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https://www.readbyqxmd.com/read/28822648/cyclooxygenase-2-inhibitors-and-free-flap-complications-after-autologous-breast-reconstruction-a-retrospective-cohort-study
#1
Christian Bonde, Hoda Khorasani, Jens Hoejvig, Henrik Kehlet
BACKGROUND: A key component of modern analgesics is the use of multimodal opioid-sparing analgesia (MOSA). In the past, our analgesic regime after autologous breast reconstruction (ABR) included either NSAID or a selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 inhibitors are superior to NSAIDs because of the well-known side effects of NSAID treatment (bleeding/gastrointestinal ulcers). However, COX-2 inhibitors have been suggested to increase flap failure rates. We report our experience in using COX-2 inhibitors as part of our post-operative MOSA after ABR using free flaps...
June 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28821939/analgesic-use-in-patients-with-knee-and-or-hip-osteoarthritis-referred-to-an-outpatient-center-a-cross-sectional-study-within-the-amsterdam-osteoarthritis-cohort
#2
Jesper Knoop, Joyce van Tunen, Martin van der Esch, Leo D Roorda, Joost Dekker, Marike van der Leeden, Willem F Lems
Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted...
August 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28821396/the-new-hdac1-inhibitor-lg325-ameliorates-neuropathic-pain-in-a-mouse-model
#3
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/28820803/perioperative-breast-analgesia-a-qualitative-review-of-anatomy-and-regional-techniques
#4
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28820793/codeine-plus-acetaminophen-for-pain-after-photorefractive-keratectomy-a-randomized-double-blind-placebo-controlled-add-on-trial
#5
Vinicius B P Pereira, Renato Garcia, Andre A M Torricelli, Adriana Mukai, Samir J Bechara
BACKGROUND: Pain after photorefractive keratectomy (PRK) is significant, and the analgesic efficacy and safety of oral opioids in combination with acetaminophen has not been fully investigated in PRK trials. PURPOSE: To assess the efficacy and safety of the combination of codeine plus acetaminophen (paracetamol) versus placebo as an add-on therapy for pain control after PRK. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial...
August 17, 2017: Cornea
https://www.readbyqxmd.com/read/28820778/src-kinase-inhibition-attenuates-morphine-tolerance-without-affecting-reinforcement-or-psychomotor-stimulation
#6
Fiona A Bull, Daniel T Baptista-Hon, Claire Sneddon, Lisa Wright, Wendy Walwyn, Tim G Hales
BACKGROUND: Prolonged opioid administration leads to tolerance characterized by reduced analgesic potency. Pain management is additionally compromised by the hedonic effects of opioids, the cause of their misuse. The multifunctional protein β-arrestin2 regulates the hedonic effects of morphine and participates in tolerance. These actions might reflect µ opioid receptor up-regulation through reduced endocytosis. β-Arrestin2 also recruits kinases to µ receptors. We explored the role of Src kinase in morphine analgesic tolerance, locomotor stimulation, and reinforcement in C57BL/6 mice...
August 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28820497/anesthetic-agents-of-plant-origin-a-review-of-phytochemicals-with-anesthetic-activity
#7
REVIEW
Hironori Tsuchiya
The majority of currently used anesthetic agents are derived from or associated with natural products, especially plants, as evidenced by cocaine that was isolated from coca (Erythroxylum coca, Erythroxylaceae) and became a prototype of modern local anesthetics and by thymol and eugenol contained in thyme (Thymus vulgaris, Lamiaceae) and clove (Syzygium aromaticum, Myrtaceae), respectively, both of which are structurally and mechanistically similar to intravenous phenolic anesthetics. This paper reviews different classes of phytochemicals with the anesthetic activity and their characteristic molecular structures that could be lead compounds for anesthetics and anesthesia-related drugs...
August 18, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28820231/interventions-for-treating-persistent-pain-in-survivors-of-torture
#8
REVIEW
Emma Baird, Amanda C de C Williams, Leslie Hearn, Kirstine Amris
BACKGROUND: Persistent (chronic) pain is a frequent complaint in survivors of torture, particularly but not exclusively pain in the musculoskeletal system. Torture survivors may have no access to health care; where they do, they may not be recognised when they present, and the care available often falls short of their needs. There is a tendency in state and non-governmental organisations' services to focus on mental health, with poor understanding of persistent pain, while survivors may have many other legal, welfare, and social problems that take precedence over health care...
August 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28819604/posterior-knee-loose-bodies-treated-by-posterior-knee-arthroscopy
#9
Ho Lam Chai, Tun Hing Lui
INTRODUCTION: The posterior portion of the knee joint, which includes the tibial attachment of the posterior cruciate ligament and the posterior horn of the menisci, has been called a "blind spot" because it is difficult to observe this area under arthroscopy through standard anterior portals. Posteromedial, posterolateral, and posterior transseptal portals have been developed for visualization and instrumentation of the posteromedial and posterolateral compartments of the knee joint...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819330/synthesis-and-investigation-of-mixed-%C3%AE-opioid-and-%C3%AE-opioid-agonists-as-possible-bivalent-ligands-for-treatment-of-pain
#10
Ruben S Vardanyan, James P Cain, Saghar Mowlazadeh Haghighi, Vlad K Kumirov, Mary I McIntosh, Alexander J Sandweiss, Frank Porreca, Victor J Hruby
Several studies have suggested functional association between μ-opioid and δ-opioid receptors and showed that μ-activity could be modulated by δ-ligands. The general conclusion is that agonists for the δ-receptor can enhance the analgesic potency and efficacy of μ-agonists. Our preliminary investigations demonstrate that new bivalent ligands constructed from the μ-agonist fentanyl and the δ-agonist enkephalin-like peptides are promising entities for creation of new analgesics with reduced side effects for treatment of neuropathic pain...
