Articles: acute-pain.
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Bmc Musculoskel Dis · Jan 2013
Does a patient's physical activity predict recovery from an episode of acute low back pain? A prospective cohort study.
Advice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP). However, no research has assessed whether objective measurements of physical activity predict outcome and recovery in acute low back pain. ⋯ These results question the predictive role of physical activity in LBP recovery, and the assumption that activity levels change as LBP symptoms resolve. The importance of a patient's perception of activity limitation in recovery from acute LBP was also highlighted.
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Comparative Study
Morphine versus fentanyl for pain due to traumatic injury in the emergency department.
The analgesic response and safety of intravenous morphine versus fentanyl for adult trauma patients who presented to the emergency department (ED) were evaluated. Median pain reduction on the numeric rating scale (0-10; 0 = no pain and 10 = worst possible pain) after opioid administration was similar between the groups (2 vs 2; P = .67). ⋯ There were no significant differences in drug-induced adverse effects between groups. Fentanyl produced a similar but more rapid analgesic response compared with morphine in trauma patients.
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Neuroendocrinol Lett · Jan 2013
Comparative Study Clinical TrialCore needle biopsy of thyroid nodules - evaluation of diagnostic utility and pain experience.
A crucial problem in the non-operative diagnosis of thyroid nodules is the significant amount of non-diagnostic biopsies. This is a challenge for practicing endocrinologists especially when the results of the repeated biopsies remain non-diagnostic. The lack of a concrete preoperative diagnosis may result in unnecessary thyroidectomies in patients. Alternatively, it may also lead to the delayed diagnosis of cancer. One method of biopsy specimen acquisition that could potentially increase the diagnostic accuracy of thyroid biopsies is the application of core-needles. The aim of the study was to compare the diagnostic value and patient tolerability of core-needle aspiration biopsies (CNAB) with fine-needle aspiration biopsies (FNAB). ⋯ CNAB did not prove to be superior to FNAB. Despite the larger needle gauge used during core-needle biopsies, the patients' tolerability was comparable to conventional fine-needle biopsies.
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Healthcare providers' beliefs and comfort with analgesics can impact medication decisions. Interprofessional educational interventions (IPE) improve medication delivery processes ultimately resulting in better patient care. The purpose of this study was to determine the impact on nurses' satisfaction and comfort with administering intranasal fentanyl for pediatric pain management in the Emergency Department (ED) before and following IPE. ⋯ The use of IPE facilitated knowledge sharing to improve nurses' comfort with administering analgesic medication and the quality of patient care services.
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Drug Healthc Patient Saf · Jan 2013
Patient considerations in the use of tapentadol for moderate to severe pain.
Poorly controlled acute and chronic pain can increase morbidity, impair quality of life and prolong disability. Over 80 percent of post surgical patients report moderate to severe uncontrolled postoperative pain. Over-reliance on potent opioid agonists can lead to several opioid related side effects such as gastrointestinal intolerability, respiratory depression and cognitive impairment. ⋯ The most common side effects of tapentadol are nausea (30%), vomiting (18%), dizziness (24%), and somnolence (15%). Tapentadol, due to its potential synergistic effects on norepinephrine levels, is contraindicated in patients who have taken monoamine oxidase inhibitors within the last 14 days. Caution has to be exercised with the use of tapentadol IR and tapentadol ER in the presence of other central nervous system depressants such as neuroleptics, opioids, illicit drugs, muscle relaxants, sedatives, and anxiolytics.