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Pain and Therapy

Kathryn G Tippey, Mary Yovanoff, Larry S McGrath, Peter Sneeringer
INTRODUCTION: Opioid overdose rescue situations are time-critical, high-stress scenarios that frequently require nonmedical first responders or bystanders to intervene and administer naloxone to avoid opioid-induced fatalities. Training nonmedical personnel to respond during such mentally constraining situations presents the human factors challenge of how best to design a safe and effective lay delivery system. This paper comparatively evaluates the ease of use of two nasal naloxone administration products: NARCAN® Nasal Spray and a naloxone prefilled syringe with nasal atomizer (PFS-NA)...
March 15, 2019: Pain and Therapy
Charlie Piermarini, Omar Viswanath
No abstract text is available yet for this article.
March 12, 2019: Pain and Therapy
Tatsunori Ikemoto, Kazuhiro Hayashi, Young-Chang Arai, Makoto Nishihara, Shinsuke Inoue, Masayuki Inoue, Yukiko Shiro, Takahiro Ushida
INTRODUCTION: Picky eating appears to be associated with poor health outcomes and thus it might have a role in musculoskeletal pain in adults. However, this relationship has not been investigated yet. The aim of the present study was to determine whether the number of musculoskeletal pain regions was associated with picky eating, which was characterized by food intake balance of familiar products or self-identification. METHODS: A total of 4660 adult subjects were enrolled in this study...
March 12, 2019: Pain and Therapy
Anthony J Lisi, Mickey Scheinowitz, Richard Saporito, Anthony Onorato
INTRODUCTION: Low back pain (LBP) poses a significant burden of disease worldwide, and identifying safe and effective non-pharmacologic treatment options for LBP is a research priority. The aim of this study was to pilot a clinical trial of a portable pulsed electromagnetic field (PEMF) therapy device for subjects with mixed duration non-specific LBP. METHODS: This work was a randomized, double-blind, sham-controlled, parallel-group study conducted at a chiropractic school outpatient clinic...
March 12, 2019: Pain and Therapy
Ryosuke Takahashi, Yusuke Iwahori, Yukihiro Kajita, Yohei Harada, Yoshitaka Muramatsu, Tatsunori Ikemoto, Masataka Deie
INTRODUCTION: Manipulation under ultrasound-guided fifth and sixth cervical nerve root block (MUC) is a recognized form of treatment for patients with persistent frozen shoulder (FS). This study aimed to investigate the confirmatory hypothesis testing that the MUC has a significant clinical effect on FS refractory to conservative treatments and to assess its adverse events. METHODS: This is a retrospective observational study on patients with FS treated in the past 8 years...
February 11, 2019: Pain and Therapy
Ivan Urits, Matthew Borchart, Morgan Hasegawa, Justin Kochanski, Vwaire Orhurhu, Omar Viswanath
Cannabis users have long reported therapeutic properties of the plant for a variety of conditions, some of which include nausea, emesis, seizures, cancer, neurogenic diseases and pain control. Research has elucidated many cannabinoid pharmacodynamic and pharmacokinetic properties, expanding the potential use of cannabinoids as a medical therapy. Due to the inconsistent delivery and control of the active components involved with smoking, pharmaceutical companies are investigating and prioritizing routes other than smoke inhalation for therapeutic use of cannabinoids...
February 5, 2019: Pain and Therapy
Irving Haber, Joseph Pergolizzi, Jo Ann LeQuang
Unwashed poppy seeds are widely available online through private websites or via well-known sellers such as eBay and Amazon. These seeds can be used to produce a tea that contains an opioid content sufficient to produce psychoactive effects and to cause withdrawal symptoms when discontinued abruptly, yet their sale and distribution is legal in the United States. Clinicians may not be aware of poppy seed tea and some individuals may use it habitually or as an analgesic. There is a paucity of literature on this topic, although a few cases of poppy seed tea intoxication and dependence have been reported...
February 5, 2019: Pain and Therapy
Luca Cravello, Simona Di Santo, Giustino Varrassi, Dario Benincasa, Paolo Marchettini, Marina de Tommaso, Jacob Shofany, Francesca Assogna, Daniele Perotta, Katie Palmer, Antonella Paladini, Fulvia di Iulio, Carlo Caltagirone
The presence of pain in elderly persons with cognitive decline is often neglected, under-reported, underestimated, misdiagnosed and not adequately treated, with consequences that have a strong impact on health, independence in activities of daily living and quality of life. There is no empirical evidence that people with dementia experience less pain; therefore, in patients with severe cognitive impairment the progression of cognitive decline dramatically affects the ability to verbalize the presence of pain...
January 21, 2019: Pain and Therapy
Himanshu D Patel, R B Uppin, A Ramakrishnam Naidu, Y Ratnakar Rao, Suhas Khandarkar, Amit Garg
INTRODUCTION: Low back pain is a common problem worldwide causing deterioration of health and quality of life. Low back pain is often associated with muscle spasm. We investigated the combined effect of muscle relaxants and pain killers for low back pain. METHODS: In this open-label, prospective, multicenter study, patients with acute low back pain received a single tablet of either the fixed dose combination of chlorzoxazone 500 mg and ibuprofen 400 mg (manufacturer: Dr...
January 16, 2019: Pain and Therapy
Maria Clemente, Carla Roero, Veronica Perlo, Elena Peila, Anna De Luca
INTRODUCTION: Acute lumbosacral radicular syndrome is often a medical disorder of difficult management. Epidural steroid injection is a useful approach for the herniated disc and radiculitis. The transforaminal approach is usually considered more effective and target-specific, but it can be associated with permanent lower extremity paralysis. A caudal approach with an adjustable catheter has been widely used in adhesiolysis in chronic low back pain, but there are no reports of its application in acute radicular pain...
