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Chronic pain is a major problem of our society and has significant consequences on the very day life of a great number of patients. Nowadays, the drugs used in order to treat this syndrome show unsatisfying efficiency and multiple side effects which is a fact that compromises the patient’s compliance. Therefore, the development of a safe and effective treatment is of a primordial importance. Indeed, multiple studies are actually focusing on the elaboration of molecules for that purpose that result from original approaches. The goal of this essay is to investigate the different pathways that lead to chronic pain and to explain thoroughly some of these approaches that are representative of this attempt. Three distinct of them are thereby going to be depicted. Firstly, one approach targeting the P2X receptor is going to be exposed and secondly follows another one targeting heteromeric complexes and improving in that way the efficiency of opioid drugs. Finally, a molecular construction targeting the central nervous system via a mechanism of cell tropism is going to be detailed (development of a Clostridial chimera). In other words, the aim of my essay is to discover the progress that has been made in this domain, as well as some new molecules, that seem the most promising and may give the answer to the problematic of chronic pain. La douleur chronique constitue un problème médical majeur dans notre société et qui concerne un grand nombre de patients en impactant très fortement leur quotidien.Les médicaments utilisés actuellementpour traiter ce syndrome ne sont pas suffisamment efficaces et leurs nombreux effets secondaires compromettent très souvent la compliance des patients. La demande pour l'élaboration d’un traitement sûr et judicieux est donc accrue. Dans cette voie, plusieurs molécules prometteuses, retrouvées dans des approches originales pour contrer la douleur, sont étudiées pour le moment. Le but de ce travail est d'investiguer les différents circuits impliqués dans le développement des syndromes douloureux et d'approfondir certaines de ces approches représentatives de cette démarche qui permettraient de développer des nouvelles molécules actives. Trois approches distinctes seront ainsi examinées. Premièrement, nous abordons l'approche visant les récepteurs purinergiques P2X, puis dans un deuxième temps, celle permettant d'améliorer l'efficacité des médicaments opioïdes en utilisant des molécules qui visent des complexes hétérométriques. Et pour finir, nous envisagerons l'usage de constructions moléculaires présentant un tropisme cellulaire afin de cibler le système nerveux central (développement d' une molécule chimère dérivant de Clostridium).Ce mémoire est, donc, le fruit d’une interpellation personnelle concernant le progrès effectué dans ce domaine, ainsi que quelques nouvelles approches qui pourraient éventuellement constituer l'avenir dans le traitement de la douleur chronique.

