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Akire SC, Bayraktar N. Outcomes of Pain Management Among Postoperative Patients: A Cross-sectional Study. J Perianesth Nurs 2024; 39:240-245. [PMID: 37897477 DOI: 10.1016/j.jopan.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Postoperative pain management has always been a significant challenge for both hospital staff and surgical patients. Determination of pain management outcomes among surgically treated patients may help develop pain management strategies, improve health services that would yield better outcomes, and increase patient satisfaction. This study aimed to assess the outcomes of pain management among postoperative patients. DESIGN The study was a descriptive cross-sectional study. METHODS The research was performed on postoperative patients at two university hospitals in North Cyprus from July to September 2019. The study sample consisted of 90 patients from both hospitals. The Turkish Version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) was used for data collection. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to report the present study. FINDINGS This study showed that the overall mean for pain severity and the worst pain experienced by patients after 24 hours was slightly higher than medium. Examination of interference of the pain with functions demonstrated that patients experienced problems with physical activities and sleeping. The most experienced side effects were nausea and drowsiness, and the most common emotions were anxiety and helplessness during the postsurgery period. The satisfaction rate of the patients with postoperative pain management was relatively high. CONCLUSIONS A holistic approach with evidence-based practices is crucial for adequate postoperative pain management. The recommendations include the development of individual pain outcome strategies to improve overall satisfaction with pain management among postoperative patients.
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Affiliation(s)
| | - Nurhan Bayraktar
- Nursing Department, School of Health Sciences, Atilim University, Incek, Golbasi Ankara, Turkey.
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Tang Q, Gao S, Wang C, Zheng K, Zhang J, Huang H, Li Y, Ma Y. A prospective cohort study on perioperative percutaneous balloon compression for trigeminal neuralgia: safety and efficacy analysis. Neurosurg Rev 2024; 47:86. [PMID: 38366200 DOI: 10.1007/s10143-024-02323-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
With the recent emergence of percutaneous balloon compression (PBC) as a promising treatment for trigeminal neuralgia (TN), there is a growing need for research on its safety and efficacy. This study was designed to evaluate the safety and efficacy of PBC in the treatment of TN patients during the perioperative period. This study involved a total of 400 TN patients who were selected and treated with PBC at our institution. The clinical data and short-term outcomes were analyzed based on sex, initial PBC treatment for TN, and subsequent PBC treatment for recurrent TN after previous PBC or microvascular decompression (MVD) or radiofrequency thermocoagulation (RFT). No statistically significant difference was found when comparing postoperative pain relief between male and female patients with TN. Nevertheless, female patients were found to be more vulnerable than male patients to abnormal facial sensations (P = 0.001), diplopia (P = 0.015), postoperative headache (P = 0.012), and hyposmia (P = 0.029). Additionally, it was observed that there was no substantial difference in the postoperative pain relief rate between the first-time PBC group and PBC for recurrent TN patients postoperatively following procedures such as PBC, MVD, and RFT. In conclusion, this study has shown that PBC treatment is effective in managing TN in both males and females, regardless of whether the treatment was administered as a primary intervention or following prior surgical procedures such as PBC, MVD, or RFT. Nonetheless, it is noted that the risk of postoperative complications appears to be higher in female patients compared to male patients.
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Affiliation(s)
- Qianqian Tang
- Dalian Medical University, Dalian, Liaoning Province, China
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Shihui Gao
- Dalian Medical University, Dalian, Liaoning Province, China
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Changming Wang
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China.
| | - Kai Zheng
- Department of Anesthesiology, Jinan Eighth Hospital, Shandong, China.
| | - Jing Zhang
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Haitao Huang
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Yanfeng Li
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Yi Ma
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
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3
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Tang Q, Gao S, Wang C, Guan Z, Zhang J, Huang H, Li Y, Ma Y, Yan Z. Clinical observation of perioperative negative emotional changes in patients with percutaneous balloon compression for primary trigeminal neuralgia: A prospective cohort study. J Clin Neurosci 2024; 120:5-11. [PMID: 38159423 DOI: 10.1016/j.jocn.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To investigate the prevalence of negative emotions in trigeminal neuralgia (TN) patients, to identify risk factors associated with anxiety and depression, and further to explore the impact of percutaneous balloon compression (PBC) on anxiety and depression in TN patients during the perioperative period. METHODS 400 patients with primary TN treated with PBC at our institution from November 2021 to April 2023 were included. We analyzed visual analogue scale (VAS) and the Hospital Anxiety and Depression Scale (HADS) scores. The patients' clinical data and short-term clinical outcomes were gathered and subjected to statistical analysis. RESULTS This study included a total of 400 patients diagnosed with primary TN. Patients who had high pain intensity (OR 1.20, 95 % CI 1.02-1.41; p = 0.025) or a history of multiple previous TN procedures (OR 1.49, 95 % CI 1.03-2.16; p = 0.036), were more prone to anxiety. Patients who were female (OR 1.59, 95 % CI 1.03-2.44; p = 0.036), had high pain intensity (OR 1.28, 95 % CI 1.08-1.52; p = 0.004) or had a history of multiple previous TN procedures (OR 1.48, 95 % CI 1.11-1.98; p = 0.008), were more likely to have depression. Significant improvements in anxiety and depressive symptoms were observed in patients who experienced pain relief after PBC (p < 0.001). CONCLUSIONS Female gender, high pain intensity, and a history of multiple prior TN procedures are associated risk factors for anxiety and depression in TN patients. PBC can provide patients with a high pain relief rate and significantly improve their anxiety and depression symptoms during the perioperative period.
