A multifunctional role for GRP in mammals has been firmly established. GRP and its receptors are present in the brains and peripheral tissues of several non-mammalian species including teleost fish, but little is known about the ventilatory and cardiovascular effects of GRP in these vertebrates. The goal of this study was to compare the central and peripheral actions of trout GRP on ventilatory and cardiovascular variables in the unanesthetized rainbow trout. Compared to vehicle only, intracerebroventricular injection of GRP (1- 50 pmol) significantly (P < 0.05) elevated the ventilation frequency (VF) and the ventilation amplitude (VA) and consequently the total ventilation (VTOT). The maximum hyperventilatory effect of GRP (VTOT: +225 %), observed at a dose of 50 pmol, was mostly due to its stimulatory action on VA (+170 %) rather than VF (+20%). In addition, GRP produced a significant increase in mean dorsal aortic blood pressure (PDA) (50 pmol; +35 %) and heart rate (HR) (50 pmol; +25 %). Intra-arterial (IA) injections of GRP (5-100 pmol) were without consistent effect on the ventilatory variables. The doses of 50 and 100 pmol GRP elevated PDA by the same amount (+20 %) (P < 0.05) but only the 50 pmol dose significantly increased HR (+15 %). In conclusion, our study suggests that endogenous GRP within the brain of the trout may act as a potent neurotransmitter and/or neuromodulator in the regulation of cardio-ventilatory functions. In the periphery, endogenous GRP may act as local and/or circulating hormone with an involvement in vasoregulatory mechanisms.

Définir les critères thérapeutiques et cliniques, ainsi que les obstacles et les contre-indications pris en compte lors de la prescription d’opioïdes forts (OF).

To investigate the feasibility and effect of a multimodal program for improving chronic cervicogenic headache (CGH) via the addition of sagittal cervical spine alignment correction.Pilot, parallel-group, randomized controlled trial.60 patients with CGH, straightening of the cervical lordosis, and forward head posture (FHP) were randomly assigned using permuted-block randomization either to a control (n = 30) or an experimental group (n = 30).Subjects in both groups received a multimodal program where the denneroll cervical spine extension traction orthotic was added to the experimental group only. Feasibility was assessed through recruitment rate, compliance rate, adherence rate, safety, and global satisfaction in addition to clinical outcome measures: FHP distance, cervical lordosis, headache frequency, headache disability inventory (HDI), headache impact test-6 (HIT-6), and daily defined dose (DDD). Evaluations were performed at: baseline, 10 weeks, 1 year follow up, and 2-year follow up. The assessor was blind to group allocation for all measured outcomes.The recruitment rate was 60%, 78 % out of them completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded and greater overall satisfaction with the interventions was reported. Greater improvements were found for the experimental group's cervical lordosis (f = 259.9, P< < .001) and FHP (f = 142.5, P< < .001). At 10 weeks, both groups showed equal improvements in CGH outcomes: headache frequency (P = 0.07), HDI (P = 0.07), HIT-6 (P = .2), and DDD (P = .3). In contrast, at the 1-year and 2-year follow up, between group differences were found for all CGH outcomes, P < .00, indicating greater improvement in the experimental group.The results indicated feasibility for recruitment rate, compliance rate, exercise session adherence, safety, and global satisfaction. At 1-year and 2-year follow-up, the addition of the denneroll orthotic device revealed positive influence on CGH management outcomes.The trial was retrospectively registered with the Pan African Clinical Trial Registry (PACTR201605001650300).

Près de 20 % des adultes souffrent de douleurs chroniques. Malgré l’existence de recommandations sur l’utilisation de la classe des opioïdes forts (OF), des barrières à la prescription existent. Pour comprendre les représentations mentales et les comportements précédant la prescription d’OF, un questionnaire a été adressé à 500 médecins dans le département du Finistère. Cent quatorze réponses ont été retournées (22,8 %).

