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https://www.readbyqxmd.com/read/28090416/post-traumatic-arthritis-of-the-tarsometatarsal-joint-complex-a-case-report
#1
Chirag Kapoor, Amit Patel, Maulik Jhaveri, Paresh Golwala
Tarsometatarsal (TMT) arthritis is characterized by instability and pain in the foot. The commonest cause is post-traumatic arthritis. A Lisfranc injury involves the articulation between the medial cuneiform and the base of the second metatarsal, which is considered a keystone to midfoot integrity. Neglected or undertreated injury to the Lisfranc joint complex leads to secondary arthritis and significant disability. We present a case of a young male patient with a two-year-old neglected Lisfranc joint injury and secondary osteoarthritis of the first, second, and fourth TMT joints, which we treated surgically with arthrodesis using screws, with a good functional outcome on final follow-up...
December 9, 2016: Curēus
https://www.readbyqxmd.com/read/28066825/a-blinded-randomised-placebo-controlled-trial-investigating-the-efficacy-of-morphine-analgesia-for-procedural-pain-in-infants-trial-protocol
#2
Rebeccah Slater, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E Norman, Chetan Patel, Kayleigh Stanbury, Amy Hoskin, Gabrielle Green
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia...
November 15, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28030517/pain-assessment-in-children-younger-than-8-years-in-out-of-hospital-emergency-medicine-reliability-and-validity-of-evendol-score
#3
Alexandra Beltramini, Michel Galinski, Jean Louis Chabernaud, Ramon Ruiz Almenar, Michael Tsapis, Nathalie Sybille Goddet, Katia Kessous, Bruno Falissard, Elisabeth Fournier-Charrière
OBJECTIVE: Pain in children is underestimated and undertreated in out-of-hospital emergency medicine. In this setting, caregivers need a reliable pain scale, but none has been validated. A single observational pain scale for all children younger than 8 years, EVENDOL, has been validated in emergency pediatric units. We study the feasibility of EVENDOL score in an out-of-hospital emergency setting. METHODS: This prospective multicenter study included all conscious children younger than 8 years transported by a mobile intensive care unit between October 2008 and May 2010...
December 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27999523/assessment-and-treatment-of-psychiatric-distress-sexual-dysfunction-sleep-disturbances-and-pain-in-multiple-sclerosis-a-survey-of-members-of-the-consortium-of-multiple-sclerosis-centers
#4
Elizabeth S Gromisch, Laura C Schairer, Eliana Pasternak, Stella H Kim, Frederick W Foley
Background: Psychiatric distress (depression and anxiety), sexual dysfunction, sleep disturbances, and pain are frequent comorbidities in multiple sclerosis (MS) that have the potential to interfere with functioning and quality of life. Often, patients benefit from a combination of medical and psychotherapeutic interventions. However, the literature suggests that many of these issues have been underdiagnosed or undertreated. To better understand current practices, this study aimed to gain a multidisciplinary perspective on how MS providers assess and treat these five problems...
November 2016: International Journal of MS Care
https://www.readbyqxmd.com/read/27965524/healthcare-providers-knowledge-and-current-practice-of-pain-assessment-and-management-how-much-progress-have-we-made
#5
Khawla Nuseir, Manal Kassab, Basima Almomani
Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients. Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan. Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#6
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27845483/prevalence-of-pain-in-the-departments-of-surgery-and-oncohematology-of-a-paediatric-hospital-that-has-joined-the-project-towards-pain-free-hospital
#7
G Marchetti, A Vittori, V Tortora, M Bishop, G Lofino, V Pardi, E A De Marco, G Manca, A Inserra, R Caruso, I Ciaralli, F Locatelli, S Bella, A E Tozzi, S Picardo
BACKGROUND: Among hospitalized adults and children pain is undertreated. This study wants to assess the effectiveness of pain therapy in two departments of a large children's hospital. MATERIALS AND METHODS: During a single day work three committees, administering a questionnaire to patients or parents, have evaluated the adherence to international recommendations (JCI and WHO) in the management of analgesic therapy. Patient demographics, prevalence and intensity (moderate and/or severe) of pain (during hospitalization, 24 hours before and at the time of the interview), analgesia (type, route, duration and frequency of administration) and Pain Management Index (=analgesic score-pain score) were recorded...
