The Clinical journal of pain
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Comparative Study Clinical Trial
Function and the patient with chronic low back pain.
To undertake a comparative examination of the reliability and validity of two frequently used self-report measures of functional disability, the Pain Disability Index (PDI) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). ⋯ These findings support other recent work in favor of the PDI. The PDI had a slightly higher internal consistency and was more sensitive than the OLBPDQ.
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To demonstrate the possibilities of the use of oral ketamine in the treatment of postherpetic neuralgia. ⋯ Oral ketamine may provide an alternative in the treatment of postherpetic neuralgia. The possible mechanism of action by its N-methyl-D-aspartate (NMDA) blocking properties is discussed.
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Clinical Trial
Profile of Caucasian women with possible genetic predisposition to reflex sympathetic dystrophy: a pilot study.
To test possible human lymphocyte antigen (HLA) associations in subjects with reflex sympathetic dystrophy (RSD), and to determine correlation of HLA associations to treatment outcomes. ⋯ The results of this pilot study are the first to suggest a possible genetic diathesis in RSD patients with poor treatment outcome. If this finding can be confirmed in larger studies, strictly defined RSD could constitute the third neuroimmune disorder (besides multiple sclerosis and narcolepsy) associated with DR2(15). Gene(s) conferring susceptibility to RSD may be present within or near the MHC region of the short arm of chromosome 6. Due to the small size of our study group it is imperative that larger studies be done in RSD patients employing strict diagnostic criteria to confirm or refute our original observations.
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Some studies have found significant relations between both the factor scores and subscales of the Coping Strategies Questionnaire (CSQ) and various measures of adjustment to chronic pain. In their review of the literature on coping with chronic pain, Jensen et al. (Pain 1991;47:249-83) suggest that conceptual overlap between the subscales may inflate these observed correlations. In the present study, we examine the factor structure of the CSQ subscales which reflect coping, excluding the CSQ subscales which measure appraisal or activity. We then examine the relationship between the CSQ factors and subscales and pain adjustment, while controlling for selected variables. ⋯ The results suggest that praying/hoping and catastrophizing are related to poorer adjustment to chronic pain, that ability to control and decrease pain are related to better adjustment, and that catastrophizing appears to be a separate construct from depression. The results also suggest that the individual CSQ subscales may have greater utility in terms of examining coping, appraisals, and pain adjustment compared to the composite scores.
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To search for generalizable, psychological predictors of chronic pain treatment outcome. ⋯ The "general predictors" of chronic pain treatment outcome may be difficult to find. Therefore, planning treatment for the individual patient may always have to be based on accurate multiaxial and multidimensional assessment of patient functioning.