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Management of chronic pain

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https://www.readbyqxmd.com/read/29470544/validation-of-the-what-matters-index-a-brief-patient-reported-index-that-guides-care-for-chronic-conditions-and-can-substitute-for-computer-generated-risk-models
#1
John H Wasson, Lynn Ho, Laura Soloway, L Gordon Moore
INTRODUCTION: Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models...
2018: PloS One
https://www.readbyqxmd.com/read/29467019/clinical-and-cost-effectiveness-of-the-star-care-pathway-compared-to-usual-care-for-patients-with-chronic-pain-after-total-knee-replacement-study-protocol-for-a-uk-randomised-controlled-trial
#2
Vikki Wylde, Wendy Bertram, Andrew D Beswick, Ashley W Blom, Julie Bruce, Amanda Burston, Jane Dennis, Kirsty Garfield, Nicholas Howells, Athene Lane, Candy McCabe, Andrew J Moore, Sian Noble, Tim J Peters, Andrew Price, Emily Sanderson, Andrew D Toms, David A Walsh, Simon White, Rachael Gooberman-Hill
BACKGROUND: Approximately 20% of patients experience chronic pain after total knee replacement. There is little evidence for effective interventions for the management of this pain, and current healthcare provision is patchy and inconsistent. Given the complexity of this condition, multimodal and individualised interventions matched to pain characteristics are needed. We have undertaken a comprehensive programme of work to develop a care pathway for patients with chronic pain after total knee replacement...
February 21, 2018: Trials
https://www.readbyqxmd.com/read/29465612/patient-with-2-hematologic-malignancies-presenting-as-neurolymphomatosis
#3
Ahmad Daher, Carlos Kamiya-Matsuoka, Karin Woodman
Peripheral nervous system damage from hematologic malignancies is related to neoplastic cells infiltration of peripheral nerves or to monoclonal antibody production cross-reacting with peripheral nerves' antigens. Neurolymphomatosis (NL), a rare manifestation of hematologic malignancies, occurs when malignant cells invade the peripheral nerves leading to various manifestations. Here, we report a case of NL with 2 hematologic malignancies in a 79-year-old woman presenting with lower extremity pain/weakness. Investigation revealed anemia, IgM kappa monoclonal gammopathy, and elevated anti-MAG titer...
March 2018: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/29465470/opioid-addiction-diversion-and-abuse-in-chronic-and-cancer-pain
#4
Vijay Kata, Matthew B Novitch, Mark R Jones, Best O Anyama, Erik M Helander, Alan D Kaye
PURPOSE OF REVIEW: The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. RECENT FINDINGS: There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties...
February 19, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29464435/palliative-care-for-movement-disorders
#5
REVIEW
Christina L Vaughan, Benzi M Kluger
PURPOSE OF REVIEW: While care for patients with movement disorders has traditionally focused on motor symptoms, there is increasing evidence that optimal care for these disorders is more complex both in terms of the spectrum of symptoms experienced by patients (e.g., pain, depression) and the multidimensional needs of patients and their families. Palliative care is an approach to the care of patients and families affected by serious illnesses that seeks to relieve suffering by addressing complex medical symptoms, psychosocial issues, spiritual well-being, and goals of care...
February 21, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29464216/demographic-and-clinical-characteristics-among-turkish-homeless-patients-presenting-to-the-emergency-department
#6
Selman Yeniocak, Asım Kalkan, Ozgur Sogut, Gökce Akgül Karadana, Mehmet Toptas
Objective: Since the homeless are at greater risk of encountering health problems than the general population, the reasons for and incidence of their presentations to emergency departments also vary. The purpose of this study was to determine the sociodemographic and clinical characteristics of Turkish homeless patients who brought to the emergency department by ambulance. Materials and methods: The records of homeless adult patients brought to the ED by 112 emergency service ambulance teams over a 1-year period from January to December, 2014, were examined retrospectively...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29462878/diagnostic-utility-of-high-sensitivity-troponins-for-echocardiographic-markers-of-structural-heart-disease
#7
Tom Kai Ming Wang, Clementina Dugo, Yvonne Gillian, Wynne Yvonne, Semple Heather, Smith Kevin, Cleave Peter, Christiansen Jonathan, To Andrew, Amir Nezar, Tony Scott, Boswell Ross, Gladding Patrick
The conventional use of high-sensitivity troponins (hs-troponins) is for diagnosing myocardial infarction however they also have a role in chronic disease management. This pilot study assessed the relationship of hs-troponins with echocardiographic markers of left ventricular hypertrophy (LVH) and structural heart disease (SHD). Patients undergoing computer gomography (CT) coronary angiogram for low-intermediate risk chest pain and healthy volunteers were recruited. Hs-troponins Singulex I, Abbott I and Roche T and N-terminal pro-brain natriuretic peptide (NT-proBNP) were evaluated in relation to SHD parameters including left ventricular hypertrophy (LVHEcho ) and left atrial enlargement (LAEEcho ) on echocardiography...
