Korean Journal of Pain最新文献

{"title":"Calcium/calmodulin-dependent protein kinase II is involved in the transmission and regulation of nociception in naïve and morphine-tolerant rat nucleus accumbens.","authors":"Kai Wen Xi, De Duo Chen, Xin Geng, Yan Bian, Min Xin Wang, Hui Bian","doi":"10.3344/kjp.22372","DOIUrl":"10.3344/kjp.22372","url":null,"abstract":"<p><strong>Background: </strong>Synaptic plasticity contributes to nociceptive signal transmission and modulation, with calcium/calmodulin-dependent protein kinase II (CaMK II) playing a fundamental role in neural plasticity. This research was conducted to investigate the role of CaMK II in the transmission and regulation of nociceptive information within the nucleus accumbens (NAc) of naïve and morphine-tolerant rats.</p><p><strong>Methods: </strong>Randall Selitto and hot-plate tests were utilized to measure the hindpaw withdrawal latencies (HWLs) in response to noxious mechanical and thermal stimuli. To induce chronic morphine tolerance, rats received intraperitoneal morphine injection twice per day for seven days. CaMK II expression and activity were assessed using western blotting.</p><p><strong>Results: </strong>Intra-NAc microinjection of autocamtide-2-related inhibitory peptide (AIP) induced an increase in HWLs in naïve rats in response to noxious thermal and mechanical stimuli. Moreover, the expression of the phosphorylated CaMK II (p-CaMK II) was significantly decreased as determined by western blotting. Chronic intraperitoneal injection of morphine resulted in significant morphine tolerance in rats on Day 7, and an increase of p-CaMK II expression in NAc in morphine-tolerant rats was observed. Furthermore, intra-NAc administration of AIP elicited significant antinociceptive responses in morphine-tolerant rats. In addition, compared with naïve rats, AIP induced stronger thermal antinociceptive effects of the same dose in rats exhibiting morphine tolerance.</p><p><strong>Conclusions: </strong>This study shows that CaMK II in the NAc is involved in the transmission and regulation of nociception in naïve and morphine-tolerant rats.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 2","pages":"163-172"},"PeriodicalIF":3.4,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/c7/kjp-36-2-163.PMC10043793.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9196231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current scenario and future applicability of antivirals against herpes zoster.","authors":"Sang Hun Kim","doi":"10.3344/kjp.22391","DOIUrl":"https://doi.org/10.3344/kjp.22391","url":null,"abstract":"<p><p>Herpes zoster (HZ) is a common disease in the aging population and immunocompromised individuals, with a lifetime risk of 20%-30% that increases with age. HZ is caused by reactivation of the varicella-zoster virus (VZV), which remains latent in the spinal dorsal root ganglia and cranial sensory ganglia after resolution of the primary VZV infection. The main focus of HZ management is rapid recovery from VZV infection as well as the reduction and prevention of zoster-associated pain (ZAP) and postherpetic neuralgia (PHN). The use of antivirals against VZV is essential in the treatment of HZ. However, limited antivirals are only licensed clinically for the treatment of HZ, including acyclovir, valacyclovir, famciclovir, brivudine, and amenamevir. Fortunately, some new antivirals against different types of <i>Herpesviridae</i> have been investigated and suggested as novel drugs against VZV. Therefore, this review focuses on discussing the difference in efficacy and safety in the currently licensed antivirals for the treatment of HZ, the applicability of future novel antivirals against VZV, and the preventive or therapeutic effects of these antivirals on ZAP or PHN.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"4-10"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/40/kjp-36-1-4.PMC9812693.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mechanism of human neural stem cell secretomes improves neuropathic pain and locomotor function in spinal cord injury rat models: through antioxidant, anti-inflammatory, anti-matrix degradation, and neurotrophic activities.","authors":"I Nyoman Semita,&nbsp;Dwikora Novembri Utomo,&nbsp;Heri Suroto,&nbsp;I Ketut Sudiana,&nbsp;Parama Gandi","doi":"10.3344/kjp.22279","DOIUrl":"https://doi.org/10.3344/kjp.22279","url":null,"abstract":"<p><strong>Background: </strong>Globally, spinal cord injury (SCI) results in a big burden, including 90% suffering permanent disability, and 60%-69% experiencing neuropathic pain. The main causes are oxidative stress, inflammation, and degeneration. The efficacy of the stem cell secretome is promising, but the role of human neural stem cell (HNSC)-secretome in neuropathic pain is unclear. This study evaluated how the mechanism of HNSC-secretome improves neuropathic pain and locomotor function in SCI rat models through antioxidant, anti-inflammatory, anti-matrix degradation, and neurotrophic activities.