bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between quality of pain and depression: A post-operative assessment of pain after caesarian section among women in Ghana
Authors: Adzika V.A. , Glozah F.N. , Ayim-Aboagye D. , Ahorlu C.S.K. , Ekuban M. 
Published: August 2017

Abstract

Background and aims
Post-operative pain after caesarean operation remains one of the major complains after delivery. With the rising rate of caesarean deliveries, the assessment and management of acute pain has become a major concern for medical professionals in Ghana. The aim was to determine the association between the neuroplasticity of pain and depression using a postoperative pain assessment among women after caesarean section in Ghana.

Methods
A descriptive pilot studies consisting of 54 women who have undergone caesarean operations and reported of acute pain after three months were conducted in King David Hospital and Neptune Medical centre. A purposeful sampling was used to complete the Numeric Pain Scale (NPS) and the Wong-Baker FACES Pain Rating Scale to justify the inclusion criteria. While the Pain Quality Assessment Scale (PQAS) and the Beck Depression Inventory (BDI) were completed by participant.

Results
On the characteristics of their pain respondents scored above 7, on average, for hot pains (7.04 ±2.028, minimum of 5 and maximum of 10), unpleasant pains (7.33±1.907, minimum of 5 and maximum of 10), intense and deep pain (7.35 ±1.825, minimum of 5 and maximum of 10) and intense but surface (7.38 ±1.784, minimum of 5 and maximum of 10), each with a minimum of 5 and a maximum of 10. This implies that for each of those types of pain, respondents scored very high levels of intensity. Similarly, on intensity of pain sensation (6.43 ±1.814, minimum of 5 and maximum of 10), sharpness of pain (6.53±1.772, minimum of 5 and maximum of 10), how dull their pains felt (6.38 ±2.603, minimum of 0 and maximum of 10) sensitiveness of their skins (6.75 ±1.9, minimum of 4 and maximum of 10) and how itchy (6.98±2.137, minimum of 4 and maximum of 10) their skins felt with their respective standard deviations. On the depression scale, more than half of the respondents (51.9%) captured in this study had moderate depression.

Conclusions
We ultimately sought to conduct a test of association between ten indicators of quality of pain and depression. There turned out to be significant association between intensity of pain and depression (χ2 = 21.507; p < 0.001) simply implying that where there is a rise in intensity of pain, there is likely going to be depression. There was also a significant association between sharp sensation and depression (χ2 =31.256).
The link between chronic musculoskeletal pain and sperm quality in overweight orthopedic patients
Authors: Dardmeh F. , Alipour H. , Nielsen H.I. , Rasmussen S. , Der Horst G. Van , Gazerani P. 
Published: August 2017

Abstract

Aims
The association between low fertility potential and an overweight is well recognized. In addition, a link between pain and overweight condition has been identified. However, it is not known whether overweight pain patients present any alterations in fertility potentials. Hence, the current study provided a profounder vision into the possible relation between an overweight condition, chronic musculoskeletal pain, and fertility potential in overweight male patients.

Methods
This “observational study” was based on 10 overweight chronic pain patients (OP and 10 healthy matched controls (OC) from the referrals to the orthopedic department at Aalborg University Hospital, Aalborg, Denmark. The study was approved by the regional Ethics Committee of the Northern Jutland, Denmark and conducted from June 2014 to December 2015. Semen samples were obtained from all participants and assessed for sperm concentration, motility, and kinematic parameters with the Sperm Class Analyzer (SCA®, Spain). Pressure pain thresholds (PPT) were also measured by a handheld pressure algometer in 16 pre-defined points of the subjects in both groups.

Results
The OP group demonstrated a decline in PPT values compared to the (OC); however, difference between the two was insignificant. But, the OP group showed a lower percentage of static and non-progressive motile sperm (P < 0.05). The sperm kinematic parameters (progressive motility, VCL, VSL, VAP and BCF) also demonstrated a lower trend in OP group in comparison with the controls.

