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Chronic non cancer pain

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https://www.readbyqxmd.com/read/28802882/chronic-opioid-therapy-modifies-qst-changes-following-ketamine-infusion-in-chronic-pain-patients
#1
Dermot P Maher, Yi Zhang, Shihab Ahmed, Tina Doshi, Charlene Malarick, Kristin Stabach, Jianren Mao, Lucy Chen
The long-term effects of opioids on sensitization processes are believed to be mediated through the NDMA receptor. QST changes observed following a ketamine infusion have been previously described but the effect that chronic opioids will have is not known. The results of this prospective randomized factorial trial compared the thermal QST changes observed following a 0.05 mg/kg ketamine infusion or a saline placebo in chronic pain subjects who were either opioid-naïve or were chronically using opioids for chronic non-cancer pain are presented...
August 9, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28782266/population-exposure-response-modeling-supported-selection-of-naloxegol-doses-in-phase-3-studies-in-patients-with-opioid-induced-constipation
#2
Nidal Al-Huniti, Hongmei Xu, Diansong Zhou, Sergey Aksenov, Robert Fox, Khanh H Bui
Naloxegol is approved for the treatment of opioid-induced constipation (OIC) in adults with chronic non-cancer pain. Population exposure-response models were developed using data from a Phase 2 study comprising 185 adults with OIC. The weekly probability of response defined as having ≥3/week spontaneous bowel movements (SBMs) and ≥1 SBM/week increase over baseline was characterized by a longitudinal mixed-effects logistic regression dose-response model, and the probability of time to discontinuation was modeled with a Weibull distribution function...
August 7, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28770976/non-steroidal-anti-inflammatory-drugs-nsaids-for-chronic-non-cancer-pain-in-children-and-adolescents
#3
REVIEW
Christopher Eccleston, Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28770975/paracetamol-acetaminophen-for-chronic-non-cancer-pain-in-children-and-adolescents
#4
REVIEW
Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson, David G Williams, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28745394/opioids-for-chronic-non-cancer-pain-in-children-and-adolescents
#5
REVIEW
Tess E Cooper, Emma Fisher, Andrew L Gray, Elliot Krane, Navil Sethna, Miranda Al van Tilburg, Boris Zernikow, Philip J Wiffen
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as importantWe designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) in order to review the evidence for children's pain utilising pharmacological interventions in children and adolescents...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28743856/kaposi-sarcoma-in-an-human-immunodeficiency-virus-hiv-seronegative-mediterranean-female-report-of-a-rare-case
#6
Marios Grigoriou, Konstantinia E Kofina, Aristeidis Ioannidis, Domniki K Gerasimidou, Christoforos Efthymiadis, Thomas Zaramboukas
BACKGROUND Kaposi sarcoma is a malignancy commonly linked to HIV infection or immunosuppression. An association with human herpes virus 8 (HHV-8) infection has also been reported. We present a case of classic Kaposi sarcoma in a female Mediterranean patient. CASE REPORT A 57-year-old white female of Greek ethnicity, with no history of HIV infection or immunosuppression, presented to the Surgical Out-patient Department of our Center, with complaints of extensive discolored skin lesion on both legs, initially considered as chronic vein insufficiency...
July 26, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28737843/non-steroidal-anti-inflammatory-drugs-nsaids-for-cancer-related-pain-in-children-and-adolescents
#7
REVIEW
Tess E Cooper, Lauren C Heathcote, Brian Anderson, Marie-Claude Grégoire, Gustaf Ljungman, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for persisting pain in children acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28736104/opioid-induced-constipation-relief-of-fixed-ratio-combination-prolonged-release-oxycodone-naloxone-compared-with-oxycodone-and-morphine-for-chronic-non-malignant-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Lang Huang, Jian-Guo Zhou, Yu Zhang, Fei Wang, Yi Wang, Da-Hai Liu, Xin-Juan Li, Shui-Ping Lv, Su-Han Jin, Yu-Ju Bai, Hu Ma
BACKGROUND: Opioid-induced constipation (OIC) is one of the most frequent and severe adverse events (AEs) following treatment with opioids. Recent studies have indicated that fixed-ratio combination prolonged-release oxycodone/naloxone (OXN PR) could decrease OIC with similar pain relief compared with other opioids. OBJECTIVES: We systematically reviewed (PROSPERO registration numbers: CRD42016036244) the constipation relief of OXN PR compared with other opioids regardless of formulation, prolonged-release or extended-release used for the relief of chronic pain...
July 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#9
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28696784/the-role-of-tramadol-in-pain-management-in-latin-america-a-report-by-the-change-pain-latin-america-advisory-panel
#10
Joäo Batista Santos Garcia, Osvandré Lech, Durval Campos Kraychete, María Antonieta Rico, John Jairo Hernández-Castro, Frantz Colimon, Carlos Guerrero, Manuel Sempértegui Gallegos, Argelia Lara-Solares, José Alberto Flores Cantisani, César Amescua-Garcia, María Del Rocío Guillén Núñez, María Del Rosario Berenguel Cook, Aziza Jreige Iskandar, Patricia Bonilla Sierra
OBJECTIVE: Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. METHODS: Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on pain care quality...
July 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28690839/recent-advances-in-understanding-and-managing-cancer-pain
#11
REVIEW
Marcin Chwistek
Cancer pain remains a significant clinical problem worldwide. Causes of cancer pain are multifactorial and complex and are likely to vary with an array of tumor-related and host-related factors and processes. Pathophysiology is poorly understood; however, new laboratory research points to cross-talk between cancer cells and host's immune and neural systems as an important potential mechanism that may be broadly relevant to many cancer pain syndromes. Opioids remain the most effective pharmaceuticals used in the treatment of cancer pain...
