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Guidelines for management of chronic pain

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https://www.readbyqxmd.com/read/29334992/the-efficacy-of-a-multimodal-physical-activity-intervention-with-supervised-exercises-health-coaching-and-an-activity-monitor-on-physical-activity-levels-of-patients-with-chronic-nonspecific-low-back-pain-physical-activity-for-back-pain-payback-trial-study
#1
Crystian B Oliveira, Márcia R Franco, Chris G Maher, Anne Tiedemann, Fernanda G Silva, Tatiana M Damato, Michael K Nicholas, Diego G D Christofaro, Rafael Z Pinto
BACKGROUND: Physical activity plays an important role in the management of chronic low back pain (LBP). Engaging in an active lifestyle is associated with a better prognosis. Nevertheless, there is evidence to suggest that patients with chronic LBP are less likely to meet recommended physical activity levels. Furthermore, while exercise therapy has been endorsed by recent clinical practice guidelines, evidence from systematic reviews suggests that its effect on pain and disability are at best moderate and not sustained over time...
January 15, 2018: Trials
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#2
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#3
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#4
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29287308/chikungunya-virus-arthritis-implications-of-acute-and-chronic-inflammation-mechanisms-on-patient-management
#5
REVIEW
Ali Zaid, Patrick Gérardin, Adam Taylor, Helen Mostafavi, Denis Malvy, Suresh Mahalingam
In the past decade, arboviruses - arthropod-borne viruses - have been the focus of public health institutions worldwide following a spate of devastating outbreaks. Chikungunya virus (CHIKV), an arbovirus that belongs to the alphavirus genus, is a re-emerging arthritogenic virus that has caused explosive outbreaks since 2006, notably in the Reunion Island, and more recently in the Caribbean, South America, India and South-East Asia. The severity of arthritic disease caused by CHIKV has prompted public health authorities of affected countries to develop specific guidelines to tackle this pathogen...
December 29, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29282906/what-can-we-do-for-chronic-scrotal-content-pain
#6
REVIEW
Wei Phin Tan, Laurence A Levine
Chronic scrotal content pain remains one of the more challenging urological problems to manage. This is a frustrating disorder to diagnose and effectively treat for both the patient and clinician, as no universally accepted treatment guidelines exist. Many patients with this condition end up seeing physicians across many disciplines, further frustrating them. The pathogenesis is not clearly understood, and the treatment ultimately depends on the etiology of the problem. This article reviews the current understanding of chronic scrotal content pain, focusing on the diagnostic work-up and treatment options...
December 2017: World Journal of Men's Health
https://www.readbyqxmd.com/read/29280484/intranasal-tissue-necrosis-associated-with-opioid-abuse-case-report-and-systematic-review
#7
REVIEW
Danielle A Morrison, Sarah K Wise, John M DelGaudio, Naweed I Chowdhury, Joshua M Levy
OBJECTIVE: Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. DATA SOURCES: MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29273083/effectiveness-costs-and-cost-effectiveness-of-chiropractic-care-and-physiotherapy-compared-with-information-and-advice-in-the-treatment-of-non-specific-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#8
Filip Gedin, Martin Skeppholm, Kristina Burström, Vibeke Sparring, Mesfin Tessma, Niklas Zethraeus
BACKGROUND: Low back pain is a global public health problem and a leading cause of disability all over the world. The lifetime prevalence of low back pain is 70-80% and a significant proportion of people affected develop chronic low back pain (CLBP). Besides a severe negative impact on people's health and health-related quality of life, CLBP is associated with substantial costs for society. Medical costs for the management of CLBP and costs for production losses due to absenteeism from work are sizeable...
December 22, 2017: Trials
https://www.readbyqxmd.com/read/29251636/ce-managing-postoperative-pain
#9
Renee C B Manworren, Debra B Gordon, Robert Montgomery
: Acute postoperative pain remains undertreated despite the dramatic increase in opioid prescribing in the United States over the past 20 years. Inadequately relieved postoperative pain may be a risk factor for persistent postoperative pain, chronic pain, and disability. In an effort to promote evidence-based strategies for optimal postoperative pain management, the American Pain Society published a new postoperative pain management guideline in 2016. Its 32 recommendations for interdisciplinary and multimodal postoperative pain management are stratified according to risks and benefits, based on varying levels of evidence...
