Visceral pain: mechanisms of peripheral and central sensitization.


:This paper describes the responses of peripheral and central visceral nociceptive systems to acute injury and discusses these observations in relation to the concept of 'pre-emptive analgesia'. Visceral nociceptors are known to respond to injury but are also known to become sensitized to non-noxious stimuli during the inflammatory process that follows intense noxious stimulation. The afferent barrages triggered in visceral nociceptors by the acute injury and the enhanced responses evoked in sensitized nociceptors during the repair process can, in turn, increase the excitability of central nociceptive systems. The maintenance of central hypersensitivity is, however, dependant on the continuing presence of afferent volleys from sensitized nociceptors because the central changes cannot be sustained in the absence of a peripheral drive. Therefore it is proposed that the concept of 'pre-emptive analgesia', as such, has no neurophysiological basis. Any analgesic procedure aimed at reducing postoperative pain must not only prevent the arrival in the CNS of the initial afferent barrage evoked in nociceptive endings but also reduce or eliminate the persistent discharges of sensitized nociceptors during the inflammatory repair process that are critically important for the maintenance of the central pain state.


Ann Med


Annals of medicine


Cervero F




Has Abstract


1995-04-01 00:00:00












  • New treatment options for substance abuse from a public health viewpoint.

    abstract::Naltrexone is the first safe and effective pharmaceutical adjunct for use in the treatment of alcohol abuse. Theoretically it could be effective also as a means for terminating methadone maintenance and in the treatment of other forms of substance abuse. Two general types of protocols have been used with naltrexone. O...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Sinclair JD

    更新日期:1998-08-01 00:00:00

  • Population screening for colorectal cancer, the goals and means.

    abstract::The causes of colorectal cancer are complex and in most cases obscure, making primary prevention impossible at present. Secondary prevention by finding and treating early asymptomatic cancers may possibly reduce mortality from this very common cancer. Results from conventional treatment have changed little during rece...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Kronborg O

    更新日期:1991-10-01 00:00:00

  • Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults.

    abstract:BACKGROUND:Heart rate (HR), heart rate variability (HRV), and inflammation are all associated with cardiovascular morbidity and mortality. The aim of this study was to assess potential interrelationships between these parameters in a young and healthy population. METHODS:Healthy individuals aged 25-41 years were inclu...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Aeschbacher S,Schoen T,Dörig L,Kreuzmann R,Neuhauser C,Schmidt-Trucksäss A,Probst-Hensch NM,Risch M,Risch L,Conen D

    更新日期:2017-02-01 00:00:00

  • Sleep and cardiac rhythm in healthy men.

    abstract::Cardiac rhythm during sleep was analysed in 168 healthy men aged 19 to 30 (mean 21.8) years using continuous nocturnal ECG recordings. Thirty five of the subjects were endurance athletes; 99 were recorded at home and 69 at a garrison during military service. The number of short term (less than one min) accelerations o...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Viitasalo M,Halonen L,Partinen M,Iivanainen M,Kala R,Eisalo A

    更新日期:1991-04-01 00:00:00

  • Undetermined stroke with an embolic pattern--a common phenotype with high early recurrence risk.

    abstract:INTRODUCTION:Undetermined strokes with an embolic pattern (USEP) represent a common phenotype. We assessed their frequency and compared USEP with cardioembolic stroke with a known source and non-cardioembolic stroke etiology. METHODS:Study patients were 540 consecutive ischemic stroke patients admitted to Helsinki Uni...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Putaala J,Nieminen T,Haapaniemi E,Meretoja A,Rantanen K,Heikkinen N,Kinnunen J,Strbian D,Mustanoja S,Curtze S,Pakarinen S,Lehto M,Tatlisumak T

    更新日期:2015-01-01 00:00:00

  • Course of mixed connective tissue disease in children.

    abstract::Mixed connective tissue disease (MCTD) was first reported 25 years ago. This report provides an assessment of the course of juvenile (J) MCTD in 224 patients available in the literature until 1996, including our own 33 patients. Most patients improved and remissions were observed in 3-5% (up to 27%). Among the long-te...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Michels H

