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March 2011 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for March 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Early Rehabilitation Post-Knee Arthroplasty Beneficial

THURSDAY, March 31 (HealthDay News) -- Starting rehabilitation within 24 hours of total knee arthroplasty for osteoarthritis reduces the average hospital stay and the requisite number of sessions to achieve autonomy and normal gait and balance, according to a study published online March 7 in Clinical Rehabilitation.

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Osteoarthritis Patients Show Increased Pain Sensitivity

THURSDAY, March 31 (HealthDay News) -- Patients suffering from osteoarthritis (OA) are more sensitive to experimental pain at multiple body sites compared to healthy controls, according to a study published in the March issue of Arthritis Care & Research.

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Suicide in Musculoskeletal Patients at Older Age

THURSDAY, March 31 (HealthDay News) -- Suicide victims who have back pain or other musculoskeletal diseases (MSD) are older than those without MSD, according to a study published in the April 1 issue of Spine.

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Online Health Records Less Used by Minorities, Poor

WEDNESDAY, March 30 (HealthDay News) -- Online personal health records (PHRs) are less frequently used by racial or ethnic minorities and patients with low annual income, according to a study published in the March 28 issue of the Archives of Internal Medicine.

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Cannabis Use Tied to Poor Cognitive Function in MS

TUESDAY, March 29 (HealthDay News) -- Cannabis use among multiple sclerosis (MS) patients is associated with negative impacts on cognitive function, according to a study published in the March 29 issue of Neurology.

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Bariatric Surgery Weight Loss Tied to Migraine Improvement

TUESDAY, March 29 (HealthDay News) -- Severely obese people who suffer from migraines experience improvement in their headaches after losing a significant amount of weight following bariatric surgery, according to a study published in the March 29 issue of Neurology.

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Depression Tied to Worse Arthritic Knee Pain in Elderly

FRIDAY, March 25 (HealthDay News) -- Older adults who have minimal to moderate radiographic evidence of knee osteoarthritis (OA) have an increased likelihood of having more severe symptoms if they have coexisting depression, according to a study published in the March 16 issue of The Journal of Bone & Joint Surgery.

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Surgeon Enthusiasm for Spinal Surgery Drives Rates

FRIDAY, March 25 (HealthDay News) -- Surgical rates for degenerative diseases of the lumbar spine (DDLS) are mainly affected by surgeon enthusiasm for surgery and not by disease prevalence or community resources, according to a study published in the March 15 issue of Spine.

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Use of Strategies to Reduce Risk of Opioid Misuse Is Low

FRIDAY, March 25 (HealthDay News) -- The use of opioid risk-reduction strategies by primary care physicians is limited, even among patients at particular risk of misuse, according to a study published online Feb. 24 in the Journal of General Internal Medicine.

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U.S. Shingles Vaccine Approval Expanded

THURSDAY, March 24 (HealthDay News) -- The Zostavax shingles vaccine is now approved by the U.S. Food and Drug Administration for people aged 50 and older.

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Knee Replacement Improves Level of Physical Activity

THURSDAY, March 24 (HealthDay News) -- People who undergo total knee arthroplasty (TKA) for osteoarthritis experience substantial improvements in the level of physical activity within the first year after surgery, but their activity level is not correlated with clinical outcome, according to a study published in the March issue of Arthritis Care & Research.

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Reduced Hours for Trainees Has Had Little Effect in U.S.

THURSDAY, March 24 (HealthDay News) -- Reducing work hours for doctors in training to less than 80 per week has had little impact on patient outcomes or postgraduate training in the United States, according to a literature review published online March 22 in BMJ.

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Qigong Comparable to Exercise for Treating Neck Pain

WEDNESDAY, March 23 (HealthDay News) -- In patients with chronic neck pain, Qigong is comparable to exercise therapy and superior to no treatment, according to a study published in the March 15 issue of Spine.

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Chronic Widespread Pain Not Linked to Physical Trauma

MONDAY, March 21 (HealthDay News) -- Physically traumatic events are not associated with the development of chronic widespread pain (CWP), although being involved in a road accident may confer a modestly increased risk, according to a study published online March 21 in Arthritis Care & Research.

