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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/29166574/altered-tnf-%C3%AE-response-by-aconibal-%C3%A2-and-methotrexate-in-a-lipopolysaccharide-induced-setting-of-inflammatory-conditions-potential-on-a-synergistic-combination
#1
Gunhyuk Park, Seoung Hoon Lee, Ji-Ye Han, Dal-Seok Oh
ETHNOPHARMACOLOGICAL RELEVANCE: Aconitum carmichaelii (AC) is a common herbal medicine used as anti-inflammatory and analgesic agent in Eastern Asia. In Korea, a commercial processed AC (Aconibal(®)) is traditionally used to treat the symptoms of spondylosis deformans and rheumatic pain. AIM OF STUDY: Rheumatoid arthritis (RA) is systemic and auto-immune disease characterized by chronic inflammation. Methotrexate (MTX) is often the first-line therapy for RA. If MTX monotherapy is ineffective or RA is initially severe, adding a tumor necrosis factor (TNF)-α inhibitor to the treatment can be beneficial...
November 19, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29160603/relationship-between-self-reported-cognitive-difficulties-objective-neuropsychological-test-performance-and-psychological-distress-in-chronic-pain
#2
K S Baker, S J Gibson, N Georgiou-Karistianis, M J Giummarra
BACKGROUND: Persons with chronic pain often report problems with cognitive abilities, such as memory or attention. There is limited understanding of whether objective performance is consistent with subjective reports, and how psychological factors contribute. We aimed to investigate these relationships in a group of patients expressing cognitive concerns, and evaluate the utility of self-report tools for pain management settings. METHOD: Participants with chronic pain (n = 41) completed standardized neuropsychological tests, and self-report measures of cognitive functioning, pain, mood and sleep, as part of a broader study investigating cognitive performance in pain...
November 21, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29160596/chronic-pain-and-opioid-abuse-factors-associated-with-health-related-quality-of-life
#3
Jermaine D Jones, Jonathan S Vogelman, Rachel Luba, Mudassir Mumtaz, Sandra D Comer
BACKGROUND AND OBJECTIVES: While research on the separate relationships between health-related quality of life (HRQOL) and chronic pain, and HRQOL and opioid abuse has been sparse, even less work has investigated the factors associated with HRQOL in individuals who have both chronic pain and meet criteria for opioid use disorder. The data presented in this analysis should allow a better understanding the factors important to quality of life among this dual-diagnosed population. METHODS: Individuals with dual diagnoses of chronic pain and opioid use disorder were recruited for clinical research studies at Columbia University Medical Center...
November 21, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29158689/assessment-of-chronic-pain-and-access-to-pain-therapy-a-cross-sectional-population-based-study
#4
Rosaria Del Giorno, Paolo Frumento, Giustino Varrassi, Antonella Paladini, Stefano Coaccioli
Background: Chronic pain (CP) has been shown as an important public health problem, and several studies emphasize the need to strengthen the health care and social systems to reduce its marginalization. This study aimed to: evaluate the epidemiology of CP in the general population in an Italian area; and assess the awareness of a specific law, unanimously approved in Parliament, which provides citizens the right to access pain management (Italian Law 38/2010). Methods: A cross-sectional population-based study carried out during the spring of 2014 at Narni, Umbria, Italy...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#5
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29150315/surgical-options-for-osteoporotic-vertebral-compression-fractures-complicated-with-spinal-deformity-and-neurologic-deficit
#6
Kalliopi Alpantaki, Michael Dohm, Panagiotis Korovessis, Alexander G Hadjipavlou
INTRODUCTION: This paper describes surgical options for Osteoporotic vertebral compression fracture (OVCF) with acute flexible or chronic rigid kyphosis, and pseudarthrosis complicated with pain and neurologic deficit. METHODS: This study has two components. a) A prospective clinical study of surgical treatment of 31 patients (age: 69±11 years) with either acute flexible or progressive pseudarthrotic kyphosis manifested with severe pain or neurological deficit between 2010 and 2014...
