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Pain in Inflammatory Bowel Disease Is Not Improved During Hospitalization: The Impact of Opioids on Pain and Healthcare Utilization.

Most patients with IBD experience pain, especially during acute disease exacerbations. Opioid use continues to be more prevalent in IBD than any other chronic gastrointestinal condition, and the majority of IBD patients consume narcotics during hospitalization despite the risks of infection and death.

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Visual snow syndrome: a comparison between an Italian and British population.

Visual snow manifests as a pan-field, dynamic visual disturbance described as continuous TV-static-like tiny flickering dots. Current diagnostic criteria further require at least two additional symptoms for the Visual Snow Syndrome (VSS) from: palinopsia (afterimages and trailing), entoptic phenomena (floaters, blue field entoptic phenomenon, photopsia, self-light of the eye), photophobia and nyctalopia. Our objective was to compare the phenotype of VSS in an Italian and British population.

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Sleep Disturbance Predicts Less Improvement in Pain Outcomes: Secondary Analysis of the SPACE Randomized Clinical Trial.

Sleep disturbance may limit improvement in pain outcomes if not directly addressed in treatment. Moreover, sleep problems may be exacerbated by opioid therapy. This study examined the effects of baseline sleep disturbance on improvement in pain outcomes using data from the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial, a pragmatic 12-month randomized trial of opioid vs nonopioid medication therapy.

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Training endogenous pain modulation: a preliminary investigation of neural adaptation following repeated exposure to clinically-relevant pain.

Analgesic treatments that aim to eliminate pain display marginal success in relieving chronic pain and may increase pain vulnerability. Repeated exposure to pain may result in increased pain modulation via engagement of anti-nociceptive brain regions. It was hypothesized that repeated exposure to delayed onset muscle soreness (DOMS) would result in increased pain modulatory capacity (PMC) via functional neural adaptation. 23 healthy participants completed Baseline and Follow Up resting-state fMRI and quantitative sensory testing (QST) visits 40 days apart. Participants were randomized to two groups: A Repeated DOMS Group (RD Group) that received four, weekly DOMS inductions and a Control Group that received one baseline induction. Daily pain ratings were collected for seven days post-induction, as were quantitative sensory testing (QST) metrics at baseline and Follow Up. Regional functional connectivity (FC) was estimated among areas involved in pain modulation. Seed and network FC was estimated among areas involved in pain modulation and sensory processing. Changes in FC were compared between groups. The RD Group displayed significant reductions in post-DOMS pain ratings and significant changes in thermal QST measures. RD Group participants displayed greater adaptation in nucleus accumbens-medial prefrontal cortex (NAc-mPFC) FC and in sensorimotor network (SMN) connectivity with the dorsomedial, ventromedial, and rostromedial prefrontal cortices. Changes in SMN-PFC connectivity correlated with reductions in post-DOMS affective distress. Results suggest that repeated exposure to clinically-relevant pain results in adaptations among brain regions involved in pain modulation. Repeated exposure to clinically-relevant pain may serve as a mechanism to increase PMC via inhibition of emotional valuation of painful stimuli.

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Children’s physical pain: relations with maternal and paternal pain and prediction from maternal depressive symptoms and hope during infancy.

Chronic pain is common in children and increases their risk for developing a chronic pain condition in adulthood, yet relatively little is known about early parental psychosocial factors that predict the development of chronic pain in childhood. We examined the extent to which chronic pain frequency in a community sample of 6-year-old children was related to frequency of chronic pain in their parents, and was prospectively predicted by early maternal risk (i.e., depressive symptoms) and promotive (i.e., hope) factors. Fifty primary caregivers (94% mothers) of 6-year-old twin children who were enrolled in a larger study during children's infancy were randomly selected to complete a telephone interview regarding their own, their partner's, and their children's pain symptoms and functioning. Pain symptom scores were derived by summing the number of seven possible body areas that were painful at least monthly during the prior 6 months. Pain symptoms at three or more sites were coded as multisite pain. Prior maternal depressive symptoms and hope were assessed when children were aged 12-months. Pain symptom scores were positively correlated within families, and risk of child pain increased in a dose-response fashion according to whether neither, one, or both parents experienced multisite pain. Maternal hope but not depressive symptoms prospectively predicted fewer painful body regions in children five years later. Findings suggest that pain runs in families and pain in childhood may be influenced by early maternal psychosocial factors. Future research should focus on how parents' own health and psychological attributes influence risk for children's chronic pain.

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Social Relationship Quality Among Patients With Chronic Pain: A Population-Based Sample.

Chronic daily pain is experienced by 11.2% of United States adults and psychosocial factors have significant impact on self-reported pain. Most research in this area has focused on pain-related conditions, not the general population. This study sought to understand the associations between clinically significant chronic pain and multiple dimensions of social relationship quality in a general population.

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The association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes.

Childhood maltreatment is a global public health issue linked to a vast mortality and morbidity burden. This study builds on current literature to explore the risk of developing central sensitivity syndromes (CSS) (consisting of somatic and visceral pain syndromes) subsequent to childhood maltreatment exposure.

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Identification of Candidate Genes Associated with Postherpetic Neuralgia Susceptibility.

Postherpetic neuralgia (PHN) is one of the most common complications of herpes zoster (HZ). Heritable factors have been found to play a role in various clinical pain symptoms. However, the effect of gene variability on the susceptibility of PHN remains poorly understood.

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Migraines During Pregnancy and the Risk of Maternal Stroke.

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Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017.

To report the level and trends of prevalence, incidence and years lived with disability (YLDs) for osteoarthritis (OA) in 195 countries and territories from 1990 to 2017 by age, sex and Socio-demographic index (SDI; a composite of sociodemographic factors).

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