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https://www.readbyqxmd.com/read/29223211/perinatal-and-neonatal-implications-of-sickle-cell-disease
#1
Cathi Phillips, Margaret Peggy Boyd
Sickle cell disease is the genetic disorder most commonly detected with state-mandated newborn screening. Women with sickle cell disease struggle with psychosocial, emotional, and physical challenges throughout their lives. Pregnancy for women with sickle cell disease brings greater risk for maternal and fetal morbidity and mortality and increased likelihood of hospitalization for complications, including sickle cell pain crisis. Chronic maternal opioid use for pain can place newborns at risk for neonatal abstinence syndrome...
December 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/29222304/targeting-novel-mechanisms-of-pain-in-sickle-cell-disease
#2
REVIEW
Huy Tran, Mihir Gupta, Kalpna Gupta
Patients with sickle cell disease (SCD) suffer from intense pain that can start during infancy and increase in severity throughout life, leading to hospitalization and poor quality of life. A unique feature of SCD is vaso-occlusive crises (VOCs) characterized by episodic, recurrent, and unpredictable episodes of acute pain. Microvascular obstruction during a VOC leads to impaired oxygen supply to the periphery and ischemia reperfusion injury, inflammation, oxidative stress, and endothelial dysfunction, all of which may perpetuate a noxious microenvironment leading to pain...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#3
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#4
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222126/autoimmune-crmp5-neuropathy-phenotype-and-outcome-defined-from-105-cases
#5
Divyanshu Dubey, Vanda A Lennon, Avi Gadoth, Sean J Pittock, Eoin P Flanagan, John E Schmeling, Andrew McKeon, Christopher J Klein
OBJECTIVE: To establish the phenotype and clinical outcomes of collapsin response-mediator protein-5 (CRMP5) autoimmune neuropathy in comparison with anti-neuronal nuclear antibody type 1 (ANNA1)-immunoglobulin G (IgG) neuropathy. METHODS: Patients with CRMP5-IgG and/or ANNA1-IgGs were identified in our service-line testing, and medical records were reviewed. RESULTS: One hundred five patients with CRMP5-IgG neuropathy (88% smokers; 69% having cancer, most commonly small cell lung cancer [75%]) were identified and compared to 51 patients with ANNA1-IgG neuropathy, 27 with coexisting CRMP5-IgG...
December 8, 2017: Neurology
https://www.readbyqxmd.com/read/29221844/gabapentin-as-an-adjuvant-therapy-for-prevention-of-acute-phantom-limb-pain-in-pediatric-patients-undergoing-amputation-for-malignant-bone-tumors-a-prospective-double-blind-randomized-controlled-trial
#6
Xiandi Wang, Ying Yi, Dingbo Tang, Yi Chen, Yanhua Jiang, Jun Peng, Jiwei Xiao
CONTEXT: Gabapentin is reported to have an analgesic effect of reducing phantom-limb pain(PLP) in adult patients. There's no study on preoperative use of gabapentin in pediatric population in term of PLP prevention. OBJECTIVE: To determine whether gabapentin could be used as an adjuvant agent of opioid-based pain control to lower the rate of phantom-limb pain in pediatric patients undergoing amputation for malignant bone tumors in observation period of 60 days post-operatively...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29220525/impact-of-opioid-dose-reduction-and-risk-mitigation-initiatives-on-chronic-opioid-therapy-patients-at-higher-risk-for-opioid-related-adverse-outcomes
#7
Manu Thakral, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Sascha Dublin, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Michael Von Korff
Objective: We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients. Design: Interrupted time series. Setting: Group Health Cooperative (GH), a health care delivery system and insurance within Washington State, between 2006 and 2014...
December 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29220110/non-responsiveness-and-susceptibility-of-opioids-side-effects-related-to-cancer-patients-clinical-characteristics-a-post-hoc-analysis
#8
Oscar Corli, Anna Roberto, Michael I Bennett, Francesca Galli, Nicole Corsi, Eliana Rulli, Raffaella Antonione
BACKGROUND: Response to opioids is not always positive in cancer patients. A considerable proportion of patients do not respond (non-responders, NRs) or experience severe toxicity. The aim of this analysis was to assess the role of demographic characteristics, pain features, comorbidities and ongoing therapy on the lack of efficacy and on the occurrence of severe adverse drug reactions (ADRs). METHODS: This is a post-hoc analysis of a randomized controlled trial that involved 520 patients and was aimed to evaluate the efficacy and safety of four strong opioids...
