Articles: pain-clinics.
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No comparative effectiveness data exist on nonopioid analgesics and nonbenzodiazepine anxiolytics to treat pain with anxiety. We examined the relationship between drug class and central nervous system (CNS) active drug polypharmacy on pain and anxiety levels in Medicare enrollees receiving home health (HH) care. This retrospective cohort study included enrollees with diagnoses and 2+ assessments of pain and anxiety between HH admission and discharge. ⋯ For patients with daily pain plus anxiety, pain was best reduced with one medication or any drug combination without opioid/benzodiazepine; anxiety was best reduced with combinations other than opiate/benzodiazepine. Gabapentinoids or SNRI achieved clinically meaningful pain control. Selective serotonin reuptake inhibitors provided clinically meaningful anxiety relief.
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Osteoarthritis (OA) is a highly prevalent and disabling joint disease, characterized by pathological progressive joint deformation and clinical symptoms of pain. Disease-modifying treatments remain unavailable, and pain-mitigation is often suboptimal, but recent studies suggest beneficial effects by inhibition of the voltage-gated sodium channel Na V 1.7. We previously identified compound 194 as an indirect inhibitor of Na V 1.7 by preventing SUMOylation of the Na V 1.7-trafficking protein, collapsin response mediator protein 2. ⋯ We found that the monoiodoacetate model induced (1) increased pain-like behaviors and calcium responses of glutamatergic neurons in the parabrachial nucleus after evoked cold and mechanical stimuli, (2) conditioned place aversion to mechanical stimulation, (3) functional weight bearing asymmetry, (4) increased sodium currents in dorsal root ganglia neurons, and (5) increased calcitonin gene-related peptide-release in the spinal cord. Crucially, administration of 194 improved all these pain-related outcomes. Collectively, these findings support indirect inhibition of Na V 1.7 as an effective treatment of OA-related pain through the inhibition of collapsin response mediator protein 2-SUMOylation via compound 194.
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Observational Study
Prevalence and epidemiological characteristics of chronic pain in the Spanish population. Results from the pain barometer.
Chronic pain (CP) is a public health problem worldwide. ⋯ Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Due to its high prevalence and impact on quality of life, chronic pain has become one of the main health problems nowadays. Attention must be paid to it both from a clinical and social perspective, trying to raise awareness among the population of its possible causes and consequences. In routine clinical practice, greater consideration is given to groups of people with a higher prevalence of chronic pain, such as women and people with middle age, and with no chronic pain to prevent the appearance of chronic pain.
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Fabry disease (FD) is a rare X-linked lysosomal disorder caused by alpha-galactosidase deficiency consecutive to a pathogenic variant in the GLA gene. Age at onset is highly variable, with a wide clinical spectrum including frequent renal, cardiac, skin and nervous system manifestations. Since pain can be an indicator of underlying FD, we wanted to estimate the prevalence of FD in a population of chronic pain patients. ⋯ Although a systematic search for FD does not seem relevant in the context of unexplained chronic pain in adults, a positive family history of FD or the presence of additional FD related organ features must lead to consider this rare disease diagnosis. Therefore, pain specialists need to be aware of main features of FD, including pain characteristics.
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Prior exposure to others' facial expressions of pain can lead to a facilitation of pain responses, including its corresponding response channel, namely facial responses to pain. It has been questioned, however, whether this vicarious pain facilitation occurs only when observing others' pain or whether the observation of other negative expressions can trigger similar facilitation of facial responses to pain. The study aimed to test this, by comparing the impact of viewing others' facial expressions of pain versus another negative expression (sadness) and two control expressions (neutral, happiness) on facial responses to pain. ⋯ Facial responses to pain - along with subjective and autonomic responses - are reduced when observing others' expressions of happiness, demonstrating pain modulation by positive affective social signals, which may also transfer to clinical contexts.