Medicine and Health Sciences Commons^™

A Six-Month Comparison Of Orthodontic Pain Associated With Fixed Edgewise Appliances And Clear Aligners, Victor Chan

Theses and Dissertations

Title: A Six-Month Comparison of Orthodontic Pain Associated with Clear Aligners and Fixed Edgewise Appliances

Objective: To document and compare pain perception, intensity, and analgesic use over a sixmonth period between patients treated with fixed appliances (FA) and clear aligners (CA).

Methods: A prospective, parallel, two-arm, multi-center, longitudinal cohort study was conducted with 87 adults treated with CA (n=59) or FA (n=28). Subjects were selected according to inclusion and exclusion criteria. A seven-item, digital survey was sent at three timepoints (preappointment, 2-days post-appointment, and 7-days post-appointment) at each adjustment over a six-month period. The variables measured included pain experience, pain …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

Pharmacological Assessment Of Adjuncts To Enhance Mu-Opioid Receptor Agonist Antinociception In Male Rhesus Monkeys: Does One + One = Three?, Jeremy Cornelissen

Theses and Dissertations

Mu-opioid receptor (MOR) agonists are effective agents for pain management, but are also limited by a number of undesirable effects. One approach to enhance the therapeutic effects and minimize the undesirable effects of MOR agonists may be to combine MOR agonists with an adjunct targeting a different receptor system. This targeted medical approach, known as “combination therapy”, aims to augment the desired effects of the MOR agonist (i.e. antinociception) and/or diminish the undesirable deleterious side effects of the MOR agonist. This dissertation investigated the utility of this approach in an assay of thermal nociception and schedule-controlled responding in male rhesus …

Enhancing Adherence To Prescribed Opioids Using A Mobile-Base Application: A Pilot Study Of Feasibility In Chronic Non-Cancer Pain, Daniel M. Sop

Theses and Dissertations

In this study we present feasibility of a mobile monitoring and reporting system that would provide an accurate unbiased screening tool to systematically analyze opioid adherence in Sickle cell disease patients. In addition, the software simultaneously measures pain. The Mobile Applications Rating Scale: a new and validated tool for assessing the quality of health mobile apps for engagement, functionality, aesthetics, information quality, subjective quality, relevance and overall impact was administered post usage to evaluate the application.

A total of 28 patients were recruited to review and test the software at one sitting. The majority of the population found the application …

Effects Of Chemotherapy On Motivated Behavior And Opioid Reward In Rats, Luke P. Legakis

Theses and Dissertations

Paclitaxel, vincristine, oxaliplatin, and bortezomib are cancer chemotherapy drugs with adverse effects that include chemotherapy-induced neuropathic pain (CINP) as well as depression of behavior and mood. In the clinical setting, opioids are often used concurrently with or following chemotherapy to treat pain related to the cancer or CINP, but repeated opioid exposure can also increase the risk of opioid abuse. This dissertation evaluated the effect of chemotherapy treatment on motivated behaviors and opioid reward in rats. The main findings of this evaluation are as follows: (1) Chemotherapy, at doses that produce robust and sustained mechanical hypersensitivity produce only weak or …

Effects Of Mu Opioid Receptor Agonists On Intracranial Self-Stimulation In The Absence And Presence Of “Pain” In Rats, Ahmad Altarifi

Theses and Dissertations

Pain is a significant health problem. Mu opioid receptor agonists are used clinically as analgesics, but their use is constrained by high abuse liability. Intracranial self-stimulation (ICSS) is a preclinical behavioral procedure that has been used to assess abuse potential of opioids, and drug-induced facilitation of ICSS is interpreted as an abuse-related effect. ICSS can also be used as a behavioral baseline to detect affective dimensions of pain. Specifically, pain-related depression of ICSS can model pain-related depression of behavior and mood, and drug-induced blockade of pain-related ICSS depression can serve as a measure of affective analgesia. This dissertation used mu …

Effect Of Cannabinoids On Pain-Stimulated And Pain-Depressed Behavior In Rats, Andrew Kwilasz