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Affiliation(s)
- Qianqian Tang
- Dalian Medical University, Dalian, Liaoning Province, China; Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Shihui Gao
- Dalian Medical University, Dalian, Liaoning Province, China; Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Changming Wang
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China.
| | - Zhanying Guan
- Department of Anesthesiology, Liaoning Jinqiu Hospital, Shenyang, China
| | - Jing Zhang
- Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Haitao Huang
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Yanfeng Li
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Yi Ma
- Department of Neurosurgery II, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China
| | - Zenglong Yan
- Third Department of Extraskeletal Surgery, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China.
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4
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Simon CB, Bishop MD, Wallace MR, Staud R, DelRocco N, Wu SS, Dai Y, Borsa PA, Greenfield WH, Fillingim RB, George SZ. Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial. THE JOURNAL OF PAIN 2023; 24:1465-1477. [PMID: 37178095 PMCID: PMC10523877 DOI: 10.1016/j.jpain.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/03/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
Shoulder pain is a highly prevalent musculoskeletal condition that frequently leads to suboptimal clinical outcomes. This study tested the extent to which circulating inflammatory biomarkers are associated with reports of shoulder pain and upper-extremity disability for a high-risk genetic by psychological subgroup (catechol-O-methyltransferase [COMT] variation by pain catastrophizing [PCS]). Pain-free adults meeting high-risk COMT × PCS subgroup criteria completed an exercise-induced muscle injury protocol. Thirteen biomarkers were collected and analyzed from plasma 48 hours after muscle injury. Shoulder pain intensity and disability (Quick-DASH) were reported at 48 and 96 hours to calculate change scores. Using an extreme sampling technique, 88 participants were included in this analysis. After controlling for age, sex, and BMI, there were moderate positive associations between higher c-reactive protein (CRP; βˆ = .62; 95% confidence interval [CI] = -.03, 1.26), interleukin-6 (IL-6; βˆ = 3.13; CI = -.11, 6.38), and interleukin-10 (IL-10; βˆ = 2.51; CI = -.30, 5.32); and greater pain reduction from 48 to 96 hours post exercise muscle injury. Using an exploratory multivariable model to predict pain changes from 48 to 96 hours, we found participants with higher IL-10 were less likely to experience a high increase in pain (βˆ = -10.77; CI = -21.25, -2.69). Study findings suggest CRP, IL-6, and IL-10 are related to shoulder pain change for a preclinical high-risk COMT × PCS subgroup. Future studies will translate to clinical shoulder pain and decipher the complex and seemingly pleiotropic interplay between inflammatory biomarkers and shoulder pain change. PERSPECTIVE: In a preclinical high-risk COMT × PCS subgroup, 3 circulating inflammatory biomarkers (CRP, IL-6, and IL-10) were moderately associated with pain improvement following exercise-induced muscle injury.
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Affiliation(s)
- Corey B Simon
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, Florida
| | - Margaret R Wallace
- Department of Molecular Genetics and Microbiology, UF Genetics Institute, University of Florida, Gainesville, Florida
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, Florida
| | - Natalie DelRocco
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Paul A Borsa
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | | | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Steven Z George
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
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Schirle L, Samuels DC, Faucon A, Cox NJ, Bruehl S. Polygenic Contributions to Chronic Overlapping Pain Conditions in a Large Electronic Health Record Sample. THE JOURNAL OF PAIN 2023; 24:1056-1068. [PMID: 36736868 PMCID: PMC10257768 DOI: 10.1016/j.jpain.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
Chronic overlapping pain conditions (COPCs) are believed to share common etiological mechanisms involving central sensitization. Genetic and environmental factors putatively combine to influence susceptibility to central sensitization and COPCs. This study employed a genome-wide polygenic risk score approach to evaluate genetic influences on 8 common COPCs. COPCs were identified by International Classification of Disease codes in Vanderbilt's deidentified clinical biorepository (BioVU), with each COPC condition empirically weighted for the level of central sensitization based on prior work. A centralized pain score (CPS) was calculated for 55,340 individuals by summing the weighted number of COPCs. Overall, 12,502 individuals (22.6%) were diagnosed with at least 1 COPC, with females exhibiting nearly twice the mean CPS as males. To assess the genetic influence on centralized pain in COPCs, 6 pain polygenic risk scores (PRSs) were developed using UK Biobank data to predict 6 pain criteria (no pain, neck/shoulder, abdomen, hip, knee, low back pain). These PRSs were then deployed in the BioVU cohort to test for association with CPS. In regression models adjusted for age, sex, and BMI, all pain PRSs except hip pain were significantly associated with CPS. Our findings support a shared polygenic influence across COPCs potentially involving central sensitization mechanisms. PERSPECTIVE: This study used a polygenic risk score approach to investigate genetic influences on chronic overlapping pain conditions. Significant findings in this study provide evidence supporting previous hypotheses that a shared polygenic influence involving central sensitization may underly chronic overlapping pain conditions and can guide future biomarker and risk assessment research.
