The Clinical journal of pain
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Comparative Study
Psychiatric history and psychologic adjustment as risk factors for aberrant drug-related behavior among patients with chronic pain.
To investigate the role of psychiatric history and psychologic adjustment on aberrant drug-related behavior among patients prescribed opioids for noncancer pain. ⋯ Psychiatric factors, such as a history of mood disorder, psychologic problems, and psychosocial stressors, may place patients at risk for misuse of prescription opioids. Future studies to elucidate the risk of medication misuse and aberrant drug behavior among this patient population are needed.
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Assessment of pain in patients with whiplash-associated disorders has been previously reported using a variety of instruments. However, the reproducibility of the findings derived from such measurements has not been explored with respect to this particular patients group. ⋯ On the basis of the current patient sample, this study demonstrates that although PPT findings may generally be applied for monitoring change in chronic whiplash patients, the use of VAS scores should be limited to patients whose initial score is above 4. It is also suggested that if the PPT is to serve as an outcome measure, its measurement should be performed by the same tester.
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We describe a case of spontaneous complex regional pain syndrome developing first in the left arm and 2 years later in the right foot of a 14-year-old girl. Physical examination showed abnormalities in tactile and thermal sensitivity. ⋯ We suggest that the observed electrophysiologic alterations could result from a temporary dysfunction of attentional systems, which are assumed to contribute greatly to the LEPs vertex complex. Further studies are needed to test this hypothesis.
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The aim was to investigate whether increased pericranial tenderness or decreased pressure pain threshold (PPT) was related to headache intensity, duration, and frequency in chronic tension-type headache (CTTH). ⋯ Increased tenderness may predispose the patients to other perpetuating factors in inducing headache attacks. Further research is needed to clearly define the role of pericranial tender tissues or other factors in the genesis and maintenance of CTTH.
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Review Historical Article
Opioids: after thousands of years, still getting to know you.