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Undertreated pain

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https://www.readbyqxmd.com/read/29030932/a-prospective-audit-of-pain-profiles-following-general-and-urological-surgery-in-children
#1
Caroline A Wilson, David Sommerfield, Thomas F E Drake-Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S von Ungern-Sternberg
BACKGROUND: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. AIM: To determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes)...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29019634/pain-assessment-in-newborns-infants-and-children
#2
Alexandra Beltramini, Kolia Milojevic, Dominique Pateron
Pain in children is underestimated and undertreated because of lack of pain assessment tools. Pain assessment depends on the cognitive development of the child being tested, clinical context, and pain typology. For children older than age 6 years, pain assessment is based on a self-report. For children younger than age 6 years, behavioral pain scales are needed to assess pain. Numerous pain scales exist. Many are reliable and some are recommended, but all have specific conditions for their use. In this article, we review the available pain scales for children from birth to adolescence...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28980440/self-report-pain-assessment-tools-for-cognitively-intact-older-adults-integrative-review
#3
Youjeong Kang, George Demiris
BACKGROUND: Pain is common in older adults, but it is often underreported or undertreated partly because many consider pain to be a normal consequence of ageing. Among the plethora of available self-report pain assessment tools, there is no synthetised evidence which tools are indicated for use among cognitively intact older adults. PURPOSE OF THE STUDY: To understand documented self-report pain assessment tools that have been used among cognitively intact older adults, and to describe their characteristics including overall performance as well as studies demonstrating their use...
October 5, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28975575/oncologist-s-knowledge-and-implementation-of-guidelines-for-breakthrough-cancer-pain-in-spain-conoce-study
#4
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/28918691/measuring-musculoskeletal-pain-in-infants-children-and-adolescents
#5
Zoe A Michaleff, Steven J Kamper, Jennifer N Stinson, Lise Hestbaek, Christopher M Williams, Paul Campbell, Kate M Dunn
Synopsis Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state)...
October 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28831272/pain-reporting-and-analgesia-management-in-270-children-with-a-progressive-neurologic-metabolic-or-chromosomally-based-condition-with-impairment-of-the-central-nervous-system-cross-sectional-baseline-results-from-an-observational-longitudinal-study
#6
Stefan J Friedrichsdorf, Andrea C Postier, Gail S Andrews, Karen Es Hamre, Rose Steele, Harold Siden
Little is known about the prevalence, characterization and treatment of pain in children with progressive neurologic, metabolic or chromosomal conditions with impairment of the central nervous system. The primary aims of this study were to explore the differences between parental and clinical pain reporting in children with life-limiting conditions at the time of enrollment into an observational, longitudinal study and to determine if differences in pain experiences were associated with patient- or treatment-related factors...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28821396/the-new-hdac1-inhibitor-lg325-ameliorates-neuropathic-pain-in-a-mouse-model
#7
Maria Domenica Sanna, Luca Guandalini, Maria Novella Romanelli, Nicoletta Galeotti
Current analgesic therapies for treatment of neuropathic pain are unsatisfactory. Neuropathic pain is, therefore, undertreated and there is a significant need for a better pharmacotherapy. Increasing evidence indicate that histone deacetylation is a critical step in nerve injury pain. To obtain an innovative treatment for the management of neuropathic pain, we investigated the pharmacological effects produced by the new histone deacetylase (HDAC)-1 selective inhibitor, LG325, in a mouse model of trauma-induced peripheral mononeuropathy provoked by spared nerve injury (SNI)...
August 15, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28811049/marijuana-and-cannabinoids-in-esrd-and-earlier-stages-of-ckd
#8
Joshua L Rein, Christina M Wyatt
Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28769555/naloxegol-in-opioid-induced-constipation-a-new-paradigm-in-the-treatment-of-a-common-problem
#9
REVIEW
Stephanie C Yoon, Heather C Bruner
Opioid-induced constipation (OIC) imposes a significant burden for patients taking pain medications, often resulting in decreased quality of life. Treatment of OIC with traditional medications for functional constipation can be incompletely effective, leading to nonadherence with opioid treatment and undertreated pain. An emerging class of medications that counteract the adverse effects of opioids in the gastrointestinal tract while preserving central nervous system-based pain relief may represent a paradigm shift in the prevention and treatment of OIC...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28764789/exploring-how-nurses-assess-monitor-and-manage-acute-pain-for-adult-critically-ill-patients-in-the-emergency-department-protocol-for-a-mixed-methods-study
#10
Wayne Varndell, Margaret Fry, Doug Elliott
BACKGROUND: Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown...
August 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28743558/the-association-of-nurses-assessment-and-certainty-to-pain-management-and-outcomes-for-nursing-home-residents-in-jordan
#11
Mohammad Rababa
Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables...
July 22, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28729010/evaluation-of-emergency-department-management-of-opioid-tolerant-cancer-patients-with-acute-pain
#12
Pina M Patel, Lauren F Goodman, Sheri A Knepel, Charles C Miller, Asma Azimi, Gary Phillips, Jillian L Gustin, Amber Hartman
CONTEXT: There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during emergency department (ED) encounters. OBJECTIVES: To determine if opioid-tolerant cancer patients presenting with acute pain exacerbations receive adequate initial doses of as needed (PRN) opioids during ED encounters based on home oral morphine equivalent (OME) use. METHODS: We performed a retrospective cohort study of opioid-tolerant cancer patients who received opioids in our ED over a two-year period...
