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https://www.readbyqxmd.com/read/28108941/factors-associated-with-emergency-department-useamong-veteran-psychiatric-patients
#1
Daniel M Blonigen, Kathryn S Macia, Xiaoyu Bi, Paola Suarez, Luisa Manfredi, Todd H Wagner
Frequent utilization of emergency department (ED) services contributes substantially to the cost of healthcare nationally and is often driven by psychiatric factors. Using national-level data from the Veterans Health Administration (VHA), the present study examined patient-level factors associated with ED use among veteran psychiatric patients. Veterans who had at least one ED visit with a psychiatric diagnosis in fiscal years 2011-2012 (n = 226,122) were identified in VHA administrative records. Andersen's behavioral model of healthcare utilization was used to identify need, enabling, and predisposing factors associated with frequency of ED use (primary outcome) in multivariate regression models...
January 21, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28108642/the-potential-role-for-smartphones-among-older-adults-with-chronic-noncancer-pain-a-qualitative-study
#2
Joshua E Richardson, Jennifer I Lee, Anita Nirenberg, M Carrington Reid
: OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. DESIGN:  Qualitative study. SETTING:  One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28108179/symptomatic-treatment-of-cough-among-adult-patients-with-lung-cancer-chest-guidelines-and-expert-panel-report
#3
Alex Molassiotis, Jaclyn A Smith, Peter Mazzone, Fiona Blackhall, Richard S Irwin
BACKGROUND: Cough among patients with lung cancer is a common but often undertreated symptom. We have used a recent Cochrane systematic review, among other sources of evidence, to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. METHODS: The American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on data from the Cochrane systematic review on the topic, uncontrolled studies, case studies, and the clinical context...
January 17, 2017: Chest
https://www.readbyqxmd.com/read/28107590/endocannabinoid-activation-of-cb1-receptors-contributes-to-long-lasting-reversal-of-neuropathic-pain-by-repetitive-spinal-cord-stimulation
#4
L Sun, L Tai, Q Qiu, R Mitchell, S Fleetwood-Walker, E A Joosten, C W Cheung
BACKGROUND: Spinal cord stimulation (SCS) has been shown to be effective in the management of certain neuropathic pain conditions, however, the underlying mechanisms are incompletely understood. In this study, we investigated repetitive SCS in a rodent neuropathic pain model, revealing long-lasting and incremental attenuation of hyperalgesia and a mechanism of action involving endocannabinoids. METHOD: Animals were implanted with monopolar electrodes at the time of partial sciatic nerve injury...
January 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28105279/nanoconjugated-nap-as-a-potent-and-periphery-selective-mu-opioid-receptor-modulator-to-treat-opioid-induced-constipation
#5
Guoyan G Xu, Olga Yu Zolotarskaya, Dwight A Williams, Yunyun Yuan, Dana E Selley, William L Dewey, Hamid I Akbarali, Hu Yang, Yan Zhang
Opioids are the mainstay for cancer and noncancer pain management. However, their use is often associated with multiple adverse effects. Among them, the most common and persistent one is probably opioid-induced constipation (OIC). Periphery selective opioid antagonists may alleviate the symptoms of OIC without compromising the analgesic effects of opioids. Recently our laboratories have identified one novel lead compound, 17-cyclopropylmethyl-3,14β-dihydroxy-4,5α-epoxy-6β-[(4'-pyridyl)acetamido]morphinan (NAP), as a peripherally selective mu opioid receptor ligand carrying subnanomolar affinity to the mu opioid receptor and over 100-folds of selectivity over both the delta and kappa opioid receptors, with reasonable oral availability and half-life, and potential to treat OIC...
January 12, 2017: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28103764/multimodal-pediatric-pain-management-part-2
#6
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf speaks to Commissioning Editor Jade Parker: Stefan Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota in Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The pain and palliative care program is devoted to control acute, chronic/complex and procedural pain for inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
January 20, 2017: Pain Management
https://www.readbyqxmd.com/read/28103678/an-advance-in-prescription-opioid-vaccines-overdose-mortality-reduction-and-extraordinary-alteration-of-drug-half-life
#7
Atsushi Kimishima, Cody J Wenthur, Bin Zhou, Kim D Janda
Prescription opioids (POs) such as oxycodone and hydrocodone are highly effective medications for pain management, yet they also present a substantial risk for abuse and addiction. The consumption of POs has been escalating worldwide, resulting in tens of thousands of deaths due to overdose each year. Pharmacokinetic strategies based upon vaccination present an attractive avenue to suppress PO abuse. Herein, the preparation of two active PO vaccines is described that were found to elicit high-affinity antiopioid antibodies through a structurally congruent drug-hapten design...
January 20, 2017: ACS Chemical Biology
https://www.readbyqxmd.com/read/28103434/analgesic-effect-of-quetiapine-in-a-mouse-model-of-cancer-induced-bone-pain
#8
Mi Hwa Heo, Jin Young Kim, Ilseon Hwang, Eunyoung Ha, Keon Uk Park
Background/Aims: Cancer-induced bone pain (CIBP) is one of the most common pains in patients with advanced neoplasms. Because of treatment-associated side effects, more than half of cancer patients are reported to have inadequate and undermanaged pain control. New mechanism-based therapies must be developed to reduce cancer pain. Quetiapine is a commonly used atypical antipsychotic drug. We report a study of the potential analgesic effects of quetiapine in a mouse model of CIBP and examine the mechanism of bone pain by analyzing the expression of various nociceptors...
