The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Intrathecal coadministration of bupivacaine diminishes morphine dose progression during long-term intrathecal infusion in cancer patients.
To determine the difference in intrathecal morphine dose progression between a continuous intrathecal infusion of a morphine/bupivacaine mixture and morphine for pain relief in patients with cancer. ⋯ The diminished intrathecal morphine dose increase in the combination group is considered to be due to a synergistic effect of bupivacaine on the intrathecal morphine-induced antinociception. A dose increment during long-term intrathecal infusion in cancer patients appears to be related to both disease progression and tolerance phenomena.
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Randomized Controlled Trial Clinical Trial
Nerve root sleeve injections in patients with failed back surgery syndrome: a comparison of three solutions.
To evaluate outcome in patients with failed back surgery syndrome treated with nerve root sleeve injections. ⋯ Overall, although injections induced analgesia at 1 month, these effects were reduced at 3- and 6-month follow-ups. No statistical differences were found between the three treatment groups (after 1 month, p = 0.71; after 3 months, p = 0.69; after 6 months, p = 0.66. The Friedman test showed a significant decrease in treatment score as a function of time in groups B and C (p = 0.015) but not in group A (p = 0.074). Corticosteroids seem responsible for the last phenomenon.
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Randomized Controlled Trial Clinical Trial
Chronic pain management in a health maintenance organization.
The purpose of this study is to investigate the management of chronic pain in a large health maintenance organization using cognitive-behavioral techniques and a blinded control group. ⋯ Gains were achieved in pain severity, negative mood, pain affect, self-control, and pain interference with the patient's life. Other behavioral variables and activity did not improve. Except in self-control, pain affect, and distracting responses from their significant others, the blinded minimal treatment group demonstrated similar findings. Patient satisfaction with treatment strongly favored the treatment group with over 78% of the treatment participants satisfied with the care provided.
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Randomized Controlled Trial Clinical Trial
Does gender affect appraisal of pain and pain coping strategies?
To investigate the impact of gender and a set of pain characteristics on the threat or challenge appraisal of pain and the impact of these appraisals on the coping strategies used to manage the pain. ⋯ Interference of pain has a greater impact on threat appraisal of pain for women. Increasing threat appraisal is associated with health care utilization for women, but women's more frequent use of several coping strategies is unrelated to their appraisal of pain. Appraisal of pain may have important implications on coping and overall well-being of women and men.
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Randomized Controlled Trial Clinical Trial
Cognitive-behavioral treatment in unselected rheumatoid arthritis outpatients.
This trial was performed to evaluate the efficacy of an adjunctive cognitive-behavioral treatment compared with rheumatological treatment alone in unselected rheumatoid arthritis outpatients. ⋯ Cognitive-behavioral therapy has proven an effective adjunct to standard treatment of rheumatoid arthritis outpatients. These effects were shown in an unselected sample with increasing disease activity and with comparable changes in medication during treatment. We recommend cognitive-behavioral treatment as an desirable adjunct to standard medical treatment of rheumatoid arthritis.