The Clinical journal of pain
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Case Reports Clinical Trial
Gabapentin adjunctive therapy in neuropathic pain states.
This is a report of a trial of the new antiepileptic agent gabapentin in patients with intractable neuropathic pain. ⋯ Gabapentin provides analgesic activity for patients with neuropathic pain and has the advantage of a low side effect profile and drug toxicity.
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To determine the clinical usefulness of the long-term intrathecal administration of midazolam and clonidine in patients with refractory neurogenic and musculoskeletal pain. ⋯ Intrathecal infusion of midazolam and clonidine produced promising results in four patients with refractory chronic benign pain. Further research will be necessary to determine the efficacy and the risk-to-benefit ratio of long-term administration of this combination.
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The analysis of patient data concerning psychological structure and functioning produced an instrument to determine whether a neurostimulator ought to be implanted or not. ⋯ The correlation between the I.F. and the E.F. was calculated for the 40 patients by the Spearman correlation test. A coefficient value of 0.8083 (p = 0.000) was found, indicating the existence of a very close correlation between the predictive I.F. and the E.F. The indication scale appears to be a useful instrument for clinical psychologists to predict the success rate of a spinal cord stimulator in this group of patients.
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Randomized Controlled Trial Clinical Trial
Gender differences in the expression of depressive symptoms among chronic pain patients.
To investigate the extent to which gender differences in the expression of depressive symptomatology exist among chronic pain patients. ⋯ Gender differences in total BDI scores were not revealed for the total general sample or depressed subsample, but gender differences in the expression of depressive symptoms (i.e., item level responses) were found via separate discriminant function analyses on the total general sample and depressed subsample. Consistent with previous studies performed on diverse samples, females' higher endorsement of body image distortion was noted in both of our samples. Females also endorsed significantly higher levels of fatigue in our total sample. Items that were not significant in our total sample include females' higher levels of loss of appetite and crying. In the depressed subsample, items probing pessimism and failure were not statistically significantly different to males' endorsing higher levels of each. Sensitivity to these gender differences is suggested in clinical practice. The likely consequences that these differences in the experience and expression of distress have on coping activities (e.g., help-seeking responses) and the reactions of others (e.g., health-care providers) are highlighted.
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This study validated a measure entitled the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) for assessing the attitudes and beliefs of health care providers about functional expectation for chronic low back pain patients. HC-PAIRS was developed by modifying the Pain and Impairment Relationship Scale (PAIRS) used to assess the attitudes and beliefs of chronic pain patients. ⋯ These results suggested that HC-PAIRS can be used to measure health care providers' attitudes and beliefs about the degree to which chronic low back pain justifies impairments and disability. HC-PAIRS may be useful to health care providers interested in examining this notion.