sinatra, Raymond

2011-01-01

389

Are Phytochelatins Involved in Differential Metal Tolerance or Do They Merely Reflect Metal-Imposed Strain?  

PubMed Central

Plants from nontolerant and copper-tolerant populations of Silene vulgaris both produce phytochelatins upon exposure to copper. The threshold copper concentration for induction of phytochelatin and the copper concentration at which maximum phytochelatin contents occurs increase proportionally with the level of tolerance to copper. When exposed to their own highest no-effect concentration or 50%-effect concentration of copper for root growth, tolerant and nontolerant plants exhibit equal phytochelatin contents in the root apex, which is the primary copper target. This also holds for distinctly tolerant nonsegregating F3 families, derived from a single cross of a nontolerant plant to a tolerant one. Therefore, the phytochelatin content of the root apex can be used as a quantitative tolerance-independent measure of the degree of toxicity experienced by the plant. Differential copper tolerance in S. vulgaris does not appear to rely on differential phytochelatin production. PMID:16669061

Schat, Henk; Kalff, Mechteld M. A.

1992-01-01

390

[Multimodal pain therapy].  

PubMed

Chronic pain has both high prevalence and a significant economic impact in Germany. The most common chronic pain types are low back pain and headache. On the one hand, the management of chronic pain patients is incomplete, yet it is often overtreated in orthopaedic surgical settings with interventional procedures. The reason for this is the structure of outpatient management and the way it is paid for in Germany. Pain management of patients with private insurance cover is no better because of "doctor shopping". Medical guidelines could be of some help in improving the situation, but they are widely unknown, and have still to demonstrate whether they have any impact on GP treatment pathways. The "gold standard" multimodal pain therapy shows significant improvement in many studies compared to monomodal therapy regimes and interventional regimes, but is too rarely recommended by the patients' physicians, whether GPs or specialists. Because of the huge number of institutions nowadays that, for the sake of form, offer such multimodal therapies, these need to be differentiated in terms of their structural and process quality. A first step is the "k edoq" project. It is essential to improve knowledge of the principles of modern pain management. This includes better networking and communication between doctors, physiotherapists and psychologists, and at the grassroots level, providing the public with more detailed and better information. PMID:25000627

Böger, A

2014-06-01

391

Low back pain.  

PubMed Central

Low back pain is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations. Few cases of back pain are due to specific causes; most cases are non-specific. Acute back pain is the most common presentation and is usually self-limiting, lasting less than three months regardless of treatment. Chronic back pain is a more difficult problem, which often has strong psychological overlay: work dissatisfaction, boredom, and a generous compensation system contribute to it. Among the diagnoses offered for chronic pain is fibromyalgia, an urban condition (the diagnosis is not made in rural settings) that does not differ materially from other instances of widespread chronic pain. Although disc protrusions detected on X-ray are often blamed, they rarely are responsible for the pain, and surgery is seldom successful at alleviating it. No single treatment is superior to others; patients prefer manipulative therapy, but studies have not demonstrated that it has any superiority over others. A WHO Advisory Panel has defined common outcome measures to be used to judge the efficacy of treatments for studies. PMID:14710509

Ehrlich, George E.

2003-01-01

392

[Congenital insensitivity to pain].  

PubMed

Congenital insensitivity to pain (CIP) is a rare syndrome with various clinical expressions, characterized by a dramatic impairment of pain perception since birth. In the 1980s, progress in nerve histopathology allowed to demonstrate that CIP was almost always a manifestation of hereditary sensory and autonomic neuropathies (HSAN) involving the small-calibre (A-delta and C) nerve fibres which normally transmit nociceptive inputs along sensory nerves. Identification of the genetic basis of several clinical subtypes has led to a better understanding of the mechanisms involved, emphasizing in particular the crucial role of nerve growth factor (NGF) in the development and survival of nociceptors. Recently, mutations of the gene coding for the sodium channel Nav1.7--a voltage-dependent sodium channel expressed preferentially on peripheral nociceptors and sympathetic ganglia--have been found to be the cause of CIP in patients showing a normal nerve biopsy. This radical impairment of nociception mirrors the hereditary pain syndromes associated with "gain of function" mutations of the same ion channel, such as familial erythromelalgia and paroxysmal extreme pain disorder. Future research with CIP patients may identify other proteins specifically involved in nociception, which might represent potential targets for chronic pain treatment. Moreover, this rare clinical syndrome offers the opportunity to address interesting neuropsychological issues, such as the role of pain experience in the construction of body image and in the empathic representation of others' pain. PMID:18808773

