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https://www.readbyqxmd.com/read/29223211/perinatal-and-neonatal-implications-of-sickle-cell-disease
#1
Cathi Phillips, Margaret Peggy Boyd
Sickle cell disease is the genetic disorder most commonly detected with state-mandated newborn screening. Women with sickle cell disease struggle with psychosocial, emotional, and physical challenges throughout their lives. Pregnancy for women with sickle cell disease brings greater risk for maternal and fetal morbidity and mortality and increased likelihood of hospitalization for complications, including sickle cell pain crisis. Chronic maternal opioid use for pain can place newborns at risk for neonatal abstinence syndrome...
December 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/29222304/targeting-novel-mechanisms-of-pain-in-sickle-cell-disease
#2
REVIEW
Huy Tran, Mihir Gupta, Kalpna Gupta
Patients with sickle cell disease (SCD) suffer from intense pain that can start during infancy and increase in severity throughout life, leading to hospitalization and poor quality of life. A unique feature of SCD is vaso-occlusive crises (VOCs) characterized by episodic, recurrent, and unpredictable episodes of acute pain. Microvascular obstruction during a VOC leads to impaired oxygen supply to the periphery and ischemia reperfusion injury, inflammation, oxidative stress, and endothelial dysfunction, all of which may perpetuate a noxious microenvironment leading to pain...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#3
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#4
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29220525/impact-of-opioid-dose-reduction-and-risk-mitigation-initiatives-on-chronic-opioid-therapy-patients-at-higher-risk-for-opioid-related-adverse-outcomes
#5
Manu Thakral, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Sascha Dublin, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Michael Von Korff
Objective: We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients. Design: Interrupted time series. Setting: Group Health Cooperative (GH), a health care delivery system and insurance within Washington State, between 2006 and 2014...
December 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29215508/opioid-knowledge-and-prescribing-practices-among-obstetrician-gynecologists
#6
Annetta M Madsen, Lauren M Stark, Phinnara Has, Jenna B Emerson, Jay Schulkin, Kristen A Matteson
OBJECTIVE: To describe obstetrician-gynecologists' (ob-gyns) knowledge and prescribing practices regarding opioid analgesics. METHODS: We conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who are part of the Collaborative Ambulatory Research Network. We used a sequential mixed-method approach. We collected data on opioid knowledge and typical prescribing practices, including number, type, and indication for prescriptions...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215492/postoperative-opioid-use-complications-and-costs-in-surgical-management-of-lumbar-spondylolisthesis
#7
Daniel Vail, Tej D Azad, Chloe O'Connell, Summer S Han, Anand Veeravagu, John K Ratliff
STUDY DESIGN: Retrospective analysis on a national longitudinal database (2007-2014). OBJECTIVE: To determine the association between arthrodesis and complication rates, costs, surgical revision, and postoperative opioid prescription. SUMMARY OF BACKGROUND DATA: Arthrodesis in patients receiving laminectomy for lumbar spondylolisthesis remains controversial. However, population-level evidence to support the use of arthrodesis remains limited...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29213167/pain-assessment-and-management-the-knowledge-attitude-and-practice-of-sudanese-paediatric-residents
#8
Mohammed A A Alhassan, Fathelrahman E Ahmed, Abdolmoneim A Bannaga
This was a prospective, descriptive, cross sectional study that was conducted in 9 major paediatric hospitals accredited for training of residents in Sudan to assess the knowledge, attitude and practice of residents in paediatrics on issues related to pain assessment and pain management in children A semi-structured and validated questionnaire was distributed to 174 residents working in these hospitals. One hundred and twenty residents, out of 174, responded by filling the questionnaire, with a response rate of 68%...
2017: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/29211767/investigating-endogenous-%C3%A2%C2%B5-opioid-receptors-in-human-keratinocytes-as-pharmacological-targets-using-novel-fluorescent-ligand
#9
Cheryl Leong, Christine Neumann, Srinivas Ramasamy, Bhimsen Rout, Lim Yi Wee, Mei Bigliardi-Qi, Paul L Bigliardi
Opioids in skin function during stress response, regeneration, ageing and, particularly in regulating sensation. In chronic pruritus, topical treatment with Naltrexone changes μ-opioid receptor (μ-OR) localization to relieve itch. The molecular mechanisms behind the effects of Naltrexone on μ-OR function in reduction of itching behavior has not been studied. There is an immediate need to understand the endogenous complexity of μ-OR dynamics in normal and pathological skin conditions. Here we evaluate real-time behavior of μ-OR-Endomorphine complexes in the presence of agonist and antagonists...
