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Mixed pain: clinical practice recommendations
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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.

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Mixed Convection in a Square Cavity Filled with Porous Medium with Bottom Wall Periodic Boundary Condition
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Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic  pressure sinusoidal  amplitude  range and

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Publication Date
Tue Aug 11 2020
Journal Name
Bdj Open
An in vitro assessment of the physical properties of manually- mixed and encapsulated glass-ionomer cements
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Abstract<sec> <title>Objectives

The last decade has seen a variety of modifications of glass-ionomer cements (GICs), such as inclusion of bioactive glass particles and dispensing systems. Hence, the aim was to systematically evaluate effect of mixing modes and presence of reactive glass additives on the physical properties of several GICs.

Materials and methods

The physical properties of eight commercial restorative GICs; Fuji IX GP Extra (C&H), KetacTM Fill Plus Applicap (C&H), Fuji II LC (C&H), Glass Carbomer Ce

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Publication Date
Wed Oct 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of dental arches symmetry in a sample of Iraqi children at the mixed dentition stage
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Background: Little is known about asymmetry of children's dental arches, the purpose of this study was to verify the presence of asymmetry of dental arches among Iraqi children in the mixed dentition stage. Materials and methods: The sample included 52 pairs of dental casts, 27 pairs belong to males and 25 pairs for females. Three linear distances were utilized on each side on the dental arch: Incisal-canine distance, canine-molar distance and incisal-molar distance, which represent the dental arch segmental measurements using the digital sliding calipers, which is accurate up to 0.02 mm. Results: No significant sides' differences with high correlation coefficient were found between the right and left incisal-canine, canine-molar and in

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Publication Date
Wed Dec 31 2014
Journal Name
Complex Metals
Formation of polymeric assemblies of six-coordinate metal complexes with mixed bridges of dicarboxylato-azido moieties
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New biscarboxylato zwitterionic ligands, namely bis(N-carboxylatoethyl)-4,4 -dipyridinum) L1 and bis(Ncarboxylatopropyl)-)-4,4 -dipyridinum) L2, were synthesized from the reaction of 4,4 -dipyridine with 3-bromopropanoic acid and 4-bromobutanoic acid, respectively. The reaction of these ligands and the azido coligand with some metal ions resulted in the formation of polymeric complexes of general formulae [Cr2(Ln)(N3)4]Cl2·H2O and [M2(Ln)(N3)4] xH2O, where (M = Mn(II), Fe(II), Co(II), Ni(II), Cu(II), Zn(II) and Cd(II); n = 1, 2; x = 1, 1, 1, 1, 0, 1, and 1, respectively.) The oxygens of the carboxylato group are coordinated to the metal ion in a bidentate fashion. The mode of bonding and overall geometry of the complexes were determin

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Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Engineering
Mixed Convection Heat Transfer in a Vertical Saturated Concentric Annulus Packed with a Metallic Porous Media
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Mixed convection heat transfer in a vertical concentric annulus packed with a metallic porous media and heated at a constant heat flux is experimentally investigated with water as the working fluid. A series of experiments have been carried out with a Rayleigh number range from Ra=122418.92 to 372579.31 and Reynolds number that based on the particles diameter of Red=14.62, 19.48 and 24.36. Under steady state condition, the measured data were collected and analyzed. Results show that the wall surface temperatures are affected by the imposed heat flux variation and Reynolds number variation. The variation of the local heat transfer coefficient and the mean Nusselt number are presented and analyzed. An empirical

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Publication Date
Thu Jun 08 2023
Journal Name
Egyptian Journal Of Chemistry
Ring Opining polymerization of caprolactone And Antibacterial activity by Mixed Ligand of Metal(II) and (III)
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Reaction of L1 [((E)-N1-(nitrobenzylidene)benzene-1,2-diamine] and L2( m-aminophenol), and one equivalent of di- or tri-valent metals(Cr(ӀӀӀ), Mn(ӀӀ), Fe(ӀӀӀ), Co(ӀӀ), Ni(ӀӀ), Cu(ӀӀ) and Zn(ӀӀ) afforded the complexes [M(L1)(L2)2]Cl, M=Cr(ӀӀӀ) and Fe(ӀӀӀ) and the complexes [M(L1)(L2)2] M= Mn(ӀӀ), Co(ӀӀ), Ni(ӀӀ), Cu(ӀӀ) and Zn(ӀӀ). The structure of the Schiff base ligand and their complexes are characterized by (C:H:N), FT.IR, UV.Vis, 1HNMR, 13CNMR and mass spectral. The presence of metal in the complexes are characterized by flame atomic absorption. The spectral data of the complexes have revealed the octahedral geometry. The (L1), (L2) and mixed ligand metal complexes were screened for their ability as cataly

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Publication Date
Wed Feb 14 2024
Journal Name
Russian Journal Of General Chemistry
Preparation, Characterization, and Biological Activity of Mixed Schiff Base Ligand Complexes with Amino Acid L-Proline
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Publication Date
Thu May 02 2013
Journal Name
Diyala Journal For Pure Sciences
Synthesis and Characterization of Mixed Ligands of Dithizone and Schiff Base Complexes with Selected Metal Ions.
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Salicylaldehyde was react with 4-amino-2,3-dimethyl-1-phenyl-3-pyrazoline-5-on to produce the Schiff base ligand 2,3-dimethyl-1-phenyl-4-salicylidene-3-pyrazoline-5-on (L). The prepared ligand was identified by Microelemental Analysis, and FT.IR, UV-Vis spectroscopic techniques. A new complexes of Fe(III),Co(II),Ni(II),Cu(II),Ce(III) and Pb(II) with mixed ligands of dithizone (DTZ) and Schiff base were prepared in aqueous ethanol with a 2:2:1 M:L:DTZ. The prepared complexes were characterized using flame atomic absorption, (C.H.N) Analysis, FT.IR and UV-Vis spectroscopic methods as well as magnetic susceptibility and conductivity measurements. In addition biological activity of the ligands and complexes against two selected type of bacteria

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Publication Date
Tue Jul 28 2026
Journal Name
Chemistry Africa
Structural Characterization and Biological Assessment of Platinum(IV) Schiff Base Mixed-Ligand Complex with Anthranilic Acid
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A Schiff base ligand (L) was used as primary ligand and potassium anthranilate (Anth) was used as the secondary ligand in the molar ratio M: L:2Anth to synthesize a new platinum(IV) mixed-ligand complex [Pt(L)(Anth)₂]Cl₂. The Schiff base ligand was synthesized by the condensation of 4-Aminoantipyrine with 4-Hydroxybenzaldehyde and was verified as a bidentate ligand. The UV-visible, FT-IR, 1 H NMR, 13 C NMR, CHN elemental analysis, molar conductance, chloride ion determination and melting point measurements were used to characterize the ligand and the complex. The results of the molar conductance showed that the electrolytic behavior was 1:2, where the two chloride ions were present outside the coordination sphere, while the spectroscopi

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Publication Date
Sun Sep 01 2024
Journal Name
Inorganic Chemistry Communications
Investigation of optical, mechanical, thermal, wettability, and antibacterial activity of polyvinyl alcohol mixed with clay nanoparticles
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