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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#1
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28627447/pain-with-traumatic-brain-injury-and-psychological-disorders
#2
REVIEW
Samar Khoury, Rodrigo Benavides
Traumatic brain injury (TBI) is the cause for long-term disability in more than 3 million patients in the US alone, with chronic pain being the most frequently reported complain. To date, predisposing mechanisms for chronic pain in TBI patients are largely unknown. Psychological disorders, including post-traumatic stress disorder, depression and anxiety following TBI are commonly reported comorbidities to post-traumatic pain. Long term consequences can be debilitating and affect quality of life even when the injury is mild...
June 13, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#3
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625114/the-role-of-testosterone-supplemental-therapy-in-opioid-induced-hypogonadism-a-retrospective-pilot-analysis
#4
Omer A Raheem, Sunil H Patel, David Sisul, Tim J Furnish, Tung-Chin Hsieh
Chronic opioid therapy for pain management is known to induce several endocrine changes. The authors examined the effect of testosterone supplemental therapy (TST) in patients with chronic, noncancer pain undergoing opioid therapy. It was hypothesized that treatment of opioid-induced hypogonadism (OIH) can reduce opioid requirements in patients suffering from chronic pain and approve their quality of life. Over 18 months period, patients with OIH were identified in a tertiary referral pain center, Numerical Rating Scale (NRS) pain scores and daily morphine equivalent dose (MED) were the primary outcomes measured...
July 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#5
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#6
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28619687/use-of-the-central-sensitization-inventory-csi-as-a-treatment-outcome-measure-for-chronic-spinal-pain-disorder-patients-in-a-functional-restoration-program
#7
Randy Neblett, Meredith M Hartzell, Mark Williams, Kelley R Bevers, Tom G Mayer, Robert J Gatchel
BACKGROUND CONTEXT: The Central Sensitization Inventory (CSI) is a valid and reliable patient-reported instrument designed to identify patients whose presenting symptoms may be related to Central Sensitization (CS). Part A of the CSI measures a full array of 25 somatic and emotional symptoms associated with CS, and Part B asks if patients have previously been diagnosed with one or more specific Central Sensitivity Syndromes (CSSs) and related disorders. The CSI has previously been validated in a group of chronic pain patients who were screened by a trained psychiatrist for specific CSS diagnoses...
June 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28612149/35-year-experience-with-surgical-treatment-of-hidradenitis-suppurativa
#8
Richard E Burney
BACKGROUND: Hidradenitis suppurativa is a painful and disfiguring chronic inflammatory condition affecting both men and women. Medical treatments, such as antibiotics and immunosuppressive agents, are often ineffective. Over time, patients can suffer from recurrent abscesses, chronic purulent drainage, scarring, and contractures that can only be corrected by surgical excision. There is no agreement, however, on the best way for the surgeon to manage this condition. The purpose of this review is to describe the results of surgical treatment of this condition in a large cohort of patients managed by local excision of hidradenitis, healing by secondary intention and reoperation as needed...
June 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28609146/chronic-pain-management-group-psychotherapy-for-psychiatric-inpatients-a-pilot-study
#9
Patricia J Osborne, Gladys Janice Jimenez-Torres, Yulia Landa, Jane Mahoney, Alok Madan
Individuals with serious mental illness (SMI) experience significant comorbid chronic pain (CP). Little is known about CP management in psychiatric inpatient settings. To address this gap in clinical practice, the authors developed CP management group psychotherapy for adult inpatients with SMI. In this report, the authors highlight (1) the theoretical underpinnings of and execution of the psychotherapy group, (2) the characteristics of participants in the pilot phase of the group, and (3) outcomes of group participants...
2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28601423/crohn-disease-epidemiology-diagnosis-and-management
#10
REVIEW
Joseph D Feuerstein, Adam S Cheifetz
Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills...
June 7, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28598064/emphysematous-gastritis-with-air-in-portal-venous-system
#11
Omesh Goyal, Ajesh Bansal, Prerna Goyal
Emphysematous gastritis is a rare but severe form of phlegmonous gastritis caused by gastric mucosal disruption and infection of stomach wall by gas-forming bacteria. Ingestion of corrosive substances is the most common predisposing factor, followed by alcohol abuse, abdominal surgery, diabetes and immunosuppression. Patients usually present with abdominal pain, vomiting, diarrhea, constipation and/or gastro-intestinal hemorrhage. Characteristic radiological findings include presence of gas in the gastric wall...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28597731/new-perspectives-for-chronic-pain-treatment-a-patent-review-2010-2016
#12
REVIEW
Lícia T S Pina, Daniele N Gouveia, Janara S Costa, Jullyana S S Quintans, Lucindo J Quintans-Júnior, Rosana S S Barreto, Adriana G Guimarães
Chronic pain is a major problem of public health worldwide and is responsible for the increase in health costs. The therapeutic options available in the market for the treatment of chronic pain are often rather ineffective due to; the high number of adverse reactions, tolerance and dependence, reducing the quality of life, pharmacotherapy adherence and functional capacity. Hence, several studies have been conducted in the search for new treatment alternatives for chronic pain syndromes. Areas covered: This review brings together the therapeutic patents published over the past six years reporting the discovery of new drugs for the treatment of chronic pain, based on the perspective that these compounds are candidates for the management of chronic pain conditions...
