Pain medicine : the official journal of the American Academy of Pain Medicine
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To review clinical strategies for long-term opioid management as well as strategies to assess and monitor patients with moderate to severe chronic pain who may be at risk for aberrant drug-related behaviors. ⋯ Vigilance and frequent interactions may sometimes be inadequate to prevent problematic behaviors; therefore, pharmacologic strategies designed to deter abusive behaviors are also discussed.
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To assess the effects of preclinic group education sessions and system redesign on tertiary pain medicine units and patient outcomes. ⋯ The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction.
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1) Determine and compare prevalence for homicide-suicide (H-S) affirmation in community non-patients (N=478), community patients (N=158), acute pain patients (APPs; N=326), and chronic pain patients (CPPs; N=341); and 2) Develop H-S predictor models in APPs and CPPs. ⋯ The prevalence of H-S affirmation within APPs and CPPs is not insignificant. The APPs predictor model points to a close association between H-S affirmation and suicidality. The CPPs model indicates that there is a close association between H-S affirmation, and anger/hostility and anger directed at physicians. These results, however, should not lead to the belief that CPPs are at greater risk for actual H-S completion for the following reasons: 1) H-S is an extremely rare event; and 2) predictive validity of the H-S item for actual H-S completion has not been determined.
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The purpose is to define the origin of radiculopathy of patients with degenerative lumbar scoliosis-stenosis and to assess the correlation between percentage of initial radicular leg pain relief with selective nerve root injections and lateral canal dimensions. ⋯ In degenerative lumbar scoliotic curves, radicular symptoms are attributed mainly to nerve roots exiting from the concavity of the lumbosacral hemicurve. No evidence was found that the rate of initial relief from selective nerve root injections correlates with the degree of stenosis noted in the MRI.
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Two Australian public hospital multidisciplinary pain centers (MPCs) situated on opposite sides of the country. ⋯ System plasticity is as important to the process of integrated health care as it is to our understanding of the complexity of the lived experience of pain. Better-informed consumers partnered with responsive health professionals drive the proposed paradigm shift in service delivery. The changes better align the needs of consumers with the ability of health care providers to meet them, thus achieving the twin goals of patient empowerment and system efficiency.