The pain of chronic pancreatitis: a persistent clinical challenge

Abstract: The pain of chronic pancreatitis represents a major challenge to those working in the field, including pain specialists, gastroenterologists and surgeons. This article describes the different aetiologies of chronic pancreatitis and lists the models for the pathogenesis of pain, including novel ideas such as the role of the immune system in the modulation of pain. The patient profile …

Veterans and chronic pain

Summary points 1. Musculoskeletal problems are the commonest reason for medical discharge in all the British armed forces. By definition, these problems are chronic and resistant to treatment. 2. Pain is also common in veterans who have experienced severe injuries (polytrauma), often accompanied by post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) orpost concussive syndr…

Gut pain & visceral hypersensitivity

Abstract: Visceral pain is a highly complex entity whose experience is variable in health and disease. It can occur in patients with organic disease and also in those without any readily identifiable structural or biochemical abnormality such as in the functional gastrointestinal disorders (FGID). Despite considerable progress in our understanding of the culpable underlying mechanisms signifi…

The psychological impact of torture

Abstract: Many refugees in the developed world are survivors of torture and present with health needs without their traumatic experience being disclosed or identified. Chronic pain is a common problem, as are symptoms of post-traumatic stress disorder (PTSD), anxiety, depression, and other distress. Current circumstances, particularly poverty, uncertainty about asylum, separation from or loss …

Pharmacogenetics of analgesic drugs

Summary points •• Individual variability in pain perception and differences in the efficacy of analgesic drugs are complexphenomena and are partly genetically predetermined. •• Analgesics act in various ways on the peripheral and central pain pathways and are regarded as one ofthe most valuable but equally dangerous groups of medications. •• While pharmacokinetic properties of dr…

Traumatic amputations

Abstract: Traumatic amputations remain one of the most emotionally disturbing wounds of conflict, as demonstrated by their frequent use in films to illustrate the horrors of war. Unfortunately, they remain common injuries, particularly following explosions, and, in addition, many survivors require primary amputation for unsalvageable injuries or to save their life. A third group, late amputat…

Can a pain management programme approach reduce healthcare use? Stopping the …

Abstract: Patients with chronic musculoskeletal pain are frequent users of healthcare. Whilst evidence suggests that a multidisciplinary pain management programme (PMP) approach is effective in reducing patients’ levels of distress and disability, there is little research examining the cost-effectiveness of such an approach. The present study sought to address this by examining the impact a …

Endometriosis-associated pain syndrome: a nurse-led approach

Abstract: Endometriosis is an enigmatic disease and its fundamental cause is still unknown. Endometriosis associated pain syndrome is a common problem; it is underdiagnosed and patients suffering from the syndrome are rarely seen in specialist pain clinics. The correlation between the extent of the disease and pain is weak. Endometriosis-associated pain syndrome may be cyclical or persistent…

Is cognitive behavioural therapy for insomnia effective in treating insomnia …

Abstract: Aim: This paper systematically reviews clinical trials investigating the effectiveness of cognitive behavioural therapy for insomnia and pain in patients with chronic non-malignant pain. Method: A systematic search of MEDLINE, PSYCINFO, EMBASE, CINHAL and Cochrane library and register of trials was conducted. Results: Essential components of cognitive behavioural therapy for in…

Evidence-based clinical practice guidelines on the management of pain in olde…

The British Pain Society and British Geriatric Society have collaborated to produce comprehensive pain management guidelines based on an extensive systematic review of the available literature by a professional multidisciplinary group. This guidance reviews the epidemiology and management of pain in older people with the aim of providing best practice recommendations for the management of pain …

Diagnosis and treatment of failed back surgery syndrome in the UK: mapping of…

Abstract: Background: Chronic back pain is a serious public health issue, associated with poor quality of life and disability. There is a specific group of chronic back pain sufferers whose pain persists despite their having undergone anatomically successful lumbosacral spine surgery. These patients are known as having failed back surgery syndrome (FBSS) and are frequently seen in pain clinics…

Ecological Risk Assessment for Residual Coal Fly Ash at Watts Bar Reservoir, …

ABSTRACT: Benthic invertebrate communities were assessed after the December 2008 release of approximately 4.1 million m3 coal fly ash from a disposal dredge cell at the Tennessee Valley Authority (TVA) Kingston Fossil Plant on Watts Bar Reservoir in Roane County, Tennessee, USA. Released ash filled the adjacent embayments and the main channel of the Emory River, migrating into reaches of the E…

Opioids and endocrine dysfunction

Abstract: The endocrine effects of opioids used for the management of persistent pain are poorly understood by clinicians and patients, and hormone levels are rarely measured. It is recognized that opioids exert this effect via the hypothalamic-pituitary-gonadal axis. Additional effects on adrenal hormones, weight, blood pressure and bone density may also occur. Symptoms and signs of sex hormo…

