�Opioid medications are essential for helping to lighten all types of serious pain. However, relatively recent evidence suggests that in some patients they rump paradoxically exasperate the annoyance.
"Actually, this possible negative effect of opioids, such as morphine, to reason increased sensitivity to hurting was observed in the 19th Century," says Peggy Compton, RN, PhD. "Today, we call this opioid-induced hyperalgesia, or OIH."
Compton is an Associate Professor of Nursing at the UCLA School of Nursing, Los Angeles, and a well-known researcher and writer in the pain direction field. Her extensive critical review of the clinical grounds on OIH, exclusively for Pain Treatment Topics and published at the Pain-Topics.org website, is titled "The OIH Paradox: Can Opioids Make Pain Worse?"
The full text file can be accessed 'here.
Fortunately, it seems that OIH does non arise in the majority of patients taking opioid analgesics, just when it does occur it can be difficult to wangle. In addition to OIH, pain increasing during opioid therapy hindquarters indicate several other weather that must be considered, including: 1) worsening pain-causing disease, 2) tolerance to opioid effects, 3) opioid withdrawal symptoms, or 4) pseudoaddiction (opioid-seeking due to unrelieved painfulness). For these conditions, increasing the opioid dose unremarkably helps relieve pain.
A patient world Health Organization is addicted to opioids may kvetch of declension pain just may not be helped by increasing the opioid dose. In fact, signs of habituation may emerge further, such as difficulty controlling opioid use, a preoccupation with obtaining opioids, or other misbehavior.
In the typeface of OIH, increasing the opioid dose will in reality make the pain worsened. Often, the pain is difficult for the patient role to report and can spread beyond the original point of pain. According to Compton's review, several strategies may help forestall OIH or to administer with OIH if it occurs:
-- The opioid dose should be kept as low as is clinically in force for managing pain.
-- Additional medications can be used to help downplay the demand for opioids, such as COX-2 inhibitors, dextromethorphan, and others.
-- Long-acting opioids are preferred over shorter-acting formulations for chronic hurting.
-- If a peculiar opioid becomes ineffective, it is much helpful to rotate to a wholly different opioid drug (synthetic heroin is especially useful for opioid rotation).
-- New research suggests combining low-doses of opioid antagonists (eg, naltrexone) with opioid therapy to counteract development of OIH.
Compton observes that there are still many unanswered questions about OIH, and research investigations are ongoing. Meanwhile, it is essential for healthcare providers to carefully monitor patients' responses to opioid therapy and recognise that various opioid-related responses other than OIH crapper lessen opioid-analgesic effectiveness. In some cases, higher dosing is requisite; however, if OIH occurs, other strategies should be employed to provide patients the pain relief they need and deserve.
Pain Treatment Topics and the associated Pain-Topics.org website provide open and free access to noncommercial, evidence-based clinical news, information, research, and education on the causes and effective treatment of the many types of pain conditions. It is independently produced and presently supported by an unrestricted educational ulysses Simpson Grant from Covidien/Mallinckrodt Inc., St. Louis, MO, a leading manufacturer of generic opioid analgesic products.
Pain-Topics.org
More info
Thursday 28 August 2008
Monday 18 August 2008
Petersfield Company Fined £10,500 For Health And Safety Breaches, UK
�The Health and Safety Executive (HSE) is urgency companies to assess the risks to their employees from photo to vibration, after a Hampshire company was fined �10,500 for ignoring the guard of a worker.
Tews Engineering Limited, based in Petersfield, Hampshire, pleaded guilty to contravening Section 2(1) of the Health and Safety at Work etc Act 1974 by failing to protect the health of employees, and Regulation 3(1) of The Management of Health & Safety at Work Regulations 1999 for weakness to carry out a proper danger assessment. The company was fined �8,500 for the first offence and �2000 for the second offence, plus costs of �10,D at Aldershot Magistrates Court yesterday, following a prosecution by HSE.
HSE Inspector Ray Kelly said:
"The worker in this case has suffered unnecessary, permanent disability because of a failure to manage his health and safety at work. Employers should submit heed that when HSE finds evidence of glaring breaches of health and safety law, particularly where there is a history of previous warnings and advice as was the case here, we will not waver to engage."
The employee, Bill Leonard, made a complaint to HSE approximately his exuberant use of vibrating tools while working at Tews Engineering, which had caused him to suffer 'Hand Arm Vibration Syndrome' (HAVS).
