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Chronic pain treatment units

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https://www.readbyqxmd.com/read/29911684/insurance-companies-fighting-the-peer-review-empire-without-any-validity-the-case-for-addiction-and-pain-modalities-in-the-face-of-an-american-drug-epidemic
#1
K Blum, W Jacobs, E J Modestino, N DiNubile, D Baron, T McLaughlin, D Siwicki, I Elman, M Moran, E R Braverman, P K Thanos, R D Badgaiyan
The United States are amid an opioid overdose epidemic; we are challenged to provide non-addicting/non-pharmacological alternatives to assist in pain attenuation. There are proven strategies available to manage chronic pain effectively without opioids. Utilization review providers for insurance companies often ignore medicine based scientific peer-reviewed studies that warn against the chronic use of opioid medications, as well as the lack of evidence to support long-term use of opioids for pain. This paradigm must change if we are to indeed change the drug-embracing culture in American chronic pain management...
October 4, 2018: SEJ Surg Pain
https://www.readbyqxmd.com/read/29911649/systemic-administration-of-wy-14643-a-selective-synthetic-agonist-of-peroxisome-proliferator-activator-receptor-alpha-alters-spinal-neuronal-firing-in-a-rodent-model-of-neuropathic-pain
#2
Bright N Okine, Clare Spicer, Paul Millns, Andrew Bennett, Victoria Chapman
Background and aims The clinical management of chronic neuropathic pain remains a global health challenge. Current treatments are either ineffective, or associated with unwanted side-effects. The development of effective, safe therapies requires the identification of novel therapeutic targets using clinically relevant animal models of neuropathic pain. Peroxisome proliferator activated receptor alpha (PPARα), is a member of the nuclear hormone family of transcription factors, which is widely distributed in the peripheral and central nervous systems...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29889356/spinal-cord-stimulation-scs-trial-outcomes-after-conversion-to-a-multiple-waveform-scs-system
#3
Nameer Haider, Dwight Ligham, Brett Quave, Kirk E Harum, Eduardo A Garcia, Christopher A Gilmore, Nathan Miller, Gregory A Moore, Amarpreet Bains, Kristen Lechleiter, Roshini Jain
OBJECTIVE: Spinal cord stimulation (SCS) for chronic intractable pain is typically delivered in pulses, classically programmed between approximately 20 and 100 Hz. Though some recent studies suggest that better pain relief is obtained, with only 10 kHz stimulation, other studies show that single-therapy trials do not always lead to permanent implantation. We evaluated SCS outcomes in subjects given trials with multiple waveforms who did not experience satisfactory trial relief with 10 kHz stimulation only...
June 11, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29882581/icu-delirium-a-diagnostic-and-therapeutic-challenge-in-the-intensive-care-unit
#4
Katarzyna Kotfis, Annachiara Marra, Eugene Wesley Ely
Many patients treated in the intensive care unit (ICU) experience pain, that is a source of suffering and leaves a long-term imprint (chronic pain, post-traumatic stress disorder). Nearly 30% of patients experience pain at rest, the percentage increases to 50% during nursing procedures. Pain in ICU patients can be divided into four categories: continuous ICU treatment-related pain/discomfort, acute illness-related pain, intermittent procedural pain and pre-existing chronic pain present before ICU admission...
June 8, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29878893/the-use-and-utility-of-low-dose-naltrexone-capsules-for-patients-with-fibromyalgia
#5
Brianna Cote, Bethany Ross, Jeff Fortner, Deepa Rao
Fibromyalgia is a syndrome associated with chronic, widespread musculoskeletal pain, fatigue, depression, and cognitive dysfunction. With few U.S. Food and Drug Administration-approved treatment options, there is evidence that low-dose naltrexone, an opioid antagonist approved for opioid and alcohol dependence at high doses, may have efficacy in the treatment of fibromyalgia and chronic pain. At the doses required for fibromyalgia treatment, naltrexone needs to be compounded, and no data currently exists regarding the long-term stability of low-dose naltrexone capsules...
