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

This investigation examined the role of sex in perceptions of leg muscle pain during exercise. Males (N = 26; age = 23.2 +/- 3.9) and females (N = 26; age = 21.9 +/- 3.5) matched on weekly energy expenditure completed a ramped maximal cycle ergometry test. Leg muscle pain thresholds were determined and pain intensity ratings as well as ratings of perceived exertion were obtained during and after exercise. The power output at pain threshold was lower in females (129.9 +/- 46.5 watts) compared to males (148.2 +/- 56.6 watts). Peak power output and peak pain intensity ratings were lower (P < 0.001) in females (211.3 +/- 39.1 watts; 5.5 +/- 2.9) compared to males (303.6 +/- 27.5 watts; 8.5 +/- 2.3). A Sex X Relative Intensity (i.e., % peak power output) ANOVA revealed that females reported lower pain ratings at each relative intensity examined (F = 17.7; df = 1.50; p < 0.001). The primary conclusion of this investigation is that females rate naturally occurring leg muscle pain as less intense than males when data are relativized to peak power output.
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PMID:Sex differences in naturally occurring leg muscle pain and exertion during maximal cycle ergometry. 977 39

Poor countries can ill-afford ineffective health care. An effective disease intervention is one which produces a net improvement in beneficiaries' quality of life and/or increases life expectancy. Unlike developed countries, very little research has been done in developing countries on the measures of the ultimate output of health care. The objectives of this study were to: (i) apply the existing health-related quality of life (HRQoL) methods in eliciting health state valuations from farmers, teachers and health professionals living and working in the schistosomiasis endemic Mwea Irrigation Scheme in Kenya; (ii) determine whether there is significant difference between average health states valuations from the three main groups of people at risk of schistosomiasis infection; and (iii) assess the relative effect of different respondent characteristics and health states prognosis on valuations. The instrument consists of seven health state descriptions-each defined along six functional dimensions: self-care, mobility, livelihood activities, energy, social participation and pain. Cardinal health state values were measured using a visual-analogue-scale (VAS). Values were elicited from three random samples of farming general public, medical professionals and teachers. The Kruskal-Wallis one-way ANOVA test showed that there is significant difference in the average health state values (for mild, moderate, severe, very severe and comatose states) obtained from the three samples. Generally, except for the valuation of the immediately following state, the other explanatory variables are not statistically significant determinants of valuations for the mild, moderate, severe and very severe states. The results suggest that VAS valuations are primarily affected by prognosis. There is urgent need for more representative and systematic HRQoL studies to test the relevance of the Western-based generic instruments in African countries contexts, with a view to developing more appropriate tool(s) if necessary.
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PMID:Economic evaluation in schistosomiasis: valuation of health states preferences. A research note. 980 12

There is limited research on the connection between the Holocaust and chronic pain, despite evidence suggesting that medical and psychological sequelae are common in survivors. The goals of this study were: (1) to define Holocaust survivors' (n = 33) chronic pain characteristics as manifested 50 years after the war, (2) to compare survivors with controls (n = 33) who did not experience World War II atrocities, and (3) to investigate the connection between past trauma and chronic pain. Data were collected through questionnaires that included a detailed medical and pain history, visual analog scale (VAS), McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI), Symptom Check List-90 (SCL-90), and Pain Disability Index (PDI). A comparison of variables between the two groups was conducted using multivariate analysis of variance (MANOVA) and ANOVA, and canonical discriminant analysis. Results showed that Holocaust survivors reported higher pain levels (73 +/- 18 vs. 56 +/- 21; P < 0.005), more pain sites (4.5 6 2.8 vs. 2.7 6 1.4; P < 0.05), and significantly higher depression scores (17.6 +/- 8.4 vs. 9.2 +/- 4.6; P < 0.001); they tended to utilize more medical services (5.9 +/- 3.0 vs. 5.1 +/- 2.8). Nonetheless, survivors did not regard themselves more disabled as compared with controls. They reported a higher activity level as measured by walking distance capacity, and spent significantly fewer hours resting (4.3 +/- 3.6 vs. 7 +/- 4.6; P < 0.05). This paradoxical combination of high pain intensity, moderate to severe depression, and high activity level characterizes Holocaust survivors' chronic pain. It is conceivable that by remaining active Holocaust survivors fight back their pain, distress, and depression. These findings suggest that Holocaust atrocities affect survivors' chronic pain even years later.
J Pain Symptom Manage 1999 Mar
PMID:Chronic pain in Holocaust survivors. 1009 61

