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Pain in critical care

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https://www.readbyqxmd.com/read/28820518/living-with-hepatocellular-carcinoma-near-the-end-of-life-family-caregivers-perspectives
#1
Lissi Hansen, Susan J Rosenkranz, Kathleen Wherity, Anna Sasaki
PURPOSE/OBJECTIVES: To explore family caregivers' perspectives of caring for patients with terminal hepatocellular carcinoma (HCC) as patients approached the end of life.
. RESEARCH APPROACH: Longitudinal, qualitative descriptive design.
. SETTING: Oregon Health and Science University in Portland and Veterans Affairs Portland Health Care System in Oregon.
. PARTICIPANTS: 13 family caregivers with a mean age of 56 years (range = 22-68 years)...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#2
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28808371/efficacy-of-osteopathic-manipulative-treatment-approach-in-the-patient-with-pulmonary-fibrosis-in-critical-care-outpatient-department
#3
Manu Goyal, Kanu Goyal, Kanimozhi Narkeesh, Asir John Samuel, Narkeesh Arumugam, Subhasish Chatterjee, Sorabh Sharma
The purpose of the present case study was to explore the efficacy of osteopathic manipulative treatment (OMT) in patient with pulmonary fibrosis (PF) in the critical care outpatient department. Here, we present a 48-year-old male case with breathlessness, increased frequency of defecation, and pain in and around the nape of neck with diagnosed pulmonary fibrosis. He scored 3 on a patient-reported modified Medical Research Council (mMRC) dyspnea scale. Osteopathic examination reveals multiple somatic findings across the chest and abdominal region and treated by OMT...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28808362/a-study-on-the-psychometric-properties-of-revised-nonverbal-pain-scale-and-original-nonverbal-pain-scale-in-iranian-nonverbal-ventilated-patients
#4
Hoda Chookalayi, Mehdi Heidarzadeh, Mohammad Hasanpour, Sajjad Jabrailzadeh, Fatemeh Sadeghpour
BACKGROUND AND AIMS: The nonverbal pain scale is one of the instruments which study pain in nonverbal-ventilated patients with regard to the changes of behavioral and physiological indices. The purpose of the study is to survey the psychometric properties of revised-nonverbal pain scale (R-NVPS) and original-nonverbal pain scale (O-NVPS) in ventilated patients hospitalized in critical care units. MATERIALS AND METHODS: Four nurses studied pain in sixty patients hospitalized in trauma, medical, neurology, and surgical critical care units using R-NVPS and O-NVPS at six times (before, during, and after nociceptive and nonnociceptive procedures)...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#5
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28800982/pain-measurement-in-mechanically-ventilated-patients-after-cardiac-surgery-comparison-of-the-behavioral-pain-scale-bps-and-the-critical-care-pain-observation-tool-cpot
#6
Saskia Rijkenberg, Willemke Stilma, Robert J Bosman, Nardo J van der Meer, Peter H J van der Voort
OBJECTIVES: The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for sedated and unconscious critically ill patients. The aim of this study was to compare the reliability, internal consistency, and discriminant validation of the BPS and the CPOT simultaneously in mechanically ventilated patients after cardiac surgery. DESIGN: A prospective, observational cohort study. SETTING: A 20-bed closed-format intensive care unit with mixed medical, surgical, and cardiac surgery patients in a teaching hospital in Amsterdam, The Netherlands...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#7
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#8
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28791431/glycine-receptors-and-glycine-transporters-targets-for-novel-analgesics
#9
REVIEW
Hanns Ulrich Zeilhofer, Mario A Acuña, Jacinthe Gingras, Gonzalo E Yévenes
Glycinergic neurotransmission has long been known for its role in spinal motor control. During the last two decades, additional functions have become increasingly recognized-among them is a critical contribution to spinal pain processing. Studies in rodent pain models provide proof-of-concept evidence that enhancing inhibitory glycinergic neurotransmission reduces chronic pain symptoms. Apparent strategies for pharmacological intervention include positive allosteric modulators of glycine receptors and modulators or inhibitors of the glial and neuronal glycine transporters GlyT1 and GlyT2...
August 8, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28782423/maternal-anaemia-after-delivery-prevalence-and-risk-factors
#10
Carola Medina Garrido, Jaime León, Adriana Romaní Vidal
The purpose of this study was to assess the prevalence of postpartum anaemia and determine the clinical risk factors for this condition to provide a viable alternative to postpartum haemoglobin measurement. In total, 1415 patients at Hospital Universitario del Tajo, Madrid, who underwent postpartum haemoglobin testing were included, and risk factors for having an Hb level <10 g/dl were determined. We found that 29% of the mothers were anaemic, and birth canal lacerations, caesarean delivery, episiotomy and South American origin were identified as the main risk factors for this condition...
