Mixed pain, defined by the concurrent involvement of nociceptive, neuropathic, and sometimes nociplastic mechanisms, poses a significant diagnostic and therapeutic challenge within modern pain medicine. This complex pain phenotype is increasingly recognized as a prevalent and burdensome clinical entity, yet it remains substantially underdiagnosed and sub-optimally managed across diverse healthcare settings. Epidemiological data indicate that mixed pain affects a substantial proportion of patients with chronic pain syndromes and is consistently associated with more severe symptomatology, prolonged pain duration, functional impairment, diminished quality of life, and escalated healthcare resource utilization compared to pain of a single mechanism. In response to this unmet clinical need, the present recommendations aim to provide a structured, evidence-informed framework for the diagnosis and management of mixed pain. Developed through a rigorous process involving systematic literature review and multidisciplinary expert consensus, this document emphasizes the importance of mechanism-based therapeutic strategies tailored to the individual patient’s pain profile. Central to the approach is the implementation of multimodal and interdisciplinary care models that address the biological, psychological, and functional dimensions of mixed pain. These recommendations are intended for a broad spectrum of healthcare professionals, including primary care physicians, pain specialists, neurologists, oncologists, physiatrists, nurses, pharmacists, physical and occupational therapists, and clinical psychologists. The target population encompasses patients affected by mixed pain conditions such as chronic low back pain with radiculopathy, cancer-related pain, persistent post-surgical pain, and osteoarthritis complicated by central sensitization. By facilitating accurate diagnosis and integrated treatment planning, these recommendations seek to advance clinical practice, reduce the burden of mixed pain, and enhance patient-centered outcomes. This guidance aims to transform mixed pain care by promoting mechanism-based, multidisciplinary strategies with direct clinical applicability.
This paper is concerned with introducing and studying the o-space by using out degree system (resp. i-space by using in degree system) which are the core concept in this paper. In addition, the m-lower approximations, the m-upper approximations and ospace and i-space. Furthermore, we introduce near supraopen (near supraclosed) d. g.'s. Finally, the supra-lower approximation, supraupper approximation, supra-accuracy are defined and some of its properties are investigated.
The mixed ligands complexes of 8-hydroxyquinoline and Schiff base 1, 5-dimethyl-4-(5- oxohexan-2-ylideneamino)-2-phenyl-1H-pyrazol-3 (2H)-one (L) with Cr(III) , Mn(II), Fe(II), Co(II) , Ni(II), Cu(II) and Zn(II) ions were prepared. The compounds have been characterized by NMR, FT-IR, UV-Vis and mass spectra, elemental microanalysis (C.H.N.), magnetic moment, chloride contain, atomic absorption and molar conductance. All prepared complexes were octahedral geometry. Compound structures treated theoretically using the program hyper chem. 8 in gas phase at 298°K. The compounds were also screened for their bioactive property such as antifungal and antibacterial.
The aim of this study was to compare the effect of conventional implant site preparation technique and a combination of conventional/piezosurgery preparation on implant stability measured at different time intervals, insertion torque, and preparation time. A randomized controlled study was designed, it included 26 patients who received 54 dental implants randomly assigned to 2 groups; in the control group, implants were installed after conventional preparation with drills whereas the study group received implants after mixed conventional/piezosurgery preparation. The outcome variables included: implant stability measured immediately after implant insertion, at 8 weeks and 16 weeks postoperatively, insertion torque and preparation time. All
... Show MoreThis text and guide discusses the surgical and medical management of congenital heart diseases in both adult and children. It describes the disease, pathology, treatment, complications and follow-up with extensive use of didactic material to educate the reader to the practicalities of the subject. It details the novel research via an extensive literature review, while covering all aspects of the surgical and medical treatment of congenital heart disease. It includes review of the laparoscopic techniques and epidemiology of each disease involved and their prevalence to provide the reader with the full clinical picture. Clinical and Surgical Aspects of Congenital Heart Diseases: Text and Study Guide provides a thorough practical reference fo
... Show MoreKE Sharquie, AA Noaimi, HG Mahmood, SM Al-Ogaily, Journal of Cosmetics, Dermatological Sciences and Applications, 2015 - Cited by 6
Objective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;
... Show MoreThis review discusses the gingival biotypes, their characteristics, analysis based on the measurement of the dentopapillary complex. Also discuss their response to inflammation, surgery, and ridge healing after tooth extraction, their influence in the behavior of the peri-implant tissue