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https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#1
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28806638/patient-preferences-and-extended-release-naltrexone-a-new-opportunity-to-treat-opioid-use-disorders-in-ukraine
#2
Ruthanne Marcus, Iuliia Makarenko, Alyona Mazhnaya, Alexei Zelenev, Maxim Polonsky, Lynn Madden, Sergii Filippovych, Sergii Dvoriak, Sandra A Springer, Frederick L Altice
BACKGROUND: Scaling up HIV prevention for people who inject drugs (PWID) using opioid agonist therapies (OAT) in Ukraine has been restricted by individual and structural factors. Extended-release naltrexone (XR-NTX), however, provides new opportunities for treating opioid use disorders (OUDs) in this region, where both HIV incidence and mortality continue to increase. METHODS: Survey results from 1613 randomly selected PWID from 5 regions in Ukraine who were currently, previously or never on OAT were analyzed for their preference of pharmacological therapies for treating OUDs...
August 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28806561/delirium-and-exposure-to-psychoactive-medications-in-critically-ill-adults-a-multi-centre-observational-study
#3
Lisa D Burry, David R Williamson, Sangeeta Mehta, Marc M Perreault, Ioanna Mantas, Ranjeeta Mallick, Dean A Fergusson, Orla Smith, Eddy Fan, Sebastien Dupuis, Margaret Herridge, Louise Rose
PURPOSE: Investigate the relationship between psychoactive drugs and delirium. MATERIALS AND METHODS: Prospective observational study of 520 critically ill adult patients admitted ≥24h to 6 intensive care units (ICUs). Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4). RESULTS: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806222/transient-receptor-potential-vanilloid-1-antagonists-prevent-anesthesia-induced-hypothermia-and-decrease-postincisional-opioid-dose-requirements-in-rodents
#4
Andras Garami, Mohab Ibrahim, Kerry Gilbraith, Rajesh Khanna, Eszter Pakai, Alexandra Miko, Erika Pinter, Andrej A Romanovsky, Frank Porreca, Amol M Patwardhan
BACKGROUND: Intraoperative hypothermia and postoperative pain control are two important clinical challenges in anesthesiology. Transient receptor potential vanilloid 1 has been implicated both in thermoregulation and pain. Transient receptor potential vanilloid 1 antagonists were not advanced as analgesics in humans in part due to a side effect of hyperthermia. This study tested the hypothesis that a single, preincision injection of a transient receptor potential vanilloid 1 antagonist could prevent anesthesia-induced hypothermia and decrease the opioid requirement for postsurgical hypersensitivity...
August 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28806217/the-effect-of-ondansetron-on-acute-opioid-tolerance-in-patients-receiving-intrathecal-opioids-prior-to-cesarean-delivery
#5
Kevin C Greer, Abdullah S Terkawi, Siny Tsang, Priyanka Singla, Marcel E Durieux, Mohamed Tiouririne
BACKGROUND: Multiple animal studies suggest that ondansetron ameliorates opioid-induced hyperalgesia and tolerance. In this study, we aimed to determine if the administration of ondansetron prior to spinal anesthesia would have an effect on intrathecal opioid-induced acute opioid tolerance, postoperative pain, and analgesic requirements in patients undergoing cesarean delivery with spinal anesthesia. METHODS: Eighty-six patients undergoing elective cesarean delivery were recruited and randomly allocated to receive either 8 mg intravenous ondansetron (n = 44) or placebo (n = 42) in a prospective, double-blind design...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28806211/the-opiorphin-analog-str-324-decreases-sensory-hypersensitivity-in-a-rat-model-of-neuropathic-pain
#6
Alain Van Elstraete, Philippe Sitbon, Leila Hamdi, Victor Juarez-Perez, Jean-Xavier Mazoit, Dan Benhamou, Catherine Rougeot
BACKGROUND: Neuropathic pain represents a therapeutic challenge, and treatments with increased efficacy and tolerability still need to be developed. Opiorphin protects endogenous enkephalins from degradation, potentiating enkephalin-dependent analgesia via the activation of opioid pathways. Enkephalins are natural ligands of opioid receptors, with strong affinity for δ-opioid receptors. Expression of functional δ-opioid receptors increases in sensory neurons after peripheral nerve injury in neuropathic pain models...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28806176/evaluating-the-use-of-ketamine-for-pain-control-with-sickle-cell-crisis-in-pregnancy-a-report-of-2-cases