A prospective, non-randomized study evaluated the effects of tonsillectomy and/or adenoidectomy (T +/- A) on acoustic and perceptual aspects of vocal function. Thirty-one children, ranging in age from 4 to 15 years participated and measurements were made prior to and 3 months following surgery. Twenty-three children had T +/- A and eight had adenoidectomy alone. Quantitative acoustic measures included: laryngeal (vocal fundamental frequency, FO) and supralaryngeal characteristics of sustained vowels (F1 and F2 formants, formant bandwidths, two-dimensional measures of vowel space) and temporal properties of consonant-vowel productions (diadochokinetic syllable rates). Perceptual measures were based on samples of continuous speech, using the Buffalo voice profile (BVP) and parental interviews/questionnaires were used to evaluate other aspects of surgery (i.e. subjective speech changes, protracted pain, difficulty swallowing, bleeding, etc.). Based on ANOVA, no significant post-surgical changes were detected for the majority of acoustic speech measures studied (vocal F0, formant bandwidths, measures of vowel space or diadochokinetic rates). However, the F2 formant frequency for vowels /i/ and /a/ increased and F1 decreased for /o/ following surgery. These changes had the largest effect on the structure of vowel /i/, which became more acute and diffuse following surgery. Furthermore, of the majority of perceptual measured studied with the BVP, 92% showed no change postoperatively. However, in the category of resonance, a significant decrease in hyponasality was detected. These results demonstrate that removing soft tissue from the oropharynx has only minimal impact on quantitative or qualitative (perceptual) aspects of vocal function, when measurements are made approximately 15 weeks post surgery.
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PMID:Effects of tonsillectomy and/or adenoidectomy on vocal function: laryngeal, supralaryngeal and perceptual characteristics. 1020 89

This study measured the attitudes of Finnish paediatric nurses to children in pain and the connection between nurses' attitudes, nurses' attributes and nurses' own view of their knowledge and ability to take care of children in pain. The measurements were based on a purpose-designed instrument consisting of a 41-item Likert-type questionnaire and demographic data. The convenience sample consisted of paediatric nurses at all five university hospitals in Finland (n = 303). The response rate was 87%. ANOVA and non-parametric Kruskal-Wallis ANOVA were used as statistical methods. The results show that, taken as a whole, the attitudes of these nurses do not hinder effective pain management but there are some misconceptions that need further attention. It also emerged that such attributes as nurses' age, education, experience, place of work and field of expertise do not have a significant effect on nurses' attitudes. Nurses working in operating theatres felt they had a limited scope to work together with parents and in some hospitals nurses felt they had limited scope to work together with other staff groups. The units differed significantly in nurses' views about the unit's possibilities to provide treatment for pain. The findings of this study indicate that although nurses' attitudes to pain management are mainly positive, there is much variation in how they feel they can actually provide quality care to control pain. More attention should be paid to training nurses and to providing knowledge about the treatment of pain in children. Future research should look at nurses' existing knowledge base as well as their activities in the assessment and management of pain.
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PMID:Finnish nurses' attitudes to pain in children. 1021 Apr 72

