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Pharmacological management

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https://www.readbyqxmd.com/read/28229252/pain-in-patients-with-pancreatic-cancer-prevalence-mechanisms-management-and-future-developments
#1
REVIEW
Andreas I Koulouris, Paul Banim, Andrew R Hart
Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence...
February 22, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28228940/beneficial-effects-of-nonpharmacological-interventions-in-the-management-of-essential-hypertension
#2
REVIEW
Anastasios Vamvakis, Eugenia Gkaliagkousi, Areti Triantafyllou, Eleni Gavriilaki, Stella Douma
Essential hypertension is a major health problem causing excess cardiovascular morbidity and mortality. Management of essential hypertension consists of pharmacological and nonpharmacological interventions. In order to prevent and/or treat hypertension, parameters like nutrition, body weight, and physical exercise should be evaluated and taken under consideration for improvement. A large body of evidence clearly support that the role of salt, alcohol, fruits, and vegetables is important for high blood pressure...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28228331/-efficacy-and-safety-of-available-therapies-in-the-management-of-idiopathic-overactive-bladder-a-systematic-review-of-the-literature
#3
J Moyson, F Legrand, M Vanden Bossche, T Quackels, T Roumeguère
OBJECTIVE: Study the efficacy and adverse events of different pharmacological lines in the treatment of idiopathic overactive bladder (iOAB). METHODS: PubMed research on meta-analyses and randomized controlled trials (RCT) focused on the efficacy and adverse effects of anticholinergics, botulinum toxin and mirabegron since 2005. RESULTS: Ten meta-analyses of anticholinergics were selected; 16 randomized controlled trials (ERC) comparing botulinum toxin A to either anticholinergic or placebo and 10 ERC studying mirabegron...
February 19, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28228096/labour-pain-experiences-and-perceptions-a-qualitative-study-among-post-partum-women-in-ghana
#4
Lydia Aziato, Angela Kwartemaa Acheampong, Kitimdow Lazarus Umoar
BACKGROUND: Women have experienced severe labour pain over the years and various attempts have been made to effectively manage labour pain. However, there is paucity of literature on the labour pain experience and perceptions about labour pain with the contemporary Ghanaian health system. Therefore this study sought to gain an in-depth understanding on labour pain experiences and perceptions of post-partum women. METHODS: The study adopted an exploratory descriptive qualitative approach and collected data through individual interviews...
February 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28228081/the-neurobiology-and-psychiatric-perspective-of-vaginismus-linking-the-pharmacological-and-psycho-social-interventions
#5
Zuri Shahidii Kadir, Hatta Sidi, Jaya Kumar, Srijit Das, Marhani Midin, Najwa Baharuddin
Vaginismus is an involuntary muscle contraction of the outer third of vaginal barrel causing sexual penetration almost impossible. It is generally classified under sexual pain disorder (SPD). In Diagnostic and Statistical Manual, 5th edition, it is classified under the new rubric of Genito-Pelvic Pain/Sexual Penetration Disorder. This fear-avoidance condition poses an ongoing significant challenge to the medical and health professionals due to the very demanding needs in health care despite its unpredictable prognosis...
February 22, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28224836/irritable-bowel-syndrome-in-adults-symptoms-treatment-and-management
#6
Rhian Sunderland
Irritable bowel syndrome (IBS) is a complex functional bowel disorder. It can be difficult to treat because of its presentation with multiple symptoms and aggravating factors. GPs and gastroenterologists regularly see patients return for advice on symptom management. IBS is often misdiagnosed, and is not always managed effectively, despite the guidance available to clinicians. This article aims to inform readers about the symptoms and sub-classifications of IBS and the range of pharmacological and non-pharmacological treatments available, to enable nurses to understand and manage symptoms of the condition in this group of patients...
