Pain medicine : the official journal of the American Academy of Pain Medicine
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The aim of this study was to investigate pain patterns and the distribution of myofascial trigger points (MTPs) in whiplash-associated disorders (WADs II and III) as compared with mechanical neck pain (MNP). ⋯ Active MTPs are more prominent in WAD than MNP and related to current pain intensity and size of the spontaneous pain distribution in whiplash patients. This may underlie a lower degree of sensitization in MNP than in WAD.
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To provide pediatric care providers with insight into lidocaine infusions for analgesia. ⋯ Our limited experience suggests that lidocaine infusions are well tolerated in the adolescent and young adult pain population, with side effects resolving quickly with interruption or discontinuation of the infusion if necessary. Future studies are warranted to examine safety, efficacy, mechanism of actions, and its long-term impact on a developing central nervous system.
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We aimed to determine Axis-I psychiatric disorders in patients with chronic pain (CP) and compare control subjects determined by a structured clinical interview. Another objective of the study was to examine whether there is an association between psychiatric disorders and quality of sleep, quality of life, and demographic and clinical characteristics in patients with CP. ⋯ Results of this study suggest that psychiatric morbidity in patients with CP is frequently seen and may adversely affect quality of sleep and quality of life of the patients. Therefore, the patients with CP should be examined with respect to their mental status.
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Post-traumatic stress disorder (PTSD) and pain have a well-documented high comorbidity; however, the underlying mechanisms of this comorbidity are currently poorly understood. The aim of this psychophysical study was to investigate the behavioral response to a prolonged suprathreshold pain stimulus in subjects with combat-related PTSD and combat controls (CC) for clinical evidence of central sensitization. ⋯ These findings are consistent with a significantly higher degree of acute central sensitization in individuals with PTSD. Increased acute central sensitization may underlie increased vulnerability for developing pain-related conditions following combat trauma.
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Case Reports
Rapid-onset opioids for the treatment of breakthrough cancer pain: two cases of drug abuse.
In the last few years, the use of opioids for cancer pain has rapidly increased and new molecules have been developed. Currently, rapid-onset opioids are widely used in clinical practice for breakthrough cancer pain (BTcP). However, the tolerability of these molecules is still a matter of debate. ⋯ The reported cases are explicative as they occurred in patients suffering from different types of cancer and with different causes of BTcP. Further investigations are needed to identify factors predicting addiction to this new class of molecules.