September 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/27837033/pain-in-dementia-use-of-observational-pain-assessment-tools-by-people-who-are-not-health-professionals
#8
Delaine A Ammaturo, Thomas Hadjistavropoulos, Jaime Williams
OBJECTIVE: Pain is prevalent among older adults but is often underestimated and undertreated, especially in people with severe dementia who have limited ability to self-report pain. Pain in patients with moderate to severe dementia can be assessed using observational tools. Informal caregivers (relatives of seniors with dementia) are an untapped assessor group who often bear the responsibility of care for their loved ones. Our objective was to evaluate the ability of laypeople to assess pain using observational measures originally developed for use by health care professionals...
November 10, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27714773/histamine-h4-receptor-agonist-induced-relief-from-painful-peripheral-neuropathy-is-mediated-by-inhibition-of-spinal-neuroinflammation-and-oxidative-stress
#9
Maria Domenica Sanna, Laura Lucarini, Mariaconcetta Durante, Carla Ghelardini, Emanuela Masini, Nicoletta Galeotti
BACKGROUND AND PURPOSE: Neuropathic pain is under-treated, with a detrimental effect on quality of life, partly because of low treatment efficacy, but also because pathophysiological mechanisms are not fully elucidated. To clarify the pathobiology of neuropathic pain, we studied the contribution of neuroinflammation and oxidative stress in a model of peripheral neuropathy. We also assessed an innovative treatment for neuropathic pain by investigating the effects of histamine H4 receptor ligands in this model...
January 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/27704172/improvement-of-postoperative-pain-control-processes-and-outcomes-in-veterans-of-a-surgical-intensive-care-unit
#10
Melissa S D'Andrea, P Marco Fisichella
BACKGROUND: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. PATIENTS AND METHODS: We retrospectively review 713 consecutive veterans admitted to our SICU...
October 4, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27681227/acceptability-of-a-telecare-intervention-for-persistent-musculoskeletal-pain
#11
Rebecca E Guilkey, Claire B Draucker, Jingwei Wu, Zhangsheng Yu, Kurt Kroenke
INTRODUCTION: Persistent musculoskeletal pain is a prevalent, disabling, and often undertreated condition. This paper examines the acceptability of a telecare intervention for this condition. METHODS: The Stepped Care to Optimize Pain Care Effectiveness (SCOPE) intervention couples automatic symptom monitoring (ASM) with optimized analgesic care management by a nurse-physician team. Data from participants in the telecare intervention arm (n = 124) of a randomized control trial of SCOPE were analysed to determine the acceptability of the telecare intervention as indicated by patient use and satisfaction...
September 27, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27670427/cluster-headache-in-greece-an-observational-clinical-and-demographic-study-of-302-patients
#12
Michail Vikelis, Alan M Rapoport
BACKGROUND: Cluster headache (CH) is considered the most excruciating primary headache syndrome; although much less prevalent than migraine, it is not rare as it affects more than 1/1000 people. While its clinical presentation is considered stereotypic, atypical features are often encountered. Internationally, cluster headache is often misdiagnosed, undertreated and mistreated. METHODS: We prospectively studied 302 CH patients, all examined by the same headache specialist...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27665572/evaluation-of-perfusion-index-as-a-tool-for-pain-assessment-in-critically-ill-patients
#13
Ahmed Hasanin, Sabah Abdel Raouf Mohamed, Akram El-Adawy
Pain is a common and undertreated problem in critically ill patients. Pain assessment in critically ill patients is challenging and relies on complex scoring systems. The aim of this work was to find out the possible role of the perfusion index (PI) measured by a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, USA) in pain assessment in critically ill patients. A prospective observational study was carried out on 87 sedated non-intubated patients in a surgical intensive care unit. In addition to routine monitoring, a Masimo pulse oximeter probe was used for PI measurement...
September 24, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27604271/post-craniotomy-pain-management-beyond-opioids
#14
REVIEW
Lauren K Dunn, Bhiken I Naik, Edward C Nemergut, Marcel E Durieux
Craniotomy pain may be severe and is often undertreated. Pain management following craniotomy is a balancing act of achieving adequate analgesia but avoiding sedation, respiratory depression, hypercapnia, nausea and vomiting, and hypertension. Opioids are a first-line analgesic therapy; however, concern that opioid-related adverse effects (sedation, respiratory depression) may interfere with neurologic assessment and increase intracranial pressure has limited use of these drugs for intracranial surgery. Non-opioid analgesics avoid these effects and may be useful as part of a multimodal regimen for post-craniotomy pain...
