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Guidelines for management of chronic pain

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https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#1
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#2
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28609151/optimal-wound-care-management-in-hidradenitis-suppurativa
#3
Abrahem Kazemi, Kelly Carnaggio, Maureen Clark, Cynthia Shephard, Ginette A Okoye
Hidradenitis suppurativa (HS) presents the problem of a chronic, relapsing, painful, draining wound. There is a myriad of HS wound care management strategies implemented by clinicians and patients that is centered around which dressings to use. Many factors affect which HS wound care dressing is the most appropriate to use such as the type of HS wound, cost, ease of application, patient comfort, absorbency, and odor management among many others. In this work, the authors prepare a set of guidelines for optimal HS wound care dressing use based on a tier system, ideal characteristics of HS dressings, and the type of HS lesion...
June 13, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28559086/laparoscopic-intervention-in-acute-crohn-s-disease-involving-an-ovary
#4
Iwona Gawron, Lukasz Chmura, Dariusz Adamek, Krzysztof Skotniczny, Kazimierz Pityński, Artur Ludwin
Crohn's disease (CD) is a chronic inflammatory disorder that may involve any part of the gastrointestinal tract. Acute manifestations in female internal reproductive organs are rare and have been described in only a few cases. A 27-year-old nulligravida diagnosed with CD presented with pelvic pain, fever, and a palpable mass (confirmed by ultrasound) in the right lower quadrant of the abdomen. She underwent diagnostic laparoscopy because of worsening symptoms suggestive of a tubo-ovarian abscess. The right adnexa were excised after adhesiolysis...
May 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28549402/indications-for-medical-compression-stockings-in-venous-and-lymphatic-disorders-an-evidence-based-consensus-statement
#5
Eberhard Rabe, Hugo Partsch, Juerg Hafner, Christopher Lattimer, Giovanni Mosti, Martino Neumann, Tomasz Urbanek, Monika Huebner, Sylvain Gaillard, Patrick Carpentier
Objective Medical compression stockings are a standard, non-invasive treatment option for all venous and lymphatic diseases. The aim of this consensus document is to provide up-to-date recommendations and evidence grading on the indications for treatment, based on evidence accumulated during the past decade, under the auspices of the International Compression Club. Methods A systematic literature review was conducted and, using PRISMA guidelines, 51 relevant publications were selected for an evidence-based analysis of an initial 2407 unrefined results...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28537982/selective-cannabinoids-for-chronic-neuropathic-pain-a-systematic-review-and-meta-analysis
#6
Howard Meng, Bradley Johnston, Marina Englesakis, Dwight E Moulin, Anuj Bhatia
BACKGROUND: There is a lack of consensus on the role of selective cannabinoids for the treatment of neuropathic pain (NP). Guidelines from national and international pain societies have provided contradictory recommendations. The primary objective of this systematic review and meta-analysis (SR-MA) was to determine the analgesic efficacy and safety of selective cannabinoids compared to conventional management or placebo for chronic NP. METHODS: We reviewed randomized controlled trials that compared selective cannabinoids (dronabinol, nabilone, nabiximols) with conventional treatments (eg, pharmacotherapy, physical therapy, or a combination of these) or placebo in patients with chronic NP because patients with NP may be on any of these therapies or none if all standard treatments have failed to provide analgesia and or if these treatments have been associated with adverse effects...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28536363/update-on-treatment-guideline-in-fibromyalgia-syndrome-with-focus-on-pharmacology
#7
REVIEW
Sanam Kia, Ernet Choy
Fibromyalgia syndrome (FMS) is a chronic condition with unknown aetiology. The pathophysiology of the disease is incompletely understood; despite advances in our knowledge with regards to abnormal central and peripheral pain processing, and hypothalamo-pituitary-adrenal dysfunction, there is no clear specific pathophysiological therapeutic target. The management of this complex condition has thus perplexed the medical community for many years, and several national and international guidelines have aimed to address this complexity...
May 8, 2017: Biomedicines
https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#8
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28530481/hormone-replacement-therapy-in-pre-menopausal-women-undergoing-bilateral-salpingo-oophorectomy-for-benign-disease-a-review-of-practice
#9
Alison Richardson, Emily West, Mike Cust
Introduction The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment. Objectives To determine compliance with NICE guidelines at the Royal Derby Hospital. Study design We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28524908/cancer-related-pain-assessment-and-management-with-putting-evidence-into-practice-interventions%C3%A2
#10
Jeannine M Brant, Linda H Eaton, Margaret M Irwin
Many evidence-based pharmacologic and nonpharmacologic strategies exist to manage acute, chronic, refractory, and breakthrough cancer pain. This supplement includes an overview of cancer pain assessment, which is the foundation of pain management. Following the overview are four systematic reviews covering 462 studies on cancer pain management. The Oncology Nursing Society Putting Evidence Into Practice (PEP) expert panel summarized the evidence and provided recommendations for practice based on PEP guidelines...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#11
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28502036/perceptions-of-painful-diabetic-peripheral-neuropathy-in-south-east-asia-results-from-patient-and-physician-surveys
#12
Rayaz A Malik, Emre Aldinc, Siew-Pheng Chan, Chaicharn Deerochanawong, Chii-Min Hwu, Raymond L Rosales, Chun-Yip Yeung, Koichi Fujii, Bruce Parsons
There are no data on physician-patient communication in painful diabetic peripheral neuropathy (pDPN) in the Asia-Pacific region. The objective of this study was to examine patient and physician perceptions of pDPN and clinical practice behaviors in five countries in South-East Asia. Primary care physicians and practitioners, endocrinologists, diabetologists, and patients with pDPN completed separate surveys on pDPN diagnosis, impact, management, and physician-patient interactions in Hong Kong, Malaysia, the Philippines, Taiwan, and Thailand...
