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Undertreated pain

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https://www.readbyqxmd.com/read/29904819/perioperative-management-of-patients-with-addiction-to-opioid-and-non-opioid-medications
#1
REVIEW
Donna-Ann Thomas, Praba Boominathan, Jyotsna Goswami, Sudipta Mukherjee, Nalini Vadivelu
PURPOSE OF REVIEW: With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addicted patients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. RECENT FINDINGS: Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths...
June 14, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29892324/addressing-the-opioid-epidemic-impact-of-opioid-prescribing-protocol-at-the-university-of-minnesota-school-of-dentistry
#2
Robert Nadeau, Kristopher Hasstedt, Ashley Brooke Sunstrum, Chad Wagner, Harold Tu
Prescription opioid medications continue to be abused on an epidemic level and have been shown to be a "gateway" drug to heroin abuse. Individuals experimenting with opioids commonly fall in the 10- to 19-year age range in which dentists are the highest prescribers. To reduce the number of excess opioids, the Department of Oral and Maxillofacial Surgery, University of Minnesota, developed and implemented an evidence-based opioid prescribing policy. Data were collected via electronic health record for the previous year and compared with the year following the protocol implementation...
June 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29876923/chronic-pain-and-attention-in-older-community-dwelling-adults
#3
Guusje van der Leeuw, Suzanne G Leveille, Zhiyong Dong, Ling Shi, Daniel Habtemariam, William Milberg, Jeffrey M Hausdorff, Laura Grande, Peggy Gagnon, Robert R McLean, Jonathan F Bean
OBJECTIVES: To examine the cross-sectional relationship between chronic pain and complex attention in a population of community-living older adults. DESIGN: Prospective cross-sectional cohort study. SETTING: Population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. PARTICIPANTS: Individuals aged 71 to 101 (N=354). MEASUREMENTS: Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory...
June 6, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29872283/pain-as-a-challenge-in-nursing-home-residents-with-behavioral-and-psychological-symptoms-of-dementia
#4
Tomasz Nowak, Agnieszka Neumann-Podczaska, Ewa Deskur-Śmielecka, Arkadiusz Styszyński, Katarzyna Wieczorowska-Tobis
Introduction: In patients with dementia, observational scales are recommended for use in the assessment of pain. Unfortunately, their application is rare, and as a consequence pain is frequently underdiagnosed and undertreated in these types of subjects. Thus, the aim of the study was to assess analgesic treatment in nursing home residents with cognitive impairment and to delineate the relationship between pain and behavioral and psychological symptoms of dementia. Patients and methods: The research was conducted in 2 nursing home facilities in Wielkopolska, Poland...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29851450/current-and-emerging-options-to-combat-the-opioid-epidemic
#5
Courtney Kominek
Today's management of chronic pain presents a challenging clinical dilemma. Although clinicians wish to relieve a patient's suffering, they must do so without undertreating the pain or contributing to the drug abuse problem. Following a steady rise in opioid prescription rates from 2006 to 2012, increased national attention for the obioid abuse epidemic likely contributed to the decline in prescribing rates from 2012 to 2016. Although opioids have helped many patients, they are also associated with adverse events and a growing national crisis of misuse, abuse, and overdose...
May 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29796025/relationship-between-serum-methadone-concentration-and-cold-pressor-pain-sensitivity-in-patients-undergoing-methadone-maintenance-therapy
#6
Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose...
2018: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/29779012/adaptive-frameworks-of-chronic-pain-daily-remakings-of-pain-and-care-at-a-somali-refugee-women-s-health-centre
#7
Kari Campeau
Pain is an intensely subjective experience and one that is difficult for healthcare professionals to treat. Chronic pain, often diffuse, cyclical and involving many systems of the body, is often not well treated in a medical system that relies on discrete symptoms, identifiable causes, external pathogens and physician specialisation. Pain has its own problems specific to Somali diaspora populations, where chronic pain is prevalent but often undertreated, and where Somali patients face barriers of access to medicine...
