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Pain in critical care

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https://www.readbyqxmd.com/read/28635354/the-effects-of-food-on-opioid-induced-nausea-and-vomiting-and-pharmacological-parameters-a-systematic-review
#1
Robert B Raffa, Robert Colucci, Joseph V Pergolizzi
Opioids remain the standard of care for treating moderate to severe pain resulting from surgery or injury in cases of acute pain, and are recommended for patients who have not responded to nonopioid analgesics. Effective management of pain has an impact on clinical course and often depends on achieving an acceptable balance between opioid efficacy, safety, and tolerability. Common opioid-related adverse events such as nausea and vomiting are associated with an overall lower achievement of effective pain management and patient satisfaction...
June 21, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#2
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28624885/cardiac-rehabilitation-following-acute-coronary-syndrome-in-women
#3
REVIEW
Amanda L Bennett, Carl J Lavie, Sherry L Grace
Acute coronary syndrome (ACS) is among the leading burdens of disease among women. It is a significant driver of morbidity and chronically undermines their quality of life. Cardiac rehabilitation (CR) is indicated for ACS patients in clinical practice guidelines, including those specifically for women. CR is a multi-component model of care, proven to reduce mortality and morbidity, including in women. However, women are significantly less likely to be referred to CR by providers, and if they are referred, to enroll and adhere to programs...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#4
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28619390/the-effect-of-massage-on-acute-postoperative-pain-in-critically-and-acutely-ill-adults-post-thoracic-surgery-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Madalina Boitor, Céline Gélinas, Melissa Richard-Lalonde, Brett D Thombs
Critical care practice guidelines identify a lack of clear evidence on the effectiveness of massage for pain control. To assess the effect of massage on acute pain in critically and acutely ill adults post-thoracic surgery. Medline, Embase, CINAHL, PsychInfo, Web of Science, Scopus and Cochrane Library databases were searched. Eligible studies were randomized controlled trials (RCTs) evaluating the effect of massage compared to attention control/sham massage or standard care alone on acute pain intensity post-thoracic surgery...
June 12, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28618123/-pain-relieved-but-still-struggling-critically-ill-patients-experiences-of-pain-and-other-discomforts-during-analgosedation
#6
Helene Berntzen, Ida Torunn Bjørk, Hilde Wøien
AIM & OBJECTIVE: To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts, and wakefulness. BACKGROUND: Patients experience both pain and discomfort while in the intensive care unit (ICU). International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favoring pain management, light sedation and early mobilization was implemented in our university hospital medical and surgical ICU in Norway in 2014...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28614969/short-hospitalization-after-caesarean-delivery-effects-on-maternal-pain-and-stress-at-discharge
#7
Vincenzo Zanardo, Lara Giliberti, Francesca Volpe, Alphonse Simbi, Pietro Guerrini, Matteo Parotto, Gianluca Straface
PURPOSE: To characterize predischarge maternal pain and stress after Caesarean delivery and short hospitalization. MATERIALS AND METHODS: This is a descriptive study with 60 women in the postoperative period of Caesarean section and 60 control women after vaginal delivery. Pain and stress were measured by McGill Pain Questionnaire (MGPQ, Melzack and Torgerson, 1971) and by the Stress Measure (Psychological Stress Measure (PSM), Lemyre, 1987), respectively at mother-infant dyad discharge, scheduled at 36 hours after delivery...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28612201/supportive-care-in-pancreatic-ductal-adenocarcinoma
#8
REVIEW
B Laquente, A Calsina-Berna, A Carmona-Bayonas, P Jiménez-Fonseca, I Peiró, A Carrato
Pancreatic ductal adenocarcinoma (PDAC) is one of the cancers with poorest prognosis and represents the third leading cause of cancer-related deaths in Western countries. Despite advances in diagnostic procedures and treatment, diagnosis is made in most cases when the disease is locally advanced or metastatic. Supportive care aims to improve symptoms, reduce hospital admission rates, and preserve quality of life. Proper symptomatic management is critical to allow administration of chemotherapy and radiotherapy...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28609560/resolving-the-contributions-of-anaesthesia-surgery-and-nerve-injury-on-brain-derived-neurotrophic-factor-expression-in-the-medial-prefrontal-cortex-of-male-rats-in-the-cci-model-of-neuropathic-pain
#9
James W M Kang, Kevin A Keay, David Mor
The medial prefrontal cortex (mPFC) is critical for selecting and shaping complex behavioral responses. In rodent models of neuropathic pain there is evidence for both structural and functional changes in the mPFC. Brain derived neurotrophic factor (BDNF) plays a critical role in the normal functioning of the mPFC. It has been suggested that the disruption of complex behaviors and mood seen in some neuropathic pain patients is mediated in part by alterations of BDNF in this cortical region. In Sprague-Dawley rats, mPFC levels of BDNF and TrkB mRNA and protein, were quantified and compared to controls (n = 24) 6 days after either: (a) halothane (1...
