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https://www.readbyqxmd.com/read/29933827/pain-and-addiction-an-integrative-therapeutic-approach
#1
REVIEW
Ajay Manhapra, William C Becker
The current opioid crisis highlights an urgent need for better paradigms for prevention and treatment of chronic pain and addiction. Although many approach this complex clinical condition with the question, "Is this pain or is this addiction?," it is more than the sum of its parts. Chronic pain among those with dependence and addiction often evolves into a complex disabling condition with pain at multiple sites, psychosocial dysfunctions, medical and psychiatric disorders, polypharmacy, and polysubstance use, all interacting with each other in complex ways (multimorbidity)...
July 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29933826/sleep-management-among-patients-with-substance-use-disorders
#2
REVIEW
Subhajit Chakravorty, Ryan G Vandrey, Sean He, Michael D Stein
Sleep and substance use disorders commonly co-occur. Insomnia is commonly associated with use and withdrawal from substances. Circadian rhythm abnormalities are being increasingly linked with psychoactive substance use. Other sleep disorders, such as sleep-related breathing disorder, should be considered in the differential diagnosis of insomnia, especially in those with opioid use or alcohol use disorder. Insomnia that is brief or occurs in the context of active substance use is best treated by promoting abstinence...
July 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29932454/use-of-prescription-drugs-among-women-diagnosed-with-epithelial-ovarian-cancer-in-denmark
#3
Anton Pottegård, Søren Friis, Freija Verdoodt, Christian Dehlendorff, Jesper Hallas, Susanne Krüger Kjaer
Epithelial ovarian cancer patients often suffer from chronic diseases requiring drug treatment. We assessed temporal patterns of drug use among ovarian cancer patients MATERIAL AND METHODS: We identified all post-menopausal women with epithelial ovarian cancer in Denmark 2005-2012 and a comparison cohort of age-matched women without cancer. We calculated rates of new drug treatment and total drug use and examined use of new and prevalent drugs before and after diagnosis. Analyses were stratified by histological type and stage of epithelial ovarian cancer RESULTS: We identified 2,742 patients...
June 22, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29932046/chronic-headache-due-to-overuse-of-analgesics-and-anti-migraine-agents
#4
Hans-Christoph Diener, Dagny Holle, Thomas Dresler, Charly Gaul
BACKGROUND: The frequent or regular use of analgesics and anti-migraine drugs can make headache more frequent and induce the transformation of episodic to chronic headache. Chronic headache due to medication overuse is defined as headache that is present on ≥ 15 days per month for at least three months in a patient who previously suffered from primary headaches, and who takes analgesics on ≥ 15 days per month or anti-migraine drugs (triptans or ergot alkaloids), opioid drugs, or combined analgesics on ≥ 10 days per month...
June 1, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29930516/receptor-receptor-interactions-of-g-protein-coupled-receptors-in-the-carotid-body-a-working-hypothesis
#5
Andrea Porzionato, Elena Stocco, Diego Guidolin, Luigi Agnati, Veronica Macchi, Raffaele De Caro
In the carotid body (CB), a wide series of neurotransmitters and neuromodulators have been identified. They are mainly produced and released by type I cells and act on many different ionotropic and metabotropic receptors located in afferent nerve fibers, type I and II cells. Most metabotropic receptors are G protein-coupled receptors (GPCRs). In other transfected or native cells, GPCRs have been demonstrated to establish physical receptor-receptor interactions (RRIs) with formation of homo/hetero-complexes (dimers or receptor mosaics) in a dynamic monomer/oligomer equilibrium...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29929599/end-stage-renal-disease-chronic-itch-and-its-management
#6
REVIEW
Radomir Reszke, Jacek C Szepietowski
End-stage renal disease chronic itch is a frequent symptom that bothers patients with advanced stages of chronic kidney disease. The pathogenesis of the chronic itch symptom is complex and not yet fully understood and includes many metabolic, immunologic, and neurogenic factors. A significant burden of the disease results in decreased quality of life with sleep impairment, depressive symptoms, and increased mortality of affected individuals. No treatment of choice is available; topical therapy (emollients), phototherapy (UV-B), and systemic therapy (antiepileptics, opioid agonists, and antagonists) provide significant relief in varying percentages of patients...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929592/prurigo-nodularis-and-its-management
#7
REVIEW
Claudia Zeidler, Gil Yosipovitch, Sonja Ständer
Prurigo nodularis occurs with chronic pruritus and the presence of single to multiple symmetrically distributed, hyperkeratotic, and intensively itching nodules. Diverse dermatologic, systemic, neurologic, or psychiatric conditions can lead to prurigo nodularis. Structural analysis demonstrated a reduced intraepidermal nerve fiber density and increased dermal levels of nerve growth factor and neuropeptides such as substance P and calcitonin gene-related peptide. Novel therapy concepts such as inhibitors at neurokinin-1, opioid receptors, and interleukin-31 receptors have been developed...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29928864/definition-development-and-prevalence-of-new-persistent-opioid-use-following-hysterectomy
#8
Carolyn W Swenson, Neil S Kamdar, Kristian Seiler, Daniel M Morgan, Paul Lin, Sawsan As-Sanie
BACKGROUND: Opioids used for postoperative pain control after surgery have been associated with an increased risk of chronic opioid use. Hysterectomy is the most common major gynecologic procedure in the United States; however, we lack a data-driven definition of new persistent opioid use specific to hysterectomy. OBJECTIVE: 1) Determine a data-driven definition of new persistent opioid use among opioid naïve women undergoing hysterectomy; 2) Determine the prevalence of and risk factors for new persistent opioid use...
