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https://www.readbyqxmd.com/read/29351097/effect-of-epidural-infusion-bolus-delivery-rate-on-the-duration-of-labor-analgesia-a-randomized-clinical-trial
#1
Elizabeth M S Lange, Cynthia A Wong, Paul C Fitzgerald, Wilmer F Davila, Suman Rao, Robert J McCarthy, Paloma Toledo
BACKGROUND: Programmed intermittent boluses of local anesthetic have been shown to be superior to continuous infusions for maintenance of labor analgesia. High-rate epidural boluses increase delivery pressure at the catheter orifice and may improve drug distribution in the epidural space. We hypothesized that high-rate drug delivery would improve labor analgesia and reduce the requirement for provider-administered supplemental boluses for breakthrough pain. METHODS: Nulliparous women with a singleton pregnancy at a cervical dilation of less than or equal to 5 cm at request for neuraxial analgesia were eligible for this superiority-design, double-blind, randomized controlled trial...
January 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#2
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29277312/-subcostal-transversus-abdominis-plane-block-can-improve-analgesia-after-laparoscopic-cholecystectomy
#3
Vladimir Vrsajkov, Nedjica Mančić, Dunja Mihajlović, Suzana Tonković Milićević, Arsen Uvelin, Jelena Pantić Vrsajkov
BACKGROUND AND GOAL OF STUDY: After laparoscopic cholecystectomy, patients have moderate pain in the early postoperative period. Some studies shown beneficial effects of subcostal transversus abdominis plane block on reducing this pain. Our goal was to investigate influence of subcostal transversus abdominis plane block on postoperative pain scores and opioid consumption. MATERIALS AND METHODS: We have randomized 76 patients undergoing laparoscopic cholecystectomy to receive either subcostal transversus abdominis plane block (n=38) or standard postoperative analgesia (n=38)...
December 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29276236/janus-kinase-inhibitors-for-the-treatment-of-rheumatoid-arthritis
#4
Senir Turan, Scot Walker
Rheumatoid arthritis (RA) is a disease where the immune system attacks the linings of the joints, resulting in joint pain, stiffness, swelling, and destruction. Although many products are available for the treatment of RA, limitations such as adverse reactions and tolerance greatly affect adherence. Many of the current biologic disease-modifying antirheumatic drugs on the market are injectables, leaving a void to be filled for a product that can be taken orally. The most advanced of these approaches, the Janus kinase (JAK) inhibitors, are oral drugs that have not only made a breakthrough in RA, but also other skin conditions...
November 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29229211/the-use-of-rapid-onset-fentanyl-in-children-and-young-people-for-breakthrough-cancer-pain
#5
Lucy Coombes, Kimberley Burke, Anna-Karenia Anderson
BACKGROUND AND AIMS: No published studies have looked at the dosing and use of rapid onset fentanyl preparations in children. The primary aim of this study was to assess whether there is a correlation between effective dose of rapid onset fentanyl and background oral morphine equivalent analgesia in children less than 18 years old. Secondary objectives included establishing whether there is a correlation between effective dose of rapid onset fentanyl and age and weight. Reported side effects were also reviewed...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29226545/nitrous-oxide-oxygen-mixture-for-analgesia-in-adult-cancer-patients-with-breakthrough-pain-a-randomized-double-blind-controlled-trial
#6
Q Liu, L-L Gao, Y-L Dai, Y-X Li, Y Wang, C-F Bai, G-X Mu, X-M Chai, W-J Han, L-J Zhou, Y-J Zhang, L Tang, J Liu, J-Q Yu
BACKGROUND: The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. METHODS/DESIGN: A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen...
December 11, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29223010/pelvic-abscess-complicating-sigmoid-colon-perforation-by-migrating-intrauterine-device-a-case-report-and-review-of-the-literature
#7
Omar Toumi, Houssem Ammar, Abdessalem Ghdira, Amine Chhaidar, Wided Trimech, Rahul Gupta, Randa Salem, Jamel Saad, Ibtissem Korbi, Mohamed Nasr, Faouzi Noomen, Mondher Golli, Khadija Zouari
INTRODUCTION: Intrauterine devices (IUDs) are commonly used as a contraceptive method. However, they may cause rare but potentially serious complications such as migration through the uterine wall and gastrointestinal perforation. PRESENTATION OF CASE: We report a case of a 26-year woman, carrying an IUD for 2 years, who presented to the emergency with pelvic pain with breakthrough bleeding. Abdominal imaging revealed the presence of two devices the first of which was located in the uterine cavity and the other in the wall of the sigmoid colon associated with a 5-centimeter pelvic collection...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29220110/non-responsiveness-and-susceptibility-of-opioids-side-effects-related-to-cancer-patients-clinical-characteristics-a-post-hoc-analysis
#8
Oscar Corli, Anna Roberto, Michael I Bennett, Francesca Galli, Nicole Corsi, Eliana Rulli, Raffaella Antonione
BACKGROUND: Response to opioids is not always positive in cancer patients. A considerable proportion of patients do not respond (non-responders, NRs) or experience severe toxicity. The aim of this analysis was to assess the role of demographic characteristics, pain features, comorbidities and ongoing therapy on the lack of efficacy and on the occurrence of severe adverse drug reactions (ADRs). METHODS: This is a post-hoc analysis of a randomized controlled trial that involved 520 patients and was aimed to evaluate the efficacy and safety of four strong opioids...
