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Acute pain service

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https://www.readbyqxmd.com/read/28940900/successful-control-of-pain-from-malignant-psoas-syndrome-by-spinal-opioid-with-local-anesthetic-agents
#1
Takashi Yamaguchi, Katsuyuki Katayama, Mina Matsumoto, Yoshifumi Sato, Noriko Nakayama, Ko Hisahara
BACKGROUNDS: Malignant psoas syndrome (MPS) is a rare but distressing pain syndrome observed in advanced cancer patients. Pain due to MPS is often refractory to multi-modal analgesic treatment, including opioid analgesics. As only one case demonstrating the efficacy of neuraxial analgesia in managing pain due to MPS has been reported, its role in MPS remains uncertain. CASES: We present three cases demonstrating the successful management of pain due to MPS using spinal opioids with local anesthetic agents...
September 23, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#2
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#3
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#4
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28891060/a-survey-of-acute-pain-services-in-the-uk
#5
M Rockett, R Vanstone, J Chand, D Waeland
The organisational state of inpatient pain management in UK hospitals is difficult to determine. We sent an electronic questionnaire to 209 acute pain service leads throughout the UK. Questions were about staffing and service provision. We received 141 responses (67%); 47% of all UK hospitals. Each service was responsible for a median (IQR [range]) of 566 (400-839 [120-2800]) beds. Each acute pain specialist nurse was responsible for 299 (238-534 [70-1923]) beds. The mean (SD) number of consultant hours per week was 5...
October 2017: Anaesthesia
https://www.readbyqxmd.com/read/28887789/deaths-from-opioid-overdosing-implications-of-coroners-inquest-reports-2008-2012-and-annual-rise-in-opioid-prescription-rates-a-population-based-cohort-study
#6
Elspeth E Shipton, Ashleigh J Shipton, Jonathan A Williman, Edward A Shipton
INTRODUCTION: In the late 1990s multiple physicians and advocacy organizations promoted increased use of opioids for the treatment of acute, chronic and cancer pain. There has been an exponential growth in opioid prescribing in the last 20 years in the United States of America, in Australia, and in other developed Western countries. There are negative consequences associated with the liberal use of opioids. The primary aim of this population-based cohort study is to investigate the opioid-related death rate in New Zealand between 1 January 2008 and 31 December 2012...
September 8, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28871016/health-related-quality-of-life-in-residents-aged-18-years-and-older-with-and-without-disease-findings-from-the-first-provincial-health-services-survey-of-hunan-china
#7
Xin Deng, Peng Dong, Lingling Zhang, Danping Tian, Lin Zhang, Wei Zhang, Li Li, Jing Deng, Peishan Ning, Guoqing Hu
OBJECTIVE: Published research has not considered acute diseases and injuries in assessing the impact of varying disease counts on health-related quality of life (HRQoL). We used Chinese value sets of EQ-5D-3L to examine the relationship between the number of diseases individuals had (including chronic diseases, acute diseases and injuries) and their HRQoL. METHODS: A total of 19 387 individuals aged 18 years and older were included in the study. Using data from the First Provincial Health Services Survey of Hunan, China, HRQoL was assessed with the EQ-5D-3L scale, a standardized instrument developed by the EuroQoL group...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862475/a-survey-of-canadian-interprofessional-student-run-free-clinics
#8
Enoch Ng, Tina Hu
Student-run free clinics (SRFCs) have existed in Canada since 1971, providing interprofessional healthcare to underserved populations. SRFCs are seen as vehicles for socially accountable health professional education. Literature on how Canadian SRFC function is lacking. Web-based surveys were sent to student leaders from Canadian SRFCs regarding their 2014 activities. All six fully-functioning SRFCs responded reporting on the following: services provided, professions involved, governing structure, funding sources, clients seen, types of care sought, students and preceptors involved, as well as perceived strengths, weaknesses, opportunities and threats...
September 1, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28862129/duration-of-intravenous-antibiotic-therapy-for-children-with-acute-osteomyelitis-or-septic-arthritis-a-feasibility-study
#9
Hans de Graaf, Priya Sukhtankar, Barbara Arch, Nusreen Ahmad, Amanda Lees, Abigail Bennett, Catherine Spowart, Helen Hickey, Annmarie Jeanes, Kate Armon, Andrew Riordan, Jethro Herberg, Scott Hackett, Carrol Gamble, Delane Shingadia, Ann Pallett, Stuart C Clarke, Philip Henman, Marieke Emonts, Mike Sharland, Adam Finn, Andrew J Pollard, Colin Powell, Peter Marsh, Claire Ballinger, Paula R Williamson, Nicholas Mp Clarke, Saul N Faust
BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#10
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28842974/economics-of-inhaled-oxygen-use-as-an-acute-therapy-for-cluster-headache-in-the-united-states-of-america
#11
Megan O'Brien, Janet H Ford, Sheena K Aurora, Sriram Govindan, Deborah E Tepper, Stewart J Tepper
BACKGROUND: Cluster headache (CH) is a primary headache disorder associated with low levels of diagnosis and high unmet medical need. The pain attacks, associated anxiety, and fear in anticipation of the attacks are extremely debilitating to a patient with CH. For acute therapy, treatment guidelines recommend inhalation of high flow oxygen during the period of an attack. However, the use of oxygen for treatment of CH remains largely underutilized. OBJECTIVES: The objectives of the study, which covered each of the US states, were to map the current market landscape of medical grade oxygen for use in CH and to develop a cost simulator based on a patient's needs and geography...
