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Biomedical subjects

Christine Miaskowski

Publications and source records attributed to Christine Miaskowski.

76 records · Page 5Linked to original sources
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Potential mechanisms for altered iron metabolism in human immunodeficiency virus disease.

Recently, anemia associated with human immunodeficiency virus (HIV) disease has received more attention as our understanding of the significance of anemia in this population has grown and more emphasis is placed on the quality of life of people living with HIV/AIDS. Although the diagnosis and treatment of anemia in HIV disease has been discussed in great detail, the prevalence and pathophysiology of the two most common forms of anemia, iron deficiency anemia (IDA) and the anemia of chronic disease (ACD), have not received much attention despite the difficulty and importance of differentiating between these two anemias. In addition, little attention has been given to iron overload, which has serious implications in individuals with HIV disease. This article proposes a model of altered iron metabolism in HIV disease as a basis for explaining the pathophysiology and implications of IDA, ACD, and iron overload in this population. Implications for clinical practice and recommendations for future research are discussed.

Anemia↗
PubMedDate not supplied

The PRO-SELF(c): Pain Control Program--an effective approach for cancer pain management.

PURPOSE/OBJECTIVES: To describe the PRO-SELF(c): Pain Control Program, an educational approach that provides patients and family caregivers with the knowledge, skills, and nursing support needed to improve pain relief. DATA SOURCES: Published research studies, articles, and conference abstracts. DATA SYNTHESIS: Patients with cancer and family caregivers lack knowledge about pain management and side effects. Engaging in self-care behaviors improves patients' health outcomes. CONCLUSIONS: The PRO-SELF: Pain Control Program is an effective approach that can be used to help patients with cancer and their family caregivers obtain the knowledge and skills that are needed to manage pain. Three key strategies for delivering the PRO-SELF program are (a) provision of information using academic detailing, (b) skill building with ongoing nurse coaching, and (c) interactive nursing support. IMPLICATIONS FOR NURSING: Adequate pain relief is vital to decreasing cancer morbidity and improving patients' quality of life. The PRO-SELF: Pain Control Program should be implemented in all settings where cancer care takes place.

Aged↗
PubMedDate not supplied

Meeting the challenges in cancer pain management.

Improved life expectancy among patients with cancer has unfortunately resulted in significant increases in the number of patients experiencing chronic, intractable pain-neuropathic pain syndromes, in particular. Yet treatment for this pain is frequently suboptimal. This is due, at least partially, to the generalized nature of available therapeutics, which are often aimed toward symptom management and temporal pain properties rather than targeted directly toward the multiple mechanisms underlying the generation and propagation of pain. Although the future of pain medicine undoubtedly lies with improved formulations, kinetics, and metabolic characteristics, the current armamentarium nevertheless has proven effective in promoting beneficial outcomes and improved life quality in cancer patients with neuropathic pain. Novel, evidence-based guidelines recommend several agents for first-line consideration, including gabapentin, the lidocaine (5%) patch, tramadol hydrochloride, tricyclic antidepressants, and opioid analgesics. However, in oncology perhaps more than in any other field, pain is dynamic and ever-changing in response to a variety of factors, including chemotherapeutic, radiation, or surgical interventions. For this reason, patient-specific assessment and continual monitoring are warranted when selecting a therapeutic regimen. General considerations, particularly when an opioid agent is utilized, should include pharmacoclinical, pharmacoeconomic, and pharmacogenetic variables.

Analgesia↗