The Clinical journal of pain
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Controlled Clinical Trial
Confirmatory factor analysis of the coping strategies questionnaire-revised in samples of oncology outpatients and inpatients with pain.
The aims of this study of oncology outpatients with cancer pain were to perform an exploratory factor analysis (EFA) of the 48-item Coping Strategy Questionnaire (CSQ) and a confirmatory factor analysis of the 6-factor solution of the Coping Strategy Questionnaire-Revised (CSQ-R) suggested by Riley and Robinson in 1997. In addition, differences in latent factor means and in the CSQ-R subscale scores between inpatients and outpatients were evaluated. ⋯ The 27-item CSQ-R is recommended for use as a clinical instrument. However, further research of the 6-factor structure is recommended to identify reasons for the correlated errors.
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Multicenter Study Clinical Trial
Normal-release oral morphine starting dose in cancer patients with pain.
To evaluate whether the current European Association for Palliative Care recommendation regarding the starting dose of 5 mg of normal-release morphine (NRM) sulfate oral solution every 4 hours in opioid naive patients or 10 mg in patients already being treated with "weak" opioids is effective and could be proposed as starting routine dose in clinical practice. Secondary aims were to estimate the percentage of patients who were high responders to NRM and to study the association of baseline patient characteristics with both high analgesic responsivity and the need of opioid dose escalation. ⋯ These data show that empiric standard doses of NRM during titration, recommended by European Association for Palliative Care, are effective in clinical practice.
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No study has previously analyzed pressure pain sensitivity of nerve trunks in migraine. This study aimed to examine the differences in mechanical pain sensitivity over specific nerves between patients with unilateral migraine and healthy controls. ⋯ In patients with unilateral migraine, we found increased mechano-sensitivity of the supra-orbital nerve on the symptomatic side of the head. Outside the head, the same patients showed increased mechano-sensitivity of the main peripheral nerves of both upper limbs, without asymmetries. Such diffuse hypersensitivity of the peripheral nerves lends further evidence to the presence of a state of hyperexcitability of the central nervous system in patients with unilateral migraine.
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This study was designed to provide a cross-sectional analysis of pain prevalence, chronicity, and severity as well as the impact of pain on psychological and social variables in inpatients in various departments of a German teaching hospital. ⋯ The results of this study indicate that in most medical disciplines pain is more than merely a symptom of disease. In many instances pain should be considered a serious comorbidity that can influence the outcome of medical and surgical treatment. Recent research has shown that prevention of the pain chronification process is the most promising strategy for avoiding the development of intractable pain. Acceptance, recognition, and assessment of pain as a risk factor at an early stage are essential factors. A first step might involve routine screening for pain on admission to any hospital facility, and subsequently evaluating the impact of pain on biopsychosocial functions.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of lacosamide in diabetic neuropathic pain: an 18-week double-blind placebo-controlled trial of fixed-dose regimens.
The aims of this multicenter, randomized, placebo-controlled, double-blind trial were to confirm the efficacy of lacosamide at a daily dose of 400 mg/d and to explore the efficacy, safety, and tolerability of lacosamide 200 mg/d and 600 mg/d in the treatment of painful diabetic neuropathy. ⋯ Safety and efficacy analyses indicated that lacosamide 400 mg/d provided an optimal balance between efficacy and side effects in patients with painful diabetic neuropathy.