Opioid Induced Hyperalgesia Prevented by Buprenorphine?
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain. Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids. I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals. I, meanwhile, kept my finger under the table, but had the thought that some of the people pointing would be the first to complain if they were forced to stop pain medication prematurely for their own good or ‘for the good of the community.’ Doctors can’t see into the future. I suspect most cases of opioid overuse began with well-intended efforts to provide temporary pain relief. But then for a variety of reasons things didn’t go as planned. Maybe the planned knee or back surgery never took place because of patient indecision or insurance problems. Maybe the lumbar strain didn’t heal after 6-8 weeks the way it was supposed to. In any case, doctors who work with pain patients know what happens next. Before the next appointment, the doctor plans to tell the patient that the time has come to stop opioids. But after that suggestion, the patient...
Authors: Ravalli S, Szychlinska MA, Lauretta G, Di Rosa M, Musumeci G Abstract Introduction: Osteoarthritis (OA) is a degenerative disease which primarily affects hyaline cartilage, leading to pain, stiffness and loss of mobility of the entire articulation. Diagnosis is commonly based on symptoms and radiographs, but there is a growing interest in detecting novel biomarkers, in serum, urine and synovial fluid, which can be predictors of disease onset and progression.Areas covered: This review provides an overview of the main biomarkers currently used in OA clinical practice, with a focus on lubricin, a surface glyc...
My fellowship program director told me that they used USMLE scores to rank applicants.
CONCLUSIONS: We found DEGs and DEMs in FM patients through bioinformatics analysis, which may be involved in the occurrence and development of FM and serve as potential targets for diagnosis and treatment. PMID: 32083545 [PubMed - as supplied by publisher]
CONCLUSIONS: The authors' findings showed that, irrespective of the direction of tape application, the elastic tape applied over the triceps surae does not generate any significant alteration on the excitability of the reflex pathway for different subpopulations of motor units. The authors therefore suggest a re-examination of the current recommendations on taping direction in clinical and sports activities. PMID: 32087597 [PubMed - as supplied by publisher]
Authors: Alikhajeh Y, Barabadi E, Mohammad Rahimi GR Abstract CONTEXT: In many societies, although chronic low back pain (LBP) is a significant problem, there is no consensus on the optimal therapeutic intervention. OBJECTIVE: To compare the impact of aquatic exercise (AE) and kinesio taping (KT) on the pain intensity and functional incapacity in women with chronic nonspecific LBP. DESIGN: Randomized controlled trial. SETTING: Outpatient clinic. PARTICIPANTS: Thirty-six women with chronic nonspecific LBP (mean [SD]: age = 50.69 [4.187] y) participated. INTERVENTIONS: Participants randomly a...
ConclusionMost patients with SFMCs could obtain good subjective, clinical and imaging results by appropriate surgical treatment. Early surgery could improve postoperative outcomes.
ConclusionsO. rosea produces different phenolic compounds capable of reducing the inflammation and secondary mechanical hyperalgesia produced by K/C administration. They also reduced proinflammatory cytokines and increased anti-inflammatory cytokines. Finally, NF-κB modulation was reduced by the administration of O. rosea. Therefore, O. rosea could be considered of interest in inflammatory and painful diseases.Graphical abstract
Discussion and conclusion: Maybe it was a case of drug-induced liver disease, however therapeutic dosages of all administered drugs only once. The mechanisms involved were not investigated, but may be the result of allergic and immunologic aspects caused by ketoprofen and facilitated by a history of hypersensitivity to other NSAIDs as reported by the patient. As for jaundice can be attributed to drug toxicity since laboratory parameters did not reveal any evidence of liver disease. PMID: 32079429 [PubMed - as supplied by publisher]
DiscussionPsychotherapy of SAD should consider patient’s attachment and focus on the establishment of a solid therapeutic alliance in an early therapy stage.
Publication date: Available online 22 February 2020Source: NeuroImageAuthor(s): Ima Trempler, Paul-Christian Bürkner, Nadiya El-Sourani, Ellen Binder, Paul Reker, Gereon R. Fink, Ricarda I. SchubotzAbstractThe brain's sensitivity to and accentuation of unpredicted over predicted sensory signals plays a fundamental role in learning. According to recent theoretical models of the predictive coding framework, dopamine is responsible for balancing the interplay between bottom-up input and top-down predictions by controlling the precision of surprise signals that guide learning.Using functional MRI, we investigated whether ...
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