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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/29346579/web-based-cognitive-behavior-therapy-for-chronic-pain-patients-with-aberrant-drug-related-behavior-outcomes-from-a-randomized-controlled-trial
#1
Honoria Guarino, Chunki Fong, Lisa A Marsch, Michelle C Acosta, Cassandra Syckes, Sarah K Moore, Ricardo A Cruciani, Russell K Portenoy, Dennis C Turk, Andrew Rosenblum
Objective: There is high unmet need for effective behavioral treatments for chronic pain patients at risk for or with demonstrated histories of opioid misuse. Despite growing evidence supporting technology-based delivery of self-management interventions for chronic pain, very few such programs target co-occurring chronic pain and aberrant drug-related behavior. This randomized controlled trial evaluated the effectiveness of a novel, web-based self-management intervention, grounded in cognitive behavior therapy, for chronic pain patients with aberrant drug-related behavior...
January 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29340913/a-randomized-pilot-trial-of-a-novel-behavioral-intervention-for-chronic-pain-tailored-to-individuals-with-hiv
#2
Jessica S Merlin, Andrew O Westfall, Dustin Long, Susan Davies, Michael Saag, William Demonte, Sarah Young, Robert D Kerns, Matthew J Bair, Stefan Kertesz, Janet M Turan, Meredith Kilgore, Olivio J Clay, Joanna Starrels, Dorothy Pekmezi, Mallory O Johnson
Chronic pain is an important and understudied comorbidity in people living with HIV (PLWH). We conducted a pilot trial of Skills TO Manage Pain (STOMP), an innovative social cognitive theory-based pain self-management intervention tailored to PLWH, to assess feasibility, acceptability, and preliminary efficacy. Eligibility criteria included being HIV+, ≥ moderate pain for ≥ 3 months and a score of ≥ 4 on the three-item PEG pain severity and interference scale. Participants were randomized in a 1:1 fashion to STOMP or a usual care comparison...
January 16, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29337024/moderators-of-treatment-outcomes-following-telehealth-self-management-and-education-in-adults-with-multiple-sclerosis-a-secondary-analysis-of-a-randomized-controlled-trial
#3
Dawn M Ehde, Anne Arewasikporn, Kevin N Alschuler, Abbey J Hughes, Aaron P Turner
OBJECTIVE: To examine moderators of treatment effects in a randomized controlled trial comparing a telehealth self-management intervention to a telehealth MS education intervention for fatigue, pain, and mood in adults with multiple sclerosis (MS). DESIGN: Secondary analysis of a single-blind randomized controlled trial. SETTING: community. PARTICIPANTS: Adults with MS and chronic fatigue, chronic pain, and/or moderate depressive symptoms (N=163) recruited from across the United States...
January 11, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29323821/implementing-population-medicine-in-a-pain-management-practice
#4
Barbara Koschak, David A Bryce, J Timothy Harrington
PURPOSE: To document and improve the quality of our chronic pain management using population management methods. METHODS: An analytic registry was developed, and all new patients were enrolled for 12 months. Patient demographics, standardized pain and function measures, and treatments were recorded. Usual care was provided. The registry was used to organize care and analyze management and outcomes. RESULTS: Of 454 total patients, only 154 (34%) completed a 6-month cycle of care...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29319390/an-exploration-of-pain-experiences-and-their-meaning-in-people-with-chronic-obstructive-pulmonary-disease
#5
Annemarie L Lee, Samantha L Harrison, Roger S Goldstein, Dina Brooks
BACKGROUND: Pain is a common symptom in people with chronic obstructive pulmonary disease (COPD) which negatively influences quality of life and psychological well-being. However, our understanding of how those with COPD interpret the experience of pain is very limited. OBJECTIVES: To explore how individuals with moderate to severe COPD experience pain. METHODS: Eight patients diagnosed with COPD who reported experiencing pain for greater than three months participated in in-depth interviews...
