Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Lumbar spinal stenosis (LSS) causes low back pain, leg pain, numbness in the leg, and neurogenic intermittent claudication. Epidural steroid injection (ESI) has been used for treating spinal stenosis symptoms. We hypothesized that dural pulsation was variable for lumbar spinal stenosis. In cases of the presence of dural pulsation, the pain relief after the ESI was better than in the absence of dural pulsation. This study aimed at investigating the relationships between the presence or absence of spinal dural pulsations and the efficacy of ESI. ⋯ The ESI was effective in patients with spinal stenosis in short-term follow-up. Dural pulsation of the spinal cord was a positive predictive factor for the ESI effect, but the grade of spinal stenosis severity had no effect on the effectiveness of ESI.
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Observational Study
Does Postgraduate Education Deepen Temporomandibular Disorders Insights for Dental Professionals?
Objective: This study aims to investigate the impact of postgraduate education on the comprehension of Temporomandibular Disorders (TMDs) among dental professionals. Methods: A cross-sectional observational study was conducted, involving 348 dental professionals, including students and practicing dentists, categorized based on their educational background into two groups: bachelor's degree or lower (Group B) and master's degree or higher (Group M). Questionnaires were utilized to assess attitudes and knowledge across four TMDs-related domains. ⋯ Conclusions: Postgraduate education deepened dental professionals' understanding of TMDs. Students improved more in the domains of "diagnosis" and "treatment and prognosis," whereas practicing dentists enhanced more in the "etiology" domain. To further advance postgraduate education, there is a need for more systematic course designs for TMDs, emphasizing the enhancement of knowledge related to examination methods and treatment options.
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Opioid nonadherence represents a significant barrier to cancer pain treatment efficacy. However, there is currently no effective prediction method for opioid adherence in patients with cancer pain. We aimed to develop and validate a machine learning (ML) model and evaluate its feasibility to predict opioid nonadherence in patients with cancer pain. ⋯ The best model obtained in this study, the LR model, had an AUC_ROC of 0.82, accuracy of 0.82, and specificity of 0.71. The DCA showed that clinical interventions for patients at high risk of opioid nonadherence based on the LR model can benefit patients. The strongest predictors for adherence were, in order of importance, beliefs about medicines questionnaire (BMQ)-harm, time since the start of opioid, and BMQ-necessity. Discussion. ML algorithms can be used as an effective means of predicting adherence to opioids in patients with cancer pain, which allows for proactive clinical intervention to optimize cancer pain management. This trial is registered with ChiCTR2000033576.
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Background: The neuropathic characteristics of pain occurring after an osteoporosis (OP)-related fracture are often under-recognized. The aim of this pilot study is to identify, in patients suffering from pain localized on the site of a previous osteoporotic fracture, the presence of neuropathic characteristics, their medical management, and their impact on quality of life. Methods: This pilot cross-sectional study on consecutive patients in University Hospital, Rheumatology Department, Clermont-Ferrand, France, was approved by the Ethics Committee (IRB number 2023-CF34). ⋯ NCCP patients had more intense pain (NPRS = 5.1 ± 2.9 vs. 2.9 ± 2.7, ES = 0.82 [0.18; 1.44], p=0.019) and impaired sleep compared to patients without NCCP (ES = 0.71 [0.08; 1.33], p=0.043). A remarkable point was that patients had no specific oral or topical treatment for NCCP and were only taking on demand paracetamol and nonsteroidal anti-inflammatory drugs. Conclusions: Future research should focus on the neuropathic characteristics of pain patients with OP, in order to better manage OP-related pain.
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Background: Current evidence indicates that some phenotypic characteristics, such as eye or hair color, might be associated with the experience of pain. We, therefore, compared the anesthetic success rate of inferior alveolar nerve block (IANB) and postoperative pain scores between light eyes and dark eyes in female patients who experienced symptomatic irreversible pulpitis (SIP) in a mandibular molar. Methods: This prospective, parallel-group, observational study was registered with ClinicalTrials.gov (NCT06206304). ⋯ Conclusion: Pain scores decreased significantly after RCT in both groups on all days (p < 0.05). No significant differences were found in the success rate of IANB and postop pain scores between light- and dark-eyed female patients who experienced SIP in a mandibular molar. Trial Registration: ClinicalTrials.gov identifier: NCT06206304.