Ketamine has been the commonest abusive substance used by Hong Kong teenager since 2005. It is also the fourth commonest poison encountered in Hong Kong Poison Information Centre (HKPIC) poisoning data in 2010. From June 2008 to July 2011, HKPIC managed 188 and 96 cases of acute and chronic ketamine ...

There has been a growing interest in opioid-induced hyperalgesia (OIH), which is an increased sensitivity to pain caused by opioid exposure. Multiple underlying pathways may contribute to the development of OIH, and the mechanism may vary with the duration of opioid exposure, dose, type and route of administration. In addition, ...

OBJECTIVE: We aimed to assess whether the risk factors for severe shoulder pain, especially exposure to arm elevation, were still relevant after a 12-year follow-up, even following retirement. METHODS: All men participating in the ARPEGE ancillary study of the GAZEL cohort (followed-up since 1989) and who answered the 1994 or ...

Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine ...

Inflammatory enthesitis is a hallmark of spondyloarthropathies (SSA) and may antedate other clinical manifestations. The involvement of Achilles tendon and plantar aponeurosis is common, with strong tendency toward fibrosis and calcification. We are describing imaging characteristics in a patient with positive HLA B-27 antigen with bilateral calcific achilles tendonitis who ...

: Raynaud's phenomenon is a well-described pathologic state in which there is episodic vasospasm followed by vasodilation. It is described most commonly in the digits but also has been shown to affect the nipple vasculature. Raynaud's phenomenon of the nipple may result in discontinuation of breastfeeding secondary to pain and ...

Sodium hypochlorite (NaClO) is used extensively as a disinfectant or bleaching agent. Most studies describe ingestion or inhalation route of this product with rare complication and fatalities. Despite global daily exposures, data about bleach injection is limited. Here we report intentional infusion of 20 mL, sodium hypochlorite 5% diluted in ...

Abstract Purpose: Static magnetic field (SMF) exposure was shown experimentally to beneficially affect the healing process. The aim of this randomized, controlled trial was to evaluate the pain-inhibitory effect of local exposure to SMF on temporomandibular disorders, on alveolitis and on aphta in the oral mucosa. Materials and methods: Pain ...

ABSTRACT: BACKGROUND: Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated ...

OBJECTIVE: To describe clinical fracture rates, back pain, and health-related quality of life (HRQOL) in postmenopausal women with osteoporosis who are receiving glucocorticoids (GC), during a 36-month study of teriparatide treatment for up to 18 months, with an additional 18-month followup period when patients were receiving other osteoporosis medications. METHODS: ...

OBJECTIVE: The purpose of the current study was to determine, whenever the patients complained of probable symptoms of discogenic low back pain and had obvious disc pathological changes on magnetic resonance imaging (MRI) but showed negative in discography, whether we could absolutely exclude the diagnosis of discogenic pain or not. ...

The infrapatellar fat pad (IFP), also known as Hoffa's fat pad, is an intracapsular, extrasynovial structure that fills the anterior knee compartment, and is richly vascularized and innervated. Its degree of innervation, the proportion of substance-P-containing fibres and close relationship to its posterior synovial lining implicates IFP pathologies as a ...

Recent reports suggest deficits in conditioned pain modulation (CPM) and enhanced suprathreshold heat pain response (SHPR) potentially play a role in the development of chronic pain. The purpose of this study was to investigate whether central pain processing was altered in 2 musculoskeletal shoulder pain models. The goals of this ...

van der Meulen I, van de Sandt-Koenderman ME, Ribbers GM. Melodic Intonation Therapy: present controversies and future opportunities. This article describes the state of the art of Melodic Intonation Therapy (MIT), a structured aphasia therapy program using the melodic aspects of language (intonation, rhythm, and stress) to improve language production. ...

Frozen shoulder is commonly encountered in general orthopaedic practice. It may arise spontaneously without an obvious predisposing cause, or be associated with a variety of local or systemic disorders. Diagnosis is based upon the recognition of the characteristic features of the pain, and selective limitation of passive external rotation. The ...

The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate ...

BackgroundArthroscopy is increasingly used to improve pain and function in athletes with hip joint pathology. Surgical techniques have evolved to utilise arthroscopic femoral osteoplasty to address potential morphological contributors to pathology.PurposeInvestigate pain and function outcomes following hip arthroscopy with and without femoral osteoplasty in individuals with intra-articular hip pathology.Study designSystematic ...

