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  • 1
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2021
    In:  Scandinavian Journal of Pain Vol. 21, No. 3 ( 2021-07-27), p. 512-521
    In: Scandinavian Journal of Pain, Walter de Gruyter GmbH, Vol. 21, No. 3 ( 2021-07-27), p. 512-521
    Abstract: Persistent pain is common in HIV patients and breast cancer (BC) survivors. The aim of this study was to compare two patient groups with neuropathic pain (NP) regarding several psychological variables and Health-related Quality of Life. Although, treatment of pain is always planned individually, the knowledge of the differences and similarities between the patient groups may help us to understand more precisely the targets of the interventions for pain. Methods Eighty nine BC and 73 HIV patients with symptoms of neuropathic pain (patients with ≥3/7 in the Douleur Neuropathique four interview part (DN4i)) participated in a cross-sectional study. Patients completed questionnaires about mood (HADS), symptoms of insomnia (ISI), pain catastrophizing (PCS), personality (TIPI), Mental and Physical Health-related Quality of Life (M/PHrQoL, RAND/SF-36), and pain intensity and interference (BPI). Analyses were applied by using t-tests and linear regression to assess associations between the studied factors. Results HIV patients reported higher anxiety (p 〈 0.001), depressive symptoms (p 〈 0.001), pain catastrophizing (p 〈 0.001) and pain interference (p 〈 0.001), poorer sleep (p 〈 0.001), and lower HrQoL in all dimensions compared with BC survivors. There were significant differences in personality traits extraversion, emotional stability, and agreeableness between the two patient groups. In HIV patients, pain interference ( β =−0.344, p 〈 0.001) and mood ( β =−0.580, p 〈 0.001) and in the BC group, mood ( β =−0.591, p 〈 0.001), extraversion ( β =0.229, p=0.005) and sleep ( β =−0.154, p=0.042) associated with MHrQoL. Pain interference (HIV β =−0.645, p 〈 0.001, BC β =−0.491, p 〈 0.001) and age (HIV β =−0.016, p=0.042 and BC β =−0.018, p=0.019) associated with PHrQoL in both groups, and catastrophizing in the BC group ( β =−0.303, p 〈 0.001). Conclusions HIV patients and BC survivors with neuropathic pain, measured with DN4i, have significant differences in various health-related variables and Health-related Quality of Life with both patient groups reporting low HrQoL. The differences in low HrQoL may reflect the fundamental differences between these diseases, BC survivors in remission and HIV patients living with a chronic disease that is under control. This study brings information about the diversity of different patient populations with symptoms of neuropathic pain, and how neuropathic pain associates with wide range of health-related factors. Interventions to support better coping with the symptoms of neuropathic pain could be tailored more individually if the background disease is taken into account.
    Type of Medium: Online Resource
    ISSN: 1877-8860 , 1877-8879
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2020
    In:  Scandinavian Journal of Pain Vol. 20, No. 3 ( 2020-07-28), p. 545-553
    In: Scandinavian Journal of Pain, Walter de Gruyter GmbH, Vol. 20, No. 3 ( 2020-07-28), p. 545-553
    Abstract: Psychological resilience refers to successful adaptation or a positive outcome in the context of significant life adversity, such as chronic pain. On the other hand, anxiety closely associates with pain. The aim of this study was to explore how anxiety and psychological resilience together associate with persistent and experimental pain. Methods In a cross-sectional design, we studied 160 patients who had previously been treated for breast cancer and who now reported at least moderate pain (NRS ≥ 4) in any area of the body. Psychological resilience was measured on the Resilience Scale-14, anxiety on the Hospital Anxiety and Depression Scale, and intensity and interference of persistent pain by means of the Brief Pain Inventory. The cold pressor test was conducted to assess sensitivity to experimental cold pain. Results The results showed that resilience associated with pain interference in persistent pain, and that anxiety moderated this effect. Higher psychological resilience was associated with lower pain interference and this association was stronger in patients with low anxiety than among patients with high anxiety. These effects were visible with regard to persistent pain but not in experimental cold pain. Conclusions These results indicate that chronic pain and experimental pain as well as pain severity and pain interference are psychologically different phenomena. Psychological resilience protects against pain interference but effectively only in patients with low anxiety. It is necessary also to consider protective factors in addition to vulnerability factors in cases of persistent pain. Implications Resilience has been considered a potential target for intervention in chronic pain. However, high levels of anxiety might diminish the protective effect of psychological resilience in clinical settings. Therefore, it is important to treat anxiety in addition to resilience enhancing interventions. Patients with low psychological distress might be more suitable for resilience enhancing interventions than patients with high anxiety.
