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Chronic pain units

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https://www.readbyqxmd.com/read/28652205/opioid-analgesics-administered-for-pain-on-the-inpatient-pediatric-setting
#1
Gary A Walco, Nancy Gove, Jennifer Phillips, Steven J Weisman
This study aimed to describe utilization of opioid medications among infants, children, and adolescents on the inpatient setting. These data are needed to guide clinical trials and improve research methodologies, as well as to inform more about possible sources of opioid misuse in the United States. A retrospective chart review was conducted covering a span of one year, with a special focus on the prescription of opioids for long-term treatment of chronic pain. Opioid medications were prescribed for less than 5 days in the overwhelming majority (75%) of patients...
June 23, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28652067/pain-intensity-interference-and-medication-use-after-spinal-cord-injury-relationship-with-risk-of-mortality-after-controlling-for-socioeconomic-and-other-health-factors
#2
James S Krause, Yue Cao, Jillian M R Clark
OBJECTIVE: To identify the relationships of pain intensity, pain interference, and pain medication use with risk of mortality after spinal cord injury (SCI), controlling for demographic, injury, socioeconomic, and health factors. DESIGN: Prospective data collection occurred in 2007-2009 as part of a larger longitudinal study initiated in 1997-1998. Mortality status was determined as of December 31, 2014 using the National Death Index. A 3-stage Cox proportional hazards model was generated, with different sets of predictors entered at each step...
June 23, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28648165/-psychosocial-treatment-of-pain-at-general-practitioners-and-in-specialist-pain-treatment-units
#3
Gitte Handberg
Patients with complex chronic pain conditions are often difficult to treat with analgesia alone. Psychosocial intervention is needed to help them gain control and find an appropriate level of activity. This article summarizes the possibilities of psychosocial treatment of pain patients at the general practitioners and in specialist units of multidisciplinary pain treatment. The theoretical frame used is cognitive behavioural therapy. In practice, psychoeducation, mindfulness, and relaxation exercises are introduced to the patients to help them with daily life activity and work...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28647935/evaluation-of-patients-with-acute-chest-pain-using-spect-myocardial-perfusion-imaging-prognostic-implications-of-mildly-abnormal-scans
#4
Ronen Goldkorn, Alexey Naimushin, Roy Beigel, Ekaterina Naimushin, Michael Narodetski, Shlomi Matetzky
BACKGROUND: While patients presenting to emergency departments (ER) with chest pain are increasingly managed in chest pain units (CPU) that utilize accelerated diagnostic protocols for risk stratification, such as single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), data are lacking regarding the prognostic implications of mildly abnormal scans in this population. OBJECTIVES: To evaluate the prognostic implications of mildly abnormal SPECT MPI results in patients with acute chest pain...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#5
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28623933/transferring-research-from-a-university-to-the-united-kingdom-national-health-service-the-implications-for-impact
#6
Helen Payne
The aim of this article is to inform readers of the author's reflections on the experience of transferring university-based research into the commercial sector, and of the processes and strategies employed when preparing for impact in so doing. Concepts for the transfer are illustrated by the author's reflection on aspects that arose during the birthing and subsequent start-up of a university spin-off, Pathways2Wellbeing, a form of reflection-on-action. This is the vehicle for the adaption required to transfer research into the delivery of a specialised clinic in the United Kingdom National Health Service for people with medically unexplained, persistent, bodily symptoms such as fibromyalgia, chronic fatigue and chronic pain...