Danziger, N; Willer, J-C

2009-02-01

393

Pain Perception Is Increased in Congenital but Not Late Onset Blindness  

PubMed Central

There is now ample evidence that blind individuals outperform sighted individuals in various tasks involving the non-visual senses. In line with these results, we recently showed that visual deprivation from birth leads to an increased sensitivity to pain. As many studies have shown that congenitally and late blind individuals show differences in their degree of compensatory plasticity, we here address the question whether late blind individuals also show hypersensitivity to nociceptive stimulation. We therefore compared pain thresholds and responses to supra-threshold nociceptive stimuli in congenitally blind, late blind and normally sighted volunteers. Participants also filled in questionnaires measuring attention and anxiety towards pain in everyday life. Results show that late blind participants have pain thresholds and ratings of supra-threshold heat nociceptive stimuli similar to the normally sighted, whereas congenitally blind participants are hypersensitive to nociceptive thermal stimuli. Furthermore, results of the pain questionnaires did not allow to discriminate late blind from normal sighted participants, whereas congenitally blind individuals had a different pattern of responses. Taken together, these results suggest that enhanced sensitivity to pain following visual deprivation is likely due to neuroplastic changes related to the early loss of vision. PMID:25244529

Slimani, Hocine; Danti, Sabrina; Ptito, Maurice; Kupers, Ron

2014-01-01

394

Pregabalin: in the treatment of painful diabetic peripheral neuropathy.  

PubMed

Pregabalin, the pharmacologically active S-enantiomer of 3-aminomethyl-5-methyl-hexanoic acid, has a similar pharmacological profile to that of its developmental predecessor gabapentin, but showed greater analgesic activity in rodent models of neuropathic pain. The exact mechanism of action of pregabalin is unclear, although it may reduce excitatory neurotransmitter release by binding to the alpha2-delta protein subunit of voltage-gated calcium channels. Oral pregabalin at fixed dosages of 300 and 600 mg/day, administered three times daily, was superior to placebo in relieving pain and improving pain-related sleep interference in three randomised, double-blind, multicentre studies of 5-8 weeks' duration in a total of 724 evaluable patients with painful diabetic peripheral neuropathy (DPN). Significant reductions in weekly mean pain scores (primary endpoint) and sleep interference scores were observed at 1 week and sustained thereafter. A significant reduction in pain was apparent on the first day of treatment with pregabalin 300 mg/day. Twice daily fixed (600 mg/day) or flexible (150-600 mg/day) pregabalin was also effective in reducing pain and sleep interference in two 12-week placebo-controlled trials in a total of 733 randomised DPN patients. Pregabalin was well tolerated in DPN patients; mild-to-moderate dizziness, somnolence and peripheral oedema were the most common adverse events. PMID:15563250

Frampton, James E; Scott, Lesley J

2004-01-01

395

Opioid receptor-triggered spinal mTORC1 activation contributes to morphine tolerance and hyperalgesia  

PubMed Central

The development of opioid-induced analgesic tolerance and hyperalgesia is a clinical challenge for managing chronic pain. Adaptive changes in protein translation in the nervous system are thought to promote opioid tolerance and hyperalgesia; however, how opioids drive such changes remains elusive. Here, we report that mammalian target of rapamycin (mTOR), which governs most protein translation, was activated in rat spinal dorsal horn neurons after repeated intrathecal morphine injections. Activation was triggered through ? opioid receptor and mediated by intracellular PI3K/Akt. Spinal mTOR inhibition blocked both induction and maintenance of morphine tolerance and hyperalgesia, without affecting basal pain perception or locomotor functions. These effects were attributed to the attenuation of morphine-induced increases in translation initiation activity, nascent protein synthesis, and expression of some known key tolerance-associated proteins, including neuronal NOS (nNOS), in dorsal horn. Moreover, elevating spinal mTOR activity by knocking down the mTOR-negative regulator TSC2 reduced morphine analgesia, produced pain hypersensitivity, and increased spinal nNOS expression. Our findings implicate the ? opioid receptor–triggered PI3K/Akt/mTOR pathway in promoting morphine-induced spinal protein translation changes and associated morphine tolerance and hyperalgesia. These data suggest that mTOR inhibitors could be explored for prevention and/or reduction of opioid tolerance in chronic pain management. PMID:24382350

Xu, Ji-Tian; Zhao, Jian-Yuan; Zhao, Xiuli; Ligons, Davinna; Tiwari, Vinod; Atianjoh, Fidelis E.; Lee, Chun-Yi; Liang, Lingli; Zang, Weidong; Njoku, Dolores; Raja, Srinivasa N.; Yaster, Myron; Tao, Yuan-Xiang

