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September 2011 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for September 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.

Doctors, Patients Identify Tacit Clues in Their Interactions

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

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Spinal MRI Reviewer Accuracy Equal Across Training Levels

FRIDAY, Sept. 30 (HealthDay News) -- Doctors at multiple levels of training can accurately and efficiently interpret the integrity of the posterior ligamentous complex (PLC) on spinal magnetic resonance imaging (MRI), according to a study published in the August issue of The Spine Journal.

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U.S. Nonelderly Mental Health Disability Up 1997 to 2009

THURSDAY, Sept. 29 (HealthDay News) -- Self-reported mental health disability in nonelderly U.S. adults has increased slightly from 1997 to 2009, especially among adults who reported disability due to other chronic conditions and a greater level of psychological distress but who had no contact with mental health professionals over the past year, according to a study published online Sept. 22 in the American Journal of Public Health.

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Three Weekly Hyaluronate Shots Improve Ankle Arthritis

THURSDAY, Sept. 29 (HealthDay News) -- Three weekly intra-articular injections of hyaluronate are safe and effective for patients with unilateral ankle arthritis, according to a study published in the Sept. 21 issue of The Journal of Bone & Joint Surgery.

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Stratified Care May Be Best Option for Back Pain Patients

THURSDAY, Sept. 29 (HealthDay News) -- Stratifying back pain patients by prognosis may be more effective and less costly than a one-size-fits-all approach, according to research published online Sept. 29 in The Lancet.

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Elderly Recover Adequately After Cervical Laminoplasty

WEDNESDAY, Sept. 28 (HealthDay News) -- Elderly patients with cervical spondylotic myelopathy (CSM) can benefit from laminoplasty and have adequate recoveries in terms of achieved Japanese Orthopedic Association (JOA) scores for cervical myelopathy, according to a study published online Sept. 8 in Spine.

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DMARDs Found to Be Effective Treatment for Juvenile Arthritis

WEDNESDAY, Sept. 28 (HealthDay News) -- Disease-modifying anti-rheumatic drugs (DMARDs) may be more effective than ibuprofen or steroids in controlling juvenile idiopathic arthritis (JIA), but there is little strong evidence to support their long-term use, according to a new report released by the U.S. Department of Health and Human Service's Agency for Healthcare Research and Quality (AHRQ).

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U.S. Docs Feel They Give More Patient Care Than Required

TUESDAY, Sept. 27 (HealthDay News) -- Many primary care physicians in the United States believe that their patients are receiving too much medical care, and that the pressure to do more than is necessary could be reduced by malpractice reform, adjusting financial incentives, and spending more time with patients, according to a study published in the Sept. 26 issue of the Archives of Internal Medicine.

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Bigger Osteophyte Size Ups Severe Cartilage Damage Risk

TUESDAY, Sept. 27 (HealthDay News) -- For patients with magnetic resonance imaging (MRI)-diagnosed tibiofemoral osteoarthritis, the likelihood of severe cartilage damage increases with increasing osteophyte size, and only a small proportion of knees exhibit atrophic and hypertrophic phenotypes, according to a study published online Sept. 14 in Arthritis & Rheumatism.

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Reasons for Referral to Specific Docs Differ Among Physicians

TUESDAY, Sept. 27 (HealthDay News) -- Primary care physicians (PCPs) and medical and surgical specialists differ in their reasons for selecting specific colleagues for referrals, with PCPs more concerned about physician communication and medical record sharing than specialists, according to a study published online Sept. 16 in the Journal of General Internal Medicine.

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Lower Walking Speed, Altered Gait in Overweight Women

MONDAY, Sept. 26 (HealthDay News) -- Overweight, older women have altered gait and reduced walking performance due to poor relative strength and rate of torque development (RTD) of lower-extremity muscles compared to older women of normal weight, according to a study published in the October issue of the Journal of Electromyography and Kinesiology.

