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Pain and Therapy

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https://www.readbyqxmd.com/read/29873010/a-review-of-chronic-musculoskeletal-pain-central-and-peripheral-effects-of-diclofenac
#1
REVIEW
Fabiola Atzeni, Ignazio Francesco Masala, Piercarlo Sarzi-Puttini
Diclofenac is widely used to manage chronic inflammatory and degenerative joint diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis, and extra-articular rheumatism. Its various mechanisms of action make it particularly effective in treating nociceptive pain, but it is also an alternative for treating spinal and chronic central pain. Osteoarthritis and rheumatoid arthritis are the most frequently encountered arthritic conditions in adults. The management of nociceptive pain requires a sequential hierarchical approach, with the initial NSAID treatment being characterized by the replacement of one drug with another, or complete discontinuation usually because of insufficient pain control...
June 5, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29860585/a-review-of-the-burden-of-trauma-pain-in-emergency-settings-in-europe
#2
REVIEW
Patrick D Dißmann, Maxime Maignan, Paul D Cloves, Blanca Gutierrez Parres, Sara Dickerson, Alice Eberhardt
Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006-December 2017)...
June 2, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29767395/behavioral-therapy-approaches-for-the-management-of-low-back-pain-an-up-to-date-systematic-review
#3
REVIEW
Kristallia Vitoula, Annalena Venneri, Giustino Varrassi, Antonella Paladini, Panagiota Sykioti, Joy Adewusi, Panagiotis Zis
Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression...
May 16, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29752701/pain-agreements-and-healthcare-utilization-in-a-veterans-affairs-primary-care-population-a-retrospective-chart-review
#4
Cynthia Kay, Erica Wozniak, Alice Ching, Joanne Bernstein
INTRODUCTION: The prevalence of chronic pain is enormous. In America, the management of chronic pain and opioids remains a critical focus. Guidelines recommend pain agreements as part of the management of chronic pain and opioids; however, evidence of improvement in patient outcomes is lacking. An aspect of patient outcome includes utilization of healthcare resources, such as emergency department visits and hospitalizations. It remains uncertain whether the use of pain agreements lessens healthcare utilization...
May 11, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29691801/a-brief-history-of-the-opioid-epidemic-and-strategies-for-pain-medicine
#5
REVIEW
Mark R Jones, Omar Viswanath, Jacquelin Peck, Alan D Kaye, Jatinder S Gill, Thomas T Simopoulos
The opioid epidemic has resulted from myriad causes and will not be solved by any simple solution. Consequent to a staggering increase in opioid-related deaths in the USA, various governmental inputs and stakeholder strategies have been proposed and implemented with varying success. This article summarizes the history of opioid use and explores the causes for the present day epidemic. Recent trends in opioid-related data demonstrate an almost fourfold increase in overdose deaths from 1999 to 2008. Tragically, opioids claimed over 64,000 lives just last year...
April 24, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29623667/a-review-of-the-opioid-epidemic-what-do-we-do-about-it
#6
REVIEW
Edward A Shipton, Elspeth E Shipton, Ashleigh J Shipton
The opioid epidemic, with its noticeable increase in opioid prescriptions and related misuse, abuse and resultant deaths in the previous 12 years, is a particularly North American phenomenon. Europe, and particularly low- and middle-income countries, appear to be less influenced by this problem. There is undisputable value in using opioids not only in the treatment of acute pain, but in cancer pain as well. However, opioids are progressively being prescribed more and more for chronic non-cancer pain, despite inadequate data on their efficacy...
April 6, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29623654/tapentadol-extended-release-in-the-treatment-of-severe-chronic-low-back-pain-and-osteoarthritis-pain
#7
REVIEW
Joseph V Pergolizzi, Robert Taylor, Jo Ann LeQuang, Robert B Raffa, John Bisney
Tapentadol is a novel pain reliever with apparently synergistic dual mechanisms of action, capable of addressing both nociceptive and neuropathic components of chronic pain. As an effective analgesic with good tolerability, tapentadol may be appropriate for patients suffering from severe chronic pain associated with low back pain (LBP) or osteoarthritis (OA). Efficacy studies of tapentadol in populations of patients with severe chronic LBP or OA pain suggest that tapentadol is non-inferior to oxycodone. Its tolerability, especially with respect to gastrointestinal (GI) side effects, may be better than that of other strong opioids in clinical trials and analyses of multiple trials...