December 8, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#9
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29219169/pharmacokinetics-and-pharmacodynamics-of-sublingual-sufentanil-for-postoperative-pain-management
#10
REVIEW
T van de Donk, S Ward, R Langford, A Dahan
Achieving successful treatment of postoperative pain remains a challenge. Recently, a sufentanil sublingual tablet system has been developed for treatment of moderate-to-severe postoperative pain. The phenylpiperidine sufentanil is a potent analgesic that rapidly crosses the blood-brain barrier and selectively activates central μ-opioid receptors. The system makes use of a hand-held dispenser system, which contains forty 15-μg sufentanil sublingual micro-tablets. The patient can release one tablet at 20-min intervals using a unique radiofrequency adhesive tag, which is wrapped around the patient's thumb...
December 8, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29218466/acute-herpes-zoster-and-post-herpetic-neuralgia-in-primary-care-a-study-of-diagnosis-treatment-and-cost
#11
Brendan Crosbie, Sinead Lucey, Lesley Tilson, Lisa Domegan, Jennifer Kieran
Acute herpes zoster and its complication post herpetic neuralgia represent a significant challenge to primary care physicians in their care of an ageing population of patients. This was a cross-sectional observational study by means of a quantitative survey of 1,000 general practitioners registered in Ireland exploring the frequency of diagnosis, methods of treatment and cost of AHZ and PHN in primary care. We recorded an 18% response rate (n = 184) with an 83% completion rate (n = 152/184). 80% of cases of AHZ occurred in patients aged 50 years or more with 81% of study participants encountering cases at a rate of 1-3 patients per month...
December 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29217856/adductor-canal-block-for-post-operative-analgesia-after-simultaneous-bilateral-total-knee-replacement-a-randomised-controlled-trial-to-study-the-effect-of-addition-of-dexmedetomidine-to-ropivacaine
#12
Rakhee Goyal, Gaurav Mittal, Arun Kumar Yadav, Rishab Sethi, Animesh Chattopadhyay
Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB) is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18-75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29217257/upregulation-of-bdnf-and-interleukin-1%C3%A3-in-rat-spinal-cord-following-noxious-hind-paw-stimulation
#13
Josef Donnerer, Ingrid Liebmann
The aim of the present study was to investigate the protein levels of BDNF and IL-1ß in the lumbar dorsal horn of the rat by Western blot analysis following a noxious thermal hind paw stimulation. Ten min, 1h and 3h after the combined chemical and thermal stimulation an up to 2-fold increase in BDNF and Il-1ß protein expression was observed in the lumbar dorsal spinal cord. A pretreatment with the opioid analgesic morphine or the glial cell activation inhibitor minocycline partly attenuated protein expression...
December 5, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29216521/the-use-of-palliative-medications-before-death-from-prostate-cancer-swedish-population-based-study-with-a-comparative-overview-of-european-data
#14
Magdalena Lycken, Linda Drevin, Hans Garmo, Pär Stattin, Jan Adolfsson, Ingela Franck Lissbrant, Lars Holmberg, Anna Bill-Axelson
BACKGROUND: Symptoms of terminal cancer have previously been reported as undertreated. The aim of this study was to assess the use of palliative medications before death from prostate cancer. METHODS: This Swedish register study included men who died from 2009 to 2012 with prostate cancer as the underlying cause of death. We assessed the proportion who collected a prescription of androgen deprivation therapy, non-steroidal anti-inflammatory drugs, paracetamol, opioids, glucocorticoids, antidepressants, anxiolytics and sedative-hypnotics and the differences in treatment related to age, time since diagnosis, educational level, close relatives and comorbidities...
