scholarly journals Neuromodulation for Pelvic and Urogenital Pain

2018 ◽  
Vol 8 (10) ◽  
pp. 180 ◽  
Author(s):  
Holly Roy ◽  
Ifeoma Offiah ◽  
Anu Dua
Keyword(s):  
Pelvic Pain ◽  
Peripheral Nerves ◽  
Dorsal Root ◽  
Clinical Problem ◽  
Male And Female ◽  
Pain Syndromes ◽  
Patient Groups ◽  
Urogenital Pain ◽  
Major Clinical Problem

Chronic pain affecting the pelvic and urogenital area is a major clinical problem with heterogeneous etiology, affecting both male and female patients and severely compromising quality of life. In cases where pharmacotherapy is ineffective, neuromodulation is proving to be a potential avenue to enhance analgesic outcomes. However, clinicians who frequently see patients with pelvic pain are not traditionally trained in a range of neuromodulation techniques. The aim of this overview is to describe major types of pelvic and urogenital pain syndromes and the neuromodulation approaches that have been trialed, including peripheral nerve stimulation, dorsal root ganglion stimulation, spinal cord stimulation, and brain stimulation techniques. Our conclusion is that neuromodulation, particularly of the peripheral nerves, may provide benefits for patients with pelvic pain. However, larger prospective randomized studies with carefully selected patient groups are required to establish efficacy and determine which patients are likely to achieve the best outcomes.

Cancer-induced bone pain

2015 ◽  
Author(s):  
Lesley A. Colvin ◽  
Marie Fallon
Keyword(s):  
Bone Pain ◽  
Clinical Presentation ◽  
Clinical Problem ◽  
Current Therapy ◽  
Pain Mechanisms ◽  
Pain Syndromes ◽  
Current Therapies ◽  
Underlying Mechanisms ◽  
Laboratory Models ◽  
Major Clinical Problem

Bone is the third most common site of metastatic disease, after liver and lung, with approximately 75% of these patients suffering from related pain. Cancer-induced bone pain (CIBP) is a major clinical problem, with limited options for predictable, rapid, and effective treatment for some of the elements without unacceptable adverse effects. Our understanding of how current therapy acts is based mainly on studies in non-cancer pain syndromes, which are likely to be quite different, not only in clinical presentation, but also in terms of pathophysiology. It can be difficult to study the specific neurobiological changes associated with CIBP, although development of laboratory models of isolated bone metastases has allowed more specific study of pain mechanisms in this syndrome. In order to evaluate our current therapies properly and direct the development of new therapies logically, it is important to understand the underlying mechanisms of CIBP. This chapter discusses pain processing and the mechanisms and management of CIBP.

scholarly journals The fibroblast-derived protein PI16 controls neuropathic pain

2020 ◽  
Vol 117 (10) ◽  
pp. 5463-5471 ◽  
Author(s):  
Pooja Singhmar ◽  
Ronnie The Phong Trinh ◽  
Jiacheng Ma ◽  
XiaoJiao Huo ◽  
Bo Peng ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Dorsal Root ◽  
Clinical Problem ◽  
Endothelial Barrier ◽  
Leukocyte Infiltration ◽  
Spared Nerve Injury ◽  
Protein Levels ◽  
Major Clinical Problem

Chronic pain is a major clinical problem of which the mechanisms are incompletely understood. Here, we describe the concept that PI16, a protein of unknown function mainly produced by fibroblasts, controls neuropathic pain. The spared nerve injury (SNI) model of neuropathic pain increases PI16 protein levels in fibroblasts in dorsal root ganglia (DRG) meninges and in the epi/perineurium of the sciatic nerve. We did not detect PI16 expression in neurons or glia in spinal cord, DRG, and nerve. Mice deficient in PI16 are protected against neuropathic pain. In vitro, PI16 promotes transendothelial leukocyte migration. In vivo, Pi16−/− mice show reduced endothelial barrier permeability, lower leukocyte infiltration and reduced activation of the endothelial barrier regulator MLCK, and reduced phosphorylation of its substrate MLC2 in response to SNI. In summary, our findings support a model in which PI16 promotes neuropathic pain by mediating a cross-talk between fibroblasts and the endothelial barrier leading to barrier opening, cellular influx, and increased pain. Its key role in neuropathic pain and its limited cellular and tissue distribution makes PI16 an attractive target for pain management.

