The Clinical journal of pain
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Pain management in patients with TN is challenging, as facial pain often does not respond well to conventional therapies. Botulinum toxin type A (BTX-A) has been suggested as a potential treatment option, but there is limited evidence regarding its long-term efficacy. This review aimed to analyze the current data for the use of in the treatment of trigeminal neuralgia (TN) and highlight the evidence for its efficacy and safety. ⋯ Current evidence indicates that BTX-A injection is an effective and safe option for patients with refractory TN or not responding to medical or surgical management. However, more high-quality studies are needed to further confirm its efficacy.
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Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain. ⋯ Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents' opioid decision-making with longer-term pain and opioid-related outcomes.
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Perceived injustice (PI), assessed by the Injustice Experience Questionnaire (IEQ), is an important trigger of anger. Both PI and anger are associated with adverse chronic pain outcomes, and with comorbid mental health severity. We aimed examined the roles of PI and anger in mediating pain across Fibromyalgia patients, with and without comorbid anxiety/depression (FM+A/D, FM-A/D, respectively), as well as rheumatoid arthritis (RA), and pain-free controls (PFC). We hypothesized the highest levels of PI, anger, and pain in FM+A/D patients, followed by FM-A/D, RA, and PFC, thus also validating a Hebrew version of the IEQ. ⋯ Our findings validate a Hebrew IEQ and highlight the importance of PI and state and trait anger in the differential manifestation of mental health comorbidity in FM.