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  1 / 1099 MEDLINE  
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[PMID]:28463345
[Au] Autor:Upadhyaya MA; Nasrallah HA
[Ad] Endereço:The Everest Foundation, Los Angeles, CA USA E-mail: mupadhya@bronxleb.org
[Ti] Título:The intense desire for healthy limb amputation: A dis-proprioceptive neuropsychiatric disorder.
[So] Source:Ann Clin Psychiatry;29(2):125-132, 2017 05.
[Is] ISSN:1547-3325
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The first mention of a condition in which apparently nonpsychotic individuals have a strong, unrelenting desire to amputate ≥1 of their healthy limbs was published nearly 4 decades ago. Once dismissed as a paraphilia, the condition in recent years has been re-investigated with neurologic testing and imaging, yielding evidence suggesting it may be attributable to a neuroanatomical anomaly. METHODS: A literature review of data was conducted of recently published studies with pinprick testing, magnetic resonance imaging (MRI)/functional MRI imaging, magnetoencephalography, and interviews of individuals with a desire for limb amputation. RESULTS: Published literature on this condition features studies with a limited number of participants. However, the results indicate that affected individuals predominantly desire amputation of the left lower limb, and correspondingly, usually have changes in cortical thickness in the right parietal lobe. CONCLUSIONS: Further investigation of this condition is warranted, particularly, more research into the precise nature of the anomalous neuroanatomy, biopsychosocial background of those with the condition, and longitudinal perspective of the childhood onset and evolution of symptoms. Large sample studies involving a collaborative effort across multiple sites are required.
[Mh] Termos MeSH primário: Amputação/psicologia
Transtornos Dismórficos Corporais
Técnicas de Rastreamento Neuroanatômico/métodos
Distúrbios Somatossensoriais
[Mh] Termos MeSH secundário: Transtornos Dismórficos Corporais/patologia
Transtornos Dismórficos Corporais/psicologia
Lateralidade Funcional
Seres Humanos
Imagem por Ressonância Magnética/métodos
Testes Neuropsicológicos
Distúrbios Somatossensoriais/patologia
Distúrbios Somatossensoriais/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  2 / 1099 MEDLINE  
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[PMID]:28954102
[Au] Autor:Duarte I; Silveira JEPS; Hafner MFS; Toyota R; Pedroso DMM
[Ad] Endereço:Dermatology Clinic of Santa Casa de Misericórdia de São Paulo - Hospital and School of Medicine- São Paulo (SP), Brazil.
[Ti] Título:Sensitive skin: review of an ascending concept.
[So] Source:An Bras Dermatol;92(4):521-525, 2017 Jul-Aug.
[Is] ISSN:1806-4841
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Sensitive skin is a condition characterized by stinging, burning and itching sensations. The diagnosis, pathophysiology and treatment of sensitive skin are still under discussion. In the last years, studies on its epidemiology have been performed, showing a high prevalence and impact on quality of life. Brazilian population was also considered in these studies. Cosmetics, climate changes and skin barrier impairment are the main factors that contribute for skin hyperreactivity. New studies are trying to bring new knowledge about the theme. This review will describe data on epidemiology, triggering factors, pathophysiology, diagnosis and treatment.
[Mh] Termos MeSH primário: Dermatopatias
Distúrbios Somatossensoriais
[Mh] Termos MeSH secundário: Brasil/epidemiologia
Causalidade
Cosméticos/efeitos adversos
Dermatite/diagnóstico
Dermatite/epidemiologia
Dermatite/fisiopatologia
Meio Ambiente
Seres Humanos
Dermatopatias/diagnóstico
Dermatopatias/epidemiologia
Dermatopatias/etiologia
Dermatopatias/terapia
Testes Cutâneos/métodos
Distúrbios Somatossensoriais/diagnóstico
Distúrbios Somatossensoriais/epidemiologia
Distúrbios Somatossensoriais/etiologia
Distúrbios Somatossensoriais/terapia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cosmetics)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE


  3 / 1099 MEDLINE  
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[PMID]:28622488
[Au] Autor:Treleaven J
[Ti] Título:Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain.
[So] Source:J Orthop Sports Phys Ther;47(7):492-502, 2017 Jul.
[Is] ISSN:1938-1344
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Synopsis There is considerable evidence to support the importance of cervical afferent dysfunction in the development of dizziness, unsteadiness, visual disturbances, altered balance, and altered eye and head movement control following neck trauma, especially in those with persistent symptoms. However, there are other possible causes for these symptoms, and secondary adaptive changes should also be considered in differential diagnosis. Understanding the nature of these symptoms and differential diagnosis of their potential origin is important for rehabilitation. In addition to symptoms, the evaluation of potential impairments (altered cervical joint position and movement sense, static and dynamic balance, and ocular mobility and coordination) should become an essential part of the routine assessment of those with traumatic neck pain, including those with concomitant injuries such as concussion and vestibular or visual pathology or deficits. Once adequately assessed, appropriate tailored management should be implemented. Research to further assist differential diagnosis and to understand the most important contributing factors associated with abnormal cervical afferent input and subsequent disturbances to the sensorimotor control system, as well as the most efficacious management of such symptoms and impairments, is important for the future. J Orthop Sports Phys Ther 2017;47(7):492-502. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7052.
[Mh] Termos MeSH primário: Tontura/fisiopatologia
Transtornos Neurológicos da Marcha/fisiopatologia
Lesões do Pescoço/fisiopatologia
Cervicalgia/fisiopatologia
Distúrbios Somatossensoriais/fisiopatologia
Transtornos da Visão/fisiopatologia
[Mh] Termos MeSH secundário: Movimentos Oculares/fisiologia
Movimentos da Cabeça/fisiologia
Seres Humanos
Equilíbrio Postural/fisiologia
Propriocepção/fisiologia
Transtornos das Sensações/fisiopatologia
Córtex Sensório-Motor/fisiopatologia
Traumatismos em Chicotada/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.2519/jospt.2017.7052


  4 / 1099 MEDLINE  
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[PMID]:28602269
[Au] Autor:Corkum JP; Kuta V; Tang DT; Bezuhly M
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
[Ti] Título:Sensory outcomes following brachial plexus birth palsy: A systematic review.
[So] Source:J Plast Reconstr Aesthet Surg;70(8):987-995, 2017 Aug.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Brachial plexus birth palsy (BPBP) affects approximately 1.5 in 1000 live births and can lead to significant functional impairment and reduced quality of life. To date, studies have focused on grading motor function and strength to assess patient outcomes, with less attention paid to sensory recovery. The authors aimed to systematically review the current literature on sensory outcomes following BPBP. METHODS: A systematic review of the best evidence available assessing sensory outcomes following BPBP was conducted. Two independent reviewers used a predefined search strategy to query Cochrane, MEDLINE, EMBASE, and Web of Science databases. Articles written in English reporting sensory outcomes in patients with BPBP, such as tactile sensation, pain, and proprioception, were included for review. A kappa score was calculated to ensure reviewer agreement. RESULTS: Twenty-nine reports with 1647 cases were included. Tactile sensation was most frequently assessed (75.9%), followed by pain (44.8%) and proprioception (17.2%). Among all cases included in the analysis, 75.8% of articles were found to have patients with suboptimal results in sensory outcomes. The majority of articles (86.2%) were case series or case reports; no level 1 or 2 evidence studies were identified. CONCLUSION: Sensory outcomes are underreported following BPBP, and significant deficits and neuropathic pain are not uncommon and likely underappreciated in this patient population. The current report underscores the need for prospective studies that look beyond motor recovery alone and evaluate sensory outcomes following BPBP.
[Mh] Termos MeSH primário: Traumatismos do Nascimento/complicações
Neuropatias do Plexo Braquial/complicações
Dor/etiologia
Propriocepção
Distúrbios Somatossensoriais/etiologia
Tato
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE


  5 / 1099 MEDLINE  
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[PMID]:28596465
[Au] Autor:Akita S; Akiyama T; Mimura M
[Ad] Endereço:Department of Neuropsychiatry, Keio University School of Medicine.
[Ti] Título:[Somatoparaphrenia].
[So] Source:Brain Nerve;69(6):629-638, 2017 Jun.
[Is] ISSN:1881-6096
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Somatoparaphrenia (SP) typically occurs after a right-hemisphere stroke, where the patient refers to his/her hemiplegic left hand as belonging to someone else. In this report, we review the literature for the brain structures affected in SP. We also report three cases with varying degrees of SP: a typical case, one case where SP affected the visceral sensations, and one case where a concurring psychiatric condition lead to a very complex, bizarre delusion.
[Mh] Termos MeSH primário: Distúrbios Somatossensoriais
[Mh] Termos MeSH secundário: Encefalopatias/complicações
Encefalopatias/diagnóstico por imagem
Delusões
Seres Humanos
Distúrbios Somatossensoriais/etiologia
Distúrbios Somatossensoriais/fisiopatologia
Distúrbios Somatossensoriais/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE
[do] DOI:10.11477/mf.1416200794


