The Association Between Physicians' Communication and Patient-Reported Outcomes in Spine Surgery.
Abstract STUDY DESIGN: Retrospective cohort study using prospectively collected data. OBJECTIVE: Determine the association between satisfaction with physician communication and patient-reported outcomes in the inpatient spine surgery setting. SUMMARY OF BACKGROUND DATA: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Ther...
Source: Pain Physician - July 19, 2020 Category: Anesthesiology Authors: Rabah NM, Levin JM, Winkelman RD, Mroz TE, Steinmetz MP Tags: Spine (Phila Pa 1976) Source Type: research

Orthopedic manifestation as the presenting symptom of acute lymphoblastic leukemia.
Conclusion: The primary physician should maintain a high index of suspicion despite a normal peripheral smear. PMID: 32675920 [PubMed] (Source: Pain Physician)
Source: Pain Physician - July 19, 2020 Category: Anesthesiology Authors: Raj B K A, Singh KA, Shah H Tags: J Orthop Source Type: research

Tracheobronchopathia osteochondroplastica: rare but not to be forgotten.
We report a case of a 59-year-old male with a one-month history of pleuritic chest pain who was diagnosed with tracheobronchopathia osteochondroplastica (TO). TO is a rare benign condition characterized by protruding submucosal nodules into the tracheobronchial lumen. The disease is generally asymptomatic, with rare cases of progressive nodularity, cough, dyspnoea, and haemoptysis. Diagnosis can be made via bronchoscopic visualization of bony and cartilaginous nodules on tracheal walls. Although generally benign, the rarity of this condition makes diagnosis difficult even for trained pulmonologists and frequently predispos...
Source: Pain Physician - July 3, 2020 Category: Anesthesiology Authors: Gul F, Peterson E, Dejoy R, Eiger G, Mora Carpio A, Gupta E Tags: Respirol Case Rep Source Type: research

A Case of Unknown Primary Cancer with a Tumor Formed in the Retroperitoneum: A Case Report.
CONCLUSIONS: CUP has various disease states, and it is necessary to finish the examination immediately and shift to treatment. More effective treatment including immune checkpoint inhibitor for CUP is needed in the future. PMID: 32602104 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - July 1, 2020 Category: Anesthesiology Authors: Tsuda B, Hirabayashi K, Sakaeda S, Ishida R, Mizuno M, Yokoyama K, Terao M, Morioka T, Okamura T, Watanabe T, Niikura N Tags: Tokai J Exp Clin Med Source Type: research

Fatal accident involving a welder employed by a shipping container company, associated with the use of tramadol and antidepressant agents.
We present the case of a welder who, while working for a shipping container company, fell from height without a safety harness and subsequently died as a result of a traumatic brain injury. Post-mortem examination revealed a cardiac blood tramadol concentration of 2.83 mg/L, which is 3-4 times higher than the maximum therapeutic dose. The combined use of synthetic opioids and antidepressants may heighten the adverse neurological and psychiatric effects. A review of the literature, identified studies, including previous reports of fatalities, supported our causal hypothesis of a serotonin syndrome. This syndrome can lead to...
Source: Pain Physician - July 1, 2020 Category: Anesthesiology Authors: Sanz-Gallen P, Amigó de Bonet N, Canals ML, Martí-Amengual G Tags: Int Marit Health Source Type: research

Treatment of lower limb arterial disease by Dardik graft: It takes one to know one.
CONCLUSION: This article provide a historical review of the use, outcomes and complications of HUV. Even though it is no longer commercially available, the knowledge of this type of substitute still remains inspirational for the development of innovative vascular conduits and fundamental for the new generations of physician both in diagnostics and in the management of complications. PMID: 32571562 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 24, 2020 Category: Anesthesiology Authors: Borghese O, Pisani A, Sapienza P Tags: J Med Vasc Source Type: research

