scholarly journals Quantitative sensory testing in elderly: longitudinal study

2018 ◽  
Vol 76 (11) ◽  
pp. 743-750
Author(s):  
Luciana Alvarenga da Silva ◽  
Omar Jaluul ◽  
Manoel Jacobsen Teixeira ◽  
José Tadeu Tesseroli de Siqueira ◽  
Wilson Jacob Filho ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Quantitative Sensory Testing ◽  
Hemoglobin Concentration ◽  
Clinical Aspects ◽  
Mean Corpuscular Hemoglobin ◽  
Sensory Testing ◽  
Geriatric Service ◽  
Sensitivity Changes ◽  
Healthy Participants

ABSTRACT Objective: To evaluate elderly patients in a geriatric service, along with their sensory characteristics and their association with clinical aspects. Methods: This was a descriptive longitudinal study. We enrolled 36 healthy participants of both sexes in this study. The following instruments were used and evaluations performed: clinical evaluation, Mini-Mental State Exam, and quantitative sensory testing. Results: During the follow-up, there was reduction of mean corpuscular volume at each evaluation (p < 0.001) and significant increase in mean corpuscular hemoglobin concentration (p < 0.001). There was an increase of the olfactory (p < 0.001), salty (p = 0.024), sour (p = 0.020), bitter (p = 0.001), facial cold (p = 0.019), hand cold (p = 0.004), facial tactile (p < 0.001), hand tactile (p = 0.012) and facial vibration (p = 0.018) thresholds. Previous existing morbidities were associated with sensitivity changes in the individuals in this sample. Conclusion: This longitudinal study suggests that the loss of sensitivity with aging may be associated with the presence of morbidities in elders.

Chronic pain in children after cardiac surgery via sternotomy

2013 ◽  
Vol 24 (5) ◽  
pp. 893-899 ◽  
Author(s):  
Mette H. Lauridsen ◽  
Anders D. Kristensen ◽  
Vibeke E. Hjortdal ◽  
Troels S. Jensen ◽  
Lone Nikolajsen
Keyword(s):  
Chronic Pain ◽  
Cardiac Surgery ◽  
Quantitative Sensory Testing ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Sensory Testing ◽  
Sensory Abnormalities ◽  
Scar Area ◽  
Post Operative Pain

AbstractIntroductionChronic pain is common after sternotomy in adults with reported prevalence rates of 20–50%. So far, no studies have examined whether children develop chronic pain after sternotomy.Material and methodsPostal questionnaires were sent to 171 children 10–60 months after undergoing cardiac surgery via sternotomy at the age of 0–12 years. The children were asked to recall the intensity and duration of their post-operative pain, if necessary with the help from their parents, and to describe the intensity and character of any present pain. Another group of 13 children underwent quantitative sensory testing of the scar area 3 months after sternotomy.ResultsA total of 121 children, median (range) age 7.7 (4.2–16.9) years, answered the questionnaire. Their age at the time of surgery was median (range) 3.8 (0–12.9) years, and the follow-up period was median (range) 4 (0.8–5.1) years. In all, 26 children (21%) reported present pain and/or pain within the last week located in the scar area; in 12 (46%) out of the 26 children, the intensity was ≥4 on a numeric rating scale (0–10). Quantitative sensory testing of the scar area revealed sensory abnormalities – pinprick hyperalgesia and brush and cold allodynia – in 10 out of 13 children.ConclusionChronic pain after cardiac surgery via sternotomy in children is a problem that should not be neglected. The pain is likely to have a neuropathic component as suggested by the sensory abnormalities demonstrated by quantitative sensory testing.

Pain due to Ehlers-Danlos Syndrome Is Associated with Deficit of the Endogenous Pain Inhibitory Control

Pain Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 1929-1935 ◽  
Author(s):  
Caterina Maria Leone ◽  
Claudia Celletti ◽  
Gianfranco Gaudiano ◽  
Paola Anna Puglisi ◽  
Alessandra Fasolino ◽  
...  
Keyword(s):  
Test Stimulus ◽  
Inhibitory Control ◽  
Quantitative Sensory Testing ◽  
Sensory Testing ◽  
Ehlers Danlos Syndrome ◽  
Small Fiber ◽  
Maximum Pain ◽  
Stimulus Rating ◽  
Danlos Syndrome ◽  
Healthy Participants

