The Clinical journal of pain
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Pain is the most common reason for admission to the Emergency Department (ED) in patients with sickle cell disease (SCD). It can be associated with severe complications and impairs quality of life. Pain management in the ED should be well-defined and aggressive. The objective of this study was to evaluate pain management in the pediatric ED of a country recently facing SCD and to identify priority areas of intervention. ⋯ Pain represents the main reason for admission to the ED in children with SCD even in countries recently facing SCD. Educational interventions obtained significant but still limited improvement in pain management. The diffusion of national guidelines with defined pain evaluation and treatment protocols represents a priority to further ameliorate care of SCD children.
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Multicenter Study Meta Analysis
Treatment of chronic, intractable pain with a conventional implantable pulse generator: a meta-analysis of 4 clinical studies.
To provide further short-term (6 mo) and long-term (1 y) evidence for the use of spinal cord stimulation (SCS) with a conventional implantable pulse generator in the management of chronic, intractable pain. ⋯ This analysis provides further evidence of the safety and effectiveness of SCS in treating chronic intractable pain of the trunk and/or limbs. Specifically, it underscores a high level of effectiveness and acceptable safety concerns in the use of nonrechargeable SCS devices.
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Randomized Controlled Trial
Validation of two novel electronic devices to time-link transcutaneous electrical nerve stimulation and pain report in patients with chronic back pain.
The analgesic effectiveness of transcutaneous electrical nerve stimulation (TENS) is uncertain. Negative findings, interpreted as ineffectiveness, might be due to poor methodological quality. Monitoring is necessary to differentiate between ineffectiveness and low implementation fidelity. Electronic data-logging devices, "TLOG" and "TSCORE," were developed to monitor and time-link TENS and pain report. TLOG records the time and duration of TENS use and output parameters; TSCORE records time-stamped pain scores. The purpose was to determine the accuracy, reliability, and acceptability of the devices. ⋯ TLOG and TSCORE are accurate, reliable, and acceptable devices for monitoring TENS implementation fidelity and pain outcome, with potential for improving TENS research methodology and clinical application.
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Randomized Controlled Trial
Sensory impairment in obese patients? Sensitivity and pain detection thresholds for electrical stimulation after surgery-induced weight loss, and comparison with a nonobese population.
Obese patients have a high prevalence of painful musculoskeletal disorders that may decrease after massive weight loss. Pain thresholds may be different in obese participants. ⋯ Further studies are required to explore sensory dysfunction in obese individuals and to investigate the implications of this dysfunction for pain management.
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Randomized Controlled Trial
Effect of targeted strength, endurance, and coordination exercise on neck and shoulder pain among fighter pilots: a randomized-controlled trial.
To explore in Danish F-16 pilots: (1) the effect on neck and shoulder pain of a 24-week training intervention including targeted training of the deep neck muscles; (2) selected clinical signs and symptoms at baseline; (3) the prevalence and intensity of neck and shoulder pain. ⋯ High prevalences of self-reported neck and shoulder pain and clinical signs and symptoms were found among Gz-exposed F-16 pilots with repeated whiplash-like exposures. Twenty-four weeks of targeted training combining deep neck muscle, strength, and endurance training proved effective in reducing neck pain.