New guidelines on opioid tapering tells doctors to go slow

Rules advise clinicians to be careful and deliberate in cutting dosages for people in chronic pain.
Source: Washington Post: To Your Health - Category: Consumer Health News Authors: Source Type: news

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Patients with critical limb ischemia are exposed to qualitative and quantitative malnutrition as a result of anorexia caused by chronic pain, insomnia, overuse of analgesics, and limitation of mobility. Furthermore, malnutrition is a well-known factor that causes coagulation disorders and immunosuppression, and it directly adversely affects the wound healing process. The aim of this study was to assess the influence of qualitative and quantitative malnutrition on the results of revascularization procedures as frequency of large amputations in patients with critical lower limb ischemia.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Chronic low back pain (CLBP) is highly prevalent, associated with substantial socioeconomic impact, and commonly attributed to neurologic and musculoskeletal causes. We observed an unexpected prevalence of CLBP preoperatively among our patients with proximal venous outflow obstruction (PVOO) of the iliac veins undergoing stent placement. We undertook this study to better characterize these patients.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Publication date: Available online 19 October 2019Source: NeuroImageAuthor(s): Kenneth F. Valyear, Benjamin A. Philip, Carmen M. Cirstea, Pin-Wei Chen, Nathan Baune, Noah Marchal, Scott H. FreyAbstractAnimal models reveal that deafferenting forelimb injuries precipitate reorganization in both contralateral and ipsilateral somatosensory cortices. The functional significance and duration of these effects are unknown, and it is unclear whether they also occur in injured humans. We delivered cutaneous stimulation during functional magnetic resonance imaging (fMRI) to map the sensory cortical representation of the intact hand a...
Source: NeuroImage - Category: Neuroscience Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
This study was aimed to identify the predictors of splenic sequestration crisis (SSC) among pediatric patients with sickle cell disease (SCD).This prognosis study was carried out in the pediatric immuno-hematology unit, over 20 years (1998 to 2017), enrolling patients with SCD. The cox model was used in multivariate analysis.Among 423 patients with SCD (240 S/S phenotype, 128 S/B0, 30 S/B+, 14 S/O arab and 11 S/C), 150(35.4%) had at least one episode of SSC. The average age of patients at the first episode was 48.3 months ± 32.4(2–168). Recurrence of SSC was observed in 117 patients (78%). Spleen size ≥...
Source: Blood Cells, Molecules, and Diseases - Category: Hematology Source Type: research
A common treatment for a chronic pain condition that affects millions of Canadians may not be as safe as once thought, and experts say a growing body of research shows it could be doing more harm than good.
Source: CBC | Health - Category: Consumer Health News Tags: News/Health Source Type: news
CONCLUSIONS: The adaptation process was successful in generating an engaging mindfulness training program that was highly relevant to the military context. Obtaining input from stakeholders, such as military healthcare providers and active-duty soldiers, and iterative feedback and modification, were key to the process. Moreover, the program was designed to maintain the integrity and core elements of MBIs while adapting to military culture. A future randomized controlled trial design will be used to evaluate the effectiveness of the intervention in improving chronic pain in military personnel. This program is responsive to ...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Over the past two decades, the federal and state governments, industry, and professionals have taken significant actions to address opioid abuse, addiction, and overdose, including efforts to determine the appropriateness of prescribing opioid analgesics to patients with acute and chronic pain (Greene, et  al., 2018; Jones, et al., 2018). Without a doubt, many of these efforts have been necessary. Some measures, however, have focused sharply on reducing the supply of prescription opioids, which has contributed toward confusion and fear among prescribers and restricted access to controlled prescript ion medication...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Editorial Source Type: research
We describe a case of posttraumatic chronic intercostal neuralgia, in which successful pain relief was achieved via repeated injections of local anesthetic and steroid combinations in the serratus anterior plane under ultrasonographic guidance. This novel technique is easy to administer, reliable, and warrants further investigation with regard to its use for rehabilitation of patients who are experiencing posttraumatic chronic neuropathies of the chest wall.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Case Report Source Type: research
Authors: Carlesso LC, Neogi T Abstract Knee pain in osteoarthritis is complex and complicated by the fact that osteoarthritis is considered to be a disorder of multiple phenotypes. This complexity challenges our understanding as to why some people remain relatively symptom-free, while others progress to persistent pain. One approach to understanding the mechanisms underlying the transition to persistent pain is by identifying pain susceptibility phenotypes in people with or at risk of knee osteoarthritis. Using variables representative of the multidimensional nature of pain in people who were free of persistent pai...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
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