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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study evaluated anxiety sensitivity, along with depression and pain severity, as predictors of pain-related fear and anxiety in a heterogeneous chronic pain population (n=68). The results indicated that the global anxiety sensitivity factor, as indexed by the Anxiety Sensitivity Index (ASI: Reiss, Peterson, Gursky & McNally, 1986: Reiss, S., Peterson, R. A., Gursky, M. & McNally, R. J. (1986). Anxiety, sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1-8) total score, was a better predictor of fear of and anxiety about pain relative to the other relevant variables. Additionally, the physical concerns subscale of the ASI was a better predictor of pain-related fear dimensions characterized by high degrees of physiological symptoms and behavioral activation on both the Fear of Pain Questionnaire-III (FPQ-III; McNeil & Rainwater, 1998: McNeil, D. W. & Rainwater, A. J. (1998). Development of the Fear of Pain Questionnaire-III. Journal of Behavioral Medicine.) and Pain Anxiety Symptoms Scale (PASS; McCracken, Zayfert & Gross, 1992: McCracken, L. M., Zayfert, C. & Gross, R. T. (1992). The Pain Anxiety Symptoms Scale: Development and validation of a scale to measure fear of pain. Pain, 50, 67-73). In a related way, the ASI psychological concerns subscale was a better predictor of pain-related anxiety dimensions characterized by cognitive symptoms of anxiety. Overall, these findings reiterate the importance of anxiety sensitivity in understanding pain-related fear and anxiety, and suggest anxious and fearful responding can be predicted more accurately with higher levels of correspondence between a particular anxiety sensitivity domain and events that closely match that fear.
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PMID:Anxiety sensitivity in the prediction of pain-related fear and anxiety in a heterogeneous chronic pain population. 1140 Jul 12

Adequate control of blood sugar has been repeatedly shown to translate into reductions in diabetic complications. Although insulin therapy in patients with type 2 diabetes can achieve and maintain near-normal glycemic goals associated with reductions in microvascular and macrovascular end points, it is often reserved for the later stages of management of these patients because of real or perceived concerns; these include fear and anxiety about worsening diabetes, failure of self-management, loss of quality of life, the pain of self-injection, and the possibility of multiple daily injections. Risks of hypoglycemia, weight gain, and cardiovascular disease may be concerns of physicians, but these risks are either manageable or, in the case of cardiovascular disease, unfounded. Taken together, the barriers to insulin therapy frequently compel physicians to consider it a treatment of last resort. Some of the more common barriers have been addressed through device options such as insulin pens and jet injectors, which may improve convenience but do not alleviate pain and discomfort. Transdermal delivery options using iontophoresis or ultrasound are in early stages of development, but methods based on transmucosal delivery-including buccal, nasal, and pulmonary routes-are further advanced. In particular, recent evidence shows that pulmonary forms of insulin are as safe and effective as rapid-acting injected insulin, and are well accepted by patients even over long-term periods of use. These innovative delivery systems may help overcome the barriers to insulin use.
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PMID:Evaluation of alternative strategies for optimizing glycemia: progress to date. 1243 59

Nociceptin/orphanin FQ (N/OFQ), the endogenous ligand of the NOP receptor, regulates several central functions such as pain transmission, learning and memory, fear and anxiety and feeding and locomotor activity. It has been recently reported that NOP receptor antagonists induce antidepressant-like effects in the mouse forced swimming test (FST), i.e. reduce immobility time. This assay was used in the present study for further investigating the involvement of the NOP receptor in depression states. In male Swiss mice, intracerebroventricular injection (i.c.v) of the novel NOP receptor antagonist, UFP-101 (1-10 nmol) dose-dependently reduced the immobility time (control 192 +/- 14 s, UFP-101 91 +/- 15 s). The effect of 3 or 10 nmol UFP-101 was fully or partially reversed, respectively, by the coadministration of 1 nmol N/OFQ, which was inactive per se. NOP receptor knockout mice showed a reduced immobility time compared with their wild-type littermates (wild-type 215 +/- 10 s, knockout 143 +/- 12 s). Moreover, i.c.v. injected UFP-101 (10 nmol) significantly reduced immobility time in wild-type mice but not in NOP receptor knockout animals. In conclusion, these results, obtained using a combined pharmacological and genetic approach, indicate that blockade of the N/OFQ-NOP receptor signalling in the brain produces antidepressant-like effects in the mouse FST. These findings support the NOP receptor as a candidate target for the development of innovative antidepressant drugs.
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PMID:Blockade of nociceptin/orphanin FQ-NOP receptor signalling produces antidepressant-like effects: pharmacological and genetic evidences from the mouse forced swimming test. 1275 99