Efficacy of a Natural Topical Skin Ointment for Managing Split-Thickness Skin Graft Donor Sites: A Pilot Double-blind Randomized Controlled Trial.
Abstract OBJECTIVE: To evaluate the safety and efficacy of a new topical skin ointment with natural ingredients (aloe vera, honey, and peppermint) for dressing skin graft donor sites. DESIGN: A double-blind, placebo-controlled, randomized clinical trial. PATIENTS AND INTERVENTION: Researchers enrolled patients who were referred for split-thickness skin graft after burns or surgical wounds on the scalp or face area. For each patient, a thin layer of skin (depth, 0.04 mm; approximate size, less than 15 × 7 cm) was harvested from the thigh by a plastic surgeon with an electric or manual dermatome. The...
Source: Pain Physician - June 17, 2020 Category: Anesthesiology Authors: Abbasi MS, Rahmati J, Ehsani AH, Takzare A, Partoazar A, Takzaree N Tags: Adv Skin Wound Care Source Type: research

Evaluation of Ophthalmology Inpatients Consultation in a Nigerian Tertiary Eye Care Centre.
CONCLUSION: Inpatient consultations is very useful to the patient and managing physician. Although a better knowledge in the identification of common ophthalmic conditions can help to reduce the number of inpatient consults from other medical specialties. PMID: 32476114 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 3, 2020 Category: Anesthesiology Authors: Kayoma DH, Ukponmwan CU, Ese-Onakewhor JN Tags: West Afr J Med Source Type: research

Mesothelioma in Familial Mediterranean Fever With Colchicine Intolerance: A Case Report and Literature Review.
In conclusion, we suggest that in the presence of intolerance or resistance to colchicine, interleukin (IL)-1 inhibition could suppress peritoneal inflammation and prevent MSTs. PMID: 32477360 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 3, 2020 Category: Anesthesiology Authors: Talerico R, Cardillo C, De Vito F, Schinzari F, Soldato M, Giustiniani MC, Verrecchia E, Manna R Tags: Front Immunol Source Type: research

Authorized Agent-Controlled Analgesia for Pain Management in Critically Ill Adult Patients.
Abstract BACKGROUND: Patient-controlled analgesia is commonly used for adult patients requiring parenteral opioid analgesia in the postoperative setting. However, many patients are unable to use patient-controlled analgesia because of physical or cognitive limitations. Authorized agent-controlled analgesia, in which a nurse or family member activates the patient-controlled analgesia device, has been studied in the pediatric population but has received little attention in adults. OBJECTIVE: To evaluate the efficacy of authorized agent-controlled analgesia in critically ill adult patients. METHODS: A retro...
Source: Pain Physician - June 1, 2020 Category: Anesthesiology Authors: Benjenk I, Messing J, Lenihan MJ, Hernandez M, Amdur R, Sirajuddin S, Davison D, Schroeder ME, Sarani B Tags: Crit Care Nurse Source Type: research

The Impact Of Academic Medical Center Policies Restricting Direct-To-Physician Marketing On Opioid Prescribing.
We examined restrictions on gifts and meals, speaking and consulting engagements, and industry representatives' access to academic medical centers, as well as rules requiring conflict-of-interest disclosures. Bans on sales representatives were associated with a 4.7 percent reduction in the total volume of opioids prescribed and disclosure requirements with a 2.5 percent reduction, while having all four marketing restriction policies was associated with an 8.8 percent reduction. Policies that restrict direct-to-physician pharmaceutical marketing may curb opioid prescribing, but additional patient-level resear...
Source: Pain Physician - June 1, 2020 Category: Anesthesiology Authors: Eisenberg MD, Stone EM, Pittell H, McGinty EE Tags: Health Aff (Millwood) Source Type: research

Patient Perceptions of Gout Management Goals: A Cross-sectional Internet Survey.
CONCLUSIONS: Patient identification of gout symptom control and serum urate level monitoring as the most important treatment goals is informative for clinicians and guideline developers. PMID: 32453285 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - May 28, 2020 Category: Anesthesiology Authors: Singh JA, Edwards NL Tags: J Clin Rheumatol Source Type: research

