The Clinical journal of pain
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Neurocognitive symptoms (NCSs) may be early indicators of opioid-related harm. We aimed to evaluate the incidence and potential attribution of opioid-related NCS among patients on long-term opioid therapy (LOT) by using natural language processing to extract data from the electronic health records within the Veterans Health Administration. ⋯ This study suggests that opioid-related NCS are most likely to occur during LOT, indicating a potential temporal association with opioid use. These findings highlight the importance of monitoring NCS in patients on LOT as part of a broader strategy to mitigate opioid-related harms.
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Although numerous studies have identified associations between socioeconomic, behavioral, dietary, and physical factors and migraine, the causal nature of these relationships has yet to be adequately established. ⋯ Our study robustly supports the significant causal roles of specific socioeconomic, behavioral, and dietary factors with physical measurement in the development of migraine. Notably, coffee intake, oily fish intake, and educational attainment appear protective, whereas poultry intake and extensive mobile phone use elevate risk. These insights pave the way for developing targeted preventive strategies for migraine.
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Opioid use disorder (OUD) is a large, growing, and difficult-to-treat problem. It has been associated with poor sleep, which has a relationship of mutual exacerbation with pain. These interrelationships have prompted interest in how pain catastrophizing (pain-related distortions of cognition), interacts with pain and sleep quality and quantity in those with OUD. ⋯ Pain catastrophizing is a significant mediator of the relationship between the mutually exacerbating factors of sleep quality and pain intensity, and is, therefore, an important treatment target in this population. In addition, objective TST and self-reported TST were only moderately correlated and behaved differently in mediation models, suggesting that more research is needed to understand the relationship between perceived sleep quality and sleep quantity.
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An emerging concept in the chronic pain literature, high-impact chronic pain (HICP), refers to pain that occurs very frequently and results in major disruption of daily life. Previous epidemiologic investigations have noted that lower educational attainment, age, and race appear to be associated with the frequency of HICP, but condition-specific investigations of HICP have been less common. ⋯ These findings suggest that HICP affects more than 1 out of 5 UCPPS patients, with significant associated morbidity. Demographic and clinical characteristics associated with HICP may be useful for identifying at-risk UCPPS patients.