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Chronic pain units

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https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#1
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27906080/tonic-and-burst-spinal-cord-stimulation-waveforms-for-the-treatment-of-chronic-intractable-pain-study-protocol-for-a-randomized-controlled-trial
#2
Konstantin V Slavin, Richard B North, Timothy R Deer, Peter Staats, Kristina Davis, Roni Diaz
BACKGROUND: Burst stimulation is a novel form of neurostimulation for the treatment of chronic pain which has demonstrated promise in small uncontrolled studies, but has not yet gained approval for use in the U.S. We report the study methods for an ongoing multicenter, randomized, controlled, cross-over study designed to gain United States Food and Drug Administration (FDA) approval for burst stimulation. METHODS: Participants who are candidates for a currently approved neurostimulation device were enrolled and screened...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27904118/acquired-factor-v-inhibitors-in-a-patient-with-end-stage-renal-disease
#3
Atsushi Kitazawa, Hideo Misawa, Katsuhiro Nagahori, Ryo Koda, Atsunori Yoshino, Shinya Kawamoto, Tetsuro Takeda
We report a case of acquired factor V inhibitors (AFVIs) in a patient with end-stage renal disease receiving warfarin therapy for atrial fibrillation. A 72-year-old Japanese man was admitted to our hospital complaining of tarry stools and abdominal pain. The laboratory findings revealed eosinophilia (52.1%), prolonged activated partial thromboplastin time (APTT) (98 s), PT (84 s), a factor V (FV) activity of <3%, and an FV inhibitor level of 6 Bethesda units/mL. After administration of prednisolone was started, his coagulation findings improved...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27901398/discriminating-between-neuropathic-pain-and-sensory-hypersensitivity-using-the-chronic-pain-questions-cpq
#4
Karin S Coyne, Brooke M Currie, Sean Donevan, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Lucy Abraham, Christine Thompson, Alesia Sadosky, Marina Brodsky
OBJECTIVE: The Chronic Pain Questions (CPQ) were developed for clinical use with the aim of supporting primary care physicians in the screening, assessment and monitoring of patients with chronic pain. The purpose of this study was to examine the ability of the CPQ to discriminate between patients with neuropathic pain (NeP) versus those with sensory hypersensitivity (SH). METHODS: Adult men and women with a diagnosis of a NeP or SH condition were recruited from 5 clinical sites across the United States...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#5
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27884150/identifying-and-prioritizing-lower-value-services-from-dutch-specialist-guidelines-and-a-comparison-with-the-uk-do-not-do-list
#6
Joost Johan Godert Wammes, M Elske van den Akker-van Marle, Eva W Verkerk, Simone A van Dulmen, Gert P Westert, Antoinette D I van Asselt, R B Kool
BACKGROUND: The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom)...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27873179/oxycodone-deterx-%C3%A2-a-novel-abuse-deterrent-extended-release-analgesic-option-for-the-treatment-of-patients-with-chronic-pain
#7
REVIEW
Jeff Gudin
BACKGROUND: Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx(®) (Xtampza(®) ER, Collegium Pharmaceutical, Inc...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27871509/a-cross-sectional-study-of-preoperative-medication-adherence-and-early-postoperative-recovery
#8
Anthony P Notaras, Elisabeth Demetriou, Jessica Galvin, Erez Ben-Menachem
STUDY OBJECTIVE: To quantify the impact of preoperative medication adherence on recovery length of stays and complication rates. DESIGN: Cross-sectional analytical study. SETTING: Postanesthetic care unit (PACU) of a single-center tertiary hospital. PATIENTS: Surgical patients admitted for surgery at our institution over a 4-month period. INTERVENTION: A data collection tool was used to collect demographic data, length of stay in recovery, prespecified conditions likely to impact on PACU recovery (chronic pain, insulin-dependent diabetes, epilepsy, hypertension, on a methadone program, and Parkinson disease), medication compliance, and complications in PACU...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867438/total-sleep-deprivation-and-pain-perception-during-cold-noxious-stimuli-in-humans
#9
Robert A Larson, Jason R Carter
BACKGROUND AND AIMS: A substantial portion of the population suffers from chronic pain leading to significant health care costs and lost productivity. Loss of sleep duration and quality are widely reported in patients suffering from a variety of acute or chronic pain conditions. Conversely, sleep loss has been known to elevate pain perception; thus a potential bi-directional relationship exists between sleep deprivation and pain. To date, the majority of studies examining the relationship between experimentally induced pain and sleep loss have focused on the measurement of pain threshold...
