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https://www.readbyqxmd.com/read/29474345/opioid-related-genetic-polymorphisms-do-not-influence-postoperative-opioid-requirement-a-prospective-observational-study
#1
Frédéric Aubrun, Noël Zahr, Olivier Langeron, Nicolas Boccheciampe, Nathalie Cozic, Lisa Belin, Jean-Sebastien Hulot, Frederic Khiami, Bruno Riou
BACKGROUND: Among the various factors that may influence the pharmacological response to opioids, genetic polymorphisms [single nucleotide polymorphisms (SNP)] have generated some interest. OBJECTIVES: To examine the influence on morphine dose requirements and adverse events in the postoperative period of four SNP [opioid receptor mu1 (OPRM1), ATP-binding cassette subfamily B, member 1 (ABCB1) ex-21 and ex-26, catechol-o-methyltransferase (COMT)] in candidate genes involved in morphine pharmacodynamics and pharmacokinetics...
February 22, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29474216/anesthesia-and-analgesia-for-gynecological-surgery
#2
Allana Munro, Ana Sjaus, Ronald B George
PURPOSE OF REVIEW: High-quality analgesia has been linked to improved patient satisfaction as well as improved short-term and long-term postoperative outcomes. Acute surgical pain is a modifiable risk factor for development of chronic postoperative pain, which is reported by up to 26% of gynecologic surgical patients. In other surgical populations, multimodal analgesia has shown improved pain control and decreased reliance on opioids. This review examines recent evidence for various analgesic modalities applied specifically to the gynecologic surgical population...
February 22, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29473770/exploring-factors-contributing-to-medication-errors-with-opioids-in-australian-specialist-palliative-care-inpatient-services-a-multi-incident-analysis
#3
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
BACKGROUND: Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorbidities. Understanding factors contributing to opioid errors in inpatient palliative care services is a largely underexplored, yet, essential aspect of patient safety...
February 23, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29473323/adult-spinal-opioid-receptor-%C3%A2%C2%B51-expression-after-incision-is-altered-by-early-life-repetitive-tactile-and-noxious-procedures-in-rats
#4
Nynke J van den Hoogen, Roel Ri van Reij, Jacob Patijn, Dick Tibboel, Elbert Aj Joosten
Clinical and experimental data suggests that noxious stimulation at critical stages of development results in long-term changes on nociceptive processing in later life. Here, we use an established, well-documented rat model of repetitive noxious procedures closely mimicking the clinical situation in the NICU. In order to understand molecular changes underlying the long-term consequences of repetitive stimulation of the developing nociceptive system the present study aims to analyse the presence of the µ-opioid-receptor-1 (OPRM1)...
February 22, 2018: Developmental Neurobiology
https://www.readbyqxmd.com/read/29472948/craving-and-drug-reward-a-comparison-of-celecoxib-and-ibuprofen-in-detoxifying-opiate-addicts
#5
Sara Jafari, Sana Khajehpour, Emran Mohammad Razzaghi, Kazem Heidari, Mehdi Soleimani, Padideh Ghaeli
Objective: Craving for substance abuse is a usual and complicated problem in patients, with opioid addiction who are in opioid detoxifying process. Craving has been added as one of the diagnostic criteria of substance use disorders in DSM-5. The present trial aimed at comparing the effects of celecoxib versus ibuprofen in reducing pain and decreasing the desire to use opiates in patients undergoing opiate detoxification (n = 32). Method: A total of 32 patients (both inpatients and outpatients), who were undergoing opiate detoxification procedure and met the inclusion criteria entered this 4- week study...
October 2017: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/29472575/glial-cell-type-specific-changes-in-spinal-dipeptidyl-peptidase-4-expression-and-effects-of-its-inhibitors-in-inflammatory-and-neuropatic-pain
#6
Kornél Király, Márk Kozsurek, Erika Lukácsi, Benjamin Barta, Alán Alpár, Tamás Balázsa, Csaba Fekete, Judit Szabon, Zsuzsanna Helyes, Kata Bölcskei, Valéria Tékus, Zsuzsanna E Tóth, Károly Pap, Gábor Gerber, Zita Puskár
Altered pain sensations such as hyperalgesia and allodynia are characteristic features of various pain states, and remain difficult to treat. We have shown previously that spinal application of dipeptidyl peptidase 4 (DPP4) inhibitors induces strong antihyperalgesic effect during inflammatory pain. In this study we observed low level of DPP4 mRNA in the rat spinal dorsal horn in physiological conditions, which did not change significantly either in carrageenan-induced inflammatory or partial nerve ligation-generated neuropathic states...