April 5, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29594972/a-pharmacological-rationale-to-reduce-the-incidence-of-opioid-induced-tolerance-and-hyperalgesia-a-review
#8
REVIEW
Giustino Varrassi, Mariella Fusco, Stephen D Skaper, Daniele Battelli, Panagiotis Zis, Stefano Coaccioli, Maria Caterina Pace, Antonella Paladini
Chronic pain is an important health and social problem. Misuse and abuse of opioids in chronic non-cancer pain management seem to be a huge problem, in some countries. This could probably affect the normal use of such analgesics in patients in need of them. Basic and clinical researches should find the solution to mitigate the potential damage. Dysregulation of mast cell and microglia activation plays an important role in the pathogenesis and management of chronic pain. Persistent mast cell activation sensitizes nociceptors and initiates central nervous system inflammatory processes, involving microglial cell activation and sensitization of spinal somatosensory neurons...
March 28, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29470789/evaluation-of-psychometric-and-linguistic-properties-of-the-italian-adolescent-pain-assessment-scales-a-systematic-review
#9
REVIEW
Flavio Marti, Antonella Paladini, Giustino Varrassi, Roberto Latina
INTRODUCTION: Adolescents' pain experiences are complex and multidimensional, and evaluating pain only from a sensory and affective point of view may be in many instances limiting and inadequate; this is the reason why it is of paramount importance to identify the tools which can better assess the pain experienced by young patients. A person-oriented approach is highly encouraged, as it may better investigate the cognitive and behavioral development typical of this age group. The aim of this review paper is to describe the available tools which are able to adequately assess pain intensity in adolescents, in particular those validated in Italian...
June 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29196945/pain-in-platin-induced-neuropathies-a-systematic-review-and-meta-analysis
#10
REVIEW
Vasiliki Brozou, Athina Vadalouca, Panagiotis Zis
INTRODUCTION: Platin-induced peripheral neuropathy (PIPN) is a common cause of PN in cancer patients. The aim of this paper is to systematically review the current literature regarding PIPN, with a particular focus on epidemiological and clinical characteristics of painful PIPN, and to discuss relevant management strategies. METHODS: A systematic computer-based literature search was conducted on the PubMed database. RESULTS: This search strategy resulted in the identification of 353 articles...
December 1, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178038/neuropathic-pain-the-scope-of-the-problem
#11
EDITORIAL
Giorgio Cruccu, Andrea Truini
No abstract text is available yet for this article.
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178037/a-review-of-neuropathic-pain-from-diagnostic-tests-to-mechanisms
#12
REVIEW
Andrea Truini
Neuropathic pain develops when the somatosensory nervous system is affected by a lesion or disease. Diagnostic tests aimed at assessing somatosensory afferent pathway damage are therefore useful for diagnosing neuropathic pain. Neuropathic pain manifests with a range of different symptoms such as ongoing burning pain, squeezing or pressure pain, paroxysmal electric shock-like sensations, stabbing pain, or mechanical dynamic allodynia. The various types of neuropathic pain are associated with different underlying nerve fiber abnormalities...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178036/neuropathic-pain-and-sleep-a-review
#13
REVIEW
Luigi Ferini-Strambi
Neuropathic pain is associated with sleep disturbances, and in turn poor sleep quality leads to increased pain sensitivity, so it is essential to assess sleep alongside neuropathic pain. Responses to drugs are inconsistent and identifying the best treatment option that will reduce pain and improve sleep quality remains challenging for clinicians. Anticonvulsants such as pregabalin and gabapentin improve neuropathic pain and have a positive effect on comorbid sleep disturbances. Opioids and antidepressants are effective in reducing pain but can exacerbate sleep disturbances...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178035/a-review-of-the-emotional-aspects-of-neuropathic-pain-from-comorbidity-to-co-pathogenesis
#14
REVIEW
Riccardo Torta, Valentina Ieraci, Francesca Zizzi
