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(Health) Pain: Study: Fetuses Can't Feel Pain

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PostPosted: Fri Apr 14, 2006 7:49 am    Post subject: (Health) Pain: Study: Fetuses Can't Feel Pain Reply with quote

Study: Fetuses can't feel pain
United Press International

BIRMINGHAM, England, April 13 (UPI) -- A senior psychologist at Britain's University of Birmingham says he has found good evidence that fetuses cannot feel pain.

Stuart Derbyshire says his study indicates proposals to tell women seeking abortions that their unborn child will feel pain, or to provide pain relief during abortions, are scientifically unsound and may put women at unnecessary risk.

Derbyshire examined the neurological and psychological evidence to support a concept of fetal pain. He says he concluded that although still immature, the neural circuitry necessary for processing pain can be considered complete by 26 weeks' gestation.

He argues pain experience requires not only development of the brain, but also development of the mind to accommodate the subjectivity of pain. And he says development of the mind only occurs outside the womb.

He said the biological development to support pain experience is ongoing, but the environment after birth -- necessary to the development of pain experience -- is yet to occur. So, he says, as such, fetuses cannot experience pain.

Derbyshire says, however, the absence of pain in the fetus does not resolve the question of the morality of abortion.


Questions to explore further this topic:

A primer on the brain and the nervous system

What is pain?

Abdominal pain

Arthritis pain

Back and neck pain

Cancer pain

Chest pain

Complex regional pain syndrome


Foot pain

Hand pain


Muscle pain

Neuropathic pain

Pelvic pain

Shoulder pain

Thigh pain


Why is there pain?

How does one feel pain?

What are the different types of pain?


What are pain scales?

What is chronic pain?

What therapies are used to address pain?

What are pain medications?

How can one manage chronic pain?

What is acupuncture?

What is complementary therapy?


Pain Alleviation and "Anesthesia"

What is sedation analgesia?

What is general anesthesis?

What is epidural anesthesia?

Anesthesis: options and considerations

What is the relationship between pain and emotions?


Can the mind control pain?

Pain and aging§ion=1&&chapter=11&&page=1

Pain and cancer

Can premature babies feel pain?

Can infants feel pain?

What is colic?

Acetaminophen and children

How can one measure pain in a child?

Managing pain in children


Last edited by adedios on Sat Jan 27, 2007 4:40 pm; edited 3 times in total
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PostPosted: Mon Apr 17, 2006 11:40 am    Post subject: Study points toward alternatives for Vioxx and Celebrex Reply with quote

Queen's University
17 April 2006

Study points toward alternatives for Vioxx and Celebrex

New type of anti-inflammatory drugs may reduce COX-2 cardiovascular problems, says Queen's researcher
Kingston, Ont. – Researchers at Queen's University and the University of Pennsylvania have identified one reason why drugs like Celebrex and Vioxx – once popular for the treatment of pain and inflammation – cause heart problems.
Their findings offer the prospect of a new generation of anti-inflammatory drugs that will bypass this issue, says co-author Colin Funk, a professor of Biochemistry and Physiology at Queen's, and Canada Research Chair in Molecular, Cellular and Physiological Medicine. Although these results are in mice, not people, they raise an exciting possibility which can be tested in humans, he adds.

The study is published in the on-line edition of the Journal of Clinical Investigation.

Since the association of selective inhibitors of COX-2 such as Vioxx, Bextra and Celebrex with an increased incidence of heart attack and stroke, there has been intense interest in understanding the mechanism involved. Clarification of this issue offers the prospect of conserving the clinical benefit of these drugs for patients with arthritis, while managing the risk, the researchers say.

Co-author with Dr. Funk on the study is Dr. Garret FitzGerald, director of Penn's Institute for Translational Medicine and Therapeutics. Funding comes from the U.S. National Institutes of Health and a grant from Merck.

The investigators first compared genetically manipulated mice that mimic the impact of either COX-2 inhibitors or low-dose aspirin with healthy mice treated with or without COX-2 inhibitors, such as Celebrex. "The trials showed that COX-2 inhibitors confer a small, but absolute cardiovascular risk using the same mechanism by which they relieve pain and inflammation," Dr. Funk reports.

With these mice they were able to show that the likely outcome of aspirin is to diminish the hazardous effects of the COX-2 inhibitors. The investigators were surprised to find that not only the clotting response, but also the rise in blood pressure caused by drugs like Celebrex, was reduced. Although these studies indicate that aspirin would limit the cardiovascular risk, however, it would also be expected to add to the risk of stomach problems.

A more promising finding came from a drug target that might substitute for COX-2: an enzyme called microsomal prostaglandin E synthase (mPGES)-1. The researchers showed that blocking this enzyme in mice did not predispose the animals to thrombosis or elevate blood pressure.

"Selective inhibitors of mPGES-1 may retain much of the benefit of drugs like Vioxx and Celebrex, while diminishing the risk of heart attack and stroke by having precisely the opposite effect on prostacyclin [a protective fat that Vioxx and Celebrex depresses]," says Dr. FitzGerald.

PLEASE NOTE: PDF copies of the study are available upon request.


Nancy Dorrance, Queen's News & Media Services, 613.533.2869
Therese Greenwood, Queen's News & Media Services, 613.533.6907

Attention broadcasters: Queen's has facilities to provide broadcast quality audio and video feeds. For television interviews, we can provide a live, real-time double ender from Kingston fibre optic cable. Please call for details.
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PostPosted: Tue Apr 18, 2006 5:11 pm    Post subject: Shoulder pain Reply with quote

Shoulder pain
Wed Apr 19, 2006
Manila Bulletin

Gary S Sy, MD

SHOULDER pain is an extremely common complaint, and there are many common causes of this problem. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have shoulder pain, some common causes include:

* Bursitis/Rotator Cuff Tendonitis

The most common diagnosis in patients with shoulder pain is bursitis or tendonitis of the rotator cuff.

* Rotator Cuff Tear

Rotator cuff tears occur when the tendons of the rotator cuff separate from the bone. Surgery is sometimes necessary for this condition.

* Frozen Shoulder

Also called ‘adhesive capsuliitis,’ this is a common condition that leads to stiffness of the joint.

Physical therapy and stretching are extremely important aspects of treatment.

* Calcific Tendonitis

Calcific tendonitis is a condition of calcium deposits within a tendon — most commonly within the rotator cuff tendons. Treatment of calcific tendonitis depends on the extent of symptoms.

* Shoulder Instability

Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.

* Shoulder Dislocation

A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula.

* Shoulder Separation

Also called an AC separation, these injuries are the result of a disruption of the acromioclavicular joint. This is a very different injury from a dislocation!

