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https://www.readbyqxmd.com/read/29149142/mapping-the-association-between-vitamin-d-and-low-back-pain-a-systematic-review-and-meta-analysis-of-observational-studies
#1
Joshua Zadro, Debra Shirley, Manuela Ferreira, Ana Paula Carvalho-Silva, Sarah E Lamb, Cyrus Cooper, Paulo H Ferreira
BACKGROUND: Low back pain (LBP) is the highest contributor to disability worldwide, with current intervention strategies only providing small to moderate analgesic effects. The use of vitamin D supplementation for LBP has gained interest due to its proposed anti-inflammatory and neuromodulatory properties. However, it is still unclear whether vitamin D levels differ between those with and without LBP or if vitamin D levels are associated with pain intensity. OBJECTIVES: We aim to investigate the association between vitamin D levels and LBP and to determine if vitamin D levels correlate with pain intensity in individuals with LBP...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148295/is-naloxone-the-best-antidote-to-reverse-tramadol-induced-neuro-respiratory-toxicity-in-overdose-an-experimental-investigation-in-the-rat
#2
Camille Lagard, Isabelle Malissin, Wassila Indja, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
CONTEXT: Since the banning of dextropropoxyphene from the market, overdoses, and fatalities attributed to tramadol, a WHO step-2 opioid analgesic, have increased markedly. Tramadol overdose results not only in central nervous system (CNS) depression attributed to its opioid properties but also in seizures, possibly related to non-opioidergic pathways, thus questioning the efficiency of naloxone to reverse tramadol-induced CNS toxicity. OBJECTIVE: To investigate the most efficient antidote to reverse tramadol-induced seizures and respiratory depression in overdose...
November 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29145288/efficacy-of-cold-application-on-pain-during-chest-tube-removal-a-randomized-controlled-trial-a-consort-compliant-article
#3
Ling-Yu Hsieh, Yi-Rong Chen, Mei-Chun Lu
BACKGROUND: Use of analgesics is the most common method to alleviate the pain induced by chest tube removal (CTR), but patient response to medication can vary and may not be achieved complete relaxation. This study was to determine the effectiveness of cold application in combination with standard analgesic administration before CTR on CTR-induced pain. METHODS: A prospective, randomized, single-blind, sham-controlled study was conducted. In addition to the same routine care, subjects in the experimental group (n = 30) received cold application of 600-g ice packs 15 minutes before CTR, whereas subjects in the sham group (n = 30) received tap water packs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143901/combined-vertebral-augmentation-and-radiofrequency-ablation-in-the-management-of-spinal-metastases-an-update
#4
REVIEW
Ning Mao Kam, Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Brooks, William C Torreggiani, Peter L Munk, Michael J Lee, Ronil V Chandra, Hamed Asadi
Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29142219/electroacupuncture-attenuates-induction-of-inflammatory-pain-by-regulating-opioid-and-adenosine-pathways-in-mice
#5
Hsien-Yin Liao, Ching-Liang Hsieh, Chun-Ping Huang, Yi-Wen Lin
Although inflammatory pain is a common clinical condition, its mechanisms are still unclear. Electroacupuncture (EA), a well-known method of pain management, may reduce inflammatory pain by regulating neurons, astrocytes, and inflammatory signaling pathways. Injections of complete Freund's adjuvant (CFA), which can initiate cell-mediated inflammatory pain, resulted in significant hyperalgesia, which was subsequently prevented by EA. In CFA-injected mice, a dramatic increase was observed in the expression of the following proteins in the dorsal root ganglion and spinal cord dorsal horn: the astrocytic marker GFAP, S100B, RAGE, pPKCε, COX-2, pERK, and pNFκB...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#6
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29139254/-clinical-analysis-of-cervus-and-cucumis-polypeptide-injection-for-lumbar-vertebrae-diseases-based-on-real-world-hospital-information-system
#7
Ming-Yue Gao, Yan-Ming Xie, Yuan-Yuan Li, Yin Zhang, Yan Zhuang
To analyze the clinical drug use characteristics and medication rules of cervus and cucumis polypeptide injection (CCP injection) for the patients with lumbar vertebra diseases. Based on the electronic medical data of 6 990 patients with CCP injection for lumbar vertebra diseases from 25 first-class hospitals over the whole country from 2004, statistical analysis was conducted for their general information, diagnostic information, orders information, laboratory test information and treatment results. The results showed that the age distribution was highest in patients aged 45 to 64 (3 883, 55...
