Pain medicine : the official journal of the American Academy of Pain Medicine
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Observational Study
Age- and procedure-specific differences of epidural analgesia in children--a database analysis.
Several audits demonstrated the safety of epidural catheters in children undergoing surgery. Within the present data analysis, we investigated whether older compared with younger children and children with specific types of surgical procedures might report higher pain scores. ⋯ This database analysis demonstrated that older children and children undergoing thoracic or spine surgery reported significant higher pain scores most likely because they received less additional opioids. Therefore, a more "aggressive" pain treatment (including opioids on demand under appropriate monitoring) might further improve postoperative care.
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Sustained abnormal postures (i.e., fixed dystonia) are the most frequently reported motor abnormalities in complex regional pain syndrome (CRPS), but these symptoms may also develop after peripheral trauma without CRPS. Currently, there is no valid and reliable measurement instrument available to measure the severity and distribution of these postures. The range of motion scale (ROMS) was therefore developed to assess the severity based on the possible active range of motion of all joints (arms, legs, trunk, and neck), and the present study evaluates its reliability and validity. ⋯ The ROMS is a reliable and valid instrument to evaluate the severity and distribution of sustained abnormal postures.
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Clinicians and educators rely on the published medical information. They trust that original research and narrative or systematic reviews are reliable and the authorship is transparent, but this is not always the case. Disclosure of conflicts of interest by authors is required by most journals, disclosure will not detect ghost or guest authorship. ⋯ Industry, universities, research centers, and professional medical associations should be clear and unequivocal in condeming these practices. Processes need to be in place to investigate and, if need be, deal with violations. Clearly, we must all participate in this endeavor for professional, ethical, and most importantly, best patient care reasons.
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Observational Study
Screening for neuropathic characteristics in failed back surgery syndromes: challenges for guiding treatment.
Neuropathic pain screening tools have shown promise in identifying common neuropathic pain characteristics that derive from diverse etiologies (e.g., diabetic peripheral neuropathy, postherpetic neuralgia). However, no prior studies have specifically assessed whether these tools are capable of discerning the underlying pain mechanisms in the vast, heterogeneous group of patients diagnosed with failed back surgery syndrome (FBSS). ⋯ Unlike other neuropathic syndromes, the neuropathic component of FBSS is less reliably identified by the LANSS and DN4.
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Observational Study
Chronic pain in "probable" vascular dementia: preliminary findings.
In a previous study, the levels of pain reported by patients with "possible" vascular dementia (VaD) were higher than those reported by older individuals without dementia. ⋯ As VaD patients may experience greater pain than controls, it is essential for prescribers to be aware of the presence of this neuropathology if these patients are to receive adequate treatment.