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Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

A Randomized Placebo-Controlled Trial of the Anti-Nerve Growth Factor Antibody Tanezumab in Subjects With Cancer Pain Due to Bone Metastasis.

BackgroundThis phase III, randomized, double-blind, placebo-controlled, parallel-group study assessed the efficacy and safety of tanezumab in subjects with cancer pain predominantly due to bone metastasis receiving background opioid therapy.MethodsSubjects were randomized (stratified by (1) tumor aggressiveness and (2) presence/absence of concomitant anticancer treatment) to placebo or tanezumab 20 mg. Treatment was administered by subcutaneous injection every 8 weeks for 24 weeks (3 doses) followed by a 24-week safety follow-up period. The primary outcome was change in daily average pain in t

Exploring the impact of opioid use on outcomes in allogeneic hematopoietic stem cell transplantation.

IntroductionHematological malignancies and allogeneic hematopoietic cell transplantation (alloHCT) often necessitate the use of opioids due to significant pain. This study aimed to investigate the impact of opioid use on the clinical outcomes of patients undergoing alloHCT.MethodsA retrospective cohort study was conducted by merging data from our local transplant database with anonymized pharmacy records obtained from the Institute for Clinical Evaluative Sciences (ICES). We analyzed 681 patients who underwent alloHCT at Princess Margaret Cancer Centre between January 2010 and December 2019. P

Patient-Reported Outcomes with Peripheral Nerve Stimulation for Low Back Pain from Vertebral Plana Deformities: A Case Series.

Objectives: This study evaluated peripheral nerve stimulation (PNS) as a treatment for vertebra plana fractures, focusing on its impact on pain intensity, physical function, anxiety, depression, fatigue, social role participation, and pain interference. The goal was to assess whether PNS could serve as a minimally invasive alternative for managing pain in patients with severe vertebral fractures. Methods: Four patients with lumbar vertebra plana fractures received PNS implants for 60 days. Pain scores and PROMIS-29 domains (physical function, anxiety, depression, fatigue, social participation,

Analgesic efficacy of zoledronic acid and its effect on functional status of prostate cancer patients with metastasis.

ObjectivesA multi-centered observational study evaluated the efficacy of zoledronic acid for improving pain and mobility, and preventing skeletal-related events (SRE) (fracture, spinal compression, pain-relieving radiotherapy), in patients with prostate cancer and bone metastasis.Materials and methodsMales (n = 218) with prostate cancer and bone metastasis undergoing oncologic therapy received zoledronic acid (4 mg iv/month) for 6 months. Parameters evaluated were: 1) pain and movement after 2 consecutive doses; 2) quality of life; 3) SRE incidence and time-to-appearance. Medication tolerance

A Multimodal Clinical Approach for the Treatment of Bone Metastases in Solid Tumors.

ContextBone metastasis (BM) is a frequent complication of cancer, representing the third most common site of secondary spread in solid cancers behind the lung and liver. Bone metastasis is found in up to 90% of prostate and breast cancer patients. They can cause significant complications, such as pathological fractures and paralysis of the spine, which decrease daily functioning and quality of life (QoL) and worsen prognosis. The growing life expectancy of cancer patients due to improvements in systemic therapies may further increase BM's eventuality and clinical burden in cancer patients.Evid

Review of Hematology-Oncology Emergencies for Internal Medicine Residents.

The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover sp

Management of Itch in the Elderly: A Review.

Chronic itch is common in the elderly patient and may be caused by a variety of known dermatologic and non-dermatologic conditions and can have a significant effect on quality of life. Age-related changes in barrier function, immunosenescence, and neuronal changes and neuropathies are common predisposing factors to chronic itch in this age group. Certain primary dermatologic conditions are more common in the elderly and can cause chronic itch. Also, co-morbid diseases particularly of the renal, hepatobiliary, or hematologic systems, psychologic conditions, or medications may contribute to chro

Clinical and Therapeutic Implications of Male Obesity.

The prevalence of obesity, a disorder linked to numerous comorbidities and metabolic complications, has recently increased dramatically worldwide and is highly prevalent in men, even at a young age. Compared to female patients, men with obesity more frequently have delayed diagnosis, higher severity of obesity, increased mortality rate, and only a minority of obese male patients are successfully treated, including with bariatric surgery. The aim of this review was to present the current state of knowledge about the clinical and therapeutic implications of obesity diagnosed in males.

Anorectal Complications in Acute Leukaemia: A retrospective analysis of clinical characteristics, management and outcomes in a tertiary care setting in Oman.

OBJECTIVES: Anorectal complications are common and serious issues among patients with haematological malignancies, leading to significant morbidity and mortality. Limited data are available on their incidence, microbiology screening and management. This study aimed to improve the understanding of these complications in patients diagnosed with acute leukaemia in Oman. METHODS: This retrospective study was conducted at Sultan Qaboos University Hospital, Muscat, Oman and included patients diagnosed with acute leukaemia who developed anorectal complications over the past decade (2015-2024). RESU

Efficacy of repetitive transcranial magnetic stimulation on postoperative pain in patients undergoing video-assisted thoracoscopic surgery: study protocol for a prospective, single-center, randomized controlled trial.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is a key treatment for many cardiothoracic issues, but intraoperative factors can lead to acute postoperative pain (APSP), impacting recovery and quality of life. While multimodal analgesic methods are used, they have notable side effects. Repetitive transcranial magnetic stimulation (rTMS) offers a non-invasive pain relief option by stimulating the primary motor cortex (M1), effective in chronic pain management. However, its role in preventing and treating APSP after VATS needs confirmation through high-quality clinical trials. METHODS/

Managing treatment-related peripheral neuropathy in patients with multiple myeloma.

Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be observed at the onset of the disease, due to the effect of monoclonal protein or radicular compression, but more often is treatment related. Vinca alkaloids in the past era, and more recently, thalidomide and bortezomib are mainly responsible. Degeneration of dorsal root ganglion is common, prevalently related to angiogenesis inhibition and cytokine modulation in the case of thalidomide and inhibition of the ubiquitin proteasome system in the case of bortezomib. Sensory ne

The history of cancer pain and bone-targeted agents: 10 most commonly asked questions.

The prevalence of pain and skeletal complications of metastatic bone disease is high and an important factor, which contributes to decreased quality of life and low survival rate. Bone-targeted agents are well-established therapies to reduce the skeletal-related events in patients with bone metastasis. However, the analgesic effect of these medications is still controversial. The objective of this review is to summarize the existing evidence about the use of bone-targeted agents in the treatment of metastatic bone pain, trying to answer to the 10 most commonly asked questions in this matter. T

Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain.

BackgroundBortezomib-induced peripheral neuropathy (BIPN) is a common and debilitating side effect. Our pilot study demonstrated that acupuncture is safe and can decrease total neuropathic symptoms. However, there is lack of knowledge in which individual BIPN symptoms benefited from acupuncture.PurposeTo characterize individual symptoms reduced by acupuncture in patients with BIPN.MethodsPatients with multiple myeloma treated with bortezomib who developed BIPN grade 2 or above, based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), were enrolled and rece

Patient perceptions of symptoms and concerns during cancer chemotherapy: 'affects my family' is the most important.

BackgroundCancer chemotherapy is associated with a variety of side effects/adverse events. It is very important that patients adhere to the planned chemotherapy regimen, which necessitates a minimum of side effects and that these side effects be kept under control. We have investigated patients' concerns and symptoms during chemotherapy with the aim to seek solutions that will improve patients' quality of life during chemotherapy.MethodsForty-nine patients with malignant diseases on parenteral antineoplastic agents were sequentially enrolled in this study. These patients completed a questionna

Palliative patients who may benefit from intranasal delivery of symptomatic drugs: a two-center observational study evaluated the administration of morphine and dexamethasone in Polish hospices.

IntroductionPatients receiving hospice care at the end of life often suffer from a variety of ailments. They may need medication to alleviate symptoms for the rest of their lives. The most common and recommended way to take opioids and steroids is orally. Less frequently, the subcutaneous or intravenous routes are used. The intranasal route is a relatively uncommon but interesting alternative for administering drugs.AimThe study aims to identify hospice patients who may benefit from changing the standard opioid and steroid administration route to intranasal delivery.Material and methodsThe ele

Paediatric intestinal pseudo-obstruction: a scoping review.

Paediatric intestinal pseudo-obstruction (PIPO) encompasses a group of rare disorders in which patients present with the clinical features of bowel obstruction in the absence of mechanical occlusion. The management of PIPO presents a challenge as evidence remains limited on available medical and surgical therapy. Parenteral nutrition is often the mainstay of therapy. Long-term therapy may culminate in life-threatening complications including intestinal failure-related liver disease, central line thrombosis and sepsis. Intestinal transplantation remains the only definitive cure in PIPO but is a

Clinical Efficacy and Potential Mechanisms of Acupoint Stimulation Combined With Chemotherapy in Combating Cancer: A Review and Prospects.

Although chemotherapy is the first-line treatment strategy for a variety of tumors, its side effects have limited its efficacy. This review summarizes the progress on the use of acupoint stimulation to combat chemotherapy-associated side effects, including chemotherapy-induced peripheral neuropathy (CIPN), cognitive impairment (CICI), and gastrointestinal toxicity (GI), as well as myelosuppression and immunosuppression. It was found that acupoint stimulation attenuated CIPN and GI by modulating the 5-hydroxytryptamine system in dorsal root ganglia, the dorsal horn of the spinal cord, and the d

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… Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy - A Meta-Analysis and Systematic Review. Clin Epidemiol (2021) 13:907–19. doi: 10.2147/CLEP.S324193 73. Tsai CL, Liu LC, Liao CY, Liao WL, Liu YH, Hsieh CL. …

Role of Cannabidiol for Improvement of the Quality of Life in Cancer Patients: Potential and Challenges.

There is currently a growing interest in the use of cannabidiol (CBD) to alleviate the symptoms caused by cancer, including pain, sleep disruption, and anxiety. CBD is often self-administered as an over-the-counter supplement, and patients have reported benefits from its use. However, despite the progress made, the mechanisms underlying CBD's anti-cancer activity remain divergent and unclear. Herein, we provide a comprehensive review of molecular mechanisms to determine convergent anti-cancer actions of CBD from pre-clinical and clinical studies. In vitro studies have begun to elucidate the mo

Repetitive Transcranial Magnetic Stimulation: Is it an Effective Treatment for Cancer Pain?

Cancer is a major public health issue, with an estimated 20 million new cases and 9.7 million cancer-related deaths worldwide in 2022. Approximately 44.5% of patients experience cancer pain, significantly impacting their quality of life and causing physical and psychological burdens. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, shows potential in managing cancer pain. This review summarizes current research on rTMS for cancer pain, focusing on pain directly caused by tumors, pain from cancer treatments, postoperative pain, and cancer-related sy