The Clinical journal of pain
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Case Reports
Headache in acromegaly: dramatic improvement with the somatostatin analogue SMS 201-995.
Two acromegalic patients with severe headache, persisting after pituitary adenomectomy followed by radiotherapy in one, were treated with the somatostatin analogue SMS 201-995. Both had been resistant to conventional headache therapy and experienced dramatic and rapid relief after the first injection of the analogue. This result persisted with long-term treatment of the drug. Although the mechanism of action of SMS 201-995 in pain remains unclear, the rapid and efficacious analgesic effect of this compound may be one more indication for its use in pituitary tumors associated with cephalalgias.
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Case Reports
Reflex sympathetic dystrophy and posttraumatic stress disorder. Multidisciplinary evaluation and treatment.
Reflex sympathetic dystrophy (RSD) may co-occur with posttraumatic stress disorder (PTSD). A case study is reported of a challenging adolescent patient who presented to a chronic pain service with RSD and PTSD. A multidisciplinary approach utilizing nerve-block therapy with adjunctive pharmacologic treatment, physical rehabilitation, and behavioral/cognitive psychological therapy was employed to produce a significant reduction in pain as well as a more physically and psychologically functional adolescent. The diagnosis and treatment of each disease is essential for the successful resolution of symptoms.
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This study examined the relationship of pain drawings to somatization in patients with sickle cell disease (SCD). Sixty-nine adult patients with SCD completed a pain drawing in which they shaded in areas of the body in which they experienced pain and also completed the symptom checklist (SCL) 90-R as an index of psychological distress. ⋯ The results suggest that health care professionals who treat SCD patients need to consider pain patterns. In individuals with pain patterns atypical for SCD, the psychological status of the patient may need to be evaluated to facilitate optimal pain management.
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This study examined the relation between marital satisfaction, psychological distress, self-reported pain, disability, and clinical findings in 63 chronic low-back pain (CLBP) patients from primary health care centers. The relation between marital satisfaction and psychological distress in their spouses was also studied. ⋯ In male CLBP patient couples, marital dissatisfaction and psychological distress were much less significantly related. This gender difference should be taken into account in the treatment of CLBP couples.