Conclusions
This study presented that sperm quality declines in overweight chronic pain patients. Since the control group consisted of pain free overweight individuals, we propose that chronic musculoskeletal pain could potentially affect sperm quality, distinct from what an overweight alone does to the male fertility potential. However, further investigation in overweight chronic pain patients of different types is required before a general conclusion can be made. In addition, mechanisms underlying such effects need further clarification.
Cell-based platform for studying trigeminal satellite glial cells under normal and inflammatory conditions
Authors: Vinterhøj H.S.H. , Duroux M. , Gazerani P. 
Published: August 2017

Abstract

Aims
Satellite glial cells (SGCs) in sensory ganglia contribute to the pathogenesis of chronic pain. In vitro, providing enough fresh primary SGCs poses some practical limitations; hence, frozen stocks of primary cells for culture could be an attractive alternative for cell-based studies or drug screening. This study was designed to investigate the morphology and marker expression of frozen and freshly isolated trigeminal SGCs under normal and inflammatory conditions.

Methods
SGCs from trigeminal ganglia of three male Sprague–Dawley rats and three frozen (sub cultured and passaged) batches of stored primary SGCs were cultured. Their morphology was observed by phase microscopy and the phenotype was characterized by immunocytochemistry of glutamine synthetase (GS) and glial fibrillary acidic protein (GFAP). Lipopolysaccharide (LPS) was used to simulate a state of neurogenic inflammation in vivo. A pilot test was performed to determine the optimal concentration of LPS to activate SGCs based on GFAP expression. A long-term activation of the SGCs with 50 ng/mL LPS was chosen for further characterization.

Results
The fresh and frozen primary SGCs elicited similar phenotypes based on GS marker expression. However, frozen primary SGCs differed in terms of size and morphology. GFAP was constantly expressed in frozen primary SGCs regardless of LPS stimulation. Activation of primary fresh SGCs with LPS spread the GFAP expression from around the cell body throughout the longer processes and activation was only seen in the LPS treatment.

Conclusions
The phenotypic marker, GS was independent of culture conditions. There was no difference in upregulation of GFAP in thawed SGCs regardless of LPS stimulation. This indicates that freeze-thawing might activate SGCs and therefore frozen and passaged cells cannot be suitable for use in cell-based models for inflammation. Fresh primary cells are therefore optimal for studying SGCs under normal and inflammatory conditions.
The encoding of the thermal grill illusion in the human spinal cord
Authors: Fardo F. , Finnerup N. , Haggard P. 
Published: August 2017

Abstract

Aims
The spatial alternation of innocuous cold and warm stimuli on the skin can paradoxically provoke a hot, burning sensation, known as the thermal-grill illusion (TGI). Whether the TGI depends on spinal or supraspinal integration mechanisms is still debated. To assess whether the TGI can be accounted by integration of cold and warm afferent signals in the spinal cord, we leveraged anatomical knowledge on the spatial arrangement of dermatomes and spinal segmental projections.

Methods
We stimulated a series of skin locations on the right arm using one cold (∼20 °C) and one warm thermode (∼40°C). The two stimulus locations had identical physical distance on the skin. However, the distance between the cold and heat projection signals in the spinal cord varied across three conditions. Cold and warm inputs were delivered (1) within the same dermatome (e.g., C5–C5); (2) across the dermatome boundary of two adjacent spinal segments (e.g., C5–C6); (3) across the dermatome boundary of two non-adjacent spinal segments (e.g., C5–T1). In two experiments, we obtained an estimate of the strength of the TGI by asking 32 healthy participants to complete a temperature matching task.

Results
Participants overestimated the actual average temperature of the two thermodes (Exp. 1) and the cold temperature of one of the two thermodes (Exp. 2). However, this effect was significantly larger when cold and heat stimuli were delivered within the same dermatome (+6.57 ± 3.99°C and +9.88 ± 5.60 °C) or between dermatomes projecting to adjacent spinal segments (+6.26 ±4.44°C and +9.48 ± 5.83 °C), compared to when cold and heat stimuli projected to non-adjacent spinal segments (+3.46 ± 4.46 °C and +4.80 ± 3.21 °C).

Conclusions
These results demonstrate that the strength of the illusion is modulated by the segmental distance between cold and heat spinal signals, and show that the perceived quality and intensity of thermal stimuli depends upon low-level spatial summation mechanisms in the spinal cord.
Effect of cocoa on endorphin levels and craniofacial muscle sensitivity in healthy individuals
Authors: Simoni A.H. , Randers A. , Jønsson K. , Arpe S. , Poulsen J.N. , Gazerani P. 
Published: August 2017

Abstract

Aims
Migraine headache is a recurrent incapacitating neurovascular disorder. A combination of events occurring within the trigeminovascular system has been suggested to underlie migraine pathogenesis, including release of inflammatory neuropeptides with subsequent effects on meningeal vessels and sensory transmission. Increased craniofacial muscle tenderness is also present in patients with migraine and a lower β-endorphin concentration has been observed in these patients. Several external factors have been identified, which can modulate migraine. One such factor is cocoa, though controversies still exist whether this substance exerts pro-algesic or analgesic effects. The present study evaluated effects of pure cocoa on a mechanically-induced headache model in healthy individuals. Serum β-endorphin concentrations were also measured to identify if any changes occurred in response to cocoa consumption.

