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https://www.readbyqxmd.com/read/27923102/pain-treatment-continues-to-be-inaccessible-for-many-patients-around-the-globe-second-phase-of-opioid-price-watch-a-cross-sectional-study-to-monitor-the-prices-of-opioids
#1
Tania Pastrana, Roberto Wenk, Lukas Radbruch, Ebtesam Ahmed, Liliana De Lima
BACKGROUND: Strong opioids are a cornerstone of pain treatment, of which morphine is considered an essential analgesic by the World Health Organization. Access to opioids is limited, due to restrictive laws, limited education, and high prices. This is the second phase of a global project to monitor and report the dispensing price of opioids with the specific aim to expand and increase the information and allow further analysis of the challenges in their availability and affordability...
December 6, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27922950/a-prospective-randomized-comparative-trial-of-targeted-steroid-injection-via-epidural-catheter-versus-standard-c7-t1-interlaminar-approach-for-the-treatment-of-unilateral-cervical-radicular-pain
#2
Zachary L McCormick, Ariana Nelson, Meghan Bhave, Mikhail Zhukalin, Mark Kendall, Robert J McCarthy, Dost Khan, Geeta Nagpal, David R Walega
BACKGROUND AND OBJECTIVES: No study has compared cervical interlaminar epidural steroid injection (CIESI) with epidural catheter advancement to the side and level of pathology versus standard C7-T1 CIESI. This study investigated whether cervical radicular pain is more effectively treated by CIESI with a targeted epidural catheter versus a standard C7-T1 approach. METHODS: Prospective, randomized, single-blinded trial. PRIMARY OUTCOME: Numerical Rating Scale (NRS) pain at 1 month...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27922948/fluoroscopic-guidance-increases-the-incidence-of-thoracic-epidural-catheter-placement-within-the-epidural-space-a-randomized-trial
#3
Michelle C Parra, Kristin Washburn, Jeremiah R Brown, Michael L Beach, Mark P Yeager, Patricia Barr, Kathy Bonham, Kathryn Lamb, Randy W Loftus
BACKGROUND AND OBJECTIVES: Thoracic epidural analgesia can reduce postoperative pain and cardiopulmonary morbidity, but it is associated with a high rate of clinical failure. Up to 50% of clinical failure is thought to be related to technical insertion. In this study, patients undergoing thoracic surgery were randomized to one of two catheter insertion techniques: fluoroscopically guided or conventional loss of resistance with saline/air. Our primary aim was to examine whether fluoroscopic guidance could increase the incidence of correct catheter placement and improve postoperative analgesia...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27922843/persistent-breast-pain-among-women-with-histories-of-breast-conserving-surgery-for-breast-cancer-compared-with-women-without-histories-of-breast-surgery-or-cancer
#4
Sara N Edmond, Rebecca A Shelby, Francis J Keefe, Hannah M Fisher, John E Schmidt, Mary S Soo, Celette S Skinner, Gretchen M Ahrendt, Jessica Manculich, Jules H Sumkin, Margarita L Zuley, Dana H Bovbjerg
OBJECTIVES: This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer. METHODS: Breast cancer survivors (n=200) were recruited at their first postsurgical surveillance mammogram (6 to 15 mo postsurgery). Women without a breast cancer history (n=150) were recruited at the time of a routine screening mammogram. All women completed measures of breast pain, pain interference with daily activities and intimacy, worry about breast pain, anxiety symptoms, and depression symptoms...
January 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27922842/what-s-in-a-name-healthcare-providers-perceptions-of-pediatric-pain-patients-based-on-diagnostic-labels
#5
Taylor A Betsch, Ayala Y Gorodzinsky, G Allen Finley, Michael Sangster, Jill Chorney
OBJECTIVES: Diagnostic labels can help patients better understand their symptoms and can influence providers' treatment planning and patient interactions. Recurrent pain is common in childhood; however, there are various diagnostic labels used. The objective of this study was to evaluate the influence of diagnostic labels on pediatric healthcare providers' perceptions of pediatric chronic pain patients. METHODS: Using an online survey, providers were randomly assigned to one of two vignette conditions (differing only in diagnostic label provided) and completed questionnaires about their perceptions of the vignette patient...
