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Integrative pain management

Rosechelle M Ruggiero
The entity of chronic critical illness (CCI) has shown a rise in the past decades for popularity and prevalence. CCI is loosely defined as the group of patients who require the intensive care setting for weeks to months; its hallmark is prolonged mechanical ventilation. The outcomes of chronically critically ill patients have been dismal and have not improved over time; 1-year survival hovers at approximately 50%. Given the high mortality, prognostic variables are important when making medical decisions. CCI encompasses a syndrome that includes altered pathophysiology across a variety of organ systems...
March 2018: American Journal of the Medical Sciences
Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Leen Aerts, Lorraine Grangier, Isabelle Streuli, Patrick Dällenbach, Roberto Marci, Jean-Marie Wenger, Nicola Pluchino
Endometriosis-associated pelvic pain is a major health concern in women of childbearing age. Controlled studies have shown that endometriosis can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life. Furthermore, women with endometriosis report significantly more sexual dysfunctions compared to healthy women. Empirical studies indicate that specific psychosocial factors may modulate pain experience, pain-related distress and treatment outcome...
February 8, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Marie Fallon, Jane Walker, Lesley Colvin, Aryelly Rodriguez, Gordon Murray, Michael Sharpe
Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to either implement EPAT or to continue UC...
March 15, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Scott A Mosley, J Kevin Hicks, Diane G Portman, Kristine A Donovan, Priya Gopalan, Jessica Schmit, Jason Starr, Natalie Silver, Yan Gong, Taimour Langaee, Mike Clare-Salzler, Petr Starostik, Young D Chang, Sahana Rajasekhara, Joshua E Smith, Heloisa P Soares, Thomas J George, Howard L McLeod, Larisa H Cavallari
INTRODUCTION: Pain is one of the most burdensome symptoms associated with cancer and its treatment, and opioids are the cornerstone of pain management. Opioid therapy is empirically selected, and patients often require adjustments in therapy to effectively alleviate pain or ameliorate adverse drug effects that interfere with quality of life. There are data suggesting CYP2D6 genotype may contribute to inter-patient variability in response to opioids through its effects on opioid metabolism...
March 10, 2018: Contemporary Clinical Trials
Sujeewa P B Thalgaspitiya, Buddhika T B Wijerathne, Buddhika D B Thennakoon
The Indian crested porcupine, Hystrix indica, is a large rodent with the unique feature of long quills. These quills are an integral part of its defense mechanism against predators. Injuries resulting from human contact with quills may cause pain, bleeding, and swelling. Quill-related injuries are common among animals such as dogs, cats, and some wild animals. The mechanism of injury, consequences, and management of injuries to humans from H indica quills are rarely described. In this report, we describe the injuries and management of a man who sustained injury from H indica quills...
March 9, 2018: Wilderness & Environmental Medicine
Thomas Krysztofiak, John Byrne
High-sensitivity cardiac troponin assays have emerged as a powerful tool in the management of patients presenting acutely to hospital with suspected cardiac chest pain. Recent guidelines emphasize the reassurance offered by low troponin concentrations early after admission. We describe a patient with known coronary artery disease, who presented with a classical history of recurrent myocardial ischaemia. High-sensitivity cardiac Troponin-I concentrations remained in the low-normal sex-specific reference range, despite serial testing on the day of admission, and despite recurrent pain with dynamic ECG changes...
January 1, 2018: Scottish Medical Journal
Masood Umer, Yasir Mohib, Muhammed Atif, Muhammad Nazim
Background: Renal cell carcinoma account for 3% of all cancers, with peak incidence between 60 and 70 years of age predominantly affecting male population. Renal carcinoma is the most common malignancy of kidney constitutes for 80-90% of renal neoplasm with an overall 45% five years survival rate. Majority are diagnosed incidentally during investigation for other disease process of abdomen. Classical triad of gross hematuria, pain and palpable mass in abdomen is rare accounting to only 6-10%...
March 2018: Annals of Medicine and Surgery
Paolo Ceruti, Sara Lonni, Francesca Baglivo, Giampietro Marchetti
Malignant pleural mesothelioma (MPM) is an asbestos-related aggressive tumor, that requires proper diagnosis and management. Symptoms are nonspecific and chest computed tomography (CT) and chest ultrasound (US) are important radiological tools in the initial workup to identify early pathological signs. Performing a medical thoracoscopy (MT) is essential for a definitive diagnosis of MPM. The procedure, integrated with a prior US, allows a global evaluation of the pleural cavity and the execution of multiple targeted biopsies, with low risk of complications...
January 2018: Journal of Thoracic Disease
Jenna Goesling, Lewei A Lin, Daniel J Clauw
PURPOSE OF REVIEW: Chronic pain impacts millions of people in the USA. At the heart of the problem of chronic pain remains the complex psychosocial aspects associated with living with chronic pain. Given the overlap between chronic pain and mental health, a promising treatment approach is to improve how we integrate psychiatry into pain management. RECENT FINDINGS: Treatment of chronic pain and comorbid mental health issues requires a multidisciplinary approach...
