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https://www.readbyqxmd.com/read/30104833/a-double-blind-randomized-control-trial-to-compare-the-effect-of-varying-doses-of-intrathecal-fentanyl-on-clinical-efficacy-and-side-effects-in-parturients-undergoing-cesarean-section
#1
Muhammad Asghar Ali, Samina Ismail, Muhammad Sohaib, Asiyah Aman
Background and Aims: It is a common practice to add intrathecal lipophilic opioids to local anesthetics to improve the quality of subarachnoid block. This study was designed to find a dose of intrathecal fentanyl, which can improve the quality of surgical anesthesia with minimal side effects in parturients undergoing cesarean section under spinal anesthesia with intrathecal bupivacaine. Material and Methods: In a prospective randomized double-blind study, 243 parturients undergoing cesarean section under spinal anesthesia were randomly allocated to receive 10, 15, or 25 μg of intrathecal fentanyl with 10 mg of 0...
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/30081203/tranexamic-acid-inhibits-the-plasma-and-non-irradiated-skin-markers-of-photoaging-induced-by-long-term-uva-eye-irradiation-in-female-mice
#2
Keiichi Hiramoto, Yurika Yamate, Daijiro Sugiyama, Kazunari Matsuda, Yasutaka Iizuka, Tomohiko Yamaguchi
Photoaging can be induced by long-term ultraviolet (UV)A eye irradiation, but an ameliorating method for such photoaging is not known. In this study, we examined the effects of tranexamic acid (trans-4-aminomethylcyclohexanecarboxylic acid) on photoaging of the skin induced by UVA eye irradiation. We used the C57BL/6 j female mice and locally exposed their eyes to UVA at a dose of 110 kJ/m2 using an FL20SBLB-A lamp multiple times a week for one year. The plasma urocortin 2, β-endorphin, methionine enkephalin (OGF), and histamine content, as well as the expression of the corticotropin-releasing hormone receptor (CRHR) type 2, μ-opioid receptor, opioid growth factor receptor (OGFR), T-bet, and GATA3 increased in the mice subjected to UVA eye irradiation...
August 2, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/30060727/development-and-implementation-of-a-survey-to-assess-health-care-provider-s-competency-attitudes-and-knowledge-about-perinatal-palliative-care
#3
Simone Stenekes, Jamie L Penner, Michael Harlos, Marie-Claude Proulx, Erin Shepherd, Stephen Liben, Genevieve Thompson, Grace MacConnell, Marie-Claude Grégoire, Harold Hal Siden
Perinatal palliative care is an emerging area of health care. To date, no published tools assess health-care provider's knowledge and level of comfort in providing such care. A 2-phase study was undertaken to develop and implement a survey to evaluate the self-assessed competency, attitudes, and knowledge of health-care providers working in perinatal palliative care. Phase 1 included a review of the literature and appraisal of palliative and death-related instruments to inform the initial draft of the Perinatal Palliative Care Survey (PPCS)...
July 31, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/30048644/naltrexone-and-nalmefene-attenuate-cocaine-place-preference-in-male-mice
#4
Kyle A Windisch, Brian Reed, Mary Jeanne Kreek
Cocaine addiction treatment is difficult due to the current lack of approved pharmacotherapuetics. Several preclinical and clinical studies have demonstrated that the mu opioid receptor (MOPr) antagonist/kappa opioid receptor (KOPr) partial agonist naltrexone (NTX) reduces the subjective effects and self-administration of cocaine. However, very limited research has examined the ability of the structurally similar MOPr antagonist/KOPr partial agonist nalmefene (NMF) to reduce cocaine reward. Here we examine the effect of low (1 mg/kg) and high (10 mg/kg) doses of NTX or NMF on cocaine place preference...