May 2018: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/29808107/subjective-experiences-and-sensitivities-in-women-with-fibromyalgia-a-quantitative-and-comparative-study
#6
P De Roa, P Paris, J L Poindessous, O Maillet, A Héron
Fibromyalgia is a chronic widespread pain syndrome associated with chronic fatigue. Its pathogenesis is not clearly understood. This study presents subjective experiences and sensitivities reported by fibromyalgia patients, which should be considered in primary care to avoid medical nomadism, as well as stigmatization of the patients. The prevalence of significant characteristics was compared with others patients consulting at the same pain unit who suffer from rebel and disabling form of chronic migraine. Psychometric tests were anonymously completed by 78 patients of the Pain Unit (44 fibromyalgia patients and 34 migraine patients)...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29787472/a-randomised-placebo-controlled-clinical-trial-with-the-%C3%AE-2-3-5-subunit-selective-gabaa-positive-allosteric-modulator-pf-06372865-in-patients-with-chronic-low-back-pain
#7
Rachel Gurrell, Pinky Dua, Gang Feng, Maria Sudworth, Mark Whitlock, David S Reynolds, Richard P Butt
The effect of PF-06372865, a subtype selective positive allosteric modulator (PAM) of the γ-aminobutyric acid type A (GABAA) receptor, on chronic low back pain was investigated in a randomised, placebo and active-controlled Phase 2 clinical trial. The parallel treatment group trial consisted of a 1 week single-blind placebo run in phase, followed by 4 weeks double-blind treatment. Patients were randomised to receive either PF-06372865, naproxen or placebo BID for 4 weeks. The primary endpoint was the numerical rating score (NRS) of low back pain intensity (LBPI) after 4 weeks of active treatment...
May 21, 2018: Pain
https://www.readbyqxmd.com/read/29784054/systematic-literature-review-and-assessment-of-patient-reported-outcome-instruments-in-sickle-cell-disease
#8
Grammati Sarri, Menaka Bhor, Seye Abogunrin, Caroline Farmer, Savita Nandal, Rashid Halloway, Dennis A Revicki
BACKGROUND: Sickle cell disease (SCD) is a chronic condition associated with high mortality and morbidity. It is characterized by acute clinical symptoms such as painful vaso-occlusive crises, which can impair health-related quality of life (HRQL). This study was conducted to identify validated patient-reported outcome (PRO) instruments for use in future trials of potential treatments for SCD. METHODS: A systematic literature review (SLR) was performed using MEDLINE and EMBASE to identify United States (US)-based studies published in English between 1997 and 2017 that reported on validated PRO instruments used in randomized controlled trials and real-world settings...
May 21, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29756097/evaluation-of-stressors-in-intensive-care-units
#9
Yücel Gültekin, Zerrin Özçelik, Seda Banu Akıncı, Halil Kaya Yorgancı
Objective: Physical and psychological stressors adversely affect the treatment and length of stay of patients in intensive care units. In this study, we aimed to describe environmental and psychological stressors affecting intensive care unit patients and to determine their priorities. Material and Methods: In this study, the 40-item Intensive Care Unit Environmental Stressor Scale was administered to patients in the General Surgery Intensive Care Unit and the Anesthesiology and Reanimation Intensive Care Unit...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29738296/microcurrent-as-an-adjunct-therapy-to-accelerate-chronic-wound-healing-and-reduce-patient-pain
#10
Harikrishna K R Nair
OBJECTIVE: The primary aim is to assess the efficacy of microcurrent, a form of electrical stimulation, as an adjunct therapy in accelerating healing in chronic wounds by reducing wound size and pain level. The secondary aim is to assess the qualitative changes in these parameters: inflammatory symptoms, vasodilation, sleep quality, gait and frequency of bowel movement. METHOD: Eligible patients with chronic wounds were enrolled between March and June 2016, from the Wound Care Unit, Hospital Kuala Lumpur in this consecutive case series...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29718816/a-post-marketing-surveillance-study-of-chronic-wounds-treated-with-a-native-collagen-calcium-alginate-dressing
#11
Matthew Sabo, Lam Le, Raphael A Yaakov, Marissa Carter, Thomas E Serena
Chronic wounds (ie, wounds that fail to progress through a normal, orderly, timely sequence of repair) continue to pose significant clinical and economic burdens. A prospective, descriptive, 3-week post-marketing surveillance study was conducted across 3 wound care centers in the United States to evaluate the effectiveness of a collagen calcium alginate dressing on chronic wounds in conjunction with standard care (SC) practices (eg, offloading, debridement, compression) to support healing. Eligible participants had to be >18 years of age, have at least 1 chronic wound, and no known sensitivity to collagen...
