https://www.clinsurggroup.us/journals/open-journal-of-pain-medicine A Peertechz Open Access Journal en-us 21 Sep, 2024 https://www.clinsurggroup.us/articles/OJPM-8-138.php Time is both a content and a container, the flow and the framework of flow. It contains time to better let it go. Faced with death, the order of linear time explodes under the onslaught of the emotions that overwhelm us. The guts of time explode. With imminent death, the dramatic nature of time appears in a furious way: time pushes us, sword in our back, towards the precipice, it nibbles away our capital of life every day. The blackout is coming soon. What to do to live the moment yet to be lived? Above all: take care of time. My ambition is what I call here “care of time”. Take care of time before taking care of body and soul. Wait for time to better live what remains to be lived. 30 May, 2024 https://www.clinsurggroup.us/articles/OJPM-8-137.php Periodontal and per-implant microsurgery have revolutionized the field of dental surgery, enabling precise and minimally invasive procedures with improved outcomes. The advent of microsurgical instruments, enhanced magnification systems, and specialized suturing techniques has allowed clinicians to achieve superior aesthetic and functional results while minimizing patient discomfort and morbidity. Furthermore, emerging technologies such as digital planning and guided surgery have complemented microsurgical techniques, enabling more predictable outcomes and patient-centered treatment approaches. The review aims to discuss the principles of microsurgery, including flap design, tissue handling, and suture placement, and explores their applications in the management of mucogingival defects and periimplantitis. Continued research and clinical advancements in this field are essential to further enhance treatment outcomes and refine surgical protocols for the benefit of patients and practitioners. 01 Dec, 2023 https://www.clinsurggroup.us/articles/OJPM-7-136.php Artificial Intelligence (AI) has become indispensable to all people, primarily for the purposes of speaker recognition, voice identification, educational purposes, workplace, and health care. Based on a speaker’s voice characteristics, identification and recognition of the speaker is accomplished. The voice is affected by both intra- and interspeaker variability. In addition to this, a condition known as structural abnormalities can cause resonance, which can seriously affect voice quality. As a result, speakers may experience difficulties when using AI-based devices. The study aims to investigate the effects of speech with cleft lip and palate on speaker recognition. The review stated that even after surgery, some people with cleft lip and palate exhibit hypernasality and poor speech intelligibility depending on the severity of the cleft. The author discovered that artificial intelligence has been applied to surgical procedures. In children with corrected cleft lip and palate, acoustic analysis revealed poor benchmarking for speaker identification. The most prevalent type of hypernasality also affects speech intelligibility. Thus, more research on speaker recognition using different algorithms and hypernasality is essential. These can help speakers who have CLP to use AI freely and without any issues. Even with its flaws, people with CLP can still learn more about using AI. 13 Apr, 2023 https://www.clinsurggroup.us/articles/OJPM-7-135.php Phantom limb pain is mainly experienced in people who have suffered limb amputation, its study and analysis are relevant to know the causes and help patients to reduce pain. On the other hand, brain-computer interfaces encode brain signals and decode them for communication with a device. Through the motor imagination of the movement of the amputated limb and with the help of a brain-computer interface, an amputee patient can reduce or eliminate pain. The objective of this paper is to give an introduction to brain-computer interfaces as a tool for the reduction of phantom limb pain. Therefore, the applications of interfaces in relation to pain are highlighted, some related studies are discussed, and their benefits and disadvantages are analyzed. Finally, it is established that phantom limb pain research benefits from incorporating brain-computer interfaces as part of non-pharmaceutical therapy because it is a tool that provides feedback on the reconfiguration of the cerebral cortex in relation to pain. 19 Jan, 2023 https://www.clinsurggroup.us/articles/OJPM-7-134.php Introduction: Considering that the cell phone and/or smartphones had become part of the human being and thus brought problems to people’s health. Objective: To investigate the existing relationship between the use of mobile telephone devices and the health problems of the user, focusing on musculoskeletal injuries of the cervical spine and hand and as hypotheses had the existence or not of this relationship. Methodology: A field study, cross-sectional, with a quantitative approach, of the descriptive type, was