The Clinical journal of pain
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The objectives of this study are (1) to assess the presence of myofascial trigger points (TrPs) and widespread pressure hyperalgesia; and (2) to assess the relationship between the presence of active TrPs, pain intensity, and widespread pressure hypersensitivity in individuals with postmeniscectomy pain. ⋯ The referred pain elicited by active TrPs reproduced knee symptoms in patients with postmeniscectomy pain. Patients also showed localized reduction of PPT. The number of TrPs was associated with the intensity of pain and pressure hyperalgesia. Our findings suggest the presence of peripheral sensitization in patients with postmeniscectomy pain could be associated with the presence of active TrPs.
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Multicenter Study
Italian Oncological Pain Survey (IOPS): A Multicentre Italian Study of Breakthrough Pain Performed in Different Settings.
A survey of breakthrough pain (BTP) was performed in five palliative care units (PCU), seven oncology departments (ONC), and nine pain clinics (OPC). ⋯ This survey performed by an Italian observatory expert review group, has confirmed that the BTP represents a clinically relevant condition with a negative impact on the patient's quality of life. BTP was detected in all settings involved. A number of factors are associated with the BTP. Also factors regarding the course of disease and setting of care have been assessed. This information may help in stratifying patients or predicting the risk of development of BTP with specific characteristics.
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Assessing pain in young children requires astute judgment by observers. Multidimensional observational scales for pediatric pain contribute by providing behavioral cues believed to characterize pain in children; yet, few measurement items have undergone rigorous psychometric evaluation. This is the case with facial expression, which has been widely recognized as the most sensitive and specific nonverbal indicator of pain. The criteria for identifying facial expressions of pain differ substantially across scales and are frequently inconsistent with empirical descriptions. ⋯ The facial items varied considerably in coder judgment reliability as well as criterion (empirical and convergent), content, and face validity. Observational scales should provide behavioral cues that correspond to empirical descriptions of the facial expression of pain.
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To begin to address the problem of heterogeneity of distribution of oxycodone (OC) in humans, we developed an organ-specific microcirculatory capillary-tissue exchange 2-compartment model for studying regional OC mass transport. ⋯ Organ-specific OC mass transport kinetics provide new information for OC dosing in pain management. The model promotes patient safety in opioid prescribing because it allows predictions to be made about the relative contribution that OC recycling makes to circulating OC levels. The model indicates that pharmacologic modulation of the microcirculation may give way to site-specific delivery of opioids in the future. Our study demonstrates that translation of bench in silico research data into clinical practice, although still challenging, is feasible and can assist in OC dose regimen design for patient safety.
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Mindfulness and pain catastrophizing are important constructs in pain research, and there are theoretical reasons for suspecting that measures of the 2 constructs should be related in predictable ways. The present study investigated the association of pain catastrophizing (Pain Catastrophizing Scale) with mindfulness (Five Facet Mindfulness Questionnaire). The Penn State Worry Questionnaire was included to control for confounding of worry; the influence of demographics was explored. ⋯ These findings suggest that it is important to assess more general cognitive-emotional constructs, such as worry, when making inferences about the influence of mindfulness or changes in mindfulness upon catastrophic thinking in response to pain.