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Chronic pain treatment units

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https://www.readbyqxmd.com/read/29652682/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#1
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/29628828/pain-assessment-in-the-critically-ill-mechanically-ventilated-adult-patients-comparison-between-skin-conductance-algesimeter-index-and-physiologic-indicators
#2
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/29617060/a-prospective-real-world-analysis-of-onabotulinumtoxina-in-chronic-migraine-post-nice-u-k-technology-appraisal
#3
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
#4
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
#5
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/29578090/impact-on-health-care-costs-for-adolescents-receiving-adjunctive-internet-delivered-cognitive-behavioral-therapy-results-of-a-randomized-controlled-trial
#6
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
#7
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/29565950/pulsed-radiofrequency-treatment-for-chronic-post-surgical-orchialgia-a-double-blind-sham-controlled-randomized-trial-three-month-results
#8
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
https://www.readbyqxmd.com/read/29538696/spinal-cord-stimulation-for-the-treatment-of-chronic-pain-reduces-opioid-use-and-results-in-superior-clinical-outcomes-when-used-without-opioids
#9
Lucy Gee, Heather C Smith, Zohal Ghulam-Jelani, Hirah Khan, Julia Prusik, Paul J Feustel, Sarah E McCallum, Julie G Pilitsis
BACKGROUND: Chronic pain causes a significant burden to the US health care system, is difficult to treat, and remains a significant contributor to increased opioid use in the United States. Spinal cord stimulation (SCS) has been FDA approved for the treatment of chronic pain. OBJECTIVE: To evaluate the hypothesis that SCS reduces opioid use, and alone maintains clinical outcome measures of pain and psychosocial determinants of health. METHODS: In this prospective cohort study, we evaluated 86 patients undergoing SCS surgery for the treatment of chronic pain between September 2012 and August 2015...
March 12, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29526669/chronic-pain-tbi-and-ptsd-in-military-veterans-a-link-to-suicidal-ideation-and-violent-impulses
#10
Shannon M Blakey, H Ryan Wagner, Jennifer Naylor, Mira Brancu, Ilana Lane, Meghann Sallee, Nathan A Kimbrel, Eric B Elbogen
The polytrauma clinical triad refers to the co-occurrence of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD). Despite research implicating dyadic relationships between these conditions and adverse outcomes, scant research has examined the polytrauma clinical triad's relation to suicide or violence. The present cross-sectional study was designed to examine whether this complex clinical presentation increases risk of suicidal ideation and violent impulses after accounting for other established risk factors...
March 8, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29524230/transfusion-transmitted-malaria-masquerading-as-sickle-cell-crisis-with-multisystem-organ-failure
#11
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
https://www.readbyqxmd.com/read/29522897/interdisciplinary-team-based-care-for-patients-with-chronic-pain-on-long-term-opioid-treatment-in-primary-care-ppact-protocol-for-a-pragmatic-cluster-randomized-trial
#12
Lynn DeBar, Lindsay Benes, Allison Bonifay, Richard A Deyo, Charles R Elder, Francis J Keefe, Michael C Leo, Carmit McMullen, Meghan Mayhew, Ashli Owen-Smith, David H Smith, Connie M Trinacty, William M Vollmer
BACKGROUND: Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care...
March 6, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29509514/anesthetic-considerations-for-patients-on-antidepressant-therapy-part-ii
#13
Mana Saraghi, Leonard Golden, Elliot V Hersh
Millions of patients take antidepressant medications in the United States for the treatment of depression or anxiety disorders. Some antidepressants are prescribed off-label to treat problems such as chronic pain, low energy, and menstrual symptoms. Antidepressants are a broad and expansive group of medications, but the more common drug classes include tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors. A miscellaneous or "atypical" category covers other agents...
