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Chronic non cancer pain

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https://www.readbyqxmd.com/read/29790354/-opioids-and-new-trends-in-pain-therapy
#1
Jan Lejčko
Opioids are well known for their ability to reduce the perception of pain without a loss of consciousness. However, the influence of opioids on organism is very complex. Clinical pharmacology of currently available opioid analgesics is determined by three major factors - their opioid receptor properties, pharmacokinetic properties and genetic polymorphism in the opiate receptor and cytochrome P450 isoform. In acute severe pain are opioids very efficient. Long-term experience with opioid analgesia in patients with cancer pain has shown high favorable risk/benefit ratio...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29788455/a-10-yr-analysis-of-chronic-pelvic-pain-and-chronic-opioid-therapy-in-the-women-veteran-population
#2
Sara B Cichowski, Rebecca G Rogers, Yuko Komesu, Erin Murata, Clifford Qualls, Allison Murata, Glen Murata
Introduction: Chronic pelvic pain (CPP) affects an estimated 30% of women Veterans. Previous research shows high rates of narcotic abuse in the women Veteran population. Narcotics are not recommended for the treatment of CPP. Understanding how CPP impacts narcotic prescribing in the women Veteran population is critical to addressing the public health crisis of opioid abuse. Our objective was to compare chronic opioid therapy (COT) prescribed 5 yr prior to and following CPP diagnosis and to identify predictors of COT as well as adverse events associated with COT...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29781244/oprm1-influence-on-and-effectiveness-of-an-individualized-treatment-plan-for-prescription-opioid-use-disorder-patients
#3
Javier Muriel, César Margarit, Beatriz Planelles, María J Serralta, Carmen Puga, María-Del-Mar Inda, Esperanza Cutillas, Domingo Morales, José F Horga, Ana M Peiró
Screening for opioid use disorder should be considered in chronic non-cancer pain (CNCP) patients with long-term use of opioids. The aim of our study was to assess the effectiveness of an individualized treatment plan (ITP) for prescription opioid dependence that included screening of pharmacogenetic markers. An observational prospective study was performed using prescription opioid-dependent CNCP outpatients (n = 88). Patients were divided into nonresponders, responders, or high responders according to their response to the ITP...
May 20, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29765246/efficacy-of-opioids-versus-placebo-in-chronic-pain-a-systematic-review-and-meta-analysis-of-enriched-enrollment-randomized-withdrawal-trials
#4
Diana S Meske, Oluwadolapo D Lawal, Harrison Elder, Valerie Langberg, Florence Paillard, Nathaniel Katz
Introduction: Opioids have been used for millennia for the treatment of pain. However, the long-term efficacy of opioids to treat chronic non-cancer pain continues to be debated. To evaluate opioids' efficacy in chronic non-cancer pain, we performed a meta-analysis of published clinical trials for μ-opioid receptor agonists performed for US Food and Drug Administration approval. Methods: MEDLINE and Cochrane trial register were searched for enriched enrollment randomized withdrawal studies (before June 2016)...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29754428/tapering-off-long-term-opioid-therapy-in-chronic-non-cancer-pain-patients-a-randomized-clinical-trial
#5
Geana Paula Kurita, Jette Højsted, Per Sjøgren
BACKGROUND: The indications for initiating long-term opioid treatment (L-TOT) for chronic non-cancer pain (CNCP) are often unclear and associated with problematic use. This study aimed at evaluating the efficacy of stabilizing opioid therapy followed by a sequential opioid tapering off program in CNCP patients. METHODS: A randomized clinical trial with a medications stabilization period (Phase 1) followed by a opioid tapering off program (Phase 2). In Phase 2, patients were randomized to Control Group (stable treatment) or Taper off Group (sequential opioid dose reduction) and assessed at baseline, after stabilization and up to six months...