August 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29125423/management-of-chronic-neuropathic-pain-with-single-and-compounded-topical-analgesics
#8
Nebojsa Nick Knezevic, Tatiana Tverdohleb, Farid Nikibin, Ivana Knezevic, Kenneth D Candido
The goal of our review was to emphasize important aspects that physicians should take into consideration when prescribing topical analgesics as part of chronic neuropathic pain treatment. We discuss the dermatopharmacokinetics and microstructural components of the skin, differences between topical and transdermal drug delivery, and topical medication effects on peripheral neuropathy and central sensitization. Even though the US FDA approved topical analgesics are 8%-capsaicin and 5%-lidocaine patches for treating postherpetic neuralgia, there are many other studies conducted on the efficacy of topical ketamine cream, clonidine gel, topical gabapentin, topical baclofen and topical phenytoin for peripheral neuropathic pain, either alone or in combination with other formulations...
November 10, 2017: Pain Management
https://www.readbyqxmd.com/read/29122372/sufentanil-sublingual-tablet-30mcg-for-moderate-to-severe-acute-pain-in-the-emergency-department
#9
James R Miner, Zubaid Rafique, Harold S Minkowitz, Karen P DiDonato, Pamela P Palmer
BACKGROUND: Pharmacological properties of the sufentanil sublingual tablet 30mcg (SST 30mcg) could offer potential analgesic advantages in settings requiring noninvasive, acute pain management. The feasibility of using SST 30mcg for moderate-to-severe pain management in the emergency department (ED) was evaluated. METHODS: This open-label, multicenter feasibility study included patients aged ≥18years who presented to the ED with moderate-to-severe pain (≥4 on the numeric rating scale of pain intensity (NRS); opioid-tolerant patients were excluded...
October 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29121327/short-acting-opioids-are-associated-with-comparable-analgesia-to-long-acting-opioids-in-patients-with-chronic-osteoarthritis-with-a-reduced-opioid-equivalence-dosing
#10
Ameer Ghodke, Stephanie Barquero, Paul R Chelminski, Timothy J Ives
Setting: There are no studies that exist within the primary care setting that address optimal opioid therapy in osteoarthritis patients. In light of the recently released US Centers for Disease Control and Prevention guidelines on opioid use in chronic noncancer pain, there is a pressing need to better characterize the effectiveness of long- and short-acting opioids. Objective: To examine the effectiveness of short-acting opioids (SAO) vs long-acting opioids (LAO) and combination therapies (SAO and LAO) for treating chronic osteoarthritis pain in a retrospective trial...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29119061/emla-anaesthetic-cream-for-debridement-of-burns-a-study-of-plasma-concentrations-of-lidocaine-and-prilocaine-and-a-review-of-the-literature
#11
Stefan Lillieborg, Leif Aanderud
The lidocaine-prilocaine cream (EMLA(TM)) effectively reduces the pain from debridement of chronic leg ulcers. Studies have demonstrated that when applied to leg ulcers, plasma concentrations of the local anaesthetics are well below the threshold for CNS toxicity. However, there are minimal pharmacokinetic data available from EMLA application to burn wounds. This study evaluated EMLA cream for debridement of burns with regard to plasma concentrations of lidocaine and prilocaine, and reviewed the published literature on safety and efficacy of lidocaine-prilocaine applied epicutaneously to burns...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/29114833/effect-of-a-single-dose-of-oral-opioid-and-nonopioid-analgesics-on-acute-extremity-pain-in-the-emergency-department-a-randomized-clinical-trial
#12
Andrew K Chang, Polly E Bijur, David Esses, Douglas P Barnaby, Jesse Baer
Importance: The choice of analgesic to treat acute pain in the emergency department (ED) lacks a clear evidence base. The combination of ibuprofen and acetaminophen (paracetamol) may represent a viable nonopioid alternative. Objectives: To compare the efficacy of 4 oral analgesics. Design, Settings, and Participants: Randomized clinical trial conducted at 2 urban EDs in the Bronx, New York, that included 416 patients aged 21 to 64 years with moderate to severe acute extremity pain enrolled from July 2015 to August 2016...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29114224/chlorpheniramine-potentiates-the-analgesic-effect-in-migraine-of-usual-caffeine-acetaminophen-and-acetylsalicylic-acid-combination
#13
Victor A Voicu, Ion Mircioiu, Roxana Sandulovici, Constantin Mircioiu, Cristina Plesa, Bruno S Velescu, Valentina Anuta