Lessons learnt from delayed diagnosis of FGF-23-producing tumour-induced osteomalacia and post-operative hungry bone syndrome.
We present a 36-year-old man initially presenting with diffuse bone and joint pain who was inappropriately treated for presumed ankylosing spondylitis for 2 years. Whole-body bone scan suggested metabolic bone disease, prompting referral to our endocrine institution. He was subsequently diagnosed with persistent hypophosphataemia, inappropriately high renal tubular phosphate excretion, 1,25-dihydroxyvitamin D3 suppression, severe osteoporosis and severe osteomalacia. FGF-23 concentrations (140 ng/L) were raised 3-fold above the upper limit of normal. Initial Gallium-68 (68Ga) DOTATATE positron emission tomography...
Source: Pain Physician - May 28, 2020 Category: Anesthesiology Authors: Kumar S, Diamond T Tags: Bone Rep Source Type: research

Comparison of Silicone Sheets and Paper Tape for the Management of Postoperative Scars: A Randomized Comparative Study.
CONCLUSIONS: The silicone sheet group showed statistically significant differences in comparison with the paper tape group in terms of scar appearance as determined by the VAS. However, the differences were too small to be clinically meaningful. PMID: 32427792 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - May 21, 2020 Category: Anesthesiology Authors: Lin YS, Ting PS, Hsu KC Tags: Adv Skin Wound Care Source Type: research

10  kHz Spinal Cord Stimulation for Combined Alleviation of Post-Laminectomy Syndrome and Chronic Abdominal Pain: A Case Report.
We describe the use of high-frequency SCS to alleviate the patient's post-laminectomy pain as well as his abdominal pain. Our case describes SCS use with multi-level lead placement targeting both post-laminectomy pain and abdominal pain. We describe a strategy that can be useful to patients with concurrent pain from more than one source. Our case also adds to the growing evidence supporting the use of SCS for treating chronic visceral pain syndromes. PMID: 32431535 [PubMed] (Source: Pain Physician)
Source: Pain Physician - May 21, 2020 Category: Anesthesiology Authors: Berger AA, Hasoon J, Urits I, Viswanath O, Gill J Tags: J Pain Res Source Type: research

Proposed Modifications in the 6-minutue Walk Test for Potential Application in Patients with mild Coronavirus Disease 2019 (COVID-19): A Step to Optimize Triage Guidelines.
PMID: 32433249 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - May 19, 2020 Category: Anesthesiology Authors: Mantha S, Tripuraneni SL, Roizen MF, Fleisher LA Tags: Anesth Analg Source Type: research

The role of clinical pharmacology in enhanced recovery after surgery protocols: a comprehensive review.
Abstract Clinical pharmacology has had an enormous impact in the development of anaesthesia practice. Improvement in drugs and the use of long-acting local anaesthetics in peri-pheral nerve blocks have reduced hospital stays and opioid consumption in both the hospital and ambulatory surgery settings. Ambulatory surgery centres are revolutionary because they provide an alternative to hospital-based outpatient services and generally provide favourable patient outcomes. Enhanced recovery after surgery (ERAS) was established in 2001 to improve patient care and increase the number of available ambulatory surgery centre...
Source: Pain Physician - May 18, 2020 Category: Anesthesiology Authors: Kaye A, Renschler J, Cramer K, Klein K, Granier A, Hart B, Kassem H, Urits I, Cornett E, Viswanath O Tags: Anaesthesiol Intensive Ther Source Type: research

Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study.
, Danova M, Rossetti S, Amore A, Crispo A, Facchini G Abstract Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. Methods: A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, ...
Source: Pain Physician - May 17, 2020 Category: Anesthesiology Authors: Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, Madeddu G, Magistri P, Bimonte S, Trovò M, Gnagnarella P, Cuomo A, Cascella M, Lleshi A, Nasti G, Facchini S, Fiorica F, Di Francia R, Nunnari G, Pellicanò GF, Guglielmino A, Danova M, Tags: Front Oncol Source Type: research

