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https://www.readbyqxmd.com/read/28635354/the-effects-of-food-on-opioid-induced-nausea-and-vomiting-and-pharmacological-parameters-a-systematic-review
#1
Robert B Raffa, Robert Colucci, Joseph V Pergolizzi
Opioids remain the standard of care for treating moderate to severe pain resulting from surgery or injury in cases of acute pain, and are recommended for patients who have not responded to nonopioid analgesics. Effective management of pain has an impact on clinical course and often depends on achieving an acceptable balance between opioid efficacy, safety, and tolerability. Common opioid-related adverse events such as nausea and vomiting are associated with an overall lower achievement of effective pain management and patient satisfaction...
June 21, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28635352/a-randomized-controlled-trial-comparing-two-types-of-retractors-at-caesarean-delivery
#2
Abbey J Hardy-Fairbanks, Todd Mackenzie, Martin McCarthy, Marlene B Goldman, Michele R Lauria
The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius(®)) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius(®) versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day. Additional outcome variables were collected through a provider survey and chart review...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#3
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28627395/the-opioid-epidemic-is-an-historic-opportunity-to-improve-both-prevention-and-treatment
#4
Robert L DuPont
The current narrative describing the national opioid epidemic as the result of overprescribing opioid pain medicines fails to capture the full dimensions of problem and leads to inadequate and even confounding solutions. Overlooked is the fact that polysubstance use is nearly ubiquitous among overdose deaths, demonstrating that the opioid overdose death problem is bigger than opioids. The foundation of the nation's opioid overdose crisis - and the totality of the nation's drug epidemic - is widespread recreational pharmacology, the use of drugs for fun or "self-medication...
June 13, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28623983/clinical-presentation-of-women-with-pelvic-source-varicose-veins-in-the-perineum-as-a-first-step-in-the-development-of-a-disease-specific-patient-assessment-tool
#5
Kathleen Gibson, Renee Minjarez, Brian Ferris, Moni Neradilek, Matthew Wise, Julianne Stoughton, Mark Meissner
OBJECTIVE: Pelvic venous incompetence can cause symptomatic varicose veins in the perineum, buttock, and thigh. Presentation, symptom severity, and response to treatment of pelvic source varicose veins are not well defined. Currently available tools to measure the severity of lower extremity venous disease and its effects on quality of life may be inadequate to assess disease severity in these patients. The purpose of this study was to evaluate the histories, demographics, and clinical presentations of women with pelvic source varicose veins and to compare these data to a population of women with nonpelvic source varicose veins...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28623010/-influence-of-the-working-conditions-on-sickness-absence-due-to-common-diseases
#6
Manuel Vaquero-Álvarez, Esther Álvarez-Theurer, Manuel Romero Saldaña
OBJECTIVE: To estimate the importance of the working environment in sickness absence, as well as to show possible relationships with clinical-work variables. DESIGN: A descriptive observational study. SITE: Medical Inspection of an Andalusian province. PARTICIPANTS: A total of 1016 workers on certified sick leave due to a common illness. MAIN MEASUREMENTS: A self-report questionnaire was used to collect demographic data, profession, activity, risk assessment, and perceived occupational cause, on patients who voluntarily gave their consent when they were reviewed during 2015...
June 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28622379/end-of-life-care-for-people-with-dementia-the-views-of-health-professionals-social-care-service-managers-and-frontline-staff-on-key-requirements-for-good-practice
#7
Richard Philip Lee, Claire Bamford, Marie Poole, Emma McLellan, Catherine Exley, Louise Robinson
BACKGROUND: Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia. METHODS AND FINDINGS: Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads...