March 2017: Journal of Heterocyclic Chemistry
https://www.readbyqxmd.com/read/28818631/topical-medical-cannabis-tmc-a-new-treatment-for-wound-pain-three-cases-of-pyoderma-gangrenosum
#11
Vincent Maida, Jason Corban
Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#12
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 18, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28817527/studies-on-postoperative-analgesic-efficacy-focusing-the-statistical-methods-and-broadening-outcome-measures-and-measurement-tools
#13
Honorio T Benzon, Edward J Mascha, Christopher L Wu
No abstract text is available yet for this article.
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28817416/nicotinic-modulation-of-descending-pain-control-circuitry
#14
Iboro C Umana, Claire A Daniele, Brooke A Miller, Keith Gallagher, Meghan A Brown, Chandrika Abburi, Peggy Mason, Daniel S McGehee
Along with the well-known rewarding effects, activation of nicotinic acetylcholine receptors (nAChRs) can also relieve pain, and some nicotinic agonists have analgesic efficacy similar to opioids. A major target of analgesic drugs is the descending pain modulatory pathway, including the ventrolateral periaqueductal gray (vlPAG) and the rostral ventromedial medulla (RVM). Although activating nAChRs within this circuitry can be analgesic, little is known about the subunit composition and cellular effects of these receptors, particularly within the vlPAG...
July 3, 2017: Pain
https://www.readbyqxmd.com/read/28816876/osteoporotic-thoracolumbar-fractures-how-are-they-different-classification-and-treatment-algorithm
#15
Shanmuganathan Rajasekaran, Rishi M Kanna, Klaus J Schnake, Alexander R Vaccaro, Gregory D Schroeder, Said Sadiqi, Cumhur Oner
Osteoporotic vertebral fractures constitute at least 50% of the osteoporotic fractures that happen worldwide. Occurrence of osteoporotic fractures make the elderly patient susceptible for further fractures and increases the morbidity due to kyphosis and pain; the mortality risk is also increased in these patients. Most fractures occur in the thoracic and thoracolumbar region and are often stable. Different descriptive and prognostic classification systems have been described, but none are universally accepted...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816506/inhibition-of-monoacylglycerol-lipase-another-signalling-pathway-for-potential-therapeutic-targets-in-migraine
#16
Rosaria Greco, Chiara Demartini, Anna Maria Zanaboni, Laura Berliocchi, Daniele Piomelli, Cristina Tassorelli
Background Drugs that modulate endocannabinoid signalling are effective in reducing nociception in animal models of pain and may be of value in the treatment of migraine. Methods We investigated the anti-nociceptive effects of inhibition of monoacylglycerol lipase (MGL), a key enzyme in the hydrolysis of the 2-arachidonoylglycerol, in a rat model of migraine based on nitroglycerin (NTG) administration. We evaluated c-fos expression in specific brain areas and nociceptive behavior in trigeminal and extra-trigeminal body areas...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28816231/molecular-mechanisms-of-the-analgesic-action-of-wu-tou-decoction-on-neuropathic-pain-in-mice-revealed-using-microarray-and-network-analysis
#17
Yan-Qiong Zhang, Chao Wang, Qiu-Yan Guo, Chun-Yan Zhu, Chen Yan, Dan-Ni Sun, Qiong-Hong Xu, Na Lin
Wu-tou Decoction (WTD) is a classic herbal formula in traditional Chinese medicine for the treatment of joint diseases, neuropathic pain (NP) and inflammatory pain. In this study we investigated whether WTD produced analgesic action in a mouse spinal nerve ligation (SNL) model and elucidated the underlying molecular mechanisms. Mice were subjected to SNL and orally treated with WTD (3.15, 6.30 or 12.60 g·kg(-1)·d(-1)) for 21 d. SNL induced mechanical hyperalgesia and heat hyperalgesia characterized by rapid and persistent pain hypersensitivity...
August 17, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28816033/selection-of-12-hour-sustained-release-acetaminophen-paracetamol-formulation-through-comparison-of-pharmacokinetic-profiles-of-4-sustained-release-prototype-formulations-and-standard-acetaminophen-formulation-an-open-label-randomized-proof-of-principle-pharmacokinetic
#18
Yong Yue, Dongzhou J Liu
Acetaminophen (APAP; paracetamol), a widely used analgesic and antipyretic, is available in modified-release and immediate-release (IR) formulations requiring 3- or 4-times-daily dosing. This phase 1 open-label crossover study compared pharmacokinetic profiles of single 2000-mg doses of 4 different sustained-release (SR) formulations of APAP (designed to allow twice-daily dosing) against two 1000-mg doses (taken 6 hours apart) of standard IR APAP in 14 healthy volunteers. The primary end point was duration of time that plasma APAP concentration exceeded a plasma concentration (TC ) of 4 μg/mL...
August 16, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#19
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#20
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
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