    更新日期:1997-10-01 00:00:00

  • Decreased androgen levels and obesity in men.

    abstract::Obesity in males is accompanied by a significant decrease in testosterone levels. This decrease is essentially a consequence of the decrease of the sex hormone binding hormone (SHBG) binding capacity, itself probably the consequence of the increased insulin levels. In moderate obesity, free testosterone levels are nor...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Vermeulen A

    更新日期:1996-02-01 00:00:00

  • Mechanisms and consequences of phagocyte adhesion to endothelium.

    abstract::Leukocyte adhesion to endothelium is essential for the development of an appropriate immune-inflammatory response. The vital importance of leukocyte-endothelial adhesive interactions in host defense and homeostasis is illustrated by the clinical manifestations of patients with congenital defects of leukocyte adhesion ...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Repo H,Harlan JM

    更新日期:1999-06-01 00:00:00

  • Genomic imprinting: concept and clinical consequences.

    abstract::One of the major discoveries in modern genetics is the phenomenon of genomic, or parental, imprinting. The parent-of-origin effects seen after transmission of an imprinted gene from parents to their children do not follow the genetic rules postulated by Gregor Mendel. This has obvious consequences for genetic counsell...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Mannens M,Alders M

    更新日期:1999-02-01 00:00:00

  • Dyslipidemia is a strong predictor of myocardial infarction in subjects with chronic kidney disease.

    abstract:AIM:To evaluate dyslipidemia as predictor of myocardial infarction (MI) in subjects with or without chronic kidney disease (CKD). METHODS:In 142,394 middle-aged Swedes referred for laboratory evaluation, glomerular filtration rates (GFR) were estimated using the Modification of Diet in Renal Disease study equation. CK...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Holzmann MJ,Jungner I,Walldius G,Ivert T,Nordqvist T,Ostergren J,Hammar N

    更新日期:2012-05-01 00:00:00

  • Coenzyme Q10, alpha-tocopherol and free cholesterol in HDL and LDL fractions.

    abstract::Twenty-three randomly selected plasma samples from apparently healthy, middle aged men were analysed for coenzyme Q10 (CoQ10), alpha-tocopherol (AT) and free cholesterol (FC) in: 1) whole plasma, 2) the HDL lipoprotein fraction after LDL precipitation (VLDL + LDL). CoQ10, AT and FC in plasma averaged 0.69 +/- .11, 6.7...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Johansen K,Theorell H,Karlsson J,Diamant B,Folkers K

    更新日期:1991-12-01 00:00:00

  • Carotid intima-media thickness and markers of inflammation, endothelial damage and hemostasis.

    abstract:BACKGROUND:Different soluble molecules involved in inflammation, endothelial damage, or hemostasis are recognized as potential cardiovascular risk markers. Studies to assess the role of these markers in the atherosclerotic process by evaluating their relationship to carotid intima-media thickness (C-IMT) tend to provid...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Baldassarre D,De Jong A,Amato M,Werba JP,Castelnuovo S,Frigerio B,Veglia F,Tremoli E,Sirtori CR

    更新日期:2008-01-01 00:00:00

  • Clinical and biological importance of cytogenetic abnormalities in childhood and adult acute lymphoblastic leukemia.

    abstract::Among the approximately 7,000 cytogenetically abnormal childhood and adult B- and T-lineage acute lymphoblastic leukemias (ALL) published to date, numerous recurring chromosomal aberrations and abnormality patterns have been identified, and it has been clearly shown that the cytogenetic features often correlate closel...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Johansson B,Mertens F,Mitelman F

    更新日期:2004-01-01 00:00:00

  • Coexistence of hereditary coproporphyria with acute intermittent porphyria.

    abstract::A new form of acute hepatic porphyria with double genetic defect--deficiency of porphobilinogen deaminase and coproporphyrinogen oxidase--is described. Among 17 studied family members this double enzymatic deficiency was found in five individuals, deficiency of porphobilinogen deaminase in four, and deficiency of copr...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Gregor A,Kostrzewska E,Tarczynska-Nosal S,Stachurska H