2014-01-01

396

Single dose oral lumiracoxib for postoperative pain  

PubMed Central

Background Lumiracoxib is a novel selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 inhibitors have been developed to avoid COX-1 related gastrointestinal (GI) problems. Lumiracoxib has analgesic and anti-inflammatory activity comparable with traditional non-steriodal anti-inflammatory drugs (tNSAIDs) in the management of post-operative pain, but with the advantage of better GI tolerability. Objectives To review the analgesic efficacy, duration of analgesia, and adverse effects of a single oral dose of lumiracoxib for moderate to severe postoperative pain in adults and compare it with established analgesics. Search strategy We searched CENTRAL (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to March 2007), EMBASE (1974 to 2006), and PubMed (February 2007). Selection criteria Single oral dose, randomised placebo controlled trials of lumiracoxib, in acute postoperative pain, in adult patients. Data collection and analysis Trials were quality scored and data extracted by two review authors independently. Summed pain relief (TOTPAR) was extracted and converted into dichotomous information yielding the number of patients with at least 50% pain relief. These derived results were used to calculate the relative benefit (RB) and number-needed-to-treat (NNT) for one patient to achieve at least 50% pain relief. Main results Three studies (737 patients) met the inclusion criteria. In total 211 patients were treated with lumiracoxib 400 mg, 51 with lumiracoxib 100 mg, and 161 with placebo. Active comparators were naproxen 500 mg (60 patients), rofecoxib 50 mg (102), celecoxib 200 mg (101), and ibuprofen 400 mg (51). One hundred patients (48%) given lumiracoxib 400 mg had at least 50% pain relief over six hours, compared with 17 (11%) given placebo; RB 4.8 (95% CI 2.9 to 7.9), NNT 2.7 (2.2 to 3.5). Weighted median time to use of rescue medication was 7.4 hours for lumiracoxib 400 mg and 1.8 hours for placebo. Patient global assessment at study endpoint was rated as “excellent” by 71 patients (34%) given lumiracoxib 400 mg and 5 (3%) given placebo. Median time to onset of analgesia was shorter for lumiracoxib 400 mg (0.6 to 1.5 hours) than placebo (>12 hours), and use of rescue medication within 12 hours occurred in 64 patients (58%) given lumiracoxib 400 mg and 100 (91%) given placebo. Adverse events reported were generally mild to moderate in severity, with one serious adverse event reported in a patient given placebo. Authors’ conclusions Lumiracoxib 400 mg given as a single oral dose, is an effective analgesic for acute postoperative pain. PMID:17943921

Roy, Yvonne M; Derry, Sheena; Moore, R Andrew

2014-01-01

397

The respiratory cycle modulates brain potentials, sympathetic activity, and subjective pain sensation induced by noxious stimulation.  

PubMed

To test the hypothesis that a respiratory cycle influences pain processing, we conducted an experimental pain study in 10 healthy volunteers. Intraepidermal electrical stimulation (IES) with a concentric bipolar needle electrode was applied to the hand dorsum at pain perceptual threshold or four times the perceptual threshold to produce first pain during expiration or inspiration either of which was determined by the abrupt change in an exhaled CO2 level. IES-evoked potentials (IESEPs), sympathetic skin response (SSR), digital plethysmogram (DPG), and subjective pain intensity rating scale were simultaneously recorded. With either stimulus intensity, IES during expiration produced weaker pain feeling compared to IES during inspiration. The mean amplitude of N200/P400 in IESEPs and that of SSR were smaller when IES was applied during expiration. The magnitude of DPG wave gradually decreased after IES, but a decrease in the magnitude of DPG wave was less evident when IES was delivered during expiration. Regardless of stimulus timing or stimulus intensity, pain perception was always concomitant with appearance of IESEPs and SSR, and changes in DPG. Our findings suggest that pain processing fluctuates during normal breathing and that pain is gated within the central nervous system during expiration. PMID:24667456

Iwabe, Tatsuya; Ozaki, Isamu; Hashizume, Akira

2014-07-01

398

Neural networks with dynamical thresholds  

NASA Astrophysics Data System (ADS)

We incorporate local threshold functions into the dynamics of the Hopfield model. These functions depend on the history of the individual spin (= neuron). They reach a maximal height if the spin remains constant. The resulting one-pattern model has ferromagnetic, paramagnetic, and periodic phases. This model is solved by a master equation and approximated by simplified systems of equations that are substantiated by numerical simulations. When several patterns are included as memories in the model, it exhibits transitions-as well as oscillations-between them. The latter can be excluded by known methods. By introducing threshold functions which affect only spins which remain positive, thus mimicking fatigue of the individual neurons, one can obtain open-ended movement in pattern space. Using couplings which form pointers from one pattern to another, our system leads to self-driven temporal sequences of patterns, resembling the process of associative thinking.

