These circuits provide a potential neural basis for observed positive associations between anger-out and pain responsiveness. The role of endogenous opioids in modulating activity in these interlinked brain regions is explored, and implications for understanding pain-related effects of anger-out are described.
An opioid dysfunction hypothesis is presented in which inadequate endogenous opioid inhibitory activity in these brain regions contributes to links between trait anger-out and pain. A series of studies is presented that supports the opioid dysfunction hypothesis, further suggesting that gender and genetic factors may moderate these effects. Finally, possible implications of interactions between trait anger-out and state behavioral anger expression on endogenous opioid analgesic activity are described. (c) 2009 Elsevier Selleckchem CP673451 Ltd. All rights reserved.”
“Objectives. Except for compression therapy, physical therapy has scarcely been evaluated in the treatment of chronic venous disorders (CVD). Spa treatment is a popular way to administer physical therapy for CVD in France, but its efficacy has not been evaluated yet. SGC-CBP30 purchase This study aimed to assess the efficacy
of balneotherapy associated with patient education, as performed in the spa resort of La Lechere, in patients with advanced chronic venous insufficiency (CEAP clinical classes C4/C5).
Methods. The study was a randomized controlled trial, spa therapy being administered on top of the usual LY294002 medical care. Evaluation was by a blinded independent investigator. Subjects were patients with primary or post-thrombotic CVD with skin changes but no active ulcer (C4a, C4b, or C5), living
in Grenoble area, and willing to undergo a spa treatment course in La Lechere. The treated group had the three week spa treatment course in La Lechere, soon after randomization; the control group also had a spa treatment, but starting at day 365. The treatment consisted of four balncology sessions per day, six days a week during three weeks, and three educational workshops. An independent follow-tip was performed in Grenoble hospital every three months for 15 months. The main outcome criterion was the severity of the skin changes, as evaluated by means of malleolar chromametry. Quality of life, as measured by the Chronic Venous Insufficiency Questionnaire 2 scale, a visual analog scale (VAS) for leg symptoms, and the occurrence of leg ulcers were used as secondary criteria. The year after spa treatment in the treated group was compared with the year before spa treatment in the control group.
Results. Fifty-nine subjects were enrolled (29 in the treatment group and 30 in the control group). No statistically significant difference between groups was found at study onset regarding age, sex, etiology, CEAP “”C”" class, and the outcome variables.