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    Manejo del dolor agudo y crónico en pacientes ancianos
    (Asociacion de Medicos Anestesiologos de Chile, 2024)
    Josefina Yates
    ;
    Martín Lacassie
    ;
    Eduardo Vega Pérez
    ;
    Antonia Cárdenas
    ;
    Cristóbal Pedemonte
      6
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    Pregabalin for Neuropathic Pain and Itch in Recessive Dystrophic Epidermolysis Bullosa
    (American Medical Association (AMA), 2024-12-01)
    Margarita Calvo
    ;
    Macarena Tejos-Bravo
    ;
    Alvaro Passi-Solar
    ;
    Fernanda Espinoza
    ;
    FUENTES BUSTOS, MARIA IGNACIA  
    <jats:sec><jats:title>Importance</jats:title><jats:p>Patients with recessive dystrophic epidermolysis bullosa (RDEB) experience neuropathic pain and itch. There is a lack of evidence on any treatment for these symptoms in patients with RDEB.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>To test the efficacy of pregabalin in the treatment of neuropathic pain and itch in patients with RDEB.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>A randomized, double-blinded, crossover trial of oral pregabalin (50-300 mg/d) vs placebo was conducted at 2 sites, Toronto (Canada) and Santiago (Chile) from January 1, 2019, to December 31, 2020. Patients eligible to participate were diagnosed with RDEB, aged 8 to 40 years, not pregnant or lactating (if female), and had evidence of probable neuropathic pain and itching defined as distal thermal sensory loss (confirmed by thermal roller), score of 4 or greater on the <jats:italic>Douleur Neuropathique</jats:italic> 4 questionnaire (DN4), and score greater than 4 on the 10-point visual analog scale [VAS]). Patients with a clinically important or poorly controlled medical or psychiatric condition or pregabalin intolerance or allergy were excluded. Of 41 patients screened, 3 were not eligible and 28 declined enrollment. Data analyses were performed in 2021 through 2023.</jats:p></jats:sec><jats:sec><jats:title>Intervention</jats:title><jats:p>Participants received both pregabalin and matched placebo (titrated to a maximum-tolerated dose of 300 mg/day) in a randomized sequence so that comparisons could be made within participants and between groups.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>Difference in the mean pain and itch scores between pregabalin and placebo treatment (measured using VAS) before and after intervention.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In all, 10 participants were randomized to 2 groups, 6 patients (mean [SD] age, 26.7 [8.1] years; 3 females [50%]) in group 1, and 4 patients (mean [SD] age, 26.5 [7.8] years, 2 females [50%]) in group 2. Group 1 received a sequence of pregabalin-placebo while group 2 received placebo-pregabalin. Pregabalin significantly reduced mean (SD) pain scores by 1.9 (1.5) points when controlling for sequence and treatment period vs baseline, while placebo had 0.1 (2.0) points of reduction. The effect of pregabalin was a mild but significant reduction in itch compared to baseline (mean [SD] points, 0.9 [2.2]), whereas the placebo produced no reduction (0.1 [2.5]). The mean pregabalin dose was generally well tolerated.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>The results of this randomized crossover trial indicate that pregabalin significantly reduced pain and itch scores from baseline compared to placebo in patients with RDEB. This feasibility study provided preliminary data on the efficacy of pregabalin in managing pain and itch in RDEB and gathered essential data to inform the design of a larger cohort trial.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/study/NCT03928093">NCT03928093</jats:ext-link></jats:p></jats:sec>
    Scopus© Citations 3  2
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    International perspective on healthcare provider gender bias in musculoskeletal pain management: a scoping review protocol
    (2022)
    Katherine Fisher Wilford
    ;
    Maria Jesus Mena-Iturriaga
    ;
    Margaret Vugrin
    ;
    Macarena Wainer
    ;
    Phillip S Sizer
    <jats:sec><jats:title>Introduction</jats:title><jats:p>Chronic pain affects millions of individuals worldwide. Healthcare provider gender bias in the management of these individuals has societal and individual ramifications. Yet, a thorough and comprehensive literature summary on this topic is lacking. Therefore, this study aims to systematically: (1) identify and map the available scientific and grey literature as it relates to healthcare provider gender bias in the assessment, diagnosis and management of (chronic) musculoskeletal pain and (2) identify current gaps that necessitate further research.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>This scoping review will be conducted in accordance with recent guidelines, and the results will be reported via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The following databases will be searched: PubMed (National Library of Medicine), Embase (Elsevier), Scopus (Elsevier), CINAHL Complete (Ovid), Academic Search Complete (Ebscohost), Pre-Prints Database (National Library of Medicine) and Rehabilitation Reference Center from inception to August 2022. Additionally, relevant grey literature will be identified. All screening will be done by two independent reviewers during two stages: first title/abstract screening followed by full-text screening. Data will be extracted from the bibliometric, study characteristics, and pain science families of variables. Results will be descriptively mapped, and the frequency of concepts, population, characteristics and other details will be narratively reported. Additionally, results will be presented in tabular and graphical form.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>As this study will neither involve human subject participation nor utilisation of protected data, ethical approval is not required. This study’s methodological approach follows current recommendations. Study findings will be disseminated through conference presentations and international peer-review journal publication. In addition, infographics available in English, Spanish and German will be disseminated.</jats:p></jats:sec><jats:sec><jats:title>Registration details</jats:title><jats:p>This project will be registered in Open Science Framework prior to data collection.</jats:p></jats:sec>
      17Scopus© Citations 1
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    Scopus© Citations 4  2
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    Scopus© Citations 8  1
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    Receptors involved in dexketoprofen analgesia in murine visceral pain
    (2020)
    V Noriega
    ;
    F Sierralta
    ;
    P Poblete
    ;
    N Aranda
    ;
    R Sotomayor-Zárate
      52Scopus© Citations 2
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      12  1Scopus© Citations 21