Pain medicine : the official journal of the American Academy of Pain Medicine
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Medical experts frequently use imaging studies to illustrate points in their court testimony. This article reviews how these studies impact the credibility of expert testimony with judges and juries. The apparent "objective" evidence provided by such imaging studies can lend strong credence to a judge's or jury's appraisal of medical expert's testimony. ⋯ Recent advances in brain imaging may profoundly impact forensic expert testimony. Functional magnetic resonance imaging and other physiologic imaging techniques currently allow visualization of the activation pattern of brain regions associated with a wide variety of cognitive and behavioral tasks, and more recently, pain. While functional imaging technology has a valuable role in brain research and clinical investigation, it is important to emphasize that the use of imaging studies in forensic matters requires a careful scientific foundation and a rigorous legal assessment.
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This review highlights research on sex-based differences in pain perception and treatment. We sought to illuminate the complex factors contributing to differences in pain and analgesic responses between males and females, ranging from psychosocial to biological processes. ⋯ Collectively, greater understanding of the factors that commonly and differentially affect the disparity in pain perception, as well as analgesic response, are beginning to illuminate research targets and promising areas of therapeutic intervention for improved pain management.
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Multicenter Study
Impact of physician and patient gender on pain management in the emergency department--a multicenter study.
Pain is a complex experience influenced by factors such as age, race, and ethnicity. We conducted a multicenter study to better understand emergency department (ED) pain management practices and examined the influence of patient and provider gender on analgesic administration. ⋯ Provider gender as opposed to patient gender appears to influence pain management decisions in the ED.
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Multicenter Study
Are spirituality and religiosity resources for patients with chronic pain conditions?
We studied whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of "Spiritual and Religious Attitudes in Dealing with Illness"), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of "Adaptive Coping with Disease"), life satisfaction, and appraisal dimensions. ⋯ The associations between spirituality/religiosity, positive appraisals. and internal adaptive coping strategies indicate that the utilization of spirituality/religiosity goes far beyond fatalistic acceptance, but can be regarded as an active coping process. The findings support the need for further research concerning the contributions of spiritual coping in adjustment to chronic pain.
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Chronic regional pain syndrome (CRPS) is a severe pain condition that usually results from an injury or surgical procedure. The pain in CRPS often spreads from the site of injury, and with time becomes refractory to conventional therapy. The present study was undertaken to evaluate the effects of 5-day continuous intravenous lidocaine treatment in patients afflicted with CRPS. ⋯ Intravenous lidocaine administration titrated to 5 mg/L demonstrated: 1) a significant decrease in mechanical and thermal allodynia for three months, 2) lessened associated inflammatory components of CRPS, and 3) only minimal side effects and no severe complications.