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Chronic pain units

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https://www.readbyqxmd.com/read/28438496/from-the-implementing-best-practice-guidelines-in-pain-assessment-and-management-on-a-women-s-psychiatric-inpatient-unit-exploring-patients-perceptions
#1
Cheryl Rolin-Gilman, Bonnie Fournier, Kristin Cleverley
Assessing and managing chronic pain in women with histories of interpersonal trauma, mood disorders and co-morbid addiction is complex. The aim of this paper is to report on the findings from a quality improvement project exploring women's experiences who have co-occurring mental health issues, addiction and chronic pain. Exploring perceptions was an initial step in implementing the Registered Nurses' Association of Ontario (RNAO) Best Practice Guideline (BPG) on the Assessment and Management of Pain. Focus group discussions were conducted using an exploratory design with 10 women who were hospitalized in an acute psychiatric unit...
April 21, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#2
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#3
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#4
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28422296/keeping-out-and-getting-in-reframing-emergency-department-gatekeeping-as-structural-competence
#5
Mara Buchbinder
Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28420517/ileocecal-endometriosis-diagnosis-and-management
#6
Ana López Carrasco, Alicia Hernández Gutiérrez, Paula A Hidalgo Gutiérrez, Roberto Rodríguez González, José L Marijuán Martín, Ignacio Zapardiel, Javier de Santiago García
OBJECTIVE: Ileocecal endometriosis is rare. Symptoms range from no symptoms, cramps, vomiting, to acute intestinal obstruction. Our objective was to review our cases, clarify, and resume its most appropriate management focusing on the factors to determine diagnosis. This is a retrospective study by revision of medical charts of all ileal endometriosis cases of our unit from 2006 to 2014. CASE REPORT: Seven cases were found; three (43%) had previous endometriosis laparoscopic diagnosis, four (57%) had partial bowel obstruction episodes, three (43%) had chronic pelvic pain, and one developed acute intestinal obstruction in postoperative ileostomy closure...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#7
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28419751/clinical-characteristics-of-fibromyalgia-in-a-chronic-pain-population
#8
Mark Gostine, Fred Davis, Bradley Roberts, Rebecca Risko, Michael Asmus, Joseph C Cappelleri, Alesia Sadosky
OBJECTIVE: To compare fibromyalgia (FM) characteristics among patients identified in a community-based chronic pain cohort based on traditional International Classification of Diagnoses Ninth Revision, ICD-9 diagnostic coding, with that of patients identified using a novel predictive model. METHODS: This retrospective study used data collected from July 1999 to February 17, 2015 in multiple chronic pain clinics in the United States. Patients were assigned to the FM case group based on specific inclusion criteria using ICD-9 codes or, separately, from results of a novel FM predictive model that was developed using random forest and logistic regression techniques...
April 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28416998/prevalence-and-trends-of-pain-associated-with-chronic-diseases-and-personal-out-of-pocket-medical-expenditures-in-korea
#9
Sun Mi Shin
BACKGROUND: There have been few studies about pain using a big data. The purpose of this study was to identify the prevalence of pain, and trends of pain associated with chronic diseases and personal out-of-pocket medical expenditures over time. METHODS: Subjects were 58,151 individuals, using the Korea Health Panel from 2009 to 2013. Chi-square and multinomial logistic regression were conducted to identify the prevalence and odds ratios (ORs) of pain. Repeated measures ANOVA was used to find the trend over these 5 years...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28412229/characteristics-and-factors-associated-with-pain-in-older-homeless-individuals-results-from-the-hope-home-study
#10
John C Landefeld, Christine Miaskowski, Lina Tieu, Claudia Ponath, Christopher T Lee, David Guzman, Margot Kushel
Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5-10 (scale 0-10). The median age of participants was 58 years...
April 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28410920/potential-drug-interaction-with-opioid-agonist-in-the-setting-of-chronic-low-dose-opioid-antagonist-use
#11
James B Leonard, Vidya Nair, Christopher J Diaz, Jonathan B Penoyar, Penelope A Goode
Low dose naltrexone (LDN) has been evaluated in several small studies for the treatment of inflammatory conditions. It is thought to work through modulation of inflammatory mediators and upregulation of endogenous opioid receptors. This may hypersensitize patients to exogenous opioids. Drug-drug interaction screening tools built into electronic health records and other services identify the interaction as risk of opioid withdrawal rather than hypersensitivity. We present a case of a drug-drug interaction in a patient who was receiving LDN treatment of multiple sclerosis...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28402559/occipital-nerve-stimulation-attenuates-neuronal-firing-response-to-mechanical-stimuli-in-the-ventral-posteromedial-thalamus-of-a-rodent-model-of-chronic-migraine
#12
Ian Walling, Heather Smith, Lucy E Gee, Brian Kaszuba, Arun Chockalingam, Andrei Barborica, Cristian Donos, Damian S Shin, Julie G Pilitsis
BACKGROUND: Chronic migraine (CM) is a highly debilitating disease, and many patients remain refractory to medicinal therapy. Given the convergent nature of neuronal networks in the ventral posteromedial nucleus (VPM) and the evidence of sensitization of pain circuitry in this disease, we hypothesize CM rats will have increased VPM neuronal firing, which can be attenuated using occipital nerve stimulation (ONS). OBJECTIVE: To determine whether VPM firing frequency differs between CM and sham rats, and whether ONS significantly alters firing rates during the application of mechanical stimuli...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28393741/impact-and-acceptability-of-lay-health-trainer-led-lifestyle-interventions-delivered-in-primary-care-a-mixed-method-study
#13
Shelina Visram
Aim To evaluate the impact and acceptability of offering one-to-one lifestyle interventions delivered by lay health trainers in the primary care setting. BACKGROUND: Chronic conditions represent major causes of ill-health, avoidable disability, pain and anxiety, and tend to be more prevalent in less affluent groups. This is due, in part, to the link between unhealthy lifestyles and lower socio-economic status, although factors such as poverty, worklessness and social exclusion play a larger role...