December 4, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29215508/opioid-knowledge-and-prescribing-practices-among-obstetrician-gynecologists
#15
Annetta M Madsen, Lauren M Stark, Phinnara Has, Jenna B Emerson, Jay Schulkin, Kristen A Matteson
OBJECTIVE: To describe obstetrician-gynecologists' (ob-gyns) knowledge and prescribing practices regarding opioid analgesics. METHODS: We conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who are part of the Collaborative Ambulatory Research Network. We used a sequential mixed-method approach. We collected data on opioid knowledge and typical prescribing practices, including number, type, and indication for prescriptions...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215370/opioid-use-after-discharge-in-postoperative-patients-a-systematic-review
#16
Adina E Feinberg, Tyler R Chesney, Sanjho Srikandarajah, Sergio A Acuna, Robin S McLeod
BACKGROUND: Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opioid prescribed. Secondary outcomes included adequacy of pain control and disposal methods for unused opioids. OBJECTIVE: The objective of this study is to characterize postdischarge opioid consumption and prescription patterns in surgical patients...
December 5, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29215369/from-data-to-practice-increasing-awareness-of-opioid-prescribing-data-changes-practice
#17
Cornelius A Thiels, Kristine T Hanson, Robert R Cima, Elizabeth B Habermann
: We hypothesized that the recent attention to the opioid epidemic, combined with internal dissemination of data on prescribing practices, impacted our institution's opioid prescribing at discharge from elective surgery. We reviewed our recent practice to assess whether this increasing awareness resulted in reductions of opioid prescriptions for patients with acute pain. Data on prescribing for patients undergoing elective surgery between 2016 and early 2017 demonstrated that opioid prescribing practices have improved in the recent era without an observed increase in refill rates...
December 5, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29214743/gc-ms-ms-detects-potential-pregabalin-abuse-in-susceptible-subjects-hair
#18
Federica Ianni, Kyriaki Aroni, Alessio Gili, Roccaldo Sardella, Mauro Bacci, Massimo Lancia, Benedetto Natalini, Cristiana Gambelunghe
Pregabalin, a GABA analogue, binds to the alpha 2 delta subunit of voltage-dependent calcium channels. It is recognized as efficacious in pathologies such as epilepsy, neuropathic pain and anxiety disorders. Since pregabalin prescriptions have increased worldwide, reports of its abuse have been accumulating, mainly in patients with opioid abuse disorders. The present study investigated potential pregabalin abuse by means of hair analysis, a matrix that provides valuable retrospective information. Half of the pool of 280 susceptible patients had been occasional drug users and were being monitored for driving licence renewals...
December 7, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29214506/pharmacokinetics-of-oral-and-intravenous-paracetamol-acetaminophen-when-co-administered-with-intravenous-morphine-in-healthy-adult-subjects
#19
Robert B Raffa, Jayne Pawasauskas, Joseph V Pergolizzi, Luke Lu, Yin Chen, Sutan Wu, Brant Jarrett, Randi Fain, Lawrence Hill, Krishna Devarakonda
BACKGROUND AND OBJECTIVE: Several features favor paracetamol (acetaminophen) administration by the intravenous rather than the oral route in the postoperative setting. This study compared the pharmacokinetics and bioavailability of oral and intravenous paracetamol when given with or without an opioid, morphine. METHODS: In this randomized, single-blind, parallel, repeat-dose study in healthy adults, subjects received four repeat doses of oral or intravenous 1000 mg paracetamol at 6-h intervals, and morphine infusions (0...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29213167/pain-assessment-and-management-the-knowledge-attitude-and-practice-of-sudanese-paediatric-residents
#20
Mohammed A A Alhassan, Fathelrahman E Ahmed, Abdolmoneim A Bannaga
This was a prospective, descriptive, cross sectional study that was conducted in 9 major paediatric hospitals accredited for training of residents in Sudan to assess the knowledge, attitude and practice of residents in paediatrics on issues related to pain assessment and pain management in children A semi-structured and validated questionnaire was distributed to 174 residents working in these hospitals. One hundred and twenty residents, out of 174, responded by filling the questionnaire, with a response rate of 68%...
2017: Sudanese Journal of Paediatrics
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