Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Osteoarthritis (OA) patients who are overweight or obese report higher levels of pain compared with their normal-weight OA counterparts. Evidence suggests that overweight or obese OA patients also experience pain relief from eating foods high in calories, fat or sugar. Eating to alleviate pain may be problematic because it can lead to additional weight gain, which may contribute to heightened pain. ⋯ Using ecological momentary assessments as a novel approach, the present study provides preliminary data supporting a relationship between pain and food intake among overweight and obese OA patients. Continued advances in our understanding of the relationship between pain and eating behaviour may help to optimize intervention strategies for these patients.
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The issue of how to address patient pain in the outpatient setting remains challenging. At the London Regional Cancer Program (London, Ontario), patients complete the Edmonton Symptom Assessment System (ESAS) before most visits. ⋯ Active pain management plans were documented in 83% of visits. However, patients who reported severe pain that was assessed as benign or unknown in etiology received intervention less frequently, perhaps indicating that oncologists either consider themselves less responsible for noncancer pain, or believe that pain chronicity may lead to a higher ESAS pain score without indicating a need for acute intervention. Further study is needed to determine the subsequent effect of the care plans on patient-reported ESAS pain scores at future clinic visits.
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Observational Study
Breakthrough pain in patients with controlled or uncontrolled basal pain: an observational study.
Breakthrough pain (BTP) is traditionally defined as a pain exacerbation in patients with chronic controlled pain. However, this definition has recently been challenged. ⋯ Patients with uncontrolled baseline pain experienced BTP flares with higher frequency, but similar intensity and duration with respect to patients with controlled pain at baseline. Notably, a close follow-up and adequate management of the BTP episodes led to an improvement of BTP in the observed patients.
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Rho-kinases (ROCKs), a family of small GTP-dependent enzymes, are involved in a range of pain models, and their inhibition typically leads to antinociceptive effects. ⋯ The results of the present study suggest that ROCKs participate in the local mechanisms associated with nociception⁄antinociception and inflammation, with a possible involvement of the nitric oxide⁄cGMP⁄protein kinase G pathway. Also, drug effects following local administration may differ markedly from the effects following systemic administration. Finally, separate treatment of pain and edema may be needed to maximize clinical benefit in inflammatory pain.