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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/29790354/-opioids-and-new-trends-in-pain-therapy
#1
Jan Lejčko
Opioids are well known for their ability to reduce the perception of pain without a loss of consciousness. However, the influence of opioids on organism is very complex. Clinical pharmacology of currently available opioid analgesics is determined by three major factors - their opioid receptor properties, pharmacokinetic properties and genetic polymorphism in the opiate receptor and cytochrome P450 isoform. In acute severe pain are opioids very efficient. Long-term experience with opioid analgesia in patients with cancer pain has shown high favorable risk/benefit ratio...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29781960/a-peripherally-restricted-cannabinoid-1-receptor-agonist-as-a-novel-analgesic-in-cancer-induced-bone-pain
#2
Hong Zhang, Dominique M Lund, Haley A Ciccone, William D Staatz, Mohab M Ibrahim, Tally M Largent-Milnes, Herbert H Seltzman, Igor Spigelman, Todd W Vanderah
Many malignant cancers, including breast cancer, have a propensity to invade bones, leading to excruciating bone pain. Opioids are the primary analgesics used to alleviate this cancer-induced bone pain (CIBP) but are associated with numerous severe side effects, including enhanced bone degradation, which significantly impairs patients' quality of life. In contrast, agonists activating only peripheral CB1 receptors (CB1Rs) have been shown to effectively alleviate multiple chronic pain conditions with limited side effects, yet no studies have evaluated their role(s) in CIBP...
May 16, 2018: Pain
https://www.readbyqxmd.com/read/29779791/effectiveness-of-a-mindfulness-based-intervention-in-the-management-of-musculoskeletal-pain-in-nursing-workers
#3
Shirlene Aparecida Lopes, Bruna Pesce Vannucchi, Marcelo Demarzo, Ângelo Geraldo José Cunha, Maria do Patrocínio Tenório Nunes
BACKGROUND: Chronic pain is a prevalent disorder in nursing workers worldwide. Several studies have proposed measures to mitigate this critical scenario. Mindfulness-based interventions (MBI) have been found to have promising results in the treatment of this disorder. AIMS: To quantify the effectiveness of an adapted mindfulness program (AMP) in the management of musculoskeletal pain (MSP) in nursing technicians of a Brazilian university hospital. DESIGN: This study was a clinical, prospective, open, repeated measures trial, with data collection between January and July 2015...
May 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29777618/guideline-of-guidelines-bladder-pain-syndrome
#4
REVIEW
Sachin Malde, Stefano Palmisani, Adnan Al-Kaisy, Arun Sahai
Bladder pain syndrome (BPS) is a severely debilitating, chronic disorder of unknown aetiology that has a significant negative impact on quality of life. A community-based study of American women has reported a high prevalence of 2.7% - 6.5% [1]. Despite this, there is still a lack of consensus worldwide on how to define the condition, the nomenclature to use, and how to optimally treat patients. This is reflected in the considerable variation in management worldwide, and the divergent recommendations in national and international guidelines...
May 19, 2018: BJU International
https://www.readbyqxmd.com/read/29774774/undertreatment-of-pain-and-low-use-of-opioids-in-latin-america
#5
César Amescua García, Joao Batista Santos Garcia, María Del Rosario Berenguel Cook, Frantz Colimon, José Alberto Flores Cantisani, Carlos Guerrero, María Del Rocío Guillén Núnez, John Jairo Hernández Castro, Durval Campos Kraychete, Argelia Lara-Solares, Osvandré Lech, María Antonieta Rico Pazos, Manuel Sempértegui Gallegos, Lizandra Pattaro Marcondes
Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries...
May 18, 2018: Pain Management
https://www.readbyqxmd.com/read/29772106/the-relationships-between-pain-catastrophizing-subcomponents-and-multiple-pain-related-outcomes-in-japanese-outpatients-with-chronic-pain-a-cross-sectional-study
#6
Tomonori Adachi, Aya Nakae, Tomoyuki Maruo, Kenrin Shi, Lynn Maeda, Youichi Saitoh, Masahiko Shibata, Jun Sasaki
OBJECTIVES: The present study sought to examine associations between the pain catastrophizing subcomponents and multiple pain-related outcomes in Japanese individuals with chronic pain. METHODS: A cross-sectional study design was employed with 213 chronic pain outpatients. The participants were recruited from three units at one university hospital and from a pain clinic at a municipal hospital. Study measures were used to assess pain catastrophizing, anxiety, depression, pain interference, and pain severity...
