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https://www.readbyqxmd.com/read/29451883/management-of-post-abortion-complications-in-botswana-the-need-for-a-standardized-approach
#1
Tadele Melese, Dereje Habte, Billy M Tsima, Keitshokile Dintle Mogobe, Mercy N Nassali
BACKGROUND: Post abortion complications are the third leading cause of maternal death after hemorrhage and hypertension in Botswana where abortion is not legalized. This study aimed at assessing the management of post abortion complications in Botswana. METHODS: A retrospective study was conducted at four hospitals in Botswana in 2014. Socio-demographic, patient management and outcomes data were extracted from patients' medical records. Descriptive statistics and chi-square test were used to analyze and present the data...
2018: PloS One
https://www.readbyqxmd.com/read/29445297/managing-severe-pain-and-abuse-potential-the-potential-impact-of-a-new-abuse-deterrent-formulation-oxycodone-naltrexone-extended-release-product
#2
REVIEW
Joseph V Pergolizzi, Robert Taylor, Jo Ann LeQuang, Robert B Raffa
Proper management of severe pain represents one of the most challenging clinical dilemmas. Two equally important goals must be attained: the humanitarian/medical goal to relieve suffering and the societal/legal goal to not contribute to the drug abuse problem. This is an age-old problem, and the prevailing emphasis placed on one or the other goal has resulted in pendulum swings that have resulted in either undertreatment of pain or the current epidemic of misuse and abuse. In an effort to provide efficacious strong pain relievers (opioids) that are more difficult to abuse by the most dangerous routes of administration, pharmaceutical companies are developing products in which the opioid is manufactured in a formulation that is designed to be tamper resistant...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29441736/the-legal-doctrine-on-the-liability-of-physicians-in-medical-malpractice-lawsuits-involving-complex-regional-pain-syndrome
#3
SuHwan Shin, Seung Gyeong Jang, KyeongTae Min, Won Lee, So Yoon Kim
BACKGROUND: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. METHODS: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015...
February 26, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29429037/long-term-follow-up-of-whiplash-injuries-reported-to-insurance-companies-a-cohort-study-on-patient-reported-outcomes-and-impact-of-financial-compensation
#4
Eric Rydman, Sari Ponzer, Rosa Brisson, Carin Ottosson, Hans Pettersson-Järnbert
PURPOSE: The long-term outcome of Whiplash-associated disorder (WADs) has been reported to be poor in populations from medical settings. However, no trials have investigated the long-term prognosis of patients from medico-legal environment. For this group, the "compensation hypothesis" suggests financial compensation being associated with worsened outcome. The aims of this study were to describe long-term (2-4 years) non-recovery rates in participants with WAD recruited from insurance companies and to investigate the association between self-reported non-recovery and financial compensation...
February 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29399427/myocardial-ischemia-with-cannabinoid-use-in-an-adolescent
#5
Jeet J Mehta, Arjun K Mahendran, Ravi K Bajaj, Arpan R Doshi
A 16-year-old male presented to the emergency department with chest pain after smoking a synthetic cannabinoid from a vape pen. He had rising troponin I levels, and his exercise stress echocardiogram showed distal apical and septal hypokinesis that resolved at six-month follow-up. This case report raises concern about cardiac ischemia related to synthetic cannabinoid abuse in the pediatric population in the current era of cannabis legalization.
November 30, 2017: Curēus
https://www.readbyqxmd.com/read/29377381/medical-cannabis-a-forward-vision-for-the-clinician
#6
REVIEW
M A Fitzcharles, E Eisenberg
Medical cannabis has entered mainstream medicine and is here to stay. Propelled by public advocacy, the media and mostly anecdote rather than sound scientific study, patients worldwide are exploring marijuana use for a vast array of medical conditions including management of chronic pain. Contrary to the usual path of drug approval, medical cannabis has bypassed traditional evidence-based study and has been legalized as a therapeutic product by legislative bodies in various countries. While there is a wealth of basic science and preclinical studies demonstrating effects of cannabinoids in neurobiological systems, especially those pertaining to pain and inflammation, clinical study remains limited...
