Associations between pain thresholds for heat, cold and pressure, and Pain Sensitivity Questionnaire scores in healthy women and in women with persistent pelvic pain

Background The Pain Sensitivity Questionnaire (PSQ) is a self‐rating instrument developed as a time‐ and cost‐saving alternative to quantitative sensory testing (QST). The aims of the study were to assess (a) the associations between PSQ scores and QST in women with persistent pelvic pain and in pain‐free controls and (b) to what extent demographic variables and psychological distress influenced PSQ scores. Methods Fifty‐five healthy women and 37 women with persistent pelvic pain participated. All filled in the PSQ and Hospital Anxiety and Depression Scale and had QST (heat, cold and pressure pain thresholds) performed on six locations on the body. Information on age, body mass index, smoking habits and pain duration were collected. Principal component analysis and orthogonal partial least square regressions were used. Results The patients scored significantly higher on PSQ than the controls. Significant multivariate correlations between pain thresholds and PSQ scores were found only in the patient group. In the patient group, the heat and cold pain thresholds correlated more strongly with PSQ scores than the pressure pain threshold. Conclusions The PSQ score was significantly higher in pelvic pain patients, and correlations between QSTs and the PSQ were only found for patients. Significance The PSQ reflects pain sensitivity in women with PPP and can be used as a non‐invasive and painless way to assess this condition in clinical practice.Funding Agencies|Medical Research Council of Southeast Sweden; Swedish Research Council; County council of Ostergotland; Linkoping University; IMI Paincare</p

Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis

INTRODUCTION: Endometriosis is a gynecological disorder that may cause considerable pelvic pain in women of fertile age. Determining pain mechanisms is necessary in order to optimize the treatment of the disease. The objective of the study was to evaluate pain thresholds in women with persistent pelvic pain with and without confirmed endometriosis, and healthy, unaffected controls, and analyze how pain thresholds in these cohorts related to duration of pelvic pain, quality of life, and symptoms of anxiety and depression. MATERIAL AND METHODS: Pain thresholds for heat, cold and pressure were assessed with quantitative sensory testing on six locations on a reference group of 55 healthy women and on 37 women with persistent pelvic pain who had been admitted for diagnostic laparoscopy on the suspicion of endometriosis. Validated instruments were applied to assess quality of life and symptoms of anxiety and depression. Data were analyzed by means of uni- and multivariate analysis of variance and Spearman's rank-order correlation. RESULTS: The women with persistent pelvic pain had significantly lower pain thresholds compared with the reference women. In the women with pain, no differences were observed in pain thresholds between women with (n = 13) and women without (n = 24) biopsy-proven endometriosis. The duration of pelvic pain correlated significantly positively with reduced pain thresholds, ie, the longer the duration, the more sensitization. In the persistent pelvic pain group, pain thresholds for heat correlated significantly with the Short Form Health Survey 36 dimension of bodily pain, and thresholds for cold correlated with Short Form Health Survey 36 bodily pain and with symptoms of depression. CONCLUSIONS: Our results showed widespread alterations in pain thresholds in women with persistent pelvic pain that are indicative of central sensitization and a time-dependent correlation. Women with pelvic pain and suspicion of endometriosis should probably be treated more thoroughly to prevent or at least minimize the concomitant development of central sensitization.Funding agencies:  Medical Research Council of Southeast Sweden; Region Ostergotland; Linkoping University</p

Total pain in a patient with lung cancer diagnosis

Pain is experienced by most cancer patients. According to the definition of the International Society forthe Study of Pain (IASP), pain is an unpleasant sensory and emotional experience associated with, or resemblingthat associated with, actual or potential tissue damage. This very “medical” definition indicatesthat pain is a mental, subjective, sensual, emotional, and unpleasant phenomenon. In palliative care, thereis often a need for a better and deeper understanding of what “total” pain can be. The case of a youngpatient with lung cancer diagnosis presented an opportunity to describe characteristics of such pain, whichencompasses physical, mental, social and spiritual suffering

Marshall Rosenberg’s non-violent communication as the language of life in a doctor–patient relationship

The aim of the article is to present Marshall Bertrand Rosenberg’s concept of non-violent communication(NVC) and usefulness in the doctor-patient relationship. M. B. Rosenberg’s concept of NVC was basedon the assumption that a person’s natural ability is empathy directed towards other people and towardsthemselves. However, our culture suppresses these natural abilities. The language offers many expressionsthat block natural compassion because they are overfilled with moral judgments, judging comparisons,punishments, arousing feelings of guilt or shame. The author of NVC proposes a four-phase model ofempathic non-violent and non-manipulative communication, which is the basis for changes in the thoughtprocess: observing without judging, recognising, relating the feelings currently experienced to needs (values)and formulating concrete requests instead of demands

Inter-decadal variability in potential glacier surface melt energy at Vestari Hagafellsjökull (Langjökull, Iceland) and the role of synoptic circulation

