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Although knee pain is prevalent among community-dwelling older adults, little is known about how people in general handle their pain. We will conduct a survey to explore how knee pain affects people's lives and which treatments or self-management strategies they have chosen (or are being offered), and how these interact concerning pain reduction and maintenance of function.
Obstetric anal sphincter injuries (OASIS) encompass both third and fourth degree perineal tears. These tears can have a significant impact on women's quality of life in the short and long term. One of the most distressing immediate complications of this severe perineal injury is perineal pain. Women can also experience postpartum depression, dyspareunia, and altered sexual function after OASIS. This is a randomized controlled trial to study the effects of three interventions (placebo, low dose intravenous ketamine plus epidural morphine, or epidural morphine alone) on acute pain after OASIS. The objective of this study is to assess the incidence of perineal pain in postpartum patients 1 week after obstetric anal sphincter injuries.
A novel measure of nociception is the nociception level (NoL) index. The NoL index ranges from 0 to 100 and is based on a combination of nociception-related physiologic variables, which estimates the nociceptive/antinociceptive state. The purpose of this project is to conduct an observational study of the PMD-200 noninvasive monitor (Medasense Biometrics Ltd., Ramat Gan, Israel), As this is an observational study, this monitor will not be used for clinical decision making, and the point of the study is to assess what happens with the NoL index during routine care. After thorough discussion with patients and written informed consent is provided in the pre-operative unit, patients will be transferred to the operating room. Patients will be connected to a vital sign monitor and any other medical equipment needed for the surgical procedure, as required by the standard of practice. The PMD-200 finger probe will be connected to the left hand middle finger (or right). The PMD-200 will be activated after the induction of general anesthesia. A calibration period of 1-2 minutes will be performed. At the conclusion of the surgical procedure, the PMD200 will be disconnected from the patient. All the phases of anesthetic care are performed at the discretion of the anesthesiologist, but the time of administration of analgesics, muscle relaxants and other medications during anesthetic care will be recorded. The investigators will also record the time point of intubation (placement of breathing tube), extubation (removal of breathing tube), skin incision and any other significant surgical stimulation or noxious stimulation during the procedure. The investigators will be comparing NOL values prior to and following noxious stimuli, administration of analgesic agents and during non-noxious periods.
Children born with severe brain-based developmental disabilities frequently experience persistent unexplained periods of pain and irritability, often compounded by a limited capacity to communicate their distress. The investigators call this entity Pain and Irritability of Unknown Origin (PIUO). The investigators have designed a systematic approach, called the PIUO Pathway, to address the management of these children's pain and irritability with the goals of reducing pain symptoms, improving the day-to-day lives of the child and family, and simplifying treatment options for clinicians.
Fibromyalgia (FM) patients have increased windup (WU). However, WU of FM patients is only quantitatively but not qualitatively different from healthy controls (HC). Thus WU abnormalities of FM patients could be the result of supra-spinal and not the result of spinal pain mechanisms. The study team will test this hypothesis by sensitizing FM patients with topical capsaicin. The study team hypothesize that at baseline the slopes of sensitivity adjusted WU of FM patients are not statistically different from HC. However, after capsaicin application, the slopes of sensitivity adjusted WU will be significantly different from baseline and greater than those of HC, suggesting central sensitization. This would imply that FM patients are sensitive to heat pain but not sensitized.
The simplicity of the implementation and the effectiveness of hypno-analgesia (via the magic glove technique) has already been proven in some research work, during the installation of peripheral venous route. An unpublished preliminary study has shown that this method appears to be the most effective in preventing pain during pediatric propofol injection. The purpose is to compare the effectiveness of hypno-analgesia of the hand by the "magic glove technique" to lidocaine used in an extemporaneous mixture in the prevention of pain with injection of propofol during intravenous induction in children aged 7 to 14 years
Aim 1: Develop and manualize the MY-Skills intervention. Using focus groups, clinical reasoning, literature, and findings from previously tested interventions of yoga and self-management, the researchers will develop, refine, and standardize the MY-Skills intervention for chronic pain. In parallel, the researchers will develop a control group that includes exercise and health and wellness education. The expected outcomes include MY-Skills intervention workbooks for participants and training and teaching manuals for interventionists leading the MY-Skills intervention group and control group. Aim 2: Assess feasibility and acceptability of MY-Skills and research procedures including planned assessments. In this small RCT, the researchers will examine feasibility and acceptability of the 8-week MY-Skills procedures and intervention compared to an exercise and health and wellness education control group. Participants will include 30 caregiving dyads randomly assigned to the two groups (15 dyads for My-Skills and 15 dyads for control group; N = 30 dyads/60 participants). The primary hypothesis is that MY-Skills will be feasible and acceptable to caregiving dyads, as measured by benchmarks for recruitment, screening, attendance, and completion of assessments and intervention. Surveys will be administered and focus groups will be conducted to understand participant satisfaction and experiences with MY-Skills. After each intervention session, interventionists, caregivers, and care recipients will rate their satisfaction with the session content and activities.