    Type of Medium: Online Resource
    ISSN: 1877-8879 , 1877-8860
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
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  • 3
    In: Neuromodulation: Technology at the Neural Interface, Elsevier BV, Vol. 25, No. 4 ( 2022-06), p. 538-548
    Type of Medium: Online Resource
    ISSN: 1094-7159
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2008283-6
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  • 4
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2012
    In:  Experimental Brain Research Vol. 223, No. 1 ( 2012-11), p. 19-32
    In: Experimental Brain Research, Springer Science and Business Media LLC, Vol. 223, No. 1 ( 2012-11), p. 19-32
    Type of Medium: Online Resource
    ISSN: 0014-4819 , 1432-1106
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
    detail.hit.zdb_id: 1459099-2
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  • 5
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  European Journal of Pain Vol. 24, No. 2 ( 2020-02), p. 413-422
    In: European Journal of Pain, Wiley, Vol. 24, No. 2 ( 2020-02), p. 413-422
    Abstract: Douleur Neuropathique 4 (DN4) is a screening questionnaire to help identify neuropathic pain (NP) in clinical practice and research. We tested the accuracy of the DN4 questionnaire in stratifying possible NP (pNP) and definite NP (dNP) in patients operated for breast cancer. Methods We studied 163 patients from a longitudinal cohort of breast cancer operated patients 4–9 years after surgery. pNP or dNP were classified according to the NP grading system. Surgeon‐verified intercostobrachial nerve resection was used as a confirmatory test for dNP. A receiver‐operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to test the diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of the DN4. Additionally, we studied clinical factors that associated with a positive screening outcome in the interview part of the DN4 (DN4i). Results DN4i and DN4 showed significant accuracy in stratifying patients with pNP or dNP with cut‐off scores 3 and 4 resulting to sensitivity of 66.2% and 79.4% and specificity of 77.8% and 92.6%, respectively. pNP and dNP patients showed differences in sensory descriptors of pain according to DN4i items. Screening positive on DN4i associated with dNP and younger age. Conclusions Full DN4 could stratify pNP and dNP patients in a chronic postsurgical NP patient group operated for breast cancer. Additionally, DN4i showed significant accuracy in stratifying pNP and dNP, but an examination is necessary to obtain proper accuracy. Demographic factors may have an impact on the screening outcome of DN4i. Significance DN4 stratifies possible and definite postsurgical peripheral neuropathic pain. DN4i may also show this, but full DN4 is more accurate. We confirm DN4i as a valid screening tool for NP.
    Type of Medium: Online Resource
    ISSN: 1090-3801 , 1532-2149
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2002493-9
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  • 6
    Online Resource
    Online Resource
    SAGE Publications ; 2002
    In:  Journal of Telemedicine and Telecare Vol. 8, No. 3_suppl ( 2002-12), p. 26-28
    In: Journal of Telemedicine and Telecare, SAGE Publications, Vol. 8, No. 3_suppl ( 2002-12), p. 26-28
    Abstract: In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2002
    detail.hit.zdb_id: 2007700-2
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  • 7
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2022
    In:  Scandinavian Journal of Pain Vol. 22, No. 3 ( 2022-07-26), p. 515-525
    In: Scandinavian Journal of Pain, Walter de Gruyter GmbH, Vol. 22, No. 3 ( 2022-07-26), p. 515-525
    Abstract: Psychobiological temperament and cognitive-evaluative character link to coping with chronic pain. The aim was to study possible independent role of temperament and character dimensions both in chronic and experimental pain in chronic post-surgical pain patients. This is a substudy of a previously published larger cohort of patients with intercostobrachial nerve injury after breast cancer surgery. Methods We recruited 241 women who had been treated for breast cancer 4–9 years before. They had a surgeon-verified intercostobrachial nerve injury with or without chronic post-surgical neuropathic pain (CPSNP). The patients filled in the Temperament and Character Inventory (TCI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Brief Pain Inventory (BPI), and underwent the cold pressor test (CPT). Results 201 (83%) patients reported chronic pain and 135 (56%) met the criteria for CPSNP. Patients with CPSNP showed higher levels of Harm Avoidance (HA) temperament than non-CPSNP patients, which was associated with lower cold pain tolerance and greater increase of pain intensity during CPT. HA subscales Fear of Uncertainty and Fatigability contributed to a stronger pain experience. For character dimensions, CPSNP patients reported higher levels of Self-Transcendence (ST) and lower levels of Self-Directedness (SD) and Cooperativeness (CO) than non-CPSNP patients. Cold pain tolerance, intensity, or unpleasantness did not associate with character dimensions. Conclusions Psychobiological temperament, but not character, is independently from other psychological factors associated with primary pain processing in an experimental pain setting. Patients with and without CPSNP showed different profiles on both temperament and character dimensions suggesting a combination of heightened emotional vulnerability and lowered personality adaptability in CPSNP patients. Character dimensions associated with clinical but not experimental pain. Ethical committee number The study protocol was approved by the Ethics Committee of the Helsinki and Uusimaa Hospital District (reference number: 149/13/03/00/14). Trial registry number The study is registered in ClinicalTrials.gov (NCT 02487524).