carried out in March and April 2019 with academics from the Physiotherapy course at Centro Universitário de João Pessoa- Unipê. Data collection was carried out through a questionnaire that explored questions related to socio-demographic data, the reasons why the devices are used, the quantification of hours of use per day and the postures adopted, among others. Discussions: The data were analyzed and described through tabulation in Microsoft Excel version 2016 through simple descriptive statistics and in that same program, graphs and tables were constructed for a better display of the results that were confronted with the scientific literature. The sample was mostly female, single, brown, with income between one and five minimum wages and right-handed. Conclusion: There are reasons for this relationship to exist and that the problems arising from this interaction continue to grow since users, despite feeling pain, heaviness, numbness and tingling, among others, do not abandon their devices and because it is a theme that involves the world, it needs to be special attention from the scientific community. 19 Jan, 2023 https://www.clinsurggroup.us/articles/OJPM-7-133.php Introduction: The deleterious effects of immobility in the ICU can be minimized by having early mobilization within their strategies, which consists of an interprofessional plan that proposes the improvement of inactivity and which aims to reduce the problems caused by hospitalization with appropriate exercises for high-age individuals. Risk and its bed. Objective: To identify the effects of this physical therapy technique on patients hospitalized in this hospital sector. Methodology: This is an integrative review, with a survey in March 2020, in the Scientific Electronic Library Online (SCIELO), PubMed and Virtual Health Library (VHL) databases, with the inclusion criteria: experimental articles and clinical cases with purposes included in the study strategy, written in Portuguese and English, published between 2015 and 2020, available in full in the online collection and exclusion: articles referring to another area of ​​health, incomplete and integrative, systematic reviews, bibliographic or meta-analysis, using the descriptors: “Efficacy”, “Early Mobilization” and “UCI”. Results: The findings from this research made it possible to identify that physiotherapy is effective in carrying out early mobilization protocols, providing important results, such as: length of stay, important gains in functionality, pain reduction, improvement in respiratory muscles and time reduction of mechanical ventilation. Conclusion: Physiotherapy is important in the process of hospitalization of ICU patients, especially in the use of early mobilization protocols, and these were effective in the studies selected for this research. 19 Jan, 2023 https://www.clinsurggroup.us/articles/OJPM-7-132.php Objective: To investigate, through scientific literary findings, the effects of occupational stress on interpersonal relationships in the work environment. Methodology: This is an integrative literature review, with a descriptive and qualitative approach, carried out through a survey in the Scielo, Pubmed and Lilacs databases, with the words indexed in the DeCs: Psychology, Occupational Stress and Burnout Syndrome. As well as the Boolean operator ‘’AND’’ to perform the crossing between the descriptors. Articles related to the proposed theme, published between the years 2016 to 2021, available in full, with no language restriction; in addition to theses, dissertations and monographs. Results and discussions: The findings of the scientific literature exposed in this research could show that occupational stress has a total impact on interpersonal relationships and on emotional exhaustion, constituting a network conducive to the emergence and development of Burnout syndrome. Final considerations: The research included in this study could unanimously prove that occupational stress leads to a decline in interpersonal and organizational relationships, which directly compromises the mental health of professionals, generating a risk of harm to the health of the worker, with the syndrome of Burnout is the most prevalent pathology in this context. 14 Dec, 2022 https://www.clinsurggroup.us/articles/OJPM-6-131.php Objectives: Fibromyalgia (FM) is a widespread condition that is difficult to manage medically. Often algologists are faced with patients who are poorly compliant with pharmacological treatment or with concomitant mood problems. There are treatments tailored to temperament and character patterns. In this study using the division into pain persistence and pain avoidance patterns, a stratification was hypothesized to facilitate its medical management using self-administered questionnaires. Methods: We screened the population consisting of FM patients to four different questionnaires, namely the Temperament and Character Inventory (TCI), Hospital Anxiety and Depression Scale, Short form 36 and the INTERMED- Self Assessment. Results: A total of thirty-two patients were enrolled. The analyzed population showed preponderant pain avoidance characteristics (90.7%). The persistence pattern proved to be present in only 9.3% of the population. The FM patients examined also reported an incidence of anxiety disorder of 71.9% and depressive disorder of 75%. Conclusion: Dividing the population with FM into patterns yielded uniform results. This justifies a multidisciplinary approach in these FM patients. The high incidence of anxiety and depression from the test results is an outcome that suggests the adoption of the HADS tool in the antalgic evaluation of FM patients. 