The Clinical journal of pain
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Comparative Study Clinical Trial Controlled Clinical Trial
Spousal responses are differentially associated with clinical variables in women and men with chronic pain.
Spousal responses have been related to clinical variables in patients with chronic pain. For example, solicitous responses from spouses have been associated with greater levels of pain and disability among patients with chronic pain. However, few investigators have determined whether spousal solicitousness produces different effects in women versus men with chronic pain. The present study examined pain reports, medication use, psychosocial factors, functional measures, and pain tolerance in patients with chronic pain. ⋯ These results extend previous findings demonstrating a relationship between spousal responses and patients' adjustment to pain; however, the pattern of these effects appears to be moderated by the sex of the patient. Implications for assessment and treatment of chronic pain are discussed.
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Clinical Trial Controlled Clinical Trial
Sex differences in cortisol response to noxious stress.
Evidence has accumulated that men and women show different responses to noxious stimuli, with women exhibiting greater sensitivity to pain than men. Data concerning sex differences in cortisol response patterns have revealed inconsistent results so far. The purpose of the present study was to examine sex differences in subjective pain and cortisol response to a noxious stressor. ⋯ The present study demonstrates that men show a larger cortisol response to a noxious stressor than women that is not attributable to sex differences in subjective pain. The conclusion of a causal relation between larger cortisol responses and higher pain tolerance thresholds in men is tempting but yet speculative.
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There is clinical experimental evidence that extracranial arterial vasodilation, extracranial neurogenic inflammation, and decreased inhibition of central pain transmission are involved in the pathogenesis of the migraine headache. The migraine aura is likely caused by a neurophysiologic phenomenon akin to Leão's cortical spreading depression, a wave of short-lasting neuronal excitation that travels over the cerebral cortex, followed by prolonged depression of cortical neuronal activity. ⋯ The process driving the pathogenesis of the migraine attack and susceptible to the migraine trigger factors may be located in the brain stem.
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To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people. ⋯ The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.
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Randomized Controlled Trial Clinical Trial
Does the type of arthroscopic surgery modify the analgesic effect of intraarticular morphine and bupivacaine? A preliminary study.
To analyze the different analgesic response to intraarticular morphine and bupivacaine in different types of arthroscopic surgery. ⋯ The analgesic effect of morphine and bupivacaine is different depending on the type of arthroscopic surgery. Intraarticular bupivacaine is effective in surgeries with a low inflammatory response. For surgeries with a higher inflammatory response, morphine has a better analgesic effect. Postoperative intraarticular analgesic therapy should be indicated according to the performed arthroscopic procedure.