August 6, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28766103/protocol-driven-decision-support-within-e-referral-systems-to-streamline-patient-consultation-triaging-and-referrals-from-primary-care-to-specialist-clinics
#11
Ehsan Maghsoud-Lou, Sean Christie, Samina Raza Abidi, Syed Sibte Raza Abidi
Patient referral is a protocol where the referring primary care physician refers the patient to a specialist for further treatment. The paper-based current referral process at times lead to communication and operational issues, resulting in either an unfulfilled referral request or an unnecessary referral request. Despite the availability of standardized referral protocols they are not readily applied because they are tedious and time-consuming, thus resulting in suboptimal referral requests. We present a semantic-web based Referral Knowledge Modeling and Execution Framework to computerize referral protocols, clinical guidelines and assessment tools in order to develop a computerized e-Referral system that offers protocol-based decision support to streamline and standardize the referral process...
September 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28764789/exploring-how-nurses-assess-monitor-and-manage-acute-pain-for-adult-critically-ill-patients-in-the-emergency-department-protocol-for-a-mixed-methods-study
#12
Wayne Varndell, Margaret Fry, Doug Elliott
BACKGROUND: Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown...
August 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28763103/the-lack-of-analgesic-use-oligoanalgesia-in-small-animal-practice
#13
REVIEW
B T Simon, E M Scallan, G Carroll, P V Steagall
Oligoanalgesia is defined as failure to provide analgesia in patients with acute pain. Treatment of pain in emergencies, critical care and perioperatively may influence patient outcomes: the harmful practice of withholding analgesics occurs in teaching hospitals and private practices and results in severe physiological consequences. This article discusses the prevalence, primary causes, species and regional differences and ways to avoid oligoanalgesia in small animal practice. Oligoanalgesia may be addressed by improving education on pain management in the veterinary curriculum, providing continuing education to veterinarians and implementing pain scales...
August 1, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28762471/clinical-presentation-of-terbinafine-induced-severe-liver-injury-and-the-value-of-laboratory-monitoring-a-critically-appraised-topic
#14
REVIEW
O N Kramer, J Albrecht
CONTEXT: Many physicians monitor liver function tests during terbinafine therapy. OBJECTIVE: Evaluate the symptoms of published cases of terbinafine associated severe DILI (Drug Induced Liver Injury) to assess the utility of laboratory monitoring. DATA SOURCES: We based our search on the Liver Tox database of the National Institute of Health, but searched PUBMED as well as EMBASE. In addition, we hand-searched the references of the papers we found...
August 1, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28756301/effectiveness-of-psychological-interventions-delivered-by-non-psychologists-on-low-back-pain-and-disability-a-qualitative-systematic-review
#15
REVIEW
Geoff P Bostick
BACKGROUND CONTEXT: Psychological treatments delivered by non-psychologists have been proposed as a way to increase access to care to address important psychological barriers to recovery in people with low back pain (LBP). PURPOSE: Synthesize randomized controlled trials (RCTs) that assess the effectiveness of psychological interventions delivered by non-psychologists in reducing pain intensity and disability in adults with LBP, compared to usual care. STUDY DESIGN: Systematic review without meta-analysis METHODS: RCTs including adult patients with all types of musculoskeletal LBP were eligible...
July 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28751843/anmco-simeu-consensus-document-in-hospital-management-of-patients-presenting-with-chest-pain
#16
Guerrino Zuin, Vito Maurizio Parato, Paolo Groff, Michele Massimo Gulizia, Andrea Di Lenarda, Matteo Cassin, Gian Alfonso Cibinel, Maurizio Del Pinto, Giuseppe Di Tano, Federico Nardi, Roberta Rossini, Maria Pia Ruggieri, Enrico Ruggiero, Fortunato Scotto di Uccio, Serafina Valente
Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: (i) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; and (ii) the increasing percentage of hospitalizations of low-risk cases...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28749248/update-in-perioperative-medicine-practice-changing-evidence-published-in-2016
#17
Dennis W Regan, Deanne Kashiwagi, Brian Dougan, Karna Sundsted, Karen Mauck
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change...
July 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28744666/lessons-for-patient-education-around-long-acting-injectable-prep-findings-from-a-mixed-method-study-of-phase-ii-trial-participants
#18
Kathrine Meyers, Kristina Rodriguez, Atrina L Brill, Yumeng Wu, Melissa La Mar, Debora Dunbar, Beryl Koblin, David Margolis, Magdalena E Sobieszczyk, Hong Van Tieu, Ian Frank, Martin Markowitz, Sarit A Golub
This study aimed to identify patients' physical and psychosocial experiences of an investigational long-acting injectable PrEP product to aid in the development of patient and provider education materials. Twenty-eight participants of a Phase 2 safety, tolerability, and acceptability study of long-acting integrase inhibitor cabotegravir (CAB-LA) were interviewed on their physical and psychosocial experiences of the injections. Five themes emerged through a framework analysis on these interview transcripts: (1) injection-related pain is highly variable across individuals; (2) pain is more impactful after the injections than during; (3) patient anxiety is critical, but does not determine the experience of injections and decreases over time; (4) intimacy and awkwardness of gluteal injections impacts patients' experiences; (5) patient education and care strategies can mitigate the above factors...
July 25, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#19
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28743558/the-association-of-nurses-assessment-and-certainty-to-pain-management-and-outcomes-for-nursing-home-residents-in-jordan
#20
Mohammad Rababa
Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables...
July 22, 2017: Geriatric Nursing
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