Latest & greatest articles for pain

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Top results for pain

101. Effect of Ubrogepant vs Placebo on Pain and the Most Bothersome Associated Symptom in the Acute Treatment of Migraine: The ACHIEVE II Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Ubrogepant vs Placebo on Pain and the Most Bothersome Associated Symptom in the Acute Treatment of Migraine: The ACHIEVE II Randomized Clinical Trial. Ubrogepant is an oral calcitonin gene-related peptide receptor antagonist under investigation for acute treatment of migraine.To evaluate the efficacy and tolerability of ubrogepant compared with placebo for acute treatment of a single migraine attack.Phase 3, multicenter, randomized, double-blind, placebo-controlled, single-attack (...) , clinical trial (ACHIEVE II) conducted in the United States (99 primary care and research clinics; August 26, 2016-February 26, 2018). Participants were adults with migraine with or without aura experiencing 2 to 8 migraine attacks per month.Ubrogepant 50 mg (n = 562), ubrogepant 25 mg (n = 561), or placebo (n = 563) for a migraine attack of moderate or severe pain intensity.Co-primary efficacy outcomes were pain freedom and absence of the participant-designated most bothersome migraine-associated

2019 JAMA

102. Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions

Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions 1 Published 11 November 2019 1 SMC2194 pentosan polysulfate sodium 100mg hard capsules (Elmiron®) Consilient Health Ltd 04 October 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE (...) : following a full submission considered under the orphan equivalent process pentosan polysulfate sodium (Elmiron ® ) is accepted for use within NHSScotland. Indication under review: for the treatment of bladder pain syndrome characterised by either glomerulations or Hunner’s lesions in adults with moderate to severe pain, urgency and frequency of micturition. In patients with bladder pain syndrome and glomerulations or Hunner’s lesions, pentosan polysulfate sodium was associated with significantly more

2019 Scottish Medicines Consortium

103. Patellofemoral Pain

Patellofemoral Pain Clinical Practice Guidelines RICHARD W. WILLY, PT , PhD • LISA T . HOGLUND, PT , PhD • CHRISTIAN J. BARTON, PT , PhD LORI A. BOLGLA, PT , PhD • DAVID A. SCALZITTI, PT , PhD • DAVID S. LOGERSTEDT , PT , PhD ANDREW D. LYNCH, PT , PhD • LYNN SNYDER-MACKLER, PT , ScD, FAPTA • CHRISTINE M. MCDONOUGH, PT , PhD Patellofemoral Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical (...) © 2019 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.cpg2 | september 2019 | volume 49 | number 9 | journal of orthopaedic & sports physical therapy Patellofemoral Pain: Clinical Practice Guidelines DIAGNOSIS A Clinicians should use reproduction of retropatellar or peri- patellar pain during squatting as a diagnostic test for patellofemoral pain (PFP). Clinicians should also use perfor- mance of other functional activities that load the patellofemoral joint (PF J

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

104. Gliptins: joint pain and exposure to NSAIDs

Gliptins: joint pain and exposure to NSAIDs Prescrire IN ENGLISH - Spotlight ''Gliptins: joint pain and exposure to NSAIDs'', 1 November 2019 {1} {1} {1} | | > > > Gliptins: joint pain and exposure to NSAIDs Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight In the November issue of Prescrire International - Gliptins: joint pain and exposure (...) to NSAIDs FREE DOWNLOAD In the Adverse Effects section of the November issue, the results of a study by the independent French medical journal Prescrire, based on data from France's national health insurance system. Full text available for free download. Summary Joint and muscle pain are part of the adverse effect profile of gliptins. In France, Prescrire carried out a study, using data from the mandatory national health insurance system, showing that patients taking gliptins are more frequently exposed

2019 Prescrire

105. Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder

Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Health Services Research & Development Management eBrief (...) no. 160 » Issue 160 October 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Brief: Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Acute pain management in patients with opioid use disorder (OUD) can be challenging due to several factors including increased pain sensitivity and higher opioid tolerance. Use of medications for OUD (MOUD) including methadone, buprenorphine/naloxone, or naltrexone adds to the complexity of acute pain management

2019 Veterans Affairs - R&D

106. Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration

Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration 1 Public Summary Document Application No. 1466 – Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration Applicant: The Interventional Radiology Society of Australasia (IRSA) Date of MSAC consideration: MSAC 75 th Meeting, 28-29 March 2019 MSAC 74 th Meeting, 22-23 November 2018 Context for decision: MSAC makes its advice in accordance with its Terms (...) , MSAC deferred its advice regarding public funding of vertebroplasty for severely painful osteoporotic vertebral fractures of less than either 3 or 6 weeks duration. MSAC considered that a stakeholder meeting, to provide a broader clinical perspective and patient input, could inform the uncertainties in the application. MSAC also considered that an independent meta-analysis of the individual patient data (IPD) from all relevant randomised trials would be informative to further address uncertainties

