The literature contains numerous studies on the diagnosis, pathogenesis, atypical locations, and clinical (hormonal) and surgical management of the disorder. However, no information is available on the management of endometriosis involving pain refractory to the usual treatment from the perspective of a pain unit. Our hospital has a pain ...

ABSTRACT Acetaminophen injection is an antipyretic and analgesic agent recently marketed in the United States as Ofirmev. A recent review published in the Journal of Pain & Palliative Care Pharmacotherapy focused on the labeled uses of acetaminophen injection in the United States. A variety of studies were excluded that may ...

Surgical castration is a common management practice performed on male pigs to prevent the occurrence of boar taint. Surgical castration is known to cause physiological and behavioral changes in pigs indicative of pain-induced distress; however, it is commonly performed without pain relief. The objective of this study was to evaluate ...

A 93-year-old woman was seen in the emergency department because of a 3-hour history of chest pain and shortness of breath. An electrocardiogram showed ST-segment elevations. A diagnostic procedure was performed.

Clinical theory suggests that altered alignment of the shoulder girdle has the potential to create or sustain symptomatic mechanical dysfunction in the cervical and thoracic spine. The alignment of the shoulder girdle is described by two clavicle rotations, i.e, elevation and retraction, and by three scapular rotations, i.e., upward rotation, ...

Subcutaneous (SC) rehydration therapy (SCRT), originally referred to as "hypodermoclysis," shows promise as an alternative to intravenous (IV) fluid administration for treatment of dehydration. A simple, safe, and effective technique, SCRT is indicated for treatment of mild-to-moderate dehydration. Augmentation of SCRT with administration of a recombinant human formulation of the ...

Prior research has found that sex differences in pain are partially due to individual variations in gender roles. In a laboratory study, we tested the hypothesis that the presence of covert gender role cues can also moderate the extent to which women and men experience pain. Specifically, we varied gender ...

As our knowledge of the mechanisms underlying the sensation of pain continues to expand, researchers are constantly searching for novel therapeutic targets. One such novel pain pathway involves thrombin and its associated protease-activated receptor (PAR). Besides its traditional role in haemostasis, thrombin has multiple roles in both the central and ...

Pain management in conditions of chronic inflammation is a clinical challenge, and increasing our understanding of the mechanisms driving this type of pain is important. In the previous issue of Arthritis Research & Therapy, Boettger and colleagues examine the role of IL-6 in antigen-induced arthritis using the IL-6 neutralizing soluble ...

We investigated the roles of β- and α(2)-adrenoceptors within the central nucleus of the amygdala (CeA) in the negative affective and sensory components of visceral pain in rats. We observed a dose-dependent reduction of intraperitoneal acetic acid-induced conditioned place aversion by bilateral injections of timolol, a β-adrenoceptor antagonist, or clonidine, ...

Conservative treatment still has an important role to play, despite the increasing possibilities of surgical treatment. Treatment starts at the site of trauma. Transportation and immobilisation in braces are discussed. Skeletal skull traction can be used for realignment and reduction, and eventually used in halo-vest treatment. The advantages and disadvantages ...

Integration of surgery and systemic therapies represents the best management option for most patients with metastatic renal cell carcinoma. Cytoreductive nephrectomy, metastasectomy, and consolidative surgery can all play a vital role in this challenging patient population. Relevant issues in this era relate to the timing of surgery, the role of ...

OBJECTIVE: To examine the pharmacist's role in managing toothache pain from the patient's perspective. DESIGN: Cross-sectional study. SETTING: Maryland during April and May 2006. PARTICIPANTS: 5,556 low-income white, black, and Hispanic households were screened to identify 398 households with at least one adult who had experienced a toothache during the ...

The role of surgery in the management of dysphagia is clear in some areas and controversial in others. Evaluation for the causes of dysphagia can elucidate conditions in which surgery can improve safety, quality of life, or both. Surgical therapy, when indicated, is safe and effective for many causes of ...

The endocannabinoid system and cannabinoid-based treatments have been involved in a wide number of diseases. In particular, several studies suggest that cannabinoids and endocannabinoids may have a key role in the pathogenesis and therapy of multiple sclerosis (MS). In this study we highlight the main findings reported in literature about ...

BACKGROUND: The potential role of valve surgery in infective endocarditis (IE) management is controversial. No randomized trials have been conducted to date; accordingly, some studies use propensity score analysis (PSA) to minimize selection bias in observational studies. METHODS: A systematic review of the literature addressing the role of valve surgery ...

Inflammatory conditions can lead to persistent debilitating pain, and the activation of N-methyl-D-aspartate receptors (NMDARs) has been shown to play an important role in the processing of inflammatory pain. Postsynaptic density protein-95 (PSD-95), a scaffolding protein, has been identified to interact with NMDARs at neuronal synapses of the central nervous ...

