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https://www.readbyqxmd.com/read/28449262/predictive-mechanisms-linking-brain-opioids-to-chronic-pain-vulnerability-and-resilience
#1
REVIEW
Anthony Kenneth Peter Jones, Christopher Andrew Brown
Chronic pain is a major global healthcare problem that is currently inadequately treated. In addition, the current use of opioids for treatment has reached far beyond the paucity of evidence for long-term benefits relative to risks. Benefit-risk models for opioid and non-opioid treatments would benefit from a rational, mechanism-based understanding of neuroplastic and neurochemical contributions to chronic pain. Here we evaluate the findings and limitations of representative research investigating brain neuroplasticity and neurochemistry in chronic pain...
April 27, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28434097/impact-of-a-complementary-integrative-medicine-program-on-the-need-for-supportive-cancer-care-related-medications
#2
Ilanit Shalom-Sharabi, Noah Samuels, Efraim Lev, Ofer Lavie, Lital Keinan-Boker, Elad Schiff, Eran Ben-Arye
OBJECTIVE: Despite the growing evidence supporting the use of complementary/integrative medicine (CIM) in the treatment of chemotherapy-induced toxicities, little is known on CIM impact of these therapies regarding the use of medications for supportive cancer care. In this study, we examined the impact of CIM on the need for supportive cancer care-related medications. PATIENTS AND METHODS: Patients with breast or gynecological cancer referred to and attending an integrative physician (IP) consultation for gastrointestinal (GI) concerns were designated as the treatment group; those not attending as controls...
April 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28428504/-assessment-and-strategy-for-nociceptive-pain-in-cancer
#3
Gakuji Osawa, Etsuko Aruga
Pain is classified as either nociceptive pain, which results from a nociceptor stimulation, or neuropathic pain, which results from a lesion of the neural pathway. Clinically, in many cases, pain consists of a single origin but multiple origins are also possible. In this paper, we outline an assessment and strategy for nociceptive pain in cancer. The onset time, location, feature, strength, and etiology were included as categories for the assessment of pain. Furthermore, we added a psychosocial assessment to the physical assessment, which ensured comprehensive pain evaluation...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28413136/opioid-use-after-total-knee-arthroplasty-trends-and-risk-factors-for-prolonged-use
#4
Nicholas A Bedard, Andrew J Pugely, Robert W Westermann, Kyle R Duchman, Natalie A Glass, John J Callaghan
BACKGROUND: The United States is in the midst of an opioid epidemic. Little is known about perioperative opioid use for total knee arthroplasty (TKA). The purpose of this study was to identify rates of preoperative opioid use, evaluate postoperative trends and identify risk factors for prolonged use after TKA. METHODS: Patients who underwent primary TKA from 2007-2014 were identified within the Humana database. Postoperative opioid use was measured by monthly prescription refill rates...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28405033/post-caesarean-analgesia-what-is-new
#5
REVIEW
Sukhyanti Kerai, Kirti Nath Saxena, Bharti Taneja
Adequate post-operative analgesia after caesarean section (CS) is vital as it impacts the distinct surgical recovery requirements of the parturient. Although newer analgesic modalities and drugs for post-caesarean analgesia have been introduced over the recent years, review of the literature suggests suggests that we are far from achieving the goals of optimum post-operative analgesia. We conducted a systematic review of recent advances in modalities for post-caesarean analgesia. After systematic search and quality assessment of studies, we included a total of 51 randomised controlled trials that evaluated the role of opioids, transversus abdominis plane (TAP) block, wound infiltration/infusion, ketamine, gabapentin and ilioinguinal-iliohypogastric nerve block (II-IH NB) for post-caesarean analgesia...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28385954/using-m-health-tools-to-reduce-the-misuse-of-opioid-pain-relievers
#6
Elise Omaki, Renan Castillo, Karen Eden, Steve Davis, Eileen McDonald, Umbreen Murtaza, Andrea Gielen
BACKGROUND: Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider. METHODS: This multisite, randomised trial will evaluate an m-health programme designed to aid the patient in making an informed decision about their pain treatment...
April 6, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28365208/postoperative-hyperalgesia-a-clinically-applicable-narrative-review
#7
REVIEW
Avi A Weinbroum
Postoperative hyperalgesia (POH) is a condition characterized by signs and symptoms of pain despite the provision of conventional analgesia. In most cases, anesthesiologists are called upon soon after surgery, but occasionally it may occur as a late event. Persistent uncontrolled pain may transform into chronic or neuropathic pain. Correct diagnosis of POH is essential since similar phenomenon may exacerbate if misdiagnosed, while proper treatment is frequently achievable by pharmacological remedies. This review will describe the causes for POH and its bio-neuro-pharmacological basis, and clinical symptoms and signs directing the physician towards correct diagnosis of this paradoxical condition of pain, as well as modes capable of preventing POH from occurring...