The Relationship of Sleep Duration with Ethnicity and Chronic Disease in a Canadian General Population Cohort.
Abstract Study Objectives: Sleep duration is an important marker of sleep quality and overall sleep health. Both too little and too much sleep are associated with poorer health outcomes. We hypothesized that ethnicity-specific differences in sleep duration exist. Methods: This cross-sectional study utilized questionnaire data from the Ontario Health Study (OHS), a multi-ethnic population-based cohort of Canadian adult residents aged 18 to 99 years, who provided medical, socio-demographic, and sleep information. Generalised linear models were used to investigate the association of sleep duration with ethnicity...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Singh M, Hall KA, Reynolds A, Palmer LJ, Mukherjee S Tags: Nat Sci Sleep Source Type: research

Ectopic Pregnancy: Diagnosis and Management.
Abstract Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic inflammatory disease, cigarette smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established. The definitive diagnosi...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Hendriks E, Rosenberg R, Prine L Tags: Am Fam Physician Source Type: research

Equivalent Pain Relief with Different Doses of Ibuprofen.
PMID: 32352261 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Shaughnessy AF Tags: Am Fam Physician Source Type: research

Top 20 Research Studies of 2019 for Primary Care Physicians.
This article summarizes the clinical questions and bottom-line answers from the top 20 POEMs of 2019. Taking blood pressure medications at night results in a large mortality reduction over six years compared with morning dosing. Automated devices are the best way to measure blood pressure. Nonfasting lipid profiles are preferred over fasting lipid profiles, and nonfasting and fasting lipid profiles are equally effective at predicting risk. The benefit of statins for primary prevention in people 75 years and older is uncertain at best. Aspirin has no net benefit for primary prevention of cardiovascular disease and has no ef...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Ebell MH, Grad R Tags: Am Fam Physician Source Type: research

Endometrial Biopsy: Tips and Pitfalls.
Abstract Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in postmenopausal women. Pregnancy is the only absolute contraindication to the procedure. The biopsy is performed with an endometrial biopsy catheter that is inserted through the cervix into the uterine cavity. The catheter's piston is then drawn out to create suction. Tissue sampling occurs by rolling the catheter while moving it in a...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Williams PM, Gaddey HL Tags: Am Fam Physician Source Type: research

Topical Analgesic and Local Anesthetic Agents for Pain Associated with Chronic Leg Ulcers: A Systematic Review.
Abstract GENERAL PURPOSE: To provide information about the effectiveness of topical analgesic and local anesthetic agents for reducing pain associated with chronic leg ulcers. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Distinguish adverse reactions to topical analgesics and local anesthetic agents.2. Evaluate the effectiveness of topical analgesics and local anesthetic age...
Source: Pain Physician - April 20, 2020 Category: Anesthesiology Authors: Purcell A, Buckley T, King J, Moyle W, Marshall AP Tags: Adv Skin Wound Care Source Type: research

Acute toxicity outcomes and dosimetric implications from incidental irradiation of adjacent tissues in tangent field hypofractionated breast radiotherapy.
Conclusions: For HF-WBI, doses to nTIB over the prescription predicted acute toxicities independent of breast doses. These data support inclusion of TIB as a region of interest in treatment planning and protocol design. PMID: 32214909 [PubMed] (Source: Pain Physician)
Source: Pain Physician - March 29, 2020 Category: Anesthesiology Authors: Alcorn SR, Sloan L, McNutt TR, Stinson SF, Asrari F, Croog VJ, Floreza B, Weaver A, Wright JL Tags: Rep Pract Oncol Radiother Source Type: research

The role of telehealth as a platform for postoperative visits following rotator cuff repair: a prospective, randomized controlled trial.
Abstract BACKGROUND: The application of telehealth for surgical follow-up has gained recent exposure in orthopedic care. Although the results following joint arthroplasty are encouraging, the role of telemedicine for postoperative care following arthroscopic rotator cuff repair still needs to be defined. The goal of this study was to evaluate the safety, efficacy, and socioeconomic benefits of telehealth as a platform for postoperative follow-up. METHODS: This was a prospective, randomized controlled trial that enrolled 66 patients who underwent follow-up in the office vs. via telemedicine for postoperative v...
Source: Pain Physician - March 22, 2020 Category: Anesthesiology Authors: Kane LT, Thakar O, Jamgochian G, Lazarus MD, Abboud JA, Namdari S, Horneff JG Tags: J Shoulder Elbow Surg Source Type: research