    更新日期:1994-04-01 00:00:00

  • The circadian clock: from molecules to behaviour.

    abstract::Circadian rhythms are a cardinal feature of living organisms. The stereotypical organization of homeostatic, endocrine and behavioural variables around the 24-hour cycle constitutes one of the most conserved attributes among species. It is now well established that circadian rhythmicity is not a learned behaviour, but...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Florez JC,Takahashi JS

    更新日期:1995-08-01 00:00:00

  • Non-pharmacological means to prevent fractures among older adults.

    abstract::Bone fractures affecting elderly people are a true public health burden, because they represent one of the most important causes of long-standing pain, functional impairment, disability, and death among this population. Compromised bone strength (osteoporosis) and falling, alone, or more frequently in combination, are...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Kannus P,Uusi-Rasi K,Palvanen M,Parkkari J

    更新日期:2005-01-01 00:00:00

  • Mucosal immunity and viral infections.

    abstract::The mucosal surfaces are the first portals of entry for most infectious agents, among which respiratory and intestinal viruses are of greatest epidemiological importance. To combat these infections, the immune system uses unspecific and specific mechanisms. Unspecific responses include the production of virus-induced ...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Freihorst J,Ogra PL

    更新日期:2001-04-01 00:00:00

  • Systemic effects of controlled exposure to diesel exhaust: a meta-analysis from randomized controlled trials.

    abstract:INTRODUCTION:Ambient air pollution is associated with adverse cardiovascular events. This meta-analysis aimed to investigate the short-term association between air pollution and cardiovascular effects on healthy volunteers. METHODS:We searched databases to identify randomized trials with controlled human exposures to ...

    journal_title:Annals of medicine

    pub_type: 杂志文章,meta分析


    authors: Vieira JL,Macedo FY,Benjo AM,Guimarães GV,Contreras JP,Bocchi EA

    更新日期:2017-03-01 00:00:00

  • Heart rate dynamics and vulnerability to ventricular tachyarrhythmias.

    abstract::Sudden arrhythmic death is the most common mode of death in Western countries. An increased understanding of the pathophysiology and trigger mechanisms of life-threatening ventricular tachyarrhythmias in patients with structural heart disease can provide a logical basis for improved therapeutic strategies in the preve...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Huikuri HV

    更新日期:1997-08-01 00:00:00

  • Field cancerization: are multiple primary cancers monoclonal or polyclonal?

    abstract::Second primary cancers are a difficult problem in the upper aerodigestive tract and in several other organ sites. Among patients with early stage head and neck cancers, second primary tumours are a primary cause of death. It has been postulated that such second cancers represent new tumours developing from carcinogen-...

    journal_title:Annals of medicine

    pub_type: 社论,评审


    authors: Carey TE

    更新日期:1996-06-01 00:00:00

  • The role of bronchoalveolar lavage in the microbiological diagnosis of pneumonia in patients with haematological malignancies.

    abstract::In the aetiological diagnosis of pulmonary infections in patients affected by haematological malignancies we evaluated the utility of bronchoalveolar lavage (BAL). One hundred and twenty-seven BAL were performed in 119 patients. In our series, we identified the agent of pneumonia in 53.5% of episodes with the best res...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Pagano L,Pagliari G,Basso A,Marra R,Sica S,Frigieri L,Morace G,Ardito F,Leone G

    更新日期:1997-12-01 00:00:00

  • Increased plasma interleukin-1 receptor antagonist levels in men with visceral obesity.

    abstract:BACKGROUND:Adipose tissue (AT) is an important source of interleukin-1 receptor antagonist (IL-1Ra). Its expression is markedly increased in obesity. AIMS AND METHODS:To quantify the associations of IL-1Ra with body fat distribution as well as to examine the respective contributions of IL-1Ra and visceral adiposity to...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Cartier A,Bergeron J,Poirier P,Alméras N,Tremblay A,Lemieux I,Després JP