</p><p><strong>Methods: </strong>A proper experimental study investigated 15 <i>Rattus norvegicus</i> divided into normal, control, and treatment groups (30 μL HNSC-secretome, intrathecal in the level of T10, three days post-traumatic SCI). Twenty-eight days post-injury, specimens were collected, and matrix metalloproteinase (MMP)-9, F2-Isoprostanes, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, and brain derived neurotrophic factor (BDNF) were analyzed. Locomotor recovery was evaluated via Basso, Beattie, and Bresnahan scores. Neuropathic pain was evaluated using the Rat Grimace Scale.</p><p><strong>Results: </strong>The HNSC-secretome could improve locomotor recovery and neuropathic pain, decrease F2-Isoprostane (antioxidant), decrease MMP-9 and TNF-α (anti-inflammatory), as well as modulate TGF-β and BDNF (neurotrophic factor). Moreover, HNSC-secretomes maintain the extracellular matrix of SCI by reducing the matrix degradation effect of MMP-9 and increasing the collagen formation effect of TGF-β as a resistor of glial scar formation.</p><p><strong>Conclusions: </strong>The present study demonstrated the mechanism of HNSC-secretome in improving neuropathic pain and locomotor function in SCI through antioxidant, anti-inflammatory, anti-matrix degradation, and neurotrophic activities.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"72-83"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/51/kjp-36-1-72.PMC9812698.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10510127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imbalance in the spinal serotonergic pathway induces aggravation of mechanical allodynia and microglial activation in carrageenan inflammation.","authors":"Junxiu Jin,&nbsp;Dong Ho Kang,&nbsp;Jin Jeon,&nbsp;Hyung Gon Lee,&nbsp;Woong Mo Kim,&nbsp;Myung Ha Yoon,&nbsp;Jeong Il Choi","doi":"10.3344/kjp.22297","DOIUrl":"https://doi.org/10.3344/kjp.22297","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effect of an excess and a deficit of spinal 5-hydroxytryptamine (5-HT) on the mechanical allodynia and neuroglia activation in a rodent pain model of carrageenan inflammation.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats were implanted with an intrathecal (i.t.) catheter to administer the drug. To induce an excess or deficit of 5-HT in the spinal cord, animals were given either three i.t. 5-HT injections at 24-hour intervals or a single i.t. injection of 5,7-dihydroxytryptamine (5,7-DHT) before carrageenan inflammation. Mechanical allodynia was measured using the von Frey test for 0-4 hours (early phase) and 24-28 hours (late phase) after carrageenan injection. The changes in the activation of microglia and astrocyte were examined using immunofluorescence of the dorsal horn of the lumbar spinal cord.</p><p><strong>Results: </strong>Both an excess and a deficit of spinal 5-HT had no or a minimal effect on the intensity of mechanical allodynia during the early phase but prevented the attenuation of mechanical allodynia during the late phase, which was observed in animals not treated with i.t. 5-HT or 5,7-DHT. Animals with an excess or deficit of 5-HT showed stronger activation of microglia, but not astrocyte, during the early and late phases, than did normal animals.</p><p><strong>Conclusions: </strong>Imbalance in the descending 5-HT pathway in the spinal cord could aggravate the mechanical allodynia and enhance the activation of microglia, suggesting that the spinal 5-HT pathway plays an essential role in maintaining the nociceptive processing in balance between facilitation and inhibition in inflammatory pain caused by carrageenan inflammation.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"51-59"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/c4/kjp-36-1-51.PMC9812699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk analysis of musculoskeletal pain intervention using corticosteroid during COVID-19 pandemic: a cohort study.","authors":"Azwan Aziz Mohamad,&nbsp;Nahar Azmi Mohamed","doi":"10.3344/kjp.22249","DOIUrl":"https://doi.org/10.3344/kjp.22249","url":null,"abstract":"<p><strong>Background: </strong>Most international bodies recommended against musculoskeletal steroid injection during the COVID-19 pandemic, fearing that the immunosuppressive effects of the steroid could worsen COVID-19 infection, thus prolonging the suffering of patients with severe musculoskeletal disease. The authors' aim is to analyze the risk of COVID-19 infection after musculoskeletal injections.