December 5, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27922701/elolyckor-kan-ge-skador-som-visar-sig-efter-l%C3%A3-ng-tid-det-akuta-omh%C3%A3-ndertagandet-kan-vara-avg%C3%A3-rande-p%C3%A3-sikt
#6
Martin Tondel, Anna Blomqvist, Kristina Jakobsson, Tohr Nilsson, Bodil Persson, Sara Thomée, Lars-Gunnar Gunnarsson
Immediate and delayed outcomes after electrical injury. A guide for clinicians In Sweden about 300 electrical injuries are recorded each year at the Swedish National Electrical Safety Board. Most of our knowledge of the health consequences of these arise from clinical case series. Severe electrical injuries have direct thermal effects and may result in ventricular fibrillation, skin burns, as well as muscular and nerve affection. Long-term consequences include pain, vascular symptoms, cognitive and neurological symptoms and signs...
December 1, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27922624/association-of-pain-social-support-and-socioeconomic-indicators-in-patients-with-spinal-cord-injury-in-iran
#7
Z Khazaeipour, E Ahmadipour, V Rahimi-Movaghar, F Ahmadipour, A R Vaccaro, B Babakhani
STUDY DESIGN: Descriptive cross-sectional study. OBJECTIVES: Pain is a prevalent complication of individuals with spinal cord injury (SCI). Our objective was to examine the association between social support, socioeconomic factors and psychosocial factors and pain to develop more effective management strategies. SETTING: Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: The Persian version of the Brief Pain Inventory was used to measure the pain, and the Multidimensional Scale of Perceived Social Support was used to measure social support through structured face-to-face interviews in SCI individuals...
December 6, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27922579/srs-22r-scores-in-non-operated-adolescent-idiopathic-scoliosis-patients-with-curves-greater-than-forty-degrees
#8
W Timothy Ward, Nicole A Friel, Tanya S Kenkre, Maria M Brooks, Joanne A Londino, James W Roach
STUDY DESIGN: Case control comparative series OBJECTIVE.: Describe surgical range adolescent idiopathic scoliosis (AIS) patients electing to forgo surgery and compare health related quality of life outcomes to a similar cohort of operated AIS patients by the same single surgeon. SUMMARY OF BACKGROUND DATA: No data have been published either documenting SRS-22r scores of non-operated patients with curves ≥ 40° or comparing these scores to a demographically similar operated cohort...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#9
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27920850/choledochoduodenal-fistula-in-the-setting-of-crohn-s-disease
#10
Shane Knipping, Ravi Rajpoot, Roozbeh Houshyar
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920807/underdiagnosis-of-osteoporotic-vertebral-fractures-in-patients-with-fragility-fractures-retrospective-analysis-of-over-300-patients
#11
Vanna Bottai, Stefano Giannotti, Gloria Raffaetà, Maurizio Mazzantini, Francesco Casella, Gaia De Paola, Agnese Menconi, Francesca Falossi, Giulio Guido
Osteoporosis (OP) is a silent disease unless a fracture occurs; it is a major health problem, mainly due to fragility fractures, that occur at vertebral and peripheral sites. Vertebral fractures (VF) are probably the most common fragility fractures, but they go often unrecognized. The main clinical symptoms of VF are acute and chronic back pain, spinal deformity, reduced mobility and impaired quality of life. They are frequently associated with other fragility fractures. We examined 478 patients at our outpatient clinic, who were referred for fragility fracture occurrence...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920806/hereditary-multiple-exostoses-a-review-of-clinical-appearance-and-metabolic-pattern
#12
REVIEW
Giovanni Beltrami, Gabriele Ristori, Guido Scoccianti, Angela Tamburini, Rodolfo Capanna
Hereditary multiple exostoses (HME) is an inherited genetic condition characterized by the presence of multiple exostoses (osteochondromas). MHE is a relatively rare autosomal dominant disorder, mainly caused by loss of function mutations in two genes: exostosin-1 (EXT1) and exostosin-2 (EXT2). These genes are linked to heparan sulfate (HS) synthesis, but the specific molecular mechanism leading to the disruption of the cartilage structure and the consequent exostoses formation is still not resolved. The aim of this paper is to encounter the main aspects of HME reviewing the literature, in order to improve clinical features and evolution, and the metabolic-pathogenetic mechanisms underlying...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920801/implications-of-analgesics-use-in-osteoporotic-related-pain-treatment-focus-on-opioids