Methods
Healthy volunteers (8 men and 7 women, average age: 22±1.8 years) participated in a crossover study (approval number: N-20160015) consisting of two sessions with consumption of water or cocoa. A mechanical headband (custom-made, Aalborg University) was utilized to induce a moderate headache with pain rated as 4 on a Visual Analogue Scale (VAS0–10). In each session Pressure Pain Threshold (PPT) was measured by a hand held algometer at temporalis muscles and blood samples were collected to assess β-endorphin levels by ELISA. ANOVA analysis and independent two-sample t-tests were performed for comparisons. P < 0.05 was considered as significant.

Results
Consumption of cocoa compared to water did not change the pressure sensitivity in the craniofacial region without mechanical headband. No changes occurred in PPT with the mechanical headband either.Regardless of substance consumption (water/cocoa), endorphin levels remained unchanged.

Conclusions
Findings demonstrated that pure cocoa in the applied concentration and within the timeline of this study did not seem to exert any analgesic or pro-algesic effect on the mechanical sensitivity of craniofacial muscles or β-endorphin levels.
The impact of naloxegol treatment on gastrointestinal transit and colonic volume
Authors: Grønlund D. , Olesen A.E. , Poulsen J.L. , Brock C. , Drewes A.M. 
Published: August 2017

Abstract

Aims
Opioid treatment is associated with gastrointestinal (GI) side effects, known as opioid-induced bowel dysfunction (OIBD). Symptoms of OIBD are caused by opioid receptor activation in the enteric nervous system, which results in increased GI transit time and increased faecal volume in the colon. OIBD can be experimentally induced in healthy participants through oral oxycodone treatment. The aim of this study was to investigate whether administration of naloxegol, a peripherally restricted opioid antagonist, could reduce GI symptoms, GI transit time, and colorectal volume, using an experimental model of OIBD.

Methods
In a double blind crossover trial, twenty-five healthy males were randomly assigned to a six day treatment of oral oxycodone in combination with either oral naloxegol or placebo. At baseline and at day six, participants filled in the Patient Assessment of Constipation Symptom questionnaire, and colorectal volume was quantified with a magnetic resonance imaging method. Participants swallowed a small electromagnetic capsule, which allowed determination of total and segmental GI transit times, using the 3D-Transit system.

Results
In the established model of oxycodone induced OIBD, fewer GI symptoms were observed during naloxegol treatment, compared to placebo (P <0.01). Naloxegol decreased median total transit time by 27% (56 vs 71 h, P < 0.05) and decreased colorectal transit time by 33% (45 vs 59 h, P < 0.01), compared to placebo. No difference in colorectal volume was found between the two treatments.

Conclusions
In an experimental model of OIBD, GI symptoms and GI transit time were reduced during treatment with naloxegol, compared to placebo. However, naloxegol treatment did not reduce colorectal volume. These findings add information on the potential of naloxegol to be used in prevention and treatment of OIBD.
Painful diabetic polyneuropathy and quality of life in Danish type 2 diabetic patients
Authors: Gylfadottir Sandra Sif , Christensen Diana Hedevang , Nicolaisen Sia Kromann , Thomsen Reimar Wernich , Nielsen Jens Steen , Itani Mustapha , Sindrup Søren , Jensen Troels Staehelin , Finnerup Nanna Brix 
Published: August 2017

Abstract

Background and aims
Painful polyneuropathy (PPN) is a disabling complication of diabetes. This study aims to determine its prevalence and relationship with Quality of Life (QoL) in a nationwide prospective cohort of incident recently diagnosed Danish type 2 diabetic patients.

Methods
We sent a detailed questionnaire on neuropathy, pain and QoL to 6726 patients prospectively enrolled from general practitioners and hospital specialist outpatient clinics into the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients who reported pain in both feet and a score ≥3 on the Douleur Neuropathique (DN4) questionnaire were considered to have possible PPN. QoL and pain intensity were measured on a numeric rating scale (NRS, 0–10). The Michigan Neuropathy Screening Instrument (MNSI) was used to assess neuropathy.

