Enhanced Itch Intensity Is Associated with Less Efficient Descending Inhibition Processing for Itch But Not Pain Attenuation in Chronic Dermatology Patients

Pain Medicine ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. 2538-2545
Author(s):  
Michal Granot ◽  
Sarit Yakov ◽  
Michal Ramon
Keyword(s):  
Health Care ◽  
Brief Pain Inventory ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Descending Inhibition ◽  
Cross Sectional ◽  
Dermatology Clinic ◽  
Clinical Pain ◽  
The Individual ◽  
Pain Symptoms

Abstract Objectives The study aims were 1) to investigate the direction of mutual inhibitory pathways on itch intensity by utilizing conditioned pain modulation paradigms for pain and itch attenuation and 2) to explore whether itch severity is affected by the individual pain sensitivity profile, as well as pain scores reported during the tests and the past week. Design Cross-sectional. Setting Testing was conducted at the Department of Dermatology, Rambam Health Care Campus. Subjects Forty patients suffering from chronic skin disorders associated with itch and treated in the Dermatology Clinic at Rambam Health Care Campus participated in the study. Methods Efficacy of descending inhibition was evaluated by two conditioned pain modulation (CPM) paradigms: by pruriception (CPMItch) induced by cold and heat as counterstimuli to inhibit itch intensity and by nociception (CPMPain). Severity and interference of clinical pain were assessed using the Brief Pain Inventory (BPI). Results Robust CPMItch responses were obtained following the various noxious stimulations. No associations were observed between CPMPain and CPMItch, itch severity, skin disease severity, and clinical pain symptoms. According to the linear regression model, itch severity was independently associated with less efficient CPMItch (B = –0.750, P < 0.001) and more efficient CPMPain (B = 0.031, P = 0.016), which affects itch in opposing manners. Conclusions Findings indicate that the intrinsic capacity to inhibit pain and itch by exposure to exogenous noxious stimuli autonomously affects itch intensity in an opposing manner. These findings may shed new light on the mutual mechanistic similarity and dissimilarity between pain and itch and their hierarchy.

scholarly journals Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Jiang-Ti Kong ◽  
Rosa N. Schnyer ◽  
Kevin A. Johnson ◽  
Sean Mackey
Keyword(s):  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Acupuncture Analgesia ◽  
Mechanistic Studies ◽  
Sensory Testing ◽  
Descending Inhibition ◽  
Future Directions ◽  
Nociceptive Transmission ◽  
Clinical Pain ◽  
Neurophysiological Data

We discuss the emerging translational tools for the study of acupuncture analgesia with a focus on psychophysical methods. The gap between animal mechanistic studies and human clinical trials of acupuncture analgesia calls for effective translational tools that bridge neurophysiological data with meaningful clinical outcomes. Temporal summation (TS) and conditioned pain modulation (CPM) are two promising tools yet to be widely utilized. These psychophysical measures capture the state of the ascending facilitation and the descending inhibition of nociceptive transmission, respectively. We review the basic concepts and current methodologies underlying these measures in clinical pain research, and illustrate their application to research on acupuncture analgesia. Finally, we highlight the strengths and limitations of these research methods and make recommendations on future directions. The appropriate addition of TS and CPM to our current research armamentarium will facilitate our efforts to elucidate the central analgesic mechanisms of acupuncture in clinical populations.

scholarly journals Achievements and Challenges in Implementing Urban Family Physician Program in Iran: Viewpoint of Managers and Executives

2019 ◽  
Author(s):  
Mohammad Javad Kabir ◽  
Hasan Ashrafian Amiri ◽  
Zahra Hassanzadeh-Rostami ◽  
Reza Momtahen ◽  
Rasoul Zafarmand ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Physician ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Sustainable Resources ◽  
Urban Family ◽  
The Individual ◽  
Challenges And Strategies

