MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'NeLM - Pain control' source. Sun, 21 Mar 2010 13:42:27 +0100 http://www.medworm.com/index.php?rid=3213573&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2010---January%2F27%2FReview-Low-risk-of-severe-dermatological-reactions-to-NSAIDs%2F Source: American Journal of Health-System Pharmacy Area: News A review of the medical literature has found that the risk of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) is extremely low. The greatest risk can be seen in older patients, women, and patients within the first month of treatment initiation.   The authors of this review searched for studies, case series and case reports of SJS and TEN associated with NSAIDs and cyclooxygenase-2-selective NSAIDs available in the United States. From the available data they made the following observations (data from abstract as full report not available): . "oxicam" derivatives appeared to have the greatest association with SJS and TEN. T... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3213573 Wed, 27 Jan 2010 00:00:00 +0100 3213573 http://www.medworm.com/index.php?rid=3209499&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FLong-term-opioid-management-for-chronic-noncancer-pain%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Opioid therapy for chronic noncancer pain (CNCP) is controversial due to concerns regarding long-term effectiveness and safety, particularly the risk of tolerance, dependence, or abuse.   Objectives To assess safety, efficacy, and effectiveness of opioids taken long-term for CNCP.   Search strategy We searched 10 bibliographic databases up to May 2009.   Selection criteria We searched for studies that: collected efficacy data on participants after at least 6 months of treatment; were full-text articles; did not include redundant data; were prospective; enrolled at least 10 participants; reported data of participants who had CNCP. Randomized controlled trials (RCTs) and pr... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3209499 Tue, 26 Jan 2010 00:00:00 +0100 3209499 http://www.medworm.com/index.php?rid=3205632&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FFeldene-CapsulesIntramuscular-Injection-MELT-piroxicam---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes changes to: Section 4.4 - Special warnings and precautions for Use - piroxicam should be administered with caution to patients who are known to be poor CYP2C9 metabolisers. Section 5.2 - Pharmacokinetic Properties - piroxicam metabolism is primarily mediated by cytochrome P450 CYP 2C9 in the liver. Poor CYP2C9 metabolizers should be administered piroxicam with caution as they may have abnormally high plasma levels due to reduced metabolic clearance. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3205632 Mon, 25 Jan 2010 00:00:00 +0100 3205632 http://www.medworm.com/index.php?rid=3186554&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCochrabe-review-Local-anaesthetic-wound-infiltration-and-abdominal-nerves-block-during-caesarean-section-for-postoperative-pain-relief%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Caesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Local anaesthetics, either on their own or in combination with opioids or nonsteroidal antiinflammatory drugs, have been employed as an adjunct to other postoperative pain relief strategies. Conflicting reports were noted.   Objectives To assess the effects of local anaesthetic agent wound infiltration/irrIgation and/or abdominal nerve blocks on post-caesarean section pain and the mother's well being and interaction with her baby.   Search strateg... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3186554 Tue, 19 Jan 2010 00:00:00 +0100 3186554 http://www.medworm.com/index.php?rid=3168408&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2010---January%2F13%2FStudy-of-lacosamide-versus-placebo-for-painful-diabetic-neuropathy-does-not-meet-its-primary-endpoint%2F Source: Diabetes Care Area: News According to the results of a study published early online in Diabetes Care, lacosamide was well tolerated in patients with diabetic peripheral neuropathy (DPN), but it was not statistically superior to placebo in reducing average pain scores at four weeks.   The trial included adults with type 1 or 2 diabetes, who had symptomatic DPN for 6 months to 5 years (score ?4 on an 11-point NPRS), and HbA1c <12%.  Participants were randomised to placebo or lacosamide (400 or 600mg/day) over 6-week titration and 12-week maintenance periods.  Concomitant paracetamol was permitted as rescue medication.  The primary endpoint was intra-individual change in average daily NPRS score from baseline to the last 4 weeks.   