The Clinical journal of pain
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To describe the presence of widespread pressure pain hyperalgesia and myofascial trigger points (TrPs) in neck and shoulder muscles in patients with postmastectomy pain. ⋯ Our findings revealed bilateral widespread pressure pain hypersensitivity in patients with postmastectomy pain. In addition, the local and referred pain elicited by active TrPs reproduced neck and shoulder/axillary complaints in these patients. These results suggest peripheral and central sensitization in patients with postmastectomy pain.
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The aims of this study were 2-fold: (1) to investigate the consequences of opioid use in individuals with chronic pain in the Danish population, and (2) to investigate the development of and recovery from chronic pain from 2000 to 2005. ⋯ The annual incidence for the development of and the recovery from chronic pain was 2.7% and 9.4%, respectively. Increasing age up to 64 years, short education, poor self-rated health, high body mass index, and physical strain at work were predictors of chronic pain. The odds of recovery from chronic pain were almost 4 times higher among individuals not using opioids compared with individuals using opioids. In addition, use of strong opioids was associated with poor health-related quality of life. Furthermore, the results indicated that individuals with chronic pain using strong opioids pain had a higher risk of death than individuals without chronic pain (HR: 1.67; 95% CI: 1.03-2.70). However, this study cannot exclude disease severity as the primary cause of increased mortality.
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Patients' beliefs and expectations about their pain have been identified as important disabling factors in chronic musculoskeletal pain. Besides fear-avoidance beliefs and pain-related fear, cognitions such as thought suppression as well as pain/task persistence behavior have been shown to be associated with pain and disability. The aim of this report is to present a critical evaluation of research, based on the avoidance-endurance model of pain. ⋯ Although both, fear-avoidance and endurance responses have been identified in patients with chronic musculoskeletal pain, currently evidence to confirm their hypothesized consequences for daily functioning is incomplete. Finally, thoughts on the development of differentially targeted and individually scheduled behavioral interventions are reported, including suggestions for further research.
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To review the (1) reliability, validation, feasibility, and clinical utility and (2) the use of the Premature Infant Pain Profile (PIPP) from 1996 to 2009 to determine the effectiveness of pain management strategies. ⋯ The PIPP continues to be a reliable and valid measure of acute pain in infants with numerous positive validation studies. There is substantial support for the use of the PIPP as an effective outcome measure in pain intervention studies in infants. Further research with health professionals is required to better support the feasibility and clinical utility of this measure.
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Randomized Controlled Trial Comparative Study
Morphine versus oxycodone in pancreatic cancer pain: a randomized controlled study.
According to experimental findings, oxycodone (OX) could have some advantages over morphine (MO) in clinical models of visceral pain. It was hypothesized that OX could have some advantages over MO in terms of efficacy and dose escalation in pancreatic cancer pain. ⋯ OX and MO provided similar analgesia and adverse effects with similar escalating doses in patients with pancreatic cancer pain, resembling observations reported in the general cancer pain population. The experimental hypothesis that OX would be superior to MO in the clinical model of pancreatic cancer pain was not confirmed.