Long-term use of opioids may depend on the doctor who prescribes them
You may have heard of the phrase “primum non nocere” — the Latin phrase that doctors are supposed to follow that instructs them to “first, do no harm.” Doctors also have an important ethical obligation to alleviate pain. But what happens when these two mandates collide? That, unfortunately, is the case with opioid pain relievers: powerful medicines like oxycodone, hydrocodone, and hydromorphone. These medications are potent pain relievers, but this relief comes at a serious, and sometimes deadly, cost.
The United States is now in the era of an “opioid epidemic” in which deaths from opi...
Source: Harvard Health Blog - March 27, 2017 Category: Consumer Health News Authors: Scott Weiner, M.D. Tags: Addiction Drugs and Supplements Pain Management Source Type: blogs
21st Century Scourge
The CDC recently put out apaperin their Morbidity and Mortality Weekly Report (MMWR) that studied the likelihood of long term opiate use after initial treatment with an opioid medication for acute pain. The results, for me as a regular prescriber of opioid medications, were fairly shocking. The study randomly reviewed 10% of patient records from the Lifelink database over the time period of 2006-2015. If a patient was given a prescription for an opioid for longer than 10 days, there was a 1 in 5 chance that patient would be a regular opiate user one year later. That's just staggering.Few are unaware of ...
Source: Buckeye Surgeon - March 25, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Some medications don ’ t help back pain as much as we thought
This study found that NSAIDs don’t work as well for back pain as many people think. However, it is not true (as stated by some headlines about this study) that NSAIDs were not effective at all. Some people did improve with these medications. The trick is figuring out in advance who is most likely to get better with NSAID therapy. We can’t yet do that very well.
Here’s my suggestion: if you take an NSAID for spinal pain (or just about any other pain), keep track of how you’re feeling. A “pain diary” is one way to do this. If you aren’t clearly better in a week or two, talk to your doctor about adjusting the do...
Source: Harvard Health Blog - March 2, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Back Pain Drugs and Supplements Pain Management Source Type: blogs
A Rare Intervention for an Unusual Exposure
Children like to put things in their mouth, ears, nose, and eyes. A 9-year-old boy superglued his right eye shut and came to our pediatric emergency department. He thought the glue was an over-the-counter eye lubricant and filled his entire eye with the glue.Overdoses and poisonings are a dangerous threat to children. In fact, unintentional poison overdose or ingestion has continued to claim hundreds of children's lives. More than 300 children in the United States ages 0 to 19 are seen at EDs for poisoning and two of them die each year. (CDC. April 28, 2016; http://bit.ly/2kjVmhO.)Not all toxic exposures are i...
Source: The Procedural Pause - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Rare Intervention for an Unusual Exposure
Children like to put things in their mouth, ears, nose, and eyes. A 9-year-old boy superglued his right eye shut and came to our pediatric emergency department. He thought the glue was an over-the-counter eye lubricant and filled his entire eye with the glue.Overdoses and poisonings are a dangerous threat to children. In fact, unintentional poison overdose or ingestion has continued to claim hundreds of children's lives. More than 300 children in the United States ages 0 to 19 are seen at EDs for poisoning and two of them die each day. (CDC. April 28, 2016;
http://bit.ly/2kjVmhO.)Not all toxic exposures a...
Source: The Procedural Pause - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Nobody wants the flu. But what happens if you get it and you ’ re pregnant?
First…
It’s strongly recommended that pregnant women get the flu shot. The flu vaccine is safe throughout pregnancy and is the first step to protecting you and your baby from it.
Of course even if you get the vaccine it is still possible to get the flu so make sure to get plenty of rest and use your frequent trips to the bathroom to wash your hands often throughout the day.
Second…
If you think you have the flu contact your doctor right away. Most healthy adults with the flu become mildly ill, and start to feel better in 7 to 10 days. However, if you catch the flu early, your doctor can prescribe an an...
Source: Cord Blood News - February 15, 2017 Category: Perinatology & Neonatology Authors: Maze Cord Blood Tags: babies pregnancy flu pregnancy health Source Type: blogs
The 4 symptoms that mean your child must stay home from school or daycare
Follow me on Twitter @drClaire
It’s a decision every parent faces regularly: whether or not to keep a sick child home from school.
It would seem like a simple decision. If your child is sick, of course they shouldn’t go to school or daycare. But besides the fact that it’s not practical to keep a child home for every sniffle, keeping a child home can be a real hardship for working parents — and it means that a child is missing out on learning and other activities. So it’s a decision that should be made as wisely as possible.
Sometimes the decision is clear. Your kid looks awful and you can’t imagine sitting them...
