Painful conditions

  • 文章类型: Journal Article
    Pain could be an unknown non-motor symptom in Huntington\'s Disease (HD). The aim is therefore, to study the prevalence of pain interference, painful conditions and analgesic use across the different stages of HD and compare these levels to non-HD gene mutation carriers.
    A cross-sectional analysis of the Enroll-HD study was conducted in premanifest, manifest HD gene mutation carriers (n = 3989 and n = 7,485, respectively) and in non-HD gene mutation carriers (n = 3719). To investigate group differences, multivariable logistic regression analysis was performed with pairwise comparisons.
    In the HD mutation carriers, the overall prevalence of pain interference was 34% (95% CI 31%-35%), of painful conditions 17% (95% CI 15%-19%) and analgesic use 13% (95% CI 11%-15%). Compared to non-mutation carriers, the prevalence of pain interference was significantly higher in the middle stage of HD (33% [95% CI 31%-35%] vs 42% [95% CI 39%-45%], P = 0,02), whereas the prevalence of painful conditions was significant lower in the late and middle stage of HD (17% [95% CI 16%-18%] vs 12% [95% CI 10%-14%], 15% [95% CI 13%-17%], P < 0,01]. No significant group difference was present in analgesic use.
    The prevalence of pain interference increases as HD progresses, however, the prevalence of painful conditions and analgesics do not increase accordingly. Further studies are necessary to investigate the aetiology of pain in HD and the risk for undertreatment of pain.
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  • 文章类型: Journal Article
    Chronic pain is a global problem affecting up to 20% of the world\'s population and has a significant economic, social and personal cost to society. Sensory neurons of the dorsal root ganglia (DRG) detect noxious stimuli and transmit this sensory information to regions of the central nervous system (CNS) where activity is perceived as pain. DRG neurons express multiple voltage-gated sodium channels that underlie their excitability. Research over the last 20 years has provided valuable insights into the critical roles that two channels, NaV1.7 and NaV1.9, play in pain signalling in man. Gain of function mutations in NaV1.7 cause painful conditions while loss of function mutations cause complete insensitivity to pain. Only gain of function mutations have been reported for NaV1.9. However, while most NaV1.9 mutations lead to painful conditions, a few are reported to cause insensitivity to pain. The critical roles these channels play in pain along with their low expression in the CNS and heart muscle suggest they are valid targets for novel analgesic drugs.
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  • 文章类型: Journal Article
    背景:现在有相当多的证据将儿童逆境与各种成人健康问题联系起来。不幸的是,几乎所有这些研究都依赖于对儿童事件的回顾性评估,造成偏见的脆弱性。在这项研究中,我们试图利用允许对儿童事件进行前瞻性和回顾性评估的数据来源,研究3种相关性.
    方法:1994年一项针对0至11岁儿童的全国调查,从“知识最渊博的人”(通常是母亲)收集了有关儿童的数据。可以将这些受访者的n=1977的数据与随后的成人研究中从同一人收集的数据联系起来。后一项调查包括童年逆境的回顾性报告。我们检查了与前瞻性和回顾性评估儿童期逆境相关的三个成人健康结果:主要抑郁发作,过度饮酒和痛苦的条件。
    结果:尽管与回顾性评估的相关性更强,但发现了儿童期逆境(通过回顾性和前瞻性方法评估)与重度抑郁症之间的强关联。在痛苦的情况下发现了较弱的关联,但这些并不取决于评估方法。无论评估方法如何,都没有发现过量饮酒的关联。
    结论:这些发现有助于减轻人们的担忧,即童年逆境和成年期间的健康结果之间的关联仅仅是回忆偏差的产物。在这项研究中,回顾性和前瞻性评估策略产生了相似的结果.
    BACKGROUND: Considerable evidence now links childhood adversity to a variety of adult health problems. Unfortunately, almost all of these studies have relied upon retrospective assessment of childhood events, creating a vulnerability to bias. In this study, we sought to examine three associations using data sources that allowed for both prospective and retrospective assessment of childhood events.
    METHODS: A 1994 national survey of children between the ages of 0 and 11 collected data from a \'person most knowledgeable\' (usually the mother) about a child. It was possible to link data for n = 1977 of these respondents to data collected from the same people in a subsequent adult study. The latter survey included retrospective reports of childhood adversity. We examined three adult health outcomes in relation to prospectively and retrospectively assessed childhood adversity: major depressive episodes, excessive alcohol consumption and painful conditions.
    RESULTS: A strong association between childhood adversities (as assessed by both retrospective and prospective methods) and major depression was identified although the association with retrospective assessment was stronger. Weaker associations were found for painful conditions, but these did not depend on the method of assessment. Associations were not found for excessive alcohol consumption irrespective of the method of assessment.
    CONCLUSIONS: These findings help to allay concerns that associations between childhood adversities and health outcomes during adulthood are merely artefacts of recall bias. In this study, retrospective and prospective assessment strategies produced similar results.
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