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https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#1
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29668655/efficacy-and-safety-of-methylnaltrexone-for-opioid-induced-constipation-in-patients-with-chronic-noncancer-pain-a-placebo-crossover-analysis-erratum
#2
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29659913/a-randomized-double-blind-non-inferiority-study-of-hydromorphone-hydrochloride-immediate-release-tablets-versus-oxycodone-hydrochloride-immediate-release-powder-for-cancer-pain-efficacy-and-safety-in-japanese-cancer-patients
#3
Satoshi Inoue, Yoji Saito, Satoru Tsuneto, Etsuko Aruga, Hiroshi Takahashi, Mitsutoshi Uemori
Background: Hydromorphone is a standard opioid analgesic for cancer pain that, prior to this study, was not approved in Japan, where options for opioid switching are limited. We aimed to investigate the efficacy and safety of hydromorphone (DS-7113b) immediate-release tablets in opioid-naïve cancer patients with moderate to severe cancer pain. Methods: Multicenter, active-controlled, randomized, double-blind, parallel-group, non-inferiority study of 183 cancer patients over 20 years of age at 50 clinical sites in Japan...
April 12, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29628834/comparison-of-analgesic-efficacy-and-safety-of-continuous-epidural-infusion-versus-local-infiltration-and-systemic-opioids-in-video-assisted-thoracoscopic-surgery-decortication-in-pediatric-empyema-patients
#4
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Introduction: The stripping of the densely innervated and inflamed parietal pleura in empyema during video-assisted thoracoscopic surgery (VATS) decortication can lead to significant pain and major postoperative respiratory compromise. Hence, we compared the analgesic efficacy of continuous epidural infusion versus local infiltration and systemic opioids in children undergoing VATS decortications. Methodology: Following ethics approval and informed consent, forty patients from 1 to 12 years of age were randomized into two groups, Group E (epidural) and Group L (local infiltration) after induction of anesthesia...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29621475/management-of-opioid-induced-constipation-in-patients-with-malignancy
#5
Jose M Garcia, Tatyana A Shamliyan
No abstract text is available yet for this article.
April 2, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29618109/patient-values-and-preferences-regarding-opioids-for-chronic-noncancer-pain-a-systematic-review
#6
Anna Goshua, Samantha Craigie, Gordon H Guyatt, Arnav Agarwal, Regina Li, Justin S Bhullar, Naomi Scott, Jasmine Chahal, Sureka Pavalagantharajah, Yaping Chang, Rachel Couban, Jason W Busse
Objective: Shared-care decision-making between patients and clinicians involves making trade-offs between desirable and undesirable consequences of management strategies. Although patient values and preferences should provide the basis for these trade-offs, few guidelines consider the relevant evidence when formulating recommendations. To inform a guideline for use of opioids in patients with chronic noncancer pain, we conducted a systematic review of studies exploring values and preferences of affected patients toward opioid therapy...
November 22, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29578946/the-bivalent-ligand-mcc22-potently-attenuates-nociception-in-a-murine-model-of-sickle-cell-disease
#7
Giuseppe Cataldo, Mary M Lunzer, Julie K Olson, Eyup Akgün, John D Belcher, Gregory M Vercellotti, Philip S Portoghese, Donald A Simone
Sickle cell disease (SCD) is a chronic inflammatory disorder accompanied by chronic pain. In addition to ongoing pain and hyperalgesia, vaso-occlusive crises-induced pain can be chronic or episodic. Since analgesics typically used to treat pain are not very effective in SCD, opioids, including morphine, are a primary treatment for managing pain in SCD but are associated with many serious side effects, including constipation, tolerance, addiction, and respiratory depression. Thus, there is a need for the development of novel treatments for pain in SCD...
