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Integrative pain management

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https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#1
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 18, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28814263/acute-pain-management-in-hospitalized-children
#2
Ria Dancel, Edmund Allen Liles, Darren Fiore
BACKGROUND: Acute pain in hospitalized pediatric patients is prevalent. Recent shifts in the paradigm of pediatric acute pain management focus less on reliance on opioids, due to their adverse side effects and risk of dependence, and more on multimodal pain management. OBJECTIVE: We sought to review the most recent studies on acute pain management in hospitalized pediatric patients. METHODS: We searched the Cochrane Database and PubMed for articles published in the past five years regarding the treatment of acute pain in pediatric patients focusing on large randomized or quasi-randomized control trials, cohort trials, and meta-analyses...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28812985/interventions-to-support-integrated-psychological-care-and-holistic-health-outcomes-in-paediatrics
#3
REVIEW
Roz Shafran, Sophie D Bennett, Mhairi McKenzie Smith
There are strong calls from many national and international bodies for there to be a 'holistic' and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies...
August 16, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28811270/developing-and-evaluating-jiapp-acceptability-and-usability-of-a-smartphone-app-system-to-improve-self-management-in-young-people-with-juvenile-idiopathic-arthritis
#4
Ran A Cai, Dominik Beste, Hema Chaplin, Socrates Varakliotis, Linda Suffield, Francesca Josephs, Debajit Sen, Lucy R Wedderburn, Yiannakis Ioannou, Stephen Hailes, Despina Eleftheriou
BACKGROUND: Flare-ups in juvenile idiopathic arthritis (JIA) are characterized by joint pain and swelling and often accompanied with fatigue, negative emotions, and reduced participation in activities. To minimize the impact of JIA on the physical and psychosocial development and well-being of young people (YP), it is essential to regularly monitor disease activity and side effects, as well as to support self-management such as adherence to treatment plans and engagement in general health-promoting behaviors...
August 15, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28806822/-multiple-myeloma-current-status-in-diagnostic-testing-and-therapy
#5
Michael Kehrer, Sebastian Koob, Andreas Strauss, Dieter Christian Wirtz, Jan Schmolders
Background Multiple myeloma is a haematological blood cancer of the bone marrow and is classified by the World Health Organisation (WHO) as a plasma cell neoplasm. In multiple myeloma, normal plasma cells transform into malignant myeloma cells and produce large quantities of an abnormal immunoglobulin called monoclonal protein or M protein. This ultimately causes multiple myeloma symptoms such as bone damage or kidney problems. The annual worldwide incidence of multiple myeloma is estimated to be 6 - 7/100,000 and accounts for 1% of all cancer...
August 14, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28805585/understanding-and-treating-pain-syndromes-in-parkinson-s-disease
#6
Marialuisa Gandolfi, Christian Geroin, Angelo Antonini, Nicola Smania, Michele Tinazzi
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805581/nonmotor-parkinson-s-and-future-directions
#7
Nataliya Titova, K Ray Chaudhuri
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are integral to the condition largely regarded as a motor syndrome. A range of NMS underpin the prodromal stage of Parkinson's and are present with variable frequency, range, and nature across the whole journey of a patient with Parkinson's from the onset of the motor disease to palliative stage. These symptoms also are key determinants of quality of life of the patient as well as the carer. Despite this, recognition management and focused treatment of NMS of PD remain poor...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28802475/integrative-pain-management
#8
REVIEW
Robert Alan Bonakdar
Chronic pain is one of the most common conditions seen in the clinic, and it is often one of the most frustrating for both clinicians and patients. This condition stems from common comorbidities, including depression, insomnia, fatigue, and physical deconditioning, which often create barriers to recovery. In addition, chronic pain has had divergent approaches for treatment, including an overemphasis on analgesia and curative treatments while underemphasizing the biopsychosocial needs of those in pain. This article attempts to provide an initial framework for approaching those in pain and initiating patient-centered options to support improvements in pain, function, and self-care...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28797863/palliative-care-development-in-mongolia
#9
Odontuya Davaasuren, Frank Ferris
CONTEXT: Since the year 2000, Mongolia has established the foundation measures for a national palliative care program and has made several significant achievements. METHODS: Systematic reviews and observational studieson palliative care development in Mongolia have taken place overthe past 16 years. RESULTS: Mongolia began palliative care development in 2000 with the creation of the Mongolian Palliative Care Society and the Palliative Care Department...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#10
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28780728/predictive-model-of-complexity-in-early-palliative-care-a-cohort-of-advanced-cancer-patients-palcom-study
#11
Albert Tuca, Mónica Gómez-Martínez, Aleix Prat
PROPOSAL: Model of early palliative care (PC) integrated in oncology is based on shared care from the diagnosis to the end of life and is mainly focused on patients with greater complexity. However, there is no definition or tools to evaluate PC complexity. The objectives of the study were to identify the factors influencing level determination of complexity, propose predictive models, and build a complexity scale of PC. PATIENTS AND METHOD: We performed a prospective, observational, multicenter study in a cohort of advanced cancer patients with an estimated prognosis ≤ 6 months...