January 10, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29318178/outcomes-after-dermal-allograft-reconstruction-of-chronic-or-subacute-pectoralis-major-tendon-ruptures
#6
Julie A Neumann, Christopher M Klein, Carola F van Eck, Hithem Rahmi, John M Itamura
Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29317847/pharmacogenetic-guidance-individualized-medicine-promotes-enhanced-pain-outcomes
#7
Lisa Lynn Dragic, Erica L Wegrzyn, Michael E Schatman, Jeffrey Fudin
The use of pharmacogenomics has become more prevalent over the past several years in treating many disease states. Several cytochrome P450 enzymes play a role in the metabolism of many pain medications including opioids and antidepressants. Noncytochrome P450 enzymes such as methylenetetrahydrofolate reductase (MTHFR) and catechol-O-methyl transferase (COMT) also play a role in the explanation of opioid dosage requirements as well as in response to certain antidepressants. We present the case of a patient with reduced COMT and MTHFR expression treated with leucovorin 10 mg daily for the management of chronic pain...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29317354/laccase-catalyzed-elimination-of-morphine-from-aqueous-systems
#8
Daniela Huber, Klaus Bleymaier, Alessandro Pellis, Robert Vielnascher, Andreas Daxbacher, Katrin J Greimel, Georg M Guebitz
Pharmaceuticals contaminate the environment for several reasons, including metabolic excretion after intake, industrial waste and improper disposal. The narcotic drug morphine is commonly utilized for chronic pain management, and the distribution of morphine in aqueous systems and in waste waters is of high concern. Here. the removal of morphine by a laccase from Myceliophthora thermophila both in its free form as well as immobilized on Accurel MP1000 beads was investigated. Complete morphine elimination was achieved within 30 min for the free and the immobilized enzyme (70% bound protein) for concentrations between 1 and 1,000 mg L-1 according to LC-TOF mass spectrometry analysis...
January 6, 2018: New Biotechnology
https://www.readbyqxmd.com/read/29308277/fibromyalgia-has-a-high-prevalence-and-impact-in-cardiac-failure-patients
#9
Anthea C Gist, Emma K Guymer, Andrew E Ajani, Geoffrey O Littlejohn
Objective: Chronic cardiac failure (CCF) shares several clinical features with fibromyalgia (FM), a syndrome of increased central sensitivity and musculoskeletal pain. FM frequently coexists with other chronic illness. Musculoskeletal pain is reported in patients with CCF; however, the prevalence and impact of FM in patients with CCF is not known. This research aims to assess the prevalence and effects of concurrent FM in patients with CCF and to identify other coexisting central sensitivity syndromes...
December 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29304958/editorial-commentary-proximal-hamstring-syndrome-another-pain-in-the-buttock
#10
EDITORIAL
Dean K Matsuda
Proximal hamstring injuries cause buttock pain and may result in significant weakness and sciatic neuralgia. Avulsion ruptures involving 2 or more tendons with >2-cm retraction may benefit from early open surgical repair. More chronic equivalents may benefit from Achilles allograft reconstruction. Chronic proximal hamstring syndrome causing posterior thigh and sit pain may occur from less severe, often repetitive injury to the proximal hamstring origin with secondary sciatic neuralgia from local adhesions or scar entrapment...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#11
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29294650/interpersonal-violence-exposure-and-chronic-pain-in-adult-sickle-cell-patients
#12
Julian D Ford, Damion J Grasso, Sasia Jones, Teresa Works, Biree Andemariam
Almost half of sickle cell disease (SCD) patients develop chronic, debilitating physical pain with uncertain genesis for which they primarily receive opiate-based palliative treatment. Psychological trauma exposure, especially interpersonal victimization, has been linked to the perception of pain in several medical diseases, but has yet to be examined in SCD patients. This study examines self-reported chronicity of pain and use of prescribed opiates in 50 adult SCD patients with and without a history of interpersonal violence exposure...
February 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29287308/chikungunya-virus-arthritis-implications-of-acute-and-chronic-inflammation-mechanisms-on-patient-management
#13
REVIEW
Ali Zaid, Patrick Gérardin, Adam Taylor, Helen Mostafavi, Denis Malvy, Suresh Mahalingam
In the past decade, arboviruses - arthropod-borne viruses - have been the focus of public health institutions worldwide following a spate of devastating outbreaks. Chikungunya virus (CHIKV), an arbovirus that belongs to the alphavirus genus, is a re-emerging arthritogenic virus that has caused explosive outbreaks since 2006, notably in the Reunion Island, and more recently in the Caribbean, South America, India and South-East Asia. The severity of arthritic disease caused by CHIKV has prompted public health authorities of affected countries to develop specific guidelines to tackle this pathogen...
December 29, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29284303/-i-am-free-in-my-wheelchair-but-pain-does-have-a-say-in-it-though-the-meaning-and-experience-of-quality-of-life-when-living-with-paraplegia-and-chronic-pain
#14
Melanie Hughes, Amy E Burton, Robert C Dempsey
This study investigated how wheelchair-using individuals with paraplegia and chronic pain make sense of the factors associated with quality of life based on interviews using photo-elicitation and interpretative phenomenological analysis. Three superordinate themes emerged in the analysis: experiencing quality of life through the perception of self and identity, interpersonal relationships as facilitators and barriers to quality of life and life in a wheelchair: pain experience and management. Quality of life for those living with paraplegia and chronic pain is experienced as a complex interaction across several life domains...
December 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/29280484/intranasal-tissue-necrosis-associated-with-opioid-abuse-case-report-and-systematic-review
#15
REVIEW
Danielle A Morrison, Sarah K Wise, John M DelGaudio, Naweed I Chowdhury, Joshua M Levy
OBJECTIVE: Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. DATA SOURCES: MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29279787/acute-chest-syndrome-in-children-with-sickle-cell-disease
#16
REVIEW
Shilpa Jain, Nitya Bakshi, Lakshmanan Krishnamurti
Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29273083/effectiveness-costs-and-cost-effectiveness-of-chiropractic-care-and-physiotherapy-compared-with-information-and-advice-in-the-treatment-of-non-specific-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#17
Filip Gedin, Martin Skeppholm, Kristina Burström, Vibeke Sparring, Mesfin Tessma, Niklas Zethraeus
BACKGROUND: Low back pain is a global public health problem and a leading cause of disability all over the world. The lifetime prevalence of low back pain is 70-80% and a significant proportion of people affected develop chronic low back pain (CLBP). Besides a severe negative impact on people's health and health-related quality of life, CLBP is associated with substantial costs for society. Medical costs for the management of CLBP and costs for production losses due to absenteeism from work are sizeable...
December 22, 2017: Trials
https://www.readbyqxmd.com/read/29258584/lymphocyte-opioid-receptors-as-innovative-biomarkers-of-osteoarthritic-pain-for-the-assessment-and-risk-management-of-opioid-tailored-therapy-before-hip-surgery-to-prevent-chronic-pain-and-opioid-tolerance-addiction-development-opmarkart-opioids-markers-arthroprosthesis
#18
Valentina Malafoglia, Monica Celi, Carolina Muscoli, Sara Ilari, Filomena Lauro, Luigino Antonio Giancotti, Chiara Morabito, Maurizio Feola, Umberto Tarantino, William Raffaeli
BACKGROUND: The incidence of post-surgical chronic pain ranges between 20% and 40% in Europe. Osteoarthritis pain after prosthesis implantation is one of the most severe secondary syndromes, depending not only on surgery but also on organic changes before and after joints replacement. No data are available about risk factors. An excessive inflammatory response plays a central role but a best therapy is not defined yet. It is not clear whether opioid administration could influence post-surgical pain and lead to tolerance or addiction...
December 19, 2017: Trials
https://www.readbyqxmd.com/read/29249862/celiac-plexus-block-and-neurolysis-in-the-management-of-chronic-upper-abdominal-pain
#19
REVIEW
Joshua Cornman-Homonoff, Daniel J Holzwanger, Kyungmouk S Lee, David C Madoff, David Li
Chronic upper abdominal pain occurs as a complication of various malignant and benign diseases including pancreatic cancer and chronic pancreatitis, and when present may contribute to lower quality of life and higher mortality. Though various pain management strategies are available as part of a multimodal approach, they are often incompletely effective and accompanied by side effects. Pain originating in upper abdominal viscera is transmitted through the celiac plexus, which is an autonomic plexus located in the retroperitoneum at the root of the celiac trunk...
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29245283/successful-treatment-of-erythema-induratum-with-topical-application-of-antituberculous-drugs-a-case-report
#20
Xueling Mei, Junying Zhao
RATIONALE: Erythema induratum, a chronic recurrent lobular panniculitis with vasculitis, is strongly associated with Mycobacterium tuberculosis infection. The recommended drugs include isoniazid, rifampicin, and pyrazinamide, which are typically administered in combination (orally or intravenously). Till date, there are no reports about topical application of anti-tuberculous (anti-TB) drugs for treatment of erythema induratum. PATIENT CONCERNS: Herein, we present the case of a 73-year-old woman with recurrent ulceration, scarring and obvious pain in her lower legs...
December 2017: Medicine (Baltimore)
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