March 29, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28363631/erratum-to-421-a-novel-non-opioid-conesnail-peptide-based-analgesic-as-a-therapeutic-alternative-for-the-treatment-of-chronic-pain-j-pain-17-s79-s80-2016
#8
(no author information available yet)
No abstract text is available yet for this article.
April 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28363315/providing-chronic-pain-management-in-the-fifth-vital-sign-era-historical-and-treatment-perspectives-on-a-modern-day-medical-dilemma
#9
REVIEW
D Andrew Tompkins, J Greg Hobelmann, Peggy Compton
BACKGROUND: Over 100 million Americans are living with chronic pain, and pain is the most common reason that patients seek medical attention. Despite the prevalence of pain, the practice of pain management and the scientific discipline of pain research are relatively new fields compared to the rest of medicine - contributing to a twenty-first century dilemma for health care providers asked to relieve suffering in the "Fifth Vital Sign" era. METHODS: This manuscript provides a narrative review of the basic mechanisms of chronic pain and history of chronic pain management in the United States - including the various regulatory, health system and provider factors that contributed to the decline of multidisciplinary pain treatment in favor of the predominant opioid treatment strategy seen today...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28350586/predictors-of-outcome-in-conservative-and-minimally-invasive-surgical-management-of-pain-originating-from-the-sacroiliac-joint-a-pooled-analysis
#10
Julius Dengler, Bradley Duhon, Peter Whang, Clay Frank, John Glaser, Bengt Sturesson, Steven Garfin, Daniel Cher, Aaron Rendahl, David Polly
STUDY DESIGN: A pooled patient-level analysis of two multicenter randomized controlled trials and one multicenter single-arm prospective trial. OBJECTIVE: To identify predictors of outcome of conservative and minimally invasive surgical management of pain originating from the sacroiliac joint (SIJ). SUMMARY OF BACKGROUND DATA: Three recently published prospective trials have shown that minimally invasive SIJ fusion (SIJF) using triangular titanium implants produces better outcomes than conservative management for patients with pain originating from the SIJ...
March 27, 2017: Spine
https://www.readbyqxmd.com/read/28345245/pain-depressive-symptoms-and-medication-in-german-patients-with-rheumatoid-arthritis-results-from-the-linking-patient-reported-outcomes-with-claims-data-for-health-services-research-in-rheumatology-proclair-study
#11
Kathrin Jobski, Andres Luque Ramos, Katinka Albrecht, Falk Hoffmann
PURPOSE: Pain and depressive symptoms are common in patients with rheumatoid arthritis (RA). Information on the prevalence and treatment of both conditions in German RA patients is scarce. METHODS: Using data from a nationwide statutory health insurance fund (BARMER GEK), 6193 RA patients aged 18 to 79 years were provided with a questionnaire covering a variety of items such as demographics, medical condition and quality of life in 2015. Pain caused by the joint disorder (11-point scale) was classified as none existent/mild, moderate or severe...
March 26, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28341346/stimulation-of-%C3%AE-opioid-receptors-dilates-retinal-arterioles-by-neuronal-nitric-oxide-synthase-derived-nitric-oxide-in-rats
#12
Eriko Someya, Asami Mori, Kenji Sakamoto, Kunio Ishii, Tsutomu Nakahara
Opioids contribute to the regulation of cerebral vascular tone. The purpose of this study was to examine the effects of herkinorin, a non-opioid μ-opioid receptor agonist derived from salvinorin A, on blood vessels in the rat retina and to investigate the mechanism underlying the herkinorin-induced retinal vasodilatory response. Ocular fundus images were captured using an original high-resolution digital fundus camera in vivo. The retinal vascular responses were evaluated by measuring the diameter of retinal arterioles in the fundus images...
