Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Effect of Transcranial Direct Current Stimulation of the Motor Cortex on Visceral Pain in Patients with Hepatocellular Carcinoma.
Hepatocellular carcinoma (HCC) is frequently associated with visceral pain. Transcranial direct current stimulation (tDCS) has been proven to reduce chronic pain; however, its effectiveness in malignant visceral pain is unknown. This study aimed to investigate the effects of tDCS in patients with visceral pain due to HCC. ⋯ tDCS proved to be an effective and clinically relevant therapeutic strategy for visceral pain due to HCC.
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To understand the relationship between opioid use in patients with congestive heart failure and outcomes, we compared length of stay (LOS), 30-day readmission rates, and 30- and 90-day mortality in patients discharged with a primary diagnosis of congestive heart failure (CHF) who were taking opioids. ⋯ Opioid use at admission or discharge in patients with CHF did not appear to affect outcomes.
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Randomized Controlled Trial
Movement Does Not Promote Recovery of Motor Output Following Acute Experimental Muscle Pain.
To examine the effect of motor activity on the magnitude and duration of altered corticomotor output following experimental muscle pain. ⋯ Performance of motor activity immediately following the resolution of acute muscle pain did not alter the magnitude or duration of corticomotor depression. Understanding corticomotor depression in the postpain period and what factors promote recovery has relevance for clinical pain syndromes where ongoing motor dysfunction, in the absence of pain, may predispose to symptom persistence or recurrence.
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To assess cognitive performance of chronic pain (CP) patients diagnosed with three types of pain-neuropathic pain (NP), musculoskeletal (MSK), and fibromyalgia (FM)-and to analyze the factors influencing cognitive difficulties in each group. ⋯ These results highlight the importance of taking into account the type of pain when assessing cognitive performance in CP patients and demonstrate the influence of the emotional state of the patient, especially if depression is present.
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Identifying pain generators in tissue deep in the skin can require uncomfortable, complicated, and invasive tests. We describe pilot studies testing the hypothesis that ultrasound image-guided, intense focused ultrasound (ig-iFU) can noninvasively and differentially stimulate the end of transected nerves in the residual limbs of amputee patients. ⋯ Transected nerves had greater sensitivity to iFU stimulation than ipsilateral and contralateral control tissue, including intact nerve. These results support the view that ig-iFU may one day help physicians identify deep, tender tissue in patients who report experiencing pain.