May 17, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29765923/insomnia-with-musculoskeletal-pain-in-postmenopause-associations-with-symptoms-mood-and-quality-of-life
#7
Cristina Frange, Helena Hachul, Camila Hirotsu, Sergio Tufik, Monica Levy Andersen
Objectives: To investigate the relationship between insomnia (INS) combined with chronic musculoskeletal pain (MSP) in postmenopausal women and its characteristics regarding MSP, menopausal and mood symptoms, sleep and quality of life (QOL). Methods: A cross-sectional control study in 4 groups of postmenopausal women: control (n = 15), MSP (n = 15), INS (n =15) and INS + MSP (n = 17). Sixty-two participants completed questionnaires and had blood collected, and 43 underwent polysomnography...
April 2018: Journal of Menopausal Medicine
https://www.readbyqxmd.com/read/29765785/spondylocostal-dysostosis-a-literature-review-and-case-report-with-long-term-follow-up-of-a-conservatively-managed-patient
#8
Brendan R Southam, Adam P Schumaier, Alvin H Crawford
Introduction: Patients with spondylocostal dysostosis (SCD) have congenital spine and rib deformities associated with frequently severe thoracic insufficiency and respiratory compromise. The literature is largely composed of case reports and small cohorts, and there is little information regarding adults with this condition. In this report, we describe the natural history of a conservatively treated patient and include quality-of-life issues such as childbearing, athletic participation, and occupational selection...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29763740/combining-magnetic-resonance-imaging-mri-and-medical-infrared-thermography-mit-in-the-pre-and-per-operating-management-of-severe-hidradenitis-suppurativa-hs
#9
Stéphane Derruau, Yohann Renard, Hervé Pron, Redha Taiar, Ellie Abdi, Guillaume Polidori, Sandrine Lorimier
Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurrent skin disease. Surgical excision of wounds appears to be the only curative treatment for the prevention of recurrence of moderate to severe stages. Magnetic resonance imaging (MRI) is a standard reference examination for the detection of HS peri-anal inflammatory fistula. In this case study, the use of real-time medical infrared thermography, in combination with MRI as appropriate imaging, is proposed. The aim is to assist surgeons in the pre- and peri-surgical management of severe perianal hidradenitis suppurativa with the intent to ensure that all diseased lesions were removed during surgery and therefore to limit recurrence...
May 12, 2018: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29762767/concerns-and-help-seeking-among-patients-using-opioids-for-management-of-chronic-noncancer-pain
#10
Briony Larance, Gabrielle Campbell, Teleri Moore, Suzanne Nielsen, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Wayne Hall, Richard Mattick, Courtney O'Donnell, Louisa Degenhardt
Background: The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. Methods: Data were collected from 1,086 people prescribed opioids for CNCP via a large prospective cohort called the Pain and Opioids IN Treatment (POINT) study. Patients' characteristics and help-seeking were examined according to scores on the Prescribed Opioids Difficulties Scale (PODS)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29761101/fibromyalgia-syndrome-a-case-report-on-controlled-remission-of-symptoms-by-a-dietary-strategy
#11
Silvia Maria Lattanzio, Francesca Imbesi
A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#12
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29758357/pharmacopuncture-with-scolopendra-subspinipes-suppresses-mechanical-allodynia-in-oxaliplatin-induced-neuropathic-mice-and-potentiates-clonidine-induced-anti-allodynia-without-hypotension-or-motor-impairment
#13
Seo-Yeon Yoon, Jeong-Yun Lee, Dae-Hyun Roh, Seog Bae Oh
Chemotherapy-induced neuropathic pain is a common dose-limiting side effect of anticancer drugs but lacks an effective treatment strategy. Scolopendra subspinipes (SS) has been used in traditional medicine to treat chronic neuronal diseases. Moreover, pharmacopuncture with SS (SSP) produces potent analgesia in humans and experimental animals. In this study, we examined the effect of SSP into the ST36 acupoint on oxaliplatin-induced mechanical allodynia in mice. Acupoint treatment with SSP (0.5%/20 μL) significantly reduced mechanical allodynia produced by a single oxaliplatin injection (10 mg/kg, i...
May 11, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29754321/chronic-low-back-pain-a-mini-review-on-pharmacological-management-and-pathophysiological-insights-from-clinical-and-pre-clinical-data
#14
REVIEW
Thomas S W Park, Andy Kuo, Maree T Smith
Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population...
