Multiple Symptoms and Multiple Illnesses
The term comorbidity has been defined as follows: The presence of coexisting or additional diseases with reference to an initial diagnosis or with reference to the index condition that is…
“Who Knows?”: 10 Steps to Better Prognostication
Although prognostication is most often associated with survival prediction, it is inextricably linked in a triad with diagnosis and treatment. Indeed, there is always the question of the likelihood (prognosis)…
Negotiating Goals of Care: Changing Goals Along the Trajectory of Illness
Negotiating goals of care is an example of patient-centered medical decision making, which differs significantly from the problem-oriented method practiced commonly in health care in the United States. A patient-centered…
Communication Skills
Introduction: the Role of Communication in Palliative Care Palliative care is all about the relief of suffering; most tangibly, palliative care aims to relieve the symptoms associated with terminal illness….
Comprehensive Assessment
Medical care depends on the traditional patient history and physical examination, an approach to patient assessment that has developed gradually over the course of the modern medical era. Variants that…
Motor Cortex Stimulation for Relief of Chronic Pain
Chapter Overview Chapter Synopsis: Many types of chronic pain can be improved by electrical stimulation of nerve tissue: in the periphery, at the spinal cord, and even in motor cortex….
Deep Brain Stimulation
Chapter Overview Chapter Synopsis: Most applications of electrical stimulation for the treatment of intractable pain are delivered at the spinal cord or in the periphery, but deep brain stimulation (DBS)…
Cost-Effectiveness of Neurostimulation
Chapter Overview Chapter Synopsis: Health care is expensive; and the up-front costs of electrical stimulation are significant, particularly when compared to more conventional treatments such as pharmacological interventions. Many insurance…
The Future of Neurostimulation
Chapter Overview Chapter Synopsis: Neurostimulation has made significant strides since Shealy first implanted a spinal cord stimulator in 1967. This chapter addresses some of these advances and others that may…
Peripheral Subcutaneous Stimulation for Intractable Pain
Chapter Overview Chapter Synopsis: Peripheral subcutaneous stimulation (PSS) provides a minimally invasive form of neurostimulation for intractable pain. This technique, also called peripheral nerve field stimulation , targets the small,…
