Group Of Painful Disorders Research Articles

Serum Metabolic Profiles of the Tryptophan-Kynurenine Pathway in the high risk subjects of major depressive disorder

Previous reports have shown that during chronic inflammation, the tryptophan (TRP)-kynurenine (KYN) pathway plays a pivotal role in the onset of depression. The aim of this study was to investigate the characteristics of the serum TRP-KYN pathway metabolite profile in high-risk subjects of major depressive disorder (HRMDD) defined by depression scores. The concentrations of TRP-KYN pathway metabolites {TRP, KYN, 3-hydroxyanthranilic acid (3HAA), 3-hydroxykynurenine (3HK), kynurenic acid (KYNA) and anthranilic acid (AA)} were assessed in serum from HRMDD, chronic pain disorder patients and healthy controls. In serum from HRMDD, elevated levels of AA and decreased levels of TRP were observed, but the levels of other metabolites were not changed. Furthermore, the change in the AA2nd/AA1st ratio in subjects who progressed from a healthy state to a depressive state was correlated with an increase in the CES-D score. The level of IL-1 receptor antagonist (IL-1RA) was negatively correlated with that of AA. Interestingly, we confirmed AA as a possible biomarker for depression-related symptoms, since the metabolite profiles in the chronic pain disorder group and chronic unpredictable mild stress model mice were similar to those in the HRMDD. These results suggest that AA may be an effective marker for HRMDD.

Fecal Calprotectin as a Useful Non-Invasive Screening Marker for Eosinophilic Gastrointestinal Disorder in Korean Children.

BackgroundEosinophilic gastrointestinal disorder (EoGID) is an emerging disease condition in Korean children, but its diagnosis requires invasive endoscopic biopsies. Fecal calprotectin (FCal) is a noninvasive biomarker for intestinal inflammation to differentiate organic gastrointestinal diseases from functional abdominal pain disorder. This study aimed to evaluate the diagnostic accuracy of FCal and to determine the optimal cutoff to differentiate EoGID from functional abdominal pain disorder.MethodsA total of 253 children (122 boys, 131 girls; mean age 12.2 ± 3.6, range 2.9–17.8 years) who underwent endoscopy with biopsies for chronic gastrointestinal symptoms were recruited, except for 38 children diagnosed with inflammatory bowel disease, and divided into EoGID (n = 67) and functional abdominal pain disorder (n = 186). FCal, white blood cell (WBC) counts, eosinophil counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were measured in all subjects at initial diagnosis.ResultsFCal levels weakly correlated with WBC (r = 0.127, P = 0.044) and CRP (r = 0.126, P = 0.040) but not with ESR and eosinophil count. FCal levels were significantly higher in the EoGID group than in the functional abdominal pain disorder group (mean 179.5 ± 242.9 mg/kg vs. 44.3 ± 68.1 mg/kg; P < 0.001), while WBC, ESR, CRP, and eosinophil count did not differ between the two groups (all P > 0.05). An optimal cutoff of FCal 73.2 mg/kg distinguished EoGID from functional abdominal pain disorder with a sensitivity of 50.7% and a specificity of 84.6%.ConclusionFCal is a useful and reliable noninvasive marker for differentiating EoGID from functional abdominal pain disorder in Korean children with chronic gastrointestinal symptoms when optimal cutoffs are applied.

Work-related self-reported musculoskeletal disorders in hypermarket cashiers: a study in south of Portugal.