12 Dec, 2022 https://www.clinsurggroup.us/articles/OJPM-6-130.php The reviewed monography by Mateusz entitled J. Kuczabski „Health Security Implications for National Security” fills a significant gap, because, despite the availability of extensive foreign and domestic literature on health safety, it is difficult to find a commonly agreed definition. The potentially useful distinction between “health and safety”, “health system”, “healthcare system” and “health security” has not been developed in the literature. Interestingly, the author notes significant discrepancies in the understanding and application of the concept of health security existing even in UN agencies, for example between the United Nations Development Program (UNDP) and the World Health Organization (WHO). The results of the research by M. J. Kuczabski presented and prepared by the author may serve as an indication of the direction of future transformations in the field of health security and health policy in relation to the Polish security system. 18 Oct, 2022 https://www.clinsurggroup.us/articles/OJPM-6-129.php Reports describe the association between platelet activation, adhesion, and aggregation, as well as polymorphisms in genes encoding platelet membrane glycoproteins with a predisposition to coronary artery disease (CAD). This study investigates associations between HPA-1, -3 and C807T polymorphisms and CAD. A cross-sectional study involving 114 women who underwent coronary angiography was performed. The CAD+ group consisted of 63 women while the CAD- group of 51 women. Hematological and biochemical parameters were evaluated by electronic methods. Polymorphisms were investigated by PCR-RFLP and PCR-SSP and participants answered an epidemiological questionnaire and provided anthropometric data. Blood pressure was also measured. Statistical analyses were performed using EpiInfo v. 7.0 software. Results showed that age, diabetes mellitus, hypertension, and hyperlipidemia were associated with CAD. In addition, CAD+ women showed elevated glucose, TG, and VLDL-c levels and reduced HDL-c levels. No significant difference was observed between the allelic and genotypic distributions of the polymorphisms HPA-1, -3, and C807T in CAD+ and CAD- groups. However, CAD+ women carriers of the variant 3b allele had elevated TG and sP-selectin levels while the carriers of the variant 807T allele had reduced CT and LDL-c levels. Hence, our data suggest that the polymorphism HPA-3 increases, indirectly, the risk of CAD development and occurrence while polymorphism C807T reduces this effec. 17 Aug, 2022 https://www.clinsurggroup.us/articles/OJPM-6-128.php Siphonochillus aethiopicus, known as African ginger, is indigenous to South Africa and has multiple traditional uses in health to treat human diseases. The multiple traditional uses of African ginger have exacerbated the over-harvesting of the plant species from the wild for trade on the traditional medicine market. The wild populations of African ginger have almost completely depleted from the wild and a few African ginger cultivation sites have been established in South Africa, to conserve the plant species. The aim of the study was to compare the major chemical markers of the cultivated and wild harvested African ginger from Mpumalanga using Liquid Chromatography-Mass Spectrometry (LC-MS). The Council for Scientific and Industrial Research (CSIR) wild-harvested African ginger dated 2010 was used as a reference sample for comparison purposes. The LC-MS data generated from the ethanol extracts of the cultivated African ginger detected the presence of 4,4a,5,8a,9-tetrahydro-3,5,8a-trimethylnaptho[2,3-b]furan-8. This chemical marker was also detected in the wild harvested African ginger as compared to a previous study, which auto oxidised in the referenced sample over time. This study supports the efforts to conserve African ginger through cultivation for further development in commercialisation. 