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August 2013 Briefing - Pain Management

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

Discontinuing Aspirin Seven Days Before Spinal Surgery OK

FRIDAY, Aug. 30 (HealthDay News) -- Patients who discontinue aspirin use seven days or more before lumbar fusion surgery have no differences in histological outcomes compared with those who do not use aspirin, according to a study published in the Aug. 15 issue of Spine.

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Structural Brain Changes More Common in Migraineurs

THURSDAY, Aug. 29 (HealthDay News) -- Structural brain changes seem to be more common for migraineurs, and the incidence rate of migraine is inversely related to household income, according to research published online Aug. 28 and 29 in Neurology.

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Final Rules Issued for Individual Shared Responsibility Mandate

WEDNESDAY, Aug. 28 (HealthDay News) -- Starting 2014, the individual shared responsibility provision of the Affordable Care Act, which calls for each individual to have basic health insurance coverage, will be implemented, according to a statement from the U.S. Department of the Treasury.

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Health Care Savings With Early Accountable Care Organizations

WEDNESDAY, Aug. 28 (HealthDay News) -- Early accountable care organization initiatives correlate with lower spending for elderly Medicare beneficiaries, but not necessarily with improved quality, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

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Spinal Surgery Helps Neuro Functioning in Dialysis Patients

WEDNESDAY, Aug. 28 (HealthDay News) -- Patients with spinal disorders undergoing hemodialysis can reliably achieve neurological and functional improvement from spinal surgery, according to a study published in the August issue of the Journal of Spinal Disorders & Techniques.

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Cognitive, Physical Impairment Mar Driving in Chronic Whiplash

MONDAY, Aug. 26 (HealthDay News) -- Cognitive and physical impairments have an independent effect on self-reported driving difficulty in individuals with chronic whiplash-associated disorder, according to a study published in the Aug. 15 issue of Spine.

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Heroin Incidence Up for Those Using Non-Medical Pain Relief

MONDAY, Aug. 26 (HealthDay News) -- The rate of heroin initiation is much higher among those who have previously used non-medical pain relievers (NMPR), although only a small percentage of those using NMPRs actually progress to heroin use, according to a report published by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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Calcium + Vitamin D Does Not Reduce Joint Symptoms

MONDAY, Aug. 26 (HealthDay News) -- Calcium plus vitamin D supplementation does not reduce the frequency or severity of joint symptoms in women, according to a study published online Aug. 19 in the Journal of the Academy of Nutrition and Dietetics.

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Multimodal Analgesia Lessens Post-Op Morphine Needs

FRIDAY, Aug. 23 (HealthDay News) -- A multimodal analgesia combination appears to be safe and effective for pain relief after lumbar decompressive laminectomy, according to a study published in the August issue of the Journal of Spinal Disorders & Techniques.

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Reference Pricing Changes Consumers' Choices

FRIDAY, Aug. 23 (HealthDay News) -- Consumer cost sharing resulting from reference pricing redirects patient volumes and reduces hospital prices for orthopedic surgery, according to research published in the August issue of Health Affairs.

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Baseline Pain Severity Predicts Worse Long-Term LBP Outcomes

THURSDAY, Aug. 22 (HealthDay News) -- Patients' baseline pain and the perception that their pain will persist are significant predictors of poor outcomes for low back pain (LBP) over the short and long term, according to a study published in the August issue of The Journal of Pain.

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Tofacitinib Ups Rheumatoid Arthritis Treatment Response

THURSDAY, Aug. 22 (HealthDay News) -- The addition of tofacitinib to rheumatoid arthritis (RA) treatment regimens improves patient response to non-biologic disease-modifying antirheumatic drugs (DMARDs), according to a study published in the Aug. 20 issue of the Annals of Internal Medicine.

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Implications, Solutions for U.S. Health Disparities Discussed

TUESDAY, Aug. 20 (HealthDay News) -- Research on health disparities in the United States, the policy implications of these disparities, and suggestions for improvement of disparities are discussed in "Health Policy Brief: Health Gaps," published Aug. 15 in Health Affairs.

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Lateral Wedges No Better Than Neutral Insole for Knee OA

TUESDAY, Aug. 20 (HealthDay News) -- For patients with knee osteoarthritis, the use of lateral wedges offers no significant benefit versus a neutral insole comparator, according to research published in the Aug. 21 issue of the Journal of the American Medical Association.

