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- Hansson, Emma, et al.
(author)
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Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa).
- 2011
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In: Pain Medicine. - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 12, s. 942-952
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Journal article (peer-reviewed)abstract
- Objective. The aim of this prospective study is to assess the effect of liposuction on the pain experienced by women with Dercum's disease (adiposis dolorosa). Design. Pain was examined preoperatively and at 3 months, and 1, 2, 3, and 5 years after liposuction. The subjective pain sensation was evaluated with a visual analog scale and number of words chosen, and the objective pain sensation with the mechanical pressure pain threshold. Setting. Dercum's disease is characterized by obesity and pronounced pain in the adipose tissue. The pain is chronic and often disabling and resistant to traditional analgesics and other pain treatment. However, five reports have been published on the encouraging effect of liposuction. Patients. Pain was evaluated in 53 patients with Dercum's disease that had been operated on with liposuction. As controls, 58 nonoperated subjects with Dercum's disease and 41 obese abdominoplasty patients were followed for 5 years. Results. Both subjective and objective pain measurements revealed a statistically significant decrease in the pain experienced by the Dercum patients after surgery as compared with preoperatively. However, the pain relief diminished over time. Furthermore, a significant postoperative difference could be seen between the Dercum operated group and the Dercum controls as regards measured pain. The difference decreased over time but still lingered 5 years postoperatively. Conclusion. The results suggest that liposuction might alleviate pain in patients with Dercum's disease. However, it is difficult to determine whether the effect is due to the actual surgery or to other factors.
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| 2. |
- Jakobsson, Ulf
(author)
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Tobacco Use in Relation to Chronic Pain: Results from a Swedish Population Survey.
- 2008
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In: Pain Medicine. - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; Jun 18, s. 1091-1097
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Journal article (peer-reviewed)abstract
- Objective. To study the relationship between tobacco use and pain intensity. Design. An age-stratified cross-sectional study was carried out in southern Sweden in 2005. Sample. The population study consists of 384 people, aged 18-102 years, with chronic pain. Measurement. Data collection took place by means of a postal questionnaire. Comparisons of pain intensity were made between smokers and nonsmokers, and between users and nonusers of moist snuff. A multiple linear regression analysis was carried out in order to identify the determinants of pain intensity. Results. Among respondents with chronic pain, smokers experienced a higher pain intensity than nonsmokers, although there was no evidence of such a difference among snuff users. The regression analysis revealed that gender (i.e., women) and smoking significantly increased pain intensity. Conclusions. Pain intensity was highest among daily smokers and those who had quit. Thus, interventions to prevent smoking (to stop smoking and in particular not to start smoking) among people with chronic pain may not only be considered a method to improve health but also to reduce pain.
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| 3. |
- Kvorning, Nina, et al.
(author)
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Plasma Adrenaline Increases in Anesthetized Patients Given Electro-acupuncture Before Surgery
- 2010
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In: Pain Medicine. - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 11:7, s. 1126-1131
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Journal article (peer-reviewed)abstract
- Purpose. In anesthetized patients, electro-acupuncture (EA) has been found to reduce sevoflurane-induced suppression of cranial and spinal motor responses to surgery without influencing the level of anesthesia. The underlying mechanisms are unclear. In the present study, blood samples were analyzed to evaluate if the increased clinical motor responses to surgery in patients subjected to EA under sevoflurane anesthesia are also reflected in higher plasma levels of catecholamines, adrenocorticotrophic hormone (ACTH), or cortisol. Methods. Blood samples were obtained before anesthetic induction, soon after the study or control procedures had been completed under general anesthesia, and after 30 minutes of surgery under steady-state anesthesia with 1.8% of sevoflurane, in 45 healthy female patients, scheduled for sterilization by laparoscopy, randomized for bilateral 2 Hz-burst EA (study group; n = 22) or control (control group; n = 23) procedures. Result. Plasma levels of adrenaline were found to approach the higher preanesthetic level after 30 minutes of surgery in patients given EA stimulation but to remain low in control patients (P < 0.05)-in agreement with the stronger clinical motor responses to skin incision in the EA group. Plasma levels of noradrenaline, ACTH, and cortisol did not change in or differ between the two groups. Conclusion. The clinical facilitation of both cranial and spinal motor responses to surgery in patients given acupuncture under sevoflurane anesthesia is associated with increased plasma levels of adrenaline, possibly reflecting sympathetic activation.