Previous research has shown that lesions of the medial prefrontal cortex (MPFC) inhibit fear-related behavior in rats (Brain Res. 969 (2003) 183-194). However, at present little is known about the role of specific neurotransmitter receptor systems within the MPFC in the mediation of fear and anxiety. For example, extensive research has demonstrated the effectiveness of benzodiazepines in decreasing fear-related behavior. However, no research has yet been published regarding the effects of micro-infusions of benzodiazepines, or any other GABA-A receptor agonist, into the MPFC. In addition, previous work has suggested that there may be functional differences between the dorsal and ventral subregions of the MPFC in regard to fear and anxiety. Therefore, the present study examined the effects of dorsal and ventral MPFC infusions of the benzodiazepine midazolam in two well-validated animal models of anxiety, the elevated plus maze and the shock probe burying test. The results showed that bilateral (5 microg/side) infusions of midazolam into the MPFC produced anxiolytic effects in both behavioural tests, without affecting general activity or pain sensitivity. Furthermore, these anxiolytic effects were found in both the dorsal and ventral regions of the MPFC. The present findings indicate that the benzodiazepine receptors of the MPFC are capable of modulating fear-related behaviors.
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PMID:Infusions of midazolam into the medial prefrontal cortex produce anxiolytic effects in the elevated plus-maze and shock-probe burying tests. 1467 Jun 28

The incidence of cancer increases exponentially with age and a large number of cancer patients are the older members of society. In many developing and some developed countries, the disease is usually detected at a stage when it is too late for aggressive anticancer therapy to have the desired effect. Most cancer patients suffer moderate to severe pain during the terminal phase of the disease. This pain is unpredictable and produces fear and anxiety in patients and family members. Morphine is the gold standard analgesic to control this pain, but its availability is restricted. The fear of diversion of morphine for non-medical uses has led to severe control on its availability. Studies have shown that diversion of medical morphine is not really an issue. This paper describes attempts to increase morphine availability through the courts in India. The courts have issued directives to improve the availability of the drug, yet 97% of Indian patients have very poor access to the drug. There is a need to improve access to pain-free end-of-life care. In the absence of morphine, physicians lack experience in its use. They need to be educated to provide for their patients a pain-free life. Patients and their families need to be educated that cancer need not end in a painful death. It is not adequate to be able to manage cancer alone; one needs to free the society from fear of cancer.
J Pain Palliat Care Pharmacother 2003
PMID:Freedom from pain--a mirage or a possibility? Experience in attempts to change laws and practices in India. 1502 47

Attempts have been made to attribute the particular features of general anaesthesia such as hypnosis, analgesia, amnesia and autonomic stability to certain brain regions. In the present study, we examined the effects of the commonplace volatile anaesthetic isoflurane on synaptic transmission in an in vitro slice preparation of the murine amygdala. Despite the established role of this limbic structure in the formation of aversive memories, conditioned fear and anxiety, as well as pain processing and regulation of sympathetic tone, the influence of volatile anaesthetics on synaptic signalling has not yet been investigated in this region of the brain. Evoked postsynaptic currents were monitored from principal neurons in the basolateral nucleus of the amygdala by means of patch-clamp recording. The mixed postsynaptic currents were mediated by non-NMDA, NMDA, GABA A and GABA B receptors. Isoflurane added to the perfusion medium reduced the strength of synaptic signalling following the activation of non-NMDA, NMDA, and GABA B receptors, whereas the GABA A receptor-mediated responses were enhanced. The overall reduction of neuronal excitability was also reflected in a reduction of field potential amplitudes. Isoflurane neither changed the membrane resting potential nor the input resistance of principal neurons in the amygdala. The present results may contribute to the understanding of how stress reactions and long-lasting neuroplastic processes are suppressed under general anaesthesia.
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PMID:Isoflurane modulates glutamatergic and GABAergic neurotransmission in the amygdala. 1534 99