The evidence base for managing older persons with low back pain

Abstract: It has been suggested that older persons are less likely to receive optimal care for pain, and a recent population study suggested that management of low back pain (LBP) in primary care differed with older age. Low back pain is the most commonly reported regional pain syndrome, and the objective of the current review was to determine the evidence base for managing LBP in older perso…

Equianalgesic doses of opioids their use in clinical practice

Edisi

(2012), 6(1)

ISBN/ISSN

DOI: 10.1177/2049463

Deskripsi Fisik

British Journal of Pain 6(1) 43– 46 © The British Pain Society 2012

Judul Seri

Pain

No. Panggil

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Interprofessional pain learning and working: different perspectives

After suffering a stroke Mr Martin Stephen1 decided to write about his experience, narrating a moving yet entertaining story towards recovery. Interestingly, to achieve this very recovery he felt he needed to get out of hospital and cure himself. Reading about his hospital experience I thought that the care he received did not place him at its centre and was fragmented. It consisted of healthc…

Opioids, pain and addiction – practical strategies

Summary points 1. Addiction can occur with the repeated exposure of a biogenetically predisposed person to an addictive substance or behaviour. 2. In the patient with pain on opioid therapy, use the ‘4 Cs’ to diagnose addiction. 3. Screening and risk stratification of all patients considered for opioid therapy is a key element of ‘universal precautions’ in pain management. 4. There …

Failed back surgery syndrome: a suggested algorithm of care

Abstract: Failed back surgery syndrome (FBSS) is a complex condition which can be very difficult to treat. In this article, we propose a pragmatic algorithm for the management of the syndrome. The management of this condition should include a comprehensive initial assessment to rule out treatable cause, pharmacological optimisation, psychological techniques and neuromodulation. There is good e…

Neuraxial (epidural and intrathecal) opioids for intractable pain

Summary Points 1. Neuraxial opioids are considered for use in patients who have resistant intractable pain that fails to respond to other treatment options or pain that responds to analgesia but for which the doses required result in unacceptable side-effects. 2. Neuraxial opiods can be considered for both chronic non-malignant pain and chronic cancer related pain. 3. Effectiveness in chroni…

Education as part of wider health policy and improvement strategies

Summary points 1. The majority of people living with persistent pain will receive treatment for the pain from nonspecialists in pain management who may not have received the necessary training to deliver highquality care. 2. There is now a wide range of learning platforms and packages available, but these may struggle to reach beyond those with a specialist interest. Addressing this will requ…

Reducing the distance: providing challenging and engaging online postgraduate…

Summary points: 1. Health professionals need access to flexible, high-quality, advanced education in pain management. 2. There are multiple pedagogical distances to be negotiated in the delivery of effective postgraduate education. 3. A critical consideration in the design and delivery of effective online learning for postgraduateeducation in pain management is how to: actively engage studen…

Interprofessional pain education: definitions, exemplars and future directions

Summary points1–6 1. The management of pain frequently requires healthcare professionals (HCPs) to work together; thus, educational preparation should afford them opportunities to learn about the management of pain together. 2. Survey data suggest that most HCPs’ curricula do not provide opportunities for learners to come together to learn about pain and understand their professional rol…

Evaluating the impact of pain education: how do we know we have made a differ…

Summary points 1. Education is a core activity for most healthcare professionals working in pain management and an effective evaluation strategy should assess its impact. 2. Evaluation may have one or more purposes: accountability, development or knowledge generation. Other key principles include making evaluation integral to the education process, reflecting with learners on progress, self…

A decade of improvement in pain education and clinical practice in developing…

Summary points: 1. Epidemiological studies, in the late 1990s and early 2000s, on the extent of pain in the community of western countries revealed a prevalence of around 18%, with significant effects on work and social activities despite 30 years of pain education programmes. 2. A survey by the International Association for the Study of Pain (IASP) Developing Countries on the extent of pain …

Competition in Canada’s Agricultural Value Chains: The Case of Grain

To open this address, I would like to advocate for membership in the Canadian Agricultural Economics Society (CAES). The fact that applied economics offers theory and methods that help us address topics as diverse as the Canadian grain value chain and the economics of species at risk speaks well for the future of our discipline. There is a vast array of work for us to do. Membership in the CAES…

Treatment of AnemiaWith Epoetin in Kidney Transplant Recipients

Abstract: The aim of this study was to analyze the prevalence and efficacy of renal anemia treated with epoetin in maintenance kidney transplant recipients in Slovenia. By the end of 2009, 107 out of 537 patients (19.9%) had been treated with epoetin.A cohort of 49 patients (45.8%) were analyzed in detail: 11 patients received epoetin alfa, 18 epoetin beta, 10 darbepoetin alfa, and 10 patients…

