I ’m a doctor. I worry every time I prescribe painkillers to a patient. - Vox

"Please, I need my Oxycodone! " my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I 'd had too many times with too many patients over the past few months. "My arthritis is always worst in the winter, " he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it carries a significant risk of abuse. M said he needed the pills for their pain-relieving effects. He wanted a new prescription. I was disinclined. Opioids are highly addictive. They 're often abused. Worst, they decrease the body 's drive to breathe, making them deadly in some cases. As much as I wanted to trust M, his story didn 't quite add up. Was he abusing the drug, even selling it? Given the rising toll of prescription narcotics, these questions weren 't unreasonable. In Massachusetts where I am a physician, unintentional deaths from opioid overdoses increased from 5.3 to 10.1 per 100,000 residents between 2000 and 2013. In 2014, the number jumped to 18.6 per 100,000. These numbers include overdoses from heroin, which works the same way as opioid pills. Some people who become addicted to painkillers, unable to afford more med...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs

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Conclusions This study demonstrated a limited role of continuous passive motion in patients operated with total knee arthroplasty. Thus, there is at this stage no indication for continuous passive motion procedures in patients operated with total knee arthroplasty as a standard postoperative care.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Background Many nonconclusive studies have been conducted on low back pain (LBP) in adolescents and associated factors. Objective The aim was to assess the lifetime prevalence and associated factors of LBP in adolescents. Materials and Methods A questionnaire was administered in high school students (14–19-yr-old participants) in Veneto region (Italy). The self-administered, structured questionnaire included anthropometric data; psychologic factors and lifestyle; presence, intensity, and family history of LBP; referral to professional health care for LBP; and a short version of the International Phy...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
No abstract available
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Letters to the Editor Source Type: research
Although hemodialysis treatment is one of the main treatment methods in chronic kidney failure, it also causes many health problems. A variety of complementary and integrative therapies are used to relieve or minimize hemodialysis symptoms. Fatigue (60%-97%) is also one of these problems. Therefore, we have conducted a systematic review to determine the effect of complementary and integrative therapies on fatigue in hemodialysis patients. Relevant studies published from 2005 to 2019, in PubMed, EBSCOhost, ScienceDirect, and Cochran Library databases have been reviewed. In the study, initially, 21 039 pieces of data were ob...
Source: Holistic Nursing Practice - Category: Nursing Tags: FEATURES Source Type: research
Conclusions: The majority of reported cardiac telemetry downtime events were unplanned and without documented contingency plans. A robust contingency plan with defined staff roles and responsibilities will serve to lessen anxiety during downtimes and mitigate potential risk of patient harm.
Source: Journal of Nursing Care Quality - Category: Nursing Tags: Articles Source Type: research
HEART disease: Around twice as many people are living with heart and circulatory diseases in the UK than with cancer and Alzheimer's disease combined according to the British Heart Foundation. Could a seemingly innocent and popular drug be contributing to these shocking statistics?
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Background: Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear. Methods: We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC’s Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for>1 year. Results: Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were nume...
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Study Source Type: research
In this study, we aimed to assess the utility of structuring chest pain pathway (CPP) with the instantaneous case-by-case feedback protocol using WhatsApp and its impact on improving 2 major key performance indicators—the impact on initial emergency room (ER) door-to-electrocardiogram (ECG) time, and door-to-balloon time—in a predefined 6-month corrective action period. Methods: A prospective, quality improvement plan was set to reduce door-to-first-ECG and door-to-balloon times to less than 10 and 90 minutes, respectively, in all acute coronary syndrome cases (including STEMI cases), from August 2020 to...
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Study Source Type: research
Conclusions: Using evidence-based chest pain decision aids in a community hospital ED is feasible and acceptable. Key barriers and facilitators for implementation were identified. Further research in community hospitals is needed to verify findings, examine generalizability, and test implementation strategies.
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Study Source Type: research
AbstractOur previous studies have identified miR-483-3p to be highly expressed in synoviocytes from patients with rheumatoid arhtirits (RA); however, its effects on inflammation of RA fibroblast-like synoviocytes (FLSs) have remained unclear. The expression of miR-483-3p and cytokines in RA FLSs was detected using quantitative real-time polymerase chain reaction. Enzyme-linked immunosorbent was conducted to determine interleukin (IL)-33 production from RA FLSs. Western blotting was employed to quantify the levels of p-ERK and total ERK. Overexpressed miR-483-3p significantly increased the mRNA and protein expression of IL-...
Source: Inflammation - Category: Allergy & Immunology Source Type: research
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