04 Aug, 2022 https://www.clinsurggroup.us/articles/OJPM-6-127.php Monkeypox is a rare viral disease that is endemic in many African countries. However, within days, dozens of cases of monkeypox were confirmed in at least 12 non-African countries. It first appeared in the UK and was reported on 7 May 2022. The discovery of the virus in many patients and in different populations around the world within a few days raised the issue of scientific, medical, managerial, and social logic. The cases reported to date have no established travel links to endemic areas, but a recent mass event may have served as a focus for amplification. Epidemiological investigations are ongoing. With increased surveillance in non-endemic countries, it is likely that more cases of monkeypox will be identified and confirmed. With all this, we must ask ourselves, as we did with the advent of COVID-19, whether the population is seriously threatened and whether or not we should be concerned about the new virus in the future. 26 Aug, 2021 https://www.clinsurggroup.us/articles/OJPM-5-126.php Objective: To assess the Prevalence of Low Back Pain among the Dentists of Karachi, Pakistan Methodology: A cross sectional survey was conducted in many different hospitals of Karachi, Pakistan from October to December 2015. A self-constructed questionnaire which includes the demographic Characterstics and other questions were duration of work per day, work experience of a participants, onset of pain, aggravating factors. Among the 68 dentists SPSS version 17 was used to analyze the data. Results: The majority (n=38, 55.8%) of the participants belongs to age group of 36 to 45 years, (n=36, 52.9%) were female and (n=25, 36.7%) were specialized in the dental surgery. Moreover in the prevalence the (n=65, 96 %%) of the participants reported they are suffering from lower back pain. After checking the working status of respondents we found that (n= 34, 52.3%) were working more than 8 hours in a day, while (n=29, 44.6%) of responded that they had work experience between 5 to 10 years. In the onset of pain (n=23, 35.3%) reported that they usually start feeling pain within 1 to 2 hours of working especially when they use to bend their lower back. Conclusion: This Study finalized that there is 96% prevalence of lower back pain among the dentists working in Karachi Pakistan. 07 Jun, 2021 https://www.clinsurggroup.us/articles/OJPM-5-125.php Cancer pain treatment following the World Health Organization guidelines is effective and feasible. However, the evidence supporting the use of opioids for mild to moderate pain on the Second step of the analgesic ladder is widely discussed. The present assessment compares the efficacy and safety of the use of tramadol in comparison to morphine in the treatment of cancer pain patients. This blind and random study was conducted at the National Cancer Institute at Gezira state in the period from April to October 2018. A total of 100 patients divided into two groups (50 patients for each group) were included in this study. In group one, the patients received tramadol whereas group two received oral morphine and the average dose was 5mg every 4 hours. On the other hand, the average dose of tramadol was 100mg every 6 hours. Our results showed that satisfaction from tramadol was 92%, in other words, 8% were not satisfied, and the most observed side effects were Nausea, Loss of appetite, and Dry mouth. However, morphine satisfaction was 90% while 10% was not satisfied and Nausea, Loss of appetite, and Dry mouth were the most side effects observed. In conclusion, results suggest that tramadol can be used in the treatment of cancer pain, as well as morphine with a slight advantage of tramadol over morphine for the lesser percentage of side effects compared to morphine. 03 May, 2021 https://www.clinsurggroup.us/articles/OJPM-5-124.php Objective: We aimed to investigate the effects of vitamin D3, vitamin C, vitamin E and zinc supplements on pain and functional capacity in Chronic Low Back Pain (CLBP). Methods: 20 patients (female/male:10/10) with CLBLP, aged between 28 and 57 years (mean age: 41.25±9.12), participated in the study. Mcgill Pain Questionnaire (MPQ) was used to measure the state of pain. Pain-related functional capacity was evaluated through Roland Morris Disability Questionnaire (RMDQ). Fear-Avoidance Beliefs Questionnaire (FABQ) used to assess fear-avoiding beliefs based on physical activity and the effects of work in chronic low back pain. The Finger Floor Test (FFT)used to assess the flexibility of trunk flexion. Evaluations were performed before and after treatment. Result: Before treatment; the mean of MPQ was 50,55±6,03, the mean of FFT was 5,5±2,35 cm, the mean of RMDQ was 14,9±2,38, the mean of FABQ was 50,7±5,68. After treatment; the mean of MPQ was 23,45±5,35, the mean of FFT was 2,45±0,89 cm, the mean of RMDQ was 6,95±1,70, the mean of FABQ was 22,5±5,73. The results were statistically significant difference between before and after assesment scores (p<0,05). Conclusion: Vitamin D, C, E and zinc have been found to be effective in the treatment of patients with chronic low back pain. 31 Mar, 2021 https://www.clinsurggroup.us/articles/OJPM-5-123.php Introduction: Post-Operative Pain (POP) is a common patient problem subsequently surgical procedure. Uncontrolled POP reduces physical, social and overall recovery of the patient. Effective pain management requires faultless knowledge. Objective: To determine Knowledge and its