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Affiliation(s)
- Lori Schirle
- Vanderbilt University School of Nursing, Nashville, Tennessee.
| | - David C Samuels
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Genetics Institute, Nashville, Tennessee
| | | | - Nancy J Cox
- Vanderbilt Genetics Institute, Nashville, Tennessee; Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
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Asai A, Suzuki F, Tsujiguchi H, Hara A, Miyagi S, Kannon T, Suzuki K, Nakamura M, Shimizu Y, Nguyen TTT, Pham KO, Kasahara T, Nakai S, Hayashi K, Shibata A, Amatsu T, Konoshita T, Kambayashi Y, Tsuboi H, Tajima A, Nakamura H. Relationship between fatty acid intake and chronic neck/shoulder/upper limb pain without elevated CRP in a Japanese population: a cross-sectional analysis of the Shika study. J Nutr Sci 2022; 11:e38. [PMID: 35720172 PMCID: PMC9161036 DOI: 10.1017/jns.2022.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
Although chronic pain (CP) is classified as inflammatory or non-inflammatory, the involvement of fatty acid intake in this process has not yet been examined in detail. Therefore, the present study investigated whether the relationship between CP and fatty acid intake differs between high and low C-reactive protein (CRP) levels in middle-aged and elderly individuals in the Shika study. One-thousand and seven males and 1216 females with mean ages of 68⋅78 and 69⋅65 years, respectively, participated in the present study. CRP was quantified by blood sampling from participants who responded to a CP questionnaire. The brief-type self-administered diet history questionnaire (BDHQ) was used to assess fatty acid intake. Interactions were observed between CP and CRP on monounsaturated fatty acids (MUFA) and eicosadienoic acid in a two-way analysis of covariance adjusted for sex, age, lack of exercise, lack of sleep, current smoking and drinking status, and BMI. MUFA (OR 1⋅359) and eicosadienoic acid (OR 1⋅072) were identified as significant independent variables for CP in a multiple logistic regression analysis, but only in the low CRP group. Only a high intake of MUFA and eicosadienoic acid was associated with chronic neck/shoulder/upper limb pain without elevated CRP. In psychogenic and neuropathic pain without elevated CRP, an increased intake of MUFA and eicosadienoic acid, a family member of n -6 fatty acids, appears to affect CP. Further longitudinal studies are needed to elucidate this relationship.
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Affiliation(s)
- Atsushi Asai
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama, Fukushima 963-8611, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, 14-1 Mukaimotorimachi, Komatsu, Ishikawa 923-0961, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam
| | - Kim Oanh Pham
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Shingo Nakai
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Takashi Amatsu
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime 794-8555, Japan
| | - Hirohito Tsuboi
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 1 Kakuma-machi, Kanazawa 920-1192, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
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Graham-Engeland J, DeMeo NN, Jones DR, Mathur A, Smyth JM, Sliwinski MJ, McGrady ME, Lipton RB, Katz MJ, Engeland CG. Individuals with both higher recent negative affect and physical pain have higher levels of C-reactive protein. Brain Behav Immun Health 2022; 21:100431. [PMID: 35243409 PMCID: PMC8881375 DOI: 10.1016/j.bbih.2022.100431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/02/2022] Open
Abstract
Conceptualizing physical pain and negative affect as potentially interactive, we hypothesized that higher levels of peripheral inflammatory markers would be observed consistently only among individuals with both higher negative affect and pain symptomatology. Participants were generally healthy midlife adults from the Bronx, NY (N = 212, Mage = 46.77; 60.8% Black, 25.5% Hispanic/Latina/o) recruited as part of a larger study. Key measures were: reported pain intensity and pain interference at baseline, recent negative affect averaged from self-reports 5x/day for 7 days, and peripheral inflammatory markers (C-reactive protein [CRP] and a composite cytokine measure based on seven cytokines). Controlling for age, BMI, gender, and education, recent negative affect significantly interacted with both pain variables to explain variance in CRP, with higher CRP levels observed only in individuals with both higher negative affect and either higher pain intensity or pain interference. These findings contribute to an emerging literature suggesting that negative affect, pain, and inflammation are related in important and complex ways.
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8
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Willey CJ, Sim JJ. Risk Factors for Pain in Autosomal Dominant Polycystic Kidney Disease: A New Research Trajectory. Kidney Med 2021; 3:481-483. [PMID: 34401715 PMCID: PMC8350823 DOI: 10.1016/j.xkme.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Cynthia J. Willey
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island
| | - John J. Sim
- Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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9
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Marttinen MK, Kautiainen H, Vuorimaa H, Kauppi MJ. Pain experience in an aging adult population during a 10-year follow-up. Scand J Pain 2021; 21:716-723. [PMID: 34114388 DOI: 10.1515/sjpain-2021-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This 10-year follow-up study aimed to examine the persistence of SF-36 pain intensity and pain-related interference and to identify baseline factors that may relate to pain experience among community-dwelling aging adults. METHODS Questionnaire and clinical data on a total of 1,954 participants (mean age at baseline 63 years) were collected in 2002, 2005, 2008, and 2012. Based on pain reports, four pain intensity, pain interference (PIPI) groups were formed at each time point: PIPI group I: none to mild pain intensity and interference; II: moderate to extreme pain intensity, none to mild pain-related interference; III: None to mild pain intensity, moderate to extreme pain-related interference, IV: Moderate to extreme pain intensity and interference. RESULTS Participants with the most pain at baseline improved their pain situation the most during the follow-up. Higher BMI was associated with pain interference, and metabolic syndrome (MetS) and musculoskeletal diseases with both pain intensity and interference (p<0.05, statistically significant interaction between pain intensity and pain interference) at baseline. According to multivariate logistic regression analysis the following baseline characteristics were associated with remaining in PIPI group I throughout the follow-up: presence of musculoskeletal disease (OR 0.22 [95% CI 0.16-0.30]), high BMI (OR 0.93 [95% CI 0.90-0.97]), high household income (OR 1.46 [95% CI 1.07-1.98]), good childhood home environment (OR 1.03 [95% CI 1.00-1.05]). CONCLUSIONS Multiple factors may affect pain persistence in late adulthood with varying effect on pain intensity and pain-related interference. Pain situation of even those with most pain may be improved.
