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Chronic pain treatment units

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https://www.readbyqxmd.com/read/27919449/nonsteroidal-anti-inflammatory-drugs-may-affect-cytokine-response-and-benefit-healing-of-combat-related-extremity-wounds
#1
Felipe A Lisboa, Matthew J Bradley, Matthew T Hueman, Seth A Schobel, Beverly J Gaucher, Edda L Styrmisdottir, Benjamin K Potter, Jonathan A Forsberg, Eric A Elster
BACKGROUND: After adequate operative debridement and antimicrobial therapies, combat-related extremity wounds that either heal or fail are both associated with a distinct inflammatory response. Short-term use of nonsteroidal anti-inflammatory drugs in postoperative pain management may affect this response and, by consequence, the healing potential of these wounds. We investigated whether patients treated with nonsteroidal anti-inflammatory drugs had a distinct inflammatory response; different rates of critical colonization, defined as >10(5) colony forming units on quantitative bacteriology; and healing potential...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27915497/current-and-future-development-of-extended-release-abuse-deterrent-opioid-formulations-in-the-united-states
#2
Lynn R Webster, John Markman, Edward J Cone, Gwendolyn Niebler
Prescription opioid misuse and abuse in the United States (US) is epidemic and is a major burden on healthcare resources and costs to society. The need to significantly reduce the risks of prescription opioid misuse and abuse must be balanced with the important needs of patients with chronic pain who may benefit from treatment with opioids. The use of abuse-deterrent formulations (ADFs) of prescription opioids is one approach that could reduce the risk of prescription opioid abuse and misuse while maintaining access to opioids...
December 3, 2016: Postgraduate Medicine
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
#3
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
#4
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/27884150/identifying-and-prioritizing-lower-value-services-from-dutch-specialist-guidelines-and-a-comparison-with-the-uk-do-not-do-list
#5
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
#6
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/27865036/relationship-between-opioid-treatment-and-rate-of-healing-in-chronic-wounds
#7
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
#8
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
#9
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/27807396/laparoscopic-management-of-mobile-cecum
#10
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
#11
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/27785090/5-lidocaine-medicated-plaster-for-the-treatment-of-chronic-peripheral-neuropathic-pain-complex-regional-pain-syndrome-and-other-neuropathic-conditions
#12
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
#13
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/27760823/modulation-of-activity-and-conduction-in-single-dorsal-column-axons-by-kilohertz-frequency-spinal-cord-stimulation
#14
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
https://www.readbyqxmd.com/read/27754719/provider-experiences-with-the-identification-management-and-treatment-of-co-occurring-chronic-noncancer-pain-and-substance-use-in-the-safety-net
#15
Jamie Suki Chang, Margot Kushel, Christine Miaskowski, Rachel Ceasar, Kara Zamora, Emily Hurstak, Kelly R Knight
BACKGROUND: In the United States and internationally, providers have adopted guidelines on the management of prescription opioids for chronic noncancer pain (CNCP). For "high-risk" patients with co-occurring CNCP and a history of substance use, guidelines advise that providers monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. OBJECTIVE: We report primary care provider experiences in the safety net interpreting and implementing prescription opioid guideline recommendations for patients with CNCP and substance use...
October 18, 2016: Substance Use & Misuse
https://www.readbyqxmd.com/read/27750063/assessment-of-predictors-of-the-impact-of-fibromyalgia-on-health-related-quality-of-life-12-months-after-the-end-of-an-interdisciplinary-treatment
#16
Josune Martín, Fernando Torre, Urko Aguirre, Angel Padierna, Begoña Matellanes, José M Quintana
OBJECTIVE: Fibromyalgia is a chronic pain disorder with a range of comorbid symptoms, including anxiety. We aimed to prospectively identify predictors of the long-term impact of fibromyalgia on health-related quality of life after the end of an interdisciplinary intervention. METHODS: 138 patients with fibromyalgia, selected from a hospital pain management unit, participated in a 6-week interdisciplinary treatment that combined coordinated psychological, medical, educational, and physiotherapeutic interventions...
October 11, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27749151/pharmacoeconomic-analysis-of-pain-medications-used-to-treat-adult-patients-with-chronic-back-pain-in-the-united-states
#17
Drishti Shah, Vamshi Ruthwik Anupindi, Varun Vaidya
Chronic back pain is an extremely common health problem. The largest category for pain therapy costs includes nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However, there has been limited evidence outlining their effectiveness in terms of quality of life for the treatment of chronic back pain. The authors performed a comparative pharmacoeconomic analysis of chronic back pain patients using NSAIDs versus those using opioids alone or combination opioid analgesics. This pharmacoeconomic evaluation was conducted using the Medical Expenditure Panel Survey (MEPS)...
October 17, 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27736158/long-term-outcomes-of-double-layered-polytetrafluoroethylene-membrane-covered-self-expandable-segmental-metallic-stents-uventa-in-patients-with-chronic-ureteral-obstructions-is-it-really-safe
#18
Myong Kim, Bumsik Hong, Hyung Keun Park
PURPOSE: To evaluate the long-term clinical efficacy and safety of double-layered polytetrafluoroethylene membrane-covered self-expandable segmental metallic stents (Uventa) in patients with chronic ureteral obstruction. MATERIALS AND METHODS: In a retrospective study, a total of 50 ureter units (44 patients) with chronic obstructions were included from July 2010 to May 2015. Indications for Uventa placement were primary stenting for malignant ureteral obstruction, failed conventional polymeric Double-J stent (PS), or percutaneous nephrostomy (PCN) technique, with comorbidities or fears limiting PS/PCN changes, or with irritation or pain due to PS/PCN...
December 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27722115/clinical-and-functional-outcomes-of-acute-lower-extremity-compartment-syndrome-at-a-major-trauma-hospital
#19
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/27719737/the-other-side-of-vitamin-d-therapy-%C3%A2-a-case-series-of-acute-kidney-injury-due-to-malpractice-related-vitamin-d-intoxication%C3%A2
#20
Muzafar Wani, Imtiaz Wani, Khurshid Banday, Mohd Ashraf
BACKGROUND: Vitamin D deficiency is highly prevalent in Indian Kashmir. Many people get injectable vitamin D (600,000 IU/injection). At times, the dose prescribed is far above the permissible limit. We report 62 patients with malpractice-related vitamin D intoxication, presenting with hypercalcemia and acute kidney injury (AKI). METHODS: The diagnosis was made on basis of (1) history of multiple intramuscular vitamin D injections (2) toxic serum levels of 25-OH vitamin D and (3) exclusion of common causes of hypercalcemia (malignancy and hyperparathyroidism)...
November 2016: Clinical Nephrology
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