Source: Harvard Health Blog - February 7, 2017 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Children's Health Infectious diseases Parenting Source Type: blogs
How much does it hurt? | Mosaic
One night in May, my wife sat up in bed and said, " I ' ve got this awful pain just here. " She prodded her abdomen and made a face. " It feels like something ' s really wrong. " Woozily noting that it was 2am, I asked what kind of pain it was. " Like something ' s biting into me and won ' t stop, " she said." Hold on, " I said blearily, " help is at hand. " I brought her a couple of ibuprofen with some water, which she downed, clutching my hand and waiting for the ache to subside.An hour later, she was sitting up in bed again, in real distress. " It ' s worse now, " she said, " really nasty. Can you phone the doctor? " Mi...
Source: Psychology of Pain - January 11, 2017 Category: Anesthesiology Source Type: blogs
Is aspirin a wonder drug?
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Imagine that after years of painstaking research, scientists announced the development of a breakthrough treatment that costs pennies a pill, saves lives, and could reduce healthcare spending by nearly $700 billion in the coming years. And you wouldn’t even need a prescription to get it. Perhaps this all sounds too good to be true. But, according to a new study, we already have such a drug: it’s called aspirin.
An analysis of aspirin use
Based on current recommendations, only about 40% of people who should be taking aspirin are doing so. In this new report, researchers asked: what mig...
Source: Harvard Health Blog - December 22, 2016 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Health Managing your health care Prevention Source Type: blogs
Be prepared mentally, physically, and socially for residency
Nothing compares to the apprehension of starting residency.
OK, that’s not true, but it’s really high up there on nerve-wracking firsts.
I remember my first day as a resident. In a matter of a few hours, I went from being human furniture to being asked to make life-altering decisions. I was overwhelmed, to say the least. Here are some pieces of advice that I wish senior residents would have emphasized before I started this journey.
Be prepared: Mentally
This should be obvious to any person with a type A personality (i.e., most physicians). Nevertheless, it’s vital to have the tools of the trade before you start see...
Source: Kevin, M.D. - Medical Weblog - December 15, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/nora-ekeanya" rel="tag" > Nora Ekeanya, DO < /a > Tags: Education Hospital Residency Source Type: blogs
Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective
This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included.
Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them.
Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case.
While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of celec...
Source: Harvard Health Blog - November 23, 2016 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Arthritis Drugs and Supplements Health Heart Health Pain Management Source Type: blogs
Drug for PDA closure in newborn – Cardiology MCQ
Which of the following is not meant for closure of patent ductus arteriosus in a newborn baby?
a) Paracetamol
b) Prostaglandin E1
c) Ibuprofen
d) Indomethacin
Correct answer: b) Prostaglandin E1
Prostaglandin E1 is used for maintaining ductal patency in ductus dependent circulations [1]. Both oral [2] and intravenous paracetamol [3] have been used for pharmacological closure of patent ductus arteriosus in new borns. Indomethacin was the earlier drug being used for pharmacological ductal closure, but seldom used now because of its adverse effect. Then came ibuprofen, which is still being used. Paracetamol is the lates...
Source: Cardiophile MD - November 22, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Trying My Best
In thinking back to that first Vraylar dosage, I do not think I considered everything that happened after I took it.I remember *perhaps* feeling quite relaxed after I took it, but I had a nagging headache, a different kind of headache than one of my thousand types of " regular " headaches I get daily it seems. I was actually so relaxed and a bit sleepy that I had laid in bed.I am not exactly sure how long that lasted, but I do remember thinking I would feel better if that headache went away. I had tried everything, as I usually do. The regulars - Advil, Naproxen and Excedrin Migraine and had waited. Not...
Source: bipolar.and.me - November 20, 2016 Category: Psychiatry Source Type: blogs
Research and Reviews in the Fastlane 160
Welcome to the 160th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - November 16, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Emergency Medicine Intensive Care R&R in the FASTLANE Resuscitation EBM Education literature recommendations research and reviews Source Type: blogs
Parents: How smart are you about antibiotics?
Follow me on Twitter @drClaire
It’s National Get Smart about Antibiotics week, an annual effort by the Centers for Disease Control and Prevention (CDC) to help make sure that we use antibiotics wisely.
Out of all the visits children make to health care providers, 1 in 5 result in a prescription for antibiotics. That’s about 50 million prescriptions a year. But here’s the worrisome part: 10 million of those prescriptions are for respiratory illnesses that antibiotics aren’t likely to help. Basically, 1 in 5 of those 50 million prescriptions shouldn’t have been written in the first place.
This is a real problem. An...
Source: Harvard Health Blog - November 15, 2016 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Children's Health Infectious diseases Pets Source Type: blogs
