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sickle cell opioid

Ying Wang, Jianxun Lei, Mihir Gupta, Fei Peng, Sarah Lam, Ritu Jha, Ellis Raduenz, Al J Beitz, Kalpna Gupta
Integrative approaches such as electroacupuncture, devoid of drug effects are gaining prominence for treating pain. Understanding the mechanisms of electroacupuncture induced analgesia would benefit chronic pain conditions such as sickle cell disease (SCD), for which patients may require opioid analgesics throughout life. Mouse models are instructive in developing a mechanistic understanding of pain, but the anesthesia/restraint required to administer electroacupuncture may alter the underlying mechanisms. To overcome these limitations, we developed a method to perform electroacupuncture in conscious, freely moving, unrestrained mice...
September 30, 2016: Scientific Reports
Khuthala Mnika, Gift D Pule, Collet Dandara, Ambroise Wonkam
Sickle cell disease (SCD) is a blood disease caused by a single nucleotide substitution (T > A) in the beta globin gene on chromosome 11. The single point mutation (Glu6Val) promotes polymerization of hemoglobin S (HbS) and causes sickling of erythrocytes. Vaso-occlusive painful crises are associated with recurrent and long-term use of analgesics/opioids and hydroxyurea (HU) by people living with SCD. The present analysis offers a state-of-the-art expert review of the effectiveness of pharmacogenomics/genetics of pain management in SCD, with specific focus on HU and opioids...
October 2016: Omics: a Journal of Integrative Biology
C Patrick Carroll, Carlton Haywood, Sophie M Lanzkron
OBJECTIVES: Sickle cell disease (SCD) is associated with a high level of emergency department and hospital utilization, as well as a high rate of hospital readmissions. At Johns Hopkins Hospital, as at other institutions, SCD accounts for a large proportion of readmissions. Our study examined patient and hospitalization factors involved in readmissions at Johns Hopkins Hospital. METHODS: Patients at the Johns Hopkins Sickle Cell Center for Adults with a readmission in fiscal year 2011 were compared with an age- and sex-matched sample of clinic patients for comorbidities, complications, and prior utilization...
September 2016: Southern Medical Journal
Jennifer Horst, Melissa Frei-Jones, Elena Deych, William Shannon, Evan D Kharasch
BACKGROUND: Vaso-occlusive episodes (VOEs) are a significant source of morbidity among children and adults with sickle cell disease (SCD). There is little information on methadone use for SCD pain. This investigation evaluated methadone pharmacokinetics in children and adults with SCD, with a secondary aim to assess pain relief and opioid consumption. PROCEDURE: Participants included children (<18 years) and adults with a VOE requiring hospitalization. Patients were randomly assigned to receive standard care (opioid patient-controlled analgesia; control group) or one dose of intravenous methadone (0...
August 30, 2016: Pediatric Blood & Cancer
Thomas Kannampallil, William L Galanter, Suzanne Falck, Michael J Gaunt, Robert D Gibbons, Robert McNutt, Richard Odwazny, Gordon Schiff, Allen J Vaida, Diana J Wilkie, Bruce L Lambert
Pain care for hospitalized patients is often suboptimal. Representing pain scores as a graphical trajectory may provide insights into the understanding and treatment of pain. We describe a 1-year, retrospective, observational study to characterize pain trajectories of hospitalized adults during the first 48 hours after admission at an urban academic medical center. Using a subgroup of patients who presented with significant pain (pain score>4; n=7,762 encounters) we characterized pain trajectories and measured area under the curve, slope of the trajectory for the first two hours after admission, and pain intensity at plateau...
August 19, 2016: Pain
Amanda M Brandow, Mark Nimmer, Timothy Simmons, T Charles Casper, Lawrence J Cook, Corrie E Chumpitazi, J Paul Scott, Julie A Panepinto, David C Brousseau
The impact of emergency department (ED) treatment on outcomes of sickle cell disease (SCD) acute pain hospitalizations is not well described. We investigated whether length of stay (LOS) and change in health-related quality of life (HRQL) are affected by initial opioid dose and time to administration. We conducted secondary analyses of data from the randomized-controlled Magnesium for children in Crisis (MAGiC) trial. The primary outcome was LOS. Secondary outcome was change in HRQL, assessed using PedsQL SCD Pain and Hurt and Pain Impact Domains measured in ED and at discharge...
