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Pain Management Ethics

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https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#1
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#2
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29764889/autologous-stem-cells-in-achilles-tendinopathy-ascat-protocol-for-a-phase-iia-single-centre-proof-of-concept-study
#3
Andrew J Goldberg, Razi Zaidi, Deirdre Brooking, Louise Kim, Michelle Korda, Lorenzo Masci, Ruth Green, Paul O'Donnell, Roger Smith
INTRODUCTION: Achilles tendinopathy (AT) is a cause of pain and disability affecting both athletes and sedentary individuals. More than 150 000 people in the UK every year suffer from AT.While there is much preclinical work on the use of stem cells in tendon pathology, there is a scarcity of clinical data looking at the use of mesenchymal stem cells to treat tendon disease and there does not appear to be any studies of the use of autologous cultured mesenchymal stem cells (MSCs) for AT...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29764876/integrated-versus-non-integrated-peripheral-intravenous-catheter-which-is-the-most-effective-system-for-peripheral-intravenous-catheter-management-the-optimum-study-a-randomised-controlled-trial-protocol
#4
Maria Isabel Castillo, Emily Larsen, Marie Cooke, Nicole M Marsh, Marianne C Wallis, Julie Finucane, Peter Brown, Gabor Mihala, Peter J Carr, Joshua Byrnes, Rachel Walker, Prudence Cable, Li Zhang, Candi Sear, Gavin Jackson, Anna Rowsome, Alison Ryan, Julie C Humphries, Susan Sivyer, Kathy Flanigan, Claire M Rickard
INTRODUCTION: Peripheral intravenous catheters (PIVCs) are frequently used in hospitals. However, PIVC complications are common, with failures leading to treatment delays, additional procedures, patient pain and discomfort, increased clinician workload and substantially increased healthcare costs. Recent evidence suggests integrated PIVC systems may be more effective than traditional non-integrated PIVC systems in reducing phlebitis, infiltration and costs and increasing functional dwell time...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29735869/effects-of-a-cyclic-nsaid-regimen-on-levels-of-gingival-crevicular-fluid-prostaglandin-e-2-and-interleukin-1%C3%AE-a-6-month-randomized-controlled-clinical-trial
#5
B F Oduncuoglu, N A Kayar, S Haliloglu, B Serpek, T Ataoglu, N O Alptekin
Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E2 (PGE2 ) and interleukin-1β (IL-1β) in the gingival crevicular fluid (GCF) of individuals with periodontitis...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29730631/effectiveness-of-extrinsic-feedback-for-management-of-non-specific-low-back-pain-a-systematic-review-protocol
#6
Daniel Cury Ribeiro, Aleksandra Katarzyna Mącznik, Stephan Milosavljevic, J Haxby Abbott
INTRODUCTION: Low back pain is the greatest cause of years lived with disability worldwide and is linked with high societal and economic burden. Neuromuscular control impairments are a common clinical presentation in patients with non-specific low back pain. Musculoskeletal physiotherapists commonly use feedback as a part of the management of low back disorders. This systematic review will aim to assess the effectiveness of extrinsic biofeedback for reducing pain, disability and recurrence of pain in patients with non-specific low back pain...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29702268/vascular-entrapment-of-both-the-sciatic-and-pudendal-nerve-causing-persistent-sciatica-and-pudendal-neuralgia
#7
Ahmet Kale, Gulfem Basol, Taner Usta, Isa Cam
STUDY OBJECTIVE: To demonstrate the laparoscopic approach to malformed branches of the vessels entrapping the nerves of the sacral plexus. DESIGN: A step-by-step explanation of the surgery using video (instructive video). The Ethics Committee ruled that approval was not required for this video. SETTING: Derince Education and Research Hospital, Turkey PATIENT: : The 26-year-old patient who had failed the medical therapy, complained about numbness and burning pain on the right side of the vagina and pain radiating to the lower limb for approximately 36 months period...
