The Clinical journal of pain
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Case Reports
Favorable Outcome of an Acute Complex Regional Pain Syndrome With Immunoglobulin Infusions.
To emphasize that complex regional pain syndrome (CRPS), a disabling disorder with the implication of aberrant inflammation, vasomotor dysfunction, and maladaptive neuroplasticity, might be treated with a high dose of intravenous immunoglobulin infusions (IVIG). ⋯ This observational study emphasizes that high-dose IVIG may be a treatment option in the acute phase of CRPS.
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Epidemiologic studies in the non-human immunodeficiency virus (HIV) positive population have shown greater health care utilization among persons with chronic non-cancer pain on opioid therapy. However, we are not aware of any similar data in the HIV positive population. ⋯ In our study HIV positive individuals with chronic pain were more likely to be seen in the ER and be hospitalized if they were on opioids. However, after controlling for other variables, the association with opioids no longer remained significant.
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Randomized Controlled Trial Retracted Publication
Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial.
To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain. ⋯ The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.
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Obstructive sleep apnea (OSA) has become an epidemic worldwide, and OSA patients frequently present for surgery. Comorbidities such as cardiovascular disease, diabetes, hypertension, stroke, gastrointestinal disorder, metabolic syndrome, chronic pain, delirium, and pulmonary disorder increase the perioperative risk for OSA patients. ⋯ Management of acute postoperative pain in OSA patient remains complex. A comprehensive strategy is needed to reduce the complications and adverse events related to administration of analgesics and anesthetics.
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Review
Subcutaneous and Perineural Botulinum Toxin Type A For Neuropathic Pain: A Descriptive Review.
Botulinum toxin is a neurotoxin that has been widely used in chronic pain for the treatment of multiple conditions with a component of localized muscle spasm. Recent studies suggest that botulinum toxin is effective in the treatment of neuropathic pain syndromes such as postherpetic neuralgia or painful scars. ⋯ On the basis of the analysis of the reports published in the literature, it would seem that fractioned peripheral subcutaneous and perineural injections of botulinum toxin type A may be useful for the treatment of various chronic pain conditions with neuropathic component.