The Clinical journal of pain
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Comparative Study
Personality factors in the explanation of sex differences in pain catastrophizing and response to experimental pain.
To examine the effects of personality and pain catastrophizing upon pain tolerance and pain ratings and to examine the impact of an experimental pain induction on subsequent ratings of catastrophizing. ⋯ The results suggest that sex differences in catastrophizing and pain responsivity are partially accounted for by the dispositional tendency to describe oneself as emotionally vulnerable. The findings also suggest that pain catastrophizing may be situational as well as dispositional.
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A 39-year-old male presented with penile pain related to ejaculation. No urogenital, infectious, or neurologic diseases were associated with the symptoms. The pain was refractory to conventional analgesics and several neuropathic pain therapies. Oral topiramate was titrated to 75 mg daily, and within a month, the patient's pain improved from 8 to 1 out of 10, which has been maintained for 6 months.
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Comparative Study
Evidence-based assessment of acute pain in older adults: current nursing practices and perceived barriers.
To report data on current nurse practice behaviors related to evidence-based assessment of acute pain in older adults, perceived stage of adoption of pain assessment practices, and perceptions of barriers to optimal assessment in this population. ⋯ Our data suggest that pain is not being assessed and reassessed in a manner that is consistent with current practice recommendations in older adult patients with pathologic processes that highly suggest the presence of acute pain.
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The objective of this study is to determine the effect of oral ketamine on pain and allodynia associated with multiple sclerosis. A 60-year-old woman with multiple sclerosis was referred to our clinic because of severe pain and allodynia. Oral ketamine was started at a dose of 20 mg once a day and increased to twice a day. Oral ketamine was effective in the treatment of the pain and allodynia associated with multiple sclerosis.
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The objective of this study is to investigate sympathetic nervous system involvement in 2 patients with painful legs and moving toes. The first case was studied several years after the initiating trauma produced a peripheral nerve lesion and demonstrated the characteristic sequence of progression of pain and moving toes from the injured leg to the contralateral leg. The second case was initially studied within 3 months of an injury that did not produce definitive signs of a peripheral nerve lesion. ⋯ These symptoms and signs disappeared after lumbar sympathectomy, and re-emerged when signs of sympathetic reinnervation were detected. We concluded that sympathetic neuronal discharge may provoke pain by activating an impulse generator in the affected limb. Sympathetic involvement in the painful legs and moving toes syndrome appeared to be greater in the second case than the first, presumably due to differences in the initial injury or stage of the condition.