scholarly journals Chronicle of scientific gatherings of doctors of the St. Petersburg clinic for mental and nervous diseases. Protocol of appointment 19/3 96

2020 ◽  
Vol V (3) ◽  
pp. a7-a11
Author(s):  
V. M. Bekhterev
Keyword(s):  
Pain Relief ◽  
Pain Treatment ◽  
Sciatic Pain

Chairman prof. Bekhterev, with: Erlitsky, Rosenbakh. Dobrotvorskiy, Borispolskiy, Trapeznikov, Zhukovskiy. Gize, Ostankov, Osipov, Remers, Telyatnik.Borispolskiy. Sciatic pain treatment by Scottish souls. The speaker, on the basis of his observations in the treatment of 32 cases of chronic sciatic pain by Scottish souls, came to the conclusion that the latter represent an excellent means that enhances the exchange in the diseased nerve, being the best anti-neuralgic means in general with neuralgia. Out of 32 cases, he had 23 complete cures. 7 pain relief and only 2 without any result.

Pain Intensity after Laseruvulopalatoplasty and Tonsillectomy

2003 ◽  
Vol 128 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Hannu Kokki ◽  
Elina Nikanne ◽  
Mikko Aho ◽  
Jukka Virtaniemi
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Pain Treatment ◽  
Antiinflammatory Drug ◽  
Nonsteroidal Antiinflammatory Drug ◽  
Free Access ◽  
Fentanyl Citrate ◽  
Rescue Analgesia ◽  
Parallel Group ◽  
At Home

OBJECTIVE: The first objective of this study was to evaluate pain intensity and opioid consumption during the first 24 hours after uvulopalatoplasty and tonsillectomy in the hospital, and the second was to evaluate pain intensity and its progression during the first 2 weeks after surgery at home. STUDY DESIGN AND SETTINGS: In a prospective parallel group study, 51 patients with uvulopalatoplasty or tonsillectomy were studied. Ketoprofen, a nonsteroidal antiinflammatory drug, and fentanyl citrate, an opioid, were used as analgesics. RESULTS: Despite ketoprofen infusion and free access to a patient-controlled pump with fentanyl citrate for rescue analgesia, inadequate pain relief was common both after uvulopalatoplasty (35%) and after tonsillectomy (28%) during the first 24 hours after surgery. The consumption of fentanyl citrate was similar after both operations. At home, pain intensity was highest in the mornings during the first 5 days, and 10 patients had some pain still after 2 weeks. Also at home, high pain scores were reported commonly in both groups. CONCLUSION: Sgnificant pain after uvulopalatoplasty and tonsillectomy lasted for several days. Ketoprofen in the commercial capsule form proved to be too short acting for overnight pain relief. SIGNIFICANCE: Pain treatment in patients with uvulopalatoplasty and tonsillectomy should be improved to allow patients a peaceful recovery after surgery.

Predicting the Evolution of Pain Relief

2021 ◽  
Vol 2 (4) ◽  
pp. 1-28
Author(s):  
Anderson Bessa Da Costa ◽  
Larissa Moreira ◽  
Daniel Ciampi De Andrade ◽  
Adriano Veloso ◽  
Nivio Ziviani
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Predictive Models ◽  
Pain Treatment ◽  
Explanatory Models ◽  
Robust Algorithms ◽  
Local Structures ◽  
Patient Will ◽  
Data Points ◽  
Using Data

