Articles related to PAIN MANAGEMENT

The story of “Dr. H,” an up-and-coming physician who was charged with 14 counts of murder in June 2019 after prescribing patients extremely high doses of fentanyl. The prosecution said Dr. H had intended to hasten or cause the deaths of the 14 patients, and it did not matter whether they were severely ill or close to dying. The defense argued the physician was merely relieving the patients’ suffering and that they died from their underlying diseases or being removed from ventilators. Who did the jury agree with?

The editorialists noted that, because of the slow pace of clinical trials, their findings will likely be the best available evidence for some time: “While we await better evidence, we believe that clinicians should meet patients with chronic pain ‘where they are.’ Conventional analgesic medications are effective only in a subset of persons…clinicians can compassionately witness, record, and offer guidance to help patients with chronic pain use cannabis wisely.”

This is a 1.75-hour credit expert round-table featuring members of UPMC faculty. The group dialogue together on the state-of the art in pancreatic cancer and their experience in biliary stenting including advantages of metal versus plastic stenting, and their experience in recent advances in molecular testing of pancreatic cysts, identifying those patients that will benefit from targeted surveillance of pancreatic cancer, and methods of performing PDAC surveillance and their outcomes. They also discuss prevention and management of post-op complications, and pain control in this population.

“The guideline was never intended to set a standard of care in the treatment of pain, much less was it intended to serve as a means to criminally prosecute clinicians. While the new guideline is a substantial improvement, harm from the 2016 guideline will not be easily erased and will require more specific wording than is currently present.” (Requires free registration / login)

The CDC has released updated guidelines for prescribing opioids. The newest guidelines focus on patient-centered decisions and reduce some limitations on prescribing that were put in place back in 2016. The updated guidance recognizes the ongoing increase in opioid-related deaths, but seeks to give physicians and patients more direction in managing individual therapy.

A 56-year-old man has had right-upper-quadrant abdominal pain for several months but is otherwise healthy. He does not drink alcohol, has not been exposed to other hepatotoxins, and takes no medications. On physical examination, vital signs are normal. Abdominal examination reveals hepatosplenomegaly. The remainder of the physical exam is normal. What would you do?