Horn, D.; Usher, M.

1989-07-01

399

Scaling behavior of threshold epidemics  

NASA Astrophysics Data System (ADS)

We study the classic Susceptible-Infected-Recovered (SIR) model for the spread of an infectious disease. In this stochastic process, there are two competing mechanism: infection and recovery. Susceptible individuals may contract the disease from infected individuals, while infected ones recover from the disease at a constant rate and are never infected again. Our focus is the behavior at the epidemic threshold where the rates of the infection and recovery processes balance. In the infinite population limit, we establish analytically scaling rules for the time-dependent distribution functions that characterize the sizes of the infected and the recovered sub-populations. Using heuristic arguments, we also obtain scaling laws for the size and duration of the epidemic outbreaks as a function of the total population. We perform numerical simulations to verify the scaling predictions and discuss the consequences of these scaling laws for near-threshold epidemic outbreaks.

Ben-Naim, E.; Krapivsky, P. L.

2012-05-01

400

Immune Tolerance and Transplantation  

PubMed Central

Successful allogeneic hematopoietic stem cell transplantation (HSCT) and solid organ transplantation require development of a degree of immune tolerance against allogeneic antigens. T lymphocytes play a critical role in allograft rejection, graft failure, and graft versus host disease (GVHD). T cell tolerance occurs by two different mechanisms; i) depletion of self-reactive T cells during their maturation in the thymus (central tolerance) ii) suppression/elimination of self-reactive mature T cells in the periphery (peripheral tolerance). Induction of transplant tolerance improves transplantation outcomes. Adoptive immunotherapy with immune suppressor cells including regulatory T cells, NK-T cells, veto cells and facilitating cells are promising therapies for modulation of immune tolerance. Achieving mixed chimerism with the combination of thymic irradiation and T cell depleting antibodies, costimulatory molecule blockade with/without inhibitory signal activation and elimination of alloreactive T cells with varying methods including pre or post-transplant cyclophosphamide administration appear to be effective methods to induce transplant tolerance. PMID:23206840

Alpdogan, Onder; van den Brink, Marcel RM

2012-01-01

401

[Chronic pain and depression].  

PubMed

Chronic pain and depression are frequently associated. Links between them are numerous and well documented. It is known for example that depression is associated with a greater number and higher intensity of pain symptoms. Similarly the presence of pain complicates the diagnostic evaluation and aggravates the prognosis of depression. The question of the causality link has no clear answer. Taking care of these patients implies to acknowledge the different aspects of their suffering in a holistic bio-psycho-social model. Treatment or medication, for instance antidepressants, should be a post-scriptum to the construction of a therapeutic relationship. PMID:19626761

Rentsch, D; Piguet, V; Cedraschi, C; Desmeules, J; Luthy, C; Andreoli, A; Allaz, A F

2009-06-17

402

Pain in renal disease.  

PubMed

ABSTRACT Pain is the presenting symptom in 20 to 30% of patients with autosomal dominant polycystic kidney disease (ADPKD) and occurs in 50 to 60% of patients at some stage of the disease process, but its frequency increases with age and size of the cysts. Back pain is caused by kidney enlargement as well as rupture, hemorrhage, or infection of cysts. Other causes of pain include nephrolithiasis and urinary tract infections (UTIs). Analgesic options for patients with ADPKD include transcutaneous electrical nerve stimulation (TENS), spinal cord stimulation, low-dose opioids, and local anesthetics. PMID:25348222

Santoro, Domenico; Satta, Ersilia

2014-12-01

403

On the Pebbling Threshold Spectrum  

Microsoft Academic Search

A configuration of pebbles on the vertices of a graph is solvable if one can\\u000aplace a pebble on any given root vertex via a sequence of pebbling steps. A\\u000afunction is a pebbling threshold for a sequence of graphs if a randomly chosen\\u000aconfiguration of asymptotically more pebbles is almost surely solvable, while\\u000aone of asymptotically fewer pebbles is