July 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/28590310/medical-management-of-endometriosis
#13
Saima Rafique, Alan H Decherney
Endometriosis is a chronic medical condition that affects around 6% to 10% of reproductive age women. Pelvic pain, dysmenorrhea, and infertility are the most common presenting symptoms. The disease is characterized by estrogen-dependent growth of the endometrial glands and stroma outside the endometrial cavity. The diagnosis requires a high degree of suspicion and can be only confirmed on histopathology. Treatment includes medical and surgical options. Both hormonal and nonhormonal medical options are available and are tried at first with a goal to control pain and stop the growth of the endometriotic lesions...
June 5, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28586818/association-between-persistent-pain-and-memory-decline-and-dementia-in-a-longitudinal-cohort-of-elders
#14
Elizabeth L Whitlock, L Grisell Diaz-Ramirez, M Maria Glymour, W John Boscardin, Kenneth E Covinsky, Alexander K Smith
Importance: Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown. Objective: To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline. Design, Setting, and Participants: Cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000...
June 5, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28582349/perioperative-factors-associated-with-chronic-central-pain-after-the-resection-of-intramedullary-spinal-cord-tumor
#15
Yuki Onishi-Kato, Masaya Nakamura, Akio Iwanami, Masayoshi Kato, Takeshi Suzuki, Shizuko Kosugi, Nobuyuki Katori, Saori Hashiguchi, Koichi Tsuzaki, Junzo Takeda, Hiroshi Morisaki
OBJECTIVE: Some patients experience severe chronic pain after intramedullary spinal cord tumor (IMSCT) resection, but the underlying mechanisms have yet to be fully elucidated. We aimed to investigate perioperative factors associated with chronic pain after IMSCT resection. MATERIALS AND METHODS: We analyzed data from a postal survey and the medical records of patients who had undergone IMSCT resection in our institution between 2000 and 2008. Chronic pain was assessed using the Neuropathic Pain Symptom Inventory score, and its associations with factors related to tumor pathology, patient demographics, neurological findings, surgery, anesthesia, and perioperative management were determined...
July 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28579823/use-of-immediate-release-opioids-as-supplemental-analgesia-during-management-of-moderate-to-severe-chronic-pain-with-buprenorphine-transdermal-system
#16
Sanford Silverman, Robert B Raffa, Marc J Cataldo, Monica Kwarcinski, Steven R Ripa
BACKGROUND: The buprenorphine transdermal system (BTDS) is approved in the US for the management of chronic pain. Due to its high affinity for μ-opioid receptors with a slow dissociation profile, buprenorphine may potentially displace or prevent the binding of competing μ-opioid-receptor agonists, including immediate-release (IR) opioids, in a dose-dependent manner. Health care professionals may assume that the use of IR opioids for supplemental analgesia during BTDS therapy is not acceptable...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28579820/cannabis-and-intractable-chronic-pain-an-explorative-retrospective-analysis-of-italian-cohort-of-614-patients
#17
Guido Fanelli, Giuliano De Carolis, Claudio Leonardi, Adele Longobardi, Ennio Sarli, Massimo Allegri, Michael E Schatman
BACKGROUND: Despite growing interest in the therapeutic use of cannabis to manage chronic pain, only limited data that address these issues are available. In recent years, a number of nations have introduced specific laws to allow patients to use cannabis preparations to treat a variety of medical conditions. In 2015, the Italian government authorized the use of cannabis to treat several diseases, including chronic pain generally, spasticity in multiple sclerosis, cachexia and anorexia among AIDS and cancer patients, glaucoma, Tourette syndrome, and certain types of epilepsy...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28578675/a-case-report-of-bicornis-bicollis-uterus-with-unilateral-cervical-atresia-an-unusual-aetiology-of-chronic-debilitating-pelvic-pain-in-a-cameroonian-teenager
#18
Julius Sama Dohbit, Esther Meka, Joel Noutakdie Tochie, Igor Kamla, Darolles Mwadjie, Pascal Foumane
BACKGROUND: Congenital uterine anomalies like bicornis or bicornuate uterus are relatively rare in sub-Saharan Africa. They are associated with an increased rate of spontaneous abortion, preterm delivery, and infertility. The occurrence of bicornis bicollis uterus with unilateral cervical atresia is exceptional and its management is controversial. We hereby report a rare cause of chronic pelvic pain in a Cameroonian teenager due to unilateral obstructive hematometra and hematosalpinx in the non-communicating horn of a bicornis bicollis uterus...
June 2, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28578439/long-term-use-of-bisphosphonates-in-osteoporosis
#19
Basmah K Alwahhabi, Basil A Alsuwaine
To report and describe the management and response to treatment of patients referred to the osteoporosis clinic after prolonged use of bisphosphonate BPs) (4 years and more) with and without new fracture (any site) or any other new skeletal symptoms.  Methods: This is a single center observational retrospective cohort study conducted from January 2009 to May 2016 in a tertiary center. We describe cause of referral, X-rays findings, management, and response to treatment. Results: Thirty-four patients, aged 46-89 years, were collected...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28576699/chronic-instability-of-the-thumb-metacarpo-phalangeal-joint-seven-year-outcomes-of-three-surgical-techniques
#20
C Agout, G Bacle, J Brunet, E Marteau, B Charruau, J Laulan
BACKGROUND: Severe sprain of the thumb metacarpo-phalangeal joint (TMCPJ) is a common injury whose functional outcome is good when repair is performed at the acute stage. The diagnosis is often missed, however, leading to chronic instability. The optimal treatment of chronic TMCPJ instability is controversial. The objective of this study was to compare the clinical outcomes of the three main surgical techniques used to treat chronic TMCPJ instability. HYPOTHESIS: Arthrodesis is the best surgical option when ligament repair is not feasible...
May 30, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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