La Carta forestale della Basilicata.

A comment is made on the Forest Map of Regione Basilicata (Southern Italy)

Quality of light — is laser necessary for effective photobiostimulation?

Is true laser, with its unique qualities of coherence, collimation and monochromaticity, necessary for effective photobiostimulation, or is a simpler form of light sufficient? Doubt has been cast on the importance of coherence and collimation in influencing biostimulation. It is hypothesised that monochromaticity (or singularity of wavelength) is the only characteristic of laser necessary for photostimulation. If wavelength is the important factor in phototherapy, the clinician must consider which wavelengths are capable of producing specific effects within living tissues. In addition, it is important to distinguish the quality of light provided by a unit and whether it will give the desired results without a large financial outlay. This article reviews the unique properties of laser, discusses their contribution to photobiostimulation and looks at apparatus which provide these properties

Self-report and pain behaviour among patients with chronic pain

Objectives: To determine the relationship between pain behaviors and self-report of pain and disability in patients with chronic pain

Pain scores and side effects in response to low Level Laser Therapy (Lllt) for myofascial trigger points

Clinically, Low Level Laser Therapy - LLLT has been used successfully in the treatment of chronic pain but many have questioned the scientific basis for its use. Many studies have been poorly designed or poorly controlled. A double-blind, placebocontrolled, random-allocation study was designed to analyse the effect of second daily infrared (IR) laser (820 nm, 25 mW) and visible red laser (670 nm, 10 mw) at 1 J/cm and 5 J/c0m on chronic pain. Forty-one consenting subjects with chronic pain conditions exhibiting myofascial trigger points in the neck and upper trunk region underwent Five treatment sessions over a two week period. To assess progress, pain scores were measured using visual analogue scales before and after each treatment. The incidence of side effects was recorded. All groups demonstrated significant reductions in pain over the duration of the study with those groups which received infrared (820 nm) laser at 1 J/cm and 5 J/cm. demonstrating the most significant effects (p < 0.001). Only those subjects who had active laser treatment experienced side effects. Results indicated that responses to LLLT at the parameters used in this study are subject to placebo and may be dependent on power output, dose and/or wavelength

Plasma ACTH and β-endorphin levels in response to low Level Laser Therapy (Lllt) for myofascial trigger points

The mechanism by which laser phototherapy (Low Level Laser Therapy - LLLT) induces analgesia in the treatment of chronic pain is not understood. To investigate a possible role for opioids in this treatment, a double-blind, placebo-controlled study was designed to compare the effect of two dosages (1 J/cm and 5 J/cm ) of an infrared (IR) laser (820 nm), a visible red laser (670 nm) and a near-monochromatic light emitting device (660 nm, 30 nm bandwidth) on trigger points. Fifty-six consenting subjects with chronic pain conditions exhibiting myofascial trigger points in the neck and upper trunk region underwent six experimental sessions over a two week period. Blood samples were withdrawn before and after treatment on three of six appointments. Plasma was assayed for β-endorphin (radioimmunoassay, RIA) and adrenocorticotropic hormone (ACTH -two-site immunoradiometric assay, IRMA) to assess opioid response. ACTH was shown to have a cumulative response to treatment with a significant response to a 1 J/cm infrared laser (p < 0.001) and a 5 J/cm red laser (p < 0.05). β-endorphin was noted to be significantly elevated between days one and four (p < 0.05) in subjects who received IR (5 J/cm) laser therapy. Results indicated that the analgesic response to phototherapy may be mediated through hormonal/opioid mechanisms, and that responses to LLLT are dose and wavelength dependent. A mechanism is proposed by which peripheral stimulation using LLLT may elicit activity in the central pathways

Successful Use of Gabapentin in Acute Pain Management Following Burn Injury: A Case Series

Pain after burn injury has multiple qualities, including neuropathic and hyperalgesic elements. This element of the burn patients' pain experience is frequently difficult to manage and contributes significantly to their suffering. The onset may be either immediate or delayed. Gabapentin has established efficacy in the reduction of burn-induced hyperalgesia and allodynia in animal and human experimental burn models. This article reports a case series of six patients who, following admission to hospital with burn injury, described burning dysesthesia at either the injury or graft donor site. These patients were prescribed gabapentin in addition to standard analgesia. The use of gabapentin resulted in a rapid reduction in the severity of the neuropathic element of the pain. The medication was well tolerated, with no severe adverse reactions. Conclusions. This case series introduces the use of gabapentin as a potentially important therapy in the management of neuropathic pain following burn injury. Further research is required to define the use of gabapentin in this specific setting

Pregabalin in severe burn injury pain: A double-blind, randomised placebo-controlled trial

This randomised, double-blind, placebo-controlled trial assessed the efficacy and tolerability of pregabalin to alleviate the neuropathic component of moderate to severe burn pain. Patients aged 18 to 65 years admitted to a burns unit with a 5% or greater total body surface area burn injury were screened to participate in the trial. Using the Neuropathic Pain Scale (NPS), patients scoring 4 or higher on 'hot' pain or 'sharp' pain were invited to participate. Consenting patients were randomly assigned to receive pregabalin or placebo for 28 days with individual dose titration commencing at 75 mg twice daily to a maximum pregabalin dose of 300 mg twice daily. The primary outcome measure was the patients' daily response to the sharp and hot pain of the NPS. Secondary outcome measures included the remaining elements of the NPS, daily opioid requirement, length of hospital stay, pain at 6 months, and side effects of nausea, vomiting, drowsiness and giddiness. For patients administered pregabalin, the primary outcome measures hot (P = .01) and sharp (P = .04) pain were significantly reduced compared with those in patients administered placebo. Secondary outcome measures of itch, unpleasantness, surface pain, and procedural pain were significantly lower (P < .05) in the pregabalin group. Adverse effects were uncommon, with no difference between the treatment groups. There was no significant difference between the pregabalin and placebo treatment groups with respect to opioid consumption, duration of hospital stay, or pain at 6 months. Pregabalin was efficacious and well tolerated in patients after severe burn injury and whose pain was characterised by features of acute neuropathic pain. In this study, pregabalin was well tolerated and significantly reduced several elements of the neuropathic pain scale including hot pain, unpleasantness of the pain, surface pain, and itch, and also significantly reduced procedural pain. © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved