Articles: neuralgia.
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Sensory profiling in neuropathic pain using quantitative sensory testing (QST) has not been extended to central neuropathic pain due to spinal cord injury (SCI). This study aims to fill this gap by evaluating sensory profiles in patients with neuropathic SCI pain. ⋯ The evaluation of sensory phenotypes by quantitative sensory testing in central neuropathic pain due to SCI adds a new perspective on sensory phenotypes in comparison to peripheral neuropathic pain. The described thermal and mechanical hyperalgesia combination might represent involvement of the spinothalamic tract. In addition, there was a trend towards older age and longer time since injury in patients with loss of function.
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Recurrent acute and chronic pancreatitis (RAP, CP) are complex, progressive inflammatory diseases with variable pain experiences impacting patient function and quality of life. The genetic variants and pain pathways in patients contributing to most severe pain experiences are unknown. We used previously genotyped individuals with RAP/CP from the North American Pancreatitis Study II (NAPS2) of European Ancestry for nested genome-wide associated study (GWAS) for pain-severity, chronicity, or both. ⋯ The implications for treating pancreatic pain are great in that we can no longer focus on just the pancreas. Furthermore, new treatments designed for pain disorders in other tissues may be effective in some patient with pain syndromes from the pancreas. Further research is needed to replicate and extend these observations so that new, genetics-guided rational treatments can be developed and delivered.
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Clinical Trial
Twelve-Month Clinical Trial Results of a Novel, Dorsal Horn Dendrite Stimulation Waveform for Chronic Neuropathic Low Back Pain.
The aim of this study was to evaluate the effectiveness and safety of a novel subperception spinal cord stimulation (SCS) waveform paradigm designed to target the dorsal horn dendrites for treating chronic neuropathic low back pain (LBP). The final 12-month results are reported here. ⋯ The Clinicaltrials.gov registration number for the study is ACTRN12618000647235 (anzctr.org.au).
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Peripheral nerve stimulation (PNS) has emerged as a minimally invasive percutaneous procedure addressing neuropathic pain. However, the percutaneous cylindrical lead ultrasound-guided implantation procedure requires expertise that limits widespread PNS utilization. To overcome these challenges, a microinvasive endoscopy device has very recently been developed, enhancing the precision of PNS implantation by providing accurate visualization of the targeted nerve. We aimed to determine the feasibility, safety, clinical effectiveness, and energy consumption of PNS therapy by means of ultrasound guidance combined with microendoscopy. ⋯ Implanted PNS by means of ultrasound combined with microendoscopy was safe and provided clinical benefits with very low energy consumption (15-440 times less than spinal cord stimulation) in patients with upper or lower limb neuropathic pain. Microendoscopy would offer extended PNS indications, overcoming limitations associated with ultrasound alone. Future research is nonetheless needed to provide stronger evidence through randomized controlled trial design.
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Our objective is to study the relationship between armed conflict injuries and pain and the treatments that have been applied to Ukrainian injured soldiers in our hospital. ⋯ The study of injuries caused in current armed conflicts can help us anticipate complications and understand and treat pain early to improve the independence of patients, especially of amputee patients.