June 17, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28611162/a-large-chronic-pericardial-effusion-in-an-ultramarathon-runner-with-anti-ccp-positive-rheumatoid-arthritis
#7
Thomas J McClelland, Rose Penfold, Stefan Kluzek, Navraj S Nagra
Pericardial effusions arise as an extra-articular manifestation of rheumatoid arthritis (RA). Pericardial effusions are often asymptomatic, particularly in the early phase, but patients are at risk of cardiac tamponade as the effusion progresses. We discuss the case of a 40-year-old male ultramarathon runner with RA who presented with mild pleuritic chest pain and exertional dyspnoea after a recent long-haul flight. Despite a relative tachycardia, his observations were otherwise unremarkable. His blood tests revealed a C-reactive protein (CRP) of 86 mg/L and an anti-cyclic citrullinated peptide (anti-CCP) titre of 360 units/mL...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28579911/impact-of-the-lymphatic-filariasis-control-program-towards-elimination-of-filariasis-in-vanuatu-1997-2006
#8
Tammy Allen, Fasihah Taleo, Patricia M Graves, Peter Wood, George Taleo, Margaret C Baker, Mark Bradley, Kazuyo Ichimori
BACKGROUND: Lymphatic filariasis (LF) occurs when filarial parasites are transmitted to humans through mosquitoes. The filarial worms affect the lymphatic system which leads to abnormal enlargement of body parts, chronic pain, disability, and social discrimination. In 1999, a commitment was made to eliminate LF from the Pacific Region by 2010. The Pacific Program to Eliminate LF began, with Vanuatu being one of the 16 endemic countries included in this program. METHODS: In 1997/1998 a LF prevalence baseline survey was conducted to determine the need for mass drug administration (MDA) in Vanuatu...
2017: Tropical Medicine and Health
https://www.readbyqxmd.com/read/28569654/-unexpected-and-distressing-understanding-and-improving-the-experience-of-transferring-palliative-care-inpatients-to-residential-care
#9
Voula Kallianis, Lynette Joubert, Sue Gorman, Sonia Posenelli, Carolyn Lethborg
The survival of patients with advanced cancer, coupled with the increased presence of end-stage chronic illnesses in an aging population, is leading to a demand in palliative care. Due to the ongoing need for acute-pain and symptom control in hospice/palliative care units, few are able to offer long-stay admission for those whose symptoms have stabilized. When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility may then be necessary. A core component of the role of palliative-care social workers involves working with patients and their families/carers when the care pathway shifts and the option of residential aged care facility (RACF) needs to be considered...
June 1, 2017: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/28569130/meta-analysis-of-electroacupuncture-in-cardiac-anesthesia-and-intensive-care
#10
Sven Asmussen, Rene Przkora, Dirk M Maybauer, John F Fraser, Filippo Sanfilippo, Kristofer Jennings, Michael Adamzik, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28560220/medical-and-surgical-treatment-of-hidradenitis-suppurativa-a-review
#11
REVIEW
Nicolò Scuderi, Ambra Monfrecola, Luca Andrea Dessy, Gabriella Fabbrocini, Matteo Megna, Giuseppe Monfrecola
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%. The central pathogenic event in HS is believed to be the occlusion of the upper part of the folliculopilosebaceous unit, leading to the rupture of the sebofollicular canal with the consequent development of perifollicular lymphohistiocytic inflammation. The HS treatment choices are influenced by disease severity and its individual subjective impact, involving both medical and surgical interventions...
May 2017: Skin Appendage Disorders
https://www.readbyqxmd.com/read/28555313/uneven-intervertebral-motion-sharing-is-related-to-disc-degeneration-and-is-greater-in-patients-with-chronic-non-specific-low-back-pain-an-in-vivo-cross-sectional-cohort-comparison-of-intervertebral-dynamics-using-quantitative-fluoroscopy
#12
Alan Breen, Alexander Breen
PURPOSE: Evidence of intervertebral mechanical markers in chronic, non-specific low back pain (CNSLBP) is lacking. This research used dynamic fluoroscopic studies to compare intervertebral angular motion sharing inequality and variability (MSI and MSV) during continuous lumbar motion in CNSLBP patients and controls. Passive recumbent and active standing protocols were used and the relationships of these variables to age and disc degeneration were assessed. METHODS: Twenty patients with CNSLBP and 20 matched controls received quantitative fluoroscopic lumbar spine examinations using a standardised protocol for data collection and image analysis...
May 29, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28551069/gene-expression-of-sphingolipid-metabolism-pathways-is-altered-in-hidradenitis-suppurativa
#13
Mohammed Dany, Dirk Elston
BACKGROUND: Hidradenitis suppurativa (HS) is a debilitating skin disease characterized by painful recurrent nodules and abscesses caused by chronic inflammation. Early events in the development of HS are believed to occur in the folliculopilosebaceous unit; however, the signaling pathways behind this mechanism are unknown. Sphingolipids, such as ceramide, are essential components of the skin and appendages and have important structural and signaling roles. OBJECTIVE: We sought to explore whether the gene expression of enzymes involved in sphingolipid metabolic pathways is altered in HS...
