摘要:

Pressure threshold is the minimum pressure inducing pain or discomfort. A force gauge (11-kg gauge), to which a rubber disc with an exactly 1-cm2surface is attached, has been proven to be adequate for quantification of tenderness in soft tissues. The pressure threshold measurement (PTM) is useful for documentation and identification of tender spots, as well as quantification of the degree of tenderness (pain). Normal values were established in 24 male and 26 female volunteers at nine different sites, frequently affected by trigger points, including trapezius, supraspinatus, infraspinatus, teres major, lumbar paraspinals, (two sites), and gluteus and pectoralis muscles. The deltoid was used as reference for usually normal muscle sensitivity. The clinical use of PTM is discussed, and includes quantification of tenderness for medicolegal purposes, but primarily to prove to patients and other health professionals the presence of trigger points or tender spots. The reaction to different treatment modalities, such as physiotherapy and drugs, can be assessed quantitatively. After properly administered trigger point injections, consisting of needling of entire abnormal area, PTM increases, usually by 4 kg/cm2. Failure to raise PTM indicates that the injection was incomplete, and the procedure should be repeated. PTM correlates well with changes of clinical status and can be used for monitoring tenderness, inflammation, and the activity of arthritis.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Eleven patients who had previously known pain relief from high-frequency transcutaneous electrical nerve stimulation (TENS), and 12 control patients were prospectively studied to determine the relationship between high-frequency TENS-induced analgesia, serum β-endorphin levels, and the effect of naloxone hydrochloride (1 mg) or sodium chloride intravenous injection on pain relief. The chronic pain group experienced effective pain relief from TENS, but failed to show an increase in β-endorphin serum levels or a reversal of the analgesic effect after naloxone or saline interruption. The control group similarly did not demonstrate an increase in their β-endorphin serum levels. This study confirms previous work showing that high-intensity, continuous-stimulation TENS is not reversed by naloxone hydrochloride. It also demonstrates that high-frequency TENS delivered in this mode does not result in an increase in serum levels of β-endorphin in patients with pain (and TENS response), or in a control group of healthy subjects without pain.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A sample of 180 patients treated at The Boulder Pain Control Center was randomly chosen to participate in Goal Attainment Scaling (GAS). Of these participants, a total of 76 returned for a 6-month follow-up assessment. Data from these patients were used for two studies: (a) a study of the construct validity of the GAS as a treatment outcome measure, and (b) an assessment of treatment efficacy using the GAS. For the first study, Rao's canonical factor analysis was used to judge the construct validity of the GAS scores. There is moderate statistical evidence to show that GAS can add to our understanding of the structure of pain treatment outcome measures. For the second study, a simple comparison of the treatment group (n = 76) with a control group (n = 129) on several functional, verbal, and sociocultural outcome measures showed that GAS participation accounted for 24.7% of the variance in improvement after treatment.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Eighty-five patients in an outpatient pain management program were surveyed concerning the employment status of their significant others. A statistically significant portion of these patients had chosen spouses who had professional health-care skills. The mechanism of assortative mating explains this tendency of emotionally needy chronic pain patients to seek nurturant spouses with complementary dependency needs.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This study compared the psychological functioning of 275 individuals requesting outpatient treatment for one of five chronic pain syndromes: tension headaches, backaches, migraine headaches, temporomandibular pain, and gastrointestinal pain syndromes. The measure used to assess psychological functioning was the SCL-90. Results show a continuum of acknowledged psychological distress among the groups, with the least amount reported by temporomandibular joint pain patients, and the greatest degree of psychological disturbance reported by the gastrointestinal pain patients. Between these two groups were the migraine patients, backache patients, and the tension headache patients, ranging in this sequence from the low to the higher end of reported psychological symptoms. Demographic and health utilization data, along with duration of pain and referral mechanisms, are also reported for each of the groups.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Single intravenous doses of dezocine (2.5, 5, or 10 mg), morphine (5 mg), and placebo were compared in a 6-h double-blind study of 164 patients with moderate or severe postoperative pain. The efficacy scores (verbal and analog pain intensity and pain relief scales) and the percentages of patients with at least moderate pain relief all showed a significant (p < 0.05) advantage for 10 mg of dezocine over placebo during the first 2 h: 5 mg of dezocine was significantly superior to placebo for up to 1 h, and morphine was significantly superior for only 30 min. Regardless of the efficacy criterion, 5 mg of dezocine was at least as effective as 5 mg of morphine, and there was a consistent advantage for 10 mg of dezocine over 5 mg of morphine at most evaluations for at least 2 h; the differences between the 10-mg dezocine and morphine groups were significant (p < 0.05) at 30 min through 2 h. Side-effects were few and mild or moderate in all treatment groups, and there were no statistically significant differences between the groups in the frequency of side-effects. The physician and patient evaluations were significantly (p < 0.05) more favorable for 5 and 10 mg of dezocine and morphine than for placebo. The percentage of patients who rated treatment as either good or excellent was highest in the 10-mg dezocine group (73%), followed by the 5-mg dezocine (50%) group, the 5-mg morphine (33%) group, the 2.5-mg dezocine (19%) group, and the placebo (10%) group. The results indicate that intravenous dezocine is safe and provides significantly more effective analgesia than placebo, and that the 5-mg dose is at least as effective as 5 mg of morphine.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Burning Mouth Syndrome (BMS) is a poorly characterized intraoral pain disorder that appears to affect primarily postmenopausal women. The present report reviews from a historical perspective many of the etiologies for BMS that have been proposed and the supporting evidence for each.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Abnormalities have already been reported in the phenotypic frequency of the major histocompatibility complex antigens and in the relative proportions of the leukocyte subsets in patients affected by episodic cluster headache (ECH). Circulating immune complexes (CIC) and leukocyte subsets have been studied in 19 patients affected by episodic cluster headache during and in the absence of periods of crisis. The presence of CIC was determined in another five patients outside periods of crisis. CIC were evaluated using two techniques based on different principles revealing different types of CIC: the solid phase Clq method, and the conglutinin radioimmune assay. Monoclonal antibodies have been used to phenotype total T, helper/suppressor, K and NK leukocyte subsets, and monocytes. The findings demonstrate an increased incidence of CIC in the 19 ECH patients followed with time (37%) with respect to control subjects (10%), and an increase in Leu7-positive cells (K and NK cells) and in LeuM3-positive cells (monocytes). Interestingly, when patients were grouped according to the presence of CIC, only CIC-positive patients showed the previously described abnormalities. This would suggest that the cell-mediated immune alterations present in these patients may interact with the presence of CIC.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We report temporary management of cancer pain by concomitant epidural administration of morphine and norepinephrine in a patient with metastatic endometrial adenocarcinoma, already tolerant to high doses of narcotics administered systemically and epidurally.

ISSN:0749-8047    

出版商:OVID    

年代:1986

数据来源: OVID