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https://www.readbyqxmd.com/read/29049117/chronic-opioid-use-after-surgery-implications-for-perioperative-management-in-the-face-of-the-opioid-epidemic
#1
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/29048579/development-of-high-grade-osteosarcoma-in-a-patient-with-recurrent-giant-cell-tumor-of-the-ischium-while-receiving-treatment-with-denosumab
#2
Shinji Tsukamoto, Alberto Righi, Daniel Vanel, Kanya Honoki, Davide Maria Donati, Costantino Errani
Malignant transformation of giant cell tumor of bone (GCTB) without radiotherapy exposure is exceptionally rare, occurring in less than 1% of GCTBs. The safety and efficacy of denosumab in patients with GCTB was recently reported. We herein report a case of a benign recurrent GCTB with an H3F3A mutation that underwent secondary malignant transformation during treatment with denosumab. A 29-year-old woman underwent curettage of a GCTB of the left ischium in 2005. Ten years after the first surgery, the GCTB recurred locally...
November 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29046777/effect-of-palmitoylethanolamide-on-inflammatory-and-neuropathic-pain-in-rats
#3
Tai-Kyung Seol, Wonho Lee, Sunah Park, Kyu Nam Kim, Tae Yeon Kim, You Na Oh, Jong Hun Jun
BACKGROUND: A growing body of evidence suggests that neuroinflammation, which is characterized by infiltration of immune cells, activation of mast cells and glial cells, and production of inflammatory mediators in the peripheral and central nervous systems, plays an important role in the induction and maintenance of chronic pain. Palmitoylethanolamide (PEA), which is a type of N-acylethanolamide and a lipid, has an anti-inflammatory effect. Relative to the anti-inflammatory effect, little is known about its analgesic effect in chronic pain...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046638/blockade-of-cannabinoid-cb1-receptors-in-the-dorsal-periaqueductal-gray-unmasks-the-antinociceptive-effect-of-local-injections-of-anandamide-in-mice
#4
Diego C Mascarenhas, Karina S Gomes, Tatiani Sorregotti, Ricardo L Nunes-de-Souza
Divergent results in pain management account for the growing number of studies aiming at elucidating the pharmacology of the endocannabinoid/endovanilloid anandamide (AEA) within several pain-related brain structures. For instance, the stimulation of both Transient Receptor Potential Vanilloid type 1 (TRPV1) and Cannabinoid type 1 (CB1) receptors led to paradoxical effects on nociception. Here, we attempted to propose a clear and reproducible methodology to achieve the antinociceptive effect of exogenous AEA within the dorsal periaqueductal gray (dPAG) of mice exposed to the tail-flick test...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29042070/geriatric-palliative-care-meeting-the-needs-of-a-growing-population
#5
Rebecca M Saracino, Mei Bai, Leslie Blatt, Larry Solomon, Ruth McCorkle
The implementation of effective geriatric palliative care (PC) services will be increasingly important as the number of patients ages ≥65 years continues to grow. However, literature characterizing the utilization of PC services by older adults remains scant. The objective of these analyses was to characterize the nature and outcomes of PC services for older adults. A retrospective analysis of records of inpatient PC consultations provided to patients ≥65 years at an academic hospital was performed (N = 743)...
October 14, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29040904/malignant-fibrous-histiocytoma-in-the-right-portion-of-the-mandible-with-metastasis-in-pancreas
#6
Javier Biurrun Chamale, Marco Bruno, Facundo Mandojana, Llugdar José, Lucas Armando, Doniquian Alejandro
BACKGROUND: Malignant fibrous histiocytoma is a sarcoma of uncertain origin that can be found both in soft tissues and in bones. It is currently called undifferentiated pleomorphic sarcoma not otherwise specified and it represents a final common pathway in several tumors that are subject to the progress of dedifferentiation. Local recurrence of the tumor in the same location where it was originated occurs in 20-30% of the total number of soft tissue sarcomas. It is less frequent in limbs and more likely to recur in retroperitoneal sarcomas and in head and neck...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29040143/extragingival-pregnancy-pyogenic-granuloma-on-the-lip
#7
Maitena Canivell-Zabaleta, Guiomar Martin-Lozano, Erika Olmos-Juarez, Maria Fontillon-Alberdi, Pedro Infante-Cossio
Pregnancy pyogenic granuloma is considered a benign common growth that usually develops on the gingiva in the second and third trimester of gestation, in response to local irritation, trauma or hormonal factors. Here, the authors report a case of a primigravida who presented an extragingival pyogenic granuloma with a rapid progression in the post-partum. The occurrence on the lower lip in the first few days after delivery was a relatively rarity in the present case which provoked a meaningful state of anxiety and cancerophobia to the female...
