The "right" target in the management of pain

The "right" target in the management of pain - It is logical that the main goal of pain management should be to reduce the pain. 

However, a recent editorial in the New England Journal of Medicine made a strong case for looking beyond the pain intensity assessed what is the pain management "success".

The "balance" the management of chronic pain 

Here's the problem: For people with chronic pain, pain affects nearly every aspect of their lives. At the same time, treatment to relieve chronic pain also have the potential to influence many aspects of a person's life. 

Our best medications for pain relief have many unpleasant side effects. Even non-pharmacological interventions (such as physical therapy) and complementary therapies (such as acupuncture) usually not only have a unique effect.

This means that if we give priority to reducing the pain any other result, we end up doing as much damage as we do it well. In particular, the authors suggest that the editorial focus solely on reducing the intensity of pain, and the creation of a moral mandate to relieve pain, have contributed to the crisis of opiates in that country. In recent decades we have seen a steady increase in prescriptions for opioids, misuse and abuse of opiates and related overdose deaths. 

Patient surveys also show that people with chronic pain care more about the experience less pain. They care more enjoy life, have a strong sense of emotional well-being, increased physical activity, improve sleep and reduce fatigue, and to participate in social and recreational activities. These objectives must be weighed against the disadvantages of pain.

For example, opioids such as oxycodone (OxyContin) may reduce the intensity of pain and make it easier to fall asleep. But they make people tired, cause constipation and memory problems, and bear the risk of abuse and overdose. 

How the pros and cons cell is very personal and varies from patient to patient. For some people, the risk of abuse is small side effects are minor, and the drug reduced a lot of pain. For others, these drugs reduce the pain just a bit, so that fatigue and cognitive side effects are so bad that it is difficult to carry out routine activities such as driving or going to work.

The future of pain 

The authors also suggest that editorial treatment to control pain is not only that but also individualized multimodal (ie, a combination of different therapies) can produce the most benefits with the least damage. A solid base of scientific research supports this position.

For example, a person with chronic back pain, a recent history of alcohol abuse and depression and insomnia may do better with a combination of non-opioid analgesics for pain, cognitive behavioral therapy and antidepressant, while the other person, also with chronic low back pain can get the best results with a combination of low-dose opioids daily and weekly acupuncture.

Dr. Robert Jamison hospital at Harvard-affiliated Brigham and Women of shown that behavioral treatment to improve adhesion of opioids in patients suffering from chronic pain actually reduced rates of drug abuse among patients most likely to abusing these drugs. 

The "success" of pain is very individual. So you can not assume that what you read or hear online with other people (eg, "Drug X is large, you should try" or "drug Y is terrible, why would prescribe this") represent how a drug will work for you.

The field of pain management needs a lot more research to determine which patients are most likely to benefit from a given treatment. Perhaps, for example, patients Younger migraine sufferers can gain more drug A, while elderly patients with tension-type headaches can do better with drug B.

This kind of categorization, known as the "phenotype", provide a basis for management Custom pain, ideally, it would improve the clinical management of people with pain and minimize damage related to treatment.

Above all, I believe the combination therapies that not only reduce pain, but contribute to long quality life goals with a renewed focus on individualized treatment approach represents significant progress in the field of management pain and are important steps towards the full effectiveness of our duties to suffering patients. 
By: Robert R. Edwards, Ph.D.   

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The cause of diabetes.

Sometimes we do not realize that what we do every day it can cause disease and harm to the body. I think the slogan "Prevention is better than cure." is right.

On the last occasion I have written about diabetes symptoms and treatment of diabetes naturally. This time we will know the cause of diabetes, so that we can avoid early as possible so as not already affected by diabetes.

Causes of diabetes include

1. Habit of smoking.
Already a wealth of information ranging from the clinic to the hospital stating "Smoking is injurious to health."
For those addicted to cigarettes is much less pronounced initially but over time the offender will feel the symptoms of diabetes in itself. 

