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https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#1
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29042187/exploring-patient-experiences-of-a-pain-management-centre-a-qualitative-study
#2
Manasi M Mittinty, John Lee, Amanda C de C Williams, Natasha Curran
BACKGROUND AND AIMS: To improve care and management of patients with chronic pain it is important to understand patients' experiences of treatment, and of the people and the environment involved. As chronic pain patients often have long relationships with medical clinics and pain management centres, the team and team interactions with the patients could impact the treatment outcome. The aim of this study was to elicit as honest as possible an account of chronic pain patients' experiences associated with their care and feed this information back to the clinical team as motivation for improvement...
October 14, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29038868/the-global-spine-care-initiative-a-review-of-reviews-and-recommendations-for-the-non-invasive-management-of-acute-osteoporotic-vertebral-compression-fracture-pain-in-low-and-middle-income-communities
#3
REVIEW
Arthur Ameis, Kristi Randhawa, Hainan Yu, Pierre Côté, Scott Haldeman, Roger Chou, Eric L Hurwitz, Margareta Nordin, Jessica J Wong, Heather M Shearer, Anne Taylor-Vaisey
PURPOSE: The purpose of this review was to develop recommendations for non-invasive management of pain due to osteoporotic vertebral compression fractures (OVCF) that could be applied in medically underserved areas and low- and middle-income countries. METHODS: We conducted a systematic review and best evidence synthesis of systematic reviews on the non-invasive management of OVCF. Eligible reviews were critically appraised using the Scottish Intercollegiate Guidelines Network criteria...
October 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29037537/validation-of-two-chinese-version-pain-observation-tools-in-conscious-and-unconscious-critically-ill-patients
#4
Li-Hua Cheng, Yun-Fang Tsai, Cheng-Hsu Wang, Pei-Kwei Tsay
OBJECTIVES: To compare the construct validities of the Chinese-versions Critical-Care Pain Observation Tool and Behavioural Pain Scale as measures of critically ill patients' pain by (a) discriminant validation of behavioural scales and vital signs (e.g. heart rate and mean arterial pressure) during a non-nociceptive procedure (noninvasive blood pressure] assessment) and a nociceptive procedure (endotracheal suctioning), (b) criterion validation of behavioural scales and vital signs with patients' self-reported pain and (c) testing the interrater reliability of both scores...
October 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29036629/nanotechnology-a-promising-new-paradigm-for-the-control-of-pain
#5
Krishnan V Chakravarthy, Frank J Boehm, Paul J Christo
Objective: The objective of this article is to critically review both preclinical and clinical studies that focus on the use of nanotechnology for both acute and chronic pain management, surveying both diagnostic and therapeutic applications. The article also provides information on nanotechnology for pain practitioners, so that they may better understand how this technology works and how it may be applied to their day-to-day clinical practice. Study Design: Narrative review...
June 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29033606/the-pain-depression-disability-pathway-in-those-with-low-back-pain-a-moderation-analysis-of-health-locus-of-control
#6
Paul Campbell, Kate Hope, Kate M Dunn
Low back pain (LBP) is common, impacts on the individual and society, and is a major health concern. Psychological consequences of LBP, such as depression, are significant barriers to recovery, but mechanisms for the development of depression are less well understood. One potential mechanism is the individual's health locus of control (HLoC), that is, perception of the level of control an individual has over their health. The objective of this study is to investigate the moderation effect of HLoC on the pain-depression-disability pathway in those with LBP...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29025397/a-qualitative-study-of-patient-education-needs-for-hip-and-knee-replacement
#7
Deborah Kennedy, Amy Wainwright, Lucy Pereira, Susan Robarts, Patricia Dickson, Jennifer Christian, Fiona Webster
BACKGROUND: Quality health information is key to patient engagement, self-management and an enhanced healthcare experience. There is strong evidence to support involving patients and their families in the development and evaluation of health-related educational material. These factors were the impetus for our high volume joint replacement centre to undertake a qualitative study to elicit patient experiences to inform the development of effective strategies and education along the care continuum for hip and knee replacement...
October 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29024708/nationwide-quality-of-hospice-care-findings-from-the-centers-for-medicare-medicaid-services-cms-hospice-quality-reporting-program-hqrp
#8
Nan Tracy Zheng, Qinghua Li, Laura C Hanson, Kathryn L Wessell, Natalie Chong, Noha Sherif, Ila H Broyles, Jennifer Frank, M Alexis Kirk, Carol R Schwartz, Alan F Levitt, Franziska Rokoske
BACKGROUND: With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high quality care and have the information they need when selecting a hospice. Towards these goals, CMS has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. OBJECTIVES: This article presents a first look at the national hospice HIS quality data...
