Pain
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Comparative Study
Exposure to movement in chronic back pain: evidence of successful generalization across a reaching task.
According to the fear-avoidance model, kinesiophobia (pain-related fear) is an important factor in the development of chronic pain and disability through the maintenance of maladaptive avoidance behaviors. Using a paradigm that required repeated exposure to a reaching task, the current study investigated generalization of pain and harm expectancy corrections (i.e., the tendency to bring expectations in line with experience) in chronic low back pain sufferers with high versus low levels of kinesiophobia. Sixty participants were asked to consecutively perform four adaptations of a reaching task, each introducing an element of increased intensity. ⋯ Further, highly kinesiophobic female, but not male, participants demonstrated greater overprediction of harm relative to low kinesiophobic counterparts during the first reaching trial. Finally, in contrast to previous investigations, highly kinesiophobic participants showed successful generalization of pain expectancy corrections across movement tasks. Possible clinical implications of the findings are noted.
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Randomized Controlled Trial Comparative Study
Is pain relief equally efficacious and free of side effects with repeated doses of oral sucrose in preterm neonates?
The aim of the present study was to examine the efficacy and potential side effects of repeated doses of oral sucrose for pain relief during procedures in NICU. Thirty-three preterm neonates were randomly allocated in blind fashion into two groups, the sucrose group (SG=17) and the control group (CG=16). The responses of neonates to pain and distress were assessed during blood collection on four consecutive assessment (ass.) days. ⋯ There were significantly fewer SG neonates crying during A (ass.2), P (ass.2 and ass.4), and D (ass.3). There was no statistical difference between-groups for physiological response. The efficacy of sucrose was maintained for pain relief in preterm neonates with no side effects.
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Recently, local morphologic alterations of the brain in areas ascribable to the transmission of pain were detected in patients suffering from phantom pain, chronic back pain, irritable bowl syndrome, fibromyalgia and two types of frequent headaches. These alterations were different for each pain syndrome, but overlapped in the cingulate cortex, the orbitofrontal cortex, the insula and dorsal pons. ⋯ As it seems that chronic pain patients have a common "brain signature" in areas known to be involved in pain regulation, the question arises whether these changes are the cause or the consequence of chronic pain. The author suggests that the gray matter change observed in chronic pain patients are the consequence of frequent nociceptive input and should thus be reversible when pain is adequately treated.
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Comparative Study
Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study.
Irritable bowel syndrome (IBS) affects up to 22% of the general population. Its aetiology remains unclear. Previously reported cross-sectional associations with psychological distress and depression are not fully understood. ⋯ After adjustment for age, gender and baseline abdominal pain status, high levels of illness behaviour (odds ratio (OR)=5.2; 95% confidence interval (95% CI) 2.5-11.0), anxiety (OR=2.0; 95% CI 0.98-4.1), sleep problems (OR=1.6; 95% CI 0.8-3.2), and somatic symptoms (OR=1.6; 95% CI 0.8-2.9) were found to be independent predictors of IBS onset. This study has demonstrated that psychosocial factors indicative of the process of somatisation are independent risk markers for the development of IBS in a group of subjects previously free of IBS. Similar relationships are observed in other "functional" disorders, further supporting the hypothesis that they have similar aetiologies.
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Cross-sectional research in clinical samples, as well as experimental studies in healthy adults, suggests that the experiences of pain and sleep are bi-directionally connected. However, whether sleep and pain experiences are prospectively linked to one another on a day-to-day basis in the general population has not previously been reported. This study utilizes data from a naturalistic, micro-longitudinal, telephone study using a representative national sample of 971 adults. ⋯ Results suggested that hours of reported sleep on the previous night was a highly significant predictor of the current day's pain frequency (Z=-7.9, p<.0001, in the structural equation model); obtaining either less than 6 or more than 9h of sleep was associated with greater next-day pain. In addition, pain prospectively predicted sleep duration, though the magnitude of the association in this direction was somewhat less strong (Z=-3.1, p=.002, in the structural equation model). Collectively, these findings indicate that night-to-night changes in sleep affect pain report, illuminating the importance of considering sleep when assessing and treating pain.