Feasibility of Imported Self-Management Program for Elderly People with Chronic Pain: A Single-Arm Confirmatory Trial.

Introduction: Multidisciplinary pain management programs incorporating a cognitive-behavioral therapy (CBT) approach have been reported to be helpful for elderly people with chronic pain. However, it is unclear whether the same program for elderly people with chronic pain would translate to different cultures. This study investigated whether a multidisciplinary program based on that of Nicholas et al.

The Non-Avoidant Pacing Scale: Development and Preliminary Validation.

Despite widespread use as a chronic pain management strategy, pacing has been linked with higher levels of pain and disability. A recent meta-analysis found a positive correlation between existing measures of pacing and avoidance, which may partially account for these poorer outcomes. A measure was developed to differentiate pacing from avoidance by emphasizing non-pain-contingent pacing behaviors and nonavoidance of pain.

3D MRI Modeling of Thin and Spatially Complex Soft Tissue Structures without Shrinkage: Lamprey Myosepta as an Example.

3D imaging techniques enable the nondestructive analysis and modeling of complex structures. Among these, MRI exhibits good soft tissue contrast, but is currently less commonly used for nonclinical research than X-ray CT, even though the latter requires contrast-staining that shrinks and distorts soft tissues. When the objective is the creation of a realistic and complete 3D model of soft tissue structures, MRI data are more demanding to acquire and visualize and require extensive post-processing because they comprise noncubic voxels with dimensions that represent a trade-off between tissue contrast and image resolution.

The Relationship Between Pacing and Avoidance in Chronic Pain: A Systematic Review and Meta-Analysis.

Unlabelled: Activity pacing is ubiquitous in chronic pain management and aims to reduce pain-contingent avoidance of activity to improve functioning. A meta-analysis, however, has linked pacing with higher levels of pain and disability. One potential explanation is an overlap between existing measures of pacing and avoidance, leading to links with poorer outcomes that are typically associated with avoidance.

Clinical perineural invasion of the trigeminal and facial nerves in cutaneous head and neck squamous cell carcinoma: Outcomes and prognostic implications of multimodality and salvage treatment.

Background: Clinical perineural invasion (PNI) of the trigeminal and facial nerves from cutaneous head and neck squamous cell carcinoma (cutaneous HNSCC) is a rare clinical entity that poses unique therapeutic challenges.

Methods: A retrospective chart review of a skull base oncology database was performed of patients with the diagnosis of clinical PNI from a cutaneous HNSCC. Patients who were previously untreated underwent multimodal treatment entailing surgical resection and postoperative radiotherapy (PORT) and patients who were previously treated with radiotherapy underwent salvage surgical resection between the years 2006 and 2012.

Long-term outcomes from training in self-management of chronic pain in an elderly population: a randomized controlled trial.

This study compares the outcomes, from pretreatment to 1-year follow-up, of an outpatient, CBT-based pain self-management program (PSM) that included exercises, pain education, and pain coping strategies, with a control condition (exercise-attention control, EAC) that included exercises and a control for the attention of the treatment team. We previously reported short-term results (to 1-month follow-up) from the same study. This new paper considers the important issue of maintenance of treatment-related gains.

Radiologic and Audiologic Findings in the Temporal Bone of Patients with CHARGE Syndrome.

Background: CHARGE syndrome is a common congenital anomaly. Hearing loss affects 60%-90% of these children. As temporal bone computed tomography (CT) has become more sophisticated, more abnormalities of the middle and inner ear have been found.

The mediating role of catastrophizing in the relationship between pain intensity and depressed mood in older adults with persistent pain: A longitudinal analysis.

Background And Aims: Depression is common in older adults with persistent pain. Cognitive-behavioural models of pain propose that the relationship between pain and depression is influenced or mediated by interpretations of events (cognitions), rather than by the event itself. Almost exclusively, the evidence for this position has come from studies of people aged less than 65 years.

Evaluation of a faecal calprotectin care pathway for use in primary care.

Background: National Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a 'traffic light' system for risk and a clinical management pathway.

The effectiveness of psychological treatments for chronic pain in older adults: cautious optimism and an agenda for research.

Purpose Of Review: To explores the potential role of psychological treatments for older people who are affected by chronic pain.

Recent Findings: It is now widely recognized that chronic pain is a highly prevalent health problem among older people, and guidelines have evolved to assist with the assessment and management of chronic pain. However, despite the fact that psychological treatments have been shown to be effective for a range of other conditions such as depression and anxiety, there is a relative paucity of studies focused on pain management.

Self-management intervention for chronic pain in older adults: a randomised controlled trial.

This study compared an outpatient pain self-management (PSM) program, using cognitive-behavioural therapy and exercises, with 2 control conditions in 141 chronic pain patients aged > 65 years. Results immediately posttreatment indicated that relative to the Exercise-Attention Control (EAC) group, the PSM group was significantly improved on measures of pain distress, disability, mood, unhelpful pain beliefs, and functional reach. The mean effect size for these gains was 0.

