The Clinical journal of pain
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Observational Study
Anterior Cutaneous Nerve Entrapment Syndrome in Children: A Prospective Observational Study.
Anterior cutaneous nerve entrapment syndrome (ACNES) is often an overlooked cause of abdominal pain. Data for pediatric patients, especially with regard to the treatment modalities are scarce. The aim of this study was to present a treatment modality of ACNES with combined local subfascial anesthetic and corticosteroid injection in a prospectively collected cohort of pediatric patients. ⋯ ACNES in children can be successfully treated by a combined local subfascial anesthetic and corticosteroid trigger point infiltration.
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To identify the changes of local coherence and intrinsic brain activity in resting-state idiopathic trigeminal neuralgia (ITN) patients by using regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) analysis. ⋯ Our results showed that ITN patients exhibited significantly abnormal spontaneous brain activity in several brain regions that are involved in pain modulation and perception. The present study reflects the maladaptive process of daily pain attacks and may enhance the understanding of how chronic pain affects local intrinsic brain activity.
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Randomized Controlled Trial Comparative Study
Cortical Pain Response of Newborn Infants to Venepuncture: A Randomized Controlled Trial Comparing Analgesic Effects of Sucrose Versus Breastfeeding.
Sucrose administration and breastfeeding decrease behavioral expressions of pain in neonates. However, recent studies indicated that there is a persistent cortical response with sucrose. This study compared the efficacy of sucrose administration versus breastfeeding to decrease cortical responses to pain during venepuncture. ⋯ There was no difference in the cortical responses to pain during venepuncture in newborn infants who were administered sucrose versus those who were breastfed.
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Hyperalgesia and allodynia are typical signs of neuropathic pain. Quantitative sensory testing (QST) is a validated tool to clinically assess these phenomena. However, whether QST reveals findings that are reported by the patients is unclear. The aim of this study was therefore to investigate the association between self-reported symptoms assessed with the painDETECT questionnaire (PDQ) with results of validated QST. ⋯ Results demonstrate that self-reported PDQ symptoms cannot predict abnormal QST values. The poor predictive power of the PDQ may depend on several factors based on possibility of comparison between PDQ and QST and also on methodical issues. Both, symptoms (questionnaires) and signs address complementary aspects of the pain experience and should be considered for diagnosis and treatment of neuropathic pain.
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In chronic low back pain (CLBP) patients, study of altered brain metabolites in the anterior cingulate cortex (ACC) using magnetic resonance spectroscopy (MRS) could reveal the detailed pathology of CLBP and depression. The aim was to detect the central difference between CLBP and controls by means of measuring the metabolites in the ACC, and to analyze the correlations between depression and metabolites in ACC. ⋯ Lower NAA levels and higher Glx/creatine and Glx/myoinositol ratios in the ACC of CLBP participants compared with controls were revealed. The result suggests the hypothesis that excessive Glx leads to neuronal dysfunction and/or death, which was reflected as a low NAA level in the ACC of individuals with CLBP. Measurement of these metabolites using MRS potentially helps evaluate CLBP patients' condition and psychological status objectively.