#7
Alexis C Gimovsky, Kate Fritton, Eugene Viscusi, Amanda Roman
Sickle cell crises occur frequently during pregnancy and are difficult to treat, even with high-dose opioids. Analgesia with ketamine has been suggested as an alternative, but its use during pregnancy is underreported. Two pregnant patients with uncontrolled sickle cell pain were treated with ketamine. Patient A reported no decrease in her pain, but her opioid requirements decreased. Patient B's pain resolved during ketamine administration. No serious maternal or neonatal adverse effects occurred. Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28806097/opioid-demand-before-and-after-anterior-cruciate-ligament-reconstruction
#8
Chris A Anthony, Robert W Westermann, Nicholas Bedard, Natalie Glass, Matt Bollier, Carolyn M Hettrich, Brian R Wolf
BACKGROUND: Surgeons and health care systems have received a call to action in an effort to curtail the current opioid epidemic. PURPOSE: To (1) define the natural history of opioid demand after anterior cruciate ligament reconstruction (ACLR), (2) consider how filling preoperative opioid prescriptions affects opioid demand after ACLR, and (3) evaluate the effect of additional procedures during ACLR and patient age on postoperative opioid demand. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28805972/in-vitro-pharmacological-characterization-of-a-novel-unbiased-nop-receptor-selective-nonpeptide-agonist-at-403
#9
Federica Ferrari, Davide Malfacini, Blair V Journigan, Mark F Bird, Claudio Trapella, Remo Guerrini, David G Lambert, Girolamo Calo', Nurulain T Zaveri
Nociceptin/orphanin FQ (N/OFQ) regulates several biological functions via selective activation of the N/OFQ receptor (NOP), a member of the opioid receptor family. We recently identified a new high affinity and highly selective NOP agonist AT-403. In this study, we characterized the functional profile of AT-403 and compared it to other known nonpeptide NOP agonists Ro 65-6570, Ro 2q, SCH-221510, MCOPPB, AT-202 and SCH-486757, using the following assays: GTPγ[(35) S] stimulated binding, calcium mobilization assay in cells-expressing human NOP or classical opioid receptors and chimeric G proteins, bioluminescence resonance energy transfer (BRET) based assay for studying NOP receptor interaction with G protein and arrestin, and the electrically stimulated mouse vas deferens bioassay...
August 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28805471/prolonged-release-oxycodone-and-naloxone-treatment-counteracts-opioid-induced-constipation-in-patients-with-severe-pain-compared-to-previous-analgesic-treatment
#10
Gineke Koopmans-Klein, Joeri Van Op den Bosch, Yvonne van Megen, Hans Prenen, Frank Huygen, Isabelle Mancini
OBJECTIVE: Treatment with prolonged-release oxycodone/naloxone (PR OXN) has been shown to improve opioid induced constipation (OIC) in constipated patients. This publication reports on a real-life observational study investigating the efficacy of PR OXN with regard to bowel function in patients switching to PR OXN from WHO-step 1, step 2 and step 3 opioids. METHODS: Patients with chronic pain experiencing insufficient pain relief and/or unacceptable side effects were switched to PR OXN and monitored in this observational study with respect to efficacy regarding bowel function and efficacy regarding pain relief in comparison with previous analgesic therapy...
August 14, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28805336/matrix-stimulation-in-cancer-pain-methodology-safety-and-effectiveness
#11
M Mücke, M Tils, R Conrad, D Kravchenko, H Cuhls, L Radbruch, M Marinova, V Peuckmann-Post, R Rolke
BACKGROUND: This feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low-frequency electrical stimulation (LFS). METHODS: Low-frequency matrix stimulation (4 Hz) was applied to the skin within the 'Head's zones' referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3-day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3-day follow-up period without therapy...
