Pain medicine : the official journal of the American Academy of Pain Medicine
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To determine whether race is a predictor of a patient's likelihood of being prescribed selective cyclooxygenase-2 inhibitors (COX-2s) versus other nonsteroidal anti-inflammatory agents (NSAIDs) in Medicaid managed care plans (MCO). ⋯ Patient race is a significant predictor of COX-2 prescriptions in the Medicaid population, even after adjusting for other demographic and clinical variables. Cost to the patient was not a factor, as the patient copayment was 1 US dollar for any prescription.
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Clinical Trial
Modulation of central hypersensitivity by nociceptive input in chronic pain after whiplash injury.
Chronic pain after whiplash injury is associated with hypersensitivity of the central nervous system to peripheral stimulation. It is unclear whether central hypersensitivity is modulated by peripheral nociceptive input. We hypothesized that changes in nociceptive input would correlate with changes in magnitude of central hypersensitivity. ⋯ Different mechanisms underlie hyperalgesia localized at areas surrounding the site of pain and hyperalgesia generalized to distant body areas. Central hypersensitivity as a determinant of neck pain is probably a dynamic condition that is influenced by the presence and activity of a nociceptive focus.
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This is a structured, evidence-based review of all available studies on the potential effectiveness of the atypical neuroleptics for the treatment of pain (analgesia). To determine what evidence, if any, exists for, or against, the effectiveness of the atypical neuroleptics for analgesia. ⋯ Based on the above results, it was concluded that the reviewed data were generally consistent, suggesting that some of the atypicals may have an analgesic effect. There were, however, few double-blind, placebo-controlled studies, and many of the reports/studies had less than 50 patients. As such, this question requires further research.