August 26, 2017: Headache
https://www.readbyqxmd.com/read/28839885/emergency-general-surgery-hot-clinics-reduce-admission-rates-and-duration-of-inpatient-stay
#12
Francesca Th'ng, Christos Skouras, Alice Paterson-Brown, Rajan Ravindran, Peter Lamb, Andrew de Beaux, Simon Paterson-Brown, Damian J Mole
OBJECTIVE: To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through. DESIGN: Prospective service evaluation study. SETTING: HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28838932/consultation-for-total-pain-in-high-risk-obstetrics
#13
Warren Mackie-Jenkins, Regina M Tosca, Hunter Groninger
Palliative care (PC) consultation rarely takes place in the clinical setting of high-risk obstetrics, where 'total pain' may be undermanaged. Here, we present a case of a young woman carrying twins and hospitalised for acute abdominal pain. Workup for her pain revealed non-viable fetal tissue positioned in the uterine horn; the remaining fetus was viable. Initial attempts to control the patient's pain with strong parenteral opioids by the obstetrics team and the acute pain service failed. The PC service was consulted to assist...
August 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28831330/impact-of-traumatic-lower-extremity-injuries-beyond-acute-care-movement-based-considerations-for-resultant-longer-term-secondary-health-conditions
#14
REVIEW
Courtney M Butowicz, Christopher L Dearth, Brad D Hendershot
Significance: Advances in field-based trauma care, surgical techniques, and protective equipment have collectively facilitated the survival of a historically large number of service members (SMs) following combat trauma, although many sustained significant composite tissue injuries to the extremities, including limb loss (LL) and limb salvage (LS). Beyond the acute surgical and rehabilitative efforts that focus primarily on wound care and restoring mobility, traumatic LL and LS are associated with several debilitating longer term secondary health conditions (e...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28821891/an-audit-of-829-paediatric-epidurals-in-a-tertiary-singapore-hospital-complications-and-conundrums
#15
Jolin Wong, Serene St Lim
INTRODUCTION: The incidence of complications related to epidural analgesia remains less well defined in the paediatric population as compared to adults. A retrospective review of prospectively collected data was performed to review and quantify risks of both adverse events and complications related to epidural analgesia in our Singaporean paediatric population. MATERIALS AND METHODS: Data from the Acute Pain Service (APS) was prospectively collected over 19 years...
July 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28814263/acute-pain-management-in-hospitalized-children
#16
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/28807443/acute-mass%C3%A4-ve-pulmonary-embolism-assoc%C3%A4-ated-w%C3%A4-th-olanzap%C3%A4-ne-a-case-report
#17
Emine Keles, Sevinc Sarinc Ulasli, Nursel Calik Basaran, Elif Babaoglu, Deniz Koksal
Treatment with low-potency anti-psychotic agents is an important risk factor in the development of pulmonary embolism (PE). We report a case of 74years old female patient receiving olanzapine for psychotic depression admitted to the emergency service with the complaints of chest pain and shortness of breath. She had tachypnea, hypotension and tachycardia. Arterial blood gas analysis showed hypoxemia-hypocapnia and D-dimer level was high. Computed tomographic pulmonary angiography (CTPA) demonstrated pulmonary embolism in both main pulmonary arteries, through lobar and segmental branches...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28802544/a-role-of-the-endothelial-nitric-oxide-system-in-acute-renal-colic-caused-by-ureteral-stone
#18
Emre Bulbul, Elif Funda Sener, Nahide Ekici Gunay, Bahadir Taslidere, Elif Taslidere, Serhat Koyuncu, Nurullah Gunay
BACKGROUND AND AIMS: Endothelial nitric oxide synthase gene polymorphisms play a role in some pathophysiological processes. In this study, the possible effects of endothelial nitric oxide synthase gene polymorphisms on ureteral stone disease in patients who were admitted to the emergency department with severe pain due to renal colic are examined. MATERIALS AND METHODS: The study groups were designed as controls and patients. The control group was formed from the healthy volunteers who applied to the blood center next to the emergency service...
August 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28795967/the-perioperative-surgical-home-a-new-role-for-the-acute-pain-service
#19
Michael P Zaccagnino, Angela M Bader, Christine N Sang, Darin J Correll
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28790344/morbidity-pattern-of-traditional-chinese-medicine-primary-care-in-the-hong-kong-population
#20
Wendy Wong, Cindy Lo Kuen Lam, Xiang Zhao Bian, Zhang Jin Zhang, Sze Tuen Ng, Shong Tung
Primary care manages >90% of illnesses requiring medical services in Hong Kong, in which 9,513 registered Chinese medicine practitioners (CMPs) provide 8.2% of the consultations. This is the first study aimed to determine the morbidity pattern in different Traditional Chinese Medicine (TCM) primary care settings in Chinese population. 55,312 patients' encounters were classified by the International Classification of Primary Care-2 (ICPC-2) from 260 of CMPs. Mean patient age was 50.5 years, with more females than males (67...
August 8, 2017: Scientific Reports
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