associated factors towards POP management among nurses working in referral hospitals, northwest Ethiopia. Methods: Data were collected from Nurses from March 08 to April 23, 2019. Nurses who are working in the surgical track were included in the study. The data were analyzed by SPSS version 20 Software. Result: The nurses’ level of good knowlegde towards POP management was 43.46%. The multivariable logistic regression analysis showed; master of science degree (AOR=3.125, 95%CI (2.53-10.11)], bachelor of science degree [(AOR=2.10,95%CI (1.86, 9.05), having 5 to10 years working experience [(AOR= 2.661, 95%CI (1.278, 5.540), having 10 to 15 years of working experience [(AOR= 2.581 95%CI (1.758, 11.938)], having 15 to 20 years working experience [AOR=4.62,95%CI (1.28, 6.68), having >20 years of working experience [AOR=7.27,95%CI (1.44, 11.95), receiving training [AOR=1.59, 95%CI (1.06, 2.39) were factors significaantly associated with the level of knowledge regarding POP management. Conclusion: This study indicated that the good level of knowledge towards POP management was poor. Educational level, working experience and receiving training were factors significantly associated with nurses’ level of Knowledge towards POP management. Finally, we recommend that the training program for nurses concerning to the POP management guidelines and treatment protocols should be designed to improve their knowledge. Further, health education program for nurses may be necessary to take place. 31 Dec, 2020 https://www.clinsurggroup.us/articles/OJPM-4-122.php Background: One out of three cancer patients suffers pain, and half of those patients suffer Breakthrough Pain (BTP). In patients with advanced, metastatic, or terminal disease the number suffering BTP increases to two out of three patients. BTP is defined as a peak of pain intensity of short duration in patients with stable and acceptable analgesia provided by analgesics given around the clock. Context and purpose of the study: An observational study was performed at the Hospital at Home Unit at the University and Polytechnic Hospital La Fe of Valencia (Spain) to evaluate whether opioid therapy could significantly reduce BTP from baseline within 30 minutes of administration and achieve clinically meaningful differences. Results: In total, 424 BTP episodes were recorded in the study. The incidence of BTP per patient over the study period was 13.7 episodes. There were significant pre-and post-treatment differences in pain intensity as measured on a Visual Analogy Scale (VAS) of 0-100 points/100 (p<0.05). The mean difference of pain between pre- and post-treatment was 35.28 (CI95% 33.55-37.35). The intensity of BTP was highly variable for individual patients, with 70% of the variability being greater than 30 points/100 and 50% being greater than 40 points/100. The most frequent intensity of BTP was moderate. The most frequent time of BPT was the morning/early afternoon. The items related to clinically relevant pain relief after opioid therapy were: level of basal pain, type of basal medication (fentanyl patches), and gender (female). Conclusions: It is recommended to check daily for the appearance of BTP in patients with advanced, metastatic or terminal cancer, especially in Units such as Hospital at Home Units. We have observed that among opioids drugs, fentanyl patches and slow release morphine, which are the most frequently used opioids for the treatment of BTP, are the ones which achieved a clinically important difference in pain score, independently of the pre-treatment pain severity (mild, moderate or severe) of the patient. The adverse events detected in the present study were few although we estimate that they were probably under-represented. Hence, we recommend that the doctors should ask on daily basis patients suffering from advanced cancer and being treated with opioid drugs for BTP for adverse events and/or insist the patients to report them. 27 Nov, 2020 https://www.clinsurggroup.us/articles/OJPM-4-121.php Background and objectives: Sedation with propofol is a part of the anesthetic induction procedure because it provides anxiolysis, amnesia and hypnosis; however, up to 5% of patients have pain at propofol injection and of these, 1% of them have severe or excruciating pain. There are several techniques that are used to avoid it, including previous venous administration of lidocaine, a local anesthetic. Although it is widely used, this procedure is not absent of risks, since many adverse reactions are reported when using lidocaine, such as blurred vision, nausea, headache and many others Central Nervous System symptoms. The current randomized controlled study evaluated the Number Needed to Treat (NNT) of patients that receives lidocaine to reduce pain associated to propofol administration during anesthesia induction. Methods: This is a prospective, double-blinded, randomized trial with 970 adult subjects who were submitted to propofol administration in the induction of anesthesia. Investigated groups were previously treated randomly, either with lidocaine or saline and then they were interrogated about pain during propofol injection. Results: There were no differences in demographics between the study groups. Pain outcome was reduced in patients who received lidocaine (5%; 95% CI, 3.63–6.37) in relation to saline (14.2%; 95% CI, 12.0-16.4). However, the number needed to treat (NNT= 10.9) for prevention of this effect was considerably high. Conclusion: This study suggests that the use of lidocaine prior to propofol application is not justified, if considered the risk factors for the patient and the savings related with the procedure. Clinical trial registration: UTN 1111-1215-1557. 