August 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28805236/comparison-of-intrathecal-morphine-and-surgical-site-infusion-of-ropivacaine-as-adjuncts-to-intravenous-patient-controlled-analgesia-in-living-donor-kidney-transplant-recipients
#12
Joo-Hyun Jun, Gaab-Soo Kim, Jeong Jin Lee, Justin S Ko, Sung Joo Kim, Pil Hyun Jeon
INTRODUCTION: This prospective observational study compared the postoperative analgesic effectiveness of intrathecal morphine (ITM) and surgical-site infusion (SSI) of ropivacaine as adjuncts to intravenous (IV) patient-controlled analgesia (PCA) (fentanyl) in living-donor kidney transplant recipients. METHODS: Patients undergoing living-donor kidney transplantation receiving ITM or SSI in addition to IV PCA were included. Rescue analgesia was achieved with IV meperidine, as required...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#13
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28803601/ultrasound-guided-transversus-abdominis-plane-block-improves-postoperative-analgesia-and-early-recovery-in-patients-undergoing-retroperitoneoscopic-urologic-surgeries-a-randomized-controlled-double-blinded-trial
#14
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
Objective To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. Methods This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28803090/palliative-care-in-rwanda-aiming-for-universal-access
#15
Eric L Krakauer, Marie-Aimee Muhimpundu, Diane Mukasahaha, Jean-Claude Tayari, Christian Ntizimira, Blaise Uhagaze, Théodosie Mugwaneza, Aimable Ruzima, Egide Mpanumusingo, Magnus Gasana, Vincent Karamuka, Jean-Luc Nkurikiyimfura, Paul Park, Peter Barebwanuwe, Neo Tapela, Shekinah N Elmore, Gene Bukhman, Mhoira Leng, Liz Grant, Agnes Binagwaho, Richard Sezibera
In 2011, Rwanda's Ministry of Health (MoH) set a goal of universal access to palliative care by 2020. Toward this audacious egalitarian and humanitarian goal, the MoH worked with partners to develop palliative care policies and a strategic plan, secure adequate supplies of opioid for the country, initiate palliative care training programs, and begin studying a model for integrating coordinated palliative care into the public healthcare system at all levels. It also initiated training of a new cadre of home-based care practitioners (HBCPs) to provide palliative care in the home...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803088/treat-the-pain-program
#16
Megan O'Brien, Amanda Schwartz, Laura Plattner
CONTEXT: Globally, low and middle-income countries are home to 70% of cancer deaths and 99% of HIV deaths, but they consume just 7% of opioid analgesics. OBJECTIVE: The American Cancer Society's Treat the Pain program partners with governments in low and middle-income countries to improve access to high-quality essential pain medicines. METHOD: Treat the Pain has developed the MORPHINE Framework to provide a structure to describe challenges to access to pain relief and to group and sequence interventions to address these challenges...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803087/effect-of-prophylactic-fentanyl-buccal-tablet-on-episodic-exertional-dyspnea-a-pilot-double-blind-randomized-controlled-trial
#17
David Hui, Kelly Kilgore, Susan Frisbee-Hume, Minjeong Park, Diane Liu, Diwakar D Balachandran, Eduardo Bruera
CONTEXT: Episodic dyspnea is one of the most common, debilitating and difficult-to-treat symptoms. OBJECTIVE: We conducted a pilot study to examine the effect of prophylactic FBT on exercise-induced dyspnea. METHODS: In this parallel, double-blind randomized placebo-controlled trial, opioid-tolerant patients were asked to complete a 6 minute walk test (6MWT) at baseline, then a second 6MWT 30 minutes after a single dose of FBT (equivalent to 20-50% of their total opioid dose) or matching placebo...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803083/the-impact-of-combined-use-of-opioids-antipsychotics-and-anxiolytics-on-survival-in-the-hospice-setting
#18
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Aleksandar Čubranić
CONTEXT: Opioids and sedatives are the cornerstone of symptom management in the end-of-life patients, but undertreatment is a common problem. Although several studies explored the individual effect of opioids, anxiolytics and antipsychotics on survival, not much is known regarding their combined use. As these drugs share similar and potentially fatal side effects, primarily respiratory depression which occurs more often during night-hours, it is crucial to explore whether their interaction poses a danger for fragile hospice patients...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803078/safety-and-effectiveness-of-palliative-drug-treatment-in-the-last-days-of-life-a-systematic-literature-review
#19
REVIEW
Kristian Jansen, Dagny Faksvåg Haugen, Lisa Pont, Sabine Ruths
CONTEXT: Dying patients commonly experience potentially distressing symptoms. Palliative care guidelines recommend opioids, anticholinergics, antipsychotics and benzodiazepines for symptom relief. OBJECTIVES: To systematically review the effectiveness and safety of palliative drug treatment in the last days of life of adult patients, focusing on the management of pain, dyspnea, anxiety, restlessness, and death rattle. METHODS: A systematic search of the literature published before December 2016 in PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane, ClinicalTrials...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803076/palliative-care-in-vietnam-long-term-partnerships-yield-increasing-access
#20
Eric L Krakauer, Dang Huy Quoc Thinh, Quach Thanh Khanh, Hoang Thi Mong Huyen, Tran Diep Tuan, Than Ha Ngoc The, Do Duy Cuong, Tran Van Thuan, Nguyen Phi Yen, Pham Van Anh, Nguyen Thi Phuong Cham, Kathleen P Doyle, Nguyen Thi Hai Yen, Luong Ngoc Khue
Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health (MoH), major public hospitals, and medical universities. An empirical analysis of palliative care need by the MoH in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations...
August 9, 2017: Journal of Pain and Symptom Management
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