November 12, 2017: Injury
https://www.readbyqxmd.com/read/29143474/chronic-intestinal-pseudo-obstruction-progress-in-management
#7
REVIEW
G Di Nardo, T B Karunaratne, S Frediani, R De Giorgio
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of gastrointestinal dysmotility (often due to derangement of the innervation/smooth muscle/interstitial cells of Cajal) with recurrent episodes of intestinal subocclusion mimicking a mechanical obstruction. Because of its complexity and heterogeneity, CIPO is often misdiagnosed or remains unrecognized until advanced stages. Management is a critical aspect in CIPO patient care. So far, most prokinetic drugs have not proven efficacy in restoring intestinal propulsion, thus nutritional support, fluid/electrolyte replacement, and antibiotics are the mainstay of treatment...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29140934/response-of-symptomatic-persistent-chronic-disseminated-candidiasis-to-corticosteroid-therapy-in-immunosuppressed-pediatric-patients-case-study-and-review-of-the-literature
#8
Vered Shkalim-Zemer, Itzhak Levi, Salvador Fischer, Hannah Tamary, Joanne Yakobovich, Gali Avrahami, Gil Gilad, Sara Elitzur, Isaac Yaniv, Ronit Elhasid, Michal Manistersky, Itamar Shalit
BACKGROUND: Chronic disseminated candidiasis (CDC) is a severe invasive fungal infection principally observed during neutrophil recovery in patients with acute leukemia treated with intensive chemotherapy. Its pathophysiology remains unclear. We describe the management of six children with symptomatic CDC who did not respond to antifungal therapy. METHODS: The databases of the hematology-oncology departments of two tertiary pediatric medical centers were searched for all patients diagnosed with CDC from 2003 to 2015 who responded to corticosteroids after failing antifungal therapy...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140286/evidence-to-use-botulinum-toxin-injections-in-tension-type-headache-management-a-systematic-review
#9
REVIEW
Mieszko Wieckiewicz, Natalia Grychowska, Marek Zietek, Gniewko Wieckiewicz, Joanna Smardz
Tension-type headache (TTH) is the most common type of chronic recurring head pain. It can occur twice as often in women as in men. It is the most common type of headache. Its lifetime prevalence is 30% to 78% in the general population. TTH treatment should be multilevel. It often consists of taking pain medication, muscle relaxants, antidepressants, using biofeedback therapy, acupuncture, and attending behavioral therapy. Several clinical trials also suggest that botulinum toxin (BTX) may be an effective treatment option for such patients...
November 15, 2017: Toxins
https://www.readbyqxmd.com/read/29138912/long-term-follow-up-after-non-operative-management-of-blunt-splenic-and-liver-injuries-a-questionnaire-based-survey
#10
Peter Moreno, Matthias Von Allmen, Tobias Haltmeier, Daniel Candinas, Beat Schnüriger
BACKGROUND: Non-operative management (NOM) of blunt splenic or liver injuries (solid organ injury, SOI) has become the standard of care in hemodynamically stable patients. However, the incidence of long-term symptoms in these patients is currently not known. The aim of this study was to assess long-term symptoms in patients undergoing successful NOM (sNOM) for SOI. METHODS: Long-term posttraumatic outcomes including chronic abdominal pain, irregular bowel movements, and recurrent infections were assessed using a specifically designed questionnaire and analyzed by univariable analysis...
November 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29127615/fungal-and-parasitic-cns-infections
#11
Pratibha Singhi, Arushi Gahlot Saini
Central nervous system fungal infections can be broadly divided into those that infect a healthy host such as Cryptococcus, Coccidioides, Histoplasma, Blastomyces, Sporothrix spp., and those that cause opportunistic infections in an immunocompromised host such as Candida, Aspergillus, Zygomycetes, Trichosporon spp. The clinical manifestations of central nervous system fungal infections commonly seen in children in clinical practice include a chronic meningitis or meningoencephalitis syndrome, brain abscess, rhino-cerebral syndrome and rarely, a fungal ventriculitis...
November 11, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29127076/tailored-web-based-interventions-for-pain-systematic-review-and-meta-analysis
#12
Geraldine Martorella, Madalina Boitor, Melanie Berube, Suzanne Fredericks, Sylvie Le May, Céline Gélinas
BACKGROUND: Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated...
November 10, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29126848/evaluation-of-external-vibratory-stimulation-as-a-treatment-for-chronic-scrotal-pain-in-adult-men-a-single-center-open-label-pilot-study
#13
Yash S Khandwala, Fernando Serrano, Michael L Eisenberg
BACKGROUND AND AIMS: Chronic scrotal pain is a common yet poorly understood urologic disease. Current treatment paradigms are sub-optimal and include anti-inflammatory drugs and opioids as well as invasive surgical management such as microdenervation of the spermatic cord. In this study, the efficacy of external vibratory stimulation (EVS) was evaluated as an alternative treatment option for idiopathic scrotal pain. MATERIALS AND METHODS: Ten consecutive patients presenting to an academic urology clinic between December 2016 and April 2017 with scrotal pain were prospectively enrolled...