Of 513 patients sc... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3168408 Wed, 13 Jan 2010 00:00:00 +0100 3168408 http://www.medworm.com/index.php?rid=3139724&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FAxorid-100-mg20-mg-and-200mg20mg-modified-release-capsules-ketoprofenomeprazole---New-product%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Each modified-release capsule contains ketoprofen 100 mg or 200 mg and omeprazole 20 mg. They are licensed for symptomatic treatment of rheumatoid arthritis, ankylosing spondylitis and osteoarthritis in patients with a previous history or who are at risk of developing NSAID associated gastric ulcers, duodenal ulcers and gastroduodenal erosions in whom continued treatment with ketoprofen is essential. The daily dose is 100 mg/20 mg to 200 mg/20 mg depending of the severity of symptoms. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3139724 Mon, 04 Jan 2010 00:00:00 +0100 3139724 http://www.medworm.com/index.php?rid=3116305&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FDiclofenac-for-acute-pain-in-children%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Diclofenac is commonly used for acute pain in children, but is not licensed for this indication in all age groups.   Objectives 1) Assess the efficacy of diclofenac for acute pain in children. 2) Assess the safety of diclofenac for short-term use in children. 3) Identify gaps in the evidence to direct future research.   Search strategy Seventeen databases indexing clinical trial reports were searched in February 2005 (with an update search as part of this first review in May 2008). A hand search of Paediatric Anaesthesia was undertaken and summaries obtained of adverse reaction reports from the UK Yellow Card Scheme and World Health Organization (WHO) Monitoring Centre. The reference lists of in... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3116305 Wed, 23 Dec 2009 00:00:00 +0100 3116305 http://www.medworm.com/index.php?rid=3116304&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FCovhrane-review-Duloxetine-for-treating-painful-neuropathy-or-chronic-pain%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Duloxetine is a balanced serotonin and noradrenaline reuptake inhibitor licensed for the treatment of major depressive disorders, urinary stress incontinence and the management of neuropathic pain associated with diabetic peripheral neuropathy. A number of trials have been conducted to investigate the use of duloxetine in neuropathic and nociceptive painful conditions.   Objectives To assess the benefits and harms of duloxetine for treating painful neuropathy and different types of chronic pain.     Search strategy We searched The Cochrane Neuromuscular Group Specialized Register (10 March 2009), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2009), MEDL... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3116304 Wed, 23 Dec 2009 00:00:00 +0100 3116304 http://www.medworm.com/index.php?rid=3102642&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FTopical-capsaicin-for-chronic-neuropathic-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Topical creams with capsaicin are used to treat pain from a wide range of chronic conditions including neuropathic pain. Following application to the skin capsaicin causes enhanced sensitivity to noxious stimuli, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. There is uncertainty about the efficacy and tolerability of capsaicin for treating painful chronic neuropathies.   Objectives To review the evidence from controlled trials on the efficacy and tolerability of topically applied capsaicin in chronic neuropathic pain in adults.   Search strategy Cochrane CENTRAL, MEDLINE, EMBASE and Oxford Pain Relief Database, searched in May 2009. &... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3102642 Fri, 18 Dec 2009 00:00:00 +0100 3102642 http://www.medworm.com/index.php?rid=3085490&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F14%2FNew-national-IV-monograph-on-oxycodone-OxyNorm%2F Source: Medusa Area: News A new IV monograph on oxycodone (OxyNorm®) is now available from the NHS injectable medicines guide website (Medusa) at the link below (registration required for access). (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3085490 Mon, 14 Dec 2009 00:00:00 +0100 3085490 http://www.medworm.com/index.php?rid=3080269&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F11%2FMHRA-issues-new-guidance-for-retailers-on-best-practice-for-sale-of-analgesics%2F Source: MHRA Area: News The MHRA has launched new guidance for retailers on the best practice for the sale of analgesics to ensure that they are meeting a customer's immediate need for pain relief while helping to minimise stockpiling and the risk of overdose. The guidance reiterates the following:   . No more than two packs should be sold in one transaction.   . Promotions that encourage the sale of more than one pack at a time should be discouraged.   . The maximum pack size for pain relief medicines in a general sale outlet is 16 tablets or capsules. A pharmacy may sell larger packs containing up to 32 tablets or capsules under the supervision of a pharmacist.   . Medicines legislation states that it is illegal to sell more than 1... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3080269 Fri, 11 Dec 2009 00:00:00 +0100 3080269 http://www.medworm.com/index.php?rid=3072558&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F09%2FInhaled-high-flow-oxygen-effective-in-cluster-headache%2F Source: JAMA Area: News A controlled trial indicates that high-flow oxygen is effective in relieving pain from cluster headache.   Cluster headache is extremely painful, being considered as the most severe pain known to humans, and is difficult to treat. The most effective current therapy is sumatriptan, however recommendations limit the total daily dose for this and similar drugs. Limited data support the use of high-flow oxygen, however it is not widely used in part because of the paucity of robust evidence for benefit.   This placebo-controlled randomised crossover trial was intended to provide better data. It involved patients with confirmed episodic or chronic cluster headache. They were provided with treatment cylinders labelled 1 or 2, one of which contained oxyge... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3072558 Wed, 09 Dec 2009 00:00:00 +0100 3072558 http://www.medworm.com/index.php?rid=3068244&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSingle-dose-oral-sulindac-for-acute-postoperative-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Sulindac is a non-steroidal anti-inflammatory drug (NSAID) licensed for use in rheumatic disease and other musculoskeletal disorders in the UK, and widely available in other countries worldwide. This review sought to evaluate the efficacy and safety of oral sulindac in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.   Objectives To assess the efficacy of single dose oral sulindac in acute postoperative pain, and any associated adverse events.   Search strategy We searched Cochrane CENTRAL, ... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3068244 Tue, 08 Dec 2009 00:00:00 +0100 3068244 http://www.medworm.com/index.php?rid=3068243&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSingle-dose-oral-tiaprofenic-acid-for-acute-postoperative-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Tiaprofenic acid is a a non-steroidal anti-inflammatory drug (NSAID). It is widely available around the world, with indications for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, periarticular disorders, and strains and sprains. This review sought to evaluate the efficacy and safety of oral tiaprofenic acid in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.   Objectives To assess the efficacy of single dose oral tiaprofenic acid in acute postoperative pain, and any associated adverse ... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3068243 Tue, 08 Dec 2009 00:00:00 +0100 3068243 http://www.medworm.com/index.php?rid=3053661&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FThe-relative-efficacy-of-meperidine-for-the-treatment-of-acute-migraine-a-meta-analysis-of-randomized-controlled-trials%2F The objectives and inclusion criteria of the review were clear and a wide range of relevant sources ... (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3053661 Thu, 03 Dec 2009 00:00:00 +0100 3053661 http://www.medworm.com/index.php?rid=3053660&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---December%2F03%2FNew-Drug-Application-submitted-to-FDA-for-tapentadol-ER-for-management-of-chronic-pain%2F Source: BioSpace Area: News A New Drug Application has been submitted to the FDA for tapentadol ER tablets for the management of moderate to severe chronic pain in patients 18 years of age or older. Tapentadol is a centrally acting oral analgesic that binds to mu-opioid receptors and inhibits noradrenaline re-uptake. An immediate release tablet is already approved by the FDA for the relief of moderate to severe acute pain. