The silent epidemic of chronic pain in older adults

Publication date: Available online 17 April 2019Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Anthony F. Domenichiello, Christopher E. RamsdenAbstractChronic pain is highly prevalent among older adults where it is associated with significant suffering, disability, social isolation, and greater costs and burden to health care systems. Pharmaceutical treatment of chronic pain in older adults is usually only partially effective and is often limited by side effects including urinary retention, constipation, sedation, cognitive impairment, and increased risk of falls. Since older adults are underrepresented in clinical trials testing treatments for chronic pain, the potential impacts of polypharmacy and frailty on reported outcomes and side effect profiles are largely unknown. Thus, for current treatments providers and patients must balance anticipated benefits of pain reduction with the known and unknown risks of treatment. Chronic pain is also a risk factor for premature death as well as accelerated cognitive decline, suggesting potential shared mechanisms between persistent pain (or its treatment) and dementia. Cognitive decline and dementia may also impact pain perception and the ability to report pain, complicating treatment decisions. Associations between persistent pain and the risks of premature death and accelerated cognitive decline make estimates for chronic pain in these populations particularly challenging. Future research is needed ...
Source: Progress in Neuro Psychopharmacology and Biological Psychiatry - Category: Psychiatry Source Type: research

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Authors: Ko JH, Kim SN Abstract MicroRNAs (miRNAs) are the main regulators of diverse physiological processes. Recently, miRNAs have emerged as significant players related to the effect of acupuncture although the biological mechanisms connecting the function of these miRNAs with the effect of acupuncture are not well understood. In animal models of various diseases, such as neurological disease, cardiovascular disease, myopathy, and pain, a number of miRNAs were altered after administration of electroacupuncture or manual acupuncture. Nonetheless, there are a limited number of studies published so far. This paper ...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
In this study, we report that the Protium javanicum methanol extract (Pj-ME) plays an important role in suppressing nitric oxide (NO) levels without cytotoxicity. The effect of Pj-ME in LPS-induced expression leads to reduced inflammatory cytokine expression, specifically inducible nitric oxide synthase (iNOS), cyclooxygenase (COX-2), and tumor necrosis factor (TNF-α). Pj-ME significantly inhibited LPS-induced protein expression of the nuclear factor-kappa B (NF-κB) signaling pathway in a time-dependent manner. Syk and Src were identified as putative signaling molecules of Pj-ME-mediated anti-inflammatory activ...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Publication date: Available online 24 May 2019Source: Colloids and Surfaces B: BiointerfacesAuthor(s): Shuoshuo Yang, Yong Wang, Shan Luo, Chenjie Shan, Yibo Geng, Tinghong Zhang, Sunren Sheng, Xingjie ZanAbstractBone related implants have huge potential market in global. Improving the implant outcomes and probability of implant success are highly pursued to relieve the pain of patients and burden on native healthy system. There are growing evidence to support reactive oxygen species (ROS) directly involved in bone diseases and failure of implants. Taking advantage of the antioxidant property of tannic acid (TA) and biocom...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
I'm a PGY-3 who has been getting a lot of postpartum patients recently whose ob/gyn placed them on disability for postpartum depression or anxiety, and then they come to me asking for their disability to be extended. Some of them have therapists, but apparently only an MD can extend disability. I have very mixed feelings about this, specifically because while I don't think maternity leave in this country is long enough, and some of them are quite symptomatic, I don't think that not going to... Extending disability
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Psychiatry Source Type: forums
This study aimed to explore the effect of winter temperatures on the risk factors, etiology, coagulation, and degree of neurological impairment in patients with ischemic stroke using temperature and rainfall data from the Guangzhou Meteorological Bureau during the winter months of December, January, and February. MATERIAL AND METHODS We divided 112 patients with ischemic stroke into low-temperature and non-low-temperature groups. The low-temperature group experienced an average daily winter temperature of 13°C on admission. Neurological deficits were scored and monitored using the National Institutes of Health Stroke S...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Publication date: Available online 24 May 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Veliyaveettil Muhamed Khaleeld, Narendran Pushpasekaran, Nithin Prabhu, Alagu Pandiyan, George Mathew KoshyAbstractIntroductionStable reduction and rigid fixation of the sacrum and posterior ring structures are of paramount importance in the management of complex pelvic ring disruptions, Tiles B and C. The major concern with the use of conventional methods, like iliosacral screws and iliolumbar fixations is the increased risk for surgical and implant-related morbidity, especially in difficult situations, such as comm...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Publication date: Available online 25 May 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Klaira Lerma, Paul D. BlumenthalAbstractMedical and surgical methods can both be recommended for second trimester abortion (after 12-weeks gestational age). Induced abortion with a mifepristone and misoprostol regimen is the preferred approach; where mifepristone is not available, misoprostol-alone for medical abortion is also effective. Dilation and evacuation (D&E) is the procedure of choice for surgical abortions and adequate cervical preparation contributes significantly to safety. Availabili...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
Publication date: Available online 24 May 2019Source: Brain StimulationAuthor(s): Alberto Benussi, Valentina Dell’Era, Valentina Cantoni, Rosanna Turrone, Andrea Pilotto, Antonella Alberici, Maria Sofia Cotelli, Cristina Rizzetti, Alessandro Padovani, Barbara BorroniAbstractObjectiveTo determine whether motor cortex inhibition by stimulation over the cerebellum with a figure-of eight coil (MISC8) may be reduced in patients with Progressive Supranuclear Palsy (PSP).MethodsPaired pulse TMS was used to evaluate MISC8, in patients with different forms of parkinsonism and dementia. The primary outcome measures were sensit...
Source: Brain Stimulation - Category: Neurology Source Type: research
Publication date: Available online 24 May 2019Source: The LancetAuthor(s): Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Ashfaq Shuaib, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut TatlisumakSummaryBackgroundSphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potentia...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionReducing the pressure of the pneumoperitoneum to 8-10 mm of Hg did not lower the incidence &intensity of postoperative shoulder-tip pain. It can jeopardize the surgeon`s comfort because of inadequate exposure. Routine use of low-pressure pneumoperitoneum in laparoscopic cholecystectomy cannot be recommended.
Source: Current Medicine Research and Practice - Category: General Medicine Source Type: research
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