Efficacy and harms of long ‐term opioid therapy in chronic non‐cancer pain: Systematic review and meta‐analysis of open‐label extension trials with a study duration ≥ 26 weeks

ConclusionsWithin the context of open ‐label extension studies, opioids maintain reduction of pain and disability and are rather well tolerated and safe. LtOT can be considered in carefully selected and monitored patients with low back, osteoarthritis and neuropathic pain who experience a clinically meaningful pain reduction with at l east tolerable adverse events in short‐term opioid therapy.
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: SYSTEMATIC REVIEW Source Type: research

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by Drew Rosielle (@drosielle)This is the second in a series of several posts about many aspects of my current thinking about opioids.The first post is here:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Over-prescribing fueled the current drug overdose epidemic, and many of us who thought we were stamping out needless suffering contributed to the epidemic.A lot of what I read and believed about opioids early on in my career was wrong.I ’m old enough to remember those heady days in which there was a pretty large and ‘successful’ movement in American medicine to gr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Clinical reasoning is a cornerstone of evidence-based healthcare, in fact some would argue it’s the cornerstone of all healthcare. While there are many different processes, the ultimate purpose of clinical reasoning is to ensure the person seeking help has their needs identified then met, and the clinician has a basis upon which to decide which treatment they should offer. The approach we use in clinical reasoning, including the information we prioritise and search for, and the way we synthesise the information to make sense of it will depend on the model we have to explain our treatment approach. For example, if...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice embodiment intersubjectivity making sense persistent pain Source Type: blogs
This article, however, is more of a commentary on high level strategy and the effects of regulation, coupled with a desire to forge ahead rather than hold back in the matter of treating aging, thus I concur with much more of what is said than is usually the case. For decades, one of the most debated questions in gerontology was whether aging is a disease or the norm. At present, excellent reasoning suggests aging should be defined as a disease - indeed, aging has been referred to as "normal disease." Aging is the sum of all age-related diseases and this sum is the best biomarker of aging. Aging and its d...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
For over 20 years, Linda Buonanno lived in fear that her irritable bowel syndrome (IBS) would suddenly interrupt her daily routine with frequent trips to the bathroom and unbearable cramping. Buonanno, now a 71-year-old medical assistant and hairdresser from Methuen, Mass., tried everything from drugs to dairy-free diets. Nothing worked. She remembers a particularly tough period over 10 years ago, when she was working on the factory floor of a medical-device company for up to 10 hours a day, six days a week. When an IBS episode would strike, her co-workers would cover for her as she huddled in a corner, keeled over in pain...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized medicine Research Source Type: news
In this study, the “tailored” group underwent seven days of monitoring using an accelerometer, the results were downloaded, analysed and an individualised pacing plan developed by the therapists. The plan was intended to highlight times when the person had high or low levels of activity (as compared with their own average, and averages drawn from previous studies of people with the same diagnosis), and to point out associations between these activity levels and self reported symptoms. Participants were then provided with ideas for changing their activity levels to optimise their ability to sustain activity and ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: 'Pacing' or Quota Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Pain conditions Research function Motivation pain management self management Therapeutic approaches values Source Type: blogs
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In this study, researchers put some numbers to the correlation, and improve on previous attempts to rule out wealth and other effects as significant contributing causes. A study finds that a Chinese policy is unintentionally causing people in northern China to live 3.1 years less than people in the south, due to air pollution concentrations that are 46 percent higher. These findings imply that every additional 10 micrograms per cubic meter of particulate matter pollution reduces life expectancy by 0.6 years. The elevated mortality is entirely due to an increase in cardiorespiratory deaths, indicating that air poll...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study didn't measure whether receiving the cardiosphere-derived cells extended lifespans, so we have a lot more work to do. We have much to study, including whether CDCs need to come from a young donor to have the same rejuvenating effects and whether the extracellular vesicles are able to reproduce all the rejuvenating effects we detect with CDCs." Cardiac and systemic rejuvenation after cardiosphere-derived cell therapy in senescent rats Cardiosphere-derived cell (CDC) therapy has exhibited several favourable effects on heart structure and function in humans and in preclinical models; however,...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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