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- Bäckryd, Emmanuel, Docent, 1974-
(författare)
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Att navigera mellan opioidrädsla och opiocentrism i dagens vård : Undvik stereotyp förskrivning med hjälp av grundlig smärtanalys och individualiserad analys av risk och nytta [Navigating between opiophobia and opiocentrism in today's healthcare]
- 2022
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Ingår i: Läkartidningen. - Stockholm : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Opioids are an essential category of medicines, and opiophobia should therefore be shunned. However, it is also important to avoid opiocentrism, i.e., the phenomenon of giving an unduly central place to opioids in the practice of pain medicine. To find a way between these two extremes, it is essential to do a thorough pain assessment and a risk analysis. In this paper, the question of how to best prescribe opioids is related to a "Pain Analysis 3×3" framework in which 3 areas, each consisting of 3 points, are discussed: 1) Is the pain acute, chronic, or cancer-related? 2) Is the pain nociceptive, neuropathic, or nociplastic? 3) Have biological, psychological and social/contextual aspects been taken into consideration (the bio-psycho-social model of pain)? Chronic nociplastic pain conditions such as e.g. fibromyalgia, irritable bowel syndrome or "unspecific" back pain are generally unsuitable for treatment with opioids.
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- Bäckryd, Emmanuel, Docent, 1974-
(författare)
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Doctoral supervision as leadership : a practice-based proposal with special reference to the university hospital setting
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Leadership issues seem to be strangely absent from discussions about what good doctoral supervision is. The purpose of this paper is to explore the concept of doctoral supervision as a form of leadership, with special reference to the university hospital setting. From a personal reflective practice point of view, James Kouzes and Barry Posner's The Five Practices of Exemplary Leadership® Model is used as a lens through which Anne Lee’s concepts of doctoral research supervision are viewed. Four out of five of Lee’s concepts seem to be leadership-related, when viewed from the perspective of Kouzes & Posner, namely “enculturation”, “critical thinking”, “emancipation”, and “relationship development”. The fifth concept, “functional”, can instead be viewed to reflect managerial skills. Hence, it seems meaningful to view doctoral supervision as a form of leadership. The present concept paper should be viewed as hypothesis-generating, and future studies should examine the proposed hypothesis in a more in-depth fashion, using appropriate empirical methodologies and not as in the present paper mere practice-based reflections.
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- Bäckryd, Emmanuel, Docent, 1974-, et al.
(författare)
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Långvarig smärta – relationen till ångest och depression är komplex [Chronic pain and its relationship with anxiety and depression] : Fyra möjliga samband – en konceptuell översikt
- 2023
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 120
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Tidskriftsartikel (refereegranskat)abstract
- Depression and anxiety are highly prevalent in chronic pain. Clinicians often interpret depression/anxiety as consequences of chronic pain, but some psychiatrists contend that the consequence hypothesis is overrated and that psychiatric symptoms in pain patients should be understood as part of the psychiatric disease. In this overview, the potential bidirectional nature of the relationship between chronic pain and depression/anxiety is discussed on a conceptual level. Two additional possible ways of understanding the relationship are presented: psychological vulnerability can be a risk factor for the chronification of pain, and an underlying mild chronic pain can be exacerbated when the patient encounters a new psychosocial stressor. In clinical practice, it is important not to get stuck in a fruitless chase for a causal understanding. However, it is of great value for clinicians to reflect upon the complexity and dynamic nature of the relationship between pain and depression/anxiety.
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- Bäckryd, Emmanuel, Docent, 1974-
(författare)
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Långvariga smärttillstånd får ny klassifikation i ICD-11 Chronic pain as a disease : [Chronic pain as a disease: An overview of pain diagnoses in ICD-11]
- 2023
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 120
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Pain is a symptom that can be associated with dangerous diseases such as cancer. Hence, to avoid delay in diagnosis of an underlying serious condition, it is important to be thorough when assessing pain. However, all pains are not symptoms of an underlying disease. Instead, many chronic pain conditions can be viewed as diseases in their own right. Indeed, sometimes the pain is the disease - such is for instance the case for fibromyalgia, painless fibromyalgia being a contradiction in terms. The new classification of chronic pain conditions according to the eleventh version of International Classification of Diseases (ICD-11) is presented and discussed. It is argued that the classification makes pain medicine visible as an academic discipline; that it may contribute to a legitimization process in which the suffering of pain patients is recognized semantically and taxonomically; and that it opens up new research possibilities in the chronic pain field.
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- Bäckryd, Emmanuel, Docent, 1974-, et al.
(författare)
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Många fallgropar i opioidstatistik
- 2021
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen förlag AB. - 0023-7205 .- 1652-7518. ; 36/37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Bäckryd, Emmanuel, et al.
