Journal of Pain & Palliative Care Pharmacotherapy最新文献

Fistulae can severely impact a patient's quality of life, causing physical pain and excessive malodorous discharge. Beyond the physical symptoms, they also impose significant psychological and social burdens. This report presents a unique case involving the intravenous administration of a single dose of infliximab to a terminally ill patient with rectal adenocarcinoma complicated by severe enterocutaneous fistulae in the genital, subscrotal, and gluteal regions. This home-based intervention not only improved the patient's quality of life but also alleviated caregiver burdens and facilitated the timely completion of end-of-life tasks.

Hematopoietic stem cell transplantation is one of the important treatment modalities for a wide range of malignant and nonmalignant hematological disorders, as well as congenital and acquired disorders of the immune system. Through bone marrow transplantation, candidates face unique challenges throughout the treatment process, which can be accompanied by high physical and psychological burdens. To address the challenges, emerging interventions, such as supportive and palliative care, have shown significant potential for improving quality of life, enhancing overall well-being, alleviating pain, and reducing patient symptoms. The integration of supportive and palliative care in all types of bone marrow transplantation has become increasingly crucial throughout all phases of transplantation, including pre-, during, and post. Therefore, there has to be a specialized team available that can provide complete care, from diagnosis to post-transplantation. Supportive and palliative care requires collaboration for their shared efforts in meeting the special needs of the patients, increasing their quality of life, hope, mood, and well-being. Accordingly, supportive and palliative care, as an integral part of the transplant process, provides patients comprehensive care that addresses their physical, emotional, and psychological well-being.

The widespread implementation of intrathecal infusion systems (IIS) in managing chronic pain underscores the pivotal role of family caregivers in ensuring effective treatment outcomes and enhancing patients' quality of life. We conducted a comprehensive literature search across databases including PubMed, Medline, and Web of Science. Research indicates that family caregivers primarily face barriers such as insufficient professional knowledge, technical difficulties, psychological and emotional strain, and a lack of adequate financial and social support. These challenges can compromise the efficacy of pain management and increase caregivers' burdens. In response, recent studies have concentrated on offering targeted educational programs and training, fostering support networks, and encouraging technological innovations and policy reforms. Such initiatives aim to bolster caregivers' capabilities and alleviate their psychological and financial stress, thereby enhancing the overall effectiveness of pain management strategies. The significance of the review is that it highlights the central role of family carers in chronic pain management and points to the importance of enhancing their caring capacity. Future research directions should include the development of more systematic caregiver support programs, an in-depth exploration of the effectiveness of multidisciplinary collaborative models, and an assessment of the promise of emerging technologies for use in the family caregiving environment.

The aim of this work was to assess the effectiveness of full-spectrum cannabis (THC and CBD) extracts as adjuvants in the treatment of chronic pain. This is a prospective, open label, longitudinal study. Major cannabinoids were analyzed in herbal preparations using high performance liquid chromatography (HPLC). Subjects were included when chronic pain diagnosis criteria was met according to physicians' diagnosis. A patient stratification protocol was developed using a visual analogue scale to measure pain, a numerical scale for life quality parameters and a self-administered health survey. Eighty-eight patients aged between 35 and 88 years were included. A significant decrease in both pain and other life quality parameters was observed between time zero and subsequent time intervals, excepting the "appetite" variable. Overall, 51 individuals reported a decrease in pain, 38 a decrease in anxiety and 48 in insomnia, with "decrease" defined as symptom reduction of 50% or more between the first and last consultation. In addition, 23 subjects reduced or discontinued other analgesics and/or anti-inflammatory drugs during the trial. Adverse effects were mild and reversible. These results are consistent with previous studies, supporting effectiveness and safety of cannabis extracts as adjuvants in the treatment of chronic pain.

Low-dose naltrexone (LDN) has demonstrated mixed efficacy in treating fibromyalgia. This systematic review and meta-analysis aimed to evaluate the efficacy of LDN for fibromyalgia. We systematically searched electronic databases and gray literature from inception to May 2024. Included studies were clinical trials in humans published in English, reporting mean changes in pain scores and fibromyalgia symptom severity, comparing baseline to endpoint and LDN to placebo. Of 575 identified articles, eight met the eligibility criteria. In the LDN group, the Standardized Mean Difference (SMD) for pain decreased by 1.03 (95% confidence interval (CI): -1.25, -0.80; I² = 25%), and fibromyalgia symptom severity decreased by 1.02 (95% CI: -1.35, -0.69; I² = 52%) post-LDN treatment compared to the baseline. However, no significant differences in mean change in pain (SMD -0.50, 95% CI: -1.19, 0.19; I² = 91%) and fibromyalgia symptoms severity scores (SMD -0.67, 95% CI: -1.67, 0.34; I² = 95%) were observed between the LDN and placebo groups. Although LDN marginally reduced pain and symptom severity from baseline, these effects were not superior to placebo. This suggests that LDN may not provide significant clinical benefit over placebo in fibromyalgia management, warranting further research.

Chronic pancreatitis presents a formidable challenge in pain management, often leading to significant suffering and reduced quality of life for affected individuals. The intricate interplay of factors contributing to this pain, including inflammation and neural sensitization, has garnered increasing attention in recent research. Among the key players in this scenario are the transient receptor potential vanilloid 1(TRPV1) channels located in dorsal root ganglion (DRG) neurons. These channels, known for their role in pain perception, exhibit heightened sensitivity and altered expression patterns in the context of chronic pancreatitis. Sensitization of TRPV1 channels amplifies their response to various pain triggers, exacerbating the perception of discomfort. Furthermore, dysregulated expression of TRPV1 within DRG neurons contributes to the chronic pain phenotype associated with pancreatitis. Understanding the nuanced mechanisms governing TRPV1 modulation in DRG neurons promises to unlock novel therapeutic avenues for managing chronic pancreatitis pain. By targeting TRPV1 channels specifically in DRG neurons, researchers aim to develop treatments that alleviate pain while minimizing adverse effects, ultimately offering hope for improved outcomes and enhanced well-being for individuals grappling with this debilitating condition.

What do we already know about this topic?Significant obstacles to providing effective pain relief still exist despite major improvements in pain management strategies.How does this research contribute to the field?It highlights the necessity for a thorough comprehension of the complex nature of pain management, where nurses play a crucial role, in the context of patient care.What are the implications of this research for theory, practice, or policy?It highlights the need for healthcare organizations and educational institutions to give nurses priority in their ongoing training and education, with an emphasis on cultivating a holistic and compassionate approach to pain management.