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PAIN Reports
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2471-2531
Published by LWW Wolters Kluwer Homepage  [311 journals]
  • Delayed onset of severe chronic pain in CASPR2 autoantibody–associated
           Morvan syndrome in a former UK swine abattoir worker

    • Authors: Goebel; Andreas; Moore, Austen Peter; Jacob, Anu
      Abstract: imageIntroduction: Autoantibody-mediated autoimmunity directed against targets within the voltage-gated potassium channel complex (VGKCC autoantibodies) has been implicated in causing neuropathic pain.Methods: We report the case of a 76-year-old, United Kingdom male who was diagnosed with contactin-associated protein 2 (CASPR2) autoantibody–associated Morvan syndrome, a rare neurological condition.Results: He had previously worked in a swine abattoir; exposure to aerosol within swine abattoirs has been reported to elicit an immune response resulting in the production of these autoantibodies; however, unusually, his manifestations emerged with several years' latency. Although this patient's Morvan syndrome–associated seizures were well-controlled with antiepileptic drugs, his neuropathic pain and painful muscle fasciculations did not respond to pharmacological interventions. He refused pain management program treatment, but high-dose immunoglobulin treatment or treatment with rituximab, reported to be sometimes effective in this group, was not initiated because of concerns regarding his general frailty.Discussion and Conclusion: This case highlights issues around the identification and treatment of rare patients with chronic pain who have voltage-gated potassium channel complex autoantibodies; it also emphasizes the possibility that former swine abattoir workers might be at risk of developing neuropathic pain even years after their vocational exposure.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • On the feasibility of accessing acute pain–related facial expressions in
           the human fetus and its potential implications: a case report

    • Authors: Bernardes; Lisandra Stein; Ottolia, Juliana Fontan; Cecchini, Marina; Filho, Antônio Gomes de Amorim; Teixeira, Manoel Jacobsen; Francisco, Rossana Pulcineli Vieira; de Andrade, Daniel Ciampi; Grupo de Estudo da Dor Fetal (Fetal Pain Study Group
      Abstract: imageIntroduction: Although pain facial assessment is routinely performed in term and preterm newborns by the use of facial expression–based tools such as the Neonatal Facial Coding System, the assessment of pain during the intrauterine life has not been extensively explored.Objective: Describe for the first time, an experimental model to assess and quantify responses due to acute pain in fetuses undergoing anaesthesia for intrauterine surgery recorded by high-resolution 4D ultrasound machines.Methods/results-case report: A 33-year-old pregnant woman had congenital left diaphragmatic hernia of poor prognosis diagnosed, and her fetus was treated by fetoscopic endotracheal occlusion. Later, during the removal of the fetal endotracheal balloon by ultrasound-guided puncture, we have recorded facial expressions of the foetus before and after the anaesthetic puncture by the use of 4D ultrasound recordings, which were presented to 3 blinded coders instructed to use the Neonatal Facial Coding System for acute pain facial coding. The procedure was safe and feasible.Conclusion: This is the first description of a recordable acute pain model in the human fetus by the use of a facial expression–based tool. The possibility to assess pain-related intrauterine behaviours would allow not only for the monitoring of the efficacy of anaesthetic procedures in the fetus but would also open the way to explore the evolution of pain-related facial responses during the fetal neurodevelopment. This method may pave the way for objective assessments of pain in fetuses, should it endure the steps of formal validation studies.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • Heme oxygenase-1 inducer and carbon monoxide–releasing molecule enhance
           the effects of gabapentinoids by modulating glial activation during
           neuropathic pain in mice

    • Authors: Godai; Kohei; Kanmura, Yuichi
      Abstract: imageIntroduction: Neuropathic pain is one of the most difficult-to-treat symptoms. Although gabapentinoids are classified as first-line drugs, they have only modest efficacy.Objectives: The aim of this study was to investigate whether treatment with the heme oxygenase-1 (HO-1) inducer cobalt protoporphyrin IX (CoPP) or the carbon monoxide–releasing molecule tricarbonyldichlororuthenium (II) dimer (CORM-2) can enhance the antinociceptive effects produced by gabapentinoids in mice with neuropathic pain.Methods: Neuropathic pain was induced by spared nerve injury (SNI) of the sciatic nerve. The mechanical threshold was tested using von Frey filaments. The expression of spinal HO-1, HO-2, the Ca2+ channel α2δ1 subunit, microglial markers, and M1 or M2 microglial markers was examined using reverse transcription polymerase chain reaction.Results: Treatment with CoPP or CORM-2 alleviated mechanical allodynia induced by SNI. CoPP or CORM-2 enhanced the antiallodynic effects of gabapentinoids (pregabalin or gabapentin) during SNI-induced mechanical allodynia. HO-1 inhibitor tin protoporphyrin IX (SnPP) prevented the antiallodynic effects of gabapentinoids (pregabalin or gabapentin) during SNI-induced mechanical allodynia. CoPP or CORM-2 increased HO-1 and Ca2+ channel α2δ1 subunit gene expression and the decreased gene expression of microglial markers, M1 microglial marker, or tumor necrosis factor in the ipsilateral spinal dorsal horn of mice with SNI. SnPP prevented HO-1 induction and glial inhibition, which were produced by gabapentinoids during SNI-induced mechanical allodynia.Conclusions: This study suggests that HO-1 plays crucial roles in the antiallodynic effects of gabapentinoids. Gabapentinoids attenuate the glial activation induced by SNI and some of these effects are mediated by HO-1.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • Granulocyte-macrophage colony-stimulating factor receptor expression in
           clinical pain disorder tissues and role in neuronal sensitization