Background:Work-related musculoskeletal disorders are a group of painful disorders which arise from work situations with continuous repetitive movements, carried out with speed and without time for recovery. In the performance of their job tasks, supermarket cashiers are exposed to this type of ergonomic stress.Objectives:This study aimed to determine the incidence of self-reported injuries in Portuguese hypermarket cashiers and to identify the related factors.Methods:The sample included 176 hypermarket cashiers, aged between 18 and 65 years (39.57±11.11), 167 (94.9%) of them women. Symptoms and exposure of interest have been collected through an interview-based questionnaire. The presence of carpal tunnel syndrome was assessed by Phalen’s test.Results:One hundred and seventeen (66.5%) cashiers reported an injury during employment, 100 (56.8%) of them reporting an injury in the previous 6 months. A total of 166 injuries were reported, corresponding to 1.14 injuries per 1,000 hours of work. The most common injuries were non-specific pain (30.4%), located in the shoulder (23.2%), cervical (22%) and lumbar spine (22%). Part-time workers showed a 2.25 times greater risk of injury (95% CI: 1.17-4.32; p=0.015) than full-time workers. Cashiers with more than 6 years of employment length had a 3.59 times higher risk of injury (95% CI: 1.84-6.99; p≤0.001) than those who had been working for a shorter period.Conclusions:Our data showed a high rate of reported injuries among hypermarket cashiers, especially among part-time workers and those with the highest length of employment.

A cross-sectional study on the prevalence of work-related musculoskeletal disorders in the employees of pharmaceutical industry

Background: Work-related musculoskeletal disorders (WRMDs) are a group of painful disorders of muscles, tendons, and nerves. Carpal tunnel syndrome, tendonitis, thoracic outlet syndrome, and tension neck syndrome are examples. Fascination with technology, overly ambitious business expectation, and neglected human factor risks can have serious effects on manufacturers, suppliers, and service enterprises. As India is one of the largest and growing hubs in the world of manufacture industry, there is a great need to identify such problem. In this study, we identified such problems and discussed it. Objectives: The aim of this study is to gather data to identify jobs or work conditions that are most problematic, using sources such as injury and illness logs, medical records, and job analyses. Materials and Methods: Data collection was done by personal interview, history and physical examinations, specific symptoms questionnaire, and rapid upper limb assessment (RULA) survey for WRMDs. Results: In our study, we found that prevalence of neck pain was highest followed by back pain in general. Most participants had complained that pain only aggravated when they continue work without taking rest. On examination, the presence of cervical spine tenderness was highest, followed by hand joints and lumbar spine tenderness. In admin and skilled participants, RULA score was up to 4 (satisfactory and modification required), but in unskilled participants, RULA was up to 7 (not satisfactory and immediate changes may require). Conclusion: Work activities which are frequent and repetitive or activities with awkward postures cause these disorders which may be painful during work or at rest. Most WRMD affects the hands, wrists, elbows, neck, and shoulders.

Miniscalpel-Needle Treatment Is Effective for Work-Related Neck and Shoulder Musculoskeletal Disorders.

Background. Work-related musculoskeletal disorders (MSDs) are a group of painful disorders of muscles, tendons, and nerves, such as neck and shoulder MSD. This study was designed to use miniscalpel-needle (MSN) technique as an intervention for work-related MSDs. Methods. Thirty-one patients with work-related MSDs and 28 healthy subjects were enrolled as controls in this study. The MSD symptoms of each patient were assessed by visual analog scale (VAS) and neck disability index (NDI). Blood samples were collected from control subjects and MSD patients before and after treatment. Serum levels of C-reactive protein (CRP) and tumor necrosis factor (TNF) were measured using ELISA. Results. Prior to MSN treatment, serum levels of CRP and TNF were significantly higher in the MSD patients than the healthy controls. Serum CRP levels correlated with VAS and NDI scores, and serum TNF levels correlated with NDI scores. Compared to pretreatment, VAS and NDI scores were significantly lower in MSD patients after MSN treatment, while serum CRP and TNF levels were significantly lower compared with the healthy control levels. Conclusions. Our results indicate that MSN may be an effective intervention for work-related MSDs and be associated with lower serum levels of inflammatory biomarkers.

