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Chronic pain treatment units

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https://www.readbyqxmd.com/read/29049278/illicit-drug-use-illicit-drug-use-disorders-and-drug-overdose-deaths-in-metropolitan-and-nonmetropolitan-areas-united-states
#1
Karin A Mack, Christopher M Jones, Michael F Ballesteros
PROBLEM/CONDITION: Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. REPORTING PERIOD: Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015...
October 20, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29049121/opioids-for-the-treatment-of-chronic-pain-mistakes-made-lessons-learned-and-future-directions
#2
Jane C Ballantyne
An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause of the "epidemic" of prescription opioid abuse in the United States. Yet, an examination of the statistics that led the US Centers for Disease Control and Prevention to declare that prescription opioid abuse had reached epidemic levels shows that the abuse occurrences and deaths are arising outside the hospital or hospice setting, which strongly implicates the outpatient use of opioids to treat chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#3
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049114/alternatives-to-opioids-in-the-pharmacologic-management-of-chronic-pain-syndromes-a-narrative-review-of-randomized-controlled-and-blinded-clinical-trials
#4
Andrea L Nicol, Robert W Hurley, Honorio T Benzon
Chronic pain exerts a tremendous burden on individuals and societies. If one views chronic pain as a single disease entity, then it is the most common and costly medical condition. At present, medical professionals who treat patients in chronic pain are recommended to provide comprehensive and multidisciplinary treatments, which may include pharmacotherapy. Many providers use nonopioid medications to treat chronic pain; however, for some patients, opioid analgesics are the exclusive treatment of chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#5
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#6
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29025534/-endovascular-treatment-of-a-gastroduodenal-artery-pseudoaneurysm-rupture-after-a-car-accident
#7
Sofia Dutra, Filipe Veloso Gomes, Tiago Bilhim, Élia Coimbra
The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of 'backdoor' and 'frontdoor' embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography...
September 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28977113/primary-sclerosing-cholangitis-in-children-and-adolescents
#8
Eleonora Druve Tavares Fagundes, Alexandre Rodrigues Ferreira, Caroline Caldeira Hosken, Thaís Costa Nascentes Queiroz
BACKGROUND: Primary sclerosing cholangitis is a rare disease, but its prevalence has been underestimated in children and adolescents due to broad variation in clinical presentation as well as diagnostic challenges in this life period. OBJECTIVE: To evaluate children and adolescents with primary sclerosing cholangitis and to describe their clinical, laboratorial, histopathological, and cholangiography conditions. METHODS: This is an observational descriptive research that took place from 2005 to 2016 and included all the patients seen in the Outpatient Unit for Pediatric Hepatology of Hospital das Clinicas of UFMG who had been diagnosed with primary sclerosing cholangitis before the age of 18...
October 2, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28972120/fremanezumab-a-humanized-monoclonal-anti-cgrp-antibody-inhibits-thinly-myelinated-a%C3%AE-but-not-unmyelinated-c-meningeal-nociceptors
#9
Agustin Melo-Carrillo, Andrew M Strassman, Rony-Reuven Nir, Aaron Schain, Rodrigo Noseda, Jennifer Stratton, Rami Burstein
Calcitonin gene-related peptide (CGRP), the most abundant neuropeptide in primary afferent sensory neurons, is strongly implicated in the pathophysiology of migraine headache, but its role in migraine is still equivocal. As a new approach to migraine treatment, humanized anti-CGRP monoclonal antibodies (CGRP-mAb) were developed to reduce the availability of CGRP, and were found effective in reducing the frequency of chronic and episodic migraine. We recently tested the effect of fremanezumab (TEV-48125), a CGRP-mAb, on the activity of second-order trigeminovascular dorsal horn neurons that receive peripheral input from the cranial dura, and found a selective inhibition of high-threshold but not wide-dynamic range class of neurons...
September 29, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28971220/lower-urinary-tract-symptoms-that-predict-microscopic-pyuria
#10
Rajvinder Khasriya, William Barcella, Maria De Iorio, Sheela Swamy, Kiren Gill, Anthony Kupelian, James Malone-Lee
INTRODUCTION AND HYPOTHESIS: Urinary dipsticks and culture analyses of a mid-stream urine specimen (MSU) at 10(5) cfu ml(-1) of a known urinary pathogen are considered the gold standard investigations for diagnosing urinary tract infection (UTI). However, the reliability of these tests has been much criticised and they may mislead. It is now widely accepted that pyuria (≥1 WBC μl(-1)) detected by microscopy of a fresh unspun, unstained specimen of urine is the best biological indicator of UTI available...
