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https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#1
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28097195/rapidly-expanding-infectious-aortic-aneurysm-caused-by-perforated-colon-cancer
#2
Taufiek Konrad Rajab, Daniel E Rinewalt, Michael Belkin, Joel E Goldberg, Haiyang Zhou
A 50-year-old male smoker presented with a perforated colon cancer and underwent an extended right colectomy. Feculent peritonitis was treated with empiric antibiotics. Postoperatively he developed severe back pain and rising leukocytosis. Serial computed tomography revealed a rapidly expanding infrarenal aortic aneurysm. He was urgently treated with extra-anatomic bypasses and aortic resection. No organisms grew from the resected aortic wall. He was discharged in stable condition, and the ileostomy was reversed 9 months later...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28096645/peri-and-post-menopausal-women-with-complex-adnexal-masses-ascites-and-raised-ca-125-is-it-ovarian-cancer-or-tuberculosis
#3
Rashmi Bagga, Tanuja Muthyala, Subhas Chandra Saha, Shalini Gainder, Pradip Kumar Saha, Radhika Srinivasan, Arvind Rajwanshi, Nalini Gupta
Pelvic and peritoneal tuberculosis may resemble advanced ovarian cancer due to the presence of ascites, complex adnexal masses, peritoneal deposits and raised CA-125 level, especially in peri- and postmenopausal women. Other common features among women with these two conditions are abdominal pain and distension, weight loss and reduced appetite. As the treatment of pelvic-peritoneal tuberculosis is completely different from that of ovarian cancer, it is important to reach a correct diagnosis. Sometimes women with pelvic-peritoneal tuberculosis may be subjected to a laparotomy for suspected ovarian cancer which is likely to increase their morbidity...
October 2016: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28095837/enhancing-the-quality-of-life-for-palliative-care-cancer-patients-in-indonesia-through-family-caregivers-a-pilot-study-of-basic-skills-training
#4
Martina Sinta Kristanti, Sri Setiyarini, Christantie Effendy
BACKGROUND: Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia...
January 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28095834/barriers-to-venipuncture-induced-pain-prevention-in-cancer-patients-a-qualitative-study
#5
Marilène Filbet, Philip Larkin, Claire Chabloz, Anne Chirac, Léa Monsarrat, Murielle Ruer, Wadih Rhondali, Cyrille Collin
BACKGROUND: Procedural pain reduces the quality of life of cancer patients. Although there are recommendations for its prevention, there are some obstacles for its management. The purpose of this study was to analyze the barriers to procedural pain prophylaxis in cancer patients reflecting the views of the nurses. METHODS: We used qualitative methodology based on semi-structured interviews conducted with nurses, focusing on practices of venipuncture-induced and needle change for implantable central venous access port (ICVAP) pain management in cancer patients...
January 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28094662/clinical-and-psychological-moderators-of-the-effect-of-mindfulness-based-cognitive-therapy-on-persistent-pain-in-women-treated-for-primary-breast-cancer-explorative-analyses-from-a-randomized-controlled-trial
#6
M Johannsen, M S O'Toole, M O'Connor, A B Jensen, R Zachariae
BACKGROUND: Mindfulness-based intervention has been found efficacious in reducing persistent pain in women treated for breast cancer. Little, however, is known about possible moderators of the effect. We explored clinical and psychological moderators of the effect on pain intensity previously found in a randomized controlled trial of mindfulness-based cognitive therapy (MBCT) with women treated for breast cancer with persistent pain. MATERIAL AND METHODS: A total of 129 women treated for breast cancer reporting persistent pain were randomized to MBCT or a wait-list control...
January 17, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28094198/late-side-effects-and-cosmetic-results-of-accelerated-partial-breast-irradiation-with-interstitial-brachytherapy-versus-whole-breast-irradiation-after-breast-conserving-surgery-for-low-risk-invasive-and-in-situ-carcinoma-of-the-female-breast-5-year-results
#7
Csaba Polgár, Oliver J Ott, Guido Hildebrandt, Daniela Kauer-Dorner, Hellen Knauerhase, Tibor Major, Jaroslaw Lyczek, José Luis Guinot, Jürgen Dunst, Cristina Gutierrez Miguelez, Pavel Slampa, Michael Allgäuer, Kristina Lössl, Bülent Polat, György Kovács, Arnt-René Fischedick, Rainer Fietkau, Alexandra Resch, Anna Kulik, Leo Arribas, Peter Niehoff, Ferran Guedea, Annika Schlamann, Richard Pötter, Christine Gall, Wolfgang Uter, Vratislav Strnad
BACKGROUND: We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. METHODS: We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries...
