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The objective of this investigation was to examine the distribution of galcanezumab and a control immunoglobulin 4 antibody containing the same constant regions as galcanezumab, into peripheral and central tissues.
Learn More >Excessive prescription of opioids has become a national problem. Providers must attempt to decrease the amount of opioids prescribed while still providing patients with adequate pain relief after surgery.
Learn More >Persistent arm pain is a common problem following breast cancer surgery. Little is known about genetic factors that contribute to this type of postsurgical pain. Study purpose was to explore associations between persistent arm pain phenotypes and genetic polymorphisms among fifteen genes involved in catecholaminergic and serotonergic neurotransmission. Women (n=398) rated the presence and intensity of arm pain monthly for six months following breast cancer surgery. Three distinct latent classes of patients were identified (i.e., No Arm Pain (41.6%), Mild Arm Pain (23.6%), and Moderate Arm Pain (34.8%). Logistic regression analyses were used to evaluate for differences between genotype or haplotype frequencies and the persistent arm pain classes. Compared to the No Arm Pain class, three SNPs and one haplotype, in four genes, were associated with membership in the Mild Arm Pain class: COMT rs4633, HTR2A haplotype B02 (composed of rs1923886 and rs7330636), HTR3A rs1985242, and TH rs2070762. Compared to the No Arm Pain class, four SNPs in three genes were associated with membership in the Moderate Arm Pain class: COMT rs165656, HTR2A rs2770298 and rs9534511, and HTR3A rs1985242. Findings suggest that variations in catecholaminergic and serotonergic genes play a role in the development of persistent arm pain. PERSPECTIVE – Limited information is available on genetic factors that contribute to persistent arm pain following breast cancer surgery. Genetic polymorphisms in genes involved in catecholaminergic and serotonergic neurotransmission were associated with two persistent arm pain phenotypes. Findings may be used to identify patients are higher risk for this common pain condition.
Learn More >To investigate suicidality related to cluster headache and factors associated with increased suicidality in cluster headache patients.
Learn More >Nocebo hyperalgesia is an increase in pain through the expectation of such an increase as a consequence of a sham treatment. Nocebo hyperalgesia can be induced by observation of a model demonstrating increased pain via verbal pain ratings. The aim of the present study was to investigate whether observing natural pain behavior, such as facial pain expressions, can also induce nocebo responses.
Learn More >Diagnostic uncertainty, the perception of a lack of or incorrect label to explain symptoms, has been reported by parents of youth with chronic pain. This study was the first to examine diagnostic uncertainty in both youth with chronic pain and their parents using qualitative methodology. Individual, face-to-face, semi-structured interviews were conducted with twenty youth with chronic pain recruited from a pediatric chronic pain program. Independent interviews were also conducted with one of their parents. Interviews explored participants' memories and perceptions around diagnosis. In-depth thematic analysis revealed four themes: (1) The Function of a Diagnosis. Parents and youth struggled with the meaning of the diagnosis, needed further explanation for the pain, and perceived the 'right' diagnosis (i.e., one that fit with their beliefs) as justification for the pain. (2) Haunted by Something Missing. Negative test results did not provide relief or counter the belief that something serious could have been missed by clinicians. (3) The Search for an Alternative Diagnosis. A search persisted for the 'right' diagnosis, particularly when a non-pharmacological treatment plan was provided. (4) Mistrust in the Medical System. Clinician communication and perceptions of clinicians' uncertainty impacted parent and youth 'buy in' to the diagnosis. Findings suggest that many youth with chronic pain and their parents experience diagnostic uncertainty, which is integrally tied to their past experiences with the medical system. Greater understanding of diagnostic uncertainty may help tailor how clinicians deliver diagnoses to achieve 'buy in', increase understanding of pain and diagnosis, and improve treatment response. Perspective: A major challenge that youth with chronic pain and their parents face is understanding the cause of the pain. Youth with chronic pain and their parents experience uncertainty about their diagnosis, which may be linked to their 'buy in' and treatment response.
Learn More >Prescription opioid misuse is a public health problem that leads to overdose. Although existing interventions focus on limiting prescribing to patients at high risk, individuals may still access prescription opioids dispensed to family members.
Learn More >Intensive interdisciplinary treatment is emerging as an effective treatment of chronic pain in youth. These programs often include a parental component with the belief that targeting parental distress and responses to a child's pain will improve outcomes. However, few studies have evaluated the impact of a parental intervention in the interdisciplinary treatment of pediatric chronic pain. The present study consists of a nonrandomized pre-post design to evaluate change in psychological and behavioral functioning of parents who participated in intensive parent programming that utilized Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), delivered within the context of an interdisciplinary intensive 3-week pain treatment program for youth with chronic pain.
Learn More >The primary aim of this exploratory study was to assess the relationship between anxiety sensitivity and emotional disorders, migraine characteristics, and migraine-related fear and avoidance behaviors in women with probable migraine.
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