Pain medicine : the official journal of the American Academy of Pain Medicine
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Observational Study
Chronic spinal and oral morphine-induced neuroendocrine and metabolic changes in noncancer pain patients.
Interactions between opioid use and hormonal function are documented in the literature. However, it is unclear if therapeutic intrathecal opioid therapy can induce hormonal changes, compared to oral opioid therapy. ⋯ Hypogonadotrophic hypogonadism was more prevalent in the morphine groups and was correlated with clinical findings. Significant bone mass loss occurred in morphine users, even without hormone dysfunction when compared to nonopioid treatment. Growth hormone, thyroid stimulating hormone, adrenocorticotrophic hormones, and cardiovascular risk parameters were less compromised in morphine users.
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To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey responses. ⋯ These data suggest that demographic factors, preadmission medications, and PACU pain scores but not analgesic medications are associated with patient satisfaction with regards to both pain management and overall satisfaction.
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Phantom limb pain is a painful sensation perceived in the absent limb following surgical or traumatic amputation. Phantom limb sensations, which are nonpainful, occur in nearly all amputees. Deafferentation can also produce similar symptoms. Here we report the presence of phantom pain in a deafferented limb. ⋯ This is a report of phantom limb sensations and phantom pain following BPA in an intact but flaccid and insensate limb.
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Observational Study
Do male and female general practitioners differently prescribe chronic pain drugs to older patients?
The aim of this study was to identify the relationship between general practitioner (GP) gender and prescribing practice of chronic pain drugs in older adults. ⋯ Male and female GPs prescribe analgesics in a similar manner. However, male GPs prescribe more antineuropathic pain drugs, but fewer SySADOA.
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For decades, the heterogeneity of the amputee population and the complex interaction of biopsychosocial factors have confounded researchers' attempts to develop an effective treatment for phantom limb pain. Therefore, it remains difficult to treat, and affected patients often experience decreased quality of life, increased psychological distress, and poorer health outcomes. ⋯ In the case study, we report a novel strategy for the peripheral placement of neuromodulation leads for the treatment of phantom limb pain in a patient who subsequently described complete and consistent pain relief independent of significant variations in psychosocial stress.