2017: F1000Research
https://www.readbyqxmd.com/read/28666143/prevalence-of-prescription-opioid-use-disorder-among-chronic-opioid-therapy-patients-after-health-plan-opioid-dose-and-risk-reduction-initiatives
#12
Michael Von Korff, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Manu Thakral, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Sascha Dublin
BACKGROUND: No studies have assessed the comparative effectiveness of guideline-recommended interventions to reduce risk of prescription opioid use disorder among chronic opioid therapy (COT) patients. We compared the prevalence of prescription opioid use disorder among COT patients from intervention clinics that had implemented opioid dose and risk reduction initiatives for more than 4 years relative to control clinics that had not. METHODS: After a healthcare system in Washington State implemented interventions to reduce opioid dose and risks, we surveyed 1588 adult primary care COT patients to compare the prevalence of prescription opioid use disorder among COT patients from the intervention and control clinics...
June 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28660479/nerve-growth-factor-antagonists-is-the-future-of-monoclonal-antibodies-becoming-clearer
#13
Bernard Bannwarth, Marie Kostine
Although there is an unmet need for pain medications that are both effective and safe, virtually no novel analgesics have been approved over the past two decades. In view of both experimental and clinical evidence of a major role for nerve growth factor (NGF) in the generation and maintenance of a wide range of pain states, the clinical development of humanised anti-nerve growth factor monoclonal antibodies (anti-NGF mAbs) aroused particular interest. However, the US Food and Drug Administration (FDA) placed a clinical hold on anti-NGF mAb clinical studies in late 2010, first because of reports of serious joint-related adverse events, and afterwards because of sympathetic nervous system safety concerns...
June 28, 2017: Drugs
https://www.readbyqxmd.com/read/28652428/grid-climbing-behaviour-as-a-pain-measure-for-cancer-induced-bone-pain-and-neuropathic-pain
#14
Sarah Falk, Simone Gallego-Pedersen, Nicolas C Petersen
Despite affecting millions of people, chronic pain is generally treated insufficiently. A major point of focus has been the lack of translation from preclinical data to clinical results, with the predictive value of chronic pain models being a major concern. In contrast to current focus on stimulus-based nociceptive responses in preclinical research, development of behavioural tests designed to quantify suspension of normal behaviour is likely a more equivalent readout for human pain-assessment tests. In this study, we quantified grid-climbing behaviour as a non-stimulus-evoked behavioural test for potential use as a measure of neuropathic and cancer-induced bone pain in mice...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28648166/-pain-in-the-dying-patient
#15
Bodil Abild Jespersen, Mette Asbjørn Neergaard
Pain is one of the most frequent symptoms in patients with advanced chronic illnesses. However, knowledge of prevalence and intensity of pain in the last days of life is poor. This review shows that more than half of patients who are dying from either cancer or non-malignant diseases experience pain, but only very few patients have unbearable pain. More knowledge of pain in the last days of life is needed, and teaching symptom management in the dying patient ought to be compulsory at the medical schools in Denmark...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28648164/-pharmacological-treatment-of-chronic-non-cancer-pain
#16
Gitte Handberg
19% of the grown-up Danish population suffer from a chronic pain condition. Most patients are treated by general practi-tioners (GPs), and only a smaller group need specialist treatment. This article goes through the pharmacological possibilities available with a special focus on treatment by GPs. For chronic pain as fibromyalgia and low back pain non-steroidal anti-inflammatory drugs and paracetamol are not recommended on a regular basis. The main pharmacological treatment is tricyclic antidepressants and gabapentinoids...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28647616/photodynamic-therapy-in-dermatology-beyond-non-melanoma-cancer-an-update
#17
REVIEW
Xiang Wen, Yong Li, Michael R Hamblin
Photodynamic therapy (PDT) employs a photosensitizer (PS) and visible light in the presence of oxygen, leading to production of cytotoxic reactive oxygen species, which can damage the cellular organelles and cause cell death. In dermatology PDT has usually taken the form of topical application of a precursor in the heme biosynthesis pathway, called 5-aminolevulinic acid (or its methyl ester), so that an active PS, protoporphyrin IX accumulates in the skin. As PDT enhances dermal remodeling and resolves chronic inflamation, it has been used to treat cutaneous disorders include actinic keratoses, acne, viral warts, skin rejuvenation, psoriasis, localized scleroderma, some non-melanoma skin cancers and port-wine stains...
June 21, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#18
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28632148/claw-foot-a-case-report
#19
Alessandro Innocenti, Francesco Ciancio, Cecilia Taverna, Sara Tanini, Aurelio Portincasa, Domenico Parisi, Marco Innocenti, Vincenzo De Giorgi
A cutaneous horn could be defined as a conical projection on the surface of skin made of cornified material and resembling an animal horn. These lesions most commonly affect light-skinned men aged between 50 to 89 years and usually appear in sun exposed areas. Radiation, chronic irritation and even human papilloma virus-2 infection may be precipitating factors. More than half of the cases originate from either malignant or premalignant lesions, therefore the base of the lesion must be carefully examined histologically...
June 8, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28622286/are-cannabinoids-an-effective-treatment-for-chronic-non-cancer-pain
#20
Rubén F Allende-Salazar, Gabriel Rada
The use of cannabinoids has been proposed as an analgesic for different painful conditions, especially for chronic pain refractory to usual treatment. However, its real efficacy and safety remains controversial. We sought to determine whether cannabinoids are an effective treatment for chronic non-cancer pain. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
June 14, 2017: Medwave
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