January 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#10
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#11
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29228823/current-practice-in-the-rehabilitation-of-complex-regional-pain-syndrome-a-survey-of-practitioners
#12
Caroline Miller, Mark Williams, Peter Heine, Esther Williamson, Neil O'connell
INTRODUCTION: International clinical guidelines for Complex Regional Pain Syndrome recommend a wide range and variation of rehabilitation therapies as the core treatment. It is likely that most therapists employ a range of approaches when managing people with Complex Regional Pain Syndrome but a recent Cochrane review identified little evidence relating to the effectiveness of multi-modal rehabilitation. There is need for up to date trials of rehabilitation for Complex Regional Pain Syndrome, but in order to develop a clear model of best practice that can be rigorously evaluated we need to understand current practice...
December 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#13
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#14
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29211040/promoting-long-term-health-among-people-with-spinal-cord-injury-what-s-new
#15
Mary Ann McColl, Shikha Gupta, Karen Smith, Alexander McColl
A key ingredient to successful health promotion is a primary care provider who can offer an informed first response to lifestyle issues, emerging problems and chronic challenges. This article aims to assist family physicians to play their role in promoting the health of people with SCI, by summarizing the latest evidence in the management of spinal cord injury in primary care. This study used a scoping review methodology to survey peer-reviewed journal articles and clinical guidelines published between January 2012 to June 2016...
December 6, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29204977/managing-concerning-behaviors-in-patients-prescribed-opioids-for-chronic-pain-a-delphi-study
#16
Jessica S Merlin, Sarah R Young, Joanna L Starrels, Soraya Azari, E Jennifer Edelman, Jamie Pomeranz, Payel Roy, Shalini Saini, William C Becker, Jane M Liebschutz
BACKGROUND: Current guideline-recommended monitoring of patients prescribed long-term opioid therapy (LTOT) for chronic pain will likely result in increased identification of behaviors of concern for misuse and addiction, but there is a dearth of empiric evidence about how these behaviors should be managed. OBJECTIVE: To establish expert consensus about treatment approaches for common and challenging concerning behaviors that arise among patients on LTOT. DESIGN: We used a Delphi approach, which allows for generation of consensus...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29203460/treatment-of-low-back-pain-with-a-digital-multidisciplinary-pain-treatment-app-short-term-results
#17
Stephan Huber, Janosch A Priebe, Kaja-Maria Baumann, Anne Plidschun, Christine Schiessl, Thomas R Tölle
BACKGROUND: Even though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases. OBJECTIVE: The objective of this paper was to report on the retrospective short-term results of a digital multidisciplinary pain app for the treatment of LBP...
December 4, 2017: JMIR rehabilitation and assistive technologies
https://www.readbyqxmd.com/read/29180551/supporting-better-access-to-chronic-pain-specialists-the-champlain-base%C3%A2-econsult-service
#18
Clare Liddy, Catherine Smyth, Patricia A Poulin, Justin Joschko, Matthew Sheppard, Erin Keely
INTRODUCTION: Excessive wait times for chronic pain are associated with significant reductions in quality of life and worse health outcomes. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service can improve access to specialist care for patients with chronic pain by facilitating electronic communication between primary care providers (PCPs) and specialists. We explored the content of eConsult cases sent to chronic pain specialists to identify the major themes emerging from exchanges between PCPs and specialists regarding patients with chronic pain...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29178843/a-qualitative-evidence-synthesis-to-explore-healthcare-professionals-experience-of-prescribing-opioids-to-adults-with-chronic-non-malignant-pain
#19
Fran Toye, Kate Seers, Stephanie Tierney, Karen Louise Barker
BACKGROUND: Despite recent guidelines suggesting that patients with chronic non-malignant pain might not benefit, there has been a significant rise in opioid prescription for chronic non-malignant pain. This topic is important because an increasing number of HCPs are prescribing opioids despite very limited evidence for long-term opioid therapy for chronic non-malignant pain outside of end-of-life care. To better understand the challenges of providing effective treatment, we conducted the first qualitative evidence synthesis to explore healthcare professionals' experience of treating people with chronic non-malignant pain...
November 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29178033/a-review-of-neuropathic-pain-from-guidelines-to-clinical-practice
#20
REVIEW
Giorgio Cruccu, Andrea Truini
Neuropathic pain is a chronic condition representing a significant burden for patients, society, and healthcare systems. The prevalence of neuropathic pain in the general population has been estimated at 7-8% and is expected to increase in the future. Neuropathic pain differs from nociceptive pain and requires a different therapeutic approach; and the management of neuropathic pain is complicated and challenging. This chapter discusses clinical practice guidelines for neuropathic pain and their usefulness in clinical practice...
December 2017: Pain and Therapy
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