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Non pharmacologic pain

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https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#1
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28096255/sheppheartcabg-trial-comprehensive-early-rehabilitation-after-coronary-artery-bypass-grafting-a-protocol-for-a-randomised-clinical-trial
#2
Ida Elisabeth Højskov, Philip Moons, Niels Viggo Hansen, Søren La Cour, Peter Skov Olsen, Christian Gluud, Per Winkel, Jane Lindschou, Lau Caspar Thygesen, Ingrid Egerod, Selina Kikkenborg Berg
INTRODUCTION: Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28086853/taking-action-to-reduce-pain-action-study-rationale-design-and-protocol-of-a-randomized-trial-of-a-proactive-telephone-based-coaching-intervention-for-chronic-musculoskeletal-pain-among-african-americans
#3
Rozina H Bhimani, Lee J S Cross, Brent C Taylor, Laura A Meis, Steven S Fu, Kelli D Allen, Sarah L Krein, Tam Do, Robert D Kerns, Diana J Burgess
BACKGROUND: Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. METHODS/DESIGN: The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain...
January 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28075519/an-update-of-management-of-insomnia-in-patients-with-chronic-orofacial-pain
#4
REVIEW
Galit Almoznino, Yaron Haviv, Yair Sharav, Rafael Benoliel
In this review we discuss the management of chronic orofacial pain (COFP) patients with insomnia. Diagnostic work-up and follow-up routines of COFP patients should include assessment of sleep problems. Management is based on a multidisciplinary approach, addressing the factors that modulate the pain experience as well as insomnia and including both non-pharmacological and pharmacological modalities. Parallel to treatment, patients should receive therapy for co-morbid medical and psychiatric disorders, and possible substance abuse that may be that may trigger or worsen the COFP and/or their insomnia...
January 11, 2017: Oral Diseases
https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#5
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some laboratory tests (complete blood count, C-reactive protein, serum calcium, creatine phosphokinase, thyroid stimulating hormone, 25-OH vitamin D) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28074409/management-of-depression-in-patients-with-dementia-is-pharmacological-treatment-justified
#6
REVIEW
Andrew H Ford, Osvaldo P Almeida
Depression in the context of dementia is common and contributes to poorer outcomes in individuals and those who care for them. Non-pharmacological treatments are the preferred initial approach to managing these symptoms but data in support of these are scarce. There are a number of pharmacological treatment options available to clinicians but efficacy is uncertain and concern about potential side effects in an aging and vulnerable population needs to be taken into consideration. This review aims to provide a concise overview of pharmacological treatments for depression in dementia...
January 10, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28073097/moringa-oleifera-a-species-with-potential-analgesic-and-anti-inflammatory-activities
#7
Claudia Lizbeth Martínez-González, Laura Martínez, Efraín J Martínez-Ortiz, María Eva González-Trujano, Myrna Déciga-Campos, Rosa Ventura-Martínez, Irene Díaz-Reval
Moringa oleifera has long been used in large demand in folk medicine to treat pain. The present study was undertaken to examine the antinociceptive and anti-inflammatory spectrum of M. oleifera leaf extracts discriminating the constituents' nature by using different kind of experimental models in rats. Pharmacological evaluation of a non-polar and/or polar extracts at several doses (30-300mg/kg, p.o.) was explored through experimental nociception using formalin test, carrageenan-induced paw edema and arthritis with subcutaneous injection of collagen in rats...
