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Chronic pain management

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https://www.readbyqxmd.com/read/29232246/the-role-of-fdg-pet-in-diabetic-myonecrosis-a-rare-and-underrecognized-complication-of-diabetes
#1
Guillaume Chaussé, Gad Abikhzer
A 66-year-old man with poorly controlled type 2 diabetes was admitted for acute bilateral calf pain in the context of coronary artery disease, chronic renal failure, and peripheral neuropathy. Lower-extremity Doppler ultrasound excluded deep vein thrombosis. FDG-PET was performed to exclude a suspected infection because of elevated white blood cells and inflammatory markers but normal creatinine kinase levels. PET scan demonstrated intense bilateral calf muscle and left thigh muscle uptake, which in combination with the patient's history was consistent with diabetic myonecrosis, a rare end-stage complication of diabetes...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#2
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29230336/metastatic-spinal-cord-compression-secondary-to-liver-cancer
#3
Daniel Gams Massi, Japhari Nyassinde, Ngor Side Diagne, Ramy Abdennaji, Kamadore Toure, Moustapha Ndiaye, Amadou Gallo Diop, Mouhamadou Mansour Ndiaye
Metastatic spinal cord compression (MSCC) is a medical emergency that requires rapid diagnosis and treatment to reduce pain, to preserve neurological functioning, and to prolong survival. The diagnosis of liver cancer is often neglected in the differential diagnosis of MSCC. Treatment is usually palliative and evolution is often fatal. This is a case report of a 28-year-old patient living in Mauritania hospitalized in November 2014 at the neurology department of Fann national teaching hospital in Dakar, for the management of a chronic dorsal spinal cord compression...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29229430/self-guided-online-cognitive-behavioral-strategies-for-chemotherapy-induced-peripheral-neuropathy-a-multicenter-pilot-randomized-wait-list-controlled-trial
#4
Robert Knoerl, Ellen M L Smith, Debra L Barton, David A Williams, Janean E Holden, John C Krauss, Beth LaVasseur
The purpose of this pilot, parallel, randomized-controlled trial was to examine the efficacy of a self-guided online cognitive and behaviorally-based pain management intervention (PROSPECT) to reduce "worst" pain for individuals with chronic painful chemotherapy-induced peripheral neuropathy (CIPN). Secondary outcomes included "average" pain, non-painful CIPN symptom severity, impression of change, and pain interference. Sixty patients with chronic painful CIPN were recruited from five outpatient academic and community cancer centers...
December 8, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29229053/management-of-back-pain-related-disorders-in-a-community-with-limited-access-to-health-care-services-a-description-of-integration-of-chiropractors-as-service-providers
#5
Peter C Emary, Amy L Brown, Douglas F Cameron, Alexander F Pessoa, Jennifer E Bolton
OBJECTIVE: The purpose of this study was to evaluate a chiropractic service for back pain patients integrated within a publicly funded, multidisciplinary, primary care community health center in Cambridge, Ontario, Canada. METHODS: Patients consulting for back pain of any duration were referred by their medical doctor or nurse practitioner for chiropractic treatment at the community health center. Patients completed questionnaires at baseline and at discharge from the service...
November 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/29228823/current-practice-in-the-rehabilitation-of-complex-regional-pain-syndrome-a-survey-of-practitioners
#6
Caroline Miller, Mark Williams, Peter Heine, Esther Williamson, Neil O'connell
INTRODUCTION: International clinical guidelines for Complex Regional Pain Syndrome recommend a wide range and variation of rehabilitation therapies as the core treatment. It is likely that most therapists employ a range of approaches when managing people with Complex Regional Pain Syndrome but a recent Cochrane review identified little evidence relating to the effectiveness of multi-modal rehabilitation. There is need for up to date trials of rehabilitation for Complex Regional Pain Syndrome, but in order to develop a clear model of best practice that can be rigorously evaluated we need to understand current practice...
December 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29227712/a-comparison-of-pain-fatigue-dyspnea-and-their-impact-on-quality-of-life-in-pulmonary-rehabilitation-participants-with-chronic-obstructive-pulmonary-disease
#7
Yi-Wen Chen, Pat G Camp, Harvey O Coxson, Jeremy D Road, Jordan A Guenette, Michael A Hunt, W Darlene Reid
In addition to dyspnea and fatigue, pain is a prevalent symptom in chronic obstructive pulmonary disease (COPD). Understanding the relative prevalence, magnitude, and interference with aspects of daily living of these symptoms can improve COPD management. Therefore, the purposes of this study were to: (1) compare the prevalence and magnitude of dyspnea, fatigue, and pain and how each limits aspects of daily living; (2) determine the association between pain and the other two symptoms; and (3) assess the impact of these symptoms on quality of life in COPD...