14 Jul, 2020 https://www.clinsurggroup.us/articles/OJPM-4-120.php Background: The management of Breakthrough cancer Pain (BTcP) remains unsatisfactory. Although many barriers to BTcP management have been identified, oncologists have not been able to overcome them. The aim of this study is to identify the barriers preventing proper BTcP management that Spanish medical oncologists have found, and to reach a consensus in order to draft the appropriate recommendations to overcome them. Methods: This study is based on two surveys conducted by oncologists. The first survey was designed to reach a consensus on the main barriers (related to patients, physicians and healthcare organizations) that stand in the way of BTcP control. The second survey (a Delphi questionnaire) was based on the barriers evaluated in the first survey, including recommendations assessed using the two-round Delphi methodology. 28 May, 2020 https://www.clinsurggroup.us/articles/OJPM-4-119.php Introduction: Orofacial pain can be highly distressing, affecting 10% of the population and is associated with psychological symptoms. This study aims to assess the frequency of such psychological symptoms in orofacial pain patients compared to a control group and how these symptoms change with treatment. The effect of social deprivation will also be explored. Method: We conducted a prospective study comparing 342 consecutive referrals to the pain clinic over a nine-year period with 100 controls. Exclusion criteria involved patients with dental/dentoalveolar pain or trigeminal neuralgia. The chronic faical pain patient’s data was collected from validated questionnaires completed at every consultation. The somatic diagnoses were based on a interview process with one consultant conducting the pain clinic. 14 Apr, 2020 https://www.clinsurggroup.us/articles/OJPM-4-118.php Recent study reveals that 2 million people suffer from pain everyday worldwide and cancer pain is one major neglected public health problem especially in Ethiopia. 13 Jan, 2020 https://www.clinsurggroup.us/articles/OJPM-4-117.php Purpose: Breakthrough Pain (BTP) observed in up to 66% of cancer patients, is more common in patients with advanced cancer stages and is usually associated with a poor prognosis. 17 Dec, 2019 https://www.clinsurggroup.us/articles/OJPM-3-116.php Introduction: Opioid-Induced Constipation (OIC) is a common distressing symptom associated with cancer pain treatment. Consensus guidelines for management of OIC are limited and little is known about the decision making of Health Care Professionals (HCP) for the management of OIC. The aim of this study was to learn about the diagnostic and treatment criteria of OIC management in clinical practice in patients with cancer. 06 Dec, 2019 https://www.clinsurggroup.us/articles/OJPM-3-115.php Purpose: The objective of the study was to analyses how Opioid-Induced Constipation (OIC) is managed in cancer patients in clinical practice for comparison against the current recommendations for the management of patients with OIC. 06 Sep, 2019 https://www.clinsurggroup.us/articles/OJPM-3-114.php Malignant hyperthermia (MH) is a hypermetabolic disease induced by the administration of anesthetic drugs in patients with genetic susceptibility. Its incidence ranges from 0.02% to 0.0153%. Here, we report the case of an 18-year-old male patient with no previous relevant surgical, medical, or family history of disease, who while undergoing a scheduled orthopedic surgical procedure under general anesthesia for the correction of left congenital talipes equinovarus, presented hyperthermia (41.8°C), muscular stiffness, tachycardia, trismus, increased blood pressure, and increased CO2 levels two hours after the induction of anesthesia. 04 Sep, 2019 https://www.clinsurggroup.us/articles/OJPM-3-113.php Objective: The aim of the present study was to determine if there exists referred medial scapula pain from C6 or C7 cervical spinal stenosis. Scapula pain of neurologic origin at present is felt to be mediated mainly by C5 through the dorsal scapular nerve. An interventional spine clinic noted a series of patients with medial scapula pain without C5 stenosis, however many of these patients had either C6 or C7 stenosis. 