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https://www.readbyqxmd.com/read/29034725/polypharmacy-and-risk-of-falls-and-fractures-for-patients-with-hiv-infection-and-substance-dependence
#1
Theresa W Kim, Alexander Y Walley, Alicia S Ventura, Gregory J Patts, Timothy C Heeren, Gabriel B Lerner, Nicholas Mauricio, Richard Saitz
Although people with HIV infection (PLWH) are at higher risk of polypharmacy and substance use, there is limited knowledge about potential harms associated with polypharmacy such as falls and fractures in this population. The study objective was to determine whether polypharmacy, as measured by the number and type of medication, is associated with falls and fractures among PLWH and DSM-IV substance dependence in the past year or ever injection drug use (IDU). We identified the number of medications by electronic medical record review in the following categories: (i) systemically active, (ii) non-antiretroviral (non-ARV), (iii) sedating, (iv) non-sedating as well as any opioid medication and any non-opioid sedating medication...
October 16, 2017: AIDS Care
https://www.readbyqxmd.com/read/29034602/gender-and-arch-effects-on-the-use-of-non-opioid-analgesics-for-post-endodontic-pain-reduction
#2
Wail M Elzaki, Hassan M Ziada, Neamat H Abubakr, Yahia E Ibrahim
This study aimed to evaluate the secondary outcomes of gender and arch and their impact on pain reduction following initial endodontic therapy. 185 medications, including placebo were prepared, and 170 participants completed the trial. Group 1, received a single dose of Paracetamol alone (G-1), Group 2 received combined Ibuprofen/Paracetamol (G-2). Group 3 received combined Mefenamic acid/Paracetamol (G-3), group 4 received combined Diclofenac K/Paracetamol (G-4) and Group 5 received a placebo (G-5). There were no statistically significant differences in pain reduction between males and females whilst there were statistically significant differences between them and the placebo group...
October 16, 2017: Australian Endodontic Journal: the Journal of the Australian Society of Endodontology Inc
https://www.readbyqxmd.com/read/28986540/reactive-metabolites-of-acetaminophen-activate-and-sensitize-the-capsaicin-receptor-trpv1
#3
Mirjam J Eberhardt, Florian Schillers, Esther M Eberhardt, Linus Risser, Jeanne de la Roche, Christine Herzog, Frank Echtermeyer, Andreas Leffler
The irritant receptor TRPA1 was suggested to mediate analgesic, antipyretic but also pro-inflammatory effects of the non-opioid analgesic acetaminophen, presumably due to channel activation by the reactive metabolites parabenzoquinone (pBQ) and N-acetyl-parabenzoquinonimine (NAPQI). Here we explored the effects of these metabolites on the capsaicin receptor TRPV1, another redox-sensitive ion channel expressed in sensory neurons. Both pBQ and NAPQI, but not acetaminophen irreversibly activated and sensitized recombinant human and rodent TRPV1 channels expressed in HEK 293 cells...
October 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28982207/transient-receptor-potential-vanilloid-1-inhibitors-block-laparotomy-and-opioid-induced-infarct-size-reduction-in-rats
#4
Helen M Heymann, Yun Wu, Yao Lu, Nir Qvit, Garrett J Gross, Eric R Gross
BACKGROUND AND PURPOSE: In light of the opioid epidemic, physicians are increasingly prescribing non-opioid analgesics to surgical patients. Transient receptor potential vanilloid 1 (TRPV1) inhibitors are potentially alternative pain therapeutics for surgery. Here we examined in rodents whether cardioprotection conferred by two occurrences during surgery, a laparotomy or morphine delivery, is mediated by TRPV1. We further tested whether an experimental analgesic peptide (known as P5) targeted against the TRPV1 C-terminus region interferes with laparotomy- or morphine-induced cardioprotection...
October 5, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28981581/systematic-review-to-determine-which-validated-measurement-tools-can-be-used-to-assess-risk-of-problematic-analgesic-use-in-patients-with-chronic-pain
#5
R Lawrence, D Mogford, L Colvin
Misuse of prescription opioids, and other drugs prescribed for chronic pain, has increased, with major concerns about harm. This review was undertaken to identify validated measurement tools for risk assessment and monitoring of chronic non-cancer pain patients being considered for, or currently prescribed, analgesic drugs with abuse potential.Selected databases (Embase, Medline, Cochrane library/CENTRAL, PsycINFO, PubMed, CINAHL) were systematically searched for studies evaluating tools for risk of analgesic misuse, either before, or during, analgesic therapy for chronic pain, using predetermined inclusion/exclusion criteria...
