Pain medicine : the official journal of the American Academy of Pain Medicine
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In a companion article, we synthesized current clinical and preclinical data to formulate hypotheses about the etiology of drug administration catheter-tip inflammatory masses. In this article, we communicate our recommendations for the detection, treatment, mitigation, and prevention of such masses. ⋯ Attentive follow-up and maintenance of an index of suspicion should permit timely diagnosis, minimally invasive treatment, and avoidance of neurological injury from catheter-tip inflammatory masses. Whenever it is feasible, positioning the catheter in the lumbar thecal sac and/or keeping the daily intrathecal opioid dose as low as possible for as long possible may mitigate the seriousness, and perhaps, reduce the incidence of such inflammatory masses.
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Retrospective chart review. ⋯ FBSS is a syndrome consisting of a myriad of surgical and nonsurgical etiologies. Approximately one half of FBSS patients have a surgical etiology. Approximately 95% of patients can be provided a specific diagnosis.
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The purpose of this study was to develop expert-based guidelines for a medical student curriculum on chronic pain evaluation and management in older adults. ⋯ We have developed curriculum content guidelines for educating medical students about the evaluation and management of chronic pain in older adults. Once curricula are developed, their efficacy, in particular their influence on patient outcomes, must be evaluated.
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To examine the use of intravenous immunoglobulin (i.v.i.g.) in chronic pain. ⋯ Overall, 20% of patients had>70% pain relief and 27.7% of patients reported relief between 25% and 70%. Six patients (4.6%) had moderately increased pain levels for a duration of up to 9 weeks. Good relief, of more than 70%, was found in all major symptom groups. Patients with pain of short duration (<2 years) reported high relief rates (33.8% of patients in this group reported relief of >70%). No serious adverse events were reported. conclusions: i.v.i.g. may be effective in patients suffering from chronic pain. Controlled studies are needed to evaluate the efficacy of i.v.i.g. in these patients. Patients with a good response to i.v.i.g. may be models for the study of neuroimmune interactions in chronic pain.
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Randomized Controlled Trial Clinical Trial
Watch needle, watch TV: Audiovisual distraction in preschool immunization.
To evaluate the effectiveness of audiovisual distraction compared with a blank TV screen in the reduction of pain associated with intramuscular immunization. ⋯ Watching cartoons did not distract children during needle injection nor reduce their pain. Looking at the TV screen was related to lower behavioral pain scores in the total sample.