Pain medicine : the official journal of the American Academy of Pain Medicine
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The subject of this publication has been focused on local considerations for facilitating regional best practice, including identifying and uniformly adopting the most relevant international guidelines on opioid use (OU) in chronic pain management. ⋯ The CPLA advisory panel considered the "Safe and effective use of opioids for chronic non-cancer pain" (published in 2010 by the NOUGG of Canada) to be valid, relevant to Latin America, practical, evidence-based, concise, unambiguous, and sufficiently educational to provide clear instruction on OU and pain management and, thus, recommended for uniform adoption across the Latin America region.
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To determine the effectiveness and risks of fluoroscopically-guided cervical medial branch thermal radiofrequency neurotomy (CMBTRFN) for treating chronic neck pain of zygapophysial joint origin. ⋯ If performed as described in the International Spine Intervention Society Guidelines, fluoroscopically-guided CMBTRFN is effective for abolishing zygapophysial joint pain and carries only minor risks.
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Observational Study
Profiles of Urine Drug Test in Clinical Pain Patients vs Pain Research Study Subjects.
To examine similarities and differences in urine drug test (UDT) results in clinical pain patients and pain subjects participating in pain research studies. ⋯ These results support previous findings that PUD is a common finding in clinical pain patients, particularly in those prescribed opioid therapy, and we suggest that UDT be used as routine screening testing in pain research studies.
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Patients with dementia, whose ability to provide self-report of pain is often impaired, are in crucial need of observers who can detect the patients' pain-indicative behaviors appropriately, to initiate treatment. The facial display of pain promises to be especially informative for that purpose. The age of the observer has been shown to have a critical influence on observational emotion recognition (with age-related decrements in facial emotion recognition) but has not yet been studied as such for pain recognition. ⋯ Age does not only lead to a decline in recognition of facial expressions of emotions but age also affects the quality of observational pain recognition in others. However, given that older observers' performance was only slightly reduced, clearly suggests that older caregivers are surely not at risk of becoming visual agnostic for the pain in others.
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Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements. ⋯ A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.