European Journal of Pain SupplementsVolume 5, Issue S1 p. 41-42 T219 FAILED PAIN TREATMENTS AFTER REOPERATION FOR FAILED BACK SURGERY SYNDROME (FBSS) N. Mimassi, N. Mimassi Consultation Douleurs Chroniques Rebelles, Service EFN, Hôpital Morvan - CHRU Brest, BrestSearch for more papers by this authorF. Marchand, F. Marchand Consultation Douleurs Chroniques Rebelles, Service EFN, Hôpital Morvan - CHRU Brest, BrestSearch for more papers by this authorD. Baron, D. Baron Consultation Multidisciplinaire Douleurs Chroniques, Centre Rééducation Fonctionnelle de Trestel, Centre Hospitalier Lannion, Lannion, FranceSearch for more papers by this author N. Mimassi, N. Mimassi Consultation Douleurs Chroniques Rebelles, Service EFN, Hôpital Morvan - CHRU Brest, BrestSearch for more papers by this authorF. Marchand, F. Marchand Consultation Douleurs Chroniques Rebelles, Service EFN, Hôpital Morvan - CHRU Brest, BrestSearch for more papers by this authorD. Baron, D. Baron Consultation Multidisciplinaire Douleurs Chroniques, Centre Rééducation Fonctionnelle de Trestel, Centre Hospitalier Lannion, Lannion, FranceSearch for more papers by this author First published: 30 January 2012 https://doi.org/10.1016/S1754-3207(11)70137-7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume5, IssueS1September 2011Pages 41-42 RelatedInformation

European Journal of Pain SupplementsVolume 4, Issue S1 p. 144-144 510 LIVING WITH NEUROPATHIC PAIN: CONSEQUENCES OF PSYCHOLOGICAL FACTORS IN THE DISEASE EVOLUTION I. Franco, I. Franco Pain Department, University Hospital, BronSearch for more papers by this authorF. Marchand, F. Marchand University Hospital, BrestSearch for more papers by this authorN. Mimassi, N. Mimassi University Hospital, BrestSearch for more papers by this authorD. Perronet, D. Perronet Pain Department, General Hospital, Macon, FranceSearch for more papers by this author I. Franco, I. Franco Pain Department, University Hospital, BronSearch for more papers by this authorF. Marchand, F. Marchand University Hospital, BrestSearch for more papers by this authorN. Mimassi, N. Mimassi University Hospital, BrestSearch for more papers by this authorD. Perronet, D. Perronet Pain Department, General Hospital, Macon, FranceSearch for more papers by this author First published: 06 January 2012 https://doi.org/10.1016/S1754-3207(10)70515-0Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume4, IssueS1April 2010Pages 144-144 RelatedInformation

Introduction: Sjogren's syndrome is an auto-immune disease that can affect multiple areas of the body. Pain in Sjogren's syndrome affects everyone differently. Local or widespread pain can be described. Objectives: The aim of this retrospective study was to describe clinical pain manifestations, specially neuropathic pain and perspectives in the evaluation and treatment of primary or secondary SS. Materials and methods: Patients 11. Neurological and muscular examination, pain evaluation: VAS, DN4, Saint-Antoine questionnaire, von Frey hairs. Results: The clinical manifestations were: Arthralgia, arthritis pain, oral mucosa burning sensation, temporomandibular disorders, tension type headache and migraine Widespread muscular pain, abdominal pain, glossodynia Painful sensory neuropathy with or without sensory ataxia, autonomic disorders. Discussion: Although this study confirms that chronic pain in SS is related to different etiologies, we did not find any characteristic clinical pain symptoms in relation with SS. In patients with neuropathy, initial symptom of neuropathy was constantly paresthesia or painful dysesthesia in the distal portions of the extremities, with later extending proximally to involve the entire legs and arms. Clinical sign's of small nervous fiber were noted. Autonomic sign's are described. Conclusion: Beside the non neuropathic pain, we note in some patients the development of painful sensory neuropathy. Perspectives: Neuropathic pain in SS must be evaluated and diagnosed early in the disease evolution. Use of QST and the development of new therapeutics agents: AV411 a glial attenuator that suppresses pro-inflammatory cytokines IL-1 beta, TNF alpha, IL-6, and Tapentadol with its opioid and noradrenergic mechanisms help to treat neuropathic pain in SS.