Background: Urban family physician program is one of the relatively large reforms in Iran's health care system implemented in Fars and Mazandaran provinces since 2012. Nearly five years after implementation of the program, this study aimed to identify the achievements and challenges of this program from the viewpoints of managers and administrators. Methods: This cross-sectional study was conducted in winter of 2016. The research population included administrators and experts monitoring the urban family physician program and representatives of the family physicians and health care providers selected using the census method. The data collection tool was a two-part researcher-made questionnaire containing 15 questions with confirmed validity. To collect data, 29 panels of experts were held and the collected information was analyzed by SPSS 23 using independent t-tests and ANOVA. Results: Among the total of 647 participants in 2 provinces, 1540 achievement cases, 2387 challenge cases, and 1641 strategies were found. The average numbers of achievements, challenges, and strategies stated by each person were 2.38 ± 2.0, 3.70 ± 2.7, and 2.54 ± 2.0, respectively. The most frequent achievements, challenges, and strategies were increased disease detection and care (430), untimely payment to physicians (198), and providing sustainable resources for timely payments (119).  The means of achievements, challenges, and strategies had significant relationship with some of the individual and social variables (p < 0.05). Conclusion: This study showed that increasing the rate of detection was the most important achievement and lack of timely payment was the biggest challenge of the program, which should be considered by policy makers.

scholarly journals Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsovinar Harutyunyan ◽  
Varduhi Hayrumyan
Keyword(s):  
Health Care ◽  
Public Opinion ◽  
Health Care System ◽  
Telephone Survey ◽  
Equal Access ◽  
Cross Sectional ◽  
Political Environments ◽  
The Government ◽  
The Individual ◽  
Care System

Abstract Background Few studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population’s satisfaction with the health care system and identify factors associated with it in Armenia. Methods We conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between potential determinants and satisfaction. Results A substantial proportion of respondents (45.5%) were dissatisfied or very dissatisfied with the health system. About 49% of respondents negatively evaluated the ability of the system to provide equal access to care. About 69% of respondents thought that the responsibility for an individual’s health should be equally shared between the individual and the government or that the government’s share should be larger. The adjusted odds of satisfaction were higher among individuals with better health status, those who positively rated equal access and respect to patients in the system, those thinking that the responsibility for health should be equally shared between the individual and the government, and those who tended to trust the government. Conclusions This study enriched our understanding of factors that shape the population’s satisfaction with the health care system in different cultural and political environments. We recommend further exploration of public opinion about those system attributes that are not directly linked to patient experiences with care, but might be equally important for explaining the phenomenon of satisfaction.

scholarly journals Impaired Conditioned Pain Modulation in Young Female Adults with Long-Standing Patellofemoral Pain: A Single Blinded Cross-Sectional Study

Pain Medicine ◽  
2015 ◽  
pp. pnv017 ◽  
Author(s):  
Michael Skovdal Rathleff ◽  
Kristian Kjær Petersen ◽  
Lars Arendt-Nielsen ◽  
Kristian Thorborg ◽  
Thomas Graven-Nielsen
Keyword(s):  
Cross Sectional Study ◽  
Patellofemoral Pain ◽  
Young Female ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Conditioned Pain Modulation Is Not Impaired in Individuals with Frozen Shoulder: A Case-Control Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12330
Author(s):  
Marta Aguilar-Rodríguez ◽  
Lirios Dueñas ◽  
Mercè Balasch i Bernat ◽  
Mira Meeus ◽  
Filip Struyf ◽  
...  
Keyword(s):  
Frozen Shoulder ◽  
Pressure Pain Threshold ◽  
Conditioning Stimulus ◽  
Cross Sectional Study ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Central Pain ◽  
Cross Sectional ◽  
Pain Mechanisms ◽  
The Absolute

