keyword
https://read.qxmd.com/read/38518272/psychedelic-therapy-a-primer-for-primary-care-clinicians-ketamine
#21
JOURNAL ARTICLE
Viviana D Evans, Alejandro Arenas, Kenneth Shinozuka, Burton J Tabaac, Bryce D Beutler, Kirsten Cherian, Chelsey Fasano, Owen S Muir
BACKGROUND: Ketamine, an arylcyclohexylamine dissociative anesthetic agent, has evolved into a versatile therapeutic. It has a rapid-onset, well-understood cardiovascular effects and a favorable safety profile in clinical use. Its enantiomeric compound, esketamine, was approved by the Food and Drug Administration in 2019 for both treatment-resistant depression and major depressive disorder with suicidal ideation. AREAS OF UNCERTAINTY: Research indicates dose-dependent impacts on cognition, particularly affecting episodic and working memory following both acute administration and chronic use, albeit temporarily for the former and potentially persistent for the latter...
March 2024: American Journal of Therapeutics
https://read.qxmd.com/read/38517751/evidence-for-the-induction-of-analgesic-cross-tolerance-between-opioid-and-apelin-apj-systems-in-male-rats
#22
JOURNAL ARTICLE
Elham Abbasloo, Saeed Esmaeili-Mahani, Firas Kobeissy, Theresa Currier Thomas
BACKGROUND: Opioids are potent pain relievers for managing severe pain. However, their effectiveness is hindered by tolerance, which causes the need for higher doses and leads to adverse effects. In a previous study, we found that prolonged use of apelin, similar to opioids, results in a tolerance to its analgesic effects. It remains unclear whether there is a cross-tolerance between morphine and apelin, meaning if the analgesic effects of one can reduce the effectiveness of the other...
March 22, 2024: Journal of Studies on Alcohol and Drugs
https://read.qxmd.com/read/38517401/moving-forward-with-pain-an-interview-with-john-d-loeser
#23
JOURNAL ARTICLE
John D Loeser
John D Loeser speaks to Thomas York, Journal Development Editor of Pain Management . John D Loeser is Professor, emeritus, of Neurological Surgery and Anesthesiology and Pain Medicine at the University of Washington where he has been a faculty member since 1969. He was the Director of the Multidisciplinary Pain Center at the University of Washington from 1983 to 1997. He has been active in research, teaching and patient care in the field of Pain Management for over 45 years. He was a founding member and served as president of the American Pain Society and the International Association for the Study of Pain...
March 22, 2024: Pain Management
https://read.qxmd.com/read/38516882/connecting-chronic-pain-and-opioid-use-disorder-clinical-trials-through-data-harmonization-wake-forest-impowr-dissemination-education-and-coordination-center-idea-cc
#24
JOURNAL ARTICLE
Meredith C B Adams, Robert W Hurley, Umit Topaloglu
The National Institutes of Health (NIH) has developed the NIH HEAL Integrative Management of chronic Pain and OUD for Whole Recovery (IMPOWR) network to address the interconnected nature of chronic pain (CP) and opioid use disorder (OUD), which are influenced by mental health. The network aims to develop integrated treatment pathways across multiple sites in the United States. The IMPOWR Dissemination, Education, and Coordination Center (IDEA-CC) is proposed to support the NIH HEAL IMPOWR network by developing a CP- and OUD-focused infrastructure that includes measures of stigma, trauma, and quality of life...
March 22, 2024: Subst Use Addctn J
https://read.qxmd.com/read/38514357/ultrasound-guided-erector-spinae-nerve-block-for-relief-of-endometriosis-pain-in-the-emergency-department
#25
Robert Stenberg, Kristen Septaric, Erin L Simon
Endometriosis is a debilitating chronic condition often accompanied by severe pelvic pain and infertility issues. When outpatient medical management is not adequate, controlling pain can be challenging for providers in the acute setting. We report the case of a 23-year-old female with a past medical history of endometriosis who presented to a freestanding emergency department with a chief complaint of 10/10 pelvic pain on a numeric rating scale. She had tried non-steroidal inflammatory medications and heat with no success...