October 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29021995/tumor-induced-osteomalacia
#9
Pablo Florenzano, Rachel I Gafni, Michael T Collins
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome clinically characterized by bone pain, fractures and muscle weakness. It is caused by tumoral overproduction of fibroblast growth factor 23 (FGF23) that acts primarily at the proximal renal tubule, decreasing phosphate reabsorption and 1α-hydroxylation of 25 hydroxyvitamin D, thus producing hypophosphatemia and osteomalacia. Lesions are typically small, benign mesenchymal tumors that may be found in bone or soft tissue, anywhere in the body...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/29021727/analgesia-sedation-and-arousal-status-in-burn-patients-the-gap-between-recommendations-and-current-practices
#10
A Lavrentieva, N Depetris, I Rodini
Assessment and treatment of pain, agitation and delirium are integral parts of the management of critically ill patients. The purpose of this review is to describe how pain, delirium and agitation are managed in general intensive care units and in burn units, and to address whether management of these issues is compatible with internationally accepted recommendations. A substantial gap exists between the conception of the guidelines, clinical practice and physicians' statements regarding pain, sedation and delirium management...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29019421/management-of-acute-pain-in-the-postoperative-setting-the-importance-of-quality-indicators
#11
Winfried Meissner, Frank Huygen, Edmund A M Neugebauer, Jürgen Osterbrink, Dan Benhamou, Neil Betteridge, Flaminia Coluzzi, José De Andres, William Fawcett, Dominique Fletcher, Eija Kalso, Henrik Kehlet, Bart Morlion, Antonio Montes Pérez, Joseph Pergolizzi, Michael Schäfer
Despite the introduction of evidence-based recommendations for postoperative pain management (POPM), the consensus is that pain control remains suboptimal. Barriers to achieving patient-satisfactory analgesia include deficient knowledge regarding POPM among staff, lack of instructions, insufficient pain assessments and sub-optimal treatment. Effective monitoring of POPM is essential to enable policy makers and healthcare providers to improve the quality of care. Quality indicators (QIs) are quantitative measures of clinical practice that can monitor, evaluate and guide the quality of care provided to patients...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29017475/reliability-validity-and-responsiveness-of-the-german-self-reported-foot-and-ankle-score-sefas-in-patients-with-foot-or-ankle-surgery
#12
Dariusch Arbab, Katharina Kuhlmann, Christoph Schnurr, Bertil Bouillon, Christian Lüring, Dietmar König
BACKGROUND: Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures and are increasingly used in clinical trials to assess outcomes of health care. The intention of this study was to develop and culturally adapt a German version of the Self-reported Foot and Ankle Score (SEFAS) and to evaluate reliability, validity and responsiveness. METHODS: According to Cross Cultural Adaptation of Self-Reported Measure guidelines forward and backward translation has been performed...
October 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28988019/acute-intermittent-porphyria-after-right-hemi-colectomy
#13
Shadi Alshammary, Reem Al Dulaijan, Khaldoon Saleh, Hazem Zakaria, Ahmed Eldamati, Norah Alwakeel, Abdulmohsen Al-Mulhim
INTRODUCTION: Acute intermittent porphyria is a rare autosomal dominant metabolic disease. It is caused by a genetic mutation that results in deficiency of porphobilinogen deaminase enzyme, the third enzyme in heme biosynthesis. Acute intermittent porphyria precipitated by surgery is very rare. CASE PRESENTATION: We present a 24 year-old woman who developed acute intermittent porphyria five days after right hemi-colectomy. Her presentation included neuro-visceral and psychiatric manifestations, and severe hyponatremia...
September 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28986186/fatal-abdominal-compartment-syndrome-due-to-severe-triglyceride-induced-pancreatitis-in-early-pregnancy
#14
Tamanna Chibber, Paul S Gibson
Serum levels of maternal lipids rise physiologically in normal pregnancy, and women with underlying hypertriglyceridemia may experience dramatic elevations which place them at risk for pancreatitis. We describe the case of a woman with severe familial hypertriglyceridemia and prior pancreatitis who discontinued her lipid-lowering therapy early in pregnancy. She promptly developed severe abdominal pain and was hospitalized with acute pancreatitis during the late first trimester. Despite aggressive medical treatment and critical care monitoring, she developed abdominal compartment syndrome (ACS) with associated acute renal failure, which progressed to cardiorespiratory failure and was ultimately fatal...
October 3, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28981493/acute-abdominal-pain-changes-in-the-way-we-assess-it-over-a-decade
#15
Kirsten de Burlet, Anna Lam, Peter Larsen, Elizabeth Dennett
AIMS: Acute abdominal pain accounts for 5-10% of all emergency department visits. Rapid and accurate diagnosis is critical to ensure optimal outcomes. In the last decade, increased use of CT scans and the introduction of surgical short stay units has changed the way this group of patients is managed. The aim of this study was to evaluate the effects of these changes on patient management. METHODS: A retrospective clinical study was undertaken including all patients admitted with abdominal pain under general surgery in the years 2004, 2009 and 2014...