Neuropathic pain is characterized by both sensory and affective disturbances, supporting the notion that pain and mood disorders share common pathogenetic mechanisms. Moreover, biological and neuroimaging data show that common brain areas are involved in the modulation of painful and emotional experiences. Improved understanding of the molecular mechanisms underlying the role of neuroinflammation in regulation of affective behavior in neuropathic pain states is important for the development of novel therapeutic strategies...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178034/pharmacotherapy-for-neuropathic-pain-a-review
#15
REVIEW
Diego Fornasari
Neuropathic pain, comprising a range of heterogeneous conditions, is often severe and difficult to manage, and this may result in a chronic condition that negatively affects the overall functioning and quality of life in patients. The pharmacotherapy of neuropathic pain is challenging and for many patients effective treatment is lacking; therefore, evidence-based recommendations are essential. Currently, there is general agreement on which drugs are appropriate for the first-line treatment of neuropathic pain, whereas debate continues regarding second- and third-line treatments...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29178033/a-review-of-neuropathic-pain-from-guidelines-to-clinical-practice
#16
REVIEW
Giorgio Cruccu, Andrea Truini
Neuropathic pain is a chronic condition representing a significant burden for patients, society, and healthcare systems. The prevalence of neuropathic pain in the general population has been estimated at 7-8% and is expected to increase in the future. Neuropathic pain differs from nociceptive pain and requires a different therapeutic approach; and the management of neuropathic pain is complicated and challenging. This chapter discusses clinical practice guidelines for neuropathic pain and their usefulness in clinical practice...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#17
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29080097/hydromorphone-hydrochloride-use-during-various-interventional-radiology-procedures-pain-control-and-adverse-events-a-case-series-audit-analysis
#18
Thea Moran, Amit Prabhakar, James H Diaz, Alan David Kaye
INTRODUCTION: This project studied pain control and the development of adverse events before, during, and after the administration of hydromorphone hydrochloride for various interventional radiology (IR) procedures. METHODS: We performed a retrospective analysis of 100 patients (men = 58; women = 42) sedated with peri-procedural intravenous (IV) hydromorphone in association with various IR procedures. We stratified the procedures as follows: abscess drainages (M = 8; F = 8), arteriograms (M = 1; F = 0), biliary interventions (M = 3; F = 2), bone biopsies (M = 2; F = 2), non-bone biopsies (M = 26; F = 19), non-tunneled venous catheters (M = 1; F = 1), tunneled venous catheters (M = 7; F = 5), embolization (M = 4; F = 0), IVC filter placement (M = 1; F = 1), nephrostomy tube placement (M = 1; F = 4), and percutaneous nephrolithotomy tube placements (M = 4; F = 0)...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29058253/why-we-still-need-to-speak-about-sex-differences-and-sex-hormones-in-pain
#19
EDITORIAL
Anna Maria Aloisi
In the world of pain, we must always consider the presence of gender. In nociception, as well as in pain, women are different from men in many, if not all, aspects of the system. Nociception is the sum of several events that occur from the periphery to the CNS, and there is much evidence that female nociception differs from male nociception. Moreover, it has to be considered that pain results from a male or a female cortex. Genetic, anatomical, physiological, hormonal, psychological, and social factors have been considered to explain the differences present at both levels...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29052805/sublingual-buprenorphine-efficacy-in-renal-colic-pain-relief-a-randomized-placebo-controlled-clinical-trial
#20
Javad Mozafari, Kambiz Masoumi, Arash Forouzan, Hassan Motamed, Malehi Amal Saki, Marzieh Dezham
INTRODUCTION: This study was designed to compare the analgesic efficacy of sublingual (SL) buprenorphine and intravenous (IV) ketorolac for renal colic pain relief. METHODS: The present study was carried out as a double-blind, double-dummy randomized clinical trial in patients diagnosed with acute renal colic attending the emergency department. The study subjects were 63 patients with confirmed renal stones. The subjects were randomly divided into two groups. One group, which included 32 patients, received SL buprenorphine tablets (2 mg) with an IV placebo, and another group, including 31 patients, received ketorolac tromethamine (30 mg) with a SL placebo...
December 2017: Pain and Therapy
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