    更新日期:2009-01-01 00:00:00

  • Sequence analysis of the genes encoding for H+/K+-ATPase in autoimmune gastritis.

    abstract:BACKGROUND:H+/K+-ATPase is the target autoantigen in autoimmune gastritis (AIG), an organ-specific autoimmune disease with a strong hereditary component. AIM:To detect possible polymorphisms in H+/K+-ATPase alpha- and beta-subunits in AIG patients. METHODS:Blood samples from 12 Finnish AIG patients were sequenced for...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Oksanen AM,Lemmelä SM,Järvelä IE,Rautelin HI

    更新日期:2006-01-01 00:00:00

  • Vaginal contraceptive rings.

    abstract::Steroids diffuse through polysiloxone at a constant rate, and steroids placed in the vagina rapidly pass through the vaginal epithelium into the circulation. Combining these principles led to the development of contraceptive vaginal rings (CVR) consisting of various progestins, with and without oestrogen, placed in fl...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Mishell DR Jr

    更新日期:1993-04-01 00:00:00

  • The effectiveness of teriparatide in the clinical practice--attenuation of the bone mineral density outcome by increasing age and bisphosphonate pretreatment.

    abstract:BACKGROUND:Teriparatide is a potent anabolic agent for severe osteoporosis. OBJECTIVES:A primary objective of this retrospective study was to define the efficacy of teriparatide in terms of bone mineral density (BMD) changes and relief of back pain in clinical practice. METHODS:The patient population comprises 119 os...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Koski AM,Löyttyniemi E,Väänänen H,Laine H,Niskanen L,Nevalainen PI,Korpi-Hyövälti E,Välimäki MJ

    更新日期:2013-05-01 00:00:00

  • Prophylactic cancer vaccination by targeting functional non-self.

    abstract::Despite the monumental success of childhood prophylactic vaccination, there is no similar program designed to provide protection as we age against adult onset diseases like breast cancer. Instead, the predominant focus of current cancer vaccine strategy is to vaccinate after the tumors become established. This strateg...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Tuohy VK,Jaini R

    更新日期:2011-08-01 00:00:00

  • Distribution of interleukin-1 receptor antagonist genotypes in sudden unexpected death in infancy (SUDI); unexplained SUDI have a higher frequency of allele 2.

    abstract:AIMS:This investigation was designed to explore the role of IL-1RN genotype in unexplained infant deaths (including sudden infant death syndrome (SIDS)), non-infectious infant deaths, and infectious infant deaths, and to investigate whether IL-1RN genotype is related to the finding of organisms in normally sterile site...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Highet AR,Berry AM,Goldwater PN

    更新日期:2010-01-01 00:00:00

  • Menkes disease: recent advances and new insights into copper metabolism.

    abstract::Copper is a trace element necessary for the normal function of several important enzymes but copper homeostasis is still poorly understood. In recent years remarkable progress has been made in this field following the isolation of the gene defective in Menkes disease. Menkes disease and occipital horn syndrome are X-l...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Tümer Z,Horn N

    更新日期:1996-04-01 00:00:00

  • Childhood predictors of the metabolic syndrome in adulthood. The Cardiovascular Risk in Young Finns Study.

    abstract:BACKGROUND:Obese youths may be susceptible to develop the metabolic syndrome (MS) later in life. AIM:To study childhood predictors of MS in adulthood. METHOD:Prospective cohort study including 2,195 subjects, aged 3-18 years at base-line in 1980, who were re-examined in 1983, 1986, and 2001. RESULTS:In adults (aged ...

    journal_title:Annals of medicine

    pub_type: 杂志文章


    authors: Mattsson N,Rönnemaa T,Juonala M,Viikari JS,Raitakari OT

    更新日期:2008-01-01 00:00:00

  • Fitting the right non-vitamin K antagonist oral anticoagulant to the right patient with non-valvular atrial fibrillation: an evidence-based choice.

    abstract::Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban,...

    journal_title:Annals of medicine

    pub_type: 杂志文章,评审


    authors: Li YG,Pastori D,Lip GYH

    更新日期:2018-06-01 00:00:00