The Clinical journal of pain
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Comparative Study
What do patients expect from their first visit to a pain clinic?
To examine patients' expectations of their first outpatient visit to a pain clinic. We asked patients what would be the most satisfying and the most disappointing outcomes of their visit and whether they expected changes in medication and further investigations to result from their consultation. ⋯ For patients attending pain clinics, the explanation of their pain problem is rated as important as the cure or relief of their pain. Improved understanding of patient expectations by pain clinic clinicians may lead to greater patient satisfaction and reduced treatment dropout.
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Case Reports
Painful hallucinations and somatic delusions in a patient with the possible diagnosis of neuroborreliosis.
Neuroborreliosis has become the most frequently recognized tick-borne infection of the nervous system in Europe and the United States. In addition to dermatological, cardiac, articular, and neurologic manifestations, psychiatric disorders such as depression, panic attacks, and schizophrenia-like psychosis can also arise. We report on a 61-year-old woman who developed a severe pain syndrome following several tick bites. ⋯ However, increasing delusions disclosed a psychotic episode, which ceased over time. We discuss therapeutic difficulties and psychiatric complications in the absence of a clear-cut diagnosis of neuroborreliosis. Although this patient might have suffered from late-onset schizophrenia with painful hallucinations right from the start of her disease, the case highlights psychiatric complications that might be associated with neuroborreliosis.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tiagabine and gabapentin for the management of chronic pain.
Agents that modulate gamma-aminobutyric acid transmission, such as gabapentin, are widely used for the management of chronic pain disorders/syndromes; however, the usefulness of the selective gamma-aminobutyric acid reuptake inhibitor tiagabine in this therapeutic area has yet to be investigated. This study evaluated the effectiveness and safety of tiagabine and gabapentin for the treatment of chronic pain. ⋯ These results suggest that tiagabine and gabapentin are effective in the management of chronic pain, with tiagabine having a greater beneficial effect on sleep quality.
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Comparative Study
Studies on the operative outcomes and mechanisms of microvascular decompression in treating typical and atypical trigeminal neuralgia.
To evaluate the operative outcomes and mechanisms of microvascular decompression in treating typical and atypical trigeminal neuralgia. ⋯ The operative outcome of microvascular decompression in patients with typical trigeminal neuralgia was better than that of patients with atypical trigeminal neuralgia, which perhaps related to short duration, late onset of pain, limited distribution, artery compression, and complete operative decompression.
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Randomized Controlled Trial Meta Analysis Comparative Study Clinical Trial
The time to onset and overall analgesic efficacy of rofecoxib 50 mg: a meta-analysis of 13 randomized clinical trials.
To determine the time to onset of analgesia of rofecoxib based on a patient-level meta-analysis of randomized, placebo-controlled, postoperative oral surgery pain studies. ⋯ In this meta-analysis of over 1200 rofecoxib-treated patients, a single dose of rofecoxib 50 mg demonstrated a rapid onset of analgesia in approximately half an hour combined with sustained effectiveness, supporting its use as a treatment of acute pain.