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https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#1
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/28815604/chronic-morphine-reduces-the-readily-releasable-pool-of-gaba-a-presynaptic-mechanism-of-opioid-tolerance
#2
Adrianne R Wilson-Poe, Hyo-Jin Jeong, Christopher W Vaughan
The midbrain periaqueductal grey (PAG) plays a critical role in tolerance to the analgesic actions of opioids such as morphine. While numerous studies have identified the postsynaptic adaptations induced by chronic morphine treatment in this and other brain regions, the presence of presynaptic adaptations remains uncertain. We examined GABAergic synaptic transmission within rat PAG brain slices from animals which underwent a low dose morphine treatment protocol which produces tolerance, but not withdrawal. Evoked GABAergic IPSCs (inhibitory postsynaptic currents) were less in morphine compared to control saline treated animals...
August 16, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28812173/melatonin-attenuates-pain-hypersensitivity-and-decreases-astrocyte-mediated-spinal-neuroinflammation-in-a-rat-model-of-oxaliplatin-induced-pain
#3
Ye-Song Wang, Yuan-Yuan Li, Wei Cui, Li-Bin Li, Zhao-Cai Zhang, Bao-Ping Tian, Gen-Sheng Zhang
Neuroinflammatory response in spinal dorsal horn has been demonstrated to be a critical factor in oxaliplatin-induced pain. Melatonin has been shown to have anti-inflammatory and anti-allodynia effects in both preclinical and clinical studies. In the present study, we investigated the role of systemic administration of melatonin on oxaliplatin-induced pain. Intraperitoneal (i.p.) injection with oxaliplatin induced significantly mechanical allodynia and thermal hyperalgesia. Melatonin (i.p.) significantly alleviated mechanical allodynia and thermal hyperalgesia in the oxaliplatin but not sham-treated rats...
August 15, 2017: Inflammation
https://www.readbyqxmd.com/read/28810429/individual-differences-in-pain-sensitivity-predict-the-experience-of-unfairness
#4
Haixia Wang, Kefeng Li, Xiaofei Xie
Pain has shaped our evolutionary history, and pain-free experiences are critical for our health. There are, however, enormous individual differences in pain sensitivity, and the psychological consequences of this heterogeneity are only poorly understood. Here, we investigated whether individual differences in pain sensitivity predicted the experience of unfairness. We found that the magnitude of pain sensitivity correlated with the extent to which participants experienced unfairness. This association was due to the shared human alarm system of unfairness and pain sensitivity...
January 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810131/prescription-opioid-registry-protocol-in-an-integrated-health-system
#5
G Thomas Ray, Amber L Bahorik, Paul C VanVeldhuisen, Constance M Weisner, Andrea L Rubinstein, Cynthia I Campbell
OBJECTIVES: To establish a prescription opioid registry protocol in a large health system and to describe algorithms to characterize individuals using prescription opioids, opioid use episodes, and concurrent use of sedative/hypnotics. STUDY DESIGN: Protocol development and retrospective cohort study. METHODS: Using Kaiser Permanente Northern California (KPNC) electronic health record data, we selected patients using prescription opioids in 2011...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28808924/a-critical-evaluation-on-moh-current-treatments
#6
REVIEW
Andrea Negro, Martina Curto, Luana Lionetto, Simona Guerzoni, Luigi Alberto Pini, Paolo Martelletti
Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH)...
August 15, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28808857/the-surgeon-s-role-in-treating-chronic-pancreatitis-and-incidentally-discovered-pancreatic-lesions
#7
Vikrom K Dhar, Brent T Xia, Syed A Ahmad
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28808608/intrathecal-catheter-associated-inflammatory-mass-in-a-neurofibromatosis-type-1-patient-receiving-fentanyl-and-bupivacaine
#8
Derek G Southwell, Joseph A Osorio, Christopher S Liverman, Lauren M Friedman, Ramana K Naidu, Lawrence R Poree, Melanie M Henry, Line Jacques
BACKGROUND: Catheter-associated inflammatory masses (CIMs) are a rare but serious complication of intrathecal drug delivery devices. CIM formation is influenced by local medication concentration, which is determined in part by flow dynamics at the catheter tip. Underlying spinal pathologies, such as neoplasms, may alter flow at the catheter tip, thereby contributing to CIM formation. Moreover, they may also complicate the clinical and radiologic diagnosis of a CIM. CASE DESCRIPTION: A 36-year-old man with neurofibromatosis type 1 presented to our emergency department with complaints of increased back pain and leg weakness...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28808371/efficacy-of-osteopathic-manipulative-treatment-approach-in-the-patient-with-pulmonary-fibrosis-in-critical-care-outpatient-department
#9
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
#10
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/28807753/a-critical-evaluation-of-validity-and-utility-of-translational-imaging-in-pain-and-analgesia-utilizing-functional-imaging-to-enhance-the-process
#11
REVIEW
Jaymin Upadhyay, Christian Geber, Richard Hargreaves, Frank Birklein, David Borsook
Assessing clinical pain and metrics related to function or quality of life predominantly relies on patient reported subjective measures. These outcome measures are generally not applicable to the preclinical setting where early signs pointing to analgesic value of a therapy are sought, thus introducing difficulties in animal to human translation in pain research. Evaluating brain function in patients and respective animal model(s) has the potential to characterize mechanisms associated with pain or pain-related phenotypes and thereby provide a means of laboratory to clinic translation...
