Methadone for critically ill patients under mechanical ventilation in the intensive care unit: a systematic review.

Purpose: Pain may pose significant challenges in the intensive care unit, especially in mechanically ventilated patients. Methadone has recently emerged as an alternative option for eliciting acute analgesia. In this systematic review, we evaluated the use of methadone in mechanically ventilated patients in the intensive care unit.

Prospective preference assessment for the Ecstasy for Alleviating Severe Chronic Neuropathic Pain (EASE-Pain) trial.

Purpose: Emerging evidence suggests that 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy may be a promising intervention for chronic pain. We designed the Ecstasy for Alleviating Severe Chronic Neuropathic Pain (EASE-Pain) trial, a randomized controlled trial comparing MDMA with an active placebo (methylphenidate) for pain relief. We sought to conduct a prospective preference assessment (PPA) prior to the trial, with the objectives to 1) assess willingness to participate in the trial, 2) identify participants' motivations and concerns to enhance enrolment and acceptability, and 3) compare demographic and health characteristics between willing and nonwilling participants.

Percutaneous cholangioscopy-assisted rendezvous endoscopic retrograde cholangiography technique for a difficult postliver transplant anastomotic stricture.

Background And Aims: In cases of postliver transplant biliary stricture with double-duct anastomsis, double-duct stenting is absolutely necessary to preserve graft function.

Methods: We present a successful technique of percutaneous cholangioscopy-assisted rendezvous ERCP for difficult anastomotic stricture after failure of cholangioscopy-guided wire negotiation and percutaneous transhepatic biliary drainage.

Results: We achieved successful completion of biliary drainage through right anterior sectoral duct and right posterior duct stenting with subsequent dilatation of the stricture.

Spinal cord stimulation for chronic pain: a retrospective cohort study of patients from a Canadian tertiary centre.

Purpose: Spinal cord stimulation (SCS) is a surgical intervention for patients with neuropathic pain refractory to medical management. There are limited data on its outcomes from Canadian centres. We aimed to describe the indications, patient- and procedure-related characteristics, and outcomes of patients who underwent SCS implantation at a Canadian tertiary centre.

Practice advisory for intravenous management of headache disorders in hospitalized patients: a review of the evidence and consensus recommendations.

Introduction: Patients hospitalized for headache treatment pose unique challenges to the healthcare system. Currently, there is a lack of evidence-based guidance on management. This practice advisory aims to fill this critical gap by systematically reviewing the existing literature and providing comprehensive, evidence-based recommendations for managing headache patients during hospitalization.

Evolution of Electroconvulsive Therapy Practice During the COVID-19 Pandemic: A Systematic Review.

The COVID-19 pandemic disrupted the provision of electroconvulsive therapy (ECT) across the globe, challenging ECT services to develop protocols that preserve access to this life-saving treatment. This systematic review maps the literature on global ECT practice during the COVID-19 pandemic. The English-language literature was searched through OVID (MEDLINE, PsycINFO, and Embase) on August 7, 2024.

Early cholangioscopy-guided lithotripsy for clearance of biliary stones associated with narrow lower bile duct.

Background And Study Aims: Stones larger than the distal common bile duct (CBD) are difficult to remove with conventional techniques. Large papillary balloon dilatation (> 12 mm) of the biliary sphincter is an effective technique for stone removal but is associated with risk of leak in patients with narrower lower CBD. Mechanical or cholangioscopy-guided lithotripsy has been used in this situation for clearance of the bile duct.

Endoscopic Ultrasound-Guided Gastrojejunostomy as a Primary Treatment Modality for Malignant Gastric Outlet Obstruction: A Large Multicenter Experience.

Objectives: This work aims to describe technical feasibility and clinical outcomes of endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) as a first line treatment option for malignant gastric outlet obstruction (mGOO).

Methods: This is a large multicenter study where patients undergoing EUS-GJ across seven tertiary care centers from India were analyzed. The primary outcomes were technical success defined as correct stent placement without any leak, and clinical success defined as improvement in gastric outlet obstruction symptom score (GOOSS) on follow-up.

Fundic gland adenocarcinoma.

Gastric malignancy is one of the most common malignancies diagnosed worldwide. Over the past many decades, extensive research has been made into the risk factors, pathogenesis and prognosis of gastric adenocarcinoma. However, gastric adenocarcinoma of the fundic gland (GA-FG) has been recently defined, and not much is known about its risk factors and pathogenesis.

Prospective Preference Assessment for the Psilocybin for Enhanced Analgesia in Chronic nEuropathic PAIN (PEACE-PAIN) Trial.

Background: Negative perceptions of psilocybin and challenges of participant enrollment may represent barriers to conducting a randomized controlled trial examining psilocybin for chronic neuropathic pain.

Aim: Prior to trial initiation, we aimed to examine patient attitudes toward the trial via a prospective preference assessment.

Methods: Twenty-six patients with chronic neuropathic pain participated in a prospective preference assessment comprising quantitative (survey) and qualitative (interview) components.