Risk Assessment Considerations With Regard to the Potential Impacts of Pestic…

ABSTRACT: Simple, deterministic screening‐level assessments that are highly conservative by design facilitate a rapid initial screening to determine whether a pesticide active ingredient has the potential to adversely affect threatened or endangered species. If a worst‐case estimate of pesticide exposure is below a very conservative effects metric (e.g., the no observed effects concentrati…

European Public Finances and the Great Recession: France, Germany, Ireland, I…

Abstract: We compare economic trends over the financial crisis, and the tax and benefit reforms implemented in response, across six EU countries. Countries where the crisis led to a relatively greater increase in public spending than a decline in tax revenues – in particular, France and Italy – are found to have implemented consolidations that are more reliant on tax increases than spendin…

Smoking and polyphenols’ addition to improve freshwater mullet (Mugil cepha…

The combined effects of hot smoking and added quince polyphenol (0.8% and 1.6% v/w) on the quality attributes of mullet (Mugil cephalus) fillets were evaluated. Biochemical parameters that were monitored in the fillets during 75 days of storage (4
1 °C) included trimethylamine (TMA-N), volatile basic nitrogen (TVB-N), fatty acids and amino acids. Data were submitted to principal component a…

Regulation of relationships between heterogeneous farmers and an aquifer acco…

Abstrak: Many environmental problems are due to damage caused by pollutants that accumulate with a time lag following their emission. In this study, we focus on nitrates used in agriculture, which can pollute groundwater many years after their initial application. A dynamic optimal control problem with heterogeneous farmers is proposed. The usual structural parameters such as the discount rate,…

A Balance Sheet Perspective on Financial Success: Why Starting Early Matters

This paper offers four ideas. First, a balance sheet perspective on financial success is constructive, and that a meaningful measure of the success of financial capability efforts is the health of one’s balance sheet. Second, given relatively weak balance sheets among younger Americans before and after the Great Recession, and given that economically vulnerable families assumed greater balanc…

Heavy metals in marine fish meat and consumer health: a review

Abstract: The numerous health benefits provided by fish consumption may be compromised by the presence of toxic metals and metalloids such as lead, cadmium, arsenic and mercury, which can have harmful effects on the human body if consumed in toxic quantities. The monitoring of metal concentrations in fish meat is therefore important to ensure compliance with food safety regulations and consequ…

The antioxidant and anti-cadmium toxicity properties of garlic extracts

Abstract: Cadmium (Cd) contamination is a highly dangerous international problem because it can transfer into the food chain and become bioaccumulated, endangering human health. Cd detoxication is very interesting particularly the method providing no undesirable side effects. Cd also causes lipid oxidation that leads to undesired food quality. Garlic (Allium sativum L.) has been used as conven…

Amino acids, peptides, and proteins as chemically bonded stationary phases �…

The selectivity of chromatographic separation depends mostly on the stationary phase and mobile phase composition. Despite being a material with bonded simple organic molecule, a wide group of stationary phases contain immobilized compound that possesses biological activity. Stationary phases that contain amino acids and peptides as well as enzymes and proteins are alternative materials that ma…

International Differences in Fiscal Outcomes during the Global Crisis

We examine the cross-country dispersion in fiscal outcomes during 2008–09. Controlling for output, we find that the declines in the overall and structural fiscal balances were larger for those countries experiencing larger increases in unemployment and where credit growth during the pre-crisis period was more rapid. However, controlling for output and unemployment, there is no systematic cova…

German Public Finances through the Financial Crisis

Abstract: The German experience of the financial crisis was very different from that of most other European countries. Germany was hit by a very strong shock that was relatively concentrated in the exporting, manufacturing industries. In addition, the German labour market was very resilient during the crisis due to earlier labour market reforms and policy instruments facilitating labour hoard…

Reducing ethylene levels along the food supply chain: a key to reducing food …

Abstract: Excessive waste along the food supply chain of 71 (UK, Netherlands) to 82 (Germany) kg per head per year sparked widespread criticism of the agricultural food business and provides a great challenge and task for all its players and stakeholders. Origins of this foodwaste include private households, restaurants and canteens, aswell as supermarkets, and indicate that 59–65% of this …

Circulating and myometrial markers of oxidative stress in pregnant women with…

Abstract: Aim: The objective of this study was to identify the relationship between fetal growth restriction (FGR) and oxidativestress. The mechanisms that protect against oxidative stress in the local microenvironment were investigated by comparing the activities of the markers, both in the circulation and myometrium. Materials and Methods: Myometrial tissue and serum levels of malondialdehyd…

