High Rates of Undiagnosed Psychological Distress Exist in a Referral Population for Spinal Cord Stimulation in the Management of Chronic Pain

BackgroundNeuropathic pain affects various dimensions of patient health including physical, psychological, and socioeconomic. The spectrum of psychological dysfunction that accompanies this pain phenotype is unknown, as well as differences based on the etiology of the pain among patients referred for spinal cord stimulation (SCS). MethodsWe prospectively assessed SCS referral patients with neuropathic pain for features of psychological distress, either mood or anxiety. Demographic data included age, gender, diagnosis, marital status, and educational level. Screening tools were applied for neuropathic pain (Douleur Neuropathic Quatre and Leeds Assessment of Neuropathic Symptoms and Signs) and psychological distress (Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]). Descriptive statistics defined disease prevalence, compared by gender and diagnosis. Logistic regression correlated pain intensity with severity of psychopathology. ResultsAmong 150 patients with suitable neuropathic pain diagnoses and no treatable structural pathology, 57% were women, median age was 54 years, and 35% and 42% admitted to routine smoking and alcohol use, respectively. The most common diagnoses were complex regional pain syndrome (46%) and failed back surgery syndrome (38%). Depression symptoms were screened positive by BDI in 63% of patients, and anxiety symptoms were screened positive by BAI in 23% of patients. Pain intensity correlated with BDI scores (p
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research

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CONCLUSION: Individuals with DD undergoing PMT presented higher rates of recurrence of periodontitis and tooth loss when compared to individuals without DD. Additionally, the interaction between DD and smoking significantly increased the risk for the recurrence of periodontitis. PMID: 32224545 [PubMed - in process]
Source: Journal of the International Academy of Periodontology - Category: Dentistry Tags: J Int Acad Periodontol Source Type: research
Publication date: Available online 31 March 2020Source: Journal of Trace Elements in Medicine and BiologyAuthor(s): Joanna Owsianowska, Magdalena Sylwia Kamińska, Mateusz Bosiacki, Dariusz Chlubek, Beata Karakiewicz, Anna Jurczak, Marzanna Stanisławska, Katarzyna Barczak, Elżbieta Grochans
Source: Journal of Trace Elements in Medicine and Biology - Category: Biochemistry Source Type: research
Conclusions: Older adults who begin using cannabis are likely using for what they perceive to be medicinal purposes for a range of issues. However, they receive minimal guidance from their family physicians and instead obtain information from non-clinician sources.Clinical implications: Cannabis screening should be included in geriatric assessments and medicine reconciliation. Continuing education for clinicians needs to address knowledge gaps about cannabis use among older adults. PMID: 32223535 [PubMed - as supplied by publisher]
Source: Clinical Gerontologist - Category: Geriatrics Tags: Clin Gerontol Source Type: research
Conclusions: Continuing shifts in society's cultural landscape, ongoing emphasis on value versus volume, and other industry fiscal imperatives continue to evoke an evolution in end-of-life care. The attainment of successful outcomes by professional case managers with those populations will be dependent on awareness and comprehension of regulations, legislation, and reimbursement; the influences of ongoing industry trends; availability of emerging resources; and ongoing technological advances. Ethical excellence remains at the core of case management across the interprofessional workforce and the transitions of care. Imp...
Source: Professional Case Management - Category: Health Management Tags: Articles Source Type: research
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Source: Journal of Public Health Management and Practice - Category: Health Management Tags: State of Public Health Source Type: research
In this study, we examined the effect of laparoscopic-guided transversus abdominis plane block (LG TAP) for further optimizing multimodal pain control.MethodsThis is a retrospective analysis of a prospectively collected database of 140 consecutive patients undergoing LSG without TAP block (pre-TAP group) compared to 131 patients undergoing LSG with LGTAP (TAP group). All operations were performed laparoscopically utilizing uniform clinical pathways. Baseline characteristics for both groups were comparable. Both groups received standardized anesthesia. Outcomes included time to postoperative ambulation, pain scores, PCA vol...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundEnhanced recovery after surgery (ERAS) protocols have been extensively proven in lower gastrointestinal surgery to decrease postoperative physiologic stress and length of stay (LOS). ERAS in bariatric surgery (ERABS) varies immensely from each program with inconsistent results with a predominant goal of reducing LOS. Our focus in implementing enhanced recovery after bariatric surgery (ERABS) protocols is aimed at reducing postoperative pain and opioid use.MethodsThis is a retrospective review of patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (VSG) at a single hig...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Authors: Kohashi R, Shinozaki T, Sekine N, Watanabe K, Takanezawa D, Nishihara C, Ozasa K, Ikeda M, Noma N, Okada-Ogawa A, Imamura Y Abstract Burning mouth syndrome (BMS) is classified into idiopathic orofacial pain conditions. Although central and peripheral neuropathic mechanisms are believed to be involved, the etiology remains to be fully elucidated. The present study examined temporal brain responses to an ongoing hot stimulus to investigate the pain modulating system in patients with BMS. The thermal stimulation sequence comprised baseline (32°C, 40 s) to warm (40°C, 32 s) to baseline (32°C, 40 s)...
Source: Journal of oral science - Category: Dentistry Tags: J Oral Sci Source Type: research
Authors: Katagiri A, Kato T Abstract Neuropathic pain is characterized by sensory abnormalities, such as mechanical allodynia and heat hyperalgesia, associated with alteration in the peripheral and central nervous systems. After trigeminal nerve injury, phenotypic changes that involve the expression of calcitonin gene-related peptide occur in large- and medium-sized myelinated neurons; primary afferent neurons exhibit hyperexcitability because of neuron-glia interactions in the trigeminal ganglion. Increased nociceptive inputs from C- and Aδ-fiber and innocuous inputs from Aβ-fiber into the trigeminal sp...
Source: Journal of oral science - Category: Dentistry Tags: J Oral Sci Source Type: research
Authors: Tsujimura T, Inoue M Abstract Swallowing has a vital function in airway protection and is the next step after mastication. Swallowing impairment, which is known as dysphagia, is frequently accompanied by pain. Previous clinical studies have shown that orofacial pain affects swallowing function. Thus, it was hypothesized that orofacial noxious inputs may modulate swallowing function. Previous studies using anesthetized animals has proposed that the facial skin-nucleus tractus solitarii (NTS), masseter muscle-NTS, lingual muscle-NTS, and lingual muscle-paratrigeminal nucleus-NTS pathways may be involved in t...
Source: Journal of oral science - Category: Dentistry Tags: J Oral Sci Source Type: research
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