October 2, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28968191/the-genetics-of-pain-implications-for-therapeutics
#11
Jane E Sexton, James J Cox, Jing Zhao, John N Wood
Pain is an increasing clinical challenge affecting about half the population, with a substantial number of people suffering daily intense pain. Such suffering can be linked to the dramatic rise in opioid use and associated deaths in the United States. There is a pressing need for new analgesics with limited side effects. Here, we summarize what we know about the genetics of pain and implications for drug development. We make the case that chronic pain is not one but a set of disease states, with peripheral drive a key element in most...
October 2, 2017: Annual Review of Pharmacology and Toxicology
https://www.readbyqxmd.com/read/28967360/what-can-we-learn-from-osteoarthritis-pain-in-companion-animals
#12
REVIEW
Dorothy Cimino Brown
The lack of successful translation of basic research discoveries into safe and effective treatments for chronic pain patients has led to increased scrutiny of the preclinical models used in pain research, particularly for osteoarthritis, where there is a significant disconnect between the animal models used to study the structural versus symptomatic aspects of the disease. Companion dogs offer a unique opportunity to assess osteoarthritis pain in a physiologically relevant 'model' of the disease. Approximately 20% of the canine pet population spontaneously develops osteoarthritis, translating to at least 15 million dogs in the United States alone...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28953954/epidemiological-clinical-diagnostic-and-economic-features-of-an-immigrant-population-of-chronic-schistosomiasis-sufferers-with-long-term-residence-in-a-non-endemic-country-north-metropolitan-area-of-barcelona-2002-2016
#13
Sílvia Roure, Lluís Valerio, Olga Pérez-Quílez, Gema Fernández-Rivas, Octavio Martínez-Cuevas, Albert Alcántara-Román, Diego Viasus, M Luisa Pedro-Botet, Miquel Sabrià, Bonaventura Clotet
BACKGROUND: Schistosomiasis, one of the neglected tropical diseases (NTD) listed by the WHO, is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Complications of long-term infestation include liver cirrhosis, bladder tumors and kidney failure. The objective of this study was to carry out a clinical and epidemiological characterization of a schistosomiasis-diagnosed immigrant population with long-term residencein the EU as well as to evaluate the diagnostic methods available to date...
2017: PloS One
https://www.readbyqxmd.com/read/28947562/magnitude-and-characteristics-of-patients-who-survived-an-acute-myocardial-infarction
#14
Mayra Tisminetzky, Tracy Y Wang, Jerry Gurwitz, Lisa A Kaltenbach, David McManus, Joel Gore, Eric Peterson, Robert J Goldberg
BACKGROUND: The purpose of this study was to describe the magnitude and characteristics of patients who did not experience any significant major adverse cardiovascular event early (within 6 weeks) and late (during the first year) after hospital discharge for an acute myocardial infarction (AMI). METHODS AND RESULTS: Data from 12 243 patients discharged after an AMI from 233 sites across the United States in the TRANSLATE-ACS (Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study were analyzed...
September 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935654/opioid-prescription-morbidity-and-mortality-in-united-states-dialysis-patients
#15
Paul L Kimmel, Chyng-Wen Fwu, Kevin C Abbott, Anne W Eggers, Prudence P Kline, Paul W Eggers
Aggressive pain treatment was advocated for ESRD patients, but new Centers for Disease Control and Prevention guidelines recommend cautious opioid prescription. Little is known regarding outcomes associated with ESRD opioid prescription. We assessed opioid prescriptions and associations between opioid prescription and dose and patient outcomes using 2006-2010 US Renal Data System information in patients on maintenance dialysis with Medicare Part A, B, and D coverage in each study year (n=671,281, of whom 271,285 were unique patients)...
