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https://www.readbyqxmd.com/read/29671505/care-of-the-colorectal-cancer-survivor
#1
Kristina Burgers, Clint Moore, Lori Bednash
Colorectal cancer is the fourth most common cancer in the United States and has a five-year survival rate of 65%. The American Cancer Society and other experts have released guidelines on surveillance, health promotion, screening for other malignancies, and management of treatment effects. Surveillance for disease recurrence should occur every three to six months for the first two to three years, then every six months for a total of five years. Each visit should include a history and physical examination, routine care for chronic medical conditions, and screening for other primary cancers according to guidelines for the general population...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#2
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29656511/neuropathic-pain-a-patient-centred-approach-to-measuring-outcomes
#3
Steve Hwang, Floortje van Nooten, Ted Wells, Aisling Ryan, Bruce Crawford, Christopher Evans, Marci English
BACKGROUND: Neuropathic pain (NP) is a complex, chronic pain state initiated by a primary lesion or dysfunction of the nervous system and presents as a variety of symptoms across multiple disease states. OBJECTIVE: To develop a patient-centred conceptual model of symptoms and impacts in subjects with diabetic peripheral neuropathy (DPN) or post-herpetic neuralgia (PHN) that can inform the measurement strategy in clinical trials. METHOD: Thirty subjects with DPN or PHN participated in in-person interviews which were performed until saturation was achieved...
April 15, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29652682/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#4
Jack Diep, David Tian Chin, Somdatta Gupta, Faraz Syed, Ming Xiong, Jianguo Cheng
Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29649027/pain-and-its-long-term-interference-of-daily-life-after-critical-illness
#5
Christina J Hayhurst, Jim C Jackson, Kristin R Archer, Jennifer L Thompson, Rameela Chandrasekhar, Christopher G Hughes
BACKGROUND: Persistent pain likely interferes with quality of life in survivors of critical illness, but data are limited on its prevalence and risk factors. We sought to determine the prevalence of persistent pain after critical illness and its interference with daily life. Additionally, we sought to determine if intensive care unit (ICU) opioid exposure is a risk factor for its development. METHODS: In a cohort of adult medical and surgical ICU survivors, we used the brief pain inventory (BPI) to assess pain intensity and pain interference of daily life at 3 and 12 months after hospital discharge...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628828/pain-assessment-in-the-critically-ill-mechanically-ventilated-adult-patients-comparison-between-skin-conductance-algesimeter-index-and-physiologic-indicators
#6
Puneet Khanna, Chandralekha Chandralekha, Ravinder Kumar Pandey, Ankur Sharma
Background and Objectives: Critically ill patients are unable to communicate effectively, so it is difficult to assess their pain and analgesic requirement. Skin conductance algesimeter (SCA) index is a device that primarily measures changes in skin conductance real time to assess pain. Methods: We planned this quantitative prospective observational study to assess pain in the critically ill mechanically ventilated patients in comparison to physiologic indicators such as blood pressure and heart rate...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628609/management-of-chronic-deep-vein-thrombosis-in-women
#7
REVIEW
Rulon L Hardman
Chronic deep vein thrombosis (DVT) affects hundreds of thousands of women in the United States. Chronic DVT can lead to pain, edema, venous ulcers, and varicosities. While there are limited data regarding the management of chronic DVT, several interventional radiology groups aggressively treat chronic DVT to aid patient symptom resolution. Recanalization of occluded veins and venous stenting re-establishes deep vein flow and decreases venous hypertension.
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29626741/prescription-opioid-misusing-chronic-pain-patients-exhibit-dysregulated-context-dependent-associations-investigating-associative-learning-in-addiction-with-the-cue-primed-reactivity-task
#8
Eric L Garland, Craig J Bryan, Lydia Kreighbaum, Yoshio Nakamura, Matthew O Howard, Brett Froeliger
BACKGROUND: Associative learning undergirds the development of addiction, such that drug-related cues serve as conditioned stimuli to elicit drug-seeking responses. Plausibly, among opioid misusing chronic pain patients, pain-related information may serve as a conditioned stimulus to magnify opioid cue-elicited autonomic and craving responses through a process of second-order conditioning. METHODS: We utilized a novel psychophysiological probe of pain-opioid conditioned associations, the Cue-Primed Reactivity (CPR) task...
