Biomedical subjects

Stephen N Palmer

Publications and source records attributed to Stephen N Palmer.

4 recordsLinked to original sources

PubMed2005

Pharmacogenetics of anesthetic and analgesic agents.

Predicting a patient's response to a particular drug has long been a goal of clinicians. Rapid advances in molecular biology have enabled researchers to identify associations between an individual's genetic profile and drug response. Pharmacogenetics is the study of the molecular mechanisms that underlie individual differences in drug metabolism, efficacy, and side effects. The pharmacogenetics of commonly used anesthetic and analgesic agents are reviewed.

Analgesics↗

PubMed2004

Lessons learned from a multiple-dose post-operative analgesic trial.

Patients undergoing major surgery often require several days of post-operative analgesic management. However, little data are available on the course of post-operative pain during this period. Such data would be extremely helpful in planning treatment, formulating pain management guidelines, and determining how to construct multiple-dose post-operative analgesic clinical trials. The objectives of this study were to determine (1) if post-operative pain severity, as measured by a modified version of the Brief Pain Inventory (BPI), can be categorized as mild, moderate, or severe in terms of modified BPI pain interference scores, (2) the relationship between modified BPI pain ratings and responses to a categorical item that specifically measures post-sternotomy pain, and (3) the relationship between global ratings of study medication effectiveness and other pain measures. This study is a reanalysis of data from patients who underwent coronary artery bypass graft procedures. We found that the pain severity level cut points developed for chronic pain apply equally well to post-operative pain. Based on this classification scheme, 18% of patients reported moderate pain after day 3, while 14% reported severe pain. Only 9% of patients reported experiencing moderate-to-severe pain approximately 2 weeks later, at the end of the study. Describing pain as mild, moderate, or severe could be a simple, meaningful clinical trial outcome measure. Because most patients experience only mild pain 6 days after surgery, long-term clinical trials of post-operative pain control may be more efficient and cost-effective if they focus on the subset of patients with persistent moderate or severe pain.

Aged↗

PubMed2003

Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults.

This study compared the severity of fatigue in patients with cancer to the fatigue reported by depressed psychiatric patients and community-dwelling adults. Data were collected for this study during the process of validating a new fatigue assessment tool, the Brief Fatigue Inventory (BFI). The sample included 354 cancer patients, 72 psychiatric patients, and 290 non-patient volunteers. Study subjects reported severity of fatigue and the degree to which fatigue interfered with various aspects of life. Data were also collected on sleep disturbance and demographic variables that might correlate with fatigue. The psychiatric patients reported significantly higher levels of fatigue and fatigue-related interference than the cancer patients, who reported more severe fatigue and interference than the community subjects. The sleep disturbance scores of the cancer patients and the community subjects were significantly correlated with fatigue severity. Although the majority of the psychiatric patients reported sleep disturbance, their sleep disturbance scores were not significantly associated with fatigue severity.

Adolescent↗

PubMedDate not supplied

The utility and validity of the modified brief pain inventory in a multiple-dose postoperative analgesic trial.

OBJECTIVES: Patients undergoing major surgery often require several days of postoperative analgesia. However, few data exist on the longitudinal course of postoperative pain and the psychometric properties of pain assessment tools used in this setting. Our objective was to validate use of the modified Brief Pain Inventory through reanalysis of pain data from a multiple-dose, placebo-controlled, randomized trial of analgesia after coronary artery bypass graft surgery. METHODS: Four hundred sixty-two patients who underwent coronary artery bypass graft surgery via median sternotomy were administered a shortened form of the original Brief Pain Inventory that contained 3 severity and 5 interference items. Additionally, patients were presented with a single-item measure of procedure-specific pain. Daily pain and interference ratings were available from days 4 to 14 postoperatively. We performed factor analysis to evaluate the consistency with which the modified Brief Pain Inventory items loaded on 2 separate factors corresponding to the original Brief Pain Inventory's pain severity and pain interference subscales. We calculated 2 reliability measures, internal consistency and test-retest reliability, for each subscale. RESULTS: The modified Brief Pain Inventory consistently measured 2 underlying constructs, severity and interference, with Cronbach alphas of 0.85 or greater for the 2 Brief Pain Inventory scales, and test-retest stability coefficients ranging from 0.58 to 0.95 for each pair of consecutive assessment periods. The procedure-specific pain question showed substantial overlap with a general measure of pain severity, suggesting concurrent validity. DISCUSSION: The modified Brief Pain Inventory was stable and valid over the assessment period, suggesting that it can be used during the subacute postoperative period to assess postoperative pain among patients with coronary artery bypass graft surgery.

Aged↗