Pain medicine : the official journal of the American Academy of Pain Medicine
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We examined stereotyping of chronic pain sufferers among women aged 18-40 years and determined whether perceived stereotyping affects seeking care for women with chronic vulvar pain. ⋯ Perceived negative stereotyping among chronic pain sufferers is common, particularly negative perceptions about physicians. In fact, chronic vulvar pain sufferers who felt stigmatized were more likely to have sought care than those who did not feel stigmatized.
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Clinical Trial
MRI verification of ultrasound-guided infiltrations of local anesthetics into the piriformis muscle.
Patients presenting with buttock pain syndromes are common. Up to 8% of these conditions may be attributed to piriformis syndrome. Included in several therapeutic and diagnostic approaches, injections directly into the piriformis muscle may be performed. Because the muscle lies very close to neurovascular structures, electromyographic, fluoroscopic, computed tomographic, and magnetic resonance imaging (MRI) guidance have been employed. In few studies, an ultrasound-guided technique was used to inject a local anesthetic into the piriformis muscle without impairing adjacent neuronal structures. ⋯ MRI confirmed the correct placement of the local anesthetic within the muscle. The dispersion of the fluid 30 minutes after the injection could be visualized. Moreover, only one subject experienced slight motor deficits without anatomical correlate. This ultrasound-guided method will be further employed in ongoing clinical studies.
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To assess the cost impact of dose escalation with intrathecal drug therapy and polyanalgesic admixtures and determine if increased cost is justified by improved pain control. ⋯ Polyanalgesia, while more costly, is justified based on its effectiveness in restoring pain control. Superior results are achieved when polyanalgesia is initiated early. Cost modeling enabled price prediction for the purposes of developing program budgets.
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To estimate the yearly economic burden of opioid-related poisoning in the United States. ⋯ Opioid-related poisoning causes a substantial burden to the United States each year. Costs related to mortality account for the majority of costs. Interventions designed to prevent or reverse opioid-related poisoning can have significant impacts on cost, especially where death is prevented.