Modeling from data usually has two distinct facets: building sound explanatory models or creating powerful predictive models for a system or phenomenon. Most of recent literature does not exploit the relationship between explanation and prediction while learning models from data. Recent algorithms are not taking advantage of the fact that many phenomena are actually defined by diverse sub-populations and local structures, and thus there are many possible predictive models providing contrasting interpretations or competing explanations for the same phenomenon. In this article, we propose to explore a complementary link between explanation and prediction. Our main intuition is that models having their decisions explained by the same factors are likely to perform better predictions for data points within the same local structures. We evaluate our methodology to model the evolution of pain relief in patients suffering from chronic pain under usual guideline-based treatment. The ensembles generated using our framework are compared with all-in-one approaches of robust algorithms to high-dimensional data, such as Random Forests and XGBoost. Chronic pain can be primary or secondary to diseases. Its symptomatology can be classified as nociceptive, nociplastic, or neuropathic, and is generally associated with many different causal structures, challenging typical modeling methodologies. Our data includes 631 patients receiving pain treatment. We considered 338 features providing information about pain sensation, socioeconomic status, and prescribed treatments. Our goal is to predict, using data from the first consultation only, if the patient will be successful in treatment for chronic pain relief. As a result of this work, we were able to build ensembles that are able to consistently improve performance by up to 33% when compared to models trained using all the available features. We also obtained relevant gains in interpretability, with resulting ensembles using only 15% of the total number of features. We show we can effectively generate ensembles from competing explanations, promoting diversity in ensemble learning and leading to significant gains in accuracy by enforcing a stable scenario in which models that are dissimilar in terms of their predictions are also dissimilar in terms of their explanation factors.

Choice of spinal cord stimulation versus targeted drug delivery in the management of chronic pain: a predictive formula for outcomes

2020 ◽  
pp. rapm-2019-100859
Author(s):  
Nagy Mekhail ◽  
Diana S Mehanny ◽  
Sherif Armanyous ◽  
Shrif Costandi ◽  
Youssef Saweris ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Spinal Cord ◽  
Pain Relief ◽  
Targeted Drug Delivery ◽  
Spinal Cord Stimulation ◽  
Pain Treatment ◽  
Cleveland Clinic ◽  
Cost Effective ◽  
Implantable Devices ◽  
Targeted Drug

Contemporary nonmalignant pain treatment algorithms commence with conservative non-invasive strategies, later progressing from minimally invasive interventions to invasive techniques or implantable devices. The most commonly used implantable devices are spinal cord stimulation (SCS) systems or targeted drug delivery (TDD) devices. Historically, SCS had been considered in advance of TDD, positioning TDD behind SCS failures. Following Institutional Review Board approval, data were extracted from electronic medical records of patients who underwent SCS trial in the Department of Pain Management at Cleveland Clinic from 1994 to 2013. The sample size was analyzed in two cohorts: those who succeeded with SCS and those who failed SCS and consequently proceeded to TDD. Univariate and multivariate analyses were performed and a predictive formula for successful outcomes was created. 945 patients were included in the cohort of which 119 (12.6%) subjects achieved adequate pain relief with TDD after failure of SCS. Gender, age, depression and primary pain diagnosis were significantly different in this subgroup. Males were 52% less likely to experience pain relief with SCS. The odds of SCS success decreased as age increased by 6% per year. Patients with comorbid depression, interestingly, were 63% more likely to succeed with SCS. A logistic model was created to predict SCS success which was used to create a predictive formula. Older male patients diagnosed with spine-related pain were more likely to benefit from TDD than SCS. This observation potentially identifies a subgroup in whom consideration for TDD in advance of SCS failure could prove more efficient and cost effective. These retrospective findings warrant prospective comparative studies to validate this derived predictive formula.

Pain Relief in Areas of Deprivation and Conflict

2017 ◽  
Author(s):  
John Corey ◽  
Kelly McQueen
Keyword(s):  
Palliative Care ◽  
Pain Relief ◽  
Pain Treatment ◽  
Great Variability ◽  
Political Issues ◽  
Treatment Beliefs ◽  
Pain And Suffering ◽  
Education Training ◽  
Pain Care ◽  
Hiv Aids

This chapter addresses pain relief in areas of deprivation and conflict. There is variability in the causes of pain worldwide, including HIV/AIDS, torture-related pain and suffering, and war-related injuries. There is also great variability in the availability of adequate pain treatment worldwide due to limitations of education, training, knowledge of pain and its treatment, beliefs and communication about pain, and the inadequacy of access to drugs and palliative care in many countries. Research reflects the importance of extending pain care worldwide and addressing ethical and political issues surrounding pain care.

