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Chronic pain management

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https://www.readbyqxmd.com/read/29677029/kindlin-1-regulates-astrocyte-activation-and-pain-sensitivity-in-rats-with-neuropathic-pain
#1
Baisong Zhao, Yongying Pan, Haiping Xu, Xingrong Song
BACKGROUND AND OBJECTIVES: Astrocyte activation has been implicated in the pathogenesis of neuropathic pain, but the involvement of kindlin-1 in astrocyte activation and neuropathic pain has not yet been illustrated. Using a chronic constriction injury (CCI) rat model of neuropathic pain, we investigated the expression levels of kindlin-1 during neuropathic pain and the influences of kindlin-1 on regulating pain sensitivity. METHODS: Neuropathic pain was induced in rats by CCI of the sciatic nerve...
April 19, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29676223/opiate-free-tricuspid-valve-replacement-case-report
#2
Jeffrey P Cardinale, George Gilly
The utility of opioid pain medications for perioperative analgesia is well described. However, opioids have many dangerous side effects including respiratory depression, acute tolerance, hyperalgesia, and chronic opioid dependence. Multimodal approaches continue to be used in more invasive and complex surgical procedures for enhanced recovery and decreased postoperative complications from opioid administration. The current case report centers on a 30-year-old male recovering from opioid addiction presenting with severe tricuspid regurgitation scheduled to undergo a tricuspid valve replacement...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29675635/intussusception-after-roux-en-y-gastric-bypass-laparoscopic-management
#3
Enrico Facchiano, Emanuele Soricelli, Luca Leuratti, Viviana Caputo, Giovanni Quartararo, Marcello Lucchese
INTRODUCTION: Intussusception represents an uncommon cause of intestinal obstruction after Rouxen-Y gastric bypass. Symptoms are not specific and clinical presentation may vary from acute intestinal obstruction with or without bowel necrosis to intermittent or chronic pain. CT scan is the diagnostic test of choice. MATERIALS AND METHODS: A 38-year-old woman who had undergone RYGBP 5 months prior was admitted to our Emergency Department with acute abdominal pain, alimentary and bilious vomiting, and fever...
April 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29674981/comparative-effect-of-collaborative-care-pain-medication-and-duloxetine-in-the-treatment-of-major-depressive-disorder-and-comorbid-sub-chronic-pain-results-of-an-exploratory-randomized-placebo-controlled-multicenter-trial-cc-paindip
#4
Eric W de Heer, Jack Dekker, Aartjan T F Beekman, Harm W J van Marwijk, Tjalling J Holwerda, Pierre M Bet, Joost Roth, Lotte Timmerman, Christina M van der Feltz-Cornelis
Objective: Evidence exists for the efficacy of collaborative care (CC) for major depressive disorder (MDD), for the efficacy of the consequent use of pain medication against pain, and for the efficacy of duloxetine against both MDD and neuropathic pain. Their relative effectiveness in comorbid MDD and pain has never been established so far. This study explores the effectiveness of CC with pain medication and duloxetine, and CC with pain medication and placebo, compared with duloxetine alone, on depressive and pain symptoms...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29673974/randomized-controlled-trial-of-nurse-delivered-cognitive-behavioral-therapy-versus-supportive-psychotherapy-telehealth-interventions-for-chronic-back-pain
#5
Thomas Rutledge, J Hampton Atkinson, Rachael Holloway, Tatiana Chircop-Rollick, John D'Andrea, Steven R Garfin, Shetal Patel, Donald B Penzien, Mark Wallace, Anne L Weickgenant, Mark Slater
This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ)...
