The Clinical journal of pain
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Numerous potential complications are associated with the use of programmable intrathecal (IT) drug delivery systems. Radiation is often assumed to cause dysfunctions of the programmable IT device. However, radiation-induced failure of this device and limits of dose exposure have not clinically documented. ⋯ Estimated cumulative doses to the pump were in the range of 28.5 to 36 Gy when the alarm occurred after 20 daily treatments. The IT pump itself exposed to this high-dose radiation did not pose any risk to the patient or the environment. This is the first case description about the pump malfunction secondary to clinical radiotherapy, which is very useful to physicians who manage the pain and radiotherapy for cancer patients.
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To evaluate interrater reliability using 5 newly trained observers in the assessment of pressure pain threshold (PPT) using a fixed-angle algometer. ⋯ This study provides new evidence that trained observers can apply an algometer at a consistent rate and provide highly reliable measures of PPT in healthy humans, when PPT is calculated as the mean of 3 trials.
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Self-report is the "gold standard" for pain assessment, however, observational pain scales, such as Doloplus-2 must be used for patients who cannot communicate. In this follow-up study, we report the psychometric properties of the observational Doloplus-2 scale using the visual analog scale (VAS) pain score as a gold standard and evaluate its performance. ⋯ The observational Doloplus-2 scale correlates moderately with self-assessment pain score and has adequate internal consistency. Our data also suggest that Doloplus-2 could be substantially shortened as the brief version performed similarly to the complete Doloplus-2.
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The purpose of this study was to compare sleep of adolescents with chronic pain and healthy adolescents using both subjective and objective sleep assessments, and to identify correlates of poor sleep. ⋯ Adolescents with chronic pain evidenced poorer sleep quality, increased insomnia symptoms, and less efficient sleep with more wake bouts in comparison with healthy adolescents, findings that require replication in a larger sample. Assessment and management of sleep disturbances is an important aspect of care for children and adolescents with chronic pain.
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Clinical Trial
Unipedicular vertebroplasty for osteoporotic compression fracture using an individualized needle insertion angle.
In the classic transpedicular vertebroplasty, second needle placement is routinely required at the same level. However, each patient requires a different needle insertion angle (NIA) at each site. Therefore, precise NIA is required for each fractured vertebral body. In this study, we performed a unipedicular approach through an individualized NIA that had been evaluated with axial magnetic resonance imaging before vertebroplasty. ⋯ Unipedicular PVP can be performed safely, provided the operator has a thorough knowledge of the bony landmarks and the anatomy of the pedicle. A unipedicular approach could be considered first using individualized NIA at each vertebral level.