* Labral Tear

There are several patterns of a torn labrum and the type of treatment depends on the specific injury.

* SLAP Lesion

The SLAP lesion is also a type of labral tear. The most common cause is a fall onto an outstretched hand.

* Arthritis

Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery.

* Biceps Tendon Rupture

A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint.

When do you need to call your doctor about your shoulder pain?

If you are unsure of the cause of your shoulder pain, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of these conditions must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

* Inability to carry objects or use the arm

* Injury that causes deformity of the joint

* Shoulder pain that occurs at night or while resting

* Shoulder pain that persists beyond a few days

* Inability to raise the arm

* Swelling or significant bruising around the joint or arm

* Signs of an infection, including fever, redness, warmth

* Any other unusual symptoms

What are the best treatments for shoulder pain?

The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment.

Not all treatments listed here are appropriate for every condition, but may be helpful in your situation.

* Rest: The first treatment for many common conditions that cause shoulder pain is to rest the joint, and allow the acute inflammation to subside. It is important, however, to use caution when resting the joint, because prolonged immobilization can cause a frozen shoulder.

* Ice and Heat Application: Ice packs and heat pads are among the most commonly used treatments for shoulder pain. So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last? Read on for more information about ice and heat treatment.

* Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. A good routine should be established, and following some specific suggestions will help you on your way.

* Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.

Some specific exercises may help you strengthen the muscles around the joint and relieve some of the pain associated with many conditions.

* Anti-Inflammatory Medication: Non-steroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with shoulder pain caused by problems such as arthritis, bursitis, and tendonitis.

* Cortisone injections: Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with shoulder pain. Discuss with your doctor the possible benefits of a cortisone injection for your shoulder pain condition.

Dr. Gary S. Sy, M.D. is the Medical Director of Life Extension Medical Center located at The Garden Plaza Hotel (formerly Swiss Inn Hotel) 1370 General Luna St., Paco, Manila. He is a Diplomate in Gerontology and Geriatrics, advocate Diet-Nutritional Therapy, and conducts free seminar every Friday about age-related health problems. For more details, please call telephone numbers: 400-4205 or 522-4835 local 315. E-mail address:

Please tune in at DZRH 666 kHz "Operation Tulong" every Wednesday and Friday at 10 p.m. to 11 p.m. and DZMM 630 kHz "Gabay sa Kalusugan" awarded as "2005 CMMA as Best Educational Radio Program," every Sunday at 11 a.m. to 12 noon. Please watch "Kalusugan TV" every Saturday at RPN 9 from 11:30 a.m.-12 nn.
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PostPosted: Mon May 29, 2006 9:23 am    Post subject: New understanding of COX-1 and COX-2 enzymes Reply with quote

New understanding of COX-1 and COX-2 enzymes could lead to revised classification of pain meds, Queen’s study shows

Monday May 29, 2006

KINGSTON, Ont. – COX-1 and COX-2 enzymes may be blocked by pain medications such as Advil and Vioxx in a more complex manner than was previously understood, a Queen’s University study has found.

“The results of the study have potential implications for how we classify the commonly used anti-inflammatory and pain drugs for aches, pains, and fever,” says Colin Funk, a professor of Biochemistry and Physiology at Queen’s and Canada Research Chair in Molecular, Cellular and Physiologiocal Medicine.

Published on-line in Nature Medicine, the study was conducted in collaboration with University of Pennsylvania researchers.

The study was initiated to explore the biochemistry associated with COX-2 inhibitors such as Vioxx, Bextra and Celebrex, which are now associated with an increased incidence of heart attack and stroke. Researchers looked at mice that were genetically modified so that their COX-2 was inhibited – to create a physiology in mice that roughly mimics that of users of COX-2 inhibitors. They found that the COX-1 enzymes in the mice “hooked up” in an unanticipated way with their remaining COX-2 enzymes creating what is called a new heterodimer.

Dr. Funk’s co-researcher, Queen’s biochemist Robert Campbell, has developed a computer model to show how the COX-1/COX-2 molecules can associate.

“It’s possible the COX-2 inhibitor medications may affect the resulting new enzyme which is a mix of COX-1 and COX-2,” says Dr. Funk.

This effect is being further explored by scientists and may lead to a broadened understanding of the biochemistry of common pain medications. It is now pointing toward possible alternatives to drugs like Vioxx and Celebrex, says Dr. Funk.

The study was supported by grants from the US National Institutes of Health, the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Ontario.

A study published April 13 by The Journal of Clinical Investigation (JCI) by the same research team found that new types of anti-inflammatory drugs may reduce COX-2 cardiovascular problems. That study was conducted after this one and incorporated the genetically modified mice created in this study.

The JCI study found a drug target that might substitute for COX-2: an enzyme called microsomal prostaglandin E synthase (mPGES)-1. The researchers showed that this drug did not predispose the animals to thrombosis or elevate blood pressure.

PLEASE NOTE: PDF copies of the study are available upon request


Sarah Withrow, Queen’s News & Media Services, 613-533-3280
Therese Greenwood, Queen’s News & Media Services, 613-533-6907
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PostPosted: Tue Aug 22, 2006 8:39 am    Post subject: 'Mint' pain killer takes leaf out of ancient medical texts Reply with quote

University of Edinburgh
21 August 2006

'Mint' pain killer takes leaf out of ancient medical texts

A new synthetic treatment inspired by ancient Greek and Chinese remedies could offer pain relief to millions of patients with arthritis and nerve damage, a new University of Edinburgh study suggests.

The Greek scholar Hippocrates treated sprains, joint pains and inflammation by cooling the skin, and traditional Chinese remedies used mint oil to the same end. Now scientists have discovered that cooling chemicals which have the same properties as mint oil have a dramatic pain-killing effect when applied in small doses to the skin. Unlike conventional pain killers, these compounds are likely to have minimal toxic side-effects, especially because they are applied externally to the skin. This should mean they are ideal for chronic pain patients for whom conventional pain killers often do not work.

The Edinburgh study sets out exactly how the 'mint oil' compounds (and related more powerful chemicals) work. They act through a recently discovered receptor (a protein which is capable of binding with these chemicals) which is found in a small percentage of nerve cells in the human skin. The scientists have found that when this receptor, called TRPM8, is activated by the cooling chemicals or cool temperatures, it inhibits the 'pain messages' being sent from the locality of the pain to the brain. Thus, the new treatment makes good use of the body's own mechanisms for killing pain.