March 22, 2018: Pain
https://www.readbyqxmd.com/read/29564045/analgesic-efficacy-and-safety-of-prolonged-release-oxycodone-naloxone-in-korean-patients-with-chronic-pain-from-spinal-disorders
#8
Chang Ju Hwang, Sung Soo Chung, Kyu-Yeol Lee, Jae Hyup Lee, Seong-Hwan Moon, Jin-Hyok Kim, Kyu-Jung Cho, Jae-Sung Ahn, Dong-Soo Kim, Ye-Soo Park, Hye-Jeong Park
Background: A prolonged-release formulation of oxycodone/naloxone has been shown to be effective in European populations for the management of chronic moderate to severe pain. However, no clinical data exist for its use in Korean patients. The objective of this study was to assess efficacy and safety of prolonged-release oxycodone/naloxone in Korean patients for management of chronic moderate-to-severe pain. Methods: In this multicenter, single-arm, open-label, phase IV study, Korean adults with moderate-to-severe spinal disorder-related pain that was not satisfactorily controlled with weak opioids and nonsteroidal anti-inflammatory drugs received prolonged-release oral oxycodone/naloxone at a starting dose of 10/5 mg/day (maximum 80/40 mg/day) for 8 weeks...
March 2018: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29561298/pre-operative-chronic-opioid-therapy-a-risk-factor-for-complications-readmission-continued-opioid-use-and-increased-costs-after-one-and-two-level-posterior-lumbar-fusion
#9
Nikhil Jain, Frank M Phillips, Tristan Weaver, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis. OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use. SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery...
March 20, 2018: Spine
https://www.readbyqxmd.com/read/29555103/the-mexican-consensus-on-chronic-constipation
#10
J M Remes-Troche, E Coss-Adame, A Lopéz-Colombo, M Amieva-Balmori, R Carmona Sánchez, L Charúa Guindic, R Flores Rendón, O Gómez Escudero, M González Martínez, M E Icaza Chávez, M Morales Arámbula, M Schmulson, J L Tamayo de la Cuesta, M Á Valdovinos, G Vázquez Elizondo
INTRODUCTION: Significant advances have been made in the knowledge and understanding of the epidemiology, pathophysiology, diagnosis, and treatment of chronic constipation, since the publication of the 2011 guidelines on chronic constipation diagnosis and treatment in Mexico from the Asociación Mexicana de Gastroenterología. AIMS: To present a consensus review of the current state of knowledge about chronic constipation, providing updated information and integrating the new scientific evidence...
March 16, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29551424/mouse-model-demonstrates-strain-differences-in-susceptibility-to-opioid-side-effects
#11
Andrew Young, Archana Viswanath, Mythili Kalladka, Junad Khan, Eli Eliav, Scott R Diehl
Individual differences have been observed in responses to opioid drugs, including common side effects. In this study, the inbred mouse strains A/J and C57BL/6J were used to determine whether their specific strain differences correlate with differences in susceptibility to respiratory depression and constipation. To measure the effects of morphine on respiration, morphine at 15 and 40 mg/kg was injected subcutaneously. Respiratory parameters were then measured 30 and 60 minutes later. To measure the effects on constipation, 5, 15, 40, and 60 mg/kg doses were administered subcutaneously three times daily for three days...
March 15, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29535905/frequency-and-prognostic-impact-of-consistently-low-edmonton-symptom-assessment-system-score-in-the-patients-treated-with-palliative-radiotherapy
#12
Carsten Nieder, Thomas A Kämpe
Introduction Our department's standard work-flow includes assessment of all the patients with the Edmonton Symptom Assessment System (ESAS), a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of zero-10, before the palliative radiotherapy (PRT). Based on previous research, we hypothesized that the patients with minimal or moderate total symptom burden might have better overall survival after the PRT than those with at least one higher symptom score. Methods We performed a retrospective analysis of 94 patients and calculated actuarial survival from the first day of the PRT (Kaplan-Meier method)...
January 6, 2018: Curēus
https://www.readbyqxmd.com/read/29531415/lead-poisoning-outbreak-among-opium-users-in-the-islamic-republic-of-iran-2016-2017
#13
Talat Ghane, Nasim Zamani, Hossein Hassanian-Moghaddam, Ali Beyrami, Alireza Noroozi
Objective: To describe an outbreak of lead poisoning among opium users in the Islamic Republic of Iran and estimate the number of affected people in the country. Methods: We used data from the country's largest poison treatment centre to illustrate the epidemiology of an outbreak of lead poisoning in oral opium users. We describe the government's referral and treatment guidelines in response to the outbreak. Based on the number of individuals treated and previous studies on the prevalence of oral opium use we estimated the total number of people at risk of lead-contaminated opium nationwide...