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Affiliation(s)
- Maiju K Marttinen
- The Finnish Center for Pediatric and Adolescent Pain Management and Research, Helsinki University Hospital, Helsinki, Finland.,Department of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Vuorimaa
- The Finnish Center for Pediatric and Adolescent Pain Management and Research, Helsinki University Hospital, Helsinki, Finland
| | - Markku J Kauppi
- Department of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland.,Clinicum, University of Helsinki, Helsinki, Finland
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10
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Basem JI, White RS, Chen SA, Mauer E, Steinkamp ML, Inturrisi CE, Witkin LR. The effect of obesity on pain severity and pain interference. Pain Manag 2021; 11:571-581. [PMID: 34102863 DOI: 10.2217/pmt-2020-0089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Obesity is one of the most prevalent comorbidities associated with chronic pain, which can severely interfere with daily living and increase utilization of clinical resources. We hypothesized that a higher level of obesity, measured by BMI, would be associated with increased pain severity (intensity) and interference (pain related disability). Materials & methods: Participant data was pulled from a multisite chronic pain outpatient database and categorized based on BMI. Results: A total of 2509 patients were included in the study. We found significant differences between BMI groups for all pain severity scores (worst, least, average, current) and total pain interference score. Obese patients had significantly higher scores than normal weight patients. Conclusion: We found obesity to be associated with increased pain severity and pain interference.
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Affiliation(s)
- Jade I Basem
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Robert S White
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Stephanie A Chen
- Department of Anesthesiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Elizabeth Mauer
- Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, NY 10065, USA
| | - Michele L Steinkamp
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10065, USA
| | | | - Lisa R Witkin
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10065, USA
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11
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Qian M, Shi Y, Yu M. The association between obesity and chronic pain among community-dwelling older adults: a systematic review and meta-analysis. Geriatr Nurs 2020; 42:8-15. [PMID: 33197704 DOI: 10.1016/j.gerinurse.2020.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To systematically review studies and explore the association between obesity and chronic pain among community-dwelling older adults. METHODS A comprehensive literature search was conducted in 9 databases and the Pubmed search engine from their inception to March 19, 2020. Studies that investigated the associations between overweight/obesity and chronic pain among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze the eligible studies. RESULTS Totally 14 studies with 40,999 participants were included in this review, and 8 of these studies were meta-analyzed. The meta-analyses showed that both overweight (pooled OR = 1.166, 95% CI: 1.104-1.232, p < 0.01) and obesity (pooled OR = 1.786, 95% CI: 1.530-2.085, p < 0.01) had significant associations with chronic pain among older adults. CONCLUSIONS Overweight and obesity are both associated with chronic pain among older adults. It is suggested that body weight control strategies might be incorporated into the pain management program for older adults with obesity.
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Affiliation(s)
- Min Qian
- School of Nursing, Peking University, Beijing, P.R. China.
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, P.R. China
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, P.R. China.
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12
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Brennan PL. Life Stressors: Elevations and Disparities Among Older Adults with Pain. PAIN MEDICINE (MALDEN, MASS.) 2020; 21:2123-2136. [PMID: 32955090 PMCID: PMC7593801 DOI: 10.1093/pm/pnaa189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine stressor elevations among older adults with pain, and gender and race disparities in the dual burdens of late-life pain and stressors. DESIGN Cross-sectional. SETTING Community. SUBJECTS Participants in the Longitudinal Late-Life Health study (LLLH; N = 1,884) and the Health and Retirement Study (HRS; N = 7,704). METHODS Pain and stressor measures were harmonized across the LLLH and HRS samples. Analyses of covariance were conducted to determine the effects of older adults' pain, gender, race, and interactions between these factors, on their stressors in nine separate life domains, and in stressors overall. RESULTS In both the LLLH and HRS samples, older adults with painful conditions (joint, back, headache, chest pain), more numerous painful conditions, more severe pain, and more pain interference had elevated stressors in all life domains, compared with older adults without or with less serious pain. Pain was more prevalent among women and nonwhites than men and whites. Stressor exposure was higher for men than women in most life domains; it was higher for nonwhites than whites in all life domains. For certain types of pain and life domains, pain and gender, as well as pain and race, interacted to predict stressor elevations. CONCLUSIONS Late-life pain is associated with elevations in stressors, and there are gender and race disparities in the dual burdens of heightened pain and elevated stressors in later life. Pain and stressors are not consistently more strongly linked among older women than older men, or among older nonwhite than older white persons.
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Affiliation(s)
- Penny L Brennan
- Institute for Health & Aging, University of California, San Francisco, San Francisco, California, USA
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13
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Nguyen NP, Kim SY, Daheim J, Neduvelil A. Social Contribution and Psychological Well-Being among Midlife Adults with Chronic Pain: A Longitudinal Approach. J Aging Health 2020; 32:1591-1601. [PMID: 32762575 DOI: 10.1177/0898264320947293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Contributing to the welfare of others has been shown to have positive effects on people's social and psychological well-being (PWB). The current study examined whether social contribution (SC) could alleviate the negative effects of chronic pain on PWB through perceived social support (PSS) among midlife and older adults. Methods: The study consisted of 520 participants with chronic pain from the two waves of the Midlife in the United States dataset (MIDUS II and III). Results: Results from the longitudinal moderated mediation analysis indicated that SC at Time 2 (T2) significantly buffered the negative effect of pain interference (PI) at Time 1 (T1) on PSS at T2, which indirectly alleviated the negative effect of PI at T1 on PWB at T2. Discussion: The study suggested the protective role of SC and prosocial behaviors in mitigating the detrimental effects of chronic pain on social support and PWB.