May 19, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29775691/pain-in-maintenance-hemodialysis-patients-a-multicenter-study
#8
Tatiana Talya Fleishman, Jacob Dreiher, Pesach Shvartman
CONTEXT: Pain is a common complaint in maintenance hemodialysis (MHD) patients, yet is often inadequately assessed and undertreated. OBJECTIVES: To evaluate the prevalence, characteristics, intensity, and impact of pain in MHD patients. METHODS: In a cross-sectional study conducted between 2013 and 2015, 336 MHD patients from five hemodialysis units in hospitals owned by Clalit were interviewed and evaluated. Study tools included the Brief Pain Inventory, The Leeds Assessment of Neuropathic Symptoms and Signs pain scale, demographic and clinical characteristics...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29763832/the-impact-of-a-pain-assessment-intervention-on-pain-score-and-analgesic-use-in-older-nursing-home-residents-with-severe-dementia-a-cluster-randomised-controlled-trial
#9
Hanne Marie Rostad, Inger Utne, Ellen Karine Grov, Milada Cvancarova Småstuen, Martine Puts, Liv Halvorsrud
BACKGROUND: Pain is highly prevalent in older adults, especially those in institutional settings such as nursing homes. The presence of dementia may increase the risk of underdiagnosed and undertreated pain. Pain assessment tools are not regularly used in clinical practice, however, there are indications that the regular use of pain assessments tools may influence the recognition of pain by nursing staff and thereby affect pain management. OBJECTIVES: To assess whether regular pain assessment using a pain assessment tool is associated with changes in i) pain scores and ii) analgesic use in nursing home residents with severe dementia...
April 30, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29742248/pain-in-charcot-marie-tooth-disease-an-update
#10
Helen Azevedo, Camila Pupe, Rouse Pereira, Osvaldo J M Nascimento
Charcot-Marie-Tooth (CMT) disease, the most common inherited peripheral neuropathy, has pain as one of its clinical features, yet it remains underdiagnosed and undertreated. This literature review assessed data related to pain from CMT to determine its prevalence, type and importance as a symptom, which, unlike other symptoms, is likely to be treated. The research encompassed 2007 to 2017 and included five articles that addressed pain from CMT. All of the papers concurred that pain is frequently present in CMT patients, yet its classification remains undefined as there has been no consensus in the literature about the mechanisms that cause it...
April 2018: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29732985/treatment-of-chronic-articular-pain-in-adults-with-hemophilia
#11
E Carlos Rodriguez-Merchan
INTRODUCTION: Adult people with hemophilia (PWH) mainly use Factor VIII/Factor IX (FVIII/FIX) to lessen chronic articular pain, followed in frequency by nonsteroidal anti-inflammatory drugs. Analgesics are used by only one-third of adult PWH. Limitations in activities of daily living are encountered in the large majority of PWH, and most describe pain as affecting their state of mind. A review of the literature on their treatment is important because chronic pain in adult PWH is often undertreated or wrongly treated, causing psychological problems for these patients...
May 3, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29691245/health-related-quality-of-life-in-chinese-inpatients-with-lung-cancer-treatedin-large-general-hospitals-across-sectional-study
#12
Wen Gu, Yan-Min Xu, Bao-Liang Zhong
OBJECTIVE: In China, psychosocial problems of patients with cancer are under-recognised and undertreated in medical oncology practice. This study examined the health-related quality of life (QOL) in inpatients with lung cancer treated in large general hospitals and explored the demographic, clinical and psychosocial factors associated with QOL. DESIGN: Cross-sectional study. PARTICIPANTS AND SETTING: Altogether, 148 inpatients with lung cancer were consecutively recruited from two large general hospitals in Tianjin, China...
April 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678597/anxiety-but-not-depressive-like-behaviors-are-related-to-facial-hyperalgesia-in-a-model-of-trigeminal-neuropathic-pain-in-rats
#13
Eder Gambeta, Marcio Augusto Batista, Gabriel Paz Maschio, Joelle de Melo Turnes, Erika Ivanna Araya, Juliana Geremias Chichorro
Trigeminal neuralgia (TN) is a painful condition characterized by excruciating facial pain, which has a serious impact on quality of life. Depression and anxiety have been commonly associated with TN, but clinical studies report that these comorbidities are frequently underdiagnosed and undertreated in TN patients. Herein it was investigated if rats submitted to the infraorbital nerve constriction (CION), a model of trigeminal neuropathic pain, would display anxiety- and depressive-like behaviors in addition to the facial sensory changes in different time points after the nerve injury...
