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Ibuprofen efficacy, tolerability and safety in obese children: a systematic review.

Childhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.

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Opioid-reduced anesthesia based on esketamine in gynecological day surgery: a randomized double-blind controlled study.

Opioid-reduced anesthesia may accelerate postoperative rehabilitation by reducing opioid-related side effects. The objective was to investigate the feasibility of opioid-reduced general anesthesia based on esketamine and to observe postoperative nausea and vomiting (PONV), postoperative pain, hemodynamics and other adverse reactions in gynecological day surgery compared with the traditional opioid-based anesthesia program.

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Associations of poor sleep quality, chronic pain and depressive symptoms with frailty in older patients: is there a sex difference?

Sleep disturbance, chronic pain and depressive symptoms later in life are modifiable risk factors and may contribute to frailty. However, much less is known about sex differences in the association between these concurrent symptoms and frailty in older patients. Therefore, we conducted this study to explore the associations of poor sleep quality, chronic pain, and depressive symptoms with frailty in older patients, and the sex-specific associations.

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Efficacy of perineural hypertonic saline injection versus acupoints of foot in the management of diabetic neuropathy: a multicenter, double-blinded randomized controlled trial.

Painful diabetic polyneuropathy is one of the most common disabling problems worldwide. We aimed to determine if a perineural injection of hypertonic saline compared with foot acupoints decreased the neuropathic pain score in patients with diabetes. Patients were assigned to receive either perineural or acupoints injection of hypertonic saline 5% in their feet for three weekly sessions. Douleur Neuropathique 4 (DN4) questionnaire for neuropathic pain was assessed. Both groups observed a significant reduction of the DN4 score throughout 8 weeks of follow-up. Both perineural and acupoints hypertonic saline injections of the foot could improve neuropathic pain in patients with diabetes.

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Spinal Cord Stimulation for Painful Diabetic Neuropathy.

Spinal cord stimulation (SCS) technology has been recently approved by the US Food and Drug Administration (FDA) for painful diabetic neuropathy (PDN). The treatment involves surgical implantation of electrodes and a power source that delivers electrical current to the spinal cord. This treatment decreases the perception of pain in many chronic pain conditions, such as PDN. The number of patients with PDN treated with SCS and the amount of data describing their outcomes is expected to increase given four factors: (1) the large number of patients with this diagnosis, (2) the poor results that have been obtained for pain relief with pharmacotherapy and noninvasive non-pharmacotherapy, (3) the results to date with investigational SCS technology, and (4) the recent FDA approval of systems that deliver this treatment. Whereas traditional SCS replaces pain with paresthesias, a new form of SCS, called high-frequency 10-kHz SCS, first used for pain in 2015, can relieve PDN pain without causing paresthesias, although not all patients experience pain relief by SCS. This article describes (1) an overview of SCS technology, (2) the use of SCS for diseases other than diabetes, (3) the use of SCS for PDN, (4) a comparison of high-frequency 10-kHz and traditional SCS for PDN, (5) other SCS technology for PDN, (6) deployment of SCS systems, (7) barriers to the use of SCS for PDN, (8) risks of SCS technology, (9) current recommendations for using SCS for PDN, and (10) future developments in SCS.

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Trigeminal afferents sense locomotion-related meningeal deformations.

The trigeminal sensory innervation of the cranial meninges is thought to serve a nociceptive function and mediate headache pain. However, the activity of meningeal afferents under natural conditions in awake animals remains unexplored. Here, we used two- and three-dimensional two-photon calcium imaging to track the activity of meningeal afferent fibers in awake mice. Surprisingly, a large subset of afferents was activated during non-noxious conditions such as locomotion. We estimated locomotion-related meningeal deformations and found afferents with distinct dynamics and tuning to various levels of meningeal expansion, compression, shearing, and Z-axis motion. Further, these mechanosensitive afferents were often tuned to distinct directions of meningeal expansion or compression. Thus, in addition to their role in headache-related pain, meningeal sensory neurons track the dynamic mechanical state of the meninges under natural conditions.

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Pain analgesia or desensitization? A longitudinal lab-based study on the link between pain and nonsuicidal self-injury.

Mounting evidence suggests that individuals who engage in nonsuicidal self-injury (NSSI) have lower pain sensitivity (e.g., pain thresholds and tolerances) than individuals without a history of NSSI. However, research has been largely cross-sectional, so it is unclear whether low pain sensitivity may increase risk for NSSI, or whether NSSI diminishes pain sensitivity over time. In the present study, the relations among NSSI frequency, versatility (number of NSSI methods), pain threshold, and pain tolerance were examined using a longitudinal research design. Participants included 156 undergraduate students at a large university (87% female; Mage = 19.79) with a recent history of NSSI. Participants reported on their NSSI engagement and completed a cold pressor task in a baseline session, as well as at one year follow-up. Eight regression models were run to examine the nature of the association between the two pain measures (i.e., pain threshold and tolerance) and the two NSSI measures (i.e., frequency and versatility). Pain tolerance and pain threshold predicted NSSI versatility over time, but NSSI frequency and versatility did not predict pain threshold or tolerance over time. Results suggest that low pain sensitivity may be a risk factor for severe NSSI engagement.

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Somatosensation a la mode: plasticity and polymodality in sensory neurons.

Our understanding of how peripheral damage-sensing neurons (nociceptors) respond to noxious stimuli is fundamental to the development of effective analgesics. To date, numerous studies have presented diverging hypotheses on how nociceptors encode modality-specific stimuli, including labelled-line, intensity dependence or pattern theory. In this short review, we appraise data from electrophysiological, behavioural, imaging and molecular expression studies from the last 60 years, in order to obtain a coherent view of modality-specific sensing in peripheral sensory neurons. We propose a mechanistic explanation for the broad range of values obtained for the incidence of polymodal nociceptors that reconciles apparently contradictory data.

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Evolution of a chronic pain management program in a Northwestern Ontario community: from structural elements to practical application.

Chronic pain is a highly prevalent health problem especially in rural regions. There is a dearth of comprehensive pain management programs particularly in rural areas.

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California cannabis cultivation and processing workers: A qualitative analysis of physiological exposures and health effects.

Cannabis is a multi-billion-dollar California industry, but little is known about the occupational hazards or health experiences of cannabis cultivation workers. Respiratory and dermal exposures, musculoskeletal hazards, and other agricultural hazards have been identified in previous research. Even in a post-legalization framework, cannabis work is stigmatized and most cannabis is still produced illegally. Qualitative research is essential for establishing rapport with cannabis workers to understand their experiences and concerns.

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