October 2016: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/27865036/relationship-between-opioid-treatment-and-rate-of-healing-in-chronic-wounds
#10
Victoria K Shanmugam, Kara S Couch, Sean McNish, Richard L Amdur
Opioids are routinely used analgesics in patients with chronic wounds; however the impact of opioid exposure on wound healing is poorly understood. The purpose of this study was to investigate the association between opioid exposure and wound outcome in the WE-HEAL study. This longitudinal observational study was conducted on 450 subjects enrolled in the WE-HEAL biorepository. Data were collected prospectively including baseline characteristics, pain score, longitudinal opioid exposure, and total wound surface area (tWSA)...
November 16, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27852965/a-randomized-placebo-controlled-pilot-study-of-the-efficacy-and-safety-of-d-cycloserine-in-people-with-chronic-back-pain
#11
Thomas J Schnitzer, Souraya Torbey, Kristi Herrmann, Gagan Kaushal, Renita Yeasted, A Vania Apkarian
BACKGROUND: Few effective pharmacological treatment options exist for chronic back pain, the leading cause of disability in the US, and all are associated with significant adverse effects. OBJECTIVE: To determine the efficacy and safety of D-cycloserine, a partial agonist to the N-methyl-D-aspartate receptor, in the treatment of chronic low back pain. METHODS: A total of 41 participants with chronic back pain who met all inclusion and exclusion criteria were enrolled in a double-blind, placebo-controlled randomized pilot trial of D-cycloserine...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27845196/chronic-fatigue-syndrome-and-chronic-widespread-pain-in-adolescence-population-birth-cohort-study
#12
Tom Norris, Kevin Deere, Jon H Tobias, Esther Crawley
: Whilst many studies have investigated the overlap between pain phenotypes and chronic fatigue syndrome (CFS) in adults, little is known about the relationship between these conditions in adolescents. The study's aim was therefore to identify whether a relationship exists between chronic widespread pain (CWP) and CFS in adolescents and investigate whether the two share common associations with a set of covariates. A questionnaire was administered to offspring of the Avon Longitudinal Study of Parents and Children at age 17, asking about site, duration, and pain intensity, from which participants with CWP were identified...
November 11, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27822391/ultrasound-guided-genicular-nerve-thermal-radiofrequency-ablation-for-chronic-knee-pain
#13
Joshua Wong, Nicholas Bremer, Paul D Weyker, Christopher A J Webb
Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27807396/laparoscopic-management-of-mobile-cecum
#14
Carlos Augusto Gomes, Cleber Soares, Fausto Catena, Salomone Di Saverio, Massimo Sartelli, Camila Couto Gomes, Felipe Couto Gomes
BACKGROUND AND OBJECTIVES: The mobile cecum is an embryologic abnormality and has been associated with functional colon disease (chronic constipation and irritable bowel syndrome). However, unlike functional disease, the primary treatment is operative, using laparoscopic cecopexy. We compare the epidemiology and pathophysiology of mobile cecum syndrome and functional colon disease and propose diagnostic and treatment guidelines. METHOD: This study was a case-control series of 15 patients who underwent laparoscopic cecopexy...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27802876/something-for-pain-responsible-opioid-use-in-emergency-medicine
#15
Reuben J Strayer, Sergey M Motov, Lewis S Nelson
The United States is currently experiencing a public health crisis of opioid addiction, which has its genesis in an industry marketing effort that successfully encouraged clinicians to prescribe opioids liberally, and asserted the safety of prescribing opioids for chronic non-cancer pain, despite a preponderance of evidence demonstrating the risks of dependence and misuse. The resulting rise in opioid use has pushed drug overdose deaths in front of motor vehicle collisions to become the leading cause of accidental death in the country...