03 Sep, 2019 https://www.clinsurggroup.us/articles/OJPM-3-112.php The greatest challenge facing anesthesiologists in the current clinical context is to provide adequate perioperative care, achieving suffi cient control of acute pain and at the same time make responsible use of intraoperative opioids. 26 Aug, 2019 https://www.clinsurggroup.us/articles/OJPM-3-111.php Objective: Breakthrough cancer pain (BTcP) is still underestimated and a percentage of patients are not adequately treated, affecting their quality of life. The aim of this review was to generate a series of expert recommendations based on clinical experience and current scientifi c data on the management of BTcP. 31 May, 2019 https://www.clinsurggroup.us/articles/OJPM-3-110.php Background: During the oncological disease, patients may suffer a special type of pain called breakthrough pain (BTP), defined as a transient exacerbation of pain that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. Opioids are an essential part of BTP treatment, and its dosing adjustment should be performed irrespective of the basal dose of analgesia. However, in clinical practice it is unknown how opioids titration is completed. The context and purpose of the study: The objective of the study was to assess opioid titration process for the treatment of breakthrough pain (BTP) in cancer patients in usual clinical practice. 31 Dec, 2018 https://www.clinsurggroup.us/articles/OJPM-2-109.php This multivariate, prospective, monocentric, observational study evaluates the experimental application of an interactive e-learning module on the topic of dental pain, which deals with the content of interdisciplinary diagnostics and therapy of dental pain. The module (“Toothache Clinic”) was offered to dentistry students during the first, second and fourth clinical semesters. A total of n = 138 students took part. 15 Nov, 2018 https://www.clinsurggroup.us/articles/OJPM-2-108.php Pain due to chronic idiopathic axonal polyneuropathy (CIAP) is often treated with therapies based on general neuropathic pain guidelines, which are mainly developed with randomized clinical trials having evaluated treatments for painful diabetic neuropathy (PDN) and post-herpetic neuralgia 30 Oct, 2018 https://www.clinsurggroup.us/articles/OJPM-2-107.php Kambo is the name of a complex mixture of a number of bioactive peptides, secreted via the skin of a tropical frog, Phyllomedusa bicolor. Since centuries this secretion is harvested from the living animal by members of tribes living in the Amazonian forest, and applied to little wounds in the arms or legs, in order to enhance hunting skills. 18 Oct, 2018 https://www.clinsurggroup.us/articles/OJPM-2-106.php The article published on the July 31, 2018 issue of the New York Times science section, “After Doctors Cut Their Opioids, Patients Turn to a Risky Treatment for Back Pain” raises several thoughtful and concerning issues in pain management, including the lack of proven efficacy of spinal injections and the rising utilization of injections for the management of pain. In the interest of full disclosure, we are a group of Harvard spine and pain specialists from the department of Physical Medicine and Rehabilitation that emphasizes the importance of exercise, discourages opioid therapy for non-malignancy related pain, performs spinal injection procedures, and commonly practices non-FDA approved interventions. We take issue with several assumptions made by the author, as follows: 15 Jun, 2017 https://www.clinsurggroup.us/articles/OJPM-1-105.php To use spinal opioids appropriately, it is necessary to understand the pharmacokinetics and clinical pharmacology of these drugs including which opioids produce selective spinal analgesia and which do not. Briefly, spinal selectivity is highest for hydrophilic opioids and lowest for lipophilic opioids. 22 Apr, 2017 https://www.clinsurggroup.us/articles/OJPM-1-104.php Chronic pain is a severe complication of mesh-based inguinal hernia repair. In this prospective, clinical, randomized, double-blind study we investigated the biocompatibility of three different meshes and their influence on chronic pain. 23 Feb, 2017 https://www.clinsurggroup.us/articles/OJPM-1-103.php Background: Postoperative sternal pain is one of the most important factors affecting patients’ quality of life during the early post-operative days. Optimal pain management after cardiac surgery improve comfort and wellbeing of the patients. 10 Feb, 2017 https://www.clinsurggroup.us/articles/OJPM-1-102.php Introduction: Intralipid therapy is recommended for patients with local anesthetics like bupivacaine, but it is not advisable for patients with short acting local anesthetic toxicity like lidocaine. 28 Jan, 2017 https://www.clinsurggroup.us/articles/OJPM-1-101.php Pain is often endorsed by patients with postural orthostatic tachycardia syndrome (POTS). A retrospective chart analysis of adolescents diagnosed with PTS from January 2014-December 2015 at the pediatric cardiology clinic at Children’s National Health System were reviewed. 93% of the subjects reported pain at the time of diagnosis, with 46% of the sample reporting more than one site of pain.