The findings would doubtless have been of interest to Hippocrates, the founding father of modern medicine. Writing in the fifth century BC, in chapter 5 of his classic text, Aphorisms, he stated: "Swellings and pains in the joints, ulceration, those of a gouty nature, and sprains, are generally improved by a copious affusion of cold water, which reduces the swelling, and removes the pain; for a moderate degree of numbness removes pain."

Professor Susan Fleetwood-Walker, who jointly led the study with Dr Rory Mitchell, says:

"This discovery of the pain-relieving properties of mint oil and related compounds has great potential for alleviating the suffering of millions of chronic pain patients, including those with arthritis or those who have had nerve damage or spinal injury following major accidents. Conventional painkillers such as morphine are often ineffective in cases of chronic pain, and simply lowering the temperature of the skin is too inexact."

"Our discovery means that patients can be given low doses of a powerful pain killer, delivered through the skin, without side effects. We hope clinical trials on the compounds will begin within the year."

The research has been funded by the Wellcome Trust and the Medical Research Council, and its findings appear in the journal, Current Biology.
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PostPosted: Tue Aug 29, 2006 2:41 pm    Post subject: Pest control research leads to pain control discovery Reply with quote

University of California - Davis
28 August 2006

Pest control research leads to pain control discovery

A newly discovered enzyme inhibitor, identified by researchers originally looking for biological pest controls, may lead to pain relief for sufferers of arthritis and other inflammatory diseases, say researchers at the University of California, Davis. The finding, hailed by a noted inflammatory disease expert "as the most important discovery in inflammation in more than a decade," may also reduce side effects associated with the painkiller, Vioxx.

Lead author Kara Schmelzer, a post-doctoral researcher in principal investigator Bruce Hammock's lab, tested the novel compounds on rodents and found them to be as potent at a low-dose as Vioxx and Celebrex, but without the changes in blood chemistry linked to heart attacks. Vioxx and Celebrex belong to a class of drugs known as Cox-2 inhibitors. The enzyme targeted by the newly discovered inhibitors is also found in humans. (Enzymes are proteins that speed up chemical reactions.)

"The reason this is so exciting is that this is a novel way to reduce inflammation, with a combination therapy," Schmelzer said. "We're going after a new enzyme target, not going after the Cox-2 inhibitors."

Their research is reported in a paper entitled "Enhancement of Antinociception by Coadministration of Nonsteroidal Anti-Inflammatory Drugs and Soluble Epoxide Hydrolase Inhibitors," published in the current edition of Proceedings of the National Academy of Sciences.

"Our laboratory was initially interested in regulating the development of insect larvae," said Hammock, a distinguished professor of entomology and member of the National Academy of Sciences. The discovery switched the focus of the research from "pest control to pain control."

M. Eric Gershwin, chief of the Division of Rheumatology, Allergy and Clinical Immunology at the UC Davis School of Medicine and a distinguished professor of medicine, called the discovery "the most important discovery in inflammation in more than a decade." Gershwin, who was not affiliated with this study, is noted for his research on rheumatoid arthritis and other inflammatory diseases. His lab investigates the mechanisms leading to immunological alterations and autoimmunity.

As of 2004, physicians prescribed anti-inflammatory medication for more than 73 million patients. But many of the people suffer from pharmacological properties or side effects of the medications. Merck, the pharmaceutical company that manufactured and marketed Vioxx, a Cox-2 selective nonsteroidal anti-inflammatory drug (NSAID), voluntarily pulled the pain killer from the market in September 2004 due to safety concerns. A 12-month study, published in 2000, showed a four-fold increased risk of heart attacks. Merck hopes to replace it with another medication, Acoxia.

However, the class of drugs benefits millions of sufferers from inflammation and pain, Hammock said. The UC Davis study may mean a solution to the dilemma of whether to use the drugs.

"Combination therapies have long been used to treat inflammation while reducing side effects," Schmelzer wrote. She said the present study was designed to evaluate the therapeutic potential of combination treatment with NSAIDs and enzyme inhibitors (a previously undescribed soluble epoxide hydrolase inhibitor or sEHIs) in lipopolysaccharide (LPS)-challenged mice.

"We used LPS as an inflammatory agent, which is a component of some bacterial cell walls," said, co-author Steven Jinks. His laboratory examined the effects of these compounds in rodent inflammatory pain ehavior models. "Inflammatory mediators sensitize pain receptors and cause the animal to withdraw more quickly from a noxious stimulus, an indication of 'hyperalgesia' or heightened response to a painful stimulus. The sEH inhibitors reverse hyperalgesia and bring their withdrawal reaction back into the normal range.

Hammock said "these sEHIs are of similar or greater potency in reducing inflammation in rodents to Vioxx, but also when combined with Vioxx can dramatically reduce the concentrations of the Cox 2 inhibitor needed," Hammock said.

"The combination of Vioxx with the new sEHIs shifts blood chemistry toward the normal condition which may reduce the tendency toward blood clots," said UC Davis scientist Bora Inceoglu, a post-doctoral researcher and member of the research team.

The paper will be online at

Schmelzer, Inceoglu and Hammock teamed with: In-Hae Kim, post-doctoral researcher in Hammock's lab; Steven Jinks, assistant adjunct professor, Department of Anesthesiology and Pain Medicine, UC Davis School of Medicine; Jason Eiserich, associate professor, Division of Nephrology, Department of Internal Medicine, UC Davis School of Medicine; and Lukas Kubala, former UC Davis post-doctoral researcher in Eiserich's lab.

Four UC Davis departments collaborated on the project: entomology, internal medicine, anesthesiology and pain medicine, and physiology and membrane biology, along with the UC Davis Cancer Research Center.

The work drew grant support from the National Institute of Environmental Health Sciences, Superfund Basic Research Program, and the Center for Children's Environmental Health and Disease Prevention, as well as a research award from the UC Davis Health Systems to Eiserich; a Paul F. Gulyassy Endowed Professorship to Eiserich and a UC Davis Department of Anesthesiology and Pain Medicine award to Jinks.
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PostPosted: Tue Jan 23, 2007 7:57 am    Post subject: New activation mechanism for pain sensing channel Reply with quote

Scripps Research Institute
22 January 2007

Scripps Research study reveals new activation mechanism for pain sensing channel

First-time findings describe potential new pain therapy target
The study was published January 21, 2007 in an advanced online edition of the journal Nature.

The researchers found that TRPA1, a protein that helps transmit pain signals, is a direct sensor of reactive chemicals. "While many noxious and pungent compounds were known to activate this pain receptor, we discovered that they do so by directly and irreversibly binding to the cysteine amino acids of this protein," said Ardem Patapoutian, a Scripps Research scientist whose laboratory conducted the study. "Our study shows that TRPA1 activation is directly linked to chemical insult."

