No Access and Still in Pain

2020 ◽  
pp. 101-108
Author(s):  
Lindsay B. Ragsdale
Keyword(s):  
Gastrointestinal Tract ◽  
Pain Control ◽  
Medication Administration ◽  
Pain Medication ◽  
Intravenous Access ◽  
Skin Integrity ◽  
Dosing Strategies ◽  
Integrative Therapies ◽  
Control Pain ◽  
Selection Of

Pain management for children can be intimidating for providers unfamiliar with pediatric practice. Finding the correct dose can involve weight-based dosing and calculations of suspensions, which are overall more involved than adult dosing strategies. When there is a lack of intravenous access or the inability to use the gastrointestinal tract, finding the correct route of pain medication for children can be challenging. However, following simple strategies can help find the best option for pain relief. The least invasive route of medication administration should be selected first, and nonpharmacologic strategies should be layered in to enhance pain control. Pain should be assessed regularly, and therapy should be escalated when indicated. The pain medication should be matched with the type of pain and anticipated duration of painful stimulus. Skin integrity, weight-based dosing limitations, and prognosis should be considered in the selection of agents. Comfort position, supportive caregiver, and distraction and integrative therapies depending on age should be integrated into any treatment regimen.

scholarly journals International survey: real-world pain management strategies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Hagen ◽  
A Georgescu
Keyword(s):  
Pain Management ◽  
Real World ◽  
Pain Control ◽  
Online Survey ◽  
Management Strategies ◽  
Pain Medication ◽  
International Survey ◽  
Nationally Representative ◽  
Online Panels ◽  
Control Pain

Abstract Background Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies. Methods From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region. Results Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain. Conclusions This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use. Key messages More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.

Microencapsulation: A Prospective to Protect Probiotics

2020 ◽  
Vol 16 (6) ◽  
pp. 891-899 ◽  
Author(s):  
Wissam Zam
Keyword(s):  
Gastrointestinal Tract ◽  
Food Industry ◽  
Health Benefits ◽  
Probiotic Bacteria ◽  
Bacterial Cells ◽  
Beneficial Effects ◽  
Host Health ◽  
Resistant Strains ◽  
Selection Of

Probiotics are viable microorganisms widely used for their claimed beneficial effects on the host health. A wide number of researchers proved that the intake of probiotic bacteria has numerous health benefits which created a big market of probiotic foods worldwide. The biggest challenge in the development of these products is to maintain the viability of bacterial cells during the storage of the product as well as throughout the gastrointestinal tract transit after consumption, so that the claimed health benefits can be delivered to the consumer. Different approaches have been proposed for increasing the resistance of these sensitive microorganisms, including the selection of resistant strains, incorporation of micronutrients, and most recently the use of microencapsulation techniques. Microencapsulation has resulted in enhancing the viability of these microorganisms which allows its wide use in the food industry. In this review, the most common techniques used for microencapsulation of probiotics will be presented, as well as the most usual microcapsule shell materials.

The In Vitro Sensitivities of 70 Strains of Shigella

PEDIATRICS ◽  
1964 ◽  
Vol 34 (5) ◽  
pp. 705-707
Author(s):  
WILLIAM D. DONALD
Keyword(s):  
Clinical Trials ◽  
Gastrointestinal Tract ◽  
Tetracycline Resistance ◽  
The Other ◽  
Drug Of Choice ◽  
High Degree ◽  
As Toxicity ◽  
Selection Of

In vitro sensitivities of 70 shigella strains isolated over a recent 18-month period are reported. The high degree of sulfadiazine resistance casts some doubt on the selection of this agent as the drug of choice in the treatment of shigellosis, at least in this community. Some of the other agents, although inhibiting the growth of the organisms in vitro, have disadvantages such as toxicity or failure of absorption from the gastrointestinal tract. Tetracycline resistance was found in only 7% of the organisms tested, but from this and other reports we may anticipate the occurrence of more organisms resistant to this agent. The results of the sensitivities to ampicillin are encouraging and further studies including clinical trials of this agent are in order.

Application of Immunohistochemistry to Liver and Gastrointestinal Neoplasms: Liver, Stomach, Colon, and Pancreas

2008 ◽  
Vol 132 (3) ◽  
pp. 490-499 ◽  
Author(s):  
Stephen A. Geller ◽  
Deepti Dhall ◽  
Randa Alsabeh
Keyword(s):  
Gastrointestinal Tract ◽  
Personal Experience ◽  
Recent Literature ◽  
Malignant Tumors ◽  
Chemotherapeutic Agents ◽  
Gastrointestinal System ◽  
Data Sources ◽  
Gastrointestinal Neoplasms ◽  
Metastatic Neoplasm ◽  
Selection Of

Abstract Context.—Immunohistochemistry has become an integral component of the practice of pathology. Newer antibodies allow for increasingly precise diagnoses for tumors that previously could not be easily identified. Recently, immunohistochemical evaluations have begun to allow pathologists to actively assist in determining prognosis and even in selecting therapies. Objective.—To summarize the usefulness of currently available immunostains for the study of liver and gastrointestinal system neoplasms and to make recommendations for panels of immunostains that can be particularly helpful. Data Sources.—Information has been collected from recent literature as well as from personal experience and practice. Conclusions.—Many immunostains are now available for the practicing pathologist that allow for increasing accuracy in diagnosis of liver and gastrointestinal tract neoplasms. Panels of immunostains can be used to differentiate between various tumors and also to identify site of origin in the case of a metastatic neoplasm. Immunostains that allow for prognostic determinations and for guidance in the selection of chemotherapeutic agents can also be used by pathologists to assist in the management of patients with malignant tumors affecting the liver and gastrointestinal tract.

