Articles: chronic.
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Randomized Controlled Trial
Duloxetine and Subacute Pain after Knee Arthroplasty when Added to a Multimodal Analgesic Regimen: A Randomized, Placebo-controlled, Triple-blinded Trial.
Duloxetine is effective for chronic musculoskeletal and neuropathic pain, but there are insufficient data to recommend the use of antidepressants for postoperative pain. The authors hypothesized that administration of duloxetine for 15 days would reduce pain with ambulation at 2 weeks after total knee arthroplasty. ⋯ When included as a part of a multimodal analgesic regimen for knee arthroplasty, duloxetine does not reduce subacute pain with ambulation.
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The beneficial effects of smoking cessation on the progression of COPD are well established. Nevertheless, many patients with COPD continue to smoke. ⋯ These findings reinforce that young and socioeconomically disadvantaged patients have more difficulties achieving timely smoking cessation. A novel finding is that patients with milder COPD are less likely to quit. The findings suggest a need for interventional studies focusing on these subgroups to ensure abstinence to halt disease progression.
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Living with a patient with chronic pain is now known to have a negative impact on physical and mental health of the caregivers. Research indicates that adaptive coping strategies can reduce the burden that pain has on patients. Yet, it is unknown whether coping strategies can also affect the physical and mental health of the spouses of patients with chronic pain. In the present research, we investigated the role of coping strategies used by spouses of patients with pain in the relationship between the pain intensity of the patients and the physical and mental health of their spouses. ⋯ Implications for clinical practice are discussed. Our findings suggest that screening for coping strategies used by spouses of patients with pain might complement clinical interventions aimed at promoting the physical and mental health of patients and their partners.
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Acta Anaesthesiol Scand · Sep 2016
Long term end-stage renal disease and death following acute renal replacement therapy in the ICU.
In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors. ⋯ The need of acute RRT was associated with markedly increased long term risk of death and ESRD; in contrast its use was not associated with 30-day mortality. In addition to acute RRT, decreased kidney function and peripheral vascular disease before ICU admission were risk factors for ESRD. It seems warranted offering medical follow-up to patients after acute RRT in ICU.
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Headache (HA) is a significant cause of morbidity globally. Despite many available treatment options, HAs that are refractory to conservative management can be challenging to treat. Third occipital nerve (TON) and greater occipital nerve (GON) irritation are potential etiologic agents of primary and cervicogenic HAs that can be targeted using minimally invasive treatment options such as nerve blocks or radiofrequency ablation. However, a substantial number of patients that undergo radiofrequency ablation do not experience pain relief despite a positive diagnostic medial branch block (MBB). ⋯ Chronic pain, cervicogenic headache, third occipital nerve, greater occipital nerve, injectate spread, radiofrequency ablation.