Uncategorized

Some children with chronic abdominal wall pain or groin pain do not have an inguinal hernia but suffer from anterior cutaneous nerve entrapment syndrome (ACNES). Diagnosing ACNES is challenging, especially in children as a diagnostic gold standard is lacking. A paediatric questionnaire containing 17 simple items was earlier found to discriminate between abdominal pain due or ACNES or IBS. Scores range from 0 points (ACNES very unlikely) to 17 points (ACNES very likely). The present study investigates whether this 17-item questionnaire predicted treatment success in children receiving therapy for ACNES.

Several studies on use of erenumab for migraine treatment have been published over recent years. However, its long-term safety and effectiveness have not been consistently established in the literature yet. We aimed to perform a qualitative and quantitative analysis of the long-term safety and effectiveness of erenumab for the treatment of migraine headaches.

Accumulating evidence demonstrates a role of the cerebellum in nociception. Some studies suggest that this is mediated via endogenous pain modulation. Here, we used t-DCS to test the effects of modulation of cerebellar function on nociception and endogenous pain modulation. Anodal, cathodal, and sham cerebellar t-DCS were investigated in a cross-over design in 21 healthy subjects. The nociceptive flexor (RIII) reflex, conditioning pain modulation (CPM), and offset analgesia (OA) paradigms were used to assess endogenous pain modulation. Somatosensory evoked potentials (SEPs) and pain ratings were used to assess supraspinal nociception and pain perception, respectively. No significant t-DCS effects were detected when including all t-DCS types and time points (baseline, 0, 30, 60 min post t-DCS) in the analysis. Exploratory analysis revealed an increased RIII reflex size immediately after cathodal t-DCS (compared to sham, P = 0.046, η = 0.184), in parallel with a trend for a decrease in electrical pain thresholds (P = 0.094, η = 0.134), and increased N120 SEP amplitudes 30 min after cathodal compared to anodal t-DCS (P = 0.007, η = 0.374). OA was increased after anodal compared to sham stimulation (P = 0.023, η = 0.232). Exploratory results suggested that cathodal (inhibitory) cerebellar t-DCS increased pain perception and reduced endogenous pain inhibition while anodal (excitatory) t-DCS increased endogenous pain inhibition. Results are principally compatible with activation of endogenous pain inhibition by cerebellar excitation. However, maybe due to limited t-DCS skull penetration, effects were small and unlikely to be clinically significant.

Tension-type headache (TTH) refers to a type of functionalism disease, which is commonly characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity. Has significantly impacts on people's work and life. Ear acupuncture as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat TTH. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of ear acupuncture in TTH.

Objective This study is aimed to systematically review the treatment outcomes between percutaneous balloon compression (PBC) and microvascular decompression (MVD) in patients with trigeminal neuralgia. Methods A systematic review in accordance with the PRISMA guideline was performed using PubMed, Embase and Cochrane CENTRAL databases. Only those articles with more than 5 years' follow-up length were included in this investigation. In order to uniformly assess the postoperative outcome, we defined pain relief for those totally pain free, while the postoperative hospitalization and last follow-up period as early and long-term, respectively. The facial numbness was quantified with BNI score. Results After database searching and screening, 7797 cases were enrolled finally according the criteria. The early pain relief rates were 94.1% (1551/1649) and 89.9% (4962/5482) following PBC and MVD (OR=0.603, p<0.05), while the long-term 58.1% (921/1566) and 74.9% (4549/6074) (OR=2.089, p<0.05), respectively. Although a significant higher facial numbness occurred in PBC group in the early stage, it was mostly diminished 5 years later compared with MVD group. At long-term follow-up, hypoacousia and facial palsy occurred more often in MVD group (p<0.05). Conclusions Both MVD and PBC provide a satisfactory outcome for the patients in long-term. As a simple, safe and reliable technique, PBC should not be shrugged off by neurosurgeons.

Epidural fibrosis is a major cause of postlaminectomy syndrome or "failed back surgery syndrome," which may occur after spinal surgical interventions. It reduces the quality of life, and is characterized by persistent back/low back pain and radicular leg pain. The aim of this experimental study was to investigate the efficacy of locally applied batimastat after laminectomy in preventing postoperative epidural fibrosis.

This study aimed to assess patients' preferences of nonsurgical treatments for chronic low back pain (CLBP).

Acetaminophen is a common analgesic and antipyretic drug used in human medicine and might be an alternative to non-steroidal anti-inflammatory drugs for treating pain and pyrexia in foals. The pharmacokinetics and safety of differing doses of acetaminophen have not been investigated in foals.

Smoking and vaping throughout adolescence and early adulthood leads to nicotine dependence. Nicotine withdrawal is associated with somatic and affective withdrawal symptoms that contribute to smoking and relapse. Affective nicotine withdrawal symptoms in humans include craving for cigarettes, depression, anxiety, trouble sleeping, and cognitive deficits. Herein, we review clinical studies that investigated nicotine dependence in people who smoke or vape. We also discuss studies that investigated the development of dependence in animals with oral nicotine intake, nicotine aerosol self-administration, and intravenous nicotine self-administration. Clinical studies report that adolescents who smoke daily develop nicotine dependence before those who smoke infrequently, but ultimately all smokers become dependent in adulthood. Preclinical studies indicate that rats that self-administer nicotine also become dependent. Rats that self-administer nicotine display somatic withdrawal signs and affective withdrawal signs, including increased anxiety and depressive-like behavior, cognitive deficits, and allodynia. Most nicotine withdrawal signs were observed in rodents with daily (7 days/week) or intermittent long access (23-h) to nicotine. Clinical smoking studies report symptoms of nicotine dependence in adolescents of both sexes, but virtually all preclinical nicotine self-administration studies have been done with adult male rats. The role of sex and age in the development of dependence in nicotine self-administration studies remains under-investigated. However, the role of sex and age in nicotine withdrawal has been thoroughly evaluated in studies in which nicotine was administered noncontingently. We discuss the need for volitional nicotine self-administration studies that explore the gradual development of dependence during adolescence and adulthood in rodents of both sexes. Implications: The reviewed clinical studies investigated the development of nicotine dependence in male and female adolescent and young adult smokers and vapers. These studies indicate that most adolescent smokers and vapers gradually become nicotine dependent. Preclinical studies with rodents show that nicotine intake in widely used self-administration models also leads to dependence. However, almost all animal studies that investigated the development of nicotine dependence have been conducted with adult male rats. To better model smoking and vaping, it is important that nicotine intake in rats or mice starts during adolescence and that both sexes are included.

With >700 transplant surgeries performed each year, Toronto General Hospital (TGH) is currently one of the largest adult transplant centers in North America. There is a lack of literature regarding both the identification and management of chronic postsurgical pain (CPSP) after organ transplantation. Since 2014, the TGH Transitional Pain Service (TPS) has helped manage patients who developed CPSP after solid organ transplantation (SOT), including heart, lung, liver, and renal transplants.