The proneness to react to noxious stimuli varies widely between individuals and pain ratings of seemingly identical noxious stimuli may range from "no pain" to "excruciating pain" . Imaging studies in healthy subjects have provided useful information on the identification of the inter-individual variability in pain perception [2,3,4]. These studies have shown that subjective pain reports are closely related to the degree of neuronal activity in several brain regions known to be identified in pain processing. Furthermore, there has been a growing interest in understanding structural and functional mechanisms of inter-individual variability in responses to identical noxious stimuli [5,6,7]. Yet, the relationship between pain perception and various anatomical and functional connectivity within resting state brain networks is not completely understood. With regard to the anatomical correlate of pain sensitivity, differences in grey matter may reflect neural processes contributing to the construction and modulation of pain in healthy individuals. As such, studies are inconsistent regarding this issue, showing positive  or inverse connections  between pain sensitivity and brain morphology. The inconsistency regarding this issue warrant further investigation which may elucidate the relationship between differences in pain sensitivity and regional grey matter and may provide novel insights into brain mechanisms contributing to that topic. Understanding brain morphology and connectivity within specific regions associated with pain processing can provide reliable anchor for the individual differences in pain response. A widely used approach to examine brain morphology from MRI images is voxel based morphometry (VBM). VBM tests for statistically significant differences in regional gray matter (GM) density between study groups, and its temporal changes. Diffusion tensor imaging (DTI) is a type of diffusion weighted imaging with the advantage of being able to resolve individual functional tracts within the white matter (WM) thus, DTI parameters serve as indirect measures of structural connectivity via the degree of integrity of WM tracts.
All patients scheduled for lumbar spine surgery due to discogenic low back pain and/or sciatica, will be screened by the principal investigator for presence of inclusion/exclusion criteria. Their baseline neurological function before surgery will be assessed and recorded for recruitment into one of the three study groups. MRI scans will be assessed for the calculation of disc protrusion size. Experimental sensory and pain assessments and questionnaires will be performed at list 24 hours before surgery. Blood sample for pro-inflammatory mediator will be obtained at the same time as the experimental sensory and pain tests. Pre-operative pain and MPQ will be assessed pre-operatively (back and leg pain separately), and again on day 30 after surgery. Blood tests for ESR, CRP will be drawn before surgery, during the surgery, and on 30 after surgery. During surgery, intervertebral disc material will be harvested and divided into 4 specimens for culture and inflammatory mediator analysis. Repeat neurological assessment will be performed 30 after surgery.
Para-athletes are submitted and intense efforts in training and competitions that often overlap in days and weeks. In this sense, and in the search for better brands and indexes, it is necessary to use recovery methods that allow less late muscle pain and better physical performance. Recovery methods are widely used in athletes of various modalities, however there are no studies that point out their effects on para-athletes. This highlights the need for studies on this topic. Paragliding athletes, who train at the Londrina Yacht Club, Londrina Canoeing and Rowing School, who present paraplegia after spinal cord injury, with motor level T10 or lower, without any problem of thermoregulation will participate in the study. All were male and female, with no complaints of musculoskeletal pain or history of upper limb muscle injuries in the last six months and with the same demand for training and competitions. Initially an evaluation will be performed where 1RM, VO2 max, pain, spasticity, body temperature, heart rate variability and electromyographic signal of the involved muscles will be tested. After three days they will be induced to fatigue through a protocol in the traction exercise and immediately directed to one of the 3 intervention groups: ice pack, immersion in cold water or rest. The same baseline evaluations will be repeated after 24, 48 and 72 hours. It is expected that the group submitted to immersion in cold water presents better parameters for pain and sports performance.