  6 / 1099 MEDLINE  
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[PMID]:28422633
[Au] Autor:Turville M; Carey LM; Matyas TA; Blennerhassett J
[Ad] Endereço:Megan Turville, B. OT (Hons), B. BSc, is Doctoral Candidate, Department of Community and Clinical Allied Health, School of Allied Health, College of Science, Health, and Engineering, La Trobe University, Melbourne, Victoria, Australia; and Neurorehabilitation and Recovery, Stroke Division, Florey In
[Ti] Título:Change in Functional Arm Use Is Associated With Somatosensory Skills After Sensory Retraining Poststroke.
[So] Source:Am J Occup Ther;71(3):7103190070p1-7103190070p9, 2017 May/Jun.
[Is] ISSN:0272-9490
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills. METHOD: Data were pooled (N = 80) from two randomized controlled trials of somatosensory retraining. We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity. Somatosensory discrimination skills were measured using standardized modality-specific measures. RESULTS: Participants' arm use improved after somatosensory retraining (z = -6.80, p < .01). Change in arm use was weakly associated with somatosensation (tactile, ß = 0.31, p < .01; proprioception, ß = -0.17, p > .05; object recognition, ß = 0.13, p < .05). CONCLUSION: Change in daily arm use was related to a small amount of variance in somatosensory outcomes. Stroke survivors' functional arm use can increase after somatosensory retraining, with change varying among survivors.
[Mh] Termos MeSH primário: Atividades Cotidianas
Braço/fisiopatologia
Distúrbios Somatossensoriais/reabilitação
Reabilitação do Acidente Vascular Cerebral
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Terapia Ocupacional/métodos
Propriocepção
Ensaios Clínicos Controlados Aleatórios como Assunto
Distúrbios Somatossensoriais/etiologia
Distúrbios Somatossensoriais/fisiopatologia
Acidente Vascular Cerebral/complicações
Tato
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.5014/ajot.2017.024950


  7 / 1099 MEDLINE  
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[PMID]:28335745
[Au] Autor:Enax-Krumova EK; Pohl S; Westermann A; Maier C
[Ad] Endereço:Department of Neurology, BG University Hospital Bergmannsheil GmbH, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum, Germany. elena.krumova@rub.de.
[Ti] Título:Ipsilateral and contralateral sensory changes in healthy subjects after experimentally induced concomitant sensitization and hypoesthesia.
[So] Source:BMC Neurol;17(1):60, 2017 Mar 23.
[Is] ISSN:1471-2377
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In unilateral neuropathic pain. e.g. after peripheral nerve injury, both positive and negative sensory signs occur often, accompanied by minor but equally directed contralateral sensory changes. To mimic this feature, we experimentally aimed to induce concomitant c-fibre sensitization and block in healthy subjects and analyzed the bilateral sensory changes by quantitative sensory testing (QST) using the protocol of the German Research Network on Neuropathic Pain. METHODS: Twenty eight healthy subjects were firstly randomized in 2 groups to receive either topical capsaicin (0.6%, 12 cm , application duration: 15 min.) or a lidocaine/prilocaine patch (25/25 mg, 10 cm , application duration: 60 min.) on the right volar forearm. Secondly, 7-14 days later in the same area either at first capsaicin (for 15 min.) and immediately afterwards local anesthetics (for 60 min.) was applied (Cap/LA), or in inversed order with the same application duration (LA/Cap). Before, after each application and 7-14 days later a QST was performed bilaterally. STATISTICS: Wilcoxon-test, ANOVA, p < 0.05. RESULTS: Single application of 0,6% capsaicin induced thermal hypoesthesia, cold hypoalgesia, heat hyperalgesia and tactile allodynia. Lidocaine/prilocaine alone induced thermal and tactile hypoesthesia as well as mechanical and cold hypoalgesia, and a heat hyperalgesia (to a smaller extent). Ipsilaterally both co-applications induced a combination of the above mentioned changes. Significant contralateral sensory changes occurred only after the co-application with concomitant sensitization and hypoesthesia and comprised increased cold (Cap/LA, LA/Cap) and mechanical detection as well as cold pain threshold (LA/Cap). CONCLUSION: The present experimental model using combined application of capsaicin and LA imitates partly the complex sensory changes observed in patients with unilateral neuropathic pain and might be used as an additional surrogate model. Only the concomitant use both agents in the same area induces both positive and negative sensory signs ipsilaterally as well as parallel contralateral sensory changes (to a lesser extent). TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01540877 , registered on 23 February 2012.
[Mh] Termos MeSH primário: Anestésicos Locais/farmacologia
Capsaicina/farmacologia
Lidocaína/farmacologia
Neuralgia/fisiopatologia
Prilocaína/farmacologia
Fármacos do Sistema Sensorial/farmacologia
Distúrbios Somatossensoriais/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Anestésicos Locais/administração & dosagem
Capsaicina/administração & dosagem
Feminino
Voluntários Saudáveis
Seres Humanos
Hipestesia/induzido quimicamente
Hipestesia/fisiopatologia
Lidocaína/administração & dosagem
Masculino
Meia-Idade
Modelos Neurológicos
Prilocaína/administração & dosagem
Fármacos do Sistema Sensorial/administração & dosagem
Distúrbios Somatossensoriais/induzido quimicamente
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Sensory System Agents); 046O35D44R (Prilocaine); 98PI200987 (Lidocaine); S07O44R1ZM (Capsaicin)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1186/s12883-017-0839-9


