scholarly journals Nutraceutical Alternatives to Pharmaceutical Analgesics in Osteoarthritis

2021 ◽  
Author(s):  
Shane M. Heffernan ◽  
Gillian E. Conway
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Physical Function ◽  
Joint Pain ◽  
Cardiovascular Events ◽  
Health Concern ◽  
Western World ◽  
Gastrointestinal Complications ◽  
The Us ◽  
Analgesic Use

Chronic pain is a considerable health concern worldwide, effecting almost 30% of all European adults. Osteoarthritis (OA), a progressive pro-inflammatory condition, is one of the leading causes of chronic pain (effecting 13% of all those over 50 years, globally) and is the most common cause of joint pain. The prevalence of non-steroidal anti-inflammatory drug (NSAIDs) and analgesic use has been well studied and is abundant throughout the western world, with women being the greatest users and ibuprofen generally being the most reported NSAID. In the US, 65% of all OA patients are prescribed NSAIDs for pain management and form part of the current recommended strategy for OA clinical management. While some NSAIDs and analgesics are effective at improving pain and physical function, they come with significant and harmful side effects such as gastrointestinal complications, renal disturbances and severe cardiovascular events. Given these side-effects, any reduction in NSAID and analgesia use (and the resulting potentially harmful side effects) is of particular importance to OA public health. As such, a number of non-pharmaceutical alternatives (bioactive nutraceuticals) have been developed that may reduce NSAID and analgesia use while maintaining pain reduction and improvements in physical function. This chapter will discuss select nutraceuticals that are not currently in mainstream use but may have the potential to aid in the treatment of OA.

scholarly journals Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Leah Zallman ◽  
Sonia L. Rubens ◽  
Richard Saitz ◽  
Jeffrey H. Samet ◽  
Christine Lloyd-Travaglini ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Substance Use ◽  
Side Effects ◽  
Substance Use Disorders ◽  
Opioid Use ◽  
Attitudinal Barriers ◽  
Primary Care Patients ◽  
Opioid Use Disorders ◽  
Analgesic Use

Attitudinal barriers towards analgesic use among primary care patients with chronic pain and substance use disorders (SUDs) are not well understood. We evaluated the prevalence of moderate to significant attitudinal barriers to analgesic use among 597 primary care patients with chronic pain and current analgesic use with 3 subscales from the Barriers Questionaire II: concern about side effects, fear of addiction, and worry about reporting pain to physicians. Concern about side effects was a greater barrier for those with opioid use disorders (OUDs) and non-opioid SUDs than for those with no SUD (OR (95% CI): 2.30 (1.44–3.68), P<0.001 and 1.64 (1.02–2.65), P=0.041, resp.). Fear of addiction was a greater barrier for those with OUDs as compared to those with non-opioid SUDs (OR (95% CI): 2.12 (1.04–4.30), P=0.038) and no SUD (OR (95% CI): 2.69 (1.44–5.03), P=0.002). Conversely, participants with non-opioid SUDs reported lower levels of worry about reporting pain to physicians than those with no SUD (OR (95% CI): 0.43 (0.24–0.76), P=0.004). Participants with OUDs reported higher levels of worry about reporting pain than those with non-opioid SUDs (OR (95% CI): 1.91 (1.01–3.60), P=0.045). Concerns about side effects and fear of addiction can be barriers to analgesic use, moreso for people with SUDs and OUDs.

171 Habitual Sleep Duration and Chronic Pain in the US Population Over A 10-Year Period: Implications for Sleep Health Disparities

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A69-A70
Author(s):  
Chloe Craig ◽  
Kathryn Kennedy ◽  
Sadia Ghani ◽  
Michael Perlis ◽  
Azizi Seixas ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Sleep Duration ◽  
Joint Pain ◽  
Face Pain ◽  
Wide Range ◽  
The Us ◽  
Race Ethnicity ◽  
Pain Experiences

