Pain medicine : the official journal of the American Academy of Pain Medicine
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The objective was to investigate the long-term development of pain and hyperalgesia after patella fractures. The secondary objective was to report the association between tibiofemoral and patellofemoral osteoarthritis, pain, and hyperalgesia. ⋯ The present study suggests that long-lasting local hyperalgesia following a patella fracture is common. No side-to-side difference at the forearms were observed, indicating that the observed local hyperalgesia was not part of a generalized sensitization.
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Although duloxetine has been approved for clinical therapy for diabetic peripheral neuropathic pain, the exact mechanism underlying the anti-allodynic effects in rat models of diabetes mellitus remains obscure. We attempted to identify whether duloxetine exerts anti-allodynic effects via inhibition of the TLR4-Myd88-dependent pathway in diabetic neuropathic pain (DNP) rats. ⋯ Our findings indicated that duloxetine mitigated mechanical and thermal withdrawal thresholds in STZ-injected rats and rescued the overexpression of the TLR4-Myd88-dependent pathway in the spinal dorsal horn in these rats. Whether these changes directly contributed to the reduction of thermal and mechanical withdrawal behavior needs to be further explored.
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Identify prescribing trends for opioid use in non-malignant chronic pain (NMCP) from the National Ambulatory Medical Care Survey (NAMCS). Determine predictors of opioid use based on patient-specific factors. ⋯ Differences exist between those prescribed and not prescribed opioids. Results from this study paired with increased education and further research regarding the appropriate prescribing and monitoring of opioids may help enhance awareness, diminish treatment disparities and improve safe and appropriate use of opioids in the NMCP population.
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Letter Case Reports
The Relationship of Auriculotemporal Neuralgia and Epicrania Fugax.
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To understand the relationship between opioid use in patients with congestive heart failure and outcomes, we compared length of stay (LOS), 30-day readmission rates, and 30- and 90-day mortality in patients discharged with a primary diagnosis of congestive heart failure (CHF) who were taking opioids. ⋯ Opioid use at admission or discharge in patients with CHF did not appear to affect outcomes.