Pain medicine : the official journal of the American Academy of Pain Medicine
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Review
A structured evidence-based review on the meaning of nonorganic physical signs: Waddell signs.
This is a structured, evidence-based review of all available studies addressing the concept of nonorganic findings: Waddell signs (WSs). ⋯ Based on the above results, the following conclusions were made: 1) WSs do not correlate with psychological distress; 2) WSs do not discriminate organic from nonorganic problems; 3) WSs may represent an organic phenomenon; 4) WSs are associated with poorer treatment outcome; 5) WSs are associated with greater pain levels; 6) WSs are not associated with secondary gain; and 7) As a group, WS studies demonstrate some methodological problems.
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Patients receiving opioid treatment for chronic pain, many of whom were hospitalized with medical complications of substance abuse, were asked to complete a screening questionnaire to help validate a simple self-administered survey. Questions relating to tobacco abuse and prior treatment for drug and alcohol abuse distinguished patients with addiction and pain from opioid-treated chronic pain patients.
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Multicenter Study Clinical Trial
Conversion to oral controlled-release oxycodone from intravenous opioid analgesic in the postoperative setting.
This study assessed conversion factors utilized by physicians to transfer postoperative patients from intravenous opioids to oral controlled-release (CR) oxycodone and the subsequent analgesic effectiveness. ⋯ Administered at least 12 hours following abdominal, orthopedic, or gynecologic surgery, an initial oral CR oxycodone dose calculated by multiplying the amount of IV morphine used in the previous 24 hours (immediate postoperative period) by a conversion factor of 1.2, on average, provided adequate pain control during the subsequent 12-hour dosing interval and for a maximum of 7 days. Adverse events were consistent with opioid side effects.