February 15, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29462351/one-on-one-care-management-and-procurement-of-naloxone-for-ambulatory-use
#8
Richard Whittington, Kathleen Whittington, John Whittington, Joel Porter, Karla Zimmermann, Holly Case, Stacey Berg
Background: Morbidity and mortality from prescription opioids has reached unprecedented levels. Opioids remain part of chronic pain treatment in primary care. This study was designed to determine whether one-on-one care management increases procurement of Naloxone, an opioid antagonist shown to reduce morbidity and mortality in opioid overdoses. Methods: Participants included all patients ≥18 years enrolled in a primary care-based chronic pain management program and who were prescribed a daily dose of opioids for treatment of chronic pain...
February 16, 2018: Journal of Public Health
https://www.readbyqxmd.com/read/29462062/back-pain-and-co-occurring-conditions-findings-from-a-nationally-representative-sample
#9
Elizabeth M Badley, Dov B Millstone, Anthony V Perruccio
STUDY DESIGN: Cross-sectional population-level health survey. OBJECTIVE: To describe the frequency of co-occurring conditions with back pain; to identify risk factors for back pain controlling for co-occurring conditions; and to examine the association between back pain and individual co-occurring conditions. SUMMARY OF BACKGROUND DATA: Back pain shares risk factors with a range of other conditions. Most studies have considered risk factors for back pain without taking into account the potential influence of co-occurring conditions...
February 16, 2018: Spine
https://www.readbyqxmd.com/read/29461336/sex-differences-in-antinociceptive-response-to-%C3%AE-9-tetrahydrocannabinol-and-cp-55-940-in-the-mouse-formalin-test
#10
Rebecca A LaFleur, Ronald P Wilson, Daniel J Morgan, Angela N Henderson-Redmond
Cannabinoids have shown promise for the treatment of intractable pain states and may represent an alternative pharmacotherapy for pain management. A growing body of clinical evidence suggests a role for sex in pain perception and in cannabinoid response. We examined cannabinoid sensitivity and tolerance in male and female mice expressing a desensitization-resistant form (S426A/S430A) of the cannabinoid type 1 receptor (CB1R). Mice were assessed for acute and inflammatory nociceptive behaviors in the formalin test following pretreatment with either vehicle or mixed CB1R/CB2R agonists, Δ-9-tetrahydrocannabinol ([INCREMENT]-THC) (1-6 mg/kg) or CP 55,940 (0...
February 15, 2018: Neuroreport
https://www.readbyqxmd.com/read/29461242/photodynamic-treatment-with-nanoemulsified-5-aminolevulinic-acid-and-narrow-band-red-light-for-field-cancerization-due-to-occupational-exposure-to-ultraviolet-light-irradiation
#11
U Wollina, B Gaber, A Koch
Actinic keratosis (AK) is a premalignant epithelial disease that develops on skin chronically exposed to ultraviolet-light. For outdoor workers, AK is an occupational hazard with a potential for malignant transformation into squamous cell carcinoma. Various topical treatments are used to treat AK's. Photodynamic therapy (PDT) promises the highest cure rates. We performed a prospective single center trial evaluating effects of PDT treatment for field cancerization due to occupational exposure to ultraviolet light irradiation in patients unresponsive to the treatment regimen with topical diclofenac gel...
January 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29460009/the-global-spine-care-initiative-applying-evidence-based-guidelines-on-the-non-invasive-management-of-back-and-neck-pain-to-low-and-middle-income-communities
#12
REVIEW
Roger Chou, Pierre Côté, Kristi Randhawa, Paola Torres, Hainan Yu, Margareta Nordin, Eric L Hurwitz, Scott Haldeman, Christine Cedraschi
PURPOSE: The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. METHODS: We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries...
February 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29456124/a-multicenter-study-of-total-pancreatectomy-with-islet-autotransplantation-tpiat-post-prospective-observational-study-of-tpiat
#13
Melena D Bellin, Maisam Abu-El-Haija, Katherine Morgan, David Adams, Gregory J Beilman, Srinath Chinnakotla, Darwin L Conwell, Ty B Dunn, Martin L Freeman, Timothy Gardner, Varvara A Kirchner, Luis F Lara, Leslie Long-Simpson, Jaimie D Nathan, Bashoo Naziruddin, John A Nyman, Timothy L Pruett, Sarah J Schwarzenberg, Vikesh K Singh, Kerrington Smith, Jennifer L Steel, Martin Wijkstrom, Piotr Witkowski, James S Hodges
BACKGROUND/OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is considered for managing chronic pancreatitis in selected patients when medical and endoscopic interventions have not provided adequate relief from debilitating pain. Although more centers are performing TPIAT, we lack large, multi-center studies to guide decisions about selecting candidates for and timing of TPIAT. METHODS: Multiple centers across the United States (9 to date) performing TPIAT are prospectively enrolling patients undergoing TPIAT for chronic pancreatitis into the Prospective Observational Study of TPIAT (POST), a NIDDK funded study with a goal of accruing 450 TPIAT recipients...
