Pain medicine : the official journal of the American Academy of Pain Medicine
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Intrathecal inflammatory masses or granuloma have been described extensively in the literature in patients receiving chronic spinal infusions for pain. After an extensive literature review, no reported cases of baclofen causing this disorder when administered as a sole agent were identified. Intrathecal baclofen has been used to treat spasticity secondary to stroke, multiple sclerosis, cerebral palsy, spinal cord injury, and other neurological disease. ⋯ We report two cases of inflammatory mass in patients receiving baclofen as a sole intrathecal agent. The authors would recommend vigilance in any patient receiving intrathecal baclofen. If the suspicion arises of this problem, a magnetic resonance imaging or computerized tomography myelogram should be obtained with a focus on the catheter tip.
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To measure the prevalence of pain in a community-dwelling population, to gauge the impact of pain on their daily activities, and to describe the measures they used for pain management. ⋯ This study provides an estimate of the prevalence of pain in the Chinese community in Hong Kong. Western medicine as well as Chinese and alternative methods is popular.
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Multicenter Study
Chronic pain and violent ideation: testing a model of patient violence.
Physicians are at risk of patient-perpetrated violence. The objective of this study was to test a clinical model of patient violence, which had been developed previously by Fishbain and colleagues. The developers of this model believed that it would be associated with increased risk of violence in pain patients. ⋯ Using the Battery for Health Improvement 2 as a measure, the findings of this study consistently supported the Fishbain Model of violence risk, and also reinforced the need for psychological assessment and management when working with chronic pain patients. Suggestions for intervention were also offered, but further research will be necessary to see whether these interventions are effective in decreasing patient violence.
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Randomized Controlled Trial
Client-centered therapy vs exercise therapy for chronic low back pain: a pilot randomized controlled trial in Brazil.
Psychological interventions targeting maladaptive pain behaviors and depressive symptoms are commonly used in the management of chronic pain. ⋯ This was the first study to investigate the effects of client-centered therapy and exercise for patients with chronic LBP. Our results showed that client-centered therapy is less effective than exercise in reducing disability at short term.
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To evaluate the concurrent validity of the short form of an interactive computerized quality of life (ICQOL-SF) measure for patients with chronic pain. ⋯ The five-item short-form interactive computerized method to assess quality of life demonstrates adequate concurrent validity and would be a useful, brief software measure in the assessment of persons with chronic pain. Additional studies are needed to determine the reliability and sensitivity to change of the ICQOL-SF.