European journal of pain : EJP
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Pain centers manage only selected patients, and have long waiting lists. Some patients spontaneously send letters, before the visit, and these letters represent the first contact between the patients and the pain centers. We report a study of the content and format of these letters, for a patient perspective analysis. ⋯ Patients' letters constitute original narrative material to be integrated into clinical analysis, especially for pain management. Patients' letters analyses may improve the patient physician relationship, by understanding patient's perspectives, beliefs and expectations.
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The ion channel TRPV1 is mainly expressed in small diameter dorsal root ganglion (DRG) neurons, which are involved in the sensation of acute noxious thermal and chemical stimuli. Direct modifications of the channel by diverse signalling events have been intensively investigated, but little is known about the composition of modulating macromolecular TRPV1 signalling complexes. Here, we hypothesize that the novel adaptor protein ankyrin-rich membrane spanning protein/kinase D interacting substrate (ARMS) interacts with TRPV1 and modulates its function in rodent DRG neurons. ⋯ The study identifies ARMS as an important component of the signalling complex regulating the sensitivity of excitatory ion channels (TRPV1) in peripheral sensory neurons (DRG neurons) and transfected cells.
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The phenomenon of temporal summation to repetitive pressure pain stimuli is an important central neural mechanism for pain intensity encoding. This study evaluated the time-dependent behaviour of mechanical characteristics of soft tissue during repeated cuff stimulation used for eliciting temporal summation of cuff pressure-evoked pain. Such information of tissue mechanics is important for the interpretation of the pain response evoked during sequential stimulations. ⋯ The temporal summation of pain during sequential cuff stimulation is inexplicable by the time-dependent response of mechanical stress and strain in soft tissue.
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Randomized Controlled Trial
Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial.
Web-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life. ⋯ The comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations.
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Rates of depression and anxiety in cardiac surgery patients are higher than in the general population. The development of persistent post-surgical pain (PPSP) in this population is also concerning. The objectives of this study were to (1) identify anxiety and depression trajectories of cardiac surgery patients over a 2-year period; (2) examine demographic and clinical characteristics associated with trajectory memberships and (3) determine if anxiety and/or depression trajectories predict PPSP. ⋯ This article presents the relationship between anxiety and depression profiles over 2 years in cardiac surgery patients and persistent post-surgical pain. These results suggest the importance of evaluating how early identification and treatment of high-risk patients could prevent PPSP. These results provide potential detection and prevention avenues of chronic pain for high-risk patients based on their anxiety trajectory.