Pain medicine : the official journal of the American Academy of Pain Medicine
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Pain represents one of the most important predictors of quality of life in patients with osteoarthritis (OA). Prior studies were conducted in hospital settings and/or failed to control important factors such as depression, obesity, or physical activity. Therefore, the aim of the study was to determine factors associated with pain intensity in a large sample of OA patients in primary care. ⋯ A variety of physical and psychological factors were associated with pain intensity. Appropriate pain treatment of OA patients in primary care should consider as many of these factors as possible. Further research is needed to assess if a more comprehensive and proactive approach will result in less pain and in increased quality of life.
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Review Meta Analysis
Efficacy and safety of mu-opioid antagonists in the treatment of opioid-induced bowel dysfunction: systematic review and meta-analysis of randomized controlled trials.
Opioid-induced bowel dysfunction (OBD) is characterized by constipation, incomplete evacuation, bloating, and increased gastric reflux. OBD occurs both acutely and chronically, in multiple disease states, resulting in increased morbidity and reduced quality of life. ⋯ Insufficient evidence exists for the safety or efficacy of naloxone or nalbuphine in the treatment of OBD. Long-term efficacy and safety of any of the opioid antagonists is unknown, as is the incidence or nature of rare adverse events. Alvimopan and methylnaltrexone both show promise in treating OBD, but further data will be required to fully assess their place in therapy.
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Review Case Reports
Inadvertent disk injection during transforaminal epidural steroid injection: steps for prevention and management.
To report two cases of disk injection during transforaminal epidural steroid injection, and to discuss ways to prevent and manage this under-appreciated complication. ⋯ These cases and similar complications following transforaminal epidural steroid injections provide anecdotal evidence that recent imaging studies, repeated not only for qualitatively new symptoms but after a sustained quantitative increase in pain, may reduce the complication risk. Data extrapolated from studies on diskitis suggest that administering parenteral, and possibly also intradiskal antibiotics, immediately after inadvertent disk injection is appreciated, may reduce the infectious risk.
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Multicenter Study Comparative Study Clinical Trial
The self-administered 24-item geriatric pain measure (GPM-24-SA): psychometric properties in three European populations of community-dwelling older adults.
To explore the feasibility and psychometric properties of a self-administered version of the 24-item Geriatric Pain Measure (GPM-24-SA). ⋯ The GPM-24-SA is a promising tool for self-administered assessment of pain in community dwelling older adults. However, because of incomplete response and uncertainty in factor structure, further refinement and psychometric evaluation of the GPM-24-SA is needed before it could be recommended for widespread use.