October 6, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28977906/trypsin-protease-activated-receptor-2-signaling-contributes-to-pancreatic-cancer-pain
#16
Jiao Zhu, Xue-Rong Miao, Kun-Ming Tao, Hai Zhu, Zhi-Yun Liu, Da-Wei Yu, Qian-Bo Chen, Hai-Bo Qiu, Zhi-Jie Lu
Pain treatment is a critical aspect of pancreatic cancer patient clinical care. This study investigated the role of trypsin-protease activated receptor-2 (PAR-2) in pancreatic cancer pain. Pancreatic tissue samples were collected from pancreatic cancer (n=22) and control patients (n=22). Immunofluorescence analyses confirmed colocalization of PAR-2 and neuronal markers in pancreatic cancer tissues. Trypsin levels and protease activities were higher in pancreatic cancer tissue specimens than in the controls...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28976483/part-ii-the-effects-of-aromatherapy-and-guided-imagery-for-the-symptom-management-of-anxiety-pain-and-insomnia-in-critically-ill-patients-an-integrative-review-of-current-literature
#17
Naheed Meghani, Mary Fran Tracy, Niloufar Niakosari Hadidi, Ruth Lindquist
This review is part II of a 2-part series that presents evidence on the effectiveness of aromatherapy and guided imagery for the symptom management of anxiety, pain, and insomnia in adult critically ill patients. Evidence from this review supports the use of aromatherapy for management of pain, insomnia, and anxiety in critically ill patients. Evidence also supports the use of guided imagery for managing these symptoms in critical care; however, the evidence is sparse, mixed, and weak. More studies with larger samples and stronger designs are needed to further establish efficacy of guided imagery for the management of anxiety, pain, and insomnia of critically ill patients; to accomplish this, standardized evidence-based intervention protocols to ensure comparability and to establish optimal effectiveness are needed...
November 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28971346/combined-pet-mri-global-warming-summary-report-of-the-6th-international-workshop-on-pet-mri-march-27-29-2017-t%C3%A3-bingen-germany
#18
REVIEW
D L Bailey, B J Pichler, B Gückel, G Antoch, H Barthel, Z M Bhujwalla, S Biskup, S Biswal, M Bitzer, R Boellaard, R F Braren, C Brendle, K Brindle, A Chiti, C la Fougère, R Gillies, V Goh, M Goyen, M Hacker, L Heukamp, G M Knudsen, A M Krackhardt, I Law, J C Morris, K Nikolaou, J Nuyts, A A Ordonez, K Pantel, H H Quick, K Riklund, O Sabri, B Sattler, E G C Troost, M Zaiss, L Zender, Thomas Beyer
The 6th annual meeting to address key issues in positron emission tomography (PET)/magnetic resonance imaging (MRI) was held again in Tübingen, Germany, from March 27 to 29, 2017. Over three days of invited plenary lectures, round table discussions and dialogue board deliberations, participants critically assessed the current state of PET/MRI, both clinically and as a research tool, and attempted to chart future directions. The meeting addressed the use of PET/MRI and workflows in oncology, neurosciences, infection, inflammation and chronic pain syndromes, as well as deeper discussions about how best to characterise the tumour microenvironment, optimise the complementary information available from PET and MRI, and how advanced data mining and bioinformatics, as well as information from liquid biomarkers (circulating tumour cells and nucleic acids) and pathology, can be integrated to give a more complete characterisation of disease phenotype...
October 2, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28970658/pain-measurement-in-mechanically-ventilated-patients-with-traumatic-brain-injury-behavioral-pain-tools-versus-analgesia-nociception-index
#19
Ali Jendoubi, Ahmed Abbes, Salma Ghedira, Mohamed Houissa
INTRODUCTION: Pain is highly prevalent in critically ill trauma patients, especially those with a traumatic brain injury (TBI). Behavioral pain tools such as the behavioral pain scale (BPS) and critical-care pain observation tool are recommended for sedated noncommunicative patients. Analysis of heart rate variability (HRV) is a noninvasive method to evaluate autonomic nervous system activity. The analgesia nociception index (ANI) device (Physiodoloris(®), MDoloris Medical Systems, Loos, France) allows noninvasive HRV analysis...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28964481/pediatric-pancreas-transplantation-including-total-pancreatectomy-with-islet-autotransplantation
#20
Alexander J Bondoc, Maisam Abu-El-Haija, Jaimie D Nathan
Unlike other solid-organ transplants, whole pancreas transplantation in children is relatively rare, and it occurs more frequently in the context of multivisceral or composite organ transplantation. Because children only infrequently suffer severe sequelae of type 1 diabetes mellitus, pancreas transplantation is rarely indicated in the pediatric population. More commonly, pediatric pancreas transplant occurs in the setting of incapacitating acute recurrent or chronic pancreatitis, specifically islet autotransplantation after total pancreatectomy...
August 2017: Seminars in Pediatric Surgery
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