March 27, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29617060/a-prospective-real-world-analysis-of-onabotulinumtoxina-in-chronic-migraine-post-nice-u-k-technology-appraisal
#9
Anna P Andreou, Michele Trimboli, Adnan Al-Kaisy, Madeleine Murphy, Stefano Palmisani, Cherylin Fenech, Thomas Smith, Giorgio Lambru
OBJECTIVES: The National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK) recommend the use of OnabotulinumtoxinA (BoNTA, Botox® ) in the management of chronic migraine (CM) following specific guidelines within the National Health Service (NHS). In view of the lack of data on the efficacy of this therapy following implementation of this guidelines in clinical practice and on the evaluation of guidance' compliance, we evaluate the effectiveness and safety of BoNTA in CM patients following the NICE guidelines...
April 4, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29616278/rehabilitation-service-models-for-people-with-physical-and-or-mental-disability-living-in-low-and-middle-income-countries-a-systematic-review
#10
Andréa D Furlan, Emma Irvin, Claire Munhall, Mario Giraldo-Prieto, Laura Fullerton, Robert McMaster, Shivang Danak, Alicia Costante, Kristen B Pitzul, Rohit P Bhide, Stanislav Marchenko, Quenby Mahood, Judy A David, John F Flannery, Mark Bayley
OBJECTIVE: To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries. DATA SOURCES: CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed. STUDY SELECTION: Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language...
April 3, 2018: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29614943/primary-care-management-of-non-specific-low-back-pain-key-messages-from-recent-clinical-guidelines
#11
Matheus Almeida, Bruno Saragiotto, Bethan Richards, Chris G Maher
Research in the past decade supports some major changes to the primary care management of non-specific low back pain (LBP). The present article summarises recommendations from recently published United Kingdom, Danish, Belgian and United States guidelines to alert readers to the important changes in recommendations for management, and the recommendations from previous guidelines that remain unchanged. Main recommendations: Use a clinical assessment to triage patients with LBP. Further diagnostic workup is only required for the small number of patients with suspected serious pathology...
April 2, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29610827/association-of-medical-and-adult-use-marijuana-laws-with-opioid-prescribing-for-medicaid-enrollees
#12
Hefei Wen, Jason M Hockenberry
Importance: Overprescribing of opioids is considered a major driving force behind the opioid epidemic in the United States. Marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose. Marijuana liberalization, including medical and adult-use marijuana laws, has made marijuana available to more Americans. Objective: To examine the association of state implementation of medical and adult-use marijuana laws with opioid prescribing rates and spending among Medicaid enrollees...
April 2, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29607410/willingness-to-participate-in-longitudinal-research-among-people-with-chronic-pain-who-take-medical-cannabis-a-cross-sectional-survey
#13
Marcus A Bachhuber, Julia H Arnsten, Joanna L Starrels, Chinazo O Cunningham
Background: Regulatory barriers limit clinical trials of medical cannabis in the United States. Longitudinal cohort studies may be one feasible alternative that could yield clinically relevant information. Willingness to participate in such studies is not known. Materials and Methods: In October 2016, we surveyed a convenience sample of patients with chronic pain from two New York registered organizations (responsible for growing, processing, distributing, and retailing medical cannabis products). After a vignette describing a longitudinal cohort study involving weekly patient-reported outcomes and quarterly assessments of physical functioning and urine and blood tests, we asked about respondents' willingness to participate...