December 11, 2017: COPD
https://www.readbyqxmd.com/read/29225879/change-in-bowel-habit-abdominal-pain-and-a-palpable-abdominal-mass-in-a-58-year-old-female
#8
Julian Peacock, Zane Perkins
Giant colonic diverticulum is a rare complication of diverticulosis, which may present in the acute or chronic setting. Colonic resection and en bloc resection of the diverticulum are the favored management, however, conservative treatment remains an option that could be considered in asymptomatic patients with minimal symptoms.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29225469/pelvic-vein-incompetence-clinical-perspectives
#9
REVIEW
David M Riding, Vivak Hansrani, Charles McCollum
Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%-30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. In these patients, clinical management focuses on symptom control rather than treatment. It is possible that pelvic vein incompetence (PVI) is a cause of CPP, although the quality of studies investigating an association is generally low...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29224919/assessment-of-tapentadol-api-abuse-liability-with-the-researched-abuse-diversion-and-addiction-related-surveillance-radars-system
#10
Suzanne K Vosburg, S Geoffrey Severtson, Richard C Dart, Theodore J Cicero, Steven P Kurtz, Mark W Parrino, Jody L Green
Tapentadol, a Schedule II opioid with a combination of µ-opioid activity and norepinephrine reuptake inhibition, is used for the management of moderate to severe acute and chronic pain. Its dual-mechanism of action is thought to reduce opioid-related side effects that can complicate pain management. Since approval, tapentadol has been tracked across multiple outcomes suggesting abuse liability, and a pattern of relatively low, although not absent, abuse liability has been found. This retrospective cohort study further details the abuse liability of tapentadol as an Active Pharmaceutical Ingredient (API) when both immediate-release and extended-release formulations were on the market together (4Q2011 to 2Q2016)...
December 7, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#11
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29223784/thalidomide-attenuates-development-of-morphine-dependence-in-mice-by-inhibiting-pi3k-akt-and-nitric-oxide-signaling-pathways
#12
Muhammad Imran Khan, Majid Momeny, Sattar Ostadhadi, Samane Jahanabadi, Shahram Ejtemaee-Mehr, Bilqees Sameem, Ghazaleh Zarrinrad, Ahmad Reza Dehpour
Morphine dependence and the subsequent withdrawal syndrome restrict its clinical use in management of chronic pain. The precise mechanism for the development of dependence is still elusive. Thalidomide is a glutamic acid derivative, recently has been reconsidered for its clinical use due to elucidation of different clinical effects. Phosphoinositide 3-kinase (PI3K) is an intracellular transducer enzyme which activates Akt which in turns increases the level of nitric oxide. It is well established that elevated levels of nitric oxide has a pivotal role in the development of morphine dependence...
December 6, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29222302/pain-measurement-tools-in-sickle-cell-disease-where-are-we-now
#13
REVIEW
Deepika S Darbari, Amanda M Brandow
Pain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#14
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#15
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222221/acute-pancreatitis-following-oesophagogastroduodenoscopy
#16
Nnamdi Arinze Nwafo
Acute pancreatitis is a well-recognised complication of endoscopic procedures like endoscopic retrograde cholangiopancreatography but not oesophagogastroduodenoscopy (OGD). I report a case of a 33-year-old woman, admitted with severe epigastric pain and vomiting 2 hours after an elective OGD for evaluation of chronic gastrointestinal symptoms. Pancreatitis was diagnosed on the basis of elevated lipase (40 790 U/L; normal 11-82) and findings on imaging studies. Other common causes of acute pancreatitis such as gallstones, alcohol and medications were ruled out...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29222031/evaluation-of-the-effect-of-mesotherapy-in-the-management-of-back-pain-in-police-working-dog
#17
João Ca Alves, Ana Mmp Dos Santos, Ângelo Dp Fernandes
OBJECTIVE: To evaluate the feasibility and effectiveness of mesotherapy in dogs compared with a positive control group. STUDY DESIGN: Experimental, randomized, blinded study. ANIMALS: Fifteen working police dogs with chronic back pain. METHODS: Animals were divided randomly into control (CG; n = 5) and treatment groups (TG; n = 10). A combination of 140 mg lidocaine, 15 mg dexamethasone and 20 mg thiocolchicoside was administered to group TG along with a 70-day course of a placebo, administered as if it was carprofen...
August 19, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#18
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29220782/mindfulness-based-interventions-for-chronic-pain-evidence-and-applications
#19
REVIEW
Muhammad Hassan Majeed, Ali Ahsan Ali, Donna M Sudak
Chronic pain is estimated to occur in from 5.5% to 33% of the world's adult population (Gureje et al., 1998). Chronic pain is frequently treated with opiates, which has produced an opiate addiction crisis (Dowell et al., 2016). Several non-pharmacological treatment alternatives can help manage chronic pain. There is moderate evidence that mindfulness-based interventions (MBIs) such as meditation, yoga, and stress reduction lower the perception of pain, increase mobility, improve functioning and well-being. By integrating MBIs and other therapeutic interventions in a multi-disciplinary pain management plan, clinicians can improve treatment outcomes and potentially decrease pain-related medication utilization...
December 5, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29220541/yoga-for-stroke-rehabilitation
#20
REVIEW
Maggie Lawrence, Francisco T Celestino Junior, Hemilianna Hs Matozinho, Lindsay Govan, Jo Booth, Jane Beecher
BACKGROUND: Stroke is a major health issue and cause of long-term disability and has a major emotional and socioeconomic impact. There is a need to explore options for long-term sustainable interventions that support stroke survivors to engage in meaningful activities to address life challenges after stroke. Rehabilitation focuses on recovery of function and cognition to the maximum level achievable, and may include a wide range of complementary strategies including yoga.Yoga is a mind-body practice that originated in India, and which has become increasingly widespread in the Western world...
December 8, 2017: Cochrane Database of Systematic Reviews
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