September 14, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28967362/pain-management-in-rheumatology-research-training-and-practice
#6
REVIEW
David G Borenstein, Afton L Hassett, David Pisetsky
The Pain Management Task Force of the American College of Rheumatology published a report in 2010 highlighting pain management as a fundamental aspect of clinical practice, training and research. In the interim, the consideration of pain as a focus of attention of rheumatologists and rheumatology health professionals has become even more challenging than in 2010 because of the epidemic of opiate addiction and overdose death. The characterisation of categories of pain by mechanism (e.g., inflammation, joint degeneration, abnormalities of central pain processing) can help guide treatment...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28964926/managing-postoperative-pain-after-minimally-invasive-gynecologic-surgery-in-the-era-of-the-opioid-epidemic
#7
REVIEW
Marron Wong, Stephanie Morris, Karen Wang, Khara Simpson
In this review, we examine the evidence behind non-opioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Due to the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of Pubmed, EMBASE, and the Cochrane Database with a focus on randomized controlled trials (RCT)...
September 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28950033/alternative-viewpoint-predictors-of-response-in-emergency-department-patients-receiving-intravenous-opioids-for-severe-pain
#8
James Priano, Brian Faley
We read with great interest Predictors of Response in Emergency Department Patients Receiving Intravenous Opioids for Severe Pain(1) . We feel that while this paper helps determine response to opioids, there are other factors that should be considered. First, in this study, it is difficult to assess whether or not patients received non-opioid analgesics. A multimodal pain control strategy is recommended by many organizations(2-4) . The multimodal strategy should include at least 2 medications, with 2 different mechanisms of action to avoid reliance on a single drug for pain control...
September 26, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28948549/delayed-effects-of-neonatal-administration-of-non-opioid-analog-of-leu-enkephalin-on-cerebral-consequences-of-antenal-hypoxia
#9
A A Simankova, E N Sazonova, O A Lebed'ko
In 60-day-old male rats after antenatal hypoxia, the body weight and the absolute weight of the cerebral hemispheres were significantly lower than in the progeny of intact animals. Analysis of brain sections stained with silver nitrate revealed reduced number of nucleoli in neocortical layer II and hippocampal CA1 neurons and smaller area of neuronal nuclei in neocortical layer V and total area of nucleoli in neurons of all studied zones. The animals demonstrated increased locomotor activity in the elevated plus-maze test...
September 25, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28940900/successful-control-of-pain-from-malignant-psoas-syndrome-by-spinal-opioid-with-local-anesthetic-agents
#10
Takashi Yamaguchi, Katsuyuki Katayama, Mina Matsumoto, Yoshifumi Sato, Noriko Nakayama, Ko Hisahara
BACKGROUNDS: Malignant psoas syndrome (MPS) is a rare but distressing pain syndrome observed in advanced cancer patients. Pain due to MPS is often refractory to multi-modal analgesic treatment, including opioid analgesics. As only one case demonstrating the efficacy of neuraxial analgesia in managing pain due to MPS has been reported, its role in MPS remains uncertain. CASES: We present three cases demonstrating the successful management of pain due to MPS using spinal opioids with local anesthetic agents...
September 23, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28917616/opioid-use-following-total-hip-arthroplasty-trends-and-risk-factors-for-prolonged-use
#11
Nicholas A Bedard, Andrew J Pugely, S Blake Dowdle, Kyle R Duchman, Natalie A Glass, John J Callaghan
BACKGROUND: The purpose of this study is to answer the following questions: (1) What is the prevalence of opioid use prior to primary total hip arthroplasty (THA)? (2) What is the typical trend in opioid use following THA over the first post-operative year? (3) What are the risk factors for prolonged opioid use following primary THA? METHODS: Primary THA patients were identified in the Humana database from 2007 to 2015. Pre-operative and post-operative opioid use was measured by monthly prescription refill rates...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28911965/physiological-roles-of-cns-muscarinic-receptors-gained-from-knockout-mice
#12
REVIEW
Morgane Thomsen, Gunnar Sørensen, Ditte Dencker
Because the five muscarinic acetylcholine receptor subtypes have overlapping distributions in many CNS tissues, and because ligands with a high degree of selectivity for a given subtype long remained elusive, it has been difficult to determine the physiological functions of each receptor. Genetically engineered knockout mice, in which one or more muscarinic acetylcholine receptor subtype has been inactivated, have been instrumental in identifying muscarinic receptor functions in the CNS, at the neuronal, circuit, and behavioral level...
September 11, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28893675/design-recruitment-outcomes-and-sample-characteristics-of-the-strategies-for-prescribing-analgesics-comparative-effectiveness-space-trial
#13
Erin E Krebs, Agnes C Jensen, Sean Nugent, Beth DeRonne, Indulis Rutks, David Leverty, Amy Gravely, Siamak Noorbaloochi, Matthew J Bair, Kurt Kroenke
This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded...
