Le Journal médical libanais. The Lebanese medical journal
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Opioids remain essential drugs for the treatment of severe cancerous pain. However, many countries have developed new regulations and policies for a better availability and accessibility of these drugs. ⋯ The Ministry of Health and specifically the Narcotic Department have adjusted regulations related to opioid prescriptions and have registered many new opioid drugs in 2012 for a better pain-free life for our patients. However, there is still a lot to do in this field.
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Historical Article
[History of pain: from Greek antiquity to the 21st century].
The history of pain is one of the concepts that have divided Cartesian thinkers and mystical philosophers in the Western civilization over centuries. Depending on the historical period, different dogmas and morals intersect, oppose or attempt conciliation. ⋯ Yesterday, pain was accepted or sublimated. Today, taking care of pain is a patient basic right and an obligation for the practitioner.
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Delirium is an acute and common problem often affecting frail and older persons in the acute care hospital, but can develop in any setting. It is associated with serious complications but can also be treatable if diagnosed early and managed properly. Preventive measures should be implemented in high risk patients, such as those with malnutrition, polypharmacy, infections, previous delirium, or dementia. ⋯ Diagnosing delirium can be based on the DSM criteria, though multiple useful screening tools exist. Since delirium is almost always triggered by an underlying condition, an aggressive search for the causative insult(s) is essential in order that a targeted intervention be started promptly. Although there is neither any medication approved by the FDA for the treatment of delirium nor any robust evidence supporting the benefit of medications, there is general consensus that drug intervention can be attempted when non-pharmacological interventions have failed.