"Cysteines, one of the twenty building blocks of all proteins, are known to undergo oxidation/reduction reactions," Patapoutian continued. "Somehow the TRPA1 protein is tuned to sense cysteine modifications. In fact, any cysteine reactive agent seems to activate TRPA1, although we don't know exactly how cysteine binding translates into ion channel activation."

But this activation mechanism comes with an interesting property.

"Generally, compounds that activate ion channels bind in a lock-and-key mechanism that is readily reversible," said Lindsey Macpherson, another author of the study and a Ph.D. candidate in the Scripps Research Kellogg School of Science and Technology. "The mechanism by which noxious compounds activate TRPA1 is unique. For example, compounds that activate an ion channels through a lock-and-key mechanism have structural similarity. TRPA1 activators have no structural similarity; instead, they share a common potential for chemical reactivity, and their binding is long-lasting."

TRPA1 is not unique among proteins to be activated by cysteine modifying agents, the study noted. Another signaling protein known as Kelch-like ECH-associated protein 1 (KEAP1) is activated by many of the same compounds that activate TRPA1; KEAP1 is a sensor for oxidative damage from free radicals and upregulates expression of antioxidant enzymes. Apparently, reactive compounds can activate at least two pathways through cysteine modification as a warning against cell damage, the study concluded.

"Our findings, which are the result of a successful collaboration with the Ben Cravatt and Peter Schultz labs at Scripps Research, show that modification of reactive cysteines within TRPA1 can cause channel activation," Macpherson said. "Our research efforts are now aimed at further understanding how binding of these compounds activate the channel, and identifying the physiological role of TRPA1 in sensing oxidative stress." The protein is currently being investigated by several pharmaceutical companies as a potential target for chronic pain, Patapoutian noted.

Other authors of the study, Noxious Compounds Activate TRPA1 Ion Channels Through Covalent Modification Of Cysteines, are Adrienne E. Dubin, Michael J. Evans, Felix Marr, and Benjamin F. Cravatt of The Scripps Research Institute; and Peter G. Schultz of The Scripps Research Institute and Genomics Institute of the Novartis Research Foundation.

The study was supported by the National Institutes of Health and the Novartis Research Foundation.

About The Scripps Research Institute
The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Currently operating from temporary facilities in Jupiter, Scripps Florida will move to its permanent campus in 2009.
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PostPosted: Wed Mar 07, 2007 7:59 am    Post subject: On the (sound) track of anesthetics Reply with quote

University of Copenhagen
6 March 2007

On the (sound) track of anesthetics

Danish scientists challenge the accepted scientific views of how nerves function and of how anesthetics work. Their research suggests that action of nerves is based on sound pulses and that anesthetics inhibit their transmission.

Every medical and biological textbook says that nerves function by sending electrical impulses along their length. "But for us as physicists, this cannot be the explanation. The physical laws of thermodynamics tell us that electrical impulses must produce heat as they travel along the nerve, but experiments find that no such heat is produced," says associate professor Thomas Heimburg from the Niels Bohr Institute at Copenhagen University. He received his Ph.D. from the Max Planck Institute in Göttingen, Germany, where biologists and physicists often work together – at most institutions these disciplines are worlds apart. Thomas Heimburg is an expert in biophysics, and when he came to Copenhagen, he met professor Andrew D. Jackson, who is an expert in theoretical physics. They decided to work together in order to study the basic mechanisms which govern the way nerves work.

Physics explains biology

Nerves are 'wrapped' in a membrane composed of lipids and proteins. According to the traditional explanation of molecular biology, a pulse is sent from one end of the nerve to the other with the help of electrically charged salts that pass through ion channels in the membrane. It has taken many years to understand this complicated process, and a number of the scientists involved in the task have been awarded the Nobel Prize for their efforts. But – according to the physicists – the fact that the nerve pulse does not produce heat contradicts the molecular biological theory of an electrical impulse produced by chemical processes. Instead, nerve pulses can be explained much more simply as a mechanical pulse according to the two physicists. And such a pulse could be sound. Normally, sound propagates as a wave that spreads out and becomes weaker and weaker. If, however, the medium in which the sound propagates has the right properties, it is possible to create localized sound pulses, known as "solitons", which propagate without spreading and without changing their shape or losing their strength.

The membrane of the nerve is composed of lipids, a material that is similar to olive oil. This material can change its state from liquid to solid with temperature. The freezing point of water can be lowered by the addition of salt. Likewise, molecules that dissolve in membranes can lower the freezing point of membranes. The scientists found that the nerve membrane has a freezing point, which is precisely suited to the propagation of these concentrated sound pulses. Their theoretical calculations lead them to the same conclusion: Nerve pulses are sound pulses.

Anesthetized by sound

How can one anesthetize a nerve so that feel ceases and it is possible to operate on a patient without pain? It has been known for more than 100 years that substances like ether, laughing gas, chloroform, procaine and the noble gas xenon can serve as anesthetics. The molecules of these substances have very different sizes and chemical properties, but experience shows that their doses are strictly determined by their solubility in olive oil. Current expertise is so advanced that it is possible to calculate precisely how much of a given material is required for the patient. In spite of this, no one knows precisely how anesthetics work. How are the nerves "turned off"? Starting from their theory that nerve signals are sound pulses, Thomas Heimburg and Andrew D.

Jackson turned their attention to anesthesia. The chemical properties of anesthetics are all so different, but their effects are all the same - curious!

But the curious turned out to be simple. If a nerve is to be able to transport sound pulses and send signals along the nerve, its membrane must have the property that its melting point is sufficiently close to body temperature and responds appropriately to changes in pressure. The effect of anesthetics is simply to change the melting point – and when the melting point has been changed, sound pulses cannot propagate. The nerve is put on stand-by, and neither nerve pulses nor sensations are transmitted. The patient is anesthetized and feels nothing.

Biophysical Journal:
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PostPosted: Tue Mar 27, 2007 7:57 am    Post subject: Pain control after surgery reduces days of hospitalization Reply with quote

University of Pittsburgh Medical Center
26 March 2007

Pain control after surgery reduces days of hospitalization

University of Pittsburgh study finds effective analgesia cuts length-of-stay by nearly a day
ORLANDO, Fla., March 26 -- Effective postoperative pain control using continuous peripheral nerve block reduced average length-of-stay by nearly a day, University of Pittsburgh School of Medicine physicians reported today during the 81st Clinical and Scientific Congress of the International Anesthesia Research Society at the Buena Vista Palace in Orlando, Fla.

