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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/28528364/a-randomized-double-blind-placebo-controlled-trial-of-a-multi-strain-probiotic-in-treatment-of-symptomatic-uncomplicated-diverticular-disease
#1
Charlotte L Kvasnovsky, Ingvar Bjarnason, Ana Nora Donaldson, Roy A Sherwood, Savvas Papagrigoriadis
BACKGROUND: Diverticular disease is a significant burden on healthcare systems that is managed, surgically or medically, mainly as an emergency or acute condition. There are no standardized treatment recommendations for symptomatic uncomplicated disease. We hypothesized that a probiotic would reduce abdominal pain in such patients. METHODS: We conducted a single-center, double-blind, placebo-controlled trial of probiotic treatment (Symprove) in adult patients with moderate-to-severe chronic, non-acute symptomatic diverticular disease...
May 20, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28513082/the-impact-of-osteoarthritis-on-difficulty-walking-a-population-based-study
#2
Lauren K King, Tetyana Kendzerska, Esther J Waugh, Gillian A Hawker
OBJECTIVE: To assess the relationship of hip and knee osteoarthritis (OA) to walking difficulty. METHODS: A population cohort aged ≥55 years recruited from 1996-98 (n=28,451) completed a standardized questionnaire assessing demographics, health conditions, joint complaints and functional limitations, including difficulty walking in the past 3 months. Survey data were linked to health administrative databases; self-report and administrative data were used to identify health conditions...
May 17, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28510996/tramadol-with-or-without-paracetamol-acetaminophen-for-cancer-pain
#3
REVIEW
Philip J Wiffen, Sheena Derry, R Andrew Moore
BACKGROUND: Tramadol is an opioid analgesic licensed for use in moderate to severe pain. It is considered as a low risk for abuse, so control regulations are not as stringent as for 'strong' opioids such as morphine. It has a potential role as a step 2 option of the World Health Organization (WHO) analgesic ladder. OBJECTIVES: To assess the benefits and adverse effects of tramadol with or without paracetamol (acetaminophen) for cancer-related pain. SEARCH METHODS: We searched the following databases using a wide range of search terms: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS...
May 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28508867/bloating-and-abdominal-distension-old-misconceptions-and-current-knowledge
#4
REVIEW
Juan R Malagelada, Anna Accarino, Fernando Azpiroz
Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of bloating and distension on their well-being. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen. To avoid mishaps, organic bloating, and distension should always be considered first and appropriated assessed. Functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia and in that context patients tend to regard them as most troublesome...
May 16, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28486896/the-effect-of-rapid-response-system-revision-on-standard-and-specific-intensive-care-unit-outcomes-in-a-regional-hospital
#5
K Joshi, V Campbell, M Landy, C M Anstey, R Gooch
Hospital systems for the recognition (afferent limb) and management (efferent limb) of deteriorating patients, or Rapid Response Systems (RRSs), are being mandated worldwide, in spite of conflicting evidence regarding their efficacy. We have evaluated the impact of an Adult Deterioration Detection System (Q-ADDS)-based RRS specifically on illness severity at intensive care unit (ICU) admission and ICU length of stay (LOS), as well as previously studied endpoints. We undertook a retrospective, single-centre observational study comparing equivalent 18-month periods before the Q-ADDS-based RRS, and after implementation...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28482390/-clinical-analysis-of-11-children-with-pancreatic-cystic-fibrosis
#6
G L Wang, C N Zhao, J Zhou, F H Yu, H Q Shen, J Zhang, S Y Zhao, X W Xu
Objective: To increase the recognition of pancreatic cystic fibrosis (PCF) in children and facilitate diagnosing and treatment of this rare entity. Method: This is a retrospective analysis of children who presented to Beijing Children's Hospital affiliated to Capital Medical University from January 2010 to December 2015. We describe their clinical features, laboratory testing and management. Result: Eleven children were diagnosed with PCF by genetic testing or sweat chloride test during these 5 years, including 4 boys and 7 girls...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28482063/physical-pain-and-emotion-regulation-as-the-main-predictive-factors-of-health-related-quality-of-life-in-women-living-with-endometriosis
#7
Gabriella Márki, Attila Bokor, János Rigó, Adrien Rigó
STUDY QUESTION: To what extent are pain symptoms, psychological variables (anxiety, depression and distress) and emotion regulation associated with women's health in endometriosis? SUMMARY ANSWER: Physical pain symptoms and emotion regulation difficulties via psychological stress negatively affect the health-related quality of life (HRQoL) of women living with endometriosis. WHAT IS KNOWN ALREADY: There are some missing links in the definitive treatment and recovery from endometriosis...