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Neck Disability Index Estimates SF-6D Utility Scores

FRIDAY, March 18 (HealthDay News) -- In patients with cervical degenerative disorders, Short Form-6D (SF-6D) utilities can be estimated using a Neck Disability Index (NDI) regression model, according to a study published online March 15 in Spine.

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Professional Values of U.S. and U.K. Doctors Examined

THURSDAY, March 17 (HealthDay News) -- A core of professional values exists among doctors in the United States and the United Kingdom, though significant differences exist in how these values are expressed and prioritized, according to a study published online March 7 in BMJ Quality & Safety.

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Short Nurse Staffing Linked to Higher Patient Mortality

WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.

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Drug-Related Poisonings Highest in Young Children

MONDAY, March 14 (HealthDay News) -- Emergency department visits for unintentional drug-related poisonings in the United States are highest among children age 0 to 5 and more prominent in rural areas, and young women have the highest rate of drug-related poisonings with suicidal intent, according to research published online March 3 in the American Journal of Emergency Medicine.

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Long-Term Increase in Death Rates After Head Injury

FRIDAY, March 11 (HealthDay News) -- Head injury is associated with increased susceptibility to death for at least 13 years after hospital admission, according to a study published online Jan. 31 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Risk of Infection, Malignancy With Anti-TNF Therapy Unclear

FRIDAY, March 11 (HealthDay News) -- Patients with early rheumatoid arthritis taking anti-tumor necrosis factor (TNF) therapy without prior use of disease-modifying anti-rheumatic drugs (DMARD)/methotrexate do not have an increased risk of serious infections or malignancies, according to a meta-analysis published online Feb. 25 in Arthritis & Rheumatism.

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Surgery Found Suitable for Discogenic Low Back Pain

FRIDAY, March 11 (HealthDay News) -- Surgical therapy is suitable for patients with discogenic low back pain (DLBP), with posterolateral fusion with pedicle screws (PLF) reserved for patients who are unsuitable for anterior interbody fusion (ABF) surgery, according to a study published in the March 1 issue of Spine.

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Automated Propofol and Remifentanil Delivery Effective

FRIDAY, March 11 (HealthDay News) -- Automated delivery of propofol and remifentanil using a controller maintains the Bispectral Index (BIS) values better than manual administration during general anesthesia, according to a study published in the March issue of Anesthesia & Analgesia.

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Pulsed Electrical Stimulation As Effective As Placebo

THURSDAY, March 10 (HealthDay News) -- For patients with moderate to severe osteoarthritis of the knee who suffer from mild to moderate symptoms, 26 weeks of pulsed electrical stimulation (PES) therapy is no more effective than placebo, according to a study published online Feb. 10 in Arthritis & Rheumatism.

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Benlysta Approved for Lupus

THURSDAY, March 10 (HealthDay News) -- Benlysta (belimumab) has been approved by the U.S. Food and Drug Administration to treat lupus, the first medication sanctioned for the condition in the United States since 1955.

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HealthGrades Finds Rates of Patient Safety Events Vary

WEDNESDAY, March 9 (HealthDay News) -- Patients treated at hospitals rated with a HealthGrades Patient Safety Excellence Award have, on average, a 46 percent lower risk of experiencing a patient safety incident compared to those treated at the lowest-ranked hospitals, according to the eighth annual HealthGrades Patient Safety in American Hospitals Study published online March 9.

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Ethnic Differences Seen in Academic Measures for U.K. Docs

WEDNESDAY, March 9 (HealthDay News) -- United Kingdom-trained physicians and medical students with ethnic minority backgrounds tend to underperform academically compared to their white peers, according to a meta-analysis published online March 8 in BMJ.

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Pharmacological Meta-Analyses Rarely Report Disclosures

TUESDAY, March 8 (HealthDay News) -- Meta-analyses of pharmacological treatments rarely include information addressing primary study funding and conflicts of interest (COIs) of the authors for the included randomized control trials (RCTs), according to a study published in the March 9 issue of the Journal of the American Medical Association.

