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Biomedical subjects

Francine Rainone

Publications and source records attributed to Francine Rainone.

3 recordsLinked to original sources

Milk thistle.

Milk thistle has been used as a cytoprotectant for the treatment of liver disease, for the treatment and prevention of cancer, and as a supportive treatment of Amanita phalloides poisoning. Clinical studies are largely heterogeneous and contradictory. Aside from mild gastrointestinal distress and allergic reactions, side effects are rare, and serious toxicity rarely has been reported. In an oral form standardized to contain 70 to 80 percent silymarin, milk thistle appears to be safe for up to 41 months of use. Significant drug reactions have not been reported. Clinical studies in oncology and infectious disease that are under way will help determine the efficacy and effectiveness of milk thistle.

Amanita↗

Pain management by the family physician: the family practice pain education project.

Pain is a common complaint of patients who visit a family physician, and its appropriate management is a medical mandate. The fundamental principles for pain management are: placing the patient at the center of care; adequately assessing and quantifying pain; treating pain adequately; maximizing function; accounting for culture and gender differences; identifying red and yellow flags early; understanding and differentiating tolerance, dependence and addiction; minimizing side effects; and being familiar with and using CAM therapies when good evidence of efficacy exists. The pharmacologic management of pain requires thorough knowledge of nonsteroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors, and opioids. A table of equianalgesic dosages is useful because patients may need to move from one opioid to another. Accompanying this article are papers discussing 5 common pain disorders seen by family physicians, including: neck pain, low back pain, joint pain, pelvic pain, and cancer/end of life pain. The family physician who learns these principles of pain management and the algorithms for these common pain disorders can serve patients well.

Analgesics↗

Treating adult cancer pain in primary care.

Family physicians take pride in addressing the totality of a patient's experience of disease and are skilled in a multidisciplinary approach to care. As such, they have an important role to play in managing adult cancer pain. Although 75% to 90% of cancer patients could receive adequate pain relief from routine pharmacologic therapies delivered by family physicians, pain continues to be undertreated in this population. Pain is a global experience affecting the whole person. Our role as patient advocates and educators makes us well suited to participate in the current national attempt to redress the lack of attention to this important component of suffering. This article reviews commonly seen cancer pain syndromes, with specific recommendations concerning assessment, reassessment, management, and indications for consultation.

Adult↗