Most visited page on Sciencebase.com
So…that time of year…what was the most visited page on Sciencebase.com? As if you care…
Well, of the 800,000 total visits to the site in 2017 (so far, at one time the site used to get almost that many visits every month!), served 4.4 million pages, the most visited was an article asking whether great tit beaks are getting longer! A piece showcasing my photos of three grey herons did well too, as did a post about the wren. The story of Grace Darling in October, 175 years after her death was popular, just beating an explanation as to why the sun over the UK went red in the autumn. My music promo page droppe...
Source: David Bradley Sciencebase - Songs, Snaps, Science - December 22, 2017 Category: Science Authors: David Bradley Tags: Science Source Type: blogs
New painkillers could thwart opioids ’ fatal flaw | Science | AAAS
When people die from overdoses of opioids, whether prescription pain medications or street drugs, it is the suppression of breathing that almost always kills them. The drugs act on neuronal receptors to dull pain, but those in the brain stem also control breathing. When activated, they can signal respiration to slow, and then stop. The results are well-known: an epidemic of deaths —about 64,000 people in the United States alone last year.Countering this lethal side effect without losing opioids' potent pain relief is a challenge that has enticed drug developers for years. Now, for the first time, the U.S. Food and Dr...
Source: Psychology of Pain - November 17, 2017 Category: Anesthesiology Source Type: blogs
Here ’s what death really sounds like
7 a.m. began as it always did; the overnight doc was threatening to quit while rubbing her bloodshot eyes and smearing mascara beneath them. Between heavy sighs, she listed the patients transferring into my care ending with Mr. Mandel.
“He’s eighty-something,” she explained, “hospice care. Cancer with metastases. Came in from home because family ran out of morphine and he was in a lot of pain. Anyway, he’s actively dying now, so they don’t really want to put him back in the car and drive him home.” With that, she shoved a handful of dry cereal in her mouth and shuffled out.
I hung my stethoscope over one shou...
Source: Kevin, M.D. - Medical Weblog - November 6, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/molly-m-murray" rel="tag" > Molly M. Murray, PA-C < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs
The Modern-Day Plague
Part 1 in a Four-part SeriesA 32-year-old man was taken to the ED by EMS after being found unresponsive in a subway station. His pupils were pinpoint, and he was breathing at fourth breaths per minute. He had a blood pressure of 94/63 mm Hg, pulse oximetry of 91% on room air, and a heart rate of 51 beats per minute. He was given 2 mg of intranasal Narcan by EMS and became more responsive, breathing at 14 breaths per minute with a blood pressure of 125/82 mm Hg, heart rate of 74 bpm, and 98% on room air. He admitted in the ED to using three bags of heroin.The opioid epidemic is a national public health crisis in the U...
Source: The Tox Cave - November 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Why opioids are such an American problem - BBC News
For every one million Americans, almost 50,000 doses of opioids are taken every day. That's four times the rate in the UK.There are often good reasons for taking opioids. Cancer patients use them for pain relief, as do patients recovering from surgery (codeine and morphine are opioids, for example).But take too many and you have a problem. And America certainly has a problem.More ...http://www.bbc.com/news/world-us-canada-41701718 (Source: Psychology of Pain)
Source: Psychology of Pain - October 29, 2017 Category: Anesthesiology Source Type: blogs
Be Prepared and End-Of-Life Conversations Needn't Be Horrible
Sex and death. It's odd that those two topics should bring so much anxiety to parents and children. But, there you have it. One – sex – is about the beginning of life. The other – death – is about the end. Both are a part of the lifecycle, but if anything, sex is easier for many to discuss than death. I've found in my experience that it isn't always the elders who shy away from end-of-life talks. Some do, of course, but many would like to discuss the arrangements they've made for finances, as well as their opinions about what measures they would want to be taken if they needed someone to make their deci...
Source: Minding Our Elders - October 27, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
If Someone Is Going To Be In Hospice At Home, Will Hospice Give The Oral Morphine To Anyone To Administer?
Originally asked by HealthCentral Community Member Z…T.
If Someone Is Going To Be In Hospice At Home, Will Hospice Give The Oral Morphine To Anyone To Administer? Does Hospice Ask A Person Who Volunteers To Be A Caregiver If He Has A Criminal/drug Past?
If hospice is supposed to be an advocate for the patient first, shouldn’t hospice vet the caregiver before giving him/her morphine to give to the patient? If hospice has no responsibility in making sure the volunteer caregiver is someone who won’t abuse the position, how can an elderly, frail patient be protected? I guess I need to know - if hospice doesn’t vet the ...
Source: Minding Our Elders - October 25, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
Fentanyl reduces effectiveness of ticagrelor for PCI – PACIFY RCT
Fentanyl is an opioid which is routinely used for periprocedural relief of during percutaneous coronary intervention (PCI). Intravenous morphine has been shown to reduce the absorption of P2Y12 inhibitors, presumably by delaying gastric emptying [1]. Platelet Aggregation with tiCagrelor Inhibition and FentanYl
(PACIFY) trial [2] evaluated the effect of intravenous fentanyl on the efficacy of ticagrelor. Ticagrelor plasma levels, platelet function and troponin levels were compared in a randomized trial with and without the use of fentanyl. There were 70 patients in this study who required PCI. Fentanyl arm had lower ticagr...