December 8, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29188558/breakthrough-in-gpcr-crystallography-and-its-impact-on-computer-aided-drug-design
#9
Antonella Ciancetta, Kenneth A Jacobson
Recent crystallographic structures of G protein-coupled receptors (GPCRs) have greatly advanced our understanding of the recognition of their diverse agonist and antagonist ligands. We illustrate here how this applies to A2A adenosine receptors (ARs) and to P2Y1 and P2Y12 receptors (P2YRs) for ADP. These X-ray structures have impacted the medicinal chemistry aimed at discovering new ligands for these two receptor families, including receptors that have not yet been crystallized but are closely related to the known structures...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29171028/the-mechanosensitive-piezo1-channel-structural-features-and-molecular-bases-underlying-its-ion-permeation-and-mechanotransduction
#10
Yubo Wang, Bailong Xiao
The evolutionarily conserved Piezo family of proteins, including Piezo1 and Piezo2, encodes the long-sought-after mammalian mechanosensitive cation channels that play critical roles in various mechanotransduction processes such as touch, pain, proprioception, vascular development and blood pressure regulation. Mammalian Piezo proteins contain over 2500 amino acids with numerous predicted transmembrane segments, and do not bear sequence homology with any known class of ion channels. Thus, it is imperative, but challenging, to understand how they serve as effective mechanotransducers for converting mechanical force into electrochemical signals...
November 24, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29170344/47%C3%A2-systematic-review-and-meta-analysis-of-analgesic-efficacy-and-safety-profile-of-single-injection-fascia-iliaca-compartment-blocks-in-the-acute-pre-operative-pain-management-of-hip-fractures
#11
Fiqry Fadhlillah, David Chan
BACKGROUND: It is hypothesised that a single injection fascia iliaca compartment block (FICB) administered in the pre-operative setting provides better analgesic control for traumatic hip fractures and is not associated with major adverse effects. Systemic analgesics, whilst effective, could lead to cardiovascular, respiratory and cognitive impairment. As a consequence, undertreatment of acute pain remains prevalent in adult patients with hip fractures, with a consistent decline seen in analgesic administration with age...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29157656/diagnosis-and-medical-treatment-of-breakthrough-pain
#12
José-Miguel Esparza-Miñana
No abstract text is available yet for this article.
November 17, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29156896/proutine-a-feasibility-study-assessing-surveillance-of-electronic-patient-reported-outcomes-and-adherence-via-smartphone-app-in-advanced-cancer
#13
Gesine Benze, Friedemann Nauck, Bernd Alt-Epping, Giuseppe Gianni, Thomas Bauknecht, Johannes Ettl, Anna Munte, Luisa Kretzschmar, Jan Gaertner
BACKGROUND: In advanced cancer, quality of life (QoL) is a major treatment goal. In order to achieve this, the identification of suffering by screening for patient-reported-outcomes (PROs, i.e., symptoms) is of utmost importance. The use of paper-pencil questionnaires is associated with significant shortcomings due to missing data, recall bias and transcription errors. Other than that, the electronic recording of PROs by mobile Health (mHealth) offers a number of advantages. The aim of this study was to test whether the routine assessment of PROs via a newly developed smartphone application (MeQoL®) is feasible...
October 26, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29127593/seom-clinical-guideline-for-treatment-of-cancer-pain-2017
#14
C Jara, S Del Barco, C Grávalos, S Hoyos, B Hernández, M Muñoz, T Quintanar, J A Meana, C Rodriguez, R de Las Peñas
Pain is a highly prevalent symptom in patients with cancer. Despite therapeutic advances and well-accepted treatment guidelines, a percentage of patients with pain are under-treated. Currently, it has been recognized that several barriers in pain management still exist and, in addition, there are new challenges surrounding complex subtypes of pain, such as breakthrough and neuropathic pain, requiring further reviews and recommendations. This is an update of the guide our society previously published and represents the continued commitment of SEOM to move forward and improve supportive care of cancer patients...
