Pain
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Numerous studies have shown an association between smoking and pain, with smokers reporting more pain and worse functioning. However, little is known about factors that impact this complex relationship. This study investigated the association between smoking, pain, and depressive symptoms. ⋯ Additionally, among former smokers, longer quit duration was associated with less pain severity. In conclusion, smoking rates were high and smoking was associated with a worse chronic pain phenotype. Importantly, depressive symptoms emerged as a critical mediating factor in helping to explain the relationship between smoking and pain.
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Meta Analysis
Investigation of neuropathic pain in treated leprosy patients in Ethiopia: a cross-sectional study.
Pain can be a significant problem for treated leprosy patients. It can be nociceptive due to tissue inflammation occurring during episodes of immune mediated reactions, or neuropathic due to leprosy affecting the somatosensory system. There are sparse epidemiological data on the prevalence and impact of neuropathic pain in treated leprosy patients. ⋯ We have validated the use of DN4 in leprosy and it is easier to use than LANSS. Depression is a common co-morbidity in patients with NP. The high prevalence and morbidity of NP in treated leprosy patients warrant clinical trials to assess the efficacy of pain therapies for leprosy-associated NP.
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Multicenter Study
Assessment and validation of prognostic models for poor functional recovery 12 months after whiplash injury: a multicentre inception cohort study.
Uncertainty surrounds prognostic factors after whiplash injury. Previously we identified a prognostic model for 6-month pain-related disability in a cohort of 80 participants with acute whiplash. Predictors included initial disability, older age, decreased cold pain thresholds, decreased neck rotation movement, posttraumatic stress symptoms and decreased sympathetic vasoconstriction. ⋯ After adjusting for site, age and Impact of Events Scale scores regained significance (r(2) = 0.56, 95% confidence interval 0.48 to 0.64). The tested model was not precise in predicting NDI as a continuous variable. However, it found good accuracy to discriminate participants with moderate to severe disability at 12 months (area under the receiver operating characteristic curve 0.89 [95% confidence interval 0.84-0.94], P<.001) which is clinically useful.
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Randomized Controlled Trial
Ethnicity interacts with the OPRM1 gene in experimental pain sensitivity.
Robust interindividual variation in pain sensitivity has been observed, and recent evidence suggests that some of the variability may be genetically mediated. Our previous data revealed significantly higher pressure pain thresholds among individuals possessing the minor G allele of the A118G SNP of the mu-opioid receptor gene (OPRM1) compared with those with 2 consensus alleles. Moreover, ethnic differences in pain sensitivity have been widely reported. ⋯ The reasons for this dichotomy are unclear; they may involve ethnic differences in haplotypic structure, or A118G may be a tag-SNP linked to other functional polymorphisms. These findings demonstrate an ethnicity-dependent association of OPRM1 genotype with pain sensitivity. Additional research is warranted to uncover the mechanisms influencing these relationships.