The Clinical journal of pain
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To prospectively describe the prevalence and predictive factors of chronic postsurgical pain (CPSP) and poor global recovery in a large outpatient population at a university hospital, 1 year after outpatient surgery. ⋯ Moderate to severe CPSP after outpatient surgery is common, and should not be underestimated. Patients at risk for developing CPSP can be identified during the preoperative phase.
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To characterize the incidence, severity, quality, and treatment of pain in a large cohort of Marfan patients. ⋯ Our findings suggest that pain symptoms in Marfan patients are underestimated and likely undertreated. We propose a need for improved patient and medical provider awareness of pain management options in this population, including the development of effective algorithms to treat pain in Marfan patients.
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To test the hypothesized associations between measures of the behavioral inhibition system (BIS) and behavioral activation system (BAS) and both the intensity and frequency of pain. ⋯ The findings are consistent with predictions based on a model hypothesizing that pain has a nonlinear impact on both BIS and BAS, with a stronger impact on BIS than BAS. If the current results are replicated in other samples, including samples of individuals with chronic pain, they have important implications for identifying biological factors that could influence pain and behavioral responses to pain, as well as for the development and evaluation of treatments that could enhance positive treatment outcomes.
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Pain practitioners would seem to have an obligation to understand and inform their patients on key issues of the evidence base on cannabinoid therapeutics. One way to fulfill this obligation might be to borrow from concepts developed in the prescription of opioids: the use of a written agreement to describe and minimize risks. Regrettably, the widespread adoption of opioids was undertaken while harmful effects were minimized; obviously, no one wants to repeat this misstep. ⋯ Undoubtedly, the knowledge base concerning risks will be an iterative process as we learn more about the long-term use of medicinal cannabis. But we should start the process now so that patients may be instructed about our current conception of what the use of medicinal cannabis entails.