June 13, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28606098/determining-the-longitudinal-validity-and-meaningful-differences-in-hrql-of-the-pedsql%C3%A2-sickle-cell-disease-module
#10
Julie A Panepinto, J Paul Scott, Oluwakemi Badaki-Makun, Deepika S Darbari, Corrie E Chumpitazi, Gladstone E Airewele, Angela M Ellison, Kim Smith-Whitley, Prashant Mahajan, Sharada A Sarnaik, T Charles Casper, Larry J Cook, Julie Leonard, Monica L Hulbert, Elizabeth C Powell, Robert I Liem, Robert Hickey, Lakshmanan Krishnamurti, Cheryl A Hillery, David C Brousseau
BACKGROUND: Detecting change in health status over time and ascertaining meaningful changes are critical elements when using health-related quality of life (HRQL) instruments to measure patient-centered outcomes. The PedsQL™ Sickle Cell Disease module, a disease specific HRQL instrument, has previously been shown to be valid and reliable. Our objectives were to determine the longitudinal validity of the PedsQL™ Sickle Cell Disease module and the change in HRQL that is meaningful to patients...
June 12, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28605119/aromatherapy-massage-for-neuropathic-pain-and-quality-of-life-in-diabetic-patients
#11
Zehra Gok Metin, Ayse Arikan Donmez, Nur Izgu, Leyla Ozdemir, Ismail Emre Arslan
PURPOSE: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life (QoL) in patients suffering from painful diabetic neuropathy. DESIGN AND METHODS: This open-label randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The study sample consisted of 46 patients, randomly allocated to an intervention group (n = 21) and a control group (n = 25). The intervention group received aromatherapy massage three times per week for a period of 4 weeks...
June 12, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28601477/family-perspectives-of-traumatically-brain-injured-patient-pain-behaviors-in-the-intensive-care-unit
#12
Brandy L Vanderbyl, Céline Gélinas
Behavioral scales allow for the pain assessment of vulnerable critically ill patients who are unable to self-report. However, validity of the use of such scales is limited in traumatic brain injury patients with an altered level of consciousness as a result of the different way that these patients express pain. Family participation is considered as an important component of pain assessment for those unable to self-report, but research in this area is minimal so far. This study aimed to describe what behaviors family caregivers deemed relevant to pain for patients with a traumatic brain injury with an altered level of consciousness in the intensive care unit...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28597358/working-towards-an-appropriate-use-of-ibuprofen-in-children-an-evidence-based-appraisal
#13
REVIEW
Maurizio de Martino, Alberto Chiarugi, Attilio Boner, Giovanni Montini, Gianluigi L De' Angelis
Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug...
