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https://www.readbyqxmd.com/read/29049119/a-review-of-opioid-sparing-modalities-in-perioperative-pain-management-methods-to-decrease-opioid-use-postoperatively
#1
Kanupriya Kumar, Meghan A Kirksey, Silvia Duong, Christopher L Wu
There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049116/basic-translational-development-of-forthcoming-opioid-and-nonopioid-targeted-pain-therapeutics
#2
Nebojsa Nick Knezevic, Ajay Yekkirala, Tony L Yaksh
Opioids represent an efficacious therapeutic modality for some, but not all pain states. Singular reliance on opioid therapy for pain management has limitations, and abuse potential has deleterious consequences for patient and society. Our understanding of pain biology has yielded insights and opportunities for alternatives to conventional opioid agonists. The aim is to have efficacious therapies, with acceptable side effect profiles and minimal abuse potential, which is to say an absence of reinforcing activity in the absence of a pain state...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29037089/patient-reported-outcomes-in-nephrolithiasis-can-we-do-better
#3
Jonathan S Ellison, Marc Williams, Francis Keeley
Purpose Nephrolithiasis contributes significantly to the world-wide health care burden. Patient-reported outcome measures (PROMs) are widely recognized as important outcome measures for patient-centered care. We sought to summarize what is currently known about PROMs in urinary stone disease and to characterize use of PROMs in randomized controlled trials (RCTs) for nephrolithiasis. Materials and Methods Health-related quality of life (HRQOL) in patients with nephrolithiasis is reviewed. A search of both MEDLINE and EMBASE databases for randomized controlled trials (RCTs) in nephrolithiasis was performed to assess utilization of PROMs in these trials...
October 17, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#4
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29029074/multimodality-imaging-evaluation-of-chagas-disease-an-expert-consensus-of-brazilian-cardiovascular-imaging-department-dic-and-the-european-association-of-cardiovascular-imaging-eacvi
#5
Maria Carmo P Nunes, Luigi Paolo Badano, J Antonio Marin-Neto, Thor Edvardsen, Covadonga Fernández-Golfín, Chiara Bucciarelli-Ducci, Bogdan A Popescu, Richard Underwood, Gilbert Habib, Jose Luis Zamorano, Roberto Magalhães Saraiva, Ester Cerdeira Sabino, Fernando A Botoni, Márcia Melo Barbosa, Marcio Vinicius L Barros, Eduardo Falqueto, Marcus Vinicius Simões, André Schmidt, Carlos Eduardo Rochitte, Manoel Otávio Costa Rocha, Antonio Luiz Pinho Ribeiro, Patrizio Lancellotti
Aims: To develop a document by Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI) to review and summarize the most recent evidences about the non-invasive assessment of patients with Chagas disease, with the intent to set up a framework for standardized cardiovascular imaging to assess cardiovascular morphologic and functional disturbances, as well as to guide the subsequent process of clinical decision-making. Methods and results: Chagas disease remains one of the most prevalent infectious diseases in Latin America, and has become a health problem in non-endemic countries...
September 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29028758/mr-neurography-of-lumbosacral-plexus-in-failed-back-surgery-syndrome
#6
Riham Dessouky, Mohammed Khaleel, Dalia N Khalifa, Hazim I Tantawy, Avneesh Chhabra
STUDY DESIGN: Retrospective clinical case series. OBJECTIVE: To study the role of MRN of lumbosacral plexus in management of patients with FBSS. SUMMARY OF BACKGROUND DATA: Failed back surgery syndrome (FBSS) is one of the major problems in health care, affecting up to 40% of patients following spine surgery. To date, no imaging modality has been used to effectively classify nerve compression, since nerve injuries are challenging to detect on conventional lumbar spine MRI...