January 29, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29338150/the-role-of-cannabinoids-in-pain-control-the-good-the-bad-and-the-ugly
#7
Joseph V Pergolizzi, Jo Ann Lequang, Robert Taylor, Robert B Raffa, Daniel Colucci
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#8
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29322905/pre-discharge-postoperative-radiographs-after-primary-total-knee-replacement-tradition-or-science
#9
S N Sambandam, V Khanna, G Rohinikumar, V Mounasamy
Consistent evidence exists on the inutility of immediate postoperative radiographs after a total knee replacement (TKR). We hypothesized that eliminating the pre-discharge film would not have any effect on the postoperative patient outcomes. Retrospective analysis of prospectively collected data was performed on 220 knees. Patients undergoing a simple primary TKR operated by 2 surgeons (Surgeon A and B) from January 2013 to July 2015 were divided into 2 groups (Groups 1 and 2 having 112 and 108 knees respectively)...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29320513/a-harm-reduction-model-of-abortion-counseling-about-misoprostol-use-in-peru-with-telephone-and-in-person-follow-up-a-cohort-study
#10
Daniel Grossman, Sarah E Baum, Denitza Andjelic, Carrie Tatum, Guadalupe Torres, Liza Fuentes, Jennifer Friedman
BACKGROUND: In Peru, abortion is legal only to preserve the life and health of the woman. A non-profit clinic system in Peru implemented a harm-reduction model for women with unwanted pregnancy that included pre-abortion care with instructions about misoprostol use and post-abortion care; they started offering telephone follow-up for clients in 2011. This study aimed to evaluate the effectiveness and safety of the harm-reduction model, and to compare outcomes by type of follow-up obtained...
2018: PloS One
https://www.readbyqxmd.com/read/29216664/-acute-scrotal-pain-in-childhood-legal-pitfalls
#11
Pia Bader, Christoph Hugemann, Detlef Frohneberg
Acute scrotal pain in childhood is an emergency.Sudden scrotal pain may be caused by a variety of diseases. Therefore, it is important to carefully consider the specific medical history and possible differential diagnoses in each case for fast and decisive action (e. g. in case of testicular torsion). As minors lack the capacity for consent, it is absolutely necessary to obtain consent from their legal guardian. However, obtaining consent in the available time frame can cause organisational challenges in an acute emergency, which may lead to situations in the daily routine where a therapeutic decision needs to be taken (including surgery) without legal security based on consent by the guardian...
December 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/29209790/-delegation-of-medical-activities-in-acute-pain-therapy
#12
REVIEW
J Erlenwein, A Moroder, E Biermann, F Petzke, A P F Ehlers, H Bitter, E Pogatzki-Zahn
Acute pain management is an interprofessional and interdisciplinary task and requires a good and trustful cooperation between stakeholders. Despite provisions in Germany according to which medical treatment can only be rendered by a formally qualified physician ("Arztvorbehalt"), a physician does not have to carry out every medical activity in person. Under certain conditions, some medical activities can be delegated to medical auxiliary personnel but they need to be (1) instructed, (2) supervised and (3) checked by the physician himself; however, medical history, diagnostic assessment and evaluation, indications, therapy planning (e...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29201926/factors-associated-with-physician-loss-in-anterior-cruciate-ligament-reconstruction-malpractice-lawsuits
#13
Steven L Bokshan, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Alan H Daniels, Brett D Owens
Background: Anterior cruciate ligament (ACL) reconstruction is among the most common orthopaedic procedures, with its incidence doubling over the past decade. To date, no studies have analyzed litigation after ACL reconstruction. Purpose: To characterize the causes of malpractice litigation after ACL reconstruction. Study Design: Cross-sectional study. Methods: A retrospective review of malpractice lawsuits after ACL reconstruction was performed using VerdictSearch, a large legal claims database encompassing nearly 180,000 legal cases, from February 1988 to May 2015...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29178487/therapeutic-benefit-of-smoked-cannabis-in-randomized-placebo-controlled-studies
#14
REVIEW
Lynneice L Bowen, Aimee L McRae-Clark
The medicinal use of marijuana has been legalized in 28 states, with a wide range of specificity for approved medical conditions. Even with the emergence of non-combustion-based delivery systems, 90% of marijuana users in 2014 used smoked marijuana. This review summarizes the data available on the use of smoked marijuana for medical purposes. A literature search was performed to retrieve randomized controlled trials exploring the efficacy of smoked cannabis for treatment of a medical condition. Studies with the primary end point listed as the effect of smoked cannabis on a disease-specific characteristic were included...
