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Pain managment

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https://www.readbyqxmd.com/read/29050458/endoscopic-treatment-of-jejunal-heterotopic-gastric-mucosa-that-caused-recurrent-intussusception
#1
Ke Ryun Ahn, Ja Seol Koo, Hwan Il Kim, Ji Hye Kim, Jee Hyun Lee, Seung Young Kim, Sung Woo Jung, Sang Woo Lee
Heterotopic gastric mucosa (HGM) is a rare anomaly in the small bowel and may be the cause of intussusception when it gets a lead point in the jejunum. All cases of intussusception due to intestinal HGM have been treated with surgical resection. A 5-year-old girl presented with chief complaints of vomiting and abdominal pain for 2 weeks. A computed tomography scan of the abdomen showed intussusception at the proximal jejunal loops. Three air reductions and one saline reduction were attempted without success...
October 18, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29049615/current-trends-in-management-of-submental-liposis-a-pooled-analysis-and-survey
#2
Sagar Patel, Russell Kridel
Importance: Since its approval by the US Food and Drug Administration for treatment of moderate to severe submental liposis in April 2015, deoxycholic acid (Kybella) has received significant media attention as a novel aesthetic treatment. Four phase 3 clinical trials have published data demonstrating the safety and efficacy of the drug compared with placebo; however, no study has juxtaposed the product with submental liposuction. Objective: To evaluate the efficacy of injectable deoxycholic acid in the treatment of isolated submental liposis...
October 19, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29049548/multimodal-analgesia-in-outpatient-head-and-neck-surgery-a-feasibility-and-safety-study
#3
Justin Oltman, Oleg Militsakh, Mark D'Agostino, Brittany Kauffman, Robert Lindau, Andrew Coughlin, William Lydiatt, Daniel Lydiatt, Russell Smith, Aru Panwar
Importance: Perioperative analgesia strategies that rely solely on narcotics may contribute to adverse effects and concerns about opioid abuse or dependence. Multimodal analgesia protocols incorporating nonnarcotic agents may reduce the need for postoperative narcotic use. Objective: To evaluate the feasibility and safety of a multimodal analgesia protocol for outpatient head and neck surgical procedures and to identify the association of the multimodal analgesia protocol with postoperative pain perception scores and patient satisfaction...
October 19, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29049315/analysis-of-the-interests-of-google-users-on-toothache-information
#4
Matheus Lotto, Patricia Estefania Ayala Aguirre, Daniela Rios, Maria Aparecida Andrade Moreira Machado, Agnes Fátima Pereira Cruvinel, Thiago Cruvinel
BACKGROUND: The knowledge on health interests of a given population of Internet users might contribute to the increase of evidence on community's dental needs, and consequently, to the improvement of public health planning. The frequency of searches for specific issues on Google can be analyzed by the application of Google Trends. AIM: In this study, we aimed to characterize the interests on toothache information of Google users from the United States, United Kingdom, Australia and Brazil...
2017: PloS One
https://www.readbyqxmd.com/read/29049229/neck-to-shoulder-pain-as-an-unusual-presentation-of-pulmonary-embolism-in-a-patient-with-cervical-spinal-cord-injury-a-case-report
#5
Dong Gyu Lee, Min Cheol Chang
RATIONALE: Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE). PATIENT CONCERNS: A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049223/myocardial-ct-perfusion-imaging-for-pre-and-postoperative-evaluation-of-myocardial-ischemia-in-a-patient-with-myocardial-bridging-a-case-report
#6
Jae Woong Lim, Heon Lee, Keun Her, Hyun Woo Park, Kyung Eun Shin
RATIONALE: Although myocardial bridging (MB) is usually considered as benign, initial medical therapy and following surgical treatment in drug-refractory cases has been widely accepted for managing symptomatic MB. Before the patient proceeds to percutaneous or surgical intervention, however, the presence of objective ischemia in the corresponding myocardial territory should be documented. PATIENT CONCERN AND INTERVENTION: We herein report a 43-year-old male complaining of chest pain in whom cardiac CT with myocardial perfusion (cCTP) showed an MB of left anterior descending artery (LAD) with preoperative perfusion defect in corresponding myocardium and normalization of perfusion after supra-arterial myotomy...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049122/case-series-of-successful-postoperative-pain-management-in-buprenorphine-maintenance-therapy-patients
#7
Barbara L Leighton, Lara W Crock
Buprenorphine maintenance therapy patients frequently have severe postoperative pain due to buprenorphine-induced hyperalgesia and provider use of opioids with limited efficacy in the presence of buprenorphine. The authors report good-to-excellent pain management in 4 obstetric patients using nonopioid analgesics, regional anesthesia, continuation of buprenorphine, and use of opioids with high μ receptor affinity.