July 17, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#13
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28709881/can-primary-care-for-back-and-or-neck-pain-in-the-netherlands-benefit-from-stratification-for-risk-groups-according-to-the-start-back-tool-classification
#14
Jasper D Bier, Janneke J W Sandee-Geurts, Raymond W J G Ostelo, Bart W Koes, Arianne P Verhagen
OBJECTIVE: To evaluate whether current Dutch primary-care clinicians offer tailored treatment to patients with lower-back pain (LBP) or neck pain (NP) according to their risk stratification, based on the Keele STarT (Subgroup Targeted Treatment) Back-Screening Tool (SBT). DESIGN: Prospective cohort study with 3 month follow-up SETTING: Primary care PARTICIPANTS: General practitioners (GPs) and physiotherapists (PTs) included patients with non-specific LBP and/or NP...
July 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28659151/pain-and-quality-of-life-evaluation-in-patients-with-localized-epidermolysis-bullosa-simplex
#15
Jennifer Brun, Christine Chiaverini, Caroline Devos, Stéphanie Leclerc-Mercier, Juliette Mazereeuw, Emmanuelle Bourrat, Annabel Maruani, Stéphanie Mallet, Claire Abasq, Alice Phan, Pierre Vabres, Ludovic Martin, Christine Bodemer, Sylvie Lagrange, Jean-Philippe Lacour
BACKGROUND: A localized form of epidermolysis bullosa simplex (EBS-l) is considered one of the mildest forms of epidermolysis bullosa (EB), with blisters limited to the palms and soles. However, these lesions can be very painful. The aim of the study was to characterize pain in patients with EBS-l and evaluate its impact on quality of life (QoL). Patients were contacted via the Research Group of the French Society of Pediatric Dermatology and the association of EB patients (DEBRA France)...
June 28, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28625286/no-345-primary-dysmenorrhea-consensus-guideline
#16
Margaret Burnett, Madeleine Lemyre
OBJECTIVE: This guideline reviews the investigation and treatment of primary dysmenorrhea. INTENDED USERS: Health care providers. TARGET POPULATION: Women and adolescents experiencing menstrual pain for which no underlying cause has been identified. EVIDENCE: Published clinical trials, population studies, and review articles cited in PubMed or the Cochrane database from January 2005 to March 2016. VALIDATION METHODS: Seven clinical questions were generated by the authors and reviewed by the SOGC Clinical Practice-Gynaecology Committee...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28602044/the-dynamic-interaction-between-pain-and-opioid-misuse
#17
REVIEW
Adrianne R Wilson-Poe, Jose A Morón
In 2014, drug overdose surpassed automobile accidents as the number one cause of accidental death for the first time in the history of the United States. The overdose epidemic is largely driven by opioids, and genuine prescription opioid analgesics play the biggest role in this phenomenon. Despite advancements in abuse deterrent formulations, prescription drug monitoring programmes and clinical assessments for the detection of abuse potential, drug overdoses continue to escalate. The Center for Disease Control has recently issued new guidelines for opioid prescription, yet even these recommendations have their shortcomings...
June 11, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28585664/identification-and-treatment-of-adolescents-with-perinatal-anxiety-and-depression
#18
Linda Paine Hughes, Tammy Austin-Ketch, Ellen M Volpe, Nancy Campbell-Heider
Perinatal mood and anxiety disorders (PMAD) are the most common, yet under-diagnosed and undertreated complication of pregnancy, affecting up to 50% of pregnant and parenting teens. PMAD are a global health issue that can have devastating effects on the mental, physical, emotional, developmental health, and social life of the mother, infant, and family. Adolescents present with similar symptoms of PMAD as their adult counterparts, but also experience isolation from their peer group and lack of resources and coping strategies, as well as difficulty sleeping and lack of concentration and ability to focus...
June 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28469039/nociceptive-brain-activity-as-a-measure-of-analgesic-efficacy-in-infants
#19
Caroline Hartley, Eugene P Duff, Gabrielle Green, Gabriela Schmidt Mellado, Alan Worley, Richard Rogers, Rebeccah Slater
Pain in infants is undertreated and poorly understood, representing a major clinical problem. In part, this is due to our inability to objectively measure pain in nonverbal populations. We present and validate an electroencephalography-based measure of infant nociceptive brain activity that is evoked by acute noxious stimulation and is sensitive to analgesic modulation. This measure should be valuable both for mechanistic investigations and for testing analgesic efficacy in the infant population.
May 3, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28460372/the-role-of-topiceuticals-in-cancer-pain
#20
Peter Paisley, Michael Serpell
PURPOSE OF REVIEW: Pain is one of the most common and feared symptoms associated with a new diagnosis of cancer and its subsequent treatment. Unfortunately, it remains undertreated in around one third of patients. It has been recently postulated that one mechanism for this could be failure to recognize neuropathic pain. One attractive option in both the case of neuropathic pain and pain associated with intolerable side effects of prescribed opioids is the use of 'topiceuticals', as a means of targeted pain relief with potentially fewer side effects...
June 2017: Current Opinion in Supportive and Palliative Care
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