bluuebunny/crossref_metadata_2025_split huggingface dataset:
The subjective sensation induced by various thermal pulse stimulation in healthy volunteers
Authors: Oono Y. , Kubo H. , Imamura T. , Matsumoto K. , Uchida S. , Takagi S. , Gazerani P. , Wang K. , Arendt-Nielsen L. , Kohase H. 
Published: August 2017

Abstract

Aims
Novel quantitative thermal stimulator devices (QTSDs) have been developed to deliver thermal pulse stimulation with regulated constant temperatures (0–45°C) with a Peltier element probe (16 cm2). The aim of this study was to investigate subjective sensation induced by the interaction between simultaneously applied painful cold and heat stimuli in various sites.

Methods
Twenty healthy subjects (12 men and 8 women, age range: 25–45 years) participated. The intensity of cold pain (CP) and heat pain (HP) stimuli were assessed by visual analogue scale (VAS) and adjusted to elicit approximately 70/100 mm. Alternately pulse stimulations (pulse duration of 40 s; 0.025 Hz) which consisted of CP, HP, or neutral temperature (32°C) were applied. Four conditions were tested and subjective sensations were assessed: (1) one QTSD was applied to non-dominant forearm and cold-heat pulse stimulation was applied.
Two QTSDs were applied to (2) non-dominant ipsilateral forearm with 5 cm apart, (3) non-dominant and contralateral forearms, (4) non-dominant forearm and ipsilateral thigh, respectively. In conditions of (2)–(4), CP-neutral pulse stimulation (C-Neutral) and neutral-HP pulse stimulation (Neutral-H) were applied simultaneously with opposite phase, respectively.

Results
CP and HP were 3.9±1.0°C (mean±SD) and 43.6±0.9°C (mean±SD), respectively. The VAS values for CP and HP were 73.4±2.0 mm (mean±SD) and 76.4 ±4.8 mm (mean±SD), respectively. Some subjects could not discriminate cold or heat sensation and some felt cold as heat (paradoxical sensation). The number of subjects with such paradoxical sensation in (1), (2), (3), (4) were 9 (45%), 2 (10%), 0 (0%) and 3 (15%), respectively.

Conclusions
In healthy volunteers, simultaneous alternately cold-heat pulse stimulation on one site triggered paradoxical thermal sensation, which to a much less degree is triggered when C-Neutral and Neutral-H were applied to different dermatomes. This suggests that the mechanism is primarily triggered peripherally.
Assessing Offset Analgesia through electrical stimulations in healthy volunteers
Authors: Ligato D. , Petersen K.K. , Mørch C.D. , Arendt-Nielsen L. 
Published: August 2017

Abstract

Background and aims
Offset Analgesia (OA) is a disproportionally large decrease of pain perception evoked by a slight decrease of a painful cutaneous heat stimulus, resulting in a lower pain perception compared to a simple constant stimulus at the same temperature. This study aimed to investigate the possibility of evoking the same disproportional analgesic effect by applying electrical stimuli.

Methods
24 subjects underwent two control-trials of 30 s constant intensity by applying either heat stimulation at 48 °C or an electrical stimulation at 150% of the individual electrical Pain Detection (ePD) on the volar forearm. OA-trials consisted of a 30 s stimulation, divided into three periods: T1 (5 s), T2 (5 s), and T3 (20 s), with stimuli intensities of 48 °C, 49°C and 48°C or 150% of ePD, 180% of ePD, and 150% of ePD.
Subjects were asked to rate the pain intensity on an electronic Visual Analog Scale (VAS; 0: no pain; 10: worst imaginable pain), and were categorized as responders if they showed more than 30% lower VAS at heat OA-trials compared to heat control-trial. Repeated measures Analysis of Variance was applied to investigate the difference in pain intensity to the electrical OA-trials, compared with the electrical control-trials.

Results
Responders to the heat OA-trial also responded to the electrical OA-trial compared to the electrical control-trial, with an analgesic effect of 3.3±0.5 VAS points (P < 0.001). However, when analyzing all subjects, no difference was found comparing the electrical OA-trial (VAS 3.8±0.5) to the electrical control-trial (VAS 6.2±0.4; P > 0.5).

