Pain
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Controlled Clinical Trial
Sucrose-induced analgesia is related to sweet preferences in children but not adults.
The present study tested the hypothesis that the efficacy of sucrose in reducing pain during the Cold Pressor Test (CPT) was related to its hedonic value. To this aim, we determined the most preferred level of sucrose and the analgesic properties of 24% w/v sucrose during the CPT in 242, 5- to 10-year-old children and their mothers. Outcome measures included pain thresholds (the time at which discomfort was first indicated) and pain tolerance (the length of time the hand was kept in the cold water bath). ⋯ That is, children who preferred >or=24%w/v sucrose exhibited an increased latency to report pain and tolerated pain for significantly longer periods of time when sucrose was held in their mouths relative to water. This effect was more pronounced among normal weight when compared to overweight/at risk for overweight children. The role that dietary habits and individual differences contribute to the preferences for sweet taste and its physiological consequences in children is an important area for future research.
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Clinical Trial
The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study.
Chronic pain in adulthood is one of the most costly conditions in modern western society. However, very little is known about the costs of chronic pain in adolescence. This preliminary study explored methods for collecting economic-related data for this population and estimated the cost-of-illness of adolescent chronic pain in the United Kingdom. ⋯ The adolescents attending a specialised pain management unit, who had predominantly non-inflammatory pain, accrued significantly higher costs, than those attending rheumatology outpatient clinics, who had mostly inflammatory diagnoses. Extrapolating the mean total cost to estimated UK prevalence data of adolescent chronic pain demonstrates a cost-of-illness to UK society of approximately 3,840 million pounds in one year. The implications of the study are discussed.
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Randomized Controlled Trial
The role of threat-expectancy in acute pain: effects on attentional bias, coping strategy effectiveness and response to pain.
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. ⋯ The present results provide support for the fear-avoidance model of pain [Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317-332] and confirm the importance of threat-expectancy in hypervigilance towards pain and fear avoidance.
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Clinical Trial
Categorising the severity of neck pain: establishment of cut-points for use in clinical and epidemiological research.
Grading pain intensity scales into simple categories provides useful information for both clinicians and epidemiologists and methods to classify pain severity for numerical rating scales have been recommended. However, the establishment of cut-points is still in its infancy and little is known as to whether cut-points are affected by age or gender. The objectives of this paper were to establish optimal cut-points in pain severity in individuals with neck pain (NP) and to investigate if the cut-points were influenced by gender, age, and NP duration. ⋯ Only small gender differences in cut-points were seen and no specific trend was noted in either single or double cut-points in different age groups. The cut-points were almost identical for acute, subacute, and chronic NP. This paper has implications for understanding the impact of using different pain intensity scales and provides reference cut-points in NP for use in future clinical and epidemiological research.
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Clinical Trial
An experimental study of viscero-visceral hyperalgesia using an ultrasound-based multimodal sensory testing approach.
Widespread visceral hypersensitivity and the overlap of symptom complexes observed in functional gastrointestinal disorders may be related to central sensitization and neuroplastic changes. A multimodal and multi-segmental model was developed to evaluate viscero-visceral hyperalgesia induced by experimental esophageal sensitization in healthy volunteers. Twelve healthy subjects were studied using a double-blinded, placebo-controlled design. ⋯ The present method demonstrated a new approach to assess multimodal sensitivity to experimental sensitization of the esophagus and related viscero-visceral hyperalgesia. Central mechanisms can explain the remote hyperalgesia to mechanical visceral stimulation and the increase in referred pain areas. The present method may be used to explore pathophysiology and pharmacological interventions in patients with visceral hypersensitivity.