Patterns of care for patients with metastatic bone disease in solid tumors: A cross-sectional study from Switzerland (SAKK 95/16).
Conclusions: This cross-sectional, non-interventional study found high implementation of guideline-recommended BTA prescribing, good pain control and low incidence of skeletal-related events. Long-term BTA randomized controlled trials have the potential to further optimize routine care outcomes for patients. PMID: 31970055 [PubMed] (Source: Pain Physician)
Source: Pain Physician - January 25, 2020 Category: Anesthesiology Authors: Mark M, Thürlimann B, Ribi K, Schär C, Dietrich D, Cathomas R, Zürrer-Härdi U, von Briel T, Anchisi S, Bohanes P, Blum V, von Burg P, Mannhart M, Caspar CB, von Moos R Tags: J Bone Oncol Source Type: research

Predicting a diagnosis of acute coronary syndrome during telephone evaluation by an emergency dispatcher: the SCARE predictive scale.
CONCLUSION: The SCARE scale had good discrimination and calibration properties. The scale should be further validated in an external sample from a multicenter study before it is implemented by emergency dispatch centers. PMID: 31909908 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - January 9, 2020 Category: Anesthesiology Authors: Guerineau A, Rozelle C, Sevestre E, Narcisse S, Laribi S, Giovannetti O Tags: Emergencias Source Type: research

Utilizing clinical characteristics and patient-reported outcome measures to categorize lupus subtypes.
CONCLUSION: Fatigue, widespread pain, sleep dysfunction, and mood disorders are common symptoms in SLE. Identifying these symptoms as Type 2 SLE may be a method to improve patient communication and understanding. The level of Type 2 SLE impacts patients' perception of disease and self-reported symptoms. The SLAQ may need to be re-interpreted based on the fibromyalgia severity scale. PMID: 31909888 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - January 7, 2020 Category: Anesthesiology Authors: Rogers JL, Eudy AM, Pisetsky D, Criscione-Schreiber LG, Sun K, Doss J, Clowse MEB Tags: Arthritis Care Res (Hoboken) Source Type: research

Adaptations in Pediatric Anesthesia Care and Airway Management in the Resource-Poor Setting.
Abstract The need for safe and quality pediatric anesthesia care in low- and middle-income countries (LMICs) is huge. An estimated 1.7 billion children do not have access to surgical care and the majority are in LMICs. In addition, most LMICs do not have the requisite surgical workforce including anesthesia providers Surgery is usually performed at three levels of facilities: district, provincial, and national referral hospitals. Unfortunately, the manpower, equipment, and other resources available to provide surgical care for children vary greatly at the different level facilities. The majority of district level ...
Source: Pain Physician - January 7, 2020 Category: Anesthesiology Authors: Manyumwa P, Chimhundu-Sithole T, Marange-Chikuni D, Evans FM Tags: Paediatr Anaesth Source Type: research

Survey of analgesia and sedation in pediatric intensive care units in Japan.
CONCLUSIONS: This study is the first survey conducted by physicians regarding pain and agitation management in PICUs in Japan, and the results revealed great diversity in practice. The implementation strategies to assess pain, delirium, and withdrawal syndrome, as well as to set goals regarding sedation level, are lacking. Protocols for analgesia and sedation management are uncommon. PMID: 31910495 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - January 7, 2020 Category: Anesthesiology Authors: Koizumi T, Kurosawa H Tags: Pediatr Int Source Type: research

