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https://www.readbyqxmd.com/read/28723795/comparison-of-postoperative-pain-between-laparoscopic-and-robot-assisted-partial-nephrectomies-for-renal-tumors-a-propensity-score-matching-analysis
#1
Seok-Joon Jin, Jun-Young Park, Doo-Hwan Kim, Syn-Hae Yoon, Eunkyul Kim, Jai-Hyun Hwang, Cheryn Song, Young-Kug Kim
Robot-assisted partial nephrectomy (RAPN) has emerged as an alternative to laparoscopic partial nephrectomy (LPN) for removal of renal tumors. Several advantages of robotic surgery have been reported, but there is no comparative study on postoperative pain between the 2 techniques. Therefore, we compared the postoperative numerical rating scale (NRS) of pain intensity between patients who underwent LPN and those who underwent RAPN.We included 705 patients who underwent either LPN (n = 200) or RAPN (n = 505) for renal tumors between January 2000 and September 2016...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723731/the-combined-effect-of-cyp2b6-genotype-and-other-candidate-genes-on-a-steady-state-serum-concentration-of-methadone-in-opioid-maintenance-treatment
#2
Marianne K Kringen, Fatemeh Chalabianloo, Jean-Paul Bernard, Jørgen G Bramness, Espen Molden, Gudrun Høiseth
BACKGROUND: A considerable inter-individual variability in methadone pharmacokinetics is seen in patients on methadone maintenance treatment. The aim of this study was to clarify the impact of the reduced function CYP2B6*6 variant allele together with variants in other candidate genes on a steady-state methadone concentration in a naturalistic setting. METHODS: Information of methadone serum concentration, dose, age, gender and CYP2C9, CYP2C19, and CYP2D6 genotypes were collected from a routine therapeutic drug monitoring (TDM) database while variant alleles in CYP2B6 and CYP3A5 were retrospectively genotyped...
July 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28723312/alcohol-marijuana-and-opioid-use-disorders-5-year-patterns-and-characteristics-of-emergency-department-encounters
#3
Amber L Bahorik, Derek D Satre, Andrea H Kline-Simon, Constance M Weisner, Kelly C Young-Wolff, Cynthia I Campbell
BACKGROUND: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorder in an integrated health system. METHODS: In a retrospective design, electronic health record (EHR) data identified patients with ≥ 1 of three common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574)...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#4
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723266/age-of-initiation-psychopathology-and-other-substance-use-are-associated-with-time-to-use-disorder-diagnosis-in-persons-using-opioids-nonmedically
#5
Ty S Schepis, Jahn K Hakes
BACKGROUND: Nonmedical use of prescription opioids (NMUPO) is an ongoing public health challenge, as NMUPO is associated with psychopathology, other drug use and fatal overdose. These concomitant risks are greatest in those with opioid use disorder (OUD), but the development of NMUPO-related use disorder is poorly understood. The primary aim of this study was to establish factors associated with the development of and time to OUD among persons engaged in NMUPO. METHODS: Data were from Wave 1 of the National Epidemiologic Study on Alcohol and Related Conditions, with 1,755 participants endorsing lifetime NMUPO...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723265/a-text-mining-analysis-of-the-public-s-reactions-to-the-opioid-crisis
#6
Elizabeth M Glowacki, Joseph B Glowacki, Gary B Wilcox
BACKGROUND: Opioid abuse has become an epidemic in the United States. On August 25, 2016, the former Surgeon General of the United States sent an open letter to care providers asking for their help with combatting this growing health crisis. Social media forums like Twitter allow for open discussions among the public and up-to-date exchanges of information about timely topics like opioids. Therefore, the goal of the current study is to identify the public's reactions to the opioid epidemic by identifying the most popular topics tweeted by users...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723256/quantitative-testing-of-buprenorphine-and-norbuprenorphine-to-identify-urine-sample-spiking-during-office-based-opioid-treatment
#7
Joji Suzuki, Jennifer Zinser, Mohammed Issa, Claudia Rodriguez
BACKGROUND: Patients may spike urine samples with buprenorphine during office-based opioid treatment to simulate adherence to prescribed buprenorphine, potentially to conceal diversion of medications. However, routine immunoassay screens do not detect instances of spiking, as these would simply result in a positive result. We report on our clinic's experience using quantitative urine testing for buprenorphine and norbuprenorphine to facilitate the identification of urine spiking. METHODS: This is a retrospective chart review of 168 consecutive patients enrolled in outpatient buprenorphine treatment at an urban academic medical setting between May 2013 and August 2014...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723253/end-of-life-services-among-patients-with-cancer-evidence-from-cancer-registry-records-linked-with-commercial-health-insurance-claims
#8
Cara L McDermott, Catherine Fedorenko, Karma Kreizenbeck, Qin Sun, Bruce Smith, J Randall Curtis, Ted Conklin, Scott D Ramsey
PURPOSE: Despite guidelines emphasizing symptom management over aggressive treatment, end-of-life care for persons with cancer in the United States is highly variable. In consultation with a regional collaboration of patients, providers, and payers, we investigated indicators of high-quality end-of-life care to describe patterns of care, identify areas for improvement, and inform future interventions to enhance end-of-life care for patients with cancer. METHODS: We linked insurance claims to clinical information from the western Washington SEER database...