August 12, 2016: American Journal of Hematology
Jin Han, Santosh L Saraf, Xu Zhang, Michel Gowhari, Robert E Molokie, Johara Hassan, Chaher Alhandalous, Shivi Jain, Jewel Younge, Taimur Abbasi, Roberto F Machado, Victor R Gordeuk
Pain, the hallmark complication of sickle cell disease (SCD), is largely managed with opioid analgesics in the United States, but comprehensive data regarding the long-term use of opioids in this patient population is lacking. The pain medication prescription records from a cohort of 203 SCD patients were analyzed. Twenty-five percent were not prescribed opioid medications while 47% took only short-acting opioids, 1% took only long-acting opioids, and 27% took a combination of short-acting and long-acting opioids...
July 28, 2016: American Journal of Hematology
Josue Santos, Sasia Jones, Daniel Wakefield, James Grady, Biree Andemariam
Background. A treatment algorithm for sickle cell disease (SCD) pain in adults presenting to a single emergency department (ED) was developed prioritizing initiation of patient controlled analgesia (PCA) for patients awaiting hospitalization. Objectives. Evaluate the proportion of ED visits in which PCA was started in the ED. Methods. A two-year retrospective chart review of consecutive SCD pain ED visits was undertaken. Data abstracted included PCA initiation, low versus high utilizer status, pain scores, bolus opioid number, treatment times, and length of hospitalization...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Roseann S Gammal, Kristine R Crews, Cyrine E Haidar, James M Hoffman, Donald K Baker, Patricia J Barker, Jeremie H Estepp, Deqing Pei, Ulrich Broeckel, Winfred Wang, Mitchell J Weiss, Mary V Relling, Jane Hankins
After postoperative deaths in children who were prescribed codeine, several pediatric hospitals have removed it from their formularies. These deaths were attributed to atypical cytochrome P450 2D6 (CYP2D6) pharmacogenetics, which is also implicated in poor analgesic response. Because codeine is often prescribed to patients with sickle cell disease and is now the only Schedule III opioid analgesic in the United States, we implemented a precision medicine approach to safely maintain codeine as an option for pain control...
July 2016: Pediatrics
C Patrick Carroll, Sophie Lanzkron, Carlton Haywood, Kasey Kiley, Megan Pejsa, Gyasi Moscou-Jackson, Jennifer A Haythornthwaite, Claudia M Campbell
Chronic opioid therapy (COT) for chronic non-cancer pain is frequently debated, and its effectiveness is unproven in sickle cell disease (SCD). The authors conducted a descriptive study among 83 adult SCD patients and compared the severity of disease and pain symptoms among those who were prescribed COT (n=29) with those who were not using COT. All patients completed baseline laboratory pain assessment and questionnaires between January 2010 and June 2014. Thereafter, participants recorded daily pain, crises, function, and healthcare utilization for 90 days using electronic diaries...
July 2016: American Journal of Preventive Medicine
Nadia S Ruta, Samir K Ballas
No abstract text is available yet for this article.
May 5, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Samir K Ballas
In the 1970s, sickle cell pain was treated with trial and error approach by increasing or decreasing the dose of an opioid or switching from one analgesic to another. This approach was controversial with criticism and doubt about its usefulness. Since then, advances in determining the structure of opioid receptors and the role of the CYP450 enzymes in metabolizing opioids revealed that these anatomic and metabolic findings are not the same in all persons, thus explaining the variability in response to opioids among patients...
May 2016: Journal of Clinical Medicine Research
Nivan Zoheiry, Maha Alkokani, Richard Ward, Angela Mailis
No abstract text is available yet for this article.
April 5, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Crystal Y Zheng, Caterina P Minniti, Mark H Chaitowitz
We describe a case of delirium occurring in a hospitalized sickle cell patient. Following admission for a typical pain crisis, the patient continued to report unrelieved pain with marked agitation for several days, despite escalating doses of opioid analgesia, and ultimately required intubation following development of acute chest syndrome (ACS). After some delay, it was discovered that he had been using a synthetic cannabinoid (K2) which may have precipitated his pain crisis and, with hindsight, explained his prolonged period of delirium...
