Articles: chronic.
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The use of technology to provide chronic pain self-management interventions has increased in the recent years. Individual studies have primarily focused on a single technology-assisted modality and direct comparisons of different technology-assisted modalities are rare. Thus, little is known about the relative strengths and weaknesses of each technology-assisted modality. ⋯ Future trials should focus on direct comparisons of technology-assisted interventions with in-person treatment and head to head comparisons of different technology-assisted modalities. Additional areas of focus include quantifying the cost of technology-assisted interventions, examining the effect of treatment "dose" on outcomes, and establishing guidelines for developing treatments for the technology-assisted environment.
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No single aetiological factor has been proven to cause long-standing groin pain in athletes and no sole operative technique (either open or laparoscopic) has been shown to be the preferred method of repair. The aim of this systematic review was to determine whether there are any differences in the return to full sporting activity following laparoscopic repair of groin pain in athletes. ⋯ Laparoscopic surgery for elite athlete groin pain is increasingly becoming more common with almost 1000 patients reported since 1997. No particular laparoscopic technique appears to offer any advantage over the other.
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Randomized Controlled Trial Comparative Study
Impact of epidural analgesia on quality of life and pain in advanced cancer patients.
Patients with advanced cancer often experience chronic postoperative pain and poor quality of life. The objective of this study was to determine if epidural self-controlled analgesia reduced the incidence of chronic pain and improved the quality of life when compared with intravenous self-controlled analgesia. A total of 50 patients diagnosed with advanced cancer who received analgesia treatment were randomly divided into two groups, epidural self-controlled analgesia group (EA group, n = 26) and intravenous self-controlled analgesia group (IA group, n = 24). ⋯ The VAS in the EA group was significantly lower than that in the IA group (p < .05), and the Karnofsky score in the EA group was significantly higher than that in the IA group (p < .05). Moreover, patients treated with EA felt more satisfied and experienced fewer complications than those with IA (p < .05). The epidural self-controlled analgesia may greatly improve the quality of life and relieve the pain in patients with advanced cancer.
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Obstructive sleep apnea (OSA) is a chronic breathing disorder that contributes to many other health problems (Epstein et al., 2009). It is present but undiagnosed in a large percentage of the population (Adesanya, Lee, Grilich, & Joshi, 2010). Pain is recognized as a public health problem in the United States, affecting millions of people of all ages (Committee on Advancing Pain Research, Care, and Education Board on Health Sciences Policy, 2011). ⋯ Opioid analgesics used to treat pain may cause sedation and respiratory depression by themselves. When administered to individuals with OSA, the risk for harmful respiratory events increases. This article reviews the assessment and monitoring needed to administer opioids safely to individuals with OSA and identifies best practices from a review of the literature.
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Comparative Study Observational Study
Haemodynamic and biochemical responses to fluid bolus therapy with human albumin solution, 4% versus 20%, in critically ill adults.
Fluid bolus therapy (FBT) is common in critically ill patients. With the exception of use in patients with traumatic brain injury, FBT with human albumin solution (HAS) appears safe and perhaps superior in severe sepsis. ⋯ Haemodynamically, FBT with 100mL of 20% HAS performs in an equivalent way to 500 mL of 4% HAS but delivers much less fluid, sodium and chloride.