November 10, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29066928/assessment-and-treatment-of-breakthrough-cancer-pain-from-theory-to-clinical-practice
#15
REVIEW
Renato Vellucci, Rocco Domenico Mediati, Silvia Gasperoni, Massimo Mammucari, Franco Marinangeli, Patrizia Romualdi
Breakthrough cancer pain (BTcP) is a common condition in oncological patients. However, its management is still suboptimal. Improved knowledge of BTcP and its management in clinical practice may have immediate importance for all physicians involved in the supportive care of cancer patients. This review critically discusses the most important concepts for the correct diagnosis of BTcP and presents some intriguing cases of the management of this condition in clinical practice. Overall, the most appropriate therapeutic choice appears to be a rapid-onset opioid (ROO), and in particular, the nasal route of administration is the quickest and most convenient mode of administration for the management of BTcP, especially when the patient needs rapid resolution of pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28975575/oncologist-s-knowledge-and-implementation-of-guidelines-for-breakthrough-cancer-pain-in-spain-conoce-study
#16
R López López, C Camps Herrero, P Khosravi-Shahi, V Guillem Porta, A Carrato Mena, J Garcia-Foncillas, J J Cruz Hernández, P Gascón Vilaplana, A Antón Torres, E Diaz-Rubio, M Feyjoo Saus, E Aranda Aguilar
PURPOSE: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. METHODS: Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline...
October 3, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28974843/characteristics-and-treatment-of-breakthrought-pain-btcp-in-palliative-care
#17
Samir Husic, Semir Imamovic, Srecko Matic, Aziz Sukalo
INTRODUCTION: This research was to follow characteristics of breakthrough pain caused by cancer (BTcP) and other most common sympthoms (ESAS) at patients in advanced stage of cancer disease in palliative care. PATIENTS AND METHODS: Prospective study included 433 patients which were treated in Palliative Care Centre in UKC Tuzla, Bosnia and Herzegovina. Group 1 was consisted of 353 patients whose basal cancer pain of intensity 4-7 NRS was treated weak opiates (basal analgetic- fixed combination of tramadol/paracetamol (37...
August 2017: Medical Archives
https://www.readbyqxmd.com/read/28972650/characterisation-of-a-rat-model-of-bortezomib-induced-painful-neuropathy
#18
Natalie A Duggett, Sarah J L Flatters
BACKGROUND: Bortezomib (Velcade®) is a breakthrough treatment for multiple myeloma, significantly improving patient survival. However, its use is limited by painful neuropathy often resulting in dose reduction/cessation of first-line treatment due to lack of treatment. The aim of this study was to characterise a clinically-relevant rat model of bortezomib-induced painful neuropathy, using established evoked measures and novel ethological techniques, to aid drug discovery. EXPERIMENTAL APPROACH: Adult male Sprague-Dawley rats were injected intraperitoneally (i...
October 3, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28956872/-a-contribute-to-improve-understanding-and-management-br-of-cancer-pain-the-breakthrough-pain-br-just-pain-specific-symptom-or-something-else
#19
Sara Campagna, Valerio Dimonte
No abstract text is available yet for this article.
July 2017: Assistenza Infermieristica e Ricerca: AIR
https://www.readbyqxmd.com/read/28914555/evaluation-of-the-quality-of-care-of-elderly-patients-with-chronic-and-breakthrough-pain-treated-with-opioids-sand-study
#20
Manuel Jesús Rodríguez, Rosalía de la Torre, Josefa Luisa Ortega, José Manuel Trinidad, Diego Benítez, Antonio Javier Jiménez, Almudena Sanz-Yagüe, Begoña Soler, Luis Miguel Torres
OBJECTIVE: The objective of this study was to evaluate the quality of care of elderly patients with treatment for chronic pain (CP) and breakthrough pain (BTP). METHODS: A cross-sectional observational study was conducted in 20 pain units, selecting patients aged 70 years or older with baseline controlled CP in treatment with opioids and a diagnosis of BTP. Patients were classified as first episode of BTP or patient in follow-up. The patients completed the SF-12 quality of life questionnaire, Brief Pain Inventory, Lattinen Index, and Edmonton Symptoms Assessment Scale...
October 12, 2017: Current Medical Research and Opinion
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