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Critical care

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19 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27301691/guideline-for-prescribing-opioids-for-chronic-pain
#1
Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services
Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs. The Centers for Disease Control and Prevention (CDC) developed and published the Guideline for Prescribing Opioids for Chronic Pain to provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing) outside of active cancer treatment, palliative care, and end-of-life care...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#2
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27464203/treatment-of-opioid-use-disorders
#3
REVIEW
Marc A Schuckit
This article provides an overview of the current treatment of opioid-related conditions, including treatments provided by general practitioners and by specialists in substance-use disorders. The recent dramatic increase in misuse of prescription analgesics, the easy accessibility of opioids such as..
July 28, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27670788/acute-kidney-injury-2016-diagnosis-and-diagnostic-workup
#4
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27556781/wound-healing-part-i-basic-science
#5
Jeffrey E Janis, Bridget Harrison
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the basic physiologic events in normal wound healing. 2. Understand the differences in healing among skin, bone, cartilage, and tendon. 3. Identify factors that may compromise or delay wound healing. 4. Describe methods for optimal closure of a wound. SUMMARY: Understanding the physiology and pathophysiology of normal wound healing and potential impediments to its end will allow the plastic surgeon to maximize postoperative outcomes and, in some instances, avoid unnecessary surgical interventions...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27650441/the-cold-pressor-test-as-a-predictor-of-prolonged-postoperative-pain-a-prospective-cohort-study
#6
Cameron MacLachlan, Edward A Shipton, J Elisabeth Wells
INTRODUCTION: Presently, it is difficult to predict which patients are at increased risk of ongoing pain problems postoperatively. This study followed a group of patients from the week before their operation until 3 months after it, to identify potential risk variables. METHODS: Fifty-four patients undergoing moderate-major gynaecological surgery at Christchurch Women's Hospital were recruited and assessed preoperatively over an 11-week period. At this initial assessment, participants were subjected to a cold pressor test (CPT)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27643833/the-epidemiology-of-chronic-pain
#7
Gary J Macfarlane
No abstract text is available yet for this article.
October 2016: Pain
https://www.readbyqxmd.com/read/27408698/mechanisms-of-low-back-pain-a-guide-for-diagnosis-and-therapy
#8
REVIEW
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
https://www.readbyqxmd.com/read/27477022/bleeding-related-to-disturbed-fibrinolysis
#9
REVIEW
Krasimir Kolev, Colin Longstaff
The components and reactions of the fibrinolysis system are well understood. The pathway has fewer reactants and interactions than coagulation, but the generation of a complete quantitative model is complicated by the need to work at the solid-liquid interface of fibrin. Diagnostic tools to detect disease states due to malfunctions in the fibrinolysis pathway are also not so well developed as is the case with coagulation. However, there are clearly a number of inherited or acquired pathologies where hyperfibrinolysis is a serious, potentially life-threatening problem and a number of antifibrinolytc drugs are available to treat hyperfibrinolysis...
October 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27468181/anorectal-emergencies
#10
Varut Lohsiriwat
Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer...
July 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/24646389/relationship-of-female-sex-hormones-with-pain-perception-focus-on-estrogens
#11
Anna Maria Aloisi, Giuseppina Sorda
SUMMARY The role of gonadal hormones has slowly gathered the right attention in the study of chronic pain mechanisms. The clear presence of sex differences in chronic pain and the number of studies showing the power of gonadal hormones to modify pain-induced behavioral responses appear to have convinced clinicians and researchers. Indeed, available data strongly indicate that more studies on gonadal hormones would certainly enhance the possibility of greatly increasing the knowledge of pain mechanisms and, thus, treatments...
May 2011: Pain Management
https://www.readbyqxmd.com/read/24654719/the-five-pillars-of-pain-management
#12
Allan Gordon
SUMMARY The last 10-15 years have seen an increase in the use of opioids in chronic noncancer pain. The consequences of increased use only gradually became apparent. The five pillars of pain management were developed as a convenient mechanism for the management of chronic noncancer pain and to allow for a comprehensive approach to patient care. The mnemonic ADDOP was developed: 'A' pillar one - assessment including risk and symptom assessment; 'D' pillar two - defining and treating the underlying condition; 'D' pillar three - making a pain diagnosis and going down an established path of treatment; 'O' pillar four - other treatments embracing the biopsychosocial model and treating co-morbidities; 'P' pillar five - patient self-management, personal responsibility and patient education...