2018: Anesthesia Progress
https://www.readbyqxmd.com/read/29505462/opiate-dependence-or-addiction-a-review-of-the-centers-for-disease-control-and-prevention-guidelines-for-management-of-chronic-pain
#14
Gina C Dobbs, Susanne A Fogger
In the wake of epidemic of opioid overdoses in the United States, patients who are receiving treatment for chronic pain with opioid have come under increasing scrutiny. The Centers for Disease Control and Prevention issued a guideline for managing chronic pain in 2016, which makes recommendations for opioids based on current evidence. This review will highlight key components of the guideline including differentiating addiction from dependence to assist nurses to better inform patient care in managing chronic pain...
January 2018: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/29502519/identifying-prognostic-factors-for-conservative-treatment-outcomes-in-servicemen-with-chronic-exertional-compartment-syndrome-treated-at-a-rehabilitation-center
#15
Mariëtte Z Meulekamp, Peter van der Wurff, Alfred van der Meer, Cees Lucas
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center...
November 28, 2017: Military Medical Research
https://www.readbyqxmd.com/read/29499683/what-women-say-about-their-dysmenorrhea-a-qualitative-thematic-analysis
#16
Chen X Chen, Claire B Draucker, Janet S Carpenter
BACKGROUND: Dysmenorrhea is highly prevalent and is the leading cause of absence from school and work among women of reproductive age. Evidence suggests that dysmenorrhea may also be a risk factor for other chronic pain conditions. Limited research has examined women's experience with dysmenorrhea using qualitative data. Research is warranted to address issues and needs that are important from women's own perspectives. Therefore, the purpose of this study was to describe women's salient thoughts about their experiences of dysmenorrhea...
March 2, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29488206/rehabilitation-of-neuromotor-disabilities-in-aquatic-microgravity-environment
#17
Giovanni Barassi, Rosa Grazia Bellomo, Annamaria Porreca, Giuseppe Giannuzzo, Giuseppe Irace, Leonardo Trivisano, Raoul Saggini
The aquatic environment has a high potential in rehabilitation treatment of acute lesions and in chronic diseases. The Safe Bearing Back method is proposed to stimulate the reorganization of deteriorated sensory neuromotor skills. The aim of the present study was to verify the effectiveness and the long-term maintenance of the benefits of a specific thermal rehabilitation training in neuromotor and neurological disabilities. Seventy four patients were evaluated using the Functional Independence Measure (FIM), Tinetti Gait-Balance Scale (TIN), and Visual Analog Scale (VAS) for pain...
February 28, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29473354/-clinical-observation-on-severe-acute-pancreatitis-treated-with-electroacupuncture-at-dachangshu-bl-25-and-shangjuxu-st-37-combined-with-ulinastatin
#18
Li Zhao, Xueqing Li, Zhimin Shi
OBJECTIVE: To observe the clinical therapeutic effects on severe acute pancreatitis (SAP) treated with electroacupuncture (EA), sparse-dense wave and 2 Hz/15 Hz, at Dachangshu (BL 25) and Shangjuxu (ST 37) assisting ulinastetin and explore the effective therapeutic method for SAP. METHODS: A total of 120 patients of SAP were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine western medicine was adopted with the intravenous drip with ulinastatin...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29465470/opioid-addiction-diversion-and-abuse-in-chronic-and-cancer-pain
#19
Vijay Kata, Matthew B Novitch, Mark R Jones, Best O Anyama, Erik M Helander, Alan D Kaye
PURPOSE OF REVIEW: The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. RECENT FINDINGS: There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties...
February 19, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29455923/prevalence-location-and-characteristics-of-chronic-pain-in-intensive-care-survivors
#20
Anne Kathrine Langerud, Tone Rustøen, Cathrine Brunborg, Ulf Kongsgaard, Audun Stubhaug
A growing number of studies have addressed the long-term consequences of intensive care unit (ICU) treatment, but few have studied the prevalence of chronic pain and pain characteristics longitudinally. The goal of the work described here was to investigate the prevalence and characteristics of chronic pain in ICU survivors 3 months and 1 year after ICU discharge and to identify risk factors for chronic pain 1 year after ICU discharge. The design used was an explorative and longitudinal study. The patients in this work had stayed >48 hours in two mixed ICUs in Oslo University Hospital, a tertiary referral hospital...
February 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
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