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pain medication

Patrick C Kennedy, Helen Purtill, Kieran O'Sullivan
BACKGROUND: Many patients reporting musculoskeletal pain present to Primary Care Physiotherapy with costly comorbid overlapping complaints that remain medically unexplained. These subjective health complaints (SHC) incorporate coexisting multi-site musculoskeletal pain and varied non-musculoskeletal complaints (e.g. anxiety, tiredness). The role of these non-musculoskeletal complaints is acknowledged in spinal musculoskeletal disorders, but less so for peripheral musculoskeletal disorders...
March 8, 2018: Musculoskeletal Science & Practice
C Roger Goucke, Pongparadee Chaudakshetrin
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention...
April 2018: Anesthesia and Analgesia
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
Hannah M Carl, A Karim Ahmed, Nancy Abu-Bonsrah, Rafael De la Garza Ramos, Eric W Sankey, Zachary Pennington, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Justin M Sacks, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE Resection of metastatic spine tumors can improve patients' quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection...
March 16, 2018: Journal of Neurosurgery. Spine
Frantisek Nehaj, Juraj Sokol, Michal Mokan, Veronika Jankovicova, Frantisek Kovar, Marianna Kubaskova, Stanislav Mizera, Marian Mokan
The patient database at the First Department of Internal Medicine in Martin, the Central Slovak Institute for Cardiac and Vascular Diseases in Banska Bystrica, and the National Slovak Institute of Cardiovascular Diseases in Bratislava was searched to identify patients with benign tumors of the heart seen during the 5-year period between 2011 and 2016. Forty-one patients with primary cardiac myxomas were identified and their medical records were reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes...
2018: BioMed Research International
Aldo Berti, Michelle Granville, Robert E Jacobson
A case of an extremely healthy, active, 96-year-old patient, nonsmoker, is reviewed. He was initially treated for left V1, V2, and V3 trigeminal neuralgia in 2001, at age 80, with stereotactic radiosurgery (SRS) with a dose of 80 Gy to the left retrogasserian trigeminal nerve. He remained asymptomatic for nine years until his trigeminal pain recurred in 2010. He was first treated medically but was intolerant to increasing doses of carbamazepine and gabapentin. He underwent a second SRS in 2012 with a dose of 65...
January 12, 2018: Curēus
Işıl Kasapoğlu, Pınar Türk, Aylin Dayan, Gürkan Uncu
OBJECTIVE: The aim of the study was to compare patients with endometriosis to those without endometriosis regarding performance rates, difficulties and complications associated with transvaginal oocyte retrieval (TVOR) procedures. MATERIAL AND METHODS: A prospective cohort study was conducted at the IVF Unit of the Division of Reproductive Endocrinology and Infertility Department of an University Hospital. Fifty-eight patients with endometriosis and 61 patients without endometriosis underwent a TVOR procedure consecutively...
March 16, 2018: Journal of the Turkish German Gynecological Association
Leen Aerts, Lorraine Grangier, Isabelle Streuli, Patrick Dällenbach, Roberto Marci, Jean-Marie Wenger, Nicola Pluchino
Endometriosis-associated pelvic pain is a major health concern in women of childbearing age. Controlled studies have shown that endometriosis can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life. Furthermore, women with endometriosis report significantly more sexual dysfunctions compared to healthy women. Empirical studies indicate that specific psychosocial factors may modulate pain experience, pain-related distress and treatment outcome...
February 8, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Amin A Ramzan, Stacy Fischer, Mary K Buss, Renata R Urban, Bruce Patsner, Linda R Duska, Christine M Fisher, Carolyn Lefkowits
As the only oncologists that provide both medical and surgical care, gynecologic oncologists encounter an exceptionally broad range of indications for prescribing opioids in clinical situations ranging from management of acute post-operative pain to chronic cancer-related pain to end-of-life care. While opioids are essential to the practice of gynecologic oncology, they can also have significant side effects and can be misused. Due to the explosive growth of opioid prescriptions and opioid-related overdoses and deaths during the first decade of the 21st century, there has been a recent concerted public health effort to prevent and treat opioid misuse through both legislation and education [1]...
March 12, 2018: Gynecologic Oncology
K Niki, Y Okamoto, S Nakajima, E Uejima
There have been no investigations examining the analgesic effect of rescue administration of intravenous acetaminophen (IV APAP) for pain in cancer patients. Fifty cancer patients who received IV APAP for pain at Ashiya Municipal Hospital (Hyogo, Japan) between January 2014 and July 2016 were retrospectively evaluated. The degree of pain was evaluated using a 4-point verbal rating scale. Pain intensity differences ≥ 1 defined the IV APAP effective group, and the patient' characteristics were compared by a medical chart review...
