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Iatrogenic opioid dependence is endemic and legal: Genetic addiction risk score (GARS) with electrotherapy a paradigm shift in pain treatment programs
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作者 Kenneth Blum David Han +15 位作者 Marlene Oscar-Berman Gary Reinl Nicholas DiNubile Margaret A. Madigan Anish Bajaj Bernard William Downs John Giordano Wayne Westcott leonard smith Eric R. Braverman Kristina Dushaj Mary Hauser Thomas Simpatico Thomas McLaughlin Joan Borsten Debmayla Barh 《Health》 2013年第11期16-34,共19页
The mounting endemic of prescription iatrogenic opioid dependence in pain patients provoked this treatise about an alternative method that can be used to treat pain, improve function and reduce the risk of opioid depe... The mounting endemic of prescription iatrogenic opioid dependence in pain patients provoked this treatise about an alternative method that can be used to treat pain, improve function and reduce the risk of opioid dependence. It is well known that as well as the side effects reported for chronic opioid therapy, genetically predisposed individuals are at risk for opioid dependence. We propose the use of the Genetic Addiction Risk Score (GARS) assessment to identify patients early in treatment who should avoid narcotic pain medications. Primarily, this review will be an exploration of the mechanisms of action of an electrotherapeutic alternative to narcotic treatment that can be used to augment tissue healing and reduce the pain associated with human injuries and neuropathies. This particular electrotherapeutic device was developed at the Electronic Waveform Laboratory in Huntington Beach, California and is called the H-Wave? device. The primary effect of the H-Wave?device is stimulation (HWDS) of small diameter fibers of “red-slow-twitch” skeletal muscle. Mechanisms of action of HWDS have been investigated in both animal and human studies. They include edema reduction, induction of nitric oxide dependent augmented microcirculation and angiogenesis, small muscle contraction that eliminates transcapillary fluid shifts, reducing the painful effects of tetanizing fatigue and gradual loading of healing injured muscle tissue that helps repair and remodeling. A recent metaanalysis found a moderate-to-strong-positive effect of the HWDS in providing pain relief, reducing the requirement for pain medication, with the most robust effect being increased functionality. We are proposing that GARS can be used to identify those at risk of developing opioid dependence and that the need for opioid analgesia can be reduced by use of this electro therapeutic alternative to opioid analgesia in the treatment of pain and injuries. 展开更多
关键词 MICROCIRCULATION Angiogenesis ANALGESIC Therapy Electrical Device Stimulation Tissue Loading Remodeling GENETIC ADDICTION Risk Score (GARS) Reward Deficiency Syndrome (RDS)
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公共慈善、私营机构和国家干预:英格兰疯人的制度化护理(1600-1815)
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作者 傅益东(译) 赵炜煜(译) 《医疗社会史研究》 2021年第1期116-135,317,共21页
1600年至1815年是英国政治、经济和社会发生重大变革的时期之一。为社会伤病人员提供服务的范畴越来越广,其中包括那些患有精神疾病的人。1676年在伦敦重新开业的伯利恒医院规模宏大,成为公共慈善事业的典范。18世纪,其他精神病院在伦... 1600年至1815年是英国政治、经济和社会发生重大变革的时期之一。为社会伤病人员提供服务的范畴越来越广,其中包括那些患有精神疾病的人。1676年在伦敦重新开业的伯利恒医院规模宏大,成为公共慈善事业的典范。18世纪,其他精神病院在伦敦等城市相继建立。此类机构主要为贫民提供服务。然而,社会中上层人群中日益严重的精神错乱问题也刺激了私营事业的发展。从1650年起,“私立疯人院”在伦敦乃至整个英国逐渐兴起,截至1800年至少已有60家机构成立。它们提供给病人的服务条件差异悬殊,这引起了公众关注度的与日俱增,并使政府在1774年予以立法管控。来自改革者的压力导致1808年立法的实现,国家开始资助疯人院的筹建工作。1815年,政府主导的一次重大调查,旨在将针对服务精神失常群体的公立和私立机构在实践过程中的优缺点公之于众。 展开更多
关键词 社会阶层 疯人院 精神病院
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