Mr Leonard informed his employer of his symptoms and asked to be re-deployed for the sake of his health. However, the caller continued to require him to work predominantly with vibrating tools, exacerbating his health problems. Mr Leonard now has permanent wrong to his hand, devising it impossible for him to persist in his work.
Notes
1. Regulation 3(1) of The Management of Health & Safety at Work Regulations 1999 states: Every employer shall make a suited and sufficient assessment of the risks to the health and safety of his employees to which they are exposed whilst they ar at work.
2. Section 2(1) of the Health & Safety at Work etc Act 1974 states: It shall be the duty of every employer to check, so far as is reasonably practicable, the health, safety and welfare at work of all his employees.
3. The maximum penalty in the lower court for breaching Section 2 of the HSW Act is �20,000.
4. More information on safe habit of vibrating tools is available here.
http://www.hse.gov.uk
More info
Tews Engineering Limited, based in Petersfield, Hampshire, pleaded guilty to contravening Section 2(1) of the Health and Safety at Work etc Act 1974 by failing to protect the health of employees, and Regulation 3(1) of The Management of Health & Safety at Work Regulations 1999 for weakness to carry out a proper danger assessment. The company was fined �8,500 for the first offence and �2000 for the second offence, plus costs of �10,D at Aldershot Magistrates Court yesterday, following a prosecution by HSE.
HSE Inspector Ray Kelly said:
"The worker in this case has suffered unnecessary, permanent disability because of a failure to manage his health and safety at work. Employers should submit heed that when HSE finds evidence of glaring breaches of health and safety law, particularly where there is a history of previous warnings and advice as was the case here, we will not waver to engage."
The employee, Bill Leonard, made a complaint to HSE approximately his exuberant use of vibrating tools while working at Tews Engineering, which had caused him to suffer 'Hand Arm Vibration Syndrome' (HAVS).
Mr Leonard informed his employer of his symptoms and asked to be re-deployed for the sake of his health. However, the caller continued to require him to work predominantly with vibrating tools, exacerbating his health problems. Mr Leonard now has permanent wrong to his hand, devising it impossible for him to persist in his work.
Notes
1. Regulation 3(1) of The Management of Health & Safety at Work Regulations 1999 states: Every employer shall make a suited and sufficient assessment of the risks to the health and safety of his employees to which they are exposed whilst they ar at work.
2. Section 2(1) of the Health & Safety at Work etc Act 1974 states: It shall be the duty of every employer to check, so far as is reasonably practicable, the health, safety and welfare at work of all his employees.
3. The maximum penalty in the lower court for breaching Section 2 of the HSW Act is �20,000.
4. More information on safe habit of vibrating tools is available here.
http://www.hse.gov.uk
More info
Friday 8 August 2008
The Go-Betweens
Artist: The Go-Betweens
Genre(s):
Rock: Pop-Rock
Discography:
Oceans Apart
Year: 2003
Tracks: 10
Friends Of Rachel Worth
Year: 2000
Tracks: 10
1978-1990
Year: 1990
Tracks: 22
Tallulah
Year: 1987
Tracks: 10
Before Hollywood
Year: 1982
Tracks: 10
The Go-Betweens were perchance the quintessential fad band of the '80s: they came from an stranger locus (Brisbane, Australia), touched to a major transcription center (in their cause, London) in a sustained bid to do a vocation out of music, released record album afterward album of music apparently tailor-made for the radio receiver in spite of their having little use for modern-day Top 40 musical/lyrical formulas, and earned considerable critical praise and a little simply impassioned international fan pedestal of trading operations. Although the Go-Betweens were absent throughout the '90s earlier re-forming in the new millennium, both of the band's songwriters embarked on good solo careers in the meanwhile and, piece seldom reaching the high the Go-Betweens scaly, they still managed to uphold the group's legacy.
Robert Forster and Grant McLennan began as a couple of teenagers possessed with the earthy john Rock of Dylan, CCR, and the Velvet Underground and encouraged by the Australian kindling of the Saints. As gathered on The Able Label Singles, their first-class honours degree two singles show a affectionateness for seedy, British Invasion/new wave-influenced pop/rock. Picking up lasting drummer Lindy Morrison, they recorded their debut LP, affected to England, and signed a transient deal with Rough Trade. Going for a lavish, melodious healthy crammed with nonstandard rock 'n' roll instrumentation, they went on to record basketball team more than first-class LPs. Though their pre-Beggars Banquet albums were traditionally voiceless to detect in the States, that label lastly reissued all half a dozen albums on CD in 1996.
