European journal of pain : EJP
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Pain perception in others can be influenced by different contextual factors. In clinical settings, the repeated exposure to others' pain has been proposed as a factor that could explain underestimation of patients' pain by health care providers. Previous research supported this idea by showing that repeated exposure to persons in pain biases the subsequent willingness to impute pain in others. However, it remains unclear if the effect of repeated exposure on the detection of pain extends to deliberate pain estimation of stimuli presented for a longer period. ⋯ By demonstrating that repeated exposure to others' pain diminished subsequent pain estimation in others, this study adds relevant information on the factors that could contribute to pain underestimation in health care professionals. WHAT DOES THIS STUDY ADD?: Repeated exposure to facial expressions of intense pain not only biases pain detection, but also pain estimation in others. Prior exposure to facial expressions of pain compared to exposure to neutral ones leads to a reduced estimation of others' pain. This effect is not specific to pain as exposure to another negative emotion (fear) also biases subsequent pain estimation. These results support the interpretation that the underestimation of patients' pain by health care professionals could be related to repeated exposure to other's pain.
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Amylin is a peptide from the calcitonin gene-related peptides (CGRP) family that is expressed by nociceptors. Amylin may modulate pain via a spinal action. ⋯ Overall, data suggested that amylin modulates pain with an inflammatory component and the autoanalgesic/inhibitory mechanisms occurring in the interphase of the formalin test. Amylin might have affected the nociceptive system at different levels (spinal cord and brain), explaining the different effects observed according to the time of amylin injection. WHAT DOES THIS STUDY ADD?: Amylin modulated formalin interphase and tonic pain behaviours probably by targeting spinal neurons and affecting supraspinal areas involved in affective and modulatory components of pain. Activation of spinal amylin-receptors may contribute to the initiation of inflammatory pain mechanisms.
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Review Meta Analysis
Patients with sciatica still experience pain and disability 5 years after surgery: A systematic review with meta-analysis of cohort studies.
The clinical course of patients with sciatica is believed to be favourable, but there is conflicting evidence on the postoperative course of this condition. We aimed to investigate the clinical course of sciatica following surgery. ⋯ Although surgery is followed by a rapid decrease in pain and disability by 3 months, patients still experience mild to moderate pain and disability 5 years after surgery. WHAT DOES THIS REVIEW ADD?: This review provides a quantitative summary of the postoperative course of patients with sciatica. Patients with sciatica experienced a rapid reduction in pain and disability in the first 3 months, but still had mild to moderate symptoms 5 years after surgery. Although no significant differences were found, microdiscectomy showed larger improvements compared to other surgical techniques.
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Review Meta Analysis
Psychological correlates of acute postsurgical pain: A systematic review and meta-analysis.
Due to the frequency of surgeries, acute postsurgical pain (APSP) is a common problem. However, the role of psychological factors in the experience of this kind of pain has not been well established. In this review, we focused on presurgical psychological factors associated with the experience of APSP. ⋯ WHAT DOES THIS REVIEW ADD?: Pain catastrophizing, optimism, expectation of pain, neuroticism, anxiety (state and trait), negative affect and depression were classified as likely associated with acute postsurgical pain, and locus of control was classified as unlikely associated with acute postsurgical pain. Anxiety was the psychological variable most frequently measured before surgery. Pain catastrophizing was most strongly linked with acute postsurgical pain.
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The COMFORT scale is a measurement tool to assess distress, sedation and pain in nonverbal paediatric patients. Several studies have described the COMFORT scale, but no formal assessment of the methodological quality has been undertaken. Therefore, we performed a systematic review to study the clinimetric properties of the (modified) COMFORT scale in children up to 18 years. ⋯ WHAT DOES THIS REVIEW ADD?: An in-depth assessment of the clinimetric properties of the COMFORT scale. The COMFORT scale shows overall an adequate reliability in providing information on distress, sedation and pain. Construct validity varies from good to excellent for distress, from moderate to excellent for sedation, and from poor to excellent for pain.