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April 2013 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for April 2013. 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.

Renewed Efforts From AAFP to Repeal OTC Provision in ACA

TUESDAY, April 30 (HealthDay News) -- Members of the American Academy of Family Physicians (AAFP) and other medical associations are urging further consideration of Section 9003 of the Patient Protection and Affordable Care Act (ACA) that requires holders of tax-preferred health care accounts to obtain a physician's prescription to use funds from those accounts to pay for over-the-counter (OTC) medications. The concerns have been laid out in a letter to the chair and the ranking member of the House Committee on Ways and Means.

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FDA Announces New Network to Focus Exclusively on Patients

MONDAY, April 29 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new interactive tool for educating patients, their advocates, and consumers about the processes involved in medication development.

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FDA: Purveyors of Phony Botox Targeting U.S. Practices

MONDAY, April 29 (HealthDay News) -- Medical practices that purchase Botox may unwittingly be purchasing a fraudulent product not approved by the U.S. Food and Drug Administration for sale in the United States, according to an April 26 drug safety alert issued by the agency.

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Medical Interns Spending Less Time With Patients

FRIDAY, April 26 (HealthDay News) -- Medical interns are spending less time with patients and more time at a computer since new rules limiting total work hours were instituted in 2011, according to a study published online April 18 in the Journal of General Internal Medicine.

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Standard Criteria Needed for Spinal Stenosis Diagnosis

FRIDAY, April 26 (HealthDay News) -- There is a need for a consensus on criteria to define and classify lumbar spinal stenosis, according to a review published in the April 15 issue of Spine.

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Saturday Marks Sixth Annual Rx Drug Take-Back Day

FRIDAY, April 26 (HealthDay News) -- United States residents across the nation will have an opportunity to safely and anonymously unload expired, unwanted prescription medications on Saturday, April 27, during the sixth annual National Prescription Drug Take-Back Day.

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Mindfulness-Based Cognitive Therapy Improves PTSD

FRIDAY, April 26 (HealthDay News) -- Mindfulness-based cognitive therapy (MBCT) can provide significant and clinically meaningful improvement in posttraumatic stress disorder (PTSD) symptoms, according to a pilot study published online April 17 in Depression and Anxiety.

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Review: All Approved Drugs Similarly Prevent Migraines

THURSDAY, April 25 (HealthDay News) -- There is no significant difference in effectiveness in approved drugs for preventing episodic migraine frequency by 50 percent or more, according to a review published in the April issue of the Journal of General Internal Medicine.

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Analgesics in Endurance Events Can Have Serious Adverse Effects

THURSDAY, April 25 (HealthDay News) -- Analgesic use before endurance sports can cause serious medical events, according to a study published online April 19 in BMJ Open.

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Physicians Less Empathetic in Talking to Heavy Patients

THURSDAY, April 25 (HealthDay News) -- Primary care physicians (PCPs) are less likely to bond with overweight and obese patients, according to research published online March 20 in Obesity.

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Pill Form of Marijuana Found to Alleviate Pain for Longer Period

WEDNESDAY, April 24 (HealthDay News) -- Dronabinol (Δ9 tetrahydrocannabinol [THC]), a pharmaceutical formulation of the psychoactive component of marijuana, produces a longer duration of pain relief than smoked marijuana, according to a small study published online April 22 in Neuropsychopharmacology.

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Diagnostic Errors Are the Leading Type of Malpractice Claim

WEDNESDAY, April 24 (HealthDay News) -- In the past 25 years, diagnostic errors have been the leading type of malpractice claim and account for the highest proportion of total payments, according to a study published online April 22 in BMJ Quality & Safety.

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Parental Permissiveness Linked to Rx Drug Abuse, Misuse

TUESDAY, April 23 (HealthDay News) -- Nearly one-quarter of teenagers misuse or abuse a prescription drug at least once in their lifetime, with perceived parental permissiveness linked to misuse and abuse of prescription drugs as well as use of alcohol and marijuana, according to a report published online April 23 by The Partnership at Drugfree.org.

