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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
#1
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...
September 15, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28903357/intratumoral-acidosis-fosters-cancer-induced-bone-pain-through-the-activation-of-the-mesenchymal-tumor-associated-stroma-in-bone-metastasis-from-breast-carcinoma
#2
Gemma Di Pompo, Silvia Lemma, Lorenzo Canti, Nadia Rucci, Marco Ponzetti, Costantino Errani, Davide Maria Donati, Shonagh Russell, Robert Gillies, Tokuhiro Chano, Nicola Baldini, Sofia Avnet
Cancer-induced bone pain (CIBP) is common in patients with bone metastases (BM), significantly impairing quality of life. The current treatments for CIBP are limited since they are often ineffective. Local acidosis derived from glycolytic carcinoma and tumor-induced osteolysis is only barely explored cause of pain. We found that breast carcinoma cells that prefer bone as a metastatic site have very high extracellular proton efflux and expression of pumps/ion transporters associated with acid-base balance (MCT4, CA9, and V-ATPase)...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28887457/spinal-mirna-124-regulates-synaptopodin-and-nociception-in-an-animal-model-of-bone-cancer-pain
#3
Sara Elramah, María José López-González, Matthieu Bastide, Florence Dixmérias, Olivier Roca-Lapirot, Anne-Cécile Wielanek-Bachelet, Anne Vital, Thierry Leste-Lasserre, Alexandre Brochard, Marc Landry, Alexandre Favereaux
Strong breakthrough pain is one of the most disabling symptoms of cancer since it affects up to 90% of cancer patients and is often refractory to treatments. Alteration in gene expression is a known mechanism of cancer pain in which microRNAs (miRNAs), a class of non-coding regulatory RNAs, play a crucial role. Here, in a mouse model of cancer pain, we show that miR-124 is down-regulated in the spinal cord, the first relay of the pain signal to the brain. Using in vitro and in vivo approaches, we demonstrate that miR-124 is an endogenous and specific inhibitor of synaptopodin (Synpo), a key protein for synaptic transmission...
September 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28873028/randomized-prospective-evaluation-of-intraoperative-intravenous-acetaminophen-in-pediatric-adenotonsillectomy
#4
Christopher A Roberts, Shivani Shah-Becker, Ashley O'Connell Ferster, Aaron Baker, Lauren E Stahl, Khaled Sedeek, Michele M Carr
Objective To establish the safety and efficacy of single-dose intraoperative intravenous (IV) acetaminophen in postoperative pain management following adenotonsillectomy in addition to a standardized regimen of oral pain medication. Study Design Randomized, controlled prospective clinical trial. Setting Single academic medical center. Subjects and Methods Patients between the ages of 3 and 17 years scheduled for tonsillectomy or adenotonsillectomy by a single surgeon between December 2014 and November 2016 were recruited...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28870800/cancer-pain-with-a-neuropathic-component-a-cross-sectional-study-of-its-clinical-characteristics-associated-psychological-distress-treatments-and-predictors-at-referral-to-a-cancer-pain-clinic
#5
Paulo Reis-Pina, Anand Acharya, Peter G Lawlor
CONTEXT: In patients with cancer pain, identifying a neuropathic pain component (NPC) may inform the selection of subsequent therapeutic interventions. OBJECTIVES: To determine the prevalence, clinical characteristics, associated psychological distress, pre-referral treatment, and predictors of cancer pain with a NPC in patients referred to a cancer pain clinic. METHODS: Participants had standard assessments and documentation: Brief Pain Inventory ratings; presence of a NPC, based on a DN4 (neuropathic pain screening scale) score ≥4 combined with a physician's clinical assessment (blinded to DN4 result); the Hospital Anxiety Depression Scale (HADS) and Emotional Thermometer scores...
September 1, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28769766/breakthrough-cancer-pain-is-associated-with-spinal-gap-junction-activation-via-regulation-of-connexin-43-in-a-mouse-model
#6
Xin Li, Siqing Jiang, Hui Yang, Qian Liao, Shousong Cao, Xuebin Yan, Dong Huang
Breakthrough cancer pain (BTcP) is a high-intensity, short-duration, unpredictable and uncontrollable pain. Recent studies have shown that activation of gap junction (GJ) in spinal cord plays an important role in the pathogenesis of BTcP. We examined the expressions of Glial fibrillary acidic protein (GFAP), connexin (Cx) 43 protein and phosphorylation of Cx43 (p-Cx43) in the spinal cord of mice. In addition, we investigated the effects of Gap26, a selective GJ blocker, on the expressions of GFAP, Cx43 and p-Cx43 in BTcP mice...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28744772/breakthrough-pain-management-with-sublingual-fentanyl-tablets-in-patients-with-cancer-age-subgroup-analysis-of-a-multicenter-prospective-study
#7
Jordi Guitart, María Isabel Vargas, Vicente De Sanctis, Jordi Folch, Rafael Salazar, José Fuentes, Joan Coma, Julia Ferreras, Jordi Moya, Albert Tomás, Pere Estivill, Francisco Rodelas, Antonio Javier Jiménez, Almudena Sanz
INTRODUCTION: Breakthrough pain (BTP) management in patients with cancer is challenging, especially in the elderly. However, no studies examining the influence of age on BTP medication have been conducted. The aim of this work was to investigate the effect of sublingual fentanyl tablets (SFTs) in terms of efficacy, safety, and quality of life in two age categories. METHODS: We performed age subgroup analyses (<65 and ≥65 years) from a recently completed study conducted in Spain...