Results
A total of 5371 (79.8%) returned a complete questionnaire. 848 (15.8%) recently diagnosed type 2 diabetic patients reported pain in both feet. Of the 619 patients with pain who completed the DN4 questionnaire, 404 (65.2%) had a DN4 score ≥ 3, corresponding to a prevalence in the total population of possible PPN of 10.3%. Mean pain intensity was 5.2 (SD 2.2) and 89% had a MNSI score ≥ 3. Patients with possible PPN had a substantially lower QoL score than those without PPN (median QoL score 6 versus 8 (p < 0.001)), also when correcting for MNSI score.

Conclusions
Ten percent of newly diagnosed type 2 diabetic patients in Denmark had possible PPN. Patients with PPN had lower QoL than patients without PPN.
“What about me?”: A qualitative explorative study on perspectives of spouses living with complex chronic pain patients
Authors: Thrysøe Hansen L. , Nielsen L.I. , Gazerani P. , Petrini L. 
Published: August 2017

Abstract

Aims
Being a close relative of a chronic pain patient affects family life. No study has been carried out in Denmark to explore relatives’ life experiences and challenges while living with complexchronic pain patients. Hence, the aim of the study was to investigate the experiences of living with chronic pain patients from their spouses’ perspectives. In particular, this study focused on how spouses describe: (i) their everyday tasks and roles as a spouse; (ii) the types of changes and challenges that the pain condition brings into their partnership lives; (iii) a gender difference in these experiences; and (iv) the type of help they wish to receive from the healthcare system.

Methods
Two focus group interviews were conducted in Multidisciplinary Pain Center, Køge, including a total of 11 spouses (6 men). The spouses were contacted via their partners who were referred to public pain clinics. Focus group interview was chosen because is a suitable method for exploratory studies. The approach was phenomenological and transcriptions of interview records were used for analysis.

Results
Eight categories emerged from the data analysis: psychological burden, physical burden, the pain invisibility, roles, loss, worries concerning medicine, self-care, and needs concerning help and support. The differences between gender were vague. Spouses for whom the patient pain condition was a new situation (<1 year) appeared to worry more.

Conclusions
The study demonstrated that the spouses’ lives were dramatically affected. They had to support the family financially, do most of the household chores, be optimistic, a parent, and a pain care giver. The spouses experienced daily worries about several points including pain medicine by the patients. This study also highlighted an essential need for psychological support for coping with the changing life situation, the point that is currently neglected to a great extent.
Increased postural stiffness in patients with knee osteoarthritis who are highly sensitized
Authors: Hirata R.P. , Skou S.T. , Simonsen O. , Rasmussen S. , Graven-Nielsen T. 
Published: August 2017

Abstract

Aims
To evaluate the effect of widespread pain sensitization on postural stability during quiet standing tasks in patients with knee osteoarthritis.

Methods
Patients (56) stood quietly on a force platform for 1 min in 4 conditions (each repeated 3 times): (i) firm surface (FS) with open eyes (OE), (ii) FS with closed eyes (CE), (iii) soft foam surface (SS) with OE, and (iv) SS with CE. Postural stability was quantified by Center of Pressure (CoP) variables extracted from the force platform. Pressure pain thresholds (PPTs), were assessed bilaterally with a handheld pressure algometer (1 cm2 probe) at: (i) four sites in the knee region (3 cm medial to the midpoint of the medial edge of the patella; 2 cm proximal to the superior edge of the patella; 3 cm lateral to the mid-point of the lateral edge of the patella; and centre of the patella), (ii) tibialis anterior muscle, and (iii) extensor carpi radialis longus muscle. The PPT values from tibialis anterior and extensor carpi radialis longus muscles were used to divide the patients in high and low sensitization groups (two-steps clustering).

Results
PPT values at bilateral knees sites were lower in the high sensitivity [median (range) of all sites: 423 (153, 1129) kPa] compared with low sensitivity group [822 (305, 2051) kPa] (P < 0.05). CoP range in the anterior–posterior direction was reduced in high sensitivity group (41±16 mm) compared with the low sensitivity group (51±16 mm) during the SS with CE (P < 0.05) condition.