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Spinal Radiosurgery Ups Risk of Vertebral Fracture

TUESDAY, Aug. 20 (HealthDay News) -- Vertebral compression fracture (VCF) is a common adverse effect in patients receiving spine stereotactic body radiotherapy (SBRT), according to research published online Aug. 19 in the Journal of Clinical Oncology.

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Increasing Operating Costs Top Concern for Medical Practices

TUESDAY, Aug. 20 (HealthDay News) -- The top five concerns of medical practice executives all relate to financial management, with dealing with increasing operating costs reported as the most difficult daily challenge, according to a report published by the Medical Group Management Association (MGMA).

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Expansion of Pharmacists' Practice Will Benefit Patients

MONDAY, Aug. 19 (HealthDay News) -- The expanding scope of pharmacists' practice will potentially improve patient care but has implications for physicians, according to an article published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.

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Bloodspot-Based Biomarker Test Identifies Fibromyalgia

MONDAY, Aug. 19 (HealthDay News) -- A rapid biomarker-based method using blood samples is able to accurately differentiate patients with fibromyalgia syndrome (FM) from those with rheumatoid arthritis (RA) or osteoarthritis (OA), according to a study published in the Aug. 21 issue of Analyst.

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HHS Awards $67 Million to Marketplace Navigators

MONDAY, Aug. 19 (HealthDay News) -- $67 million is being awarded to Navigator grant applicants and their staff, who will serve as an in-person resource for those requiring additional assistance in shopping for and enrolling in Health Insurance Marketplace plans, according to a report published by the U.S. Department of Health and Human Services.

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Osteoarthritis Pain Negatively Impacts a Spouse's Sleep

FRIDAY, Aug. 16 (HealthDay News) -- For patients with knee osteoarthritis, pain impacts spouses' sleep, according to a study published in the September issue of PAIN.

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IOM Describes Themes Relating to Patients' Role in Health Care

FRIDAY, Aug. 16 (HealthDay News) -- Themes and messages relating to the role of patients in informed care decisions, knowledge generation, and value improvement were discussed at the Institute of Medicine's (IOM) Workshop Proceedings, according to a report published Aug. 15 in conjunction with the transcript of the proceedings.

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Doctors Pessimistic About Future of U.S. Health Care

THURSDAY, Aug. 15 (HealthDay News) -- Physicians report concerns regarding health care delivery and the future of health care, according to survey findings published by athenahealth.

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Involved Patients Have Better Health Care Experiences

THURSDAY, Aug. 15 (HealthDay News) -- Health care providers and patients shape the care experience, and strategies to improve care interactions should also help patients ensure that their needs are met, according to research published in the July issue of Health Affairs.

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Post-Op PTSD Tied to Reduced Elective Lumbar Fusion Benefit

WEDNESDAY, Aug. 14 (HealthDay News) -- Postoperative posttraumatic stress disorder (PTSD) symptoms are strongly correlated with reduced clinical benefit from elective lumbar spinal fusion, according to a study published in the Aug. 1 issue of Spine.

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Physicians Should Consider Social Media As Public Space

WEDNESDAY, Aug. 14 (HealthDay News) -- A new approach is needed for resolving the physician online identity crisis, according to a viewpoint piece published in the Aug. 14 issue of the Journal of the American Medical Association.

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Medicare Reimbursement Drives Procedural Over Cognitive Care

WEDNESDAY, Aug. 14 (HealthDay News) -- Physicians treating Medicare patients are reimbursed three to five times more for performing common procedures versus providing cognitive care, according to a study published online Aug. 12 in JAMA Internal Medicine.

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Eating Fish Cuts Risk of Rheumatoid Arthritis in Women

TUESDAY, Aug. 13 (HealthDay News) -- Regular consumption of dietary long-chain n-3 polyunsaturated fatty acids (PUFAs) in fish is associated with reduced risk of rheumatoid arthritis (RA) in women, according to research published online Aug. 12 in the Annals of the Rheumatic Diseases.

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New Initiative Announced for Patient-Doc Collaboration

TUESDAY, Aug. 13 (HealthDay News) -- A new Center for Patient Partnership in Healthcare (CPPH) has been launched to advance physician-patient collaboration, according to a report published by the American College of Physicians (ACP).

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Perceived Doc Verbal Abuse Impairs Nurses' Work Attitude

TUESDAY, Aug. 13 (HealthDay News) -- For registered nurses (RNs), perceived verbal abuse by physicians correlates with less favorable work conditions and attitudes, according to a study published in Nursing Outlook.