#13
REVIEW
Renato Vellucci, Consalvo Mattia, Ludovica Celidonio, Rocco Domenico Mediati
Bone loss is asymptomatic and will progress without pain and other symptoms until the occurrence of a fracture. The occurrence of a breaking bone induce acute pain determined and supported by a mechanical, inflammatory and neuropathic component. Very often the acute component evolves in a chronic musculoskeletal component. Overall objectives of the analgesic therapy can be summarized in pain relief, improving sleep, improve mobility, reduce anxiety, emotional component and depression. Osteoporosis is predominantly a condition of the elderly, more likely to have coexisting cardiovascular disease and age-related decline in renal function, receiving treatment for one or more comorbid conditions, taking multiple medications...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920709/shoulder-pain-after-fall-septic-shock-and-pyomyositis-associated-with-breast-cancer-chemotherapy-and-lymphedema
#14
Hiromitsu Kitayama, Junko Sugiyama, Michiaki Hirayama, Yosihiro Onada, Yasushi Tsuji
BACKGROUND: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. CASE REPORT: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#15
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920574/combined-epidural-morphine-and-bupivacaine-in-the-treatment-of-lumbosacral-radicular-neuropathic-pain-a-noncontrolled-prospective-study
#16
Simone Vigneri, Gianfranco Sindaco, Marco La Grua, Matteo Zanella, Laura Ravaioli, Valentina Paci, Gilberto Pari
OBJECTIVE: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment. METHODS: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural space, and each patient received an epidural injection of morphine chlorhydrate and bupivacaine up to three times a day...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27920494/presence-or-absence-of-ocular-surface-inflammation-directs-clinical-and-therapeutic-management-of-dry-eye
#17
Robert Sambursky
BACKGROUND: The presence of clinically significant inflammation has been confirmed in the tears of 40%-65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes. PATIENTS AND METHODS: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9)...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27920487/synchronous-occurrence-of-a-hepatic-myelolipoma-and-two-hepatocellular-carcinomas
#18
Shao-Yan Xu, Hai-Yang Xie, Lin Zhou, Shu-Sen Zheng, Wei-Lin Wang
Myelolipoma is a rare tumor composed of fat and bone marrow components, most of which are located in the adrenal gland. Myelolipoma in the liver is extremely rare. To date, only 10 cases have been reported in the English-language medical literature. In one of these cases, the hepatic myelolipoma was found within a hepatocellular carcinoma (HCC). In the present study, we report the first case of the synchronous occurrence of hepatic myelolipoma and HCCs in different liver sections of one patient, a 26-year-old female who was admitted to our hospital because of a 4-d history of upper abdominal pain...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27920467/possible-therapeutic-role-of-ige-blockade-in-irritable-bowel-syndrome
#19
EDITORIAL
Eli Magen, Tinatin Chikovani
Omalizumab is a humanized monoclonal antibody that binds to the high-affinity type-I IgE Fc receptors on mast cells (MCs) and basophils, inhibiting the IgE immune pathway. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, and dysregulation of the immune system likely contributes to its etiology and/or symptomatology. Colonic biopsies from patients with IBS demonstrate considerable increase in the number of degranulating MCs releasing histamine in proximity to nerves, and this event may underlie the common IBS symptom of abdominal pain...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27920323/bridging-the-divide-between-dental-and-medical-care
#20
Gayathri Subramanian
A cancer patient delays needed dental care before radiation treatment and develops a painful, incurable disease.
December 1, 2016: Health Affairs
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