Articles: chronic.
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Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents. ⋯ Treatment gains were consistent across the sexes. One exception was for post-treatment disability in children with non-headache pain conditions; girls exhibited a significant effect of treatment relative to control condition (SMD= -0.50[-0.80,-0.20], p < .01), but no such effect was observed for boys (SMD= -0.08[-0.44,0.28], p = .66). Future research should examine whether mechanisms of treatment efficacy differ between boys and girls, and consider the impact of pre-treatment sex differences on response to treatment.
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Multicenter Study
Early experience of a new extracorporeal carbon dioxide removal device for acute hypercapnic respiratory failure.
Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. ⋯ Our data shows that ECCOR was safe and effective in this cohort. Further experience is vital to identify the patients who may benefit most from this promising therapy.
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Refractory migraine is a challenging condition with great impact on health related quality of life. Intravenous (IV) ketamine has been previously used to treat various refractory pain conditions. We present a series of patients with refractory migraine treated with intravenous ketamine in the hospital setting. ⋯ IV ketamine was safely administered in the hospital setting to patients with refractory chronic migraine. Treatment was associated with short term improvement in pain severity in 6 of 6 patients with refractory chronic migraine. Prospective placebo-controlled trials are needed to assess short term and long-term efficacy of IV ketamine in refractory chronic migraine.
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Emotional responses to pain are known to play an important role in the development and maintenance of pain. To better understand the role that pain anxiety plays in chronic pain, as well as to evaluate treatments that might treat it effectively, reliable and valid measures of pain anxiety are needed. Thus, the aim of this study was to provide additional evidence regarding the psychometric properties of the Child Pain Anxiety Symptoms Scale (CPASS) in a sample of adolescents. ⋯ The findings support the reliability and the validity of CPASS as a measure of pain-related anxiety in adolescents.