European journal of pain : EJP
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Review Multicenter Study
Biphosphonates for the therapy of complex regional pain syndrome I--systematic review.
Several studies found that biphosphonates counteract locally increased bone resorption and associated pain in patients with complex regional pain syndrome I (CRPS I). We performed a systematic review of all randomised controlled trials to assess the benefit of biphosphonates in the treatment of CRPS I patients with bone loss. ⋯ The very limited data reviewed showed that bisphosphonates have the potential to reduce pain associated with bone loss in patients with CRPS I. However, at present there is not sufficient evidence to recommend their use in practice.
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Comparative Study
A comparison of the knowledge of chronic pain and its management between final year physiotherapy and medical students.
The scientific literature reveals a surprising lack of knowledge of chronic pain mechanisms and its management amongst health care professionals, including physicians and physiotherapists. There is little information directly related to a comparison between medical and physiotherapy students' knowledge of chronic pain. This study aimed to determine and compare the level of knowledge of chronic pain and its management between final year medical (n=126) and physiotherapy students (n=62). ⋯ This will offer students from different disciplines opportunities to understand their different roles and enhance each others' learning base so that a biopsychosocial framework of care can be implemented. In this way, physiotherapists could learn more about the drug management of chronic pain and medical students could explore more collaborative patient-centred paradigms that address issues such as self-efficacy, self-management and patient empowerment. More focus needs to be paid to the education of the health professionals regarding their assumptions and understanding what 'vulnerable' means in a tissue in comparison to a person.
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Previously, it was shown that school-aged (9-14 yr) preterm and fullterm children with neonatal pain exposure exhibit elevated heat pain thresholds and heightened perceptual sensitization to tonic painful heat when tested under standard conditions [Hermann C, Hohmeister J, Demirakca S, Zohsel K, Flor H. Long-term alteration of pain sensitivity in school-aged children with early pain experiences. Pain 2006;125:278-85]. ⋯ Control children habituated significantly more to tonic heat when their mother was present. The NICU children showed overall significantly less habituation than the controls; there was no modulating effect of maternal presence. Especially in highly vulnerable children such as preterms, neonatal pain exposure and prolonged hospitalization may, aside from neuronal plasticity, promote maladaptive pain-related cognitions and foster parental behavior that reinforces the child's pain response.
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Review Meta Analysis
Summary measures of number needed to treat: how much clinical guidance do they provide in neuropathic pain?
Several systematic reviews of randomized controlled trials (RCTs) of drugs to treat neuropathic pain have reported summary estimates of efficacy - specifically, the number needed to treat (NNT). ⋯ Summary NNT estimates may have limited clinical relevance, due to problems of heterogeneity. The most that can be extracted from systematic reviews published to date is the identity of drugs that have demonstrated efficacy for specific types of neuropathic pain, and the strength of such evidence.
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Randomized Controlled Trial Multicenter Study
A randomised controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-induced constipation.
Opioid-induced constipation can have a major negative impact on patients' quality of life. This randomised, double-blinded study evaluated the analgesic efficacy of prolonged-release (PR) oral oxycodone when co-administered with PR oral naloxone, and its impact on opioid-induced constipation in patients with severe chronic pain. Another objective was to identify the optimal dose ratio of oxycodone and naloxone. ⋯ Co-administration of PR oral naloxone and PR oral oxycodone is associated with a significant improvement in bowel function compared with PR oral oxycodone alone, with no reduction in the analgesic efficacy of oxycodone.