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Severe Cutaneous Adverse Rxns Up in Allopurinol Initiators

TUESDAY, April 23 (HealthDay News) -- Allopurinol initiators have an almost 10-fold increased risk of severe cutaneous adverse reactions (SCARs) compared with nonusers, according to a study published in the April issue of Arthritis Care & Research.

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FDA Approves Updated Label for Reformulated OxyContin

FRIDAY, April 19 (HealthDay News) -- The U.S. Food and Drug Administration has approved updated labeling for Purdue Pharma L.P.'s reformulated OxyContin (oxycodone hydrochloride controlled-release) tablets, which will indicate that the reformulated product has physical and chemical properties that should make abuse by injection very difficult and reduce intranasal abuse.

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Patient-Centered Decision Making Ups Health Outcomes

FRIDAY, April 19 (HealthDay News) -- Patient-centered decision making (PCDM) is associated with improved health care outcomes, according to a study published in the April 16 issue of the Annals of Internal Medicine.

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Pot Smoking Linked to Some Metabolic Changes

FRIDAY, April 19 (HealthDay News) -- Regularly smoking pot is associated with visceral adiposity and adipose tissue insulin resistance, but not other metabolic changes such as impaired β-cell function or hepatic steatosis, according to a study published online March 25 in Diabetes Care.

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Guidelines Issued Relating to Online Medical Professionalism

THURSDAY, April 18 (HealthDay News) -- Physicians should be aware of the benefits on online media and should recognize the implications for patient confidentiality and public perception, according to a position paper published in the April 16 issue of the Annals of Internal Medicine.

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Family-Centered Teaching Rounds Good for Patients, Students

THURSDAY, April 18 (HealthDay News) -- Teaching and conducting rounds in the presence of patients and their families can be beneficial for patients and learners, according to research published online April 15 in Pediatrics.

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Relative Proportion of MRSA Increasing in S. aureus Isolates

THURSDAY, April 18 (HealthDay News) -- The relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) is increasing in S. aureus isolates, and methicillin-sensitive S. aureus (MSSA) is becoming increasingly resistant to antibiotics, according to a study published in the April issue of JAMA Dermatology.

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Community Benefit Spending Varies for Tax-Exempt Hospitals

WEDNESDAY, April 17 (HealthDay News) -- There is considerable variation in the level of community benefit expenditure by tax-exempt hospitals, according to a study published in the April 18 issue of the New England Journal of Medicine.

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Presenting Fee Data to Docs Cuts Number of Tests Ordered

WEDNESDAY, April 17 (HealthDay News) -- Presenting fee data to providers at the time of laboratory test orders is associated with a small reduction in the number of tests ordered, according to a study published online April 15 in JAMA Internal Medicine.

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Re-Op Rates ID'd for Herniated Intervertebral Disc Disease

MONDAY, April 15 (HealthDay News) -- For patients undergoing surgery for lumbar herniated intervertebral disc disease, reoperation rates reach 13.4 percent after five years, with more than half of reoperations occurring in the first year, according to a study published in the April 1 issue of Spine.

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Surgeons Support Nonphysician Screens for Low Back Pain

FRIDAY, April 12 (HealthDay News) -- Most spine surgeons are interested in a nonphysician clinician (NPC) model of care for screening of low back or low back-related leg pain for patients referred for a surgical assessment, according to a study published in the April 1 issue of Spine.

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Speech Details Practices to Improve U.S. Health Systems

THURSDAY, April 11 (HealthDay News) -- There are specific steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs, according to remarks made in an April 9 speech to the National Press Club.

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Readmission Rates ID'd After Spine Stenosis Decompression

THURSDAY, April 11 (HealthDay News) -- For patients undergoing lumbar spine stenosis decompression surgery with or without fusion, the one-year readmission rate is 9.7 or 7.2 percent, respectively, according to a study published in the April 1 issue of Spine.

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Fusion Doesn't Up Reoperation Risk With Spinal Stenosis

THURSDAY, April 11 (HealthDay News) -- For patients undergoing surgical treatment of spinal stenosis, lumbar fusion and instrumentation do not increase the rate of reoperation at index or adjacent levels compared with nonfusion techniques, according to a study published in the April 1 issue of Spine.