Abstract Introduction Chronic pain is linked with sleep disturbances, which worsen pain experiences. The nature of the bi-directional relationship between sleep and chronic pain has not been explored at the population level, especially among racial/ethnic minorities, a group disproportionately burdened by chronic pain. To address this gap, we investigated the relationship between sleep and chronic pain experiences in the US population and conducted race-stratified analyses. Methods Data from the CDC National Health Interview Survey (NHIS) was used, from 2007-2016. Sleep duration was categorized as &lt;=4hrs, 5-6hrs, 7-8hrs, 9hrs, or 10+hrs. N=298,698 provided data for analysis. Chronic pain outcomes included arthritis, joint pain, neck pain, back pain, jaw/face pain, and migraines/headaches. Covariates included age, sex, body mass index, and employment status. Race/ethnicity was included as a covariate and interaction term, categorized as Non-Hispanic White, Black/African-American, Mexican-American, Other Hispanic/Latino, Asian/Pacific-Islander, Indian/Subcontinent, American Indian/Alaskan Native, and Multiracial/Other. Weighted logistic regression analyses examined sleep as predictor and pain as outcome, adjusted for covariates. Post-hoc analyses examined sleep-by-race/ethnicity interactions. Results Prevalence in the population was 24.7%, 40.0%, 4.8%, 15.7%, 29.5%, and 15.0% for arthritis and joint, jaw/face, neck, back, and migraine/headache pain. In adjusted analyses compared to 7-8hrs, arthritis was more likely among &lt;=4hrs (OR=2.6,p&lt;0.0005), 5-6hrs (OR=1.5,p&lt;0.0005), 9hrs (OR=1.1,p=0.002), and 10+hrs (OR=1.2,p&lt;0.0005). Joint pain was also more likely among &lt;=4hrs (OR=2.8,p&lt;0.0005), 5-6hrs (OR=1.6,p&lt;0.0005), 9hrs (OR=1.1,p=0.002), and 10+hrs (OR=1.2,p&lt;0.0005). Jaw/face pain was also more likely among &lt;=4hrs (OR=3.0,p&lt;0.0005), 5-6hrs (OR=1.6,p&lt;0.0005), 9hrs (OR=1.2,p=0.001), and 10+hrs (OR=1.4,p&lt;0.0005). Neck pain was more likely among &lt;=4hrs (OR=3.0,p&lt;0.0005), 5-6hrs (OR=1.6,p&lt;0.0005), and 10+hrs (OR=1.2,p&lt;0.0005). Back pain was also more likely among &lt;=4hrs (OR=3.1,p&lt;0.0005), 5-6hrs (OR=1.7,p&lt;0.0005), and 10+hrs (OR=1.3,p&lt;0.0005). Migraines/headaches were also more likely among &lt;=4hrs (OR=3.6,P&lt;0.0005), 5-6hrs (OR=1.8,P&lt;0.0005), and 10+hrs (OR=1.4,P&lt;0.0005). Significant sleep-by-race/ethnicity interactions were seen for joint (p=0.002), jaw (p&lt;0.0005), and neck (p=0.002) pain, but not back pain (p=0.08), migraines/headaches (p=0.28), or arthritis (p=0.45). Conclusion Habitual short and long sleep are associated with a wide range of chronic pain conditions. Bidirectional relationships should be explored as a public health priority. Race/ethnicity interactions suggest that the sleep/pain experience differs by group (reasons should be explored). Support (if any) R01MD011600, R01DA051321, K24AG055602, R01AG041783

Prescription Drug Diversion and Pain

2018 ◽  
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Prescription Drug ◽  
Physical Dependence ◽  
Treatment Providers ◽  
Opioid Crisis ◽  
Drug Diversion ◽  
Life Saving ◽  
The Us ◽  
Us Government

Prescription Drug Diversion and Pain provides an interdisciplinary overview of medications used to treat chronic pain, and the benefits and risks that are posed by long-term use of opioids. Use of these life-saving medications must be carefully managed to prevent serious side effects, which may include physical dependence, addiction, and even death. In recent years, the risk of these side effects has led to increased attention on the development of alternative treatments for chronic pain. This book not only offers a single, comprehensive source for understanding the specialized nature of the opioid crisis, but also addresses provocative topics including how pain drugs came to be regulated by the US government and the rarely discussed aggressive marketing behind the spread of these drugs. Chapters are written by expert contributors from diverse backgrounds in medicine, psychiatry, pharmacy, nursing, law, and bioethics. Prescription Drug Diversion and Pain is a must-read for healthcare professionals, chronic pain patients and caregivers, policymakers and regulatory officials, drug treatment providers, and those in the pharmaceutical industry seeking to address the current opioid crisis.

World Economy: Prospects and Barriers for Recovery

2012 ◽  
pp. 61-83 ◽  
Author(s):  
M. Ershov
Keyword(s):  
World Economy ◽  
Western World ◽  
Short Time Period ◽  
Market Segments ◽  
Junk Bonds ◽  
The Past ◽  
Time Period ◽  
The Us ◽  
Global Liquidity ◽  
Short Time

According to the latest forecasts, it will take 10 years for the world economy to get back to “decent shape”. Some more critical estimates suggest that the whole western world will have a “colossal mess” within the next 5–10 years. Regulators of some major countries significantly and over a short time‑period changed their forecasts for the worse which means that uncertainty in the outlook for the future persists. Indeed, the intensive anti‑crisis measures have reduced the severity of the past problems, however the problems themselves have not disappeared. Moreover, some of them have become more intense — the eurocrisis, excessive debts, global liquidity glut against the backdrop of its deficit in some of market segments. As was the case prior to the crisis, derivatives and high‑risk operations with “junk” bonds grow; budget problems — “fiscal cliff” in the US — and other problems worsen. All of the above forces the regulators to take unprecedented (in their scope and nature) steps. Will they be able to tackle the problems which emerge?

