�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.
Subscribe to:
Posts (Atom)