Pain expert: Judge the opioid treatment, not the patient

With medications that carry significant risks, such as opioids, appropriate prescribing practices are critical to patient safety. One physician in Boston lives by a mantra that puts patients first: Judge the treatment, not the patient. We need to start re-conceptualizing chronic pain as a chronic disease, said Daniel P. Alford, MD, associate professor of medicine at the Boston University School of Medicine and director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program. “Acute pain is a symptom, and it’s life-sustaining—and you need to feel acute pain in order to survive,” Dr. Alford said. But “there is no advantage to chronic pain. Chronic pain really is a malfunctioning of the nervous system and requires, like other chronic diseases, a multimodal approach.” Assessing whether opioids are the appropriate course of treatment Many potential physical, psycho-behavioral, procedural and pharmacologic options exist for managing chronic pain. Dr. Alford follows a process that helps him to make the appropriate clinical judgment regarding whether or not opioids are an appropriate course of treatment for each individual patient: 1.  Determine whether the patient has a pain process that is likely to respond to opioid therapy. For a lot of chronic pain disorders, opioids are probably not the answer, Dr. Alford said. “For example, chronic migraine headaches, fibromyalgia and back pain … tend t...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news

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We present a 71-year-old Japanese man with metastasis prostate cancer that, during medical castration therapy, had torsades de pointes (TdP) with a QT prolongation and ventricular fibrillation (VF). His QT interval diminished after discontinuing the medical castration, and he developed no further VF recurrences for 15 months. Medical castration is a rare but possible trigger of TdP with QT prolongation and VF. PMID: 30518719 [PubMed - as supplied by publisher]
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
New research shows that cancer patients who are single receive less aggressive treatment than those who are married. NPR's Michel Martin talks with researcher Joan DelFattore about her findings.
Source: NPR Health and Science - Category: Consumer Health News Source Type: news
CONCLUSION: PUVA therapy is associated with an increased risk of CCNM inthe Mediterranean population. PMID: 30503067 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Publication date: Available online 8 December 2018Source: Results in PhysicsAuthor(s): B. Gowri Naidu, P. Sarita, G.J. Naga Raju, M.K. TiwariAbstractSynchrotron Radiation based X-ray fluorescence (SRXRF) technique was utilized for the determination of serum elemental profile in breast cancer patients group and healthy subjects group. The SRXRF experiments were performed on microprobe beamline-16, Indus-2 synchrotron radiation source at Raja Ramanna Centre for Advanced Technology (RRCAT), Indore, India. The accuracy and reliability of the experimental method were validated by using International Atomic Energy Agency (IAEA) ...
Source: Results in Physics - Category: Physics Source Type: research
Publication date: 1 March 2019Source: Colloids and Surfaces B: Biointerfaces, Volume 175Author(s): Jing Luo, Yang Cheng, Xiao-Yan He, Yi Liu, Na Peng, Zhi-Wei Gong, Kui Wu, Tao ZouAbstractTo realize efficiently cellular uptake and enhance the immunostimulation, thiolated cytosine-phosphate-guanine (CpG) oligodeoxynucleotides (ODNs) were self-assembled on hollow gold nanospheres (HGNs) to form CpG-HGNs. The cellular uptake of CpG-HGNs in immune cells was studied in RAW 264.7 cells. Due to the enhanced delivery efficiency, CpG-HGNs exhibited a higher immune stimulatory activity compared with CpG ODNs, resulting in a dramatic...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
ConclusionsThis series of patients undergoing PD with PG shows that the operation can be performed safely with excellent outcomes for a variety of malignant and benign conditions.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
ConclusionsBoth UM and CPM patients reported high satisfaction with their surgical decisions, despite differing reasons for their respective surgeries.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Publication date: Available online 8 December 2018Source: The American Journal of SurgeryAuthor(s): Brittany L. Murphy, Kristine T. Hanson, Tina J. Hieken, Sarah McLaughlin, Richard J. Gray, Elizabeth B. HabermannAbstractBackground: Given the growing emphasis on patient-centered care, we determined contributory factors to a positive experience among patients undergoing outpatient breast procedures.MethodsWe retrospectively identified patients ≥18 years-old who underwent a breast operation 7/2015-12/2016 and completed a survey within two weeks. Univariate analyses evaluated associations of factors with top survey composi...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
ConclusionWe confirm no significant differences in the perioperative and oncological outcomes between off-clamp and on-clamp RPN. Avoided ischemia benefits renal function within 1-year follow-up after surgery. At longer follow-up, difference with on-clamp is softened.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionArthroscopic knee debridement can provide good symptomatic relief and sustained benefits in significantly symptomatic patients with early degenerative knees who have failed conservative management. This is most useful in patients with mechanical symptoms secondary to degenerative meniscal tears or chondral flaps, and those with symptomatic patellofemoral osteoarthritis.
Source: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology - Category: Sports Medicine Source Type: research
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