April 24, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#8
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29664210/differential-clinical-presentation-of-adamantiades-beh%C3%A3-et-s-disease-in-non-endemic-and-endemic-areas-retrospective-data-from-a-middle-european-cohort-study
#9
Thomas Moosmann, Cécilia Veraar, Jürgen Brunner, Gustav Fraedrich, Andreas Frech, Wolfgang Horninger, Gudrun Ratzinger, Werner Streif, Barbara Teuchner, Johann Willeit, Manuela Zlamy, Tobias De Zordo, Michael Schirmer
OBJECTIVES: To assess demographical and clinical data in a Middle-European cohort of patients with Adamantiades-Behçet's disease (ABD), together with the use of medication in adherence to international guidelines. METHODS: In a retrospective cohort study, in- and outpatients of an Austrian secondary and tertiary university hospital center were analyzed independent from the medical discipline involved. After ethics approval, screening for ABD-patients in the clinical information system resulted in 1821 documents from 1997 to 2016...
April 17, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29623160/geriatric-basics-for-the-neurohospitalist
#10
REVIEW
Josef G Heckmann, Jörg Kraus, Christoph J G Lang
Due to the increasing age of the population, neurohospitalists are more frequently caring for old and very old people. Fundamental definitions and topics related to geriatric medicine are therefore of particular importance. In this review, common issues encountered in geriatric patients hospitalized on the neurology service are discussed. Focus is put on the geriatric assessment, multiprofessional diagnostic and therapeutic procedures, geriatric syndromes, pharmacotherapy of the aged, delirium, pain, and palliative management as they are relevant for the neurohospitalist...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29594190/complex-pulmonary-aspergilloma-surgical-challenges-in-a-third-world-setting
#11
Bernadette Ngo Nonga, Guy Aristide Bang, Bonaventure Jemea, Eric Savom, Perfura Yone, Ngahane Mbatchou, Jean Jacques Ze
Background: Surgery for pulmonary aspergilloma (PA), especially complex forms, is greatly challenging in a resource-poor setting such as Cameroon. We report our experience of surgical management of PA in this environment. Method: We prospectively assessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of Yaoundé. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and outcomes...
2018: Surgery Research and Practice
https://www.readbyqxmd.com/read/29574547/hip-capsular-thickness-correlates-with-range-of-motion-limitations-in-femoroacetabular-impingement
#12
Kailai Zhang, Darren de Sa, Hang Yu, Hema Nalini Choudur, Nicole Simunovic, Olufemi Rolland Ayeni
PURPOSE: Femoroacetabular impingement (FAI) is a clinical entity of the hip causing derangements in range of motion, pain, gait, and function. Computer-assisted modeling and clinical studies suggest that patients with FAI have increased capsular thickness compared to those without.A retrospective chart review was performed to assess relationships between capsular thickness, hip range of motion, and demographic factors in patients with FAI. METHODS: Local Research Ethics Board approval was obtained to extract electronic medical records for 188 patients at a single institution who had undergone hip arthroscopy...
March 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29567843/a-novel-inpatient-complex-pain-team-protocol-for-a-mixed-methods-evaluation-of-a-single-centre-pilot-study
#13
Luke Mordecai, Cecilia Vindrola-Padros, Victoria J Wood, Nicholas Swart, Stephen Morris, Amanda Williams, Natasha Curran, Ramani Moonesinghe
INTRODUCTION: Complex pain is a debilitating condition that is responsible for low quality of life and significant economic impacts. Although best practice in the treatment of complex pain employs a multidisciplinary team, many patients do not have access to this care, leading to poor outcomes. METHODS AND ANALYSIS: This study evaluates a novel inpatient complex pain team at a large London teaching hospital. A multidisciplinary pain team comprising specialist doctors, nurses, psychologists and physiotherapists was instituted for inpatients with complex pain who will undergo an intense and bespoke evidence-based programme which will then be integrated into the community...
March 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29557296/-it-s-not-much-of-a-life-the-benefits-and-ethics-of-using-life-history-methods-with-people-who-inject-drugs-in-qualitative-harm-reduction-research
#14
Magdalena Harris, Tim Rhodes
A life history approach enables study of how risk or health protection is shaped by critical transitions and turning points in a life trajectory and in the context of social environment and time. We employed visual and narrative life history methods with people who inject drugs to explore how hepatitis C protection was enabled and maintained over the life course. We overview our methodological approach, with a focus on the ethics in practice of using life history timelines and life-grids with 37 participants...