Being able to decrease the time that patients spend in the hospital helps to reduce the patient’s exposure to the risk of hospital-acquired infection and associated complications, and also has an overall economic benefit, Jacques E. Chelly, M.D., Ph.D., professor and vice chairman of the department of anesthesiology at the University of Pittsburgh School of Medicine and his colleagues found.

"For many people, the prospect of having pain is more stressful than the surgery itself," said Dr. Chelly, who is presenting these study results at the meeting. "If they know that specialists in acute pain medicine can help to minimize the pain associated with surgery, these patients are less stressed and more willing to have the surgery they need."

Dr. Chelly and his colleagues analyzed the hospitalization experiences of 1,527 patients, including 495 undergoing surgery between July 1, 2001, and Aug. 30, 2002, and 1,032 who underwent surgery following the institution of a formalized postoperative pain medicine program, called the acute interventional postoperative pain service, between July 1, 2004, and Aug. 30, 2005. The study included patients who underwent total hip or total knee replacement, chest or prostate surgery.

"Prior to the implementation of our postoperative pain management program, the average length of hospital stay was about three to five days," said Dr. Chelly, who also is director of orthopaedic anesthesia and the acute interventional postoperative pain service at UPMC Shadyside Hospital, part of the University of Pittsburgh Medical Center. "The use of the acute interventional postoperative pain service allowed patients to recover faster, and they were discharged from the hospital an average of 0.675 days per patient earlier, for a total of 597.7 days of hospitalization saved a year."

Before the introduction of the acute interventional postoperative pain service, postoperative pain was managed by surgeons and mostly limited, according to Dr. Chelly. "Morphine and PCA (patient-controlled analgesia) were used," he said. "Now, we can do a peripheral nerve block and use other medications, making postoperative pain control more effective."
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PostPosted: Fri May 04, 2007 1:15 pm    Post subject: Study shows response to financial loss parallels brain's pr Reply with quote

Society for Neuroscience

Study shows response to financial loss parallels brain's processing of pain

Findings offer new insight into gambling
WASHINGTON, DC May 4, 2007 – People process information about financial loss through mechanisms in the brain similar to those used for processing physical pain, according to a new imaging study. The results could provide a new understanding of excessive gambling.

The new study detected activity in the striatum, a region that processes signals in the brain's system of reward and defensiveness. Previous studies had shown activity in the striatum increasing when subjects were awarded money, but falling silent when subjects lost money. The new study's lead author, Ben Seymour, MD, and colleagues at the Wellcome Trust Center for Neuroimaging in London suggest that the negative value people associate with losing money stems from an evolutionarily old system involved in fear and pain. This could provide some biological justification for the popular concept of "financial pain." Their study was published in the May 2 issue of The Journal of Neuroscience.

"This work extends our understanding of how the striatum processes both gains and losses and why other experiments have had difficulty eliciting the striatum's involvement in losses," says Read Montague, PhD, at the Baylor College of Medicine, who did not participate in the research.

In the study, 24 subjects—13 male and 11 female—learned to associate abstract image cues with a specific amount of money: 50 pence (equivalent to $1) or ₤1 ($2). The researchers recorded their brain activity over 200 trials as they showed subjects first the original image then an outcome screen indicating whether they had won the associated amount of money, lost it, or received nothing.

The imaging results showed that areas of the striatum toward the front of the brain were more active when subjects did better than they expected, or when they were relieved not to lose as they had expected. Losing money or receiving less than they expected based on the previous association elicited activity in areas of the striatum toward the back of the brain. The findings bolster previous evidence from animal research indicating a gradient of reward- and aversion-based activity across the striatum from front to back.

"Although an impressive amount is known about how the brain learns about financial gains, many previous studies have failed to identify any specific system for dealing with losses," says Seymour. "Understanding how these two systems operate and interact may provide important insights into why some people gamble more than others, and why some become addicted to it."

The work was a supported by the Wellcome Trust Programme, Gatsby Charitable Foundation, Royal Society, and Medical Research Council.

The Journal of Neuroscience is published by the Society for Neuroscience, an organization of more than 36,500 basic scientists and clinicians who study the brain and nervous system. Seymour can be reached at
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PostPosted: Thu May 31, 2007 9:48 am    Post subject: JRRD releases single-topic issue on pain and pain management Reply with quote

Journal of Rehabilitation Research30 May 2007

JRRD releases single-topic issue on pain and pain management
Table of Contents--Volume 44, Number 2

Effects of depression and pain severity on satisfaction in medical outpatients: Analysis of the Medical Outcomes Study, pg. 143

Patient satisfaction is a critical measure of healthcare quality. We performed this study to see how depression and pain severity affected patient satisfaction in medical outpatients. We analyzed data from the Medical Outcomes Study and found that pain was very common and patients with depression and pain were much more likely to be dissatisfied with their healthcare. These findings may also have care-delivery implications, should dissatisfaction indicate poorer quality of care. Further study is needed to determine the reasons for dissatisfaction with care in patients with depression and pain.

Veterans seeking treatment for posttraumatic stress disorder: "What about comorbid chronic pain" pg. 153

In veterans who were being treated for posttraumatic stress disorder (PTSD), many (66%) were also diagnosed with chronic pain problems by their doctors. This is the first study to show that people with PTSD have pain-related conditions according to their doctors. The veterans who told their primary care doctor that they had pain before PTSD treatment said that their pain was less during and after the PTSD treatment. However, this finding was based on a review of charts, so other reasons could also explain the improvement in pain symptoms. More research about treatment for veterans with pain and PTSD is needed.

Prevalence and correlates of posttraumatic stress disorder and chronic severe pain in psychiatric outpatients, pg. 167

This study contributes to the growing literature on the co-occurrence of posttraumatic stress disorder (PTSD) and chronic severe pain. We found moderate rates of PTSD (46%) and chronic severe pain (40%) in a sample of psychiatric outpatients. In addition, 24% of the sample had both disorders. We found that persons with both disorders were significantly different from those with neither disorder on all variables and that they had greater physical and psychosocial stressors. In addition, persons with either PTSD or chronic severe pain alone were more likely to have a chronic medical condition, higher ratings of psychiatric distress, and more stressful life events than those with neither disorder. Mental health treatment providers should routinely assess and develop management strategies for these two disorders in psychiatric outpatients.

Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: Implications for research and practice, pg. 179

Operations Enduring Freedom and Iraqi Freedom have resulted in a growing number of seriously injured soldiers evacuated to the United States for medical care. Trauma-related pain is almost always present among these war-injured soldiers. Several military and Department of Veterans Affairs programs have been implemented to improve pain care. We describe several of these new approaches. We also present data on the soldiers treated, the services provided, and the effects of treatment. Finally, we identify some of the challenges emerging from work with this population and recommend future research and practice priorities.

