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Chronic Pain medications

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https://www.readbyqxmd.com/read/29333789/physical-training-in-a-medical-fitness-room-for-patients-with-chronic-diseases-functional-and-metabolic-outcomes
#1
Oshrat E Tayer-Shifman, Yigal Bar-On, David Pereg, Alon Y Hershko
BACKGROUND: Physical inactivity is a pivotal factor in the development and progression of various chronic diseases. However, most fitness facilities exclude unhealthy individuals. Therefore, an exercise program that admits such patients is imperative. OBJECTIVES: To evaluate the effectiveness of a fitness facility that admits adult subjects with multiple chronic diseases. METHODS: We conducted a retrospective screening of patient records from the Medical Fitness Facility at Meir Medical Center, Israel...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29330240/structured-management-of-chronic-nonmalignant-pain-with-opioids-in-a-rural-primary-care-office
#2
Kevin S McCann, Shawndra Barker, Raymond Cousins, Adam Franks, Clinton McDaniel, Stephen Petrany, Eric Riley
INTRODUCTION: The use of opioid medication for nonmalignant chronic pain (NMCP) increased dramatically during the last 20 years. There have been regulatory changes implemented to reduce the risk of harm to both patients and society. Much of the burden of monitoring these patients is falling on primary care physicians (PCPs), who do not have the time or resources to handle what is entailed in a best-practice approach to NMCP. METHODS: A retrospective study was conducted with all patients on opioid medication for NMCP who were enrolled onto an individual PCP's practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29328510/a-multidimensional-assessment-of-the-burden-of-psoriasis-results-from-a-multinational-dermatologist-and-patient-survey
#3
C E M Griffiths, S J Jo, L Naldi, R Romiti, E Guevara-Sangines, T Howe, G Pietri, I Gilloteau, C Richardson, H Tian, M Augustin
BACKGROUND: Psoriasis is a chronic, immune-mediated disease, characterised by symptoms that include itching and skin pain and is often associated with comorbidities. Patients have a substantial detriment to quality of life (QoL) and work productivity with associated cost burden. OBJECTIVE: To investigate the incremental burden of comorbidities, itch, and affected body areas among systemic eligible patients with psoriasis, using a multinational survey of dermatologists and their psoriasis patients...
January 12, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29327358/opioid-medication-use-in-patients-with-gastrointestinal-diagnoses-vs-unexplained-gastrointestinal-symptoms-in-the-us-veterans-health-administration
#4
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29325193/stabilization-of-olecranon-fractures-by-tension-band-wiring-or-plate-osteosynthesis-a-retrospective-study-of-41-cases
#5
Alexandre Fournet, Jean-François Boursier, Solène Corbeau, Adeline Decambron, Véronique Viateau, Pascal Fayolle, Anne-Sophie Bedu, Dimitri Leperlier, Mathieu Manassero
OBJECTIVES:  This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. METHODS:  Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed...
January 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29323824/a-case-of-atypical-synovitis-acne-pustulosis-hyperostosis-osteitis-sapho-syndrome-presenting-with-osteomyelitis-of-the-clavicle
#6
Chetan Sharma, Brian Chow
Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is considered after exclusion of infection and arthritis; however, microbial infection may be present in osteoarticular lesions of these patients. Chronic osteomyelitis and associated bacterial infection were detected in a recurrent osteoarticular lesion in an adolescent patient with a history of clavicle pain, who complained of recurrent swelling in the left clavicle. Most pediatric case reports of SAPHO syndrome describe patients with associated skin conditions...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322830/waiting-for-multidisciplinary-chronic-pain-services-a-prospective-study-over-2-5%C3%A2-years
#7
Anne Lj Burke, Jane L Mathias, Linley A Denson
Despite many patients waiting more than 2 years for treatment at publicly funded multidisciplinary chronic pain services, waitlist studies rarely examine beyond 6 months. We investigated psychological adjustment and health-care utilisation of individuals ( N = 339) waiting ≤30 months for appointments at an Australian tertiary pain unit. Outcomes were relatively stable during the first 6 months, but long-term deteriorations in pain-related interference, distress and pain acceptance were evident, albeit with sex differences...