May 8, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28474563/opioids-and-the-blood-brain-barrier-a-dynamic-interaction-with-consequences-on-drug-disposition-in-brain
#8
Catarina Chaves, Fernando Remião, Salvatore Cisterninoa, Xavier Declèves
Opioids are widely used in pain management whose effects are due to binding to classical opioid receptors and/or Toll-like receptors (TLR) present at the central nervous system (CNS). At the blood-brain barrier (BBB), several influx and/or efflux transporters are expressed, such as the ATP-binding cassette (ABC) P-glycoprotein (P-gp, ABCB1), Breast Cancer Resistance Protein (BCRP, ABCG2) and multidrug resistance-associated proteins (MRP, ABCC) transporters, and solute carrier transporters (SLC), and are responsible for the transport of many xenobiotics from the brain into the bloodstream or vice versa...
May 3, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28474305/analgesic-use-by-ageing-and-elderly-patients-with-chronic-non-malignant-pain-a-qualitative-study
#9
Mary-Claire Kennedy, Grainne Cousins, Martin C Henman
Background Analgesics are used in the management of chronic non-malignant pain (CNMP), a condition which is highly prevalent among older adults. CNMP may not only be physically distressing but also complicated by psychosocial and economic factors. An individual's perception and use of analgesics may be influenced by a range of factors such as perceptions of risk or benefits, ability to purchase medication or access to non-pharmacological therapies or specialist care. Objective The aim of this study was to describe the perceptions and experiences of analgesics by ageing and elderly individuals with CNMP and identify factors that influence their use...
May 4, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28473096/acr-appropriateness-criteria-%C3%A2-chronic-chest-pain-high-probability-of-coronary-artery-disease
#10
Scott R Akers, Vandan Panchal, Vincent B Ho, Garth M Beache, Richard K J Brown, Brian B Ghoshhajra, S Bruce Greenberg, Joe Y Hsu, Gregory A Kicska, James K Min, Arthur E Stillman, Jadranka Stojanovska, Suhny Abbara, Jill E Jacobs
In patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD), imaging has major and diverse roles. First, imaging is valuable in determining and documenting the presence, extent, and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions. Second, imaging findings are important in determining the course of management of patients with suspected chronic myocardial ischemia and better defining those patients best suited for medical therapy, angioplasty/stenting, or surgery...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28467566/-spinal-cord-stimulation-in-62-patients-retrospective-evaluation
#11
İrem Özdemir, Mert Akbaş, Arif Yeğin, Gözde Dağıstan, Deniz Özel Erkan
OBJECTIVES: Spinal cord stimulation (SCS) is used for various indications such as Failed Back Surgey Syndrome, peripheral causalgia, neuropathic pain, complex regional pain syndrome, reflex sympathetic dystrophy, peripheral vascular disease, ischemic heart disease and cancer pain. METHODS: This is a retrospective study. 62 patients applied SCS were included in retrospective study from february 2011-january 2015 in Akdeniz University medicine faculty algology department...
January 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/28467329/a-novel-association-to-treat-pain-tramadol-dexketoprofen-the-first-drug-of-a-new-pharmacological-class
#12
D Fornasari, M Allegri, S Gerboni, Guido Fanelli
 Acute and chronic pain have an important socio-economical impact. In order to help physicians to choose the appropriate drug, especially for cancer pain, in 1986 WHO has developed a three-step analgesic "ladder" for cancer pain relief in adults. Later it has also been used for acute pain and chronic non-cancer pain. In step I nonsteroidal anti-inflammatory drugs (NSAIDs) are considered with or without adjuvants, in step II the use of weak opioids for mild-moderate pain, with or without NSAIDs and adjuvant, is suggested, while the step III is reserved to strong opioids for moderate-severe pain with or without non-opioids or adjuvants...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28461745/depression-and-chronic-pain-in-the-elderly-links-and-management-challenges
#13
REVIEW
Panagiotis Zis, Argyro Daskalaki, Ilia Bountouni, Panagiota Sykioti, Giustino Varrassi, Antonella Paladini
Aging is an inevitable process and represents the accumulation of bodily alterations over time. Depression and chronic pain are highly prevalent in elderly populations. It is estimated that 13% of the elderly population will suffer simultaneously from the two conditions. Accumulating evidence suggests than neuroinflammation plays a critical role in the pathogenesis of both depression and chronic pain. Apart from the common pathophysiological mechanisms, however, the two entities have several clinical links...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28461226/clinical-and-functional-characteristics-of-people-with-chronic-and-recent-onset-plantar-heel-pain
#14
Allegra Barnes, Justin Sullivan, Evangelos Pappas, Roger Adams, Joshua Burns
BACKGROUND: Plantar heel pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20 percent of people remain symptomatic beyond this time-frame. The level of pain and function in this chronic heel pain group is not well described. OBJECTIVE: To identify clinical and functional characteristics associated with chronic plantar heel pain compared with heel pain of recent onset. DESIGN: Cross-sectional study SETTING: University research laboratory and private physiotherapy clinic PARTICIPANTS: A total of 71 people with plantar heel pain for longer than 12 months and 64 people with plantar heel pain for less than 6 months were recruited from the general public...