Treatment of pulmonary embolism: The use of low-molecularweight heparin in the inpatient and outpatient settings

2008 ◽  
Vol 99 (03) ◽  
pp. 502-510 ◽  
Author(s):  
Russell Hull
Keyword(s):  
Pulmonary Embolism ◽  
Outpatient Treatment ◽  
Cost Savings ◽  
Clinical Problem ◽  
Mortality And Morbidity ◽  
Outpatient Settings ◽  
Healthrelated Quality Of Life ◽  
Current Guidelines ◽  
Major Clinical Problem

SummaryPulmonary embolism (PE) remains a major clinical problem associated with considerable mortality and morbidity. In patients with PE, appropriate anticoagulant therapy has been shown to significantly reduce both recurrence and mortality. Low-molecular- weight heparin (LMWH) is at least as effective as unfractionated heparin (UFH) in the treatment of PE,with a similar risk of bleeding. Furthermore, LMWH offers more predictable pharmacokinetics and anticoagulant effects. As a result, current guidelines from both the American College of Chest Physicians and the joint American College of Physicians/American Academy of Family Physicians recommend the use of LMWH over UFH (in patients with submassive PE). Outpatient treatment with LMWH has been shown to be feasible in many patients,and offers the potential for cost-savings and improvements in healthrelated quality of life. Further data are needed to support an evidence- based recommendation for the use of LMWH in the outpatient treatment of PE.

Quality of Life following Treatment: A Preliminary Study of In- and Outpatients with Chronic Pain

1989 ◽  
Vol 18 (3) ◽  
pp. 271-282 ◽  
Author(s):  
Raymond C. Tait ◽  
Paul N. Duckro ◽  
Ronald B. Margolis ◽  
Richard Wiener
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Syndromes ◽  
Before And After ◽  
Patient Groups ◽  
Methodological Problems ◽  
Preliminary Study ◽  
Different Levels ◽  
Chronic Pain Syndromes

Using a combination of standardized and Likert-type measures of health, disability, and psychological adjustment, this study compared the quality of life reported by thirty-seven inpatients and thirty-six outpatients approximately eight months after completing treatment. While both patient groups reported treatment-related changes, inpatients were significantly more dysfunctional than outpatients both before and after treatment. The pattern of perceived improvement among inpatients reflected particular changes in narcotic use and in “up” time. For outpatients, the pattern of change pointed to increased periods of activity. The data are interpreted to reflect the need for treatments that are tailored to meet the differing levels of dysfunction of patients who present with chronic pain syndromes. Methodological problems of this and other clinical studies that compare treatment effects on patients demonstrating different levels of dysfunction are discussed.

87: Biopsychosocial Factors in Quality of Life in men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

2007 ◽  
Vol 177 (4S) ◽  
pp. 31-31
Author(s):  
J. Curtis Nickel ◽  
Dean Tripp ◽  
Shannon Chuai ◽  
Mark S. Litwin ◽  
Mary McNaughton-Collins
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome

Histamine metabolism disorder in pathogenesis of chronic pelvic pain in patients with external genital endometriosis

2017 ◽  
pp. 56-60
Author(s):  
М.Р. Оразов ◽  
В.Е. Радзинский ◽  
М.Б. Хамошина ◽  
Е.Н. Носенко ◽  
Э.С. Токаева ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Peripheral Blood ◽  
Chronic Pelvic Pain ◽  
Pain Syndrome ◽  
Histamine Level ◽  
Life Assessment ◽  
Assay Method ◽  
Histamine Metabolism