Glenn Hurlbert

2001-01-01

404

Fault-tolerant quantum computing with color codes  

E-print Network

We present and analyze protocols for fault-tolerant quantum computing using color codes. We present circuit-level schemes for extracting the error syndrome of these codes fault-tolerantly. We further present an integer-program-based decoding algorithm for identifying the most likely error given the syndrome. We simulated our syndrome extraction and decoding algorithms against three physically-motivated noise models using Monte Carlo methods, and used the simulations to estimate the corresponding accuracy thresholds for fault-tolerant quantum error correction. We also used a self-avoiding walk analysis to lower-bound the accuracy threshold for two of these noise models. We present and analyze two architectures for fault-tolerantly computing with these codes: one with 2D arrays of qubits are stacked atop each other and one in a single 2D substrate. Our analysis demonstrates that color codes perform slightly better than Kitaev's surface codes when circuit details are ignored. When these details are considered, we estimate that color codes achieve a threshold of 0.082(3)%, which is higher than the threshold of $1.3 \\times 10^{-5}$ achieved by concatenated coding schemes restricted to nearest-neighbor gates in two dimensions but lower than the threshold of 0.75% to 1.1% reported for the Kitaev codes subject to the same restrictions. Finally, because the behavior of our decoder's performance for two of the noise models we consider maps onto an order-disorder phase transition in the three-body random-bond Ising model in 2D and the corresponding random-plaquette gauge model in 3D, our results also answer the Nishimori conjecture for these models in the negative: the statistical-mechanical classical spin systems associated to the 4.8.8 color codes are counterintuitively more ordered at positive temperature than at zero temperature.

Andrew J. Landahl; Jonas T. Anderson; Patrick R. Rice

2011-08-29

405

Animal Models of Cancer Pain  

PubMed Central

Modern cancer therapies have significantly increased patient survival rates in both human and veterinary medicine. Since cancer patients live longer they now face new challenges resulting from severe, chronic tumor-induced pain. Unrelieved cancer pain significantly decreases the quality of life of such patients; thus the goal of pain management is to not only to alleviate pain, but also to maintain the patient's physiological and psychological well-being. The major impediment for developing new treatments for cancer pain has been our limited knowledge of the basic mechanisms that drive cancer pain and the lack of adequate animal cancer pain models to study the molecular, biochemical and neurobiological pathways that generate and maintain cancer pain. However this situation has recently changed with the recent development of several novel animal models of cancer pain. This review will focus on describing these animal models, many of them in rodents, and reviewing some of the recent information gained from the use of these models to investigate the basic mechanims that underlie the development and maintenance of cancer pain. Animal models of cancer pain can be divided into the following five categories: bone cancer pain models, non-bone cancer pain models, cancer invasion pain models, cancer chemotherapeutic-induced peripheral neuropathy models, and spontaneous occurring cancer pain models. These models will be important not only for enhancing our knowledge of how cancer pain is generated, but more importantly for the development of novel therapeutic regimes to treat cancer pain in both domestic animals and humans. PMID:18589864

Pacharinsak, Cholawat; Beitz, Alvin

2008-01-01

406

Clinical Issues in Pain Management Clinical Issues in Pain Management  

E-print Network

different psychological profiles Chronic pain often produces depression, interferes with activities and perception of lack of control, psychological overlay Anxiety and anger also common Pain present in 2 inhibition Psychological distress may alter functioning of pain modulatory systems Chronic pain may result

Meagher, Mary

407

No Effect of a Single Session of Transcranial Direct Current Stimulation on Experimentally Induced Pain in Patients with Chronic Low Back Pain - An Exploratory Study  

PubMed Central

Transcranial direct current stimulation (tDCS) has been shown to modulate cortical excitability. A small number of studies suggested that tDCS modulates the response to experimental pain paradigms. No trials have been conducted to evaluate the response of patients already suffering from pain, to an additional experimental pain before and after tDCS. The present study investigated the effect of a single session of anodal, cathodal and sham stimulation (15 mins/1 mA) over the primary motor cortex on the perceived intensity of repeated noxious thermal and electrical stimuli and on elements of quantitative sensory testing (thermal pain and perception thresholds) applied to the right hand in 15 patients with chronic low back pain. The study was conducted in a double-blind sham-controlled and cross-over design. No significant alterations of pain ratings were found. Modalities of quantitative sensory testing remained equally unchanged. It is therefore hypothesized that a single 15 mins session of tDCS at 1 mA may not be sufficient to alter the perception of experimental pain and in patients with chronic pain. Further studies applying repetitive tDCS to patients with chronic pain are required to fully answer the question whether experimental pain perception may be influenced by tDCS over the motor cortex. PMID:23189136

Luedtke, Kerstin; May, Arne; Jurgens, Tim P.

2012-01-01

408

The “Critical volume tolerance method” for estimating the limits of dose escalation during three-dimensional conformal radiotherapy for prostate cancer  

Microsoft Academic Search

Purpose: To describe the “Critical Volume Tolerance” (CVT) method for defining normal tissue tolerance during 3D-based dose escalation studies for prostate cancer.Methods and Materials: The CVT method predicts the tolerance to radiation for “in series”-type functional units based on the assumption that tolerance depends on a critical threshold “low-volume high-dose region.” The data used for describing this model were generated

Mack Roach; Barby Pickett; Michael Weil; Lynn Verhey

1996-01-01

409

Chronic Pain Medicines  

MedlinePLUS

... acetaminophen pills a day, tell your doctor. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Other drugs that help with pain are called nonsteroidal anti-inflammatory drugs, or NSAIDs. Examples include aspirin, ibuprofen (two brand names: Motrin, ...