Conclusions
This study suggests that responders to the heat OA-paradigm also respond to the electrical OA-paradigm.
Metastatic lung cancer in patient with non-malignant neck pain: A case report
Authors: Pawlak W.Z. , Svensson L. , Jensen P.F. 
Published: August 2017

Abstract

Background
Symptoms from disseminated cancer can develop very slowly. This could be very difficult to distinguish those symptoms from chronic disabilities and nuisances in patients with chronic non-malignant pain.

Objective
In this report, the case of a woman with both nonmalignant pain and cancer is presented.

Case report
A 54 years old woman was referred by a general practitioner to Multidisciplinary Pain Center. The diagnosis was chronic non-malignant neck pain on the basis of degenerative columnar disease. The patient was also suffering from osteoporosis. During the first visit in the Center, the patient complained of shooting pains in the neck and had tingling sensations in the fingers – most of his right hand. Moreover, the patient experienced shooting pains in the hips, lower back and spine. The multidisciplinary treatment with medication, physical therapy, TENS and cognitive behavioral therapy was offered. Paracetamol together with gabapentin was used. The patient experienced relief of pain. The doses of gabapentin was escalated up to 2400 mg daily without significant side effects. Afterwards, the dose was gradually increased to 3600 mg daily and the patient experienced fatigue, mild headache and dizziness. These symptoms were initially interpreted as side effects of gabapentin. However, the tingling sensations in the fingers were almost disappeared. The doses of gabapentin was reduced, but without relief of symptoms. Within 2 weeks, the patient developed partial paresis of the right upper limb and aphasia. The patient was urgently referred to the neurologic inpatient clinic. CT- and MR-scans showed multiple cerebral metastases. Under the diagnostic workup the lung tumor was found. The biopsy showed pulmonary adenocarcinoma.

Conclusions
The symptoms of lung cancer with cerebral metastases can mimic side effects of gabapentin.
Oxycodone and macrogol 3350 treatment reduces anal sphincter relaxation compared to combined oxycodone and naloxone tablets
Authors: Poulsen Jakob Lykke , Brock Christina , Grønlund Debbie , Krogh Klaus , Drewes Asbjørn Mohr 
Published: August 2017

Abstract

Background
Opioid analgesics inhibit anal sphincter function and contribute to opioid-induced bowel dysfunction. However, it is unknown if the inhibition can be reduced by opioid antagonism with oral naloxone, and how this compares to osmotic laxative treatment.

Aims
To compare the effects of oxycodone and macrogol 3350 treatment (OX + PEG) versus combined oral oxycodone and naloxone (OXN) on anal sphincter function and gastrointestinal symptoms.

Methods
A randomised, double-blind, crossover trial was conducted in 20 healthy, male volunteers. Participants were randomised to five days treatment of OX + PEG or OXN. Anal resting pressure, anal canal distensibility, and rectoanal inhibitory reflex-induced sphincter relaxation were evaluated at baseline and on day 5. The Patient Assessment of Constipation questionnaire (PAC-SYM), stool frequency, and stool consistency were assed daily.

Results
Sphincter relaxation was reduced after OX + PEG treatment compared to OXN (difference = −17.6% [95% Cl;−25.2, −10.2]; P < 0.001). Anal resting pressure and anal canal distensibility did not differ between the treatments. PAC-SYM abdominal symptom subscale increased during OX + PEG compared to OXN (cumulated score: 3.2±2.3 vs. 0.2±1.8; P =0.002). Number of bowel movements was higher during OX + PEG vs. OXN (5.4±1.5 vs. 4.2±1.2; P = 0.035), but there was no difference in stool consistency (3.5±0.5 vs. 3.2±0.4; P = 0.14).

Conclusions
Sphincter relaxation was significantly reduced after OX + PEG compared to OXN. Evaluation of the rectoanal inhibitory reflex may serve as an important objective measure in future trials on treatment of opioid-induced bowel dysfunction.
Dissatisfaction and persistent post-operative pain following total knee replacement – A 5 year follow-up of all patients from a whole region
Authors: Salim T. , Pedersen P. , Østgaard S.E. , Kappel K. , Blom C.S. , Zinolabedinbik P. , Simonsen O. 
Published: August 2017

Abstract

Introduction
Total knee replacement (TKR) is the treatment of choice for the millions of individuals whose osteoarthritis related pain can no longer be managed through non-invasive methods. Although most patients report improvement in pain and functioning following TKR, up to 30% report after 1–2 years persistent pain that interferes with their daily function. Further knowledge on long term results are highly demanded. The present study is the first 5 year follow-up of all patients from a whole region.