June 2016: Hemoglobin
Teresa Works, Sasia Jones, James Grady, Biree Andemariam
This article describes the impact of the integration of a licensed clinical social worker (LCSW) with expertise in behavioral health on identification of risk factors for chronic pain in a cohort of adults with sickle cell disease. Authors conducted a retrospective chart review of all visits to the adult sickle cell center during the first six months of LCSW integration. Demographics, clinical history, and LCSW notes were reviewed. Overall, 71 patients were introduced to the LCSW; 55 percent of them had chronic pain...
February 2016: Health & Social Work
Seyed-Ali Mostafavi, Reza Bidaki
OBJECTIVE: Priapism is defined by persistent, painful penile erection which occurs without sexual stimulation. Methadone is used as an analgesic and is also used in detoxification and maintenance protocol for opioid dependence treatment. Here we will report a case of a male with priapism after rapid discontinuation doses of methadone. CASE PRESENTATION: The case was a young married male who referred to a psychiatry clinic due to long-time spontaneous erections. The patient had no history of mental disorders, trauma or sickle cell anemia...
April 2015: Iranian Journal of Psychiatry
Angeliki Vgontzas, Larry Charleston, Matthew S Robbins
Children and adolescents with sickle cell disease (SCD) have a high prevalence of recurrent headaches (24.0-43.9 %). Acute presentation with headache can be diagnostically challenging, as the clinician must consider evaluation of several potentially devastating conditions including vascular diseases (stroke, hemorrhage, venous sinus thrombosis, moyamoya, posterior reversible encephalopathy syndrome), facial and orbital bone infarcts, dental pain, and osteomyelitis. Patients with SCD and primary headache disorders may benefit from comprehensive headache treatment plans that include abortive therapy, prophylactic therapy, and non-pharmacological modalities...
March 2016: Current Pain and Headache Reports
T R Kotila, O E Busari, V Makanjuola, O R Eyelade
OBJECTIVE: The objective of this report is to highlight the background factors associated with opioid abuse among Sickle Cell Disease (SCD) patients. PATIENTS: Eleven patients aged 13-53 years (mean, 26.1yrs) which included six female and five male were seen in the last six year at a tertiary health facility. The modes of abuse ranged from obtaining analgesic prescription from multiple sources, injecting analgesics and sharing analgesics between patients in the hospital...
June 2015: Annals of Ibadan Postgraduate Medicine
Tyler Shirel, Collin P Hubler, Rena Shah, Amy B Mager, Kathryn L Koch, Darshita Sheth, Michael R Uhing, Cresta W Jones, Joshua J Field
The objective of this study was to test the hypothesis that higher daily opioid dose is associated with the presence and severity of neonatal abstinence syndrome (NAS) in pregnant women with sickle cell disease (SCD). This was a retrospective study of pregnant women with SCD who required opioids. NAS was evaluated using the Finnegan scoring system and classified as none, mild, and severe. Severe NAS was defined as a Finnegan score ≥ 8 on 3 consecutive tests. Thirty-four pregnancies were examined in 30 women with SCD...
June 2016: American Journal of Hematology
Miriam O Ezenwa, Yingwei Yao, Christopher G Engeland, Robert E Molokie, Zaijie Jim Wang, Marie L Suarez, Diana J Wilkie
AIM: To test feasibility of a guided audio-visual relaxation intervention protocol for reducing stress and pain in adults with sickle cell disease. BACKGROUND: Sickle cell pain is inadequately controlled using opioids, necessitating further intervention such as guided relaxation to reduce stress and pain. DESIGN: Attention-control, randomized clinical feasibility pilot study with repeated measures. METHODS: Randomized to guided relaxation or control groups, all patients recruited between 2013-2014 during clinical visits, completed stress and pain measures via a Galaxy Internet-enabled Android tablet at the Baseline visit (pre/post intervention), 2-week posttest visit and also daily at home between the two visits...
June 2016: Journal of Advanced Nursing
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