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Cases: Use of Steroids as Adjuvants for Pain Management
Conclusion:Although there is no definitive, absolute proof that use of dexamethasone as an adjuvant agent for symptom management does not confer a potential increased risk of infection, we do have literature indicating that steroids are used to help manage and treat certain infections, and that there has not been evidence of increased new infections when used in a single dose post-operatively. The clinical take away here is that it okay to consider the use of a steroid, especially in a low dose for a short period of time, in managing pain of an inflammatory etiology (such as pleurisy), and when compared to the potential ri...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 31, 2016 Category: Palliative Care Tags: cancer hematology opioids pain riegel steroids Source Type: blogs

Encouraging Integrative, Non-opioid Approaches To Pain: A Policy Agenda
The United States is struggling to deal with an opioid epidemic that is damaging lives, resulting in overdoses, and yet not reducing chronic pain. National initiatives are underway to dramatically reduce access to prescription opioids, but these efforts lack a systematic approach to provide alternative treatments for these patients. Policy changes are urgently needed to provide better care for patients with chronic pain, and in this post, we outline three feasible policy initiatives. Innovative reimbursement initiatives by the Centers for Medicare and Medicaid Services (CMS) could frame and stimulate use of evidence-based ...
Source: Health Affairs Blog - October 4, 2016 Category: Health Management Authors: Jason Doctor, Penny Cowan, Daniella Meeker, Patricia Bruckenthal and Joan Broderick Tags: Drugs and Medical Technology Health Professionals Public Health Quality chronic pain Opioid Addiction opioids Source Type: blogs

Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider
Never heard of kratom? The media has been so focused on the ongoing opioid epidemic that it’s easy to miss a less frequently used or abused substance, like kratom. But a movement to ban or restrict the sale of kratom in cafes, at head shops and on the internet is gaining momentum across the country and states are taking legal action to curtail the public’s use of this drug. So what exactly is kratom, and why are people divided about its use? Common in the United States for almost ten years before catching the attention of the federal government, kratom is a plant grown in Southeast Asia and cultivated as a kin...
Source: Cliffside Malibu - September 21, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health drug addiction drug treatment center Source Type: blogs

Fight Aging! Newsletter, September 19th 2016
In conclusion, we found that IS status was associated with a significant increase in Hannum DNA methylation, likely as a consequence of the accumulation of cardiovascular risk factors, and near signification with Horvath method. Patients with IS were biologically older than controls, a difference that was more obvious in young stroke. This could open up the possibility of useful new biomarker of stroke risk. Latest Headlines from Fight Aging! A Profile of Kelsey Moody and Ichor Therapeutics https://www.fightaging.org/archives/2016/09/a-profile-of-kelsey-moody
Source: Fight Aging! - September 18, 2016 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

The Inevitability of the Transhumanist Vision
The article I'll point out today opens by distinguishing capitalized Transhumanism from lower case transhumanism. These are visions of the future grown in that fertile square of ground whose corners are marked by contemporary science fiction, the cutting edge of engineering, the cutting edge of science, and the entrepreneurial community. The real entrepreneurial community, I mean, the people who quietly get things done, not the loud internet-focused groups that you tend to read about in the media. Transhumanism with a small t is a simple description of what we will achieve with technology: we will transform ourselves and s...
Source: Fight Aging! - September 14, 2016 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs

What Makes Up High-Quality Primary Palliative Care in Oncology?
by Ross AlbertI ' m surprised that I ’m not hearing more about the recent ‘Guidance Statement ’ put out by the collaboration of ASCO and AAHPM on “Defining High-Quality Palliative Care in Oncology Practice.” (OPEN ACCESS PDF) It ’s a report that provides some very interesting insight into what pieces of primary palliative care should be part of general medical oncologists’ practice.When I read it the report, I was pleased to see that it waspublished in ASCO ’s journal, and I noted the impressive list of authors. My eyes briefly glazed over as the discussion moved to Delphi methodology, but a few quick ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 7, 2016 Category: Palliative Care Tags: AAHPM ASCO breast cancer colorectal cancer lung cancer oncology Source Type: blogs

The Top Five Recommendations For Improving the Patient Experience
By KATHLEEN MERKLEY and ANNE MARIE-BERKMORE Healthcare organizations are working diligently to improve patient satisfaction and the patient experience of care. After all, patient experience of care is a critical quality domain used to evaluate hospital performance under the 2016 CMS Hospital Value-Based Purchasing (VBP) Program (accounts for 25 percent of a hospital’s VBP score)—and comes with the potential for a penalty or bonus. Patient experience of care is also one of three essential dimensions of the industry-guiding IHI Triple Aim (a framework for optimizing health system performance): Improving the patient ...
Source: The Health Care Blog - September 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Health Analytics Summit HealthCatalyst Patient Experience Source Type: blogs

Fight Aging! Newsletter, September 5th 2016
This study is a good example of the degree to which the choice to remain active in later life makes a difference. That implies a range of other choices over the decades in order to raise the odds that you can in fact choose to remain active when older, such as avoiding weight gain. Moderate physical activity is associated with a greater than 50% reduction in cardiovascular death in over-65s. The 12 year study in nearly 2500 adults aged 65 to 74 years found that moderate physical activity reduced the risk of an acute cardiovascular event by more than 30%. High levels of physical activity led to greater risk reducti...
Source: Fight Aging! - September 4, 2016 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

