Pain medicine : the official journal of the American Academy of Pain Medicine
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The education of physicians is a fundamental obligation within medicine that must remain closely aligned with clinical care. And although medical education in pain care is essential, the current state of medical education does not meet the needs of physicians, patients, or society. To address this, we convened a committee of pain specialist medical student educators. ⋯ We conclude that improved medical education in pain is essential to prepare providers who manifest both competence and compassion toward their patients.
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We report a case of temporal arteritis with a sympathetic component in the orofacial region, which responded to stellate ganglion blocks (SGBs). ⋯ This case demonstrates that SGB may relieve pain related to temporal arteritis and sympathetically maintained headache and orofacial pain by reducing noxious stimulation peripherally and decreasing central pain transmission centrally.
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Epidural steroid injections (ESI) are the most commonly performed pain procedures. Despite numerous studies, controversy continues to surround their effectiveness. The purpose of this study is to determine whether a standard, clinical local anesthetic injection can predict outcomes for ESI. ⋯ The results of this study found a weak positive correlation between SQ pain scores and treatment results. Further research should consider whether pain perception in conjunction with other variables might prove to be a reliable predictor for ESI and other procedural outcomes.
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Patients with pain 3 years after injury are at risk of lifetime pain. It is not known if the predictors of chronic pain at 3 years are the same as those for earlier time points or whether other factors become important. Clarifying these factors will aid our understanding of the development of long-term pain and further inform the development of models for screening and early intervention for pain in the aftermath of injury. ⋯ Three years after serious injury, almost a quarter of patients report chronic pain, and more than a third report at least moderate pain-related disability. The predicative power of measures taken in the acute setting is not enough to support discharge screening alone as a method of triaging high-risk patients to early intervention.
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Radiotherapy affects the functioning of pacemakers. Guidelines based on dosimetric data exist regarding tolerable doses to pacemakers. Little is known about the effects of radiation on implantable drug delivery systems (IDDS). The objective of our study is to evaluate the safety of radiation treatment delivered to patients with IDDS. ⋯ IDDS failures related to external beam radiation therapy seem to represent a rare occurrence. While we do not see reason to limit radiotherapy in patients with IDDS, we recommend device check after the completion of radiotherapy as well as if the patient has an increase in pain or analgesic requirement.