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https://www.readbyqxmd.com/read/28340230/determinants-of-opioid-prescribing-for-nonmalignant-chronic-pain-in-us-outpatient-settings
#1
Rafia S Rasu, Maureen E Knell
Study Objectives.:  Identify prescribing trends for opioid use in non-malignant chronic pain (NMCP) from the National Ambulatory Medical Care Survey (NAMCS). Determine predictors of opioid use based on patient-specific factors. Design.:  This cross-sectional study analyzed NAMCS data from 2000 to 2007. Pain medications prescribed were retrieved using NAMCS drug codes. Multivariate logistic models examined determinants of opioid prescribing among NMCP patients...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340202/validity-and-reproducibility-of-the-start-back-tool-dutch-version-in-patients-with-low-back-pain-in-primary-care-settings
#2
Jasper D Bier, Raymond W J G Ostelo, Miranda L van Hooff, Bart W Koes, Arianne P Verhagen
Objective: To translate, and to investigate the reliability and validity of the STarT Back screening tool (SBT) in the primary care setting among patients with non-specific low back pain (LBP). Methods: The SBT was formally translated in Dutch following a multistep approach for forward and backward translation. General practitioners and physiotherapists included patients with LBP. Patients completed a baseline a questionnaire and a follow-up at three days and three months...
March 9, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#3
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340086/real-world-massage-therapy-produces-meaningful-effectiveness-signal-for-primary-care-patients-with-chronic-low-back-pain-results-of-a-repeated-measures-cohort-study
#4
William G Elder, Niki Munk, Margaret M Love, Geza G Bruckner, Kathryn E Stewart, Kevin Pearce
Objective.:  While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#5
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339847/telephone-delivered-exercise-advice-and-behavior-change-support-by-physical-therapists-for-people-with-knee-osteoarthritis-protocol-for-the-telecare-randomized-controlled-trial
#6
Rana S Hinman, Belinda J Lawford, Penny K Campbell, Andrew M Briggs, Janette Gale, Caroline Bills, Simon D French, Jessica Kasza, Andrew Forbes, Anthony Harris, Stephen J Bunker, Clare M Delany, Kim L Bennell
Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective.: Determine the effectiveness of incorporating exercise advice and behaviour change support by physical therapists into an existing Australian nurse-led musculoskeletal telephone service for adults with knee OA. Design.: Randomized controlled trial with nested qualitative studies...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339752/testing-shoulder-pain-mapping
#7
Levent Bayam, Rajendra Arumilli, Ian Horsley, Fatma Bayam, Lee Herrington, Lennard Funk
Objective. : A previous study on shoulder pain mapping showed specific pain patterns for common shoulder disorders. This study aimed to test those patterns for accuracy, modify shoulder pain mapping as needed, and observe their reliability and validity. Methods. : This prospective study used a two-step process and was undertaken to determine its potential utility in daily practice. New shoulder pain patients marked their pain, its character and severity, on a custom-made mapping form...
