Cleveland Clinic journal of medicine
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Most patients with cancer experience pain at some point in the disease course due to the disease itself or its treatment, or both. Pain management can involve pharmacologic (nonopioid medications, adjuvants, and opioids) and nonpharmacologic (radiation therapy, interventional procedures) therapies. This article provides a treatment approach to reduce pain for patients with cancer and improve their quality of life.
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Vaccination in pregnancy is an important part of maternity care, but maternal immunization rates continue to be below national benchmarks. Influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccinations have been shown to be safe and provide important protections to pregnant women, the fetus, and neonates. Although obstetrician-gynecologists provide the bulk of pregnancy care, general internists and medical specialists have frequent clinical encounters with maternity patients and should assist in immunization education and administration.
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Recent reports of allergic reactions to the Pfizer-BioNTech and the Moderna COVID-19 vaccines have resulted in questions about how and to whom they can be safely administered. Although anaphylaxis was not observed in clinical trials for either vaccine, there have been 21 reported possible cases of anaphylaxis associated with the Pfizer vaccine (11.1 cases per million doses administered) and 10 possible cases associated with the Moderna vaccine (2.5 anaphylaxis cases per million doses administered). ⋯ The overall incidence of anaphylaxis to COVID-19 mRNA vaccines is very low. By following recommendations from the US Centers for Disease Control and Prevention, an overwhelming majority of the US population can be safely immunized.