February 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28224474/pain-severity-and-pharmacologic-pain-management-among-community-living-older-adults-the-mobilize-boston-study
#7
Ampicha Nawai, Suzanne G Leveille, Robert H Shmerling, Guusje van der Leeuw, Jonathan F Bean
BACKGROUND: Concerns about polypharmacy and medication side effects contribute to undertreatment of geriatric pain. This study examines use and effects of pharmacologic treatment for persistent pain in older adults. METHODS: The MOBILIZE Boston Study included 765 adults aged ≥70 years, living in the Boston area, recruited from 2005 to 2008. We studied 599 participants who reported chronic pain at baseline. Pain severity, measured using the Brief Pain Inventory (BPI) severity subscale, was grouped as very mild (BPI <2), mild (BPI 2-3...
February 21, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28224284/complementary-and-alternative-medicine-use-in-rheumatoid-arthritis-considerations-for-the-pharmacological-management-of-elderly-patients
#8
REVIEW
Sizheng Zhao, Fred Otieno, Asan Akpan, Robert J Moots
Complementary and alternative medicines (CAMs) are widely used by patients with rheumatoid arthritis (RA); however, a significant proportion of these patients do not inform their physicians. This has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities and polypharmacy of potentially toxic drugs. CAM usage may affect compliance and pharmacokinetics of conventional therapy for RA and comorbidities; therefore, physicians should engage patients in dialogues regarding CAM usage...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28223446/management-of-nonalcoholic-fatty-liver-disease-in-patients-with-type-2-diabetes-a-call-to-action
#9
REVIEW
Fernando Bril, Kenneth Cusi
Traditionally a disease of hepatologists, nonalcoholic fatty liver disease (NAFLD) has recently become a major concern for a broad spectrum of health care providers. Endocrinologists and those caring for patients with type 2 diabetes mellitus (T2DM) are at center stage, as T2DM appears to worsen the course of NAFLD and the liver disease makes diabetes management more challenging. However, the nature of this relationship remains incompletely understood. Although the increasing prevalence of NAFLD is frequently attributed to the epidemic of obesity and is often oversimplified as the "hepatic manifestation of the metabolic syndrome," it is a much more complex disease process that may also be observed in nonobese individuals and in patients without clinical manifestations of the metabolic syndrome...
March 2017: Diabetes Care
https://www.readbyqxmd.com/read/28223068/parasite-control-and-skeletal-myositis-in-trypanosoma-cruzi-infected-and-exercised-rats
#10
Rômulo D Novaes, Reggiani V Gonçalves, Arlete R Penitente, Marli C Cupertino, Izabel R S C Maldonado, André Talvani, Antônio J Natali
Non-pharmacological strategies have been rarely described in the treatment of infectious diseases. Although exercise training has been recently incorporated in the clinical management of Chagas disease, the rationale basis that supports this indication is poorly understood. Thus, we investigated the effect of an aerobic exercise on the parasitism, inflammation and oxidative tissue damage in a murine model of Trypanosoma cruzi-induced skeletal myositis. Wistar rats were randomized into four groups: trained not infected (TNI) and infected (TI), sedentary not infected (SNI) and infected (SI)...
February 18, 2017: Acta Tropica
https://www.readbyqxmd.com/read/28222706/low-intensity-interventions-for-obsessive-compulsive-disorder-ocd-a-qualitative-study-of-mental-health-practitioner-experiences
#11
Judith Gellatly, Rebecca Pedley, Christine Molloy, Jennifer Butler, Karina Lovell, Penny Bee
BACKGROUND: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach...
