Articles: pain.
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Multicenter Study Comparative Study Clinical Trial
Identification of subgroups of persons with chronic pain based on profiles on the pain stages of change questionnaire.
This study sought to identify reliable subgroups of patients with chronic pain based on profiles of subscale scores on the Pain Stages of Change Questionnaire (PSOCQ), a reliable and valid measure of individuals' readiness to adopt a self-management approach to chronic pain. The PSOCQ was administered to 633 people seeking treatment for chronic pain. Participants were predominantly White, averaged 48 years of age, about half were men, and about half reported back pain as the primary complaint. ⋯ As predicted, clusters did not differ on measures of pain, disability, or demographics. Moreover, clusters differed significantly in theoretically consistent directions by scores on the Survey of Pain Attitudes, thus demonstrating criterion related validity for the clusters. Future research should examine the utility of PSOCQ profiles, relative to individual PSOCQ scale scores alone, in predicting response to self-management treatment approaches.
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Semin. Arthritis Rheum. · Aug 2005
Multicenter StudyClinical presentation of osteoarthritis in general practice: determinants of pain in Italian patients in the AMICA study.
To assess the clinical characteristics and determinants of pain observed by general practitioners (GPs) in Italian patients with osteoarthritis (OA) of the hand, hip, and knee. ⋯ The results of this study underscore the major impact of OA on care in general practice, the high frequency of OA-associated comorbidities, and the role of different risk factors in OA pain.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Topical 2% amitriptyline and 1% ketamine in neuropathic pain syndromes: a randomized, double-blind, placebo-controlled trial.
A double-blind, randomized, placebo-controlled 3-week study evaluated the efficacy of topical 2% amitriptyline, 1% ketamine, and a combination of both in treating patients with neuropathic pain. ⋯ This randomized, placebo-controlled trial examining topical 2% amitriptyline, 1% ketamine, and a combination in the treatment of neuropathic pain revealed no difference between groups. Optimization of doses may be required, because another study has revealed that higher concentrations of these agents combined do produce significant analgesia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine.
Remifentanil-induced secondary hyperalgesia has been documented experimentally in both animals and healthy human volunteers, but never clinically. This study tested the hypotheses that increased pain sensitivity assessed by periincisional allodynia and hyperalgesia can occur after relatively large-dose intraoperative remifentanil and that small-dose ketamine prevents this hyperalgesia. ⋯ A relatively large dose of intraoperative remifentanil triggers postoperative secondary hyperalgesia. Remifentanil-induced hyperalgesia was prevented by small-dose ketamine, implicating an N-methyl-d-aspartate pain-facilitator process.
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Multicenter Study
Racial differences in opioid use for chronic nonmalignant pain.
Chronic pain is a frequent cause of suffering and disability that negatively affects patients' quality of life. There is growing evidence that disparities in the treatment of pain occur because of differences in race. ⋯ Equal treatment by race occurs in nonopioid-related therapies, but white patients are more likely than black patients to be treated with opioids. Further studies are needed to better explain this racial difference and define its effect on patient outcomes.