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https://www.readbyqxmd.com/read/27902670/ketamine-infusion-for-pain-control-in-acute-pediatric-sickle-cell-painful-crises
#1
Jonathan M Hagedorn, Evelyn C Monico
OBJECTIVES: Sickle cell disease is the most common hemoglobin variant in the world and can present with recurrent vaso-occlusive painful crises. Pain control in these patients is often difficult and requires a multimodal approach. In patients with uncontrolled pain after traditional pain control methods, ketamine infusions have proven beneficial. Unfortunately, no source alone had described ketamine infusions for pediatric sickle cell patients. Our objective was to provide a thorough definitive reference for health care providers regarding the use of ketamine infusion for pain control in pediatric sickle cell painful crises...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27880985/daily-pain-in-adults-with-sickle-cell-disease-a-different-perspective
#2
Charlotte F J van Tuijn, Joep W R Sins, Karin Fijnvandraat, Bart J Biemond
Previous reports demonstrated that patients with sickle cell disease (SCD) experience pain on more than half of the observed days. Yet, these high incidences do not seem to match observations in our population. In this prospective cohort study we aimed to assess the frequency and characteristics of daily, self-reported pain among adult SCD patients in the Netherlands. Consecutive patients were enrolled during routine outpatient visits and followed up to 6 months. A total of 55 patients completed 5 982 diary observation days...
November 23, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27803072/factors-associated-with-the-prophylactic-prescription-of-a-bowel-regimen-to-prevent-opioid-induced-constipation
#3
Nancy Y Chen, Eugene Nguyen, Sheree M Schrager, Christopher J Russell
OBJECTIVE: Identify factors associated with the prophylactic prescription of a bowel regimen with an inpatient opioid prescription. METHODS: This was a retrospective cohort study from June 1, 2013, to October 31, 2014 of pediatric inpatients prescribed an oral or intravenous opioid on the general medical/surgical floors. We identified patients with or without a prophylactic prescription of a bowel regimen. We obtained patient demographics, prescriber training level and service and used multivariate logistic regression to analyze the factors associated with prophylactic bowel regimen and opioid prescription...
November 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27800652/opioid-prescription-practices-at-discharge-and-30-day-returns-in-children-with-sickle-cell-disease-and-pain
#4
Leslie M Okorji, Devin S Muntz, Robert I Liem
BACKGROUND: Acute pain episodes in children with sickle cell disease (SCD) represent a leading cause of readmissions. We examined prescription practices at the time of discharge in children with SCD presenting with acute pain to determine their impact on 30-day emergency department (ED) revisits and readmissions. METHODS: In this single-institution, 5-year retrospective study, we reviewed 290 encounters of patients with SCD aged 7-21 years hospitalized or discharged from the ED with acute pain...
November 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27797344/objective-basis-for-chronic-pain-in-patients-with-adult-sickle-cell-disease
#5
Samip Master, Abhishek Patel, Glenn Mills, Richard Mansour
Sickle Cell Disease (SCD) affects approximately 100,000 Americans and due to lack of an organized treatment approach, patients with SCD pose a high economic burden on medical services. The patients with SCD have chronic bone damage from bone marrow infraction and vaso-occulsive events. These bone damages lead to chronic pain in patients with SCD. The inadwquate treatment of chronic pain in adult patients with SCD can lead to pseudo-addictive behavior and also affect their psycho-social life. There are certain barriers to adequate pain management in adult patients with SCD, namely, limited knowledge among the clinicians, inadequate assessment, concerns about addiction, and biases against opioid use...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27687125/electroacupuncture-in-conscious-free-moving-mice-reduces-pain-by-ameliorating-peripheral-and-central-nociceptive-mechanisms
#6
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
https://www.readbyqxmd.com/read/27636225/an-expert-review-of-pharmacogenomics-of-sickle-cell-disease-therapeutics-not-yet-ready-for-global-precision-medicine
#7
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
https://www.readbyqxmd.com/read/27598369/examination-of-the-patient-and-hospitalization-characteristics-of-30-day-scd-readmissions
#8
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
https://www.readbyqxmd.com/read/27572136/pharmacokinetics-and-analgesic-effects-of-methadone-in-children-and-adults-with-sickle-cell-disease
#9
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
https://www.readbyqxmd.com/read/27548045/characterizing-the-pain-score-trajectories-of-hospitalized-adult-medical-and-surgical-patients-a-retrospective-cohort-study
#10
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
https://www.readbyqxmd.com/read/27517842/impact-of-emergency-department-care-on-outcomes-of-acute-pain-events-in-children-with-sickle-cell-disease
#11
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...
December 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27466799/patterns-of-opioid-use-in-sickle-cell-disease
#12
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
https://www.readbyqxmd.com/read/27445606/patient-controlled-analgesia-for-adults-with-sickle-cell-disease-awaiting-admission-from-the-emergency-department
#13
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
https://www.readbyqxmd.com/read/27335380/pharmacogenetics-for-safe-codeine-use-in-sickle-cell-disease
#14
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
https://www.readbyqxmd.com/read/27320469/chronic-opioid-therapy-and-central-sensitization-in-sickle-cell-disease
#15
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
https://www.readbyqxmd.com/read/27152018/the-opioid-drug-epidemic-and-sickle-cell-disease-guilt-by-association
#16
Nadia S Ruta, Samir K Ballas
No abstract text is available yet for this article.
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27081419/from-individualized-treatment-of-sickle-cell-pain-to-precision-medicine-a-40-year-journey
#17
REVIEW
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
https://www.readbyqxmd.com/read/27048344/characterization-of-chronic-pain-and-opioid-usage-in-adult-sickle-cell-disease-patients-referred-to-a-comprehensive-pain
#18
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
https://www.readbyqxmd.com/read/26956672/sickle-cell-crisis-complicated-by-synthetic-cannabinoid-abuse-a-case-report
#19
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
https://www.readbyqxmd.com/read/26946885/traumatic-exposure-history-as-a-risk-factor-for-chronic-pain-in-adult-patients-with-sickle-cell-disease
#20
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
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