Abstract:
OBJECTIVE:To study differences in treatment outcomes between patients with chronic noncancer pain taking vs those not taking maintenance opioids at admission to a pain rehabilitation program. PATIENTS AND METHODS:A nonrandomized 2-group prepost design was used to compare 356 patients admitted to the Mayo Comprehensive Pain Rehabilitation Center from January 2002 to December 2002 at admission and discharge by opioid status at admission. Measures of pain severity, interference due to pain, perceived life control, affective distress, activity level, depression, and catastrophizing (an exaggerated negative mental set associated with actual or anticipated pain experiences) were used to compare opioid and nonopioid groups. The patients entered a 3-week intensive outpatient multidisciplinary pain rehabilitation program designed to improve adaptation to chronic noncancer pain. The program uses a cognitive-behavioral model and incorporates opioid withdrawal. RESULTS:More than one third of patients (135/356) were taking opioids daily at admission. At completion of the program, all but 3 of the 135 patients had successfully discontinued opioid treatment. No significant pretreatment differences were found between the opioid and nonopioid group regarding demographics, pain duration, treatment completion, or all outcome variables, including pain severity. Significant improvement was noted at discharge for all outcome variables assessed regardless of opioid status at admission. CONCLUSION:Patients with symptomatically severe and disabling pain while taking maintenance opioid therapy can experience significant improvement in physical and emotional functioning while participating in a pain rehabilitation program that incorporates opioid withdrawal.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Rome JD,Townsend CO,Bruce BK,Sletten CD,Luedtke CA,Hodgson JEdoi
10.4065/79.6.759keywords:
subject
Has Abstractpub_date
2004-06-01 00:00:00pages
759-68issue
6eissn
0025-6196issn
1942-5546pii
S0025-6196(11)62628-1journal_volume
79pub_type
临床试验,杂志文章abstract::Dissatisfaction with the long-term results of cutaneous urinary diversion and a demand for a more socially acceptable solution have prompted the development of procedures that allow continent urinary diversion. Creation of an internal reservoir from reconstructed bowel segments, which is anastomosed to the patient's u...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62024-2
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:To determine the risk of hospitalization and death in relation to preexisting depression and anxiety among patients with cardiovascular disease (CVD). PATIENTS AND METHODS:The cohort consisted of 799 Olmsted County, MN, residents diagnosed with CVD (myocardial infarction or heart failure) from January 1, 197...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/mcp.2011.0148
更新日期:2011-11-01 00:00:00
abstract::Susac syndrome (retinocochleocerebral vasculopathy) is a syndrome of unknown pathogenesis. The triad of multifocal encephalopathy, visual loss, and hearing loss is caused by microangiopathy of the brain, retina, and cochlea. The illness tends to be monophasic, and to our knowledge, recurrence after years of remission ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.9.958
更新日期:2001-09-01 00:00:00
abstract::Hepatitis C virus infection is common, often silent, and almost always chronic and can lead to cirrhosis and hepatocellular cancer. Deaths related to chronic hepatitis C are expected to increase dramatically in the future. Many cases of infection are asymptomatic and are undiagnosed because of a lack of recognition by...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63702-6
更新日期:1998-04-01 00:00:00
abstract::The platelets of a patient with the Bernard-Soulier syndrome were studied by electron microscopy. The main abnormalities were the presence of giant and often round platelets, hypertrophic and frequently widely dilated open canalicular system, disorganized microtubules, and platelets with sparse or absent granulation....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract:OBJECTIVE:Given that patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) have a disproportionately higher prevalence of hypothyroidism compared with their non-CKD counterparts, we sought to determine the association between thyroid status, defined by serum thyrotropin (TSH) levels, and mortality among...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.01.024
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To examine 45-year trends in time use and physical activity energy expenditure (PAEE) in a nationally representative sample of US mothers. PARTICIPANTS AND METHODS:We quantified time allocation to physical activity (PA), sedentary behaviors (SED), and PAEE from 1965 to 2010 in mothers with older children (MO...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.09.009
更新日期:2013-12-01 00:00:00
abstract::Constrictive pericarditis frequently poses a diagnostic challenge because of its varied manifestations. Accurate diagnosis is essential, however, because surgical decortication may yield excellent clinical results. Although new diagnostic procedures have helped the clinician to diagnose constrictive pericarditis, the ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60850-7
更新日期:1985-06-01 00:00:00
abstract::We conducted a prospective, randomized trial to study the efficacy and tolerance of long-term versus short-term treatment with recombinant interferon alfa-2a in patients with chronic hepatitis B. Ten patients were randomly assigned to a 6-month interferon regimen, and 10 patients were assigned to a 3-week interferon t...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0025-6196(12)62144-2
更新日期:1990-10-01 00:00:00
abstract::We have observed the effects of concussion on nonanesthetized rats and humans. We believe the phenomenon in both to be identical. There are four obvious stages to concussion and the recovery therefrom: fourth stage--visceral (respiratory) and somatic immobility; third stage--return of irregular visceral (respiratory) ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:In this report, our goal was to summarize the current knowledge of the biochemical basis for the impaired DNA synthesis and neuropathy associated with vitamin B12 deficiency. MATERIAL AND METHODS:We reviewed the pertinent literature and our clinical experience with cobalamin deficiency. RESULTS:Studies have...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61046-5
更新日期:1994-02-01 00:00:00
abstract::The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. Factors contributing to poor medication...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/mcp.2010.0575
更新日期:2011-04-01 00:00:00
abstract::Cephalosporins are broad-spectrum antimicrobial agents that are often used empirically to treat suspected bacterial infections and also to treat culture-proven infections due to selected gram-positive and gram-negative microorganisms. Cephalosporins differ widely in their spectrum of activity, susceptibility to beta-l...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61731-5
更新日期:1991-10-01 00:00:00
abstract::Constipation is a common symptom that may be primary (idiopathic or functional) or associated with a number of disorders or medications. Although most constipation is self-managed by patients, 22% seek health care, mostly to primary care physicians (>50%) and gastroenterologists (14%), resulting in large expenditures ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2019.01.031
更新日期:2019-11-01 00:00:00
abstract::The first generation of multicenter randomized controlled trials of coronary artery bypass surgery vs medical treatment in the 1970s found survival advantage only in patients with left main coronary artery disease or with multiple risk factors. Over time, these results have remained reproducible and biologically plaus...