2. Take regular exercise.
Sport activities are healthy for our body metabolism, walk away, go jogging or cycling will burn the fat that has accumulated, do not get used to sleep after eating, which accumulates carbohydrates will cause diabetes.

3. Too much to drink sweet tea.
Drinking water is obviously healthier than other drinks, too much to drink sweet drinks such as tea will cause the blood sugar to rise. Drink at least 6-8 glasses of water every day. 

4. Often drinking alcoholic beverages.
Do not get used to drinking alcoholic beverages if you want to get a healthy body, a clear alcoholic beverages are also prohibited other than in a negative impact on the culprit, except for using health instructions. 

5. Familiarize Do not drink carbonated beverages.
Many soft drinks contain saccharin (an artificial sweetener) which can increase your blood sugar. 

6. Stress
Keep your body in order not to stress conditions, the specific activities that will make conditions unpleasant body remains in a relaxed state. Stress increases the hormone epinephrine and cortisol are automatically blood sugar will also rise. 

7. Lack of sleep.
Lack of sleep will cause your metabolism less than the maximum that triggers hormones in the blood that cause hunger. According to a study from the University of Chicago stated that a lack of sleep for 3 days will cause the body's ability to process glucose declined drastically, thereby increasing the risk of diabetes. 
Image:healthmeup.com

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Symptoms of diabetes.

Diabetes is a disease caused by abnormal metabolism system so that the effect on blood sugar levels rise, because the organ pancreas can no longer produce insulin is needed by the body. Glucose is essential for the health of our bodies as a source of strength and muscle tissue.

Because blood sugar levels rise, the person will have diabetes, do not let this happen because it can lead to chronic diseases and harmful to your own health.

For that let us identify what are the symptoms of diabetes that causes this to happen, so that we could detect as early as possible and treat it.

Diabetes varied kind, if blood sugar levels are in a bit of pain exceeds the normal limit then called prediabetes and not yet referred to as diabetes, or blood sugar rise during pregnancy is also not said as diabetes due to the possibility of returning to normal is still great.  

Symptoms of type 1 diabetes (occurring in children)

Diabetes that occurs in children is difficult to be detected because of flu-like illness, and this can happen in the know after a long time.

First.  
Patients often feel thirsty. Because too often secrete fluid, so people always feel thirsty and want to drink.

Second.  
Patients easily feel tired.
Because the body can not convert glucose into energy so that children often feel tired.

Third. 
Weight continues to decrease.
Because the body can not process glucose into energy so the body becomes frequent fatigue sufferers who berakhibat weight down. Normal appetite but can not grow healthy bodies. 

Fourth.  
Do not be surprised if your child does not often wet, despite being smaller. This occurs because the kidneys' ability always wanted to clean up the excess glucose in the blood so that children always want to pee.

Advanced stages of diabetes symptoms.

At one stage the symptoms of diabetes can occur in children or adolescents, but if it occurs at a later stage can happen at any age.

First. 
Frequent tingling. This happens because the blood can not flow smoothly so that oxygen supply was reduced, in because the blood vessels are damaged or not functioning anymore. 

Second.  
Weight began to fall.
This occurs because the pancreas begin no damage, the pancreas produces insulin to process glucose into energy charge, this ability is no longer normal to the pancreas resulting in insulin resistance, the body will look for other energy reserves of fat if the fat is not there then the next target is muscle. So the weight continued to decline. 

Third. 
If there is then difficult to heal wounds.
This is another effect of damage to the blood vessels and nerve tissue, resulting in damage to the patient does not feel pain when the injury occurred. The occurrence of high blood sugar and the nerve damage in case of minor injuries that sometimes people consider trivial can be enlarged over time and is likely to be large in amputation. 

Symptoms of diabetes in women. 

 Women are also prone to diabetes, to recognize it as early as possible and immediately consult a doctor if there is one.  

First. Vaginal infections.
Second. Disrupted hormone function.
Third. Depression.
Fourth. Hair loss is not fair.

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