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Z B Pi, J K Zhang, Y Peng, Y Jin, H Lin
Objective: To evaluate the efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment of lower back post-herpetic neuralgia. Methods: One hundred and twenty-eight cases of lower back or anterior abdominal wall acute post-herpetic neuralgia patients were enrolled. They were randomly divided into two groups. Group A: oral treatment only with gabapentin+ celecoxib+ amitriptyline. Group B: while taking these drugs, patients were treated with radiofrequency pulses using a portable ultrasound device and the paravertebral puncture technique...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Daiqiang Liu, Yaqun Zhou, Yawen Peng, Peng Su, Zheng Li, Qiaoqiao Xu, Ye Tu, Xuebi Tian, Hui Yang, Zhen Wu, Wei Mei, Feng Gao
Morphine tolerance remains an intractable problem, which hinders its prolonged use in clinical practice. Endoplasmic reticulum (ER) stress has been proved to play a fundamental role in the pathogenesis of Alzheimer's disease, diabetes, atherosclerosis, cancer, etc. In this study, we provide the first direct evidence that ER stress may be a significant driver of morphine tolerance. Binding immunoglobulin protein (BiP), the ER stress marker, was significantly upregulated in neurons in spinal dorsal horn in rats being treated with morphine for 7 days...
2018: Frontiers in Molecular Neuroscience
Angela Nakahara, Nicole D Ulrich, Rajiv Gala
Background: Louisiana is significantly impacted by the opioid epidemic. In preparation for a quality improvement project aimed at decreasing postpartum narcotics prescriptions, we evaluated routine prescribing practices on a postpartum unit and the number of patient-initiated encounters for postpartum pain. Methods: We conducted a retrospective medical record review of all vaginal deliveries occurring at Ochsner Baptist Medical Center in New Orleans, LA in December 2016 and January 2017...
2018: Ochsner Journal
Eboni G Price-Haywood, Wanda Robinson, Jewel Harden-Barrios, Jeffrey Burton, Todd Burstain
Background: Opioid prescription drug abuse is a major public health concern. Healthcare provider prescribing patterns, especially among non-pain management specialists, are a major factor. Practice guidelines recommend what to do for safe opioid prescribing but do not provide guidance on how to implement best practices. Methods: We describe the implementation of electronic medical record clinical decision support (EMR CDS) for opioid management of chronic noncancer pain in an integrated delivery system...
2018: Ochsner Journal
Zhipeng Zhu, Hongmei Zhou, Yunjian Ni, Cheng Wu, Caijun Zhang, Xiaoyan Ling
Purpose: Cardiac surgery patients always present with atrial fibrillation (AF) after admission to the intensive care unit, leading to high mortality and lengthy hospitalization. Dexmedetomidine (DEX) is a popular medication used for sedation in the intensive care unit; however, whether it can reduce AF needs to be analyzed. Materials and methods: Three primary databases, Medline, Embase (Ovid SP) and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched...
2018: Drug Design, Development and Therapy
Ki Jin Kim, Sang Nam Lee, Bong Hyo Lee
RATIONALE: Morphine is a representative pain killer. However, repeated use tends to induce addiction. Music therapy has been gaining interest as a useful type of therapy for neuropsychiatric diseases. OBJECTIVES: The present study examined whether Korean traditional music (KT) could suppress morphine-seeking behavior and anxiety-like behavior induced by extinction from chronic morphine use and additionally investigated a possible neuronal mechanism. MATERIAL & METHODS: Male Sprague-Dawley rats were trained to intravenously self-administer morphine hydrochloride (1...
March 17, 2018: Neuroscience Letters
Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
Grace Chai, Jing Xu, James Osterhout, Mark A Liberatore, Kathleen L Miller, Carolyn Wolff, Marisa Cruz, Peter Lurie, Gerald Dal Pan
BACKGROUND: The opioid epidemic, driven in part by increased prescribing, is a public health emergency. This study examines dispensed prescription patterns and approvals of new opioid analgesic products to investigate whether the introduction of these new drugs increases prescribing. METHODS: Prescribing patterns based on dispensed prescription claims from the U.S. retail setting were assessed with new brand and generic opioid analgesic products approved in the United States from 1997 through 2015...