Catastrophizing mediates the relationship between pain intensity and depressed mood in older adults with persistent pain.

Unlabelled: This study examined the role of catastrophizing in mediating the relationship between pain intensity and depressed mood in older adults with persistent pain using reliable and valid measures for this population. A convenience sample of 669 patients 61 years and over attending a tertiary-level referral pain center completed questionnaires measuring pain intensity, depressed mood, and catastrophizing as part of a clinical assessment process. The catastrophizing subscale of the Pain-Related Self-Statements scale (PRSS-Catastrophizing) was examined for internal consistency and factor structure.

Incomplete cochlear partition type II variants as an indicator of congenital partial deafness: a first report.

Introduction: The increased understanding on the impact of partial deafness (PD) with residual low-frequency hearing has led to new hearing rehabilitation strategies using hearing preservation techniques during cochlear implantation with the aim to make use of the combined electric acoustic stimulation (EAS) in the affected ear. As a first report, we describe minor forms of the incomplete cochlear partition type II (IP- II) involving the apical 1.5 turns, which were found in the majority of our patients presenting with congenital PD.

Impact of floating mass transducer coupling and positioning in round window vibroplasty.

Objective: The round window application of the Vibrant Sound bridge, the so-called round window vibroplasty, is gaining increasing popularity for hearing rehabilitation of patients with mixed hearing loss or conductive hearing loss. In these patients, conventional hearing amplification and/or surgical restoration is either not possible or has failed because of chronic ear disease, extensive otosclerosis, or malformations. The exact mechanisms of direct cochlear stimulation via the round window membrane are not yet completely understood.

The utility of the short version of the Depression Anxiety Stress Scales (DASS-21) in elderly patients with persistent pain: does age make a difference?

Objective: This study examined the assessment of the negative emotional constructs of depression, anxiety and stress with the short version (21 items) of the Depression Anxiety Stress Scales (DASS-21) in elderly patients (age > 60 years) with persistent pain.

Design: A convenience sample of 2,045 patients attending a tertiary referral pain centre were categorized by age and included a group aged 60 years and under (n=1,245) for assessment of age differences. Elderly patients (n=800) were divided into 3 groups: 61-70 years (n=366), 71-80 years (n=308) and 81 years and over (n=126).

Assessing pain in older people with persistent pain: the NRS is valid but only provides part of the picture.

Unlabelled: This study examined the assessment of pain intensity and pain distress with the Numerical Rating Scale (NRS) in elderly patients (age > 60 years) with persistent pain. A consecutive sample of 800 elderly patients were categorized by age into 3 groups: 61 to 70 years (n = 366), 71 to 80 years (n = 308), and 81 years and over (n = 126). Participants completed 3 Numerical Rating Scales assessing current pain intensity, and both the usual level of pain and average pain distress in the preceding week.

Preliminary outcomes of cholesteatoma screening in children using non-echo-planar diffusion-weighted magnetic resonance imaging.

Objective: Diffusion-weighted (DW) MRI imaging is evolving into an alternative to second look surgery in detection of cholesteatoma recurrence. Insights into the DW MRI appearances of postoperative or inflammatory mucosal changes have recently described using non-echo-planar, turbo spin-echo (TSE) DW MRI which reliably distinguishes between postoperative changes and cholesteatoma. We investigated the use of TSE DW MRI in our pediatric population in order to validate a rapid and cost-effective MRI sequence that can be used to screen for cholesteatoma.

Postoperative non-echo-planar diffusion-weighted magnetic resonance imaging changes after cholesteatoma surgery: implications for cholesteatoma screening.

Objectives: Diffusion-weighted (DW) magnetic resonance imaging (MRI) is emerging as an alternative to second-look surgery in ruling out residual or recurrent disease after cholesteatoma eradication. However, the DW MRI appearances of postoperative or inflammatory mucosal changes have not been well investigated, thus rendering the interpretation of postoperative DW MRI difficult in the presence of mucosal reactions. We investigated the turbo-spin echo (TSE) DW MRI changes of the middle ear and mastoid mucosa after cholesteatoma surgery and compared these with the TSE DW MRI features of cholesteatoma with an aim to identify a rapid and cost-effective purely DW MRI sequence that can be used to screen for cholesteatoma.

Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy.

Background: Germinoma is the most common and least-malignant intracranial germ cell tumor, usually found in the midline. Germinoma that arises in the basal ganglia, called ectopic germinoma, is a rare and well-documented entity representing 5% to 10% of all intracranial germinomas. The association of cerebral and/or brain stem atrophy with basal ganglia germinoma on CT and MRI is found in 33% of the cases.