Methods
Patients were interviewed by letter concerning pain, overall satisfaction and forgotten joint score (FJS). In 2011, 607 patients in the region of North Denmark had a primary TKR, of which 20 was bilateral. Still alive are 546 patients. A total of 498 answered by letter (91%) of which 13 were not able to answer detailed due to psychological reasons.

Results
A total of 290 (59%) patients were very satisfied with their TKR, 140 (30%) were satisfied and 58 (12%) dissatisfied. Pain free were 269 (55%). 163 patients (33%) experienced moderate pain and 55 (11%) had strong pain. Dissatisfaction and pain were highly correlated, especially pain at walking: Among patients reporting strong pain, 35 (64%) scored higher than 6 on the VAS-average pain last 24 h versus 46 (84%) that scored higher than 6 on the VAS-pain after 30 min’s walk.

Conclusions
Among an unselected series of patients having TKR, 12% were dissatisfied and 11% still had strong pain 5 years later. Dissatisfaction was especially correlated with pain when walking. Thus, the association between dissatisfaction, pain at activity and the individual expectations should be further focused.
Paradoxical differences in pain ratings of the same stimulus intensity
Authors: McPhee M.E. , Petersen K.K. , Hoegh M.S. , Graven-Nielsen T. 
Published: August 2017

Abstract

Aims
Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at the participants’ pain tolerance. Yet pain ratings during TSP rarely reach that initial pain tolerance pain rating. This study aimed to explore the differences between baseline pain tolerance assessed by cuff algometry and subsequent pain ratings of the same stimulus intensity, and the reliability of these ratings over 2 sessions.

Methods
In two sessions, separated by one week, 24 healthy, pain-free males had their pressure pain detection (PDT) and tolerance threshold (PTT) recorded using a staircase inflation paradigm (5 kPa increments, 1sec-ON:4sec-OFF) with a cuff algometry system. The pain intensity was assessed during cuff stimulation using an electronic visual analogue scale (VAS, 0–10 cm). Three different inflation paradigms were then performed, using the PTT level as stimulation intensity, and a 1-s duration for each stimulus: PEAKS: 3 inflations at 0.17 Hz, SLOW: 10 inflations at 0.01 Hz, FAST: 10 inflations at 0.5 Hz). Approximately 5-min was kept between the staircase assessment and the first stimulation paradigm, and between each of the 3 inflation paradigms. The PTT and first inflation VAS rating from each paradigm was extracted.

Results
The VAS rating of PTT pressure was higher in the staircase (VAS: 8.5±2.1 cm) than the first PPT stimulus in any other paradigm (PEAKS: 5.4±2.0; SLOW: 4.6±2.1; FAST: 4.0±2.3, P < 0.05). VAS ratings were also lower in each subsequent paradigm (i.e. PEAKS > SLOW > FAST, P < 0.05). Intra-class coefficients demonstrated excellent reliability for each paradigm (all ICC > 0.79) between sessions.

Conclusions
PTT, as assessed with the staircase inflation paradigm, was rated more painful during baseline assessment than when the identical stimulus profile (PPT intensity for 1-s) was applied afterwards and this finding is considered reliable.
Are we using Placebo effects in specialized Palliative Care?
Authors: Sigaard Jarl , Dinesen Birthe 
Published: August 2017

Abstract

Background
Placebo effects are positive treatment effects that occur because of the psycho-social context around the therapy. Such effects are well documented in pain treatment, as well as in the treatment of other common symptoms. Specialized Palliative Care focuses on the relief of pain and other symptoms in terminally ill cancer patients.

Aims
The aim of this study was to explore whether and/or how a Specialized Palliative Care Team might contribute to the creation of placebo effects.

Methods
The study was conducted as a qualitative study using a phenomenological/hermeneutic approach. A literature review was carried out to identify state-of-the-art knowledge about placebo effects. A triangulation of data collection techniques was used, including participant observations (n = 8.6 h) and a focus group interview with 7 members of the Specialized Palliative Care Team. Observations from six cases were also included. Data was analyzed using NVivo 11.0.

Findings
This study identified work routines and situation of the Specialized Palliative Care Team that had a potential for eliciting placebo effects. The value of patient collaboration for the creation of placebo effects was identified by members of the Specialized Palliative Care Team. The team’s knowledge and attitudes concerning placebo reflect the confusion that exists in general in this area.

Conclusions
This study found several work routines, already in use by the Specialized Palliative Care Team, well known for creating placebo effects. Increased knowledge and focus on this phenomenon may benefit patients.
Preoperative synovitis in knee osteoarthritis is predictive for pain 1 year after total knee arthroplasty
Authors: Vela Jonathan , Kjær Petersen Kristian , Arendt-Nielsen Lars , Meyer Andersen Mikkel , Simonsen Ole 
Published: August 2017

Abstract

Background
Knee osteoarthritis (KOA) was previously considered a degenerative joint disease due to wear and tear. After total Knee replacement (TKR) 13–38% of patients develop persistent post-operative pain. Emerging evidence has shown that the etiology of pain in KOA is multifaceted and may involve different structures including the synovial membrane, musculotendinous structures and neuronal tissue. Current preoperative assessment does not take these into account, thus the current study examines the role of preoperative synovitis on patient reported outcomes one-year post surgery.

Material and methods
40 patients with end-stage KOA answered the KOOS questionnaire prior to receiving total knee replacement surgery. During the procedure synovitis was scored systematically at six sites where synovial excision biopsies were obtained. Macro scoring was based on three parameters (hypertrophy, vascularity and synovitis) on a 0–4 point scale. Micro biopsies where also graded based on three parameters (synovial hyperplasia, inflammatory infiltration and activation of synovial stroma) but on a 0–3 point scale. Patients received a follow up KOOS questionnaire one-year post surgery.

Results
33 patients completed the KOOS questionnaire at follow-up. A high correlation between the micro mean, micro max, macro mean, and macro max was found. The micro mean was chosen as a proxy for the amount of synovitis. A multiple linear regression analysis, correcting for baseline values of BMI, age, smoking, point pressure thresholds (PPTs) and KOOS pain, showed that the synovitis measurement at baseline was significant for the change in KOOS pain with an effect of 22.22 (p = 0.0498). Hence, the more synovitis at baseline, the higher the follow-up KOOS Pain was compared to baseline KOOS Pain (an improvement). The standard deviation (SD) of the synovitis measure was 0.42, hence a change of 1 SD in synovitis gave an increase of 9 in KOOS Pain at follow-up compared to at baseline.

Conclusions
These preliminary results indicate that the synovitis score attained during operation is positively correlated with improvement in KOOS-pain post operatively.
PainData: A clinical pain registry in Denmark
Authors: Vægter H.B. , Høybye M.T. , Larsen S.K. , Hansen O.B. , Pedersen C.B. , Jensen P.B.F. , Handberg G. 
Published: August 2017

Abstract

Aims
Chronic pain is a significant clinical problem with few effective therapies. Objectives of this clinical registry are (1) to assist clinical decision-making, and (2) facilitate quality assurance and research projects to improve understanding and optimize treatment of patients with chronic pain.

Methods
PainData is an electronic software system developed for online data capture and clinical reporting, currently implemented in public pain clinics in Odense, Silkeborg, Aalborg, Næstved, Køge and Holbæk. The system captures patient-specific information across several bio-psychosocial domains of pain before the first consultation at the pain clinic as well as immediately after treatment, and 12 months after treatment. The registry also includes information from clinicians (e.g. pain diagnosis, and standardized pain sensitivity testing). PainData is registered as a clinical and research database with the Danish Data Protection Agency (16/39398, 14/44319).

Results
Since February 1st 2015 more than 3000 patients have completed questionnaires in PainData. The current completion rate at baseline is >80% and at follow-up is close to 50%. Pain-related data (e.g. pain-distribution, psychological distress and use of analgesics) from the registry will be presented on the poster.