</p><p><strong>Methods: </strong>This is a retrospective study of patients who visited a sports medicine clinic and received musculoskeletal steroid injections between January 1, 2020 and February 28, 2021. The collected data was compared with the national COVID-19 registry to identify positive COVID-19 patients. The patients were only considered positive for COVID-19 following corticosteroid injection within 3 months after injection.</p><p><strong>Results: </strong>Out of 502 steroid injections; 79.7% (n = 400) received a single injection in one day, 19.1% (n = 96) received steroid injections at 2 sites in one day, and 1.2% (n = 6) received steroid injections at 3 sites in one day. Using the Fisher's exact test, there was no statistically significant association of COVID-19 infection between the steroid group and control group (relative risk, 1.44; 95% confidence interval, 0.9-23.1, P = 0.654). Only one patient contracted mild COVID-19 with no post COVID complications.</p><p><strong>Conclusions: </strong>The authors recommend the use of musculoskeletal steroid injections in clinically indicated situation without having increased risk of COVID-19.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"106-112"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/33/kjp-36-1-106.PMC9812694.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10868815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary somatosensory cortex and periaqueductal gray functional connectivity as a marker of the dysfunction of the descending pain modulatory system in fibromyalgia.","authors":"Matheus Soldatelli,&nbsp;Álvaro de Oliveira Franco,&nbsp;Felipe Picon,&nbsp;Juliana Ávila Duarte,&nbsp;Ricardo Scherer,&nbsp;Janete Bandeira,&nbsp;Maxciel Zortea,&nbsp;Iraci Lucena da Silva Torres,&nbsp;Felipe Fregni,&nbsp;Wolnei Caumo","doi":"10.3344/kjp.22225","DOIUrl":"https://doi.org/10.3344/kjp.22225","url":null,"abstract":"<p><strong>Background: </strong>Resting-state functional connectivity (rs-FC) may aid in understanding the link between pain-modulating brain regions and the descending pain modulatory system (DPMS) in fibromyalgia (FM). This study investigated whether the differences in rs-FC of the primary somatosensory cortex in responders and non-responders to the conditioned pain modulation test (CPM-test) are related to pain, sleep quality, central sensitization, and the impact of FM on quality of life.</p><p><strong>Methods: </strong>This cross-sectional study included 33 females with FM. rs-FC was assessed by functional magnetic resonance imaging. Change in the numerical pain scale during the CPM-test assessed the DPMS function. Subjects were classified either as non-responders (<i>i.e.</i>, DPMS dysfunction, n = 13) or responders (n = 20) to CPM-test. A generalized linear model (GLM) and a receiver operating characteristic (ROC) curve analysis were performed to check the accuracy of the rs-FC to differentiate each group.</p><p><strong>Results: </strong>Non-responders showed a decreased rs-FC between the left somatosensory cortex (S1) and the periaqueductal gray (PAG) (<i>P</i> < 0.001). The GLM analysis revealed that the S1-PAG rs-FC in the left-brain hemisphere was positively correlated with a central sensitization symptom and negatively correlated with sleep quality and pain scores. ROC curve analysis showed that left S1-PAG rs-FC offers a sensitivity and specificity of 85% or higher (area under the curve, 0.78, 95% confidence interval, 0.63-0.94) to discriminate who does/does not respond to the CPM-test.</p><p><strong>Conclusions: </strong>These results support using the rs-FC patterns in the left S1-PAG as a marker for predicting CPM-test response, which may aid in treatment individualization in FM patients.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"113-127"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/e3/kjp-36-1-113.PMC9812696.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine.","authors":"Hafize Altay,&nbsp;Seyda Toprak Celenay","doi":"10.3344/kjp.22327","DOIUrl":"https://doi.org/10.3344/kjp.22327","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine.</p><p><strong>Methods: </strong>The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively.</p><p><strong>Results: </strong>The CA severity was only associated with TKS (r = 0.515; <i>P</i> < 0.001), GSRS-total (r = 0.336; <i>P</i> < 0.001), GSRS-abdominal pain (r = 0.323; <i>P</i> < 0.001), GSRS-indigestion (r = 0.257; <i>P</i> = 0.002), GSRS-constipation (r = 0.371; <i>P</i> < 0.001), and MIDAS scores (r = 0.178; <i>P</i> = 0.033). Attack frequency (<i>P</i> = 0.015), attack duration (<i>P</i> = 0.035) and presence of CA (<i>P</i> < 0.001) were risk factors for kinesiophobia. Attack frequency (<i>P</i> = 0.027) and presence of CA (<i>P</i> = 0.004) were risk factors for GIS symptoms.