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3053660 Thu, 03 Dec 2009 00:00:00 +0100 3053660 http://www.medworm.com/index.php?rid=3040577&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FPerfalgan-10mgmL-solution-for-infusion-paracetamol---Revised-SPC%2F Source: Manufacturer notification, eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes ??Revised SPC includes changes to: Section 4.2 (Posology and method of administration) - In adults with hepatocellular insufficiency, chronic alcoholism, chronic malnutrition (low reserves of hepatic glutathione), dehydration: the maximum daily dose must not exceed 3g (see section 4.4) Section 4.8 (Undesirable Effects)- cases of erythema, flushing, pruritus and tachycardia have been reported.   (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3040577 Mon, 30 Nov 2009 00:00:00 +0100 3040577 http://www.medworm.com/index.php?rid=3031547&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F26%2FSativex-cannabis-extract-helpful-in-intractable-pain%2F Source: J Pain Symptom Manage Area: News A controlled trial in patients with intractable pain due to cancer found that Sativex cannabis extract improved pain compared to placebo and to a tetrahydrocannabinol extract.   Severe pain in patients with cancer may be difficult to manage; while many will obtain adequate relief from opioids, some remain in significant pain despite maximal tolerated doses. There is evidence that the cannabinoids tetrahydrocannabinol (THC) and cannabidiol (CBD) may have benefits in pain relief: this trial was intended to determine whether THC alone and a THC: CBD combined extract (Sativex) were effective. Participants were patients with cancer and at least moderately severe pain not relieved by standard therapy. They were randomised to treatment with THC e... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3031547 Thu, 26 Nov 2009 00:00:00 +0100 3031547 http://www.medworm.com/index.php?rid=3019861&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F23%2FNew-national-IV-monograph-on-tramadol-Zamadol-Zydol%2F Source: Medusa Area: News A new IV monograph on tramadol (Zamadol®; Zydol®) is now available from the NHS injectable medicines guide website (Medusa) at the link below (registration required for access). (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3019861 Mon, 23 Nov 2009 00:00:00 +0100 3019861 http://www.medworm.com/index.php?rid=3001048&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FCKS-topic-review-Low-back-pain%2F Source: CKS Area: Evidence > Guidelines This Topic Review from the Clinical Knowledge Service (CKS) covers the management of acute and chronic low back pain. It covers:   . the management in primary care of non-specific low back pain without radiculopathy (sciatica) that has lasted less than about 6 weeks, and . the management in primary care of non-specific low back pain without radiculopathy (sciatica) that has lasted more than about 6 weeks. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3001048 Tue, 17 Nov 2009 00:00:00 +0100 3001048 http://www.medworm.com/index.php?rid=3001047&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FCKS-topic-review-Sciatica-lumbar-radiculopathy%2F Source: CKS Area: Evidence > Guidelines This Topic Review from the Clinical Knowledge Service (CKS) covers the symptomatic management of sciatica (lumbar radiculopathy) in primary care. It focuses on the diagnostic and pharmacologic interventions that are available for primary healthcare practitioners in the NHS to recommend or prescribe. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=3001047 Tue, 17 Nov 2009 00:00:00 +0100 3001047 http://www.medworm.com/index.php?rid=2986059&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F12%2FPublished-evidence-for-off-label-gabapentin-uses-is-incomplete%2F Source: NEJM Area: News A comparison of the published evidence for off-label uses of gabapentin with reports available to the manufacturer found significant discrepancies in outcome reporting and unpublished negative trials.   There is substantial evidence that selective and biased outcome reporting in published clinical trials exists - this is one of the reasons that clinical trial databases now available were set up. The authors of this paper report an analysis of the outcomes reported in published papers describing unlicensed (off-label) uses of gabapentin, using internal company documents made available as a result of US litigation. The off-label uses studied were migraine prophylaxis, treatment of bipolar disorders, neuropathic pain, and nociceptive pain, and the analysis de... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2986059 Thu, 12 Nov 2009 00:00:00 +0100 2986059 http://www.medworm.com/index.php?rid=2978556&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSMC-accepts-restricted-use-of-fentanyl-nasal-spray-Instanyl-in-NHSScotland%2F Source: Scottish Medicines Consortium (SMC) Area: Evidence > Drug Specific Reviews The Scottish Medicines Consortium (SMC) has accepted for restricted use within NHSScotland, fentanyl nasal spray (Instanyl®) for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain. Use should be restricted to patients who are unsuitable for other short-acting oral opioids (e.g. oral morphine) as an alternative to other buccal and sublingual fentanyl preparations. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2978556 Tue, 10 Nov 2009 00:00:00 +0100 2978556 http://www.medworm.com/index.php?rid=2964384&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FMTRAC-verdict-Oxycodone--naloxone-in-severe-pain%2F Source: MTRAC Area: Evidence > Drug Specific Reviews The Midlands Therapeutics Review and Advisory Committee (MTRAC) has reviewed the evidence on oxycodone + naloxone combination prolonged release tablets (Targinact®) for the management of severe pain.   The Committee concluded that oxycodone/naloxone prolonged-release tablets were suitable for prescribing in primary care for patients with severe opioid responsive pain who have persistent constipation despite standard laxative treatment. The evidence for efficacy and safety is relatively weak, and it has not been compared to the standard first-line treatment of an opioid plus a laxative.   Oxycodone is an established strong opioid used for treatment of severe pain, and has the usual adverse effects of this group, includ... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2964384 Thu, 05 Nov 2009 00:00:00 +0100 2964384 http://www.medworm.com/index.php?rid=2964383&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FMTRAC-verdict-Duloxetine-in-pain-due-to-diabetic-peripheral-neuropathy%2F Source: MTRAC Area: Evidence > Drug Specific Reviews The Midlands Therapeutics Review and Advisory Committee (MTRAC) has reviewed the evidence on duloxetine (Cymbalta®) for diabetic peripheral neuropathic pain in adults.   The Committee concluded that duloxetine  is suitable for primary care prescribing in this situation. It noted that the evidence for benefit was relatively strong, and that a draft NICE guideline recommends it for first-line use.   Duloxetine had been assessed in this indication in three placebo-controlled trials, reducing 24-hour pain scores to a significantly greater degree than placebo in all three. There were also benefits in a number of secondary outcomes. Adverse effects including somnolence, dizziness, fatigue, and gastro-intestinal disturb... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2964383 Thu, 05 Nov 2009 00:00:00 +0100 2964383 http://www.medworm.com/index.php?rid=2951653&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---November%2F02%2FClinical-review-Pain-management-and-sedation-for-children-in-the-emergency-department%2F Source: BMJ Area: News The authors of this review article provide an overview of published evidence to help clinicians assess, manage, and minimise pain in children presenting to hospital.  The following questions are addressed:   . How is acute pain best assessed in children? . What is the role of non-pharmacological methods in paediatric pain relief? . What is the best initial choice of analgesic drug? . How can procedures be carried out without causing further pain? . Which topical anaesthetics are available for cannulation and venepuncture? . What are the topical, local, or regional anaesthesia options for wounds and injuries? . Does procedural sedation have a role in painful emergency procedures in children? (Source: NeLM - Pain contro... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2951653 Mon, 02 Nov 2009 00:00:00 +0100 2951653 http://www.medworm.com/index.php?rid=2921270&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F23%2FEuropean-CHMP-confirms-previous-recommendation-on-withdrawal-of-non-parenteral-dextropropoxyphene-containing-medicines%2F Source: EMEA Area: News Finalising a re-examination procedure for dextropropoxyphene-containing medicines, the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has confirmed its previous recommendation to withdraw the marketing authorisation for all non-parenteral formulations of these medicines because their risks, particularly the risk of potentially fatal overdose, are greater than their benefits. However, for the parenteral formulation, the Committee concluded that the marketing authorisations should not be withdrawn but suspended until further clinical data are available which may support the re-introduction of this formulation onto the market. Further information is available from a Q&A at the link below. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2921270 Thu, 22 Oct 2009 23:00:00 +0100 2921270 http://www.medworm.com/index.php?rid=2921269&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F23%2FEuropean-CHMP-begins-referral-for-modified-release-oral-opioids-following-overdose-concerns%2F Source: EMEA Area: News The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has started a referral for modified release oral opioids (morphine, fentanyl, oxycodone and hydromorphone) due to concerns on their dissolution and their sensitivity and interaction with alcohol, which may cause dose dumping and potential overdose. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2921269 Thu, 22 Oct 2009 23:00:00 +0100 2921269 http://www.medworm.com/index.php?rid=2917300&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F22%2FMeta-analysis-of-two-studies-of-zolmitriptan-for-acute-treatment-of-cluster-headache%2F Source: Reuters Health News Area: News According to the results of a patient level meta-analysis of two randomised, crossover trials, zolmitriptan nasal spray (5 mg or 10 mg) is effective in the acute treatment of episodic and chronic cluster headache.   Both studies were double-blind, placebo-controlled, randomised studies with similar patient populations, protocol designs, doses, and clinical endpoints. Both studies (n=121; 100 male; 64.5% with episodic cluster headache ) treated three attacks, at least 24 hours apart,  in each patient,  one with placebo, one with zolmitriptan 5 mg, and one with zolmitriptan 10 mg in a randomized, crossover manner.   The primary endpoint was headache relief, assessed on a 5 point scale, at 30 minutes post dose: reduction from... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2917300 Wed, 21 Oct 2009 23:00:00 +0100 2917300 http://www.medworm.com/index.php?rid=2905841&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F19%2FMHRA-guidance-on-new-requirements-for-packaging-of-OTC-medicines-containing-codeine-and-dihydrocodeine%2F Source: MHRA Area: News The MHRA has issued guidance outlining the new requirements for all packaging components of OTC solid dose medicines containing codeine or dihydrocodeine. This follows a review in July 2009 by the Commission on Human Medicines which recommended a package of measures to minimise the risk of overuse of-and addiction to such medicines. The measures included changes to pack sizes, indications, the PIL, labelling, advertising and promotional activity. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2905841 Sun, 18 Oct 2009 23:00:00 +0100 2905841 http://www.medworm.com/index.php?rid=2895698&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FSingle-dose-oral-tenoxicam-for-acute-postoperative-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Tenoxicam is a non-steroidal anti-inflammatory drug (NSAID) licensed for use in rheumatic disease and other musculoskeletal disorders in the UK, and is widely available in other countries worldwide. This review sought to evaluate the efficacy and safety of oral tenoxicam in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.   Objectives To assess the efficacy of single dose oral tenoxicam in acute postoperative pain, and any associated adverse events.   Search strategy We searched The Cochrane... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2895698 Wed, 14 Oct 2009 23:00:00 +0100 2895698 http://www.medworm.com/index.php?rid=2895697&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F15%2FNICE-consults-on-draft-guidance-on-pharmacological-management-of-neuropathic-pain%2F Source: NICE Area: News NICE has issued for consultation from 14th October 2009 to 11th November 2009, its draft guidance on the pharmacological management of neuropathic pain. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2895697 Wed, 14 Oct 2009 23:00:00 +0100 2895697 http://www.medworm.com/index.php?rid=2887719&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDrug-Specific-Reviews%2FPregabalin-for-acute-and-chronic-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is a recently developed antiepileptic drug also used in management of chronic neuropathic pain conditions.   Objectives To assess analgesic efficacy and associated adverse events of pregabalin in acute and chronic pain.   Search strategy We searched MEDLINE, EMBASE, and CENTRAL to May 2009 for randomised controlled trials (RCTs). Additional studies were identified from the reference lists of retrieved papers and on-line clinical trial databases.   Selection criteria Randomised, double blind trials reporting on the analgesic effect of pregabalin, with subjective pain assessment by the patient as either the pr... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2887719 Mon, 12 Oct 2009 23:00:00 +0100 2887719 http://www.medworm.com/index.php?rid=2887718&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F13%2FNycomed-launches-Instanyl-intranasal-fentanyl-spray-for-relief-of-breakthrough-cancer-pain-%2F Source: Nycomed Area: News Nycomed has launched an intranasal fentanyl spray (Instanyl) for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain.   