September 21, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28933696/a-novel-topical-wound-therapy-delivery-system
#16
Ingrid Herskovitz, Flor E MacQuhae, Luis J Borda, Stephanie Bhagwandin, Juan A Paredes, Thais Polanco, John C Lantis, Paul J Kim, Tania J Phillips, Robert S Kirsner
INTRODUCTION: Wound care dressings have evolved over time, from bandaging to the development of occlusive dressings to negative pressure wound therapy. A novel therapeutic delivery system dressing has been cleared by the United States Food and Drug Administration. This semi occlusive wound dressing has been developed to provide local, continuous delivery of aqueous topical agents, such as therapeutics (anesthetics, antiseptics, antibiotics, steroids, topical beta-blockers, immune modulatory agents, growth factors, and fibrinolytic agents, among others), at a rate of about ¾ mL per day, thus maintaining a hydrated environment and providing topical treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28914555/evaluation-of-the-quality-of-care-of-elderly-patients-with-chronic-and-breakthrough-pain-treated-with-opioids-sand-study
#17
Manuel Jesús Rodríguez, Rosalía de la Torre, Josefa Luisa Ortega, José Manuel Trinidad, Diego Benítez, Antonio Javier Jiménez, Almudena Sanz-Yagüe, Begoña Soler, Luis Miguel Torres
OBJECTIVE: The objective of this study was to evaluate the quality of care of elderly patients with treatment for chronic pain (CP) and breakthrough pain (BTP). METHODS: A cross-sectional observational study was conducted in 20 pain units, selecting patients aged 70 years or older with baseline controlled CP in treatment with opioids and a diagnosis of BTP. Patients were classified as first episode of BTP or patient in follow-up. The patients completed the SF-12 quality of life questionnaire, Brief Pain Inventory, Lattinen Index, and Edmonton Symptoms Assessment Scale...
October 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28902818/-efficacy-of-sulodexide-in-treatment-of-chronic-venous-insufficiency-results-of-the-accord-trial
#18
V Iu Bogachev, O V Golovanova, I N Malysheva
OBJECTIVE: The purpose of our study was to evaluate both clinical and laboratory efficacy of sulodexide given at a daily dose of 500 lipasemic units (LSU) in patients presenting with class C3-C4 chronic venous insufficiency (CVI) according to the CEAP classification. PATIENTS AND METHODS: The study included a total of 25 patients diagnosed with C3-C4 CVI and prescribed to receive sulodexide at a daily dose of 500 LSU for 90 days. Efficacy was comprehensively controlled by the following tools: the disease-specific Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ), visual-analogue methods of assessment separate symptoms; the Venous Clinical Severity Score (VCSS), as well as ultrasonographic determination of the thickness of subcutaneous fat and crural fascia...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28898536/treatment-with-naloxegol-versus-placebo-pain-assessment-in-patients-with-noncancer-pain-and-opioid-induced-constipation
#19
Lynn Webster, Ulysses Diva, Raj Tummala, Mark Sostek
OBJECTIVE: To summarize results from pain and opioid use assessments with naloxegol in adults with opioid-induced constipation (OIC) and chronic noncancer pain. METHODS: Two phase 3 randomized, double-blind, 12-week studies evaluated the efficacy and safety of oral naloxegol (12.5 or 25 mg daily) in adults (18-<85 years) with confirmed OIC and chronic noncancer pain: KODIAC-04 (NCT01309841) and KODIAC-05 (NCT01323790). Pain level was assessed daily (11-point Numeric Rating Scale [NRS]; 0=no pain, 10=worst imaginable pain)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28888796/laparoscopic-treatment-of-gastroparesis-a-single-center-experience
#20
Kotaro Wakamatsu, Federico Perez Quirante, Lisandro Montorfano, Emanuele Lo Menzo, Yasuyuki Seto, Raul J Rosenthal
BACKGROUND: Gastroparesis (GP) is a chronic disorder of gastric motility with delayed gastric emptying. Gastric electrical stimulator (GES) implantation and Roux-en-Y gastric bypass (RYGB) are surgical options for medically refractory GP. OBJECTIVE: Evaluate operational outcomes and symptom improvement of patients with diabetic (DM) and idiopathic (IP) GP. SETTING: University Hospital, United States. METHODS: A retrospective chart review was performed of all patients who underwent surgical treatment of GP from February 2003 to December 2014...
July 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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