scholarly journals LO049: Ibuprofen or oxycodone? An observational cohort study of post-emergency department discharge management of children’s fracture pain

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S47-S47 ◽  
Author(s):  
S. Ali ◽  
A.L. Drendel ◽  
R.J. Rosychuk ◽  
S. Le May ◽  
P. McGrath ◽  
...  
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Pain Relief ◽  
Pain Treatment ◽  
School Attendance ◽  
Pain Scale ◽  
Post Injury ◽  
Maximum Pain ◽  
Emergency Department Discharge ◽  
Fracture Types

Introduction: Pediatric fracture pain is under-treated both in the emergency department (ED) and after discharge. Oral opioids and ibuprofen are amongst the top medications used to treat this pain. This study describes the post ED discharge effectiveness and safety of ibuprofen and oxycodone. Methods: A prospective cohort observational study was conducted at the Stollery Children’s Hospital (Edmonton, Alberta) from June 2010 to July 2014. Children aged 4-16 years, with an acute fracture, who were being discharged home with either ibuprofen (Ibu) or oxycodone (Oxy) for pain management were eligible for recruitment. Patients were contacted daily for three days, and at 2 and 6 weeks post-injury. Information regarding medication use, pain levels (with the Faces Pain Scale, Revised), adjuvant therapies, adverse events, and side effects and follow up was collected. Results: A total of 329 children (n=112 Oxy, n= 217 Ibu) were included. Mean age was 10.4 years (Ibu), and 12.3 years (Oxy); 68% (n=223) were male. Fracture types included forearm/wrist (47%,n=154), lower leg/ankle (14%,n=46), shoulder/clavicle (13%,n=42), and upper arm/elbow (12%,n=39). Reductions were performed in 34% of cases (n=113), while 9% (n=29) had buckle fractures. Children receiving Oxy had their eating, sleeping, play, and school attendance affected more than those receiving Ibu. More children receiving Oxy (81%, 91/112) experienced an adverse effect than those receiving Ibu (61%, 129/213) (p=0.0002); abdominal pain, dizziness, drowsiness, nausea, and vomiting were most prominent. The change in pain score (maximum pain - post-treatment pain) for Day 1 was 3.79 for Oxy and 3.61 Ibu; Day 2 was 3.68 Oxy and 3.55 Ibu; Day 3 was 3.34 Oxy and 3.66 Ibu. On Day 1, 59% (66/112) of Oxy cohort patients used other medication(s) for their pain treatment; 19% (41/213) did the same in the Ibu cohort. Conclusion: Ibuprofen and oxycodone provide similar pain relief for children with post-Ed discharge fracture pain. Oxycodone has greater impact on activities of daily living, side effects, and use of other medications to relieve pain. Oxycodone does not appear to confer any benefit over ibuprofen for pain relief, and given its negative side effect profile, this study suggests that ibuprofen is the better option. Further research is needed to determine the best combination treatment for fracture pain for children.

Pain treatment in rural Ghana—A qualitative study

2013 ◽  
Vol 4 (4) ◽  
pp. 256-256
Author(s):  
Desmond Ayim-Aboagye ◽  
Torsten Gordh
Keyword(s):  
Pain Relief ◽  
Rural Population ◽  
Pain Treatment ◽  
Psychological Symptoms ◽  
Psychological Pain ◽  
Depth Interview ◽  
Additional Protection ◽  
African Context ◽  
Traditional Practitioners ◽  
Biomedical Practitioners

