Chronic pain management

The term osteomyelitis encompasses a broad group of infectious diseases characterized by infection of the bone and/or bone marrow. The pathogenesis of these diseases can follow acute, subacute or chronic courses and involves a range of contributory host and pathogen factors. A commonly used aetiological classification distinguishes between three types of osteomyelitis: acute or chronic haematogenous disease seeded by organisms in the bloodstream, local spread from a contiguous source of infection and secondary osteomyelitis related to vascular insufficiency. ...

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Antidepressant Medications The tricyclic antidepressants [amitriptyline, imipramine, nortriptyline, desipramine (TCAs; Table 12-1)] are extremely useful for the management of patients with chronic pain. Although developed for the treatment of depression, the tricyclics have a spectrum of dose-related biologic activities that include the production of analgesia in a variety of clinical conditions. Although the mechanism is unknown, the analgesic effect of TCAs has a more rapid onset and occurs at a lower dose than is typically required for the treatment of depression.

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Opioid and COX Inhibitor Combinations When used in combination, opioids and COX inhibitors have additive effects. Because a lower dose of each can be used to achieve the same degree of pain relief, and their side effects are nonadditive, such combinations can be used to lower the severity of dose-related side effects. Fixed-ratio combinations of an opioid with acetaminophen carry a special risk. Dose escalation as a result of increased severity of pain or decreased opioid effect as a result of tolerance may lead to levels of acetaminophen that are toxic to the liver.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: DREAM is reduced in synovial fibroblasts of patients with chronic arthritic pain: is it a suitable target for peripheral pain management?

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Influence of an outpatient multidisciplinary pain management program on the health-related quality of life and the physical fitness of chronic pain patients

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Antidepressants, anticonvulsants, and antiarrhythmics have not been approved by the U.S. Food and Drug Administration (FDA) for the treatment of pain.bGabapentin in doses up to 1800 mg/d is FDA approved for postherpetic neuralgia.Note: 5-HT, serotonin; NE, norepinephrine.Since they are effective for these common types of pain and are available without prescription, COX inhibitors are by far the most commonly used analgesics. They are absorbed well from the gastrointestinal tract and, with occasional use, have only minimal side effects.

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Acute Pelvic Pain: Treatment Treatment of acute pelvic pain depends on the suspected etiology but may require surgical or gynecologic intervention. Conservative management is an important consideration for ovarian cysts, if torsion is not suspected, to avoid unnecessary pelvic surgery and the subsequent risk of infertility due to adhesions. The majority of unruptured ectopic pregnancies are now treated with methotrexate, which is effective in 84–96% of cases. However, surgical treatment may be required.

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Drinking no more than two standard drinks, defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80 proof liquor [26] in 24 hours to a maximum of 14 drinks per week for men and nine drinks per week for women, has been termed “low-risk.” However, this recommendation can vary in the context of patients’ other coexisting medical conditions such as with the use of pre- scription drugs including “pain killers” [26].

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This book is the end result of many influences, all of which have contributed to its final shape. We would like to thank all those people who have contributed to the development and formation of the ideas behind this book. This is a long list. In recent years it includes our students and colleagues at the University of Glamorgan. Prior to this our many colleagues in our own clinical practices who we have worked with and our past teachers and mentors who moulded our ideas about working with people.

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Management of acute pain, especially post-operative pain, in patients on high dose opioids is a challenge that requires in-depth knowledge of pharmacokinetics and the formulation of a careful management plan to avoid withdrawal symptoms and inadequate pain management. • Chronic pain after cancer surgery may occur in up to 50% of patients. Risk factors for the development of chronic pain after breast cancer surgery include: young age, chemo and radiotherapy, poor post-operative pain control and certain surgical factors.

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Emerging research is helping to place pain and addictive disorders on a continuum rather than on the traditional dichotomy of recent years [12–15]. It is clear to a growing number of clinicians that pain patients can, and sometimes do have concur- rent addictive disorders that decidedly complicate the management of an already challenging patient population [16–19]. It is possible for pain and addiction to exist as comorbid conditions such as the case of the alcoholic with peripheral neuro- pathic pain.

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Overall, this review provides a glimpse of the ayurvedic approach to cancer diagnosis and treatment. This review also attempts to reveal how these approaches can be employed in today’s world. Cancers of the colon, lung, breast, and prostate are most prevalent in the Western world. The mortality and morbidity in India owing to all of these cancers is very low. For example, the incidence of prostate cancer is 50-fold less in India compared with the United States.

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The heightened interest in pain management is making the need for appropriate boundary setting within the clinician–patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of pre- scription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the “at-risk” individuals from an infectious disease model.

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Góp Phần Trị Đau Nhức Kinh Niên Để góp phần với Ds Lê văn Nhân bàn luận về Điều Trị Đau Nhức Thần Kinh ở Bệnh Nhân Tiểu Đường trong Mục Dược Phẩm, và Bs Trịnh Cường cùng Ds Trịnh Nguyễn Đàm Giang với đề tài: Một Chút Hiểu Biết về Đau Nhức và Trị Liệu, trong Mục Y Khoa Thực Hành, chúng tôi xin thêm vài ý kiến bài viết trong tường trình Trị Đau Nhức Kinh Niên (Multidiciplinay Approach to the Management of Chronic Pain), của Bs Lisa J.

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Only one randomized trial, the Multicenter Study of Hydroxyurea for Sickle Cell Anemia (MSH Study), tested the efficacy of hydroxyurea in adults with sickle cell anemia, with six additional analyses either based on this trial or on followup studies. The significant hematological effects of hydroxyurea after 2 years (as compared to the placebo arm) included a small mean increase of 0.6 g/dl in total hemoglobin and a moderate absolute increase in fetal hemoglobin of 3.2 percent.

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We identified three studies that tested interventions to improve patient adherence to established therapies for chronic disease management, but none of these three showed any effect on patient adherence. However, given the small sample sizes and the studies’ diverse outcome measures, we concluded that there was only low-grade evidence that interventions did not improve patient adherence.

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Since the last issue on temporomandibular (TMD) disorders and orofacial pain presented in the Dental Clinics of North America (April 1997), there has been an explosion of scientific, technologic, and procedural advances in this complex field. The amalgamation of the science with the art of dentistry has resulted from an enhanced appreciation for and the ability to provide evidence-based diagnosis and care. Pain and compromised function are the most common reasons for which people seek health care.

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Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Evaluation of Lumbar Facet Joint Nerve Blocks in Managing Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial with a 2-Year Follow-Up...

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Are chronic low back pain outcomes improved with co-management of concurrent depression?

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In the treatment of bone pain, the second step on the WHO analgesic ladder is commonly unhelpful, with inadequate pain relief or the development of undesirable/intolerable side-effects (Eisenberg, 2005). There is currently no place for interventional treatment on the ladder and the earlier recommendations of a fourth step of interventional management are not applied widely enough. The main principles of pain management, including the use of a biopsychosocial approach, should be applied, rather than simply following the WHO ladder.

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