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https://www.readbyqxmd.com/read/28937533/chronic-poststernotomy-pain-incidence-risk-factors-treatment-prevention-and-the-anesthesiologist-s-role
#1
Amanda M Kleiman, Daniel T Sanders, Edward C Nemergut, Julie L Huffmyer
Chronic pain following median sternotomy is common after cardiac surgery. If left untreated, chronic sternal pain can reduce quality of life, affecting sleep, mood, activity level, and overall satisfaction. This has a significant societal effect given the large number of cardiac surgeries annually. Although a number of pathophysiologic processes and risk factors are assumed to contribute, the exact cause and major risk factors remain unknown. Moreover, the treatment of chronic poststernotomy pain is often inadequate, relying on opioids and other medications that provide minimal benefit to the patient and have significant adverse effects...
September 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28936881/quality-indicators-in-pediatric-colonoscopy-an-australian-tertiary-center-experience
#2
H K Singh, G D Withers, L C Ee
OBJECTIVES: Quality indicators for colonoscopy in adults are largely driven by colorectal cancer screening, and include cecal intubation rates, with rates of >90% recommended. In contrast, colorectal cancer is rare in childhood, with paucity of data on relevant quality indicators for pediatric colonoscopy. It is also unclear whether high rates of cecal intubation are achievable in small children. Our aim was to audit all colonoscopies performed in a tertiary pediatric center to examine clinical indications for procedure, completeness of examination with cecal and ileal intubation, significant findings, and complications...
September 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28934799/factors-influencing-the-application-of-a-biopsychosocial-perspective-in-clinical-judgement-of-chronic-pain-interactive-management-with-medical-students
#3
Christopher P Dwyer, Phoebe E McKenna-Plumley, Hannah Durand, Emer M Gormley, Brian W Slattery, Owen M Harney, Padraig MacNeela, Brian E McGuire
BACKGROUND: Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934794/effects-of-epidemiological-factors-and-pressure-pain-measurements-in-predicting-postoperative-pain-a-prospective-survey-of-1-002-chinese-patients
#4
Guangyou Duan, Shanna Guo, Yuhao Zhang, Ying Ying, Penghao Huang, Li Zhang, Xianwei Zhang
BACKGROUND: A high degree of inter-individual differences was noted in human basal pain as well as the reporting of clinical pain, such as postoperative pain. Understanding the effects of common epidemiological variations and preoperative experimental methods of human pain perception may contribute to individualized pain treatment for patients. OBJECTIVES: The current study was aimed to assess the role of epidemiological factors and preoperative experimental pain sensitivity for predicting postoperative pain and to analyze the potential effects of epidemiological factors on experimental pain sensitivity...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934780/efficacy-of-cannabis-based-medicines-for-pain-management-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
J Aviram, G Samuelly-Leichtag
BACKGROUND: The management of chronic pain is a complex challenge worldwide. Cannabis-based medicines (CBMs) have proven to be efficient in reducing chronic pain, although the topic remains highly controversial in this field. OBJECTIVES: This study's aim is to conduct a conclusive review and meta-analysis, which incorporates all randomized controlled trials (RCTs) in order to update clinicians' and researchers' knowledge regarding the efficacy and adverse events (AEs) of CBMs for chronic and postoperative pain treatment...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28929809/can-breast-compression-be-reduced-in-digital-mammography-and-breast-tomosynthesis
#6
Greeshma A Agasthya, Ellen D'Orsi, Yoon-Jin Kim, Priyanka Handa, Christopher P Ho, Carl J D'Orsi, Ioannis Sechopoulos
OBJECTIVE: The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality. MATERIALS AND METHODS: In this two-part study, two groups of women with prior mammograms were recruited. In part 1, subjects were positioned for craniocaudal (CC) and mediolateral oblique (MLO) views, and four levels of compression force were applied to evaluate changes in breast thickness, perceived pain, and relative tissue coverage...
September 20, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28929433/development-and-feasibility-of-a-web-application-to-monitor-patients-cancer-related-pain
#7
Wendy H Oldenmenger, Mathilde A G Baan, Carin C D van der Rijt
BACKGROUND: In the outpatient setting, pain management is often inadequate in patients with cancer-related pain, because of patient- and professional-related barriers in communication and infrequent contacts. The internet may provide new opportunities for monitoring these patients. PURPOSE: The purpose of this study was to investigate whether internet monitoring of cancer-related pain in outpatients was feasible. METHODS: We developed an internet application that contained a pain diary, eConsult, and patient pain education...
