European journal of pain : EJP
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We assessed sex differences in behavioural and neural responses to rectal pain stimuli in healthy subjects. ⋯ Healthy men and women do not differ in behavioural measures of visceral pain sensitivity. The pattern of neural activation is comparable in the majority of pain-processing brain regions, although women may differ in the activation of DLPFC which could reflect sex differences in cognitive-emotional pain regulation. Women with lower pain thresholds showed greater neural responses, which may be relevant in the pathophysiology of visceral hyperalgesia.
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Randomized Controlled Trial
Coping when pain is a potential threat: the efficacy of acceptance versus cognitive distraction.
This experiment investigated the impact of brief training in acceptance versus distraction-based pain management on experimental pain tolerance in conditions of lower and higher potential threats. One hundred fifty-one pain-free Chinese adults (93 women, 58 men) randomly assigned to acceptance, distraction or pain education control conditions engaged in a cold pressor test (CPT) after reading validated orienting information designed to prime either the safety of the CPT (lower threat) or symptoms and damaging effects of exposure to extreme cold (higher threat). ⋯ Supplementary analyses identified catastrophizing as a partial mediator of training group differences in pain tolerance. In summary, findings suggested acceptance-based coping is superior to distraction as a means of managing experimental pain, particularly when pain sensations are viewed as comparatively low in potential threat.
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This study investigated cognitive performance in fibromyalgia syndrome (FMS) and its association with cardiovascular and clinical parameters. Thirty-five patients with FMS and 29 matched healthy controls completed a neuropsychological test measuring attention and arithmetic processing. As possible factors underlying the expected cognitive impairment, clinical pain intensity, co-morbid depression and anxiety disorders, sleep complaints, medication use, as well as blood pressure parameters were investigated. ⋯ In the control group, but not in the patients, blood pressure was inversely associated with mental performance. This finding is in line with the well known cognitive impairment in hypertension. The lack of this association in FMS confirms previous research showing aberrances in the interaction between blood pressure and central nervous function in the affected patients.
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Current knowledge about the quality and appropriateness of pharmacological pain treatment in nursing home residents (NHR), particularly in NHR with moderate to severe cognitive impairment, is poor. ⋯ Our study points to a significant deficit in pain treatment in German NHR, including NHR with or without cognitive impairment.
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Despite effective analgesic therapy, inadequate pain control is frequently perceived by patients and caregivers. ⋯ Physician-patient communication and information provided to patients are essential aspects of patient perceptions and attitudes towards control of cancer-related pain. Pain is seen as a condition that may be controlled but affects the capacity to lead a normal life.