The Clinical journal of pain
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The evaluation of tenderness associated with greater trochanteric pain (GTP) syndrome is amenable to bias and depends on the examiner's experience. In this study, we tested whether the use of an electronic pressure algometer enhanced the reliability of this evaluation. ⋯ The examination of tenderness associated with GTP is facilitated by the used algometer. It is the intraindividual body-side PPT differences that yield the most sensitive measurement for the assessment of deep pain. A cut-off value of 0.8 can be used for diagnostic purposes. Interindividual differences might be considerable and could mask pathologic diagnostic findings.
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Clinical Trial
Decision analysis for epidural labor analgesia with Multiattribute Utility (MAU) model.
Epidural analgesia (EA) is an effective and safe method to relieve labor pain. Little is known about the factors associated with decision on EA. We applied Multiattribute Utility (MAU) theory to ascertain possible factors on which we based to predict whether parturients would receive EA or not (non-EA) during their labor. ⋯ These findings suggest that our MAU model can predict pre-labor decision and final decision of parturients by the incorporation of correlates with respect to knowledge and attitude.
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Comparative Study
The role of TNF-alpha in patients with chronic low back pain-a prospective comparative longitudinal study.
In this prospective longitudinal clinical study with a matched-pair design, we evaluated the role of tumor necrosis factor-alpha (TNF-alpha) and its clinical relevance in patients with chronic low back pain. ⋯ TNF-alpha seems to have a significant role in patients with chronic low back pain. However, the pathophysiology of this process, the clinical relevance of TNF-alpha and, especially, its part in a potential therapy regimen in these patients need to be more closely examined and defined in additional studies.
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Spinal cord stimulation (SCS) has been used for almost 40 years to treat refractory neuropathic pain after failed back surgery. Fully implantable non-rechargeable pulse generators have a battery life of between 2 and 5 years. A new SCS system with a rechargeable power source may last 10 to 25 years, or longer. The potential economic implications of longer battery life with a new SCS system has yet to be assessed. The study objective is to estimate the average difference in lifetime costs between rechargeable and non-rechargeable pulse generators used in treatment with SCS for failed back surgery syndrome. ⋯ A rechargeable SCS system is projected to save up to $100,000 over a patient's lifetime. Fewer pulse generator replacements will also decrease patient discomfort and morbidity from procedural complications.
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Investigations of the association between chronic pain conditions and suicidal ideation (SI) and suicide attempts (SA) have rarely taken the effect of mental disorders into account and have been limited by nonrepresentative samples. The present study used a large population-based sample to investigate the association between chronic pain conditions and SI and SA. ⋯ This is the first study to demonstrate the association between several chronic pain conditions and SI and SA while adjusting for mental disorders in a nationally representative sample. Moreover, this study demonstrates that among individuals with a mental disorder, having a chronic pain condition significantly increased the association with SI and SA.