Previous studies indicated that addition of the antihistaminic chlorpheniramine to the usual combination of acetylsalicylic acid, acetaminophen, and caffeine further increases their synergism both in terms of anti-inflammatory and analgesic effect. The present non-interventional study tested the superiority of two Algopirin® tablets, containing a total of 250 mg acetylsalicylic acid (ASA), 150 mg acetaminophen (paracetamol, PAR), 30 mg caffeine (CAF) and 4 mg chlorpheniramine (CLF) vs. a combination containing 250 mg ASA, 250 mg PAR, and 65 mg CAF recognized as "safe and effective" by FDA in treating migraine...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29112108/nitrous-oxide-70-for-procedural-analgosedation-in-a-pediatric-emergency-department-with-or-without-intranasal-fentanyl-analgesic-efficacy-and-adverse-events-if-combined-with-intranasal-fentanyl
#14
Michelle Seiler, Markus A Landolt, Georg Staubli
OBJECTIVES: Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF. METHODS: Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29109642/comparison-of-intra-articular-analgesics-in-arthroscopic-anterior-cruciate-ligament-reconstruction-surgeries-a-randomized-controlled-trial
#15
Vijayalakshmi Sivapurapu, Shishir Suranigi Murugharaj, Sai Saran Panathula Venkata
Background and Aims: Arthroscopic anterior cruciate ligament reconstruction (ACLR) is one of the most common knee surgeries done worldwide today. It involves immense pain at sites of graft harvest, tibial, and femoral tunnels, thereby delaying recovery and increased patient morbidity, and delayed rehabilitation. Various drugs and combination of drugs administered intra-articularly have been studied for analgesic efficacy. Our study gives an insight if there is any added advantage of additives morphine or clonidine to bupivacaine when compared to administering bupivacaine alone...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#16
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29105478/-possible-living-factors-influencing-the-efficacy-of-acupuncture-analgesia-between-chinese-and-western-populations-caffeine
#17
Xiang Cui, Kun Liu, Mu-Jun Zhi, Ting Zhao, Xun He, Hao Liu, Xin-Yan Gao, Bing Zhu
It has been known for thousands of years that acupuncture can relieve pain. However, the efficacy of acupuncture analgesia (AA) now has to be reconsidered due to negative reports from western countries. In the present study, the possible correlation between caffeine and the difference in AA in China and western countries was determined using the following factors:1) caffeine and pain; 2) adenosine, adenosine receptor and caffeine; 3) AA and caffeine. As a non-selective antagonist of the adenosine receptor, caffeine at low doses can be used as an adjuvant analgesic, and can augment antinociception combined with other analgesics...
October 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29101904/the-attribution-of-a-death-to-heroin-a-model-to-help-improve-the-consistent-and-transparent-classification-and-reporting-of-heroin-related-deaths
#18
Nathan C Stam, Dimitri Gerostamoulos, Paul M Dietze, Sarah Parsons, Karen Smith, Belinda Lloyd, Jennifer L Pilgrim
INTRODUCTION: Accurate attribution of heroin-related deaths, as well as the differentiation from other opioid analgesic-related deaths, is essential from a public health perspective. Heroin-related deaths involve a number of complexities where heroin-specific or non-specific metabolites and indicators (6-acetylmorphine [6-AM], morphine, and codeine) may or may not be detected. The aims of this study were therefore to develop a model for improved consistency in the attribution of heroin-related deaths and to determine areas of variation in the current decision-making processes...
October 18, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29101861/clinical-characteristics-and-overuse-patterns-of-medication-overuse-headache-retrospective-case-series-study
#19
Karolis Kluonaitis, Elena Petrauskiene, Kristina Ryliskiene
According to Eurolight project's results, frequency of medication overuse headache in Lithuania is similar to other European countries. However, data on the characteristics of the disorder is lacking. OBJECTIVE: The aim was to analyze clinical characteristics and overuse patterns of patients with medication overuse headache. PATIENTS AND METHODS: Retrospective study was conducted in out-patient department of university hospital. 57.0% of the patients were from Vilnius and 43...
October 31, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29098567/oxycodone-naloxone-prolonged-release-a-review-in-severe-chronic-pain
#20
Esther S Kim
Oral oxycodone/naloxone prolonged release (PR) [Targin(®), Targinact(®), Targiniq(®)] is a 12-hourly opioid receptor agonist and opioid receptor antagonist fixed-dose combination product that is approved in countries in the EU for the management of severe pain (adequately manageable only with opioid analgesics) in adults. Oral naloxone prevents oxycodone from binding to μ-receptors in the gastrointestinal (GI) tract, thereby counteracting opioid-induced constipation (OIC). In short-term (5- to 12-week) clinical trials of adults with moderate to severe, chronic pain and OIC (OXN3001, OXN3006, OXN3506), oxycodone/naloxone PR significantly improved OIC while providing noninferior analgesia relative to oxycodone PR; results were consistent between cancer and non-cancer patients in OXN3506...
December 2017: Clinical Drug Investigation
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