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https://www.readbyqxmd.com/read/29447356/barriers-to-the-availability-and-accessibility-of-controlled-medicines-for-chronic-pain-in-africa
#1
Elmang Nchako, Scottie Bussell, Carlos Nesbeth, Chisom Odoh
Africans endure a high burden of pain and suffering from HIV/AIDS and cancer, yet receive a meager amount of the world's pain medication. This tragedy occurs needlessly, given that inexpensive, effective and easily administered interventions are available. WHO has a 'three-step analgesic ladder' framework for managing cancer pain. This widely adopted clinical practice guideline is an integral part of palliative care programs and has also been applied to non-cancer pain. However, untreated pain is a major public health problem due to the discordance between scientific evidence and public policy...
February 13, 2018: International Health
https://www.readbyqxmd.com/read/29445602/uniportal-video-assisted-thoracoscopic-surgery-vats-sleeve-resections-for-non-small-cell-lung-cancer-patients-an-observational-prospective-study-and-technique-analysis
#2
Aris Koryllos, Erich Stoelben
Bronchus sleeve resection for operative treatment of non-small cell lung cancer (NSCLC) is a gold standard in modern thoracic surgery in cases of centrally located tumors or hilär lymph node metastases. Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-port to uniportal) and to resect larger and more centrally located malignancies minimal invasively. It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29441097/the-feasibility-of-using-ultrasound-during-follow-up-for-superficial-non-melanoma-skin-cancers-after-electronic-brachytherapy
#3
Uma Goyal, Justin Suszko, Baldassarre Stea
Purpose: Non-melanoma skin cancers (NMSCs) can be treated with a number of modalities including surgery, topical chemotherapy, or radiotherapy. Amongst the radiotherapeutic options, electronic brachytherapy (eBT) is an appealing treatment as it is usually given in a few fractions, it leads to good outcomes, and is increasingly being used. However, currently no follow-up imaging is routinely used or recommended to evaluate treatment response of NMSC. We aimed to use ultrasound (US) in follow-up after eBT for superficial NMSC to assess its feasibility in detecting possible tumor response...
December 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29440012/patterns-of-regional-variation-of-opioid-prescribing-in-primary-care-in-england-a-retrospective-observational-study
#4
Luke Mordecai, Carl Reynolds, Liam J Donaldson, Amanda C de C Williams
BACKGROUND: Opioids are a widely prescribed class of drug with potentially harmful short-term and long-term side effects. There are concerns about the amounts of these drugs being prescribed in England given that they are increasingly considered ineffective in the context of long-term non-cancer pain, which is one of the major reasons for their prescription. AIM: To assess the amount and type of opioids prescribed in primary care in England, and patterns of regional variation in prescribing...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29436434/updates-in-palliative-care-overview-and-recent-advancements-in-the-pharmacological-management-of-cancer-pain
#5
Helen Wood, Andrew Dickman, Angela Star, Jason W Boland
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436331/impact-of-adherence-to-antidepressants-on-long-term-prescription-opioid-use-cessation
#6
Jeffrey F Scherrer, Joanne Salas, Mark D Sullivan, Brian K Ahmedani, Laurel A Copeland, Kathleen K Bucholz, Thomas Burroughs, F David Schneider, Patrick J Lustman
BACKGROUND: Depression contributes to persistent opioid analgesic use (OAU). Treating depression may increase opioid cessation. Aims To determine if adherence to antidepressant medications (ADMs) v. non-adherence was associated with opioid cessation in patients with a new depression episode after >90 days of OAU. METHOD: Patients with non-cancer, non-HIV pain (n = 2821), with a new episode of depression following >90 days of OAU, were eligible if they received ≥1 ADM prescription from 2002 to 2012...
February 2018: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29431861/non-steroidal-anti-inflammatory-agents-to-induce-regression-and-prevent-the-progression-of-cervical-intraepithelial-neoplasia
#7
REVIEW
Shannon M Grabosch, Osman M Shariff, C William Helm
BACKGROUND: This is an updated version of the original Cochrane review published in 2014, Issue 4. Cervical intraepithelial neoplasia (CIN) precedes the development of invasive carcinoma of the cervix. Current treatment of CIN is quite effective, but there is morbidity for the patient related to pain, bleeding, infection, cervical stenosis and premature birth in a subsequent pregnancy. Effective treatment with medications, rather than surgery, would be beneficial. OBJECTIVES: To evaluate the effectiveness and safety of non-steroidal anti-inflammatory agents (NSAIDs), including cyclooxygenase-2 (COX-2) inhibitors, to induce regression and prevent the progression of CIN...
February 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29431608/adverse-effects-of-opioids-for-non-cancer-pain
#8
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29424302/the-role-of-5-ht1a-receptor-in-the-cancer-as-a-new-opportunity-in-medicinal-chemistry
#9
Angela Corvino, Ferdinando Fiorino, Beatrice Severino, Irene Saccone, Francesco Frecentese, Elisa Perissutti, Paola Di Vaio, Vincenzo Santagada, Giuseppe Caliendo, Elisa Magli
The 5-HT1A receptor is a pharmacologically well characterized serotonin receptor subtype and it has long been investigated because of its involvement in several physio-pathological mechanisms and treatment of neurological diseases like ansia and depression. Serotonin (5-HT) also shows many non-neural functions such as essential hypertension, embryogenesis, follicle maturation and behavior. Moreover it exerts a growth factor function on different types of non-tumoral cells, and it was also found to be related to oncogenes...
February 9, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29423535/the-population-impact-of-rheumatic-and-musculoskeletal-diseases-in-relation-to-other-non-communicable-disorders-comparing-two-estimation-approaches
#10
Daniela Simões, Fábio Azevedo Araújo, Teresa Monjardino, Milton Severo, Ivo Cruz, Loreto Carmona, Raquel Lucas
The aim of this study was to quantify the population impact of rheumatic and musculoskeletal diseases (RMDs) with other non-communicable diseases (NCDs), using two complementary strategies: standard multivariate models based on global burden of disease (GBD)-defined groups vs. empirical mutually exclusive patterns of NCDs. We used cross-sectional data from the Portuguese Fourth National Health Survey (n = 23,752). Six GBD-defined groups were included: RMDs, chronic obstructive pulmonary disease or asthma, cancer, depression, diabetes or renal failure, and stroke or myocardial infarction...
February 8, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29421366/chronic-administration-of-morphine-using-mini-osmotic-pumps-affects-spatial-memory-in-the-male-rat
#11
Erika Brolin, Sofia Zelleroth, Anna Jonsson, Mathias Hallberg, Alfhild Grönbladh, Fred Nyberg
The use of opioid analgesics to treat non-cancer pain has increased over the years. Many chronic pain patients suffer from numerous adverse effects, such as reduced quality of life, development of dependence, and cognitive impairments. Cognitive processes are regulated by several systems, one of which involves growth hormone (GH) and its secondary mediator insulin-like growth factor-1 (IGF-1), but also glutamatergic transmission, including receptors such as the N-methyl-d-aspartate (NMDA)-receptor complex. In the laboratory, repeated injections are commonly used to establish animal models of long-term or chronic drug exposure...
February 5, 2018: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/29419653/long-term-use-of-naldemedine-in-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-non-cancer-pain-a-randomized-double-blind-placebo-controlled-phase-3-study
#12
Lynn R Webster, Srinivas Nalamachu, Bart Morlion, Jyotsna Reddy, Yuko Baba, Tadaaki Yamada, Juan Camilo Arjona Ferreira
The long-term safety of naldemedine, a peripherally acting µ-opioid receptor antagonist, was evaluated in patients with opioid-induced constipation and chronic non-cancer pain in a 52-week, randomized, double-blind, phase 3 study. Eligible adults who could be on a routine laxative regimen were randomized 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 623) or placebo (n = 623). The primary endpoint was summary measures of treatment-emergent adverse events (AEs). Additional endpoints included opioid withdrawal on the Clinical Opiate Withdrawal Scale and the Subjective Opiate Withdrawal Scale, pain intensity on Numeric Rating Scale, frequency of bowel movements, and constipation-related symptoms and quality of life on the Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life scales, respectively...
February 6, 2018: Pain
https://www.readbyqxmd.com/read/29419331/-icorg-05-03-prospective-randomized-non-inferiority-phase-iii-trial-comparing-two-radiation-schedules-in-malignant-spinal-cord-compression-not-proceeding-with-surgical-decompression-the-quality-of-life-analysis
#13
K A Lee, M Dunne, C Small, P J Kelly, O McArdle, J O'Sullivan, D Hacking, M Pomeroy, J Armstrong, M Moriarty, A Clayton-Lea, I Parker, C D Collins, P Thirion
BACKGROUND: The optimal primary external beam radiation therapy (EBRT) radiation schedule for malignant epidural spinal cord compression (MSCC) remains to be determined. The ICORG 05-03 trial assessed if a 10 Gy single fraction radiation schedule was not inferior to one with 20 Gray (Gy) in five daily fractions, in terms of functional motor outcome, for the treatment of MSCC in patients not proceeding with surgical decompression. This article reports on two of the secondary endpoints, Quality of life (QoL), assessed according to the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) version 3...
February 8, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29417840/what-makes-decision-making-difficult-for-oncologists-faced-with-critical-situations-the-socio-affective-side-of-the-physician-patient-relationship
#14
Léa Restivo, Claire Julian-Reynier, Laura Peyla, Thémis Apostolidis
The aim of this qualitative study based on a Social Representations approach was to explore experienced oncologists' representations of difficult decision-making situations. In total, 22 semi-structured interviews with oncologists were conducted and analysed by performing a thematic content analysis. The thematic content analysis brought to light the main medical problem involved such as uncertainty, the lethal nature of cancer and physicians' specialties, as well as the psychosocial ones, such as patients' non-medical characteristics and the patient-physician relationships...
February 1, 2018: Journal of Health Psychology
https://www.readbyqxmd.com/read/29417799/a-synthesis-of-the-world-s-guidelines-on-photodynamic-therapy-for-non-melanoma-skin-cancer
#15
Colin A Morton
Photodynamic therapy (PDT), using topically administered photosensitizing agents, is widely approved as a treatment for certain nonmelanoma skin cancers. As a tissue-sparing non-surgical modality, there is great potential for PDT to enhance the choice of therapies available to treat, and potentially prevent, skin cancer. Treatment-specific guidelines have assessed the evidence for various photosensitizing agents and light sources, dosimetry, and evaluate reported adverse effects. Discomfort is frequently experienced during treatment but no analgesia was required in most pivotal lesion-directed studies...
February 7, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29410156/backstories-on-the-u-s-opioid-epidemic-good-intentions-gone-bad-an-industry-gone-rogue-and-watch-dogs-gone-to-sleep
#16
REVIEW
Richard deShazo, McKenzie Johnson, Ike Eriator, Kathryn Rodenmeyer
Epidemics of opioid use are old news in the United States, but an epidemic that kills over 200,000 Americans is not. A multiplicity of intertwined factors have brought us to this place. From 30,000 feet, it is the story of good intentions gone bad, a drug industry gone rogue, and government watch dog agencies gone to sleep. At ground level, it is the story of physicians unfamiliar with addictive drugs and drug addiction, new long acting opioids deceptively marketed, cheap black tar heroin, encouragement to use opioids for chronic non-cancer pain by professional organizations with conflicts of interest and without science, a culture intolerant to pain and tolerant to drug use, and the greedy response of the pharmaceutical industry and drug cartels to an expanding market opportunity...
January 31, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29409684/ongoing-strategies-and-updates-on-pain-management-in-gynecologic-oncology-patients
#17
REVIEW
Kari E Hacker, R Kevin Reynolds, Shitanshu Uppal
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
February 3, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29409108/psychometric-evaluation-and-adaptation-of-the-spine-oncology-study-group-outcomes-questionnaire-to-evaluate-health-related-quality-of-life-in-patients-with-spinal-metastases
#18
Anne L Versteeg, Arjun Sahgal, Laurence D Rhines, Daniel M Sciubba, James M Schuster, Michael H Weber, Peter Pal Varga, Stefano Boriani, Chetan Bettegowda, Michael G Fehlings, Michelle J Clarke, Paul M Arnold, Ziya L Gokaslan, Charles G Fisher
BACKGROUND: The Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ) was developed as the first spine oncology-specific health-related quality of life (HRQOL) measure. This study evaluated the psychometric properties and clinical validity of the SOSGOQ in a diverse cohort of patients with spinal metastases. METHODS: An international, multicenter, prospective observational cohort study including patients with spinal metastases who underwent surgery and/or radiotherapy was conducted by the AOSpine Knowledge Forum Tumor...
February 6, 2018: Cancer
https://www.readbyqxmd.com/read/29408808/pain-control-through-selective-chemo-axotomy-of-centrally-projecting-trpv1-sensory-neurons
#19
Matthew R Sapio, John K Neubert, Danielle M LaPaglia, Dragan Maric, Jason M Keller, Stephen J Raithel, Eric L Rohrs, Ethan M Anderson, John A Butman, Robert M Caudle, Dorothy C Brown, John D Heiss, Andrew J Mannes, Michael J Iadarola
Transient vanilloid potential 1 (TRPV1) agonists are emerging as highly efficacious non-opioid analgesics in preclinical studies. These drugs selectively lesion TRPV1+ primary sensory afferents, which are responsible for the transmission of many noxious stimulus modalities. Resiniferatoxin (RTX) is a very potent and selective TRPV1 agonist and is a promising candidate for treating many types of pain. Recent work establishing intrathecal application of RTX for the treatment of pain resulting from advanced cancer has demonstrated profound analgesia in client-owned dogs with osteosarcoma...
February 6, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29407216/pharmacological-profiling-of-sigma-1-receptor-ligands-by-novel-receptor-homomer-assays
#20
Hideaki Yano, Alessandro Bonifazi, Min Xu, Daryl A Guthrie, Stephanie N Schneck, Ara M Abramyan, Andrew D Fant, W Conrad Hong, Amy H Newman, Lei Shi
The sigma 1 receptor (σ1R) is a structurally unique transmembrane protein that functions as a molecular chaperone in the endoplasmic reticulum (ER), and has been implicated in cancer, neuropathic pain, and psychostimulant abuse. Despite physiological and pharmacological significance, mechanistic underpinnings of structure-function relationships of σ1R are poorly understood, and molecular interactions of selective ligands with σ1R have not been elucidated. The recent crystallographic determination of σ1R as a homo-trimer provides the foundation for mechanistic elucidation at the molecular level...
January 30, 2018: Neuropharmacology
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