Pain medicine : the official journal of the American Academy of Pain Medicine
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Observational Study
Thermal quantitative sensory testing to predict postoperative pain outcomes following gynecologic surgery.
To evaluate the relationship of preoperative thermal quantitative sensory testing (QST) values with postoperative pain and opiate consumption in opiate-naïve patients following gynecologic surgery. ⋯ Reduced tolerance to both heat and cold thermal pain stimulus was associated with increased postoperative analgesic requirements. Combined responses to multiple pain modalities may be more useful than a single stimulus paradigm.
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Post-traumatic stress disorder (PTSD) and pain have a well-documented high comorbidity; however, the underlying mechanisms of this comorbidity are currently poorly understood. The aim of this psychophysical study was to investigate the behavioral response to a prolonged suprathreshold pain stimulus in subjects with combat-related PTSD and combat controls (CC) for clinical evidence of central sensitization. ⋯ These findings are consistent with a significantly higher degree of acute central sensitization in individuals with PTSD. Increased acute central sensitization may underlie increased vulnerability for developing pain-related conditions following combat trauma.
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It has been documented that pain in people with dementia is often under-reported and poorly detected. The reasons for this are not clearly defined. This project aimed to explore semantic concepts of pain in people with dementia and whether this is associated with clinical pain report. ⋯ This study is the first to show that semantic memory for pain is diminished in dementia patients. When using clinical pain tools, clinicians should consider these effects which may bias clinical pain ratings when they evaluate and manage pain in these patients. This might improve the recognition and management of pain in people with dementia.
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Case Reports
Rapid-onset opioids for the treatment of breakthrough cancer pain: two cases of drug abuse.
In the last few years, the use of opioids for cancer pain has rapidly increased and new molecules have been developed. Currently, rapid-onset opioids are widely used in clinical practice for breakthrough cancer pain (BTcP). However, the tolerability of these molecules is still a matter of debate. ⋯ The reported cases are explicative as they occurred in patients suffering from different types of cancer and with different causes of BTcP. Further investigations are needed to identify factors predicting addiction to this new class of molecules.
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The aim of this study was to investigate the clinical characteristics of primary stabbing headache (PSH) and its prevalence in a neurology outpatient center at a university hospital in China. ⋯ PSH was shown to have an onset at middle age with moderate-to-severe intensity attacks localized predominantly within the first division of the trigeminal nerve. Accompanying phenomena and trigger factors were common and should be noted, implying further research to be conducted.