Management of pain in end ‐stage renal disease patients: Short review

Abstract Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes. First line should be conservative management such as exercise, massage, heat/cold therapy, acupuncture, meditation, distraction, music therapy, and cognitive behavioral therapy. Analgesics are introduced according to WHO guidelines (by the mouth, by the clock, by the ladder, for the individual, and attention to detail) using three‐step analgesic ladder model. Neuropathic pain can be controlled by gabapentin and pregabalin. Substitution/addition of opioid analgesics are indicated if pain control is not optimal. Commonly used opioids in ESRD patients are tramadol, oxycodone, hydromorphone, fentanyl, methadone, and buprenorphine. Methadone, fentanyl, and buprenorphine are the ideal analgesics in ESRD. However, complex pain syndrome requires multidrug analgesic regimen comprising opioids, non‐opioids, and adjuvant medication, which should be individualized to the patie...
Source: Hemodialysis International - Category: Hematology Authors: Tags: Review Article Source Type: research

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ConclusionsFoot orthoses can relieve pain and disability and enhance patients, but no significant differences were found between control and intervention groups.
Source: Quality of Life Research - Category: Health Management Source Type: research
ConclusionA DTF-specific HRQL tool and consensus regarding the preferred measurement tool among DTF patients is lacking. Our study indicates that HRQL of DTF patients was negatively affected in several domains. A DTF-specific HRQL measure could improve our understanding of short- and long-term effects and, ideally, can be used in both clinic and for research purposes.
Source: Quality of Life Research - Category: Health Management Source Type: research
facilitate the identification of novel non-opioid natural products with efficacious and non-addictive analgesic properties. The workshop will also discuss research barriers for the study of such natural products for pain treatment and management. We hope that through this workshop we will provide novel and important contributions to the goal of finding solutions to the current pain and opioid crisis.Air date: 2/6/2019 8:30:00 AM
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
Medtronic (NYSE:MDT) is collaborating with researchers at the Children’s National Health System to develop a miniature pacemaker intended for use with infants. The prototype version of the device was presented at the American Heart Association’s 2018 Scientific Sessions by Dr. Rohan Kumthekar of the Sheikh Zayed Institute for Pediatric Surgical Innovation, part of the Children’s National Health System. The newly developed miniature pacer is designed to be implanted through a 1 cm incision just below the ribcage, eliminating the need for open-chest surgery, according to a CNHS report. The device is im...
Source: Mass Device - Category: Medical Devices Authors: Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Research & Development Medtronic Source Type: news
We examined past year rates of NMUPPRs and major depressive episode (MDE), using data between 2008 and 2014 from the National Survey on Drug Use and Health for both youths (12-17 yrs.) and adults (18 or older). Prevalence estimates with 95% confidence intervals (CIs) were computed. Stratified analyses and generalized linear models were run to examine the association between NMUPPRs and MDE, controlling for treatments received for mental health and/or substance misuse. In order to explore whether MDE effect might change by treatment received, a model with an interaction term including MDE and treatment was fit. Results Amon...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
ConclusionDaily vibration treatment produced clinically significant shortening of the time needed for mandibular incisor anterior-posterior correction with clear aligners.
Source: Dental Technology Blog - Category: Dentistry Source Type: news
HEART attack symptoms usually include chest pain, excessive sweating and feeling dizzy. You could be at risk of myocardial infarction signs and heart disease if your legs look like this.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
CONCLUSIONS: Apart from acute monoarthritis of the lower extremities, the chronic arthritis should be kept on mind among FMF patients with articular involvement. The JSpA should be considered in FMF patients with oligoarthritis, inflammatory back pain and enthesopathy complaints with onset over 6 years. Newly proposed JSpA criteria can be used to spondyloarthropathies in childhood FMF. PMID: 30418123 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
CONCLUSIONS: This observational cross-over study demonstrates an advantage of MCT in FM patients with LBP as compared with SAT. Further randomised clinical trial studies should assess whether these results can be generalised to the FM population at large. PMID: 30418116 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Higher percentage increase of L1 to L4 and wrist bone mineral density with DMN, reduction in pain
Source: The Doctors Lounge - Oncology - Category: Cancer & Oncology Tags: Endocrinology, Family Medicine, Gynecology, Internal Medicine, Oncology, Orthopedics, Pharmacy, Journal, Source Type: news
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