RESEARCH EPIDURAL ANALGESIA TO PAIN RELIEF ON LABOR PROGRESS

2012 ◽  
pp. 31-41
Author(s):  
Quang Thuy Phung ◽  
Ngoc Thanh Cao ◽  
Quang Vinh Truong
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Relief ◽  
Epidural Anesthesia ◽  
Good Condition ◽  
Cervical Dilation ◽  
Normal Birth ◽  
Normal Limits ◽  
Constant Pain ◽  
Background Pain

Background: Pain during labor as pain in the fracture is not treated, chronic pain, so pain is very essential issues to be studied. Epidural anesthesia (NMC) has many advantages over spinal anesthesia in constant pain. Study objectives: 1. Assessing the effects analgesia by epidural anesthesia during labor. 2. Assessing progress and final results of labor for pregnant women and fetuses. Materials and Methods: The study described 37 pregnant from 38 to less than 42 weeks had a positive phase of labor to pain relief by continuous epidural anesthesia method, with cervical dilation between 3 cm and 4 cm. Results: Women feel very satisfied (67.5%) on methods of natural pain relief during labor. Most women deliver normally (73%). Evolution of the cervix takes place smoothly. Duration of labor within the normal birth. Breast sucking good condition accounted for 86.5% rate, the reflecting normal 94.6%. Conclusions: This is the effective method of pain relief during labor birth. Duration of labor in normal limits. Side effects occur less and can be well controlled. Keywords: epidural anesthesia; relief pain on labor.

Mesenchymal Stem Cells and their Exosomes: Promising Therapeutics for Chronic Pain

2019 ◽  
Vol 14 (8) ◽  
pp. 644-653 ◽  
Author(s):  
Jinxuan Ren ◽  
Na Liu ◽  
Na Sun ◽  
Kehan Zhang ◽  
Lina Yu
Keyword(s):  
Stem Cells ◽  
Chronic Pain ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Side Effects ◽  
Human Life ◽  
Analgesic Effects ◽  
Pain Models ◽  
Inflammatory Drugs ◽  
Anxiety Depression

Chronic pain is a common condition that seriously affects the quality of human life with variable etiology and complicated symptoms; people who suffer from chronic pain may experience anxiety, depression, insomnia, and other harmful emotions. Currently, chronic pain treatments are nonsteroidal anti-inflammatory drugs and opioids; these drugs are demonstrated to be insufficient and cause severe side effects. Therefore, research into new therapeutic strategies for chronic pain is a top priority. In recent years, stem cell transplantation has been demonstrated to be a potent alternative for the treatment of chronic pain. Mesenchymal stem cells (MSCs), a type of pluripotent stem cell, exhibit multi-directional differentiation, promotion of stem cell implantation, and immune regulation; they have also been shown to exert analgesic effects in several chronic pain models. Exosomes produced by MSCs have been demonstrated to relieve painful symptoms with fewer side effects. In this review, we summarize the therapeutic use of MSCs in various chronic pain studies. We also discuss ways to enhance the treatment effect of MSCs. We predict in the future, cell-free therapies for chronic pain will develop from exosomes secreted by MSCs.

Is the firearm epidemic in the US getting worse?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Tedesco ◽  
K Y C Adja ◽  
F Rallo ◽  
C Reno ◽  
M P Fantini ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
National Level ◽  
Gun Violence ◽  
Public Health Issue ◽  
Western World ◽  
Diagnostic Code ◽  
The Us ◽  
Icd 10 ◽  
Ed Visits ◽  
Annual Decline

Abstract Background The US is the least regulated firearm market in the Western world and firearm violence is a major public health issue. Firearms account for 40,000 deaths in the US annually, which is higher than other high-income countries. Although most of the gun-related deaths in the US are the result of suicide attempts and self-inflicted injuries, nearly 40% of them come from accidents, assaults, or police intervention. Methods We measured the number of non-self-inflicted firearm-related ED visits, by including patients discharged with diagnostic ICD-9-CM (ICD-10 for 2016) codes of accidents, assaults or legal intervention resulting in firearm injuries between 2006-2016. We used data from the Healthcare Cost and Utilization Project (HCUPnet). From the CDC Wide-ranging Online Data for Epidemiologic Research we obtained data on non-suicidal firearm-related deaths over the period 2006-2017. To identify the cause of death we used the ICD-10 codes. Temporal changes of rates of ED visits and deaths were evaluated using Joinpoint Software. Results In 2006 there were a total of 79,998 ED visits with a diagnostic code of firearm-related injury, and this number showed a non-significant 2.7% annual decline between 2006-2013 (p = 0.06) followed by a significant 19.4% annual increase between 2013-2016 (p &lt; 0.05), resulting in 111.305 visits in 2016. The number of non-suicidal firearm-related deaths showed a significant 2.2% annual decline between 2006-2014 (p &lt; 0.05), followed by a significant 10.3% APC (p &lt; 0.05) between 2014-2017. Conclusions Data showed steady rates until 2013 and a striking increasing trend starting from 2013. Firearm-related deaths followed the same trends. Our data show that in the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities. Analysis limitations: we used national-level aggregate data and coding accuracy may be not consistent nationwide. Key messages In the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities nationwide. The US firearm related deaths epidemic urges for new policies and preventive measures, such as stricter background checks and restrictions on guns ownership.