February 6, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29454439/management-of-an-enormous-inferior-mesenteric-vein-aneurysm
#14
Mina Guirgis, Hanna El-Khoury, Kishore Sieunarine
Venous aneurysms are rare entities, with mesenteric venous aneurysms among the rarest reported. We present a case of a 66-year-old man with abdominal pain secondary to an enormous 7.8-cm inferior mesenteric vein aneurysm. In addition, he had evidence of other venous abnormalities, including bilateral leg chronic venous insufficiency and a right varicocele. This appears to be the only reported case of an isolated inferior mesenteric vein aneurysm. Adding to its significance, this aneurysm is among the largest of any mesenteric vein aneurysm reported...
March 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29454150/assessment-of-cervical-stiffness-in-axial-rotation-among-chronic-neck-pain-patients-a-trial-in-the-framework-of-a-non-manipulative-osteopathic-management
#15
P-M Dugailly, A Coucke, W Salem, V Feipel
BACKGROUND: Cervical stiffness is a clinical feature commonly appraised during the functional examination of cervical spine. Measurements of cervical stiffness in axial rotation have not been reported for patients with neck pain. The purpose of this study was to investigate cervical spine stiffness in axial rotation among neck pain patients and asymptomatic subjects, and to analyze the impact of osteopathic management. METHODS: Thirty-five individuals (17 patients) were enrolled...
February 12, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29453925/impact-of-opioid-therapy-on-gonadal-hormones-focus-on-buprenorphine
#16
REVIEW
Anjali Varma, Mamta Sapra, Ali Iranmanesh
Objective The USA is in the midst of an opioid crisis. Understanding the impact of opioids and commonly used treatments for opioid dependence is essential for clinicians and researchers in order to educate and treat the nation's growing population with opioid use disorders. As a relatively new treatment for opioid dependence, buprenorphine is gaining popularity to the extent of becoming not only a preferred approach to the maintenance of opiate addiction, but also an option for chronic pain management. The purpose of this report is to review the available evidence on the endocrine effects of buprenorphine, particularly as it relates to the hypothalamic-pituitary-gonadal (HPG) axis, which is controversial and not fully defined...
February 17, 2018: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/29453622/cognitive-mediators-of-change-in-physical-functioning-in-response-to-a-multifaceted-intervention-for-managing-osteoarthritis
#17
Shannon Stark Taylor, Eugene Z Oddone, Cynthia J Coffman, Amy S Jeffreys, Hayden B Bosworth, Kelli D Allen
PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management. METHOD: Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care...
February 16, 2018: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/29451665/mirror-therapy-a-potential-intervention-for-pain-management
#18
Priscilla G Wittkopf, Mark I Johnson
The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29450798/catastrophizing-acceptance-and-coping-as-mediators-between-pain-and-emotional-distress-and-disability-in-fibromyalgia
#19
María J Lami, M Pilar Martínez, Elena Miró, Ana I Sánchez, Manuel A Guzmán
Catastrophizing, acceptance, and coping have an important predictive value in chronic pain; however, it is not known which of these variables has the greatest contribution in fibromyalgia (FM). This study explored the mediating role of catastrophizing, acceptance, and coping in the relationship between pain and emotional distress/disability in a FM sample. Ninety-two FM patients and 51 healthy participants controls were evaluated on pain- and psychological-related variables. Catastrophizing, acceptance, behavioral coping, and emotional coping were significantly correlated with emotional distress and/or disability...
February 15, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29450305/the-grimace-scale-reliably-assesses-chronic-pain-in-a-rodent-model-of-trigeminal-neuropathic-pain
#20
Titilola Akintola, Charles Raver, Paige Studlack, Olivia Uddin, Radi Masri, Asaf Keller
The limited success in translating basic science findings into effective pain management therapies reflects, in part, the difficulty in reliably assessing pain in experimental animals. This shortcoming is particularly acute in the field of chronic, ongoing pain. Quantitative analysis of facial expressions-the grimace score-was introduced as a promising tool, however, it is thought to reliably assess only pain of short or medium duration (minutes to hours). Here, we test the hypothesis that grimace scores are a reliable metric of ongoing neuropathic pain, by testing the prediction that chronic constriction injury of the infraorbital nerve (CCI-ION) will evoke significant increases in grimace scale scores...
August 2017: Neurobiology of Pain
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