Protecting soymilk fl avor and nutrients from photodegradation

Abstract: Five different packaging treatments were studied over a 36- day period to determine if they protected soymilk from photo- oxidation. Soymilk was packaged in high- density polyethylene ( HDPE ) bottles with and without light protective additives ( LPA ). Two controls [(1) no LPA (translucent appearance); (2) a light- protected control (foil overwrap over no LPA control)] and three LPA…

Simple Cystatin C Formula Compared to SophisticatedCKD-EPI Formulas for Estim…

Abstract: Despite the fact that the serum creatinine level is notoriously unreliable for the estimation of glomerular filtration rate (GFR) in the elderly, the serum creatinine concentration and serum creatinine-based formulas, such as the Modification of Diet in Renal Disease study equation (MDRD) are the most commonly used markers to estimate GFR.Recently, serum cystatin C-based formulas, th…

International competition in the first wave of globalization: new evidence on…

We pose a seemingly ageless question in economic history.To what extent did newentrants in the late nineteenth-century cotton-textile industry threaten the customary markets of the European core? Exploiting a newly constructed dataset on textile imports to Spain, we find that as trade costs fell, new rivals began to sell a greater variety of products. Along this dimension, competition can be sa…

Effects of amaranth addition on the pro-vitamin A content, and physical and a…

Abstract: BACKGROUND: Pro-vitamin A-biofortified maize snacks with added leafy vegetable may have a potential as nutritious and health-promoting products, especially in addressing vitamin A deficiency, which is prevalent in developing regions. The objective of the study was to determine the effects of adding amaranth leaf powder on the physical, antioxidant properties and pro-vitamin A content…

Critical assessment of “critical” liquid chromatography of block copolymers

Brief elucidation is presented of potential difficulties the researcher can face in the course of the molecular characterization of block copolymers with help of liquid chromatography under critical conditions. The impediments include the demanding identification of critical conditions, the limited area of applicable polymer molar mass, the high sensitivity of critical conditions toward minute…

Predictive value of second and third trimester fetal renal artery Doppler ind…

Aim: Intermittent assessment of renal artery flow velocity waveforms during the early stages of pregnancymay help in predicting changes in amniotic fluid dynamics. The current study sought to determine the relation of renal artery and umbilical artery flow velocity waveforms with normal pregnancies and pregnancies complicated by either polyhydramnios or oligohydramnios. Material and Methods:…

Non-Fulfilment of Debt Limits in Spanish Municipalities

Abstract: In decentralised European Monetary Union members such as Austria, Belgium, Finland, Germany and Spain, the Stability and Growth Pact can only be implemented if there is close fiscal coordination among government tiers. Thus, limits on subcentral governments’ debt are essential in this coordination. This paper analyses which political and socio-economic factors influence compliance …

A proprietary blend of quail egg for the attenuation of nasal provocation wit…

Abstract: Occasional rhinitis symptoms caused by exposure to pollution or allergens is a growing concern. Based first on empirical observation of a lesser occurrence of allergies in quail farmers and then scientific works on ovomucoids properties, we developed a dietary supplement for the relief of such occasional rhinitis symptoms. The objective of the study was to determine whether one acut…

Discrimination and the Transgender Population: Analysis of the Functionality …

Abstract: Transgender-inclusive nondiscrimination policies create a quagmire for human resources to successfully implement. There is a dearth of knowledge about the extent, features, and aptitude of policies to prevent discrimination against transgender employees. This study analyzes all 154 localities that prohibit discrimination against gender identity or expression in employment, as of Jul…

Activation via Intensive Intimacies in the Israeli Welfare-to-Work Program: A…

Abstract: This article uses a constructivist approach to scrutinize embedded actions of situated agents of governance to explore the governing of activation services in Israel. It probes beliefs, discourses, and practices of meso-level regulation administrators and street-level workers to analyze the emergence of a new stringent and disciplinary activation mode. Ultimately, this activation m…

Comparative lethality kinetic curves and predictive models of F-value for Lis…

Abstract: The objective of this work was to evaluate the kinetic of inactivation of Listeria monocytogenes using peracetic acid, chlorhexidine, and organic acids as active agent, determining the respective D-, Z-, and F-values. From our knowledge, these important results from an industrial view point are not available in the current literature, mainly for organic acids, pointing out the main c…

Dietary risk scores of toddlers are associated with nutrient intakes and soci…

Abstract: Aim: To determine the convergent validity of the toddler dietary questionnaire (TDQ), previously shown to haveGood reliability and comparative validity, by assessing whether TDQ-derived dietary risk scores are associated withnutrient intakes, socio-demographic characteristics and weight status. Methods: Parents of 117 Australian children aged 12–36 months completed a demographic…