July 2012: Pain Management
https://www.readbyqxmd.com/read/25134934/outcomes-in-pain-medicine-a-brief-review
#13
Anuj Malhotra, Sean Mackey
Pain, and particularly chronic pain, is a difficult outcome to measure due to its subjective and multidimensional nature. The Institute of Medicine estimates that 100 million Americans have chronic pain with a cost exceeding half a trillion dollars per year. There is a pressing need to identify appropriate outcome measures to better select and evaluate treatment modalities for these patients. It is also important that we demonstrate an evidence basis for these decisions given the current practice standard. Appropriate selection and implementation of these outcome measures can help accomplish both goals...
December 2012: Pain and Therapy
https://www.readbyqxmd.com/read/25135146/the-physiologic-effects-of-pain-on-the-endocrine-system
#14
Forest Tennant
Severe pain has profound physiologic effects on the endocrine system. Serum hormone abnormalities may result and these serve as biomarkers for the presence of severe pain and the need to replace hormones to achieve pain control. Initially severe pain causes a hyperarousal of the hypothalamic-pituitary-adrenal system which results in elevated serum hormone levels such as adrenocorticotropin, cortisol, and pregnenolone. If the severe pain does not abate, however, the system cannot maintain its normal hormone production and serum levels of some hormones may drop below normal range...
December 2013: Pain and Therapy
https://www.readbyqxmd.com/read/25630651/skin-matters-a-review-of-topical-treatments-for-chronic-pain-part-two-treatments-and-applications
#15
John F Peppin, Phillip J Albrecht, Charles Argoff, Burkhard Gustorff, Marco Pappagallo, Frank L Rice, Mark S Wallace
In Part One of this two-part series, we discussed skin physiology and anatomy as well as generalities concerning topical analgesics. This modality of therapy has lesser side effects and drug-drug interactions, and patients tolerate this form of therapy better than many oral options. Unfortunately, this modality is not used as often as it could be in chronic pain states, such as that from neuropathic pain. Part Two discusses specific therapies, local anesthetics, and other drugs, as well as how a clinician might use specific aspects of a patient's neuropathic pain presentation to help guide them in the selection of a topical agent...
June 2015: Pain and Therapy
https://www.readbyqxmd.com/read/25627665/skin-matters-a-review-of-topical-treatments-for-chronic-pain-part-one-skin-physiology-and-delivery-systems
#16
John F Peppin, Phillip J Albrecht, Charles Argoff, Burkhard Gustorff, Marco Pappagallo, Frank L Rice, Mark S Wallace
Chronic pain is a complex disorder with multiple etiologies for which the pathologic mechanisms are still largely unknown, making effective treatment a difficult clinical task. Achieving pain relief along with improved function and quality of life is the primary goal of pain clinicians; however, most patients and healthcare professionals consider 30% pain improvement to be clinically significant-a success level that would be unacceptable in other areas of medicine. Furthermore, patients with chronic pain frequently have multiple comorbidities, including depression and sleep apnea, and most have seen several physicians prior to being seen by a pain specialist, have more than three specific pain generators, and are taking multiple medications...
June 2015: Pain and Therapy
https://www.readbyqxmd.com/read/23984731/severe-sepsis-and-septic-shock
#17
REVIEW
Derek C Angus, Tom van der Poll
New England Journal of Medicine, Volume 369, Issue 9, Page 840-851, August 2013.
August 29, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/27405735/regional-block-who-first-thought-of-such-an-approach
#18
EDITORIAL
Michiaki Yamakage
No abstract text is available yet for this article.
August 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26976277/crystalloid-fluid-therapy
#19
REVIEW
Sumeet Reddy, Laurence Weinberg, Paul Young
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
March 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
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