Pain
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Review Meta Analysis Comparative Study
Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis.
This study systematically reviewed differences in pain perception between athletes and normally active controls. We screened MEDLINE, Sport-Discus, EMBASE, Web of Science, PsycINFO, PSYNDEX, and the citations of original studies and systematic reviews. All studies on experimentally induced pain that compared pain perception between athletes and normally active controls were eligible. ⋯ After exclusion of studies with high risk of bias, differences between groups in pain threshold were not significant any longer. Our data suggest that regular physical activity is associated with specific alterations in pain perception. Psychological and biological factors that may be responsible for these alterations are discussed.
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Sleep disturbance and pain catastrophizing are important mediators of the chronic pain experience. To date, these factors have not been considered concurrently despite compelling theoretical rationale to do so. In the present study, we examined whether pain catastrophizing not only has direct effects on clinical pain and pain-related interference, but also indirect effects through its association with sleep disturbance. ⋯ Prospective studies are needed to examine lagged associations between these constructs. These findings have important theoretical and clinical implications. Critically, interventions that reduce pain catastrophizing may concurrently improve sleep and clinical pain.
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Meta Analysis Comparative Study
Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials.
Intrathecal morphine prolongs post-operative analgesia, but at the expense of increasing nausea, vomiting, pruritus, urinary retention and risk of respiratory depression.
pearl -
Review Meta Analysis
The population prevalence of foot and ankle pain in middle and old age: a systematic review.
A systematic review and meta-analysis of population-based epidemiological studies was undertaken to determine the prevalence of foot and ankle pain in middle and old age. Searches were conducted in the following electronic databases from inception to October 2010: PubMed, EMBASE, AMED, CINAHL, Cochrane, PEDro, and SportDiscus. Full-text English language articles were included if they used population sample frames, cross-sectional design or analysis, and reported prevalence estimates for foot and/or ankle pain in adults aged 45 years and over. ⋯ Narrative synthesis of evidence from existing studies suggested preponderance in females, an age-related increase in prevalence in women but not men, that the toes/forefoot were the most common anatomical sites of pain, and that moderate disability in an aspect of daily life was reported by two-thirds of cases. This review provides estimates of the community burden of foot and ankle pain in middle and old age. By outlining the scale of this clinical problem, these findings can be used to inform health care planning and provision.
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Review Meta Analysis Comparative Study
Comparing patients' and clinician-researchers' outcome choice for psychological treatment of chronic pain.
In pain treatment, outcomes are generally defined by researchers and clinicians, predominantly using patient self-report. A large-scale survey of people with chronic pain found a more extensive range of treatment outcomes rated important (Turk et al., "Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain." PAIN 2008;137:276-85) than are conventionally used (Turk et al., "Core outcome domains for chronic pain clinical trials: IMMPACT recommendations." PAIN 2003;106:337-45). We compared outcomes from 60 randomised, controlled trials of cognitive and/or behavioural treatment for persistent pain with the 19 domains rated as most important in the survey. ⋯ Five of the 19 outcomes important to survey respondents were not measured at all, and 8 rarely. There was a positive, although modest, correlation between the methodological quality of trials and their coverage of survey respondents' outcomes. We lack measures in many areas of outcome valued by people with chronic pain, and we need to extend routine measurement of trial outcomes.