October 12, 2017: Spine
https://www.readbyqxmd.com/read/29028436/pain-management-after-hip-arthroscopy-systematic-review-of-randomized-controlled-trials-and-cohort-studies
#7
Jason J Shin, Chris L McCrum, Craig S Mauro, Dharmesh Vyas
BACKGROUND: Hip arthroscopy is often associated with significant postoperative pain and opioid-associated side effects. Effective pain management after hip arthroscopy improves patient recovery and satisfaction and decreases opioid-related complications. PURPOSE: To collect, examine, and provide a comprehensive review of the available evidence from randomized controlled trials and comparative studies on pain control after hip arthroscopy. STUDY DESIGN: Systematic review...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29027115/correlation-between-mri-and-hip-arthroscopy-in-children-with-legg-calve-perthes-disease
#8
V Tiwari, S Gamanagatti, R Mittal, H Nag, S A Khan
BACKGROUND: Most of the information available about Legg-Calve-Perthes disease (LCPD) at present is gained through imaging modalities including plain radiographs and magnetic resonance imaging (MRI). But the accuracy of MRI in this disease and its predictive value to reveal various intra-articular pathologies is not known. We correlated the findings of MRI with those seen on hip arthroscopy in children with active stage of LCPD. METHODS: We conducted a prospective observational study in which MRI findings were correlated with corresponding findings on hip arthroscopy in a cohort of 25 patients of active LCPD below 12 years of age...
October 12, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/29026048/spinal-cord-stimulation-for-chronic-non-cancer-pain-a-review-of-current-evidence-and-practice
#9
S Sc Wong, C W Chan, C W Cheung
Spinal cord stimulation provides analgesia through electrical stimulation of the dorsal column of the spinal cord via electrode leads placed into the epidural space. In traditional tonic stimulation, a painful sensation is replaced with paraesthesia. Spinal cord stimulation is effective in reducing neuropathic pain, enhancing function, and improving quality of life in different chronic pain conditions. Currently, there is most evidence to support its use for failed back surgery syndrome when multidisciplinary conventional management is unsuccessful...
October 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29025541/imaging-of-the-pericardium-a-multimodality-cardiovascular-imaging-update
#10
REVIEW
Bo Xu, Deborah H Kwon, Allan L Klein
Pericardial diseases represent diverse conditions, ranging from painful inflammatory states, such as acute pericarditis, to life-threatening tamponade and chronic heart failure due to constrictive pericarditis. Multimodality cardiovascular imaging plays important roles in diagnosis and management of pericardial conditions. This review provides a clinical update on multimodality cardiovascular imaging of the pericardium, incorporating echocardiography, multidetector computed tomography, and cardiac magnetic resonance imaging, focusing on guiding clinicians about when each cardiac imaging modality should be used in each relevant pericardial condition...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025397/a-qualitative-study-of-patient-education-needs-for-hip-and-knee-replacement
#11
Deborah Kennedy, Amy Wainwright, Lucy Pereira, Susan Robarts, Patricia Dickson, Jennifer Christian, Fiona Webster
BACKGROUND: Quality health information is key to patient engagement, self-management and an enhanced healthcare experience. There is strong evidence to support involving patients and their families in the development and evaluation of health-related educational material. These factors were the impetus for our high volume joint replacement centre to undertake a qualitative study to elicit patient experiences to inform the development of effective strategies and education along the care continuum for hip and knee replacement...
October 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29025113/innovative-technology-using-virtual-reality-in-the-treatment-of-pain-does-it-reduce-pain-via-distraction-or-is-there-more-to-it
#12
Anita Gupta, Kevin Scott, Matthew Dukewich
Objective: Virtual reality (VR) is an exciting new technology with almost endless possible uses in medicine. One area it has shown promise is pain management. This selective review focused on studies that gave evidence to the distraction or nondistraction mechanisms by which VR leads to the treatment of pain. Methods: The review looked at articles from 2000 to July 29, 2016, focusing on studies concerning mechanisms by which virtual reality can augment pain relief...