April 28, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28458507/endoscopy-and-cross-sectional-imaging-for-assessing-crohn-s-disease-activity
#15
Ryan W Stidham, Raymond K Cross
Crohn's disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss...
July 2016: Techniques in Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28451889/chronic-pain-predicting-reciprocity-of-support-among-vulnerable-predominantly-african-american-persons-living-with-hiv-aids
#16
Mary M Mitchell, Sarina R Isenberg, Allysha C Maragh-Bass, Amy R Knowlton
Among persons living with HIV/AIDS (PLHIV), approximately two-thirds report moderate to severe pain. Chronic pain can negatively affect PLHIVs' health behaviors and outcomes by interfering with their reciprocity (mutual exchange) of support in their caregiving relationships, which has been found to be associated with PLHIVs' antiretroviral adherence and viral suppression. Data were longitudinal (baseline, 6- and 12-month follow-up) from 383 PLHIV who were formerly or currently using drugs. Utilizing a longitudinal lagged fixed effects structural equation model, we found that never having pain in the past 6 months was predictive of increased reciprocity of support...
April 27, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28449352/effectiveness-and-safety-of-intrathecal-ziconotide-interim-analysis-of-the-patient-registry-of-intrathecal-ziconotide-management-prizm
#17
Timothy Deer, Richard L Rauck, Philip Kim, Michael F Saulino, Mark Wallace, Eric J Grigsby, I-Zu Huang, Fannie Mori, Geertrui F Vanhove, Gladstone McDowell
BACKGROUND: The Patient Registry of Intrathecal Ziconotide Management (PRIZM) evaluates long-term effectiveness, safety, and tolerability of intrathecal ziconotide treatment in clinical practice. METHODS: PRIZM is an open-label, long-term, multicenter, observational study of adult patients with severe chronic pain. This interim analysis (data through July 10, 2015) of ziconotide as the first versus not first intrathecal agent in pump included change from baseline in Numeric Pain Rating Scale (NPRS; primary efficacy measure) and Patient Global Impression of Change (PGIC) score...
April 27, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28442701/a-case-of-trigger-point-injection-induced-hypokalemic-paralysis
#18
Paolo K Soriano, Mukul Bhattarai, Carrie N Vogler, Tamer H Hudali
BACKGROUND Trigger-point injection (TPI) therapy is an effective modality for symptomatic treatment of myofascial pain. Serious adverse effects are rarely observed. In this report, we present the case of a 39-year-old man who experienced severe, transient hypokalemic paralysis in the context of TPI therapy with methylprednisolone, bupivacaine, and epinephrine. He was successfully treated with electrolyte replacement in a closely monitored setting. CASE REPORT A 39-year-old man with no past medical history except for chronic left hip pain from a work-related injury received a TPI with methylprednisolone and bupivacaine...
April 26, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28441313/clinical-evidence-for-spinal-cord-stimulation-for-failed-back-surgery-syndrome-fbss-systematic-review
#19
Leonardo Kapural, Erika Peterson, David A Provenzano, Peter Staats
STUDY DESIGN: A systematic review OBJECTIVE.: A systematic literature review of the clinical data from prospective studies was undertaken to assess the efficacy of spinal cord stimulation (SCS) in the treatment of FBSS in adults. SUMMARY OF BACKGROUND DATA: For patients with unrelenting back pain due to mechanical instability of the spine, degenerative disc disease, spinal injury, or deformity, spinal surgery is a well-accepted treatment option; however, even after surgical intervention, many patients continue to experience chronic back pain that can be notoriously difficult to treat...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28437059/psychotic-and-bipolar-disorders-bipolar-disorder
#20
Sarah D Holder
Bipolar disorder is a severe chronic mental illness that affects a large number of individuals. This disorder is separated into two major types, bipolar I disorder, with mania and typically recurrent depression, and bipolar II disorder, with recurrent major depression and hypomania. Patients with bipolar disorder spend the majority of time experiencing depression, and this typically is the presenting symptom. Because outcomes are improved with earlier diagnosis and treatment, physicians should maintain a high index of suspicion for bipolar disorder...
April 2017: FP Essentials
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