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https://www.readbyqxmd.com/read/28103764/multimodal-pediatric-pain-management-part-2
#1
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf speaks to Commissioning Editor Jade Parker: Stefan Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota in Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The pain and palliative care program is devoted to control acute, chronic/complex and procedural pain for inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
January 20, 2017: Pain Management
https://www.readbyqxmd.com/read/28103165/burn-wound-healing-present-concepts-treatment-strategies-and-future-directions
#2
A Oryan, E Alemzadeh, A Moshiri
Burns are the most extensive forms of soft tissue injuries occasionally resulting in extensive and deep wounds and death. Burns can lead to severe mental and emotional distress, because of excessive scarring and skin contractures. Treatment of burns has always been a difficult medical problem and many different methods have been used to treat such injuries, locally. Biofilms are a collection of microorganisms that delay wound healing. One of the new methods of prevention and treatment of burn wound infections is application of antimicrobials, which act on biofilms and prevent the wound infection...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28092666/loss-of-%C3%AE-opioid-receptor-signaling-in-nociceptors-but-not-microglia-abrogates-morphine-tolerance-without-disrupting-analgesia
#3
Gregory Corder, Vivianne L Tawfik, Dong Wang, Elizabeth I Sypek, Sarah A Low, Jasmine R Dickinson, Chaudy Sotoudeh, J David Clark, Ben A Barres, Christopher J Bohlen, Grégory Scherrer
Opioid pain medications have detrimental side effects including analgesic tolerance and opioid-induced hyperalgesia (OIH). Tolerance and OIH counteract opioid analgesia and drive dose escalation. The cell types and receptors on which opioids act to initiate these maladaptive processes remain disputed, which has prevented the development of therapies to maximize and sustain opioid analgesic efficacy. We found that μ opioid receptors (MORs) expressed by primary afferent nociceptors initiate tolerance and OIH development...
January 16, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#4
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28066881/short-acting-erythropoiesis-stimulating-agents-for-anaemia-in-predialysis-patients
#5
REVIEW
Deirdre Hahn, Christopher I Esezobor, Noha Elserafy, Angela C Webster, Elisabeth M Hodson
BACKGROUND: The benefits of erythropoiesis-stimulating agents (ESA) for chronic kidney disease (CKD) patients have been previously demonstrated. However, the efficacy and safety of short-acting epoetins administered at larger doses and reduced frequency as well as of new epoetins and biosimilars remains uncertain. OBJECTIVES: This review aimed to evaluate the benefits and harms of different routes, frequencies and doses of epoetins (epoetin alpha, epoetin beta and other short-acting epoetins) for anaemia in adults and children with CKD not receiving dialysis...
January 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28066733/viscosupplementation-with-intra-articular-hyaluronic-acid-for-hip-disorders-a-systematic-review-and-meta-analysis
#6
Eleonora Piccirilli, Francesco Oliva, Mihaela Aconstantinesei Murè, Asmaa Mahmoud, Calogero Foti, Umberto Tarantino, Nicola Maffulli
BACKGROUND: Hip joint diseases are common in adult population and their prevalence increases with age. Osteoarthritis, rheumatoid arthritis and femoroacetabular impingement are the most common chronic diseases in the hip joint. Viscosupplementation with exogenous hyaluronic acid (HA) is one of the most widely used conservative treatment aiming to improve synovial fluid properties and to decrease pain. There is no global consensus on the type of HA, method of injection and frequency, or on its efficacy in hip joint...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28049368/a-wandering-folded-liver-displaced-by-the-distended-bowel-a-new-case-report-with-review-of-the-literature
#7
Mohamed A Rabie, Charles Godavitarne
INTRODUCTION: The wandering liver is an extremely rare condition in which the liver moves significantly or 'wander' with changes in patient's lie. This is believed to be an acquired condition perhaps precipitated by persistent congenital ventral mesogastrium which acts as an axis or a mesentery for the liver to rotate. The vast majority of reported cases were associated with other chronic abnormalities of the gastrointestinal tract, especially sigmoid volvulus. PATIENTS AND METHODS: We present a case report of an acquired isolated transposition of the liver with a review of the English-language literature of wandering liver in adults and paediatric age group...
January 3, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28039531/stress-and-psychopathology-and-its-impact-on-quality-of-life-in-chronic-anal-fissure-caf-patients
#8
Özden Arısoy, Neriman Şengül, Affan Çakir
BACKGROUND: Chronic anal fissure (CAF) onset, exacerbation, and impact on quality of life are influenced by a host of psychological, physiological, and social factors. We aimed to investigate the difference in psychopathology and stress between normal and CAF groups. METHODS: Thirty CAF patients and 20 age-sex matched healthy controls were evaluated for Axis I psychopathology, depression, anxiety, and stress with Hamilton and Hospital Depression-Anxiety Scales, Perceived Stress Scale, and SF-36...
