Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis
Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States.
The recent Institute of Medicine Report assessing the state of pain care in the United States acknowledged the lack of consistent data to describe the nature and magnitude of unrelieved pain and identify subpopulations with disproportionate burdens. ⋯ Our study quantifies the magnitude of analgesic treatment disparities in subgroups of minorities. The size of the difference was sufficiently large to raise not only normative but quality and safety concerns. The treatment gap does not appear to be closing with time or existing policy initiatives. A concerted strategy is needed to reduce pain care disparities within the larger quality of care initiatives.
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Comparative Study
The impact of sexual or physical abuse history on pain-related outcomes among blacks and whites with chronic pain: gender influence.
Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes. ⋯ Our study confirms physical and mental health, and pain-related outcomes are affected by abuse history for men and women. These results support screening all patients for abuse to improve the survivor's overall health and well-being.
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Case Reports
Sternal kyphoplasty for metastatic lung cancer: image-guided palliative care, utilizing fluoroscopy and sonography.
Skeletal metastases can cause severe pain and functional impairment, secondary to direct invasion or osteolysis. Direct palliation of these metastases can reduce the burden of pain. Surgical excision or radiotherapy has been used to target these tumors. ⋯ Ultrasound imaging was used with fluoroscopy. Reproducibility, by other providers, is imperative with any emerging technique; this will facilitate wider patient access and device innovation. Hopefully, future multicenter trials will validate the efficacy and safety of this technique.
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Clinical Trial
The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing--an experimental study.
Deep and slow breathing (DSB) techniques, as a component of various relaxation techniques, have been reported as complementary approaches in the treatment of chronic pain syndromes, but the relevance of relaxation for alleviating pain during a breathing intervention was not evaluated so far. ⋯ Our results suggest that the way of breathing decisively influences autonomic and pain processing, thereby identifying DSB in concert with relaxation as the essential feature in the modulation of sympathetic arousal and pain perception.
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The objectives of this study were to investigate the associations of key constructs of relationship quality (cohesion, consensus, and satisfaction) and perceived partner responses to pain behavior (e.g., solicitous and negative responses) with the outcomes of pain and disability in those with long-term low back pain, and to explore the role of the patient's depressive symptom mood state on those associations. ⋯ Depressive symptoms play a significant role in determining the associations between relationship quality, perceived partner reactions, and pain and disability. The relationship construct of consensus and perceived solicitous responses were associated with pain and disability. These findings illustrate the importance of social context and patient mood state on the outcomes for those with low back pain.