January 1, 2018: Journal of Health Psychology
https://www.readbyqxmd.com/read/29322261/the-journey-from-genetic-predisposition-to-medication-overuse-headache-to-its-acquisition-as-sequela-of-chronic-migraine
#8
EDITORIAL
Paolo Martelletti
Migraine remains one of the biggest clinical case to be solved among the non-communicable diseases, second to low back pain for disability caused as reported by the Global Burden of Disease Study 2016. Despite this, its genetics roots are still unknown. Its evolution in chronic forms hits 2-4% of the population and causes a form so far defined Medication Overuse Headache (MOH), whose pathophysiological basis have not been explained by many dedicated studies. The Global Burden of Disease Study 2016 has not recognized MOH as independent entity, but as a sequela of Chronic Migraine...
January 10, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29321104/neurectomy-for-anterior-cutaneous-nerve-entrapment-syndrome-in-children
#9
Lindsey B Armstrong, Pradeep Dinakar, David P Mooney
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children. METHODS: Demographic and clinical data on children who underwent neurectomy for ACNES by a single surgeon from 10/2011 to 01/2017 were reviewed. RESULTS: Twenty-six patients underwent neurectomy for ACNES...
December 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29320976/the-mediational-role-of-helplessness-in-psychological-outcomes-in-systemic-lupus-erythematosus
#10
S D Mills, D Azizoddin, S Gholizadeh, G Z Racaza, P M Nicassio
Objective Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can result in disability and psychological distress. Although pain has been associated with depressive symptomatology and stress in SLE, a paucity of theoretical models have been used to explain the relationship between pain and psychological distress in this population. Thus, the present study examined helplessness as a mediator of the relationship between pain and psychological distress among patients with SLE. Methods Multiple mediation analysis was used to examine the hypothesis that learned helplessness mediates the relationship between pain and symptoms of anxiety, depression, and stress in a sample of patients with SLE ( N = 136) receiving medical care at Cedars Sinai Medical Center...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29319627/opioid-prescription-morbidity-and-mortality-in-us-transplant-recipients
#11
Kevin C Abbott, Chyng-Wen Fwu, Paul W Eggers, Anne W Eggers, Prudence P Kline, Paul L Kimmel
BACKGROUND: CDC guidelines recommend caution in prescribing opioids for chronic pain. The characteristics of opioid prescription (OpRx) among kidney transplant (KTx) recipients has not been described in a national population. METHODS: We assessed OpRx prevalence among prevalent KTx recipients, and associated duration (chronic, defined as ≥90 days in a year) and dosing (in morphine milligram equivalents per day, MME, of <50, 50-89, and ≥90) with outcomes, death and graft loss, among incident KTx recipients using 2006-2010 US Renal Data System files, including Medicare Part D for medication ascertainment...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29318334/physiotherapy-for-pelvic-pain-and-female-sexual-dysfunction-an-untapped-resource
#12
REVIEW
Bary Berghmans
INTRODUCTION AND HYPOTHESIS: Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results...
January 9, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29317847/pharmacogenetic-guidance-individualized-medicine-promotes-enhanced-pain-outcomes
#13
Lisa Lynn Dragic, Erica L Wegrzyn, Michael E Schatman, Jeffrey Fudin
The use of pharmacogenomics has become more prevalent over the past several years in treating many disease states. Several cytochrome P450 enzymes play a role in the metabolism of many pain medications including opioids and antidepressants. Noncytochrome P450 enzymes such as methylenetetrahydrofolate reductase (MTHFR) and catechol-O-methyl transferase (COMT) also play a role in the explanation of opioid dosage requirements as well as in response to certain antidepressants. We present the case of a patient with reduced COMT and MTHFR expression treated with leucovorin 10 mg daily for the management of chronic pain...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29316960/pregabalin-versus-gabapentin-in-the-treatment-of-sciatica-study-protocol-for-a-randomised-double-blind-cross-over-trial-pagpros
#14
Kelvin Robertson, Laurence A G Marshman, Maria Hennessy, Linton Harriss, David Plummer
BACKGROUND: There is currently an absence of high-grade evidence regarding the treatment of chronic sciatica (CS). Whilst gabapentin (GBP) and pregabalin (PGB) are both currently used to treat CS, equipoise exists regarding their individual use. In particular, no head-to-head study of GBP and PGB in CS exists. Despite equipoise, most countries' formulary regulatory authorities typically favour one drug for subsidy over the other. This hinders interchange wherever the favoured drug is either ineffective or not tolerated...