The literature regarding whether or not there are diurnal differences in pain perception in men and women is equivocal. The purpose of this study was to examine the influence of time of day on experimentally induced pain threshold in men and women. A secondary purpose was to measure selected psychological and physiological responses. Pressure (3000 gm force) was applied to the middle digit of the left forefinger for 2-min with the Forgione-Barber pain stimulator. Twenty-nine volunteers (women = 14; men = 15) completed two randomly assigned sessions between 6.00-8.00 in the AM and PM. Selected psychological variables (STAI,POMS) and physiological variables (BP, HR, TEMP) were assessed before application of the pressure stimulus. Data were analyzed with a 2x2 ANOVA. Results indicated that men had significantly higher (p<.05) systolic blood pressure and pain thresholds than women however, there was not a significant time of day effect for pain threshold. Significant time of day effects (p<.05) were found for systolic blood pressure and tympanic temperature. Heart rate, and tympanic temperature were found to be significantly higher (p<.05) in women in comparison to men. It is concluded that pain threshold did not differ in the AM and PM. Furthermore, men were found to have higher pain thresholds compared to the women.
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PMID:Experimentally induced pain perception in men and women in the morning and evening. 1039 60

Although it is well known that silicone gel breast implants (SGBIs) produce many "local" complications (i.e., pain, hard fibrous capsules, disfigurement, chronic inflammation, implant shell failure) and necessitate frequent surgical revisions, no large cohort retrospective quantitative analysis of clinical data has been reported to date, especially for the prevalence of failures and additional surgeries. Data from 35 different studies that encompass more than 8000 explanted SGBIs have now been analyzed and are reported here. Because examination of a prosthesis when explanted is the definitive method for determining shell integrity, the only studies that were used were ones that reported implant duration, the total number of SGBIs explanted, and the number of SGBIs for which shell rupture or failure ("not intact") was confirmed upon surgical removal. An exponential regression plot of data indicated a direct correlation of implant duration with percent shell failure (r2 = 0. 63 and r = 0.79 ). SGBI failure was found to be 30% at 5 years, 50% at 10 years, and 70% at 17 years. The failure rate was 6% per year during the first 5 years following primary implant surgery. ANOVA comparison of three implant age groups (mean implant durations of 3. 9, 10.2, and 18.9 years) indicated a highly significant statistical correlation of percent failure with implant duration (p < 0.001). Complications necessitating at least one additional surgery occurred for 33% of implants within 6 years following primary implant surgery. Shell failure was found to be an order of magnitude greater than the 4 to 6% rupture prevalence suggested by the AMA Council on Scientific Affairs in 1993, the 0.2 to 1.1% cited by manufacturers at that time, and the 5% rupture that was stated to be "not a safety standard that the FDA can accept."
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PMID:Silicone gel breast implant failure and frequency of additional surgeries: analysis of 35 studies reporting examination of more than 8,000 explants. 1039 41

The etiology of pain in anterior knee pain syndrome is a matter of controversy. The normal, articular cartilage is aneural, so defects in the surface are not thought to produce pain. Some authors have sought the origin of the pain in soft tissue structures around the knee. Knowledge of the distribution of nociceptive nerve fibers around the knee would provide insight for treating anterior knee pain syndrome. Twenty consecutive patients (28 knees), all women, with anterior knee pain syndrome (group I) participated in the study. For comparison we used two groups of patients: 20 patients with an osteoarthritic knee (group II) and 20 patients with anterior cruciate ligament rupture or meniscal lesion with no history of pain in the anterior compartment (group III). Immunohistochemical techniques using a monoclonal antibody to substance-P (SP) were employed to identify nociceptive fibers. For statistical analyses we used the one-way ANOVA test, which was corrected with the LSD test, at the level of significance P < 0.05. Results of the study demonstrate that SP-immunoreactive nerve fibers are widespread within the soft tissues around the knee. These tissues include the retinaculum, synovium, fat pad and, in some circumstances, bone. In cases of anterior knee pain, the presence of neuropeptide-containing fibers was statistically significant in the medial retinaculum (P < 0.005) and in the fat pad (P < 0.001) compared to group III, and compared to group II (P < 0.05 and P < 0.007, respectively). For lateral retinaculum this relationship was not so statistically strong (P < 0.02) and was equal in comparison between anterior knee pain patients (group I) and group II or group III. There were no statistically significant differences in the distribution of substance-P nerve fibers in the fat pad, lateral and medial retinaculum or synovium between groups II and III. The results of this study provide immunohistochemical evidence suggesting that pain may originate in the fat pad and medial retinaculum of many patients with anterior knee pain syndrome.
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PMID:Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome. A preliminary report. 1040 55