Frozen shoulder (FS) is a poorly understood condition resulting in substantial shoulder pain and mobility deficits. The mechanisms behind FS are not yet fully understood, but, similar to other persistent pain states, central pain mechanisms may contribute to ongoing symptoms in this population. The objective of this research was to investigate conditioned pain modulation (CPM) in people with FS compared with pain-free individuals. A total of 64 individuals with FS and 64 healthy volunteers participated in this cross-sectional study. CPM was assessed by using the pressure pain threshold (PPT) and an occlusion cuff (tourniquet test) as the test and conditioning stimulus, respectively. The absolute and percentage of change in PPT (CPM effect) as well as pain profiles (pro-nociceptive vs. anti-nociceptive) of individuals with FS and healthy controls were calculated. No significant differences in the absolute change in the PPT or CPM effect were found in people with FS compared to pain-free controls. Moreover, no between-group differences in the percentage of subjects with pro-nociceptive and anti-nociceptive pain profiles were observed. These results suggest that endogenous pain inhibition is normally functioning in people with FS. Altered central pain-processing mechanisms may thus not be a characteristic of this population.

scholarly journals Knowledge and awareness about occupational therapy among healthcare professionals in Al-Ahsa

2021 ◽  
Vol 8 (1) ◽  
pp. 008-012
Author(s):  
Senthil Vadivel ◽  
Paramasivan Mani ◽  
Nawaf Al Anezi ◽  
Mohammed Hamad Al Subaie ◽  
Abdullah Fahad Al Mulhim ◽  
...  
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Healthcare Professionals ◽  
National Guard ◽  
Cross Sectional Study ◽  
High Response Rate ◽  
Therapeutic Use ◽  
Cross Sectional ◽  
The Individual ◽  
Strongly Agree

Introduction and Aim: Occupational Therapy (OT) is a health care profession in which assist persons with physical, mental, or cognitive impairments through the therapeutic use of daily activities. In addition, the therapeutic use of everyday life activities (occupations) is aimed to enable the individual or groups to involve them in roles, customs and routines in home, college, place of business, society, and other settings by occupational therapist [1]. OT considers the only health care profession that enables people to do the activities they want and important for them via the therapeutic use of everyday activities [2]. Occupational therapists capacitate people of all ages to assist them by enhancing their health and inhibiting or adjusting with the injury, illness, or disability [3]. The aim of the study is to evaluate the knowledge of Occupational Therapy among healthcare professionals of National Guard Health Affairs in Al-Ahsa. Method: The study is cross-sectional study; the research was conducted in National Guard Health Affairs in Al-Ahsa. The healthcare provider’s knowledge about OT was assessed by the survey. The questionnaire consisted of seventy-five closed statements in five different aspects. The five-point Likert Scale (1=strongly disagree and 5=strongly agree) was used to measure the healthcare provider’s knowledge about OT. Results: The total numbers of participants were 218 participants, and 167 participants completed the survey showing a high response rate of 76.6%. The study found that the total knowledge among healthcare professionals about OT is moderate. Conclusion: The healthcare professionals of National Guard Health Affairs in Al-Ahsa have a moderate to minimal knowledge about OT. Further studies are needed on the importance of developing OT in the Kingdom of Saudi Arabia in general and in Al-Ahsa in particular.

scholarly journals Frequency of pain and eating disorders among professional and amateur dancers

2016 ◽  
Vol 134 (6) ◽  
pp. 501-507 ◽  
Author(s):  
Maria Angélica Kurpel Diogo ◽  
Gabriel Gomes de Oliveira Ribas ◽  
Thelma Larocca Skare
Keyword(s):  
Eating Disorders ◽  
Short Form ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Eating Attitudes ◽  
Cross Sectional ◽  
Ballet Dancers ◽  
Lower Limb Pain ◽  
Pain Symptoms ◽  
Eat 26