Theses and Dissertations

Cannabinoids produce antinociception in many preclinical models of acute and chronic pain. In contrast, cannabinoids produce inconsistent analgesia in humans, showing little or no efficacy in treating acute pain, with modest efficacy in treating chronic inflammatory pain. This discrepancy may reflect an overreliance on preclinical assays of pain-stimulated behaviors, defined as behaviors that increase in rate or intensity following delivery of a noxious stimulus. In these assays, antinociception is indicated by a reduction in pain-stimulated behaviors, and antinociception is produced either by a reduction in sensory sensitivity to the noxious stimulus (i.e. true analgesia) or by false positive motor impairment. …

Comparison Of Injection Discomfort And Anesthetic Duration Of Plain Polocaine Versus Epinephrine Containing Articaine And Lidocaine, Dana Doan

Theses and Dissertations

Purpose: To determine possible differences in the pain level and soft tissue anesthesia duration of plain polocaine versus epinephrine-containing articaine and lidocaine during intraoral injections. Methods: Forty-eight subjects received plain polocaine and one epinephrine-containing anesthetic. Injections were randomized according to the first injection a)left or right buccal sulcus and b)epinephrine or not. The second injections were the opposite conditions. Subjects then recorded discomfort on a VAS and the time anesthesia wore off. Result: The second injection’s pain rating was influenced by the first. This carry-over effect makes it impossible to analyze all of the data. An analysis of the first …

Pain Management And Menopausal Health Outcomes In Multiple Sclerosis, Rachel Jawahar

Theses and Dissertations

Background: Previous studies have addressed multiple sclerosis (MS) symptom management and improved health-related quality of life (HrQOL). Yet lowered estrogen levels in post-menopasual women with MS may further worsen physical function and symptomology and not all types of pain management have been examined. Objectives: For post-menopausal women with MS, we evaluated the extent to which smoking is associated with worsened health outcomes and HrQOL, and the extent to which menopausal hormone treatment (MHT) improves health outcomes and HrQOL. For all adult men and women with clinically diagnosed MS, we systematically reviewed pharmacological and non-pharmacological strategies for the reduction of pain. …

Symptom Clusters In Lung Cancer Patients, Debra Rattican

Theses and Dissertations

SYMPTOM CLUSTERS IN LUNG CANCER PATIENTS By Debra Rattican, PhD, RN A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Debra E. Lyon, PhD. Professor and Chair Family and Community Health Nursing The purpose of the study was to examine selected relationships among symptoms common to individuals with lung cancer. The specific aims were: 1) To examine the relationship between the symptoms of dyspnea and anxiety in patients with lung cancer. 2) To examine the relationships among the symptoms of dyspnea, anxiety, and …

Effect Of Local Anesthesia On Postoperative Pain With General Anesthesia, Belinda Campbell

Theses and Dissertations

Purpose: The aim of this study was to determine if the use of local anesthesia with general anesthesia results in less postoperative pain. The alternative hypothesis is that children will experience less postoperative discomfort when utilizing intraligamental local anesthetic during the intra-operative time period. Methods: Patients were recruited for this single blind, randomized, prospective cohort study with the following inclusion criteria: English speaking children age 3-6 years, ASA I/II requiring general anesthesia for dental treatment. Randomization was done to place patients in groups of no local anesthetic vs. local anesthetic administration. A Wong-Baker Faces Pain Scale was utilized to evaluate …

Targeting The Endocannabinoid System To Reduce Inflammatory Pain, Sudeshna Ghosh

Theses and Dissertations

The endogenous cannabinoids (endocannabinoids) anandamide (AEA) and 2-arachidonylglycerol (2-AG) exert their effects predominantly through cannabinoid CB1 and CB2 receptors, but these actions are short-lived because of rapid hydrolysis by fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), respectively. Selective inhibition of either enzyme elevates CNS levels of the appropriate endocannabinoid and produces analgesic effects with fewer psychomimetic side effects than Δ9-tetrahydrocannabinol (THC), the primary active constituent of marijuana. While cannabinoid receptor agonists and FAAH inhibitors reliably produce anti-inflammatory and anti-hyperalgesic effects in the carrageenan test and other inflammatory pain models, much less is known about the consequences of inhibiting …