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Multilevel Hemilaminectomy Economical for Lumbar Stenosis

FRIDAY, Sept. 23 (HealthDay News) -- Multilevel hemilaminectomy is a cost-effective treatment for lumbar stenosis-associated radiculopathy, and it improves pain, disability, and quality of life among patients, according to a study published in the August issue of The Spine Journal.

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Back Pain Outcomes Similar for Surgery, Cognitive Intervention

FRIDAY, Sept. 23 (HealthDay News) -- Patients with chronic low back pain (CLBP) and disc degeneration who undergo either surgery or cognitive intervention and exercise have similar results for trunk muscle strength, cross-sectional area, and density at a seven- to 11-year follow-up, according to a study published in the August issue of The Spine Journal.

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BMI, Tibiofemoral Alignment Affect Knee Implant Survival

THURSDAY, Sept. 22 (HealthDay News) -- Proper tibial, femoral, and overall anatomic alignment is important for implant survival after total knee replacement, and a higher body mass index (BMI) increases implant failure rates, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Videos Prior to Spine Surgery Aid, Strengthen Patient Choices

WEDNESDAY, Sept. 21 (HealthDay News) -- Watching an evidence-based videotape decision aid helps patients with lumbar spine disorders form and/or strengthen a treatment preference in a balanced, unbiased way, according to a study published online Aug. 15 in Spine.

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Mortality Up in Hospitals With More Minority Trauma Patients

WEDNESDAY, Sept. 21 (HealthDay News) -- The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online Sept. 19 in the Archives of Surgery.

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Work Intensity Similar Across Physician Specialties

MONDAY, Sept. 19 (HealthDay News) -- The level of physician work intensity appears to be similar among specialties, with variations in the specific dimensions of stress, physical demands, performance, and temporal demand, according to a study published online Sept. 3 in Medical Care.

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MS-Related Disorders ID'd by Proteomic Pattern Analysis

MONDAY, Sept. 19 (HealthDay News) -- Proteomic pattern analysis of cerebrospinal fluid (CSF) analysis using matrix-assisted laser desorption/ionization time-of-flight (MALDI) mass spectrometry distinguishes between similar multiple sclerosis (MS)-related disorders, according to a study published online Sept. 12 in the Annals of Neurology.

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Posterior Shoulder Dislocation Has Low Prevalence

MONDAY, Sept. 19 (HealthDay News) -- Prevalence of posterior dislocation is low, with recurrent instability the most common complication after injury, and functional deficit persisting at two years after injury, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

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Increased Basal Ganglia Gray Matter in Rheumatoid Arthritis

MONDAY, Sept. 19 (HealthDay News) -- Patients with rheumatoid arthritis (RA) have increased gray matter in the basal ganglia, especially in the nucleus accumbens and caudate nucleus, but not changes in the cortical gray matter, according to a study published online Sept. 8 in Arthritis & Rheumatism.

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Child Self-Exposure to Meds Explains Most Drug Poisoning

FRIDAY, Sept. 16 (HealthDay News) -- Child self-exposure to prescription medications was responsible for 95 percent of the cases of pediatric pharmaceutical poisonings between 2001 and 2008, with the greatest resource use and morbidity due to self-ingestion of prescription products, including opioids, sedative-hypnotics, and cardiovascular agents, according to a study published online Sept. 16 in The Journal of Pediatrics.

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Specific Pain Reduction Seen With Transdermal Buprenorphine

THURSDAY, Sept. 15 (HealthDay News) -- Transdermal buprenorphine, but not fentanyl, significantly reduces pain in experimentally induced bone-associated pain and primary hyperalgesia, according to a study published in the October issue of the British Journal of Pharmacology.

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Surgery Effective for Subaxial Cervical Synovial Cysts

THURSDAY, Sept. 15 (HealthDay News) -- Surgical resection can be an effective treatment for patients presenting with cervical radiculopathy or myelopathy who have a subaxial cervical synovial cyst with minimal postoperative complications, according to a study published in the Sept. 15 issue of Spine.

