The Clinical journal of pain
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Review Meta Analysis
Efficacy of 8 Different Drug Treatments for Patients With Trigeminal Neuralgia: A Network Meta-analysis.
Trigeminal neuralgia (TN) is commonly seen in older persons and negatively influences their daily life. Although some research on the efficacy of TN drugs has been conducted, the optimal choice still remains uncertain. Therefore, this network meta-analysis (NMA) evaluated the efficacy and performance of 8 drugs with respect to TN. ⋯ Among the 8 drugs investigated, all exhibited a capacity to alleviate TN more than the placebo except for pimozide and proparacaine. Moreover, LDC, BTX-A, and CBZ stood out for their high efficacy and could be recommended as the primary choice of treatment for TN.
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Since approval of intravenous acetaminophen (IV APAP), its use has become quite common without strong positive evidence. Our goal was to determine the effect of IV APAP on length of hospital stay (LOS) via mediation of opioid-related side effects in pediatric patients. ⋯ IV APAP hastens oral intake and is associated with decreased LOS in an adolescent surgery population likely through decreased opioid consumption. Through addition of IV APAP in this population, LOS may be decreased, an important implication in the setting of escalating health care costs.
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Over 40% of adolescents with chronic pain report experiencing pain dismissal, which is a response from another individual that is perceived as diminishing, denying, or disbelieving an individual's report of pain. Pain dismissal by physicians often leaves patients feeling discredited, which may discourage them from seeking and receiving proper treatment for their pain. The purpose of this study was to investigate how the 4 most commonly reported types of physician pain dismissal differentially affect individuals' reactions. ⋯ All 4 types of physician pain dismissal were broadly perceived negatively, suggesting that the experience of pain dismissal is likely not due to patient hypersensitivity but to physician behavior. Discussion of the psychological factors associated with pain was less likely to be perceived as dismissive. Psychologists and physicians should collaborate to develop recommended language that validates patients' experiences of pain, communicates appropriate levels of empathy, and reduces the frequency of perceived physician pain dismissal.
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Multicenter Study
Does Self-compassion Benefit Couples Coping With Vulvodynia? Associations With Psychological, Sexual, and Relationship Adjustment.
Vulvodynia, a chronic vulvovaginal pain condition, has deleterious consequences for the psychological, relational, and sexual well-being of affected women and their partners. Protective factors, which can reduce these negative effects, are increasingly studied in the field of chronic pain. One of these, self-compassion, entails qualities such as kindness toward oneself, and has been associated with better adjustment in individuals with chronic pain. Because many women with vulvodynia have a negative image of themselves in the context of sexuality, self-compassion may be especially relevant for this population. This study aimed to investigate self-compassion among couples coping with vulvodynia and its associations with psychological, sexual, and relationship adjustment, as well as pain during sexual intercourse. ⋯ Findings suggest that self-compassion is a promising protective factor in the experience of vulvodynia and associated distress. Interventions aimed at increasing self-compassion could enhance the efficacy of psychological treatments for these women and their partners. Further studies are needed to better understand the correlates of self-compassion among this population.
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To replicate a study by Schutze and colleagues on a headache sample, rather than a heterogenous chronic pain sample, investigating whether level of mindfulness predicts key components in the Fear-Avoidance Model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration. ⋯ Findings suggest that mindfulness may be integrated into the Fear-Avoidance Model of chronic pain for individuals with chronic headache/migraine. Directions for future research are discussed.