March 20, 2018: Anesthesiology
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
Zin Zayar Win, Phornpun Phokrai, Zarni Aung, Thein Zaw, Mary N Burtnick, Narisara Chantratita, Paul J Brett, Tin Maung Hlaing
Burkholderia pseudomallei , the etiologic agent of melioidosis, is an important but under-recognized cause of disease in the tropics. Although first described over a century ago as a septicemic illness associated with morphine addicts in Rangoon, Burma, there is little information regarding the incidence of melioidosis in present-day Myanmar. To address this issue, we used two recently developed and validated serological assays to detect B. pseudomallei -specific antibodies in 124 serum samples obtained from febrile patients in the delta region of Myanmar...
March 19, 2018: American Journal of Tropical Medicine and Hygiene
De-An Qin, Jie-Fu Song, Li-Ping Song, Gui-Sheng Feng
Background Pain management for multiple bone metastases is complex and often requires multidisciplinary treatment. We herein describe patient-centered multidisciplinary pain management for metastatic cancer. CASE PRESENTATION: A 61-year-old woman with multiple bone metastases of uterine cervical cancer developed intractable low back pain. After external beam radiotherapy failed, we performed lumbar spinal intralesional curettage, pedicle screw fixation, and nerve decompression. However, the neuralgia persisted...
January 1, 2018: Journal of International Medical Research
Małgorzata Łupina, Maciej Tarnowski, Irena Baranowska-Bosiacka, Sylwia Talarek, Piotr Listos, Jolanta Kotlińska, Izabela Gutowska, Joanna Listos
The present study focused upon the role of SB-334867, an orexin-1 receptor antagonist, in the acquisition of morphine-induced sensitization to locomotor activity in mice. Behavioral sensitization is an enhanced systemic reaction to the same dose of an addictive substance, which assumingly increases both the desire for the drug and the risk of relapse to addiction. Morphine-induced sensitization in mice was achieved by sporadic doses (five injections every 3 days) of morphine (10 mg/kg, i.p.), while a challenge dose of morphine (10 mg/kg) was injected 7 days later...
March 20, 2018: Molecular Neurobiology
Frédérique Rodieux, Laszlo Vutskits, Klara M Posfay-Barbe, Walid Habre, Valérie Piguet, Jules A Desmeules, Caroline F Samer
Children represent a vulnerable population in which management of nociceptive pain is complex. Drug responses in children differ from adults due to age-related differences. Moreover, therapeutic choices are limited by the lack of indication for a number of analgesic drugs due to the challenge of conducting clinical trials in children. Furthermore the assessment of efficacy as well as tolerance may be complicated by children's inability to communicate properly. According to the World Health Organization, weak opioids such as tramadol and codeine, may be used in addition to paracetamol and ibuprofen for moderate nociceptive pain in both children and adults...
2018: Frontiers in Pharmacology
Christian Lind Malte, Jonas Bundgaard, Michael Schou Jensen, Mads Frost Bertelsen, Tobias Wang
Morphine and other opioids cause respiratory depression in high doses and lower the ventilatory responses to hypoxia and hypercapnia in mammals. Recent studies indicate that turtles respond similarly, but although they are used routinely for post-surgical analgesia, little is known about the physiological effects of opioids in reptiles. We therefore investigated the effects of morphine (10 and 20 mg kg-1 ) on gas exchange and ventilation in six dwarf caiman (Paleosuchus palpebrosus) using pneumotachography in a crossover design...
March 16, 2018: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
Adam B King, Matthew D Spann, Patrick Jablonski, Jonathan P Wanderer, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions...
