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Multidisciplinary pain

Marco Rossi, Giuseppe Casale, Danilo Badiali, Federica Aielli, Maria Antonietta Aloe Spiriti, Roberto Arcioni, Francesca Bordin, Maurizio Ferrara, Gloria Morelli Sbarra, Antonio Corcione, Franco Marinangeli, Paolo Marchetti
Constipation, one of the adverse effects of opioid therapy with a major impact on quality of life, is still an unmet need for cancer patients, particularly those with an advanced and progressive disease, and for non-cancer patients chronically treated with opioids. The awareness of this condition is poor among healthcare providers, despite the recent publication of guidelines and consensus conferences. An early multidisciplinary approach of opioid-induced bowel dysfunction (OIBD), based on available therapies of proven effectiveness, could support clinicians in managing this condition, thus increasing patients' adherence to pain therapy...
February 18, 2019: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
P Hampel, A Köpnick, S Roch
BACKGROUND: This study investigated the long-term effects (12 months post-rehabilitation) of a standard inpatient multidisciplinary rehabilitation program for patients with chronic low back pain (CLBP), in which a control group (CG) received pain competence training and an intervention group (IG) received combined pain competence and depression prevention training. METHODS: In this prospective control group study with cluster-block randomization, a total of n = 583 patients were included into per protocol analyses...
February 15, 2019: BMC Psychology
David A Edwards, Traci L Hedrick, Jennifer Jayaram, Charles Argoff, Padma Gulur, Stefan D Holubar, Tong J Gan, Michael G Mythen, Timothy E Miller, Andrew D Shaw, Julie K M Thacker, Matthew D McEvoy
Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia with opioid-sparing and even opioid-free anesthesia and analgesia. However, the current state is a historically high use of opioids for both appropriate and inappropriate reasons, and patients with chronic opioid use before their surgery represent a common, often difficult-to-manage population for the enhanced recovery providers and health care team at large...
February 12, 2019: Anesthesia and Analgesia
U Muschaweck, A Koch
Groin pain in athletes is a common problem and can have extensive consequences for professional athletes. The anatomical and functional complexity of the groin as well as radiating pain from remote anatomical regions can make the differential diagnosis a challenge and requires special attention. As there are a wide variety of possible causes for groin pain, a multidisciplinary approach is required. The treating orthopedic surgeon needs to pay special attention to pre-arthritic hip deformities to avoid irreversible damage of the hip joint...
February 14, 2019: Der Radiologe
Jonathan DeAntonio, Hannah Cockrell, Hae Sung Kang, Melanie K Bean, Nancy Thompson, Matthew Brengman, Claudio Oiticica, Edmond Wickham, David Lanning
BACKGROUND: Metabolic and bariatric surgery in adolescents with severe obesity has been demonstrated to be safe and have long-term treatment efficacy. However, less than 0.1% of adolescents meeting criteria undergo surgery. METHODS: A prospective pilot study of adolescents who underwent laparoscopic gastric plication (LGP) was conducted to evaluate safety and effects on anthropometrics and weight-related medical and psychological comorbidities. RESULTS: Four adolescents enrolled and underwent LGP; two withdrew 90 days postoperatively and two were followed through 36 months...
January 23, 2019: Journal of Pediatric Surgery
Min Jung Geum, Ji Hyune Ahn, Jae Song Kim, Soo Hyun Kim, Eun Sun Son, Youn Jung Hu, Hye Jin Choi, Sandy Jeong Rhie
PURPOSE: The purpose of the study was to evaluate the impact on pain management by multidisciplinary palliative care team (mPCT) and the team pharmacist. METHODS: Patients who were admitted to palliative care unit (PCU) for at least 7 days between April 2014 and December 2015 were included. The mPCT consisted of a physician, a pharmacist, nurses, and non-clinical support staff. The team was on charge of pain management of patients who were admitted to PCU. Pain intensity was assessed at 3 time points in each patient; 1 week before PCU admission (day -7), on the day of admission (day 0), and 1 week after admission (day 7) using 0 to 10 numerical rating scale (NRS)...
February 12, 2019: American Journal of Hospice & Palliative Care
Marie-Hélène Lafage-Proust, Isabelle Courtois
Osteogenesis imperfecta (OI) is a genetic disease whose clinical phenotype and severity vary considerably. The increased risk of fractures due to bone fragility persists in adulthood, notably after 40 years of age, albeit at a lower level than during growth. Adults with OI require periodic evaluations of the other manifestations of OI including hearing loss, respiratory impairments, ocular and dental abnormalities, and cardiovascular disease. Follow-up should therefore be provided by a multidisciplinary team, at intervals tailored to disease severity...