February 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29472515/development-of-a-standardized-approach-for-managing-opioids-in-adults-with-chronic-noncancer-pain
#7
Jessica M Downes, Donald G Klepser, Jennifer Foster, Maggie Nelson
PURPOSE: The implementation of a chronic pain protocol (CPP) and its effects on the management of long-term opioid therapy are described. SUMMARY: The CPP used at a federally qualified health center and primary care clinic was updated in 2015 and included a prescribing ceiling in morphine equivalent dose (MED) per day and standardized the prescribing of chronic opioids. Intermittent urine drug screening performed at least once annually was added as a requirement of the pain management contract between the provider and the patient...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29472016/opioid-use-in-gynecologic-oncology-in-the-age-of-the-opioid-epidemic-part-i-effective-opioid-use-across-clinical-settings-a-society-of-gynecologic-oncology-evidence-based-review
#8
Carolyn Lefkowits, Mary K Buss, Amin A Ramzan, Stacy Fischer, Renata R Urban, Christine M Fisher, Linda R Duska
As the only oncologists that provide both medical and surgical oncologic care, gynecologic oncologists encounter an exceptionally broad range of indications for prescribing opioids, from management of acute post-operative pain to chronic cancer-related pain to end-of-life care. If we are to balance opioid efficacy, safety and accessibility for our patients, we must be intimately familiar with appropriate clinical use of opioids in a range of settings, and engage in the national conversation around opioid misuse and how associated regulations and legislation may impact us and our patients...
February 20, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29471504/anodyne-by-design-measuring-the-prevalence-of-esoteric-designer-opioids-in-pain-management-patients
#9
Melissa M Goggin, Stephanie D Gozum, Anna Miller, Gregory C Janis
The recent increase in illicit opioids sold on the black market, cut into heroin and masqueraded as prescription pills prompts a significant public health concern. Most designer opioids possess unknown potencies and unknown pharmacokinetics and their unregulated, variable dosages lead to rashes of overdoses. Additionally, many of the designer opioids, especially the fentanyl analogs are significantly more potent than heroin. High-profile cases involving overdoses of U-47700 and carfentanil have been reported in the media; however, the true prevalence of these and other designer opioids is unknown...
February 17, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29470801/episodic-breathlessness-in-patients-with-advanced-cancer-characteristics-and-management
#10
REVIEW
Sebastiano Mercadante
The aim of this review is to present the way in which episodic breathlessness (EB) has been recognized over the years, with regard to definition, characteristics, and management of these acute episodes that have serious consequences for patients. EB is characterized by a sudden increase in intensity of dyspnea over a short duration of time, leading to high levels of anxiety. A significant aggravation of dyspnea may occur in patients with a background of dyspnea or intermittently even without basal breathlessness...
February 22, 2018: Drugs
https://www.readbyqxmd.com/read/29470180/opioid-abuse-or-dependence-increases-30-day-readmission-rates-after-major-operating-room-procedures-a-national-readmissions-database-study
#11
Atul Gupta, Junaid Nizamuddin, Dalia Elmofty, Sarah L Nizamuddin, Avery Tung, Mohammed Minhaj, Ariel Mueller, Jeffrey Apfelbaum, Sajid Shahul
BACKGROUND: Although opioids remain the standard therapy for the treatment of postoperative pain, the prevalence of opioid misuse is rising. The extent to which opioid abuse or dependence affects readmission rates and healthcare utilization is not fully understood. It was hypothesized that surgical patients with a history of opioid abuse or dependence would have higher readmission rates and healthcare utilization. METHODS: A retrospective cohort analysis was performed of patients undergoing major operating room procedures in 2013 and 2014 using the National Readmission Database...
February 22, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29470146/towards-an-effective-peripheral-visceral-analgesic-responding-to-the-national-opioid-crisis
#12
Michael Camilleri
This is an editorial summarizing recent new developments in visceral analgesics. This promising field is important as a new approach to address abdominal pain with peripheral visceral analgesics is considered a key approach to addressing the current opioid crisis. Some of the novel compounds address peripheral pain mechanisms through modulation of opioid receptors through biased ligands, nociceptin/orphanin FQ opioid peptide (NOP) receptor or dual action on NOP and μ-opioid receptor, buprenorphine and morphiceptin analogs...
February 22, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29470104/association-between-utilization-of-chiropractic-services-for-treatment-of-low-back-pain-and-use-of-prescription-opioids
#13
James M Whedon, Andrew W J Toler, Justin M Goehl, Louis A Kazal
OBJECTIVE: Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications. DESIGN: The authors used a retrospective cohort design to analyze health insurance claims data. SETTING: The data source was the all payer claims database administered by the State of New Hampshire...
