European journal of pain : EJP
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Observational Study
Association of Pre-operative Functional Disability with Chronic Postsurgical Pain: A Prospective Observational Study.
Chronic postsurgical pain negatively affects postoperative recovery. We aimed to assess the association between preoperative functional disability and chronic postsurgical pain. ⋯ Our study showed that in patients who undergo elective abdominal surgery, 12% with preoperative functional disability experience chronic postsurgical pain after 1 year. Preoperative functional disability is associated with chronic postsurgical pain, use of preoperative pain medications and acute postoperative pain. Patients with preoperative functional disability have higher pain numerical rating scale scores at any postoperative measurement point.
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Pain, either nociceptive or neuropathic (NP), is a common symptom in Charcot-Marie-Tooth (CMT) disease. ⋯ Neuropathic pain is a frequent finding in Charcot-Marie Tooth disease and is related to Aδ fibers impairment. Patients at higher risk are those belonging to certain genetic subtypes (i.e. CMT1A and CMT2J) or with laser-evoked potentials abnormalities. While managing this disease, clinicians should be aware of this symptom in order to offer best treatment options to their patients.
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Nitric oxide (NO) levels in brain nuclei, such as the hippocampus and brainstem, are involved in morphine analgesia, but the relationship between the dorsal hippocampus (dH) and the dorsolateral periaqueductal gray matter (dlPAG) needs to be clarified, which is our goal. ⋯ Nitric oxide is involved in the dH and dlPAG in morphine-induced analgesia in the rat formalin test. Morphine has analgesic effects in both phases of the rat formalin test. The morphine response is reduced in two stages by injection of the NO precursor L-arginine but not the nNOS inhibitor L-NAME in the dH and dlPAG. By injecting L-NAME before L-arginine in both nuclei, the morphine-induced response returns in the early stages. Due to the initial injection of L-NAME into dlPAG and the subsequent injection of L-arginine at dH, morphine analgesia is not reduced at all, indicating NO modulation in the pain pathway from dH to dlPAG.