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https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#1
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29164003/the-endocannabinoid-system-in-pain-and-inflammation-its-relevance-to-rheumatic-disease
#2
REVIEW
Nicola Barrie, Nicholas Manolios
Pain is the most common manifestation of both acute and chronic inflammation that often challenges patients with rheumatic disease. Simply, we attribute this to local joint changes of pH in joints, the formation of radicals, enhanced joint pressure, or cytokine release acting on local nerves to produce pain. However, there is a more complex interplay of interactions between cytokines, mediators of inflammation, and ion channels that influence the final immune response and our perception of pain. Endocannabinoids, a group of less well-known endogenous bioactive lipids, have such manifold immunomodulatory effects able to influence both inflammation and pain...
September 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29160850/analgesic-mechanisms-of-antidepressants-for-neuropathic-pain
#3
REVIEW
Hideaki Obata
Tricyclic antidepressants and serotonin noradrenaline reuptake inhibitors are used to treat chronic pain, such as neuropathic pain. Why antidepressants are effective for treatment of neuropathic pain and the precise mechanisms underlying their effects, however, remain unclear. The inhibitory effects of these antidepressants for neuropathic pain manifest more quickly than their antidepressive effects, suggesting different modes of action. Recent studies of animal models of neuropathic pain revealed that noradrenaline is extremely important for the inhibition of neuropathic pain...
November 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29158855/clinical-evaluation-of-terap-c-vaccine-in-combined-treatment-with-interferon-and-ribavirin-in-patients-with-hepatitis-c
#4
Dorta Guridi Zaily, Castellanos Fernandez Marlen, Dueñas-Carrera Santiago, Martínez Donato Gillian, Valenzuela Silva Carmen, Cinza Estevez Zurina, Arús Soler Enrique R, Alvarez-Lajonchere Liz, González Fabián Lisset, Lazo Del Vallín Sacha, Ferrer Bataille Elena
Background: An estimated 170 million individuals worldwide are infected with the hepatitis C virus (HCV). Although treatment options using a combination of pegylated interferon and ribavirin (P-IFN/RBV) are available, sustained clearance of the virus is only achieved in approximately 40% of individuals infected with HCV genotype 1. Recent advances in the treatment of HCV using directly acting antiviral agents have been achieved; however, treatment can be very expensive and is associated with substantial side effects...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29156922/changes-in-laser-evoked-potentials-during-hypnotic-analgesia-for-chronic-pain-a-pilot-study
#5
Giovanna Squintani, Maria P Brugnoli, Emanuela Pasin, Alessia Segatti, Elisa Concon, Enrico Polati, Bruno Bonetti, Angela Matinella
BACKGROUND: Hypnotic analgesia is one of the most effective nonpharmacological methods for pain control. Hypnosis and distraction of attention from pain might share similar mechanisms by which brain responses to painful stimulation could be similarly reduced in both states. There is ample evidence for the efficacy of clinical hypnosis as a psychological intervention in the treatment of acute or chronic pain. Results are conflicting, however, with some studies showing an increase, others a reduction, and others still no change in the amplitude of event-related brain potentials during hypnosis as compared to control conditions...
November 10, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29149731/purinergic-drug-targets-for-gastrointestinal-disorders
#6
REVIEW
Geoffrey Burnstock, Kenneth A Jacobson, Fievos L Christofi
Purinergic receptors are implicated in the pathogenesis of gastrointestinal disorders and are being explored as potential therapeutic targets. Gut inflammation releases ATP that acts on neuronal, glial, epithelial and immune cells. Purinergic signalling in glia and neurons is implicated in enteric neuropathies. Inflammation activates glia to increase ATP release and alter purinergic signalling. ATP release causes neuron death and gut motor dysfunction in colitis via a P2X7-dependent neural-glial pathway and a glial purinergic-connexin-43 pathway...
November 14, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#7
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149119/pain-management-strategies-for-screening-and-monitoring-patients-receiving-chronic-opioid-therapy%C3%A2
#8
Karen Hande
The current state of pain management within the oncology setting, effectiveness of opioids for the relief of pain, and limited alternatives for chronic pain management have produced reliance on opioid medications with an inherent risk for aberrant behavior. Although standardization is lacking among prescribers who manage cancer-related pain, advanced practice RNs must act according to the available evidence that suggests assessing and monitoring for abuse and misuse. 
