827 COLON-TO-BLADDER AFFERENT CROSS-SENSITIZATION TO ENHANCE BLADDER AND URETHRAL PAIN BEHAVIORS IN RATS WITH TNBS-INDUCED COLITIS

Abstract Attorneys use the term pain and suffering to indicate the subjective, intangible effects of an individual's injury, and plaintiffs may seek compensation for “pain and suffering” as part of a personal injury case although it is not usually an element of a workers’ compensation case. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, provides guidance for rating pain qualitatively or quantitatively in certain cases, but, because of the subjectivity and privateness of the patient's experience, the AMA Guides offers no quantitative approach to assessing “pain and suffering.” The AMA Guides also cautions that confounders of pain behaviors and perception of pain include beliefs, expectations, rewards, attention, and training. “Pain and suffering” is challenging for all parties to value, particularly in terms of financial damages, and using an individual's medical expenses as an indicator of “pain and suffering” simply encourages excessive diagnostic and treatment interventions. The affective component, ie, the uniqueness of this subjective experience, makes it difficult for others, including evaluators, to grasp its meaning. Experienced evaluators recognize that a myriad of factors play a role in the experience of suffering associated with pain, including its intensity and location, the individual's ability to conceptualize pain, the meaning ascribed to pain, the accompanying injury or illness, and the social understanding of suffering.

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Faculty Opinions recommendation of Patients who display protective pain behaviors are viewed as less likable, less dependable, and less likely to return to work.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.716897965.792352809 ◽

2012 ◽

Author(s):

Joel Katz ◽

Brittany Rosenbloom

Keyword(s):

Return To Work ◽

Pain Behaviors

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How to objectively assess and observe maladaptive pain behaviors in clinical rehabilitation: a systematic search and review

Archives of Physiotherapy ◽

10.1186/s40945-021-00109-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Florian Naye ◽

Chloé Cachinho ◽

Annie-Pier Tremblay ◽

Maude Saint-Germain Lavoie ◽

Gabriel Lepage ◽

...

Keyword(s):

Back Pain ◽

Clinical Practice ◽

Critical Appraisal ◽

Inclusion Criteria ◽

Clinical Criteria ◽

Affective Factors ◽

Pain Behaviors ◽

Observation Methods ◽

Critical Appraisal Tool ◽

Secondary Objective

Abstract Background Cognitive-affective factors influence the perception of pain and disability. These factors can lead to pain behaviors (PB) that can persist and become maladaptive. These maladaptive PB will further increase the risk of chronicity or persistence of symptoms and disability. Thus, clinicians must be prepared to recognize maladaptive PB in a clinical context. To date, in the context of assessment in a rehabilitation setting, PB in clinical settings are poorly documented. The main objective of this study was to identify direct observation methods and critically appraise them in order to propose recommendations for practice. As a secondary objective, we explored and extracted the different observable PB that patients could exhibit and that clinicians could observe. Methods We conducted a comprehensive review on four databases with a generic search strategy in order to obtain the largest range of PB. For the first objective, a two-step critical appraisal used clinical criteria (from qualitative studies on barriers to implement routine measures) and psychometric criteria (from Brink and Louw critical appraisal tool) to determine which observation methods could be recommended for clinical practice. For the second objective, we extracted PB found in the literature to list potential PB that patients could exhibit, and clinicians could observe. Results From the 3362 retrieved studies, 47 met the inclusion criteria for the first objective. The clinical criteria allowed us to select three observation methods. After the psychometric step, two observation methods were retained and recommended for clinical practice: the Behavioral Avoidance Test-Back Pain (BAT-Back) and the Pain Behaviour Scale (PaBS). For the second objective, 107 studies met the inclusion criteria. The extraction of the PB allowed us to list a large range of PB and classify the data in 7 categories of PB. Conclusion Our results allowed us to recommend two observation methods for clinical practice. However, these methods have limitations and are validated only in chronic low back pain populations. With the extraction of PB presented in the literature, we contribute to better prepare clinicians to recognize PB in all patients who are experiencing pain.