July 23, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/30042277/-clinical-effects-of-opioid-switching-to-tapentadol-retrospective-analysis-of-efficacy-and-adverse-effects
#5
Masashi Homma, Hideya Kokubun, Norihito Hayashi, Akifumi Kanai, Koichiro Atsuda
The objective of our study was to evaluate the efficacy and adverse effects of opioid switching to tapentadol(TP). It was a retrospective survey carried out at the Kitasato University Hospital outpatient clinic between September 2014 and May 2016. We evaluated pain intensity using the visual analogue scale and the occurrence of adverse effects before switching, at the first evaluation after switching, and during the steady state of TP administration. We included 10 patients; of these, 3 patients discontinued TP owing to uncontrolled pain...
July 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/30031696/moving-opioid-misuse-prevention-upstream-a-pilot-study-of-community-pharmacists-screening-for-opioid-misuse-risk
#6
Mark A Strand, Heidi Eukel, Siri Burck
BACKGROUND: Prescription opioids are known to be highly addictive, contributing to the opioid epidemic which continues to besiege victims in the United States. Pharmacists are gatekeepers straddling the prescribers of opioids and their patients; therefore they are in the ideal position to screen for opioid misuse among patients receiving opioid prescriptions and counsel them on safe use. OBJECTIVES: The purpose of this study was to design the Opioid Misuse Risk Prevention Toolkit and then evaluate the utility of the toolkit by implementing it in community pharmacy practice sites...
July 17, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/30029929/does-the-amount-of-opioid-consumed-influence-how-patients-rate-their-experience-of-care-after-total-knee-arthroplasty
#7
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Alexander T Caughran, Michael A Mont, Ronald E Delanois
BACKGROUND: With legislative efforts aimed at optimizing value of care, surgeons performing total knee arthroplasty (TKA) are faced with increased responsibility of optimizing patient perception of care. However, pain after TKA may negatively influence patient perception of care, as measured by Press Ganey (PG) patient satisfaction surveys. While opioid-based medications are best suited for acute pain alleviation, awareness of a growing opioid epidemic has spurred efforts to reduce its administration...
June 30, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30020506/patient-perspectives-on-opioids-views-of-inpatient-veterans-with-chronic-pain
#8
Katherine Hadlandsmyth, Kenda R Stewart, Monica B Paez, Melissa Steffen, Molly Meth, Heather Schacht Reisinger, Hilary J Mosher
Objective: To elucidate perspectives on opioids and opioid use from hospitalized veterans with comorbid chronic pain using qualitative methods. Design: This was an analysis of individual qualitative interviews. The semistructured interview guide was developed by a hospitalist with clinical expertise in pain treatment with guidance from a medical anthropologist. Interviews aimed to understand participants' experiences of chronic pain. Setting: A Midwestern Veterans Health Administration inpatient hospital unit...
July 17, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29985664/linaclotide-for-the-treatment-of-chronic-constipation
#9
Gabrio Bassotti, Paolo Usai-Satta, Massimo Bellini
Chronic constipation (CC) is a common gastrointestinal disorder with limited treatment options. Linaclotide is a potent peptide agonist of the guanylate cyclase-C receptor. This action activates intracellular conversion of guanosine 5-triphosphate to cyclic guanosine monophosphate resulting in the stimulation of intestinal fluid secretion. Linaclotide is a promising new agent for refractory constipation. Areas covered: All published articles regarding the development, clinical efficacy, and safety of linaclotide in treating CC were reviewed...
July 9, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29984621/trauma-trainees-multiple-competing-goals-in-opioid-prescription-communication
#10
Elizabeth Troutman Adams, Elisia L Cohen, Andrew Bernard, Whittney Darnell, Donald W Helme
Prescription opioids and heroin account for more than half of all drug overdose fatalities, costing an estimated 115 American lives every day. The ongoing opioid epidemic devastates communities and represents a tremendous burden to the national economy and health care system. In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from a traumatic injury or surgery...