In 2000 the band reunited and released a new album, The Friends of Rachel Worth, which besides featured all triplet members of Sleater-Kinney. It wasn't barely a fluke, as the band recorded follow-up albums released in 2003 (Bright Yellow Bright Orange) and 2005 (Oceans Apart). Documenting a 2005 concert in their hometown, the DVD/CD parcel That Striped Sunlight Sound arrived in early 2006, just a few months before the end of McLennan in May.
Tuesday 1 July 2008
Glastonbury 2008: Five-hour delays expected as fire breaks out nearby
Glastonbury festival-goers have been warned to expect five-hour delays travelling to the festival today (June 26), due to a fire that has broken out near the site.
Sunday 22 June 2008
Yves Saint Laurent fashion to be auctioned off
NEW YORK —
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A month after the death of Yves Saint Laurent, Christie's is auctioning seven pieces of the legendary French fashion designer's clothing and jewelry representing nearly every decade of his career.
The items at the July 2 auction include a 1958 cocktail dress for Dior and a 1970s Rive Gauche camel cable-knit sweater trimmed in fox fur similar to one Jacqueline Kennedy Onassis wore.
"What's exciting about the collection is that you see the progression of his career. He was a real style-setter," said Christie's couture specialist Laura Leyfer.
Saint Laurent died on June 1 at age 71. Considered one of the most influential designers of the 20th century, his creations - from pop-art print mini-dresses to peasant skirts and elegant pantsuits - endure to this day.
The cable-knit sweater - with a pre-sale estimate of $250 to $400 - is a version of one Onassis was often photographed wearing, a style she owned in several colors, according to Christie's auction catalog.
All of the items are in excellent condition and are relatively inexpensive because they aren't new designs and have been worn, Leyfer said Friday. "That's part of the appeal and it's what makes it a collectible," she said.
Another item for sale is a dusty pink layered tulle evening dress with metallic pink and silver embroidery, which Saint Laurent designed for Dior in 1958. It's could fetch $1,000 to $1,500.
The costume jewelry includes a floral gold-tone metal and crystal stone necklace from 1990, estimated to sell for $1,000 to $1,500, and a hammered gilt-metal "ethnic" necklace from the 1970s that could bring $600 to $800.
The sale also includes pieces from other designers including Christian Lacroix, Thierry Mugler, Balenciaga and Gianni Versace.
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On the Net: http://www.christies.com
See Also
Sunday 15 June 2008
Capitol Music Group's Trink stepping down
Chairman and CEO of also may leave
NEW YORK -- The remaking of EMI continued Tuesday with the announcement that Lee Trink will step down as Capitol Music Group president at the end of June.
Because of EMI's new management structure, which breaks down label walls and in many cases eliminates the need for label presidents, Capitol Music Group chairman and CEO Jason Flom may also soon be leaving the company, sources indicate. The company declines comment on speculation.
Trink's departure would come two weeks after the scheduled June 17 release of the new Coldplay album "Viva La Vida," which is expected to be one of the biggest records of the year and a critically important release for EMI.
During the interim, Manhattan Records GM Ian Ralfini will work with the existing senior management, including Trink, and marketing staff to manage the marketing function, according to an EMI spokeswoman. He will report to EMI Music Global Marketing president Sam van der Feltz, according to an internal EMI memo.
Meanwhile, the company is searching for someone to head marketing for EMI Music North America.
NEW YORK -- The remaking of EMI continued Tuesday with the announcement that Lee Trink will step down as Capitol Music Group president at the end of June.
Because of EMI's new management structure, which breaks down label walls and in many cases eliminates the need for label presidents, Capitol Music Group chairman and CEO Jason Flom may also soon be leaving the company, sources indicate. The company declines comment on speculation.
Trink's departure would come two weeks after the scheduled June 17 release of the new Coldplay album "Viva La Vida," which is expected to be one of the biggest records of the year and a critically important release for EMI.