SUMMARY In mammals, pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) are involved in cardiovascular and respiratory regulation. Several studies have demonstrated the presence of PACAP, VIP and their receptors in various tissues of teleost fish, including the brain, but little is known about their respiratory and cardiovascular effects. The present study was undertaken to compare the central and peripheral actions of graded doses (25-100 pmol) of trout PACAP and trout VIP on ventilatory and cardiovascular variables in the unanaesthetized rainbow trout. Compared with vehicle, only intracerebroventricular injection of PACAP significantly (P<0.05) elevated the ventilation frequency and the ventilation amplitude, but both peptides significantly increased the total ventilation (). However, the maximum hyperventilatory effect of PACAP was approximately 2.5-fold higher than the effect of VIP at the 100 pmol dose (PACAP, =+5407±921 arbitrary units, a.u.; VIP, =+2056±874 a.u.; means ± s.e.m.). When injected centrally, only PACAP produced a significant increase in mean dorsal aortic blood pressure (PDA) (100 pmol: +21%) but neither peptide affected heart rate (fH). Intra-arterial injections of either PACAP or VIP were without effect on the ventilatory variables. PACAP was without significant action on PDA and fH while VIP significantly elevated PDA (100 pmol: +36%) without changing fH. In conclusion, the selective central hyperventilatory actions of exogenously administered trout PACAP, and to a lesser extent VIP, suggest that the endogenous peptides may be implicated in important neuroregulatory functions related to the central control of ventilation in trout.

European Journal of PainVolume 13, Issue S1 p. S133c-S134 444 DIFFICULTIES TO STOP SENSITIZATION TO PAIN IN THE RELATED SPONDYLARTHROPATHIES TO ANKYLOSING SPONDYLITIS N. Mimassi, N. Mimassi Pain clinic Hopital Morvan CHU Brest, Brest, FranceSearch for more papers by this authorD. Baron, D. Baron Centre hospitalier de Lannion, Trevou-Treguiniec, FranceSearch for more papers by this authorF. Marchand, F. Marchand Pain clinic Hopital Morvan CHU Brest, Brest, FranceSearch for more papers by this author N. Mimassi, N. Mimassi Pain clinic Hopital Morvan CHU Brest, Brest, FranceSearch for more papers by this authorD. Baron, D. Baron Centre hospitalier de Lannion, Trevou-Treguiniec, FranceSearch for more papers by this authorF. Marchand, F. Marchand Pain clinic Hopital Morvan CHU Brest, Brest, FranceSearch for more papers by this author First published: 12 January 2012 https://doi.org/10.1016/S1090-3801(09)60447-XRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume13, IssueS1September 2009Pages S133c-S134 RelatedInformation

The present study was undertaken to determine the central and peripheral actions of trout angiotensin III (ANG III) on heart rate (HR) and mean dorsal aortic blood pressure (PDA) in the unanaesthetized rainbow trout. Intracerebroventricular injection of ANG III (5–100 pmol) produced a significant and dose‐dependent increase in HR without significant change in PDA. In contrast, when injected peripherally ANG III (5–50 pmol) evoked a significant and dose‐dependent increase in PDA. The hypertensive responses were accompanied by a bradycardia that reached significance only for the highest dose of ANG III tested. In conclusion, our results have shown that ANG III has potent and contrasting cardiovascular actions depending on whether its site of action is the brain or the peripheral circulation. Endogenous ANG III may have important physiological functions in teleost fishes.

Cibler les soins contre les lombalgies rebelles non liées à la maladie chez la personne souffrant de la MP. Suivi des douleurs chez 49 patients traités pour une MP. Examen clinique ciblé ; évaluations : EVA ; EN ; QDSA/DN4 ; HAD, Ashworth, MMS, Quebec, Lequesne, Constant et Rachis cervical. La prévalence des douleurs chroniques est de 46 % pour la tranche d'âge jusqu'à 59 ans et de 68 % à partie de 60 ans. Les douleurs chroniques sont classées en deux catégories : a) indépendantes (28 %) de la MP : cervico-scapulaires, lombalgies, gonalgies et autres, b) dépendantes (41 %) de la MP : associées à des mouvements anormaux, aux dyskinésies, à l'akathisie et enfin, les douleurs neuropathiques notamment les brûlures. Parmi les douleurs non liées à la MP, plus de 70 % sont d'origine musculo-squelettique : lombalgies (62 %) avec les éléments sémiologiques neuropathiques, gonalgies (17 %), cervico-scapulalgies (18 %) et autres. Les douleurs en rapport direct avec la MP sont plus intenses alors que les douleurs indépendantes qui sont essentiellement représentées par les lombalgies et les douleurs dans les cuisses (44 % des cas) et les genoux. Essentiellement les soins de kiné (protocole spécifique) et le traitement antalgique. Soins de support. Pourquoi la prévalence des douleurs chroniques ostéo-articulaires est-elle plus importante dans la MP que dans la population générale ? Les douleurs non liées à la MP sont communes dans l'évolution de la maladie. Les soins antalgiques appropriés existent. Il faut identifier ces douleurs pour les soigner précocement.