Abstract Aims We investigated how treatment of pain was functioning among a rural population in African context. Methods The investigation employed the observation approach and in-depth interview approach in a rural population of about 5000 inhabitants. However, at the zenith of the study 10 patients were selected for the in-depth interview, having serious conditions, which had rendered them immobile, received a major focus in the study. With qualitative methods, we were capable of procuring rich information through narratives. ResultsThe patients employ both biomedical practitioners and traditional practitioners in the culture who have potent knowledge of culture specific disabilities. Even when patients had received satisfactory treatments leading to pain relief from the former practitioners, they still cherish some psychological pain, which demand that they consult other practitioners in the culture for further treatments. Those that only receive help from the mainstream hospitals or speciality clinics show improvement, but usually assailed by fear and excessive worry that their pains will not disappear entirely. While the younger generation patients are reluctant to reveal these consultations with traditional practitioners openly, the older group felt more positive about it and brag of having endured their ordeal because of these consultations with those who could offer them additional protection. ConclusionThe employment of different practitioners’ treatments alleviated these patients’ pain disabilities and psychological symptoms, which were that of pain relief, psychological pain, and death fear. Traditional treatment of pain has a social function, and therefore must be given attention to and recognition by biomedical-trained doctors.

scholarly journals Food-Derived Natural Compounds for Pain Relief in Neuropathic Pain

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Eun Yeong Lim ◽  
Yun Tai Kim
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Immune Responses ◽  
Pain Treatment ◽  
Physical Dependence ◽  
Natural Compounds ◽  
Number Of Patients ◽  
Potential Benefits ◽  
Somatosensory Nervous System ◽  
Injury Causes

Neuropathic pain, defined as pain caused by a lesion or disease of the somatosensory nervous system, is characterized by dysesthesia, hyperalgesia, and allodynia. The number of patients with this type of pain has increased rapidly in recent years. Yet, available neuropathic pain medicines have undesired side effects, such as tolerance and physical dependence, and do not fully alleviate the pain. The mechanisms of neuropathic pain are still not fully understood. Injury causes inflammation and immune responses and changed expression and activity of receptors and ion channels in peripheral nerve terminals. Additionally, neuroinflammation is a known factor in the development and maintenance of neuropathic pain. During neuropathic pain development, the C-C motif chemokine receptor 2 (CCR2) acts as an important signaling mediator. Traditional plant treatments have been used throughout the world for treating diseases. We and others have identified food-derived compounds that alleviate neuropathic pain. Here, we review the natural compounds for neuropathic pain relief, their mechanisms of action, and the potential benefits of natural compounds with antagonistic effects on GPCRs, especially those containing CCR2, for neuropathic pain treatment.

scholarly journals IL-7, IL-18, MCP-1, MIP1-β, and OPG as Biomarkers for Pain Treatment Response in Patients with Cancer

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. 499-510
Author(s):  
Andreas Sandner-Kiesling
Keyword(s):  
Pain Relief ◽  
Serum Level ◽  
Pain Intensity ◽  
Rating Scale ◽  
Pain Treatment ◽  
Medical Center ◽  
Primary Objective ◽  
Diagnostic Tools ◽  
Healthy Controls ◽  
Patients With Cancer

Background: Pain is one of the most common symptoms in patients suffering from advanced cancer and receiving palliative care and is often responsible for a poor quality of life. To date, there exists no published correlation between biological, measurable biomarkers and pain intensity. Objectives: The primary objective was to search and identify pain-associated cytokines (biomarkers) correlating with changes in numeric rating scale (NRS) pain scores in patients with cancer before and after pain treatment. The secondary objectives were to assess cytokine serum level differences between patients and healthy controls and to evaluate possible relationships between pain entities, pain intensity (in NRS), gender, location of primary tumor, and the patients’ cytokine baseline concentrations. Study Design: Controlled, prospective study. Setting: University medical center. Methods: Eligible patients with exacerbated cancer-related pain (NRS ≥ 5) and healthy controls with no pain were included. Serum level changes of 19 cytokines were analyzed before and during opioid treatment. Results: Of 19 analyzed biomarkers, 5 (IL-7, IL-18, MCP-1, MIP-1α, MIP-1β and OPG) turned out to correlate significantly with pain relief. In healthy controls, all analyzed cytokines showed no significant differences. In the secondary analysis, only one significant correlation was detected between OPG and pain entities. Furthermore, IL-4, IL-7, IFN-γ and OPG appeared to account for the ability to predict a patient’s gender. Limitations: Our findings should be considered as preliminary and need to be confirmed in further studies. Conclusion: Our results provide preliminary evidence of a significant correlation of pain relief in patients with cancer and at least 5 cytokines. These biomarkers may serve as the basis for development of diagnostic tools for pain assessment and could serve as potential new targets for pain control. Key words: Biomarker, cytokine, pain intensity, pain reduction, cancer-related pain, IL-7, IL-18, MCP-1, MIP-1α, MIP-1β, OPG.