February 8, 2019: Joint, Bone, Spine: Revue du Rhumatisme
Rick T van Uum, Alies Sjoukes, Roderick P Venekamp, Anne Gm Schilder, Esther de Groot, Roger Amj Damoiseaux, Sibyl Anthierens
Background: Optimal pain management is accepted as the cornerstone of acute otitis media (AOM) management, but analgesics are neither prescribed routinely nor explicitly recommended in day-to-day practice. Aim: To explore GPs views on and expectations regarding pain management in children with AOM, and how a multifaceted educational intervention aimed at optimising pain management shapes these perceptions. Design & setting: Qualitative study conducted alongside a cluster randomised controlled trial (cRCT), the PIMPOM study, in the Netherlands...
December 2018: BJGP Open
Ruth A White, Chris Hayes, Allison W Boyes, Simon Chiu, Christine L Paul
Background: GPs are central to opioid strategy in chronic non-cancer pain (CNCP). Lack of treatment alternatives and providers are common reasons cited for not deprescribing opioids. There are limited data about availability of multidisciplinary healthcare providers (MHCPs), such as psychologists, physiotherapists, or dietitians, who can provide broader treatments. Aim: To explore availability of MHCPs, and the association with GP opioid deprescribing and transition to therapeutic alternatives for CNCP...
December 2018: BJGP Open
A Giannini, M Caretto, E Russo, P Mannella, T Simoncini
Pelvic floor dysfunctions are a complex condition in elderly women; pelvic organ prolapse, urinary or fecal incontinence, constipation, pelvic pain, and sexual dysfunction are common problems. The goal of surgical treatment is functional reconstruction with symptom management and repair of anatomic defects. The recent advancements in surgical treatment of pelvic floor dysfunction allow several good options for choosing the best surgery for each patient. The vaginal procedure is traditionally the gold standard approach for elderly patients, but abdominal surgery is increasing as a mini-invasive approach and the robotic approach is gaining acceptance for treatment of pelvic floor dysfunctions...
February 2019: Climacteric: the Journal of the International Menopause Society
V Dimova, F Birklein
The acute phase of complex regional pain syndrome (CRPS) is pathophysiologically characterized by an activation of the immune system and its associated inflammatory response. During the course of CRPS, central nervous symptoms like mechanical hyperalgesia, loss of sensation, and body perception disorders develop. Psychological factors such as pain-related anxiety and traumatic events might have a negative effect on the treatment outcome. While the visible inflammatory symptoms improve, the pain often persists...
February 4, 2019: Der Anaesthesist
Sazgar S Majeed, Hawzheen A Muhammad, Jalil S Ali, Hassanain H Khudhair, Ayah Said, Shkar O Arif, Karzan M Murad, Ali H Gendari, Bamo M Muhsin, Shwan A Mohammed, Layth Mula-Hussain
PURPOSE: Ewing sarcoma (ES) is a relatively rare, highly malignant tumor of the musculoskeletal system. It is the second most common malignant bone tumor in children and adolescents in the age group of 5 to 20 years. The aim of this study was to identify the treatment outcomes of pediatric patients with ES in Sulaimani governorate, Iraq. PATIENTS AND METHODS: This was a retrospective study that reviewed the medical records of pediatric patients with ES who were managed between 2009 and 2015, with follow-up until late 2017...
January 2019: Journal of Global Oncology
Pierre Côté, Hainan Yu, Heather M Shearer, Kristi Randhawa, Jessica J Wong, Silvano Mior, Arthur Ameis, Linda J Carroll, Margareta Nordin, Sharanya Varatharajan, Deborah Sutton, Danielle Southerst, Craig Jacobs, Maja Stupar, Anne Taylor-Vaisey, Douglas P Gross, Robert J Brison, Mike Paulden, Carlo Ammendolia, J David Cassidy, Patrick Loisel, Shawn Marshall, Richard N Bohay, John Stapleton, Michel Lacerte
OBJECTIVES: To develop an evidence-based guideline for the non-pharmacological management of persistent headaches associated with neck pain (i.e., tension-type or cervicogenic). METHODS: This guideline is based on systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of clinical benefits, cost-effectiveness, societal and ethical values, and patient experiences when formulating recommendations. Target audience includes clinicians; target population is adults with persistent headaches associated with neck pain...