A Control-Theoretic Approach to Neural Pharmacology: Optimizing Drug Selection and Dosing

2016 ◽  
Vol 138 (8) ◽  
Author(s):  
Gautam Kumar ◽  
Seul Ah Kim ◽  
ShiNung Ching
Keyword(s):  
Design Method ◽  
Target Space ◽  
Theoretic Approach ◽  
Time Varying ◽  
Drug Selection ◽  
Modeling Paradigm ◽  
Dosing Strategies ◽  
Dose Dependent ◽  
Optimal Construction ◽  
Selection Of

The induction of particular brain dynamics via neural pharmacology involves the selection of particular agonists from among a class of candidate drugs and the dosing of the selected drugs according to a temporal schedule. Such a problem is made nontrivial due to the array of synergistic drugs available to practitioners whose use, in some cases, may risk the creation of dose-dependent effects that significantly deviate from the desired outcome. Here, we develop an expanded pharmacodynamic (PD) modeling paradigm and show how it can facilitate optimal construction of pharmacologic regimens, i.e., drug selection and dose schedules. The key feature of the design method is the explicit dynamical-system based modeling of how a drug binds to its molecular targets. In this framework, a particular combination of drugs creates a time-varying trajectory in a multidimensional molecular/receptor target space, subsets of which correspond to different behavioral phenotypes. By embedding this model in optimal control theory, we show how qualitatively different dosing strategies can be synthesized depending on the particular objective function considered.

scholarly journals Music Intervention to Orthopedic Patients: A Possible Alternative Solution to Control Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Chuchu Wang ◽  
Fanli Tian
Keyword(s):  
Pain Relief ◽  
Pain Control ◽  
Music Intervention ◽  
Postoperative Patient ◽  
Pain Scores ◽  
Mp3 Players ◽  
Patient Pain ◽  
Quasi Experimental ◽  
Control Pain ◽  
Orthopedic Patients

Aims and Objective. Pain is a common problem associated with postoperative orthopedic patients; the current study is aimed at evaluating music intervention as an alternative method to control pain. Methodology. The experimental design of the current study was comparative, descriptive, and quasi-experimental. 38 postoperative orthopedic patients were equipped with pocket-size MP3 players with prerecorded music tracks (instrumental and lyrical) in Hindi, English, and Urdu. After that, pre-post-pain scores were recorded with the help of designed brief patient logs. Ultimately, a satisfactory survey was completed at discharge. Major Findings. It was found that during the intervention of music, the pain was significantly reduced from 5.40 to 2.98. There was a slight relationship between listening time and pain relief. It was also found that the feedback was extremely positive and each patient suggested the use of music to others with 96.6% recommendation. Conclusion. From the current study, it was found that music intervention can be beneficial to postoperative patient pain control. Further, it is hoped that the findings of the current experimental work will lead to improvements in the care of postoperative patients.

Mediastinal Mass Excision

2019 ◽  
pp. 299-305
Author(s):  
Alan Schurle ◽  
Junaid Nizamuddin
Keyword(s):  
Intensive Care Unit ◽  
Preoperative Assessment ◽  
Paraneoplastic Syndromes ◽  
Systemic Effects ◽  
Vascular Compression ◽  
Thoracic Cavity ◽  
Intravenous Access ◽  
Perioperative Morbidity ◽  
Ventilator Management ◽  
Selection Of

Mediastinal masses are rare tumors of the thoracic cavity. Although not all types require surgical intervention, resection of these masses provides a clinical challenge for the anesthesiologist due to both local mass effects, such as airway and vascular compression, and systemic effects, including paraneoplastic syndromes. A common example includes myasthenia gravis associated with thymoma. Preoperative assessment includes viewing imaging, obtaining a thorough history, performing a focused physical examination, and reviewing laboratory values. Medically optimizing comorbid conditions prior to excision, if possible, may reduce perioperative morbidity and mortality. Intraoperative considerations include planning for postoperative analgesia, establishing an airway, selection of invasive and noninvasive monitors, choosing intravenous access sites commensurate with tumor size and location, judicious fluid administration, and ventilator management. Postoperative considerations include intensive care unit transport, analgesia, and airway maintenance.

Pain Management for Pediatric Burns in the Outpatient Setting: A Changing Paradigm?