    • Authors: Donatien; Philippe; Anand, Uma; Yiangou, Yiangos; Sinisi, Marco; Fox, Michael; MacQuillan, Anthony; Quick, Tom; Korchev, Yuri E.; Anand, Praveen
      Abstract: imageIntroduction: Granulocyte-macrophage colony-stimulating factor receptor (GM-CSFR) is highly expressed in peripheral macrophages and microglia, and is involved in arthritis and cancer pain in animal models. However, there is limited information on GM-CSFR expression in human central nervous system (CNS), peripheral nerves, or dorsal root ganglia (DRG), particularly in chronic pain conditions.Objectives: Immunohistochemistry was used to quantify GM-CSFR expression levels in human tissues, and functional sensory effects of GM-CSF were studied in cultured DRG neurons.Results: Granulocyte-macrophage colony-stimulating factor receptor was markedly increased in microglia at lesional sites of multiple sclerosis spinal cords (P = 0.01), which co-localised with macrophage marker CD68 (P = 0.009). In human DRG, GM-CSFR was expressed in a subset of small/medium diameter cells (30%) and few large cells (10%), with no significant change in avulsion-injured DRG. In peripheral nerves, there was a marked decrease in axonal GM-CSFR after chronic painful nerve injury (P = 0.004) and in painful neuromas (P = 0.0043); CD-68–positive macrophages were increased (P = 0.017) but did not appear to express GM-CSFR. Although control synovium showed absent GM-CSFR immunostaining, this was markedly increased in macrophages of painful osteoarthritis knee synovium. Granulocyte-macrophage colony-stimulating factor receptor was expressed in 17 ± 1.7% of small-/medium-sized cultured adult rat DRG neurons, and in 27 ± 3.3% of TRPV1-positive neurons. Granulocyte-macrophage colony-stimulating factor treatment sensitized capsaicin responses in vitro, which were diminished by p38 MAPK or TrkA inhibitors.Conclusion: Our findings support GM-CSFR as a therapeutic target for pain and hypersensitivity in clinical CNS and peripheral inflammatory conditions. Although GM-CSFR was decreased in chronic painful injured peripheral nerves, it could mediate CNS neuroinflammatory effects, which deserves study.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • Costs and consequences of chronic pain due to musculoskeletal disorders
           from a health system perspective in Chile

    • Authors: Vargas; Constanza; Bilbeny, Norberto; Balmaceda, Carlos; Rodríguez, María Francisca; Zitko, Pedro; Rojas, Rubén; Eberhard, María Eliana; Ahumada, Marisol; Espinoza, Manuel Antonio
      Abstract: imageBackground: Chronic pain is a prevalent and distressing condition caused by an unceasing pain lasting more than 3 months or a pain that persists beyond the normal healing time. There is evidence of inadequate management partly explained by the unawareness regarding the magnitude of the problem.Objectives: To estimate the annual expected costs and consequences of chronic pain caused by musculoskeletal diseases from the health system perspective in Chile.Methods: A Markov cohort model was built to represent chronic pain and estimate expected costs and consequences over 1-year time horizon. Transition probabilities were obtained through expert elicitation. Consequences examined were: years lost to disability (YLD), depression, anxiety, and productivity losses. Direct health care costs were estimated using local sources. Probabilistic sensitivity analysis was performed to characterize second-order uncertainty.Results: The annual expected cost due to musculoskeletal chronic pain was estimated in USD $1387.2 million, equivalent to 0.417% of the national GDP. Lower back pain and osteoarthritis of the knee explained the larger proportion of the total cost, 31.8% and 27.1%, respectively. Depression attributed to chronic pain is another important consequence accounting for USD $94 million (Bayesian credibility interval 95% $49.1–$156.26). Productivity losses were also important cost, although early retirement and presenteeism were not measured. Chronic pain causes 137,037 YLDs.Conclusion: Chronic pain is not only an important cause of disability but also responsible for high social and financial burden in Chile. Public health programs focused on managing chronic pain may decrease burden of disease and possibly reduce costs.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • The utility and validity of pain intensity rating scales for use in
           developing countries

    • Authors: Pathak; Anupa; Sharma, Saurab; Jensen, Mark P.
      Abstract: imageIntroduction: Pain intensity is the domain most often assessed in pain research. Although the Numerical Rating Scale is recommended for use in western countries, the utility and validity of this scale, relative to others, has not been established in non–western developing countries, such as Nepal.Objectives: Here, we sought to (1) identify which of 4 commonly used pain scales is most preferred by Nepalese, (2) compare error rates, (3) determine whether preference and error rates are influenced by age or education level, and (4) evaluate construct validity of each scale using factor analysis.Methods: Two hundred two adults with musculoskeletal pain from Nepal rated their worst and average pain intensity using all 4 scales and selected their most preferred scale.Results: The results indicate that the Faces Pain Scale-Revised is the most preferred scale, followed by a Verbal Rating Scale. The Numerical Rating Scale and Visual Analogue Scale were both least preferred and had higher rates of incorrect responses, especially among the older participants. However, all the scales demonstrated adequate construct validity as measures of pain intensity among those participants who could accurately use all 4 scales.Conclusion: The findings indicate that the Faces Pain Scale-Revised should be the first choice for assessing pain intensity in Nepalese adults. Research is needed to determine whether these findings replicate in other non–western and developing countries, to identify the pain intensity measure that would be the best choice for use in cross-cultural pain research.
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • Ketamine for pain management

    • Authors: Bell; Rae Frances; Kalso, Eija Anneli
      Abstract: imageNo abstract available
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
  • Continuing education in pain management: using a competency framework to
           guide professional development

    • Authors: Devonshire; Elizabeth; Nicholas, Michael K.
      Abstract: imageNo abstract available
      PubDate: Sat, 01 Sep 2018 00:00:00 GMT-
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Heriot-Watt University
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