The Clinical journal of pain
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Observational Study
Patient Controlled Analgesia for Vaso-occlusive Crisis: A Cohort Study.
Sickle cell disease (SCD) accounts for over 68,000 hospital admissions each year in the United States, with long inpatient length of stays (LOS) and frequent readmission common. Patient-controlled analgesia (PCA) has been used to treat patients admitted with vaso-occlusive crisis (VOC), but it is unknown if PCA is associated with shorter LOS and reduced risk of readmission. ⋯ Treatment with PCA may be associated with shorter LOS and may be considered as the primary modality for opioid-based pain control for patients with SCD who are admitted with painful VOC.
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Increasing pain during physical activity is an important, but often poorly assessed, barrier to engaging in activity-based rehabilitation among people with chronic musculoskeletal pain. Preliminary work has addressed this problem by developing new clinical measures of sensitivity to physical activity (SPA). Indices of SPA are generated by evaluating how pain changes in relation to brief physical tasks. Three strategies have been identified for structuring SPA-related physical tasks (self-paced, standardized, and tailored). This cross-sectional study aimed to comparatively estimate the extent of the 3 SPA tasks' evoked pain responses, predictive value of pain severity and pain interference, and their underlying psychological and sensory constructs, among 116 adults with chronic musculoskeletal pain. ⋯ This study further emphasizes SPA as an important and unique attribute of the pain experience and reveals the added value of using a tailored approach to assess SPA.
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The objective of this study was to determine which variables predict parental postvaccination pain ratings. It was hypothesized that after child behavior, parental sensitivity, and parental reports of worry would be the strongest predictors. ⋯ The study suggests that the majority of variance in parent pain ratings was not predominantly based on preschoolers' pain behaviors. Parental worry levels and their assessment of their child's worry were also significant predictors. Clinical implications are discussed.
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This study examined predictive correlations between periaqueductal gray (PAG) and anterior cingulate cortex (ACC) metabolite levels with deficient inhibitory endogenous pain modulation (EPM), including sensory and affective measures of pain during chronic whiplash injury (WHI). ⋯ The results of this study demonstrate deficient EPM at 30 seconds during tonic heat pain stimulation in WHI-P participants, compared with noninjured healthy volunteers or individuals with WHI-noP. In addition, quantification of PAG and ACC metabolites related to glutamate and glia predicted central chronic pain mechanisms related to loss of inhibitory EPM, while ACC metabolites characterized chronic pain described by descriptors and sensory changes.