April 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29706237/-pathway-to-diagnosis-and-real-life-experience-of-patients-believing-they-are-affected-by-chronic-lyme-disease
#12
E Forestier, F Gonnet, A Revil-Signorat, A C Zipper
OBJECTIVES: Chronic Lyme disease is a subject of scientific and social controversy in both Europe and the United States. The aim of our study was to analyze the pathway to diagnosis of patients believing they were affected by the disease, and to describe their real-life experience. METHOD: A qualitative study was performed with 13 patients declaring themselves to be affected by chronic Lyme disease. Interviews were analyzed by 2 general medical practice interns, supervised by a general practitioner with a diploma in socio-anthropology and an infectious diseases specialist...
April 26, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29704880/feasibility-randomized-controlled-trial-of-online-acceptance-and-commitment-therapy-for-patients-with-complex-chronic-pain-in-the-united-kingdom
#13
W Scott, J Chilcot, B Guildford, A Daly-Eichenhardt, L M McCracken
BACKGROUND: Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified. METHODS: Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone...
April 28, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29700963/reduction-in-pain-is-it-worth-the-gain-the-effect-of-opioids-on-the-gi-tract
#14
REVIEW
J Nee, V Rangan, A Lembo
The use of opioid medications for acute and chronic pain has increased significantly in the past 20 years in the United States. Given the high density of opioid receptors in the gastrointestinal tract, side effects are common in these patients including constipation, dysphagia, bloating, nausea, and vomiting. These side effects, which are experienced by most patients who take opioids, can lead to significant impairment in quality of life. Unlike other side effects from opioids, gastrointestinal side effects do not diminish with continued use, often leading patients to reduce or discontinue their opioid treatment to relieve these side effects...
May 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29699418/role-of-early-palliative-care-interventions-in-hematological-malignancies-and-bone-marrow-transplant-patients-barriers-and-potential-solutions
#15
Marco Ruiz, Patrick Reynolds, Regina Marranzini, Alina Khan, Jessica Ketterer, Amanda Brahim
INTRODUCTION: Despite advances in palliative care management of physical, psychological, and emotional symptoms along the spectrum of chronic conditions, early palliative care interventions are not used frequently and comprehensively in bone marrow transplant units. METHODS: The literature review of PubMed articles in English published until December 2017. RESULTS: Patients with hematologic malignancies and bone marrow transplant interventions are a heterogeneous group...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29696128/electromyographic-findings-after-epidural-steroid-injections-in-patients-with-radicular-low-back-pain-a-prospective-open-label-study
#16
Chrysanthi Batistaki, Athina Angelopoulou, Maria-Eleni Smyrnioti, Maria-Chrysanthi Kitsou, Georgia Kostopanagiotou
Epidural steroid injections (ESIs) are commonly used in the management of chronic lower back and leg pain. The aim of this study was to investigate the short- and long-term electromyographic and clinical outcome of patients with chronic radicular pain after ESIs. This prospective, open-label study, included patients with chronic radicular pain due to disc herniation or spinal stenosis, who underwent interlaminar, fluoroscopy-guided ESIs. Patients were assessed before ESIs, as well as after 6 and 12 months, clinically (VAS 0-10, BPI, DN4, Rolland Morris, DASS, STAI) and electromyographically for the improvement of spontaneous activity (SA) and of motor unit recruitment/interference pattern (IP/MUR)...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29681639/effectiveness-of-surgical-treatment-in-chronic-migraine
#17
Francisco Javier Amaya-Blas, Gabriel A Mecott, Alejandro Marfil-Rivera, María de Lourdes Tamayo-Esquivel, Mauricio Manuel García-Pérez, Hernán Chacón-Moreno, Sergio Pérez-Porras, Rosa Coutiño, Yanko Castro-Góvea
Objective: Migraine affects more than 35 million people in the United States of America, and 10% of the population in the world. The purpose of this study was to evaluate the effectiveness of surgical treatment in chronic migraine with frontal or occipital trigger areas. Methods: We designed a pilot, proof of concept, and prospective study to analyze the effectiveness of surgical release of trigger nerves in severe frontal or occipital chronic migraines. The study was approved by the Ethics and Investigation Committee of Hospital Universitario Dr...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29671505/care-of-the-colorectal-cancer-survivor
#18
Kristina Burgers, Clint Moore, Lori Bednash
Colorectal cancer is the fourth most common cancer in the United States and has a five-year survival rate of 65%. The American Cancer Society and other experts have released guidelines on surveillance, health promotion, screening for other malignancies, and management of treatment effects. Surveillance for disease recurrence should occur every three to six months for the first two to three years, then every six months for a total of five years. Each visit should include a history and physical examination, routine care for chronic medical conditions, and screening for other primary cancers according to guidelines for the general population...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#19
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29652682/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...
April 15, 2018: A&A practice
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