September 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28928563/comparative-study-of-constant-dose-intrathecal-hypobaric-levobupivacaine-with-varying-baricities-in-lower-limb-surgeries
#8
K P Biji, M Sunil, K T Ramadas
BACKGROUND: Hypobaric spinal anesthesia is advantageous for unilateral lower extremity fractures as it obviates pain of lying on fractured limb for performing subarachnoid block. AIMS: This study compares block characteristics and complications of three different baricities of constant dose intrathecal hypobaric levobupivacaine to determine an optimum baricity. SETTINGS AND DESIGN: One-twenty American Society of Anesthesiologists Physical Status 1 and 2 patients aged 18-65 years undergoing unilateral lower limb surgeries were divided into three equal groups for this prospective cohort study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927496/occupational-strain-as-a-risk-for-hip-osteoarthritis
#9
Annekatrin Bergmann, Ulrich Bolm-Audorff, Daniel Krone, Andreas Seidler, Falk Liebers, Johannes Haerting, Alice Freiberg, Susanne Unverzagt
BACKGROUND: Multiple epidemiological studies have revealed an association between occupational physical strain and the risk of developing hip osteoarthritis. METHODS: To determine the association between the lifting and carrying of heavy loads or other physically demanding work and the risk of hip osteoarthritis (HOA) or total hip replacement (THR), we systematically searched the literature for primary studies on the effects of exposure to physical strain and meta-analytically reviewed the results that were amenable to comparisons across studies...
September 4, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28924972/targeting-nociceptive-trp-channels-to-treat-chronic-pain-current-state-of-the-field
#10
REVIEW
Magdalene M Moran, Arpad Szallasi
Control of chronic pain is frequently inadequate and/or associated with intolerable adverse effects, prompting a frantic search for new therapeutics and new therapeutic targets. Nearly two decades of preclinical and clinical research supports the involvement of Transient Receptor Potential (TRP) channels in temperature perception, nociception and sensitization. Although there has been considerable excitement around the therapeutic potential of this channel family since the cloning and identification of TRPV1 as the capsaicin receptor more than 20 years ago, only modulators of a few channels have been tested clinically...
September 19, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28921656/animal-models-for-studying-the-etiology-and-treatment-of-low-back-pain
#11
REVIEW
Changgui Shi, Sujun Qiu, Scott M Riester, Vaskar Das, Bingqian Zhu, Atiyayein A Wallace, Andre J van Wijnen, Fackson Mwale, James C Iatridis, Daisuke Sakai, Gina Votta-Velis, Wen Yuan, Hee-Jeong Im
Chronic low back pain is a major cause of disability and health care costs. Effective treatments are inadequate for many patients. Animal models are essential to further understanding of the pain mechanism and testing potential therapies. Currently, a number of preclinical models have been developed attempting to mimic aspects of clinical conditions that contribute to low back pain. This review focused on describing these animal models and the main behavioral tests for assessing pain in each model. Animal models of low back pain can be divided into the following five categories: discogenic low back pain, radicular back pain, facet joint osteoarthritis back pain, muscle-induced low back pain, and spontaneous occurring low back pain models...
September 18, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28920710/use-of-strong-opioids-for-chronic-pain-in-osteoarthritis-an-insight-into-the-latin-american-reality
#12
Miguel Angel Ruiz Iban, Javier Benavides, Juan Pablo Forero, Sacha Bittelman, Rafael Martinez, Miguel Angel Mite, Jorge Diaz Heredia, Sergio Ulloa, Mauro Marcelo Lizárraga Ferrand
Osteoarthritis is the most common cause of arthritis and one of the principle causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids...