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049121/opioids-for-the-treatment-of-chronic-pain-mistakes-made-lessons-learned-and-future-directions
#8
Jane C Ballantyne
An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause of the "epidemic" of prescription opioid abuse in the United States. Yet, an examination of the statistics that led the US Centers for Disease Control and Prevention to declare that prescription opioid abuse had reached epidemic levels shows that the abuse occurrences and deaths are arising outside the hospital or hospice setting, which strongly implicates the outpatient use of opioids to treat chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#9
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049119/a-review-of-opioid-sparing-modalities-in-perioperative-pain-management-methods-to-decrease-opioid-use-postoperatively
#10
Kanupriya Kumar, Meghan A Kirksey, Silvia Duong, Christopher L Wu
There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049117/chronic-opioid-use-after-surgery-implications-for-perioperative-management-in-the-face-of-the-opioid-epidemic
#11
Jennifer M Hah, Brian T Bateman, John Ratliff, Catherine Curtin, Eric Sun
Physicians, policymakers, and researchers are increasingly focused on finding ways to decrease opioid use and overdose in the United States both of which have sharply increased over the past decade. While many efforts are focused on the management of chronic pain, the use of opioids in surgical patients presents a particularly challenging problem requiring clinicians to balance 2 competing interests: managing acute pain in the immediate postoperative period and minimizing the risks of persistent opioid use after the surgery...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049116/basic-translational-development-of-forthcoming-opioid-and-nonopioid-targeted-pain-therapeutics
#12
Nebojsa Nick Knezevic, Ajay Yekkirala, Tony L Yaksh
Opioids represent an efficacious therapeutic modality for some, but not all pain states. Singular reliance on opioid therapy for pain management has limitations, and abuse potential has deleterious consequences for patient and society. Our understanding of pain biology has yielded insights and opportunities for alternatives to conventional opioid agonists. The aim is to have efficacious therapies, with acceptable side effect profiles and minimal abuse potential, which is to say an absence of reinforcing activity in the absence of a pain state...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#13
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049114/alternatives-to-opioids-in-the-pharmacologic-management-of-chronic-pain-syndromes-a-narrative-review-of-randomized-controlled-and-blinded-clinical-trials
#14
Andrea L Nicol, Robert W Hurley, Honorio T Benzon
Chronic pain exerts a tremendous burden on individuals and societies. If one views chronic pain as a single disease entity, then it is the most common and costly medical condition. At present, medical professionals who treat patients in chronic pain are recommended to provide comprehensive and multidisciplinary treatments, which may include pharmacotherapy. Many providers use nonopioid medications to treat chronic pain; however, for some patients, opioid analgesics are the exclusive treatment of chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#15
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049101/molecular-targets-for-pain-management-more-than-just-mu
#16
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048590/family-functioning-medical-self-management-and-health-outcomes-among-school-aged-children-with-sickle-cell-disease-a-mediation-model
#17
Alexandra M Psihogios, Lauren C Daniel, Reem Tarazi, Kim Smith-Whitley, Chavis A Patterson, Lamia P Barakat
Background: Informed by the Pediatric Self-Management Model, the present study tested relationships between parent and family functioning, sickle cell disease (SCD) self-management, and health outcomes for children with SCD. Method: 83 children with SCD and a parent completed baseline data as part of a larger investigation of a family-based, problem-solving intervention for children with SCD (M age = 8.47). Youth and parents completed a measure of child health-related quality of life (HRQOL), and parents completed measures of family efficacy, parenting stress, and SCD self-management...
September 26, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048571/pain-in-survivors-of-pediatric-cancer-applying-a-prevention-framework
#18
Amanda L Stone, Cynthia W Karlson, Lauren C Heathcote, Abby R Rosenberg, Tonya M Palermo
To apply a biopsychosocial framework to understand factors influencing pain in survivors of pediatric cancer to inform pain prevention efforts and highlight the need for interdisciplinary care. This topical review draws from both pediatric cancer survivorship research and chronic noncancer pain research to illustrate how components of a preventative model can be applied to pain in survivorship. Pain is a common experience among long-term survivors of pediatric cancer. The pain experience in survivorship can be conceptualized in terms of biological disease and treatment factors, cognitive and affective factors, and social and contextual factors...
August 31, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048518/disease-related-predictors-of-health-related-quality-of-life-in-youth-with-eosinophilic-esophagitis
#19
Mary K Lynch, Margaux J Barnes, Reed A Dimmitt, Lisa Martin, Marc E Rothenberg, Burel R Goodin
Objective: To evaluate relations between health-related quality of life (HRQoL) and clinical symptom presentation in youth with eosinophilic esophagitis (EoE). We hypothesized that presence of dysphagia, reflux, nausea/vomiting, and epigastric pain would be related to poorer HRQoL. In predictive models, it was hypothesized that dysphagia, reflux, nausea/vomiting, and epigastric pain would each significantly and uniquely predict poorer HRQoL. Methods: This cross-sectional, two-study design included 91 dyads comprised children with EoE and their respective caregivers across two tertiary children's hospitals, Site 1 in the Midwest (N = 47) and Site 2 in the Deep South (N = 44)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048506/the-comfort-ability-pain-management-workshop-a-preliminary-nonrandomized-investigation-of-a-brief-cognitive-biobehavioral-and-parent-training-intervention-for-pediatric-chronic-pain
#20
Rachael Coakley, Tessa Wihak, Joe Kossowsky, Christina Iversen, Carolina Donado
Objective: Psychological intervention is widely recognized as an integral part of the recovery process from pediatric chronic pain, but service acquisition is often limited by resource barriers. The aim of this study was to assess the feasibility, acceptability, and satisfaction of a brief, structured, skills-based, group intervention designed expressly to address gaps in service delivery. Exploratory outcomes were also assessed. Method: Adolescents with chronic pain (n = 102; ages 10-17 years) and their mothers (n = 105) completed self-report questionnaires at baseline, 1-week, 1-month, and 3-month posttreatment...
September 18, 2017: Journal of Pediatric Psychology
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