July 25, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28711749/validation-of-the-korean-version-of-the-breakthrough-pain-assessment-tool-in-cancer-patients
#8
Jinyoung Shin, Sung Jung Cho, Jungkwon Lee, Youn Seon Choi
CONTEXT: Breakthrough cancer pain has not been properly evaluated and treated because there are relatively few available measurements. The Breakthrough Pain Assessment Tool (BAT) is currently recognized as a brief, multidimensional, and reliable measurement. OBJECTIVES: The objective of this study was to validate the Korean version of the BAT (BAT-K) in adult cancer patients. METHODS: We conducted a forward-backward translation and cross-cultural equivalence test...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28693802/the-vicious-circle-of-treatment-induced-toxicities-in-locally-advanced-head-and-neck-cancer-and-the-impact-on-treatment-intensity
#9
REVIEW
Bossi Paolo, Cossu Rocca Maria, Corvò Renzo, Depenni Roberta, Guardamagna Vittorio, Marinangeli Franco, Miccichè Francesco, Trippa Fabio
The intensity of the available treatment approaches for locally-advanced head and neck cancer (HNC) is at the upper limit of tolerance of acute toxicities. Several factors including breakthrough cancer pain, mucositis, dysphagia, local and systemic infections, and nutritional problems are related to treatment intensity. Particularly, pain, as symptom directly associated with the disease or combined with other treatment-related factors, has a major impact on quality of life of HNC patients and ultimately can influence the efficacy of treatments in HNC...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28690041/intravenous-vs-oral-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-arthroplasty-a-prospective-randomized-double-blind-clinical-trial
#10
Jason B O'Neal, Andrew A Freiberg, Marc D Yelle, Yandong Jiang, Chengwei Zhang, Yin Gu, Xiangyi Kong, Wenling Jian, Wesley T O'Neal, Jingping Wang
BACKGROUND: The efficacy of intravenous (IV) acetaminophen compared with its oral formulation for postoperative analgesia is unknown. We hypothesized that the addition of acetaminophen to a multimodal analgesia regimen would provide improved pain management in patients after total knee arthroplasty (TKA) and that the effect of acetaminophen would be variable based on the route of delivery. METHODS: The study was a single-center, randomized, double-blinded, placebo-controlled clinical trial on the efficacy of IV vs oral acetaminophen in patients undergoing unilateral TKA...
October 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28654672/cost-effectiveness-analysis-of-oral-fentanyl-formulations-for-breakthrough-cancer-pain-treatment
#11
Paolo Angelo Cortesi, Lucia Sara D'Angiolella, Renato Vellucci, Massimo Allegri, Giuseppe Casale, Carlo Favaretti, Flavia Kheiraoui, Giancarlo Cesana, Lorenzo Giovanni Mantovani
Breakthrough cancer Pain (BTcP) has a high prevalence in cancer population. Patients with BTcP reported relevant health care costs and poor quality of life. The study assessed the cost-effectiveness of the available Oral Fentanyl Formulations (OFFs) for BTcP in Italy. A decision-analytical model was developed to estimate costs and benefits associated with treatments, from the Italian NHS perspective. Expected reductions in pain intensity per BTcP episodes were translated into, percentage of BTcP reduction, resource use and Quality-Adjusted-Life-Years (QALYs)...
2017: PloS One
https://www.readbyqxmd.com/read/28623513/the-spine-instability-neoplastic-score-sins-in-the-assessment-of-response-to-radiotherapy-for-bone-metastases
#12
E Gallizia, G Apicella, T Cena, M Di Genesio Pagliuca, L Deantonio, M Krengli
BACKGROUND: Vertebral metastases are often causing pain and spine instability. Radiotherapy is of significant benefit for painful spine metastases but the response can be very variable. The spine instability neoplastic score (SINS) is a recent classification system for diagnosis of spinal instability caused by vertebral metastases. We analysed the degree of pain relief, the need of drug therapy and the imaging features and the SINS before and after radiotherapy. In particular, we investigated the possible correlation of spine instability defined by pre-treatment SINS with pretreatment pain and with response to radiotherapy...
