Opioids for acute pain: How much is too much?
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential. When does an opioid prescription make sense? It is simply impossible that pain experienced by people in the US is that staggeringly different than in the UK. So why the discrepancy? While it is possible that pain is being undertreated in the UK and more adequately treated in the US, I don’t believe that to be the case. The difference is that, in the US, prescribers were reassured for years that opioids were a safe and effective way to treat pain. And yes, they are effective, but as evidenced by the vast increase in opioid-related overdose deaths seen in the country over the past decade, they are not safe. On the other hand, medications like acetaminophen and ibuprofen — those over-the-counter pain medicines that you can get at any supermarket — actually work amazingly well for acute pain. As an example, a large survey study of over 2,000 patients who underwent a range of dental procedures discovered that ...
Authors: Consalvo V, D'Auria F, Salsano V Abstract BACKGROUND: Chronic pain still occurs in 10-12% of patients who undergo surgical groin hernia repair. Considering the high prevalence of this pathology, we performed a single-center prospective study comparing the laparoscopic trans-abdominal pre-peritoneal (TAPP) approach to the standard surgical open technique for primary uncomplicated hernia repair. METHODS: A prospective cohort of 278 patients was extracted from our dataset: 121 received a laparoscopic TAPP approach, and 157 were treated by the Lichtenstein technique in case of inguinal hernia or by the dep...
Publication date: Available online 26 March 2020Source: Chemical Engineering and Processing - Process IntensificationAuthor(s): Margherita Pettinato, Paolo Trucillo, Roberta Campardelli, Patrizia Perego, Ernesto Reverchon
Pomalidomide is potentially a less painful alternative to options such as freezing and laser ablation, and it may have a lower rate of recurrence, but copays cost about $5000 for a month's supply.Medscape Medical News
Conclusions: PMA is a highly effective and safe method for postoperative pain management in patients undergoing elective lumbar fusion surgeries by improving pain control and reducing opioid requirement. Level of Evidence: Level III.
Conclusions: In the field of disk research, some papers were heavily cited more than 100 times, suggesting these studies have substantially contributed to the body of knowledge of the intervertebral disk and findings were widely accepted by related clinicians and scientists.
Conclusions Diffuse idiopathic skeletal hyperostosis is a diagnosis with significant morbidity, despite being commonly viewed as asymptomatic. A majority of DISH patients had chronic back pain, and a large proportion required spinal surgery, although there may be several confounders. Future research is needed to systematically assess healthcare utilization by DISH patients.
Conclusions The coexistence of JHS and SpA is rare but important to recognize. These patients are difficult to diagnose as they may present late because of preserved spinal movements. It is unclear whether the preserved flexibility masks the true extent of disease or whether clinically they represent a less severe disease phenotype.
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Publication date: Available online 7 March 2020Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Jalal A. Nanji, Brendan Carvalho
Conditions: Opioid-Related Disorders; Opioid Dependence; Opioid Addiction; Opioid Withdrawal Interventions: Device: Bridge Device; Drug: Lofexidine; Drug: Placebo; Device: Sham Bridge Device Sponsors: Johns Hopkins University; National Institute on Drug Abuse (NIDA) Not yet recruiting
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