February 22, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#8
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28338449/development-of-a-preoperative-predictive-model-for-major-complications-following-adult-spinal-deformity-surgery
#9
Justin K Scheer, Justin S Smith, Frank Schwab, Virginie Lafage, Christopher I Shaffrey, Shay Bess, Alan H Daniels, Robert A Hart, Themistocles S Protopsaltis, Gregory M Mundis, Daniel M Sciubba, Tamir Ailon, Douglas C Burton, Eric Klineberg, Christopher P Ames
OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#10
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28337656/what-factors-are-associated-with-femoral-component-internal-rotation-in-tka-using-the-gap-balancing-technique
#11
Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#12
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#13
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#14
Hanna Kaisa Tolska, Annika Takala, Karin Blomgren, Katri Hamunen, Vesa Kontinen
BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28327204/lung-adenocarcinoma-with-thyroid-metastasis-a-case-report
#15
A Dao, H Jabir, A Taleb, N Benchakroun, Z Bouchbika, T Nezha, H Jouhadi, S Sahraoui, A Benider
BACKGROUND: The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION: Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28327082/out-of-hours-care-in-germany-high-utilization-by-adult-patients-with-minor-ailments
#16
R Leutgeb, P Engeser, S Berger, J Szecsenyi, G Laux
BACKGROUND: Family practitioners (FPs) who work in Out-Of-Hours Care (OOHC) - especially in rural areas - complain about high workload related to low urgency and potentially unnecessary patient presentations with minor ailments. The aim of this study was to describe Reasons for Encounter (RFEs) in primary OOHC taken into account the doctor's perspective in the context of high workload without knowing patients' motives for visiting an OOHC-centre. METHODS: Within this descriptive study, OOHC data from 2012 were evaluated from a German statutory health insurance company in the federal state of Baden-Wuerttemberg...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28326669/limited-endoscopic-high-septoplasty-prior-to-endonasal-dacryocystorhinostomy-our-experience-of-nine-cases
#17
Sang-Wook Kim, Seong Chul Yeo, Yeon-Hee Joo, Hyun-Jin Cho, Seong Wook Seo, Sea-Yuong Jeon
Primary acquired nasolacrimal duct obstruction is a clinical syndrome of unknown cause, manifested by epiphora, infection, blurred vision, and ocular and facial pain. Conservative care is usually ineffective in patients with chronic conditions; thus, dacryocystorhinostomy (DCR) has become the gold standard of treatment for such patients. Since the advent of endoscopic technologies, most patients have undergone endonasal (EN-)DCR; the success rate is comparable to that of external (EX-)DCR. This article is protected by copyright...
March 22, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28325612/cost-effectiveness-of-high-sensitivity-troponin-compared-to-conventional-troponin-among-patients-presenting-with-undifferentiated-chest-pain-a-trial-based-analysis
#18
Billingsley Kaambwa, Julie Ratcliffe, Matthew Horsfall, Carolyn Astley, Jonathan Karnon, Penelope Coates, Margaret Arstall, Christopher Zeitz, Matthew Worthley, John Beltrame, Derek P Chew
BACKGROUND: Patients with low and intermediate risk chest pain features comprise the greatest proportion presenting to emergency services for evaluation of suspected acute coronary syndromes (ACS). The efficient and timely identification of patients with these features remains a major challenge within clinical practice. Troponin assays are increasingly being used for the determination of risk among patients presenting with chest pain potentially facilitating more appropriate care. To date, no economic evaluation comparing high-sensitivity troponin T (hs-TnT) reporting to standard troponin T (c-TnT) reporting in the routine management of suspected ACS and based on longer-term clinical outcomes has been conducted...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28324698/eye-stabilization-reflexes-in-traumatic-and-non-traumatic-chronic-neck-pain-patients
#19
Britta K Ischebeck, Jurryt de Vries, Malou Janssen, Jan Paul van Wingerden, Gert-Jan Kleinrensink, Jos N van der Geest, Maarten A Frens
BACKGROUND: Many chronic neck pain patients experience problems with vision. These problems are possibly induced by deviations of the eye stabilization reflexes. It is not known whether these eye reflex alterations occur both in traumatic and non-traumatic neck pain patients. OBJECTIVE: To investigate if the cervico-ocular reflex (COR) and the vestibulo-ocular reflex (VOR) are changed in tertiary care patients with prolonged, chronic neck pain with various origin of complaints...
March 16, 2017: Musculoskelet Sci Pract
https://www.readbyqxmd.com/read/28323547/the-extent-that-health-professionals-suspect-and-address-addiction-to-medicines-in-primary-care-findings-from-a-survey-in-northwest-england
#20
Geoff Bates, Madeleine Cochrane, Adam John Mackridge
Addiction to medicines available over the counter or via prescription is of growing international concern. The authors of the current article ran an online survey of health professionals in general medical practice and community pharmacy settings in Northwest England to explore the frequency of suspecting and responding to addiction to medicines. Health professionals reported frequently identifying addiction to medicines among patients including those with long-term pain, mental health problems, sleep disorders, and other substance use disorders, but that these addictions often go unchallenged...
March 1, 2017: Journal of Addictive Diseases
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