Background: There are currently no data on the prevalence and incidence of chronic pain in the Philippines. Objective: This study was undertaken to determine the incidence and prevalence of chronic pain in the general adult population of the Philippines. It also aimed to establish the demographic profile of chronic pain sufferers, identify the causes and intensity of chronic pain, and understand the impact of chronic pain on daily living and quality of life. This study also explored current treatment practices for patients with chronic pain, their levels of satisfaction with treatment, and barriers to obtaining appropriate treatment. Methodology: The study was conducted in the Philippines via a quantitative sample survey that involved face-to-face interviews using a two-phase structured questionnaire. Results: The survey showed an overall prevalence of moderate-to-severe chronic pain (chronic pain M+S) of 10.4% of the general adult population, with an annual incidence rate of 3.4%. Chronic pain M+S was more commonly reported by women and the elderly. The most common locations of pain were the knees, back and lower back. Daily routine was affected in about half of the sufferers, but they had rational attitudes to pain and positive views of medical treatment. High consultation fees discouraged nearly two-thirds of sufferers from seeking medical advice for their pain. Despite the availability of effective pain treatments, a large proportion of patients taking prescription painkillers reported that the medication was less than effective, indicating a large gap between achievable pain relief targets and patients’ expectations of pain medications. Conclusion: The Philippines has a relatively high prevalence of chronic pain M+S. There is a need for improved pain management to ensure that patients with chronic pain receive appropriate and effective treatment.

There is a growing awareness and acceptance of the benefits for cancer pain patients derived from psychiatric contributions to pain control. Unfortunately, cancer patients with pain are more vulnerable to psychiatric complications of cancer such as depression, anxiety and delirium. Knowledge of the indications and usefulness of the psychotropic drugs in the cancer pain population will be the most rewarding, particularly because these drugs are useful not only in the treatment of psychiatric complications of cancer, but also as adjuvant analgesic agents in the management of cancer pain.
PAIN MANAGEMENT

OBJECTIVES: This study aimed to develop and validate a simple questionnaire for chronic neuropathic pain that can be administered as a screening tool by general practitioners and internists in order to help them identify patients with probable neuropathic pain.
METHODS: Following a development phase and a pilot study, the revised version of the screening tool which included eleven descriptors associated with neuropathic pain both in English and Filipino languages was validated on 120 consecutive patients with any type of pain except psychogenic pain, recruited in the out-patient clinics of six hospitals. The questionnaire was validated by assessing the sensitivity, specificity, positive and negative predictive value of each item and the overall questionnaire. The internal consistency of the questionnaire items was assessed using the Kuder-Richardson formula 20.
RESULTS: Overall, the internal consistency of the SigN-PQ using the Kuder-Richardson formula 20 was 0.7837; the sensitivity was 91.89% with specificity of 80.22%, PV (+) was 65.38% and PV(-) was 96.0%. For the English version, the descriptors with the highest scores were burning (Sensitivity: 100%, Specificity: 93%) and electricity-like (Sensitivity: 100%, Specificity: 93%). For the Filipino version, mainit (burning) has the highest sensitivity of 88% with specificity of 82.6%, followed by gumagapang (tingling) with sensitivity of 86.96% and specificity of 85.42%. The sensation of saksak (stabbing) and hiwa (lancinating) have the lowest sensitivity, 60% and 54% respectively, although their specificity scores are high. Since this study is a validation of a screening tool for neuropathic pain, the investigators decided to choose descriptors with higher sensitivity. Thus, in the final version of the SignN-PQ, the descriptors saksak and hiwa were removed.
CONCLUSION: The SigN-PQ Neuropathic Pain Questionnaire has a high overall sensitivity of 91.89% and specificity of 80.22%. The pain descriptors in the questionnaire are consistent with the descriptors cited in the literature. It is a valid screening instrument for neuropathic pain that can be easily incorporated in the daily practice of general practitioners and internists.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Neuralgia ; Pain ; Diagnosis ; General Practitioners ; Outpatients ; Research Personnel ; Sensitivity And Specificity ; Surveys And Questionnaires

Objective To study the repairing mechanism of mechanical microdamage around implants in the cortical bone of rats. Methods Thirty rats were divided into the ovariectomy group (OVX) and the sham group. At three months after the ovariectomy, a hole was drilled in the right tibial diaphysis by a metal pin. The rats were executed at 1, 2 and 4 weeks, respectively, after the hole drilling. The tetracycline and calcein labeling were performed before the execution. Bone segments containing the hole were stained with the basic fuchsin, embedded in the methylmethacrylate and cut into sections with thickness of 50 μm. Histomorphometric measurement was conducted on bone sections using Bioquant image analysis system. Results Bone resporpion cavities related to the microdamage occurred in both the OVX rats and the sham operated rats. The bone porosity and the number of bone resorption cavities were both greater in the OVX rats than that in the sham operated rats (P<0.05). In addition, the number of bone resorption cavities significantly increased with time after the surgery (P<0.05). Conclusions Increased bone porosity and resorption cavities in OVX rats may be related to the crack formation and the estrogen deficiency, which made the bone remodeling in the cortical bone of OVX rats more active. However, remarkably increased resorption cavities would reduce the bone strength and increase the risk of bone fracture.

Adult ; Aged ; China ; epidemiology ; Female ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Trauma Centers ; Trauma Severity Indices ; Wounds and Injuries ; epidemiology ; mortality

The mammalian epididymis not only plays a fundamental role in the maturation of spermatozoa, but also provides protection against various stressors. The foremost among these is the threat posed by oxidative stress, which arises from an imbalance in reactive oxygen species and can elicit damage to cellular lipids, proteins, and nucleic acids. In mice, the risk of oxidative damage to spermatozoa is mitigated through the expression and secretion of glutathione peroxidase 5 (GPX5) as a major luminal scavenger in the proximal caput epididymidal segment. Accordingly, the loss of GPX5-mediated protection leads to impaired DNA integrity in the spermatozoa of aged Gpx5