February 22, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29468854/differential-effects-of-oxycodone-and-venlafaxine-on-resting-state-functional-connectivity-a-randomized-placebo-controlled-magnetic-resonance-imaging-study
#14
Tine M Hansen, Dina Lelic, Anne E Olesen, Asbjørn Mohr Drewes, Jens B Frøkjaer
AIM: Different mechanisms may be involved in the antinociceptive effects of oxycodone (opioid) and venlafaxine (serotonin-norepinephrine reuptake inhibitor), and the aim of this study was to investigate the effect of these drugs on brain functional connectivity. METHODS: Resting state functional magnetic resonance imaging was acquired in 20 healthy volunteers before and after a 5-day treatment with oxycodone, venlafaxine, or placebo in a randomized, double-blind, crossover study...
February 21, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29468702/identifying-optimal-dosage-regimes-under-safety-constraints-an-application-to-long-term-opioid-treatment-of-chronic-pain
#15
Eric B Laber, Fan Wu, Catherine Munera, Ilya Lipkovich, Salvatore Colucci, Steve Ripa
There is growing interest and investment in precision medicine as a means to provide the best possible health care. A treatment regime formalizes precision medicine as a sequence of decision rules, one per clinical intervention period, that specify if, when and how current treatment should be adjusted in response to a patient's evolving health status. It is standard to define a regime as optimal if, when applied to a population of interest, it maximizes the mean of some desirable clinical outcome, such as efficacy...
February 21, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29468561/chronic-pain-in-medullary-sponge-kidney-a-rare-and-never-described-clinical-presentation
#16
G Gambaro, D S Goldfarb, R Baccaro, J Hirsch, N Topilow, S D'Alonzo, G Gambassi, P M Ferraro
Medullary sponge kidney (MSK) is a cause of nephrocalcinosis, associated with hematuria, renal colic, pyelonephritis. There are rare and atypical MSK cases characterized by chronic severe pain (CP), whose features are unknown, in particular the relationship with the stone disease activity. This study analyzes a cohort of MSK-CP patients belonging to three North-America self-support Facebook groups. Patients had to self-administer an on-line questionnaire (on intensity, progression and MSK-associated conditions, stone-related disease, pain features, drug use), the Brief Pain Inventory, the Fatigue Severity Score, and Wisconsin Quality of Life (WQL) in stone formers questionnaires...
February 21, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29468508/ultrasound-guided-bilateral-superficial-cervical-block-and-preemptive-single-dose-oral-tizanidine-for-post-thyroidectomy-pain-a-randomized-controlled-double-blind-study
#17
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Aysenur Dostbil, Omer Doymus, Erdem Karadeniz, Muhammet Ali Ari, Furkan Sengoz, Haci Ahmet Alici, Erkan Cem Celik
PURPOSES: The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery. METHODS: Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n = 20) received BSCPB with 0...
February 21, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29467148/controlling-postoperative-use-of-i-v-acetaminophen-at-an-academic-medical-center
#18
William R Vincent, Paul Huiras, Jennifer Empfield, Kevin J Horbowicz, Keith Lewis, David McAneny, David Twitchell
PURPOSE: Results of an interprofessional formulary initiative to decrease postoperative prescribing of i.v. acetaminophen are reported. SUMMARY: After a medical center added i.v. acetaminophen to its formulary, increased prescribing of the i.v. formulation and a 3-fold price increase resulted in monthly spending of more than $40,000, prompting an organizationwide effort to curtail that cost while maintaining effective pain management. The surgery, anesthesia, and pharmacy departments applied the Institute for Healthcare Improvement's Model for Improvement to implement (1) pharmacist-led enforcement of prescribing restrictions, (2) retrospective evaluation of i...
February 21, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29466977/the-rotterdam-elderly-pain-observation-scale-repos-is-reliable-and-valid-for-non-communicative-end-of-life-patients
#19
Anniek D Masman, Monique van Dijk, Joost van Rosmalen, Frans P M Baar, Dick Tibboel, Anneke A Boerlage
BACKGROUND: In palliative care, administration of opioids is often indispensable for pain treatment. Pain assessment may help recognize pain and guide treatment in non-communicative patients. In the Netherlands the Rotterdam Elderly Pain Observation Scale (REPOS) is recommended to this aim, but not yet validated. Therefore the objective of this study was to validate the REPOS in non-communicative or unconscious end-of-life patients. METHODS: In this observational study, the primary researcher applied the REPOS, while both the researcher and a nurse applied the Numeric Rating Scale (NRS)...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29466721/insights-from-molecular-dynamics-simulations-to-exploit-new-trends-for-the-development-of-improved-opioid-drugs
#20
REVIEW
Marta Filizola
Having accidental deaths from opioid overdoses almost quadrupled over the past fifteen years, there is a strong need to develop new, non-addictive medications for chronic pain to stop one of the deadliest epidemics in American history. Given their potentially fewer on-target overdosing risks and other adverse effects compared to classical opioid drugs, attention has recently shifted to opioid allosteric modulators and G protein-biased opioid agonists as likely drug candidates to prevent and/or reverse opioid overdoses...
February 18, 2018: Neuroscience Letters
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