March 1, 2018: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29529126/a-concise-review-of-opioid-induced-esophageal-dysfunction-is-this-a-new-clinical-entity
#14
V Ortiz, M García-Campos, E Sáez-González, P delPozo, V Garrigues
Opioids have become the most widely prescribed analgesics in Western countries. Opioid-induced bowel dysfunction is a widely known adverse effect, with constipation the most common manifestation. Most of the opioid-related effects occur in the stomach, small intestine, and colon and have been widely studied. However, the effects related to esophageal motility are less known. Recently published retrospective studies have suggested that long-term use of opioids can cause esophageal motility dysfunction, reflecting symptoms similar to motility disorders, such as achalasia and functional esophagogastric junction outflow obstruction...
February 23, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29514362/impact-of-intravenous-acetaminophen-on-lengths-of-stay-and-discharge-status-after-total-knee-arthroplasty
#15
John W Barrington, Ryan N Hansen, Belinda Lovelace, Elaine A Böing, Morad Chughtai, Jared M Newman, An T Pham, Anton Khlopas, Nipun Sodhi, Assem A Sultan, Michael A Mont
Postoperative pain remains difficult to control after total knee arthroplasty (TKA). While various modalities have been used, they have been associated with several side effects. For example, opioids have many side effects including: sedation, dizziness, nausea, vomiting, constipation, respiratory depression, and can lead to dependency. Recently, intravenous (IV) acetaminophen has been introduced as a method to manage postoperative pain. Therefore, the purpose of this study was to compare the postoperative outcomes of TKA patients who received oral acetaminophen versus IV acetaminophen...
March 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29508896/oxycodone-naloxone-in-postoperative-pain-management-of-surgical-patients
#16
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients. METHOD: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29504415/cardiovascular-safety-of-the-selective-%C3%AE-opioid-receptor-antagonist-naloxegol-a-novel-therapy-for-opioid-induced-constipation
#17
William B White, Peter Kowey, Ulysses Diva, Mark Sostek, Raj Tummala
BACKGROUND: Naloxegol is a novel selective, peripherally acting μ-opioid receptor antagonist for treating opioid-induced constipation (OIC) in patients with chronic pain syndromes. We analyzed the cardiovascular (CV) safety of naloxegol based on data from its development program prior to approval by the US Food and Drug Administration in 2015. METHODS: Comprehensive CV safety analyses were performed in 4 clinical studies of naloxegol (12.5 and/or 25 mg) in patients with noncancer pain and OIC: two 12-week, double-blind, randomized studies; a 12-week, double-blind, extension study; and a 52-week, randomized, open-label study versus usual care...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29451835/characteristics-and-outcomes-of-advanced-cancer-patients-who-received-palliative-care-at-a-public-hospital-compared-with-those-at-a-comprehensive-cancer-center
#18
Marvin Omar Delgado-Guay, Jeannette Ferrer, Jewel Ochoa, Hilda Cantu, Janet L Williams, Minjeong Park, Eduardo Bruera
BACKGROUND: Patients with advanced cancer experience severe physical, psychosocial, and spiritual distress requiring palliative care (PC). There are limited literature regarding characteristics and outcomes of patients evaluated by PC services at public hospitals (PHs). Objective, Design, Setting/Subjects, and Measurements: To compare the outcomes of advanced cancer patients undergoing PC at a PH and those at a comprehensive cancer center (CCC). We reviewed 359 consecutive advanced cancer patients (PH, 180; CCC, 179) undergoing PC...
February 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29440818/ultrasound-guided-real-time-pterygopalatine-block-for-analgesia-in-an-oral-cancer-patient
#19
Nishkarsh Gupta, Rohini Dattatri, Sachidanand Jee Bharati, Sushma Bhatnagar
Oral cancers are one of the most common cancers in India. These patients have pain during the course of the disease. Various drugs including opioid and nonsteroidal anti-inflammatory drug have been used to manage pain. However, these are associated with side effects such as constipation and vomiting. An early interventional block may decrease the requirement for analgesics and improve the overall quality of life. We describe a case of oral carcinoma successfully managed with ultrasound-guided pterygopalatine block...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#20
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
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