2018: Cannabis and Cannabinoid Research
https://www.readbyqxmd.com/read/29605985/lower-and-upper-gastrointestinal-symptoms-differ-between-individuals-with-irritable-bowel-syndrome-with-constipation-or-chronic-idiopathic-constipation
#14
Eric D Shah, Christopher V Almario, Brennan M R Spiegel, William D Chey
Background/Aims: We evaluated the distribution of lower and upper gastrointestinal (GI) symptoms among individuals with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in a nationwide survey. Methods: Individuals (≥ 18 years of age) were identified from a nationwide sample of > 70 000 United States adults. Participants completed the National Institutes of Health GI Patient Reported Outcomes Measurement Information System (NIH GI-PROMIS) questionnaire...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29601219/an-examination-of-the-perceived-impact-of-a-continuing-interprofessional-education-experience-on-opiate-prescribing-practices
#15
Roberto Cardarelli, William Elder, Sarah Weatherford, Karen L Roper, Dana King, Charlotte Workman, Kathryn Stewart, Chong Kim, William Betz
Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities...
March 30, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29590410/stated-pain-levels-opioid-prescription-volume-and-chronic-opioid-use-among-united-states-army-soldiers
#16
D Alan Nelson, Margrét V Bjarnadóttir, Vickee L Wolcott, Ritu Agarwal
Introduction: The use of opioids has increased drastically over the past few years and decades. As a result, concerns have mounted over serious outcomes associated with chronic opioid use (COU), including dependency and death. A greater understanding of the factors that are associated with COU will be critical if prescribers are to navigate potentially competing objectives to provide compassionate care, while reducing the overall opioid use problem. In this study, we study pain levels and opioid prescription volumes and their effects on the risk of COU...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29578090/impact-on-health-care-costs-for-adolescents-receiving-adjunctive-internet-delivered-cognitive-behavioral-therapy-results-of-a-randomized-controlled-trial
#17
Emily F Law, Cornelius B Groenewald, Chuan Zhou, Tonya M Palermo
The economic burden of pediatric chronic pain is high, with an estimated annual cost of $19.5 billion. Little is known about whether psychological treatment for pediatric chronic pain can alter health care utilization for youth. The primary aim of this secondary data analysis was to evaluate the effect of adjunctive internet cognitive-behavioral therapy intervention (I-CBT) or adjunctive internet education (I-EDU) on health care-related economic costs in a cohort of adolescents with chronic pain recruited from interdisciplinary pain clinics across the United States...
March 22, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29576119/pain-after-orthopaedic-surgery-differences-in-patient-reported-outcomes-in-the-united-states-vs-internationally-an-observational-study-from-the-pain-out-dataset
#18
R Zaslansky, W Meissner, C R Chapman
BACKGROUND: A previous PAIN OUT study found that American orthopaedic-surgical patients rated 'worst pain' higher than did similar European patients. This study aims to confirm these findings in a larger, international patient sample, explore whether risk factors for greater postoperative pain exist disproportionately in the American population, and confirm the findings for one procedure. METHODS: Surveyors collected patient reported outcomes (PROs) and perioperative pain management practices using PAIN OUT methodology...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29570151/incidence-and-risk-factors-for-chronic-postoperative-opioid-use-after-major-spine-surgery-a-cross-sectional-study-with-longitudinal-outcome
#19
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
BACKGROUND: Chronic opioid use is a significant public health concern. Surgery is a risk factor for developing chronic opioid use. Patients undergoing major spine surgery frequently are prescribed opioids preoperatively and may be at risk for chronic opioid use postoperatively. The aim of this study was to investigate the incidence of and perioperative risk factors associated with chronic opioid use after major spine surgery. METHODS: The records of patients who underwent elective major spine surgery at the University of Virginia between March 2011 and February 2016 were retrospectively reviewed...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29565950/pulsed-radiofrequency-treatment-for-chronic-post-surgical-orchialgia-a-double-blind-sham-controlled-randomized-trial-three-month-results
#20
Diab Fuad Hetta, Ali Mohammed Mahran, Emad Eldien Kamal
BACKGROUND: Chronic post-surgical pain in the groin region represents a challenge for the managing physician and is a burden on the quality of life of the patient. None of the existing interventions or medical treatment is satisfactory. OBJECTIVES: We aim to evaluate the analgesic efficacy of pulsed radiofrequency (PRF) applied to the ilioinguinal nerve and the genital branch of the genitofemoral nerve for patients suffering from chronic post-surgical orchialgia...
March 2018: Pain Physician
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