May 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28493225/-definition-diagnostics-and-therapy-of-chronic-widespread-pain-and-the-so-called-fibromyalgia-syndrome-in-children-and-adolescents-updated-guidelines-2017
#13
N Draheim, F Ebinger, E Schnöbel-Müller, B Wolf, W Häuser
BACKGROUND: The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS: The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n = 8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest...
May 10, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28486816/attitudes-towards-exercise-among-substance-using-older-adults-living-with-hiv-and-chronic-pain
#14
Annie L Nguyen, Jordan E Lake, M Carrington Reid, Suzette Glasner, Jessica Jenkins, Jury Candelario, Sarah Soliman, Homero E Del Pino, Alison A Moore
Chronic pain and substance use disorders occur commonly among HIV-infected persons. Recent CDC guidelines recommend non-pharmacologic approaches over opioid medications for the management of chronic pain. This is particularly relevant for persons with substance use disorders. Structured physical activity may be an effective strategy for pain reduction. We developed a combined cognitive-behavioral therapy (CBT) + exercise intervention to reduce pain, pain-related disability and substance use and improve physical function in older HIV-infected adults with chronic pain and substance use...
May 9, 2017: AIDS Care
https://www.readbyqxmd.com/read/28473096/acr-appropriateness-criteria-%C3%A2-chronic-chest-pain-high-probability-of-coronary-artery-disease
#15
Scott R Akers, Vandan Panchal, Vincent B Ho, Garth M Beache, Richard K J Brown, Brian B Ghoshhajra, S Bruce Greenberg, Joe Y Hsu, Gregory A Kicska, James K Min, Arthur E Stillman, Jadranka Stojanovska, Suhny Abbara, Jill E Jacobs
In patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD), imaging has major and diverse roles. First, imaging is valuable in determining and documenting the presence, extent, and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions. Second, imaging findings are important in determining the course of management of patients with suspected chronic myocardial ischemia and better defining those patients best suited for medical therapy, angioplasty/stenting, or surgery...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28463868/application-of-primary-care-guideline-for-chronic-low-back-pain-in-the-emergency-department
#16
Rebeca M Tacy, Sherry Donaworth, Kathleen Ballman
Chronic low back pain (CLBP) is a primary care condition that overflows into the emergency department (ED). No ED-specific practice guideline exists for the management of patients with CLBP in the ED setting. Back pain is a common chief complaint, with cases of CLBP making up to 50% of the patients seen with back pain in an urban, freestanding ED affiliated with a multicampus health system in the Midwest where 25% of patients live below the poverty line and 21.8% do not have primary care. Kolcaba's Theory of Comfort guides the implementation of an evidence-based practice application project...
April 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28458524/treatment-approaches-and-adherence-to-urate-lowering-therapy-for-patients-with-gout
#17
REVIEW
Thanda Aung, Gihyun Myung, John D FitzGerald
Gout is the most common inflammatory arthritis characterized by painful disabling acute attacks. It is caused by hyperuricemia and deposition of urate crystals in and around the joints. Long-standing untreated hyperuricemia can lead to chronic arthritis with joint damage, tophi formation and urate nephropathy. Gout is associated with significant morbidity and health care associated cost. The goal of long-term therapy is to lower the serum urate level to promote dissolution of urate crystals, reduce recurrent acute gout flares, resolve tophi and prevent joint damage...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28435321/a-behavioral-medicine-intervention-for-community-dwelling-older-adults-with-chronic-musculoskeletal-pain-protocol-for-a-randomized-controlled-trial
#18
Sara Cederbom, Eva Denison, Astrid Bergland
BACKGROUND: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#19
Katherine J Simson, Clint T Miller, Jon Ford, Andrew Hahne, Luana Main, Timo Rantalainen, Wei-Peng Teo, Megan Teychenne, David Connell, Guy Trudel, Guoyan Zheng, Gary Thickbroom, Daniel L Belavy
BACKGROUND: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain...
April 20, 2017: Trials
https://www.readbyqxmd.com/read/28394736/what-do-providers-want-to-know-about-opioid-prescribing-a-qualitative-analysis-of-their-questions
#20
Phoebe A Cushman, Jane M Liebschutz, Joseph G Hodgkin, Christopher W Shanahan, Julie L White, Ilana Hardesty, Daniel P Alford
BACKGROUND: In 2012, the US Food and Drug Administration (FDA) responded to the opioid crisis with a Risk Evaluation and Mitigation Strategy, requiring manufacturers of extended-release/long-acting opioids to fund continuing medical education based on the "FDA Blueprint for Prescriber Education." Topics in the Blueprint are "Assessing Patients for Treatment," "Initiating Therapy, Modifying Dosing, and Discontinuing Use," "Managing Therapy," "Counseling Patients and Caregivers about Safe Use," "General Drug Information," and "Specific Drug Information...
April 2017: Substance Abuse
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