Perioperative Naltrexone Management: A Scoping Review by the Perioperative Pain and Addiction Interdisciplinary Network.

Substance use disorders, including alcohol use disorder, are a public health concern that affect more than 150 million people globally. The opioid antagonist naltrexone is being increasingly prescribed to treat opioid use disorder, alcohol use disorder, and chronic pain. Perioperative management of patients on naltrexone is inconsistent and remains a controversial topic, with mismanagement posing a significant risk to the long-term health of these patients.

Pulsed Radiofrequency Neuromodulation of the Greater Occipital Nerve for the Treatment of Headache Disorders in Adults: A Systematic Review.

Background: Pulsed radiofrequency neuromodulation (PRFN) of greater occipital nerve (GON) is considered in patients with headaches failing to achieve sustained analgesic benefit from nerve blocks with local anesthetic and steroids. However, the evidence supporting this practice is unclear.

Aims: This narrative systematic review aims to explore the effectiveness and safety of GON PRFN on headaches.

Outcomes of endoscopic ultrasound-guided gallbladder drainage: A multicenter study from India (with video).

Background: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a safe and minimally invasive alternative for percutaneous cholecystostomy (PCC) in acute cholecystitis patients with high-surgical risk. Additionally, EUS-GBD serves as a rescue biliary drainage in malignant distal biliary obstruction. Despite its widespread application, data within the Indian context remains sparse.

Novel treatment with double scope technique for disconnected pancreatic duct syndrome with external pancreatic fistula.

External pancreatic fistula in association with disconnected pancreatic duct syndrome is a common sequelae of the percutaneous step-up approach for infected pancreatic necrosis and is associated with significant morbidity. The present study aimed to report the initial outcome of a novel technique of two-scope guided tractogastrostomy for management of this condition. The present study was a retrospective analysis of data from patients with external pancreatic fistula and disconnected pancreatic duct syndrome, who underwent two-scope-guided tractogastrostomy.

Psychotherapy for Ketamine's Enhanced Durability in Chronic Neuropathic Pain: Protocol for a Pilot Randomized Controlled Trial.

Background: Chronic pain affects approximately 8 million Canadians (~20%), impacting their physical and mental health while burdening the health care system with costs of upwards of US $60 billion a year. Indeed, patients are often trialed on numerous medications over several years without reductions to their symptoms. Therefore, there is an urgent need to identify new therapies for chronic pain to improve patients' quality of life, increase the availability of treatment options, and reduce the burden on the health care system.

Use of Psychedelics for Pain: A Scoping Review.

Chronic pain is a public health concern that affects approximately 1.5 billion people globally. Conventional therapeutic agents including opioid and non-opioid analgesics have been associated with adverse side effects, issues with addiction, and ineffective analgesia.

Role of patient selection and trial stimulation for spinal cord stimulation therapy for chronic non-cancer pain: a comprehensive narrative review.

Background/importance: Patient selection for spinal cord stimulation (SCS) therapy is crucial and is traditionally performed with clinical selection followed by a screening trial. The factors influencing patient selection and the importance of trialing have not been systematically evaluated.

Objective: We report a narrative review conducted to synthesize evidence regarding patient selection and the role of SCS trials.

Performance analysis of multiple input single layer neural network hardware chip.

An artificial neural network (ANN) is a computational system that is designed to replicate and process the behavior of the human brain using neuron nodes. ANNs are made up of thousands of processing neurons with input and output modules that self-learn and compute data to offer the best results. The hardware realization of the massive neuron system is a difficult task.

Co-use of cannabis and prescription opioids in adults in the USA: a population-based, cross-sectional analysis of the NHANES from 2009 to 2018.

Introduction: Cannabis and cannabinoids continue to gain popularity as adjuncts or alternatives to opioids in pain management, with evolving evidence of effectiveness. The relationship between cannabis and opioid use has previously been investigated in smaller cohorts or ecological samples, but not yet in a nationally representative sample.

Methods: A cross-sectional analysis of adults in the USA was undertaken using National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018.

Nonopioid Analgesic Prescriptions Filled after Surgery among Older Adults in Ontario, Canada: A Population-based Cohort Study.

Background: The objective was to assess changes over time in prescriptions filled for nonopioid analgesics for older postoperative patients in the immediate postdischarge period. The authors hypothesized that the number of patients who filled a nonopioid analgesic prescription increased during the study period.

Methods: The authors performed a population-based cohort study using linked health administrative data of 278,366 admissions aged 66 yr or older undergoing surgery between fiscal year 2013 and 2019 in Ontario, Canada.

Rare Combination of Distal Tibial Physeal Injury (Salter-Harris Type IV) with Sagittal Plane Fracture of Talus Body: A Case Report.

Introduction: Distal tibial physeal fractures and talus fractures are rare injuries in children and adolescents. Even rare is a combination of these two fractures. Axial compression is an accepted mechanism of injury in talus fractures with position of foot at the point of impact determining the extended patterns.