Conclusions
The lower CoP Range suggests stiffer postural strategy in patients with higher widespread pain sensitivity compared with low sensitivity patients during sensory restrictions. The lack of mobility found in high sensitivity patients under such restrictions might be related to the impaired integration of sensory information due to the parallel processing of the nociceptive information.
Efficacy of dry needling on latent myofascial trigger points in male subjects with neck/shoulders musculoskeletal pain. A case series
Authors: Heredia-Rizo A.M. , Navarro-Carmona I. , Piña-Pozo F. 
Published: August 2017

Abstract

Aims
To assess the impact of dry needling on neural mechanosensitivity and grip strength in male subjects with a history of persistent pain in the neck/shoulder area.

Methods
Case series study. Eight male subjects (mean age 25±6.24 years) with a recurrent history of bilateral neck/shoulder pain for at least 6 months, and with symptoms provoked by neck/shoulder postures or movement were recruited from a University-based clinical research center. Measurements were taken at baseline, immediately after intervention, and fifteen days later, of the pressure pain threshold (PPT) over the median, ulnar, and radial nerves, and the tibialis anterior (TA) muscle. Secondary measures included free-pain grip strength with a hydraulic dynamometer. A therapist assessed the presence of latent (not spontaneously painful, but painful upon palpation) myofascial trigger points (MTrP) over the scalene, subclavius, pectoralis minor, infraspinatus and serratus posterior superior muscles, on the most painful side. Deep dry needling was then performed on the latent MtrP by quickly inserting and partially removing the needle from the MTrP until 2 local twitch responses were provoked.

Results
PPT over the nerve trunks significantly increased after intervention (p < 0.05 for all locations). These changes remained constant in the second assessment, both in the treated (p < 0.001 for median and ulnar nerves, and p = 0.004 for radial nerve), and the non-treated upper limb (median nerve p < 0.001, ulnar nerve p = 0.003, and radial nerve p = 0.006). No statistical significance was found for PPT over the TA muscle (p > 0.05) or for grip strength (p = 0.153 on the treated side, and p = 0.564 on the non-treated upper limb).

Conclusions
Dry needling on the cervicothoracic and shoulder areas may help to improve peripheral neural features over the brachial plexus nerve trunks in subjects with recurrent neck/shoulder pain. No effect was observed for grip strength.
Renal function estimations and dose recommendations for Gabapentin, Ibuprofen and Morphine in acute hip fracture patients
Authors: Houlind M.B. , Treldal C. , Aakjær M. , Palm H. , Malmquist B. , Andersen O. , Christrup L.L. , Petersen K.K. 
Published: August 2017

Abstract

Aims
Optimization of pain management is essential for fasttrack surgery and safety in acute hip fracture (AHF) patients. Kidney function determines the doses of several postoperative painkillers, but previous studies have shown the standard Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation overestimate glomerular filtration rate (GFR) in elderly and underweight patients. The optimized Cockcroft Gault (CGop) equation might be more accurate in this patient group. The study aims to (1) investigate the differences in estimated GFR (eGFR) based on CKD-EPI and CGop and (2) to simulate this impact on recommended dosing of standard painkillers in AHF patients.

Methods
Patients admitted with AHF from January to April 2015 were included. eGFR was calculated for each patient by CKD-EPI and CGop based on the lowest measured serum creatinine between 1 and 4 days postoperatively. CKD-classification (1–5) was performed based on both eGFR values. If patients were classified differently based on the two eGFR values, then drug dosages were simulated for Morphine, Ibuprofen and Gabapentin according to prescribing recommendations in Renbase®.Two-sided Mann–Whitney test was used to compare median values between groups.

Results
176 patients (62% women) with a median age of 76 years were included. CKD-EPI (78.0mL/min/m2) estimated eGFR significantly higher compared with GGop (58.9, P < 0.001). Depending on the equation used to estimate GFR, CKD ≥ 3 (eGFR < 60 mL/min/m2) occurred in 23–53% all patients. Using CGop to estimate GFR resulted in CKD re-classification for 63% of all patients. Using CKD-EPI to estimate GFR resulted in significantly higher doses of Morphine, Ibuprofen and Gabapentin (P < 0.0001) in re-classified patients.

Conclusions
GFR estimates are significantly higher when calculated by CKD-EPI compared to CGop, and this difference results in significantly higher recommended doses of painkillers in AHF patients. Future studies should include a gold standard for measuring GFR and maybe alternative biomarkers for the renal function.