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A retrospective review of acupuncture use for the treatment of pain in sickle cell disease patients: descriptive analysis from a single institution.

ABSTRACT: OBJECTIVES:This retrospective study describes the use of acupuncture for adult sickle cell patients in a single institution. MATERIALS AND METHODS:We identified 47 sickle cell disease patients referred for acupuncture at the National Institutes of Health between January 2005 and September 2011. All patients were enrolled in a Study of the Natural History of sickle cell disease and signed consent. We reviewed patient demographics, location of acupuncture treatment sessions (inpatient vs. outpatient), number of sessions received, sites of pain, patient pain reporting, and the use of other complementary therapies. RESULTS:Of the 47 patients (60% women, median age 36 y) referred for acupuncture, 42 had homozygous SS disease (89%) and 5 had SC disease (11%). Over half of the patients (51%) reported >3 sites of pain. Only 24 patients (51%) underwent acupuncture treatment. Of those who elected not to receive acupuncture, a majority (87%) accepted some other forms of complementary therapies. Nine patients underwent only inpatient acupuncture for acute vaso-occlusive crisis. Eleven patients received only outpatient acupuncture treatment for chronic pain, and 4 patients received both inpatient and outpatient treatments. For the patients who received inpatient acupuncture treatment for acute vaso-occlusive crisis, there was a significant reduction of reported pain score immediately after acupuncture treatment with an average pain reduction of 2.1 points on the numeric pain scale (P<0.0001). Excluding the 2 outliers, 75% of patients (n=13) in the outpatient setting described their pain as improved compared with prior session. DISCUSSION:To our knowledge, this is the largest retrospective review of acupuncture use in the sickle cell population. This analysis describes the use of acupuncture and raises the possibility of its use as an adjuvant for pain management in this population. Future clinical trials are needed to evaluate acupuncture's efficacy and effectiveness for pain management in different treatment settings and for various types of pain etiologies among the sickle cell population.

SUBMITTER: Lu K

PROVIDER: S-EPMC4159140 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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A retrospective review of acupuncture use for the treatment of pain in sickle cell disease patients: descriptive analysis from a single institution.

Lu Kit K Cheng Mok-Chung Jennifer MC Ge Xiaoying X Berger Ann A Xu Dihua D Kato Gregory J GJ Minniti Caterina P CP

The Clinical journal of pain 20140901 9

<h4>Objectives</h4>This retrospective study describes the use of acupuncture for adult sickle cell patients in a single institution.<h4>Materials and methods</h4>We identified 47 sickle cell disease patients referred for acupuncture at the National Institutes of Health between January 2005 and September 2011. All patients were enrolled in a Study of the Natural History of sickle cell disease and signed consent. We reviewed patient demographics, location of acupuncture treatment sessions (inpatie ...[more]

PMID: 24322996

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Project description:BACKGROUND:In the perioperative period, intravenous lidocaine has been used as an opioid-sparing systemic analgesic with additional anti-inflammatory and anti-hyperalgesic properties. OBJECTIVE:The aim of this retrospective study was to review the utilization, efficacy, and safety of intravenous lidocaine on our Acute Pain Service (APS) and identify surgical and patient populations where this intervention was found to be useful. PATIENTS AND METHODS:This retrospective study was designed to assess acute pain management in patients who received an intravenous lidocaine infusion between February 2013 and December 2017. Data collected included demographics, surgery type, infusion duration, pain scores, analgesic consumption, and adverse effects. Pain scores included rest and active pain scores and were analyzed by surgical model and subgroups. Clinically important differences (CIDs) in pain were determined by changes in pain score difference of???2 (11-point scale) or???30% reduction in pain intensity. A patient was considered to have a true CID if a CID was observed with rest and/or active pain scores at both first to second (4-24 h) and first to final time point (4 h to infusion end) comparisons. RESULTS:In total, 544 patients received intravenous lidocaine during this period, and 394 were included in the final analysis. The average (±?standard deviation) duration of infusion was 68.60?±?49.52 h. Surgical specialties included gastrointestinal surgery (41%), orthopedics (28%), neurosurgery (15%), vascular surgery (10%), and others (6%). Overall, 56.1% of the study population experienced a CID, with reduced pain scores at rest and/or with activity. CIDs were also observed in patients with chronic pain (53.5%) and when intravenous lidocaine was used as a rescue technique (69.6%). Within the rescue cohort, opioid-dependent and opioid-naïve patients experienced 23.0% and 45.6% reductions, respectively, in their 8-h intravenous opioid consumption. In total, 37 patients in the study experienced transient signs of mild local anesthetic toxicity, which resolved with infusion titration (conservative) management. One serious adverse event required intervention, and the patient was successfully resuscitated. CONCLUSIONS:This retrospective study at a single institution with an APS policy for intravenous lidocaine in the postoperative period identifies benefits of intravenous lidocaine in certain surgical and patient populations. The findings need to be confirmed with further research.