Studies relating occupational psychological and social factors to back pain have traditionally investigated a small number of exposure factors. The current study explored longitudinally a comprehensive set of specific psychological/social and mechanical work factors as predictors of back pain severity (defined as the product of back pain intensity and duration). ...

Objectives. We used individual participant data from multiple studies to conduct a comprehensive meta-analysis of mechanical exposures in the workplace and low back pain. Methods. We conducted a systematic literature search and contacted an author of each study to request their individual participant data. Because outcome definitions and exposure measures ...

Chronic pain is a common problem in pediatric practice. The prevalence of chronic pain in children is more than 30%. Because pain indicates emotional expression as well as the physiological reaction toward infection, injury, and inflammation, both physiological and psychological assessments are essential to determine primary interventions for chronic pain. ...

OBJECTIVES: Musculoskeletal (MSK) pain is a frequent (between 40-80%) complaint of patients with systemic sclerosis (SSc). Unfortunately, there are virtually no systematic studies of the causes or the management of MSK involvement in SSc and with few exceptions there have been no controlled trials to determine what are and should ...

BACKGROUND: The NHLBI-sponsored Sickle Cell Disease Clinical Research Network (SCDCRN) conducted a multi-center, acute intervention randomized clinical trial of two methods of Patient Controlled Analgesia for acute pain. This trial was terminated early due to low enrollment. We analyzed the perceived barriers and recruitment difficulties as reported by the coordinators ...

Acute aortic dissection is one of the most fatal cardiovascular disorders that can challenge the most experienced practitioner. Despite recent progress in diagnostic tools, this vascular catastrophe is often misdiagnosed or undetected which can result in a 1%-3% mortality risk per hour. Many patients die before presenting to the hospital ...

Objectives Symptomatic groin hernias in women may be difficult to assess clinically and commonly mimic pathologic musculoskeletal and gynecologic conditions. The objective of our study was to investigate the accuracy of sonography in women with groin pain and normal physical examination findings. Methods A consecutive group of 87 women (median ...

This paper examines Ferenczi's contributions to the concepts of transference and countertransference, especially in the Clinical Diary, and the weight of these ideas in our present-day clinical work. Specifically emphasized are the circulation of archaic communication within the session, and the denial of countertransference as a re-traumatazing agent, shown in ...

Low back pain (LBP) is a symptom, not a diagnosis. The failure to differentiate underlying diagnoses in patients complaining of LBP is one of the primary reasons that studies examining treatments for LBP have yielded inconsistent results. To design a lumbar spine registry such that the accumulated data provide applicable ...

A wide clinical experience in General Surgery has brought about a remarkable knowledge about lymphatic disorders both primary and secondary ones. Diagnostic and histopathological studies of lymphatic diseases allowed to better understand etiological aspects and pathophysiological mechanisms responsible of complex clinical features correlated to lymphatic dysfunctions. Translational lymphologic basic and ...

To assess and compare the efficacy of two different dexamethasone protocols on pain prevention following periodontal surgery. 60 subjects presenting moderate to severe periodontitis with persisting clinical signs of inflammation after nonsurgical periodontal therapy on at least two adjacent teeth were scheduled for open flap debridement surgeries. This was a ...

OBJECTIVES: It is currently impossible to identify which patients with knee complaints presenting to the general practitioner will develop knee osteoarthritis (OA) pathology at a later stage. This study examines the determinants for developing OA pathology on x-ray in patients with knee complaints but no radiological OA at baseline in ...

Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of ...

OBJECTIVE: The purpose of this study was to determine if bony changes in temporomandibular joint (TMJ) osteoarthritis (OA) is correlated with pain and other clinical signs and symptoms. METHODS: Clinical data and cone beam CT (CBCT) images of 30 patients with TMJ OA were analysed. The criteria of Koyama et ...

ABSTRACT: BACKGROUND: Although CT colonography is a less invasive alternative for colonoscopy for the detection of colorectal polyps and cancer, procedural pain is common. In several studies, CT colonography pain and burden is higher than in colonoscopy. Apart from discomfort, anxiety and its related stress-induced peri- procedural side effects, this ...

Locking is an inability to fully extend the knee and is most commonly associated with meniscal pathology and loose bodies. The locked knee is an infrequent presentation in paediatric orthopaedics, and the presence of a patella protuberance as a cause has never been reported in children or adults. An adolescent ...

