The population prevalence of chronic pain in the United States was lower than previously reported, with smaller sex-related differences and some variation by race/ethnicity.

Some patients with myofascial pain from temporomandibular disorders (TMD) report pain in extra-trigeminal body regions. Our aim was to distinguish TMD as regional musculoskeletal pain syndrome (n=23) from a widespread pain syndrome (FMS; n=18) based on patients' tender point scores, pain drawings and quantitative sensory testing (QST) profiles. Referenced to 18 age- and gender-matched healthy subjects significant group differences for cold, pressure and pinprick pain thresholds, suprathreshold pinprick sensitivity and mechanical detection thresholds were found. Pain sensitivity in TMD patients ranged between those of FMS patients and healthy controls. The group of TMD patients was inhomogeneous with respect to their tender point count with an insensitive group (n=12) resembling healthy controls and a sensitive TMD group (n=9) resembling FMS patients. Nevertheless sensitive TMD patients did not fulfil diagnostic criteria for FMS in regard to widespread pain as shown by their pain drawings. TMD subgroups did not differ with respect to psychological parameters. The sensitive subgroup was more sensitive compared to healthy controls and to insensitive TMD patients in regard to their QST profile over all test areas as well as to their tenderness over orofacial muscles and trigeminal foramina. However, sensitive TMD patients had a short pain duration arguing against a transition from TMD to FMS over time. Data rather suggest an overlap in pathophysiology with FMS, e.g. a disturbance of central pain processing, in this subgroup of TMD patients. Those patients could be identified on the basis of their tender point count as an easy practicable screening tool.

The aim of this study is to investigate the effects of anxiety, depression, and coping on quality of life in patients after liver transplantation. Patients were asked to fill out a postal survey. Two hundred thirty-six of 375 patients (63%) who entered the study returned the questionnaires, and 186 of these patients could be included in the assessment. Anxiety and depression were surveyed using the Hospital Anxiety and Depression Scale; health-related quality of life, using the 36-Item Short-Form Health Survey; and coping strategies, using the Freiburg Questionnaire on Coping With Illness. In terms of physical and mental dimensions of health-related quality of life, psychosocial factors are far more relevant in liver transplant recipients than purely somatic factors, such as the number of posttransplantation complications or length of hospital stay. Through multiple regression analysis, we were able to account for 51% of the variance in the physical dimension of health-related quality of life and 58% of the variance in the mental dimension. Physical factors of depression, age, and employment and mental factors of anxiety and depression were significant for predicting healthrelated quality of life after liver transplantation. Depressive coping, anxiety, and depression, as well as aspects of the social environment, contribute considerably to determine well-being and health-related quality of life of patients after liver transplantation. O ver the past 15 years, liver transplantation has proven to be the treatment of choice in patients with terminal liver disease. The 1-year survival rate is approximately 80%; after 8 years, 61% of patients are still alive. 1 From the physician's point of view, it is necessary to optimize therapy with immunosuppressants and minimize complications with medical treatment. Diabetes mellitus, malignancies, weight gain, and, particularly, non-Hodgkin's lymphomas have been observed, in addition to increased rates of hypertension. Furthermore, the likelihood of fractures increases after transplantation. 2,3 These associated diseases, along with the transplantation procedure itself and changes in the patient's surroundings, exert considerable influence on a patient's quality of life.Previous investigations into quality of life in transplant recipients focused primarily on the relation between medical treatment and transplantation, i.e., type of immunosuppression, duration and severity of illness, and course of the transplantation (revisions, retransplantation, rejection responses), in addition to effects of these factors on patients' quality of life. 4,5 Posttransplantation health-related quality of life is impaired by disease severity and previous transplantations. 6 A controlled study found no difference in quality of life or psychiatric outcomes between patients who underwent liver transplantation because of alcoholic liver disease and those who underwent liver transplantation because of other chronic liver diseases. 7 Previous results indicated that lung, heart, and liver transplant re...

No abstract

No abstract