October 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29036904/biopsychosocial-measures-related-to-chronic-low-back-pain-postural-control-in-older-adults
#8
Ryan Hulla, Robert J Gatchel, Angela Liegey-Dougall
This study examined the biopsychosocial measures related to postural control in the growing population of older adults (i.e., 60 years and older). The sample of the study consisted of 129 older adults (M = 74.45, SD = 6.95), with 34 males and 95 females; 36 were classified with chronic low-back pain (CLBP), and 93 without chronic low-back pain (NCLBP). Physical and psychosocial constructs were analyzed as predictors for postural control measures. Additionally, gender and classification of low-back pain were examined as moderators for all physical and psychosocial measures...
October 14, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29036629/nanotechnology-a-promising-new-paradigm-for-the-control-of-pain
#9
Krishnan V Chakravarthy, Frank J Boehm, Paul J Christo
Objective: The objective of this article is to critically review both preclinical and clinical studies that focus on the use of nanotechnology for both acute and chronic pain management, surveying both diagnostic and therapeutic applications. The article also provides information on nanotechnology for pain practitioners, so that they may better understand how this technology works and how it may be applied to their day-to-day clinical practice. Study Design: Narrative review...
June 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29035124/pain-and-alcohol-use-among-latinos-in-primary-care-examining-rumination-as-an-explanatory-factor
#10
Daniel J Paulus, Joseph W Ditre, Andres G Viana, Jafar Bakhshaie, Monica Garza, Jeanette Valdivieso, Melissa Ochoa-Perez, Chad Lemaire, Michael J Zvolensky
BACKGROUND: Alcohol is a widely abused substance among Latinos. Yet, little is known regarding factors underlying hazardous drinking in this population. Growing work has linked pain to hazardous drinking, although highly limited work has focused on Latinos. OBJECTIVES: The aim of the current study was to test rumination as an underlying mechanism explaining relations between pain severity and alcohol use among Latinos. METHODS: Data from 252 low-income Latino adults (Mage = 38...
October 16, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29031990/international-standardization-of-diagnostic-criteria-for-microvascular-angina
#11
Peter Ong, Paolo G Camici, John F Beltrame, Filippo Crea, Hiroaki Shimokawa, Udo Sechtem, Juan Carlos Kaski, C Noel Bairey Merz
Standardization of diagnostic criteria for ischemic symptoms due to coronary microvascular dysfunction (CMD) is needed for further investigation of patients presenting with anginal chest pain consistent with "microvascular angina" (MVA). At the annual Coronary Vasomotion Disorders International Study Group (COVADIS) Summits held in August 2014 and 2015, the following criteria were agreed upon for the investigative diagnosis of microvascular angina: (1) presence of symptoms suggestive of myocardial ischemia; (2) objective documentation of myocardial ischemia, as assessed by currently available techniques; (3) absence of obstructive CAD (<50% coronary diameter reduction and/or fractional flow reserve (FFR) >0...
September 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29027719/glioplasticity-in-irritable-bowel-syndrome
#12
N L Lilli, L Quénéhervé, S Haddara, C Brochard, P Aubert, M Rolli-Derkinderen, T Durand, P Naveilhan, J-B Hardouin, R De Giorgio, G Barbara, S Bruley des Varannes, E Coron, M Neunlist
BACKGROUND: Growing evidence indicates a wide array of cellular remodeling in the mucosal microenvironment during irritable bowel syndrome (IBS), which possibly contributes to pathophysiology and symptom generation. Here, we investigated whether enteric glial cells (EGC) may be altered, and which factors/mechanisms lead to these changes. METHODS: Colonic mucosal biopsies of IBS patients (13 IBS-Constipation [IBS-C]; 10 IBS-Diarrhea [IBS-D]; 11 IBS-Mixed [IBS-M]) and 24 healthy controls (HC) were analyzed...
October 13, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29026635/lytic-lesions-looking-lethal-but-leaving-room-for-a-simple-cure-a-case-of-veillonella-spinal-osteomyelitis
#13
Sarah Baker, Rebecca Allyn
Introduction. Diagnosing clinically significant infection caused by Veillonella species can be a challenge. Veillonella species are usually found in polymicrobial processes and are often regarded as a contaminant. Additionally, they are slow to grow in culture and this can lead to a delay in diagnosis or a missed diagnosis. Veillonella species rarely cause serious infections, but have been found to cause bacteraemia and osteomyelitis. Case presentation. A 67-year-old man with a history of treated prostate cancer presented with 2 weeks of progressive lower back pain and weakness...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29020989/predictors-of-multidisciplinary-rehabilitation-outcomes-in-patients-with-chronic-musculoskeletal-pain-protocol-for-a-systematic-review-and-meta-analysis
#14
Elena Tseli, Wilhelmus Johannes Andreas Grooten, Britt-Marie Stålnacke, Katja Boersma, Paul Enthoven, Björn Gerdle, Björn Olov Äng
BACKGROUND: Chronic musculoskeletal pain is a major public health problem. Early prediction for optimal treatment results has received growing attention, but there is presently a lack of evidence regarding what information such proactive management should be based on. This study protocol, therefore, presents our planned systematic review and meta-analysis on important predictive factors for health and work-related outcomes following multidisciplinary rehabilitation (MDR) in patients with chronic musculoskeletal pain...