2017: PloS One
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#8
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#9
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28618043/nurses-knowledge-on-diabetic-foot-ulcer-disease-and-their-attitudes-towards-patients-affected-a-cross-sectional-institution-based-study
#10
Sriyani A Kumarasinghe, Priyadarshika Hettiarachchi, Sudharshani Wasalathanthri
AIMS AND OBJECTIVES: To assess nurses' knowledge on diabetic ulcer disease and their attitudes towards patients suffering from it and to identify factors which influence them. BACKGROUND: Diabetic wound care is an evolving specialty with the rising prevalence of diabetes foot complications. As nurses play a key role in wound care, their knowledge and attitudes are important in providing optimum care to patients. DESIGN: Descriptive cross sectional survey design...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28616956/tramadol-for-neuropathic-pain-in-adults
#11
REVIEW
Rudolf Martin Duehmke, Sheena Derry, Philip J Wiffen, Rae F Bell, Dominic Aldington, R Andrew Moore
BACKGROUND: This review is an update of a review of tramadol for neuropathic pain, published in 2006; updating was to bring the review in line with current standards. Neuropathic pain, which is caused by a lesion or disease affecting the somatosensory system, may be central or peripheral in origin. Peripheral neuropathic pain often includes symptoms such as burning or shooting sensations, abnormal sensitivity to normally painless stimuli, or an increased sensitivity to normally painful stimuli...
June 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28607658/exploring-perceptions-of-instructors-about-childbirth-preparation-training-courses-a-qualitative-study
#12
Marzieh Otogara, Akram Karimi-Shahanjarini, Seyed Mohammad Mehdi Hazavehei, Jalal Poorolajal, Nahid Radnia, Forouzan Akrami, Fahimeh Bagheri
BACKGROUND: Childbirth preparation training courses on maternal and neonatal health increase awareness, and capability of pregnant women in overcoming fear and anxiety and managing labor pains. OBJECTIVE: To identify the affecting factors and barriers of these courses from the perspective of their instructors. METHODS: This qualitative study of the content analysis type, has been conducted on 16 certified teachers of the training courses of the Hamadan city in 2015...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28604472/perioperative-pain-management-of-a-patient-taking-naltrexone-hcl-bupropion-hcl-contrave-a-case-report
#13
Allen Ninh, Sang Kim, Andrew Goldberg
A 42-year-old obese woman (body mass index = 30.2 kg/m) presented for urgent anterior cervical diskectomy and fusion. She had been taking oral naltrexone-bupropion extended-release (Contrave, Orexigen Therapeutics Inc, La Jolla, CA) for the past 6 months and continued using it until 12 hours preoperatively. Despite discontinuation of this medication, and employing an intraoperative and postoperative multimodal analgesia strategy, immediate pain control was inadequately achieved. Patients taking opioid antagonists who present for surgery pose unique challenges to the anesthesiologist and require extensive preoperative interdisciplinary discussions and planning for pain control throughout the perioperative period...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603893/allodynia-is-associated-with-initial-and-sustained-response-to-acute-migraine-treatment-results-from-the-american-migraine-prevalence-and-prevention-study
#14
Richard B Lipton, Sagar Munjal, Dawn C Buse, Alix Bennett, Kristina M Fanning, Rami Burstein, Michael L Reed
OBJECTIVE: In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine...
June 11, 2017: Headache
https://www.readbyqxmd.com/read/28601405/leisure-time-physical-activity-among-u-s-adults-with-arthritis-2008-2015
#15
Louise B Murphy, Jennifer M Hootman, Michael A Boring, Susan A Carlson, Jin Qin, Kamil E Barbour, Teresa J Brady, Charles G Helmick
INTRODUCTION: In 2016, leisure time physical activity among U.S. adults aged ≥18 years with and without arthritis was studied to provide estimates using contemporary guidelines (2008 Physical Activity Guidelines for Americans) and population-based data (U.S. National Health Interview Survey). METHODS: Estimated prevalence of: (1) meeting aerobic, muscle strengthening, and both aerobic and muscle strengthening guidelines, by arthritis status, from 2008 to 2015; and (2) meeting guidelines across selected sociodemographic characteristics and health status and behaviors, among adults with arthritis, in 2015...