August 11, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#12
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/28804005/performance-assessment-of-the-saps-ii-and-sofa-scoring-systems-in-hanta-virus-hemorrhagic-fever-with-renal-syndrome
#13
Zhenjun Yu, Ni Zhou, Ali Li, Jie Chen, Huazhong Chen, Zebao He, Fei Yan, Haihong Zhao, Jiansheng Zhu
BACKGROUND: Hemorrhagic Fever with Renal Syndrome (HFRS), caused by the hantavirus, is a natural infectious disease characterized by fever, hemorrhage and renal damage. China is the most severely endemic area for HFRS in the world. In recent years, critical scoring systems based on quantitative classification have become an important clinical tool for predicting and evaluating the prognosis of critical illness, and provide guidelines for clinical practice. METHODS: The sample comprised 384 patients with HFRS treated in the Taizhou Hospital from January 2006 to February 2017...
August 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28803262/topic-anaesthesia-with-a-eutectic-mixture-of-lidocaine-prilocaine-cream-after-elective-caesarean-section-a-randomised-placebo-controlled-trial
#14
Thomas Grosse-Steffen, Malin Krämer, Benjamin Tuschy, Christel Weiss, Marc Sütterlin, Sebastian Berlit
PURPOSE: Aim of the study was to investigate the topical application of a eutectic mixture of lidocaine/prilocaine (EMLA(®)) cream after caesarean section (CS) and its effect on postoperative pain, time to mobilisation, and time to discharge. MATERIALS AND METHODS: A total of 189 pregnant women were enrolled; full data sets were available for 139 of them, who were prospectively randomised to receive either placebo (control group) or EMLA(®) cream (study group) on the CS lesion directly as well as 24 h after surgery...
August 12, 2017: Archives of Gynecology and Obstetrics
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
#15
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
#16
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/28797041/repeat-low-level-blast-exposure-increases-transient-receptor-potential-vanilloid-1-trpv1-and-endothelin-1-et-1-expression-in-the-trigeminal-ganglion
#17
Elaine D Por, Melody L Sandoval, Chiquita Thomas-Benson, Teresa A Burke, Allison Doyle Brackley, Nathaniel A Jeske, Jeffery M Cleland, Brian J Lund
Blast-associated sensory and cognitive trauma sustained by military service members is an area of extensively studied research. Recent studies in our laboratory have revealed that low-level blast exposure increased expression of transient receptor potential vanilloid 1 (TRPV1) and endothelin-1 (ET-1), proteins well characterized for their role in mediating pain transmission, in the cornea. Determining the functional consequences of these alterations in protein expression is critical to understanding blast-related sensory trauma...
2017: PloS One
https://www.readbyqxmd.com/read/28796117/spouse-criticism-and-hostility-during-marital-interaction-effects-on-pain-intensity-and-behaviors-among-individuals-with-chronic-low-back-pain
#18
John W Burns, Kristina M Post, David A Smith, Laura S Porter, Asokumar Buvanendran, Anne Marie Fras, Francis J Keefe
Individuals with chronic pain may experience negative responses from spouse, family and friends. Responses such as overt criticism and hostility may be associated with worsening pain and function for chronic pain sufferers. We used a laboratory procedure to evaluate whether variability in spouse criticism/hostility exhibited toward chronic low back pain (CLBP) patients during a conflictual discussion predicted variability in patient pain and function during a subsequent pain-induction task. CLBP patients (n=71) and their spouses (n=71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task (SPBT)...
August 8, 2017: Pain
https://www.readbyqxmd.com/read/28795169/chronic-pain-and-chronic-stress-two-sides-of-the-same-coin
#19
Chadi G Abdallah, Paul Geha
Pain and stress share significant conceptual and physiological overlaps. Both phenomena challenge the body's homeostasis and necessitate decision-making to help animals adapt to their environment. In addition, chronic stress and chronic pain share a common behavioral model of failure to extinguish negative memories. Yet, they also have discrepancies such that the final brain endophenotype of posttraumatic stress disorder, depression, and chronic pain appears to be different among the three conditions, and the role of the hypothalamic-pituitary-adrenal axis remains unclear in the physiology of pain...
February 2017: Chronic stress
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#20
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
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