April 10, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28386399/development-of-research-priorities-in-paediatric-pain-and-palliative-care
#14
Christina Liossi, Anna-Karenia Anderson, Richard F Howard
Priority setting for healthcare research is as important as conducting the research itself because rigorous and systematic processes of priority setting can make an important contribution to the quality of research. This project aimed to prioritise clinical therapeutic uncertainties in paediatric pain and palliative care in order to encourage and inform the future research agenda and raise the profile of paediatric pain and palliative care in the United Kingdom. Clinical therapeutic uncertainties were identified and transformed into patient, intervention, comparison and outcome (PICO) format and prioritised using a modified Nominal Group Technique...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28385481/rehabilitation-services-use-and-patient-reported-outcomes-among-older-adults-in-the-united-states
#15
Nancy M Gell, Tracy M Mroz, Kushang V Patel
OBJECTIVES: To characterize rehabilitation service use among community-dwelling older adults in the United States by identifying predictors of rehabilitation utilization, patient-reported functional improvement and rehabilitation goal attainment. DESIGN: Cross-sectional analysis of the 2015 National Health and Aging Trends Study, which used an age-stratified, multistage sampling design and oversampled non-Hispanic Blacks and the oldest old (≥85 years). SETTING: Standardized, in-person home interviews and physical performance testing...
April 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28384742/how-would-you-manage-opioid-use-in-these-three-patients-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#16
Daniel P Alford, Marc L Cohen, Eileen E Reynolds
The increase in overdose deaths from prescription opioids and heroin in the United States over the past 20 years is believed to have resulted from increases in prescription of opioids for management of acute and chronic pain. Managing chronic pain is challenging for primary care clinicians for many reasons, including the lack of evidence to guide practice. The Centers for Disease Control and Prevention published a comprehensive guideline in 2016 to help clinicians with opioid prescribing for chronic pain. In this Grand Rounds, the guideline is reviewed and an expert discusses its application to 3 patients prescribed opioids to treat chronic pain...
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28381395/a-mobile-app-for-chronic-disease-self-management-protocol-for-a-randomized-controlled-trial
#17
Raymond L Ownby, Amarilis Acevedo, Drenna Waldrop-Valverde, Joshua Caballero, Michael Simonson, Rosemary Davenport, Kofi Kondwani, Robin J Jacobs
BACKGROUND: Health literacy is a critically important skill that helps people become active participants in their health care. Multiple studies in the United States and across the world have documented the association of health literacy with multiple health outcomes. In particular, the elderly and many members of minority groups have been shown to have low levels of health literacy; the same groups are disproportionately affected by chronic illnesses. These twin burdens affect the people most in need of the skills and knowledge required for coping with chronic illnesses...
April 5, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28379832/comparison-of-opioid-prescribing-patterns-in-the-united-states-and-japan-primary-care-physicians-attitudes-and-perceptions
#18
Eriko Onishi, Tadashi Kobayashi, Eve Dexter, Miguel Marino, Tetsuhiro Maeno, Richard A Deyo
INTRODUCTION: Far fewer opioids are prescribed in Japan than in the United States. METHODS: We conducted an online physician survey assessing attitudes and perceptions that might influence prescribing. A Japanese version was distributed to members of the Japan Primary Care Association and an English version to members of the American Academy of Family Physicians practicing in Oregon. RESULTS: We received 461 Japanese responses and 198 from the United States, though overall response rates were low (Japan: 10...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28379590/hepatotoxicity-of-paracetamol-and-related-fatalities
#19
R Tittarelli, M Pellegrini, M G Scarpellini, E Marinelli, V Bruti, N M di Luca, F P Busardò, S Zaami
Paracetamol, also known as acetaminophen, is the most commonly used antipyretic and pain reliever and since 1955 it is available over-the-counter as a single formulation or in combination with other substances and, as indicated by the World Health Organization, it can be used in all the three steps of pain intensity. Paracetamol toxicity is one of the most common causes of poisoning worldwide. While paracetamol is described as relatively nontoxic when administered in therapeutic doses, it is known to cause toxicity when taken in a single or repeated high dose, or after chronic ingestion...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28379058/sensitivity-and-specificity-of-clinical-findings-for-the-diagnosis-of-pelvic-congestion-syndrome-in-women-with-chronic-pelvic-pain
#20
Ana Lucia Herrera-Betancourt, Juan Diego Villegas-Echeverri, Jose Duván López-Jaramillo, Jorge Darío López-Isanoa, Jorge Mario Estrada-Alvarez
Background Pelvic congestion syndrome is among the causes of pelvic pain. One of the diagnostic tools is pelvic venography using Beard's criteria, which are 91% sensitive and 80% specific for this syndrome. Objective To assess the diagnostic performance of the clinical findings in women diagnosed with pelvic congestion syndrome coming to a Level III institution. Methods Descriptive retrospective study in women with chronic pelvic pain taken to transuterine pelvic venography at the Advanced Gynecological Laparoscopy and Pelvic Pain Unit of Clinica Comfamiliar, between August 2008 and December 2011, analyzing social, demographic, and clinical variables...
January 1, 2017: Phlebology
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