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Polymorphism in Estrogen Receptor α Linked to Back Pain

WEDNESDAY, April 10 (HealthDay News) -- For women with degenerative spondylolisthesis (DS), polymorphisms in the estrogen receptor α (ERα) are associated with back pain intensity, according to a study published in the April issue of the Journal of Spinal Disorders and Techniques.

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Functional MRI Can Be Used to Assess Physical Pain

WEDNESDAY, April 10 (HealthDay News) -- Functional magnetic resonance imaging (fMRI) can be used to as a sensitive and specific tool to assess pain elicited by noxious heat in healthy persons, according to a study published in the April 11 issue of the New England Journal of Medicine.

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Review Supports Fusion for Disc-Related Chronic Low Back Pain

WEDNESDAY, April 10 (HealthDay News) -- Clinical outcomes are positive for patients with chronic low back pain due to degenerative disc disease who undergo lumbar fusion, according to a review published in the April 1 issue of Spine.

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NYC Health Department, ER Docs Clash Over Opioid Guidelines

TUESDAY, April 9 (HealthDay News) -- There is uncertainty as to whether the New York City Emergency Department Discharge Opioid Prescribing Guidelines will aid emergency physicians as they weigh the complex decisions of relieving patient pain while working to ensure patient safety, according to opposing viewpoints published online April 8 in the Annals of Internal Medicine.

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Spinal Adjustment Relieves Symptoms Better Than NSAIDs

MONDAY, April 8 (HealthDay News) -- Spinal manipulation is significantly superior to anti-inflammatory drugs for the treatment of acute, nonspecific low back pain (LBP), according to a study published in the April issue of Spine.

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Acupuncture Reduces Pain of Chronic Low Back Discomfort

MONDAY, April 8 (HealthDay News) -- Individualized acupuncture treatment reduces some negative symptoms of chronic low back pain (cLBP) better than sham treatment, according to a study published in the April issue of Spine.

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Majority of Americans Now Favor Legalizing Marijuana

MONDAY, April 8 (HealthDay News) -- A majority of Americans (52 percent) now favor legalizing marijuana, and 72 percent feel that the government efforts to enforce marijuana laws are not worth their cost, according to research published by the Pew Research Center.

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Chronic Pain Syndromes Are Common After Ischemic Stroke

FRIDAY, April 5 (HealthDay News) -- About 10 percent of patients develop chronic pain syndromes post-stroke, and these patients are more likely to have increased functional dependence and cognitive decline, according to research published online April 4 in Stroke.

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Glucocorticoids Are Tied to Increased Risk of Clots

THURSDAY, April 4 (HealthDay News) -- Glucocorticoid users face an increased risk of venous thromboembolism (VTE), according to a study published online April 1 in JAMA Internal Medicine.

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Belgium Study Tracks Trends in End-of-Life Decision Making

WEDNESDAY, April 3 (HealthDay News) -- In Belgium, between 1998 and 2007, euthanasia was legalized and palliative care was intensified, which led to an increase in end-of-life decisions (ELDs) and fewer life-ending acts without the patient's explicit request, according to research published online March 11 in the Journal of Clinical Oncology.

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Duloxetine Is Effective for Reducing Chemotherapy Pain

TUESDAY, April 2 (HealthDay News) -- Duloxetine is effective in reducing pain in patients with painful chemotherapy-induced peripheral neuropathy, according to a study published online April 2 in the Journal of the American Medical Association.

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Motor Control Exercises Successful in Curbing Back Pain

MONDAY, April 1 (HealthDay News) -- Motor control exercises (MCE) are better at reducing pain and disability than other treatments for chronic low back pain (LBP), according to a review published in the March 15 issue of Spine.

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Study Assesses Work Force Burden of Ulcerative Colitis

MONDAY, April 1 (HealthDay News) -- Compared to the general population, patients with ulcerative colitis (UC) miss more work days, and patients who undergo colectomy do not fully restore work ability, according to research published in the March issue of Gastroenterology.

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Most Partners of U.S. Docs Satisfied in Their Relationships

MONDAY, April 1 (HealthDay News) -- Most spouses/partners of U.S. physicians report being satisfied with their relationships, with satisfaction linked to time spent together each day, according to research published in the March issue of the Mayo Clinic Proceedings.

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