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The “right” goal when managing pain

It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. Even non-drug interventions (like physical therapy) and complementary therapies (such as acupuncture) usually don’t have just one single effect. This means that, if we prioritize pain reduction over every other outcome, we may wind up doing as much harm as we do good. In particular, the authors of the editorial suggest that focusing only on lowering pain intensity, and creating a moral mandate to relieve pain, have contributed to the opioid crisis in this country. Over the past few decades, we have seen steady increases in opioid prescriptions, cases of opioid misuse and abuse, and related overdose deaths. Patient surveys also show that people with chronic pain care about more than just experiencing less pain. They care about enjoying life more, having a strong sense of emotional well-being, increasing their physical activity, improving sleep and reduci...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Health Addiction Arthritis Back Pain Cancer Migraines Pain Management Behavioral Health chronic pain managing pain Source Type: news

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Authors: Kim CG Abstract Endoscopic full-thickness resection combined with laparoscopic surgery was recently developed. These procedures could be categorized as "Cut first and then suture" and "Suture first and then cut". "Cut first and then suture" includes laparoscopic and endoscopic cooperative surgery (LECS) and laparoscopy-assisted endoscopic full-thickness resection (LAEFR). Recent studies have demonstrated the safety and efficacy of LECS and LAEFR. However, these techniques are limited by the related exposure of the tumor and gastric mucosa to the peritoneal cavity and manipulat...
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Javier Rodr íguez-Carrio, Mercedes Alperi-López, Patricia López, Francisco J. Ballina-García, Ana Suárez
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: This study reveals a mutational profile and a distinct mutation signature of T:A>A:T transversion in early-stage HCC with HBV infection, which will enrich our understanding of genetic characteristics of the early-stage HCC. PMID: 29333154 [PubMed]
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Eur Addict Res 2017;23:312 –313
Source: European Addiction Research - Category: Addiction Source Type: research
Conclusion: Compared to non-smokers, promoter-related deoxyribonucleic acid methylation of the ANP promoter was significantly elevated on days 7 and 14 of withdrawal in tobacco-dependent patients. Baseline methylation status of the ANP promoter was not significantly different from controls, arguing for an impaired regulation during withdrawal. Eur Addict Res 2017;23:306 –311
Source: European Addiction Research - Category: Addiction Source Type: research
The aim of this study was to evaluate the clinical value of PET and PET/CT in suspected recurrent cervical cancer. The recurrence of cervical cancer has a poor prognosis. Earlier intervention would lead to a better prognosis. PET and PET/CT were promising in early diagnosis of recurrence because they could detect the biological and molecular changes before the anatomical size changes occurred. However, few data concerning the clinical effect of PET and PET/CT were available. The database for PET (or positron emission tomography or FDG or fluorodeoxyglucose) AND cervical cancer (or cervical tumor or cervical neoplasm or cer...
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Review Article Source Type: research
Conclusion The SWMD20% and FV20 of FL using 20% of the maximum SPECT count as the threshold may be better predictors for the risk of RP.
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Objective The aim of the study was to determine the fraction of administered activity that was excreted and retained by a small cohort of patients who each received treatment with radium-223 dichloride (223Ra). 223Ra is an α-emitting radionuclide that has been approved for use in the treatment of bone metastases that are secondary to castration resistant prostate cancer. Patients and methods Six patients received two weight-based administrations of 223Ra 6 weeks apart. Activity excreted in the urine and faeces during the first 48 h following each treatment was assessed by direct counting of the excreta. D...
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Objective Radioiodine-131 is a radionuclide that is used for therapeutic purposes in hyperthyroidism and thyroid cancer. The aim of this study was to evaluate apoptotosis and proliferative changes in radioiodine-related kidney damage. Materials and methods Three groups (n=10/group) of rats were used as follows: the rats were in group 1 untreated, and the rats in groups 2 and 3 were treated once with oral radioiodine (111 MBq). The animals in group 2 were killed at the end of the seventh day and the rats in group 3 were killed at the end of the 10th week. The kidneys were removed and evaluated immunohistochemica...
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Conclusion The results obtained suggest the potency of the [DTPA-(PABn)-Leu5]-DAG(1–5) as a new carrier of radionuclides in radiopharmacy.
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
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