Comparison of masseter muscle referred sensations after mechanical and glutamate stimulation: a randomized, double-blind, controlled, cross-over study
Referred sensations (RS) are commonly found in various musculoskeletal pain conditions. Experimental studies have shown that RS can be elicited through glutamate injection and mechanical stimulation. Despite this, differences and similarities between these modalities in RS outcomes remain unclear. The aim of this study was to assess differences between mechanical-induced and glutamate injection–induced RS in the trigeminal region. The present randomized, double-blind, controlled, cross-over study recruited 60 healthy participants who were assessed in 2 different sessions. In both sessions, pressure was applied to the masseter muscle with 4 different forces (0.5, 1, 2, and 4 kg), and glutamate (1 mol/L or 0.25 mol/L) was injected into the same area. Participants rated their perceived masseter sensations and rated and drew any RS they experienced. No difference was found in number of participants reporting RS after glutamate injection compared with mechanical stimulation. More participants reported RS when the stimulus was painful compared with a nonpainful stimulus. Furthermore, it was shown that the more intense the stimulus, the higher the frequency of RS. Finally, RS centre-of-gravity location was similar between the 2 sessions. In summary, RS was elicited in healthy individuals through both modalities, and no differences in frequency of RS were observed in the orofacial region. Hence, RS does not seem to be modality-dependent, and only the painfulness of the stimulus...
This article provides the general thoracic surgeon a detailed description on how to manage pleural effusions using video-assisted thoracoscopic surgery in a nonintubated patient. Surgical techniques and pearls are also presented.
Conclusion: Findings suggest that mothers and fathers may differentially perceive and respond to their adolescents' pain and that CAP parent-training intervention may help align their thinking. The results further demonstrate that both parents make adaptive changes after intervention, reinforcing the value of including both parents in pediatric treatment for chronic pain.
In conclusion, lncRNA MALAT1 promotes the progression of neuropathic pain in rats by reducing miR‑154‑5p and increasing AQP9. The MALAT1/miR‑154‑5p/AQP9 axis can be used as a new therapeutic target for neuropathic pain. PMID: 31746418 [PubMed - as supplied by publisher]
(Oxford University Press USA) Opioids play an important role in how cancer patients manage pain, but the ongoing opioid epidemic has raised concerns about their potential for abuse. A new study in the Journal of the National Cancer Institute reveals that several factors are associated with a risk for persistent opioid use, including younger age, white race, unemployment at the time of cancer diagnosis, lower median income, and current or prior tobacco use.
Reviewing my MLP charts for the last shift. Two MLPs under my "supervision" - 63 year old with knee pain. No knee exam, whatsoever. Just an x-ray and "discharged". No MDM. No nothing. - 23 year old with abdominal pain. Nonspecific exam, just "diffusely tender". No degree of tenderness, just "diffusely tender". No discussion about peritoneal findings. No inspection. CBC/BMP/UA and imaging all not imported into the chart; had to do that myself (Thanks, CERNER!) No repeat exam. Just... Reviewing MLP charts. FUN TIMES!
As a vascular fellow, I was taught not to perform any open bypass procedures on those patients who claudicated and who still smoked. It was considered a waste of resources on someone who could improve his or her symptoms by stopping smoking and going on an exercise regimen. When the patient had rest pain or a nonhealing ulcer, however, we went ahead with our open bypass clinic to prevent limb loss. We did recognize that our patency rates were lower if the patient still smoked, and we knew they were high risk for other complications as well.
At one of my teaching hospitals, there is an FM program with many DOs. Some of them believe in osteopathy and twice now I have come across their recommendation to use osteopathic "manipulation" in the ICU. (most recent example was left trapezius pain in a young patient who had been in bed too long with DKA) I asked them to show me any evidence supporting such practices. None has been provided. In fact, I have been given multiple publications describing manipulations of anatomical... osteopathy in the ICU