May 13, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29745621/chronic-non-cancer-pain-in-children-we-have-a-problem-but-also-solutions
#6
Eduardo Vega, Yves Beaulieu, Rachel Gauvin, Catherine Ferland, Stephanie Stabile, Rebecca Pitt, Victor H Gonzalez Cardenas, Pablo Ingelmo
Chronic non-cancer pain in children and adolescents has been described as "a modern public health disaster" that has generated significant medical and economic burdens within society. Seen as a disease in its own right, chronic pain has short and long-term consequences that impact not only the patient´s health but also that of friends and families, due to significant parenting stress and disruptions in family life and structure. The evidence supporting pharmacological treatments and interventional procedures is limited, and no single strategy has been shown to be completely effective in children with chronic non-cancer pain...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#7
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29735382/evidence-based-nonpharmacologic-strategies-for-comprehensive-pain-care-the-consortium-pain-task-force-white-paper
#8
Heather Tick, Arya Nielsen, Kenneth R Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L Lemmon, Peter Wayne, Veronica Zador
Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC...
March 1, 2018: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29733095/assessment-of-outcomes-following-high-dose-opioid-tapering-in-a-veterans-healthcare-system
#9
Lauren Hundley, Shelley Spradley, Scott Donelenko
OBJECTIVE: To assess the impact of tapering of chronic high dose opioid therapy in veterans prompted by the implementation of the Opioid Safety Initiative in 2013. DESIGN: IRB and VA Office of Research and Development-approved retrospective, observational chart review. SETTING: North Florida/South Georgia Veterans Health System Patients: Veterans on high dose opioid therapy (≥300 mg of morphine equivalents per day) for chronic non-cancer pain as of 1/1/2012 with an opioid agreement discontinuation note documented in the medical record were included...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29731244/engagement-in-online-pain-self-management-improves-pain-in-adults-on-medication-assisted-behavioral-treatment-for-opioid-use-disorders
#10
Marian Wilson, Myles Finlay, Michael Orr, Celestina Barbosa-Leiker, Naghmana Sherazi, Mary Lee A Roberts, Matthew Layton, John M Roll
INTRODUCTION: Persistent pain has been recognized as an important motivator that can lead individuals to misuse opioids. New approaches are needed to test pain treatments that can improve outcomes for people with persistent pain in medication-assisted behavioral treatment for opioid use disorder. This study piloted an online pain self-management program to explore acceptability and treatment effects. METHODS: A sample of 60 adults diagnosed with chronic non-cancer pain and receiving medication-assisted behavioral treatment at one of two clinics were randomized into either treatment group with access to an online pain management program or waitlist attention control...
April 27, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29708541/deep-vein-thrombosis-induced-by-stasis-in-mice-monitored-by-high-frequency-ultrasonography
#11
Ryan N Rys, Mark D Blostein, Catherine A Lemarié
Venous thrombosis is a common condition affecting 1 - 2% of the population, with an annual incidence of 1 in 500. Venous thrombosis can lead to death through pulmonary embolism or results in the post-thrombotic syndrome, characterized by chronic leg pain, swelling, and ulceration, or in chronic pulmonary hypertension resulting in significant chronic respiratory compromise. This is the most common cardiovascular disease after myocardial infarction and ischemic stroke and is a clinical challenge for all medical disciplines, as it can complicate the course of other disorders such as cancer, systemic disease, surgery, and major trauma...
April 13, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29693484/the-dilemma-of-repeat-weak-opioid-prescriptions-experiences-from-swedish-gps
#12
Elsa Ekelin, Anders Hansson
OBJECTIVE: To explore general practitioners' (GP) experiences of dealing with requests for the renewal of weak opioid prescriptions for chronic non-cancer pain conditions. DESIGN: Qualitative focus group interviews. Systematic text condensation analysis. SETTING AND SUBJECTS: 15 GPs, 4 GP residents and 2 interns at two rural and two urban health centres in central Sweden. MAIN OUTCOME MEASURES: Strategies for handling the dilemma of prescribing weak opioids without seeing the patient...