May 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#13
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28328571/neuropathic-pain-induced-enhancement-of-spontaneous-and-pain-evoked-neuronal-activity-in-the-periaqueductal-gray-that-is-attenuated-by-gabapentin
#14
Vijay K Samineni, Louis S Premkumar, Carl L Faingold
Neuropathic pain is a debilitating pathological condition that is poorly understood. Recent evidence suggests that abnormal central processing occurs during the development of neuropathic pain induced by the cancer chemotherapeutic agent, paclitaxel. Yet, it is unclear what role neurons in supraspinal pain network sites, such as the periaqueductal gray, play in altered behavioral sensitivity seen during chronic pain conditions. To elucidate these mechanisms, we studied the spontaneous and thermally evoked firing patterns of ventrolateral periaqueductal gray (vlPAG) neurons in awake-behaving rats treated with paclitaxel to induce neuropathic pain...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28328148/long-term-follow-up-study-of-community-based-patients-receiving-xr-ntx-for-opioid-use-disorders
#15
Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R Levin, Edward V Nunes, John J Mariani, Adam Bisaga
BACKGROUND AND OBJECTIVES: Extended-release naltrexone (XR-NTX) is FDA-approved to prevent relapse in patients with Opioid Use Disorder. However little is known about long-term use among community-based outpatients. METHODS: Retrospective chart review and long-term follow-up survey among individuals (N = 168) who entered an outpatient XR-NTX trial between 2011 and 2015, during which participants were offered three monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of four domains: (1) substance use; (2) treatment continuation; (3) barriers; and (4) attitudes...
March 22, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28314555/the-effects-of-intra-articular-levobupivacain-versus-levobupivacain-plus-magnesium-sulfate-on-postoperative-analgesia-in-patients-undergoing-arthroscopic-meniscectomy-a-prospective-randomized-controlled-study
#16
Nurcan Kizilcik, Turhan Özler, Ferdi Menda, Çağatay Uluçay, Özge Köner, Faik Altintaş
OBJECTIVE: The aim of this study was to compared the effectiveness of intraarticular levobupivacain with levobupivacain and magnesium sulfate. METHODS: In this prospective randomized double blinded study, 96 patients (67 male, 29 female; age range: 18-65 years) with ASA (American Society of Anesthesiologist) score I and II, who had undergone arthroscopic meniscectomy operation, were divided to 3 groups that had postoperative analgesia with intra-articular saline injection (control group), levobupivacain injection (L group) or levobupivacain and magnesium sulfate injection (LM group)...
March 14, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28298770/intraperitoneal-levobupivacaine-with-or-without-clonidine-for-pain-relief-after-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#17
Nishith Govil, Parag Kumar
BACKGROUND: Irrigation of local anesthetic intraperitoneally in combination with opioids and non-opioids agents has been used to provide pain relief with varying success in laparoscopic surgeries. This randomized double blind placebo controlled study is designed to study the effect of intraperitoneal instillation of levo-bupivacaine along with clonidine for pain relief after laparascopic cholecystectomy. METHODS: 75 patients were randomized to receive 20 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296137/percutaneous-peripheral-nerve-stimulation-for-the-treatment-of-chronic-low-back-pain-two-clinical-case-reports-of-sustained-pain-relief
#18
Leonardo Kapural, Christopher A Gilmore, John Chae, Richard L Rauck, Steven P Cohen, Michael F Saulino, Amorn Wongsarnpigoon, Meredith J McGee, Joseph W Boggs
As the leading cause of disability among U.S. adults, chronic low back pain (LBP) is one of the most prevalent and challenging musculoskeletal conditions. Neuromodulation provides an opportunity to reduce or eliminate the use of opioids to treat chronic LBP, but the cost and invasiveness of existing methods have limited its broad adoption, especially earlier in the treatment continuum. The present case report details the results of a novel method of short-term percutaneous peripheral nerve stimulation (PNS) in 2 subjects with chronic LBP...
March 14, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28285863/low-dose-ketamine-use-in-the-emergency-department-a-new-direction-in-pain-management
#19
A Pourmand, M Mazer-Amirshahi, C Royall, R Alhawas, R Shesser
There is a need for alternative non-opioid analgesics for the treatment of acute, chronic, and refractory pain in the emergency department (ED). Ketamine is a fast acting N-methyl-d-aspartate (NMDA) receptor antagonist that provides safe and effective analgesia. The use of low dose ketamine (LDK) (<1mg/kg) provides sub-dissociative levels of analgesia and has been studied as an alternative and/or adjunct to opioid analgesics. We reviewed 11 studies using LDK either alone or in combination with opioid analgesics in the ED...
March 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282499/non-opioid-medications-for-the-relief-of-chronic-breathlessness-current-evidence
#20
Carlo Barbetta, David C Currow, Miriam J Johnson
To evaluate systematically randomised clinical trials investigating non-opioid medications for the management and treatment of chronic breathlessness. Areas covered: The evidence for the role of benzodiazepines, anxiolytics, selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, cannabinoids, nebulized furosemide and herbal-based treatments were critically reviewed. Search of the Clinical Trials Registry (Clinicaltrial.gov) identified ongoing studies expected to generate new data in the near future in several classes of non-opioid medications for their net effect on chronic breathlessness...
March 17, 2017: Expert Review of Respiratory Medicine
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