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40
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Text
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<a href="http://doi.org/10.1111/pme.12248" target="_blank" rel="noreferrer">http://doi.org/10.1111/pme.12248</a>
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Title
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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
Publisher
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Pain Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Subject
The topic of the resource
Biomarkers of Pain
Creator
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Backryd E; Ghafouri B; Larsson B; Gerdle B
Description
An account of the resource
OBJECTIVE: Pain 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). DESIGN: Cross-sectional, comparative, observational study. SUBJECTS: Patients with chronic, post-traumatic and/or post-surgical, neuropathic pain refractory to conventional treatment (N = 15) and healthy controls (N = 19) were included. METHODS: Samples were taken from CSF and blood, and levels of substance P and beta-endorphin were investigated using a Luminex technology kit. RESULTS: We 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). CONCLUSIONS: Patients 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.
2014-01
Identifier
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<a href="http://doi.org/10.1111/pme.12248" target="_blank" rel="noreferrer">10.1111/pme.12248</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2014
Backlog
Backryd E
Biomarkers of Pain
Gerdle B
Ghafouri B
Journal Article
Larsson B
Pain Medicine
-
Text
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<a href="http://doi.org/10.1542/peds.2013-3398" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-3398</a>
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Title
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Recognition and management of iatrogenically induced opioid dependence and withdrawal in children
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Subject
The topic of the resource
Child; Humans; United States; Analgesics; Opioid-Related Disorders; Opioid; Substance Withdrawal Syndrome; Iatrogenic Disease
Creator
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Galinkin J; Koh JL; Committee on Drugs; Section On Anesthesiology; Pain Medicine; American Academy of Pediatrics
Description
An account of the resource
Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as "a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist." Although the experience of many children undergoing iatrogenically induced withdrawal may be mild or goes unreported, there is currently no guidance for recognition or management of withdrawal for this population. Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.
2014-01
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2013-3398" target="_blank" rel="noreferrer">10.1542/peds.2013-3398</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2014
American Academy of Pediatrics
Analgesics
Backlog
Child
Committee on Drugs
Galinkin J
Humans
Iatrogenic Disease
Journal Article
Koh JL
Opioid
Opioid-Related Disorders
Pain Medicine
Pediatrics
Section On Anesthesiology
Substance Withdrawal Syndrome
United States
-
Text
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URL Address
<a href="http://doi.org/10.1111/j.1526-4637.2006.00126.x" target="_blank" rel="noreferrer">http://doi.org/10.1111/j.1526-4637.2006.00126.x</a>
<a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4637.2006.00126.x/abstract" target="_blank" rel="noreferrer">http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4637.2006.00126.x/abstract</a>
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Title
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Neurophysiological Underpinnings of Electronic Analgesic Neuromodulation for Dummies
Publisher
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Pain Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2006
Subject
The topic of the resource
Analgesic; Neuromodulation
Creator
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Brookoff D
Description
An account of the resource
Electronic neuromodulation can be a safe and effective treatment for intractable pain. Unfortunately, many physicians and other healthcare providers know nothing of neuromodulatory techniques. There is little opportunity to learn about them in medical school or during general medical training. Nearly all of the literature about neuromodulation is aimed at specialists who already have a detailed knowledge of the field. This article reviews the pathophysiology of chronic pain from the point of view of a primary care practitioner, with the aim of providing a rationale for the appropriate use of electronic neurostimulators in patients with chronic pain. In order to understand advanced pain management, it is important to first understand that pain management is not about treating pain, but about “reducing hypersensitivity.” Specifically, advanced pain management techniques are aimed at the pathophysiological processes of hyperalgesia, allodynia, neurogenic inflammation, and neural remodeling. Some approaches to electronic analgesic neuromodulation are summarized.
2006-05
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1526-4637.2006.00126.x" target="_blank" rel="noreferrer">10.1111/j.1526-4637.2006.00126.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2006
Analgesic
Backlog
Brookoff D
Journal Article
Neuromodulation
Pain Medicine
-
Text
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URL Address
<a href="http://doi.org/10.1046/j.1526-4637.2001.01041.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1526-4637.2001.01041.x</a>
Dublin Core
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Title
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Designing pain research from the patient's perspective: What trial end points are important to patients with chronic pain?