June 18, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29927768/an-update-on-the-basic-and-clinical-science-of-ketamine-analgesia
#9
Lisa V Doan, Jing Wang
OBJECTIVE: In the context of the current opioid epidemic, there has been a renewed interest in the use of ketamine as an analgesic agent. METHODS: We have reviewed ketamine analgesia. RESULTS: Ketamine is well-known as an antagonist for N-methyl-D-aspartate receptors. In addition, it can regulate the function of opioid receptors and sodium channels. Ketamine also increases signaling through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors...
June 20, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29926357/preperitoneal-bupivacaine-infiltration-reduces-postoperative-opioid-consumption-acute-pain-and-chronic-postsurgical-pain-after-bariatric-surgery-a-randomized-controlled-trial
#10
Saskia L Boerboom, Ann de Haes, Lianne Vd Wetering, Edo O Aarts, Ignace M C Janssen, Jose W Geurts, Ed T Kamphuis
INTRODUCTION: A multimodal pain treatment including local anesthetics is advised for perioperative analgesia in bariatric surgery. Due to obesity, bariatric surgery patients are at risk of respiratory complications. Opioid consumption is an important risk factor for hypoventilation. Furthermore, acute postoperative pain is an important risk factor for chronic postsurgical pain. In this study, we aimed to evaluate whether preperitoneal anesthesia with bupivacaine would reduce pain and opioid consumption after bariatric surgery...
June 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29926144/lappaconitine-a-c18-diterpenoid-alkaloid-exhibits-antihypersensitivity-in-chronic-pain-through-stimulation-of-spinal-dynorphin-a-expression
#11
Ming-Li Sun, Jun-Ping Ao, Yi-Rui Wang, Qian Huang, Teng-Fei Li, Xin-Yan Li, Yong-Xiang Wang
Lappaconitine is a representative C18-diterpenoid alkaloid extracted from Aconitum sinomontanum Nakai and has been prescribed as a pain relief medicine in China for more than 30 years. This study evaluated its antihypersensitivity activity in the rat models of neuropathic and cancer pains and explored its underlying mechanisms. Subcutaneous injection of cumulative doses of lappaconitine produced dose-dependent mechanical antiallodynia and thermal antihyperalgesia in spinal nerve ligation-induced neuropathic rats...
June 20, 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29926090/causes-of-death-after-nonfatal-opioid-overdose
#12
Mark Olfson, Stephen Crystal, Melanie Wall, Shuai Wang, Shang-Min Liu, Carlos Blanco
Importance: A recent increase in patients presenting with nonfatal opioid overdoses has focused clinical attention on characterizing their risks of premature mortality. Objective: To describe all-cause mortality rates, selected cause-specific mortality rates, and standardized mortality rate ratios (SMRs) of adults during their first year after nonfatal opioid overdose. Design, Setting, and Participants: This US national longitudinal study assesses a cohort of patients aged 18 to 64 years who were Medicaid beneficiaries and experienced nonfatal opioid overdoses...
June 20, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29925323/risk-of-opioid-misuse-in-chronic-non-cancer-pain-in-primary-care-patients-a-cross-sectional-study
#13
Johannes Maximilian Just, Linda Bingener, Markus Bleckwenn, Rieke Schnakenberg, Klaus Weckbecker
BACKGROUND: Efforts to improve treatment of pain using opioids have to adequately take into account their therapeutic shortcomings which involve addictiveness. While there are no signs of an "opioid epidemic" in Germany similar to that in the US, there is little data on the prevalence of prescription opioid misuse and addiction. Therefore, our objective was to screen primary care patients on long-term opioid therapy for signs of misuse of prescription opioids. METHODS: We recruited 15 GPs practices and asked all patients on long-term opioid therapy (> 6 months) to fill out a questionnaire including the "Current Opioid Misuse Measure" (COMM®), a self-report questionnaire...