July 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29966806/profile-risk-practices-and-needs-of-people-who-inject-morphine-sulfate-results-from-the-anrs-aerli-study
#11
Perrine Roux, Salim Mezaache, Laélia Briand-Madrid, Marie Debrus, Nicolas Khatmi, Gwenaelle Maradan, Camélia Protopopescu, Daniela Rojas-Castro, Patrizia Carrieri
AIMS: In France, a non-negligible proportion of opioid-dependent individuals inject morphine sulfate. Although it has not yet been officially approved as an opioid substitution treatment (OST), some physicians can prescribe its use for people in methadone or buprenorphine treatment failure. Longitudinal data from the ANRS-AERLI study, which evaluated an educational intervention for safer injection called AERLI, provided us the opportunity to better characterize the profile, risk practices and needs of people who inject morphine sulfate (MSI), through comparison with other injectors, and to identify correlates of HIV/HCV risk practices in this group...
June 28, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29954057/methadone-for-analgesia-in-children-with-life-limiting-illness-experience-from-a-tertiary-children-s-health-service
#12
Christine Mott, Amrita Sarpal, Krista Moss, Anthony Herbert
Methadone has the potential to assist in the management of pain in children with life-limiting illness, but its use is limited by its complex pharmacokinetic profile and limited research on its use in children. This is a retrospective review of the use of methadone as an analgesic in 16 children with life-limiting illness. Efficacy, dosing and side effect profile were analysed. Fifteen (94%) patients had improvements in their analgesia with minimal observed adverse effects. Patients were either rapidly converted from a prior opioid in one change or received methadone as an adjunct medication...
June 27, 2018: Children
https://www.readbyqxmd.com/read/29946360/the-grass-is-not-always-greener-a-multi-institutional-pilot-study-of-marijuana-use-and-acute-pain-management-following-traumatic-injury
#13
Kristin Salottolo, Laura Peck, Allen Tanner Ii, Matthew M Carrick, Robert Madayag, Emmett McGuire, David Bar-Or
Background: Widespread legislative efforts to legalize marijuana have increased the prevalence of marijuana use and abuse. The effects of marijuana on pain tolerance and analgesic pain management in the acute pain setting have not been reported. Although marijuana has been shown to have antinociceptive effects and is approved for medical use to treat chronic pain, anecdotal evidence suggests marijuana users admitted with traumatic injuries experience poorer pain control than patients who do not use marijuana...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29943054/local-infiltration-versus-laparoscopic-guided-transverse-abdominis-plane-block-in-laparoscopic-cholecystectomy-double-blinded-randomized-control-trial
#14
Rohan C Siriwardana, Sumudu K Kumarage, Bhagya M Gunathilake, Suchintha B Thilakarathne, Jeevani S Wijesinghe
BACKGROUND: Transverse abdominal plane block (TAP) is a new technique of regional block described to reduce postoperative pain in laparoscopic cholecystectomy (LC). Recent reports describe an easy technique to deliver local anesthetic agent under laparoscopic guidance. METHODS: This randomized control trial was designed to compare the effectiveness of additional laparoscopic-guided TAP block against the standard full thickness port site infiltration. 45 patients were randomized in to each arm after excluding emergency LC, conversions, ones with coagulopathy, pregnancy and allergy to local anesthetics...
June 25, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29911623/characterization-of-complex-chronic-pain-patients
#15
E-B Hysing, T Gordh, R Karlsten, L Smith
Aims Treatment of the most complex chronic pain patients, often not accepted in regular pain management programs, remains a challenge.To beable todesign interventions for these patients we must know what characterize them. The aim of this study was to characterize a subgroup of pain patients, treated in our in-patient rehabilitation programme, organized at the University Hospital in Uppsala, the only tertiary treatment for pain patients in Sweden. Methods The study was approved by the Regional Ethical Review Board in Uppsala (Dnr 2010/182)...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29911601/oral-oxycodone-for-pain-after-caesarean-section-a-randomized-comparison-with-nurse-administered-iv-morphine-in-a-pragmatic-study
#16
Boel Niklasson, Catarina Arnelo, Susanne Georgsson Öhman, Märta Segerdahl, Agneta Blanck
Background and aims The present randomized open label parallel group study was conducted to evaluate if an oral oxycodone (OXY) regimen can be at least equally effective and as safe for postoperative analgesia after caesarean section (CS) as a standard of care program using nurse-administered intravenous morphine (IVM), followed by oral codeine. Methods Eighty women (40 + 40) were scheduled for elective CS under spinal anaesthesia. All patients received postoperative multimodal analgesic therapy, including ibuprofen and paracetamol...