June 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29538203/acupuncture-for-the-treatment-of-trigeminal-neuralgia-a-protocol-for-the-systematic-review-of-randomized-controlled-trials
#15
REVIEW
Jong-In Kim, Hee-Jung Kim, Jung Ju Lee, Ji Hee Jun, Tae-Young Choi, Myeong Soo Lee
BACKGROUND: The ability of acupuncture to successfully control pain has been reported in the past. However, currently no systematic reviews exist regarding the effect of acupuncture on trigeminal neuralgia (TN). This proposed review aims to evaluate the current evidence on the efficacy of acupuncture for the management of pain in TN. METHODS: A total of 11 databases were searched from their inception. These include MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese Medical Database...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29460263/methadone-as-anticancer-treatment-hype-hope-or-hazard-a-series-of-case-reports-and-a-short-review-of-the-current-literature-and-recommendations-of-the-societies
#16
Gudrun Kreye, Eva-Katharina Masel, Klaus Hackner, Beate Stich, Friedemann Nauck
Recently, the use of methadone in cancer patients has increased due to in vitro studies indicating that methadone is capable of inducing cell death. However, thus far there are no relevant clinical studies indicating that the use of methadone can prolong survival in cancer patients. Based on low-quality evidence, methadone is a drug that has similar analgesic benefits to morphine and has a role in the management of cancer pain in adults. Other opioids such as morphine, hydromorphone, and fentanyl are easier to manage but may be more expensive than methadone in many economies...
February 19, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29458312/reflections-on-researcher-departure-closure-of-prison-relationships-in-ethnographic-research
#17
Laura Abbott, Tricia Scott
BACKGROUND: The United Kingdom has the highest incarceration rate in Western Europe. It is known that women in prison are a vulnerable female population who are at risk of mental ill-health due to disadvantaged and chaotic life experiences. Accurate numbers of pregnant women held in UK prisons are not recorded, yet it is estimated that 6%-7% of the female prison population are at varying stages of pregnancy and around 100 babies are born to incarcerated women each year. There are limited published papers that document the departure of the researcher following closure of fieldwork with women in prison...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29458257/recruiting-and-retaining-patient-caregiver-nurse-triads-for-qualitative-hospice-cancer-pain-research
#18
Olga Ehrlich, Rachel K Walker
BACKGROUND: Qualitative pain research for hospice patients with cancer and their caregivers involves recruiting and retaining participants with multiple vulnerabilities and ethical and logistical challenges. These have been reported for studies of individuals or dyads. However, there are no reports of the related challenges and outcomes where the sampled population was a hospice triad. OBJECTIVES: Qualitative research about pain management for home hospice patients with cancer contributes rich descriptive data and such studies are critical to improving cancer pain outcomes...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29436358/ethical-implications-of-rapid-whole-genome-sequencing-in-neonates
#19
Susan Givens Bell
Using rapid whole-genome sequencing (WGS), an infant's genome can now be sequenced in as little as 26 hours allowing for rapid diagnosis and precise, individualized management of monogenetic causes of disease. The potential for decreasing cost and valuable time to diagnosis along with pain and suffering is becoming a reality in the NICU. Coupled with rapidly developing technology is a need to explore the associated ethical implication.
January 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29423824/attitudes-of-irish-patients-with-chronic-pain-towards-medicinal-cannabis
#20
Ciaran Rochford, Deirdre Edgeworth, Mohammad Hashim, Dominic Harmon
BACKGROUND: Medicinal cannabis use is topical in the media in Ireland. A recent Health Products Regulatory Authority review, however, has recommended against its use for patients with chronic pain. This is despite evidence for its effectiveness in this patient's cohort and the inadequate pain management of these patients. AIM: The aim of this study was to evaluate the attitudes of Irish patients with chronic pain towards medicinal cannabis. METHODS: After institutional ethics committee approval, a 12-item questionnaire (excluding demographics) was randomly assigned to patients attending a chronic pain clinic (University Hospital Limerick)...
February 8, 2018: Irish Journal of Medical Science
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