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29146590/camkii%C3%AE-mediates-the-effect-of-il-17-to-promote-ongoing-spontaneous-and-evoked-pain-in-multiple-sclerosis
#9
Xiaoyu Hu, Fang Huang, Zaijie Jim Wang
Pain is a common and severe symptom in multiple sclerosis (MS), a chronic inflammatory and demyelinating disease of the central nervous system. The neurobiological mechanism underlying MS pain is poorly understood. In this study, we investigated the role of Ca(2+)/calmodulin dependent kinase type IIα (CaMKIIα) in driving chronic pain in MS using a mouse experimental autoimmune encephalomyelitis (EAE) model. We found that spinal CaMKIIα activity was enhanced in EAE correlating with the development of ongoing spontaneous pain and evoked hypersensitivity to mechanical and thermal stimuli...
November 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29146440/clodronate-a-vesicular-atp-release-blocker
#10
REVIEW
Yoshinori Moriyama, Masatoshi Nomura
Clodronate is a first-generation bisphosphonate used worldwide for antiresorptive therapy for osteoporosis. Although clodronate is analgesic in nature, its mechanism and efficacy were unknown for some time. Recently, clodronate was identified as a selective and potent inhibitor for vesicular nucleotide transporter (VNUT), a transporter responsible for vesicular storage of ATP. Clodronate inhibits vesicular ATP release from neurons and reduces chronic neuropathic and inflammatory pain following blockade of purinergic chemical transmission...
November 13, 2017: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/29144441/g-protein-coupled-receptors-targeted-by-analgesic-venom-peptides
#11
REVIEW
James T Daniel, Richard J Clark
Chronic pain is a complex and debilitating condition associated with a large personal and socioeconomic burden. Current pharmacological approaches to treating chronic pain such as opioids, antidepressants and anticonvulsants exhibit limited efficacy in many patients and are associated with dose-limiting side effects that hinder their clinical use. Therefore, improved strategies for the pharmacological treatment of pathological pain are urgently needed. G-protein coupled receptors (GPCRs) are ubiquitously expressed on the surface of cells and act to transduce extracellular signals and regulate physiological processes...
November 16, 2017: Toxins
https://www.readbyqxmd.com/read/29141066/vancomycin-infiltrate-induced-dermatitis-mimicking-bullous-cellulitis
#12
Sowmya Nanjappa, Matthew Snyder, John N Greene
<p>Extravasation of medications can manifest as tenderness, pain, tissue necrosis, and thrombophlebitis and lead to infection and severe long-term complications. Risk factors for leakage of medications include mechanical and pharmacologic mechanisms such as cannulation technique, vasoconstriction, and cytotoxicity. Well-known vesicants like anthracyclines, vinca alkaloids, and vasopressors are usually administered with proper caution. Often overlooked are many antimicrobial agents, which typically act via differences in osmolality and pH...
November 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29134730/role-of-central-versus-peripheral-opioid-system-in-antinociceptive-and-anti-inflammatory-effect-of-botulinum-toxin-type-a-in-trigeminal-region
#13
V Drinovac Vlah, B Filipović, L Bach-Rojecky, Z Lacković
BACKGROUND: Although botulinum toxin type A (BT-A) is approved for chronic migraine treatment, its site and mechanism of action are still elusive. Recently our group discovered that suppression of CGRP release from dural nerve endings might account for antimigraine action of pericranially injected BT-A. We demonstrated that central antinociceptive effect of BT-A in sciatic region involves endogenous opioid system as well. Here we investigated possible interaction of BT-A with endogenous opioid system within the trigeminal region...
November 13, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29126444/expectations-towards-participation-in-easily-accessible-pain-management-interventions-a-qualitative-study
#14
Torunn Hatlen Nøst, Aslak Steinsbekk, Liv Riseth, Ola Bratås, Kjersti Grønning
BACKGROUND: People with chronic pain use a range of healthcare services, but they also report a high degree of dissatisfaction with treatments. One reason for dissatisfaction might be participants' expectations towards treatments. The aim of this study was to explore expectations of people with chronic pain towards participation in easily accessible pain management interventions delivered in public primary care. METHODS: A qualitative study using semi-structured individual face-to-face interviews with 21 informants...