October 11, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29017382/which-factors-are-associated-with-the-recurrence-of-endometrioma-after-cystectomy
#15
Mehmet Küçükbaş, Meryem Kurek Eken, Gülşah İlhan, Taylan Şenol, Dilşad Herkiloğlu, Bilge Kapudere
Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. Medical treatment options can be successful in endometrioma smaller than 1 cm, but ineffective for growing and symptomatic endometriomas. Conservative surgical interventions that preserve fertility, such as laparoscopic removal or destruction of endometriotic tissue or aspiration of cystic content are typically used to treat the condition. One of the most frustrating aspects of endometrioma treatment is disease recurrence...
October 10, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28992773/clinical-decision-making-in-the-management-of-patients-with-cervicogenic-dizziness-a-case-series
#16
Francis C Jung, Sherin Mathew, Andrew E Littmann, Cameron W MacDonald
Study Design Case series. Background Although growing recognition of cervicogenic dizziness (CGD) is emerging, there is still no "gold standard" for the diagnosis of CGD. The purpose of this case series is to describe the clinical decision making utilized in the management of seven patients presenting with CGD. Case Descriptions Patients presenting with neck pain and accompanying subjective symptoms including dizziness, unsteadiness, lightheadedness, and visual disturbance were selected. Clinical evidence of a temporal relationship between neck pain and dizziness with or without sensorimotor disturbances was sought...
October 9, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28989281/efficacy-and-tolerability-of-liposomal-polyvinylpyrrolidone-iodine-hydrogel-for-the-localized-treatment-of-chronic-infective-inflammatory-dermatoses-an-uncontrolled-pilot-study
#17
Matthias Augustin, Lisa Goepel, Arnd Jacobi, Bjoern Bosse, Stefan Mueller, Michael Hopp
Infection is common in many chronic, inflammatory skin conditions but is often difficult to treat, in part due to growing bacterial resistance to antibiotics. Liposomal polyvinyl-pyrrolidone (PVP)-iodine hydrogel has a unique mode of action, combining the antiseptic and anti-inflammatory actions of PVP-iodine with the drug delivery and moisturizing properties of liposomes. We investigated the utility of liposomal PVP-iodine to treat infective dermatoses. In this prospective, single-arm (uncontrolled), open-label Phase II pilot study, patients with acne vulgaris (n=30), atopic dermatitis (n=20), impetigo contagiosa (n=10), and rosacea (n=10) received PVP-iodine (3%) hydrogel for ≤4 weeks...
2017: Clinical, Cosmetic and Investigational Dermatology
https://www.readbyqxmd.com/read/28989013/development-of-a-modified-release-formulation-of-lovastatin-targeted-to-intestinal-methanogens-implicated-in-irritable-bowel-syndrome-with-constipation
#18
Steven Hubert, Alan Chadwick, Vince Wacher, Olivia Coughlin, John Kokai-Kun, Andrew Bristol
There is growing evidence that methane production, predominantly by Methanobrevibacter smithii (M. smithii), in the intestines is a cause of constipation, pain and bloating in irritable bowel syndrome with constipation (IBS-C). M. smithii resides primarily in the large intestine but can also colonize the small intestine. In-vitro studies found that the prodrug lactone form of lovastatin, found in cholesterol lowering drugs, inhibited methane production in stool samples from patients with IBS-C. However, the cholesterol-lowering lovastatin β-hydroxyacid (HA) was ineffective at inhibiting methane production in this system...
October 6, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28980497/the-clinical-effects-of-the-venomous-lessepsian-migrant-fish-plotosus-lineatus-thunberg-1787-in-the-southeastern-mediterranean-sea
#19
Yedidia Bentur, Sergey Altunin, Iris Levdov, Daniel Golani, Ehud Spanier, Dor Edelist, Yael Lurie
CONTEXT: Plotosus lineatus is a venomous fish that has migrated from the Indo-Pacific region to the Mediterranean Sea (Lessepsian migrant). Its presence in the Mediterranean Sea was first recorded in 2002 and was observed in growing schools. Its spines contain toxins with lytic, hemolytic and edematous activities. OBJECTIVE: To characterize the injuries caused by Plotosus lineatus in the Southeastern Mediterranean Sea. METHODS: A prospective observational case series of consultations provided by a national Poison Center pertaining to Plotosus lineatus from 2007 to 2016...
October 5, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28976338/false-positive-perfusion-ventilation-spect-study-for-pulmonary-embolism-in-a-patient-with-fontan-circulation
#20
Emmanouil Panagiotidis
Fontan circulation is the consequence of an operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle. An 18-year old man with a history of congenital heart disease surgically treated with Fontan circulation, presented with pleuritic chest pain and a raised D-dimer level. Perfusion/ventilation SPECT was performed to exclude the possibility of pulmonary embolism (PE) that showed unilateral reduced perfusion of the left lung with a mismatched right upper lobe defect, suspicious of PE...
October 3, 2017: Molecular Imaging and Radionuclide Therapy
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