The Clinical journal of pain
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The International Association for the Study of Pain defines allodynia as pain due to a stimulus that does not normally provoke pain and hyperalgesia as an increased response to a stimulus, which is normally painful. However, does "normally painful" mean "any stimulation of nociceptors" or "the subjective pain response?" We argue that "normally painful" should not mean "any stimulation of nociceptors," as Von Frey monofilaments may evoke a pricking sensation--which implies the involvement of nociceptors--without necessarily leading to a subjective pain perception. In this paper, we propose that the diagnosis of either allodynia or hyperalgesia should be based on the patient's report, that is, painful versus not painful, rather than on the (sub) type of afferent fiber involved.
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Randomized Controlled Trial
Multidisciplinary rehabilitation treatment of patients with chronic low back pain: a prognostic model for its outcome.
(1) To determine if treatment outcome in chronic low back pain can be predicted by a predefined multivariate prognostic model based on consistent predictors from the literature and (2) to explore the value of potentially prognostic factors further. ⋯ The results of this study do not support the construction of a clinical prediction model. Future confirmative studies of homogeneous rehabilitation treatments and outcome measures are needed to shed more light on relevant prognostic factors.
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The Depression, Anxiety, and Positive Outlook Scale (DAPOS) was designed to measure mood in pain populations without contamination from somatic items. ⋯ Responsiveness of the DAPOS should be reassessed in treatment targeting mood change explicitly. The DAPOS scales show acceptable clinimetric and psychometric properties, and add a measurement of positive outlook to create a more balanced indication of mood in pain patients.
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Randomized Controlled Trial
Ketamine does not reduce postoperative morphine consumption after tonsillectomy in children.
Tonsillectomy is one of the most frequently performed operations in children and frequently associated with moderate-to-severe pain. ⋯ The addition of ketamine 0.25 mg/kg at induction of anesthesia did not decrease postoperative morphine consumption in children undergoing tonsillectomy.
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Correlates of pain-rating concordance for adolescents with sickle cell disease and their caregivers.
As sickle cell pain in children and adolescents with sickle cell disease (SCD) is managed primarily at home, understanding convergence of caregiver and youth pain reports may contribute to improvements in home pain management. The goal of this study was to examine concordance in pain ratings for a sample of 53 adolescents with SCD and their caregivers and to assess sociodemographic and psychosocial factors associated with concordance. ⋯ Efforts to improve home management of pain in SCD should incorporate programming designed to increase parent-child communication about pain and pain interference, confidence in disease management abilities, and improved knowledge of SCD and its care, particularly for families of older adolescents.