June 9, 2017: Drugs
https://www.readbyqxmd.com/read/28597253/effectiveness-of-a-standardized-patient-education-program-on-therapy-related-side-effects-and-unplanned-therapy-interruptions-in-oral-cancer-therapy-a-cluster-randomized-controlled-trial
#14
C Riese, B Weiß, U Borges, A Beylich, R Dengler, K Hermes-Moll, M Welslau, W Baumann
PURPOSE: Oral agents for cancer treatment are increasingly prescribed due to their benefits. However, oral cancer medications are difficult to handle and have a considerable potential for side effects. This type of therapy requires a high level of self-management competence by the patient. A standardized patient education program provided by physicians and oncology nurses may positively influence the handling of oral agents. The aim of the study was to evaluate the impact of a standardized patient education program provided by specially trained oncology nurses on therapy management regarding side effects and unplanned therapy interruptions...
June 9, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28595481/retrograde-popliteal-access-to-percutaneous-peripheral-intervention-for-chronic-total-occlusion-of-superficial-femoral-arteries
#15
Mert Dumantepe
OBJECTIVE: The aim of this study is to present our initial experience with the use of the retrograde popliteal artery access in patients with chronic total occlusions of superficial femoral artery (SFA). METHOD: From July 2012 to May 2014, a total of 28 patients (20 men, mean age 61.2 ± 11.5 years) with total occlusion of the SFA and good distal runoff were treated with percutaneous atherectomy, balloon angioplasty, and stenting (mean length 165.3 ± 57.5 mm, range 72-336 mm)...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28595447/therapeutic-suggestions-with-critically-ill-in-palliative-care
#16
Adrienn K Szilágyi, Zoltán Kekecs, Katalin Varga
Suggestions can be used without formal hypnosis, especially with critically ill patients, due to their spontaneous trance state. In this paper we outline data on the effectiveness of therapeutic suggestions. We interpret the possible mechanism of therapeutic suggestions in the context of stress cognition. Basic principles of formulating suggestions are discussed and some recommended versions of non-pharmacological pain control are provided. Case vignettes are given of how suggestions are used with critically ill ICU patients...
May 28, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#17
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
June 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28582253/translating-comprehensive-conservative-care-for-chronic-knee-pain-into-a-digital-care-pathway-12-week-and-6-month-outcomes-for-the-hinge-health-program
#18
Peter Smittenaar, Jennifer C Erhart-Hledik, Rose Kinsella, Simon Hunter, Gabriel Mecklenburg, Daniel Perez
BACKGROUND: Chronic knee pain (CKP) affects a large number of adults, many of whom do not receive best-practice care and are at high risk for unnecessary surgery. OBJECTIVE: The aim of this study was to investigate the effect of the Hinge Health 12-week digital care program (DCP) for CKP on knee pain and function, with secondary outcomes of surgery interest and satisfaction, at 12 weeks and 6 months after starting the program. METHODS: Individuals with CKP were recruited onto the 12-week program, comprising sensor-guided physical exercises, weekly education, activity tracking, and psychosocial support such as personal coaching and cognitive behavioral therapy (CBT)...
April 5, 2017: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28582249/design-and-development-of-a-telerehabilitation-platform-for-patients-with-phantom-limb-pain-a-user-centered-approach
#19
Andreas Rothgangel, Susy Braun, Rob Smeets, Anna Beurskens
BACKGROUND: Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients' adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain...
February 15, 2017: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28579349/electromagnetic-guided-placement-of-nasoduodenal-feeding-tubes-versus-endoscopic-placement-a-randomized-multicenter-trial
#20
Wouter F W Kappelle, Daisy Walter, Paul Stadhouders, Hendrik J A Jebbink, Frank P Vleggaar, Peter van der Schaar, Jan Willem Kappelle, Ingeborg van der Tweel, Medard F M Van den Broek, Frank J Wessels, Peter D Siersema, Jan F Monkelbaan
BACKGROUND AND AIMS: Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to esophagogastroduodenoscopy guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. METHODS: In 3 centers with no prior experience in EMP, patients were randomized to placement of a single lumen nasoduodenal feeding tube either with EGDP or EMP...
June 1, 2017: Gastrointestinal Endoscopy
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