Pain medicine : the official journal of the American Academy of Pain Medicine
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To provide an overview of the role of voltage-gated sodium channels in pathophysiology of acquired and inherited pain states, and of recent developments that validate these channels as therapeutic targets for treating chronic pain. ⋯ These studies suggest that isoform-specific blockers of these channels or targeting of their modulators may provide novel approaches to treatment of pain.
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An increasing number of Operation Iraqi Freedom/Operation Enduring Freedom veterans experience chronic pain. Despite treatment guidelines, there is wide variation in physicians' approaches to pain treatment, and many physicians are unsure of the best treatment approach. Research has examined factors associated with opioid prescribing, but there is little information on physician characteristics that predict patterns of clinical responses to pain. ⋯ There may be distinct patterns in primary care physicians' responses to patients with chronic pain. Relatively few physicians use the multimodal approach endorsed by proponents of the biopsychosocial model of pain treatment. Several physician and practice characteristics predict patterns of clinical action.
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The objective of the study was to determine if there is dysregulated autonomic nervous system activity as manifested by depressed heart rate variability (HRV) among veterans of Operations Enduring and Iraqi Freedom (OEF/OIF). ⋯ These preliminary findings support the high prevalence of depressed HRV and P3 among veterans seen in a level II Polytrauma Center. The findings also suggest a possible synergistic effect of pain, PTSD, and mTBI on depressed HRV. The nature and implications of these relationships require additional research to elucidate.
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Multicenter Study
Barriers and facilitators to chronic pain self-management: a qualitative study of primary care patients with comorbid musculoskeletal pain and depression.
To identify barriers and facilitators to self-management of chronic musculoskeletal pain among patients with comorbid pain and depression. ⋯ Future research is needed to confirm these findings and to design interventions that capitalize on the facilitators identified while at the same time addressing the barriers to pain self-management.
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Review Meta Analysis
Assessment and management of acute pain in adult medical inpatients: a systematic review.
To review the literature addressing effective care for acute pain in inpatients on medical wards. ⋯ Pain is a prevalent problem for medical inpatients. Clinical research is needed to guide the assessment and management of pain in this setting.