Cibler la prévalence des douleurs neuropathiques dans l'évolution des lombalgies chroniques chez les patients consultant dans une structure de consultation des douleurs chroniques rebelles. Patients sans aucun antécédent chirurgical lombaire. Durée de l'évolution des signes (5,4 mois). Aucune autre source de douleurs neuropathiques. Examen clinique standard. Exploration fonctionnelle neurologique. Imagerie. Échelle D-L Quebec pour les lombalgies Sémiologie neuropathique évaluée à l'aide des questionnaires QDSA et DN4 ; Échelle HADS pour le syndrome anxio-dépressif. Inclusion de 59 patients : [50-59 ans] ; prépondérance féminine (52 %) ; hommes (48 %). La lombalgie est le motif essentiel de la consultation. L'association de douleurs mécaniques (36,2 %) et neuropathiques (39 %) est constamment notée. L'intensité des douleurs augmente pendant la journée et l'évaluation des douleurs neuropathiques est presque équivalente chez les hommes (51 %) que chez les femmes (49 %). La prévalence importante des signes neuropathiques est dépendante de l'âge et surtout de la durée de l'évolution. Les signes neuropathiques les plus notés sont par ordre de fréquence : élancements, engourdissement, étau, brûlures, décharges électriques, picotements et allodynie à la pression. Le score HAD est élevé et corrélé avec la durée de l'évolution. L'anatomo-physiopathologie des lésions à l'origine du dysfonctionnement neurologique en lien avec la chronicité. Attirer l'attention sur l'installation rapide des douleurs neuropathiques dans les lombalgies afin de prévenir le passage à la chronicité. L'utilisation du DN4 facilite cette démarche et empêcherait l'installation de la sensibilisation périphérique dans un premier temps, puis centrale. Intérêt de l'éducation thérapeutique.

Les douleurs neuropathiques touchent un nombre important de personnes de tout âge, avec des pathologies très diverses. Plus ou moins intenses, les douleurs neuropathiques ont différentes étiologies. Elles doivent être considérées par l’ensemble des acteurs intervenants auprès du patient. Plusieurs rééducateurs du Centre de référence maladies rares neuropathies amyloïdes familiales et autres neuropathies périphériques rares (CRMR), assistés par le Comité de lutte contre la douleur (CLUD) ont mis en application la méthode de rééducation sensitive des douleurs neuropathiques développée par Claude Spicher. Cette méthode, reconnue au niveau international, est fondée sur une reprogrammation des sensations cutanées en stimulant les récepteurs sensitifs, ce qui incite le système somesthésique à se réorganiser. Elle combine une évaluation permanente et une auto-rééducation. Le patient prend ainsi en charge sa maladie de manière active, en partenariat avec les thérapeutes. L’intérêt de la rééducation sensitive est illustré par un cas clinique.Neuropathic pain affects a large number of patients of all ages and with very different pathologies. They must be considered by all the actors who intervene with the patients. Several therapists of the Rare Disease Reference Center for Familial Amyloid Neuropathies and Other Rare Peripheral Neuropathies (CRCR), assisted by the Pain Control Committee (CLUD), have applied the Spicher method for sensitive rehabilitation to reduce mechanical allodynia. This method, internationally renowned, consists in reprogramming the sensations of the skin by stimulating the sensitivity what incites the somesthetic system to be reorganized. It combines continuous evaluation and self rehabilitation. The patient thus actively takes charge of his disease, with the necessary care and supervision, in partnership with therapeutics. A clinical case illustrates the relevance of somatosensory rehabilitation.

Abstract: Although in most vertebrate species urotensin‐II (UII) is synthesized in neurons of the central nervous system, little is known regarding the physiological actions of UII in the brain. We have investigated the effects of intracerebroventricular (ICV) administration of synthetic trout UII (1, 5, and 50 pmol) on total motor activity (ACT), ventilatory frequency (VF), ventilatory amplitude (VA), and heart rate (HR) in the unanesthetized trout. ICV injection of UII increased ACT in a dose‐dependent manner, and the maximal effect was observed at a dose of 5 pmol. At doses of 1 and 5 pmol, UII did not affect VF, VA, or HR. At the highest dose tested (50 pmol), UII not only increased ACT, but also significantly activated VF, VA, and HR. In contrast, ICV injection of synthetic trout angiotensin‐II (5 pmol) did not produce any effect on ACT, VF, or VA, but sharply increased HR. These data provide the first evidence that UII can act centrally to induce motor activity in a nonmammalian vertebrate species.