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Josep-E Baños

Publications and source records attributed to Josep-E Baños.

9 recordsLinked to original sources
PubMed2006

A meta-analysis of the placebo response in acute migraine and how this response may be influenced by some of the characteristics of clinical trials.

Migraine is the most common cause of vascular headache and a highly prevalent illness. In the last 20 years, the discovery of new agents has increased clinical research on migraine. In most of clinical trials that have been conducted, the efficacy was established using a placebo as a control treatment. The objective of the study reported here was to analyse the response rate in patients who received a placebo as well as to determine how a number of the methodological factors may affect the effect of the placebo in clinical trials of acute migraine. Computer-based information searches were conducted on the Medline database. Data analysis included the outcomes 'pain relief', 'pain-free', 'associated symptoms', 'recurrence', 'patients' opinion' about pain relief and 'adverse events'. Administration route, study design and country in which the study was carried out were the methodological factors that were analyzed. Meta-analysis was computed using Mantel-Haenszel, and a total of 98 papers were considered in the final analysis. After 2 h, 28.6% of the patients of the placebo group improved and 8.8% were pain-free. The percentage of pain-free patients was the highest in the placebo and active drug groups in which the placebo or drug had been administered subcutaneously, in parallel design studies (vs. cross-over trials) and in studies performed in Europe (vs. North America). Adverse events in the placebo group were significantly higher in studies performed in North America. These data reinforce the need for knowing the magnitude of the placebo response in each specific situation during the planning of clinical trials on acute migraine.

Acute Disease↗
PubMed2006

A survey of perceptions with pain management in Spanish inpatients.

The aim of this study was to document the satisfaction with pain management in a Spanish inpatient population and its relationship with pain ratings. Two hundred fifty inpatients of four departments were interviewed: Surgery, Orthopedics, Gynecology, and Internal Medicine. A 32-item questionnaire was used, and the main variables evaluated were pain severity, dissatisfaction with pain management and caregivers, and patient expectations regarding pain relief. Relationships among the variables were analyzed by means of Spearman's correlation between item scores and regression analysis. Median satisfaction scores were consistent with "very satisfied." Mean (SD) worst pain during the past 24 hours was 68.8 (27.5) on a 100 mm visual analogue scale. "Dissatisfaction with Pain Management" correlated positively with "Dissatisfaction with Medical Staff" (0.42), and inversely with "Pain Now" (-0.41) and "Expected Pain Relief" (-0.38). Regression analysis showed that "Dissatisfaction with Pain Management" was dependent on "Pain Now," "Least Pain," and "Dissatisfaction with Medical Staff," with statistically significant beta weight values of 0.277, 0.197, and 0.280, respectively. The study shows that patients were highly satisfied with pain management, even when they were in pain. Moreover, it establishes that patient dissatisfaction with treatment was highly related to the satisfaction with caregivers and pain intensity.

Attitude to Health↗
PubMed2005

The effect of endoneurial nerve growth factor on calcitonin gene-related peptide expression in primary sensory neurons.

Recent findings indicate that calcitonin gene-related peptide (CGRP) is involved in neuropathic pain, this peptide being up-regulated in a small population of large- and medium-sized primary sensory neurons after peripheral nerve injury. In adult animals, the expression of CGRP is regulated by nerve growth factor (NGF). After nerve injury, NGF is up-regulated at the injury site for several weeks, and this up-regulation contributes to the onset of neuropathic pain. Using immunohistochemistry, we investigated the time course of the effect of an endoneurial injection of NGF on the expression of CGRP in primary sensory neurons. NGF increased the percentage of medium- to large-sized DRG neuron profiles expressing CGRP, did not modify the percentage of small-sized neurons expressing CGRP, and increased CGRP expression in the laminae III and IV of the dorsal horn. The effects of NGF were evident as soon as 1 day after endoneurial injection, and lasted for 5 days. Ten days after the injection of NGF, the patterns of CGRP expression in the DRG were normal, whereas a slight decrease in CGRP content was observed in the dorsal horn. The injection of vehicle did not produce any change on CGRP expression in primary sensory neurons. These results suggest that endoneurial NGF is responsible for the increase in CGRP expression in some large-sized neurons and their central processes observed after nerve injury in animal models of neuropathic pain. Our findings contribute to the understanding of the role of NGF in neuropathic pain.