November 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28893633/enhanced-recovery-open-versus-laparoscopic-left-donor-nephrectomy-a-randomized-controlled-trial
#14
Ahmed M Mansour, Ahmed R El-Nahas, Bedeir Ali-El-Dein, Ahmed Abdelfattah, Ahmed Hamed, Ahmed Abdel-Rahman, Ibrahim Eraky, Ahmed A Shokeir
OBJECTIVE: To compare recovery outcomes between laparoscopic donor nephrectomy (LDN) and open donor nephrectomy (ODN) within a specified Enhanced Recovery Program (ERP) for left kidney donations. MATERIALS AND METHODS: A phase III randomized trial was conducted between January 2013 and June 2015, eligible left side donors were randomized to laparoscopic or open donor nephrectomy in a 1:1 ratio with recovery optimized within a standardized ERP. The primary outcome was patient-reported measure of physical fatigue, as measured by the physical fatigue domain of the translated Multidimensional Fatigue Inventory 20 (MFI-20)...
September 8, 2017: Urology
https://www.readbyqxmd.com/read/28875436/predictors-of-daily-pain-medication-use-in-individuals-with-recurrent-back-pain
#15
John A Sturgeon, Jennifer M Hah, Yasamin Sharifzadeh, Stephanie K Middleton, Thomas Rico, Kevin A Johnson, Sean C Mackey
PURPOSE: A key component to chronic pain management regimens is the use of analgesic medications. Psychological factors, such as mood states, may also affect the use of pain medications for individuals with chronic pain, but few observational studies have examined how these factors may predict pain medication use at the daily level. METHODS: Daily assessments from 104 individuals with back pain were used to examine fluctuations in daily pain intensity, mood, sleep quality, and physical activity as predictors of the likelihood of pain medication (opioid and non-opioid) use and levels of medication use on the same day...
September 5, 2017: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/28860850/a-randomized-double-blind-study-of-hydromorphone-hydrochloride-extended-release-tablets-versus-oxycodone-hydrochloride-extended-release-tablets-for-cancer-pain-efficacy-and-safety-in-japanese-cancer-patients-exheal-a-phase-iii-study-of-extended-release-hydromorphone
#16
Satoshi Inoue, Yoji Saito, Satoru Tsuneto, Etsuko Aruga, Azusa Ide, Yasuyuki Kakurai
BACKGROUND: In Japan, there are limited options for switching opioid analgesics. Hydromorphone is an opioid analgesic that is routinely used instead of morphine for cancer pain; however, it is not yet available in Japan. The aim of this study was to assess the efficacy and safety of hydromorphone (DS-7113b) extended-release tablets in opioid-naïve patients with cancer pain not relieved by non-opioid analgesics. SUBJECTS AND METHODS: This was a multicenter, randomized, double-blind, parallel-group trial...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#17
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860712/a-comparison-of-oral-controlled-release-morphine-and-oxycodone-with-transdermal-formulations-of-buprenorphine-and-fentanyl-in-the-treatment-of-severe-pain-in-cancer-patients
#18
Krzysztof Nosek, Wojciech Leppert, Hanna Nosek, Jerzy Wordliczek, Dariusz Onichimowski
AIM OF THE STUDY: To compare analgesia and adverse effects during oral morphine and oxycodone and transdermal fentanyl and buprenorphine administration in cancer patients with pain. PATIENTS AND METHODS: Cancer patients treated at home and in outpatient clinics with severe pain (numerical rating scale score 6-10) fail to respond to non-opioids and/or weak opioids. All patients were randomized to either morphine, oxycodone, fentanyl or buprenorphine and divided into subgroups with predominant neuropathic and nociceptive pain component...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28843456/prescribing-non-opioid-drugs-in-end-stage-kidney-disease
#19
Andrew Wilcock, Sarah Charlesworth, Robert Twycross, Anne Waddington, Olivia Worthington, Fliss E M Murtagh, Jenny Beavis, Samuel King, Mary Mihalyo, Aleksandra Kotlinska-Lemieszek
Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available on www.palliativedrugs.com. Country-specific books (Hospice and Palliative Care Formulary USA, and Palliative Care Formulary, British and Canadian editions) are also available and can be ordered from www.palliativedrugs.com. The series editors welcome feedback on the articles (hq@palliativedrugs.com).
August 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28842369/old-friends-with-new-faces-are-sodium-channel-blockers-the-future-of-adjunct-pain-medication-management
#20
Ashley M Thomas, Timothy J Atkinson
Providers are being asked to decrease the emphasis and overutilization of long-term opioid therapy, but many are left without proper guidance on appropriate utilization of nonopioid therapies. Furthermore, therapeutic options are quite limited and many providers lack confidence in distinguishing available alternatives. When first-line therapy has failed in a patient, there is an apparent lack of knowledge on how to proceed with choosing subsequent therapy. To choose among alternative agents, an understanding of pharmacology, pharmacokinetics, and efficacy in targeting various pain conditions is necessary...
August 24, 2017: Journal of Pain: Official Journal of the American Pain Society
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