Pain medicine : the official journal of the American Academy of Pain Medicine
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Bodily pain and psychiatric distress are common symptoms in patients with dialysis. However, the temporal relationships have not yet been investigated. Objective. To evaluate the longitudinal association between depressive symptoms and subsequent risk of developing severe bodily pain in dialysis patients. Design. Prospective cohort study. ⋯ Results of this study suggest that depressive symptoms measured by CES-D predict the future risk of developing severe bodily pain in dialysis patients.
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To determine the long-term response to serial sacroiliac joint (SIJ) corticosteroid injections. Design. Retrospective practice audit. ⋯ SIJ corticosteroid injections appear to be an effective palliative treatment for selected patients with SIJ pain. Most patients whose pain is responsive to SIJ steroid injections improved sufficiently and remained well after 1 to 3 injections, but some required frequent injections on a long-term basis.
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The present study aimed to assess neuropathic symptoms, their stability over time and relationship to pain intensity, pain distribution, and emotional distress in patients with musculoskeletal disorders. ⋯ Our study demonstrates that neuropathic symptoms are prominent features of chronic musculoskeletal pain and are stable over time. These symptoms were closely related to emotional distress and to the diagnosis of fibromyalgia. The results lend support to the theory that neuropathic symptoms represent an underlying sensitization.
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Comment
Overriding the Jehovah's Witness patient's refusal of blood: a reply to Cahana, Weibel, and Hurst.
This article is a response to a survey on moral reasoning among Swiss health professionals that appeared in a recent issue of this journal. The authors of that survey inquired whether or not their respondents would give a blood transfusion to a Jehovah's Witness patient who clearly refused it. ⋯ The present article examines the two ethical rationales that were offered to explain the overriding respondents' answers and argues that neither one is ethically acceptable. It concludes with an account of the phenomenon of "motivated reasoning" that, so it is argued, better explains why the overriders would refuse to honor the Jehovah's Witness patient's transfusion refusal.
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To demonstrate the efficacy and safety of the addition of bupivacaine in restoring pain control and improving quality of life and activity level in patients with chronic nonmalignant pain refractory to intrathecal opioids. ⋯ The addition of intrathecal bupivacaine restores pain control, improves activity level, quality of life, and mental health in this patient group.