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Methylene blue induces an analgesic effect by significantly decreasing neural firing rates and improves pain behaviors in rats

Biochemical and Biophysical Research Communications ◽

10.1016/j.bbrc.2021.01.008 ◽

2021 ◽

Vol 541 ◽

pp. 36-42

Author(s):

Seung Won Lee ◽

Sun Wook Moon ◽

Jin Sung Park ◽

Hye Rim Suh ◽

Hee Chul Han

Keyword(s):

Methylene Blue ◽

Analgesic Effect ◽

Neural Firing ◽

Firing Rates ◽

Pain Behaviors

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The short-term efficacy of electrical pudendal nerve stimulation versus intravesical instillation for the urethral pain syndrome: a randomized clinical trial

World Journal of Urology ◽

10.1007/s00345-021-03698-2 ◽

2021 ◽

Author(s):

Tian Li ◽

Xin Y. Feng ◽

Xiao M. Feng ◽

Jian W. Lv ◽

Ting T. Lv ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Nerve Stimulation ◽

Pudendal Nerve ◽

Pain Syndrome ◽

Intravesical Instillation ◽

Short Term ◽

Pudendal Nerve Stimulation ◽

Term Efficacy ◽

Urethral Pain

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SUR1, newly expressed in astrocytes, mediates neuropathic pain in a mouse model of peripheral nerve injury

Molecular Pain ◽

10.1177/17448069211006603 ◽

2021 ◽

Vol 17 ◽

pp. 174480692110066

Author(s):

Orest Tsymbalyuk ◽

Volodymyr Gerzanich ◽

Aaida Mumtaz ◽

Sanketh Andhavarapu ◽

Svetlana Ivanova ◽

...

Keyword(s):

Spinal Cord ◽

Neuropathic Pain ◽

Sciatic Nerve ◽

Peripheral Nerve ◽

Dorsal Horn ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Thermal Sensitivity ◽

Gradual Improvement ◽

Pain Behaviors

Background Neuropathic pain following peripheral nerve injury (PNI) is linked to neuroinflammation in the spinal cord marked by astrocyte activation and upregulation of interleukin 6 (IL -6 ), chemokine (C-C motif) ligand 2 (CCL2) and chemokine (C-X-C motif) ligand 1 (CXCL1), with inhibition of each individually being beneficial in pain models. Methods Wild type (WT) mice and mice with global or pGfap-cre- or pGFAP-cre/ERT2-driven Abcc8/SUR1 deletion or global Trpm4 deletion underwent unilateral sciatic nerve cuffing. WT mice received prophylactic (starting on post-operative day [pod]-0) or therapeutic (starting on pod-21) administration of the SUR1 antagonist, glibenclamide (10 µg IP) daily. We measured mechanical and thermal sensitivity using von Frey filaments and an automated Hargreaves method. Spinal cord tissues were evaluated for SUR1-TRPM4, IL-6, CCL2 and CXCL1. Results Sciatic nerve cuffing in WT mice resulted in pain behaviors (mechanical allodynia, thermal hyperalgesia) and newly upregulated SUR1-TRPM4 in dorsal horn astrocytes. Global and pGfap-cre-driven Abcc8 deletion and global Trpm4 deletion prevented development of pain behaviors. In mice with Abcc8 deletion regulated by pGFAP-cre/ERT2, after pain behaviors were established, delayed silencing of Abcc8 by tamoxifen resulted in gradual improvement over the next 14 days. After PNI, leakage of the blood-spinal barrier allowed entry of glibenclamide into the affected dorsal horn. Daily repeated administration of glibenclamide, both prophylactically and after allodynia was established, prevented or reduced allodynia. The salutary effects of glibenclamide on pain behaviors correlated with reduced expression of IL-6, CCL2 and CXCL1 by dorsal horn astrocytes. Conclusion SUR1-TRPM4 may represent a novel non-addicting target for neuropathic pain.

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Paraurethral Leiomyoma in a Postmenopausal Woman: First European Case

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/542963 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Susy Shim ◽

Camilla Skovvang Borg ◽

Huda Galib Majeed ◽

Peter Humaidan

Keyword(s):

Smooth Muscle ◽

Postmenopausal Woman ◽

Smooth Muscle Cells ◽

Postoperative Period ◽

Transvaginal Ultrasound ◽

Reproductive Age ◽

Benign Tumors ◽

Gynecological Examination ◽

Urethral Pain ◽

Paraurethral Leiomyoma

Leiomyomas are benign tumors extending from smooth muscle cells and only few cases of paraurethral leiomyomas have been described in the literature. They are often seen in the reproductive age and around 50% of the cases are asymptomatic. We describe a 59-year-old woman with a solid mobile tumor below the symphysis revealed at a gynecological examination. Transvaginal ultrasound and MRI confirmed the tumor and excision of the paraurethral tumor was carried out. The histological examination showed a benign paraurethral leiomyoma. The postoperative period was characterized by urethral pain as well as vaginal leakage of urine.

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