Barriers to treatment optimization and achievement of patients' goals: perspectives from people living with rheumatoid arthritis enrolled in the ArthritisPower registry.
CONCLUSIONS: Most participants trusted their rheumatologist's treatment decisions and prioritized their physician's treatment goals over their own. Patients should be encouraged to share their treatment goals/expectations with their rheumatologist, in line with the treat-to-target approach. RAPID3 may be inappropriate for setting patient-centric treatment goals given the poor agreement with self-reported disease activity; most PROMIS scores showed better alignment with patients' own assessments. PMID: 31910893 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - January 7, 2020 Category: Anesthesiology Authors: Gavigan K, Nowell WB, Serna MS, Stark JL, Yassine M, Curtis JR Tags: Arthritis Res Ther Source Type: research

Social determinants of health associated with hemodialysis non-adherence and emergency department utilization: a pilot observational study.
Abstract BACKGROUND: Dialysis patients who miss treatments are twice as likely to visit emergency departments (EDs) compared to adherent patients; however, prospective studies assessing ED use after missed treatments are limited. This interdisciplinary pilot study aimed to identify social determinants of health (SDOH) associated with missing hemodialysis (HD) and presenting to the ED, and describe resource utilization associated with such visits. METHODS: We conducted a prospective observational study with a convenience sample of patients presenting to the ED after missing HD (cases); patients at local dialys...
Source: Pain Physician - January 6, 2020 Category: Anesthesiology Authors: Balhara KS, Fisher L, El Hage N, Ramos RG, Jaar BG Tags: BMC Nephrol Source Type: research

Diagnostic Performance of a Staged Pathway for Imaging Acute Appendicitis in Children.
CONCLUSION: The strategy of repeating limited focused US followed by CT scan in cases that remain inconclusive has good diagnostic accuracy and reasonable NAR and decreases the number of CT scans. PMID: 31913249 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - January 6, 2020 Category: Anesthesiology Authors: Ahmad T, Khdair Ahmad F, Manson D Tags: Pediatr Emerg Care Source Type: research

Primary Pancreatic lymphoma: a rare clinical entity.
Abstract Primary pancreatic lymphoma is a rare clinical entity representing
Source: Pain Physician - January 5, 2020 Category: Anesthesiology Authors: Dunphy L, Abbas SH, Al Shoek I, Al-Salti W Tags: BMJ Case Rep Source Type: research

End-of-life decision making by Austrian physicians - a cross-sectional study.
CONCLUSIONS: The majority of doctors perform symptom control in terminally ill patients. PAS is frequently requested but rarely carried out. Attending physicians felt the legal situation was ambiguous. Physicians should therefore receive training in current legislation relating to end-of-life choices and medical decisions. The data collected in this survey will help political decision-makers provide the necessary legal framework for end-of-life medical care. PMID: 31901225 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - January 4, 2020 Category: Anesthesiology Authors: Jahn-Kuch D, Domke A, Bitsche S, Stöger H, Avian A, Jeitler K, Posch N, Siebenhofer A Tags: BMC Palliat Care Source Type: research

Pathophysiologic Approach to Pain Therapy for Complex Pain Entities: A Narrative Review.
Abstract Pain management is challenging for both clinicians and patients. In fact, pain patients are frequently undertreated or even completely untreated. Optimal treatment is based on targeting the underlying mechanisms of pain and tailoring the management modality for each patient using a personalized approach. This narrative review deals with pain conditions that have a complex underlying mechanism and need an individualized and frequently multifactorial approach to pain management. The research is based on previously conducted studies, and does not contain any studies with human participants or anima...
Source: Pain Physician - January 4, 2020 Category: Anesthesiology Authors: Rekatsina M, Paladini A, Piroli A, Zis P, Pergolizzi JV, Varrassi G Tags: Pain Ther Source Type: research