Abstract Objectives Although pain is a common complication of the hypermobile type of Ehlers–Danlos syndrome, its underlying mechanisms are still an issue of controversy. In this psychophysical study, we aimed at testing small-fiber function and the endogenous pain inhibitory control in patients with pain due to Ehlers-Danlos syndrome. Methods In 22 patients with pain due to Ehlers-Danlos syndrome and 22 healthy participants, matched for age and sex, we tested small-fiber function using quantitative sensory testing and the endogenous pain inhibitory control using the conditioned pain modulation (CPM) protocol. As quantitative sensory testing methods, we included thermal pain and mechanical pain thresholds and the wind-up ratio. The CPM protocol consisted of two heat painful stimuli, that is, a test stimulus and a conditioning stimulus. Results All patients complained of widespread pain. Quantitative sensory testing revealed no small-fiber deficit; in the area of maximum pain, we found an increased wind-up ratio. Whereas in the healthy participants the CPM protocol showed that the test stimulus rating was significantly reduced during conditioning, in patients with pain due to hEDS, the test stimulus rating increased during conditioning. Conclusions Our psychophysical study showing that patients with pain due to hEDS have an increased wind-up ratio in the area of maximum pain and abnormal CPM protocol suggests that in this condition, pain is associated with central sensitization, possibly due to deficit of the endogenous pain inhibitory control. These data might be relevant to pharmacological treatment.

scholarly journals Intracellular Hemoglobin S Polymerization and the Clinical Severity of Sickle Cell Anemia

Blood ◽  
1998 ◽  
Vol 91 (5) ◽  
pp. 1777-1783 ◽  
Author(s):  
William N. Poillon ◽  
Bak C. Kim ◽  
Oswaldo Castro
Keyword(s):  
Hemoglobin Concentration ◽  
Significant Negative Correlation ◽  
Clinical Severity ◽  
Homogeneous Distribution ◽  
Mean Corpuscular Hemoglobin ◽  
Heterogeneous Distribution ◽  
Sickle Erythrocytes ◽  
Hb S ◽  
2,3 Dpg

Abstract Recent work has enabled us to quantitate the four variables (2,3-DPG concentration, pHi, non-S hemoglobin composition, and O2 saturation) that modulate the equilibrium solubility (csat) of Hb S inside sickle erythrocytes (SS RBCs). Using measured values of mean corpuscular hemoglobin concentration (MCHC), 2,3-DPG concentration, and %Hb (F+A2), along with estimates of pHiand the Δcsat due to partial oxygenation of SS RBCs in the microcirculation, we calculated the mean polymer fraction (fp) in erythrocytes from 46 SS homozygotes. Values of fp derived from the conservation of mass equation ranged from 0.30 to 0.59. MCHC and %Hb F were major determinants of the magnitude of fp; 2,3-DPG concentration and pHialso contributed, but to a lesser extent. A clinical severity score (CSS) was assigned to each patient based on mean hospitalization rate. There was a weak, but statistically significant, negative correlation between fp and steady state hematocrit (P = .017), but none between fp and whole blood hemoglobin concentration (P = .218). Although there was no correlation between fp and mean number of hospitalization days per year, patients with the greatest number of admissions and hospitalization days were found only among those who had an fp > 0.45. All five patients who died during the follow-up period (median, 7 years; range, 3 to 10 years) had fp values ≥0.48. However, patients with few admissions, low hospitalization days, and long survivals occurred at all fp levels. These results suggest that the clinical course of homozygous SS disease cannot be predicted by mean fpcalculations, which assume a homogeneous distribution of the five variables that modulate intraerythrocytic polymerization. A heterogeneous distribution is more likely; so the amount of polymerized Hb S could vary considerably among cell populations. Factors such as membrane abnormalities and endothelial cell interactions may also contribute to clinical severity.

scholarly journals Intracellular Hemoglobin S Polymerization and the Clinical Severity of Sickle Cell Anemia

Blood ◽  
1998 ◽  
Vol 91 (5) ◽  
pp. 1777-1783 ◽  
Author(s):  
William N. Poillon ◽  
Bak C. Kim ◽  
Oswaldo Castro
Keyword(s):  
Hemoglobin Concentration ◽  
Significant Negative Correlation ◽  
Clinical Severity ◽  
Homogeneous Distribution ◽  
Mean Corpuscular Hemoglobin ◽  
Heterogeneous Distribution ◽  
Sickle Erythrocytes ◽  
Hb S ◽  
2,3 Dpg