Publisher
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Pain Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Female; Male; Adult; Aged; Perception; Demography; Human; Sleep; Interview; Evaluation; Chronic Pain/dt [Drug Therapy]; Outcomes Research; Article; Clinical Article; Clinical Study; Controlled Study; Disease Severity; Dose Response; Empiricism; Health Center; Medical Decision Making; Medical Information; Medical Research; Methodology; Opiate/do [Drug Dose]; Opiate/dt [Drug Therapy]; Pain Assessment; Pain Clinic; qualitative analysis; Rating Scale; Urban Area
Creator
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Casarett D; Karlawish J; Sankar P; Hirschman K; Asch DA
Description
An account of the resource
Objectives. The goals of this study were to define the endpoints of pain research that are important to patients with chronic pain and to identify clinical and demographic variables that are associated with patients' choices of endpoints. Patients & Setting. Interviews were completed with 40 patients seen at the anesthesia pain clinic of an urban tertiary care medical center. Design. Each patient was presented with 4 brief (3-4 sentences) fixed information vignettes describing studies in which new medications would be evaluated. For each, patients were asked to describe how the medication being studied might offer an improvement over their current therapy. Outcome measures. Measures included structured qualitative analysis of responses, the Brief Pain Inventory, and Global Distress Index of the Memorial Symptom Assessment Scale. Results. Patients described a total of 20 endpoints. Individually, patients cited between 2 and 9 end-points each (mean 4.9, standard deviation 1.7). Of these, the most commonly cited were decrease pain, decrease opioid dose, decrease frequency of scheduled dose, increased ability to function, decrease frequency of breakthrough dose, and improve sleep. Patients with severe pain cited more endpoints than did those with mild or moderate pain (mean 5.5 vs. 4.3; Rank sum test p = 0.01). Conclusions. These data suggest that empirical research can provide data to guide the choice of endpoints in clinical studies of pain interventions.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1046/j.1526-4637.2001.01041.x" target="_blank" rel="noreferrer">10.1046/j.1526-4637.2001.01041.x</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2001
Adult
Aged
Article
Asch DA
Backlog
Casarett D
Chronic Pain/dt [Drug Therapy]
Clinical Article
Clinical Study
Controlled Study
Demography
Disease Severity
Dose Response
Empiricism
Evaluation
Female
Health Center
Hirschman K
Human
Interview
Journal Article
Karlawish J
Male
Medical Decision Making
Medical Information
Medical Research
Methodology
Opiate/do [Drug Dose]
Opiate/dt [drug Therapy]
Outcomes Research
Pain Assessment
Pain Clinic
Pain Medicine
Perception
Qualitative Analysis
Rating Scale
Sankar P
Sleep
Urban Area
-
Text
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Citation List Month
July 2017 List
Notes
<p>1526-4637<br />Zernikow, Boris<br />Ruhe, Ann-Kristin<br />Stahlschmidt, Lorin<br />Schmidt, Pia<br />Staratzke, Tobias<br />Frosch, Michael<br />Wager, Julia<br />Journal Article<br />England<br />Pain Med. 2017 May 9. doi: 10.1093/pm/pnx067.</p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Clinical And Economic Long-term Treatment Outcome Of Children And Adolescents With Disabling Chronic Pain
Publisher
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Pain Medicine
Date
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2017
Subject
The topic of the resource
Financial Burden; Health Care Utilization; Intensive Interdisciplinary Pain Treatment; Long-term Outcome; Pediatric Chronic Pain
Creator
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Zernikow B; Ruhe AK; Stahlschmidt L; Schmidt P; Staratzke T; Frosch M; Wager J
Description
An account of the resource
Objective.: Disabling pediatric chronic pain is accompanied by a significant burden to those affected and by high societal costs. Furthermore, it bears the risk of aggravation into adulthood. Studies have shown intensive interdisciplinary pain treatment to result in short-term positive effects on pain-related and psychological outcomes. In this study, we aimed to prove the stability of the long-term effects of intensive interdisciplinary pain treatment four years after treatment. Methods.: This longitudinal observational study followed adolescents who had received intensive interdisciplinary pain treatment over four years. We defined a combined end point, overall improvement (pain intensity, pain-related disability, and school/work absence), and investigated three additional psychological outcome domains (anxiety, depression, pain catastrophizing). We also examined changes to economic parameters (health care utilization, subjective financial burden) and their relationship to patient improvement. Results.: Similar patterns were observed for pain-related and psychological outcome domains, with data showing statistically and clinically significant reductions from admission to four-year follow-up. These positive effects were stable from one- to four-year follow-up. Approximately 60% of the adolescents showed an overall long-term improvement. Older age was found to be a risk factor for treatment failure. Economic parameters decreased statistically significantly, particularly for those with an overall improvement of the chronic pain disorder. Conclusions.: The results of this study support the long-term effectiveness of intensive interdisciplinary pain treatment and indicate that it can interrupt pain chronification. Future research is warranted to investigate why some of the adolescents did not show improvement and to allow for a more individualized treatment.
Identifier
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10.1093/pm/pnx067
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Financial Burden
Frosch M
Health Care Utilization
Intensive Interdisciplinary Pain Treatment
July 2017 List
Long-term Outcome
Pain Medicine
Pediatric Chronic Pain
Ruhe AK
Schmidt P
Stahlschmidt L
Staratzke T
Wager J
Zernikow B