2019 Medical Services Advisory Committee

107. Tourniquet Use Does Not Affect Functional Outcomes or Pain After Total Knee Arthroplasty: A Prospective, Double-Blinded, Randomized Controlled Trial (Abstract)

Tourniquet Use Does Not Affect Functional Outcomes or Pain After Total Knee Arthroplasty: A Prospective, Double-Blinded, Randomized Controlled Trial The use of a tourniquet during total knee arthroplasty (TKA) is controversial. Pain and return to function are believed, by some, to be influenced by the use of a tourniquet. The hypothesis of this study was that use of a tourniquet would delay postoperative functional recovery and increase pain as compared with no tourniquet use.Two hundred (...) patients were recruited for this prospective, double-blinded, randomized controlled trial. Patients were randomized to undergo TKA either with a tourniquet (100 patients) or without one (100 patients) and blinded to group allocation. Primary outcome measures were functional assessment testing using the Timed Up & Go (TUG) test and visual analog scale (VAS) pain scores. Secondary outcome measures included the stair-climb test, blood loss, surgical field visualization, and range of motion. Outcome

2019 EvidenceUpdates

108. Low Back Pain in the Emergency Department: Prevalence of Serious Spinal Pathologies and Diagnostic Accuracy of Red Flags - A Systematic Review Full Text available with Trip Pro

Low Back Pain in the Emergency Department: Prevalence of Serious Spinal Pathologies and Diagnostic Accuracy of Red Flags - A Systematic Review Very little evidence is available on the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting to the emergency department (ED). This systematic review aims to investigate the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting with low back pain

2019 EvidenceUpdates

109. A single dose of tramadol in continuous wound analgesia with levobupivacaine does not reduce post-sternotomy pain: a randomized controlled trial Full Text available with Trip Pro

A single dose of tramadol in continuous wound analgesia with levobupivacaine does not reduce post-sternotomy pain: a randomized controlled trial Medial sternotomy is commonly used in cardiac surgery, although it results in intense post-operative pain. The placement of a sternal wound catheter for the administration of local anesthetic represents an effective technique. An initial bolus of tramadol in the sternal wound catheter could potentiate the effect of the local anesthetic and decrease (...) both the post-operative pain and the morphine consumption.We conducted a prospective, randomized, double-blind study at the University Hospital Center, Dijon, France. Patients requiring scheduled or non-extreme emergency surgery for valve disease, aorta disease, atrial myxoma, or coronary artery bypass graft via sternotomy were included. A sternal wound catheter was inserted at the end of the surgery. The patients were randomized to receive either a 2 mg/kg bolus of tramadol (n=80) or a placebo (n

2019 EvidenceUpdates

110. Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial (Abstract)

Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial Pain after total knee arthroplasty (TKA) affects postoperative recovery and patient satisfaction. The analgesic benefits of corticosteroids have not been well studied. We, therefore, investigated the analgesic effects of intravenous (IV) dexamethasone (DEX) in patients undergoing a TKA.This was a randomized, double-blind, placebo-controlled (...) trial of 0.15 mg/kg of IV DEX vs saline placebo in unilateral TKA. Fifty patients/arm were recruited. Primary outcomes were pain level, determined by a visual analog scale, and the amount of morphine consumption (mg) ≤48 hours post-TKA. Secondary outcomes were rates of nausea and vomiting, C-reactive protein concentrations, and functional outcomes.The DEX group had a significantly lower mean visual analog scale score both at rest and during motion at 12, 15, 18, and 21 hours (P < .05). At 21 hours

2019 EvidenceUpdates

111. The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial (Abstract)

The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial A prospective and controlled study of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery.Assessment of dexmedetomidine added to preemptive ropivacaine infiltration for the relief of postoperative pain after lumbar fusion surgery.Single local anesthetic preemptive wound infiltration for the relief (...) of postoperative pain does not translate into major or consistent clinical benefits after lumbar fusion surgery. Dexmedetomidine added to local anesthetics prolonged the duration of blockade and enhanced the analgesic in peripheral nerve block. The effect of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery for the relief of postoperative pain has yet not been studied.Fifty-seven patients with elective posterior lumbar fusion were randomly divided into two groups. Five

2019 EvidenceUpdates

112. Pentosan polysulfate sodium for treating bladder pain syndrome

Pentosan polysulfate sodium for treating bladder pain syndrome Pentosan polysulfate sodium for treating bladder pain syndrome T echnology appraisal guidance Published: 13 November 2019 www.nice.org.uk/guidance/ta610 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration (...) to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Pentosan polysulfate sodium for treating bladder pain syndrome (TA610) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 25Contents Contents 1 Recommendations 4 2 Information about pentosan polysulfate sodium 6 3 Committee discussion 7