    Type of Medium: Online Resource
    ISSN: 1877-8860 , 1877-8879
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
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  • 8
    In: Cephalalgia, SAGE Publications, Vol. 38, No. 12 ( 2018-10), p. 1849-1863
    Abstract: To study the position of hemiplegic migraine in the clinical spectrum of migraine with aura and to reveal the importance of CACNA1A, ATP1A2 and SCN1A in the development of hemiplegic migraine in Finnish migraine families. Methods The International Classification of Headache Disorders 3rd edition criteria were used to determine clinical characteristics and occurrence of hemiplegic migraine, based on detailed questionnaires, in a Finnish migraine family collection consisting of 9087 subjects. Involvement of CACNA1A, ATP1A2 and SCN1A was studied using whole exome sequencing data from 293 patients with hemiplegic migraine. Results Overall, hemiplegic migraine patients reported clinically more severe headache and aura episodes than non-hemiplegic migraine with aura patients. We identified two mutations, c.1816G 〉 A (p.Ala606Thr) and c.1148G 〉 A (p.Arg383His), in ATP1A2 and one mutation, c.1994C 〉 T (p.Thr665Met) in CACNA1A. Conclusions The results highlight hemiplegic migraine as a clinically and genetically heterogeneous disease. Hemiplegic migraine patients do not form a clearly separate group with distinct symptoms, but rather have an extreme phenotype in the migraine with aura continuum. We have shown that mutations in CACNA1A, ATP1A2 and SCN1A are not the major cause of the disease in Finnish hemiplegic migraine patients, suggesting that there are additional genetic factors contributing to the phenotype.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2019999-5
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  • 9
    Online Resource
    Online Resource
    Elsevier BV ; 2020
    In:  British Journal of Anaesthesia Vol. 124, No. 3 ( 2020-03), p. e131-e133
    In: British Journal of Anaesthesia, Elsevier BV, Vol. 124, No. 3 ( 2020-03), p. e131-e133
    Type of Medium: Online Resource
    ISSN: 0007-0912
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2011968-9
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  • 10
    In: American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, Wiley, Vol. 132B, No. 1 ( 2005-01-05), p. 85-89
    Abstract: Chromosomal area 19p13 contains two migraine associated genes: a Ca v 2.1 (P/Q‐type) calcium channel α 1 subunit gene, CACNA1A , and an insulin receptor gene, INSR . Missense mutations in CACNA1A cause a rare Mendelian form of migraine, familial hemiplegic migraine type 1 (FHM1). Contribution of CACNA1A locus has also been studied in the common forms of migraine, migraine with (MA) and without aura (MO), but the results have been contradictory. The role of INSR is less well established: A region on 19p13 separate from CACNA1A was recently reported to be a major locus for migraine and subsequently, the INSR gene was associated with MA and MO. Our aim was to clarify the role of these loci in MA families by analyzing 72 multigenerational Finnish MA families, the largest family sample so far. We hypothesized that the potential major contribution of the 19p13 loci should be detected in a family sample of this size, and this was confirmed by simulations. We genotyped eight polymorphic microsatellite markers surrounding the INSR and CACNA1A genes on 757 individuals. Using parametric and non‐parametric linkage analysis, none of the studied markers showed any evidence of linkage to MA either under locus homogeneity or heterogeneity. However, marginally positive lod scores were observed in three families, and thus for these families the results remain inconclusive. The overall conclusion is that our study did not provide evidence of a major MA susceptibility region on 19p13 and thus we were not able to replicate the INSR locus finding. © 2004 Wiley‐Liss, Inc.
    Type of Medium: Online Resource
    ISSN: 1552-4841 , 1552-485X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2005
    detail.hit.zdb_id: 2143866-3
    SSG: 12
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