The role of the weather as a trigger of sickle cell acute painful episodes has long been debated. To more accurately describe the role of the weather as a trigger of painful events, we conducted a case-crossover study of the association between local weather conditions and the occurrence of painful ...

Microglia and/or astrocytes play a significant role in the creation and maintenance of exaggerated pain states with inflammatory and/or neuropathic etiologies. The chemokine, fractalkine, has several functions, including the newly recognized role of mediating neuropathic pain conditions. Although constitutively expressed and released during inflammation, increased release of fractalkine binds to ...

Recent insights have demonstrated a central role for dopaminergic neurotransmission in modulating pain perception and natural analgesia within supraspinal regions, including the basal ganglia, insula, anterior cingulate cortex, thalamus and periaqueductal gray. In addition, while the participation of serotonin and norepinephrine in spinal descending inhibition of pain is well known, ...

The voltage-gated sodium-channel type IX alpha subunit, known as Na(v)1.7 and encoded by the gene SCN9A, is located in peripheral neurons and plays an important role in action potential production in these cells. Recent genetic studies have identified Na(v)1.7 dysfunction in three different human pain disorders. Gain-of-function missense mutations in ...

Surgery remains the treatment of choice for mycetoma of the paranasal sinuses. Itraconazole has a useful role in reducing both the amount of surgery required and the amount of peri-operative bleeding in allergic aspergillosis, and continuing its use post-operatively for six weeks appears to reduce the recurrence rate (although a ...

This paper is about the use of an unconventional intervention for treatment-resistant OCD that we describe as 'Therapist Assumes Responsibility' (TAR). The use of TAR in this paper as a clinical treatment parallels an experimental analysis by Lopatka and Rachman (1995). Two case studies are used to illustrate TAR and ...

The EORTC QLQ-C30 health-related quality of life (HRQoL) questionnaire was developed for use in clinical cancer trials. It has also been applied in studies of patients with chronic nonmalignant pain in spite of nondocumented validity. Validation of the EORTC QLQ-C30 in this patient population and comparison with the traditional first ...

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) continue to play an increasing role in the management of peritoneal surface malignancies of gastrointestinal origin. The prognosis of patients and the responses to cytoreductive surgery and HIPEC depend on the histology, the degree of malignant transformation, the adequacy of the cytoreductive surgery, ...

Extensive experimental data have revealed a central role for oxidative stress in atherogenesis and suggested a potential role for 'antioxidant' treatment in cardiovascular disease (CVD) [1-11]. Experimental data, however, have not translated into clinical benefit: most antioxidant vitamin trials have failed to reduce cardiovascular morbidity and mortality [12]. Moreover, recent ...

Pain is an experience including physiological and psychological factors. We assume that emotions may be elicited and increased through self-perceived role identity and that change of role identity alters quality and intensity of pain perception. We used role-play strategies to assess whether pain can be better tolerated whenever, in an ...

Ureteropelvic junction obstruction (UPJO) is a well-known pathologic condition with several potential associated urologic complications. The treatment for UPJO has evolved dramatically during the past two decades with the advent of minimally invasive treatment options. This has resulted in shorter hospital stays, reduced postoperative pain, and quicker convalescence compared with ...

Minimally invasive surgery is now an option to patients as light as 1.2 kg, extending the benefits of small incisions, faster recoveries, decreased pain, and more precise procedures in critically ill neonates. This article provides a review of the historical development of minimally invasive surgery and an overview of the ...

Long-term potentiation (LTP) at synapses of nociceptive nerve fibres is a proposed cellular mechanism underlying some forms of hyperalgesia. In this review fundamental properties of LTP in nociceptive pathways are described. The following topics are specifically addressed: A concise definition of LTP is given and a differentiation is made between ...

Although the pathophysiology underlying the pain of fibromyalgia syndrome (FMS) remains unknown, a variety of clinical and investigational findings suggests a dysregulation of dopaminergic neurotransmission. We therefore investigated presynaptic dopaminergic function in 6 female FMS patients in comparison to 8 age- and gender-matched controls as assessed by positron emission tomography ...

Cycloxygenase (COX) pathways have long been targeted for the treatment of inflammatory pain, initially through the use of NSAIDs. With the demonstration of two major COX isoforms, COX-1 and COX-2, involved in the production of prostanoids, but with different distribution and regulation, selective COX-2 inhibitors have been developed. This review ...

Histoplasmosis is an endemic disease in many regions of the United States. Physicians must be aware of the clinical syndromes and take advantage of epidemiologic clues when diagnosing histoplasmosis pericarditis. Clinicians must also be familiar with the uses and limitations of a battery of serologic and mycologic tests. Finally, further ...