January 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28094194/mabp1-as-a-novel-antibody-treatment-for-advanced-colorectal-cancer-a-randomised-double-blind-placebo-controlled-phase-3-study
#8
Tamas Hickish, Thierry Andre, Lucjan Wyrwicz, Mark Saunders, Tomasz Sarosiek, Judit Kocsis, Radim Nemecek, Wojciech Rogowski, Krzysztof Lesniewski-Kmak, Lubos Petruzelka, Ron N Apte, Prasant Mohanty, Michael Stecher, John Simard, Aimery de Gramont
BACKGROUND: MABp1, an antibody that targets interleukin 1α, has been associated with antitumour activity and relief of debilitating symptoms in patients with advanced colorectal cancer. We sought to establish the effect of MABp1 with a new primary endpoint in patients with advanced colorectal cancer. METHODS: Eligible patients for the double-blind phase of this ongoing, placebo-controlled, randomised, phase 3 trial, had metastatic or unresectable disease, Eastern Cooperative Oncology Group performance status score 1 or 2, systemic inflammation, weight loss, and other disease-related morbidities associated with poor prognosis, and were refractory to oxaliplatin and irinotecan...
January 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28093034/fear-of-cancer-recurrence-and-unmet-needs-among-breast-cancer-survivors-in-the-first-five-years-a-cross-sectional-study
#9
Mai-Britt Bjørklund Ellegaard, Cai Grau, Robert Zachariae, Anders Bonde Jensen
BACKGROUND: It is unclear to which degree the services available after end of treatment are sufficient to meet the needs of women treated for breast cancer. The aim of the present study was to identify patient-reported supportive care needs and the prevalence of fear of cancer recurrence (FCR) following end of treatment in women treated for breast cancer. MATERIAL AND METHODS: Using a cross-sectional design, women treated for breast cancer (n = 155; mean age 63) completed questionnaires concerning supportive care needs and FCR...
January 17, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28093023/sustained-employability-and-health-related-quality-of-life-in-cancer-survivors-up-to-four-years-after-diagnosis
#10
Saskia F A Duijts, Jacobien M Kieffer, Peter van Muijen, Allard J van der Beek
BACKGROUND: Most cancer survivors are able to return to work at some point after diagnosis. However, literature on sustained employability and health-related quality of life (HRQoL) is limited. Therefore, the aims of this study were to explore the influence of change in employment status on HRQoL in cancer survivors long term after diagnosis, and to identify predictors of work continuation in occupationally active survivors. MATERIAL AND METHODS: We used prospective data (T0 = two years after diagnosis, T1 = one-year follow-up, and T2 = two-year follow-up) from a cohort of cancer survivors that had an employment contract and were of working age at T0 (N = 252, 69...
January 17, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28092646/ex-vivo-nonviral-gene-delivery-of-%C3%AE-opioid-receptor-to-attenuate-cancer-induced-pain
#11
Seiichi Yamano, Chi T Viet, Dongmin Dang, Jisen Dai, Shigeru Hanatani, Tadahiro Takayama, Hironori Kasai, Kentaro Imamura, Ron Campbell, Yi Ye, John C Dolan, William Myung Kwon, Stefan D Schneider, Brian L Schmidt
Virus-mediated gene delivery shows promise for the treatment of chronic pain. However, viral vectors have cytotoxicity. To avoid toxicities and limitations of virus-mediated gene delivery, we developed a novel nonviral hybrid vector: HIV-1 Tat peptide sequence modified with histidine and cysteine residues combined with a cationic lipid. The vector has high transfection efficiency with little cytotoxicity in cancer cell lines including HSC-3 (human tongue squamous cell carcinoma) and exhibits differential expression in HSC-3 (∼45-fold) relative to HGF-1 (human gingival fibroblasts) cells...
February 2017: Pain
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#12
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092324/long-term-use-of-opioids-for-nonmalignant-pain-among-community-dwelling-persons-with-and-without-alzheimer-disease-in-finland-a-nationwide-register-based-study
#13
Aleksi Hamina, Heidi Taipale, Antti Tanskanen, Anna-Maija Tolppanen, Niina Karttunen, Liisa Pylkkänen, Jari Tiihonen, Sirpa Hartikainen
Persons with Alzheimer disease (AD) commonly present with chronic nonmalignant pain, but long-term use of opioids among this population has not been studied previously. Our aim was to investigate the prevalence of long-term (≥180 days) use of opioids for nonmalignant pain and associated factors among community-dwelling persons with AD and to compare the prevalence with a matched cohort without AD. The Medication use and Alzheimer's disease (MEDALZ) cohort was used for this study, comprising all community-dwelling persons diagnosed with AD in Finland during 2005 to 2011 and their matched comparison persons without AD...