(författare)
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Serum levels of endocannabinoids and related lipids in painful vs painless diabetic neuropathy: results from the Pain in Neuropathy Study
- 2024
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Ingår i: Pain. - : LIPPINCOTT WILLIAMS & WILKINS. - 0304-3959 .- 1872-6623. ; 165:1, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- N-arachidonoylethanolamine (also known as anandamide) and 2-arachidonoylglycerol are activators of the cannabinoid receptors. The endocannabinoid system also includes structurally and functionally related lipid mediators that do not target cannabinoid receptors, such as oleoylethanolamide, palmitoylethanolamide, and stearoylethanolamide. These bioactive lipids are involved in various physiological processes, including regulation of pain. The primary aim of the study was to analyze associations between serum levels of these lipids and pain in participants in the Pain in Neuropathy Study, an observational, cross-sectional, multicentre, research project in which diabetic patients with painless or painful neuropathy underwent deep phenotyping. Our hypothesis was that painful neuropathy would be associated with higher levels of the 5 lipids compared with painless neuropathy. Secondary aims were to analyze other patient-reported outcome measures and clinical data in relationship to lipid levels. The lipid mediators were analyzed in serum samples using liquid chromatography tandem mass spectrometry (LC-MS/MS). Serum levels of anandamide were significantly higher in the painful group, but the effect size was small (Cohen d = 0.31). Using cluster analysis of lipid data, patients were dichotomized into a "high-level" endocannabinoid group and a "low-level" group. In the high-level group, 61% of patients had painful neuropathy, compared with 45% in the low-level group (P = 0.039). This work is of a correlative nature only, and the relevance of these findings to the search for analgesics targeting the endocannabinoid system needs to be determined in future studies.
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- Bäckryd, Emmanuel, Docent, 1974-
(författare)
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Stora kunskapsluckor om cannabisbaserade läkemedel
- 2021
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 43
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Bäckryd, Emmanuel, Docent, 1974-
(författare)
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Viktigt undvika stereotyp inställning
- 2022
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 119
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Ghafouri, Bijar, 1972-, et al.
(författare)
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An investigation of metabolome in blood in patients with chronic peripheral, posttraumatic/postsurgical neuropathic pain.
- 2022
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Neuropathic pain (NP) is a chronic pain condition resulting from a lesion or disease in the somatosensory nervous system. The aim of this study was to investigate the metabolome in plasma from patients with chronic peripheral, posttraumatic/postsurgical NP compared to healthy controls. Further, we aimed to investigate the correlation between pain intensity and the metabolome in plasma. The metabolic profile in plasma samples from 16 patients with chronic NP and 12 healthy controls was analyzed using a nuclear magnetic resonance spectroscopy method. Information about pain intensity, pain duration, body mass index (BMI), age, sex, and blood pressure were obtained through a questionnaire and clinical examination. Multivariate data analysis was used to identify metabolites significant for group separation and their correlation with pain intensity and duration, BMI, and age. We found 50 out of 326 features in plasma significantly contributing to group discrimination between NP and controls. Several of the metabolites that significantly differed were involved in inflammatory processes, while others were important for central nervous system functioning and neural signaling. There was no correlation between pain intensity and levels of metabolite in NP. These findings indicate that there seems to be peripheral/systemic differences in the metabolic profile between patients with chronic NP and healthy individuals.
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Långvarig smärta: smärtmedicin vol. 2
- 2021. - 1
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Boken ger läsaren en solid kunskapsbas om smärtmedicinens komplexa natur, från såväl ett vetenskapligt som ett mänskligt perspektiv.Långvarig smärta – smärtmedicin (vol. 2) är ett nytt gediget verk med ett omfattande referensmaterial baserat på den senaste evidensen och klinisk praxis och kan läsas som fördjupningslitteratur eller uppslagsverk. Boken kan användas på utbildningar för läkare, sjuksköterskor och fysioterapeuter samt övriga professioner som i sitt yrke möter människor med smärta.DEL I ger en smärtmedicinsk grund med bland annat fysiologi samt psykologiska, humanistiska och åldersmässiga aspekter av smärta. DEL II behandlar den långvariga smärtans patofysiologi och behandlingsmetoder samt farmakologi. DEL III beskriver olika smärttillstånd såsom muskuloskeletala, neuropatiska, ischemiska och viscerala tillstånd samt ett kapitel om långvarig smärta hos barn.Långvarig smärta (vol. 2) kompletteras av Akut och cancerrelaterad smärta (vol. 1). Böckerna bygger på den välrenommerade boken Smärta och smärtbehandling och har extensivt utökats i omfång och djup tack vare den senaste forskningen inom området. Tillsammans utgör de båda volymerna den i särklass mest heltäckande läroboken om smärta på svenska.
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- Mattsson, Anna, et al.
(författare)
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The treatment lottery of chronic back pain? A case series at a multidisciplinary pain centre
- 2023
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Ingår i: Scandinavian Journal of Pain. - : WALTER DE GRUYTER GMBH. - 1877-8860 .- 1877-8879. ; 23:2, s. 273-283
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesDespite the number of people affected by chronic back pain, and the many available treatment options, even the best modalities provide limited pain reduction on a group level, often without simultaneous improvements in functioning or health-related quality of life. The objective was to provide an overview of the treatment of chronic back pain in clinical practice at a multidisciplinary pain centre, and to study patient and pain characteristics in different treatment groups.Methods104 chronic back pain patients (primary ICD-10-SE-diagnosis M53.0-M54.9 excluding M54.1 and M54.3), referred to the Pain and Rehabilitation Centre, University Hospital, Linkoping in 2015, were studied using data from the Swedish Quality Registry for Pain Rehabilitation, self-reported medication data, and a retrospective medical record review.ResultsThe following treatment groups were identified: rehabilitation (n=21), analgesics (n=33), invasive intervention (n=14), and no treatment (n=35). Significant differences between groups were found with regards to age, sick leave, education level, persisting pain duration, punishing responses by significant other, previous invasive intervention, receiving sub-clinic, physician speciality and referring care level.ConclusionsOverall, patient demographics were associated with treatment strategy to a higher degree than patient-reported outcome measures. Moreover, physician speciality and organisational factors seemed to play a role in treatment choice.
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