Chronic Pain

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What is persistent pain? How do we communicate pain, not only in words but in visual images and gesture? How do we respond to the pain of another, and can we do it better? Can explaining how pain works help us handle it? This unique compilation of voices addresses these and bigger questions.Defined as having lasted over three months, persistent pain changes the brain and nervous system so pain no longer warns of danger: it seems to be a fault in the system. It is a major cause of disability globally, but it remains difficult to communicate, a problem both to those with pain and those who try to help. Language struggles to bridge the gap, and it raises ethical challenges in its management unlike those of other common conditions.Encountering Pain shares leading research into the potential value of visual images and non-verbal forms of communication as means of improving clinician-patient interaction. It is divided into four sections: hearing, seeing, speaking, and a final series of contributions on the future for persistent pain. The chapters are accompanied by vivid photographs co-created with those who live with pain.The volume integrates the voices of leading scientists, academics and contemporary artists with poetry and poignant personal testimonies to provide a manual for understanding the meanings of pain, for healthcare professionals, pain patients, students, academics and artists. The voices and experiences of those living with pain are central, providing tools for discussion and future research, shifting register between creative, academic and personal contributions from diverse cultures and weaving them together to offer new understanding, knowledge and hope.Praise for Encountering Pain 'From a remarkable variety of disciplinary and cultural perspectives - from medicine and therapy to the creative arts and philosophy - this inspirational and eye-opening collection succeeds in articulating the mysterious and overwhelmingly complex sensory experience that is pain. Pain, the encounters in this volume suggest, defies definition; it is subjective and unpredictable; it can be phantom or real. Through its radical and engaging use of testimonies, Encountering Pain never shies away from metaphor and the unfounded fear, that the allegorising of pain will dilute its reality. Examined through a multitude of verbal and non-verbal paradigms, contributors discuss the physicality of pain and its political, administrative and medical regulation; the body's trauma and expressiveness; how pain is transmuted into art. The communication of something that resists being expressed straightforwardly in verbal form metamorphoses, as you read this extraordinarily rich and innovative volume, into a metaphor for life itself, for who we are, how we become social beings by developing empathy and respect for the pain of others, for how we develop and then question through these interactions our sense of identity.' - Professor Stella Bruzzi, Dean, Faculty of Arts and Humanities, UCL'This book is the result of a collaborative, multi-disciplinary investigation into the experience of pain and how it might be understood and ameliorated. Deborah Padfield's photographs, made in collaboration with pain sufferers, reveal how an otherwise debilitating, highly subjective and individualising experience might become a topic for intersubjective communication. Through her innovative and experimental photography we learn that the photographic image can potentially play a role in the medical field by addressing 'what is felt' by the patient alongside the usual indexical medical documentation of 'what is there'. In so doing photography may provide a means of sharing perceptual experience and stimulating doctor-patient discussion around the emotional interplay of body and mind. - Gina Glover, a photographic artist working in the fields of health, genetics and science.www.ginaglover.com'This is a majestic volume. Visually striking, intellectually challenging, and experientially transformative, this book promises to change how everyone encounters pain.' - Dr Rob Boddice, Freie Universität Berlin'Deborah Padfield's book, Perceptions of Pain (2003), introduced a ground-breaking strategy through which photography became an effective tool to interpret pain - an aspect of human experience that can, so often, appear inexplicable. The powerful images in this book are further evidence of the collaborative strength of photography and its special ability to give voice to those who are excluded.' - Dewi Lewis, Publisher'A work that brings photographic, figurative and poetic images of chronic pain to the clinic and demonstrates how visual, communicative frameworks can re-voice experiences and diagnoses of pain. This major, deeply reflective collection of papers represents a turning-point in defining the multifaceted importance of painscapes in clinical, therapeutic, and humanistic advocacy work. It firmly situates the arts and humanities, alongside the sciences, in responding to the pressing need for new strategies to alleviate chronic pain.' - Prof Brian Hurwitz, Emeritus Professor of Medicine and the Arts, King's College London'Pain and its ever-increasing numbers of sufferers inhabit a kind of night world isolated from the "normal" day world. 'A bandage hides the place where each is living', W.H. Auden once wrote, while we, the healthy, 'stand elsewhere'. Encountering Pain is an attempt to narrow this rift by making sure sufferers are heard, seen, and able to speak again - so that they might be better understood. Padfield and Zakrzewska have assembled an impressive team of patients, healthcare providers, artists and academicians, all determined to make pain more visible and communicable. The authors compellingly demonstrate that language -- whether in the form of words, gestures or images - is a necessary first step towards alleviating pain. That it can often be as powerful as medicine. '- Dr David Biro, Associate Clinical Professor of Dermatology at SUNY Health Science Center @ Brooklyn and author of The Language of Pain: Finding Words, Compassion, and Relief.

Chronic pain

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Chronic pain is a part of the human condition, despite immense advancements in pain treatment and management. In many societies, easy access to opioids has created a drug abuse crisis. Unfortunately, we seem to have forgotten many techniques that have been used in the past with great success. Some of these techniques continue to be useful, particularly in areas of the globe where resources are limited. This book attempts to remind those of us in the medical profession about the existence of some of these techniques and their ongoing utility. We need to master them or keep them in our armamentarium for the good of our patients.

Chronic pain.

