Long-term effects of pain in children

2013 ◽  
pp. 30-38 ◽  
Author(s):  
Ruth E. Grunau
Keyword(s):  
Medical Care ◽  
Pain Perception ◽  
Primary Concern ◽  
Long Term Effects ◽  
Term Infants ◽  
Surgical Pain ◽  
Biological Substrate ◽  
Life Threatening ◽  
Infant Pain

Major advances in high-technology medical care have led to greatly increased survival of medically fragile infants born extremely preterm, or with major congenital anomalies or other life-threatening conditions. These infants are exposed to procedural, surgical, and post-surgical pain. For millennia human infancy was a prolonged period of adult protection, with pain rarely encountered early in life. While the biological mechanisms for perception of pain develop during the fetal period, endogenous capacities to dampen pain mature later. Until relatively recently, this biological substrate was a good fit, matching the environment of infancy. However, the revolution in medical care has led to unforeseen challenges to understand and manage infant pain. In full-term infants, the primary concern is whether early pain alters later pain sensitivity. In contrast, due to the immaturity of the developing nervous system, the greatest impact of pain is likely to occur in the least maturely born infants. Therefore, in infants born very preterm who undergo lengthy hospitalization, pain may affect multiple aspects of development. This chapter focuses on long-term effects of early pain on subsequent pain perception, neurodevelopment, brain development, and programming of stress systems in the context of clinical studies, and whether caregiving factors may ameliorate potential long-term adverse effects.

The Neurobiology of Pain

2019 ◽  
pp. 387-414
Author(s):  
Maria Fitzgerald ◽  
Michael W. Salter
Keyword(s):  
Early Life ◽  
Pain Perception ◽  
Long Term Effects ◽  
Male And Female ◽  
Functional Changes ◽  
Pain Pathways ◽  
Developmental Age ◽  
Short And Long Term ◽  
Age And Sex

The influence of development and sex on pain perception has long been recognized but only recently has it become clear that this is due to specific differences in underlying pain neurobiology. This chapter summarizes the evidence for mechanistic differences in male and female pain biology and for functional changes in pain pathways through infancy, adolescence, and adulthood. It describes how both developmental age and sex determine peripheral nociception, spinal and brainstem processing, brain networks, and neuroimmune pathways in pain. Finally, the chapter discusses emerging evidence for interactions between sex and development and the importance of sex in the short- and long-term effects of early life pain.

scholarly journals Risk surveillance and mitigation: autoantibodies as triggers and inhibitors of severe reactions to SARS-CoV-2 infection

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Catherine Chen ◽  
Aisah Amelia ◽  
George W. Ashdown ◽  
Ivo Mueller ◽  
Anna K. Coussens ◽  
...  
Keyword(s):  
Severe Disease ◽  
Surface Proteins ◽  
Prognostic Indicators ◽  
Individual Risk ◽  
Long Term Effects ◽  
Complement Components ◽  
Screening Strategies ◽  
Life Threatening ◽  
Asymptomatic Infections

AbstractCOVID-19 clinical presentation differs considerably between individuals, ranging from asymptomatic, mild/moderate and severe disease which in some cases are fatal or result in long-term effects. Identifying immune mechanisms behind severe disease development informs screening strategies to predict who are at greater risk of developing life-threatening complications. However, to date clear prognostic indicators of individual risk of severe or long COVID remain elusive. Autoantibodies recognize a range of self-antigens and upon antigen recognition and binding, important processes involved in inflammation, pathogen defence and coagulation are modified. Recent studies report a significantly higher prevalence of autoantibodies that target immunomodulatory proteins including cytokines, chemokines, complement components, and cell surface proteins in COVID-19 patients experiencing severe disease compared to those who experience mild or asymptomatic infections. Here we discuss the diverse impacts of autoantibodies on immune processes and associations with severe COVID-19 disease.

scholarly journals 25% oral dextrose as analgesia during neonatal immunisation with BCG

2018 ◽  
Vol 5 (2) ◽  
pp. 416
Author(s):  
Tania Habib Mundol ◽  
Anitha S. Prabhu ◽  
Prakash R. M. Saldanha
Keyword(s):  
Animal Studies ◽  
Optimal Dose ◽  
Pain Scale ◽  
Bcg Vaccine ◽  
Control Group ◽  
Long Term Effects ◽  
Dextrose Solution ◽  
Pain Scales ◽  
Infant Pain

