European journal of pain : EJP
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This study tested the hypothesis that chronic widespread pain (CWP) would predict low levels of physical activity (PA). Pain status and PA levels were ascertained at baseline and 32 months in community subjects. Three PA questions were used: "in comparison with others your own age, is your PA "the same" (referent), "more-much more" or "less-much less"", and "during the past month on average how many days/week have you taken exercise that has (i) lasted at least 20 min? and (ii) made you sweat?: "4-7" (referent), "1-3" or "none"". ⋯ This relationship remained after adjustment for confounders (RRR=1.9 (1.3-2.9)). A similar association was observed with exercise that lasted at least 20 min (RRR=1.9 (1.3-2.8)). The current study suggests that low self-reported levels of physical activity are a consequence of having CWP.
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Review Meta Analysis Comparative Study
Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review.
The optimal effective dose of epidural morphine that provides postoperative analgesia after caesarean section with minimal side effects remains debated. ⋯ A single bolus of epidural morphine provides better analgesia than parenteral opioids but with an effect limited to the first postoperative day after caesarean section and with an increase in morphine side effects.
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Pain and symptoms of depression and anxiety have been observed to co-exist in the community-dwelling elderly. While depression and pain have been suggested to be predictive of one another temporally, the longitudinal associations between anxiety and pain remain undefined. The aim of this study was to investigate the reciprocal longitudinal associations of self-reported pain interference and affective symptoms, as measured by the Hospital Anxiety and Depression Scale, in community-dwelling older adults and report the potentially modifying effect of co-morbid anxiety or depression on these relationships. ⋯ Adjusting for age, gender and co-morbid anxiety or depression slightly reduced the strength of the relationships, though most remained statistically significant. In conclusion, we have found evidence for both pain-depression and pain-anxiety relationships longitudinally, and in a reciprocal manner. Such findings have important implications for the future management of primary care patients presenting with symptoms of pain, anxiety or depression.
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To determine whether buprenorphine maintenance alters intrapartum or postpartum pain or medication requirements. ⋯ Buprenorphine maintained women have similar intrapartum pain and analgesic needs during labor, but experience more postpartum pain and require 47% more opioid analgesic following cesarean delivery.
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Dominant gain-of-function mutations that hyperpolarize activation of the Na(v)1.7 sodium channel have been linked to inherited erythromelalgia (IEM), a disorder characterized by severe pain and redness in the feet and hands in response to mild warmth. Pharmacotherapy remains largely ineffective for IEM patients with cooling and avoidance of triggers being the most reliable methods to relieve pain. We now report a 5 year old patient with pain precipitated by warmth, together with redness in her hands and feet. ⋯ Whole-cell voltage-clamp analysis shows a I234T-induced shift of -18 mV in the voltage-dependence of activation, accelerated time-to-peak, slowed deactivation and enhanced responses to slow ramp depolarizations, together with a -21 mV shift in the voltage-dependence of slow-inactivation. Our data show that I234T induces the largest activation shift for Na(v)1.7 mutations reported thus far. Although enhanced slow-inactivation may attenuate the gain-of-function of the I234T mutation, the shift in activation appears to be dominant, and is consistent with the severe pain symptoms reported in this patient.