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14
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Safarudin F, Iloabuchi CO, Ladani A, Sambamoorthi U. The Association of Beta-Blocker Use to Cognitive Impairment among Adults with Hypertension or Cardiovascular Diseases in the United States. CHRONIC PAIN & MANAGEMENT 2020; 4:125. [PMID: 32661512 PMCID: PMC7357995 DOI: 10.29011/2576-957x.100025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Some studies have shown that beta-blocker use is associated with better cognitive impairment. However, these studies did not control for pain. The relationship between pain and cognitive impairment has been exhaustively investigated. The association of beta blockers to cognitive impairment in the presence of chronic pain is still unknown. OBJECTIVE To examine the independent association of beta-blocker use to cognitive impairment among adults with hypertension or Cardiovascular Diseases (CVDs). METHODS We used a cross-sectional study design. We derived data on 8,279 adults from the 2015 Medical Expenditure Panel Survey (MEPS). Study participants were adults (age > 21 years), with hypertension or CVDs and without intracranial injury, Parkinson, Alzheimer's disease and Related Dementia. Cognitive impairment was measured based on 1) confusion or memory loss; 2) problems making decisions, or 3) supervision for participant's safety. Anti-hypertensive medications were categorized into 1) beta-blockers; 2) other anti-hypertensives; and 3) no antihypertensive medication. We used multivariable survey logistic regressions to examine the association between beta-blockers and cognitive impairment after controlling for biological factors, pain, chronic conditions, socioeconomic status, access to healthcare services, behavioral, socio-cultural and external environmental factors. RESULTS Overall, 24.2%, 41.9%, and 33.9% reported using beta-blockers, other antihypertensives, and no antihypertensive medications, respectively; 18.1% participants reported cognitive impairment. After controlling for pain, beta-blocker use was not significantly associated with cognitive impairment (AOR= 1.22, 95%CI= 1.00-1.49). In fully adjusted models, the AOR for beta-blockers use was 1.05 (95%CI = 0.84-1.31). CONCLUSION In this first large cross-sectional study, we found that the use of beta-blockers was not associated with cognitive impairment. Future prospective studies that include pain management and blood pressure control are needed to confirm the findings.
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Affiliation(s)
- Fnu Safarudin
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, USA
- School of Mathematics and Natural Sciences, Tadulako University, Indonesia
| | - Chibuzo O Iloabuchi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, USA
| | - Amit Ladani
- Department of Medicine, Section of Rheumatology, West Virginia University School of Pharmacy, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, USA
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15
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Park J, Sherman DG, Agogo G, Hoogendijk EO, Liu Z. Frailty modifies the intervention effect of chair yoga on pain among older adults with lower extremity osteoarthritis: Secondary analysis of a nonpharmacological intervention trial. Exp Gerontol 2020; 134:110886. [PMID: 32088398 PMCID: PMC7438234 DOI: 10.1016/j.exger.2020.110886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/12/2020] [Accepted: 02/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In an 8-week nonpharmacological pain intervention trial among older adults with lower extremity osteoarthritis (OA), we aimed to examine: a) the baseline frailty level of the participants; b) whether such intervention is more beneficial for baseline frailer older adults than for their counterparts with less frailty; and c) whether the intervention could also alter frailty. METHODS Participants were randomly assigned to either chair yoga (CY) or health education program (HEP) groups and attended twice-weekly 45-minute CY or HEP sessions for 8 weeks. Following a standard procedure, 82 variables were used to construct a frailty index (FI, 0-1). Primary outcomes were: Western Ontario and McMaster Universities (WOMAC) pain and pain interference. Linear mixed-effects models were used to evaluate the modifying effect of baseline frailty on the intervention effect of CY on primary outcomes. Similar models were used to evaluate the effect of CY on frailty. RESULTS A total of 112 participants (n = 63 CY, n = 49 HEP; 75.3 [SD = 7.5] years) with 85 females (75.9%) were included. The mean values of baseline FI for the CY and HEP groups were similar (0.428 [0.05] and 0.433 [0.05], P = 0.355). Each 0.01 increment in baseline FI was associated with higher WOMAC pain (beta = 0.28, P < 0.001) and pain interference (beta = 0.51, P < 0.001). There was a significant interaction effect between intervention, time, and baseline FI (P = 0.020 for WOMAC pain; P = 0.010 for pain interference), indicating that participants with higher level of baseline FI had greater declines in WOMAC pain and pain interference. There was no significantly greater decline in FI for the CY group compared to the HEP group (between-group difference - 0.01; P = 0.509) and there were no significant trend changes in FI (P for interaction = 0.605). CONCLUSIONS Frailty modifies the intervention effect of CY on pain among older adults with lower extremity OA, underscoring the importance of assessing frailty to improve the management of pain in this population.
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Affiliation(s)
- Juyoung Park
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - Diane G Sherman
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - George Agogo
- Centers for Disease Control and Prevention (CDC), Village Market, Nairobi, Kenya; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-location VU University Medical Center, Amsterdam, Netherlands
| | - Zuyun Liu
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA; Department of Precision Health and Data Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Sun K, Liu D, Chen J, Yu S, Bai Y, Chen C, Yao Y, Yu L, Yan M. Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery: A retrospective study. Sci Rep 2020; 10:795. [PMID: 31964955 PMCID: PMC6972772 DOI: 10.1038/s41598-020-57620-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 12/31/2019] [Indexed: 01/30/2023] Open
Abstract
Moderate-severe pain after surgical procedures is associated with decreased quality of life and increased costs. This study aimed to identify the incidence and predictive factors of moderate-severe postoperative pain within 48 hours following video-assisted thoracoscopic surgery (VATS) in a tertiary hospital. A retrospective cohort analysis was performed using medical records of adult patients who underwent VATS between January 2015 and December 2016. Logistic regression was performed to identify predictive factors for moderate-severe pain (visual analogue scale, VAS ≥ 4) within 24 hours and within 48 hours postoperatively. Of the 1164 participants, the incidence of moderate-severe pain was 12.7% within the first 24 hours and 15.6% within the first 48 hours after surgery. In multivariable analysis, the independent risk factors related to moderate-severe pain within 24 hours after surgery were younger age, increased body mass index, preoperative pain within 1 month and history of smoking. The risk factors for moderate-severe acute pain within 48 hours were almost the same, except that the number of chest tubes were also included. Moderate-severe postoperative pain following VATS is not rare, and presence of several risk factors deserves more aggressive pain management strategies perioperatively.
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Affiliation(s)
- Kai Sun
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Daiyun Liu
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Jie Chen
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Shui Yu
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Yongyu Bai
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Congcong Chen
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Yu Yao
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Lina Yu
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China
| | - Min Yan
- Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, NO. 88 Jiefang Road, Hangzhou, 310009, China.
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17
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Association of osteoarthritis and pain with Alzheimer's Diseases and Related Dementias among older adults in the United States. Osteoarthritis Cartilage 2019; 27:1470-1480. [PMID: 31200005 PMCID: PMC6750983 DOI: 10.1016/j.joca.2019.05.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/13/2019] [Accepted: 05/29/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Emerging evidence suggests that Pain Interference (PI) and certain chronic pain conditions, including Osteoarthritis (OA) may be associated with risk for Alzheimer's disease and Related Dementias (ADRD). However, research exploring the relation of OA and PI to ADRD remains sparse. OBJECTIVE To assess the association of OA and PI to ADRD using cross-sectional data from a representative sample of USA adults aged ≥65 years. DESIGN Retrospective cross-sectional. STUDY SAMPLE Older adults (age ≥ 65 years) drawn from the Medical Expenditure Panel Survey (MEPS, 2009-2015). METHODS OA was identified using both medical conditions files and participant responses to arthritis-specific queries. ADRD was ascertained using the medical conditions files. PI was defined as reported frequent PI with normal activities (PIA). OA and PIA were categorized as a composite variable: 1) OA with PIA; 2) OA without PIA; 3) No OA with PIA; and 4) No OA and no PIA (reference group). Adjusted associations of OA and PIA to ADRD were assessed using logistic regression and adjusted for biological, demographic, socio-economic, lifestyle, and health conditions. RESULTS Overall, 27.1% had OA, of whom 47.6 % reported PIA vs 31.1% of those without OA; 2.8% had diagnosed ADRD. Adults with PIA either with or without OA had significantly higher odds of ADRD relative to those without OA or PIA (Adjusted odd ratios (AOR's) = 1.37, 95%CI - 1.01, 1.86 (p = 0.04) and 1.44, 95%CI - 1.13, 1.82 (p = 0.003), respectively). CONCLUSION PIA in both the presence and absence of OA remained significantly and positively associated with ADRD after adjustment for multiple confounders.
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18
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Pain interference type and level guide the assessment process in chronic pain: Categorizing pain patients entering tertiary pain treatment with the Brief Pain Inventory. PLoS One 2019; 14:e0221437. [PMID: 31430355 PMCID: PMC6701883 DOI: 10.1371/journal.pone.0221437] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Chronic pain patients enter treatment with different problem profiles making careful assessment a necessity for more individualized treatment plans. In this cross-sectional study we assigned 320 patients entering tertiary multidisciplinary pain treatment into four categories based on whether they scored low or high on the activity and the affective pain interference dimensions of the Brief Pain Inventory (BPI). To determine whether this categorization system delineates issues that should be assessed further, the categories were compared with ANOVA and MANOVA analyses on three domains: variables affecting physical well-being (body mass index, exercise, substance use), psychological resources (mood), and pain-specific psychological factors (pain anxiety, pain acceptance). The results indicated that subjects who scored low on both interference dimensions compared similarly in weight: mean Body Mass Index (BMI) 27.0 (SD 6.0) kg/m2, and exercise: mean of 2.4 (SD 1.7) exercising sessions over 20 minutes per week, to the general population, had no depressive symptoms on average: mean Beck Depression Index II (BDI-II) score 11.7 (SD 7.5), and had the most favorable psychological reactions to pain relative to the other categories: mean total Pain Anxiety Symptoms Scale-20 (PASS-20) score 36.4 (SD 17.9). In contrast, when interference was high on activity, more physical well-being problems were evident e.g. weight: mean BMI 31.0 (SD 7.3) kg/m2, diminished exercise: mean of 1.5 (SD 1.6) exercising sessions per week, and avoidance behavior: mean PASS-20 Escape/Avoidance subscale 3.7 (95% CI: 1.7 to 5.8) scores higher in comparison to activity interference remaining low. With high affective interference, more depressive symptoms: mean BDI-II score 17.7 (SD 7.3), and more cognitive pain anxiety: mean PASS-20 Cognitive Anxiety subscale 2.8 (95% CI 0.7 to 4.8) scores higher in comparison to affective interference remaining low, emerged. Having high interference on both dimensions indicated accumulated risks for reduced physical well-being: mean BMI 29.9 (SD 6.1) kg/m2, mean of 1.2 (SD 1.7) exercising sessions per week, mood problems: mean BDI-II 20.3 (SD 10.6), and negative psychological reactions to pain: mean total PASS-20 score 53.2 (18.4). The results suggest that low interference on both dimensions may allow assessment with only physician consultations, while high interference on either dimension may call attention to distinct issues to be addressed with the help of a physiotherapist or a psychologist, whereas high interference on both dimensions highlights the need for a full multidisciplinary assessment.