April 16, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29673066/total-pancreaticoduodenectomy-with-autologous-islet-transplantation-fourteen-years-after-liver-contained-composite-visceral-transplantation
#6
Ahmed Nassar, Cristiano Quintini, Guilherme Costa, Elizabeth Lennon, Rita Bottino, Betul Hatipoglu, Koji Hashimoto, Masato Fujiki, Fouad Kandeel, R Matthew Walsh, Kareem Abu-Elmagd
Chronic pancreatitis (CP) is a severely disabling disorder with potential detrimental effects on quality of life, gut function, and glucose homeostasis. Disease progression often results in irreversible morphological and functional abnormalities with development of chronic pain, mechanical obstruction, and pancreatic insufficiency. Along with comprehensive medical management, the concept of total pancreatectomy and islet autotransplantation (TP-AIT) was introduced forty years ago for patients with intractable pain and preserved beta-cell function...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29672097/cognitive-and-affective-mechanisms-of-pain-and-fatigue-in-multiple-sclerosis
#7
Anne Arewasikporn, Aaron P Turner, Kevin N Alschuler, Abbey J Hughes, Dawn M Ehde
OBJECTIVE: To examine the extent to which pain catastrophizing, fatigue catastrophizing, positive affect, and negative affect simultaneously mediated the associations between common symptoms of multiple sclerosis (MS; i.e., pain, fatigue) and impact on daily life, depressive symptoms, and resilience. METHOD: Participants were community-dwelling adults with MS (N = 163) reporting chronic pain, fatigue, and/or moderate depressive symptoms. Multiple mediation path analysis was used to model potential mediators of pain and fatigue separately, using baseline data from a randomized controlled trial comparing two symptom self-management interventions...
April 19, 2018: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/29671836/children-s-experience-of-symptoms-narratives-through-words-and-images
#8
REVIEW
Barbara M Sourkes
Children who live with a complex chronic or life-threatening illness face extraordinary challenges. Whether they are receiving disease-oriented treatment (aimed at potential cure or prolongation of life) or palliative treatment-or both concurrently-our challenge is to enhance their comfort and minimize their distress. Symptom management is thus a critical component of pediatric palliative care. Symptoms may be either physical or psychological in nature (or a confluence of both) and their effective management has a direct impact on the child's quality of life...
April 19, 2018: Children
https://www.readbyqxmd.com/read/29671505/care-of-the-colorectal-cancer-survivor
#9
Kristina Burgers, Clint Moore, Lori Bednash
Colorectal cancer is the fourth most common cancer in the United States and has a five-year survival rate of 65%. The American Cancer Society and other experts have released guidelines on surveillance, health promotion, screening for other malignancies, and management of treatment effects. Surveillance for disease recurrence should occur every three to six months for the first two to three years, then every six months for a total of five years. Each visit should include a history and physical examination, routine care for chronic medical conditions, and screening for other primary cancers according to guidelines for the general population...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29670505/selective-fiber-degeneration-in-the-peripheral-nerve-of-a-patient-with-severe-complex-regional-pain-syndrome
#10
Adrien Yvon, Alessandro Faroni, Adam J Reid, Vivien C Lees
Aims: Complex regional pain syndrome (CRPS) is characterized by chronic debilitating pain disproportional to the inciting event and accompanied by motor, sensory, and autonomic disturbances. The pathophysiology of CRPS remains elusive. An exceptional case of severe CRPS leading to forearm amputation provided the opportunity to examine nerve histopathological features of the peripheral nerves. Methods: A 35-year-old female developed CRPS secondary to low voltage electrical injury. The CRPS was refractory to medical therapy and led to functional loss of the forelimb, repeated cutaneous wound infections leading to hospitalization...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29670394/management-of-chronic-pain-after-hernia-repair
#11
REVIEW
Kristoffer Andresen, Jacob Rosenberg
Chronic pain following inguinal hernia repair is a common problem and feared complication. Up to 16% of people experience chronic pain following the repair of a groin hernia. The aim of this review was to provide an overview of treatment strategies for patients with chronic pain following inguinal hernia repair based on best practice guidelines and current clinical routines. The optimal management of chronic pain following inguinal hernia surgery should begin with a thorough clinical examination to rule out other causes of chronic pain and to rule out a recurrence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29669658/living-with-chronic-pain
#12
Barby Ingle
A health educator who has reflex sympathetic dystrophy, an autoimmune condition involving chronic pain, shares her knowledge about living life to the fullest while dealing with a chronic health condition. Her advice encompasses dealing with the health care system, managing information, and obtaining physical and emotional self-care.
April 1, 2018: Creative Nursing
https://www.readbyqxmd.com/read/29669311/a-new-clinical-model-for-facilitating-the-development-of-pattern-recognition-skills-in-clinical-pain-assessment
#13
David M Walton, James M Elliott
Common, enigmatic musculoskeletal conditions such as whiplash-associated disorder, myofascial pain syndrome, low back pain, headache, fibromyalgia, osteoarthritis, and rotator cuff pathology, account for significant social, economic, and personal burdens on a global scale. Despite their primacy (and shared sequelae) there remains a paucity of available and effective management options for patients with both acute and chronic conditions. Establishing an accurate prognostic or diagnostic profile on a patient-by-patient basis can challenge the insight of both novice and expert clinicians...