We have previously shown that Fos-like immunoreactivity (Fos-LI) is evoked in the brainstem of ferrets following stimulation of pulpal A delta and C fibers originating from the maxillary canine. This study evaluated the effects of the mu-opioid receptor agonist fentanyl on Fos expression evoked by noxious thermal stimulation of the right maxillary and mandibular canines in pentobarbital/chloral hydrate anesthetized adult male ferrets. Pulpal heating evoked Fos expression in two distinct regions of the spinal trigeminal nuclear complex: the transitional region between subnucleus interpolaris and caudalis (Vi/Vc) and within the subnucleus caudalis (Vc). More Fos positive cells were expressed in both regions ipsilateral to the site of stimulation compared with the contralateral side (P < 0.05, ANOVA). Pretreatment with fentanyl significantly and dose-dependently suppressed the number of Fos positive cells in both the Vi/Vc transitional region and Vc (P < 0.05, ANOVA). The suppressive effect of fentanyl on Fos expression was blocked by the intravenous administration of naloxone, an opioid antagonist, indicating a specific opioid receptor effect. In addition, opioid receptor antagonism with naloxone alone enhanced Fos expression in Vi/Vc and Vc in response to heat stimulation. The administration of naloxone without heat stimulation failed to evoke Fos expression in Vi/ Vc and Vc. These findings suggest that the activation of trigeminal Vi/Vc and Vc neurons by noxious dental heat stimulation is controlled by a naloxone sensitive endogenous opioid system as indicated by Fos expression. Collectively, these results suggest that neuronal populations in Vi/Vc and Vc regions may contribute to pain responses to noxious dental stimulation and these responses can be modulated by both endogenous and exogenous opioids.
Pain 1999 Aug
PMID:The effect of fentanyl on c-fos expression in the trigeminal brainstem complex produced by pulpal heat stimulation in the ferret. 1046 25

In order to investigate the long-term effect of clinical rehabilitation measures as well as the additional effect of prescription of a special pillow in patients suffering from chronic cervicobrachialgia a total of 149 patients was investigated. All patients suffered from chronic cervicobrachialgia and were admitted for rehabilitative treatment in the orthopaedic Elfenmaar-Klinik of Bad Bertrich. For a four-week period the patients were treated with physical therapy including gymnastics, electrotherapy, thermotherapy, and massage. Additionally they underwent a health-promoting programme specially designed for patients with spondylopathia. The patients were randomly divided into two groups, one receiving a special pillow (Curavario, Pala-Medic-Company) for the use during and after the rehabilitative treatment (n = 76 or n = 73, respectively). For two weeks before the treatment, during the four-week treatment period and for two weeks after the treatment the patients had to fill in a questionnaire, comprising among others six questions on the intensity of their cervicobrachialgic symptoms (pain-intensity [local pain, radiation of pain], muscular tenseness, paraesthesia and sleep disorders [caused by pain or paraesthesia]). Three, six, and nine month after the treatment period the patients received a similar questionnaire. Immediately after the treatment period a significant reduction of mean pain intensity and muscle tenseness (p < 0.001; Rep.-Mes.-ANOVA) was found. At the same time significantly lower frequencies of pain radiation and sleep disorders caused by pain or paraesthesia (p < 0.001; chi-square-test) were found. During the following nine months the intensity of the symptoms slightly re-increased, however, all parameters were still reduced nine months after treatment compared to the values before treatment (p < 0.01). Before and during the treatment no difference between the two groups could be detected, however, the follow-up showed significantly lower scores of pain intensity (p < 0.05; Student-t-test) and sleep disorders (p < 0.01; chi-square test) in the patients who had received the special pillow. It is concluded that the rehabilitative treatment is effective in patients suffering from chronic cervicobrachialgia and that the complaints in the post-treatment period can be reduced by prescription of special pillows.
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PMID:[Prospective study of the long-term effectiveness of inpatient rehabilitation of patients with chronic cervicobrachial syndromes and the effect of prescribing special functional pillows]. 1050 91


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