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Marttinen MK, Kautiainen H, Haanpää M, Pohjankoski H, Vuorimaa H, Hintikka J, Kauppi MJ. Pain-related factors in older adults. Scand J Pain 2019; 19:797-803. [PMID: 31085750 DOI: 10.1515/sjpain-2019-0039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/20/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Pain is an evident factor affecting the quality of life in all age groups. The objective was to examine the prevalence of self-reported SF-36 bodily pain and pain-related factors in community-dwelling older adults. METHODS One thousand four hundred and twenty adults aged 62-86 years self-reported SF-36 bodily pain during the previous month. For the analysis, four pain groups were formed (group I [0-45, moderate to very severe pain intensity and interference], group II [47.5-70], group III [77.5-90], and group IV [100, no pain at all]). Additional questionnaire-provided data regarding education, wealth, life habits, and morbidity, as well as clinical data were considered. RESULTS The overall pain prevalence was 78% (SF-36 bodily pain score <100). The prevalence of cohabiting, as well as the years of education and household income were found to decrease with an increasing SF-36 bodily pain score. The prevalence of a BMI of over 30 and of central obesity emerged as the highest in group I. Morbidities were found to be most prevalent in group I. CONCLUSIONS A high prevalence of intense and interfering pain was reported. Multiple factors that were found to relate to pain have previously been demonstrated to associate with social exclusion. Increasing attention should be paid to distinguishing these factors in patients with pain, as well as targeted pain assessment and measures to improve the sense of community among older adults. IMPLICATIONS There is a lack of large studies that examine a wide scale of pain-related factors in the older adult population. To distinguish subjects with multiple such factors would help medical professionals to target their attention to patients at a high risk of chronic pain.
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Affiliation(s)
- Maiju K Marttinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Maija Haanpää
- Ilmarinen Mutual Pension Insurance Company, Helsinki, Finland.,Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland
| | - Heini Pohjankoski
- Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland
| | - Hanna Vuorimaa
- Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland
| | - Jukka Hintikka
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Psychiatry, Päijät-Häme Central Hospital, Lahti, Finland
| | - Markku J Kauppi
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland
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Mallon T, Ernst A, Brettschneider C, König HH, Luck T, Röhr S, Weyerer S, Werle J, Mösch E, Weeg D, Fuchs A, Pentzek M, Kleineidam L, Heser K, Riedel-Heller S, Maier W, Wiese B, Scherer M. Prevalence of pain and its associated factors among the oldest-olds in different care settings - results of the AgeQualiDe study. BMC FAMILY PRACTICE 2018; 19:85. [PMID: 29885656 PMCID: PMC5994256 DOI: 10.1186/s12875-018-0768-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 05/21/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life. METHODS Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI). RESULTS Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings. CONCLUSIONS Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings.
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Affiliation(s)
- Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Annette Ernst
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Kathrin Heser
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Tian D, Tian M, Zhang L, Zhao P, Cui Y, Li J. High fat diet sensitizes fibromyalgia-like pain behaviors in mice via tumor necrosis factor alpha. PLoS One 2018; 13:e0190861. [PMID: 29444083 PMCID: PMC5812560 DOI: 10.1371/journal.pone.0190861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 12/21/2017] [Indexed: 12/21/2022] Open
Abstract
Fibromyalgia (FM) and obesity are closely related. However, little is known about how obesity contributes to FM. Importantly, adequate evidence has shown that tumor necrosis factor alpha (TNF-α) plays a critical role in obesity. Thus, we hypothesized that obesity-induced TNF-α release may potentiate FM-associated pain. To test this hypothesis, we investigated the role of TNF-α in the development of FM-like pain in a mouse model of acid saline injection-induced FM. Consistent with previous reports, we showed that repeated acid saline injections induced bilateral mechanical hyperalgesia, and this effect lasted for at least 4 days after acid saline injections. This phenomenon was associated with increased levels of TNF-α in plasma, muscles, and spinal cord. Furthermore, we found that 24 weeks of high fat diet treatment significantly potentiated acid saline-induced bilateral mechanical hyperalgesia. High fat diet-treated mice exhibited robustly increased levels of TNF-α in plasma, muscles, and spinal cord after acid saline injections compared with low fat diet-treated mice. Additionally, using immunofluorescence staining, we found that the number of TNF-α positive cells in dorsal root ganglion (DRG) was increased after acid saline injections, and high fat diet treatment further sensitized this increase. Finally, we reported that acid saline-induced FM-like pain behaviors were abolished in TNFRp55-/- mice, confirming the critical role of TNF-α in the development of FM-like pain. Taken together, our results suggested that high fat diet treatment may sensitize acid saline-induced FM-like pain via increasing TNF-α levels in plasma, muscles, and DRG.