Цель исследования - изучение особенностей обмена гистамина при хронической тазовой боли у пациенток с наружным генитальным эндометриозом. Методика. В сыворотке крови 100 пациенток методом высокоточного (в нг/мл) иммуноферментного твердофазного анализа определяли концентрацию гистамина. Использованы реактивы «Histamine ЕLISA», аппарат BAE-1000 Гистамин (Labor Diagnostika Nord - LDN, Германия). Оценка выраженности болевого синдрома осуществлялась по шкале ВАШ, оценка качества жизни - на основании опросника для оценки качества жизни при эндометриозе (EHR-30), оценка тревожности - опросника Спилбергера-Ханина. Результаты. Показано статистически значимое повышение уровня гистамина у пациенток с высокой интенсивностью болевого синдрома. Женщины с наружным генитальным эндометриозом, сопровождающимся интенсивным болевым синдромом в 100% случаев обнаруживали высокие уровни ситуативной и личностной тревожности, тогда как, лишь у 40% женщин (n = 16) контрольной группы выявлен умеренный уровень тревожности. Депрессивные расстройства выявлены у 58,3% женщин с хронической тазовой болью (n = 35), из них основную часть (n = 20) составили женщины с выраженной степенью болевого синдрома по ВАШ. Заключение. Психоэмоциональное состояние женщин с тазовой болью, ассоциированной с наружным генитальным эндометриозом, характеризуется высокими уровнями депрессивных и тревожных расстройств, значительным снижением уровня качества жизни. Выявлена прямая связь между интенсивностью болевого синдрома и уровнем гистамина в периферической крови пациенток с наружным генитальным эндометриозом. Objective. To study features of histamine metabolism in patients with chronic pelvic pain associated with external genital endometriosis. Methods. For quantitative assessment of histamine level in peripheral blood was taken from 100 patients which than was centrifuged. In blood serum histamine concentration was determined by enzyme-linked immunosorbent assay method with reagents «Histamine ЕLISA» on the machine BAE-1000 Histamine (Labor Diagnostika Nord - LDN, Hermany). A pain syndrome was assessed by Visual Analog Scale (VAS), quality of life assessment - by Endometriosis Health Profile Questionnaire (EHR-30), level of anxiety was determined by Spielberger-Khanin questionnaire. The results. Showed statistically higher histamine level in patients with severe pain according to VAS. After assessment of results obtained from Spielberger-Khanin questionnaire 100% experimental group’s women with external genital endometriosis (n = 60) were noted to be have high level of state and trait anxiety, then 40% women of control group (n = 16) have moderate level of anxiety. The incidence of depression in women with chronic pelvic pain was 58.3% (n = 35) and the main part (n = 20) were women with severe stage of pelvic pain according to VAS. Conclusions. Psycho emotional condition of women with external genital endometriosis associated pelvic pain characterized by higher depression and anxiety levels, with significant decrease quality of life. Direct relationship also was found between pain syndrome intensity and histamine level in peripheral blood in patients with external genital endometriosis.

Epidemiology and antimicrobial resistance of Acinetobacter

2018 ◽  
Vol 2 (4) ◽  
pp. 46-59
Author(s):  
A.G. Salmanov ◽  
O.M. Verner ◽  
L.F. Slepova
Keyword(s):  
Antibiotic Resistance ◽  
Laboratory Testing ◽  
Immunocompromised Host ◽  
Clinical Problem ◽  
Healthcare Associated Infections ◽  
Opportunistic Bacteria ◽  
Acinetobacter Spp ◽  
Healthcare Associated ◽  
Major Clinical Problem

Species of the Acinetobacter represent opportunistic bacteria with a growing clinical significance for Healthcare-associated infections (HAIs). In this literature review, we focus on the current role of Acinetobacter in infectious pathology and describe taxonomy, pathogenicity, and antibiotic resistance of these bacteria. Pathogenesis and regulation of virulence factors in Acinetobacter spp. are described in detail. The majority of acinetobacterial infections are associated with A. baumannii and occur predominantly in an immunocompromised host. Usually, acinetobacterial  infections  are characterized by local purulent inflammation; in severe cases, meningitis and sepsis may develop. Antibiotic resistance of Acinetobacter is a major clinical problem; therefore we give special attention to laboratory testing of resistance to antibiotics as well as identification of Acinetobacter.

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