April 25, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29689036/-palliative-care-and-heart-failure-is-it-time-to-talk
#13
Massimo Romanò
Heart failure (HF) is one of the leading causes of hospitalization in high-income countries and has a profound negative impact on quality of life. In the United States there are more than 900,000 new cases per year and over one million hospital admissions with a primary diagnosis of HF. A prevalence of 6,500,000 cases (2.2% of the population of aged >20 years) was estimated for the US in 2014, in which there were 300,000 related deaths. Although survival has increased, thanks to the pharmacological and non pharmacological therapy, roughly 50% of HF patients die within 5 years of being diagnosed...
April 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#14
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29670393/relationship-between-pain-outcomes-and-smoking-history-following-video-assisted-thoracic-surgery-for-lobectomy-a-retrospective-study
#15
Tak Kyu Oh, Kwhanmien Kim, Sanghoon Jheon, Sang-Hwan Do, Jung-Won Hwang, Jin Hee Kim, Young-Tae Jeon, In-Ae Song
Purpose: The relationship between chronic smoking history and postoperative pain remains controversial. This study aimed to elucidate this relationship in non-small cell lung cancer (NSCLC) patients who underwent video-assisted thoracic surgery (VATS) lobectomy. Patients and methods: This retrospective observational study included NSCLC patients treated with VATS lobectomy between January 2011 and July 2017. Demographic and clinical information, including preoperative smoking history, was collected...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#16
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29623667/a-review-of-the-opioid-epidemic-what-do-we-do-about-it
#17
REVIEW
Edward A Shipton, Elspeth E Shipton, Ashleigh J Shipton
The opioid epidemic, with its noticeable increase in opioid prescriptions and related misuse, abuse and resultant deaths in the previous 12 years, is a particularly North American phenomenon. Europe, and particularly low- and middle-income countries, appear to be less influenced by this problem. There is undisputable value in using opioids not only in the treatment of acute pain, but in cancer pain as well. However, opioids are progressively being prescribed more and more for chronic non-cancer pain, despite inadequate data on their efficacy...
April 6, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29601405/high-risk-prescription-opioid-use-among-people-living-with-hiv
#18
Chelsea E Canan, Geetanjali Chander, Anne K Monroe, Kelly A Gebo, Richard D Moore, Allison L Agwu, G Caleb Alexander, Bryan Lau
BACKGROUND: Prescription opioid use is greater among people living with HIV (PLWH), yet little is known about the prevalence of specific types of high-risk use among these individuals. SETTING: We analyzed clinical and demographic data from the HIV Research Network (HIVRN) and prescribing data from Medicaid for non-cancer patients seeking HIV treatment at four urban clinics between 2006-2010. METHODS: HIVRN patients were included in the analytic sample if they received at least one incident opioid prescription...
March 27, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29601400/cochrane-in-corr%C3%A2-interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#19
Kim Madden, Mohit Bhandari
No abstract text is available yet for this article.
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29594972/a-pharmacological-rationale-to-reduce-the-incidence-of-opioid-induced-tolerance-and-hyperalgesia-a-review
#20
REVIEW
Giustino Varrassi, Mariella Fusco, Stephen D Skaper, Daniele Battelli, Panagiotis Zis, Stefano Coaccioli, Maria Caterina Pace, Antonella Paladini
Chronic pain is an important health and social problem. Misuse and abuse of opioids in chronic non-cancer pain management seem to be a huge problem, in some countries. This could probably affect the normal use of such analgesics in patients in need of them. Basic and clinical researches should find the solution to mitigate the potential damage. Dysregulation of mast cell and microglia activation plays an important role in the pathogenesis and management of chronic pain. Persistent mast cell activation sensitizes nociceptors and initiates central nervous system inflammatory processes, involving microglial cell activation and sensitization of spinal somatosensory neurons...
March 28, 2018: Pain and Therapy
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