Animals↗
PubMed2004

Behavioral and histological effects of endoneurial administration of nerve growth factor: possible implications in neuropathic pain.

Animal models of neuropathic pain involving incomplete nerve injury result in causalgia-like symptoms, including thermal hyperalgesia and mechanical allodynia. Although current evidence links the overexpression of nerve growth factor (NGF) to peripheral neuropathic pain, the direct effect of NGF inside a nerve has not been evaluated yet. The purpose of this study was to investigate whether a single, low-dose (1-30 ng), endoneurial administration of NGF reproduces behavioral consequences of a partial nerve injury and to analyze the changes on myelinated fibers induced by NGF. Significant thermal hyperalgesia appeared on days 3 and 5 post-injection of NGF. NGF did not evoke mechanical allodynia at any of the assayed doses. On day 1, NGF induced focal degeneration and demyelination of fibers at the site of injection. Starting on day 5 clusters of small axons enclosed within one Schwann cell and associated with fibroblasts were observed, revealing axonal sprouting. Both thermal hyperalgesia and demyelination-sprouting processes induced by NGF were dose-dependent (1-30 ng) and the time course of both effects was similar. The injection of vehicle did not produce any behavioral or histological effect. These results suggest that overexpression of NGF may induce endoneurial sprouting and triggers the development of thermal hyperalgesia, but not mechanical allodynia, in peripheral neuropathic pain states.

Animals↗
PubMed2004

Putting clinical pharmacology in context: the use of popular movies.

The usefulness of movies to illustrate the psychological and sociological conflicts of medical practice is widely recognized. However, the use of popular movies to teach less oriented medical sciences, such as pharmacology is not so common. In the present review, we report the use of three films (Awakenings, Lorenzo's Oil, and Miss Evers' Boys) as a teaching tool to allow students to better understand some conflicts which appear in the domain of clinical pharmacology. These movies may help to introduce some relevant topics such as the difficulties of planning and performing clinical research with new drugs, the need of considering bioethical principles when doing research with human beings, and the social and psychological aspects of drug therapy. The films may increase the motivation of students to understand clinical pharmacology principles and may become a driving force for an increased desire to learn.

Education, Medical, Undergraduate↗
PubMed2003

Placebo effect and placebos: what are we talking about? Some conceptual and historical considerations.

Placebos and the placebo effect have always been present in medical history. However, they have not received the same consideration over the years. Somewhere between art and science, the placebo historical references come from Ancient Egypt and cross over the major civilisations, beliefs and scientific advances. The use of placebo as a methodological tool has assumed a leading role in the last 50 years and has become an important role in controlled clinical trials, the main element of the "evidence-based-medicine" paradigm. Knowledge of the conceptual and historical considerations of placebo may help to understand its role in medical practice. Even without a consensual definition, and assuming that the placebo effect does not seem to be fully dependent on a placebo administration, one issue seems unquestionable: the placebo effect is present in clinical practice and in clinical trials, no matter which name we choose to call it.

Clinical Trials as Topic↗
PubMedDate not supplied

Analgesic use for postoperative pain: differences arise when comparing departments of surgery.

PURPOSE: The goal of the study is to analyse whether the analgesic therapy of postoperative pain during the first 2 days after surgery differs among the different surgical departments. METHODS: Patients were randomly chosen from among all those who underwent elective surgery. Characteristics of analgesic treatment (drug, dosage, schedule) and pain intensity were determined at the postoperative anaesthetic care unit and in the first and second postoperative days on the ward. All comparisons were carried out by surgical departments. RESULTS: Six hundred and twenty-three patients from six surgical departments were studied. Analgesic treatment orders varied greatly among the different departments, and these differences were statistically significant regarding number of drugs, type of drugs, analgesic schedule, and completeness of medical orders. Some differences were also observed regarding drug dosage. Patients from gynaecology and obstetrics, traumatology and orthopaedics and general surgery reported the most severe pain. CONCLUSIONS: The treatment of postoperative pain differs among the surgical departments, especially regarding analgesic schedules and completeness of analgesic orders. Analgesic therapy may often be based more on customary habits than on the patients' pain intensity.

Adolescent↗