October 2016: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/27555508/opioids-increase-sexual-dysfunction-in-patients-with-non-cancer-pain
#15
Raquel Ajo, Ana Segura, María-Del-Mar Inda, Beatriz Planelles, Luz Martínez, Guillermina Ferrández, Angel Sánchez, César Margarit, Ana-María Peiró
INTRODUCTION: Long-term opioid therapy has been found to have a strong impact on the hypothalamic-pituitary-gonadal axis that can be manifested clinically by sexual dysfunction (SD). This event is rarely reported and thus unnoticed and undertreated. AIM: To analyze the presence of SD in a large group of patients receiving long-term opioids. METHODS: A descriptive, cross-sectional pilot study of sexual health was conducted for 2 years in 750 consecutive ambulatory patients with chronic non-cancer pain (CNP) receiving opioids for at least 12 months...
September 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27497016/pain-assessment-in-noncommunicative-adult-palliative-care-patients
#16
REVIEW
Deborah B McGuire, Karen Snow Kaiser, Mary Ellen Haisfield-Wolfe, Florence Iyamu
Palliative care patients who have pain are often unable to self-report their pain, placing them at increased risk for underrecognized and undertreated pain. Use of appropriate pain assessment tools significantly enhances the likelihood of effective pain management and improved pain-related outcomes. This paper reviews selected tools and provides palliative care clinicians with a practical approach to selecting a pain assessment tool for noncommunicative adult patients.
September 2016: Nursing Clinics of North America
https://www.readbyqxmd.com/read/27479493/pain-buddy-a-novel-use-of-m-health-in-the-management-of-children-s-cancer-pain
#17
Michelle A Fortier, Winnie W Chung, Ariana Martinez, Sergio Gago-Masague, Leonard Sender
BACKGROUND: Over 12,000 children are diagnosed with cancer every year in the United States. In addition to symptoms associated with their disease, children undergoing chemotherapy frequently experience significant pain, which is unfortunately often undertreated. The field of m-Health offers an innovative avenue for pain assessment and intervention in the home setting. The current study describes the development and initial evaluation of a tablet-based program, Pain Buddy, aimed to enhance pain management and foster improved quality of life in children ages 8-18 years undergoing cancer treatment...
September 1, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27445632/finding-ways-to-lift-barriers-to-care-for-chronic-pain-patients-outcomes-of-using-internet-based-self-management-activities-to-reduce-pain-and-improve-quality-of-life
#18
Kevin Rod
Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27417446/constipation-in-elderly-patients-with-noncancer-pain-focus-on-opioid-induced-constipation
#19
Sita Chokhavatia, Elizabeth S John, Mary Barna Bridgeman, Deepali Dixit
Constipation is a common and often debilitating condition in the elderly, which may be caused by underlying disease conditions, structural abnormalities in the bowel, and a variety of medications such as anticholinergics, antidepressants, and opiates. In this review, we focus on opioid-induced constipation (OIC), which is often underrecognized and undertreated in the elderly. When opioid therapy is initiated, healthcare providers are encouraged to evaluate risk factors for the development of constipation as part of a thorough patient history...
August 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27378916/pharmacotherapy-of-pain-in-the-older-population-the-place-of-opioids
#20
REVIEW
Milica Prostran, Katarina Savić Vujović, Sonja Vučković, Branislava Medić, Dragana Srebro, Nevena Divac, Radan Stojanović, Aleksandar Vujović, Lepa Jovanović, Ana Jotić, Nataša Cerovac
Pain is a common symptom in older people. It is possible that pain is underreported in older persons due to an incorrect belief that it is an inevitable part of aging. Opioid analgesics are potent medications, with confirmed efficacy for the treatment of moderate to severe pain. These drugs are commonly used in older persons. However, there is insufficient evidence regarding safety of opioids in older patients. One of the reasons for this is the lack of randomized, controlled clinical trials. People of advanced age often have comorbidites and use other prescription drugs, as well as over-the-counter (OTC) compounds, thus making them more suceptible to the risk of interactions with opioids...
2016: Frontiers in Aging Neuroscience
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