Pain medicine : the official journal of the American Academy of Pain Medicine
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The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. ⋯ The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.
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Basilar-type migraine (BTM) is a rare subtype of migraine with aura. Impaired consciousness or coma can occur in such patients. ⋯ BTM should be considered for any patient presenting with migraine and coma. Adequate care should be taken to prevent migraine attacks.
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Attentional avoidance of negative stimuli and preference for positive stimuli (assessed prior to surgery) have been found to be predictive of postoperative pain. However, findings so far were mainly obtained in young patients with benign diagnoses. The aim of the present study was to test whether this relationship holds for aged patients with poorer prognosis. ⋯ Attentional avoidance of emotionally negative stimuli prior to surgery proved to be a powerful predictor of acute postoperative pain reflected by the consumption of analgesics; this time in a sample of aged patients with various but mainly malign diagnoses. This measure outperformed traditional predictors like depression, anxiety, as well as pain catastrophizing, and deserves further attention.
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Case Reports
A report of 3 soldiers returned to full duty after lumbar radiofrequency facet denervation in a theater of war.
To provide the advanced interventional procedure of zygapophysial joint neurotomy to soldiers meeting the diagnostic criteria in a combat environment and thus reduce medical evacuations of soldiers from a theater of war. ⋯ Medical evacuation from Iraq was prevented and all soldiers returned to rigorous combat duties including the wearing of body armour daily. We believe to be the first to report on the use of RF nerve ablation in a war time setting and with this functional outcome.
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Randomized Controlled Trial
The abuse potential of Remoxy(®), an extended-release formulation of oxycodone, compared with immediate- and extended-release oxycodone.
Remoxy(®) is a water-insoluble, highly viscous oral formulation of oxycodone extended release (ER) currently in development. The primary objective was to determine the abuse potential of Remoxy under fed conditions relative to oxycodone ER and immediate release (IR) under fasted conditions and compared with placebo (treatment group X). A secondary objective was to evaluate abuse potential under reversed fed/fasted conditions (treatment group Y). ⋯ The abuse potential of Remoxy when taken whole or chewed was significantly lower than two comparators with known abuse potential, including oxycodone IR and crushed oxycodone ER, under the fed/fasted conditions tested. Remoxy may be associated with a reduced risk potential for abuse.