September 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28919771/the-challenge-of-perioperative-pain-management-in-opioid-tolerant-patients
#13
REVIEW
Flaminia Coluzzi, Francesca Bifulco, Arturo Cuomo, Mario Dauri, Claudio Leonardi, Rita Maria Melotti, Silvia Natoli, Patrizia Romualdi, Gennaro Savoia, Antonio Corcione
The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#14
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28904559/cartilage-protection-and-analgesic-activity-of-a-botanical-composition-comprised-of-morus-alba-scutellaria-baicalensis-and-acacia-catechu
#15
Mesfin Yimam, Teresa Horm, Laura Wright, Ping Jiao, Mei Hong, Lidia Brownell, Qi Jia
Although there have been augmented advances in drug discovery, current OA management is inadequate due to the lack of successful therapies proven to be effective in modifying disease progression. For some, the risk outweighs the benefit. As a result, there is a desperate need for safe and efficacious natural alternatives. Here we evaluated a composition from Morus alba, Scutellaria baicalensis, and Acacia catechu in maintaining joint structural integrity and alleviating OA associated symptoms in monoiodoacetate- (MIA-) induced rat OA disease model...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28893656/hysteroscopic-isthmoplasty-step-by-step-technique
#16
Attilio Di Spiezio Sardo, Brunella Zizolfi, Gloria Calagna, Pierluigi Giampaolino, Filomena Paolella, Giuseppe Bifulco
BACKGROUND: Isthmocele is a characteristic semi-diverticular anomaly of the anterior isthmic wall of the uterus, located at the site of a previous cesarean delivery scar. The etiopathogenesis of isthmocele is still poorly understood, and several hypotheses have been proposed. Possible factors that could play a role in niche development include a very low incision through cervical tissue, an inadequate suturing technique during the closure of the uterine scar surgical interventions that increase adhesion formation or patient-related factors that impair wound healing, or increase inflammation or adhesion formation...
September 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28893459/placing-the-patient-at-the-centre-of-chronic-wound-care-a-qualitative-evidence-synthesis
#17
REVIEW
Naomi Fearns, Stephen Heller-Murphy, Joanna Kelly, Jenny Harbour
BACKGROUND: Chronic wounds are a major health burden and have a severe impact on well-being. This synthesis of qualitative studies was undertaken to inform a health technology assessment of antimicrobial wound dressings. It aimed to explore patients' experiences of chronic wounds and determine improvements for clinical practice. METHOD: Inclusion criteria included use of qualitative methods, and English language publication. Databases searched included MEDLINE (Ovid), MEDLINE in Process (Ovid), EMBASE (Ovid), CINAHL (EBSCOHost), and PsychInfo (EBSCOHost)...
September 5, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28882752/mechanosensitive-ion-channels-msics-in-articular-nociceptors-drive%C3%A2-mechanical-allodynia-in-osteoarthritis-oa
#18
B H He, M Christin, S Mouchbahani-Constance, A Davidova, R Sharif-Naeini
OBJECTIVE: Osteoarthritis (OA) is a disabling and highly prevalent condition affecting millions worldwide. Pain is the major complaint of OA patients and is presently inadequately managed. It manifests as mechanical allodynia, a painful response to innocuous stimuli such as joint movement. Allodynia is due in part to the sensitization of articular nociceptors to mechanical stimuli. These nociceptors respond to noxious mechanical stimuli applied to their terminals via the expression of depolarizing high-threshold mechanosensitive ion channels (MSICs) that convert painful mechanical forces into electrical signals...
September 5, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28881332/reverse-shoulder-arthroplasty-for-deltoid-deficient-shoulder-following-latissimus-dorsi-flap-transfer-case-report
#19
Mohamed Al Ateeq Al Dosari, Shamsi Hameed, Khalid Mukhtar, Aissam Elmhiregh
INTRODUCTION: The usual indication for reverse shoulder arthroplasty is glenohumeral arthritis with inadequate rotator cuff and intact deltoid muscle. We report here a case of reverse shoulder arthroplasty using a lattisimus dorsi flap in a patient with deltoid-deficient shoulder following a gunshot injury. PRESENTATION OF THE CASE: The patient was an otherwise healthy 51-year-old male with a history of gunshot injury of the left shoulder 2006. Upon presentation in 2011, the patient had a loss of most of his shoulder bony and muscular structures...
August 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28876612/laparoscopic-ventral-hernia-repair-a-single-surgeon-study-using-a-circumferential-transfascial-suture-technique
#20
G Campbell, R P Mills
BACKGROUND: The ideal technique for ventral primary and incisional hernia repair is unclear. There is a paucity of literature from South African authors. In this report, a standardised technique of intraperitoneal mesh placement and fixation is described. METHOD: A retrospective study of 152 patient records. Each patient underwent laparoscopic ventral hernia repair between 2007 and 2016 by a single surgeon. A standardised technique was used in every operation. In each case a circumferential mesh overlap of 5 centimetres from the defect was achieved...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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