Pain practice : the official journal of World Institute of Pain
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We describe the use of the antihypertensive, candesartan, with hydrochlorothiazide (ECARD Combination Tablets LD) as a preventive therapy that decreased the frequency of migraine accompanied by premonitory leg edema. Two women (aged 26 and 50 years) presented to hospital with an increasing frequency of migraine without aura accompanied by leg edema. ⋯ The use of ECARD to treat a series of migraines by controlling premonitory leg edema has not been reported. ECARD, combined with a low-dose diuretic, may have been helpful in these patients with the premonitory migraine symptom of leg edema.
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Randomized Controlled Trial
0.025% capsaicin gel for the treatment of painful diabetic neuropathy: a randomized, double-blind, crossover, placebo-controlled trial.
Topical therapy may provide additional benefit in patients with painful diabetic neuropathy (PDN). This study was conducted to study the safety and efficacy of 0.025% capsaicin gel in this condition. ⋯ 0.025% capsaicin gel is safe and well tolerated, but does not provide significant pain relief in patients with PDN.
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Review Comparative Study
Diagnosing neuropathic pain in patients with cancer: comparative analysis of recommendations in national guidelines from European countries.
Neuropathic pain is a prevalent symptom in patients with cancer, which needs a more specific algorithm than nociceptive pain or neuropathic pain from other origin. Clinical practice guidelines (CPGs) can be helpful in optimizing the diagnosis of neuropathic pain in patients with cancer. ⋯ This work demonstrates an important heterogeneity between European recommendations on diagnosis and assessment of neuropathic pain in patients with cancer. The main weaknesses are the low level of evidence and the absence of specific data focusing on neuropathic pain in patients with cancer. We recommend that physicians dealing with neuropathic pain in patients with cancer should be specially trained, that a specific methodology to develop CPGs should followed, and that specific research should be developed on the diagnosis of neuropathic pain in patients with cancer.
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Pain is a comorbid and aggravating symptom that in many conditions can be perceived differently and should therefore be managed accordingly. Numerous factors, both social and cultural, are thought to influence the analgesic prescription. However, elucidation of such areas is limited. We therefore conducted a systematic literature review to test the hypothesis that variations in provider characteristics predict the prescription of pain medication. ⋯ Our systematic review of existing literature highlights that provider's age, sex, experience, specialty, and the interplay between provider and patient characteristics are important variables in pain management. However, generalizations relating to these findings are limited by the heterogeneity of the studies and the paucity of literature in this field.
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Observational Study
Impact of physicians' sex on treatment choices for low back pain.
Little information is available regarding physicians' sex as a potential bias in making pain treatment decisions. This study investigated how sex of the medical care provider and patient characteristics influence choices that are made in the treatment of low back pain. ⋯ Physicians' sex had a significant impact on pain management decisions in patients with low back pain. Female physicians prescribed more pharmacological agents as their first choice compared to male physicians.