A Preliminary Report on Alcohol-Associated DNA Methylation Changes and Suicidal Behavior: Evidence Using Mendelian Randomization

2021 ◽  
pp. 105413732095224
Author(s):  
Charleen D. Adams
Keyword(s):  
Public Health ◽  
Dna Methylation ◽  
Suicidal Behavior ◽  
Genome Wide Association Study ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Economic Stress ◽  
Self Report ◽  
Health Concern ◽  
The Us

Suicide is a major public health concern. In 2015, it was the 10th leading cause of death in the US. The number of suicides increased by 30% in the US from 1999 to 2016, and a greater uptick in suicides is predicted to occur as a result of the COVID-19 crisis, for which the primary public-health strategy is physical distancing and during which alcohol sales have soared. Thus, current strategies for identifying at-risk individuals and preventing suicides, such as relying on self-reported suicidal ideation, are insufficient, especially under conditions of physical distancing, which exacerbate isolation, loneliness, economic stress, and possibly alcohol consumption. New strategies are urgent now and into the future. To that aim, here, a two-sample Mendelian randomization (an instrumental variables technique using public genome-wide association study data as data sources) was performed to determine whether alcohol-associated changes in DNA methylation mediate risk for suicidal behavior. The results suggest that higher alcohol-associated DNA methylation levels at cg18120259 confer a weak causal effect. Replication and triangulation of the results, both experimentally and with designs other than Mendelian randomization, are needed. If the findings replicate, the information might be utilized to raise awareness about the biological links between alcohol and suicide and possibly explored as a biomarker of risk, perhaps especially for early detection of those who may not self-report suicidal intent.

scholarly journals Cardiovascular Safety Profile of Romosozumab: A Pharmacovigilance Analysis of the US Food and Drug Administration Adverse Event Reporting System (FAERS)

2021 ◽  
Vol 10 (8) ◽  
pp. 1660
Author(s):  
Annika Vestergaard Kvist ◽  
Junaid Faruque ◽  
Enriqueta Vallejo-Yagüe ◽  
Stefan Weiler ◽  
Elizabeth M. Winter ◽  
...  
Keyword(s):  
Adverse Event ◽  
Drug Administration ◽  
Cardiovascular Events ◽  
Reporting System ◽  
Food And Drug Administration ◽  
Adverse Event Reporting System ◽  
Adverse Event Reporting ◽  
Cardiovascular Safety ◽  
Event Reporting ◽  
The Us

Background: Cardiovascular safety concerns for major cardiovascular events (MACE) were raised during the clinical trials of romosozumab. We aimed to evaluate the cardiovascular safety profile of romosozumab in a large pharmacovigilance database. Methods: All cases reported between January 2019 and December 2020 where romosozumab was reported were extracted from the Food and Drug Administration Adverse Event Reporting System (FAERS). The outcome of interest was MACE (myocardial infarction (MI), stroke, or cardiovascular death). A disproportionality analysis was conducted by estimating the reporting odds ratios (RORs) and 95% confidence intervals. Disproportionality analyses were stratified by sex and reporting region (US, Japan, other). Results: Of the 1995 eligible cases with romosozumab, the majority (N = 1188; 59.5%) originated from Japan. Overall, 206 suspected MACE reports were identified, of which the majority (n = 164; 13.8%) were from Japan, and 41 (5.2%) were from the United States (US). Among Japanese reports, patients were older and more frequently male than reports from the US. Similarly, cases with a reported MACE were older and had higher reports of cardioprotective drugs than those without cardiovascular events. Elevated reports for MACE (ROR 4.07, 95% CI: 2.39–6.93) was identified overall, which was primarily driven by the significant disproportionality measures in the Japanese reports. Conclusions: The current pharmacovigilance study identified a potential signal for elevated MACE, particularly in Japan. The results support the current safety warnings from the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) to avoid use in high-risk patients.

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