January 8, 2019: Pain and Therapy
Joseph V Pergolizzi, Hani Annabi, Christopher Gharibo, Jo Ann LeQuang
Fear of withdrawal symptoms has been cited by survey respondents as the main reason that they continued to use opioids. Lofexidine is an α2 -adrenergic agonist that decreases the sympathetic outflow that results in the characteristic symptoms of opioid withdrawal. A structural analog of clonidine, lofexidine has a higher affinity and specificity for the α2a receptors and does not reinforce opioid dependence. Withdrawal symptoms correlate approximately to the half-life of the opioid; patient factors such as age, duration of opioid exposure, physical status, and other considerations may influence the nature and duration of withdrawal symptoms...
December 18, 2018: Pain and Therapy
Tong J Gan, Robert S Epstein, Megan L Leone-Perkins, Tehseen Salimi, Sheikh Usman Iqbal, Peter G Whang
INTRODUCTION: The management of acute postoperative pain remains a significant challenge for physicians. Poorly controlled postoperative pain is associated with poorer overall outcomes. METHODS: Between April and May 2017, physicians from an online database who regularly prescribe intravenous (IV) medications for acute postoperative pain completed a 47-question survey on topics such as patient demographics, IV analgesia preferences, factors that influence prescribing decisions, and the challenges and unmet needs for the treatment of acute postoperative pain...
December 2018: Pain and Therapy
Edward A Shipton
Globally, in 2016, low back pain (LBP) contributed 57.6 million of total years lived with disability. Low Back Pain Guidelines regularly recommend the use of physical exercise for non-specific LBP. Early non-pharmacological treatment is endorsed. This includes education and self-management, and the recommencement of normal activities and exercise, with the addition of psychological programs in those whose symptoms persist. The aim of physical treatments is to improve function and prevent disability from getting worse...
December 2018: Pain and Therapy
Erik Torbjørn Løhre, Marianne Jensen Hjermstad, Cinzia Brunelli, Anne Kari Knudsen, Stein Kaasa, Pål Klepstad
INTRODUCTION: Different definitions of breakthrough pain (BTP) influence the observed BTP prevalence. This study examined BTP prevalence variability due to use of different cutoffs for controlled background pain, different assessment periods for background pain, and difference between worst and average pain intensity (PI). METHODS: Cancer patients from the EPCRC-CSA study who reported flare-ups of pain past 24 h were potential BTP cases. BTP prevalence was calculated for different cutoffs for background PI on numeric rating scales (NRS 0-10) for the past week, past 48 and past 24 h period...
November 10, 2018: Pain and Therapy
Vwaire Orhurhu, Ivan Urits, Mayowa Olusunmade, Khurram Owais, Mark Jones, Annemarie Galasso, Mariam Salisu Orhurhu, Issa Mohammed
INTRODUCTION: Co-morbid depression has been associated with poor outcomes following spine surgery and worsening of low back pain symptoms leading to failed back surgery syndrome (FBSS). Given the increasing focus of healthcare utilization and value-based care, it is essential to understand the demographic and economic data surrounding co-morbid depression amongst patients with FBSS. METHODS: Our study investigated the NIS database for FBSS patients who had co-morbid depression (ICD-9 CM codes 300...
September 14, 2018: Pain and Therapy
Elspeth E Shipton, Frank Bate, Raymond Garrick, Carole Steketee, Edward A Shipton, Eric J Visser
INTRODUCTION: Pain management is a major health care challenge in terms of the significant prevalence of pain and the negative consequences of poor management. Consequently, there have been international calls to improve pain medicine education for medical students. This systematic review examines the literature on pain medicine education at medical schools internationally, with a particular interest in studies that make reference to: a defined pain medicine curriculum, specific pain medicine learning objectives, dedicated pain education modules, core pain topics, medical specialties that teach pain medicine, elective study opportunities, hours allocated to teaching pain medicine during the curriculum, the status of pain medicine in the curriculum (compulsory or optional), as well as teaching, learning, and assessment methods...
July 30, 2018: Pain and Therapy
Concepción Pérez-Hernández, Antonio Javier Jiménez-López, Almudena Sanz-Yagüe, Javier Mar-Medina, Igor Larrañaga, Begoña Soler-López
INTRODUCTION: Breakthrough pain (BTP) has great repercussions on the quality of life, and on the use of health resources. The scope of BTP costs in cancer patients is unknown. The purpose of this study was to evaluate the economic cost of BTP in patients with cancer and the relationship with their quality of life. METHODS: A 1-month observational prospective cost-of-illness study was designed. The patients recorded the consumption of health resources and drugs related to BTP in a diary...
July 5, 2018: Pain and Therapy
Fabiola Atzeni, Ignazio Francesco Masala, Piercarlo Sarzi-Puttini
Diclofenac is widely used to manage chronic inflammatory and degenerative joint diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis, and extra-articular rheumatism. Its various mechanisms of action make it particularly effective in treating nociceptive pain, but it is also an alternative for treating spinal and chronic central pain. Osteoarthritis and rheumatoid arthritis are the most frequently encountered arthritic conditions in adults. The management of nociceptive pain requires a sequential hierarchical approach, with the initial NSAID treatment being characterized by the replacement of one drug with another, or complete discontinuation usually because of insufficient pain control...
June 5, 2018: Pain and Therapy
Patrick D Dißmann, Maxime Maignan, Paul D Cloves, Blanca Gutierrez Parres, Sara Dickerson, Alice Eberhardt
Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006-December 2017)...
June 2, 2018: Pain and Therapy
Kristallia Vitoula, Annalena Venneri, Giustino Varrassi, Antonella Paladini, Panagiota Sykioti, Joy Adewusi, Panagiotis Zis
Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression...
June 2018: Pain and Therapy
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