February 22, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28222472/telemedizin-chancen-in-der-schmerztherapie
#12
Carla Nau
Pain is generally undertreated and there is a need to differentiate and improve access to appropriate pain care. The growing Field of telehealth offers a novel opportunity for pain care, exploiting mainly communicative and pharmacological therapeutic principles. Rationale for telemedicine for the management of chronic pain are the potential to overcome timely, economical, and structural barriers for the access to specialized pain care as well as the general open mindedness of physicians and patients towards this technology...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28221313/systematic-review-and-meta-analysis-of-interventions-for-depression-and-anxiety-in-persons-with-rheumatoid-arthritis
#13
Kirsten M Fiest, Carol A Hitchon, Charles N Bernstein, Christine A Peschken, John R Walker, Lesley A Graff, Ryan Zarychanski, Ahmed Abou-Setta, Scott B Patten, Jitender Sareen, James Bolton, Ruth Ann Marrie
BACKGROUND: Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately treating these comorbidities, disease-specific outcomes and quality of life may be improved. OBJECTIVE: The aim of this study was to systematically review the literature from controlled trials of treatments for depression and anxiety in persons with RA. METHODS: We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication...
February 17, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28220940/pharmacologic-conversion-during-dofetilide-treatment-for-persistent-atrial-fibrillation
#14
Jonathan S Steinberg, Yash Shah, Barbara Szepietowska
BACKGROUND: Dofetilide is a pure IKr blocker and is one of the few drugs specifically studied and approved in the United States for the management of persistent AF. Dofetilide has been noted to have a high rate of pharmacologic conversion during initial dosing in prior smaller studies. The intent of the study was to examine the safety of an inpatient loading strategy, and the incidence and patterns of pharmacologic conversion by dofetilide during the treatment of persistent AF in a large consecutive cohort...
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#15
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#16
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28219657/non-pharmacological-treatments-for-pain-relief-tens-and-acupuncture
#17
Anne Coutaux
Acupuncture and transcutaneous electrical nerve stimulation (TENS) are nonpharmacological methods that have been used for millennia to relieve pain. As with all complementary treatments, efficacy evaluations face two hurdles: the non-feasibility of double blinding and the difficulty in identifying the optimal control population or treatment. Nevertheless, recent studies of good methodological quality have demonstrated benefits in many types of pain compared to conventional treatment. The mechanisms of action of acupuncture and TENS, which are increasingly well understood, involve endogenous pain control systems, cerebral plasticity, and nonspecific effects (e...
February 17, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28217445/the-controversy-surrounding-penile-rehabilitation-after-radical-prostatectomy
#18
REVIEW
Jonathan Clavell-Hernández, Run Wang
Radical prostatectomy (RP) techniques have been refined in the last few decades. Despite nerve-sparing surgery, erectile dysfunction (ED) still seems to be affecting more than half of patients undergoing RP. Penile rehabilitation consists of understanding the mechanisms that affect erectile function (EF) and utilizing pharmacologic agents, devices or interventions to promote male sexual function before and after any insult to the penile erectile physiologic axis. There currently is a limited amount of clinical trials that assess treatments with the goal of recovering post-prostatectomy EF...
February 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28217390/management-of-aneurysmal-subarachnoid-hemorrhage-state-of-the-art-and-future-perspectives
#19
REVIEW
Giovanni Grasso, Concetta Alafaci, R Loch Macdonald
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of strokes and carries a poor prognosis. It affects around 6 cases per 100,000 patient years occurring at a relatively young age. METHODS: Common risk factors are the same as for stroke, and only in a minority of the cases, genetic factors can be found. The overall mortality ranges from 32% to 67%, with 10-20% of patients with long-term dependence due to brain damage. An explosive headache is the most common reported symptom, although a wide spectrum of clinical disturbances can be the presenting symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216948/averrhoa-bilimbi-linn-a-review-of-its-ethnomedicinal-uses-phytochemistry-and-pharmacology
#20
REVIEW
Alhassan Muhammad Alhassan, Qamar Uddin Ahmed
Averrhoa bilimbi Linn. is principally cultivated for medicinal purposes in many tropical and subtropical countries of the world. Literature survey about this plant shows that A. bilimbi is mainly used as a folk medicine in the treatment of diabetes mellitus, hypertension, and as an antimicrobial agent. The prime objective of this review is to accumulate and organize literature based on traditional claims and correlate those with current findings on the use of A. bilimbi in the management of different ailments...
October 2016: Journal of Pharmacy & Bioallied Sciences
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