European journal of pain : EJP
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Randomized Controlled Trial
Analgesic interaction between ondansetron and acetaminophen after tonsillectomy in children: The Paratron randomized, controlled trial.
Ondansetron may reduce the analgesic effect of acetaminophen/paracetamol.
pearl -
Cognitive-behavioural models of chronic pain predict that dysfunctional assumptions about harmfulness of activities may maintain pain-related fear and disability. To assess perceived harmfulness in adolescents, the Photograph Series of Daily Activities for youth (PHODA-youth) was developed. Information concerning its methodological quality is currently lacking. ⋯ The findings support the PHODA-youth as a valid and reliable measure of the perceived harmfulness of activities in adolescents with musculoskeletal pain.
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Preoperative anxiety, a clinically significant problem for many patients undergoing surgery, is associated with prolonged and exacerbated post-operative pain. To date, the mechanisms of preoperative anxiety-induced persistent post-operative pain remain unclear. The present study aimed to provide a rat model of preoperative anxiety-induced persistent post-operative pain using the single-prolonged stress (SPS) procedure to induce preoperative anxiety-like behaviours, and to explore the role of spinal astrocytes in this phenomenon. ⋯ The data suggest that this rat model, which could mimic the clinical persistent post-operative pain induced by preoperative anxiety, may be a useful tool to explore the mechanisms as well as effective prevention and treatment for this problem. Furthermore, spinal astrocytes activation may contribute to the development of post-operative hyperalgesia in this model.
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Neuropathic pain (NP) is common in the adult population but is difficult to study in electronic health record (EHR) databases because it is a symptom rather than a pathologic diagnosis. The first step in studying NP in EHR databases is to develop methods for identifying patients with NP. The objectives of this study were to develop estimates of the prevalence of NP among patients in a primary care EHR database and describe these patients' demographic characteristics and health-care utilization. ⋯ This study represents a step towards being able to utilize EHR databases to study NP by proposing methods to identify patients with certain and probable NP in a primary care EHR database. Validation against a gold standard is the next step.
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Headache is one of the most common symptoms following traumatic head injury. The mechanisms underlying the emergence of such post-traumatic headache (PTH) remain unknown but may be related to injury of deep cranial tissues or damage to central pain processing pathways, as a result of brain injury. ⋯ Our study demonstrates that mild closed head injury is associated with enhanced processing of nociceptive information emanating from trigeminal-innervated deep cranial tissues, but not from non-cranial tissues. Based on these finding as well as the demonstration of head injury-evoked degranulation of calvarial periosteal mast cells, we propose that inflammatory-evoked enhancement of peripheral cranial nociception, rather than changes in supraspinal pain mechanisms play a role in the initial emergence of PTH. Peripheral targeting of nociceptors that innervate the calvaria may be used to ameliorate PTH pain.