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Biomedical subjects

Scott M Fishman

Publications and source records attributed to Scott M Fishman.

27 records · Page 2Linked to original sources
PubMedDate not supplied

The opioid contract.

Opioid contracts are widely used but not well studied. Despite the widespread use of the opioid contract or agreement, there is no standard approach. Some studies have found both considerable variability between opioid contracts as well as consistent core themes. While an opioid contract may be an appealing tool for obtaining informed consent, providing education, or otherwise overcoming some of the problems associated with chronic opioid therapy for noncancer pain, its efficacy is not well established. This article will consider many of the significant factors that impact clinicians and patients using a contract or agreement for chronic opioid therapy.

Analgesics, Opioid↗
PubMedDate not supplied

A case of pulsed radiofrequency lesioning for occipital neuralgia.

OBJECTIVE: This report describes a case where pulsed radiofrequency lesioning (RFL) of the greater occipital nerve (GON) offered a valuable and safe treatment for the management of greater occipital neuralgia. The case is considered in relation to a review of the medical literature on greater occipital neuralgia and RFL interventions. CASE REPORT: A 62-year-old man with a 43-year history of left suboccipital pain underwent pulsed RFL of the left GON (20-millisecond bursts at intervals of 0.5 second for 4 minutes at 42 degrees C) after failing to achieve substantial analgesia with naproxen, a transcutaneous electrical nerve stimulator (TENS) unit and a greater occipital nerve blockade (GONB) utilizing local anesthetic and steroid. After obtaining 4 months of 70% pain relief, pulsed RFL was repeated and resulted in an additional 5 months of 70% pain relief. CONCLUSIONS: Pulsed RFL of the GON is an alternative to continuous RFL with the proposed advantage of mitigating pain, as in continuous RFL, but without the potential risk of causing deafferentation pain. While placebo and other nonspecific analgesic effects cannot be ruled out, the apparent safety profile and potential efficacy of pulsed RFL suggests it may be a compelling option to consider before irreversible neuroablative therapies are applied.

Afferent Pathways↗
PubMedDate not supplied

Radiopharmaceuticals for palliation of painful osseous metastases.

Bone metastases represent the most common etiology of pain for patients with advanced cancer In the United States, the most common treatment for pain caused by bone metastases in late-stage cancer cases is external beam radiotherapy in conjunction with opioids. An alternative or adjuvant to external radiotherapy is intravenous radiopharmaceutical treatment. This review explores the pros and cons of different radiopharmaceutical options, their advantages over traditional external beam radiotherapy, and the conditions for optimal efficacy.

Bone Neoplasms↗