February 2017: Pain
https://www.readbyqxmd.com/read/28092065/impact-of-celecoxib-on-inflammation-during-cancer-surgery-a-randomized-clinical-trial
#14
Jonathan G Hiller, Shienny Sampurno, Rosemary Millen, Niketh Kuruvilla, Kwok M Ho, Rob Ramsay, Bernhard Riedel
PURPOSE: During cancer surgery, prostaglandin-mediated inflammation may promote and activate micrometastatic disease with a consequent increase in long-term cancer recurrence. Cyclooxygenase-2 inhibitors, known to have anti-proliferative properties, may offset such perioperative perturbation. We investigated the effectiveness of these agents to minimize inflammatory changes during cancer surgery. METHODS: Following ethics approval, 32 patients who were to undergo major intracavity cancer surgery were enrolled in this prospective, randomized, clinical trial...
January 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#15
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#16
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28088799/use-of-spinal-cord-diffusion-tensor-imaging-to-quantify-neural-ablation-and-evaluate-outcome-after-percutaneous-cordotomy-for-intractable-cancer-pain
#17
Aditya Vedantam, Ping Hou, T Linda Chi, Patrick M Dougherty, Kenneth R Hess, Ashwin Viswanathan
BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain. OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy. METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088576/lid-domain-plasticity-and-lipid-flexibility-modulate-enzyme-specificity-in-human-monoacylglycerol-lipase
#18
Laura Riccardi, Jose M Arencibia, Luca Bono, Andrea Armirotti, Stefania Girotto, Marco De Vivo
Human monoacylglycerol lipase (MAGL) is a membrane-interacting enzyme that generates pro-inflammatory signaling molecules. For this reason, MAGL inhibition is a promising strategy to treat pain, cancer, and neuroinflammatory diseases. MAGL can hydrolyze monoacylglycerols bearing an acyl chain of different lengths and degrees of unsaturation, cleaving primarily the endocannabinoid 2-arachidonoylglycerol. Importantly, the enzymatic binding site of MAGL is confined by a 75-amino-acid-long, flexible cap domain, named 'lid domain', which is structurally similar to that found in several other lipases...
January 11, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28088217/surgical-treatment-of-upper-cervical-spine-metastases-a-retrospective-study-of-39-cases
#19
Jian Yang, Qi Jia, Dongyu Peng, Wei Wan, Nanzhe Zhong, Yan Lou, Xiaopan Cai, Zhipeng Wu, Chenglong Zhao, Xinghai Yang, Jianru Xiao
BACKGROUND: The surgical treatment of upper cervical spine metastases are controversial up to now. By summarizing and analyzing the clinical data of the upper cervical spine involved metastases treated surgically in our center, we mainly aimed to investigate the surgical decisions and outcomes so as to provide more references for the clinical treatment of this special and complex spine metastasis. METHODS: We evaluated the patients' pre- and post-operative neck pain and neurologic function with paired t test, followed by the statistics of the selection of surgical approaches, ways of reconstruction, and related complications...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28088201/anti-allodynic-effect-of-buja-in-a-rat-model-of-oxaliplatin-induced-peripheral-neuropathy-via-spinal-astrocytes-and-pro-inflammatory-cytokines-suppression
#20
Yongjae Jung, Ji Hwan Lee, Woojin Kim, Sang Hyub Yoon, Sun Kwang Kim
BACKGROUND: Oxaliplatin, a widely used anticancer drug against metastatic colorectal cancer, can induce acute peripheral neuropathy, which is characterized by cold and mechanical allodynia. Activation of glial cells (e.g. astrocytes and microglia) and increase of pro-inflammatory cytokines (e.g. IL-1β and TNF-α) in the spinal cord play a crucial role in the pathogenesis of neuropathic pain. Our previous study demonstrated that Gyejigachulbu-Tang (GBT), a herbal complex formula, alleviates oxaliplatin-induced neuropathic pain in rats by suppressing spinal glial activation...
January 14, 2017: BMC Complementary and Alternative Medicine
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