August 31, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29021656/a-randomized-controlled-study-comparing-the-standard-tubeless-and-totally-tubeless-percutaneous-nephrolithotomy-procedures-for-renal-stones-from-a-tertiary-care-hospital
#13
Suresh Bhat, Jithin Lal, Fredrick Paul
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is an effective treatment for renal stones. Due to the significant pain and morbidity after standard PCNL because of nephrostomy tubes, various modifications of PCNL are being performed. We report a randomized trial comparing these modalities. MATERIALS AND METHODS: A total of 75 patients were randomized into three groups of 25 each: standard PCNL with nephrostomy tubes (Group 1), tubeless PCNL with ureteric stent and no nephrostomy (Group 2), and totally tubeless PCNL without ureteric catheter or nephrostomy (Group 3)...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#14
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28988103/opioid-tapering-in-patients-with-prescription-opioid-use-disorder-a-retrospective-study
#15
Kehua Zhou, Peng Jia, Swati Bhargava, Yong Zhang, Taslima Reza, Yuan Bo Peng, Gary G Wang
BACKGROUND AND AIMS: Opioid use disorder (OUD) refers to a maladaptive pattern of opioid use leading to clinically significant impairment or distress. OUD causes, and vice versa, misuses and abuse of opioid medications. Clinicians face daily challenges to treat patients with prescription opioid use disorder. An evidence-based management for people who are already addicted to opioids has been identified as the national priority in the US; however, options are limited in clinical practices...
October 4, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28983663/the-role-of-land-and-aquatic-exercise-in-ankylosing-spondylitis-a-systematic-review
#16
REVIEW
Ana Zão, Pedro Cantista
Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era...
October 5, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28980273/specialized-pain-clinics-in-primary-care-common-diagnoses-referral-patterns-and-clinical-outcomes-novel-pain-management-model
#17
Yacov Fogelman, Eli Carmeli, Amir Minerbi, Baruch Harash, Simon Vulfsons
An estimated 19% of the adult population in western countries lives with chronic pain. Pain management lies mainly within the primary care and community setting. We evaluated the outcome of a new model of secondary care clinics, conducted by primary care physicians with specialized training in pain medicine. Data on referral patterns, prevalence of pain diagnosis, and medication consumption were recorded at five secondary pain management clinics in the community setting. In total, 997 patients with pain attended 2,652 visits (average 2...
October 5, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28979577/methodologies-in-orthodontic-pain-management-a-review
#18
Asra Sabir Hussain, Meteib Joraib Al Toubity, Wael Y Elias
INTRODUCTION: Patients experience pain and discomfort during active orthodontic treatment with fixed appliances. Pain is considered a subjective response to noxious stimuli. It can vary from person to person and is influenced by certain factors such as age, gender, previous pain experiences, stress or anxiety, and type of appliance. OBJECTIVE: The objective of this literature review was to discuss conventional versus recently introduced treatment modalities used in pain management for orthodontic patients...
2017: Open Dentistry Journal
https://www.readbyqxmd.com/read/28966960/seeking-optimal-management-for-radioactive-iodine-therapy-induced-adverse-effects
#19
REVIEW
Andreas Charalambous
Radioactive iodine therapy (RAIT) is one of the important treatment modalities in the management of differentiated thyroid cancer (DTC). RAIT with iodine-131 has long been used in the management of DTC for the ablation of residual thyroid or treatment of its metastases. Despite being reasonably safe, radioiodine therapy is not always without side effects. Even relatively low administered activities of RAIT used for remnant ablation have been associated with the more clinically significant side effects of sialadenitis, xerostomia, salivary gland pain and swelling, dry eyes, excessive tearing, or alterations in taste in as many as 25% of patients...
October 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28966569/efficacy-of-endotherapy-in-the-treatment-of-pain-associated-with-chronic-pancreatitis-a-systematic-review-and-meta-analysis
#20
Mikram Jafri, Amit Sachdev, Javed Sadiq, David Lee, Ting Taur, Adam Goodman, Frank Gress
BACKGROUND: Endotherapy is a treatment modality that can be used to manage the pain associated with chronic pancreatitis. The aim of this systematic review and meta-analysis is to evaluate the efficacy of endotherapy in the management of pain associated with chronic pancreatitis. METHODS: A search of Medline, Pubmed, and Embase databases between 1988 to December 2014 was conducted to evaluate the use of endotherapy for pain relief in patients with chronic pancreatitis...
March 2017: JOP: Journal of the Pancreas
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