July 19, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28723248/reducing-opioid-misuse-among-adolescents-through-physician-education
#9
Nonie S Arora, Kayla M Marcotte, John A Hopper
Increased prescribing of opioids has been associated with an epidemic of nonmedical prescription opioid use in the United States; adolescents and young adults are particularly vulnerable to opioid misuse. The role of physicians as healthcare providers, educators, and confidants for their adolescent patients equips them to intervene in adolescent opioid misuse. We advocate for improving the education of physicians and residents regarding opioid use and misuse among adolescents. To achieve this, we can require residency education that includes opioid misuse and appropriate prescribing, widely disseminate existing resources on management of pain and opioid misuse, and develop pain management and addiction mentorship programs...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28722815/influence-of-morphine-and-naloxone-on-pain-modulation-in-rheumatoid-arthritis-chronic-fatigue-syndrome-fibromyalgia-and-controls-a-double-blind-randomized-placebo-controlled-cross-over-study
#10
Linda Hermans, Jo Nijs, Patrick Calders, Luc De Clerck, Greta Moorkens, Guy Hans, Sofie Grosemans, Tine Roman De Mettelinge, Joanna Tuynman, Mira Meeus
BACKGROUND: Impaired pain inhibitory and enhanced pain facilitatory mechanisms are repeatedly reported in patients with central sensitization pain. However, the exact effects of frequently prescribed opioids on central pain modulation are still unknown. METHODS: A randomized, double-blind, placebo-controlled cross-over trial was carried out. Ten CFS/FM patients, 11 RA patients and 20 controls were randomly allocated to the experimental (10 mg morphine or 0.2 mg/ml Naloxone) and placebo (2 ml Aqua) group...
July 19, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28722336/evidence-for-the-modulation-of-nociception-in-mice-by-central-mast-cells
#11
C L Kissel, K J Kovács, A A Larson
BACKGROUND: Hyperalgesia that develops following nerve ligation corresponds temporally and in magnitude with the number of thalamic mast cells located contralateral to the ligature. We tested the possibility that mast cells modulate nociception centrally, similar to their role in the periphery. METHODS: We examined the central effect of two hyperalgesic compounds that induce mast cell degranulation and of stabilized mast cells using cromolyn. RESULTS: Thermal hyperalgesia (tail flick) induced by nerve growth factor (NGF, a neurotrophic compound) and mechanical hyperalgesia (von Frey) induced by dynorphin A (1-17) (opioid compound) each correlated with the per cent of thalamic mast cells that were degranulated...
July 19, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28722211/using-prescription-monitoring-program-data-to-characterize-out-of-pocket-payments-for-opioid-prescriptions-in-a-state-medicaid-program
#12
Daniel M Hartung, Sharia M Ahmed, Luke Middleton, Joshua Van Otterloo, Kun Zhang, Shellie Keast, Hyunjee Kim, Kirbee Johnston, Richard A Deyo
BACKGROUND: Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. OBJECTIVE: To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program...
