Articles: human.
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To examine the use of intravenous immunoglobulin (i.v.i.g.) in chronic pain. ⋯ Overall, 20% of patients had>70% pain relief and 27.7% of patients reported relief between 25% and 70%. Six patients (4.6%) had moderately increased pain levels for a duration of up to 9 weeks. Good relief, of more than 70%, was found in all major symptom groups. Patients with pain of short duration (<2 years) reported high relief rates (33.8% of patients in this group reported relief of >70%). No serious adverse events were reported. conclusions: i.v.i.g. may be effective in patients suffering from chronic pain. Controlled studies are needed to evaluate the efficacy of i.v.i.g. in these patients. Patients with a good response to i.v.i.g. may be models for the study of neuroimmune interactions in chronic pain.
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The debate surrounding The Human Rights Act (The Human Rights Act 1998. Home Office, London) and its impact on survivors of violence, has coincided with current political emphasis and UK Government policy on promoting partnership in the development and d elivery of statutory and voluntary health and social services (Crime and Disorder Act 1998, Home Office, London, Making a difference. Department of Health, London, 1999a, Modernising health and social services national priorities guidance 2000/01-2002/03. ⋯ As this was a new and different programme, School systems did not always match the needs of the course. Changes needed to be negotiated and new systems established. However, despite the challenges, everyone involved worked collaboratively across disciplines, reflecting current British policy emphasising partnership in dealing with the consequences of violent crime (Home Office 1998a) and the Department of Health's (1999a) strategies for care delivery in the National Health Service.
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Spinal cord stimulation is the most common mode of neuromodulation used in managing chronic low back pain. It is minimally invasive and reversible as opposed to nerve ablation. The basic scientific background of the initial spinal cord stimulation trials was based on the gate control theory of Melzack and Wall. ⋯ There is substantial scientific evidence on the efficacy of spinal cord stimulation for treatment of low back and lower extremity pain of neuropathic nature. Clinical studies revealed a success rate of from 50% to 70% with spinal cord stimulation, with decreased pain intensity scores, functional improvement and decreased medication usage. This review discusses multiple aspects of spinal cord stimulation, including pathophysiology and mechanism of action, rationale, indications, technique, clinical effectiveness, and controversial aspects.
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The purpose of this study was to investigate the short-term history effect of a decreasing frequency train on force and the influence of joint angle on such effect in human dorsiflexor muscles. Six able-bodied and three spinal cord injured (SCI) subjects took part in the study. Their isometric left dorsiflexor muscles were stimulated with two-second bursts at three ankle joint positions and movements at the ankle were measured. ⋯ This was true for all the subjects at dorsiflexed positions, but the effect is highly dependent on joint ankle. At plantar flexed positions moment enhancement was seen only in SCI subjects. We conclude that effects of joint angle as well as individual muscle properties should be taken into account when optimizing muscle force by means of frequency modulation.