English

Abstract 20 million people are experiencing various workrelated musculoskeletal disorders (WRMSD)around the world. These are group of painfuldisorders of muscles, tendons, and nerves, whichoccurs as a result of frequent or repetitive activitieswith awkward postures. Software professionalswho usually adopt an awkward posture are moreprone to develop WRMSD. Evidence suggestedthat long and extended working hours and rate ofdisorders are significantly correlated. This studyaims to identify the prevalence of various WRMSDin software professionals who works in an ITindustry. 400 software professionals were selectedthrough convenient sampling method withdescriptive study design. Nordic musculoskeletalquestionnaire was given to all the participants.Data was evaluated and analyzed using SPSSsoftware. The result findings shows that low backpain ranks first among the overall WRMSD andspine related problems are most common thanperipheral extremities. Key words: Software professional, Work relatedmusculoskeletal disorders, Low back pain, Nordicmusculoskeletal questionnaire.

Prevalence of Work-related Musculoskeletal Disorders and Associated Risk Factors among Nurses in a Public Hospital

Background and purpose: Work-related musculoskeletal disorders (WMSDs) are a group of painful disorders of muscles, tendons, and nerves. Carpal t unnel syndrome, tendonitis, thoracic outlet syndrome, and tension neck syndrome are examples. Almost all work requires the use of the arms and hands, therefore, most WMSD affect the hands, wrists, elbows, neck, and shoulders. The aim of the current study was to assess the prevalence of W MSDs among hospital nurses in working time. Materials and Methods: All of nurses during the period of12 months in 10 b ody regions were evaluated in the workplaces by checklist data sheet assessment using the nordic musculoskeletal questionnaire (NMQ). A cross-sectional study was performed through 2013 using by questionnaire and nurses who experienced WMSDs for at least 1 day during the past 12 months were included in the study . Results: WMSDs were seen mostly in the neck (28.2%), knees (18.2%) and upper back (17.3%). A significant relationship was seen between sex of pa rticipants (P < 0.05) and WMSDs, and there was a positive correlation between sex of subjects and WMSDs problem in the neck (P < 0.05). Body mass index was correlated to musculoskeletal disord ers problems (P < 0.05). Conclusion: In general, subjects with patients handling/transf erring had significantly higher prevalence of symptoms in most body regions than those with light physical workloads. The female nurses are more tendency to involve and occurrence of WMSDs compared to male staffs. [*Mirmohammadi S, Yazdani J. Prevalence of Work-related Musculoskeletal Disorders and Associated Risk Factors among Nurses in a Public Hospital . IJHS 2014; 2(3): 55-61] http://jhs.mazums.ac.ir

Do the various categories of somatoform disorders differ from each other in symptom profile and psychological correlates

In routine clinical practice, the subcategories of various somatoform disorders are rarely used by the primary care physicians and there is lack of data to suggest any difference in the clinical manifestations of these subcategories. To compare the symptom profile, anxiety, depression, alexithymia, somato-sensory amplification and hypochondriasis of patients with persistent somatoform pain disorder with other subtypes of somatoform disorder. A total of 119 patients diagnosed with somatoform disorders according to the International Classification of Diseases-10th Revision (ICD-10) were evaluated for prevalence of somatic symptoms, anxiety, depression, alexithymia, hypochondriacal worry and somato-sensory amplification. No significant differences were found in the prevalence of various somatic complaints between those with persistent somatoform pain disorder group and those diagnosed with other somatoform disorders. Co-morbid anxiety and depression were seen in two-thirds of the patients, but again there was no difference in the prevalence of the same between the two groups. Similarly, no significant differences were found on alexithymia, hypochondriasis and somato-sensory amplification scales between the persistent somatoform pain disorder group and the group with other somatoform disorders. There are no significant differences between the various subcategories of somatoform disorders with regard to the prevalence of somatic symptoms, anxiety or depression and psychological correlates of alexithymia, hypochondriasis and somato-sensory amplification.