April 9, 2018: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/29669089/what-works-and-does-not-work-in-a-self-management-intervention-for-people-with-chronic-pain-qualitative-systematic-review-and-meta-synthesis
#14
Hemakumar Devan, Leigh Hale, Dagmar Hempel, Barbara Saipe, Meredith A Perry
Background: Self-management interventions fostering self-efficacy improve the well-being of people with chronic pain. Purpose: The purpose of this study was to synthesize the enablers (what works) and barriers (what does not) of incorporating self-management strategies for people in everyday life after completion of a pain self-management intervention. Data Sources: Major electronic databases (MEDLINE, AMED, PsycINFO, Cochrane Library, PubMed, CINAHL, Scopus, and Google Scholar) were searched from inception to July 2016...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669085/reducing-opioid-use-for-patients-with-chronic-pain-an-evidence-based-perspective
#15
Sarah Wenger, Jason Drott, Rebecca Fillipo, Alyssa Findlay, Amanda Genung, Jessica Heiden, Joke Bradt
The implementation of recent Centers for Disease Control and Prevention recommendations to move away from opioids and toward nonpharmacological therapies for the treatment of chronic pain could involve a difficult transition period for patients and practitioners. The focus of treatment should shift from eliminating pain completely to minimizing the impact of pain on quality of life. Many patients with chronic pain take opioids either because opioids were previously prescribed as a first-line treatment for chronic pain, on the basis of old standards of care, or because opioids were initially prescribed for acute pain...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669084/advancing-psychologically-informed-practice-for-patients-with-persistent-musculoskeletal-pain-promise-pitfalls-and-solutions
#16
Francis J Keefe, Chris J Main, Steven Z George
There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669082/cognitive-functional-therapy-an-integrated-behavioral-approach-for-the-targeted-management-of-disabling-low-back-pain
#17
Peter B O'Sullivan, J P Caneiro, Mary O'Keeffe, Anne Smith, Wim Dankaerts, Kjartan Fersum, Kieran O'Sullivan
Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669081/prediction-of-persistent-musculoskeletal-pain-at-12-months-a-secondary-analysis-of-the-optimal-screening-for-prediction-of-referral-and-outcome-ospro-validation-cohort-study
#18
Jason M Beneciuk, Trevor A Lentz, Ying He, Samuel S Wu, Steven Z George
Background: Musculoskeletal pain is a societal epidemic because it is highly prevalent and a leading contributor to disability; however, physical therapists are still challenged when predicting which patients are at high risk for persistent symptoms. Objective: The objectives of this study were to identify patient characteristics predictive of persistent musculoskeletal pain 12 months following physical therapist care and to determine the influence of anatomical region...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29668635/effect-of-intradiscal-pulsed-radiofrequency-on-refractory-chronic-discogenic-neck-pain-a-case-report
#19
So Young Kwak, Min Cheol Chang
RATIONALE: Despite medication, exercise, and medical intervention, many patients complain of persistent discogenic neck pain. To manage discogenic neck pain, we performed intradiscal pulsed radiofrequency (PRF) stimulation in a patient with chronic discogenic neck pain refractory to oral medication and epidural steroid injection. PATIENT CONCERNS: A 26-year-old man presented with a numeric rating scale (NRS) score of 7 for chronic neck pain. His pain was worse when the neck was held in one position for a prolonged period...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668612/treatment-by-ultrasound-guided-local-infiltration-in-adhesion-related-abdominal-pain-and-intractable-hiccups-a-case-report
#20
Dan Zhu, Zhi-Yong Gu, Chia-Shiang Lin, Fa-Chuan Nie, Jian Cui
RATIONALE: Abdominal pain and hiccups secondary to intra-abdominal adhesion are surgical complications that are often treated by painkillers and secondary surgeries with an unsatisfactory therapeutic effect. This study presents a new treatment method that uses ultrasound-guided local infiltration in peritoneal and abdominal wall adhesions in patients with hiccups and abdominal pain. PATIENT CONCERNS: A 62-year-old patient presented to our hospital with a history of intractable hiccups and abdominal pain for 30 years...
April 2018: Medicine (Baltimore)
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