June 16, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28615964/development-and-performance-of-a-diagnostic-prognostic-scoring-system-for-breakthrough-pain
#13
Boaz Gedaliahu Samolsky Dekel, Marco Palma, Maria Cristina Sorella, Alberto Gori, Alessio Vasarri, Rita Maria Melotti
OBJECTIVES: Variable prevalence and treatment of breakthrough pain (BTP) in different clinical contexts are partially due to the lack of reliable/validated diagnostic tools with prognostic capability. We report the statistical basis and performance analysis of a novel BTP scoring system based on the naïve Bayes classifier (NBC) approach and an 11-item IQ-BTP validated questionnaire. This system aims at classifying potential BTP presence in three likelihood classes: "High," "Intermediate," and "Low...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28603868/pre-operative-brachial-plexus-block-compared-with-an-identical-block-performed-at-the-end-of-surgery-a-prospective-double-blind-randomised-clinical-trial
#14
A Holmberg, A R Sauter, Ø Klaastad, T Draegni, J C Raeder
We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg(-1) ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28588493/p2x4-receptor-function-in-the-nervous-system-and-current-breakthroughs-in-pharmacology
#15
REVIEW
Leanne Stokes, Janice A Layhadi, Lucka Bibic, Kshitija Dhuna, Samuel J Fountain
Adenosine 5'-triphosphate is a well-known extracellular signaling molecule and neurotransmitter known to activate purinergic P2X receptors. Information has been elucidated about the structure and gating of P2X channels following the determination of the crystal structure of P2X4 (zebrafish), however, there is still much to discover regarding the role of this receptor in the central nervous system (CNS). In this review we provide an overview of what is known about P2X4 expression in the CNS and discuss evidence for pathophysiological roles in neuroinflammation and neuropathic pain...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28580818/xanthomatous-posttraumatic-fibro-osseous-lesion-of-the-rib-a-rare-and-underrecognized-entity-case-report-and-literature-review
#16
Hussein Nassereddine, Frédérique Larousserie, Raphaël Campagna, Yves Castier, Anne Couvelard, Laurence Choudat, Aurélie Sannier
Posttraumatic fibro-osseous lesion (PTFOL) is a rare lesion that typically affects the ribs and is probably a posttraumatic reactive process. Because PTFOL is often misdiagnosed as fibrous dysplasia, osteoid osteoma, benign fibrous histiocytoma or rib metastases, chest wall resection, leading to a significant morbidity, is the main treatment modality. We report the case of a 30-year-old male patient with no history of previous trauma presenting with chest pain. Computed tomography scan showed an eighth left rib well-defined ovoid and hypodense lesion with circumferential sclerotic margin and no cortical breakthrough...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28579386/microrna-and-chronic-pain-from-mechanisms-to-therapeutic-potential
#17
REVIEW
María José López-González, Marc Landry, Alexandre Favereaux
Chronic pain is a major public health issue with an incidence of 20-25% worldwide that can take different forms like neuropathic, cancer-related or inflammatory pain. Chronic pain often limits patients in their daily activities leading to despair. Thus, the goal of treatments is to relieve pain sufficiently to enable patients to go back to a normal life. Unfortunately, few patients with chronic pain obtain complete relief from the analgesics that are currently available. It is thus of prime importance to get a better understanding of chronic pain mechanisms to design new therapeutic strategies and pain-killers...
June 1, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28573274/laser-post-ionisation-combined-with-a-high-resolving-power-orbitrap-mass-spectrometer-for-enhanced-maldi-ms-imaging-of-lipids
#18
S R Ellis, J Soltwisch, M R L Paine, K Dreisewerd, R M A Heeren
Coupling laser post-ionisation with a high resolving power MALDI Orbitrap mass spectrometer has realised an up to ∼100-fold increase in the sensitivity and enhanced the chemical coverage for MALDI-MS imaging of lipids relative to conventional MALDI. This could constitute a major breakthrough for biomedical research.
June 29, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/28549593/-improving-the-quality-of-cancer-pain-management-in-palliative-care-unit-targeted-clinical-audit
#19
Colombe Tricou, Murielle Ruer, Mathilde Ledoux, Élise Perceau-Chambard, Dorothée Decrept, Claire Chabloz, Marilène Filbet
Goal This study aims to assess the quality of the cancer pain management in Palliative care unit. METHOD: The method used was the targeted clinical audit. The audit grid was built according to the recommendations of the pilot Committee, and tested until the final version with 19 items was obtained. In this retrospective study, 60 consecutive patients were studied on 2 periods of time. The first one (T1) shows the gap between the patient's chart and the expected standard, and proposes corrective measures...
July 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28539673/compartment-syndrome-and-regional-anaesthesia-critical-review
#20
Jozef Klucka, Petr Stourac, Alena Stouracova, Michal Masek, Martin Repko
Acute compartment syndrome (ACS) is a potential orthopaedic/traumatology emergency. Without prompt, precise diagnosis and immediate treatment with surgical decompressive fasciotomy it can lead to neurological dysfunction and disability. The role of regional anaesthesia (RA) in patients at risk for ACS/ and in those with developed ACS is controversial. The aim of this critical review was to answer the question, whether regional anaesthesia can delay the diagnosis. The authors use an evidence-based approach to discuss these high risk patients in considering RA as a method of choice for effective analgesia...
May 24, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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