May 24, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28546770/reduced-gabaergic-neuronal-activity-in-zona-incerta-causes-neuropathic-pain-in-a-rat-sciatic-nerve-chronic-constriction-injury-model
#14
Hyeong Cheol Moon, Young Seok Park
PURPOSE: The zona incerta (ZI) is below the ventral tier of the thalamus and has a strong influence selectively in higher-order thalamic relays. Although neuropathic pain has been suggested to result from reduced gamma-aminobutyric acid (GABA) and GABAergic signaling in the ZI, the mechanisms remain unclear. Here, the role of GABA and GABAergic signaling was investigated in the ZI in neuropathic pain using sciatic nerve chronic constriction injury (CCI) rats. MATERIALS AND METHODS: Single-unit neuronal activity was recorded, and microdialysis was performed in the ZI of CCI rats and sham-treated rats in vivo...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#15
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#16
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28529756/a-socioecological-framework-for-research-on-work-and-obesity-in-diverse-urban-transit-operators-based-on-gender-race-and-ethnicity
#17
REVIEW
BongKyoo Choi, Peter Schnall, Marnie Dobson, Haiou Yang, Dean Baker, YoungJu Seo
Urban transit (bus and rail) operators, totaling nearly 700,000 persons, are one of the heaviest occupational groups in the United States (US). Little is known about occupational risk factors for weight gain and obesity and their interrelationship with health-related behaviors, particularly among female minority (African Americans and Hispanics) transit operators who are at greater risk for obesity. As a step towards developing successful obesity interventions among urban transit operators, this paper aims to present a new socioecological framework for studying working conditions, chronic strain, health-related behaviors, weight gain/obesity, and obesity disparity in diverse urban transit operators based on gender, race, and ethnicity...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28528930/clinical-and-psychosocial-predictors-of-urologic-chronic-pelvic-pain-symptom-change-over-one-year-a-prospective-study-from-the-mapp-research-network
#18
Bruce D Naliboff, Alisa J Stephens, H Henry Lai, James W Griffith, J Quentin Clemens, Susan Lutgendorf, Larissa V Rodriguez, Craig Newcomb, Siobhan Sutcliffe, Wensheng Guo, John W Kusek, J Richard Landis
OBJECTIVE: To examine baseline clinical and psychosocial characteristics that predict 12- month symptom change in men and women with urologic chronic pelvic pain syndromes (UCPPS). METHODS: 221 female and 176 male UCPPS patients were recruited from 6 academic medical centers in the United States and evaluated at baseline with a comprehensive battery of symptom, psychosocial, and illness-impact measures. Based on biweekly symptom reports, a functional clustering procedure classified participant's outcome as worse, stable, or improved on pain and urinary symptom severity...
May 18, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28522283/-standardised-pain-assessment-in-cognitively-impaired-nursing-home-residents-comparing-the-use-of-assessment-tools-in-dementia-care-units-and-in-integrated-care-units
#19
Rebecca Palm, Erika Sirsch, Bernhard Holle, Sabine Bartholomeyczik
BACKGROUND: A large number of nursing home residents with cognitive impairments (CI) suffer from chronic pain, which is also discussed as a reason for challenging behavior. To assess pain in people with severe CI, the use of an observational pain instrument is recommended; for people without or with mild CI the gold standard is a self-rating instrument. It is unknown whether in German nursing homes pain assessment in residents with severe CI is actually conducted using observational instruments and which instruments are used...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28514026/gambling-with-life-masculinity-risk-and-danger-in-the-lives-of-unauthorized-migrant-roofers
#20
Sergio Chávez, Claire E Altman
BACKGROUND: This paper examines the occupational experiences of unauthorized immigrants employed in one of the most dangerous occupations in the United States: roofing. METHODS: We draw on 40 in-depth interviews with return migrants in Guanajuato, Mexico, to examine how the adoption of masculinity, dangerous working conditions, the labor market structure, and absence of legal status exacerbates injuries for unauthorized roofers. FINDINGS: Undocumented men return to Mexico injured with chronic pain, health complications, and trauma...
June 2017: American Journal of Industrial Medicine
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