March 15, 2024: American Journal of Emergency Medicine
https://read.qxmd.com/read/38514147/pancreatic-quantitative-sensory-testing-to-predict-treatment-response-of-endoscopic-therapy-or-surgery-for-painful-chronic-pancreatitis-with-pancreatic-duct-obstruction-study-protocol-for-an-observational-clinical-trial
#26
JOURNAL ARTICLE
Anna Evans Phillips, Elham Afghani, Venkata Sandeep Akshintala, Panayiotis Y Benos, Rohit Das, Asbjørn Mohr Drewes, Jeffrey Easler, Mahya Faghih, Charles Gabbert, Vivek Halappa, Mouen A Khashab, Søren Schou Olesen, Jami L Saloman, Biatta Sholosh, Adam Slivka, Tianxiu Wang, Dhiraj Yadav, Vikesh K Singh
INTRODUCTION: Treatment for abdominal pain in patients with chronic pancreatitis (CP) remains challenging in the setting of central nervous system sensitisation, a phenomenon of remodelling and neuronal hyperexcitability resulting from persistent pain stimuli. This is suspected to render affected individuals less likely to respond to conventional therapies. Endotherapy or surgical decompression is offered to patients with pancreatic duct obstruction. However, the response to treatment is unpredictable...
March 21, 2024: BMJ Open
https://read.qxmd.com/read/38514141/identifying-provider-patient-and-practice-factors-that-shape-long-term-opioid-prescribing-for-cancer-pain-a-qualitative-study-of-american-and-australian-providers
#27
JOURNAL ARTICLE
Soraya Fereydooni, Karl Lorenz, Azin Azarfar, Tim Luckett, Jane L Phillips, William Becker, Karleen Giannitrapani
INTRODUCTION: Prescribing long-term opioid therapy is a nuanced clinical decision requiring careful consideration of risks versus benefits. Our goal is to understand patient, provider and context factors that impact the decision to prescribe opioids in patients with cancer. METHODS: We conducted a secondary analysis of the raw semistructured interview data gathered from 42 prescribers who participated in one of two aligned concurrent qualitative studies in the USA and Australia...
March 21, 2024: BMJ Open
https://read.qxmd.com/read/38513764/repeated-morphine-exposure-alters-temporoamonic-ca1-synaptic-plasticity-in-male-rat-hippocampus
#28
JOURNAL ARTICLE
Sohrab Anvari, Mohammad Javan, Javad Mirnajafi-Zadeh, Yaghoub Fathollahi
In this study, the electrophysiological and biochemical consequences of repeated exposure to morphine in male rats on glutamatergic synaptic transmission, synaptic plasticity, the expression of GABA receptors and glutamate receptors at the temporoammonic-CA1 synapse along the longitudinal axis of the hippocampus (dorsal, intermediate, ventral, DH, IH, VH, respectively) were investigated. Slice electrophysiological methods, qRT-PCR, and western blotting techniques were used to characterize synaptic plasticity properties...
March 19, 2024: Neuroscience
https://read.qxmd.com/read/38512600/literature-review-mechanism-indications-and-clinical-efficacy-of-peripheral-nerve-stimulators-in-lower-extremity-pain
#29
REVIEW
Qing Zhao Ruan, Jason Chang, Daniel Pak, Rajesh Supra, Cyrus Yazdi, Linda Kollenburg, Erkan Kurt, David Reece, Alexandra C G Fonseca, Alaa Abd-Elsayed, Christopher L Robinson
PURPOSE OF REVIEW: Lower extremity pain is deemed by Center for Disease Control and Prevention (CDC) to be a significant source of chronic pain in adults. If not appropriately managed, patients are subjected to risks of prolonged musculoskeletal dysfunction, disruption to quality of life, and elevated healthcare expenditures. Peripheral nerve stimulation (PNS) has shown great potential in recent years demonstrating efficacy in multiple diagnoses ranging from acute post-surgical pain to complex regional pain syndrome (CRPS)...
March 21, 2024: Current Pain and Headache Reports
https://read.qxmd.com/read/38509681/assessing-blood-brain-barrier-function-in-the-context-of-pain-management
#30
JOURNAL ARTICLE
Farshad Hassanzadeh Kiabi, Saeed Gharooee Ahangar, Siavash Beiranvand
One essential component of the neurovascular system is known as the blood-brain barrier (BBB). This highly effective biological barrier plays a pivotal role in regulating the brain's internal microenvironment and carefully controlling the passage of various chemicals into and out of the brain. Notably, it serves as a safeguard for the brain, particularly when it comes to the selective transportation of drugs like opioids and non-steroidal anti-inflammatory medications (NSAIDs), which are commonly used in the management of chronic pain...
