Pain medicine : the official journal of the American Academy of Pain Medicine
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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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Randomized Controlled Trial
Treatment of chronic lumbosacral radicular pain using adjuvant pulsed radiofrequency: a randomized controlled study.
The objective of this study was to determine the effects of combining pulsed radiofrequency (PRF) treatment and transforaminal epidural injection (TFEI) to treat patients with chronic refractory lumbar radicular pain caused by lumbar spinal stenosis. ⋯ The TFEI provided significant short-term pain relief and PRF can be applied in conjunction with TFEI to achieve higher treatment efficacy compared with TFEI alone.
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Multicenter Study
Radiofrequency intradiscal biacuplasty for treatment of discogenic lower back pain: a 12-month follow-up.
Discogenic low back pain (LBP) affects a considerable number of patients suffering from chronic LBP. Recently, a growing interest has emerged in minimally invasive treatment options for discogenic LBP. Intradiscal biacuplasty (IDB), which uses cooled radiofrequency technology to ablate nociceptors in the posterior aspect of the intervertebral disc, is one such option. We previously presented 6-month results of a randomized, double-blinded, sham-controlled study. Now, we present the unblinded, 12-month follow-up data for treatment patients and 6-month data for cross-over subjects from the original sham group. ⋯ Clinically significant improvements after IDB initially reported at 6 months were maintained at 9 and 12 months. The cross-over subjects had similar improvement in all outcome measures at all observed time points.
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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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The aim of this study was to compare adherence to opioid prescribing guidelines and potential opioid misuse in patients of resident vs attending physicians. ⋯ With some variability, residents and attending physicians were only partly compliant with national guidelines. Residents were more likely to manage patients with a higher likelihood of opioid misuse.