CDC Chronic Pain Guidelines: Not so bad, but...

by Tom QuinnIn case you didn’t notice, the US Centers for Disease Control published their long-awaited (dreaded?) “CDC Guideline for Prescribing Opioids for Chronic Pain.” It made a pretty big splash: Five editorials plus the full Guideline in the online Mar 15 JAMA, front page New York Times feature article, the first hour on NPR’s “Diane Rehm Show,” (Mar 17) and multiple others. It is specifically aimed at primary care prescribers, who write about half of the scripts for opioids in the US. It is intended to “support clinicians caring for patients outside the context of active cancer care or palliative or end-of-life care.” The Guideline was published in the Mar 15 Weekly Morbidity and Mortality Report and is the first US Government guideline to address treatment of chronic pain; it is 52 pages long. A good “Cliff Notes” version of the Guideline is the JAMA piece by CDC Director Thomas Frieden, MD and Debra Houry, MD. I should point out that the document was prepared by the CDC’s Division of Unintentional Injury Prevention. The Guideline is intended to address the epidemic of opioid-related deaths, not the pandemic of chronic pain. On its face, the Guideline promotes good, standard prescribing practices, especially for potentially high-risk agents: history and diagnosis of the painful disorder, prognosis of the painful state, history of prior interventions, establishing clear treatment goals, careful selectio...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: CDC ethics opioids pain quinn The profession Source Type: blogs

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Publication date: 15 January 2019Source: Journal of Molecular Structure, Volume 1176Author(s): S. Murugavel, C. Ravikumar, G. Jaabil, Ponnusamy AlagusundaramAbstractPrevious research studies confirm that molecules containing 1,2,3-triazole moiety are potential anticancer agents which elevates effectiveness and reduces drug resistance. Present study was aimed to evaluate the anticancer activity of the synthesized novel title compound 2-(1-benzyl-5-methyl-1H-1,2,3-triazol-4-yl)-4-(2-chlorophenyl)-6-methoxypyridine (BTCP). The structural and spectral characteristics of BTCP were studied and compared with DFT results. NBO, HOM...
Source: Journal of Molecular Structure - Category: Molecular Biology Source Type: research
CONCLUSION: VR was helpful in reducing BoNT procedure-related discomfort in a majority of patients. Challenges with VR setup, patient tolerance, and selecting viewing experiences were identified to guide further research and use of VR in a clinical environment. PMID: 30223406 [PubMed - as supplied by publisher]
Source: Journal of Pediatric Rehabilitation Medicine - Category: Rehabilitation Tags: J Pediatr Rehabil Med Source Type: research
Authors: Fisher MT, Zigler CK, Houtrow AJ Abstract PURPOSE: To evaluate variables that modulate pain during intramuscular botulinum toxin A injections in children. METHODS: As part of a Quality Improvement project, this retrospective analysis compared reported pain during and five minutes post injections with patient and procedural variables using subgroup and regression analyses (N= 593 procedures with 249 unique patients). RESULTS: Mean procedural pain for all procedures (n= 563) was 3.8 ± 3.0. Most children reported no pain (83.8%) or mild pain (12.1%) five minutes after the procedure. Provider, p...
Source: Journal of Pediatric Rehabilitation Medicine - Category: Rehabilitation Tags: J Pediatr Rehabil Med Source Type: research
Conclusion Based on our findings it seems that MSU classification can be used in patients' selection to achieve the best treatment outcome after intradiscal ozone injection among patients with lumbar disc herniation. PMID: 30227808 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
Publication date: Available online 19 September 2018Source: Advances in Biological RegulationAuthor(s): Mariana L. Oliveira, Padma Akkapeddi, Daniel Ribeiro, Alice Melão, João T. BarataAbstractInterleukin 7 (IL-7) and its receptor (IL-7R, a heterodimer of IL-7Rα and γc) are essential for normal lymphoid development. In their absence, severe combined immunodeficiency occurs. By contrast, excessive IL-7/IL-7R-mediated signaling can drive lymphoid leukemia development, disease acceleration and resistance to chemotherapy. IL-7 and IL-7R activate three main pathways: STAT5, PI3K/Akt/mTOR and MEK/Erk, u...
Source: Advances in Biological Regulation - Category: Biology Source Type: research
Publication date: January 2019Source: Biomedical Signal Processing and Control, Volume 47Author(s): Jijun Tong, Yingjie Zhao, Peng Zhang, Lingyu Chen, Lurong JiangAbstractAn automatic brain tumor segmentation method based on texture feature and kernel sparse coding from FLAIR (fluid attenuated inversion recovery) contrast-enhanced MRIs (magnetic resonance imaging) is presented in this paper. First, the MRIs are pre-processed to reduce noise, enhance contrast and correct the intensity non-uniformity. Then sparse coding is performed on the first order and second order statistical eigenvector extracted from original MRIs whic...
Source: Biomedical Signal Processing and Control - Category: Biomedical Science Source Type: research
Simon Thompson, 32, from Kent, was rushed to hospital when a 'dental abscess' failed to improve despite antibiotics. He was later diagnosed with advanced Non Hodgkin's lymphoma.
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From 2011 to 2016, expenditure on cancer drugs in the United States rapidly accelerated. The first prospective study of its kind tallies the numbers.Medscape Medical News
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Clark County is about to get its first freestanding emergency department in October 2019, thanks to Mercy Health — Springfield. The $14 million freestanding emergency department, expected to break ground in October of this year, will feature 10 exam rooms with the capacity to hold patients overnight, as well as a landing pad for medical helicopters to transfer out more critical patients. Services inside th e facility will include a chest pain center; lab and imaging center with CT (computerized…
Source: bizjournals.com Health Care:Biotechnology headlines - Category: Biotechnology Authors: Source Type: news
Authors: Hilpert F, Du Bois A Abstract INTRODUCTION: Patient-reported outcomes (PROs), including quality-of-life considerations, are increasingly becoming key factors in clinical decision making. Areas covered: This review provides an overview of the current status of PROs in guiding clinical trial design and clinical decision making in patients with ovarian cancer and previews the future potential of PROs in these settings. Expert commentary: In ovarian cancer, considerable discord exists between patients and physicians regarding perceived symptom burden. During maintenance therapy, it is important that the most a...
Source: Expert Review of Anticancer Therapy - Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research
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