Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.
To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand. ⋯ Physician gender affected the way in which patient race and cognitive load influenced decisions to prescribe opioids for chronic pain. Future research is needed to further explore the potential effects of physician gender on racial biases in pain treatment, and the effects of physician cognitive load on pain treatment.
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To determine the effectiveness of cervical transforaminal injection of steroids (CTFIS) and to explore possible determinants of response in patients with cervical disc herniation. ⋯ Only a minority of patients with disc herniation or spondylosis and a proven nerve root compression benefits from CTFIS. The potential advantage for the patient must be compared with the risk of the procedure. Even with the combination of clinical and radiological findings, the prediction of a favorable outcome of CTFIS was not possible.
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Randomized Controlled Trial Multicenter Study
Single-entity hydrocodone extended-release capsules in opioid-tolerant subjects with moderate-to-severe chronic low back pain: a randomized double-blind, placebo-controlled study.
A single-agent, extended-release formulation of hydrocodone (HC) has been developed for treatment of chronic moderate-to-severe pain. This study was designed to examine the safety and efficacy of HC extended release in opioid-experienced adults with moderate-to-severe chronic low back pain (CLBP). ⋯ Extended-release HC is well tolerated and effective, without acetaminophen-associated risks of liver toxicity, for treatment of CLBP.
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Randomized Controlled Trial
Preoccupation in an early-romantic relationship predicts experimental pain relief.
Individuals involved in the early stages of a passionate romantic relationship can be consumed by the experience and report emotional dependence and constant focus on their romantic partner. A few studies have shown that viewing pictures of a romantic partner can significantly reduce experimental pain. The strength of the effect, however, varies substantially between individuals. To study why some individuals experience significant pain reduction when looking at a picture of their partner, we examined partner preoccupation. We hypothesized that a greater degree of preoccupation in the early stages of a romantic relationship would be associated with greater analgesia during a pain induction task. ⋯ In two separate experiments, viewing pictures of a romantic partner produced an analgesic effect. The degree of pain relief was positively correlated with partner preoccupation. The results suggest that preoccupation with a romantic partner during early stage romantic love is a predictor of pain relief when viewing pictures of the beloved.
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In the absence of a suitable reference standard, diagnostic local anesthetic blocks cannot be validated in the manner conventionally used for diagnostic tests. Consequently, diagnostic blocks are vulnerable to criticism for lacking validity, or being "not proven." ⋯ The eight criteria provide an axiomatic, philosophical basis for diagnostic blocks in general, and serve to show what empirical evidence needs to be gathered in order to validate a particular block. The associated metric allows the scientific evidence for different blocks to be quantified and compared.