June 20, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29923953/ketamine-for-refractory-headache-a-retrospective-analysis
#14
Eric S Schwenk, Amir C Dayan, Ashwin Rangavajjula, Marc C Torjman, Mauricio G Hernandez, Clinton G Lauritsen, Stephen D Silberstein, William Young, Eugene R Viscusi
BACKGROUND AND OBJECTIVES: The burden of chronic headache disorders in the United States is substantial. Some patients are treatment refractory. Ketamine, an N-methyl-D-aspartate antagonist, provides potent analgesia in subanesthetic doses in chronic pain, and limited data suggest it may alleviate headache in some patients. METHODS: We performed a retrospective study of 61 patients admitted over 3 years for 5 days of intravenous therapy that included continuous ketamine to determine responder rate and patient and ketamine infusion characteristics...
June 19, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29921657/oligomerization-of-mrgc11-and-%C3%AE-opioid-receptors-in-sensory-neurons-enhances-morphine-analgesia
#15
Shao-Qiu He, Qian Xu, Vinod Tiwari, Fei Yang, Michael Anderson, Zhiyong Chen, Shaness A Grenald, Srinivasa N Raja, Xinzhong Dong, Yun Guan
The μ-opioid receptor (MOR) agonist morphine is commonly used for pain management, but it has severe adverse effects and produces analgesic tolerance. Thus, alternative ways of stimulating MOR activity are needed. We found that MrgC11, a sensory neuron-specific G protein-coupled receptor, may form heteromeric complexes with MOR. Peptide-mediated activation of MrgC11 enhanced MOR recycling by inducing coendocytosis and sorting of MOR for membrane reinsertion. MrgC11 activation also inhibited the coupling of MOR to β-arrestin-2 and enhanced the morphine-dependent inhibition of cAMP production...
June 19, 2018: Science Signaling
https://www.readbyqxmd.com/read/29921501/tapentadol-a-representative-of-a-new-class-of-mor-nri-analgesics
#16
REVIEW
Renata Zajączkowska, Barbara Przewłocka, Magdalena Kocot-Kępska, Joanna Mika, Wojciech Leppert, Jerzy Wordliczek
Tapentadol is a centrally acting analgesic with a dual mode of action as a μ-opioid receptor (MOR) agonist and a noradrenaline reuptake inhibitor (NRI). It was initially approved by the US Food and Drug Administration in November 2008 for the treatment of moderate-to-severe acute pain in adult patients, and in August 2011, for chronic pain in an prolonged release form in the same population. Due to its limited protein binding capacity, the absence of active metabolites and significant microsomal enzyme induction or inhibition, tapentadol has a limited potential for drug-drug interactions...
January 31, 2018: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29916183/modulation-of-mir-139-5p-on-chronic-morphine-induced-naloxone-precipitated-camp-overshoot-in-vitro
#17
Dan-Ni Cao, Jing-Jing Shi, Ning Wu, Jin Li
Chronic exposure to morphine can produce tolerance, dependence and addiction, but the underlying neurobiological basis is still incompletely understood. c-Jun, as an important component of the activator protein-1 transcription factor, is supposed to take part in regulating gene expression in AC/cAMP/PKA signaling. MicroRNA (miRNA) has emerged as a critical regulator of neuronal functions. Although a number of miRNAs have been reported to regulate the μ-opioid receptor expression, there has been no report about miRNAs to regulate chronic morphine-induced, naloxone-precipitated cAMP overshoot...
June 18, 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29916029/correction-to-managing-concerning-behaviors-in-patients-prescribed-opioids-for-chronic-pain-a-delphi-study
#18
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
In this paper, the author degrees were presented incorrectly. The correct listing is above.
June 18, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29913934/does-co-administration-of-paroxetine-change-oxycodone-analgesia-an-interaction-study-in-chronic-pain-patients
#19
K K Lemberg, T E Heiskanen, M Neuvonen, V K Kontinen, P J Neuvonen, M-L Dahl, E A Kalso
Oxycodone is a strong opioid and it is increasingly used in the management of acute and chronic pain. The pharmacodynamic effects of oxycodone are mainly mediated by the μ-opioid receptor. However, its affinity for the μ-opioid receptor is significantly lower compared with that of morphine and it has been suggested that active metabolites may play a role in oxycodone analgesia. Oxycodone is mainly metabolized by hepatic cytochrome (CYP) enzymes 2D6 and 3A4. Oxycodone is metabolized to oxymorphone, a potent μ-opioid receptor agonist by CYP2D6...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913911/buprenorphine-clinically-useful-but-often-misunderstood
#20
Stephen Butler
Background There are a number of false myths about buprenorphine based on unconfirmed animal data, even from isolated animal organs, and early clinical research. These myths came into textbooks on pharmacology and pain about 30 years ago and have been difficult to eradicate. Animal models of pain and pain relief are notoriously unreliable as predictors of human clinical effects. The fact is that in clinical practice there is NO bell-shaped dose-response curve, there is NO plateau on the dose-response curve, and there is NO antagonist effect from buprenorphine on other mu-opioid agonists...
December 29, 2017: Scandinavian Journal of Pain
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