The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
The Reciprocal Effects of Pain Intensity and Activity Limitations: Implications for Outcomes Assessment in Clinical Trials.
To examine the reciprocal effects of pain intensity and limitations in physical functioning over time. ⋯ These analyses showed that a decrease in activity limitations results in a decrease in pain intensity. However, changes in pain intensity had no effect on subsequent activity limitations in the study sample. None of the 3 outcome variables emerged as being more responsive to treatment than the others.
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Clinical Trial
Treatment Expectations Among Adolescents With Chronic Musculoskeletal Pain and Their Parents Before an Initial Pain Clinic Evaluation.
To understand expectations regarding treatment recommendations among treatment-seeking adolescents with chronic musculoskeletal pain and their parents. ⋯ Our results document that adolescents and parents show modest levels of agreement on expectations for treatment at the time of an initial pain clinic evaluation. This may relate to expectations being internal perspectives not clearly expressed within families; thus, the initial treatment consultation may provide an important opportunity to create and align appropriate expectations. Implications of our findings are considered with respect to education, treatment, and future research to understand factors that contribute to treatment adherence and outcomes.
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Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. ⋯ These results suggest that purchase of analgesics after hysterectomy is related to preoperative factors. Compared with women with high SES, women with low SES had less favorable changes in analgesic purchase after hysterectomy.
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Review Meta Analysis
A Systematic Review and Meta-Analysis of Medical Leech Therapy for Osteoarthritis of the Knee.
Osteoarthritis of the knee is a common chronic disease among older adults. Therapeutic approaches mainly consist of physiotherapy or pharmacological therapy, but these approaches are limited over time by their cost and/or side effects. This paper presents a systematic review and meta-analysis of the effectiveness of medical leech therapy for osteoarthritis of the knee. ⋯ This systematic review found moderate to strong evidence for the reduction of pain, functional impairment, and joint stiffness after medical leech therapy in patients with osteoarthritis of the knee. Given the low number of reported adverse events, leech therapy may be a useful approach in treating this condition. Further high-quality RCTs are required for the conclusive judgment of its effectiveness and safety.
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Multicenter Study
Factors Associated With Outcome after Superior Hypogastric Plexus Neurolysis in Cancer Patients.
Superior hypogastric plexus neurolysis (SHP-N) has been shown in uncontrolled studies to provide intermediate-term benefit in a majority of patients with pain secondary to genitourinary, gynecologic, and colorectal cancers. The purpose of this is to determine factors associated with treatment outcome. ⋯ Selecting patients based on demographic and clinical variables may improve treatment outcomes for SHP-N. Larger, prospective studies are needed to confirm our results and better refine selection criteria better.