March 20, 2024: Central Nervous System Agents in Medicinal Chemistry
https://read.qxmd.com/read/38506955/pre-proenkephalin-1-is-downregulated-under-unloading-and-is-involved-in-osteoblast-biology
#31
JOURNAL ARTICLE
Chiara Puri, Charlotte Dannenberg, Argia Ucci, Marco Ponzetti, Elisa Pucci, Luciana Silvestri, Patrick Lau, Petra Frings-Meuthen, Martina Heer, Nadia Rucci, Anna Teti, Antonio Maurizi
Pre-proenkephalin 1 (Penk1) is a pro-neuropeptide that belongs to the typical opioid peptide's family, having analgesic properties. We previously found Penk1 to be the most downregulated gene in a whole gene profiling analysis performed in osteoblasts subjected to microgravity as a model of mechanical unloading. In this work, Penk1 downregulation was confirmed in the bones of two in vivo models of mechanical unloading: tail-suspended and botulinum toxin A (botox)-injected mice. Consistently, in the sera from healthy volunteers subjected to bed rest, we observed an inverse correlation between PENK1 and bed rest duration...
March 20, 2024: Calcified Tissue International
https://read.qxmd.com/read/38506917/efficacy-of-integrating-the-management-of-pain-and-addiction-via-collaborative-treatment-impact-in-individuals-with-chronic-pain-and-opioid-use-disorder-protocol-for-a-randomized-clinical-trial-of-a-digital-cognitive-behavioral-treatment
#32
JOURNAL ARTICLE
R Ross MacLean, Brett Ankawi, Mary A Driscoll, Melissa A Gordon, Tami L Frankforter, Charla Nich, Sara K Szollosy, Jennifer M Loya, Larissa Brito, Margaridha I P Ribeiro, Sara N Edmond, William C Becker, Steve Martino, Mehmet Sofuoglu, Alicia A Heapy
BACKGROUND: Chronic pain is common among individuals with opioid use disorder (OUD) who are maintained on medications for OUD (MOUD; eg, buprenorphine or methadone). Chronic pain is associated with worse retention and higher levels of substance use. Treatment of individuals with chronic pain receiving MOUD can be challenging due to their increased clinical complexity. Given the acute and growing nature of the opioid crisis, MOUD is increasingly offered in a wide range of settings, where high-quality, clinician-delivered, empirically validated behavioral treatment for chronic pain may not be available...
March 20, 2024: JMIR Research Protocols
https://read.qxmd.com/read/38506340/perioperative-pain-management-for-thoracic-surgery-a-multi-layered-approach
#33
REVIEW
Larry Tong, Che Solla, Jeffrey B Staack, Keith May, Bryant Tran
Cardiothoracic surgeries frequently pose unique challenges in the management of perioperative acute pain that require a multifaceted and personalized approach in order to optimize patient outcomes. This article discusses various analgesic strategies including regional anesthesia techniques such as thoracic epidurals, erector spinae plane blocks, and serratus anterior plane blocks and underscores the significance of perioperative multimodal medications, while providing nuanced recommendations for their use. This article further attempts to provide evidence for the efficacy of the different modalities and compares the effectiveness of the choice of analgesia...
March 20, 2024: Seminars in Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/38501738/simplified-processing-and-rapid-quantification-of-buprenorphine-norbuprenorphine-and-their-conjugated-metabolites-in-human-plasma-using-uplc-ms-ms-assessment-of-buprenorphine-exposure-during-opioid-use-disorder-treatment
#34
JOURNAL ARTICLE
Wenchen Zhao, Osama Y Alshogran, Hongfei Zhang, Anand Joshi, Elizabeth E Krans, Steve Caritis, Imam H Shaik, Raman Venkataramanan
Opioid use disorder (OUD) is a chronic neurobehavioral ailment and is prevalent in pregnancy. OUD is commonly treated with methadone or buprenorphine (BUP). Pregnancy is known to alter the pharmacokinetics of drugs and may lead to changes in drug exposure and response. A simple, specific, and sensitive analytical method for measuring the parent drug and its metabolites is valuable for assessing the impact of pregnancy on drug exposure. A new liquid chromatography-tandem mass spectrometric method that utilized a simple protein precipitation procedure for sample preparation and four deuterated internal standards for quantification was developed and validated for BUP and its major metabolites (norbuprenorphine [NBUP], buprenorphine-glucuronide [BUP-G], and norbuprenorphine-glucuronide [NBUP-G]) in human plasma...
April 2024: Journal of Mass Spectrometry: JMS
https://read.qxmd.com/read/38501680/accidental-substance-related-acute-toxicity-deaths-in-older-adults-in-2016-and-2017-a-national-chart-review-study
#35
JOURNAL ARTICLE
Jingru Helen Ha, Jacqueline Burt, Shane Randell, Amanda VanSteelandt
INTRODUCTION: Limited research exists on substance-related acute toxicity deaths (ATDs) in older adults (≥60 years) in Canada. This study aims to examine and describe the sociodemographic characteristics, health histories and circumstances of death for accidental ATDs among older adults. METHODS: Following a retrospective descriptive analysis of all coroner and medical examiner files on accidental substance-related ATDs in older adults in Canada from 2016 to 2017, proportions and mortality rates for coroner and medical examiner data were compared with general population data on older adults from the 2016 Census...
