Articles related to Pain Medicine

This 62-year-old man had a lung transplant 3 years previously for IPF and is on tacrolimus, mycophenolate, and prednisone. Which therapy is most appropriate for their zoster outbreak? IV acyclovir Oral famciclovir Oral valacyclovir Herpes zoster vaccine

Use of Carnett sign, greater trochanter palpation, and a simple extension to typical joint examination can reduce imaging and orthopedic referrals by primary care physicians and bring faster effective treatment to the patient.

The US Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) issued the 2021 National Survey on Drug Use and Health (NSDUH) this week. The NDSUH offers a window into Americans’ experiences with mental health disorders, substance use, and their pursuit of treatment during the second year of the COVID epidemic through chosen estimates by race, ethnicity, and age group. Enough said—the outcomes aren’t appealing.

The literature on chronic pain and stigma was reviewed by a group of academics from Sapienza University of Rome, Italy, who published their findings in the journal Pain and Therapy. Perhaps most unexpectedly, they discovered that stigma surrounding pain persists even in clinical settings, resulting in clinicians’ inadequate evaluations of patients’ pain, doubt about the reality of their suffering, and lower pain ratings. These factors frequently result in inadequate treatment of pain and a propensity to believe that it is solely a psychological disorder.

This 70-study meta analysis concludes that the evidence is moderate to high that bisphosphonates and denosumab reduce the risk for hip, vertebral, and other fractures. The evidence is moderate to high that abaloparatide and teriparatide reduce clinical fractures and radiographic vertebral fractures, and low to moderate that SERMs reduce radiographic vertebral fractures, but not clinical fractures.

Beyond the strong recommendation for bisphosponates as initial medical therapy in postmenopausal women with osteoporosis, the updated guidelines also suggest (not recommend) denosumab as second line therapy in women, bisphosphonates for osteoporosis in men, and romosozumab in women with very high risk of fractures. For the complete updated guideline, see Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians.