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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/28449352/effectiveness-and-safety-of-intrathecal-ziconotide-interim-analysis-of-the-patient-registry-of-intrathecal-ziconotide-management-prizm
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28435924/treatment-of-chronic-traumatic-c7-t1-grade-iii-spondylolisthesis-with-mild-neurological-deficit-case-report
#5
Jacinto Mata-Gómez, Marta Ortega-Martínez, Julio Valencia-Anguita, Ignacio Gilete-Tejero, Manuel Royano-Sánchez
Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435906/low-back-pain-in-older-adults-risk-factors-management-options-and-future-directions
#6
REVIEW
Arnold Yl Wong, Jaro Karppinen, Dino Samartzis
Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28432164/use-of-gabapentin-in-the-treatment-of-chronic-pain-in-an-adolescent-with-sickle-cell-disease
#7
Cátia R Correia, Ana Teresa Soares, Laura Azurara, Maria João Palaré
Vaso-occlusive crises are the most common manifestation of sickle cell disease (SCD) and the main cause of hospital admission in these patients. There is emerging evidence that vaso-occlusive pain has both nociceptive and neuropathic components. However, the treatment of SCD-related pain with neuropathic drugs has not yet been systematically studied, particularly in children. We describe a 14-year-old girl with SCD and multiple hospital admissions for pain management for severe acute vaso-occlusive pain episodes...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431040/prospective-assessment-of-pain-and-comfort-in-chronic-pain-patients-undergoing-interventional-pain-management-procedures
#8
Thomas Simopoulos, Daniel Leffler, Sheila Barnett, Devon Campbell, Shu Jing Lian, Jatinder S Gill
Objective.:  Interventional pain management procedures have an important role in the management of chronic pain. The present study seeks to identify the proportion of patients who experience severe pain during pain procedures either with or without sedation. There is then an attempt to identify any association of high pain levels with factors such as age, gender, ethnicity, preprocedure pain level, procedure type, tobacco use, and baseline pharmaceuticals taken for both pain and/or mood disorder management...
April 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#9
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#10
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429339/observational-multicentric-study-on-chronic-sciatic-pain-clinical-data-from-44-italian-centers
#11
G A Checchia, G Letizia Mauro, G Morico, A Oriente, C Lisi, V Polimeni, M Lucia, M Ranieri
OBJECTIVE: To provide information on the clinical presentation of sciatic neuropathy and its management in a real-world setting, and to analyze the effects of a multimodal approach based on the association of physical and pharmacological therapy. PATIENTS AND METHODS: A multicentric observational prospective study was conducted in 44 Italian tertiary centers specialized in Physical Medicine and Rehabilitation, Orthopedics, Neurology, Neurosurgery, and Rheumatology...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28420930/enterobius-vermicularis-in-tubo-ovarian-abscess-a-rare-and-interesting-incidental-finding-a-case-report
#12
Faryal Saleem, Faizan Malik, Saira Fatima
Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28419637/self-reported-prevalence-description-and-management-of-pain-in-adults-with-haemophilia-methods-demographics-and-results-from-the-pain-functional-impairment-and-quality-of-life-p-fiq-study
#13
M Witkop, A Neff, T W Buckner, M Wang, K Batt, C M Kessler, D Quon, L Boggio, M Recht, K Baumann, R Z Gut, D L Cooper, C L Kempton
INTRODUCTION: Haemophilia is characterized by frequent haemarthrosis, leading to acute/chronic joint pain. AIM: To assess self-reported prevalence, description and management of pain in adult males with mild-to-severe haemophilia and history of joint pain/bleeding. METHODS: Participants completed a pain survey and five patient-reported outcome instruments assessing pain, functional impairment and health-related quality of life (HRQoL). RESULTS: Of 381 participants enrolled, median age was 34 years; 77% had haemophilia A, 71% had severe disease and 65% were overweight/obese...
April 16, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28419385/development-and-feasibility-of-a-group-based-therapeutic-yoga-program-for-women-with-chronic-pelvic-pain
#14
Alison J Huang, Tami S Rowen, Priscilla Abercrombie, Leslee L Subak, Michael Schembri, Traci Plaut, Maria T Chao
Objective.:  To develop a group-based therapeutic yoga program for women with chronic pelvic pain (CPP) and explore the effects of this program on pain severity, sexual function, and well-being. Methods.:  A yoga therapy program for CPP was developed by a multidisciplinary panel of clinicians, researchers, and yoga consultants. Women reporting moderate to severe pelvic pain for at least six months were recruited into a single-arm trial. Participants attended twice weekly group classes focusing on Iyengar-based yoga techniques and were instructed to practice yoga at home an hour a week for six weeks...
April 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#15
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412229/characteristics-and-factors-associated-with-pain-in-older-homeless-individuals-results-from-the-hope-home-study
#16
John C Landefeld, Christine Miaskowski, Lina Tieu, Claudia Ponath, Christopher T Lee, David Guzman, Margot Kushel
Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5-10 (scale 0-10). The median age of participants was 58 years...
April 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28407737/pain-in-amaxhosa-women-living-with-hiv-aids-a-cross-sectional-study-of-ambulant-outpatients
#17
Romy Parker, Jennifer Jelsma, Dan J Stein
BACKGROUND: Pain is one of the most commonly reported symptoms in people living with HIV/AIDS, whether or not they are receiving anti-retroviral therapy. A recent systematic review identified a paucity of studies exploring pain in women in low and middle income countries. The prevalence and characteristics of pain in women living with HIV/AIDS may differ from that of men as many chronic pain conditions are more prevalent in women. The aims of this study were to establish pain prevalence, characteristics and management in amaXhosa women living with HIV/AIDS...
April 13, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28405808/staphylococcus-lugdunensis-a-neglected-pathogen-of-infections-involving-fracture-fixation-devices
#18
Piseth Seng, Madou Traore, Jean-Philippe Lavigne, Laurence Maulin, Jean-Christophe Lagier, Jean-François Thiery, Pierre-Yves Levy, Pierre-Marie Roger, Eric Bonnet, Albert Sotto, Andreas Stein
PURPOSE: Cases of fracture-fixation device infection involving Staphylococcus lugdunensis are not frequent. The clinical characteristics and the choice of treatment strategies of these infections are not obviously known to date. METHODS: We performed a review of fracture-fixation device infection involving S. lugdunensis managed by our centres. RESULTS: Among the 38 cases of fracture-fixation device infection involving S. lugdunensis, 53% were located in the tibia...
April 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#19
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28401418/development-of-a-care-guidance-index-based-on-what-matters-to-patients
#20
John H Wasson, Laura Soloway, L Gordon Moore, Paul Labrec, Lynn Ho
INTRODUCTION: Targeting resources for a designated higher-risk subgroup is a strategy for chronic care management. However, risk-designation has several limitations: it is inaccurate, seldom helpful for care guidance, and potentially misallocates care away from many patients. METHODS: To address limitations of risk designation, we tested a "what matters index" (WMI) in 19,593 adult patients with chronic conditions. The WMI contains five binary measures: insufficient confidence to manage health problems, level of pain, emotional problems, polypharmacy, and adverse medication effects...
April 11, 2017: Quality of Life Research
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