Efficacy of selected complementary and alternative medicine interventions for chronic pain, pg. 195

We review published research on commonly used complementary and alternative medicine (CAM) approaches to treating chronic pain. Our findings show that CAM therapies, as a group, have a mixed track record of efficacy. The modalities that have the best track records for pain management include biofeedback, hypnosis, and massage (mostly for low back pain and shoulder pain). In selecting a CAM modality, practitioners must weigh the pros and cons and tailor the interventions to the needs of patients with chronic pain. Other issues relevant to practitioners include additional time and energy investments, need for specialized training to administer the modality, side effects or potential toxic effects, safety in combining CAM and other modalities, likely acceptance by clients and the public, and ease of incorporation into traditional pain management practices.

Preliminary evaluation of reliability and criterion validity of Actiwatch-Score, pg. 223

Restoration of normal physical activity is a primary objective of most chronic pain rehabilitative interventions, yet few clinically practical objective measures of activation exist. We evaluated the measurement properties of the Actiwatch-Score (AW-S). We conducted separate trials to examine concordance between units when worn concurrently at the same and different body sites and to compare the AW-S with a validated optical three-dimensional motion-tracking system. The data indicate that the AW-S has excellent interunit reliability and good criterion validity, but its intersite reliability varies with activity type. These results suggest that this device, and those like it, warrants further investigation and is likely to yield valuable data regarding the optimal application of this technology.

A closer look at pain and hepatitis C: Preliminary data from a veteran population, pg. 231

Many veterans who have hepatitis C also experience pain. Researchers are learning how to care for patients who experience hepatitis C and pain. They are also learning how hepatitis C and pain can affect patients’ lives. We review research on the relationship between hepatitis C and pain. We also present findings from a survey given to patients at two Department of Veterans Affairs hospitals. Finally, we suggest how physicians and mental health providers can best care for patients with hepatitis C and pain.

Overview of the relationship between pain and obesity: "What do we know. Where do we go next" pg. 245

Many veterans who struggle with being overweight also experience pain. Researchers are beginning to learn more about how being overweight or obese can affect several health conditions, including pain. We reviewed recent research examining the relationship between pain and overweight/obesity to promote understanding of when, why, and how these conditions occur together. Additionally, we suggest ways researchers can better study the problem of weight and pain to help veterans who experience both.

Medical residents' beliefs and concerns about using opioids to treat chronic cancer and noncancer pain: A pilot study, pg. 263

Chronic pain from conditions such as arthritis or nerve injuries may be disabling and poorly controlled with aspirin, acetaminophen (Tylenol), or ibuprofen (Advil). In selected cases, opioid analgesics (e.g., morphine), combined with other treatments, can safely and more effectively relieve pain and improve function. We surveyed less experienced doctors and found that they had many fears, concerns, and negative beliefs toward using opioids to treat noncancer pain such as low back pain. If other doctors share these feelings, finding ways to increase their comfort by identifying and treating patients who might safely benefit from opioids to reduce their suffering and disability is important.

Persistent benefits of rehabilitation on pain and life quality for nonambulatory patients with spinal epidural metastasis, pg. 271

We evaluated the long-term effects of a 2-week course of rehabilitation on people with paraplegia caused by cancer compressing the spinal cord. Twelve patients received rehabilitation that focused on transfers, skin care, bladder and bowel management, nutrition, and incentive spirometry. We compared these study patients with a historical control group of 30 patients who had paraplegia from cancer but did not receive rehabilitation. Subjects were followed until death. The study patients had less pain and depression and more satisfaction with life; these benefits persisted for the remainder of their lives. In contrast, the control patients had worsening pain levels, declining satisfaction with life, and higher pain medication use for the remainder of their lives. While our study suggests that rehabilitation benefits people with cancer-related spinal cord injury, it needs to be supported by a randomized study.

Pain and palliative medicine, pg. 279

Pain control is an important part of medical care for patients with advanced illnesses. We summarize available information on pain in different patient groups near the end of life and on developments using behavioral and physical therapy methods to treat pain. Clinical trials to treat pain in patients within healthcare systems are the next topic, followed by ideas on how information technology and clinical databases can be used to guide future patient care. Finally, we present perspectives on how pain control can be studied and further improved within healthcare systems.

Moving to new settings: Pilot study of families' perceptions of professional caregivers' pain management in persons with dementia, pg. 295

Pain in persons with severe dementia is often not recognized or treated because these persons cannot communicate their needs. Family caregivers are in the best position to provide information to hospital care personnel about the patients' needs, including pain. Little research has evaluated the role of the family caregiver when patients move between care facilities. This study describes family caregivers' experiences when their family members with dementia were admitted to unfamiliar care sites and provides the caregivers' recommended changes to healthcare settings. This article is relevant to family members and healthcare professionals who care for persons with severe dementia.

Determining mild, moderate, and severe pain equivalency across pain-intensity tools in nursing home residents, pg. 305

More than 80% of nursing home residents have chronic pain, and of these, many are not getting adequate treatment. Good pain treatment begins with knowing how severe the pain is. Several different pain-intensity tools are available: one uses a number (0–10) scale, another uses words, and a third shows pictures of people in pain. We asked nursing home residents to rate their pain using all three scales. We wanted to know how the pain reported on one scale translated onto another scale. The 42,000 veterans who live in nursing homes and their families will benefit from this study.

Cognitive impairment and pain management: Review of issues and challenges, pg. 315

Research shows that pain is often not recognized in persons with communication problems related to brain disease. Older persons with dementia experience memory loss, and seriously ill and dying patients experience confusion. Treating pain will increase the comfort of all these persons. In this article, we review the types of problems that affect the brain and interfere with pain management, how pain is measured, what pain management approaches help, and future research needs. Those who care for adults with brain-related disease will find this article relevant.

Now Available Online and in Print --
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PostPosted: Mon Jun 18, 2007 9:06 am    Post subject: Study: People Literally Feel Pain of Others Reply with quote

Study: People Literally Feel Pain of Others
By Charles Q. Choi, Special to LiveScience

posted: 17 June 2007 05:18 pm ET

A brain anomaly can make the saying "I know how you feel" literally true in hyper-empathetic people who actually sense that they are being touched when they witness others being touched.

The condition, known as mirror-touch synesthesia, is related to the activity of mirror neurons, cells recently discovered to fire not only when some animals perform some behavior, such as climbing a tree, but also when they watch another animal do the behavior. For "synesthetes," it's as if their mirror neurons are on overdrive.

