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https://www.readbyqxmd.com/read/29162122/overdose-prevention-training-with-naloxone-distribution-in-a-prison-in-oslo-norway-a-preliminary-study
#1
Aase Grønlien Petterson, Desiree Madah-Amiri
BACKGROUND: Prison inmates face a ten times increased risk of experiencing a fatal drug overdose during their first 2 weeks upon release than their non-incarcerated counterparts. Naloxone, the antidote to an opioid overdose, has been shown to be feasible and effective when administered by bystanders. Given the particular risk that newly released inmates face, it is vital to assess their knowledge about opioid overdoses, as well as the impact of brief overdose prevention training conducted inside prisons...
November 21, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/29160596/chronic-pain-and-opioid-abuse-factors-associated-with-health-related-quality-of-life
#2
Jermaine D Jones, Jonathan S Vogelman, Rachel Luba, Mudassir Mumtaz, Sandra D Comer
BACKGROUND AND OBJECTIVES: While research on the separate relationships between health-related quality of life (HRQOL) and chronic pain, and HRQOL and opioid abuse has been sparse, even less work has investigated the factors associated with HRQOL in individuals who have both chronic pain and meet criteria for opioid use disorder. The data presented in this analysis should allow a better understanding the factors important to quality of life among this dual-diagnosed population. METHODS: Individuals with dual diagnoses of chronic pain and opioid use disorder were recruited for clinical research studies at Columbia University Medical Center...
November 21, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29159398/cost-effectiveness-of-publicly-funded-treatment-of-opioid-use-disorder-in-california
#3
Emanuel Krebs, Benjamin Enns, Elizabeth Evans, Darren Urada, M Douglas Anglin, Richard A Rawson, Yih-Ing Hser, Bohdan Nosyk
Background: Only 1 in 5 of the nearly 2.4 million Americans with an opioid use disorder received treatment in 2015. Fewer than half of Californians who received treatment in 2014 received opioid agonist treatment (OAT), and regulations for admission to OAT in California are more stringent than federal regulations. Objective: To determine the cost-effectiveness of OAT for all treatment recipients compared with the observed standard of care for patients presenting with opioid use disorder to California's publicly funded treatment facilities...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29158866/-tb-hiv-co-infection-associated-with-kaposi-s-sarcoma-under-opioid-substitution-treatment-using-methadone-about-a-case
#4
Viviane Marie Pierre Cisse Diallo, Louise Fortes Deguenonvo, Khardiata Diallo Mbaye, Daye Ka, Ndeye Aissatou Lakhe, Ibrahima Ndiaye, Daouda Thioub, Sylvie Audrey Diop Nyafouna, Aminata Massaly, Alassane Dièye, Moustapha Diop, Cheikh Tidiane Ndour, Moussa Seydi
Late diagnosis of HIV infection can be fatal because it favors the appearance of opportunistic infections whose management requires the use of several molecules which can cause drug interactions. We report the case of a 45-year old female patient under heroin substitution treatment, using methadone and with HIV1 under antiretroviral treatment. This patient had nonspecific pulmonary appearance associated with dry nagging cough and progressive dyspnea evolving in a feverish context. Moreover, clinical examination showed left lower limb lymphedema with painless angiomatous nodules evolving over three years associated with plaques, angiomatous nodules occurred more recently at the level of the anterior face of the thorax...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29158012/a-randomized-double-blind-placebo-controlled-proof-of-concept-study-to-evaluate-samidorphan-in-the-prevention-of-olanzapine-induced-weight-gain-in-healthy-volunteers
#5
Bernard L Silverman, William Martin, Asli Memisoglu, Lauren DiPetrillo, Christoph U Correll, John M Kane
Antipsychotic medications are associated with weight gain and adverse metabolic effects that complicate the treatment and management of schizophrenia. Olanzapine (OLZ) in particular is associated with significant weight gain and adverse metabolic effects. The present Phase 1, proof of concept, multicenter, randomized, double-blind, placebo-controlled study investigated the safety and effect on weight of a combination of OLZ (10mg) and the opioid modulator samidorphan (SAM; 5mg) in comparison to OLZ alone in healthy, male normal weight volunteers...
November 17, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29157034/effects-of-single-dose-preemptive-pregabalin-and-intravenous-ibuprofen-on-postoperative-opioid-consumption-and-acute-pain-after-laparoscopic-cholecystectomy
#6
Omer Karaca, Huseyin U Pınar, Emin Turk, Rafi Dogan, Ali Ahiskalioglu, Sezen K Solak
PURPOSE: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ıv ibuprofen. METHODS: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ıv ibuprofen before surgery...
November 20, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29156914/palliative-radiotherapy-utilization-within-a-regional-australian-palliative-care-unit
#7
Peter Eastman, Anna Dowd, James Goonan, Helen Farrell, Graham Pitson
BACKGROUND: Palliative radiotherapy has been demonstrated to be efficacious for symptom management in advanced malignancy however there are limited data investigating its use for inpatient palliative care patients. The aim of the current paper was to evaluate the utilization of radiotherapy amongst patients admitted to a regional Australian palliative care unit (PCU). METHODS: A retrospective cohort study was undertaken involving all Barwon Health PCU patients who received radiotherapy whilst an inpatient...
