Pain medicine : the official journal of the American Academy of Pain Medicine
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To describe the longitudinal course of depressive symptoms and pain experienced by continuing care retirement community (CCRC) residents and to investigate the impact of comorbid chronic activity-limiting pain and chronic high depressive symptoms on physical functioning and health service use. ⋯ Pain and depressive symptoms were both common and appeared remarkably stable over time. Depressive symptoms contributed significantly to the prediction of impairment associated with pain, and identification and treatment of such symptoms, even minor symptoms, could reduce pain-related impairment and health care costs in the elderly.
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This study aimed to test the reliability and validity of physician ratings in a broadly defined sample of women with vulvodynia and to examine the external validity of the vulvodynia subtypes. ⋯ Findings from the present study suggest that physician ratings for Friedrich's criteria can be operationalized and found to be reliable and valid in a wide range of women with vulvodynia. The absence of differences between subtypes on measures of pain, sexual function, psychological function, and quality of life challenge the clinical significance of these subtypes and support the theory that vulvodynia represents a continuum of chronic vulvar pain rather than two distinct entities.
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Comparative Study Clinical Trial Controlled Clinical Trial
Acute and chronic pain in geriatrics: clinical characteristics of pain and the influence of cognition.
This study aimed to identify which of the well-known characteristics of chronic pain patients are seen even in older patients with multiple comorbidities and considerable functional impairments and how cognition influences patients' reports of acute and chronic pain. ⋯ Geriatric inpatients with chronic pain differ from acute pain patients in pain description, pain reduction during treatment, use of analgesics, and emotional distress. Cognitive impairment seems to change the ability to localize acute pain. In our study, the perception of pain intensity was independent of cognition. Because of the small sample size, further studies are needed to confirm these findings. Multiprofessional, intense rehabilitation programs for geriatric patients with chronic pain are considered of prime importance.
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Randomized Controlled Trial Clinical Trial
Efficacy of pamidronate in complex regional pain syndrome type I.
Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD), is a painful, disabling disorder for which treatment is difficult. The aim of this study was to determine the efficacy of pamidronate in a double-blind randomized placebo-controlled trial. ⋯ Pamidronate may be a useful treatment option in the management of patients with CRPS Type I. Although treatment response was variable, the majority of patients improved. Early administration in tandem with other treatment measures is recommended.
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Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient. ⋯ This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.