March 5, 2018: Current Psychiatry Reports
Leo Nherera, Paul Trueman, Alan Horner, Tracy Watson, Alan J Johnstone
BACKGROUND: Intertrochanteric hip fractures are common and devastating injuries especially for the elderly. Surgical treatment is the optimal strategy for managing intertrochanteric fractures as it allows early rehabilitation and functional recovery. The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain limited to relatively small studies which create uncertainty in attempts to establish evidence-based best practice. METHODS: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies to assess the clinical effectiveness of two commonly used intramedullary devices: a twin screw integrated cephalomedullary nail (InterTAN) versus a single screw cephalomedullary nail (proximal femoral nail antirotation) in patients with intertrochanteric fractures...
March 2, 2018: Journal of Orthopaedic Surgery and Research
Amy Helstrom, Josh Haratz, Shirley Chen, Amy Benson, Joel Streim, David Oslin
OBJECTIVE: Few studies have explored behavioral strategies for managing chronic pain in older adults. Pain Care Management (PCM) is a telephone-based behavioral intervention for chronic pain. The present study examined chronic pain characteristics among older adults and tested the delivery of PCM as an adjunct to depression and anxiety care management. METHODS: Participants were drawn from a state-sponsored program offering care management services to community members aged 65 and older who were prescribed a psychotropic medication by a primary care provider...
March 2, 2018: International Journal of Geriatric Psychiatry
Diane M Flynn, Linda H Eaton, Honor McQuinn, Ashley Alden, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation...
December 2017: Contemporary Clinical Trials Communications
Annmarie Cano, Angelia M Corley, Shannon M Clark, Sarah C Martinez
Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners' health...
February 2018: Cognitive and Behavioral Practice
Anthony J Lisi, Stacie A Salsbury, Cheryl Hawk, Robert D Vining, Robert B Wallace, Richard Branson, Cynthia R Long, A Lucille Burgo-Black, Christine M Goertz
OBJECTIVE: The purpose of this study was to develop an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within Department of Veterans Affairs health care facilities. METHODS: The research method used was a consensus process. A multidisciplinary investigative team reviewed clinical guidelines and Veterans Affairs pain and mental health initiatives to develop seed statements and care algorithms to guide chiropractic management and collaborative care of veterans with low back pain...
February 2018: Journal of Manipulative and Physiological Therapeutics
Olöf Birna Kristjansdottir, Una Stenberg, Jelena Mirkovic, Tonje Krogseth, Tone Marte Ljoså, Kurt C Stange, Cornelia M Ruland
BACKGROUND: Self-management of chronic illness can be highly demanding and people need to mobilize their personal strengths to live well with their condition. More knowledge is needed about how people with chronic illness perceive and use their personal strengths as a basis for better integrating empowering person-centred approaches into health care. OBJECTIVE: To explore what people with chronic illness describe as their strengths relevant to their health and well-being...
February 25, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Pietro Calcagno, Matteo Viti, Alessandro Cornelli, Davide Galli, Corrado D'Urbano
INTRODUCTION: Endometriosis is the growth of endometrium outside the uterine cavity. In 5-15% of cases the disease can affect the colon and small bowel, causing complete obstruction and requiring resection in about 1% of cases. CASE SUMMARY: We describe a case of sigmoid obstruction due to endometriosis in a 38 years old woman with personal history of endometriosis. She was admitted for abdominal pain and constipation. The patient was treated with endoscopic stenting and subsequent laparoscopic sigmoidectomy...
February 14, 2018: International Journal of Surgery Case Reports
Mark S Wallace, James North, Eric J Grigsby, Leonardo Kapural, Mahendra R Sanapati, Stephen G Smith, Channing Willoughby, Patrick J McIntyre, Steven P Cohen, Richard M Rosenthal, Shaik Ahmed, Ricardo Vallejo, Farshad M Ahadian, Thomas L Yearwood, Allen W Burton, Edward J Frankoski, Jai Shetake, Sherry Lin, Brad Hershey, Benjamin Rogers, Nitzan Mekel-Bobrov
Objective: Despite the high prevalence of chronic multisite pain, there is little consensus on methods to characterize it. Commonly used assessments report only one dimension of pain, that is, intensity, thus ignoring the spatial aspect of pain. We developed a novel pain quantification index, the Integrated Pain Quantification Index (IPQI), on a scale of 0 to 1 that integrates multiple distinct pain measures into a single value, thus representing multidimensional pain information with a single value...
February 21, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jeffery A Dusek, Kristen H Griffin, Michael D Finch, Rachael L Rivard, David Watson
OBJECTIVES: An important task facing hospitals is improving pain management without raising costs. Integrative medicine (IM), a promising nonpharmacologic pain management strategy, is yet to be examined for its cost implications in an inpatient setting. This institution has had an inpatient IM department for over a decade. The purpose was to examine the relationship between changes in patients' pain, as a result of receiving IM therapy, and total cost of care during an inpatient hospital admission...
February 23, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Sarah Filiatreault, Marilyn Hodgins, Richelle Witherspoon
AIM: The aim of this review was to locate, retrieve and critically appraise practice guidelines for the management of hip fractures. Given increasing evidence that the early recognition and management of these fractures is integral to achieving optimal outcomes, recommendations for the pre-operative period were synthesised and compared. BACKGROUND: Hip fractures are associated with high rates of adverse outcomes and high healthcare costs which has resulted in the development of multiple practice guidelines to inform clinical decision-making...
February 23, 2018: Journal of Advanced Nursing
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