Psychosocial and psychophysical assessment in paediatric patients and young adults with chronic back pain: A cluster analysis.

BACKGROUND: Identifying subgroups with different clinical profiles may inform tailored management and improve outcomes. The objective of this study was to identify psychosocial and psychophysical profiles of children and adolescents with chronic back pain. METHODS: One hundred and ninety-eight patients with chronic back pain were recruited for the study. Pain assessment was mainly conducted in the form of an interview and with the use of validated pain-related questionnaires assessing their psychosocial factors and disability. All patients underwent mechanical and thermal quantitative sensory tests assessing detection and pain thresholds, and conditioned pain modulation efficacy. RESULTS: Hierarchal clustering partitioned our patients into three clusters accounting for 34.73% of the total variation of the data. The adaptive cluster represented 45.5% of the patients and was characterized to display high thermal and pressure pain thresholds. The high somatic symptoms cluster, representing 19.2% of patients, was characterized to use more sensory, affective, evaluative and temporal descriptors of pain, more likely to report their pain as neuropathic of nature, report a more functional disability, report symptoms of anxiety and depression and report poor sleep quality. The pain-sensitive cluster, representing 35.4% of the cohort, displayed deep tissue sensitivity and thermal hyperalgesia. CONCLUSIONS: This study identified clinical profiles of children and adolescents experiencing chronic back pain based on specific psychophysical and psychosocial characteristics highlighting that chronic pain treatment should address underlying nociceptive and non-nociceptive mechanisms. SIGNIFICANCE: To our current knowledge, this study is the first to conduct cluster analysis with youth experiencing chronic back pain and displays clinical profiles based on specific physical and psychosocial characteristics. This study highlights that in a clinical context, chronic pain assessment should include multiple elements contributing to pain which can be assessed in a clinical context and addressed when pathoanatomical symptoms are unidentifiable.

Preparation and characterization of diaspirin cross-linked hemoglobin solutions for preclinical studies.

During 1990 and 1991 the capability for repetitive, consecutive production of DCLHb solution to meet a rigorous and complete set of product criteria was demonstrated. In addition, through periodic monitoring of product stored under controlled conditions, the stability of all lots of DCLHb solution during frozen storage was demonstrated for more than a year. In this way, assurance was provided that the DCLHb solution used in preclinical testing met all product criteria throughout the biological testing period.

Contagious ecthyma in bighorn sheep and mountain goat in western Canada.

Contagious ecthyma (CE) is reported in bighorn sheep (Ovis c. canadensis) from several national parks in western Canada and in moutain goat (Oreamnos americanus) from Kootenay National Park, British Columbia. (This is the first report of CE in mountain goat.) Diagnosis was based on clinical signs, histopathology, transmission experiments and the demonstration of a proxvirus with the electron microscope. The infection was transmitted from wild to domestic goat, but not to domestic sheep. Most infections, some of them severe, were found in lambs and kids. Clinical signs of disease were similar to those seen in domestic sheep and goats. General body condition was poor and animals had difficulty feeding normally. All infected herds had prolonged contact with areas where salt was provided artificially (i.e., salt blocks, highways and campgrounds). Fewer infected sheep were observed annually when salt blocks were removed from Jasper National Park.