February 1, 2019: European Journal of Pain: EJP
Ehrin J Armstrong, Syed Alam, Steve Henao, Arthur C Lee, Brian G DeRubertis, Miguel Montero-Baker, Carlos Mena, Bennett Cua, Luis Mariano Palena, Richard Kovach, Venita Chandra, Amjad AlMahameed, Craig M Walker
Critical limb ischemia (CLI), defined as ischemic rest pain or nonhealing ulceration due to arterial insufficiency, represents the most severe and limb-threatening manifestation of peripheral artery disease. A major challenge in the optimal treatment of CLI is that multiple specialties participate in the care of this complex patient population. As a result, the care of patients with CLI is often fragmented, and multidisciplinary societal guidelines have not focused specifically on the care of patients with CLI...
February 1, 2019: Journal of Endovascular Therapy
Kevin P Labadie, Stephanie K Schaub, Derek Khorsand, Guy Johnson, Smith Apisarnthanarax, James O Park
BACKGROUND: Hepatocellular carcinoma (HCC) is the second most lethal malignancy worldwide. There has been virtually no change in the survivability of HCC in spite of improvement in therapies. Surgery is considered the ideal first, curative intervention, however most patients present in advanced stages with unresectable disease. Therefore, systemic and liver-directed non-operative therapies are initially offered to downstage the disease. To ensure optimal management, a multidisciplinary team approach is often warranted...
January 27, 2019: World Journal of Hepatology
B Tang, X T Wang, W J Chen, S H Zhu, Y G Chao, B Zhu, W He, B Wang, F F Cao, Y J Liu, X J Fan, H Yang, Q H Xu, H Zhang, R C Gong, W Z Chai, H M Zhang, G Z Shi, L H Li, Q B Huang, L N Zhang, M G Yin, X L Shang, X M Wang, F Tian, L X Liu, R Zhu, J Wu, Y Q Wu, C L Li, Y Zong, J T Hu, J Liu, Q Zhai, L J Deng, Y Y Deng, D W Liu
To establish the experts consensus on the management of delirium in critically ill patients. A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group. Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 36 experts to reassess all the statements. (1) Delirium is not only a mental change, but also a clinical syndrome with multiple pathophysiological changes...
February 1, 2019: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Ane Sigrid Nygaard, Mona Stedenfeldt, Pål Øian, Gro Killi Haugstad
Background and aims Chronic pelvic pain (CPP) in women is a complex condition that can seriously impact health and quality of life. Clinical guidelines for CPP place great demands on healthcare professionals, as they require both specialized knowledge about the pelvic area and knowledge of the mechanisms of chronic pain. To ensure best possible assessment and treatment of these women it is important to bring about more knowledge of the special CPP features. The purpose of this paper is to describe the characteristics of women with CPP evaluated at the University Hospital of North Norway, and further referred to physiotherapy...
January 31, 2019: Scandinavian Journal of Pain
Lars-Petter Granan, Silje Endresen Reme, Henrik Børsting Jacobsen, Audun Stubhaug, Tone Marte Ljoså
Background and aims Chronic pain is a leading cause to years lived with disability worldwide. However, few of the interventions used in pain medicine have proven efficacy, and evidence from the existing studies may not be valid for the general pain population. Therefore, it is of utmost need that we describe chronic pain conditions in their most relevant aspects, their various guises, as well as the real world outcomes of our clinical interventions. The most obvious and crude way to make these assessments are through large registries where patient characteristics, treatment characteristics (including but not limited to what, when, how often and by whom), treatment outcomes and patient outcomes are scrutinized and recorded...
January 30, 2019: Scandinavian Journal of Pain
Hirotoshi Maruo, Hajime Tsuyuki, Yuji Shimizu, Yasushi Shibasaki, Koichi Nakamura, Yukihiro Higashi, Tsuyoshi Shoji, Kazuhisa Hirayama, Masanori Yamazaki
We report the cases we encountered in our department involving 4 patients with malignant ilial lymphoma that caused ileocolic intussusception. The patients were 2 male and 2 female, aged 65-76 years. All patients' chief complaint was abdominal pain. Computed tomography revealed target signs characteristic of intussusception. Colonoscopy showed a tumor that escaped into the colon, leading to the diagnosis of ileocolic intussusception due to an ileal tumor. However, definitive diagnosis could not be achieved from biopsy...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Nureddin Ashammakhi, Olivier Clerk-Lamalice, Gamal Baroud, Mohammad Ali Darabi, Bassem Georgy, Douglas Beall, Derrick Wagoner
Back pain is the second most common reason for primary-care physician visits after the common cold. New understanding of the spine pathophysiology and biomechanics led to the development of novel injectable biomaterials to treat those pain generators. Although not all biomaterials are currently ready for common use, there is significant interest by the medical community to invest time, resources, and energy to optimize these injectables. This review introduces basic concepts and advancements in the field of bioinjectables tailored for the vertebral body...
February 2019: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
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