Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Providing Epidemiologic Data in Lumbar Spine Imaging Reports Did Not Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from a Stepped-Wedge Randomized Controlled Trial.
To evaluate the effect of inserting epidemiological information into lumbar spine imaging reports on subsequent nonsurgical and surgical procedures involving the thoracolumbosacral spine and sacroiliac joints. ⋯ Inserting epidemiological text into spine imaging reports had no effect on nonsurgical or surgical procedure utilization among patients receiving lumbar diagnostic imaging.
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Randomized Controlled Trial
The Relationship Between Corticomotor Reorganization and Acute Pain Severity: A Randomized, Controlled Study Using Rapid Transcranial Magnetic Stimulation Mapping.
Although acute pain has been shown to reduce corticomotor excitability, it remains unknown whether this response resolves over time or is related to symptom severity. Furthermore, acute pain research has relied upon data acquired from the cranial "hotspot," which do not provide valuable information regarding reorganization, such as changes to the distribution of a painful muscle's representation within M1. Using a novel, rapid transcranial magnetic stimulation (TMS) mapping method, this study aimed to 1) explore the temporal profile and variability of corticomotor reorganization in response to acute pain and 2) determine whether individual patterns of corticomotor reorganization are associated with differences in pain, sensitivity, and somatosensory organization. ⋯ Individual patterns of corticomotor reorganization during acute pain appear to be related to symptom severity, with early corticomotor depression possibly reflecting a protective response. These findings hold important implications for the management and potential prevention of pain chronicity. However, further research is required to determine whether these adaptations relate to long-term outcomes in clinical populations.
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Randomized Controlled Trial
Obturator Nerve Blockade vs. Neuromuscular Blockade for the Prevention of Adductor Spasm in Patients Undergoing Transurethral Resection of Bladder Tumors: A Randomized Controlled Trial.
The obturator nerve runs along the posterolateral walls of the bladder and electrosurgical stimulation in this region can result in adductor spasm which can occur suddenly and unexpectedly with potentially catastrophic results. ⋯ Both techniques are safe and efficacious for preventing adductor spasm. Our data and experience suggest that the ONB is relatively easy to perform and should be considered in patients with posterolateral bladder tumors.
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To create a descriptive profile of chronic pain severity in men with lifetime cumulative violence histories, as a target and/or a perpetrator, and investigate how chronic pain severity is associated with and predicted by lifetime cumulative violence severity and known determinants of chronic pain. ⋯ The association between lifetime cumulative violence severity and chronic pain severity in men is important new information suggesting the need for trauma- and violence-informed approaches to assessment and intervention with men. This is the first analysis using CLVS-44 subscales to understand which configurations of lifetime cumulative violence may be most predictive of chronic pain severity; further investigation is needed to confirm these findings.