European journal of pain : EJP
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Persistent postsurgical pain (PPSP) following thoracic surgery affects 40%-60% of patients undergoing lung resection due to malignancies. Postoperative pain-related symptoms are common, leading to limitations in activities of daily living (ADL) and deterioration in physical function, which significantly impacts quality of life. Pain-related limitations are of interest, as postsurgical pain may present as a target for intervention to improve postoperative rehabilitation. This study aimed to evaluate the association between PPSP and ADL limitations during the first 12 postoperative months after surgery for lung cancer. ⋯ Surgery remains a cornerstone in the treatment of early-stage lung cancer. Despite advances in minimally invasive techniques and rehabilitation, persisting postsurgical pain and pain-related limitations in daily activities may endure. This study investigated specifically the pain-related limitations in activities of daily living and described recovery trajectories during the first 12 postoperative months. Patients with persistent postsurgical pain experienced multiple limitations compared to pain-free patients. Although partial recovery was observed, impairments remained significant for up to 12 months after surgery.
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The management of chronic non-cancer pain (CNCP) is complex. Concerns about adverse effects associated with opioid pain medications and a lack of funding for holistic programs present challenges for decision-making among clinicians and patients. Discrete choice experiments (DCE) are one way of assessing and valuing patient treatment preferences. ⋯ A discrete choice experiment identified two groups: younger, with more private insurance, and older, with less private health insurance, each with unique pain management preferences. Clinicians should be aware that age and private health insurance may have an impact on a patient's preferences for CNCP management.
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Recurrence is common in chronic low back pain (CLBP). However, predicting the recurrence risk remains a challenge. The aim is to develop and validate a machine learning tool to predict the recurrence risk in patients with CLBP by using multidimensional medical information. ⋯ This study found that the STarT BACK tool is suboptimal in predicting the 2-year recurrence of chronic low back pain (CLBP). Our proposed multidimensional machine learning model aids clinicians in identifying patients at high risk for future recurrence of CLBP and in implementing appropriate preventive measures. Given the considerable healthcare resource utilisation associated with the frequent recurrence of CLBP, our novel model provides significant assistance in addressing this issue, demonstrating substantial clinical relevance.
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This study describes aspects of pain and how pain affects everyday life and examines the relation between chronic pain and activity limitations in people with hypermobility spectrum disorders (HSD) or hypermobility Ehlers Danlos syndrome (hEDS). ⋯ In a comparison yielding statistically significant results (p < 0.001), persons with hypermobility spectrum disorder (HSD) or hypermobility Ehlers-Danlos syndrome (hEDS) reported earlier pain onset, longer pain durations, and a greater number of pain locations but surprisingly, lower pain intensity than the reference group which consisted of a mixed group of pain conditions. These pain characteristics affected daily activities, indicating a substantial impact on daily life for those with HSD/hEDS.
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Despite functional connectivity network dysfunction among individuals with headaches, no studies have examined functional connectivity neural correlates and anatomical differences in coping with headaches. ⋯ This study highlights the potential use of emerging behavioural biomarkers in headache management, such as pain acceptance, and their role in modifying the headache experience. Notably, grey matter reorganization in the cerebellum and other known brain pain networks, could indicate brain networks that can be modified from targeted behavioural interventions to help decode the nociplastic mechanisms that predominates in headaches.