This article presents initial data on the application of a pain protocol in posttraumatic stress disorder (PTSD) to assess the neural circuitry that is involved in the disorder, with a special interest in the role of the anterior cingulate cortex (ACC). Preliminary analysis demonstrated a specific and differentiated role for ...

The present investigation examined the role of experiential avoidance in terms of acute pain tolerance and subsequent recovery. Seventy nonclinical participants completed the Acceptance and Action Questionnaire and underwent a well-established cold pressor task. Results indicated that individuals reporting higher levels of experiential avoidance had lower pain endurance and tolerance ...

The mediator role of response expectancies and the moderator role of hypnotic suggestibility were evaluated in the analogue treatment of pain. Approximately 1,000 participants were assessed for hypnotic suggestibility. Later, as part of a seemingly unrelated experiment, 188 of these individuals were randomly assigned to distraction, cognitive-behavioral package, hypnotic cognitive-behavioral ...

TRP cation channels transduce mechanical, thermal, and pain-related inflammatory signals. In this issue of Cell, it is reported that TRPA1 has a central role in the pain response to endogenous inflammatory mediators and to a diverse array of volatile irritants, including those found in tear gas and garlic. In contrast, ...

It is well known that a multitude of transmitters and receptors are involved in the nociceptive system, some of them increasing and others inhibiting the pain sensation both peripherally and centrally. These substances, which include neurotransmitters, hormones, etc., can modify the activity of nerves involved in the pain pathways. Furthermore, ...

As otolaryngologists, we are the first consulted for stridor and dysphagia. One must consider both extrinsic and intrinsic etiologies in the differential diagnosis of these symptoms. We report a series of patients with diffuse idiopathic skeletal hyperostosis (DISH) who presented with stridor or dysphagia. We describe the initial presenting symptoms, ...

Cannabinoids are antinociceptive in animal models of acute, tissue injury-, and nerve injury-induced nociception. This review examines the biology of endogenous cannabinoids (endocannabinoids) and behavioral, neurophysiological, and neuroanatomical evidence supporting the notion that cannabinoids play a role in pain modulation. Behavioral pharmacological approaches, in conjunction with the identification and quantification ...

BACKGROUND: Since the introduction of in-vitro fertilisation (IVF) tubal surgery has been less frequently undertaken as a technique to improve fertility in women with damaged fallopian tubes. There are various surgical techniques that can be used to repair blocked or damaged fallopian tubes. OBJECTIVES: To evaluate the role of tubal ...

Mounting evidence to support the safety and effectiveness of new uterine-preserving fibroid therapies is raising questions not only about changing indications for surgery but also about gynecologists' role in therapies offered by other specialists. New collaborative relationships are needed to provide the best possible treatment; without them, those lag times ...

In order to react adequately to any new challenge, it is necessary to stop all ongoing activity. The first phase in the orienting response to a novel stimulus is an arrest of all ongoing activity. Inhibition is also necessary to switch from one behaviour to another, and from one cognitive ...

Galanin (GAL) is a neuropeptide involved in pain transmission. Intraplantar GAL at low doses enhances capsaicin (CAP)-induced pain behaviors in rat, suggesting an excitatory role for GAL under acute inflammatory conditions. The mechanisms underlying this pro-nociceptive action have not yet been elucidated. Thus, the present study investigated the role of ...

The role of the scrub person requires the following abilities: assessing situations immediately, carrying out correct actions, using critical thinking and good judgment, and communicating effectively with all members of the surgical team. The scrub person greatly contributes to the success of total joint replacement surgery. He or she must ...

Albumin is the predominant product of hepatic protein synthesis and one of the more abundant plasma proteins. Among its multiple physiologic roles, it plays an essential part in the generation of colloid-oncotic pressure. In the United States, the indications for which albumin therapy are considered include hypovolemia or shock, burns, ...

This paper compares policies to tackle excessive waiting times for elective surgery in 12 OECD countries. It is found that waiting times may be reduced by acting on the supply of or on the demand for surgery (or both). On the supply side, evidence suggests that both capacity and financial ...

Transient receptor potential (TRP) ion channels are molecular gateways in sensory systems, an interface between the environment and the nervous system. Several TRPs transduce thermal, chemical, and mechanical stimuli into inward currents, an essential first step for eliciting thermal and pain sensations. Precise regulation of the expression, localization, and function ...

Chronic pelvic pain (CPP) affects more than 9 million women in the United States and results in a considerable medical, social and economic toll on affected women and their families. CPP can have multiple causes, and its diagnosis can be especially problematic for clinicians. Gynecologists who care for such women ...

Millions of cigarette smokers require surgery each year. Those who quit smoking may reduce their risk of respiratory, cardiovascular, and wound-related complications. Scheduling of surgery may present a unique opportunity to help smokers quit permanently. Primary care providers can play an important role in helping their patients scheduled for surgery ...