2017: PloS One
https://www.readbyqxmd.com/read/29210789/predicting-severity-of-acute-pain-after-cesarean-delivery-a-narrative-review
#10
Brock H Gamez, Ashraf S Habib
Cesarean delivery is one of the most common surgical procedures in the United States, with over 1.3 million performed annually. One-fifth of women who undergo cesarean delivery will experience severe pain in the acute postoperative period, increasing their risk of developing chronic pain and postpartum depression, and negatively impacting breastfeeding and newborn care. A growing body of research has investigated tools to predict which patients will experience more severe pain and have increased analgesic consumption after cesarean delivery...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29207909/the-evolving-role-of-long-term-pharmacotherapy-for-opioid-induced-constipation-in-patients-being-treated-for-noncancer-pain
#11
Brandi L Bowers, Andrew J Crannage
Nationally, the prescription of opioids for acute and chronic pain is increasing. As opioid use continues to expand and become of increased concern for health-care practitioners, so do the adverse effects and long-term management of those effects. Opioid-induced constipation (OIC) presents a unique challenge because tolerance does not develop to this particular adverse effect, making chronic pain management a delicate balance between relieving pain and preventing long-term adverse effects such as constipation and dependence...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29206984/rational-urine-drug-monitoring-in-patients-receiving-opioids-for-chronic-pain-consensus-recommendations
#12
Charles E Argoff, Daniel P Alford, Jeffrey Fudin, Jeremy A Adler, Matthew J Bair, Richard C Dart, Roy Gandolfi, Bill H McCarberg, Steven P Stanos, Jeffrey A Gudin, Rosemary C Polomano, Lynn R Webster
Objective: To develop consensus recommendations on urine drug monitoring (UDM) in patients with chronic pain who are prescribed opioids. Methods: An interdisciplinary group of clinicians with expertise in pain, substance use disorders, and primary care conducted virtual meetings to review relevant literature and existing guidelines and share their clinical experience in UDM before reaching consensus recommendations. Results: Definitive (e...
December 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#13
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29204977/managing-concerning-behaviors-in-patients-prescribed-opioids-for-chronic-pain-a-delphi-study
#14
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
BACKGROUND: Current guideline-recommended monitoring of patients prescribed long-term opioid therapy (LTOT) for chronic pain will likely result in increased identification of behaviors of concern for misuse and addiction, but there is a dearth of empiric evidence about how these behaviors should be managed. OBJECTIVE: To establish expert consensus about treatment approaches for common and challenging concerning behaviors that arise among patients on LTOT. DESIGN: We used a Delphi approach, which allows for generation of consensus...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29204843/incidence-and-risk-factors-for-hepatitis-c-virus-infection-among-illicit-drug-users-in-italy
#15
Enea Spada, Giovanni Rezza, Anna Rosa Garbuglia, Flavia Lucia Lombardo, Ornella Zuccaro, Francesca Menniti Ippolito, Elisabetta Cupellaro, Stefania Capone, Maria Rosaria Capobianchi, Alfredo Nicosia, Riccardo Cortese, Antonella Folgori, Alfonso Mele
So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007-2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis...
December 4, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/29203521/persistent-opioid-use-among-pediatric-patients-after-surgery
#16
Calista M Harbaugh, Jay S Lee, Hsou Mei Hu, Sean Esteban McCabe, Terri Voepel-Lewis, Michael J Englesbe, Chad M Brummett, Jennifer F Waljee
BACKGROUND: Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refills among adolescents and young adults who received prescription opioids after surgery compared with nonsurgical patients. METHODS: We performed a retrospective cohort study by using commercial claims from the Truven Health Marketscan research databases from January 1, 2010, to December 31, 2014...
December 4, 2017: Pediatrics
https://www.readbyqxmd.com/read/29201359/rationale-for-and-approach-to-preoperative-opioid-weaning-a-preoperative-optimization-protocol
#17
REVIEW
Heath McAnally
The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29199542/medication-use-among-pediatric-patients-with-chronic-musculoskeletal-pain-syndromes-at-initial-pain-clinic-evaluation
#18
Jessica W Guite, David D Sherry, Esther W Jarvis, Margaret O Lewen, Sarosh Khan, Francis Wickham Kraemer
AIM: To characterize medication use by adolescents with chronic musculoskeletal pain syndromes before an initial multidisciplinary clinic visit. PATIENTS & METHODS: A cross-sectional sample of 120 adolescents and parents reported on standardized assessment measures, with medication use data extracted from the medical chart and categorized. RESULTS: On average, 3.2 medications were reported; 70% used more than one pain-specific medication including opioids (17%), nonopioids (31%), psychotropics/neuropathics (45%) and other medications (13%)...
December 4, 2017: Pain Management
https://www.readbyqxmd.com/read/29199396/educational-intervention-for-physicians-to-address-the-risk-of-opioid-abuse
#19
Margaret K Pasquale, Richard L Sheer, Jack Mardekian, Elizabeth T Masters, Nick C Patel, Amy R Hurwitch, Jennifer J Weber, Anamaria Jorga, Carl L Roland
OBJECTIVE: To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse. SETTING, DESIGN AND PATIENTS, PARTICIPANTS: Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199395/projecting-the-cost-utilization-and-patient-care-impact-of-prescribing-extended-release-non-abuse-deterrent-opioids-to-chronic-pain-patients
#20
Mihran Ara Yenikomshian, Alan G White, Michael E Carson, Louis P Garrison, Gary M Oderda, Joseph E Biskupiak, Patrick R Hlavacek, Carl L Roland
OBJECTIVES: To estimate healthcare resource utilization, associated costs, and number needed to harm (NNH) from a physician's decision to prescribe extended-release (ER) non-abuse-deterrent opioids (non-ADO) as compared to ER ADOs in a chronic pain population. DESIGN: A 12-month probabilistic simulation model was developed to estimate the reduction of misuse and/or abuse from a physician's prescribing decisions for 10,000 patients. Model inputs included probabilities for opioid misuse and/or abuse-related events, opioid discontinuation, and switching from ADO to non-ADO...
September 2017: Journal of Opioid Management
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