The Clinical journal of pain
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There is considerable evidence that personality disorders, including borderline personality disorder (BPD), tend to co-occur with chronic pain. There is also evidence that mood disorders co-occur with chronic pain conditions. Given the central role of affective instability and negative mood states in BPD, we proposed that affective features of depression, anxiety, and hostility may account for the association between BPD features and the severity of pain reported in a patient sample. ⋯ These results indicate that the association between BPD features and pain is accounted for by negative affect, primarily in the form of depression. This is consistent with current theoretical perspectives on BPD. This also suggests that clinicians observing or detecting BPD features among pain patients should consider negative affect, especially depression, in addressing these issues.
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Pain after breast cancer therapy is a recognized complication found to have an adverse impact on patient's quality of life, increasing psychosocial distress. In recent years, case reports about myofascial pain syndrome are emerging in thoracic surgery as a cause of postsurgery pain. Myofascial pain syndrome is a regional pain syndrome characterized by myofascial trigger points in palpable taut bands of skeletal muscle that refers pain a distance, and that can cause distant motor and autonomic effects. ⋯ Myofascial pain syndrome is a common source of pain in women undergoing breast cancer surgery that includes axillary lymph node dissection at least during the first year after surgery. Myofascial pain syndrome is one potential cause of chronic pain in breast cancer survivors who have undergone this kind of surgery.
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According to international guidelines, nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are the cornerstone drugs for cancer pain. In clinical practice, severe cancer pain often requires 3 step analgesics and alternative routes of administration, thus NSAIDs are usually abandoned. Our aim was to evaluate feasibility, safety, and efficacy of ketoprofen combined with opioids in long-term continuous subcutaneous infusion (CSI) for cancer pain in a prospective observational open-label pilot study. ⋯ Ketoprofen CSI in combination with opioids is a feasible, safe, and effective approach to cancer pain.
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To examine the adherence to the recommendations of pain treatment among children and adolescents evaluated for a variety of chronic and recurrent pain conditions. ⋯ Results of this study support the importance of examining adherence to multidisciplinary interventions among children and adolescents with chronic pain.
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Randomized Controlled Trial Clinical Trial
Acute pressure block of the sciatic nerve relieves clinical pain but not cold pressor pain.
Acute pressure applied to the sciatic nerve has been recently reported to offer immediate short-term pain relief in patients with various diseases. This study examined the analgesic effect of this novel method on cold pressor pain compared with clinical pain. ⋯ Our study indicated that cold pressor pain and clinical pain responded differently to acute pressure blockade of the sciatic nerve. Our findings indicate that caution should be exercised when attempting to extrapolate cold pressor pain findings to clinical pain.