410

Palliative care - managing pain  

MedlinePLUS

Palliative care helps people with serious illnesses feel better. One of the problems a serious illness can cause ... Bookbinder M, McHugh ME. Symptom management in palliative care and ... Challenging pain problems. In: Walsh D, Caraceni AT, Fainsinger ...

411

Mechanism of Cancer Pain  

PubMed Central

Ongoing and breakthrough pain is a primary concern for the cancer patient. Although the etiology of cancer pain remains unclear, animal models of cancer pain have allowed investigators to unravel some of the cancer-induced neuropathologic processes that occur in the region of tumor growth and in the dorsal horn of the spinal cord. Within the cancer microenvironment, cancer and immune cells produce and secrete mediators that activate and sensitize primary afferent nociceptors. Pursuant to these peripheral changes, nociceptive secondary neurons in spinal cord exhibit increased spontaneous activity and enhanced responsiveness to three modes of noxious stimulation: heat, cold, and mechanical stimuli. As our understanding of the peripheral and central mechanisms that underlie cancer pain improves, targeted analgesics for the cancer patient will likely follow. PMID:20539035

Schmidt, Brian L.; Hamamoto, Darryl T.; Simone, Donald A.; Wilcox, George L.

2010-01-01

412

Complex Regional Pain Syndrome  

MedlinePLUS

... injury. Your doctor may also call this condition reflex sympathetic dystrophy or causalgia. The cause of the ... specifically at dealing with chronic pain. Other Organizations Reflex Sympathetic Dystrophy Syndrome Association of America Questions to ...

413

Complex Regional Pain Syndrome  

MedlinePLUS

... sometimes identify CRPS-characteristic changes in the bone metabolism. CRPS is often associated with excess bone resorption, ... person. Drugs to treat CRPS include: non-steroidal anti-inflammatory drugs to treat moderate pain, including over-the- ...

414

Angina (Chest Pain)  

MedlinePLUS

Angina is chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort also can occur in your shoulders, ...

415

[Greater trochanteric pain syndrome].  

PubMed

Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This article summarizes essential diagnostic and therapeutic steps in greater trochanteric pain syndrome. Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90?%. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases. PMID:24414233

Gollwitzer, H; Opitz, G; Gerdesmeyer, L; Hauschild, M

2014-01-01

416

Mechanisms of Neuropathic Pain  

PubMed Central

Neuropathic pain refers to pain that originates from pathology of the nervous system. Diabetes, infection (herpes zoster),nerve compression, nerve trauma, “channelopathies,” and autoimmune disease are examples of diseases that maycause neuropathic pain. The development ofbothanimal models and newer pharmacological strategies has led to an explosion of interest in the underlying mechanisms. Neuropathic pain reflects both peripheral and central sensitization mechanisms. Abnormal signals arise not only from injured axons but also from the intact nociceptors that share the innervation territory of the injured nerve. This review focuses on how both human studies and animal models are helping to elucidate the mechanisms underlying these surprisingly common disorders. The rapid gain in knowledge about abnormal signaling promises breakthroughs in the treatment of these often debilitating disorders. PMID:17015228

Campbell, James N.; Meyer, Richard A.

2007-01-01

417

Acupuncture and Knee Pain  

MedlinePLUS Videos and Cool Tools

... right-hand corner of the player. Acupuncture and Knee Pain HealthDay October 1, 2014 Related MedlinePlus Pages Acupuncture Complementary and Alternative Medicine Knee Injuries and Disorders Transcript If you’re looking ...

418

Employees with Chronic Pain  

MedlinePLUS

Accommodation and Compliance Series: Employees with Chronic Pain By Beth Loy, Ph.D. Preface Introduction Information About Americans with Disabilities Act Accommodating Employees Resources References PDF Version DOC Version Share ...

419

Associations among pain, pain attitudes, and pain behaviors in patients with metastatic breast cancer.  

