The Clinical journal of pain
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To determine (1) the natural history of prescription opioid use, (2) the predictors of long-term opioid use, and (3) the association between opioid dose and pain and function in a large cohort of workers with recent back injuries. ⋯ For the small group of workers with compensable back injuries who receive opioids longer-term (111/1843, 6%), opioid doses increase substantially and only a minority shows clinically important improvement in pain and function. The amount of prescribed opioid received early after injury strongly predicts long-term use. More research is needed to understand clinical decisions to continue or increase opioid therapy after back injury.
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To systematically identify and critically assess clinical trials that use enriched enrollment randomized withdrawal (EERW) trial design as a methodology for assessing the effect of analgesics pain. ⋯ EERW trials are an emerging type of study design that in certain settings may offer advantages over traditional trial designs in characterizing the effects of analgesic medications.
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To examine the clinical and demographic correlates of pain intensity in patients with hip and knee osteoarthritis (OA). ⋯ Pain intensity ratings for patients with lower limb OA differed significantly with respect to sex, age, body mass index, physical activity, professional activity, marital status, and conditions of assessment.
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Comparative Study
Flexion-relaxation and clinical features associated with chronic low back pain: A comparison of different methods of quantifying flexion-relaxation.
The purpose of this study was to simultaneously assess 5 surface electromyography (SEMG) ratios commonly used to quantify the flexion relaxation phenomenon in chronic low back pain patients relative to clinical and musculoskeletal abnormalities. ⋯ These data suggest that measures of flexion-relaxation that contrast SEMG during flexion or extension to MVF are more highly associated with clinical status compared with measures that contrast SEMG during flexion and extension, SEMG whereas standing to MVF, or SEMG during MVF alone.
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Intralipid has been proposed as a treatment option for local anesthetic (LA) toxicity, which does not respond to traditional resuscitation methods. This paper presents a case report of a patient who developed signs of local anesthetic toxicity and was subsequently treated with 20% Intralipid with a positive response. Some background and practical applications regarding this treatment are discussed.