  8 / 1099 MEDLINE  
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[PMID]:28328653
[Au] Autor:Baumbach P; Götz T; Günther A; Weiss T; Meissner W
[Ad] Endereço:1Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany. 2Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. 3Biomagnetic Center, Hans-Berger-Klinik for Neurology, Jena University Hospital, Jena, Germany. 4Department of Biological and Clinical Psychology, Friedrich Schiller University of Jena, Jena, Germany.
[Ti] Título:Somatosensory Functions in Survivors of Critical Illness.
[So] Source:Crit Care Med;45(6):e567-e574, 2017 Jun.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: There is growing evidence for increased levels of pain and reduced health-related quality of life in survivors of critical illness. Recent studies showed marked small nerve fiber pathology in critically ill patients, which may contribute to chronic pain states and reduced physical recovery after ICU discharge. Primary objective of this study was the comparison of somatosensory functions between survivors of critical illness 6 months after ICU discharge and controls. In post hoc analyses, we aimed to identify associations between small fiber deficits, pain, health-related quality of life, and clinical data. DESIGN: Cross-sectional study. SETTING: Study in critical illness survivors. PATIENTS: Critical illness survivors (n = 84) and controls (n = 44). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Somatosensory functions were assessed with validated quantitative sensory testing. Pain and pain-related disability were assessed with the chronic pain grade questionnaire. Health-related quality of life was assessed by means of the Short Form-36. Compared with controls, former patients showed significantly increased thermal detection thresholds and more abnormal values in thermal testing, indicating reduced small fiber functioning. In addition, compared to patients without significant small fiber deficits (n = 46, 54.8%), patients with significant small fiber deficits (n = 38, 45.2%) reported higher average pain intensity, pain-related disability, and reduced physical health-related quality of life in the SF-36. CONCLUSIONS: A large portion of former critically ill patients show small fiber deficits which seem to be associated with increased pain and reduced physical health-related quality of life. Screening of somatosensory functions in the (post-) acute setting could possibly help to identify patients at risk of long-term impairments.
[Mh] Termos MeSH primário: Estado Terminal/epidemiologia
Nível de Saúde
Unidades de Terapia Intensiva/estatística & dados numéricos
Distúrbios Somatossensoriais/epidemiologia
[Mh] Termos MeSH secundário: APACHE
Idoso
Dor Crônica/epidemiologia
Estudos Transversais
Avaliação da Deficiência
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
Limiar Sensorial
Sobreviventes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002309