The surface energy balance (SEB) of glaciers, although of considerable importance for understanding the melt response to climate change, is rarely analysed for more than a few melt seasons due to the logistical challenges of meteorological measurement campaigns on glaciers. Insight into low-frequency (inter-decadal) changes in the SEB in response to climate warming and variable atmospheric circulation patterns has thus been limited. Here this problem is addressed by using ERA-Interim reanalysis data to extend glacier-meteorological records at two locations on Vestari Hagafellsjökull (Iceland) for the period 1979–2012. Trend analysis is conducted for this series before the role of synoptic circulation in modulating surface energetics is investigated. The results indicate that potential melt energy has increased significantly throughout the period of simulation at both locations (by 19.7 and 32.4%), with the largest increase evident for the turbulent heat fluxes (36.3 and 93.1%). The synoptic conditions associated with the recent high melt rates on the proximate Greenland Ice Sheet (GrIS) do not result in similarly extreme melt conditions for our Icelandic location. We also find that the North Atlantic Oscillation Index is significantly correlated with the radiative and latent heat components of the SEB. This association remains hidden if the melt rate is assessed in isolation, highlighting the utility of the SEB approach presented here for assessing synoptic aspects of glacier-climate interactions

Validation, reproducibility and safety of trans dermal electrical stimulation in chronic pain patients and healthy volunteers

<p>Abstract</p> <p>Background</p> <p>Surrogate pain models have been extensively tested in Normal Human Volunteers (NHV). There are few studies that examined pain models in chronic pain patients. Patients are likely to have altered pain mechanisms. It is of interest to test patient pain responses to selective pain stimuli under controlled laboratory conditions.</p> <p>Methods</p> <p>The Institutional Ethic Committee approved the study. 16 patients with chronic neuropathic radiculopathy and 16 healthy volunteers were enrolled to the study after obtaining informed consent. During electrical stimulation (150 minutes for volunteers and 75 minutes for patients) the following parameters were measured every 10 minutes:</p> <p>Ongoing pain: Visual Analogue Scale (VAS) and Numeric Rate Scale (NRS)</p> <p>Allodynia (soft foam brush)</p> <p>Hyperalgesia (von Frey monofilament 20 g)</p> <p>Flare</p> <p>For each endpoint, the area under the curve (AUC) was estimated from the start of stimulation to the end of stimulation by the trapezoidal rule. The individual AUC values for both periods were plotted to show the inter- and intra-subject variability. For each endpoint a mixed effect model was fitted with random effect subject and fixed effect visit. The estimate of intra-subject variance and the mean value were then used to estimate the sample size of a crossover study required to have a probability of 0.80 to detect a 25% change in the mean value. Analysis was done using GenStat 8^thedition.</p> <p>Results</p> <p>Each endpoint achieved very good reproducibility for patients and NHV. Comparison between groups revealed trends towards:</p> <p>Faster habituation to painful stimuli in patients</p> <p>Bigger areas of hyperalgesia in patients</p> <p>Similar area of allodynia and flare (no statistical significance)</p> <p>Conclusion</p> <p>The differences demonstrated between patients and NHVs suggest that the electrical stimulation device used here may stimulate pathways that are affected in the pathological state.</p

What is the crisis of Western sciences?

© 2016, Springer Science+Business Media Dordrecht. This article is an attempt to formulate a clear definition of the concept of crisis of Western sciences introduced by Husserl in his last work. The attempt will be based on a reading of the Krisis, which will stress its underlying continuity with Husserl’s life-long concerns about the theoretical insufficiency of positive sciences, and downplay the novelty of the idea of crisis itself within Husserl’s work. After insisting on the fact that, according to Husserl, only an account of the shortcomings of the scientificity of Western sciences can justify the claim that they are undergoing a crisis, it will be argued that the common definition of the crisis of the sciences as the loss of their significance for life rests on a misunderstanding. The crisis of Western sciences will be characterized, instead, as the repercussion of the crisis of the scientificity of philosophy (and, specifically, of metaphysics) on the scientificity of positive sciences. The loss of significance of scientific knowledge for our existence will in turn appear as a further, inevitable consequence of the uprooting of the sciences from the soil of a universal philosophy culminating in metaphysics, and thus, as a phenomenon deeply intertwined with the crisis of Western sciences, but not identical to it

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

The question concerning human rights and human rightlessness: disposability and struggle in the Bhopal gas disaster

In the midst of concerns about diminishing political support for human rights, individuals and groups across the globe continue to invoke them in their diverse struggles against oppression and injustice. Yet both those concerned with the future of human rights and those who champion rights activism as essential to resistance, assume that human rights – as law, discourse and practices of rights claiming – can ameliorate rightlessness. In questioning this assumption, this article seeks also to reconceptualise rightlessness by engaging with contemporary discussions of disposability and social abandonment in an attempt to be attentive to forms of rightlessness co-emergent with the operations of global capital. Developing a heuristic analytics of rightlessness, it evaluates the relatively recent attempts to mobilise human rights as a frame for analysis and action in the campaigns for justice following the 3 December 1984 gas leak from Union Carbide Corporation’s (UCC) pesticide manufacturing plant in Bhopal, India. Informed by the complex effects of human rights in the amelioration of rightlessness, the article calls for reconstituting human rights as an optics of rightlessness