January 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29121790/knowledge-skills-and-attitudes-regarding-the-use-of-medical-cannabis-in-the-hospice-population-an-educational-intervention
#15
Kelly S Mendoza, Mary Lynn McPherson
BACKGROUND: Currently, 28 states and the District of Columbia have legalized cannabis for medical use despite its remaining Schedule I federally. Benefits of medical cannabis (MC) have been demonstrated in nausea/vomiting associated with chemotherapy, cachexia associated with HIV/AIDS, and certain types of neuropathic pain. However, it is unclear how comfortable hospice providers are with the concept of MC. OBJECTIVE: The aim of this study is to determine changes in knowledge, self-perceived skills, and attitudes (KSA) of hospice providers regarding MC after an online educational intervention...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29117023/legal-evidence-of-subjective-states-a-brain-based-model-of-chronic-pain-increases-accuracy-and-fairness-in-law
#16
Amanda C Pustilnik
Advances in structural and functional neuroimaging offer new ways to conceptualize chronic pain disorders and to prevent, diagnose, and treat chronic pain. Advances in pain science, though, do not entail changes in the concepts of chronic pain in law and culture. Authoritative legal and cultural conceptions of chronic pain continue to promote abstruse theories, characterizing these disorders as arising out of everything from a person's unmet need for love to resistance to "patriarchy." These constructs have consequences, impeding treatment and affecting whether individuals with chronic pain can obtain legal redress...
November 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29109890/gossypiboma-resection-after-eight-years-in-a-patient-with-rheumatoid-arthritis-and-diabetes
#17
Kenley Unruh, Hsien Sing Sam Hsieh
Gossypiboma is the term used to refer to a mass formed by surgical material left in the body cavity after surgery. We present the case of a middle-aged woman with a history of rheumatoid arthritis controlled with corticosteroids and biologic therapies, uncontrolled type II diabetes mellitus, and cesarean section with postoperative bleeding eight years earlier, who presents with right lower quadrant abdominal pain and is found to have a gossypiboma from her previous operation. A subsequent operation is undertaken to remove the gossypiboma...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29107306/pharmacologic-interventions-for-pain-management
#18
REVIEW
Francisca Cisneros Farrar, Danielle White, Linda Darnell
Serious life-threatening respiratory depression may occur with pharmacologic pain intervention. The nurse has an ethical and legal duty to provide safe, quality, and accountable pain management. The nurse must acquire self-efficacy for the administration of pain medications for critically ill patients to prevent serious side effects and adverse reactions. This article presents a clinical toolkit for acute pain pharmacologic management by presenting professional guidelines, evidence-based pain assessment tools, common pain medication therapy, and focused monitoring specific to the drug...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29107303/physiology-of-pain
#19
REVIEW
Deborah L Ellison
Acutely ill patients are challenging to frontline nurses because they frequently also have multiple chronic conditions. This article empowers all nurses to develop a foundational understanding of the physiology of acute and chronic pain. The skills, knowledge, and attitude to care for patients experiencing pain are a legal and ethical responsibility of all nurses. This article discusses the physiology of pain to include the neuronal receptors that respond to various painful stimuli, substances that stimulate nociceptors, the nerve pathways, modulation of the perception of pain, and acute verses chronic physiologic changes...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29077662/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#20
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...
October 26, 2017: A & A Case Reports
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