During the interim, Manhattan Records GM Ian Ralfini will work with the existing senior management, including Trink, and marketing staff to manage the marketing function, according to an EMI spokeswoman. He will report to EMI Music Global Marketing president Sam van der Feltz, according to an internal EMI memo.
Meanwhile, the company is searching for someone to head marketing for EMI Music North America.
Wednesday 4 June 2008
'Friendly Persuasions' at Pacific Serenades
With 22 seasons under its belt, Pacific Serenades still makes a major point of trying to freshen the chamber music repertoire with newly commissioned works. Sunday afternoon in Pasadena's Neighborhood Church, the series presented its 90th commission -- the U.S. premiere of "Friendly Persuasions," a song cycle for tenor by Jake Heggie (composer of opera's "Dead Man Walking") built on a great idea. Working in a form crammed to overflowing with sentimental love poetry, Heggie and his lyricist, Gene Scheer, deal instead with snapshots from the life of French composer Francis Poulenc in imaginative ways that ring true. In the first song, Poulenc has a frantic conversation with the pioneering harpsichordist Wanda Landowska, who gives him love advice -- go after that young man whom you fancy -- while demanding that he finish his new concerto for her (which turned out to be the Concert Champêtre). In another, Pierre Bernac, the baritone for whom Poulenc wrote many songs, looks on in horror as Poulenc destroys a draft of a new song.
Heggie deftly and quickly sketches the multiple musical personalities of Poulenc without imitating him per se: the manic clown in the Landowska and Bernac songs; a nostalgist in the slow waltz that ends the song lamenting a female friend, Raymonde Linossier, who died young; a serious citizen in the martial air of the song featuring French Resistance poet Paul Éluard.Heggie and Scheer also give their tenor a chance to do some vocal acting as if this were an opera, a freedom that the gifted Nicholas Phan exercised to the hilt. And the unusual ensemble for which Heggie wrote this version -- harpsichord, oboe, flute and cello -- relates directly to Poulenc's sound world (the London world premiere in April was for tenor and piano). With the configuration for Heggie's songs as a base, Phan, flutist Mark Carlson, oboist Leslie Reed, cellist David Speltz and harpsichordist Patricia Mabee were elsewhere deployed in various combinations in a clutch of Baroque sonatas, trio sonatas and arias. Phan's fresh lyric tenor found more expressive outlets in three arias from J.S. Bach's Cantatas Nos. 99, 73 and 78. Reed expertly articulated everything she touched in Boismortier's Trio Sonata in E minor, Opus 37, No. 2, and Vivaldi's Sonata in C minor, RV 53. Carlson displayed graceful Baroque chops in Bach's Sonata in B minor, BWV 1030. Speltz brandished a light, leathery, period-performance-influenced tone, and Mabee underpinned everything with solid rhythmic playing. Overall, though, Bach provided more in the way of substance and ingenuity here than his Baroque colleagues.
Heggie deftly and quickly sketches the multiple musical personalities of Poulenc without imitating him per se: the manic clown in the Landowska and Bernac songs; a nostalgist in the slow waltz that ends the song lamenting a female friend, Raymonde Linossier, who died young; a serious citizen in the martial air of the song featuring French Resistance poet Paul Éluard.Heggie and Scheer also give their tenor a chance to do some vocal acting as if this were an opera, a freedom that the gifted Nicholas Phan exercised to the hilt. And the unusual ensemble for which Heggie wrote this version -- harpsichord, oboe, flute and cello -- relates directly to Poulenc's sound world (the London world premiere in April was for tenor and piano). With the configuration for Heggie's songs as a base, Phan, flutist Mark Carlson, oboist Leslie Reed, cellist David Speltz and harpsichordist Patricia Mabee were elsewhere deployed in various combinations in a clutch of Baroque sonatas, trio sonatas and arias. Phan's fresh lyric tenor found more expressive outlets in three arias from J.S. Bach's Cantatas Nos. 99, 73 and 78. Reed expertly articulated everything she touched in Boismortier's Trio Sonata in E minor, Opus 37, No. 2, and Vivaldi's Sonata in C minor, RV 53. Carlson displayed graceful Baroque chops in Bach's Sonata in B minor, BWV 1030. Speltz brandished a light, leathery, period-performance-influenced tone, and Mabee underpinned everything with solid rhythmic playing. Overall, though, Bach provided more in the way of substance and ingenuity here than his Baroque colleagues.
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