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Think twice before tapering opioids in some patients

Bill is a 58-year-old male with a history of head and neck cancer as well as chronic low back pain who presents to his new primary care doctor for a routine checkup and visit for a medication refill. He works in construction and has been on chronic opioid therapy after his cancer — with a stable dose of 15 mg of oxycodone for over five years. At his new primary care visit, after a few meet and greet pleasantries, his new primary care doctor discusses his current medication regimen with him — ibuprofen 400mg TID and oxycodone 15mg BID. His physician expresses significant concern with his medication regimen, telling Bill that “it’s against the rules” to continue prescribing opioids for him — despite the fact that he’s been on this dose for several years. She prescribes an oxycodone taper for him and requests he return to her office in two weeks for a re-evaluation. Bill, not wanting to be a problem, takes his taper as prescribed for the first few days. However, as he’s been on opioids for over five years, he begins feeling sick — nausea, vomiting, malaise, and irritability. He tries to go back to his old dose but runs out of oxycodone. While trying to work at a construction site, Bill is having trouble completing his tasks and drops a few expensive objects. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Oncology/Hematology Source Type: blogs

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This test is a cheaper and less invasive alternative to an upper endoscopy.
Source: ABC News: Health - Category: Consumer Health News Tags: Health Source Type: news
CONCLUSION: Inserting a smaller sized peripheral intravenous catheter did not result in a lower pain sensation. Moreover, to prevent pain upon inserting a peripheral intravenous catheter, an unsuccessful attempt must be avoided. PMID: 29772984 [PubMed - in process]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
In this study, chitosan was used to coat the adsorbent for preventing the leakage of Zn2+ loaded. Meanwhile, freeze-drying method was used to enhance adsorption capacity of Zn2+-loaded cellulose beads for testosterone. The results indicate that after the adsorbent was coated by 0.02% chitosan solution, the highest adsorption percentage reached 48%, during adsorption, the Zn2+ concentration in plasma did not increase; the adsorption capacity of the adsorbent can be significantly enhanced by freeze-drying. The results may be caused by porosity of the adsorbent enlarged via freeze-drying and improved stability by coating with...
Source: Artificial Cells, Nanomedicine and Biotechnology - Category: Biotechnology Tags: Artif Cells Nanomed Biotechnol Source Type: research
A modern blend of yoga, Zen Buddhism, hypnosis and psychology, it ’s huge on the continent and it’s on its way hereMindfulness is the tried-and-tested tool of our times for anxiety, depression, chronic pain, addiction and more, but what if it ’s not your thing? For those too twitchy to sit still and focus on breathing, the ubiquitous mindfulness apps, self-help sheets and courses in schools and workplaces are little more than totems of uselessness. But you wouldn’t have this problem if you lived in France, Italy, Spain, Switzerland o r Portugal, because you’d be doing sophrology instead. It&rs...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Life and style Psychology Science Health & wellbeing Source Type: news
BOWEL cancer symptoms include stomach pain, a change in bowel habits, and finding blood in your stool. You could reveal your risk of the cancer by checking your poo after using the toilet. Should a healthy poo sink or float?
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
When pain settled into Blair Golson's hands, it didn't let go.What started off as light throbbing in one wrist 10 years ago quickly engulfed the other. The discomfort then spread, producing a pain much"like slapping your hands against a concrete wall," he says. He was constantly stretching them, constantly shaking them, while looking for hot or cold surfaces to lay them on for relief.But worse was the deep sense of catastrophe that accompanied the pain. Working in tech-related startups, he depended on his hands to type."Every time the pain got bad, I would think some variation of,'Oh no, I'm ...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs
Battino José L. Quiles Periodontal disease, a relevant public health problem worldwide, is generally considered a common pathology of elderly people. In this respect, there is agreement about that nutritional status may be a modifying factor in the progression and healing of the periodontal tissues. Vitamins have been recommended as nutraceuticals for prevention and treatment of some pathological conditions, such as cardiovascular diseases, obesity or cancer. Thus, a systematic approach to determining how the different vitamin type could ameliorate periodontal risks or improve periodontal health is necessary t...
Source: Molecules - Category: Chemistry Authors: Tags: Review Source Type: research
Conclusions RAPN in the setting of select cT2 renal masses can safely be performed with acceptable outcomes. Further studies are warranted to corroborate our findings and to better define the role of robotic nephron sparing for this challenging indication. Patient summary This report shows that robotic surgery can be used for safe removal of a large renal tumor in a minimally invasive fashion, maximizing preservation of renal function, and without compromising cancer control. This large multicenter experience suggests that robot-assisted partial nephrectomy for clinical T2 renal masses is feasible, it offers good surgical ...
Source: European Urology - Category: Urology & Nephrology Source Type: research
AbstractThe Ontario Breast Screening Program for women with a genetic predisposition to breast cancer is one of the first international models of a government-funded public health service that offers systematic genetic screening to women at a high risk of breast cancer. However, since the implementation of the program in 2011, enrolment rates have been lower than anticipated. Whilst there may be several reasons for this to happen, it does call into consideration the ‘inverse equity law’, whereby the more advantaged in society are the first to participate and benefit from universal health services. An outcome of...
Source: Journal of Community Genetics - Category: Genetics & Stem Cells Source Type: research
Publication date: Available online 19 May 2018 Source:Seminars in Cancer Biology Author(s): George Cyriac, Leena Gandhi Immune checkpoint inhibition with anti-PD-1 therapy has been notably successful in non-small cell lung cancer (NSCLC) and changed standard practice in multiple settings. However, despite some durable benefits seen, the majority of unselected patients with NSCLC fail to respond to checkpoint inhibitors. Patient selection is crucial and will become even more important in the development of combination therapies with immune checkpoint inhibitors. PD-L1 expression by immunohistochemistry (IHC) has emerged as...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
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