The Clinical journal of pain
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Clinical Trial
Decision analysis for epidural labor analgesia with Multiattribute Utility (MAU) model.
Epidural analgesia (EA) is an effective and safe method to relieve labor pain. Little is known about the factors associated with decision on EA. We applied Multiattribute Utility (MAU) theory to ascertain possible factors on which we based to predict whether parturients would receive EA or not (non-EA) during their labor. ⋯ These findings suggest that our MAU model can predict pre-labor decision and final decision of parturients by the incorporation of correlates with respect to knowledge and attitude.
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This study examined the relationship between back pain and gastrointestinal (GI) symptoms in a large scale population study with consideration of possible confounding factors. ⋯ This study has identified a strong association between back pain and GI symptoms in women. Possible factors that may account for this relationship include referred pain through viscerosomatic convergence, altered pain perception, increased spinal loading when straining during defecation, or reduced support of the abdominal contents and spine secondary to changes in function of the abdominal muscles.
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Investigations of the association between chronic pain conditions and suicidal ideation (SI) and suicide attempts (SA) have rarely taken the effect of mental disorders into account and have been limited by nonrepresentative samples. The present study used a large population-based sample to investigate the association between chronic pain conditions and SI and SA. ⋯ This is the first study to demonstrate the association between several chronic pain conditions and SI and SA while adjusting for mental disorders in a nationally representative sample. Moreover, this study demonstrates that among individuals with a mental disorder, having a chronic pain condition significantly increased the association with SI and SA.
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Comparative Study
The role of TNF-alpha in patients with chronic low back pain-a prospective comparative longitudinal study.
In this prospective longitudinal clinical study with a matched-pair design, we evaluated the role of tumor necrosis factor-alpha (TNF-alpha) and its clinical relevance in patients with chronic low back pain. ⋯ TNF-alpha seems to have a significant role in patients with chronic low back pain. However, the pathophysiology of this process, the clinical relevance of TNF-alpha and, especially, its part in a potential therapy regimen in these patients need to be more closely examined and defined in additional studies.
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To study the prevalence of upper extremity disorders (UEDs) and neck as a total and complaints of the arm, neck and/or shoulder (CANS) not caused by acute trauma or any systemic disease as defined in the CANS model in the open population and to assess sociodemographic and health characteristics of chronic symptoms. ⋯ UEDs and CANS frequently occur in the open population. Excluding acute traumas and systemic diseases reduced the prevalence of CANS and resulted in a relatively healthier population. A compound definition of CANS seems indicated because of the large overlap of affected anatomic sites.