Pain medicine : the official journal of the American Academy of Pain Medicine
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Clinical Trial
Pregabalin in the treatment of refractory neuropathic pain: results of a 15-month open-label trial.
Neuropathic pain associated with postherpetic neuralgia (PHN) and painful diabetic peripheral neuropathy (DPN) can be intractable and may not respond to commonly used treatments, such as tricyclic antidepressants (TCAs) and opioids. This long-term, open-label study was a preliminary evaluation of pregabalin for patients whose pain had been judged refractory to other treatments for neuropathic pain. ⋯ These results suggest that pregabalin may be beneficial in patients with neuropathic pain who have had an unsatisfactory response to treatment with other medications.
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Fabry disease (FD) is an X-linked lipid storage disorder showing a high prevalence and early occurrence of painful neuropathy. Early detection of this likely underdiagnosed disease is an important approach because a causal therapy is available. ⋯ Thus, somatosensory profiling in male patients with painful extremities may be useful in the detection of FD.
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The aim of this report is to determine the frequency of aberrant drug behaviors and their relationship to substance abuse disorders in a large primary sample of patients receiving opioids for chronic pain. ⋯ Patients who report four or more aberrant drug behaviors are associated with a current substance use disorder and illicit drug use, whereas subjects with up to three aberrant behaviors have a very low probability of a current substance abuse disorder. Four behaviors--oversedated oneself, felt intoxicated, early refills, increase dose on own--appear useful as screening questions to predict patients at greatest risk for a current substance use disorders.
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Although there is limited research on patient attributes that may be related to reasons for launching a malpractice suit, no such research has been performed in acute pain patients (APPs) or chronic pain patients (CPPs). The objective of this study was then to develop some statistical models that would describe such patients' attributes. ⋯ CPPs are at a greater risk than patients without pain and APPs for harboring the sue MD wish. Some patient attributes and the referral/treatment situation appear to be important predictors for harboring the sue MD wish, but differ between APPs and CPPs.
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We attempted to identify psychological comorbidities that are associated with the propensity for prescription opioid abuse. ⋯ Patients in chronic pain should be assessed for psychological and addiction disorders because they are at increased risk for abusing opioids. They should also be referred for psychosocial treatment as part of their care, where appropriate.