July 1, 2018: Physiology & Behavior
https://www.readbyqxmd.com/read/29644986/evaluation-of-fatigue-in-patients-with-pancreatic-cancer-receiving-chemotherapy-treatment-a-cross-sectional-observational-study
#14
Mariacristina Di Marco, Ivan Rubbi, Agnese Baldi, Rosaria Di Lorenzo, Daniela Magnani, Valeria Cremonini, Leopoldo Sarli, Giovanna Artioli, Paola Ferri
BACKGROUND AND AIM OF THE WORK: Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs) and negatively affects quality of life. Although CRF is frequently experienced, it is often underreported, underdiagnosed and undertreated. The objectives of this study were to evaluate the level of fatigue in patients with pancreatic cancer undergoing chemotherapy and to analyse its correlation with patients' demographic and clinical variables. METHODS: A cross-sectional observational study was implemented in the Oncology Day Hospital of a Northern Italian hospital...
February 27, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29642749/chronic-migraine-a-process-of-dysmodulation-and-sensitization
#15
Min Su, Shengyuan Yu
Chronic migraine is a common chronic daily headache featured by frequent headache attacks with at least 15 headache days per month, which brings great disease burden to both the sufferers and the society. Transformed from episodic migraine, the pathophysiology of chronic migraine is not fully understood, even though several risk factors have been associated with migraine progression. Recent studies have identified both structural and functional alterations in some brain regions of chronic migraine patients indicating that maladaptation of the top-down pain modulation and subsequent sensitization of trigeminal system may be important in the pathogenesis of chronic migraine...
January 2018: Molecular Pain
https://www.readbyqxmd.com/read/29623770/atypical-presentation-of-acute-coronary-syndrome-acs-a-case-report
#16
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29623512/incorporating-promis-symptom-measures-into-primary-care-practice-a-randomized-clinical-trial
#17
Kurt Kroenke, Tasneem L Talib, Timothy E Stump, Jacob Kean, David A Haggstrom, Paige DeChant, Kittie R Lake, Madison Stout, Patrick O Monahan
BACKGROUND: Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated. OBJECTIVE: To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes. DESIGN: Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system...
April 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29587275/efficacy-analysis-of-capsaicin-8-patch-in-neuropathic-peripheral-pain-treatment
#18
Joana Tenreiro Pinto, Frederico C Pereira, Maria C Loureiro, Ricardo Gama, Hugo L Fernandes
BACKGROUND/AIMS: Several guidelines for neuropathic pain management and various effective drugs are available; however, neuropathic pain remains undertreated. This retrospective study aimed to evaluate the efficacy of topical capsaicin 8% in peripheral neuropathic pain in a routine clinical setting. METHODS: Therapeutic efficacy was evaluated through pain intensity, using numerical pain rating scale at baseline and 7-14 days after each treatment, and using pain treatment area (PTA) assessed immediately before each treatment...
2018: Pharmacology
https://www.readbyqxmd.com/read/29572400/improving-the-management-of-pain-from-advanced-cancer-in-the-community-study-protocol-for-a-pragmatic-multicentre-randomised-controlled-trial
#19
Matthew J Allsop, Alexandra Wright-Hughes, Kath Black, Suzanne Hartley, Marie Fletcher, Lucy E Ziegler, Bridgette M Bewick, David Meads, Nicholas D Hughes, S José Closs, Claire Hulme, Sally Taylor, Kate Flemming, Julia Hackett, John L O'Dwyer, Julia M Brown, Michael I Bennett
INTRODUCTION: For patients with advanced cancer, research shows that pain is frequent, burdensome and undertreated. Evidence-based approaches to support cancer pain management have been developed but have not been implemented within the context of the UK National Health Service. This protocol is for a pragmatic multicentre randomised controlled trial (RCT) to assess feasibility, acceptability, effectiveness and cost-effectiveness for a multicomponent intervention for pain management in patients with advanced cancer...
March 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29470472/ethnic-and-sex-related-differences-in-pain-characteristics-psychological-distress-and-pain-related-disability-in-patients-attending-a-new-zealand-teaching-hospital-pain-service
#20
Andrea Burri, David Rice, Nicola Kluger, Michal Kluger
AIM: The aim of the present observational study was to provide a description of the demographic, psychological and pain characteristics of patients attending the Waitemata Pain Services (WPS), Auckland, New Zealand. METHOD: Data were collected via a comprehensive paper-pencil questionnaire handed out to 798 consecutive new patients seen at the WPS over a four-year period. RESULTS: 32.3% attending the WPS were men and 67.7% women, with a mean age of 52...
February 23, 2018: New Zealand Medical Journal
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