November 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29123661/the-psychology-of-chronic-post-surgical-pain-new-frontiers-in-risk-factor-identification-prevention-and-management
#15
Aliza Z Weinrib, Muhammad A Azam, Kathryn A Birnie, Lindsay C Burns, Hance Clarke, Joel Katz
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29122652/how-can-we-best-reduce-pain-catastrophizing-in-adults-with-chronic-non-cancer-pain-a-systematic-review-and-meta-analysis
#16
REVIEW
Robert Schütze, Clare Rees, Anne Smith, Helen Slater, Jared M Campbell, Peter O'Sullivan
Pain catastrophizing (PC), defined as an exaggerated negative cognitive-affective orientation toward pain, is one of the strongest psychological predictors of pain outcomes. While regularly included as a process variable in clinical trials, there have been no comprehensive reviews of how it can be modified. Using a registered protocol (PROSPERO 2016 CRD42016042761), we searched MEDLINE, PsychINFO, EMBASE, CINAHL, and CENTRAL up to November 2016 for all randomized controlled trials measuring PC in adults with chronic non-cancer pain...
November 6, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29121327/short-acting-opioids-are-associated-with-comparable-analgesia-to-long-acting-opioids-in-patients-with-chronic-osteoarthritis-with-a-reduced-opioid-equivalence-dosing
#17
Ameer Ghodke, Stephanie Barquero, Paul R Chelminski, Timothy J Ives
Setting: There are no studies that exist within the primary care setting that address optimal opioid therapy in osteoarthritis patients. In light of the recently released US Centers for Disease Control and Prevention guidelines on opioid use in chronic noncancer pain, there is a pressing need to better characterize the effectiveness of long- and short-acting opioids. Objective: To examine the effectiveness of short-acting opioids (SAO) vs long-acting opioids (LAO) and combination therapies (SAO and LAO) for treating chronic osteoarthritis pain in a retrospective trial...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29119706/insights-on-efficacious-doses-of-pamoras-for-patients-on-chronic-opioid-therapy-or-opioid-na%C3%A3-ve-patients
#18
K van Malderen, H Halawi, M Camilleri
BACKGROUND: Opioid-induced constipation (OIC) is a major side effect of opioid use. Centrally acting antagonists result in opioid withdrawal or worsening of pain and lead to use of peripherally acting mu-opioid receptor antagonists (PAMORAs). The required doses of the PAMORAs, methylnaltrexone and naloxegol, in the treatment of OIC are well established in chronic opioid users. OIC may occur after short duration of opioid treatment; the required doses of naloxone, naltrexone, and PAMORAs in opioid-naïve subjects (with no opioid use for at least 3 months) are unclear...
November 9, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29117657/%C3%A2-plug-free%C3%A2-connector-placement-modification-of-a-bilayer-patch-device-in-male-indirect-inguinal-hernioplasty
#19
Miroslav D Ilić, Srdjan S Putnik
The bilayer patch device (Ethicon, Prolen Hernia System®) for inguinal hernia repair has a connector that acts as a ‚plug‘ in the internal inguinal ring. The position of this ‚plug‘ component may be responsible for higher incidence of chronic pain and intestinal damage. We assumed that changing the position of the connector of a bilayer patch device (PHS®) and placing it medially in Hesselbach triangle would contribute to lower incidence of chronic pain and would not result in intestinal damage, with good clinical outcome following indirect inguinal hernioplasty...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29115665/effects-of-xist-mir-137-axis-on-neuropathic-pain-by-targeting-tnfaip1-in-a-rat-model
#20
Ying Zhao, Sen Li, Min Xiao, Yan Shi, Chang-Ming Zhao
Non-coding RNAs have been reported to participate in the pathophysiology of neuropathic pain. The objective of our study was to investigate the biological role of XIST in neuropathic pain development. In our study, we identify and validate that lncRNA XIST was markedly increased and miR-137 was significantly decreased in chronic constriction injury (CCI) rats. XIST silencing alleviated pain behaviors including both mechanical and thermal hyperalgesia in the CCI rats. XIST was predicted to interact with miR-137 by bioinformatics technology and dual-luciferase reporter assays confirmed the correlation between XIST and miR-137...
November 8, 2017: Journal of Cellular Physiology
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