March 5, 2018: Die Pharmazie
I-Ting Kuo, Kuang-Yi Chang, De-Fong Juan, Steen J Hsu, Chia-Tai Chan, Mei-Yung Tsou
Pain relief always plays the essential part of perioperative care and an important role of medical quality improvement. Patient-controlled analgesia (PCA) is a method that allows a patient to self-administer small boluses of analgesic to relieve the subjective pain. PCA logs from the infusion pump consisted of a lot of text messages which record all events during the therapies. The dosage information can be extracted from PCA logs to provide easily understanding features. The analysis of dosage information with time has great help to figure out the variance of a patient's pain relief condition...
2018: PloS One
D Roorda, M J Witvliet, L M Wellens, D V Schulten, C E J Sloots, I de Blaauw, P M A Broens, J Oosterlaan, L W E van Heurn, A F W van der Steeg
AIM: Total colonic aganglionosis (TCA) is a severe form of Hirschsprung's Disease (HD) associated with a high morbidity. This study assesses long-term functional outcome and Quality of Life (QoL) of TCA patients in a national consecutive cohort. METHODS: Medical records of all patients (n=53) diagnosed between 1995 and 2015 were reviewed on surgical and demographic characteristics. Functional outcome of all non-syndromal patients, aged ≥ four years (n=35) was assessed in medical records and with a questionnaire...
March 15, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Mehrshad Vafaie, Matthias Hochadel, Thomas Münzel, Birgit Hailer, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Michael Haude, Sebastian Barth, Claus Schmitt, Harald Darius, Lars S Maier, Hugo A Katus, Jochen Senges, Evangelos Giannitsis
BACKGROUND: Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units. METHODS: From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 15, 2018: Postgraduate Medicine
Rhondene M Miller, Ronald S Kaiser
PURPOSE OF REVIEW: The complicated nature of chronic pain involves an interplay between psychological and physical factors, often resulting in increased emotional distress and reduced quality of life. This review is designed to help the medical practitioner who is working with chronic pain patients to be aware of psychological assessment techniques that can add to comprehensive patient understanding and more effectively guide treatment. Enhanced ability to assess and understand the emotional life of the chronic pain patient provides a basis for intervening and treating more successfully...
March 14, 2018: Current Pain and Headache Reports
Robert Munashe Maweni, Nicholas Sunderland, Zahra Rahim, Emmanuella Odih, Jins Kallampallil, Thomas Saunders, Srikanth Akunuri
BACKGROUND: Hypertensive urgency is defined as a severely elevated systolic blood pressure (SBP) of ≥ 180 mmHg and/or diastolic blood pressure (DBP) of ≥ 120 mmHg, in the absence of end organ damage. It is known that there are racial differences in prevalence and severity of hypertension but there is a dearth of studies looking at hypertensive urgency in Black populations living in Europe. AIMS: We sought to define the clinical characteristics of Black patients presenting with hypertensive urgency, in order to better define the risks and complications this growing population of patients faces...
March 14, 2018: Irish Journal of Medical Science
Dennis DiGiorgi, John L Cerf, Daniel S Bowerman
Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications...
2018: Chiropractic & Manual Therapies
Cecilie Okholm, Martin Frendø, Katalin Kiss, Christian von Buchwald
BACKGROUND Facial pain and numbness are common symptoms with a variety of causes; rarely, it is an initial sign of perineural infiltration of malignant tumors. CASE REPORT Here, we report 3 challenging cases, all presenting with pain and numbness of the cheek as the primary symptoms. Upon referral, there were neither signs of severe illness nor information about previous malignant diseases, while the diagnostic work-ups revealed additional involvement of the facial nerve in 2 of the cases. Surgical removal of the perineural tissue around the infraorbital nerve revealed perineural invasion by a squamous carcinoma...
March 15, 2018: American Journal of Case Reports
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
Regina Wing Shan Sit, Keith Kwok Wai Chan, Benjamin Hon Kei Yip, Daisy Dexing Zhang, Kenneth Dean Reeves, Ying Ho Chan, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
INTRODUCTION: Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups with PFOA and customised interventions to correct underlying pathomechanics is beneficial for individuals with KOA. This study aims to evaluate whether a clinic-based patella mobilisation therapy (PMT) leads to significant improvement in pain, physical function and quality of life of individuals with KOA...
March 14, 2018: BMJ Open
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