Ubiquitin (Ub) is involved in neurodegeneration and various stress responses in the brain. The present study investigated the Ub-immunoreactive structures in the midbrain of methamphetamine (MA) abusers as a marker of drug-induced neurodegeneration. Medico-legal autopsy cases were examined: fatal MA intoxication (n=14), other fatalities of MA abusers (n=23) including those due to injuries, asphyxiation, drowning, fire and natural diseases, and control groups (n=260). In the motor nervous systems, MA abusers showed a mild increase in the diffuse-type nuclear Ub-positivity in the pigmented neurons of the substantia nigra, depending on the blood MA level and irrespectively of the immediate causes of death. The intranuclear inclusion-type Ub-positivity of the nigral neurons and the granular 'dot-like' Ub-immunoreactivity area in the crus cerebri (cortico-spinal tracts) were usually low in MA abusers, and any increases were related to the immediate causes of death and the age of subjects. Acute MA fatality showed a higher neuronal Ub-positivity in the midbrain periaqueductal gray matter (PGM), which is involved in processing pain, fear and anxiety, and regulation of respiration and circulation. These findings suggest dysfunction of the nigral dopaminergic neurons and PGM neurons in the midbrain in MA abuse, which may account for the clinical symptoms.
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PMID:Ubiquitin-immunoreactive structures in the midbrain of methamphetamine abusers. 1584 21

Nursing students often have fear and anxiety about managing pain. The most common misconceptions include fear that patients in acute pain are easily addicted to pain medication, persons who are alert experience side effects from medication such as respiratory depression, and pain is inevitable and cannot completely be relieved. Cognitive restructuring is a method of changing behavior that focuses on identifying misconceptions, influencing distorted thinking, and thereby diminishing anxiety and promoting reasoned practice.
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PMID:Pain management: cognitive restructuring as a model for teaching nursing students. 1617 Feb 66

Although individual differences in fear and anxiety modulate the pain response and may even cause more suffering than the initiating physical stimulus, little is known about the neural systems mediating this relationship. The present study provided the first examination of the neural correlates of individual differences in the tendency to (1) feel anxious about the potentially negative implications of physical sensations, as measured by the anxiety sensitivity index (ASI), and (2) fear various types of physical pain, as indexed by the fear of pain questionnaire (FPQ). In separate sessions, participants completed these questionnaires and experienced alternating blocks of noxious thermal stimulation (45-50 degrees C) and neutral thermal stimulation (38 degrees C) during the collection of whole-brain fMRI data. Regression analyses demonstrated that during the experience of pain, ASI scores predicted activation of a medial prefrontal region associated with self-focused attention, whereas FPQ scores predicted activation of a ventral lateral frontal region associated with response regulation and anterior and posterior cingulate regions associated with monitoring and evaluation of affective responses. These functional relationships cannot be wholly explained by generalized anxiety (indexed by STAI-T scores), which did not significantly correlate with activation of any regions. The present findings may help clarify both the impact of individual differences in emotion on the neural correlates of pain, and the roles in anxiety, fear, and pain processing played by medial and orbitofrontal systems.
Pain 2006 Jan
PMID:Neural correlates of individual differences in pain-related fear and anxiety. 1636 48

Free association (coupling) of 97 Hungarian primary school children (age: 8-15 yrs, 44 male, 53 female) about their teeth was collected and analysed related to lexicologic parameters, as a pilot to establish further investigations. In some cases significant (p < or = 0.05) differences within the groups related to several topics were detected in the case of the length of the text and in the case of the distribution of etymons (root of word). Gender significantly influenced the length of the text as well. Some effect of dental fear and anxiety on the length of the text, and on the etymon's distribution may also be possible. The analysis of the most frequently used words indicated some coupling of pain and fear, and the importance of the mother in how the children see dental life events.
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PMID:[Lexicologic parameters of free association (coupling) about teeth of Hungarian primary school children. An initial study]. 1646 85


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