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| 4. |
- Berna, Chantal, et al.
(author)
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Presence of Mental Imagery Associated with Chronic Pelvic Pain : A Pilot Study
- 2011
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In: Pain medicine (Malden, Mass.). - : OXFORD UNIV PRESS. - 1526-2375 .- 1526-4637. ; 12:7, s. 1086-1093
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Journal article (peer-reviewed)abstract
- Objective. To ascertain whether a small sample of patients with chronic pelvic pain experienced any pain-related cognitions in the form of mental images. Patients. Ten women with chronic pelvic pain consecutively referred from a tertiary referral center by the physicians in charge of their treatment. Outcome measures. An interview was used to determine the presence, emotional valence, content, and impact of cognitions about pain in the form of Inventory (BPI), Pain Catastrophizing Scale (PCS), Spontaneous Use of Imagery Scale (SUIS), and Hospital Anxiety and Depression Scale (HADS) were completed. Results. In a population of patients with a prolonged duration of pain and high distress, all patients reported experiencing cognitions about pain in the form of mental images. For each patient, the most significant image was both negative in valence and intrusive. The associated emotional-behavioral pattern could be described within a cognitive behavioral therapy framework. Eight patients also reported coping imagery. Conclusion. Negative pain-related cognitions in the form of intrusive mental imagery were reported by women with chronic pelvic pain. Targeting such imagery has led to interesting treatment innovation in the emotional disorders. Thus, imagery, hitherto neglected in pain phenomenology, could provide a novel target for cognitive behavioral therapy in chronic pain. These exciting yet preliminary results require replication and extension in a broader population of patients with chronic pain.
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| 10. |
- Bäckryd, Emmanuel, et al.
(author)
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Do low levels of Beta-endorphin in the cerebrospinal fluid indicate defective top-down inhibition in patients with chronic neuropathic pain? A cross-sectional, comparative study
- 2014
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In: Pain medicine (Malden, Mass.). - : Wiley-Blackwell. - 1526-2375 .- 1526-4637. ; 15:1, s. 111-119
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Journal article (peer-reviewed)abstract
- ObjectivePain medicine still lacks mechanism-specific biomarkers to guide diagnosis and treatment, and defective top-down modulation is an important factor in the pathophysiology of chronic pain conditions. Using modern analytical tools and advanced multivariate statistical analysis, the aim of this study was to revisit two classical potential biomarkers of pro- and anti-nociception in humans (substance P and beta-endorphin), focusing particularly on the cerebrospinal fluid (CSF).DesignCross-sectional, comparative, observational study.SubjectsPatients with chronic, post-traumatic and/or post-surgical, neuropathic pain refractory to conventional treatment (N = 15) and healthy controls (N = 19) were included.MethodsSamples were taken from CSF and blood, and levels of substance P and beta-endorphin were investigated using a Luminex technology kit.ResultsWe found low levels of beta-endorphin in the CSF of neuropathic pain patients (66 ± 11 pcg/mL) compared with healthy controls (115 ± 14 pcg/mL) (P = 0.017). Substance P levels in the CSF did not differ (20 ± 2 pcg/mL, 26 ± 2, P = 0.08). However, our multivariate data analysis showed that belonging to the patient group was associated with low levels of both substances in the CSF. A higher correlation between the levels of beta-endorphin and substance P in CSF was found in healthy controls than in patients (rs = 0.725, P < 0.001 vs rs = 0.574, P = 0.032).ConclusionsPatients with chronic neuropathic pain due to trauma or surgery had low levels of beta-endorphin in the CSF. We speculate that this could indicate a defective top-down modulation of pain in chronic neuropathic pain. Our results also illustrate the importance of taking a system-wide, multivariate approach when searching for biomarkers.
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