Recent work has enabled us to quantitate the four variables (2,3-DPG concentration, pHi, non-S hemoglobin composition, and O2 saturation) that modulate the equilibrium solubility (csat) of Hb S inside sickle erythrocytes (SS RBCs). Using measured values of mean corpuscular hemoglobin concentration (MCHC), 2,3-DPG concentration, and %Hb (F+A2), along with estimates of pHiand the Δcsat due to partial oxygenation of SS RBCs in the microcirculation, we calculated the mean polymer fraction (fp) in erythrocytes from 46 SS homozygotes. Values of fp derived from the conservation of mass equation ranged from 0.30 to 0.59. MCHC and %Hb F were major determinants of the magnitude of fp; 2,3-DPG concentration and pHialso contributed, but to a lesser extent. A clinical severity score (CSS) was assigned to each patient based on mean hospitalization rate. There was a weak, but statistically significant, negative correlation between fp and steady state hematocrit (P = .017), but none between fp and whole blood hemoglobin concentration (P = .218). Although there was no correlation between fp and mean number of hospitalization days per year, patients with the greatest number of admissions and hospitalization days were found only among those who had an fp > 0.45. All five patients who died during the follow-up period (median, 7 years; range, 3 to 10 years) had fp values ≥0.48. However, patients with few admissions, low hospitalization days, and long survivals occurred at all fp levels. These results suggest that the clinical course of homozygous SS disease cannot be predicted by mean fpcalculations, which assume a homogeneous distribution of the five variables that modulate intraerythrocytic polymerization. A heterogeneous distribution is more likely; so the amount of polymerized Hb S could vary considerably among cell populations. Factors such as membrane abnormalities and endothelial cell interactions may also contribute to clinical severity.

Abstract 12550: Persistent Relative Hypochromia is Associated With Adverse Outcomes in Non-anemic Patients With Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Muhammad Hammadah ◽  
Yuping Wu ◽  
Lin Li ◽  
Stanley Hazen ◽  
W.H.Wilson Tang
Keyword(s):  
Mortality Risk ◽  
Hemoglobin Concentration ◽  
Adverse Outcomes ◽  
Mean Corpuscular Hemoglobin ◽  
Good Representation ◽  
Functional Iron Deficiency ◽  
Blood Indices ◽  
Patients With Heart Failure ◽  
Mean Time

Background: We previously reported that functional iron deficiency, assessed by low mean corpuscular hemoglobin concentration (MCHC), has been associated with adverse outcomes in non-anemic patients with HF. Yet, the effect of change in MCHC levels on outcomes has not been studied before. Methods: We prospectively enrolled 1,579 subjects with HF undergoing coronary angiography, with 5-year follow-up. Blood indices [hemoglobin (Hb), MCHC, MCV, RDW] were assessed on enrollment and after 6 months of follow up by reviewing medical records. Anemia was defined as Hb levels <12 g/dL in males, and <11 g/dL in females. Results: In our population (age 66 ± 10 years, male 65%, CAD 75%), most patients were non-anemic (n=1,161, 73.5%). In non-anemic patients, mean Hb and median (IQR) MCHC were 13.3±1.2 g/dL and 34.2 (33.43-34.9) g/dL, respectively. Non-anemic HF patients with lower MCHC had higher mortality risk [Q1 vs Q4 Hazard ratio (HR) (95%CI) of 2.5(1.9-3.2), p<0.001]. Total of 552 (35%) had follow up Hb levels with a mean time between baseline and follow up levels of 169.3 ± 41.6 days. HF severity (EF, BNP), outcomes and blood indices were similar in patients with and without follow up levels, suggesting good representation of the total population. Changes in MCHC levels was studied in non-anemic patients on baseline and follow up (n=318). Most patient with low MCHC at baseline (<Q1, n=79) continued to have low MCHC on follow up (n=61), while half of the patients with high baseline MCHC (≥Q1, n=239) developed low MCHC on follow up (n=120). In comparison to patient with persistently high MCHC, patients with persistently low MCHC had a significantly increased mortality risk [HR(95%CI) of 3.5(2.1-6.1), p<0.001]. All models remained significant even after adjusting for traditional CAD risk factors, EF and baseline blood indices. Conclusion: Relative hypochromia is an independent predictor of increase mortality in patients with HF, even in the setting of normal hemoglobin levels.