ABSTRACT CONTEXT AND OBJECTIVE: The pursuit of perfection can cause anxiety and lead dancers to exceed their physical limits. The aim here was to evaluate the prevalence of pain symptoms and eating disorders among professional and amateur dancers. DESIGN AND SETTING: Observational cross-sectional study; Curitiba, PR, Brazil. METHODS: Data on 150 professional and non-professional practitioners of ballet, jazz and street dance were collected through specific questionnaires: Brief Pain Inventory-Short Form (BPI-SF), Eating Attitudes Test-26 (EAT-26), Bulimic Investigatory Test Edinburgh (BITE) and State-Trait Anxiety Inventory-T-6 (STAI-T-6). RESULTS: Pain was observed in 58.6% of the sample, equally between professionals and amateurs (P = 0.19). Ballet dancers had more lower-limb pain than the other groups (P = 0.05). EAT-26 showed a tendency towards more eating disorders among the amateurs (P = 0.06). Higher risk of eating disorders was found among ballet dancers (P = 0.004) and jazz practitioners (P = 0.02) than among street dancers. Amateurs had more symptoms on the BITE scale (P < 0.0001), more pain (P = 0.002) and higher anxiety (P < 0.0001). Eating disorders were more common among females (P = 0.01) and singles (P = 0.02). Professionals were more satisfied with their own body image than amateurs (P < 0.001). CONCLUSIONS: Pain symptoms were found in almost half of the sample, equally among professionals and amateurs as well as between the three dance styles. Female and singles had more eating disorders. Those with eating disorders had higher levels of pain and anxiety.

scholarly journals Impairment of Inhibition of Trigeminal Nociception via Conditioned Pain Modulation in Persons with Migraine Headaches

Pain Medicine ◽  
2019 ◽  
Vol 20 (8) ◽  
pp. 1600-1610 ◽  
Author(s):  
Amy E Williams ◽  
Megan M Miller ◽  
Emily J Bartley ◽  
Klanci M McCabe ◽  
Kara L Kerr ◽  
...  
Keyword(s):  
Pain Catastrophizing ◽  
Experimental Pain ◽  
Blink Reflex ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Cross Sectional ◽  
Migraine Headaches ◽  
Trigeminal Nociception ◽  
Nociceptive Blink Reflex ◽  
Pain Report

Abstract Objective To assess conditioned pain modulation efficiency in persons with and without migraine headaches. Design Cross-sectional assessment of experimental pain. Setting University campus and surrounding community in a large Midwestern US city. Subjects Twenty-three adults with and 32 without a history of migraine headaches participated in the study. Participants were mostly female (N = 40) with an average age of 23 years. Methods Four electrocutaneous stimulations of the supraorbital branch of the left trigeminal nerve were delivered at 150% of an individually determined pain threshold. Conditioned pain modulation was assessed by applying a noxious counterstimulus (forearm ischemia) and delivering four more electrocutaneous stimulations. After each stimulation, pain and the nociceptive blink reflex were assessed. Depression and pain catastrophizing were assessed to control for the potential influence of these variables on pain modulation. Results Participants with and without migraine headaches had similar baseline pain responsivity, without significant differences in pain report or nociceptive blink reflexes. Pain report was inhibited by conditioned pain modulation in both the migraine and control groups. However, unlike nonmigraine controls, participants with migraines did not exhibit an inhibition of nociceptive blink reflexes during the ischemia task. This pattern persisted after controlling for level of pain catastrophizing and depression. Conclusions Migraine sufferers exhibited impaired conditioned pain modulation of the nociceptive blink reflex, suggesting a deficiency in inhibition of trigeminal nociception, which may contribute to the development of migraine headaches.

scholarly journals Prevalence of self-reported gynaecological problems in a community of district Srinagar Kashmir valley

2017 ◽  
Vol 4 (9) ◽  
pp. 3105 ◽  
Author(s):  
Mahbooba Rasool ◽  
Taha Ayub ◽  
Sheema Samreen
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Individual Perceptions ◽  
Perceptions And Attitudes ◽  
The Individual ◽  
Good Percentage

Background: Gynaecological disorders are quite frequent in the community but still mortality is an indicator of maternal health. Treatment seeking behaviour depends upon the individual perceptions and attitudes towards health care. Methods: A community based cross sectional study in which 419 eligible women in the age group of 15-45 were enrolled and interviewed for the study. A semi structured pretested questionnaire was used. The questionnaire included information about the socio demographic characteristics of the students. Data was analysed using percentages. Results: The prevalence came out to be 20.28% which was percentage of women reporting one or more gynaecological disorders. 52.94% did not seek anywhere care or visited any health care facility. Conclusions: The study found a good percentage of women who self-reported one or more gynaecological disorder, which prompts one to find out various factors associated with this problem. 

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