July 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#13
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28722022/opioid-release-after-high-intensity-interval-training-in-healthy-human-subjects
#14
Tiina Saanijoki, Lauri Tuominen, Jetro J Tuulari, Lauri Nummenmaa, Eveliina Arponen, Kari Kalliokoski, Jussi Hirvonen
Central opioidergic mechanisms may modulate the positive effects of physical exercise such as mood elevation and stress reduction. How exercise intensity and concomitant affective changes affect central opioidergic responses is unknown. We studied the effects of acute physical exercise on the cerebral μ-opioid receptors (MOR) of 22 healthy recreationally active males using positron emission tomography (PET) and the MOR-selective radioligand [(11)C]carfentanil. MOR binding was measured in three conditions on separate days: after a 60-min aerobic moderate-intensity exercise session, after a high-intensity interval training (HIIT) session, and after rest...
July 19, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28721822/opioid-antagonists-for-pharmacological-treatment-of-gambling-disorder-are-they-relevant
#15
Caroline Victorri-Vigneau, Andrew Spiers, Pascal Caillet, Mélanie Bruneau, Gaëlle Challet-Bouju, Marie Grall-Bronnec
Background To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective This study aims to evaluate the relevance of opioid antagonists for treating GD. Method A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed...
July 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#16
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28721344/exploring-patient-characteristics-and-barriers-to-hepatitis-c-treatment-in-patients-on-opioid-substitution-treatment-attending-a-community-based-fibro-scanning-clinic
#17
Des Crowley, Walter Cullen, Eamon Laird, John S Lambert, Tina Mc Hugh, Carol Murphy, Marie Claire Van Hout
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is a major public health issue. There is substandard uptake in HCV assessment and treatment among people who inject drugs (PWID). Community fibroscanning is used to assess disease severity and target treatment. METHODS: A survey was administered to a cohort of chronically HCV infected patients attending a community fibroscanning clinic. Questions targeted diagnosis of HCV, suitability, willingness and barriers to engagement in treatment...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28721091/comparison-of-single-injection-ultrasound-guided-approach-versus-multilevel-landmark-based-approach-for-thoracic-paravertebral-blockade-for-breast-tumor-resection-a-retrospective-analysis-at-a-tertiary-care-teaching-institution
#18
Jagroop Singh Saran, Amie L Hoefnagel, Kristin A Skinner, Changyong Feng, Daryl Irving Smith
BACKGROUND: The role of thoracic paravertebral blockade (TPVB) in decreasing opioid requirements in breast cancer surgery is well documented, and there is mounting evidence that this may improve survival and reduce the rate of malignancy recurrence following cancer-related mastectomy. We compared the two techniques currently in use at our institution, the anatomic landmark-guided (ALG) multilevel versus an ultrasound-guided (USG) single injection, to determine an optimal technique. METHODS: We retrospectively reviewed records of patients who received TPVB from January 2013 to December 2014...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28721089/combination-treatment-of-neuropathic-pain-danish-expert-recommendations-based-on-a-delphi-process
#19
EDITORIAL
Jakob Vormstrup Holbech, Anne Jung, Torsten Jonsson, Mette Wanning, Claus Bredahl, Flemming W Bach
BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combination therapy had not been included in guidelines until recently. Based on clinical empiricism and scientific evidence, a Delphi consensus process provided a consolidated guidance on pharmacological combination treatment of NeP...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28720623/prescription-opioid-use-among-adults-with-mental-health-disorders-in-the-united-states
#20
Matthew A Davis, Lewei A Lin, Haiyin Liu, Brian D Sites
BACKGROUND: The extent to which adults with mental health disorders in the United States receive opioids has not been adequately reported. METHODS: We performed a cross-sectional study of a nationally representative sample of the noninstitutionalized U.S. adult population from the Medical Expenditure Panel Survey. We examined the relationship between mental health (mood and anxiety) disorders and prescription opioid use (defined as receiving at least 2 prescriptions in a calendar year)...
July 2017: Journal of the American Board of Family Medicine: JABFM
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