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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Unpublished questionnaire data collected by the authors' institution (Toronto General Hospital, Toronto, Ontario) indicates that patients often experience significant pain while undergoing lung biopsy, yet receive only a fraction of the maximum allowable dosage of analgesic. ⋯ At the authors' institution, pain associated with lung biopsy needle insertion was well controlled. Positional pain is common for patients required to be in the prone position. Potential solutions include increasing awareness of positional pain and instituting additional supportive equipment.
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Randomized Controlled Trial
Transcervical intrauterine levobupivacaine or lidocaine infusion for pain control during endometrial biopsy.
Endometrial biopsy is a common procedure for the investigation of many gynecological disorders including abnormal uterine bleeding, postmenopausal bleeding, abnormal cytology and infertility. Most women experience some degree of discomfort and pain during the procedure. Pain may occur during dilation of the cervix for insertion of the catheter and during endometrial biopsy, which further aggravates pain by inducing uterine contraction. ⋯ Transcervical intrauterine topical instillation of levobupivacaine or lidocaine causes pain relief during endometrial biopsy. However, further studies are needed to evaluate the effectiveness of intrauterine anesthesia, to determine optimal concentration, volume and waiting time according to the type of local anesthetic agent, and to assess the applicability of the method to other intrauterine procedures.
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Interventions to improve sleep in fibromyalgia may generalize to improvements in multiple symptom domains. Delta-embedded music, pulsating regularly within the 0.25 Hz to 4 Hz frequency band of brain wave activity, has the potential to induce sleep. ⋯ Delta-embedded music is a potential alternative therapy for fibromyalgia.
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Prescription monitoring or review programs collect information about prescription and dispensing of controlled substances for the purposes of monitoring, analysis and education. In Canada, it is the responsibility of the provincial institutions to organize, maintain and run such programs. ⋯ There is variability among Canadian provinces in managing prescription monitoring⁄review programs.
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Rheumatoid arthritis (RA) is a chronic, painful disease with many injurious psychological effects. Acceptance is an important component of pain management and is associated with improved quality of life, and lower levels of pain and depression. While studies have begun to identify the stages of acceptance, little is known about factors influencing the ease and speed with which patients pass through these stages. ⋯ Diagnosis of RA is notoriously difficult. Beyond the clinical difficulties, structural reasons for late diagnosis (symptoms being neglected by patients and medical professionals) were identifed. Delayed diagnosis hindered the acceptance process throughout, and led to more resistant behaviour and to a struggle to achieve the optimal formula for acceptance - accepting the losses of prepain life while still pursuing personal goals.