2020 ◽  
Vol 41 (4) ◽  
pp. 814-819
Author(s):  
Niti Shahi ◽  
Maxene Meier ◽  
Ryan Phillips ◽  
Gabrielle Shirek ◽  
Adam Goldsmith ◽  
...  
Keyword(s):  
Pain Control ◽  
Multimodal Therapy ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Medication Use ◽  
Pain Medication ◽  
Outpatient Setting ◽  
Burn Injuries ◽  
Opioid Prescription ◽  
Over The Counter

Abstract Childhood burns are common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, which can negatively influence the child’s care and increase the risk of posttraumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of pediatric outpatient burns. We sought to evaluate the current use of opioids (including the use of multimodal therapies), storage, and disposal of opioids in this patient population. Parents of burn-injured children 8 months to 18 years old, who were seen in an outpatient setting within 2 weeks of their burn injury, were queried from April to December 2019 regarding their child’s pain control, opioid medication use, over-the-counter pain medication use, opioid storage, and disposal. A total of 142 parents of burn-injured children and their parents were surveyed. The median age of the burn-injured children was 2.7 years old and the majority (54.2%; 77/142) were male. The mean total body surface area (TBSA) was 1.8% and half sustained burn injuries to one or both hands. The most frequently used regimens for constant and/or breakthrough pain control were acetaminophen (62.7%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 68.3%). Less than one fifth (26/142;18%) of patients were prescribed opioids and 88% filled their prescription. The median number of doses of opioids prescribed was eight doses, with a median of four doses of opioids unused. Only three patients used all of their prescribed opioids and no patient ≥12 years old used their entire prescription. Burns greater than 3% TBSA, irrespective of burn injury location, were associated with opioid prescription (P = .003). Approximately 40% (10/26) of parents who filled their child’s opioid prescription stored the opioid in a locked area. Fewer than one third (7/26) of patients were educated on how to dispose of excess opioid pain medication. Overall, most pediatric outpatient burn injuries can be successfully managed with over-the-counter medications. Providers, who care for burn-injured children ≤ 12 years old with burns that cover ≥3% TBSA in the outpatient setting, should consider no more than four opioid doses for initial pain control. This guideline, coupled with family and provider-centered education on multimodal therapy at the time of initial presentation and safe use of opioids, are important first steps to minimizing the use of opioids in the management of small area burns in children.

scholarly journals Potential Pharmacokinetic Drug-Drug Interactions between Cannabinoids and Drugs Used for Chronic Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Marta Vázquez ◽  
Natalia Guevara ◽  
Cecilia Maldonado ◽  
Paulo Cáceres Guido ◽  
Paula Schaiquevich
Keyword(s):  
Chronic Pain ◽  
Drug Interactions ◽  
Pain Control ◽  
Cytochromes P450 ◽  
Pain Medication ◽  
Atp Binding ◽  
Metabolizing Enzymes ◽  
Appropriate Treatment ◽  
Few Data ◽  
Pharmacokinetic Drug

Choosing an appropriate treatment for chronic pain remains problematic, and despite the available medication for its treatment, still, many patients complain about pain and appeal to the use of cannabis derivatives for pain control. However, few data have been provided to clinicians about the pharmacokinetic drug-drug interactions of cannabinoids with other concomitant administered medications. Therefore, the aim of this brief review is to assess the interactions between cannabinoids and pain medication through drug transporters (ATP-binding cassette superfamily members) and/or metabolizing enzymes (cytochromes P450 and glucuronyl transferases).

scholarly journals Scopularides Revisited: Molecular Networking Guided Exploration of Lipodepsipeptides in Australian Marine Fish Gastrointestinal Tract-Derived Fungi

Marine Drugs ◽  
2019 ◽  
Vol 17 (8) ◽  
pp. 475 ◽  
Author(s):  
Elbanna ◽  
Khalil ◽  
Bernhardt ◽  
Capon
Keyword(s):  
Gastrointestinal Tract ◽  
Molecular Networking ◽  
Human Carcinoma ◽  
X Ray ◽  
Carcinoma Cell Lines ◽  
Growth Inhibitory ◽  
Growth Inhibitory Activity ◽  
Guided Exploration ◽  
Human Carcinoma Cell ◽  
Selection Of

Chemical analysis of a cultivation of an Australian Mugil mullet gastrointestinal tract (GIT) derived fungus, Scopulariopsis sp. CMB-F458, yielded the known lipodepsipeptides scopularides A (1) and B (2). A comparative global natural product social (GNPS) molecular networking analysis of ×63 co-isolated fungi, detected two additional fungi producing new scopularides, with Beauveria sp. CMB-F585 yielding scopularides C–G (3–7) and Scopulariopsis sp. CMB-F115 yielding scopularide H (8). Structures inclusive of absolute configurations were assigned by detailed spectroscopic and C3 Marfey’s analysis, together with X-ray analyses of 3 and 8, and biosynthetic considerations. Scopularides A–H (1–8) did not exhibit significant growth inhibitory activity against a selection of Gram positive (+ve) and negative (−ve) bacteria, a fungus, or a panel of three human carcinoma cell lines.

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