January 20, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28103372/the-effect-of-epidural-levobupivacaine-and-fentanyl-on-stress-response-and-pain-management-in-patients-undergoing-percutaneous-nephrolithotomy
#9
A Ahiskalioglu, O Ahiskalioglu, A Dostbil, C Abdullah, A Megnet, M Celik, I Ilker, K Husnu
Objective: The perioperative stress response of patients who were scheduled to have percutaneous nephrolithotomy under epidural anaesthesia with opioids and local anaesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods: A total of 48 patients, between 18-65 years of age and ASA I-II, for whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups namely: Group GA (n = 24): general anaesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anaesthesia and general anaesthesia together with postoperative epidural analgesia (0...
March 14, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-non-heroin-opioid-overdoses-experience-at-an-academic-medical-center
#10
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Marin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and non-heroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. DESIGN: Retrospective cohort study. SETTING: Large, academic medical center. PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a non-heroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#11
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#12
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28096580/randomized-double-blind-comparison-of-remifentanil-and-alfentanil-in-patients-undergoing-laparoscopic-cholecystectomy-using-total-intravenous-anesthesia
#13
José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28093132/controlled-release-oxycodone-improves-pain-management-after-uterine-artery-embolisation-for-symptomatic-fibroids
#14
G M G Freire, R N Cavalcante, J M Motta-Leal-Filho, M Messina, F L Galastri, B B Affonso, R D Rocha, F Nasser
AIM: To evaluate if pre- and post-procedure administration of controlled-release oxycodone (CRO) in combination with standard analgesia improves pain control and decreases the amount of required post-procedure opioids in uterine fibroid embolisation (UFE). MATERIALS AND METHODS: Between January 2009 and March 2010, 60 consecutive women were prospectively randomised in two groups for UFE: the control group, in which 30 patients underwent the standard anaesthetic procedure and the CRO group, in which 30 patients underwent the standard anaesthetic procedure with the addition of CRO...
January 13, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28092651/long-lasting-antinociceptive-effects-of-green-light-in-acute-and-chronic-pain-in-rats
#15
Mohab M Ibrahim, Amol Patwardhan, Kerry B Gilbraith, Aubin Moutal, Xiaofang Yang, Lindsey A Chew, Tally Largent-Milnes, T Philip Malan, Todd W Vanderah, Frank Porreca, Rajesh Khanna
Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain...
February 2017: Pain
https://www.readbyqxmd.com/read/28092648/does-brief-chronic-pain-management-education-change-opioid-prescribing-rates-a-pragmatic-trial-in-australian-early-career-general-practitioners
#16
Simon Mark Holliday, Chris Hayes, Adrian J Dunlop, Simon Morgan, Amanda Tapley, Kim M Henderson, Mieke L van Driel, Elizabeth G Holliday, Jean I Ball, Andrew Davey, Neil Allan Spike, Lawrence Andrew McArthur, Parker John Magin
We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls...
February 2017: Pain
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#17
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092326/using-placebos-as-an-opioid-sparing-method-of-pain-management
#18
Carla R Jungquist, Michael L Perlis, Romanth Waghmarae
No abstract text is available yet for this article.
February 2017: Pain
https://www.readbyqxmd.com/read/28092325/persistent-pain-after-motor-vehicle-collision-comparative-effectiveness-of-opioids-vs-nonsteroidal-antiinflammatory-drugs-prescribed-from-the-emergency-department-a-propensity-matched-analysis
#19
Francesca L Beaudoin, Roee Gutman, Roland C Merchant, Melissa A Clark, Robert A Swor, Jeffrey S Jones, David C Lee, David A Peak, Robert M Domeier, Niels K Rathlev, Samuel A McLean
Each year millions of Americans present to the emergency department (ED) for care after a motor vehicle collision (MVC); the majority (>90%) are discharged to home after evaluation. Acute musculoskeletal pain is the norm in this population, and such patients are typically discharged to home with prescriptions for oral opioid analgesics or nonsteroidal antiinflammatory drugs (NSAIDs). The influence of acute pain management on subsequent pain outcomes in this common ED population is unknown. We evaluated the effect of opioid analgesics vs NSAIDs initiated from the ED on the presence of moderate to severe musculoskeletal pain and ongoing opioid use at 6 weeks in a large cohort of adult ED patients presenting to the ED after MVC (n = 948)...
February 2017: Pain
https://www.readbyqxmd.com/read/28090652/a-systematic-review-of-the-analgesic-efficacy-of-cannabinoid-medications-in-the-management-of-acute-pain
#20
REVIEW
A J Stevens, M D Higgins
BACKGROUND: Cannabinergic medications have been postulated to demonstrate efficacy in the management of pain. The aim of this systematic review was to assess the analgesic efficacy and adverse effects of cannabinoids when used for the management of acute pain. METHODS: A systematic review was performed by searching the MEDLINE, EMBASE and CENTRAL databases, and the World Health Organization International Clinical Trials Registry Platform for human randomized controlled trials that assessed the analgesic efficacy of cannabinoids compared to placebo or active comparators...
January 16, 2017: Acta Anaesthesiologica Scandinavica
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