Mayo Clinic proceedings
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Mayo Clinic proceedings · Sep 1997
Referral of patients with pain from pancreatic cancer for neurolytic celiac plexus block.
To assess whether patients with pancreatic cancer-associated pain living near a pain control center were more likely to undergo neurolytic celiac plexus block (NCPB) than those living at a distance and to determine the rationale of physicians at our institution for referring patients for NCPB. ⋯ On the basis of this study, referral patterns for NCPB in patients with pancreatic cancer do not seem to be associated with the geographic distance of a patient's residence from a pain control center. Improving appointment availability for NCPB might increase the number of patients offered this technique for control of pain.
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Although the cause of multiple sclerosis (MS) is unknown, epidemiologic studies support both genetic and environmental components of susceptibility. Reports of clusters, small "epidemics," geographic variation in prevalence, and alteration of MS susceptibility by migration support an environmental factor (or factors). ⋯ Findings from epidemiologic studies are most consistent with an environmental influence occurring on a background of genetic susceptibility as the cause of MS. Currently, there is little evidence for a single or unique environmental cause of MS.