May 12, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29753617/patient-factors-associated-with-prolonged-postoperative-opioid-use-after-total-knee-arthroplasty
#15
Robert S Namba, Anshuman Singh, Elizabeth W Paxton, Maria C S Inacio
BACKGROUND: Pain persists in a moderate proportion of patients after total knee arthroplasty (TKA). Identifying patient factors that are associated with persistent pain may lead to improved care. PURPOSE: The purpose of the study was to identify preoperative factors associated with increased opioid prescriptions after TKA. METHODS: A retrospective cohort study of TKAs in an integrated health-care system (January 2008-December 2011) was conducted...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29753112/patients-with-chronic-spinal-pain-benefit-from-pain-neuroscience-education-regardless-the-self-reported-signs-of-central-sensitization-secondary-analysis-of-a-randomized-controlled-multicentre-trial
#16
Anneleen Malfliet, Jeroen Kregel, Mira Meeus, Lieven Danneels, Barbara Cagnie, Nathalie Roussel, Jo Nijs
BACKGROUND: Pain neuroscience education is effective in chronic pain management. Central sensitization (i.e. generalized hypersensitivity) is often explained as underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome. OBJECTIVES: To examine whether patients with more or fewer symptoms of central sensitization respond differently to pain neuroscience education. DESIGN: A secondary analysis of a multicentre, triple-blind randomized controlled trial SETTING: University hospital Ghent and University Hospital Brussels, Belgium...
May 9, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29752406/the-prostaglandin-e-2-receptor-ep3-controls-cc-chemokine-ligand-mediated-neuropathic-pain-induced-by-mechanical-nerve-damage
#17
Elsa-Marie Treutlein, Katharina Kern, Andreas Weigert, Neda Tarighi, Claus-Dieter Schuh, Rolf M Nüsing, Yannick Schreiber, Nerea Ferreirós, Bernhard Brüne, Gerd Geisslinger, Sandra Pierre, Klaus Scholich
Prostaglandin (PG) E2 is an important lipid mediator that is involved in several pathophysiological processes contributing to fever, inflammation and pain. Previous studies have shown that early and continuous application of non-steroidal anti-inflammatory drugs significantly reduces pain behavior in the spared nerve injury (SNI) model for trauma-induced neuropathic pain. However, the role of PGE2 and its receptors in the development and maintenance of neuropathic pain is incompletely understood, but may help inform strategies for pain management...
May 11, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29749702/management-of-severe-chronic-pain-with-methadone-in-pediatric-patients-with-sickle-cell-disease
#18
Zachary LeBlanc, Chris Vance, Jason Payne, Jie Zhang, Lee Hilliard, Jeffrey D Lebensburger, Thomas H Howard
Vasocclusive pain crises are common among pediatric patients with sickle cell disease (SCD). Some patients with repeated pain crises develop chronic pain. We performed a retrospective cohort study of pediatric patients with SCD with chronic pain treated with methadone. We identified a significant reduction in pain hospitalizations following methadone treatment (0.35 ± 0.19 vs. 0.19 ± 0.17 hospitalizations/month, P = 0.016). In addition, we did not observe overt organ toxicity nor symptoms of opioid withdrawal during methadone wean...
May 11, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29746344/nutritional-considerations-in-pediatric-pancreatitis-a-position-paper-from-the-naspghan-pancreas-committee-espghan-pancreas-working-group
#19
Maisam Abu-El-Haija, Aliye Uc, Steven L Werlin, A Jay Freeman, Miglena Georgieva, Danijela Jojkić - Pavkov, Daina Kalnins, Brigitte Kochavi, Bart G P Koot, Stephanie Van Biervliet, Jaroslaw Walkowiak, Michael Wilschanski, Veronique D Morinville
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP) and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics...
May 8, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29740641/resistance-training-in-addition-to-multidisciplinary-rehabilitation-for-patients-with-chronic-pain-in-the-low-back-study-protocol
#20
Vegard Moe Iversen, Ottar Vasseljen, Paul Jarle Mork, Ida Reitan Berthelsen, Janne-Birgitte Bloch Børke, Gro Falkener Berheussen, Anne Therese Tveter, Øyvind Salvesen, Marius Steiro Fimland
Introduction: Chronic low back pain (LBP) is a major health problem worldwide. Multidisciplinary rehabilitation and exercise is recommended for the management of chronic LBP. However, there is a need to investigate effective exercise interventions that is available in clinics and as home-based training on a large scale. This article presents the design and rationale of the first randomized clinical trial investigating the effects of progressive resistance training with elastic bands in addition to multidisciplinary rehabilitation for patients with moderate to severe chronic LBP...
June 2017: Contemporary Clinical Trials Communications
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