Targeting The Endocannabinoid System To Reduce Nociception, Lamont Booker

Theses and Dissertations

Pain of various etiologies (e.g., visceral, inflammatory) can be a debilitating disorder that presents a problem of clinical relevance. While it is known that ∆9-tetrahydrocannabinol (THC) the primary psychoactive constituent found in marijuana produces analgesia in various rodent models of pain, its pharmacological properties are overshadowed by its psychomimetic effects. THC is the primary phytocannabinoid found in marijuana though other prevalent constituents such as the phytocannabinoids (e.g., cannabidiol (CBD), cannabinol (CBN), cannabichromene (CBC), tetrahydrocannabivarin (THCV)) may possess antinociceptive actions without the psychomimetic effects associated with THC. Indeed, these phytocannabinoids act upon the endocannabinoid system (ECS) that is comprised of the …

Haploinsufficiency Of Rai1 And Its Effect On Bdnf Expression, Sun Kim

Theses and Dissertations

Smith-Magenis Syndrome (SMS) [OMIM, #182290] is a congenital anomaly and mental retardation (MCA/MR) syndrome associated with deletion of chromosome17p11.2 [1]. The clinical phenotype has been well described and includes minor craniofacial anomalies, self-injurious behaviors as well as sleep disturbances, speech delays, and obesity [1,2,3]. The incidence of SMS is estimated to be ~ 1:15,000 - 25,000 births [2,6]. Among SMS patients, ~90% are comprised of 17p11.2 deletions, while ~10% have RAI1 mutations [8]. All 17p11.2 deletions associated with SMS include RAI1 deletion [10]. RAI1 is thought to function as a transcriptional factor although its cellular role is still unclear. First, …

Facial Expression Discriminates Between Pain And Absence Of Pain In The Non-Communicative, Critically Ill Adult Patient, Mamoona Arif-Rahu

Theses and Dissertations

BACKGROUND: Pain assessment is a significant challenge in critically ill adults, especially those unable to communicate their pain level. At present there is no universally accepted pain scale for use in the non-communicative (cognitively impaired, sedated, paralyzed or mechanically ventilated) patient. Facial expressions are considered among the most reflexive and automatic nonverbal indices of pain. The facial expression component of pain assessment tools include a variety of facial descriptors (wincing, frowning, grimacing, smile/relaxed) with inconsistent pain intensity ratings or checklists of behaviors. The lack of consistent facial expression description and quantification of pain intensity makes standardization of pain evaluation difficult. …

The Effect Of Chronic Constriction Injury On Cellular Systems Within Nociceptive Pathways In The Mouse, Michelle Hoot

Theses and Dissertations

Chronic neuropathic pain is often difficult to treat due to its resistance to therapeutic intervention. This is due in part to the poor understanding of the physiological mechanisms involved in the establishment and maintenance of neuropathic pain states. The neuropathic pain model, chronic constriction injury of the sciatic nerve, produced robust pain hypersensitivity in our mice. It also induced significant changes in the mitogen activated protein kinase family, and the cannabinoid and µ-opioid systems in three different brain areas involved in the modulation or regulation of pain states. CCI induced a 2.5 fold increase in mRNA of the kinase Raf-1 …

The Predictive Ability Of Specific Questions Related To Symptoms In The Diagnosis Of Endodontic Disease, Boyd Aaron Vaughn

Theses and Dissertations

The purpose of this study was to test the predictive ability of specific questions in diagnosis of pulpal and periradicular disease in a dental school population. 210 patients were recruited to fill out a questionnaire, and undergo a clinical examination for pulpal and/or periradicular disease.The Questionnaire asked if the patient had in the last 6 months: 1. a toothache that kept them up at night 2. a toothache that required pain killers 3. facial swelling caused by a tooth 4. injury to any teeth 5. a broken tooth 6. a tooth darker in color than the surrounding teeth 7. a …