Pain as a Human Right

On October 11, 2004, the International Association for the Study of Pain (IASP), the World Health Organization (WHO), and the European Federation of IASP Chapters (EFIC) held a Global Day against Pain campaign to promote pain relief as a human right. International leaders in pain management and public health participated in the full day program that took place in Geneva Switzerland and was simultaneously broadcast around the world through the Word Wide Web. The declaration and statements that were released and announced, and selected contents of the program are summarized in this report.     

Rho kinase as a novel molecular therapeutic target for hypertensive internal anal sphincter

BACKGROUND & AIMS: An increase in Rho kinase (ROK) activity has been associated with agonist-induced sustained contraction of the smooth muscle, but its role in the pathophysiology of spontaneously tonic smooth muscle is not known. METHODS: Present studies examined the effects of ROK inhibitor Y-27632 in the tonic smooth muscle of the rat internal anal sphincter (IAS) versus in the flanking phasic smooth muscle of the rectum. In addition, studies were performed to determine the relationship between the decreases in the basal IAS tone and the ROK activity. Confocal microscopic studies determined the cellular distribution of the smooth muscle-predominant isoform of ROK (ROCK-II) in the smooth muscle cells (SMCs). RESULTS: In in vitro studies using neurohumoral inhibitors and tetrodotoxin and the use of SMCs demonstrate direct relaxation of the IAS SMCs by Y-27632. The ROK inhibitor was more potent in the IAS than in the rectal smooth muscle. The IAS relaxation by Y-27632 correlated specifically with the decrease in ROK activity. Confocal microscopy revealed high levels of ROCK-II toward the periphery of the IAS SMCs. In in vivo studies, the lower doses of Y-27632 caused a potent and selective decrease in the IAS pressures without any adverse cardiovascular systemic effects. The ROK inhibitor also caused potent relaxation of the hypertensive IAS. CONCLUSIONS: RhoA/ROK play a crucial role in the maintenance of the basal tone in the IAS, and ROK inhibitors have a therapeutic potential in the IAS dysfunction characterized by the hypertensive IAS.     

TREATMENT OF COMPLICATED MOURNING. By Therese A. Rando. Research Press, 1993. 768 pages, $39.95.

The 10th World Congress on Pain, the triennial meeting of the International Association for the Study of Pain, continued the series' tradition as one of the premier international meetings for pain clinicians and scientists. At this meeting, held in August 2002 in San Diego, California, a broad spectrum of topics was presented, with substantial representation in both the clinical and basic science realms. Increased understanding of basic pain mechanisms, potential new targets for drug treatment of pain, ethical issues, and psychological interventions for pain were all areas of considerable interest.