Pain physician
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Canada and the United States have the highest levels of prescription opioid consumption in the world. In an attempt to curb the opioid epidemic, a variety of interventions have been implemented. Thus far, evidence regarding their effectiveness has not been consolidated. ⋯ Opioid, prescription, abuse, misuse, diversion, interventions, prescription monitoring programs.
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Practice Guideline
ASIPP Guidelines for Sedation and Fasting Status of Patients Undergoing Interventional Pain Management Procedures.
Many of the patients undergoing interventional procedures have daily regimens of medications including analgesics, muscle relaxants, and other drugs that can have significant additive/synergistic effects during the perioperative period. Further, many patients also present with comorbid states, including obesity, cardiovascular, and pulmonary disease. Consequently, in the perioperative period, a significant number of patients have suffered permanent neurologic injury, hypoxic brain injury, and even death as a result of over sedation, hypoventilation, and spinal cord injury. ⋯ These standards include monitoring of blood pressure, cardiac rhythm, temperature, pulse oximetry, and continuous quantitative end tidal CO2 monitoring. Sedation must be provided either by qualified anesthesia or non-anesthesia providers, with appropriate understanding of the medications, drug interactions, and resuscitative protocols. KEY WORDS: Guidelines, sedation, fasting status, monitoring, neurological complications.
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Approximately 30% to 80% of patients with brachial plexus avulsion (BPA) developed neuropathic pain. It is an intolerable neuropathic pain, which brings heavy burden to family and society. In addition to motor and sensory deficits, neuropathic pain can be another serious sequela that equally influences the patient. The development of a microsurgical technique has promoted the treatment and rehabilitation of brachial plexus injury, but pain relief after BPA is still a difficult problem. ⋯ Brachial plexus avulsion, small animal PET/CT, glucose metabolism, neuropathic pain, astrocyte, 18F-FDG.
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Pain is common among cancer patients. Nonclinical factors may affect receipt of pain management among Medicaid beneficiaries with cancer. ⋯ Cancer pain, pain management, Medicaid, health care disparities, breast neoplasms, colorectal neoplasms, health policies, physician practice patterns, retrospective studies, claims analyses.
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Observational Study
Gender Differences in the Association of Brain Gray Matter and Pain-Related Psychosocial Characteristics.
Although the association of gray matter morphology alterations and pain-related psychosocial characteristics with pain intensity and chronification in people with chronic spinal pain is evident, research on their mutual interaction is scarce and does not account for possible gender differences. Gender-based differences are, however, of utmost importance to consider when examining pain neurobiology. ⋯ Gray matter, brain morphology, central nervous system, illness perceptions, central sensitization.