January 7, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28062329/managing-symptoms-enhancing-patients-self-management-knowledge-and-skills-for-surgical-recovery
#8
REVIEW
Jan Odom-Forren, Susan Wesmiller
OBJECTIVES: To review postoperative symptoms experienced by patients following surgery for cancer and discuss focused, evidenced-based methods to teach the patient acute pain and symptom management to include both pharmacological and non-pharmacological strategies. DATA SOURCES: Peer reviewed articles and national guidelines. CONCLUSION: Although significant advances have been made in providing effective acute pain control, pain remains a serious consequence after cancer surgery...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28051248/movardol%C3%A2-n-acetylglucosamine-boswellia-serrata-ginger-supplementation-in-the-management-of-knee-osteoarthritis-preliminary-results-from-a-6-month-registry-study
#9
G Bolognesi, G Belcaro, B Feragalli, U Cornelli, R Cotellese, S Hu, M Dugall
OBJECTIVE: Knee Osteoarthritis (OA) is a chronic disease caused by the deterioration of cartilage in joints, which results in activation of the inflammatory response, pain, and impaired movement. Complementary therapies, particularly supplementation, in the management of moderate/severe knee OA have been gaining attention. This registry study aimed at evaluating the synergistic effect of Movardol®, a supplementation containing active ingredients with recognized anti-inflammatory activities on symptoms and levels of circulating biomarkers of knee OA...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28045073/insensitivity-to-pain-induced-by-a-potent-selective-closed-state-nav1-7-inhibitor
#10
M Flinspach, Q Xu, A D Piekarz, R Fellows, R Hagan, A Gibbs, Y Liu, R A Neff, J Freedman, W A Eckert, M Zhou, R Bonesteel, M W Pennington, K A Eddinger, T L Yaksh, M Hunter, R V Swanson, A D Wickenden
Pain places a devastating burden on patients and society and current pain therapeutics exhibit limitations in efficacy, unwanted side effects and the potential for drug abuse and diversion. Although genetic evidence has clearly demonstrated that the voltage-gated sodium channel, Nav1.7, is critical to pain sensation in mammals, pharmacological inhibitors of Nav1.7 have not yet fully recapitulated the dramatic analgesia observed in Nav1.7-null subjects. Using the tarantula venom-peptide ProTX-II as a scaffold, we engineered a library of over 1500 venom-derived peptides and identified JNJ63955918 as a potent, highly selective, closed-state Nav1...
January 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#11
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain is typically associated with a minimally invasive hysterectomy compared to a laparotomy approach but poor pain control can still be an issues. Multiple guidelines exist for managing postoperative pain yet most are not specialty-specific and are based on procedures bearing little relevance to a minimally invasive hysterectomy. OBJECTIVE: To determine if there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women undergoing a benign minimally invasive hysterectomy...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28042075/topical-treatment-of-peripheral-neuropathic-pain-applying-the-evidence
#12
REVIEW
Claudia Sommer, Giorgio Cruccu
CONTEXT: Patients with peripheral neuropathic pain (NP) may only achieve partial pain relief with currently recommended first-line oral treatments, which are also associated with systemic adverse events. Topical treatments are currently considered second- or third-line options, but a recent pharmacological treatment algorithm has called for broader first-line use of these agents. This has highlighted a need to communicate the benefits associated with topical agents, in particular around the efficacy, targeted local action and limited systemic availability resulting in minimal systemic adverse events and drug-drug interactions...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042063/hospice-use-and-pain-management-in-elderly-nursing-home-residents-with-cancer
#13
Jacob N Hunnicutt, Jennifer Tjia, Kate L Lapane
CONTEXT: Pain management is suboptimal in nursing homes. OBJECTIVES: To estimate the extent to which receipt of hospice in nursing homes (NH) increases the receipt of pain management for residents with cancer at the end-of-life. METHODS: Study participants included Medicare beneficiaries with cancer who were NH residents in the last 90 days of life in 2011-2012 (n=78,160). Residents in pain on hospice were matched to like residents without hospice by facility, type of pain assessment (self-report/staff assessment), and weeks until death (9,064 matched strata, 16,968 unique residents...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28038937/cellular-permeation-of-large-molecules-mediated-by-trpm8-channels
#14
Daniel D McCoy, Radhika Palkar, Yuening Yang, Serra Ongun, David D McKemy
While most membrane channels are only capable of passing small ions, certain non-selective cation channels have been recently shown to have the capacity to permeate large cations. The mechanisms underlying large molecule permeation are unclear, but this property has been exploited pharmacologically to target molecules, such as nerve conduction blockers, to specific subsets of pain-sensing neurons (nociceptors) expressing the heat-gated transient receptor potential (TRP) channel TRPV1. However, it is not clear if the principal mediator of cold stimuli TRPM8 is capable of mediating the permeation large molecules across cell membranes, suggesting that TRPM8-positive nerves cannot be similarly targeted...
December 27, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/28032329/pain-prevalence-in-hospitalized-children-a-prospective-cross-sectional-survey-in-four-danish-university-hospitals
#15
S Walther-Larsen, M T Pedersen, S M Friis, G B Aagaard, J Rømsing, E M Jeppesen, S J Friedrichsdorf
BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed...