March 2024: Health Promotion and Chronic Disease Prevention in Canada
https://read.qxmd.com/read/38501679/accidental-substance-related-acute-toxicity-deaths-among-youth-in-canada-a-descriptive-analysis-of-a-national-chart-review-study-of-coroner-and-medical-examiner-data
#36
JOURNAL ARTICLE
Amanda VanSteelandt, Grace Yi-Shin Chang, Katherine McKenzie, Fiona Kouyoumdjian
INTRODUCTION: Substance-related acute toxicity deaths (ATDs) are a public health crisis in Canada. Youth are often at higher risk for substance use due to social, environmental and structural factors. The objectives of this study were to understand the characteristics of youth (aged 12-24 years) dying of accidental acute toxicity in Canada and examine the substances contributing to and circumstances surrounding youth ATDs. METHODS: Data from a national chart review study of coroner and medical examiner data on ATDs that occurred in Canada between 2016 and 2017 were used to conduct descriptive analyses with proportions, mortality rates and proportionate mortality rates...
March 2024: Health Promotion and Chronic Disease Prevention in Canada
https://read.qxmd.com/read/38501569/trends-in-non-fatal-and-fatal-opioid-overdoses-during-the-first-two-years-of-the-coronavirus-disease-2019-pandemic
#37
JOURNAL ARTICLE
Chibuzor Abasilim, Lee S Friedman, Lydia Karch, Alfreda Holloway-Beth
PURPOSE: This study assessed opioid-involved overdose rates by age, sex, and race-ethnicity across strict pandemic mitigation phases and how this varied across data systems. METHODS: We examined opioid-involved overdoses using medical examiner and hospital data for Cook County, Illinois between 2016-2021. Multivariable segmented regression was used to assess weekly overdose rates across subgroups of age, sex and race/ethnicity and strict pandemic mitigation phases...
February 2024: Annals of Epidemiology
https://read.qxmd.com/read/38500669/observational-analysis-of-the-influence-of-medical-marijuana-use-on-quality-of-life-in-patients
#38
JOURNAL ARTICLE
Mark D Kelley, Marwah Obaid, Edward M Miller, Marla Bowie, Zachary S Heeter
INTRODUCTION: A significant gap exists in the understanding and utilization of medical marijuana and its effects on a patient's quality of life. This is largely attributed to Cannabis' sp. Schedule 1 classification, which has impeded the scientific investigation of its effects on the endocannabinoid system (ECS) and quality of life. Additionally, conflicting results from previous studies highlight the need for more research to provide guidance to both patients and clinicians regarding the therapeutic potential of medical marijuana...
2024: Medical cannabis and cannabinoids
https://read.qxmd.com/read/38500333/effect-of-a-multidisciplinary-review-panel-on-daily-morphine-milligram-equivalents-for-patients-with-chronic-pain
#39
JOURNAL ARTICLE
Glenn R Kauppila, Sarah M Strahm, Erica L Vogel, Stephanie M Raap, Dana H Cash, Kaitlin J Yost
INTRODUCTION/OBJECTIVE: Physicians and other health care professionals are challenged regularly to balance managing pain for patients with chronic pain receiving chronic opioid therapy (COT) with following the national guidelines and standards regarding daily morphine milligram equivalents (MME). This quality improvement project aimed to determine the effect of referral to a multidisciplinary review panel on daily MME for patients receiving COT for chronic pain. METHODS: This quality improvement project included patients who had an established relationship with a primary care or community internal medicine clinician at a large health care organization and were referred to a newly created multidisciplinary review panel for their recommendations regarding treatment of pain...
2024: Journal of Primary Care & Community Health
https://read.qxmd.com/read/38499566/co-targeting-the-kappa-opioid-receptor-and-dopamine-transporter-reduces-motivation-to-self-administer-cocaine-and-partially-reverses-dopamine-system-dysregulation
#40
JOURNAL ARTICLE
Paige M Estave, Steven E Albertson, Anushree N Karkhanis, Sara R Jones
Cocaine disrupts dopamine (DA) and kappa opioid receptor (KOR) system activity, with long-term exposure reducing inhibiton of DA uptake by cocaine and increasing KOR system function. Single treatment therapies have not been successful for cocaine use disorder; therefore, this study focuses on a combination therapy targeting the dopamine transporter (DAT) and KOR. Sprague Dawley rats self-administered 5 days of cocaine (1.5 mg/kg/inf, max 40 inf/day, FR1), followed by 14 days on a progressive ratio (PR) schedule (0...
March 18, 2024: Scientific Reports
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