Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Efficacy of Duloxetine in Patients with Central Post-Stroke Pain: A Randomized Double Blind Placebo Controlled Trial.
Central post-stroke pain (CPSP) refers to neuropathic pain in areas of the body corresponding to stroke lesions. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, is safe and effective against neuropathic pain. In this randomized double-blind placebo-controlled study, we studied the effect of duloxetine in CPSP patients. ⋯ Duloxetine can be an effective treatment option for patients with moderate to severe central post-stroke pain.
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Multicenter Study
Assessing validity of the original and Rasch versions of the central sensitization inventory with psychophysical tests in people with knee osteoarthritis.
To determine the extent of agreement between the original Central Sensitization Inventory (CSI) and the Rasch-calibrated version (RC-CSI) and to explore the association of both versions with psychophysical tests and their respective sensitivity and specificity. ⋯ Because of poor variance explained with psychophysical tests and high false positive rates, our results indicate that there is little clinical value of using either version of the CSI in people with knee osteoarthritis.
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Pain and distress are common in children undergoing medical procedures, exposing them to acute and chronic biopsychosocial impairments if inadequately treated. Clinical hypnosis has emerged as a potentially beneficial treatment for children's procedural pain and distress due to evidence of effectiveness and potential superiority to other psychological interventions. However, systematic reviews of clinical hypnosis for children's procedural pain and distress have been predominantly conducted in children undergoing oncology and needle procedures and are lacking in broader pediatric contexts. This scoping review maps the evidence of clinical hypnosis for children's procedural pain and distress across broad pediatric contexts while highlighting knowledge gaps and areas requiring further investigation. ⋯ The review suggests potential benefits of clinical hypnosis for children's procedural pain and distress and thus provides a precursor for further systematic reviews and trials investigating the effectiveness of clinical hypnosis. The review also indicates the need to further explore the feasibility, acceptability, implementation, and safety of clinical hypnosis in children undergoing painful procedures. Based on the review, researchers implementing clinical hypnosis should adequately report interventions or use treatment manuals, follow recommended research guidelines, and assess the fidelity of intervention delivery to promote replicating and comparing interventions. The review also highlights common methodological shortcomings of published trials to avoid, such as the lack of implementation frameworks, small sample sizes, inadequate reporting of standard care or control conditions, and limited evidence on pain unpleasantness outcomes.
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Percutaneous laser disc decompression (PLDD) has been regarded as an effective alternative for the treatment of cervical soft disc herniations. Repeated X-Ray scanning is essential when performing this technique. ⋯ Our results support the conclusion that ultrasound guided PLDD with fluoroscopic validation is a minimally invasive technique for patients affected by herniated cervical discs, but proper choice of patients is critical. This approach should not be performed except after adequate training under close supervision of surgeons experienced in this procedure and in interventional US.
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Young adults with chronic pain and symptoms experience disruptions to their social, emotional, physical, and vocational functioning. Interdisciplinary pain rehabilitation programs for pediatric and adult populations are not designed specifically to address the developmental needs of young adults. ⋯ The article concludes with clinical recommendations for the management of chronic pain and symptoms in young adults, applicable across multiple treatment settings.