Source: Cardiophile MD - October 20, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Gluten, Depression, and Anxiety: The Gut-Brain Link
In this study, 22 participants ate a gluten-free diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) for a three-day baseline period, and then received one of three dietary challenges (supplemented with gluten, whey, or placebo) for three days, followed by a three-day minimum washout period before starting the next diet.
Researchers assessed the participants at the end of the study using a psychological tool called the Spielberger State-Trait Personality Inventory (STPI). People in the study who consumed gluten had higher overall STPI depression scores compared to those on th...
Source: World of Psychology - October 20, 2017 Category: Psychiatry & Psychology Authors: Therese J. Borchard Tags: Alternative and Nutritional Supplements Anxiety and Panic Depression Health-related Mental Health and Wellness Research brain-gut connection celiac disease Gluten Gluten sensitivity Schizophrenia Source Type: blogs
Why do we keep prescribing heroin for our patients?
In order to fully understand the issues surrounding opioid prescribing practices, it is important to review a brief history of how these drugs came to market.
Opium was the first opioid, derived from the sap of opium poppies whose growth and cultivation dates back to 3,400 BC. In the 18th century, physicians in the U.S. used opium for multiple ailments. Towards the end of the 18th century, the addictive qualities of opium became apparent as well as the need for an alternative to opium.
In 1805, morphine and codeine were isolated from opium, and morphine was subsequently touted as a cure for opium addiction. Morphine’s us...
Source: Kevin, M.D. - Medical Weblog - September 27, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/myles-gart" rel="tag" > Myles Gart, MD < /a > Tags: Meds Emergency Medicine Pain Management Primary Care Source Type: blogs
The Latest Jaw-Dropping Numbers From the Opioid Crisis – Mother Jones
About 64,000 Americans died from drug overdoses last year —a staggering 21 percent increase from the 52,404 in 2015—according to the first government estimate of drug deaths in 2016. Overdoses now kill more Americans than HIV did at its peak in 1995, and far more than guns or cars do today.The numbers, released by the Centers for Disease Control and Prevention, are provisional and will be updated monthly, according to the agency.Fueling the rise in deaths is fentanyl, a synthetic opioid up to 100 times more potent than morphine, and fentanyl analogs, or slight tweaks on the fentanyl molecule. This has not always been t...
Source: Psychology of Pain - September 26, 2017 Category: Anesthesiology Source Type: blogs
Pharmacy Benefit Management Of Opioid Prescribing: The Role Of Employers And Insurers
In the last two decades, prescribing rates for opioids have increased nearly three-fold, from 76 million prescriptions in 1991 to approximately 207 million prescriptions in 2013. This remarkable volume of opioid prescribing is unique to the United States, where 2015 prescribing amounts were nearly four times those in Europe. Sadly, this much more frequent prescribing of addictive medications is connected to an epidemic of deaths related to abuse of opiates and other drugs of abuse. Drug overdose deaths are now considered a national emergency, topping 59,000 in 2016. The abuse of opioids can be seen as the leading...
Source: Health Affairs Blog - September 21, 2017 Category: Health Management Authors: Troyen Brennan, Richard Creager and Jennifer M. Polinski Tags: Costs and Spending Insurance and Coverage Organization and Delivery Payment Policy opiods PBMs Source Type: blogs
An August Appendectomy
In August, (one month ago today)I had an appendectomy. There was very little drama involved, the doctors office visit led straight to a same day CT scan and an emergency review with the radiologist who informed me the appendix couldn ' t be seen but the colon was most definitely inflamed and I should go to the ER if it got worse. To the ER I went that night, to a hospital where the D Care is very good (had that going for it). They admitted me under observation, coursing enough pain medications through me to make me sick for the next 14 hours. The plan was to do another CT the next day. In observation, as I was trying not t...
Source: The D-Log Cabin - September 20, 2017 Category: Endocrinology Authors: HVS Source Type: blogs
The Case For Confronting Long-Term Opioid Use As A Hospital-Acquired Condition
The first principle of medicine is to “do no harm.” Over the past two decades, the medical community has attempted to honor this principle by treating patient pain with opioid prescriptions. Unfortunately, these good intentions have driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States.
Inpatient overprescription of opioids such as morphine, oxycodone, and hydrocodone happens in a variety of ways—doctors prescribe too many doses, too large a dose, or allow patients to continue opioid treatment for too long. And many times, doctors could avoid opi...
Source: Health Affairs Blog - September 8, 2017 Category: Health Management Authors: Michael Schlosser, Ravi Chari and Jonathan Perlin Tags: Featured Health Professionals Hospitals Population Health hospital-acquired condition opioid epidemic overprescribing opioids pain management Source Type: blogs