December 30, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28007501/synergistic-attenuation-of-chronic-pain-using-mu-opioid-and-cannabinoid-receptor-2-agonists
#9
Shaness A Grenald, Madison A Young, Yue Wang, Michael H Ossipov, Mohab M Ibrahim, Tally M Largent-Milnes, Todd W Vanderah
The misuse of prescription opiates is on the rise with combination therapies (e.g. acetaminophen or NSAIDs) resulting in severe liver and kidney damage. In recent years, cannabinoid receptors have been identified as potential modulators of pain and rewarding behaviors associated with cocaine, nicotine and ethanol in preclinical models. Yet, few studies have identified whether mu opioid agonists and CB2 agonists act synergistically to inhibit chronic pain while reducing unwanted side effects including reward liability...
December 20, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/27989636/probing-the-orientation-of-inhibitor-and-epoxy-eicosatrienoic-acid-binding-in-the-active-site-of-soluble-epoxide-hydrolase
#10
Kin Sing Stephen Lee, Niel M Henriksen, Connie J Ng, Jun Yang, Weitao Jia, Christophe Morisseau, Armann Andaya, Michael K Gilson, Bruce D Hammock
Soluble epoxide hydrolase (sEH) is an important therapeutic target of many diseases, such as chronic obstructive pulmonary disease (COPD) and diabetic neuropathic pain. It acts by hydrolyzing and thus regulating specific bioactive long chain polyunsaturated fatty acid epoxides (lcPUFA), like epoxyeicosatrienoic acids (EETs). To better predict which epoxides could be hydrolyzed by sEH, one needs to dissect the important factors and structural requirements that govern the binding of the substrates to sEH. This knowledge allows further exploration of the physiological role played by sEH...
October 28, 2016: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/27984527/agomelatine-a-new-opportunity-to-reduce-neuropathic-pain-preclinical-evidence
#11
Chouki Chenaf, Eric Chapuy, Frédéric Libert, Fabien Marchand, Christine Courteix, Marianne Bertrand, Cecilia Gabriel, Elisabeth Mocaër, Alain Eschalier, Nicolas Authier
Antidepressants are first-line treatments of neuropathic pain but not all these drugs are really effective. Agomelatine is an antidepressant with a novel mode of action, acting as an MT1/MT2 melatonergic receptor agonist and a 5-HT2C receptor antagonist that involves indirect norepinephrine release. Melatonin, serotonin, and norepinephrine have been involved in the pathophysiology of neuropathic pain. Yet, no study has been conducted to determine agomelatine effects on neuropathic pain in animal models. Using 3 rat models of neuropathic pain of toxic (oxaliplatin/OXA), metabolic (streptozocin/STZ), and traumatic (sciatic nerve ligation/CCI [chronic constriction nerve injury]) etiologies, we investigated the antihypersensitivity effect of acute and repeated agomelatine administration...
January 2017: Pain
https://www.readbyqxmd.com/read/27983948/probing-the-orientation-of-inhibitor-and-epoxy-eicosatrienoic-acid-binding-in-the-active-site-of-soluble-epoxide-hydrolase
#12
Kin Sing Stephen Lee, Niel M Henriksen, Connie J Ng, Jun Yang, Weitao Jia, Christophe Morisseau, Armann Andaya, Michael K Gilson, Bruce D Hammock
Soluble epoxide hydrolase (sEH) is an important therapeutic target of many diseases, such as chronic obstructive pulmonary disease (COPD) and diabetic neuropathic pain. It acts by hydrolyzing and thus regulating specific bioactive long chain polyunsaturated fatty acid epoxides (lcPUFA), like epoxyeicosatrienoic acids (EETs). To better predict which epoxides could be hydrolyzed by sEH, one needs to dissect the important factors and structural requirements that govern the binding of the substrates to sEH. This knowledge allows further exploration of the physiological role played by sEH...
January 1, 2017: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/27983881/hysingla%C3%A2-er-a-once-daily-single-entity-hydrocodone-with-abuse-deterrent-properties-in-treating-chronic-nonmalignant-and-nonneuropathic-pain-in-patients-with-osteoarthritis
#13
Louise Taber, Stacy Baldridge, Ellie He, Steven R Ripa
OBJECTIVES: Osteoarthritis (OA)-related chronic pain is associated with physical and psychosocial impairment as well as poorer quality of life. There is limited literature on long-term opioid therapy in OA patients. This post hoc analysis of OA patients assessed the long-term safety and effectiveness of a once-daily, single-entity, extended-release formulation of hydrocodone (HYD) with abuse-deterrent properties for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which other treatment options are inadequate...