PubMed

Metastatic breast cancer (MBC) patients often experience pain which can trigger pain behaviors, such as distorted ambulation. Psychological variables, such as individuals' attitudes toward pain, play a role in pain intervention. In this study, we used the cognitive-behavioral model of pain to examine the influence of patients' attitudes toward pain (as measured by the survey of pain attitudes or SOPA) on their pain behaviors (as measured by the pain behaviors checklist). Two hundred-one MBC patients completed surveys at treatment initiation and again 3 and 6 months later. Linear Mixed Model with repeated measures analyses showed that SOPA-solicitude, SOPA-emotions, SOPA-cure, SOPA-disability, and SOPA-medication pain attitudes were consistently significantly associated with pain behaviors at each assessment time point. Additionally, the belief that a medical cure for pain exists buffered the positive association between pain severity and pain behaviors. Our findings support and extend the cognitive-behavioral model of pain and suggest that it may be useful to target pain attitudes in pain management interventions for MBC patients. PMID:23943140

Shen, Megan Johnson; Redd, William H; Winkel, Gary; Badr, Hoda

2014-08-01

420

Sodium channelopathies and pain  

Microsoft Academic Search

Chronic pain often represents a severe, debilitating condition. Up to 10% of the worldwide population are affected, and many\\u000a patients are poorly responsive to current treatment strategies. Nociceptors detect noxious conditions to produce the sensation\\u000a of pain, and this signal is conveyed to the CNS by means of action potentials. The fast upstroke of action potentials is mediated\\u000a by voltage-gated

Angelika Lampert; Andrias O. O’Reilly; Peter Reeh; Andreas Leffler

2010-01-01

421

Complex regional pain syndrome  

Microsoft Academic Search

Opinion statement  Complex regional pain syndrome (CRPS) is a heterogeneous disorder that falls in the spectrum of neuropathic pain disorders.\\u000a It is maintained by abnormalities throughout the neuraxis (the peripheral, autonomic, and central nervous systems). The pathophysiology\\u000a of CRPS is not fully known. There are no scientifically well-established treatments. The diagnostic criteria for CRPS at this\\u000a time are purely clinical, and

Ok Yung Chung; Stephen P. Bruehl

2003-01-01

422

Imaging of painful scoliosis  

Microsoft Academic Search

Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component\\u000a and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful.\\u000a In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since\\u000a idiopathic

Alun Davies; Asif Saifuddin

2009-01-01

423

Chronic pain in elderly people  

Microsoft Academic Search

Chronic pain in elderly people has only recently begun to receive serious empirical consideration. There is compelling evidence that a significant majority of the elderly experience pain which may interfere with normal functioning. Nonetheless, a significant proportion of these individuals do not receive adequate pain management. Three significant factors which may contribute to this are (1) lack of proper pain

Lucy Gagliese; Ronald Melzack

1997-01-01

424

Psychological disorder and pain description  

Microsoft Academic Search

Examined descriptions of pain by 233 patients (mean age 45 yrs) with chronic low back pain and compared them with measures of psychological disturbance. Factor analysis of responses on a pain experience questionnaire revealed dimensions of pain expression representing sensory, affective, and evaluative components. There was evidence that certain Minnesota Multiphasic Personality Inventory (MMPI) scales reflecting psychological disorder were more

Charles McCreary; Judith Turner

1983-01-01

425

Flooding tolerance in halophytes.  

PubMed

Flooding is a common environmental variable with salinity. Submerged organs can suffer from O(2) deprivation and the resulting energy deficits can compromise ion transport processes essential for salinity tolerance. Tolerance of soil waterlogging in halophytes, as in glycophytes, is often associated with the production of adventitious roots containing aerenchyma, and the resultant internal O(2) supply. For some species, shallow rooting in aerobic upper soil layers appears to be the key to survival on frequently flooded soils, although little is known of the anoxia tolerance in halophytes. Halophytic species that inhabit waterlogged substrates are able to regulate their shoot ion concentrations in spite of the hypoxic (or anoxic) medium in which they are rooted, this being in stark contrast with most other plants which suffer when salinity and waterlogging occur in combination. Very few studies have addressed the consequences of submergence of the shoots by saline water; these have, however, demonstrated tolerance of temporary submergence in some halophytes. PMID:18482227

Colmer, Timothy D; Flowers, Timothy J

2008-01-01

426

Composites Damage Tolerance Workshop  

NASA Technical Reports Server (NTRS)

The Composite Damage Tolerance Workshop included participants from NASA, academia, and private industry. The objectives of the workshop were to begin dialogue in order to establish a working group within the Agency, create awareness of damage tolerance requirements for Constellation, and discuss potential composite hardware for the Crew Launch Vehicle (CLV) Upper Stage (US) and Crew Module. It was proposed that a composites damage tolerance working group be created that acts within the framework of the existing NASA Fracture Control Methodology Panel. The working group charter would be to identify damage tolerance gaps and obstacles for implementation of composite structures into manned space flight systems and to develop strategies and recommendations to overcome these obstacles.

Gregg, Wayne

2006-01-01

427

Radiation Tolerant Antifuse FPGA  

NASA Technical Reports Server (NTRS)

The total dose performance of the antifuse FPGA for space applications is summarized. Optimization of the radiation tolerance in the fabless model is the main theme. Mechanisms to explain the variation in different products are discussed.