January 9, 2018: Trials
https://www.readbyqxmd.com/read/29316946/combined-cognitive-behavioural-and-physiotherapeutic-therapy-for-patients-with-chronic-pelvic-pain-syndrome-combi-cpps-study-protocol-for-a-controlled-feasibility-trial
#15
Christian A Brünahl, Susanne G R Klotz, Christoph Dybowski, Björn Riegel, Sonja Gregorzik, Dean A Tripp, Gesche Ketels, Bernd Löwe
BACKGROUND: Chronic pelvic pain syndrome (CPPS) is a pain condition perceived in the pelvic area for at least 6 months. While evidence of the aetiology and maintenance of CPPS is still unclear and therapy options are rare, there is preliminary evidence for the efficacy of cognitive behavioural therapy and physiotherapy. However, an integrated treatment has not yet been studied. The primary aim of this study is therefore to test the feasibility of combined psychotherapy and physiotherapy for female and male patients with CPPS...
January 9, 2018: Trials
https://www.readbyqxmd.com/read/29315426/an-e-learning-module-on-chronic-low-back-pain-in-older-adults-effect-on-medical-resident-attitudes-confidence-knowledge-and-clinical-skills
#16
Zachary G Jacobs, D Michael Elnicki, Subashan Perera, Debra K Weiner
Objective: To determine 1) the feasibility of implementing an e-learning module on chronic low back pain (CLBP) in an older adult into an existing internal medicine residency curriculum and 2) the impact of this module on resident attitudes, confidence, knowledge, and clinical skills relating to CLBP. Methods: Participants were assigned to complete either the online module (N = 73) or the Yale Office-based curriculum on CLBP (N = 70). Attitudes, confidence, and knowledge were evaluated pre- and postintervention via survey...
January 5, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29313113/epidemiology-and-contemporary-management-of-abdominal-aortic-aneurysms
#17
Brant W Ullery, Richard L Hallett, Dominik Fleischmann
Abdominal aortic aneurysm (AAA) is most commonly defined as a maximal diameter of the abdominal aorta in excess of 3 cm in either anterior-posterior or transverse planes or, alternatively, as a focal dilation ≥ 1.5 times the diameter of the normal adjacent arterial segment. Risk factors for the development of AAA include age > 60, tobacco use, male gender, Caucasian race, and family history of AAA. Aneurysm growth and rupture risk appear to be associated with persistent tobacco use, female gender, and chronic pulmonary disease...
January 9, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29312775/case-report-improvement-of-cardiac-remodeling-with-shock-wave-therapy-of-a-patient-with-ischemic-cardiomyopathy
#18
Yingnan Bai, Xiaoyan Wang, Xin Deng, Hongyi Wu, Abdel Hamid Fathy, Yan Xi, Yunzeng Zou, Jie Cui, Junbo Ge
Percutaneous coronary intervention (PCI) and coronary-artery bypass grafting (CABG) are two major preferred reperfusion strategies to restore the ischemic-related artery patency, but PCI and CABG do not necessarily guarantee the recovery of post-procedure left ventricular (LV) dysfunction and release of symptoms. Moreover, there is no definitive effective way to enhance microcirculations. Theoretically, shock wave therapy (SWT) is an option. We report here a case of patient who received SWT. The patient's medical history was characterized by chest pain for 20 years, having received CABG 13 years ago...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310515/persons-with-chronic-spinal-cord-injury-have-decreased-nk-cell-and-increased-tlr-inflammatory-gene-expression
#19
Paige Herman, Adam B Stein, Katie Gibbs, Ilya Korsunsky, Peter Gregersen, Ona Bloom
Infections are the leading cause of death for individuals with traumatic spinal cord injury (SCI). Along with increased infection rates, inflammation is often also observed in persons with chronic SCI. Together, immunological changes after SCI are also poised to impede neurological recovery and to mediate common medical consequences of SCI, including atherogenesis and neuropathic pain. The molecular mechanisms contributing to increased infection susceptibility and inflammation in persons living with SCI are poorly understood...
January 8, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29305389/before-narrative-episodic-reading-and-representations-of-chronic-pain
#20
Sara Wasson
This article suggests that some illness experience may require a reading practice less concerned with narrative coherence or self-authorship, and more interested in the value of textual fragments, episodes and moments considered outside a narrative framework. Chronic pain can pose multiple challenges to the narrative orientations celebrated in both 'survivorship' discourse and classic medical humanities scholarship. In its recalcitrance to cure, its often mysterious aetiology and its complex blend of somatic, interpersonal and affective elements, representations of chronic pain can require a richer vocabulary of temporality...
January 5, 2018: Medical Humanities
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