Background: Various animal studies have shown that repeated painful exposures can have deleterious long-term effects on neonates. Sick newborns are exposed to multiple painful procedures such as venipunctures, suctioning even removal of plasters. There are various physiologic and behavioral indicators of pain used in various standardized pain scales such as NIPS, NFCS, FLACC scale and Wong-Baker Faces pain scale. Sucrose, as an analgesic, has been used and recommended for minor painful procedures in neonates. The optimal dose of oral sucrose has not been established. The objective of this study was to study the analgesic effect of oral administration of 2 ml of 25% oral dextrose during neonatal immunization with BCG vaccine using NIPS (Neonatal/Infant Pain Scale).Methods: 40 consecutively selected newborns were given 2 ml of 25% oral dextrose solution 2 minutes prior to receiving the routine intradermal BCG vaccination. 40 consecutively selected newborns served as controls. The pain response in both groups was assessed using the standardized Neonatal Infant Pain Scale (NIPS).Results: Of the total 80 neonates included in the study, 40 were included in the dextrose group and 40 served as controls. 77.5% of the dextrose group were term babies compared to 72.5% in the control group. 20% of the dextrose group showed a NIPS score ≥6 while 40% in the control group had a similar NIPS score. Conclusions: A total of 80 newborns were included in this study, of which 40 (22 males, 18 females) received 25% oral dextrose solution prior to the BCG vaccine. The group which received dextrose was found to have less indicators of pain such as change in breathing pattern, cry and facial expression.

scholarly journals Creative Music Therapy and Neurodevelopmental Outcomes in Pre-term Infants at 2 Years: A Randomized Controlled Pilot Trial

2021 ◽  
Vol 9 ◽  
Author(s):  
Friederike Barbara Haslbeck ◽  
Hans Ulrich Bucher ◽  
Dirk Bassler ◽  
Cornelia Hagmann ◽  
Giancarlo Natalucci
Keyword(s):  
Music Therapy ◽  
Language Processing ◽  
Pilot Trial ◽  
Social Emotional Development ◽  
Long Term Effects ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Creative Music

Impaired neurodevelopment is increasingly recognized as a major health issue in children born prematurely. Creative music therapy (CMT) intends to prevent and or reduce neurobehavioral deficits in pre-term infants using musical stimulation and socio-emotional co-regulation. We conducted a randomized, clinical pilot CMT trial to test feasibility and to examine long-term neurodevelopmental outcomes in pre-term infants (NCT02434224: https://clinicaltrials.gov/ct2/show/NCT02434224). Eighty-two pre-term infants were randomized either to CMT or standard care. A specially trained music therapist provided family-integrating CMT via infant-directed singing during hospitalization. Fifty-six infants underwent follow-up at 2 years of corrected age. No significant beneficial nor adverse effects of CMT were identified in routine clinical neurodevelopmental measures (Bayley-III Scales of Infant and Toddler Development and the standardized neurological examination). Longer term follow-up (5 years) and larger future studies are recommended to elucidate possible long-term effects of music in relation to more sensitive outcomes including executive function, detailed language processing and social-emotional development.

Three scenarios illustrating ethical concerns when considering bariatric surgery in obese adolescents with Prader-Willi syndrome

2020 ◽  
Vol 46 (11) ◽  
pp. 738-742
Author(s):  
Maria Luisa Di Pietro ◽  
Drieda Zaçe
Keyword(s):  
Bariatric Surgery ◽  
Intellectual Disability ◽  
Therapeutic Option ◽  
Prader Willi Syndrome ◽  
Long Term Effects ◽  
Ethical Concerns ◽  
Severe Intellectual Disability ◽  
Threatening Condition ◽  
Life Threatening

Prader-Willi syndrome (PWS) is one of the 25 syndromic forms of obesity, in which patients present—in addition to different degrees of obesity—intellectual disability, endocrine disturbs, hyperphagia and/or other signs of hypothalamic dysfunction. In front of a severe/extreme obesity and the failure of non-invasive treatments, bariatric surgery is proposed as a therapeutic option. The complexity of the clinical condition, which could affect the long-term effects of bariatric surgery, and the frequent association with a mild to severe intellectual disability raise some ethical concerns in the treatment of obese PWS adolescents. This article analyses these issues referring to the principles of healthcare ethics: beneficence/non-maleficence (proportionality of treatments; minimisation of risks); respect of autonomy; justice. Based on these principles, three hypothetical scenarios are defined: (1) obese PWS adolescent, capable of making an autonomous decision; (2) obese PWS adolescent with a severe intellectual disability, whose parents agree with bariatric surgery; (3) obese PWS adolescent with a life-threatening condition and a severe intellectual disability, whose parents do not agree with bariatric surgery. The currently available evidence on efficacy and safety of bariatric surgery in PWS adolescents with extreme or severe obesity and the lack of adequate long-term follow-up suggests great caution even in a very life-threatening condition. Clinicians must always obtain a full IQ assessment of patients by psychologists. A multidisciplinary team is needed to analyse the clinical, psychological, social and ethical aspects and organise support for patient and parents, involving also the hospital ethical committee or, if necessary, legal authorities.