Wang, Jih-Jong; Cronquist, Brian; McCollum, John; Parker, Wanida; Katz, Rich; Kleyner, Igor; Day, John H. (Technical Monitor)

2002-01-01

428

Pain characteristic differences between subacute and chronic back pain  

PubMed Central

Back pain is commonly classified based on duration. There is currently limited information regarding differences in the clinical features of back pain between these duration-based groupings. Here, we compared the pain characteristics of patients with subacute (SBP; pain 6–16 weeks, n = 40) and chronic back pain (CBP; pain ? 1year, n = 37) recruited from the general population. CBP patients reported significantly higher pain intensity on the Visual Analogue Scale (VAS) compared to SBP patients. Based on this finding, we investigated group differences and their dependence on VAS for the Beck Depression Inventory (BDI), sensory and affective dimensions of the McGill Pain Questionnaire (MPQ-S and MPQ-A), Neuropathic Pain Scale (NPS) and the variability of spontaneous pain. Correction for VAS abolished significant group differences on the MPQ-S, MPQ-A and NPS. Only a significant difference in the variability of spontaneous pain was independent of VAS. Finally, whereas SBP patients displayed a higher incidence of unilateral pain radiating down the legs/buttocks, there was a shift towards more bilateral pain in CBP patients. In summary, SBP and CBP groups differ on three independent parameters: VAS ratings, pain location and temporal dynamics of spontaneous pain. PMID:21497139

Chanda, Mona Lisa; Alvin, Matthew D.; Schnitzer, Thomas J; Apkarian, A. Vania

2011-01-01

429

Reduced lasing threshold from organic dye microcavities  

E-print Network

We demonstrate an unexpected tenfold reduction in the lasing threshold of an organic vertical microcavity under subpicosecond optical excitation. In contrast to conventional theory of lasing, we find that the lasing threshold ...

Akselrod, G. M.

430

Starshade Shape Tolerances and Mechanical Deployment  

NASA Astrophysics Data System (ADS)

Starshade Shape Tolerances and Mechanical Deployment Dean Dailey, Tiffany Glassman, NWO Study Team The primary purpose of the New Worlds Observer (NWO) Starshade is to suppress the light from a star to 10-10 without blocking the light from planets in the habitable zone of that star. In order to successfully deploy a properly functioning Starshade 10s of meters in diameter, we must know precisely how much the shape of the Starshade is allowed to deviate from the theoretical profile without causing its performance to fall below the established threshold. We use a simulation of the optical performance of the Starshade to establish the tolerance of the Starshade to various shape deformations. These Starshade shape tolerance terms are combined into a budget set of the maximum level of tolerable deformations. These budgets become the deployed dimensional stability requirements for structural engineering to use in accessing competing deployment concepts. The effects that we consider to determine if a deployment scheme will meet the shape tolerance requirements include: 1. Mechanical piece-part manufacturing error 2. Mechanical assembly errors 3. 1 G assembly shape verification error 4. Launch Shift 5. Deployment repeatability errors 6. Thermal distortion errors 7. On-orbit dynamics - jitter 8. CME errors (coefficient of moisture expansion) 9. Contamination errors Deployed dimensional stability performance margins can then be determined for each deployment concept over each shape distortion effect and a suitable deployment concept can be selected. Each of these effects are described along with the sensitivity analysis to their contribution to the overall performance.

Dailey, Dean; Glassman, T.; NWO Study Team

2009-01-01

431

Cannabinoid Tolerance and Dependence  

Microsoft Academic Search

The use of marijuana for recreational and medicinal purposes has resulted in a large prevalence of chronic marijuana users.\\u000a Consequences of chronic cannabinoid administration include profound behavioral tolerance and withdrawal symptoms upon drug\\u000a cessation. A marijuana withdrawal syndrome is only recently gaining acceptance as being clinically significant. Similarly,\\u000a laboratory animals exhibit both tolerance and dependence following chronic administration of cannabinoids.

A. H. Lichtman; B. R. Martin

432

The Fibonacci scheme for fault-tolerant quantum computation  

E-print Network

We rigorously analyze Knill's Fibonacci scheme for fault-tolerant quantum computation, which is based on the recursive preparation of Bell states protected by a concatenated error-detecting code. We prove lower bounds on the threshold fault rate of .67\\times 10^{-3} for adversarial local stochastic noise, and 1.25\\times 10^{-3} for independent depolarizing noise. In contrast to other schemes with comparable proved accuracy thresholds, the Fibonacci scheme has a significantly reduced overhead cost because it uses postselection far more sparingly.

Panos Aliferis; John Preskill