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Accuracy of neuropathic pain measurements in patients with symptoms of polyneuropathy: validation of painDETECT, S-LANSS, and DN4.

Pain is a common symptom in patients referred to polyneuropathy assessment. Diagnostic evaluation and choice of treatment may depend on whether the pain is likely to be neuropathic or not. The present study aimed to investigate the diagnostic accuracy of three tools commonly used to differentiate between neuropathic and non-neuropathic pain. To accomplish this, we included patients with bilateral distal lower extremity pain, referred to neurological outpatient clinics at five Norwegian University hospitals for polyneuropathy assessment. The patients filled in Norwegian versions of painDETECT, the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), and the clinician-rated Douleur Neuropathique 4 (DN4). All patients underwent a clinical examination and nerve conduction measurements, and were classified according to the NeuPSIG neuropathic pain criteria (reference standard). In total, 729 patients were included, of which 63% had neuropathic pain by the reference standard. Only DN4 demonstrated high sensitivity (0.87), while all three tools had low specificity (≤0.65). Importantly, the tools' predictive ability was unsatisfactory; The probability of getting a correct test result was three quarters at best, and at worst, no better than two fifths. Consequently, we show that neither DN4, painDETECT nor S-LANSS can be confidently used to assess neuropathic pain in a neurological outpatient population with symptoms of polyneuropathy.

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Manipulation of distal radius fractures: a comparison of Bier’s block vs haematoma block.

Displaced distal radius fractures often require manipulation under anaesthesia. Many anaesthetic techniques are described, with the two most commonly used being Bier's block (BB) and haematoma block (HB). Despite national guidance preferring a BB, an HB is often performed instead. This study aims to compare the analgesic properties of a BB with those of an HB when manipulating distal radius fractures.

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The management of perioperative pain in craniosynostosis repair: a systematic literature review of the current practices and guidelines for the future.

Craniosynostosis is a condition characterized by a premature fusion of one or more cranial sutures. The surgical repair of craniosynostosis causes significant pain for the child. A key focus of craniosynostosis repair is developing effective strategies to manage perioperative pain. This study aimed to review perioperative pain control strategies for craniosynostosis repair systematically.

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Centralized nociplastic pain causing fibromyalgia: an emperor with no cloths?

The leading school of thought views fibromyalgia as a central sensitization syndrome. Nociplastic pain is the recently proposed term to mechanistically explain central sensitization. Accumulating research suggests an alternate explanation; fibromyalgia can be conceptualized as a neuropathic pain syndrome and dorsal root ganglia (not the brain) as the primary fibromyalgia pain source. There is no need to propose nociplastic pain as new chronic pain mechanism.

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Comment to “Psychological disorders in patients with chronic postoperative inguinal pain”.

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Migraine – Treatment and Preventive Therapies.

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Research Priorities Among Canadian Military Veterans Living With Chronic Pain: A Cross-Sectional Survey.

Chronic pain is a debilitating problem that disproportionately affects military veterans. We completed a qualitative study that identified 20 research priorities of Canadian veterans living with chronic noncancer pain. The aim of this study was to establish the generalizability of these priorities.

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Efficacy of an Intra-articular Ozone Injection for Chronic Knee Pain Due to Osteoarthritis.

Osteoarthritis (OA) is the most common form of arthritis, affecting an estimated 302-million people worldwide, and it's a leading cause of disability among older adults. Current treatments for OA are largely unsatisfactory. Ozone is an inexpensive, accessible, and easily applicable treatment for OA.

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Integration of Complementary Medicine for Multilocal Chronic Pain: Treatment Results From the Patient Perspective.

Chronic pain affects individuals' quality of life, physical functionality, and psychological well-being. In the case of multifactorial diseases with an increasing tendency to become chronic, individual therapies often can't alleviate symptoms. The integration of recognized naturopathic methods into a variety of therapies could increase their success.

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Pain reduction in validated rat pain models: radio frequency spectrum targeted at the low and ultra-low ends using the emulate® delivery system.

EMulate Therapeutics, Inc. (EMTx) has developed a technology to deliver time-varying magnetic fields as WAV files, emitted in the extremely low through the low spectrum of radio frequencies (DC to 22 kHz), that can be applied to regulate pain sensation. These low power fields (~30-70 milli-Gauss AC RMS) are delivered via a portable, light-weight wearable device (Voyager). A contract third-party animal research organization (ANS Biotech, S.A.) specializing in validated rat pain models, ran the studies independently of the authors. Here we report that a subset of signals demonstrated a statistically significant effect in reducing the sensation of pain in rat models for visceral pain, neuropathic pain and inflammatory pain. Furthermore, removing frequencies above 6 kHz in the original signals improve the pain reducing effects of the unmodified signal.

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