A Preferred Target Population for Comprehensive Health Promotion

1987 ◽  
Vol 8 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Gerald C. Hyner ◽  
Christopher L. Melby ◽  
Richard Petosa ◽  
Roger Seehafer ◽  
David R. Black
Keyword(s):  
Health Promotion ◽  
Medical Care ◽  
Target Population ◽  
Individual Responsibility ◽  
Behavioral Risk ◽  
Long Term Effects ◽  
Medical Care System ◽  
Health Maintenance ◽  
Comprehensive Health

Health promotion (HP) strategies have been advocated as a means of enhancing individual responsibility for health maintenance, while reducing client dependence on the medical care system. Similarly, advocates of HP have suggested that it may positively affect medical costs and physical/behavioral risk factors among others. To properly test the long-term effects of carefully planned HP interventions, a preferred target population is proposed. It is suggested that clientele would be drawn from moderate or low risk individuals who are seldom the population-of-interest within the traditional medical care model. The authors offer a model for comprehensive HP and discuss the implications of defining a target population for HP strategies.

Music Therapy in Pain and Symptom Management

1993 ◽  
Vol 9 (4) ◽  
pp. 42-48 ◽  
Author(s):  
Lucanne Magill-Levreault
Keyword(s):  
Pain Management ◽  
Music Therapy ◽  
Case Studies ◽  
Symptom Management ◽  
Pain Perception ◽  
Methods And Techniques ◽  
Life Threatening ◽  
Pain And Suffering ◽  
Sensory Processes

The use of music therapy in pain and symptom management in the care of patients with long-term and life-threatening illnesses can be an effective nonpharmacologic approach to help ameliorate pain and suffering. By altering affective, cognitive, and sensory processes, music may decrease pain perception by distraction, change in mood, increased control, use of prior skills, and relaxation. This article reviews the background of the use of music therapy in pain management, explores a theoretical framework, and describes methods and techniques. Three case studies are provided to demonstrate the work.

scholarly journals Lipids and infant formulas

1998 ◽  
Vol 11 (2) ◽  
pp. 255-278 ◽  
Author(s):  
J. S. Forsyth
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Structured Lipids ◽  
Infant Formulas ◽  
Long Term Effects ◽  
Term Infants ◽  
Cholesterol Intake ◽  
Short And Long Term ◽  
Breast Fed

AbstractThe ultimate goal in the design of infant formula is to achieve the outcome seen in breast fed infants. This review of lipids in infant formulas for term infants begins by referring to the lipid composition of human milk, and relates that to differences in lipid digestion and metabolism which exist between breast fed and formula fed infants and which may significantly influence fatty acid bioavailability.Recommendations are made for the lipid content and fatty acid composition of term infant formulas (especially for lauric, linoleic, α-linolenic, long chain 20 and 22C n-3 and n-6 polyunsaturated fatty acids and thetransfatty acids).Further research is required to define more clearly the long term nutritional, growth and developmental effects of structured lipids in formulas for term infants. More information is required on the differential handling of LCPUFA and other fatty acids at the organ and cellular level. There is a need for large (multi-centre) randomized studies to determine the short and long term functional effects of LCPUFA supplementation. Further research and development is required to determine a commercial source of LCPUFA which is safe, effective and economic. Further information is required on the short and long term effects of cholesterol intake during infancy, and in particular its relationship to LCPUFA metabolism. Long term studies should be initiated to determine the relationship of infant diet (especially saturated fatty acid and cholesterol intake) to the development of cardiovascular disease.

Analysis of risk factors for long-term effects of hypoxia in full-term infants with low Apgar score

2015 ◽  
pp. 124-127
Author(s):  
I.V. Tarasova ◽  
◽  
S.M. Kasyan ◽  
M.L. Radchenko ◽  
E.A. Shvidun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Apgar Score ◽  
Full Term ◽  
Long Term Effects ◽  
Term Infants

A Little Pain Never Hurt Anybody: A Photo-Essay on the Normalization of Sport Injuries

1994 ◽  
Vol 11 (2) ◽  
pp. 195-208 ◽  
Author(s):  
Timothy J. Curry ◽  
Richard H. Strauss
Keyword(s):  
Medical Care ◽  
Sports Medicine ◽  
Social Conditions ◽  
Photo Elicitation ◽  
Long Term Effects ◽  
Sport Injuries ◽  
Collegiate Sports ◽  
The Social ◽  
Photo Essay

This visual study explores the social conditions that promote the normalization of injuries in sport. Photographs taken at a university wrestling team’s meets and practices, and in a hospital operating room, convey some of the details and social ambience of today’s approach to collegiate sports medicine. Quotations drawn from photo-elicitation interviews with the coaches and athletes express the views of the participants. This study suggests that the normalization of injuries in sport—illustrated when universities make medical care immediately available and coaches and athletes minimize the significance of injury—encourages continued participation. Such continuation may be questioned by those concerned with the long-term effects of “playing with pain.”

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