June 7, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28599045/stress-fractures-etiology-epidemiology-diagnosis-treatment-and-prevention
#16
Joseph J Knapik, Katy Reynolds, Kyle L Hoedebecke
Stress fractures are part of a continuum of changes in healthy bones in response to repeated mechanical deformation from physical activity. If the activity produces excessive repetitive stress, osteoclastic processes in the bone may proceed at a faster pace than osteoblastic processes, thus weakening the bone and augmenting susceptibility to stress fractures. Overall stress fracture incidence is about three cases per 1,000 in active duty Servicemembers, but it is much higher among Army basic trainees: 19 per 1,000 for men and 80 per 1,000 for women...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28595427/challenging-equipotency-calculation-for-hydromorphone-after-long-term-intravenous-application
#17
Benjamin Luchting, Banafscheh Rachinger-Adam, Nikolai Hulde, Jens Heyn, Shahnaz Christina Azad
In advanced stages, most cancer patients suffer from pain which can usually be well controlled following the World Health Organization (WHO) level scheme. While the majority of patients report adequate pain relief by strong opioids (WHO III), some require an opioid rotation. Despite the existence of conversion tables, these rotations mea lead to inadequate pain control or life threatening events. Here, we report about a patient with urothelial cell carcinoma presenting in our Department of Pain Medicine with massive pain aggravation up to NRS values of 10/10 despite administration of the highest dose of intravenously applied hydromorphone...
March 16, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28595027/clinical-outcomes-of-start-low-go-slow-methadone-initiation-for-cancer-related-pain-what-s-the-hurry
#18
Pippa Hawley, Lawrance Chow, Gillian Fyles, Aria Shokoohi, Mary-Jane O'Leary, Matthew Mittelstadt
BACKGROUND: Methadone has been shown to be effective for cancer pain. Most published switching methods are complete in less than three days, requiring very close supervision, usually in an inpatient setting. This need for hospitalization is a barrier to access. We present a large retrospective study of slow outpatient methadone starts and describe our starting method. METHODS: Charts were reviewed of patients referred to the Pain and Symptom Management/Palliative Care clinics at the six BC Cancer Agency's regional centers that underwent initiation of methadone for analgesia over a 14-year period...
June 8, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28594871/association-among-presence-of-cancer-pain-inadequate-pain-control-and-psychotropic-drug-use
#19
Paula Parás-Bravo, María Paz-Zulueta, María Cristina Alonso-Blanco, Paloma Salvadores-Fuentes, Ana Rosa Alconero-Camarero, Miguel Santibañez
INTRODUCTION: Pain is a common symptom in cancer patients, and its control and management are complex. Despite the high concomitant use of psychotropic drugs among such patients, the association among pain, inadequate pain control, and psychotropic drug use has not been fully determined. This study examined the prevalence of cancer pain and inadequate pain control and the association with psychotropic drug use. MATERIALS AND METHODS: In this cross-sectional study, we investigated 402 medical records obtained by simple random sampling of oncology patients at a hospital in northern Spain from July 2012 to July 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28587505/chronic-cervical-radiculopathic-pain-is-associated-with-increased-excitability-and-hyperpolarization-activated-current-ih-in-large-diameter-dorsal-root-ganglion-neurons
#20
Da-Lu Liu, Xu Wang, Wen-Guang Chu, Na Lu, Wen-Juan Han, Yi-Kang Du, San-Jue Hu, Zhan-Tao Bai, Sheng-Xi Wu, Rou-Gang Xie, Ceng Luo
Cervical radiculopathic pain is a very common symptom that may occur with cervical spondylosis. Mechanical allodynia is often associated with cervical radiculopathic pain and is inadequately treated with current therapies. However, the precise mechanisms underlying cervical radiculopathic pain-associated mechanical allodynia have remained elusive. Compelling evidence from animal models suggests a role of large-diameter dorsal root ganglion neurons and plasticity of spinal circuitry attached with Aβ fibers in mediating neuropathic pain...
January 2017: Molecular Pain
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