October 1, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29155288/investigation-of-the-practices-legislation-supply-chain-and-regulation-of-opioids-for-clinical-pain-management-in-southern-africa-a-multi-sectoral-cross-national-mixed-methods-study
#8
Eve Namisango, Matthew J Allsop, Richard A Powell, Stefan J Friedrichsdorf, Emmanuel Bk Luyirika, Fatia Kiyange, Edward Mukooza, Chris Ntege, Eunice Garanganga, Mavis Ntombifuthi Ginindza-Mdluli, Faith Mwangi-Powell, Lidia Justino Mondlane, Richard Harding
CONTEXT: Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. OBJECTIVES: To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#9
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29153633/opioids-consumed-in-the-immediate-post-operative-period-does-not-influence-how-patients-rate-their-experience-of-care-after-total-hip-arthroplasty
#10
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Sana Virani, Michael A Mont, Ronald E Delanois
BACKGROUND: Patient perception of care, commonly measured with Press Ganey (PG) surveys, is an important metric used to determine hospital and provider reimbursement. However, post-operative pain following total hip arthroplasty (THA) may negatively affect patient satisfaction. As a result, over-administration of opioids may occur, even without marked evidence of pain. Therefore, this study evaluated whether opioid consumption in the immediate postoperative period bears any influence on satisfaction scores after THA...
November 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#11
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29153296/use-of-self-management-interventions-for-chronic-pain-management-a-comparison-between-rural-and-nonrural-residents
#12
Linda H Eaton, Dale J Langford, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152410/ultrasound-triggered-local-anaesthesia
#13
Alina Y Rwei, Juan L Paris, Bruce Wang, Weiping Wang, Christopher D Axon, María Vallet-Regí, Robert Langer, Daniel S Kohane
On-demand relief of local pain would allow patients to control the timing, intensity and duration of nerve block in a safe and non-invasive manner. Ultrasound would be a suitable trigger for such a system, as it is in common clinical use and can penetrate deeply into the body. Here, we demonstrate that ultrasound-triggered delivery of an anaesthetic from liposomes allows the timing, intensity and duration of nerve block to be controlled by ultrasound parameters. On insonation, the encapsulated sonosensitizer protoporphyrin IX produces reactive oxygen species that react with the liposomal membrane, leading to the release of the potent local anaesthetic tetrodotoxin...
2017: Nature biomedical engineering
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#14
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149151/sacroplasty-a-ten-year-analysis-of-prospective-patients-treated-with-percutaneous-sacroplasty-literature-review-and-technical-considerations
#15
Michael E Frey, Christopher Warner, Samuel M Thomas, Karan Johar, Heathpaul Singh, Maheen S Mohammad, Douglas P Beall
BACKGROUND: The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. OBJECTIVES: We aim to evaluate the long-term efficacy of sacroplasty versus non-surgical management (NSM) in treating sacral insufficiency fractures (SIFs), including the effect on pain relief, opioid and other analgesic use, patient satisfaction, and complication rates...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149144/the-efficacy-of-preoperative-gabapentin-in-spinal-surgery-a-meta-analysis-of-randomized-controlled-trials
#16
Chao Han, Ming-Jie Kuang, Jian-Xiong Ma, Xin-Long Ma
BACKGROUND: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. OBJECTIVE: To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery. STUDY DESIGN: A meta-analysis of randomized controlled studies...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#17
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149119/pain-management-strategies-for-screening-and-monitoring-patients-receiving-chronic-opioid-therapy%C3%A2
#18
Karen Hande
The current state of pain management within the oncology setting, effectiveness of opioids for the relief of pain, and limited alternatives for chronic pain management have produced reliance on opioid medications with an inherent risk for aberrant behavior. Although standardization is lacking among prescribers who manage cancer-related pain, advanced practice RNs must act according to the available evidence that suggests assessing and monitoring for abuse and misuse. 
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148033/4218t-c-polymorphism-associations-with-post-cesarean-patient-controlled-epidural-fentanyl-consumption-and-pain-perception
#19
W Xie, W Zhuang, L Chen, W Xie, C Jiang, N Liu
BACKGROUND: The utilization of intrathecal opioids is an efficacious component of post-cesarean section pain management. Given that growing evidence indicates that calcitonin gene-related peptide (CGRP) plays a key role in the development of peripheral sensitization and is associated with enhanced pain, we hypothesized that CGRP 4218T/C polymorphism is associated with the variability in fentanyl consumption for post-cesarean analgesia. METHODS: We recruited 548 patients who presented for elective cesarean delivery, and used polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to analyze CGRP 4218T/C polymorphism...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29147587/dexmedetomidine-as-part-of-a-multimodal-analgesic-treatment-regimen-for-opioid-induced-hyperalgesia-in-a-patient-with-significant-opioid-tolerance
#20
Richard K Patch Iii, Jason S Eldrige, Susan M Moeschler, Matthew J Pingree
Acute postoperative pain in patients with opioid tolerance creates a significant management challenge for anesthesiologists and pain medicine physicians. A multimodal approach is key; however other factors can complicate management such as opioid induced hyperalgesia. We present the case of a patient on large amounts of intrathecal opioids for chronic pain syndrome with opioid induced hyperalgesia after an exploratory laparotomy. Dexmedetomidine was utilized successfully as part of a controlled multimodal analgesic plan and should be a consideration for opioid tolerant patients experiencing opioid induced hyperalgesia...
2017: Case Reports in Anesthesiology
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