August 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28780544/using-mixed-methods-to-assess-fidelity-of-delivery-and-its-influencing-factors-in-a-complex-self-management-intervention-for-people-with-osteoarthritis-and-low-back-pain
#12
Elaine Toomey, James Matthews, Deirdre A Hurley
OBJECTIVES AND DESIGN: Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. SETTING: Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28771874/clinicians-perceptions-and-recognition-of-practice-improvement-strategies-to-prevent-harms-to-older-people-in-acute-care-hospitals
#13
Michele McGrath, Mari Botti, Bernice Redley
AIMS & OBJECTIVES: Explore clinicians' perceptions of practice improvement strategies used to prevent harms to older people during acute hospitalisation. BACKGROUND: Older people are vulnerable to many interrelated preventable harms during acute care hospitalisation. Improvement strategies recommend standardisation of practices to assist healthcare staff mitigate risk, however, older people continue to suffer preventable harms in acute hospitals. METHODS: A qualitative exploratory descriptive design was used to collect data using focus groups and individual interviews from a purposive sample of 33 participants...
August 3, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28765184/environmental-sensitivity-as-a-trigger-of-erythema-nodosum-and-perimenopausal-symptoms
#14
Randy Horwitz, Victoria Maizes
A 45-year-old woman presented to the University of Arizona Integrative Medicine Clinic for advice on managing recurrent erythema nodosum (EN), along with recent onset perimenopausal symptoms. Her painful EN flares had occurred two to six times per year over the past 14 years, yet had attenuated over the past 5 years until recently, and she presented with bilateral EN lesions on the shins. An environmental exposure history revealed that a new plastic-containing water pot had been introduced at her office just prior to her latest EN flare...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764789/exploring-how-nurses-assess-monitor-and-manage-acute-pain-for-adult-critically-ill-patients-in-the-emergency-department-protocol-for-a-mixed-methods-study
#15
Wayne Varndell, Margaret Fry, Doug Elliott
BACKGROUND: Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown...
August 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28757465/mini-encyclopaedia-of-the-wound-healing-opportunities-for-integrating-multi-omic-approaches-into-medical-practice
#16
Lara Stolzenburg-Veeser, Olga Golubnitschaja
Wound healing is a highly complex life-important repair process triggered by plenty of local and/or systemic organ and tissue damaging events, such as an acute surgical invasion, accidental organ and tissue damages, acute and chronic diseases, aggressive local and systemic therapeutic approaches (e.g. irradiation and systemic chemotherapy). Individual health condition determines over the quality of wound healing. Impaired wound healing, in turn, may lead, for example, to post-surgical complications frequently observed in elderly, chronic ulcers in diabetic patients, hindered and ineffective pain management, etc...
July 28, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28750961/pathoanatomical-characteristics-of-temporomandibular-dysfunction-where-do-we-stand-narrative-review-part-1
#17
REVIEW
Raymond Butts, James Dunning, Thomas Perreault, Jersey Mettille, James Escaloni
Temporomandibular dysfunction (TMD) is a complicated and multifactorial condition that affects the temporomandibular joint (TMJ) and muscles of mastication, resulting in pain and disability in 5-12% of the population. The condition involves genetic, anatomic and hormonal factors and is propagated, in part, by trauma, habitual activity, psychosocial components and occlusal variation. Yet, the exact etiology of TMD is still unknown and the most strategic conservative management of the condition is still a topic of debate...
July 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28749248/update-in-perioperative-medicine-practice-changing-evidence-published-in-2016
#18
Dennis W Regan, Deanne Kashiwagi, Brian Dougan, Karna Sundsted, Karen Mauck
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change...
July 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28742820/facilitators-and-barriers-to-physical-activity-in-people-with-chronic-low-back-pain-a-qualitative-study
#19
Laura Boutevillain, Arnaud Dupeyron, Caroline Rouch, Emilie Richard, Emmanuel Coudeyre
BACKGROUND: For medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA). OBJECTIVE: The objective of this study was to identify PA barriers and facilitators in this population. METHODS: This qualitative study included 4 discussion groups and 16 semi-structured interviews conducted among people with non-specific chronic low back pain who were involved in a specific rehabilitation program or seen in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#20
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
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