Radiation exposure to the eyes and thyroid during C-arm fluoroscopy-guided cervical epidural injections is far below the safety limit.
Conclusions: Although there was no difference in radiation exposure between the professor and the fellow, there was a difference in the distance from the X-ray field during the CEBs. Further, radiation exposure can be minimized if proper protection (thyroid protector, leaded apron, and eyewear) is used, even if the distance between the X-ray beam and the pain physician is small. Damage from frequent, low-dose radiation exposure is not yet fully understood. Therefore, safety measures, including lead-based protection, should always be enforced. PMID: 31888321 [PubMed] (Source: Pain Physician)
Source: Pain Physician - January 1, 2020 Category: Anesthesiology Authors: Choi EJ, Go G, Han WK, Lee PB Tags: Korean J Pain Source Type: research

Motion Preservation in Hallux Rigidus After Failure of Hydrogel Implantation: Treatment Considerations and a Report of 2 Cases.
Abstract Hallux rigidus is a common condition treated daily by surgeons worldwide. During the past decade, the standard treatment algorithm has been questioned by both patients and surgeons seeking alternatives to arthrodesis, which was previously considered the gold standard for advanced disease. Patients are living longer, and many have a more active lifestyle; thus, recreating and improving range of motion and achieving pain relief are increasingly desirable. The treatment spectrum and implant options for motion-preserving techniques in the metatarsophalangeal joint has been widened with the recent US Food and ...
Source: Pain Physician - December 30, 2019 Category: Anesthesiology Authors: Carpenter B, Klemeyer L Tags: J Foot Ankle Surg Source Type: research

Interventional treatments for chronic pelvic pain caused by myometrial cysts.
Abstract •Diagnosing these patients is rather difficult, majority of the patients in the case series shared chronic pelvic pain as a common symptom.•Nerve blocks with image guided fluoroscopy can potentially eliminate the patient's chronic pelvic pain.•Examples include pudendal nerve block, superior and inferior hypogastric plexus block, and ganglion impar block. PMID: 31867223 [PubMed] (Source: Pain Physician)
Source: Pain Physician - December 25, 2019 Category: Anesthesiology Authors: Viswanath O, Urits I Tags: Case Rep Womens Health Source Type: research

Use of Pocket-Sized Ultrasound Device in the Diagnosis of Shoulder Pathology.
DISCUSSION: The findings from this study demonstrate that pocket-sized, hand-held ultrasound machines may be used to identify shoulder pathology. PMID: 31855908 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - December 20, 2019 Category: Anesthesiology Authors: Lau BC, Motamedi D, Luke A Tags: Clin J Sport Med Source Type: research

Evaluating Hospital Readmissions Through the Perspective of the Returning Emergency Department Patient.
CONCLUSIONS: The data show that once patients return to the ED after discharge, it is very likely they will be admitted to the hospital. An intervention prior to the return to the ED is imperative. PMID: 31855931 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - December 20, 2019 Category: Anesthesiology Authors: Campbell D, Ditkoff J Tags: Qual Manag Health Care Source Type: research

Anesthesia hazards and the impact of physician re-entry.
PMID: 31800416 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - December 6, 2019 Category: Anesthesiology Authors: Baron EL, Burnett G, Loftus K, Sherwin M, Katz D, Levine AI Tags: Int Anesthesiol Clin Source Type: research

Genomics Testing and Personalized Medicine in the  Preoperative Setting.
This article discusses the current evidence highlighting the potential of PGx with various drug categories (including opioids, nonopioid analgesics, sedatives, β-blockers, antiemetics, and anticoagulants) used in the perioperative process and the challenges of integrating PGx into a health care system and relevant workflows. PMID: 31757315 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - November 25, 2019 Category: Anesthesiology Authors: Gabriel RA, Burton BN, Urman RD, Waterman RS Tags: Surg Oncol Clin N Am Source Type: research

National Institutes of Health-Funded Anesthesiology Research and Anesthesiology Physician-Scientists: Trends, Promises, and Concerns.
This article studies current NIH funding trends and offers potential solutions to continue the historical trend of academic innovation and research that has characterized academic Anesthesiology. Using publicly available data, specifically the NIH REPORTeR and Blue Ridge Institute for Medical Research, we examined NIH trends in funding in academic Anesthesiology departments that have Anesthesiology residency training programs. When adjusted for inflation, median NIH funding of departments of Anesthesiology declined approximately 15% between 2008 and 2017. The majority (55%) of NIH funding to academic Anesthesiology departm...
Source: Pain Physician - November 20, 2019 Category: Anesthesiology Authors: Chandrakantan A, Adler AC, Stayer S, Roth S Tags: Anesth Analg Source Type: research

