The appropriateness of strategies for managing cancer pain in individuals with advanced cancer and opioid use disorder (OUD) is addressed in a consensus statement published online Dec. 28 in JAMA Network Open.
Managing Cancer Pain
Jessica S. Merlin, M.D., Ph.D., from the University of Pittsburgh, and colleagues developed a consensus statement on the appropriateness of strategies for managing cancer pain in individuals with co-occurring advanced cancer and OUD. A total of 120 experts in palliative care, addiction, or both participated in a three-round modified Delphi process.
The researchers deemed it appropriate to continue buprenorphine-naloxone with three times-daily dosing for patients with OUD taking buprenorphine-naloxone. For patients with a prognosis of weeks to months, continuing buprenorphine-naloxone and adding a full-agonist opioid was deemed to be appropriate; appropriateness was uncertain for those with a prognosis of months to years. It was deemed appropriate to take over prescribing for a patient with OUD taking methadone dispensed at a methadone clinic and to dose two or three times daily. For patients with a diagnosis of weeks to months, continuing methadone daily while adding another full-agonist opioid was deemed appropriate, while the appropriateness was uncertain for those with a prognosis of months to years.
“Merlin et al demonstrated the urgent need for more data to inform the experts. In addition to palliative care and addiction experts, oncologists, interventional pain, mental health, and nursing professionals need to join at the table to discuss best practices in supporting and treating vulnerable patients with cancer pain and OUD,” write the authors of an accompanying editorial.
One author disclosed financial ties to UpToDate; a second author disclosed ties to Humana.
Copyright © 2020 HealthDay. All rights reserved.
Original Post: docwirenews.com
In Greece, Unvaccinated People Ages 60 and up Now Face Monthly Fines
The nation imposed the new mandate on Monday as it looks to bring its vaccination rate closer in line with the EU average. The unvaccinated will face penalties starting at 50 euros, or roughly $57.
(Image credit: Thanassis Stavrakis/AP)
Original Source: npr.org
Drones Over Nuclear Power Plants Attract Attention From Spy Agency
Sweden’s domestic intelligence service is looking into drones spotted hovering near three nuclear power plants last week
The Swedish Security Service confirmed on Monday it was leading an investigation into drones seen near the nation’s three nuclear power plants, amid concerns the country isn’t prepared for the threat of the aerial devices.
Sweden’s police force was initially tasked with p
Chance of Another Round of Winter Weather in Central NC by the End of the Week
RALEIGH, N.C. (WNCN) – Yes, central North Carolina has a chance for snow by the end of the week. But before we jump to conclusions, let’s take a moment to talk about where a low-pressure system needs to be for us to get snow.
Imagine you take an area of low pressure and slice it up into four parts. The two parts on the eastern side are warmer. It’s here where we are more likely to get rain or a mix of rain and snow.
The two parts on the western side are the cold side. It’s here where we have the best chance for snow, especially if we fall in the top left part of the low (meteorologists call it the northwest quadrant).
I bring this up because a slight shift either to the west or east has a big impact on not only what kind of wintry weather we’ll have, but also how much.
So, about this weekend. Yes, the chance for snow is once again returning to the forecast, but because the location of the low pressure is still largely unknown, it’s tricky to nail down exactly how much snow we could see, or if we get another round of mixed precipitation like this past weekend.
Another wrinkle in this next potential round for winter weather is the cold front. A strong cold front will slide through Thursday, bringing downright frigid air for central North Carolina. While this can sometimes create snow for us, it’s not always the best setup for significant, winter wonderland snow.
But in addition to the cold front, an area of low pressure is expected to develop along that cold front and slide north. Models are not in agreement with timing or amounts because of these small-scale factors.
This is why winter weather in central North Carolina is often tricky and seems like it changes every day. It’s variable and very dependent on small-scale changes.
So, we may be talking about another chance for snow by the end of the week. If it’s only tied to cold air behind the front, the totals will be low. If low pressure develops and slides off our coast, we could have decent snow totals or even another round of a wintry mix.
It’s too early to say exactly, so we’ll keep tracking it for you here on CBS 17.
Source Here: cbs17.com
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