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https://www.readbyqxmd.com/read/28821939/analgesic-use-in-patients-with-knee-and-or-hip-osteoarthritis-referred-to-an-outpatient-center-a-cross-sectional-study-within-the-amsterdam-osteoarthritis-cohort
#1
Jesper Knoop, Joyce van Tunen, Martin van der Esch, Leo D Roorda, Joost Dekker, Marike van der Leeden, Willem F Lems
Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted...
August 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28821921/anti-nociceptive-effect-of-stigmasterol-in-mouse-models-of-acute-and-chronic-pain
#2
Cristiani Isabel Banderó Walker, Sara Marchesan Oliveira, Raquel Tonello, Mateus Fortes Rossato, Evelyne da Silva Brum, Juliano Ferreira, Gabriela Trevisan
Stigmasterol is a common sterol found in plants, but the anti-nociceptive effect of this compound and its mechanism of action are not fully explored. Thus, in the present study, the anti-nociceptive effect of stigmasterol was investigated in acute and chronic models of pain and its mechanism of action. We used adult male albino Swiss mice (25-35 g) to observe the anti-nociceptive effect of stigmasterol in acetic-acid writhing test or in complete Freund's adjuvant injection, surgical incision in hind paw, or partial sciatic nerve ligation...
August 18, 2017: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#3
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820793/codeine-plus-acetaminophen-for-pain-after-photorefractive-keratectomy-a-randomized-double-blind-placebo-controlled-add-on-trial
#4
Vinicius B P Pereira, Renato Garcia, Andre A M Torricelli, Adriana Mukai, Samir J Bechara
BACKGROUND: Pain after photorefractive keratectomy (PRK) is significant, and the analgesic efficacy and safety of oral opioids in combination with acetaminophen has not been fully investigated in PRK trials. PURPOSE: To assess the efficacy and safety of the combination of codeine plus acetaminophen (paracetamol) versus placebo as an add-on therapy for pain control after PRK. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial...
August 17, 2017: Cornea
https://www.readbyqxmd.com/read/28820778/src-kinase-inhibition-attenuates-morphine-tolerance-without-affecting-reinforcement-or-psychomotor-stimulation
#5
Fiona A Bull, Daniel T Baptista-Hon, Claire Sneddon, Lisa Wright, Wendy Walwyn, Tim G Hales
BACKGROUND: Prolonged opioid administration leads to tolerance characterized by reduced analgesic potency. Pain management is additionally compromised by the hedonic effects of opioids, the cause of their misuse. The multifunctional protein β-arrestin2 regulates the hedonic effects of morphine and participates in tolerance. These actions might reflect µ opioid receptor up-regulation through reduced endocytosis. β-Arrestin2 also recruits kinases to µ receptors. We explored the role of Src kinase in morphine analgesic tolerance, locomotor stimulation, and reinforcement in C57BL/6 mice...
August 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28820514/topical-opioids-and-antimicrobials-for-the-management-of-pain-infection-and-infection-related-odors-in-malignant-wounds-a-systematic-review
#6
Kathleen Finlayson, Laisa Teleni, Alexandra L McCarthy
PROBLEM IDENTIFICATION: Patients with malignant wounds report pain, distress from odor and exudate, decreased self-esteem, and poor quality of life. This systematic review explores topical opioids, antimicrobials, and odor-reducing agents for preventing or managing malignant wound pain, infection, and odor.
. LITERATURE SEARCH: MEDLINE®, EMBASE, the Cochrane Library, CINAHL®, and reference lists were searched to identify relevant studies.
. DATA EVALUATION: Eligible study designs included interventions with pre- and postintervention data...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28819330/synthesis-and-investigation-of-mixed-%C3%AE-opioid-and-%C3%AE-opioid-agonists-as-possible-bivalent-ligands-for-treatment-of-pain
#7
Ruben S Vardanyan, James P Cain, Saghar Mowlazadeh Haghighi, Vlad K Kumirov, Mary I McIntosh, Alexander J Sandweiss, Frank Porreca, Victor J Hruby
Several studies have suggested functional association between μ-opioid and δ-opioid receptors and showed that μ-activity could be modulated by δ-ligands. The general conclusion is that agonists for the δ-receptor can enhance the analgesic potency and efficacy of μ-agonists. Our preliminary investigations demonstrate that new bivalent ligands constructed from the μ-agonist fentanyl and the δ-agonist enkephalin-like peptides are promising entities for creation of new analgesics with reduced side effects for treatment of neuropathic pain...
March 2017: Journal of Heterocyclic Chemistry
https://www.readbyqxmd.com/read/28818631/topical-medical-cannabis-tmc-a-new-treatment-for-wound-pain-three-cases-of-pyoderma-gangrenosum
#8
Vincent Maida, Jason Corban
Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28817416/nicotinic-modulation-of-descending-pain-control-circuitry
#9
Iboro C Umana, Claire A Daniele, Brooke A Miller, Keith Gallagher, Meghan A Brown, Chandrika Abburi, Peggy Mason, Daniel S McGehee
Along with the well-known rewarding effects, activation of nicotinic acetylcholine receptors (nAChRs) can also relieve pain, and some nicotinic agonists have analgesic efficacy similar to opioids. A major target of analgesic drugs is the descending pain modulatory pathway, including the ventrolateral periaqueductal gray (vlPAG) and the rostral ventromedial medulla (RVM). Although activating nAChRs within this circuitry can be analgesic, little is known about the subunit composition and cellular effects of these receptors, particularly within the vlPAG...
July 3, 2017: Pain
https://www.readbyqxmd.com/read/28817395/echo-pain-curriculum-balancing-mandated-continuing-education-with-the-needs-of-rural-health-care-practitioners
#10
Brian M Shelley, Joanna G Katzman, George D Comerci, Daniel J Duhigg, Cynthia Olivas, Summers Kalishman, Rebecca Monette, Melissa Britt, Lainey Flatow-Trujillo, Sanjeev Arora
Chronic pain is a common problem in the United States. Health care professions training at the undergraduate and graduate levels in managing chronic pain is insufficient. The Chronic Pain and Headache Management TeleECHO Clinic (ECHO Pain) is a telehealth approach at Project ECHO (Extension for Community Healthcare Outcomes), which supports clinicians interested in improving their knowledge and confidence in treating patients with chronic pain and safe opioid management. It is a vehicle for educating practicing clinicians (at the "spoke") based on work-place learning with cases selected by participants from their patient panels combined with short lectures by experts (at the "hub")...
August 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#11
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28815604/chronic-morphine-reduces-the-readily-releasable-pool-of-gaba-a-presynaptic-mechanism-of-opioid-tolerance
#12
Adrianne R Wilson-Poe, Hyo-Jin Jeong, Christopher W Vaughan
The midbrain periaqueductal grey (PAG) plays a critical role in tolerance to the analgesic actions of opioids such as morphine. While numerous studies have identified the postsynaptic adaptations induced by chronic morphine treatment in this and other brain regions, the presence of presynaptic adaptations remains uncertain. We examined GABAergic synaptic transmission within rat PAG brain slices from animals which underwent a low dose morphine treatment protocol which produces tolerance, but not withdrawal. Evoked GABAergic IPSCs (inhibitory postsynaptic currents) were less in morphine compared to control saline treated animals...
August 16, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28814895/caffeine-as-an-opioid-analgesic-adjuvant-in-fibromyalgia
#13
J Ryan Scott, Afton L Hassett, Chad M Brummett, Richard E Harris, Daniel J Clauw, Steven E Harte
BACKGROUND: Caffeine's properties as an analgesic adjuvant with nonsteroidal anti-inflammatory drugs/acetaminophen are well documented. However, little clinical research has explored caffeine's effects on opioid analgesia. This study assessed the effects of caffeine consumption on pain and other symptoms in opioid-using and nonusing chronic pain patients meeting the survey criteria for fibromyalgia. MATERIALS AND METHODS: Patients presenting to a university-based pain clinic completed validated self-report questionnaires assessing symptoms...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28814320/intrathecal-morphine-versus-femoral-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-meta-analysis
#14
Yi Tang, Xu Tang, Qinghua Wei, Hui Zhang
BACKGROUND: This meta-analysis aims to illustrate the efficacy and safety of intrathecal morphine (ITM) versus femoral nerve block (FNB) for pain control after total knee arthroplasty (TKA). METHODS: In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, Cami Info. Inc., Casalini databases, EBSCO databases, Verlag database and Google database. Data on patients prepared for TKA surgery in studies that compared ITM versus FNB for pain control after TKA were collected...
August 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28814263/acute-pain-management-in-hospitalized-children
#15
Ria Dancel, Edmund Allen Liles, Darren Fiore
BACKGROUND: Acute pain in hospitalized pediatric patients is prevalent. Recent shifts in the paradigm of pediatric acute pain management focus less on reliance on opioids, due to their adverse side effects and risk of dependence, and more on multimodal pain management. OBJECTIVE: We sought to review the most recent studies on acute pain management in hospitalized pediatric patients. METHODS: We searched the Cochrane Database and PubMed for articles published in the past five years regarding the treatment of acute pain in pediatric patients focusing on large randomized or quasi-randomized control trials, cohort trials, and meta-analyses...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28814096/ankle-block-vs-single-shot-popliteal-fossa-block-as-primary-anesthesia-for-forefoot-operative-procedures-prospective-randomized-comparison
#16
Oliver N Schipper, Kenneth J Hunt, Robert B Anderson, W Hodges Davis, Carroll P Jones, Bruce E Cohen
BACKGROUND: Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28813550/drug-free-interventions-to-reduce-pain-or-opioid-consumption-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#17
Dario Tedesco, Davide Gori, Karishma R Desai, Steven Asch, Ian R Carroll, Catherine Curtin, Kathryn M McDonald, Maria P Fantini, Tina Hernandez-Boussard
Importance: There is increased interest in nonpharmacological treatments to reduce pain after total knee arthroplasty. Yet, little consensus supports the effectiveness of these interventions. Objective: To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. Data Sources: Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Web of Science (ISI database), Physiotherapy Evidence (PEDRO) database, and ClinicalTrials...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28813190/under-pressure-the-tension-between-access-and-abuse-of-opioids-in-cancer-pain-management
#18
Judith A Paice
No abstract text is available yet for this article.
August 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28811107/local-efficacy-of-periarticular-morphine-injection-in-simultaneous-bilateral-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#19
Kentaro Iwakiri, Yoichi Ohta, Akio Kobayashi, Yukihide Minoda, Hiroaki Nakamura
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to reduce postoperative pain following total knee arthroplasty (TKA). Despite its analgesic effect, it frequently causes nausea, which is an adverse effect of opioids. It is inconclusive whether the intraoperative injection of periarticular morphine is effective peripherally. The aim of this study was to assess whether the addition of morphine to unilateral periarticular knee injections improves postoperative pain, range of motion, and swelling in patients undergoing simultaneous bilateral TKA...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28810899/chronic-pain-and-opioid-misuse-a-review-of-reviews
#20
REVIEW
Pauline Voon, Mohammad Karamouzian, Thomas Kerr
OBJECTIVE: The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse. METHODS: A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Eligible studies were systematic reviews related to chronic non-cancer pain and PO or other substance misuse...
August 15, 2017: Substance Abuse Treatment, Prevention, and Policy
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