January 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27978803/magnesium-in-pain-research-state-of-the-art
#14
Dragana Srebro, Sonja Vučković, Aleksandar Milovanović, Jovan Košutić, Katarina Savić Vujović, Milica Prostran
Magnesium has been shown to produce an antinociceptive effect on animal models of neuropathic and inflammatory pain. It has also been shown to exert an analgesic effect on humans in conditions presenting acute (postoperative pain) and chronic (neuropathic) pain. As it is known that magnesium is a physiological antagonist of the N-methyl-D-aspartate (NMDA) receptor ion channel, and that the NMDA receptor plays a key role in central sensitization, the primary mechanism through which magnesium produces its analgesic effect is believed to be blockade of the NMDA receptor in the spinal cord...
December 12, 2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#15
Kimberly Fernandes, Diana Martins, David Juurlink, Muhammad Mamdani, J Michael Paterson, Luke Spooner, Samantha Singh, Tara Gomes
AIMS: To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN: Interventional time-series analysis. SETTING: Ontario, Canada, from 2003 to 2014. PARTICIPANTS: Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INTERVENTIONS: Publication of Canadian clinical practice guidelines for use of opioids in chronic non-cancer pain (May 2010) and implementation of Ontario's Narcotics Safety and Awareness Act (NSAA; November 2011)...
2016: PloS One
https://www.readbyqxmd.com/read/27964861/pain-opioids-and-sleep-implications-for-restless-legs-syndrome-treatment
#16
Claudia Trenkwalder, Walter Zieglgänsberger, Sam H Ahmedzai, Birgit Högl
Opioid receptor agonists are known to relieve restless legs syndrome (RLS) symptoms, including both sensory and motor events, as well as improving sleep. The mechanisms of action of opioids in RLS are still a matter of speculation. The mechanisms by which endogenous opioids contribute to the pathophysiology of this polygenetic disorder, in which there are a number of variants, including developmental factors, remains unknown. A summary of the cellular mode of action of morphine and its (partial) antagonist naloxone via α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and the involvement of dendritic spine activation is described...
November 5, 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27959272/fetal-syndrome-of-endocannabinoid-deficiency-fsecd-in-maternal-obesity
#17
Natalia Schlabritz-Loutsevitch, Nadezhda German, Gary Ventolini, Eneko Larumbe, Jacques Samson
The theory of a fetal origin of adult diseases links many pathological conditions to very early life events and is known as a "developmental programming" phenomenon. The mechanisms of this phenomenon are not quite understood and have been explained by inflammation, stress, etc. In particular the epidemic of obesity, with more than 64% of women being overweight or obese, has been associated with conditions in later life such as mental disorders, diabetes, asthma, and irritable bowel syndrome. Interestingly, these diseases were classified a decade ago as Clinical Syndrome of Endocannabinoid Deficiency (CECD), which was first described by Russo in 2004...
November 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27941941/potentiation-of-amitriptyline-anti-hyperalgesic-like-action-by-astroglial-connexin-43-inhibition-in-neuropathic-rats
#18
Tiffany Jeanson, Adeline Duchêne, Damien Richard, Sylvie Bourgoin, Christèle Picoli, Pascal Ezan, Franck Mouthon, Christian Giaume, Michel Hamon, Mathieu Charvériat
Antidepressants, prescribed as first line treatment of neuropathic pain, have a limited efficacy and poorly tolerated side effects. Because recent studies pointed out the implication of astroglial connexins (Cx) in both neuropathic pain and antidepressive treatment, we investigated whether their blockade by mefloquine could modulate the action of the tricyclic antidepressant amitriptyline. Using primary cultures, we found that both mefloquine and amitriptyline inhibited Cx43-containing gap junctions, and that the drug combination acted synergically...
December 12, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27933174/a-case-of-hepatitis-c-associated-osteosclerosis-accelerated-bone-turnover-controlled-by-pulse-steroid-therapy
#19
Nobuhiro Miyamura, Shuhei Nishida, Mina Itasaka, Hirofumi Matsuda, Takeshi Ohtou, Yasuhiro Yamaguchi, Daisuke Inaba, Sadahiro Tamiya, Tetsuo Nakano
: Hepatitis C-associated osteosclerosis (HCAO), a very rare disorder in which an extremely rapid bone turnover occurs and results in osteosclerosis, was acknowledged in 1990s as a new clinical entity with the unique bone disorder and definite link to chronic type C hepatitis, although the pathogenesis still remains unknown. Affected patients suffer from excruciating deep bone pains. We report the 19th case of HCAO with diagnosis confirmed by bone biopsy, and treated initially with a bisphosphonate, next with corticosteroids and finally with direct acting antivirals (DAA: sofosbuvir and ribavirin) for HCV infection...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27922764/comparison-of-abuse-suspected-suicidal-intent-and-fatalities-related-to-the-7-day-buprenorphine-transdermal-patch-versus-other-opioid-analgesics-in-the-national-poison-data-system
#20
Paul M Coplan, Nelson E Sessler, Venkatesh Harikrishnan, Richa Singh, Charles Perkel
OBJECTIVE: Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain. METHODS: Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014...
December 21, 2016: Postgraduate Medicine
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