November 7, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29124992/efficacy-of-ketamine-for-postoperative-pain-following-robotic-thyroidectomy-a-prospective-randomised-study
#14
Jiwon Lee, Hee-Pyoung Park, Mu-Hui Jeong, Je-Do Son, Hyun-Chang Kim
Objective Although robotic thyroidectomy (RoT) is a minimally invasive surgery, percutaneous tunneling causes moderate to severe pain immediately postoperatively. We evaluated the efficacy of ketamine for postoperative pain management in patients following RoT. Methods Sixty-four patients scheduled for RoT were randomly divided into two groups. In the ketamine group (n = 32), ketamine was infused from induction of anaesthesia until the end of the procedure (0.15-mg/kg bolus with continuous infusion at 2 µg/kg/min)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29123854/local-anesthetic-toxicity-acute-and-chronic-management
#15
REVIEW
Kenichi Sekimoto, Masaru Tobe, Shigeru Saito
Local anesthetics are commonly used medicines in clinical settings. They are used for pain management during minor interventional treatments, and for postoperative care after major surgeries. Cocaine is the well-known origin of local anesthetics, and the drug and related derivatives have long history of clinical usage for more than several centuries. Although illegal use of cocaine and its abuse are social problem in some countries, other local anesthetics are safely and effectively used in clinics and hospitals all over the world...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123661/the-psychology-of-chronic-post-surgical-pain-new-frontiers-in-risk-factor-identification-prevention-and-management
#16
Aliza Z Weinrib, Muhammad A Azam, Kathryn A Birnie, Lindsay C Burns, Hance Clarke, Joel Katz
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29123622/retrospective-analysis-of-the-financial-break-even-point-for-intrathecal-morphine-pump-use-in-korea
#17
Eun Kyoung Kim, Ji Yeon Shin, Anyela Marcela Castañeda, Seung Jae Lee, Hyun Kyu Yoon, Yong Chul Kim, Jee Youn Moon
Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29123358/chronic-cancer-pain-diagnostic-dilemma-and-management-challenges
#18
Deepti Ahuja, Sachidanand Jee Bharati, Seema Mishra, Sushma Bhatnagar
A 32-year-old female, diagnosed case of neuroendocrine tumor of pancreas, was admitted to the pain and palliative care unit with complaints of diffuse abdominal pain which was severe in intensity with score on numerical rating scale-9/10. Pain was not relieved even after taking tablet morphine immediate release 360 mg every 4 hourly, paracetamol 500 mg 6 hourly, and gabapentin 300 mg 8 hourly. She had undergone distal pancreatectomy with splenectomy and also received multiple lines of chemotherapy. After making a diagnosis of opioid-induced hyperalgesia, opioid rotation from morphine to fentanyl was done...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29120931/perioperative-neurocognition-in-elderly-patients
#19
Huiqun Fu, Long Fan, Tianlong Wang
PURPOSE OF REVIEW: The extrinsic risk factors for postoperative cognitive disturbance have been a source of concern during the perioperative period, and these risk factors remain the subject of controversy. This review of recent studies focuses on the effect of these factors on postoperative cognitive disturbance during the perioperative period. RECENT FINDINGS: Impairment of cerebral autoregulation may predispose patients to intraoperative cerebral malperfusion, which may subsequently induce postoperative cognitive disturbance...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29119827/a-two-week-inpatient-programme-with-a-booster-improved-long-term-management-of-severe-chronic-paediatric-pain
#20
János Major, Zsófia K Varga, Andrea Gyimesi-Szikszai, Szilvia Ádám
In the context of limited healthcare resources and increasing demands for more cost-effective healthcare solutions, this study assessed the short- and long-term clinical outcomes and resource utilization of a two-week inpatient, interdisciplinary, pain treatment (IIPT) including individual and group cognitive behavioural, occupational, physical and recreational therapy, education and family intervention and a booster in the chronic paediatric pain setting. Using a longitudinal design with a two-year follow-up, two-week IIPT resulted in sustainable improvements in mean and maximum pain intensity, physical functioning and internalization and reductions in the mean number of medical visits, school absence and frequency of pain medication at year 2 following IIPT...
June 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
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