Thunberg's Barospirator, a Fully Encasing Predecessor of the Iron Lung.
Abstract Used as a ventilator for assisting victims of polio, the barospirator was described by Swedish physician-scientist Torsten Thunberg in 1924. An immediate predecessor of the iron lung of Philip Drinker, the barospirator fully encased the entire body. Cyclic air-pressure changes within the chamber achieved ventilation during equilibrations of intrapulmonary and ambient pressures. Pulmonary medicine innovator Alvan Leroy Barach used a modified barospirator for lung rest as a treatment of tuberculosis in the 1940s. Adverse effects included damage to patients' tympanic membranes. Despite its limited clinical s...
Source: Pain Physician - November 19, 2019 Category: Anesthesiology Authors: Haddad CS, Wang J, Alston TA Tags: J Anesth Hist Source Type: research

Assessing Right Ventricular Function in the Perioperative Setting, Part II: What About Catheters?
Abstract An-depth assessment of right ventricular function is important in a many perioperative settings. After exploring 2-dimensional echo-based evaluation, other proposed monitoring modalities are discussed. Pressure-based methods of right ventricular appraisal is discussed. Flow-based assessment is reviewed. An overview of the state of current right ventricular 3-dimensional echocardiography and its potential to construct clinical pressure-volume loops in conjunction with pressure measurements is provided. An overview of right ventricular assessment modalities that do not rely on 2-dimensional echocardiography...
Source: Pain Physician - November 5, 2019 Category: Anesthesiology Authors: Vandenheuvel M, Bouchez S, Wouters P, Mauermann E Tags: Anesthesiol Clin Source Type: research

Concurrent validity of a patient self-administered examination and a clinical examination for femoroacetabular impingement syndrome.
Conclusion: Diagnostic accuracy was statistically significantly higher for the self-exam than for the traditional clinical exam although the difference may not be clinically relevant. Although the mean accuracy remains relatively low for both exams, these values are consistent with hip exam for FAIS reported in the literature. Having established the validity of an SAE, future investigations will need to evaluate implementation in a telehealth setting. PMID: 31673405 [PubMed] (Source: Pain Physician)
Source: Pain Physician - November 3, 2019 Category: Anesthesiology Authors: Owusu-Akyaw KA, Hutyra CA, Evanson RJ, Cook CE, Reiman M, Mather RC Tags: BMJ Open Sport Exerc Med Source Type: research

Parenting, self-regulation, and treatment adherence in pediatric chronic headache: A self-determination theory perspective.
This study examined parenting factors associated with children's self-regulation and physician-rated treatment adherence using a self-determination theory framework in pediatric chronic headache. Participants were 58 children and adolescents (aged 10-17 years), who underwent initial and follow-up multidisciplinary evaluation at a headache clinic, and their mothers. Regression analyses showed that higher maternal autonomy support and structure were significantly related to children's lower treatment-related reactance and higher adherence. Maternal controllingness had associations in the opposite directions. Children'...
Source: Pain Physician - November 1, 2019 Category: Anesthesiology Authors: Caruso A, Grolnick W, Rabner J, Lebel A Tags: J Health Psychol Source Type: research

Ethics of Opioid Prescriber Regulations: Physicians, Patients, and Pain.
CONCLUSIONS: Although the importance of addressing the current opioid crisis cannot be understated, as surgeons, we must examine ethical implications of any new regulations that affect musculoskeletal patient care. PMID: 31596806 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - October 9, 2019 Category: Anesthesiology Authors: Lajam CM, Cenname J, Hutzler LH, Bosco JA Tags: J Bone Joint Surg Am Source Type: research