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Chronic pain

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

What is persistent pain? How do we communicate pain, not only in words but in visual images and gesture? How do we respond to the pain of another, and can we do it better? Can explaining how pain works help us handle it? This unique compilation of voices addresses these and bigger questions.Defined as having lasted over three months, persistent pain changes the brain and nervous system so pain no longer warns of danger: it seems to be a fault in the system. It is a major cause of disability globally, but it remains difficult to communicate, a problem both to those with pain and those who try to help. Language struggles to bridge the gap, and it raises ethical challenges in its management unlike those of other common conditions.Encountering Pain shares leading research into the potential value of visual images and non-verbal forms of communication as means of improving clinician-patient interaction. It is divided into four sections: hearing, seeing, speaking, and a final series of contributions on the future for persistent pain. The chapters are accompanied by vivid photographs co-created with those who live with pain.The volume integrates the voices of leading scientists, academics and contemporary artists with poetry and poignant personal testimonies to provide a manual for understanding the meanings of pain, for healthcare professionals, pain patients, students, academics and artists. The voices and experiences of those living with pain are central, providing tools for discussion and future research, shifting register between creative, academic and personal contributions from diverse cultures and weaving them together to offer new understanding, knowledge and hope.Praise for Encountering Pain 'From a remarkable variety of disciplinary and cultural perspectives - from medicine and therapy to the creative arts and philosophy - this inspirational and eye-opening collection succeeds in articulating the mysterious and overwhelmingly complex sensory experience that is pain. Pain, the encounters in this volume suggest, defies definition; it is subjective and unpredictable; it can be phantom or real. Through its radical and engaging use of testimonies, Encountering Pain never shies away from metaphor and the unfounded fear, that the allegorising of pain will dilute its reality. Examined through a multitude of verbal and non-verbal paradigms, contributors discuss the physicality of pain and its political, administrative and medical regulation; the body's trauma and expressiveness; how pain is transmuted into art. The communication of something that resists being expressed straightforwardly in verbal form metamorphoses, as you read this extraordinarily rich and innovative volume, into a metaphor for life itself, for who we are, how we become social beings by developing empathy and respect for the pain of others, for how we develop and then question through these interactions our sense of identity.' - Professor Stella Bruzzi, Dean, Faculty of Arts and Humanities, UCL'This book is the result of a collaborative, multi-disciplinary investigation into the experience of pain and how it might be understood and ameliorated. Deborah Padfield's photographs, made in collaboration with pain sufferers, reveal how an otherwise debilitating, highly subjective and individualising experience might become a topic for intersubjective communication. Through her innovative and experimental photography we learn that the photographic image can potentially play a role in the medical field by addressing 'what is felt' by the patient alongside the usual indexical medical documentation of 'what is there'. In so doing photography may provide a means of sharing perceptual experience and stimulating doctor-patient discussion around the emotional interplay of body and mind. - Gina Glover, a photographic artist working in the fields of health, genetics and science.www.ginaglover.com'This is a majestic volume. Visually striking, intellectually challenging, and experientially transformative, this book promises to change how everyone encounters pain.' - Dr Rob Boddice, Freie Universität Berlin'Deborah Padfield's book, Perceptions of Pain (2003), introduced a ground-breaking strategy through which photography became an effective tool to interpret pain - an aspect of human experience that can, so often, appear inexplicable. The powerful images in this book are further evidence of the collaborative strength of photography and its special ability to give voice to those who are excluded.' - Dewi Lewis, Publisher'A work that brings photographic, figurative and poetic images of chronic pain to the clinic and demonstrates how visual, communicative frameworks can re-voice experiences and diagnoses of pain. This major, deeply reflective collection of papers represents a turning-point in defining the multifaceted importance of painscapes in clinical, therapeutic, and humanistic advocacy work. It firmly situates the arts and humanities, alongside the sciences, in responding to the pressing need for new strategies to alleviate chronic pain.' - Prof Brian Hurwitz, Emeritus Professor of Medicine and the Arts, King's College London'Pain and its ever-increasing numbers of sufferers inhabit a kind of night world isolated from the "normal" day world. 'A bandage hides the place where each is living', W.H. Auden once wrote, while we, the healthy, 'stand elsewhere'. Encountering Pain is an attempt to narrow this rift by making sure sufferers are heard, seen, and able to speak again - so that they might be better understood. Padfield and Zakrzewska have assembled an impressive team of patients, healthcare providers, artists and academicians, all determined to make pain more visible and communicable. The authors compellingly demonstrate that language -- whether in the form of words, gestures or images - is a necessary first step towards alleviating pain. That it can often be as powerful as medicine. '- Dr David Biro, Associate Clinical Professor of Dermatology at SUNY Health Science Center @ Brooklyn and author of The Language of Pain: Finding Words, Compassion, and Relief.

Chronic pain