"We often flinch when we see someone knock their arm, and this may be a weaker version of what these synesthetes experience," University College London cognitive neuroscientist Jamie Ward said.

Now scientists find these synesthetes possess an unusually strong ability to empathize with others. Further research into this condition might shed light on the roots of empathy, which could help better understand autism, schizophrenia, psychopathy and other disorders linked with empathy.

For the full article:
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PostPosted: Thu Jul 05, 2007 12:14 pm    Post subject: How pain distracts the brain Reply with quote

Cell Press
5 July 2007

How pain distracts the brain

Anybody who’s tried to concentrate on work while suffering a headache knows that pain compellingly commands attention—which is how evolution helped ensure survival in a painful world. Now, researchers have pinpointed the brain region responsible for pain’s ability to affect cognitive processing. They have found that this pain-related brain region is distinct from the one involved in cognitive processing interference due to a distracting memory task.

Ulrike Bingel and colleagues at the University Medical Center Hamburg-Eppendorf published their discovery in the July 5, 2007 issue of the journal Neuron, published by Cell Press.

To search for the region responsible for pain’s ability to usurp attention, the researchers asked volunteers to perform a cognitive task involving distinguishing images, as well as a working memory task involving remembering images. The researchers asked the volunteers to perform the tasks as they experienced different levels of pain caused by the zapping of their hands by a harmless laser beam.

During these tests, the volunteers’ brains were scanned using functional magnetic resonance imaging (fMRI). In this widely used analytical technique, harmless magnetic fields and radio waves are used to scan the brain to determine blood flow across regions, which reflects brain activity.

The researchers’ experiments identified a brain region called the lateral occipital complex (LOC) as the cognitive-related area affected by both “working memory load” and pain. This finding was expected, since the LOC is known to be involved in processing images.

The researchers next sought to identify the brain region by which pain affects the functioning of the LOC. They theorized that the best candidate for this region was one called the rostral anterior cingulate cortex (rACC). This region is known to be involved in the brain’s processing of pain, and it is part of the anterior cingulate cortex, which plays an important role in “executive” functions such as attentional control. These structures are located deep in the brain in the region of connection between the two hemispheres.

Indeed, the researchers’ fMRI scans indicated that the rACC is, indeed, the brain center through which pain influences the LOC. By contrast, they found a working memory load affects the LOC through a different region, the inferior parietal cortex.

The researchers noted that the modulation of visual processing by pain that they observed in their fMRI studies is behaviorally relevant, because as their fMRI scans showed pain affecting the LOC, they also observed a parallel impairment of accuracy in subjects’ recognition of the images.

The researchers include U. Bingel, M. Rose, J. Glascher, and C. Büchel of University Medical Center Hamburg-Eppendorf, Germany. This work was supported by grants from Volkswagenstiftung, DFG and BMBF, and the EFIC Grünenthal grant 2006.

Bingel et al.: “fMRI Reveals How Pain Modulates Visual Object Processing in the Ventral Visual Stream.” Publishing in Neuron 55, 157–167, July 5, 2007. DOI 10.1016/j.neuron.2007.05.032.
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PostPosted: Thu Jul 12, 2007 2:21 pm    Post subject: Has science unearthed the Holy Grail of pain relief? Reply with quote

University of Manchester
11 July 2007

Has science unearthed the Holy Grail of pain relief?

Scientists studying one of nature’s simplest organisms have helped to unravel the structure of a key molecule that controls pain in humans.

The findings – published in the top scientific journal Nature – could rapidly advance research into the next generation of painkillers for relief of chronic conditions such as migraine and backache.

Chronic pain, unlike the acute pain associated with trauma, has no apparent physiological benefit, often being referred to as the ‘disease of pain’.

Complete and lasting relief of chronic pain is rare and often the clinical goal is pain management through one or more medications.

But now researchers at The University of Manchester have examined microscopic amoeboid organisms commonly called slime moulds in a bid to gain greater insight into these pain molecules, known as ‘P2X receptors’.

“In humans, P2X receptors look identical to one another and so scientists have had difficulty understanding how they function,” said Dr Chris Thompson, who carried out the research with Professor Alan North and Dr Sam Fountain in the Faculty of Life Sciences.

“By looking at slime mould we were effectively able to turn the evolutionary clock back a billion years to see how a more primitive P2X molecule functions.”

The team discovered that there was only a 10% similarity between human P2X and the slime mould equivalent. They were therefore able to deduce from evolutionary theory that it was these similar parts of the molecule that probably regulate pain in humans.

“It’s a big step forward in understanding how the molecule works and should make it possible to develop drugs that block the receptors’ actions,” said Dr Thompson.

“Inhibiting P2X as a potential pain-relief therapy would be the Holy Grail of rational drug design and could revolutionise the way we manage chronic pain conditions like back pain and migraine.”

The research, published in Nature tomorrow (Thursday, July 12), was funded by the Wellcome Trust, the Medical Research Council and the Lister Institute for Preventive Medicine.

Notes for editors:

In nature, the slime mould Dictyostelium exists as single-cell amoebae feeding off bacteria in the soil. When their food supply runs out they aggregate to form a ‘fruiting body’ of some 100,000 cells. Some cells become spores, while others form a stalk beneath the soil surface. These stalk cells die; they sacrifice themselves so the spores can be dispersed to new feeding grounds.
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PostPosted: Thu Jul 19, 2007 8:52 am    Post subject: Scientists a step closer to understanding how anaesthetics w Reply with quote

Imperial College London
19 July 2007

Scientists a step closer to understanding how anaesthetics work in the brain

An important clue to how anaesthetics work on the human body has been provided by the discovery of a molecular feature common to both the human brain and the great pond snail nervous system, scientists say today. Researchers hope that the discovery of what makes a particular protein in the brain sensitive to anaesthetics could lead to the development of new anaesthetics with fewer side effects.

The study focuses on a particular protein found in neurons in the brain, known as a potassium channel, which stabilises and regulates the voltage across the membrane of the neuron. Communication between the millions of neurons in the brain – which is the basis of human consciousness and perception, including perception of pain - involves neurons sending nerve impulses to other neurons. In order for this to happen, the stabilising action of the potassium channel has to be overcome. Earlier studies on great pond snails by the same team identified that anaesthetics seemed to selectively enhance the regulating action of the potassium channel, preventing the neuron from firing at all – meaning the neuron was effectively anaesthetised.