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

113. Efficacy of Systemic Steroid Use Given One Day After Total Knee Arthroplasty for Pain and Nausea: A Randomized Controlled Study Full Text available with Trip Pro

Efficacy of Systemic Steroid Use Given One Day After Total Knee Arthroplasty for Pain and Nausea: A Randomized Controlled Study Systemic steroid has been used to control pain and nausea in total knee arthroplasty (TKA), but most studies recommend a single dose administration prior to, or during, surgery. This study aimed to determine the efficacy of administration on 1 day postoperatively.Patients who were scheduled to undergo TKA were randomly assigned to the following groups: control group (...) , receiving normal saline injection; group 1, receiving 10 mg dexamethasone intravenously (IV) 1 hour before surgery; group 2, receiving 0.1 mg/kg dexamethasone (IV) 24 hours after surgery; or group 3, receiving 0.2 mg/kg dexamethasone (IV) 24 hours after surgery (n = 44-46 per group). Primary outcomes were pain and nausea visual analogue scale (VAS). Secondary outcomes were analgesic administration, rescue antiemetic administration, C-reactive protein, range of motion, and complications.Postoperative

2019 EvidenceUpdates

114. Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial (Abstract)

Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP).Randomized controlled trial.Outpatient care units.Sixty-four non-specific (...) CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups.Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy.The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment

2019 EvidenceUpdates

115. Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical (...) procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies

2019 Canadian Paediatric Society

116. Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain Full Text available with Trip Pro

Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain Within the SCOT-HEART (Scottish COmputed Tomography of the HEART Trial) trial of patients with stable chest pain, the use of coronary computed tomography angiography (CTA) reduced the rate of death from coronary heart disease or nonfatal myocardial infarction (primary endpoint).This study sought to assess the consistency and mechanisms of the 5-year reduction in this endpoint.In this open-label trial

2019 EvidenceUpdates

117. Treatment for Acute Pain: An Evidence Map

Treatment for Acute Pain: An Evidence Map Treatment for Acute Pain: An Evidence Map Technical Brief Number 33 RTechnical Brief Number 33 Treatment for Acute Pain: An Evidence Map Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-0000-81 Prepared by: Minnesota Evidence-based Practice Center Minneapolis, MN Investigators: Michelle Brasure, Ph.D., M.S.P.H., M.L.I.S. Victoria (...) A. Nelson, M.Sc. Shellina Scheiner, PharmD, B.C.G.P. Mary L. Forte, Ph.D., D.C. Mary Butler, Ph.D., M.B.A. Sanket Nagarkar, D.D.S., M.P.H. Jayati Saha, Ph.D. Timothy J. Wilt, M.D., M.P.H. AHRQ Publication No. 19(20)-EHC022-EF Oct ober 2019 ii Key Messages Purpose of review The purpose of this evidence map is to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. We map the evidence for several acute pain

2019 Effective Health Care Program (AHRQ)

118. Oral COX-2 inhibitors for pain

Oral COX-2 inhibitors for pain '); } else { document.write(' '); } ACE | Oral COX-2 inhibitors for treating pain Search > > Oral COX-2 inhibitors for treating pain - Oral COX-2 inhibitors for treating pain Published on 2 September 2019 Guidance Recommendations The Ministry of Health's Drug Advisory Committee has recommended: celecoxib 200 mg capsule; and etoricoxib 60 mg, 90 mg and 120 mg tablets for treating pain in line with their registered indications in Singapore. For patients with renal

2019 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

119. Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial. Full Text available with Trip Pro

Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial. To assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes).Double blind, parallel group, placebo controlled, multicentre trial.Hospital outpatient clinics at six hospitals in Norway.180 (...) patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017.Patients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription.The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention

2019 BMJ

120. Stressed out about stress testing? The utility of stress testing after non-ACS chest pain Full Text available with Trip Pro

Stressed out about stress testing? The utility of stress testing after non-ACS chest pain Stressed out about stress testing? The utility of stress testing after non-ACS chest pain - CanadiEM Stressed out about stress testing? The utility of stress testing after non-ACS chest pain In by Vivian Tam October 15, 2019 The Case Your next patient in the acute zone of the ED is Mr. Liu, a 53-year old man presenting with one hour of acute onset atypical chest pain. He has several risk factors (...) ​ A review of the evidence on stress testing A recent disputed the commonly cited 2% ACS miss rate after ED discharge. ​4​ In the Pope et al . study, of the 10,689 patients presenting with undifferentiated chest pain, 889 patients had acute MI. ​5​ Nineteen of the confirmed MI patients were mistakenly discharged. Therefore, of all patients presenting to the ED with undifferentiated chest pain, less than 0.2% were missed (whereas the 2% figure is derived from the 19 missed MIs of the 889 patients

2019 CandiEM