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Clinical Accuracy Spoken Here
Pain Management: Physiology

Pain is the result of a pain stimulus from organs, musculoskeletal structures or damage to nerves that activates the nonciceptors in the peripheral nervous system. This transfers to the central nervous sytem and is carried to the brain, via the spinal cord, conveying information, without conscious awareness, about damage in body tissues. Neuropathic pain differs from nociceptive pain in that it involves damage to the peripheral or central nervous system resulting in the sensation of pain. Lastly is central pain. Pain is generated from a central nervous system lesion. It is the most difficult for doctors to treat.

Pain Management: Module A, Pathophysiology www.athenaforum.com

Women’s Health: Screening for Osteoporosis

Often not diagnosed until a fall occurs, osteoporosis fractures have a cost impact in the U.S. of $18 Billion per year. Of the 10 million women who have osteoporosis only 29% have been diagnosed. According to the National Institute of Health a woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer. One-fourth of patients who had been ambulatory (and sustain a hip fracture) will require long-term care. Evaluating women at risk for osteoporosis may be as simple as referring the woman to an online screening tool.

Women’s Health: Module D, CM Role
Excellence in Case Mgmnt
Principles of CM: CM Assigned to MD

The Joint Commission states that a case manager can be positioned as a resource to, or a member of, the pre-admission evaluation by the case manager who will be following the patient during the acute care episode. This is easily accomplished in a case management model that assigns case managers to physicians and affords the opportunity to discuss with the physician any anticipated case management involvement during the patient’s actual admission.

Reference: Principles of Case Management: Module A, Access to Care

In the Headlines . . .
Tamoxifen Success Sustained:

A meta-analysis in The Lancet found that five-year treatment with tamoxifen lowered the risk of recurrence and death by about one-third in women with estrogen receptor-positive breast cancer, and that the benefit lasted for 10 years after patients stopped taking the medicine. The finding indicates "that tamoxifen as an adjuvant [additional] therapy for breast cancer has had a very successful track record that has been sustained over 30 years of use in the clinic, even though it's used less now," said Dr. Len Lichtenfeld of the American Cancer Society. HealthDay News (7/28).

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The look of confidence
  CM Excellence® Series: 
  » Principles of Case
  » Patient Advocacy
  » Utilization Management
  » Discharge Planning
  » Hospital Revenue Cycle

  Clinical Series: 
  » Asthma
  » Behavioral Health
  » Colorectal Cancer
  » COPD
  » CV Risk: Stroke & MI
  » Diabetes
  » EOL & Palliative
  » GI Disorders
  » Heart Failure
  » Multiple Sclerosis
  » Obesity Management
  » Pain Management
  » Rheumatoid Arthritis
  » Women’s Health



Cathy Wright Cathy Wright, BSN, RN
Clinical Editor
Athena Forum


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