PURPOSE: Because of the multiple possible aetiologies of painful total knee arthroplasty (TKA), the diagnosis and treatment of such patients are challenging. In a considerable number of patients, an intraarticular pathology is present, although not verifiable with clinical and diagnostic imaging techniques as in cases of primary arthrofibrosis. In these ...

OBJECTIVE: Because the ligamentum flavum occupies the spinal canal, it may contribute to clinical spinal stenosis. However, there are no published baseline values, and the relationship between ligament thickness and clinical factors has not been established. This article aims to examine these relationships. DESIGN: A validation study. SETTING: Clinical research ...

PURPOSE: The diagnosis of hip osteoarthritis is often complicated by co-existing pathology in the knee and spine, and mismatch between clinical and radiological signs. Temporary pain relief from a local anaesthetic injection into the hip joint has been reported to help localise symptoms, reducing the risk of unnecessary surgery being ...

The purpose of this study is to calculate the negative predictive value (NPV) CT of the abdomen in patients presenting to the emergency department (ED) with undifferentiated upper abdominal pain. Approved by the hospital research ethics board, this retrospective study examined consecutive patients presenting to the ED with undifferentiated upper ...

The aim of our study was to assess clinical variables with the best correlation to quality of life (QOL) assessed by medical outcome survey Short-Form 36 (SF-36) in patients with spondyloarthritides, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA). We analyzed the cohort of 54 patients (22 patients with PsA ...

Dancers spend a lot of time in the relevé position in demi-pointe and en pointe in their training and their careers. Pain from both osseous and soft tissue causes may start to occur in the posterior aspect of their ankle. This article reviews the potential causes of posterior ankle impingement ...

This is an unusual case of chronic abdominal pain following two liver transplants with at least three potential causes: traumatic neuroma, intussusception of the small bowel of the Roux loop and biliary cast. Surgical removal of the latter two factors led to resolution of the pain. The management of the ...

PURPOSE: The purpose of this study was to determine the frequency of scrotal calculi in men referred for scrotal ultrasonography (US), to identify any associated pathologies and to investigate if any relationship exists between scrotal lithiasis and pain. MATERIALS AND METHODS: This was a retrospective study in which 4084 scrotal ...

The aim of this study was to compare the efficacy of diclofenac, for the treatment of acute pain originated by lower-limb fracture and surgery, with that of diclofenac plus B vitamins. This was a single-center, prospective, randomized, and double-blinded clinical trial. Patients with lower-limb closed fractures rated their pain on ...

BACKGROUND AND PURPOSE: Pain has been reported in cystic fibrosis (CF), but its clinical significance and the physical and psychosocial impact in adults who are clinically stable and acutely unwell have not been well described. The aim of this study was to describe the intensity and location of pain and ...

Primary burning mouth syndrome (BMS) is severe, disabling and chronic intraoral pain condition for which no local or systemic cause can be found and clinical examination is normal. It mostly affects elderly citizens, especially postmenopausal women with prevalence up to 12-18%. In addition to spontaneous burning pain, patients may complain ...

Fibromyalgia (FM) is defined as chronic widespread pain (CWP) with allodynia or hyperalgesia to pressure pain, and is classified as one of the largest group of soft tissue pain syndromes. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system ...

ABSTRACT: BACKGROUND: Low back pain (LBP) is common and costly. Development of accurate and efficacious methods of diagnosis and treatment has been identified as a research priority. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the ...

In the U.S. multidisciplinary pediatric pain clinic where I conducted 18 months of fieldwork, a widely held explanatory model tied the neurobiology of intractable pain to certain features of pervasive developmental disorders (PDD) such as concrete thinking, an interest in details, and hyper-attentiveness. Clinicians used terms such as "sticky brains" and ...

Chronic alcohol consumption produces painful peripheral neuropathy for which there is no reliable successful therapy, mainly due to lack of understanding of its pathobiology. Alcoholic neuropathy involves coasting caused by damage to nerves that results from long-term excessive drinking of alcohol and is characterized by spontaneous burning pain, hyperalgesia and ...

Amlexanox appears to be most effective overall. Amlexanox 5% paste reduces ulcer size, pain duration, and healing time.

With age, individuals with sickle cell disease (SCD) experience daily chronic pain. Vitamin D deficiency (VDD) can result in chronic pain, osteoporosis, fractures, and muscle weakness. Several studies report a high prevalence of VDD in SCD; however, the clinical correlates have not been well described. We describe a case of ...