Reliability of orofacial quantitative sensory testing for pleasantness and unpleasantness

Cephalalgia ◽  
2020 ◽  
Vol 40 (11) ◽  
pp. 1191-1201
Author(s):  
Pankaj Taneja ◽  
Camilla Krause-Hirsch ◽  
Stine Laursen ◽  
Caroline Juul Sørensen ◽  
Håkan Olausson ◽  
...  
Keyword(s):  
Quantitative Sensory Testing ◽  
Intraclass Correlation ◽  
Research Network ◽  
Sensory Testing ◽  
German Research ◽  
Orofacial Region ◽  
The Right ◽  
Testing Protocols ◽  
Healthy Participants ◽  
Somatosensory Function

Background Quantitative sensory testing protocols for perceptions of pleasantness and unpleasantness based on the German Research Network on Neuropathic Pain protocol were recently introduced. However, there are no reliability studies yet published. Aim To evaluate the intra-examiner (test-retest) and inter-examiner reliability for orofacial pleasantness and unpleasantness quantitative sensory testing protocols. Methods Sixteen healthy participants from Aarhus University (11 women and five men, mean age 24, range 21–26 years) contributed. Two examiners were trained in performing the entire quantitative sensory testing protocols for pleasantness and unpleasantness, which included the additional dynamic tactile stimulation test using a goat-hair brush. Each participant underwent examination of both protocols by each examiner (inter-examiner reliability) on day 1. They returned at least 8 days following the testing to be re-examined by one examiner (intra-examiner reliability). All testing was performed on the skin of the right mandibular mental region. The intraclass correlation (ICC) was used to determine reliability. Results For the protocol investigating pleasantness, the majority of parameters had good to excellent intra-examiner (11/14: Intraclass correlation 0.67–0.87) and inter-examiner (13/14: Intraclass correlation 0.62–0.96) reliabilities. Similarly, the protocol investigating unpleasantness had good to excellent intra-examiner (intraclass correlation 0.63–0.99) and inter-examiner (intraclass correlation 0.65–0.98) reliabilities for most (13/15) of the parameters. Conclusion Intra and inter-examiner reliabilities in the majority of quantitative sensory testing parameters (apart from the summation ratio) investigating pleasantness and unpleasantness are acceptable when assessing somatosensory function of the orofacial region. Trial registration: NA

Do chronic low back pain subgroups derived from dynamic quantitative sensory testing exhibit differing multidimensional profiles?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Martin Rabey ◽  
Michelle Kendell ◽  
Shani Koren ◽  
Isabela Silva ◽  
Lauren Watts ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Quantitative Sensory Testing ◽  
Pain Sensitivity ◽  
Low Back ◽  
Sensory Testing ◽  
Cold Pain

Abstract Objectives The relationship of pain sensitivity with pain and disability in low back pain (LBP) is complicated. It has been suggested increased understanding of dynamic quantitative sensory testing (QST) might be useful in increasing understanding of these relationships. This study aimed to create subgroups based on participant responses to dynamic QST, profile these subgroups based on multidimensional variables (including clinical measures of pain and disability, psychological and lifestyle variables and static QST), and investigate the association of subgroup membership with levels of pain intensity, LBP-related disability and disability risk at 12-month follow up. Methods Participants (n=273) with dominant axial chronic non-specific LBP with duration of pain >3 months were included in this study. At baseline, eligible participants completed a self-report questionnaire to collect demographic, clinical, psychological and lifestyle data prior to dynamic and static QST. Dynamic QST measures were conditioned pain modulation (CPM) and temporal summation (TS). At 12-months follow up, clinical data were collected, including pain intensity and LBP-related disability. Sub-groups were formed by cross-tabulation. Analysis was undertaken to profile dynamic QST subgroup on demographic, clinical, psychological, lifestyle and static QST measures. Associations between dynamic QST subgroups and follow-up clinical variables were examined. Results Based on dynamic QST, participants were allocated into four subgroups; normal CPM and normal TS (n=34, 12.5%); normal CPM and facilitated TS (n=6, 2.2%); impaired CPM and normal TS (n=186, 68.1%); impaired CPM and facilitated TS (n=47, 17.2%). At baseline no differences were demonstrated between subgroups across most clinical variables, or any psychological or lifestyle measures. The two subgroups with impaired CPM were more likely to have a higher number of painful body areas. Cold pain sensitivity was heightened in both the subgroups with facilitated TS. Subgroups did not differ across pain intensity, LBP-related disability and disability risk stratification at follow-up. Conclusions The profiles of people with axial LBP did not vary significantly across dynamic QST subgroups, save for those in groups with impaired CPM being more likely to have more widespread symptoms and those with facilitated TS having heightened cold pain sensitivity. Further, subgroup membership was not related to future pain and disability. The role of dynamic QST profiles in LBP remains unclear. Further work is required to understand the role of pain sensitivity in LBP. The utility of dynamic QST subgrouping might not be in determining of future disability. Future research might focus on treatment modifying effects of dynamic QST subgroups.

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