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Long-Term Nonaspirin NSAID Use Ups Renal Cell Cancer Risk

WEDNESDAY, Sept. 14 (HealthDay News) -- Use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs), but not aspirin and acetaminophen, is associated with an increased risk of renal cell cancer (RCC), with increased duration of use correlated with an elevated risk, according to a study published in the Sept. 12 issue of the Archives of Internal Medicine.

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Many Mistakenly Believe FDA OKs Only Safe, Effective Drugs

WEDNESDAY, Sept. 14 (HealthDay News) -- A considerable proportion of the U.S. public mistakenly believes that the U.S. Food and Drug Administration approves only effective and safe drugs, but providing consumer explanations can lead to better drug choices, according to a study published in the Sept. 12 issue of the Archives of Internal Medicine.

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Abnormal Hippocampal Blood Flow Persists in Gulf War Vets

TUESDAY, Sept. 13 (HealthDay News) -- For Gulf War veterans with specific syndromes, abnormal hippocampal blood flow persists, and in some cases worsens, 11 years after initial testing, according to a study published online Sept. 13 in Radiology.

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TNF Inhibitors for RA Do Not Increase Malignancy Risk

MONDAY, Sept. 12 (HealthDay News) -- Treatment of rheumatoid arthritis (RA) with tumor necrosis factor inhibitors (TNFi) does not increase risk of malignancy, including lymphoma, but it may increase the risk of non-melanoma skin cancer and melanoma, according to a meta-analysis published online Sept. 1 in the Annals of Rheumatic Diseases.

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Opioid Delivery to Olfactory Region Ups Therapeutic Effects

FRIDAY, Sept. 9 (HealthDay News) -- Administration of opioids directly to the nasal olfactory region results in a larger fraction of drug being delivered to the central nervous system (CNS) and a significantly higher therapeutic effect without an increase in plasma drug exposure compared to drug delivery to the nasal respiratory region in rats, according to an experimental study published in the September issue of Anesthesia & Analgesia.

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Gestational NSAID Intake Tied to Spontaneous Abortion Risk

WEDNESDAY, Sept. 7 (HealthDay News) -- Exposure to any type or dosage of nonaspirin nonsteroidal anti-inflammatory drug (NSAID) in early pregnancy increases the risk of spontaneous abortion, according to a study published online Sept. 6 in CMAJ, the journal of the Canadian Medical Association.

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Odds of Board Certification Vary in New Doctors

WEDNESDAY, Sept. 7 (HealthDay News) -- Certification of recent U.S. medical school graduates by the American Board of Medical Specialties (ABMS) varies across specialties by educational and demographic factors, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Medical Students Show Racial, Cultural Patient Preference

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical students may have a preferential bias toward whites and wealthier patients, but this does not appear to influence their clinical decision making or physician-patient interactions, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Many Hospital Staff Uniforms Contaminated With Bacteria

WEDNESDAY, Sept. 7 (HealthDay News) -- More than 60 percent of hospital staff uniforms are contaminated with potentially pathogenic bacteria, including drug-resistant species, according to a study published in the September issue of the American Journal of Infection Control.

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Simvastatin Neuroprotective for Spinal Cord Ischemia in Rats

FRIDAY, Sept. 2 (HealthDay News) -- Simvastatin significantly reduces hindlimb motor dysfunction, and reduces white- and gray-matter injury 24 to 48 hours after reperfusion in rats with spinal cord ischemia, according to an experimental study published in the September issue of Anesthesia & Analgesia.

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Dexamethasone Dose of >0.1 mg/kg Reduces Post-Op Pain

THURSDAY, Sept. 1 (HealthDay News) -- Dexamethasone at doses of greater than 0.1 mg/kg decreases postoperative pain and reduces opioid consumption, according to a meta-analysis published in the September issue of Anesthesiology.

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