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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Adverse health care events are injuries occurring as a result of patient care. Significant acute pain is often caused by medical and surgical procedures in children, and it has been argued that undermanaged pain should be considered to be an adverse event. Indicators are often used to identify other potential adverse events. There are currently no validated indicators for undertreated pediatric pain. ⋯ The adverse care indicators developed in the present study are the first step in conceptualizing mismanaged pain as an adverse event.
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Pain is one of the most common reasons for individuals to seek medical advice, yet it remains poorly managed. One of the main reasons that poor pain management persists is the lack of adequate knowledge and skills of practicing clinicians, which stems from a perceived lack of pain education during the training of undergraduate medical students. ⋯ Participating patients, students and pain experts recognized a need for additional medical education about pain assessment and management. Educational approaches need to teach students to gather appropriate information about pain, to acquire knowledge of a broad spectrum of therapeutic options, to develop a mutual, trusting relationship with patients and to become aware of their own biases and prejudice toward patients with pain. The results of the present study should be used to develop and enhance existing pain curricula content.
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There is evidence that biguanides and sulfonylureas block diclofenac-induced antinociception (DIA) in rat models. However, little is known about the interaction between these hypoglycemics with respect to DIA. ⋯ Pretreatment with glibenclamide, glipizide or metformin blocked DIA in a dose-dependent manner, and combining either sulfonylurea with metformin produced even greater effects. The observed ED50s for the combinations were approximately fourfold lower than the calculated additive effects. These data indicate that sulfonylureas interact to produce antagonism of DIA. Combination therapy is a common second-line treatment for patients with diabetes and metabolic syndrome, a group that experiences pain from multiple sources. The results suggest that at least some anti-inflammatory agents may not be effective in this group.
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Review Meta Analysis
Yoga for chronic low back pain: a meta-analysis of randomized controlled trials.
To evaluate the efficacy of yoga as an intervention for chronic low back pain (CLBP) using a meta-analytical approach. Randomized controlled trials (RCTs) that examined pain and⁄or functional disability as treatment outcomes were included. Post-treatment and follow-up outcomes were assessed. ⋯ The results of the present study indicate that yoga may be an efficacious adjunctive treatment for CLBP. The strongest and most consistent evidence emerged for the short-term benefits of yoga on functional disability. However, before any definitive conclusions can be drawn, there are a number of methodological concerns that need to be addressed. In particular, it is recommended that future RCTs include an active control group to determine whether yoga has specific treatment effects and whether yoga offers any advantages over traditional exercise programs and other alternative therapies for CLBP.
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Review Meta Analysis
Does pain in individuals with multiple sclerosis affect employment? A systematic review and meta-analysis.
Individuals with multiple sclerosis (MS) experience some of the highest unemployment rates among all groups of chronic illnesses. Pain has been found to be a common reason for sick leave or early retirement in healthy populations or other groups with chronic illness; however, there is little awareness regarding the effect of pain on the work status of individuals with MS. ⋯ The results of the present study indicated that individuals with MS who experience pain were significantly more likely to report a decreased employment rate than individuals with MS who were pain free.