December 29, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28029525/-everything-is-valid-in-chronic-pain-interventions-by-older-adults-for-pain-relief
#16
Alejandra María Alvarado-García, Ángela María Salazar-Maya
OBJECTIVE: To describe interventions used by older adults with benign chronic pain. METHODS: Qualitative study with 25 older adults with benign chronic pain, inhabitants of the cities of Medellín and Bogotá. The technique used to collect information was in-depth interview. The analysis was made using the tools of the theory based on the guidelines of Strauss and Corbin. Using open, axial and selective coding, the constant comparison method allowed the identification of categories and subcategories and simultaneously memos and diagrams were made to reach theoretical saturation...
October 29, 2016: Enfermería Clínica
https://www.readbyqxmd.com/read/28024136/-new-methods-of-uterine-fibroids-treatment
#17
REVIEW
Aleksandra Marciniak, Iwona Szydłowska, Agnieszka Brodowska, Berenika Wiśniewska, Jolanta Nawrocka-Rutkowska, Andrzej Starczewski
Uterine fibroids are the most common benign tumors of the uterus. Their main symptoms are prolonged menstrual bleeding, leading over time to a secondary anemia, bleeding and spotting between periods, pelvic pain and infertility. It is recognized that fibroids are the most common indication for surgery in gynecology. Currently radical surgical treatment of fibroids is abandon. Ulipristalu acetate is used in pharmacological treatment. This medicine reduces the growth of fibroids. New non-invasive technique is also MR-guided focused ultrasound surgery using thermal tissue destruction by focusing ultrasound beam...
December 22, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28011944/bioavailability-of-aspirin-in-rats-comparing-the-drug-s-uptake-into-gastrointestinal-tissue-and-vascular-and-lymphatic-systems-implications-on-aspirin-s-chemopreventive-action
#18
L M Lichtenberger, T Phan, D Fang, S Edler, J Philip, T Li-Geng, E J Dial
Aspirin is an effective analgesic and antiplatelet drug that in addition to its ability to reduce pain, inflammation and fever, appears to have efficacy in the prevention/treatment of a range of diseases including heart disease, numerous cancers and Alzheimer's. It is important to understand the bioavailability of aspirin and its major metabolite, salicylic acid, since dosage and route of administration can vary for treating differing diseases, and the major side-effects of aspirin, upper gastrointestinal ulceration and bleeding, are dose-dependent...
October 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28009052/non-pharmacological-interventions-for-alleviating-pain-during-orthodontic-treatment
#19
REVIEW
Padhraig S Fleming, Hardus Strydom, Christos Katsaros, Lci MacDonald, Michele Curatolo, Piotr Fudalej, Nikolaos Pandis
BACKGROUND: Pain is prevalent during orthodontics, particularly during the early stages of treatment. To ensure patient comfort and compliance during treatment, the prevention or management of pain is of major importance. While pharmacological means are the first line of treatment for alleviation of orthodontic pain, a range of non-pharmacological approaches have been proposed recently as viable alternatives. OBJECTIVES: To assess the effects of non-pharmacological interventions to alleviate pain associated with orthodontic treatment...
December 23, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28003770/advances-in-the-management-of-erythropoietic-protoporphyria-role-of-afamelanotide
#20
REVIEW
Ashley M Lane, Jerome T McKay, Herbert L Bonkovsky
Erythropoietic protoporphyria (EPP) and the phenotypically similar disease X-linked protoporphyria (XLPP) are inherited cutaneous porphyrias characterized clinically by acute non-blistering photosensitivity, intolerance to sunlight, and significantly reduced quality of life. They are due to marked overproduction of protoporphyrin (PP) chiefly by erythroblasts and reticulocytes. In EPP, the underlying genetic defect is in the ferrochelatase gene, which encodes the final enzyme in the heme synthetic pathway. In XLPP, the genetic defect is a gain-of-function mutation, usually a four-base deletion, in the gene that encodes the enzyme 5-aminolevulinic acid synthase-2, the first and rate-controlling enzyme of heme synthesis in developing red blood cells...
2016: Application of Clinical Genetics
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