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Affiliation(s)
- Dan Tian
- Department of Anesthesiology, Second hospital of Jilin University, Changchun, China
| | - Miao Tian
- Department of Gynecology, Second hospital of Jilin University, Changchun, China
| | - Leilei Zhang
- Department of Anesthesiology, Second hospital of Jilin University, Changchun, China
| | - Peng Zhao
- Department of Anesthesiology, Second hospital of Jilin University, Changchun, China
| | - Yunfeng Cui
- Department of Anesthesiology, Second hospital of Jilin University, Changchun, China
| | - Jinlong Li
- Department of Gastrointestinal Surgery, Second hospital of Jilin University, Changchun, China
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Kritchevsky SB. Taking Obesity in Older Adults Seriously. J Gerontol A Biol Sci Med Sci 2017; 73:57-58. [DOI: 10.1093/gerona/glx228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Moon Y, Kim YS, Lee J, Han SH. Validity of the Korean Version of the Face, Legs, Activity, Cry, and Consolability Scale for Assessment of Pain in Dementia Patients. J Korean Med Sci 2017; 32:1852-1856. [PMID: 28960040 PMCID: PMC5639068 DOI: 10.3346/jkms.2017.32.11.1852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/14/2017] [Indexed: 01/18/2023] Open
Abstract
Pain is often associated with a more rapid progression of cognitive and functional decline, and behavioral disturbance in dementia. Therefore, it is essential to accurately assesses pain for proper intervention in patients with dementia. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale is an excellent behaviour scale which includes most of the domains that are recommended by the American Geriatrics Society to evaluate when assessing pain in patients with dementia. The purpose of this study was to develop the Korean version of the FLACC (K-FLACC) and to verify its reliability and validity in assessing pain of elderly patients with dementia. We developed the K-FLACC to consist of the five domains (face, legs, activity, cry, and consolability) with scores of 0, 1, and 2 for each domain and a total score ranging from 0 to 10 as in the original FLACC. Eighty-eight patients with dementia who visited Konkuk University Medical Center were evaluated. The K-FLACC revealed good validity as compared to the Numeric Rating Scale (NRS; r = 0.617, P < 0.001) and the Face Pain Scale (FPS; r = 0.350, P = 0.001). All of the five domains of the K-FLACC were related to the NRS and FPS, in which the activity domain showed the highest correlation. Test-retest reliability was excellent, as the intra-class correlation coefficient comparing the retest to test was 0.73 (95% confidence interval, 0.59-0.82). Our results show that the K-FLACC is a suitable and valuable scale to assess pain in patients with dementia in Korea.
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Affiliation(s)
- Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
| | - Yoon Sook Kim
- Department of Quality Improvement, Konkuk University Medical Center, Seoul, Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicines, Konkuk University Medical Center, Seoul, Korea
| | - Seol Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
- Center for Geriatric Neuroscience Research, Institute of Biomedical Science, Konkuk University, Seoul, Korea.
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Abstract
Chronic pain is one of the most common conditions seen in the clinic, and it is often one of the most frustrating for both clinicians and patients. This condition stems from common comorbidities, including depression, insomnia, fatigue, and physical deconditioning, which often create barriers to recovery. In addition, chronic pain has had divergent approaches for treatment, including an overemphasis on analgesia and curative treatments while underemphasizing the biopsychosocial needs of those in pain. This article attempts to provide an initial framework for approaching those in pain and initiating patient-centered options to support improvements in pain, function, and self-care.
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Affiliation(s)
- Robert Alan Bonakdar
- Scripps Center for Integrative Medicine, 10820 North Torrey Pines Road, Maildrop FC2, La Jolla, CA 92037, USA.
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Shiro Y, Arai YC, Ikemoto T, Hayashi K. Stool consistency is significantly associated with pain perception. PLoS One 2017; 12:e0182859. [PMID: 28793322 PMCID: PMC5549932 DOI: 10.1371/journal.pone.0182859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/25/2017] [Indexed: 12/12/2022] Open
Abstract
Background Commensal as well as pathogenic bacteria can influence a variety of gut functions, thereby leading to constipation and diarrhea in severe cases. In fact, several researchers have reported evidence supporting the association between stool consistency or constipation and the Gut microbiome (GM) composition and dysbiosis. GM influences the human health and disease via the gut-brain axis. We thus hypothesized that the pathogenic bacteria increases pain perception to some extent, which means that there could be an association between stool consistency or constipation and pain perception of healthy subjects. Design Observational study. Objectives The aim of the present study was to investigate the association between stool consistency or constipation and pain perception of healthy subjects. Methods Thirty-eight healthy subjects participated in this study. The participants were assessed on their usual stool form (the Bristol Stool Form Scale: BSFS), constipation (the Cleveland Clinic Constipation score: CCS), degree of obesity, pain perception by mechanical stimulus, cold pain threshold, and a questionnaire on psychological state. Results The BSFS was significantly and positively associated with pain perception, and showed a significant association with anxiety states. Furthermore, pain perception was significantly associated with anxiety states. However, there were no significant associations between the CCS and any independent variables. In addition, we found that a significant predictor to the pain perception was BSFS. Moreover, there were significant relationships among the psychological states, BSFS and obesity. Conclusion These results suggest that the stool form is associated with pain perception and anxiety status.
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Affiliation(s)
- Yukiko Shiro
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
| | - Young-Chang Arai
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Nagakute, Japan
- * E-mail:
| | - Tatsunori Ikemoto
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kazuhiro Hayashi
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Rehabilitation, Aichi Medical University Hospital, Nagakute, Japan
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