The Clinical journal of pain
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The efficacy of self-hypnosis in the treatment of chronic pain was evaluated using a multiple baseline design for five patients referred to the Auckland Hospital Pain Clinic. Subjects were selected for high hypnotisability using the Stanford Hypnotic Clinical Scale. Daily records of pain intensity, sleep quality, medication requirements, and self-hypnosis practice were completed. ⋯ The patients showed an increase in personal locus of control and a shift of self-concept away from physical illness on the ISCRG. The results suggest that self-hypnosis can be a highly effective technique for some patients with chronic pain but not for all. Selection criteria and clinical factors other than hypnotisability need to be considered in further research, since even highly hypnotisable subjects may derive limited benefit from self-hypnosis.
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Unilateral section of dorsal roots C5 to T1 were performed in rats, and the automutilation behavior was measured by the extent of the limb lesions expressed in arbitrary units. Changes in the scores of automutilation were studied after the injection of four substances: a morphinomimetic (pethidine) and three antibiotics, chloramphenicol, amoxicillin, and doxycycline. Effects were tested on groups of at least eight rats that were compared with another group of eight animals operated on in the same way but injected with distilled water. ⋯ The same effect was found when the animals were injected with chloramphenicol and amoxicillin. On the contrary, doxycycline was found less efficacious. These results are discussed using the hypothesis of autotomy caused by an abnormal painful sensation felt in the deafferented forelimb.
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Fifty-eight patients undergoing cervical epidural injection of corticosteroids were followed for a 6-month period. Patients with 90% pain relief lasting 6 months were considered to have excellent results, those with greater than 50% pain relief lasting at least 6 weeks were considered to have good results, and all others were considered to have poor results. ⋯ Those patients with the diagnosis of cervical spondylosis and those with subacute cervical strain had statistically significantly (p less than 0.001, difference of proportions test) better results than patients with other diagnoses. The procedure of cervical epidural steroid injection may be most effective in patients with cervical degenerative joint disease as the etiology of their cervical pain.
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The development of an acute pain service in a community hospital is described. A plan of operation is proposed, including accurate record maintenance to avoid complications. Results are presented on over 10,000 patients treated by the acute pain service.
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Migraine headache variants consist of the complicated migraine headache subtypes such as basilar artery migraine, migraine equivalents, and late-life migraine accompanients. Although these disorders occur infrequently, diagnosis may be more difficult. Generally, comprehensive diagnostic studies are required to rule out underlying pathogenic conditions that may present with similar symptom complexes. Standard migraine treatment is often useful in these disorders; however, migrainous variants deserve special therapeutic considerations.