1,720,975 research outputs found
Analysis of a population of patients who referred to a second level pain center. Clinical and demographic characteristics
No full textAbstract: Pain is the symptom that leads most patients to ask for medical intervention; if not controlled, pain may become a very costly item in the Italian Health Care system. Proper referral to a second level specialist pain center can extensively decrease the duration of a painful condition, prevent the onset of more pain and of the so-called pain syndromes, and also reduce the improper use of analgesic drugs or pain surgery. Patients should be referred to a specialist pain center when their pain is uncontrolled.
In this observational study we analyzed the clinical and demographic data of a population referred for the first time to a specialist pain center (Fondazione Salvatore Maugeri, Pavia) in the year 2008 to define patient characteristics and to understand who makes referrals and after which kind of pharmacological and interventional treatment.
Our results indicate that in Italy patients are referred to a pain center very late, which increases the duration of pain syndromes and the cost of pain management
Differences in the way men and women perceive and deal with pain
No full textLa présence de différences entre les sexes en termes de douleur est reconnue depuis longtemps. Cette étude met en évidence les nombreuses données, anciennes ou plus récentes, concernant les différences entre les sexes en termes de douleur. Ces données concernent tout particulièrement le système limbique, notamment l’hypothalamus et l’hippocampe, avec ses effets sur la stimulation et l’attention, et confirment la présence de différences entre les sexes, dues à des paramètres hormonaux et comportementaux. L’étude décrit les principales hormones gonadiques, l’estradiol et la testostérone, à travers les effets proalgésique et hypoalgésique qu’elles provoquent chez les deux sexes. Dans l’ensemble, les données tendent à soutenir la preuve clinique qui donne à la femme une meilleure capacité à retenir les stimuli douloureux, ce qui expliquerait l’incidence plus élevée des douleurs chroniques chez elle
30 years of pain treatment in Italy: past, present and future
No full textChronic pain is a situation that bring patients to ask for a medical intervention and can be originated from many different pathologic conditions. Nowadays, recent advancements in pain treatment have made possible to control pain in many patients, allowing them to return to daily activities. Anaesthesiologists are the modern pain specialists, and must know and define the origin of pain in every case: the comprehension of pain mechanisms gives them the possibility for a planned strategy of treatment. In this work we perform a overview about the "state of the art" of pain treatment in Italy analyzing what are the problems that require to focalize our attention. Therefore, sometimes many visits are necessary for a correct diagnosis and successful therapy. Pain management is still a young speciality, and the Italian pain specialist is often a self made expert who needs proper structures and dedicated people: the result is a different treatment not only between the hospitals but also in the same pain conditions. Although it seems that many of the new techniques used to control pain are successful, few studies and controlled trials have been done to verify long-term efficacy and potential adverse effects. © 2008 Elsevier Ltd. All rights reserved
The pharmacological treatment of neuropathic pain
No full textNeuropathic Pain (NP) as reported by IASP (International Association Study of Pain) is a "Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". In clinical practice NP is divided in peripheral and central pain and it is characterised by positive and negative symptoms. It is not so easy to plan out an effective therapy for this kind of pain. In this article we try to suggest a method to adapt drugs according to pain mechanisms and somatosensory pathways damages. In this "mechanisms based therapy", drugs and invasive procedures are used according to a complete examination (bedside and instrumental) of the patient's signs and symptoms. We describe characteristics of NP symptoms in order to individualise our therapeutic target and then we list the possible therapeutic drugs for these kinds of symptom
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Vertebral body innervation: Implications for pain
No full textVertebral fractures often cause intractable pain. To define the involvement of vertebral body innervation in pain, we collected specimens from male and female patients during percutaneous kyphoplasty, a procedure used for reconstruction of the vertebral body. Specimens were taken from 31 patients (9 men and 22 women) suffering high-intensity pain before surgery. In total, 1,876 histological preparations were obtained and analysed. Immunohistochemical techniques were used to locate the nerves in the specimens. The nerve fibres were labelled by indirect immunofluorescence with the primary antibody directed against Protein Gene Product 9.5 (PGP 9.5), a pan-neuronal marker; another primary antibody directed against type IV collagen (Col IV) was used to identify vessels and to determine their relationship with vertebral nerve fibres. The mean percentage of samples in which it was possible to identify nerve fibres was 35% in men and 29% in women. The percentages varied depending on the spinal level considered and the sex of the subject, nerve fibres being mostly present around vessels (95%). In conclusion, there is scarce innervation of the vertebral bodies, with a clear prevalence of fibres located around vessels. It seems unlikely that this pattern of vertebral body innervation is involved in vertebral pain or in pain relief following kyphoplasty
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Allodynic skin in post-herpetic neuralgia: Histological correlates
No full textMost post-herpetic neuralgia (PHN) patients suffer from tactile allodynia (pain evoked by lightly touching the skin) and it is frequently the dominant clinical manifestation. The pathophysiology of tactile allodynia in PHN patients is poorly understood and this is one of the major limits to the development of appropriate therapies. Epidermal nerve fibres (ENFs) are free nerve endings of small-diameter A-delta and C primary afferents, which can easily be assessed by neurodiagnostic skin biopsy (NSB). The aim of this study was to establish the correlation between the residual epidermal innervation of the allodynic skin and the intensity of tactile allodynia in that area. Twenty-five patients (13 males and 12 females) with PHN were enrolled. Eighteen patients had PHN in the thoracic dermatome, four in the cervical, two in the trigeminal and one in the lumbar. The severity of allodynia evoked by a paintbrush was graded according to an eleven-point numerical scale. A skin biopsy was obtained from the maximal allodynia area and from the contralateral skin. Nerve fibres were labelled with indirect immunofluorescence. Results showed that epidermal innervation was lower in the allodynic skin than in the contralateral skin, although there was great variability among patients. There was no correlation between severity of allodynia and epidermal innervation of the PHN skin. In conclusion, the present study further indicates peripheral nervous system involvement in PHN but does not support a direct correlation between epidermal innervation changes and tactile allodyni
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