My Achy, Achy Back
My back has been very uncooperative recently. Actually its been a real pain, or in a lot of pain. I went to my pain management doctor a while back and he said that my back has been so bad because I haven ' t had any interventional treatments (a/k/a needles in my back) in a while and its time for another one. That is due for this Thursday.But in the meantime, my back is giving me lots of grief (to put it nicely). Yesterday and Friday I was walking around hunched over in pain most of the time. My husband even cooked dinner because I was in so much pain.Last night, I got in bed before 8 PM and took a breakthrough pain pill, a...
Source: Caroline's Breast Cancer Blog - September 4, 2016 Category: Cancer & Oncology Tags: back pain medical adventures needles Source Type: blogs

How the Role of Doctors is Changing in the Wake of the Opioid Abuse Epidemic
Pushed and pulled by many competing interests, doctors are ultimately and unfortunately an important gateway to opioid-based prescriptions – and their abuse. Although providing medication to patients they see is a key part of their job, at this point an opioid-based prescription to relieve pain could cause suffering through its abuse or ease the physical suffering of chronic pain; knowing the outcome isn’t always certain. Doctors will likely always be willing to provide prescription opioids to some of their patients, and that is appropriate, but as an epidemic of prescription opioid abuse rips across the country, phys...
Source: Cliffside Malibu - August 31, 2016 Category: Addiction Authors: sheilas Tags: Richard Taite Source Type: blogs

Can we break the cycle of chronic pain in patients following orthopedic injury?
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. “You are the only one who truly understands your own pain.” As one trauma survivor from the University of Maryland Shock Trauma Center in Baltimore told us: “The pain is with you 24/7. It is nonstop. And that is the hard part, you cannot escape it.” Pain is classified into two general categories: acute and chronic. While acute pain is sudden in onset and relatively short-lived, chronic pain is usually defined as pain that lasts longer than three months. Both types of pain can affect a person physically and emotionally. ...
Source: Kevin, M.D. - Medical Weblog - August 30, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/melissa-yu-and-maureen-mccunn" rel="tag" > Melissa Yu and Maureen McCunn, MD < /a > Tags: Conditions Orthopedics Pain management Source Type: blogs

Building Resilience in Clinicians to Prevent Burnout
by Arif KamalOn the topic of palliative care clinician wellness, we are starting to recognize that there is some good news to counter all the bad. First, the bad news. If you ’re reading this, and you believe that burnout has not touched your professional life, then it is likely that the colleagues sitting to the immediate left and right of you are not so lucky. Recent survey data of over 1300 palliative care clinicians highlight a sobering statistic: almost two-thir ds of our colleagues report burnout (Kamal JPSM 2016). This is among the highest rate of all medical disciplines, and significantly higher than the 45% aver...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 23, 2016 Category: Palliative Care Tags: burnout kamal The profession Source Type: blogs

Finding Pain Relief When There ’ s Potential for Addiction
I am a woman with a family history of addiction who is also in chronic pain. What if someday I need opioids to manage that pain? First, two discs in my lower spine degenerated. Then, they herniated, both bulging out and impinging nerves, inciting an excruciating, sciatica-like pain that affected me around the clock. More than a year since my discs were damaged, pain has become my daily reality. I wake up stiff and sore as though I’ve just been hit by a car (having been hit by a car as a kid, I actually know what that feels like). The only thing I struggle with as much as the pain itself is finding the best way to treat i...
Source: World of Psychology - August 14, 2016 Category: Psychiatry & Psychology Authors: Psych Central Staff Tags: Addiction Health-related Personal Publishers The Fix Chronic Pain Drug Addiction drug counseling Epidemic Family History Laura Kiesel Medication Methadone opiods opioid addiction overdoses Pain Relief prescription drug ab Source Type: blogs

The dilemmas faced by the chronically ill
After more than fifteen years of being mostly housebound by chronic illness (which includes chronic pain), here are a few of the dilemmas I’ve faced over and over. I’m confident that I’m not alone in my “should I/shouldn’t I?” world. Do I accept an invitation from a friend to get together or do I refuse it? If I refuse the invitation, depending on who issued it, it may be the last one I’ll receive from this person. In addition, if I refuse, I’ll feel even more isolated from in-person contact than I already do. If I accept the invitation, I might be too sick to visit when the day arrives. I don’t want to d...
Source: Kevin, M.D. - Medical Weblog - August 8, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/toni-bernhard" rel="tag" > Toni Bernhard, JD < /a > Tags: Patient Pain management Patients Source Type: blogs

I Just Want Some Sleep
I keep getting these awful muscle cramps. They have gotten more and more prevalent over the past few months. Sometimes the little tiny muscles on the side of my pinky finger start to go into spasm.... they may be tiny but they can cause a lot of pain. Other times its my hamstrings - both at once (just for added fun), or the front of my calf, or the bottom of my heel. Whenever it is, I stop doing whatever it was I was doing (sleeping, reading, walking, etc) and be in pain until it decides to loosen up. I often try moving around and a little massage. Sometimes I am still achy wherever it hurt for a while longer.I asked my pa...
Source: Caroline's Breast Cancer Blog - August 6, 2016 Category: Cancer & Oncology Tags: aggravation lack of sleep pain Source Type: blogs