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U.S. Hospitals Up Exchange of Electronic Health Information

MONDAY, Aug. 12 (HealthDay News) -- Between 2008 and 2012, hospitals significantly increased their exchange of electronic health information with other providers, according to research published in the August issue of Health Affairs.

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Guidelines for Post-HIV Exposure Management Updated

MONDAY, Aug. 12 (HealthDay News) -- Management and prophylaxis recommendations have been updated for health care providers with occupational exposure to HIV, according to guidelines published in the September issue of Infection Control and Hospital Epidemiology.

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Carbon Ion Radiation Safe and Effective for Spinal Tumors

MONDAY, Aug. 12 (HealthDay News) -- In patients with inoperable spinal tumors, carbon ion radiotherapy (CIRT) is a safe and effective treatment, according to a study published online Aug. 12 in Cancer.

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Post-Op Cervical Fusion X-Rays May Be Superfluous

MONDAY, Aug. 12 (HealthDay News) -- X-rays taken during postoperative visits following cervical fusion surgery are rarely of value when history and exam are normal, according to a study published in the July issue of The Spine Journal.

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Medical Center Farmers Market Aids in Medical Home Goals

MONDAY, Aug. 12 (HealthDay News) -- A seasonal farmers market at a medical center can support the institution's commitment to the goals of the medical home, according to a study published online Aug. 1 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Physicians' Malpractice Concerns Predict More Testing

FRIDAY, Aug. 9 (HealthDay News) -- Physicians' concerns about malpractice risk predict more aggressive diagnostic testing practices in office-based care, according to a study published in the August issue of Health Affairs.

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IPAs and PHOs Viable Option for Small Independent Practices

FRIDAY, Aug. 9 (HealthDay News) -- For small and medium-size independent practices, sharing care management and information technology resources with other practices through an independent practice association (IPA) or physician-hospital organization (PHO) is a viable alternative and may improve care for patients with chronic conditions, according to a study published in the August issue of Health Affairs.

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Rheumatoid Arthritis Ups Risk of Thrombosis, Embolism

FRIDAY, Aug. 9 (HealthDay News) -- The risks of developing deep vein thrombosis (DVT) and pulmonary embolism (PE) are higher in patients with rheumatoid arthritis (RA) than in those in the general population, according to a study published online Aug. 7 in the Annals of the Rheumatic Diseases.

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Updated Guidelines Available for Lumbar Spinal Stenosis

THURSDAY, Aug. 8 (HealthDay News) -- Updated evidence-based guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis are now available, according to report published in the July issue of The Spine Journal.

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AMA, AHA Call for Realignment of Meaningful Use Stage 2

WEDNESDAY, Aug. 7 (HealthDay News) -- The American Medical Association (AMA) and American Hospital Association (AHA) are calling for additional flexibility in the timing of the adoption of stage 2 meaningful use of electronic health records, according to a letter written to the U.S. Department of Health and Human Services (HHS).

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Small-Fiber Polyneuropathy ID'd in Fibromyalgia Cases

MONDAY, Aug. 5 (HealthDay News) -- Some patients diagnosed with fibromyalgia may actually have small-fiber polyneuropathy (SFPN), according to a study published online June 7 in PAIN.

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Participation Increases in Online CME Activities

MONDAY, Aug. 5 (HealthDay News) -- The number of physicians and non-physicians participating in continuing medical education (CME) has increased, especially in online activities, according to a report published by the Accreditation Council for Continuing Medical Education (ACCME).

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FDA Warns of Serious Skin Reactions to Acetaminophen

FRIDAY, Aug. 2 (HealthDay News) -- Acetaminophen has been linked to rare but serious skin reactions, according to a drug safety communication released by the U.S. Food and Drug Administration.

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Dexamethasone Beats Placebo for Cancer-Related Fatigue

THURSDAY, Aug. 1 (HealthDay News) -- For patients with advanced cancer, dexamethasone is better than placebo for reducing cancer-related fatigue (CRF), according to a study published online July 29 in the Journal of Clinical Oncology.

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Prevalence of Peripheral Artery Disease Increasing Globally

THURSDAY, Aug. 1 (HealthDay News) -- The prevalence of peripheral artery disease is increasing in both high-income countries (HIC) and low- or middle-income countries (LMIC), according to a review published online Aug. 1 in The Lancet.

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