April 1, 2015: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29908763/acceptability-and-feasibility-of-naloxone-prescribing-in-primary-care-settings-a-systematic-review
#17
REVIEW
Emily Behar, Rita Bagnulo, Phillip O Coffin
Naloxone access through established healthcare settings is critical to responding to the opioid crisis. We conducted a systematic review to assess the acceptability and feasibility of prescribing naloxone to patients in primary care. We queried PubMed, EmBase and CINAHL for US-based, peer-reviewed, full-length, original articles relating to acceptability or feasibility of prescribing naloxone in primary care. Searches yielded 270 unduplicated articles; one analyst reviewed all titles and abstracts. Two analysts independently reviewed eligible articles for study design, study outcome, and acceptability and/or feasibility...
September 2018: Preventive Medicine
https://www.readbyqxmd.com/read/29849846/patient-controlled-intravenous-analgesia-for-advanced-cancer-patients-with-pain-a-retrospective-series-study
#18
Zhiyou Peng, Yanfeng Zhang, Jianguo Guo, Xuejiao Guo, Zhiying Feng
Objective: To compare the efficacy and side effects of patient-controlled intravenous analgesia (PCIA) with hydromorphone, sufentanil, and oxycodone on the management of advanced cancer patients with pain. Methods: Patients allocated to receive PCIA between January 2015 and December 2016 were chosen for this study. After reviewing medical records, we verified if hydromorphone, sufentanil, or oxycodone for PCIA could equally provide effective pain relief. A numeric rating scale (NRS) of cancer pain was applied before PCIA, at 4 hours after PCIA, and at the discontinuation of PCIA...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29781244/oprm1-influence-on-and-effectiveness-of-an-individualized-treatment-plan-for-prescription-opioid-use-disorder-patients
#19
Javier Muriel, César Margarit, Beatriz Planelles, María J Serralta, Carmen Puga, María-Del-Mar Inda, Esperanza Cutillas, Domingo Morales, José F Horga, Ana M Peiró
Screening for opioid use disorder should be considered in chronic non-cancer pain (CNCP) patients with long-term use of opioids. The aim of our study was to assess the effectiveness of an individualized treatment plan (ITP) for prescription opioid dependence that included screening of pharmacogenetic markers. An observational prospective study was performed using prescription opioid-dependent CNCP outpatients (n = 88). Patients were divided into nonresponders, responders, or high responders according to their response to the ITP...
May 20, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29774607/impact-of-current-and-scaled-up-levels-of-hepatitis-c-prevention-and-treatment-interventions-for-people-who-inject-drugs-in-three-uk-settings-what-is-required-to-achieve-the-who-s-hcv-elimination-targets
#20
Zoe Ward, Lucy Platt, Sedona Sweeney, Vivian D Hope, Lisa Maher, Sharon Hutchinson, Norah Palmateer, Josie Smith, Noel Craine, Avril Taylor, Natasha Martin, Rachel Ayres, John Dillon, Matthew Hickman, Peter Vickerman
AIMS: To estimate the impact of existing high-coverage needle and syringe provision (HCNSP, defined as obtaining more than one sterile needle and syringe per injection reported) and opioid substitution therapy (OST) on hepatitis C virus (HCV) transmission among people who inject drugs (PWID) in three UK settings and to determine required scale-up of interventions, including HCV treatment, needed to reach the World Health Organization (WHO) target of reducing HCV incidence by 90% by 2030...
May 17, 2018: Addiction
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