Conclusions
The clinical pain registry contains data from a large cohort of consecutively referred chronic pain patients attending public pain clinics for multidisciplinary assessment and treatment. It contains detailed baseline and outcome data on a broad range of bio-psychosocial factors. The database has significant clinical relevance as it will contribute to an increased understanding of chronic pain conditions as well as contribute to substantial knowledge on how various psychological factors influence the experience of pain and disability in patients with chronic pain. In addition, early prediction of treatment efficacy and future stratification of patients with chronic pain has the potential to optimize treatment outcome. This will be of great interest to both the individual patient and to society.
The potential use of a serious game to help patients learn about post-operative pain management – An evaluation study
Authors: Ingadóttir B. , Zoëga S. , Blöndal K. , Thue D. , Thylen I. , Jaarsmaa T. 
Published: August 2017

Abstract

Aims
To describe the evaluation of a serious computer game designed for patients to learn about post-operative pain management.

Methods
This was a usability and evaluation study. The sample consisted of 20 people, recruited from the public. The computer game was developed by an interdisciplinary team. In the game, the player controls the actions of a virtual human character who has been discharged home after surgery. The player needs to make decisions about the character’s daily activities, such as common household tasks and self-care, including pain management. The player observes how his decisions influence the character’s recovery. The usability and efficacy of the game were evaluated in one session with semi-structured interviews and questionnaires on knowledge acquisition and usability. The playing session was video recorded to assess if technical problems arose and how often the player needed assistance.

Results
The mean age of participants was 48 years (SD = 14), 11 were women. Participants described the usability of the game as high (range 3–5 on a 0–5 scale) and expressed satisfaction with this novel method of learning, despite some technological challenges. Ease of use was confirmed by observation. Knowledge of pain medications and pain management strategies improved after playing the game. The number of correct answers increased from 54%, before playing, to 71% after playing the game (p = 0.001).

Conclusions
Playing an educational computer came has the potential to improve knowledge regarding post-operative pain management. The game was well received by participants. Serious computer games can be a useful tool in enhancing patient education. The game needs to be tested with surgical patients.
Choice of rat strain in pre-clinical pain-research – Does it make a difference for translation from animal model to human condition?
Authors: Hestehave S. , Munro G. , Brønnum-Pedersen T. , Heegaard A.M. , Abelson K.S.P. 
Published: August 2017

Abstract

Aims
Translating preclinical drug-efficacy of analgesics from animal models to humans has proven challenging with many failures. Reasons are likely multifaceted, but lack of sufficiently rigorous study design, and phenotypical relevant animal models may be part of the explanation. Chronic pain is often associated with substantial comorbid burden, consisting of changes in affective state and cognitive impairment amongst other behavioral disturbances. Accordingly, many preclinical pain research activities have started to include assessment of comorbidity as a possible experimental outcome measure, but surprisingly, little consideration has been paid to the influence of animal-related factors to pain models. To address this essential issue, we have embarked on several comparative experiments in different pain-models, comparing Sprague Dawley’s (SD) from two different vendors with different inbred rat strains (Lewis (LEW), Fisher (F344) and Wistar Kyoto (WKY)) selected based on reported stress, depression, inflammatory and pain phenotypes.

Methods
Male rats were characterized in acute (hot-plate), inflammatory (Complete Freund’s Adjuvant (CFA)) and neuropathic (Spared Nerve Injury (SNI)) pain models, with dose-response to morphine (0.3–6.0 mg/kg) in hot-plate, CFA-induced hyperalgesia, and a locomotor motility-assay (LMA).

Results
F344 and SD’s were sensitive to morphine in hotplate and CFA (Minimum Effective Dose (MED) = 3.0 mg/kg). WKY rats developed a less robust mechanical hypersensitivity after CFA injection, and were less sensitive to morphine in both pain-tests (MED = 6.0 mg/kg). LEW rats were completely insensitive to morphine in the hot plate, in contrast to reversal of CFA-induced hyperalgesia (MED = 3.0 mg/kg). Additionally, neuropathic sensitivity developed with a later onset and less robustly in this strain after SNI. All strains tested in LMA exhibited sedative effects at 3.0 mg/kg.

Conclusions
Sensory phenotyping in response to acute, inflammatory and neuropathic pain, and sensitivity to morphine in these strains indicates that different pathophysiological mechanisms are engaged after injury. This could have profound implications for translating preclinical drug discovery efforts into pain-patients.