journal_title:Mayo Clinic proceedings
pub_type:
doi:10.4065/77.1.72
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To comparatively assess the natural history of patients of different ages undergoing transcatheter aortic valve replacement (TAVR). PATIENTS AND METHODS:For this study, we used the YOUNG TAVR, an international, multicenter registry investigating mortality trends up to 2 years in patients with aortic valve st...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.mayocp.2019.01.008
更新日期:2019-08-01 00:00:00
abstract::Tinnitus, a common complaint, reportedly affects more than 37 million Americans. Most often, it is associated with a sensorineural hearing loss in the high-frequency range. Tinnitus, however, is a symptom and not a disease. Complacency about this symptom complex may cause physicians to overlook a severe underlying pat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)60521-7
更新日期:1991-06-01 00:00:00
abstract::Emerging preclinical and clinic evidence described herein suggests that the mechanism of action of rifaximin is not restricted to direct antibacterial effects within the gastrointestinal tract. Data from this study were derived from general and clinical trial-specific PubMed searches of English-language articles on ri...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2015.04.016
更新日期:2015-08-01 00:00:00
abstract::Traditional treatments for men with localized prostate cancer have included both surgical removal and radiation therapy, with their potential adverse effects on patient quality of life. Thus, there has been increasing interest in the development of minimally invasive procedures that use various technologies to deliver...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/79.12.1547
更新日期:2004-12-01 00:00:00
abstract::The aim of this study was to determine whether the characteristics of esophageal symptoms may be of diagnostic utility in distinguishing dysphagia of various causes. Included in the study were a total of 499 patients with three types of dysphagia: 234 with dysphagia related to an obstructive lesion in the esophagus, 1...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62266-6
更新日期:1993-10-01 00:00:00
abstract::In ancient times, the sun was venerated as a source of life in some cultures. Scientifically, the relationship between vitamin D and sunlight and the deficiency of vitamin D in patients with rickets were ultimately discovered. In 1903, Niels Finsen was awarded the Nobel Prize in medicine or physiology for his "Finsen ...
journal_title:Mayo Clinic proceedings
pub_type: 历史文章,杂志文章
doi:10.4065/72.5.461
更新日期:1997-05-01 00:00:00
abstract::The fluoroquinolones are a new class of antimicrobial agents structurally related to nalidixic acid. They have a broad spectrum of activity against pathogens, including Pseudomonas aeruginosa, other multiresistant gram-negative bacteria, and methicillin-resistant Staphylococcus aureus but not anaerobes. They are well ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65073-3
更新日期:1987-11-01 00:00:00
abstract:FINDINGS:The prostate-specific antigen (PSA) level alone does not facilitate precise pathologic staging on an individual basis, although advanced stage tends to correlate with an increased PSA level. The staging accuracy of PSA, however, can be enhanced by considering the variables of tumor grade and clinical stage. St...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61615-2
更新日期:1994-01-01 00:00:00
abstract::Cigarette smoking is the most important preventable cause of morbidity, mortality, and excess health care costs in the United States. From 2000 through 2004, cigarette smoking caused an estimated annual average of 443,595 deaths and cost $193 billion per year in smoking-attributable productivity losses and smoking-rel...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)60523-5
更新日期:2009-08-01 00:00:00
abstract::Acute disseminated encephalomyelitis, an inflammatory demyelinating disease of the central nervous system, can occur after viral infections or vaccinations. We report the clinical and neuroimaging findings in a 52-year-old man in whom acute disseminated encephalomyelitis developed after accidental self-injection of an...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/73.12.1193
更新日期:1998-12-01 00:00:00
abstract::A rapidly growing literature strongly suggests that exercise, specifically aerobic exercise, may attenuate cognitive impairment and reduce dementia risk. We used PubMed (keywords exercise and cognition) and manuscript bibliographies to examine the published evidence of a cognitive neuroprotective effect of exercise. M...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2011.0252
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To provide external validation of the diagnostic accuracy of the Sleep Apnea Clinical Score (SACS) tool in a new setting and patient population. PATIENTS AND METHODS:We conducted a prospective cohort study. Potential participants were adult family medicine patients. We excluded patients with a SACS of 0, kno...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.01.022
更新日期:2016-04-01 00:00:00
abstract::Hypothyroidism and hyperthyroidism are common medical disorders that are often accompanied by diverse types of neurologic and neuromuscular dysfunction. Although some of these associated disorders are well known to physicians, others are not. All of these neurologic manifestations are important because they can severe...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract::Nine patients with a progressive neurologic disorder that was characterized by mental deterioration, supranuclear vertical gaze paresis, and foam cells or sea-blue histiocytes in the bone marrow are described and compared with patients who were previously described as having " neurovisceral storage disease with vertic...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61464-5
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of aspirin and nonaspirin antiplatelet agents (NAAAs) on the performance of the fecal immunochemical test (FIT). PARTICIPANTS AND METHODS:We performed a post hoc analysis of results from a clinical trial that involved 28,696 asymptomatic average-risk men and women aged 50 to 69 years i...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/j.mayocp.2013.04.016
更新日期:2013-07-01 00:00:00