The new research has identified a specific amino acid in the potassium channel which, when mutated, blocks anaesthetic activation. Lead author, Biophysics Professor Nick Franks from Imperial College London, explains how this will allow the importance of the potassium channel in anaesthetic action to be established:

“We’ve known for over 20 years now that these potassium channels in the human brain may be important anaesthetic targets. However, until now, we’ve had no direct way to test this idea. Because a single mutation can block the effects of anaesthetics on this potassium channel without affecting it in any other way, it could be introduced into mice to see if they also become insensitive to anaesthetics. If they do, then this establishes the channel as a key target.”

The group carried out their new study, published in the 20 July issue of the Journal of Biological Chemistry, by cloning the potassium channel from a great pond snail and then making a series of chimeric channels – part snail and part human. The chimeras were used to identify the location of the precise amino acid to which the anaesthetic binds on the potassium channel, giving the team a clearer picture than ever before of the precise mechanism by which anaesthetics work.

This kind of research, explains Professor Franks, is important because understanding exactly how anaesthetics work may pave the way for the development of a new generation of anaesthetics which solely affect specific anaesthetic targets, which could potentially reduce the risks and side effects associated with current anaesthetics.

“At the moment, anaesthetics have many unwanted side-effects on the human body such as nausea and effects on the heart. This is because our current drugs are relatively non-selective and bind to several different targets in the body. A better understanding of how anaesthetics exert their desirable effects could lead to much more specific, targeted alternatives being developed, which could greatly reduce these problems,” he said.
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PostPosted: Mon Sep 10, 2007 1:48 pm    Post subject: Mind–Body Interventions for Chronic Pain in Older Adults: A Reply with quote

Review Article
10 September 2007

Mind–Body Interventions for Chronic Pain in Older Adults: A Structured Review

Natalia E. Morone, MD, MSc,**Department of Medicine, Division of General Internal Medicine andNatalia E. Morone, MD, MSc, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA. and Carol M. Greco, PhD Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA *Department of Medicine, Division of General Internal Medicine and Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA


Study Design. We conducted a structured review of eight mind–body interventions for older adults with chronic nonmalignant pain.

Objectives. To evaluate the feasibility, safety, and evidence for pain reduction in older adults with chronic nonmalignant pain in the following mind–body therapies: biofeedback, progressive muscle relaxation, meditation, guided imagery, hypnosis, tai chi, qi gong, and yoga.

Methods. Relevant studies in the MEDLINE, PsycINFO, AMED, and CINAHL databases were located. A manual search of references from retrieved articles was also conducted. Of 381 articles retrieved through search strategies, 20 trials that included older adults with chronic pain were reviewed.

Results. Fourteen articles included participants aged 50 years and above, while only two of these focused specifically on persons aged ≥65 years. An additional six articles included persons aged ≥50 years. Fourteen articles were controlled trials. There is some support for the efficacy of progressive muscle relaxation plus guided imagery for osteoarthritis pain. There is limited support for meditation and tai chi for improving function or coping in older adults with low back pain or osteoarthritis. In an uncontrolled biofeedback trial that stratified by age group, both older and younger adults had significant reductions in pain following the intervention. Several studies included older adults, but did not analyze benefits by age. Tai chi, yoga, hypnosis, and progressive muscle relaxation were significantly associated with pain reduction in these studies.

Conclusion. The eight mind–body interventions reviewed are feasible in an older population. They are likely safe, but many of the therapies included modifications tailored for older adults. There is not yet sufficient evidence to conclude that these eight mind–body interventions reduce chronic nonmalignant pain in older adults. Further research should focus on larger, clinical trials of mind–body interventions to answer this question.
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PostPosted: Wed Oct 24, 2007 1:55 pm    Post subject: Watching funny shows helps children tolerate pain longer, st Reply with quote

University of California - Los Angeles

Watching funny shows helps children tolerate pain longer, study finds
23 October 2007

Watching comedy shows helps children tolerate pain for longer periods of time, according to a study by UCLA's Jonsson Comprehensive Cancer Center and the nonprofit organization Rx Laughter.

The study findings, published in the October issue of the journal Evidence-based Complementary and Alternative Medicine, suggest that humorous distraction could be used in clinical settings to help children and adolescents better handle painful procedures.

Laughter has long been viewed as good medicine, and although there are many programs that bring humor into pediatric hospitals, little research has been done on the utility of humor for children or adolescents undergoing stressful or painful procedures, such as blood draws and treatments for cancer.

Rx Laughter, an organization founded by former television executive Sherry Dunay Hilber that promotes the use of humor in healing, worked with UCLA researchers on the study, which was funded by a grant from Comedy Central. Participants watched funny classic and contemporary films and television programs while undergoing a standardized pain task — in this case, placing their hands in icy-cold water, said Dr. Margaret Stuber, a researcher at UCLA's Jonsson Comprehensive Cancer Center and first author of the study.

The group demonstrated "significantly greater pain tolerance" while viewing the funny shows, according to the study.

Stuber said that researchers documented submersion times and participants' appraisal of the pain and examined them in relation to humor indicators — the number of times the children laughed or smiled and their ratings of how funny the show was for them.

"We found that viewing funny videos increased the tolerance of pain for children but did not change their ratings of the severity of the pain," said Stuber, UCLA's Jane and Marc Nathanson Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior. "Although they kept their hands in the water longer, they didn't describe the task as any less painful than when they weren't watching the videos. However, this may mean that it simply took longer for the pain to become severe enough to remove their hand."

The number of laughs recorded was not related to either pain tolerance or appraisal, Stuber said.

Eighteen healthy children — 12 boys and six girls between the ages of 7 and 16, with a mean age of 12 — participated in the study. An ice chest was fitted with a plastic mesh screen to separate crushed ice from a plastic mesh armrest placed in 50-degree water. Water was circulated through the ice by a pump to prevent local warming. Participants placed a hand in the cold water to a depth of two inches above the wrist for up to three minutes maximum. Their hands were warmed between tests with warm towels.

Researchers took a baseline measure of submersion duration before the video was viewed, a measurement after and one while participants watched the video. The children left their hands in the icy water significantly longer when watching the funny shows, Stuber said.

Further study is needed to explore the specific mechanism behind the increased pain tolerance, Stuber said.

"Since we did not test any other types of distracters, it could be that something equally distracting but not funny would also be effective," she said. "However, the results do support the types of interventions being done at children's hospitals across the United States."

UCLA's Jonsson Comprehensive Cancer Center comprises about 235 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation's largest comprehensive cancer centers, the Jonsson Center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2007, the center was named the best cancer center in California by U.S. News & World Report, a ranking it has held for eight consecutive years.
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