European journal of pain : EJP
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Pain therapy in inpatients is regularly suboptimal and might be improved by clinical pharmacy services. In our hospital, we have implemented a software-supported 'Check of Medication Appropriateness' (CMA), which is a centralized pharmacist-led service consisting of a clinical rule-based screening for potentially inappropriate prescriptions (PIPs), and a subsequent medication review by pharmacists. We aimed to investigate the impact of the CMA on pain-related prescribing. ⋯ Prescribing of analgesics should be improved in inpatients to optimize pain control and to reduce iatrogenic harm. The Check of Medication Appropriateness (CMA) approach, comprising a clinical rule-based screening for patients at risk and a targeted medication review by pharmacists, reduced the number of pain-related potentially inappropriate prescriptions in a highly significant and sustained manner. This study presents the opportunities of a centralized clinical pharmacy service to help clinicians to further improve analgesic prescribing.
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Facial activity during pain is composed of varying combinations of a few elementary facial responses (so-called Action Units). A previous study of experimental pain showed that these varying combinations can be clustered into distinct facial activity patterns of pain. In the present study, we examined whether comparable facial activity patterns can also be identified among people suffering from clinical pain; namely, shoulder pain. ⋯ Similar to experimental pain, facial activity during evoked pain episodes in shoulder pain patients could be clustered into distinct faces of pain. Each cluster was composed of different combinations of single facial responses, namely: narrowed eyes, which is displayed either alone or in combination with opened mouth or wrinkled nose, or furrowed brows and closed eyes. These distinct faces of pain may inform the training of professionals and computers how to best recognize pain based on facial expressions.
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The current knowledge on the role of SI and ACC in acute pain processing and how these contribute to the development of chronic pain is limited. Our objective was to investigate differences in and modulation of intracortical responses from SI and ACC in response to different intensities of peripheral presumed noxious and non-noxious stimuli in the acute time frame of a peripheral nerve injury in rats. ⋯ This study showed distinct cortical processing of noxious and non-noxious peripheral stimuli in SI and ACC. The processing latency in ACC and accumulated spiking activity in SI appeared to be modulated by peripheral nerve injury, which elaborated on the function of these two areas in the processing of nociception.
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Randomized Controlled Trial
Analgesic effect of music during wound care among patients with diaphyseal tibial fractures: Randomized controlled trial.
Evidence is scarce regarding the analgesic effect of music for the relief of acute pain during the care of surgical tibial fracture wounds. ⋯ Patients with diaphyseal tibial fractures that listened to music before and during the wound dressing change showed less pain when compared to those who received the standardized pharmacologic analgesia alone.