Project description:BackgroundScientists have speculated genetic variants may contribute to an individual's unique pain experience. Although research exists regarding the relationship between single nucleotide polymorphisms and sickle cell disease-related pain, this literature has not been synthesized to help inform future precision health research for sickle cell disease-related pain. Our primary aim of this systematic review was to synthesize the current state of scientific literature regarding single nucleotide polymorphisms and their association with sickle cell disease-related pain.MethodsUsing the Prisma guidelines, we conducted our search between December 2021-April 2022. We searched PubMed, Web of Science, CINAHL, and Embase databases (1998-2022) and selected all peer-reviewed articles that included reports of associations between single nucleotide polymorphisms and sickle cell disease-related pain outcomes.ResultsOur search yielded 215 articles, 80 of which were duplicates, and after two reviewers (GG, JD) independently screened the 135 non-duplicate articles, we retained 22 articles that met the study criteria. The synthesis of internationally generated evidence revealed that this scientific area remains predominantly exploratory in nature, with only three studies reporting sufficient power for genetic association. Sampling varied across studies with a range of children to older adults with SCD. All of the included articles (n = 22) examined acute pain, while only nine of those studies also examined chronic pain.ConclusionCurrently, the evidence implicating genetic variation contributing to acute and chronic sickle cell disease-related pain is characterized by modestly powered candidate-gene studies using rigorous SCD-pain outcomes. Effect sizes and directions vary across studies and are valuable for informing the design of future studies. Further research is needed to replicate these associations and extend findings with hypothesis-driven research to inform precision health research.

Project description:Background and aimsThis retrospective review of patients with recurrent glioblastoma treated at the Preston Robert Tisch Brain Tumor Center investigated treatment patterns, survival, and safety with bevacizumab in a real-world setting.MethodsAdult patients with glioblastoma who initiated bevacizumab at disease progression between January 1, 2009, and May 14, 2012, were included. A Kaplan-Meier estimator was used to describe overall survival (OS), progression-free survival (PFS), and time to greater than or equal to 20% reduction in Karnofsky Performance Status (KPS). The effect of baseline demographic and clinical factors on survival was examined using a Cox proportional hazards model. Adverse event (AE) data were collected.ResultsSeventy-four patients, with a median age of 59 years, were included in this cohort. Between bevacizumab initiation and first failure, defined as the first disease progression after bevacizumab initiation, biweekly bevacizumab and bevacizumab/irinotecan were the most frequently prescribed regimens. Median duration of bevacizumab treatment until failure was 6.4 months (range, 0.5-58.7). Median OS and PFS from bevacizumab initiation were 11.1 months (95% confidence interval [CI], 7.3-13.4) and 6.4 months (95% CI, 3.9-8.5), respectively. Median time to greater than or equal to 20% reduction in KPS was 29.3 months (95% CI, 13.8-∞). Lack of corticosteroid usage at the start of bevacizumab therapy was associated with both longer OS and PFS, with a median OS of 13.2 months (95% CI, 8.6-16.6) in patients who did not initially require corticosteroids versus 7.2 months (95% CI, 4.8-12.5) in those who did (P = 0.0382, log-rank), while median PFS values were 8.6 months (95% CI, 4.6-9.7) and 3.7 months (95% CI, 2.7-6.6), respectively (P = 0.0243, log-rank). Treatment failure occurred in 70 patients; 47 of whom received salvage therapy, and most frequently bevacizumab/carboplatin (7/47; 14.9%). Thirteen patients (18%) experienced a grade 3 AE of special interest for bevacizumab.ConclusionsTreatment patterns and outcomes for patients with recurrent glioblastoma receiving bevacizumab in a real-world setting were comparable with those reported in prospective clinical trials.

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A retrospective review of acupuncture use for the treatment of pain in sickle cell disease patients: descriptive analysis from a single institution.

Publications

A retrospective review of acupuncture use for the treatment of pain in sickle cell disease patients: descriptive analysis from a single institution.

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