  9 / 1099 MEDLINE  
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[PMID]:28202036
[Au] Autor:Kuczynski AM; Semrau JA; Kirton A; Dukelow SP
[Ad] Endereço:University of Calgary, Calgary, AB, Canada.
[Ti] Título:Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children.
[So] Source:J Neuroeng Rehabil;14(1):13, 2017 Feb 15.
[Is] ISSN:1743-0003
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While sensory dysfunction is common in children with hemiparetic cerebral palsy (CP) secondary to perinatal stroke, it is an understudied contributor to disability with limited objective measurement tools. Robotic technology offers the potential to objectively measure complex sensorimotor function but has been understudied in perinatal stroke. The present study aimed to quantify kinesthetic deficits in hemiparetic children with perinatal stroke and determine their association with clinical function. METHODS: Case-control study. Participants were 6-19 years of age. Stroke participants had MRI confirmed unilateral perinatal arterial ischemic stroke or periventricular venous infarction, and symptomatic hemiparetic cerebral palsy. Participants completed a robotic assessment of upper extremity kinesthesia using a robotic exoskeleton (KINARM). Four kinesthetic parameters (response latency, initial direction error, peak speed ratio, and path length ratio) and their variabilities were measured with and without vision. Robotic outcomes were compared across stroke groups and controls and to clinical measures of sensorimotor function. RESULTS: Forty-three stroke participants (23 arterial, 20 venous, median age 12 years, 42% female) were compared to 106 healthy controls. Stroke cases displayed significantly impaired kinesthesia that remained when vision was restored. Kinesthesia was more impaired in arterial versus venous lesions and correlated with clinical measures. CONCLUSIONS: Robotic assessment of kinesthesia is feasible in children with perinatal stroke. Kinesthetic impairment is common and associated with stroke type. Failure to correct with vision suggests sensory network dysfunction.
[Mh] Termos MeSH primário: Paralisia Cerebral/fisiopatologia
Robótica/métodos
Distúrbios Somatossensoriais/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Paralisia Cerebral/etiologia
Criança
Exoesqueleto Energizado
Feminino
Seres Humanos
Cinestesia
Masculino
Distúrbios Somatossensoriais/etiologia
Acidente Vascular Cerebral/complicações
Acidente Vascular Cerebral/fisiopatologia
Extremidade Superior/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE
[do] DOI:10.1186/s12984-017-0221-6


  10 / 1099 MEDLINE  
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[PMID]:28091815
[Au] Autor:Bjurström MF; Álvarez R; Nicol AL; Olmstead R; Amid PK; Chen DC
[Ad] Endereço:Department of Anesthesiology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. mfbjurstrom@ucla.edu.
[Ti] Título:Quantitative validation of sensory mapping in persistent postherniorrhaphy inguinal pain patients undergoing triple neurectomy.
[So] Source:Hernia;21(2):207-214, 2017 Apr.
[Is] ISSN:1248-9204
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. METHODS: Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13). QST was conducted in four areas on the affected, painful side and in one contralateral comparison site. QST variables were compared according to sensory mapping outcomes: (o)/normal sensation, (+)/pain, and (-)/numbness. Diagnostic ability of the sensory mapping outcomes to detect QST-assessed allodynia or hypoesthesia was estimated through calculation of specificity and sensitivity values. RESULTS: Preoperatively, patients exhibited mechanical hypoesthesia and allodynia and pressure allodynia and hyperalgesia in painful areas mapped (+) (p < .05); sensory mapping outcome (+) demonstrated high ability to detect mechanical allodynia [sensitivity 0.74 (95% CI 0.61-0.86), specificity 0.94 (0.84-1.00)] and pressure allodynia [sensitivity 0.96 (0.89-1.00), specificity 1.00 (1.00-1.00)], but not thermal allodynia. Postoperatively, mapped areas of numbness (-) were associated with mechanical and thermal hypoesthesia (p < .05); (-) showed high sensitivity and specificity to detect mechanical and cold hypoesthesia. CONCLUSIONS: Sensory mapping provides an accurate clinical neuropathic assessment with strong correlation to QST findings of preoperative mechanical and pressure allodynia, and postoperative mechanical and thermal hypoesthesia in CPIP patients undergoing neurectomy.
[Mh] Termos MeSH primário: Dor Crônica/diagnóstico
Técnicas de Diagnóstico Neurológico
Hérnia Inguinal/cirurgia
Herniorrafia/efeitos adversos
Neuralgia/diagnóstico
Distúrbios Somatossensoriais/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Dor Crônica/etiologia
Dor Crônica/cirurgia
Denervação/métodos
Feminino
Virilha/inervação
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Neuralgia/etiologia
Neuralgia/cirurgia
Medição da Dor
Limiar da Dor
Projetos Piloto
Distúrbios Somatossensoriais/etiologia
Distúrbios Somatossensoriais/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE
[do] DOI:10.1007/s10029-017-1580-4



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