Paracetamol and Pain Modulation by TRPV1, UGT2B15, SULT1A1 Genotypes: A Randomized Clinical Trial in Healthy Volunteers

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 661-669 ◽  
Author(s):  
Gisèle Pickering ◽  
Isabelle Creveaux ◽  
Nicolas Macian ◽  
Bruno Pereira
Keyword(s):  
Genetic Polymorphism ◽  
Pain Relief ◽  
Healthy Volunteers ◽  
Type I Error ◽  
Pain Treatment ◽  
Pain Modulation ◽  
University Hospital ◽  
Type I ◽  
Double Blind ◽  
Paracetamol Metabolism

Abstract Background The influence of the genetic polymorphism of enzymes and receptors involved in paracetamol metabolism and mechanism of action has not been investigated. This trial in healthy volunteers investigated the link between paracetamol pain relief and the genetic polymorphism of 23 enzymes and receptors. Design This randomized double-blind crossover controlled pilot study took place in the Clinical Pharmacology Department, University Hospital, Clermont-Ferrand, France. Forty-seven Caucasian volunteers were recruited. The trial consisted of two randomized sessions one week apart with oral paracetamol or placebo, and pain changes were evaluated with mechanical pain stimuli. The genetic polymorphism of 23 enzymes and receptors was studied, and correlations were made with pain relief. All tests are two-sided with a type I error at 0.05. Results Paracetamol was antinociceptive compared with placebo (222 ± 482 kPaxmin vs 23 ± 431 kPaxmin; P = 0.0047), and the study showed 30 paracetamol responders and 17 paracetamol nonresponders. Responders were characterized by TRPV1rs224534 A allele, UGT2B15rs1902023 TT genotype, and SULT1A1rs9282861 GG genotype (P < 0.05 for all). These findings confirm for the first time the involvement of a specific TRPV1 rs224534 variant in paracetamol antinociception. They also reveal a new antinociceptive role for specific variants of hepatic phase II enzymes associated with paracetamol metabolism. Conclusions The study warrants larger clinical trials on these potential genomic markers of paracetamol analgesia in patients. Confirmation of the present findings would open the way to effective individualized pain treatment with paracetamol, the most commonly used analgesic worldwide.

scholarly journals Thoracic paravertebral block versus intravenous patient-controlled analgesia for pain treatment in patients with multiple rib fractures

2017 ◽  
Vol 45 (6) ◽  
pp. 2085-2091 ◽  
Author(s):  
Ge Yeying ◽  
Yuan Liyong ◽  
Chen Yuebo ◽  
Zhang Yu ◽  
Ye Guangao ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pulmonary Function ◽  
Pain Treatment ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Rib Fractures ◽  
Paravertebral Block ◽  
Patient Controlled Analgesia ◽  
Thoracic Paravertebral Block ◽  
Multiple Rib Fractures

Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia. Results TPVB and IVPCA provided good pain relief. VAS scores were significantly lower in the TPVB group than in the IVPCA group at rest and during coughing ( P < 0.05). Patients in the TPVB group had a higher PaO2 and PaO2/FiO2 and lower P(A–a)O2 compared with the IVPCA group ( P < 0.05). Moreover, patients in the TPVB group showed higher FVC, FEV1/FVC, and PEFR, and fewer complications than did the IVPCA group ( P < 0.05). Conclusion TPVB is superior to IVPCA in pain relief and preservation of pulmonary function in patients with MRFs.

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