Pain physician
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Review Meta Analysis
Antioxidant therapy for pain relief in patients with chronic pancreatitis: systematic review and meta-analysis.
Currently, there is no specific therapy for chronic pancreatitis (CP). The treatment of micronutrient antioxidant therapy for painful CP has been sporadically used for more than 30 years, however, its efficacy are still poorly understood. ⋯ Combined antioxidant therapy seems to be a safe and effective therapy for pain relief in CP patients. Measures of total antioxidant status may not help to monitor the efficacy of antioxidant therapy for patients with CP.
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Echogenicity of regional anesthesia needles has been tested on different preclinical models; however, previous studies were done in an ideal experimental setting utilizing high-frequency insonation and superficially located targets. Because steep-angle deep injections are typically required for spinal and other chronic pain procedures, and low-frequency transducers are used, further feasibility study is warranted. ⋯ The SonoPlex needle appeared to have better echogenicity in this study. While non-echogenic Quincke-type needle visibility was adequate in superficial placements, it was limited in deep injections. An imaging enhancement is effective in improving needle visibility and should be used whenever possible.
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Review Meta Analysis
Prevalence of pain among nonmedical prescription opioid users in substance use treatment populations: systematic review and meta-analyses.
Prescription opioid analgesics (POA) are widely used in the pharmacotherapeutic treatment of acute and chronic pain in North America, where nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in recent years. Existing epidemiological data suggest an association between NMPOU and pain problem symptoms in different populations, including samples in substance use treatment, although the extent of these correlations has not been systematically assessed. ⋯ Pain symptoms are disproportionately elevated in substance use treatment samples reporting NMPOU. Effective measures to prevent and treat NMPOU are urgently needed, although a substantive extent of NMPOU observed in this specific context may relate directly or indirectly to the presence of pain, e.g., either as an expression of ineffective pain care or as a consequence of previous POA-based interventions. At the same time, effective ways to treat and address ongoing pain issues in NMPOU samples need to be implemented, which may require ongoing opioid-based pharmacotherapeutic care aimed at both pain and dependence.
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Observational Study
Fluoroscopy procedure and equipment changes to reduce staff radiation exposure in the interventional spine suite.
Fluoroscopic guided percutaneous interventional spine procedures are increasingly performed in recent years as they have been shown to be target specific and enhance patient safety. However, ionizing radiation has been associated with stochastic effects such as cancer and genetic defects as well as deterministic effects such as cataracts, erythema, epilation, and even death. These are dose related, and hence, measures should be taken to minimize radiation exposure to patients and health care personnel to reduce these adverse effects. ⋯ Spinal injection technique and equipment changes in the procedure suite significantly reduced the rate of effective dose to the clinical staff.
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The spread of complex regional pain syndrome (CRPS) has been well documented. Many severe refractory long-standing patients have total body pain (TBP) that evolved from a single extremity injury. ⋯ TBP and objective sensory loss occur in 20% of patients with refractory long-standing CRPS.