October 24, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27799699/effectiveness-of-the-back-school-program-for-the-performance-of-activities-of-daily-living-in-users-of-a-basic-health-unit-in-porto-alegre-brazil
#16
Patrícia Thurow Bartz, Adriane Vieira, Matias Noll, Cláudia Tarragô Candotti
[Purpose] Primary care is considered the gateway to the Brazilian public health system and is responsible for managing the most prevalent problems in the population. In this study, the effects of Back School on pain, functionality, and the performance of activities of daily living (ADL) in users with chronic musculoskeletal pain were evaluated. [Subjects and Methods] Forty-four users (33 females and 11 males) participated in Back School, with five two-hour theoretical and practical meetings held once a week...
September 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27785090/5-lidocaine-medicated-plaster-for-the-treatment-of-chronic-peripheral-neuropathic-pain-complex-regional-pain-syndrome-and-other-neuropathic-conditions
#17
Enrique Calderón, María Eloísa Calderón-Seoane, Rafael García-Hernández, Luis Miguel Torres
OBJECTIVES: Chronic neuropathic pain and chronic complex regional pain syndrome (CRPS), in particular, are debilitating and difficult-to-treat conditions that have a strong impact on patient's quality of life. The aim of this study was to evaluate the effectiveness of 5% lidocaine-medicated plaster as add-on therapy in patients with chronic peripheral neuropathic pain conditions, including CRPS. PATIENTS AND METHODS: This was a single-center, prospective, observational study set in a specialized pain unit of a tertiary hospital in Spain...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27764978/the-prevalence-of-sacroiliitis-in-patients-with-acne-vulgaris-using-isotretinoin
#18
Leyla Baykal Selçuk, Deniz Aksu Arıca, Hanife Baykal Şahin, Savas Yaylı, Sevgi Bahadır
BACKGROUND/OBJECTIVE: Acne vulgaris is a chronic inflammatory disease affecting the pilosebaceous unit in the skin. Isotretinoin is a synthetic vitamin A derivative regarded as the most effective agent in the treatment of acne. There have recently been increasing reports of adverse effects of isotretinoin on the skeletal system. Our aim in this study was to evaluate the rheumatic side-effects triggered by this drug, and particularly the prevalence of sacroiliitis. MATERIALS AND METHODS: A total of 73 patients receiving isotretinoin due to moderate or severe acne vulgaris were included...
November 16, 2016: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/27764082/declines-in-opioid-prescribing-after-a-private-insurer-policy-change-massachusetts-2011-2015
#19
Macarena C García, Anton B Dodek, Tom Kowalski, John Fallon, Scott H Lee, Michael F Iademarco, John Auerbach, Michele K Bohm
Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1). In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids (2). In Massachusetts, unintentional opioid-related overdose deaths, including deaths involving heroin, increased 45% from 2012 to 2013.* In 2014, the rate of these deaths reached 20.0 per 100,000, nearly 2.5 times higher than the U.S. rate overall (3,4)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27760823/modulation-of-activity-and-conduction-in-single-dorsal-column-axons-by-kilohertz-frequency-spinal-cord-stimulation
#20
Nathan D Crosby, John J Janik, Warren M Grill
Kilohertz-frequency spinal cord stimulation (KHF-SCS) is a potential paresthesia-free treatment for chronic pain. However, the effects of KHF-SCS on spinal dorsal column (DC) axons and its mechanisms of action remain unknown. The objectives of this study were to quantify activation and conduction block of DC axons by KHF-SCS across a range of kHz frequencies (1, 5, 10, or 20 kHz) and waveforms (biphasic pulses or sinusoids). Custom platinum electrodes delivered SCS to the T10/T11 DCs of anesthetized male Sprague-Dawley rats...
October 19, 2016: Journal of Neurophysiology
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