The journal of pain : official journal of the American Pain Society
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Clinical characteristics might be associated with temporomandibular disorders (TMD) because they are antecedent risk factors that increase the likelihood of a healthy person developing the condition or because they represent signs or symptoms of either subclinical or overt TMD. In this baseline case-control study of the multisite Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) project, 1,633 controls and 185 cases with chronic, painful TMD completed questionnaires and received clinical examinations. Odds ratios measuring association between each clinical factor and TMD were computed, with adjustment for study-site as well as age, sex, and race/ethnicity. ⋯ The results indicated that TMD cases differ substantially from controls across almost all variables assessed. Future analyses of follow-up data will determine whether these clinical characteristics predict increased risk for developing first-onset pain-related TMD PERSPECTIVE: Clinical findings from OPPERA's baseline case-control study indicate significant differences between chronic TMD cases and controls with respect to trauma history, parafunction, other pain disorders, health status, and clinical examination data. Future analyses will examine their contribution to TMD onset.
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Comparative Study
"He says, she says": a comparison of fathers' and mothers' verbal behavior during child cold pressor pain.
Mothers' behavior has a powerful impact on child pain. Maternal attending talk (talk focused on child pain) is associated with increased child pain whereas maternal non-attending talk (talk not focused on child pain) is associated with decreased child pain. The present study compared mothers' and fathers' verbal behavior during child pain. Forty healthy 8- to 12-year-old children completed the cold pressor task (CPT)-once with their mothers present and once with their fathers present in a counterbalanced order. Parent verbalizations were coded as Attending Talk or Non-Attending Talk. Results indicated that child symptom complaints were positively correlated with parent Attending Talk and negatively correlated with parent Non-Attending Talk. Furthermore, child pain tolerance was negatively correlated with parent Attending Talk and positively correlated with parent Non-Attending Talk. Mothers and fathers did not use different proportions of Attending or Non-Attending Talk. Exploratory analyses of parent verbalization subcodes indicated that mothers used more nonsymptom-focused verbalizations whereas fathers used more criticism (a low-frequency occurence). The findings indicate that for both mothers and fathers, verbal attention is associated with higher child pain and verbal non-attention is associated with lower child pain. The results also suggest that mothers' and fathers' verbal behavior during child pain generally does not differ. ⋯ To date, studies of the effects of parental behavior on child pain have focused almost exclusively on mothers. The present study compared mothers' and fathers' verbal behavior during child pain. The results can be used to inform clinical recommendations for mothers and fathers to help their children cope with pain.
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The observation of pain in other individuals is known to impact the cerebral activity in regions dedicated to one's nociception, as well as the behavior toward the person in pain. However, it remains unclear whether this shared representation for pain modulates somatosensory processing to nonpainful stimuli and whether this modulation is limb specific. Twenty right-handed healthy participants viewed a series of pictures depicting right hands or right feet in painful or nonpainful situations while light repetitive (25 Hz) mechanical stimuli were applied to the hand. The cortical excitability to these nonpainful stimuli was measured through the energy in the 25-Hz frequency band of electroencephalographic data. Following picture onset, a combination of nonspecific and specific modulation of cortical excitability was found. The former was widespread over the parieto-central region and likely related to factors such as attention. The latter was mostly restricted to 3 electrodes over the parietal cortex contralateral to the stimulation of the hand, and was specifically associated with the observation of others' hand in painful scenarios. This result confirms that the observation of pain can modulate somatosensory cortical excitability in an effector-specific way. The findings add to the accumulating evidence that other people's somatic pain is mapped onto the observer's sensori-motor system and offers a new paradigm to investigate potential neurophysiological changes in care providers who are often overexposed to others' pain. ⋯ This electroencephalography study demonstrates with a quick, easily implementable, and noninvasive paradigm that the change in cortical somatosensory excitability during pain observation is limb-specific, and confirms from a neuroscience perspective that being exposed to others' pain implies more than the sharing of an affective experience.
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The objective of this study was to assess the quality of websites presenting treatment information for postherpetic neuralgia. The term "postherpetic neuralgia treatment" was searched using the Google and Yahoo search engines. Fifty websites from each were evaluated using the Journal of the American Medical Association (JAMA) benchmarks, the Health on the Net (HON) seal, and the DISCERN instrument. The treatments suggested on each website were compared with 3 recognized first-line treatment options (antidepressants, anticonvulsants, and topical lidocaine). Less than half of the included websites fulfilled all JAMA benchmark requirements. Less than one-third of the websites displayed the HON seal. The DISCERN instrument evaluation revealed that most websites were of moderate quality. Commercial websites tended to be inferior in comparison to noncommercial websites. Most websites recommended at least 2 of the 3 recommended treatments as well as several second- and third-line treatments. One-third to one-half of websites recommended a nonbeneficial treatment. In conclusion, many different postherpetic neuralgia treatments are found on the Internet and patients may be left separating recommended treatments from nonrecommended treatments without help from their healthcare providers. ⋯ This study examined the quality of websites related to postherpetic neuralgia treatment. The results demonstrated that most websites offering advice on postherpetic neuralgia treatment are of only moderate quality and often offer treatment suggestions that are nonbeneficial. Patients and providers must use caution when taking advice from these sites.