February 13, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mohammed Safwan Ali Khan, Nishat Ahmed, Misbah, Mohammed Arifuddin, Zainul Amiruddin Zakaria, Mohammad M Al-Sanea, Syeda Umme Kulsoom Khundmiri, Inshah Ahmed, Saleha Ahmed, Pooi Ling Mok
In view of the report on anti-nociceptive activity of Leathery Murdah, Terminalia coriacea {Roxb.} Wight & Arn. (Combretaceae) leaves, the present study was conducted to isolate the active constituents and identify the underlying mechanisms. The methanolic extract of T. coriacea leaves (TCLME) at doses 125, 250 and 500 mg/kg orally, was subjected to various in-vivo assays in acetic acid induced writhing and formalin induced paw-licking tests with aspirin (100 mg/kg) and morphine (5 mg/kg) as reference drugs...
March 16, 2018: Food and Chemical Toxicology
Jun-Bin Yin, Ya-Cheng Lu, Ban Feng, Zhen-Yu Wu, Ying-Biao Chen, Ting Zhang, Zhen-Zhen Kou, Ming-Ming Zhang, Han Zhang, Jin-Lian Li, Hui Li, Tao Chen, Yu-Lin Dong, Yun-Qing Li
BACKGROUND/AIMS: Spinal dorsal horn (SDH) is one of the most important regions for analgesia produced by endomorphin-2 (EM2), which has a higher affinity and specificity for the µ-opioid receptor (MOR) than morphine. Many studies have focused on substantia gelatinosa (SG, lamina II) neurons to elucidate the cellular basis for its antinociceptive effects. However, the complicated types and local circuits of interneurons in the SG make it difficult to understand the real effects of EM2...
March 15, 2018: Neuro-Signals
Marten N Basta, John E Fiadjoe, Albert S Woo, Kenneth N Peeples, Oksana A Jackson
OBJECTIVE: This study aimed to identify risk factors for adverse perioperative events (APEs) after cleft palatoplasty to develop an individualized risk assessment tool. DESIGN: Retrospective cohort. SETTING: Tertiary institutional. PATIENTS: Patients younger than 2 years with cleft palate. INTERVENTIONS: Primary Furlow palatoplasty between 2008 and 2011. MAIN OUTCOME MEASURE(S): Adverse perioperative event, defined as laryngo- or bronchospasm, accidental extubation, reintubation, obstruction, hypoxia, or unplanned intensive care unit admission...
April 2018: Cleft Palate-craniofacial Journal
Virginia A Hill, G Neil Stowe, Ryan B Paulsen, Michael Schaffer
Analysis of nail clippings may be a useful back-up for hair analysis when hair is unavailable. One aspect of using nails or hair is the ability to analyze whether drug present is from ingestion or from contamination. A common method of three 15-s rinses in methanol failed to remove drug from nails that had been soaked in either 5 or 50 μg/mL cocaine, methamphetamine or morphine for 1 h. While methanol rinsing did not remove contaminating drug, washing the nails soaked with 5 and 50 μg/mL of these drugs with an extended wash, a method developed for hair analysis and consisting of a 15-min isopropanol wash, and three 30-min and two 60-min phosphate buffer-0...
March 15, 2018: Journal of Analytical Toxicology
Megan Grabenauer, Katherine N Moore, Nichole D Bynum, Robert M White, John M Mitchell, Eugene D Hayes, Ronald Flegel
Recent advances in analytical capabilities allowing for the identification and quantification of drugs and metabolites in small volumes at low concentrations have made oral fluid a viable matrix for drug testing. Oral fluid is an attractive matrix option due to its relative ease of collection, reduced privacy concerns for observed collections and difficulty to adulterate. The work presented here details the development and validation of a liquid chromatography tandem mass spectrometry (LC-MS-MS) method for the quantification of codeine, morphine, 6-acetylmorphine, hydrocodone, hydromorphone, oxycodone and oxymorphone in neat oral fluid...
March 15, 2018: Journal of Analytical Toxicology
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