</p><p><strong>Conclusions: </strong>There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"137-146"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/e5/kjp-36-1-137.PMC9812700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-impact chronic pain: evaluation of risk factors and predictors.","authors":"İlteriş Ahmet Şentürk,&nbsp;Erman Şentürk,&nbsp;Işıl Üstün,&nbsp;Akın Gökçedağ,&nbsp;Nilgün Pulur Yıldırım,&nbsp;Nilüfer Kale İçen","doi":"10.3344/kjp.22357","DOIUrl":"https://doi.org/10.3344/kjp.22357","url":null,"abstract":"<p><strong>Background: </strong>The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP.</p><p><strong>Methods: </strong>Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores.</p><p><strong>Results: </strong>One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; <i>P</i> = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; <i>P</i> = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"84-97"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/cb/kjp-36-1-84.PMC9812691.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Still a threatening opioid wave: it is time for the protagonist to step up!","authors":"Joon-Ho Lee","doi":"10.3344/kjp.22403","DOIUrl":"https://doi.org/10.3344/kjp.22403","url":null,"abstract":"ation with opioid medication in Korea in an editorial in the Korean Journal of Pain regarding the opioid crisis in the United States [1]. What changes have occurred since then? A lot of things have happened in both the United States and Korea. First of all, fentanyl, the ‘third wave’ is continuing and even growing stronger, and now mixtures with other drugs are spreading [2]. Fentanyl is killing more people despite strong government regulations. About 108,000 people died from drug overdoses in 2021, of which 71,000 died from fentanyl or fentanyl-related analogs. Illegal fentanyl overdose deaths accounted for 77% of teenage overdose deaths in 2021 [3]. The inflow of fentanyl from abroad is increasing in various forms. Furthermore, the COVID-19 pandemic has made it harder to deal with the opioid crisis. Social distancing and isolation have made it more difficult to treat addiction, provide recovery services, and maintain mental health, and unemployment and economic poverty have created more drug addiction [2,4,5]. Recently, along with pharmaceutical companies, even the big pharmaceutical retail chains in the United States have agreed to pay $13.8 billion in a settlement to resolve thousands of lawsuits over their contributions to the opioid crisis. These include CVS, Walgreens, and Walmart. They attracted addicts by selling opioids at low prices and were punished for selling drugs recklessly without checking the suitability of the diagnosis and prescription drugs, or repeated prescriptions by doctors. Also, their branch offices did not share information about customers who were rejected while attempting to purchase drugs with problematic prescriptions. Also, a number of other lawsuits are currently underway [6,7]. In Korea, the illicit use of the fentanyl patch by adolescents has become a big social issue. They put the patch in aluminum foil and heat it to inhale the fumes. They have taken advantage of the laxity of some hospitals that prescribed fentanyl patches without checking past medical history or identification [8]. What is more surprising is that fentanyl patch prescriptions have recently been increasing in veterinary hospitals, although we don’t know the exact reason why [9]. Needless to say, there has been a surge in drug-related crime in recent years. There are a lot of articles saying that Korea is no longer a drug-free country. So what do we do now? None of the problems raised in the previous article seem to have improved. Although some guidelines have been presented, there are many points to consider including whether they were made by","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"1-3"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/09/kjp-36-1-1.PMC9812690.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No more tears from surgical site infections in interventional pain management.","authors":"Seungjin Lim,&nbsp;Yeong-Min Yoo,&nbsp;Kyung-Hoon Kim","doi":"10.3344/kjp.22397","DOIUrl":"https://doi.org/10.3344/kjp.22397","url":null,"abstract":"<p><p>As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis <i>via</i> hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.</p>","PeriodicalId":56252,"journal":{"name":"Korean Journal of Pain","volume":"36 1","pages":"11-50"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/dc/kjp-36-1-11.PMC9812697.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}