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Improvement in Fibromyalgia Pain Scale Quantified

TUESDAY, March 8 (HealthDay News) -- A two-point improvement on the Brief Pain Inventory (BPI) represents the minimum clinically important difference (MCID) for patients with fibromyalgia pain, corresponding to a 30 to 35 percent improvement from baseline, according to a study published online Feb. 10 in Arthritis Care & Research.

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Majority of Pediatric Burn Admissions Due to Scalding

TUESDAY, March 8 (HealthDay News) -- Although admission rates for burn injury declined from 1983 to 2008, more than half of burn-injury hospital admissions for children younger than 5 years of age in Western Australia are due to scalding, according to a study published online March 7 in Pediatrics.

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Corrective Lumbar Fusion Offers Modest Improvement

MONDAY, March 7 (HealthDay News) -- Patients undergoing lumbar fusion to revise a prior surgery have modest health-related quality of life improvements, according to a study published in the Feb. 15 issue of Spine.

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Remission Tied to Earlier Rheumatoid Arthritis Treatment

MONDAY, March 7 (HealthDay News) -- For patients with rheumatoid arthritis (RA), earlier treatment is associated with an increased likelihood of achieving remission, according to a study published online Feb. 18 in Arthritis Care & Research.

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Ankle Replacement Provides Pain Relief in Gouty Arthritis

MONDAY, March 7 (HealthDay News) -- Total ankle replacement provides significant pain relief and good functional results in patients with painful gouty ankle arthritis, and it is associated with a low risk of complications, according to a study published in the Feb. 16 issue of The Journal of Bone & Joint Surgery.

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FDA: Topiramate (Topamax) Tied to Risk of Oral Clefts

FRIDAY, March 4 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care providers and consumers that new data indicate that women who take topiramate (Topamax) during pregnancy increase the risk for cleft lip and cleft palate in their offspring.

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Cannabis Use in Youth Ups Incident Psychosis Risk

THURSDAY, March 3 (HealthDay News) -- Cannabis use among youth is associated with an increased risk of later incident psychotic symptoms, with continued cannabis use increasing the risk for persistent psychotic symptoms, according to a study published online March 1 in BMJ.

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Maternal Opioid Use Tied to Higher Birth Defect Risk

WEDNESDAY, March 2 (HealthDay News) -- Maternal use of opioid analgesics just prior to or during early pregnancy is associated with a modestly higher risk of certain birth defects, according to a study published online Feb. 24 in the American Journal of Obstetrics & Gynecology.

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Fish Oil May Help Cancer Patients Maintain Weight

WEDNESDAY, March 2 (HealthDay News) -- Supplementation with fish oil (FO) may help non-small-cell lung cancer patients maintain weight and muscle mass during chemotherapy, according to research published online Feb. 28 in Cancer.

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Inhaled Nitric Oxide Does Not Shorten Sickle Cell Crisis

WEDNESDAY, March 2 (HealthDay News) -- Among patients with sickle cell disease (SCD), the use of inhaled nitric oxide does not reduce the time to resolution of a vaso-occlusive pain crisis (VOC) compared to placebo, according to a study published in the March 2 issue of the Journal of the American Medical Association.

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Opioid Treatment Associated With Cognitive Dysfunction

TUESDAY, March 1 (HealthDay News) -- One-third of opioid-treated patients with cancer have possible or definite cognitive dysfunction, according to a study published online Feb. 28 in the Journal of Clinical Oncology.

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Helmets Protect Motorcyclists From Cervical Spine Injury

TUESDAY, March 1 (HealthDay News) -- Motorcyclists who wear helmets are less likely to suffer a cervical spine injury after a collision, according to a study published in the March issue of the Journal of the American College of Surgeons.

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Many Patients Do Not Consolidate Drugs Efficiently

TUESDAY, March 1 (HealthDay News) -- Many patients, especially those with low literacy, do not consolidate prescription regimens efficiently, according to a study published in the Feb. 28 issue of the Archives of Internal Medicine.

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Physician's Briefing