Ankle impingement: a review of multimodality imaging approach

Ankle impingement is defined as entrapment of an anatomic structure that leads to pain and decreased range of motion of the ankle and can be classified as either soft tissue or osseous (Bassett et al. in J Bone Joint Surg Am 72:55-59, 1990). The impingement syndromes of the ankle are a group of painful disorders that limit full range of movement. Symptoms are due to compression of soft-tissues or osseous structures during particular movements (Ogilvie-Harris et al. in Arthroscopy 13:564-574, 1997). Osseous impingement can result from spur formation along the anterior margin of the distal tibia and talus or as a result of a prominent posterolateral talar process, the os trigonum. Soft-tissue impingement usually results from scarring and fibrosis associated with synovial, capsular, or ligamentous injury. Soft-tissue impingement most often occurs in the anterolateral gutter, the medial ankle, or in the region of the syndesmosis (Van den Bekerom and Raven in Knee Surg Sports Traumatol Arthrosc 15:465-471, 2007). The main impingement syndromes are anterolateral, anterior, anteromedial, posterior, and posteromedial impingement. These conditions arise from initial ankle injuries, which, in the subacute or chronic situation, lead to development of abnormal osseous and soft-tissue thickening within the ankle joint. The relative contributions of the osseous and soft-tissue abnormalities are variable, but whatever component is dominant there is physical impingement and painful limitation of ankle movement. Conventional radiography is usually the first imaging technique performer and allows assessment of any potential bone abnormality, particularly in anterior and posterior impingement. Computed tomography (CT) and isotope bone scanning have been largely superseded by magnetic resonance (MR) imaging. MR imaging can demonstrate osseous and soft-tissue edema in anterior or posterior impingement. MR imaging is the most useful imaging modality in evaluating suspected soft-tissue impingement or in excluding other ankle pathology such as an osteochondral lesion of the talus. MR imaging can reveal evidence of previous ligamentous injury and also can demonstrate thickened synovium, fibrosis, or adjacent reactive soft-tissue edema. Studies of conventional MR imaging have produced conflicting sensitivities and specificities in assessment of anterolateral impingement. CT and MR arthrographic techniques allow the most accurate assessment of the capsular recesses, albeit with important limitations in diagnosis of clinical impingement syndromes. In the majority of cases, ankle impingement is treated with conservative measures, with surgical debridement via arthroscopy or an open procedure reserved for patients who have refractory symptoms. In this article, we describe the clinical and potential imaging features, for the four main impingement syndromes of the ankle: anterolateral, anterior, anteromedial, posterior, and posteromedial impingement.

DEVELOPMENT OF A NOVEL ERGONOMIC EVALUATION TOOL

Ergonomics or Human Factors is the scientific discipline concerned with the understanding of the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data and methods to design in order to optimize human well-being and overall system performance. Within the discipline, domains of specialization represent deeper competencies in specific human attributes or characteristics of human interaction: Physical, Cognitive and Organizational Ergonomics. Physical ergonomics is concerned with human anatomical, anthropometric, physiological and biomechanical characteristics as they relate to physical activity. The relevant topics include working postures, materials handling, repetitive movements, work-related musculoskeletal disorders, workplace layout, safety and health. Work-related musculoskeletal disorders are a group of painful disorders of muscles, tendons, and nerves. Carpal tunnel syndrome, tendonitis, thoracic outlet syndrome, and tension neck syndrome are some of the examples. Work activities which are frequent and repetitive, or activities with awkward postures cause these disorders which may be painful during work or at rest (Kourinka, 1998). One of main problems that workers who handle and move heavy loads have to face is back pain. Studies showed that 80% of the population of the world have or will have back pain in one moment of their lives. In spite of the multifactorial aspect of back pain, intervertebral disc have been shown as one of the main related sites to lower back pain development. The cumulative results are the reduction of the spine length and, consequently, the height of the person. The intervertebral disc deformation is related to the magnitude and time of application of the loads (Kilbom, 1998). Bearing this in mind, several have been the ergonomic evaluation tools that have been developed in order to classify the worker’s level of risk in having a musculoskeletal disorder in the near future. Many are the tools and many are the specifications of the several tools, resulting in an incorrect ergonomic evaluation if the incorrect tool is selected. Therefore, this paper presents some of the ergonomic evaluation tools presenting advantages and disadvantages, and in the end, proposing a combination of the selected tools in order to present universal ergonomic evaluation tool.

Women's sexual pain disorders; a clinical sexological profile

The aim of this study was to compare a group of 50 women suffering from sexual pain disorder with 50 women in sexual health (control group). Each woman was asked to complete anonymous questionnaire referring to three different assessment areas. To assess the pleasure related to erotic imagery and sexual experience, women were asked to indicate the level of pleasure perceived fantasyzing or experiencing ten sample randomized situations with three possible answers (no pleasure - little pleasure - a lot of pleasure). To assess the fit of women's own sexual experience with current models of female sexual response (Master & Johnson - Kaplan - Basson), women were asked to indicate which one, if any, of these models best described their own pattern of sexual response. To assess female sexual function, the fsfi was included in the survey instruments. The sexual pain disorder group presented a lower pleasure related to erotic imagery and sexual experience and was more likely to endorse Basson model despite MJ the consequences in the therapy are discussed.

DSM‐IV‐TR “Pain Disorder Associated with Psychological Factors” as a Nonhysterical Form of Somatization

Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful subscales, such as admission of symptoms [Ad] and denial of symptoms [Dn]). To overcome this drawback, 48 patients diagnosed as having a Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR) diagnosis of "pain disorder associated with psychological factors" were compared with 48 patients experiencing somatic pain excluding psychological factors, and 42 somatic controls without pain. MMPI Hy and hypochondriasis (Hs) scores were significantly higher in the pain disorder group than in control groups, who scored similarly. MMPI correction (K) scores and Dn scores were similar in the three groups, whereas Ad was significantly higher in the pain disorder group and lower and similar in the two control groups, respectively. In the pain disorder group, Ad and Dn were negatively correlated, whereas in control groups they were unrelated. These findings suggest that whereas a pattern of high Hs and Hy scores together with a normal K score might characterize patients with a pain disorder associated with psychological factors, elevated Hy scores per se do not indicate hysterical traits. In the pain disorder group, elevated Hy scores reflected the Ad subscale alone, indicating a strikingly high frequency of distressing somatic symptoms. They tend not to repress or deny the emotional malaise linked to symptoms, as the hysterical construct expects. The pain disorder designation should be considered a nonhysterical form of somatization.

Abnormality in the Self-monitoring Mechanism in Patients With Fibromyalgia and Somatoform Pain Disorder

Auditory hallucinations and passivity experiences are associated with an abnormality in the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced sensations. It is unclear if chronic central pain disorders such as fibromyalgia and somatoform pain disorders also involve a defect of the self-monitoring mechanism. Responses to tactile stimulation were assessed in four groups of subjects (N = 40): patients with fibromyalgia, patients with somatoform pain disorder, patients with schizophrenia with auditory hallucinations and/or passivity experiences, and normal control subjects. The subjects were asked to rate the perception of a tactile sensation on their left and right hands. The tactile stimulation was either self-produced by movement of the subject's right or left hand or externally produced by the experimenter. Normal control subjects experienced self-produced stimuli as less intense than identical, externally produced tactile stimuli. In contrast, patients with fibromyalgia, patients with somatoform pain disorder, and patients with schizophrenia with auditory hallucinations and/or passivity experiences gave the same perceptual ratings for tactile stimuli produced by themselves as those produced by the experimenter (intergroup difference, p = .043; 95% confidence interval [CI], 0.16-0.68). Post hoc tests revealed that this significance was mainly caused by the fibromyalgia (p = .046; 95% CI, -1.66-0.13) and the somatoform pain disorder group (p = .033; 95% CI, -1.71-0.06). We conclude that central pain disorders such as fibromyalgia and somatoform pain disorders interfere with the correct functioning of the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced tactile stimuli.