The Summary of Product Characteristics defines patients receiving maintenance opioid therapy as those who are taking at least 60 mg of oral morphine daily, at least 25 micrograms of transdermal fentanyl per hour, at least 30 mg oxycodone daily, at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid for a week or longer.   The product is available as Instanyl® 50, 100 and 200 micrograms/dose nasal spray, solution. The cost of the 10-dose unit packs of each of the strengths is £59.50 and the cost of the 20-dose unit packs of each of th... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2887718 Mon, 12 Oct 2009 23:00:00 +0100 2887718 http://www.medworm.com/index.php?rid=2873247&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---October%2F08%2FSmall-RCT-finds-that-cannabanoid-spray-Sativex-no-more-effective-than-placebo-for-painful-diabetic-neuropathy%2F Source: Diabetes Care Area: News A small RCT has assessed the efficacy of Sativex® spray, a cannabis based medicinal extract, as adjuvant treatment in painful diabetic neuropathy. It involved 30 subjects randomised to receive either daily Sativex or placebo. The primary outcome measure was change in mean daily pain scores and secondary outcome measures included quality of life assessments. There were improvements in pain scores in both groups but the mean change between groups was not significant and there were no significant differences in secondary outcome measures. The authors note that depression was a major confounder and may have important implications for future trials in this setting. They conclude from these findings that Sativex is no more efficacious than placebo in painful di... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2873247 Wed, 07 Oct 2009 23:00:00 +0100 2873247 http://www.medworm.com/index.php?rid=2843963&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F30%2FGabapentin-plus-nortriptyline-better-combined-than-singly-for-neuropathic-pain%2F Source: Lancet Area: News A controlled trial shows that combining gabapentin with nortriptyline gives better outcomes in neuropathic pain than either drug individually.   Gabapentin and tricyclic antidepressive drugs are both used in the treatment of neuropathic pain, however response rates are still poor even at maximum tolerated doses. Experimental evidence suggests that combinations of the two may have additive or synergistic effects, and this trial was carried out to investigate this possibility. It involved patients from one Canadian university hospital centre with confirmed neuropathic pain due to diabetic neuropathy or post-herpetic neuralgia lasting at least six months. They were randomised to three possible treatments - either drug alone, or the combination - in a three-... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2843963 Tue, 29 Sep 2009 23:00:00 +0100 2843963 http://www.medworm.com/index.php?rid=2839770&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FCyclimorph-morphine--cyclizine-10-Injection--Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.8 (undesirable effects) has been updated and now reads as follows: As Cyclimorph Injection contains morphine and cyclizine, the type and frequency of adverse effects associated with such compounds may be expected. Adverse reactions attributable to morphine include respiratory depression, raised intra-cranial pressure, orthostatic hypotension, drowsiness, confusion, dysphoria, restlessness, miosis, constipation, nausea, vomiting, skin reactions (e.g. urticaria) biliary tract and renal spasm, vertigo and difficulty with micturition. Adverse reactions attributable to cyclizine include urticaria, drug rash, drowsiness/sedation, [2]headache, dryness of the mouth, nose and throat, blurred vis... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2839770 Sun, 27 Sep 2009 23:00:00 +0100 2839770 http://www.medworm.com/index.php?rid=2839769&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FMST-morphine-sulphate-Continus-suspensions-20-30-60-100-and-200-mg---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.4 (special warnings and precautions for use) has been updated and now reads as follows: Should paralytic ileus be suspected or occur during use, MST CONTINUS suspension should be discontinued immediately.  Patients about to undergo additional pain relieving procedures (e.g. surgery, plexus blockade) should not receive MST CONTINUS suspension for 24 hours prior to the intervention.  If further treatment with MST CONTINUS suspension is indicated, then the dosage should be adjusted to the new post-operative requirement. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2839769 Sun, 27 Sep 2009 23:00:00 +0100 2839769 http://www.medworm.com/index.php?rid=2805377&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F18%2FRCT-of-dietary-intervention-and-quadriceps-strengthening-exercises-on-pain-and-function-in-overweight-people-with-knee-pain%2F Source: BMJ Area: News The effect of dietary intervention or knee strengthening exercise, or both on knee pain and knee function in overweight and obese adults in the community has been assessed in a RCT. The study involved 389 men and women aged ?45 years with a BMI ? 28.0 and self reported knee pain from 5 general practices in Nottingham, who were randomised to one of the following interventions:   . Dietary intervention plus quadriceps strengthening exercises . Dietary intervention alone . Quadriceps strengthening exercises alone . Advice leaflet only (control group)   Dietary intervention consisted of individualised healthy eating advice that would reduce normal intake by 2.5 MJ (600 kcal) a day. Interventions were delivered at home visits o... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2805377 Thu, 17 Sep 2009 23:00:00 +0100 2805377 http://www.medworm.com/index.php?rid=2790974&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F14%2FConference-report-Study-compares-fentanyl-nasal-spray-Instanyl-to-oral-transmucosal-fentanyl-Actiq-in-breakthrough-cancer-pain%2F Source: EurekAlert Area: News Findings from an open-label crossover trial comparing intranasal fentanyl spray (Instanyl®) and oral transmucosal fentanyl citrate (OTFC; Actiq®) for the treatment of breakthrough pain in patients with cancer have been presented at the 6th congress of the European Federation of Chapters of the International Association for the Study of Pain, and are summarised in a press release (See link below).   Only brief details of trial design, methodology and results are available.  The trial was multinational and compared the efficacy of the two treatments in patients who were receiving chronic opioid treatment; ease of administration and patient preference were also evaluated. The primary endpoint was time to onset of meaningful pain relief (?33% redu... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2790974 Sun, 13 Sep 2009 23:00:00 +0100 2790974 http://www.medworm.com/index.php?rid=2790975&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FInstanyl-fentanyl-50-100-and-200-mcgdose-nasal-spray---New-product%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Instanyl is a new product indicated for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain. Breakthrough pain is a transitory exacerbation of pain that occurs on a background of otherwise controlled persistent pain. Patients receiving maintenance opioid therapy are those who are taking at least 60 mg of oral morphine daily, at least 25 micrograms of transdermal fentanyl per hour, at least 30 mg oxycodone daily, at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid for a week or longer.     (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2790975 Sat, 12 Sep 2009 23:00:00 +0100 2790975 http://www.medworm.com/index.php?rid=2783277&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FTarginact-oxycodone--naloxone-5mg25mg-and-40mg20mg-prolonged-release-tablets---New-Product%2F Source: Manufacturer notification Area: Other Library Updates > SPC Changes Targinact 5mg/2.5mg and 40mg/20mg prolonged release tablets are new strengths of this product launched by Napp. These new strengths will add to the existing range of Targinact prolonged release tablets which are currently available in 10 mg/5 mg and 20 mg/10 mg tablet strengths. Targinact 5 mg/2.5 mg prolonged release tablets are intended for dose titration when initiating opioid therapy and individual dose adjustment. Targinact is indicated for severe pain, which can be adequately managed only with opioid analgesics. The opioid antagonist naloxone is added to counteract opioid-induced constipation by blocking the action of oxycodone at opioid receptors locally in the gut.   (Source: NeLM - Pain co... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2783277 Wed, 09 Sep 2009 23:00:00 +0100 2783277 http://www.medworm.com/index.php?rid=2775937&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F09%2FReview-Diagnosis-and-management-of-cervicogenic-headache%2F Source: Lancet Neurology Area: News The Lancet Neurology has featured a review on the diagnosis, and management of cervicogenic headache, which is characterised by pain referred to the head from the cervical spine. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2775937 Tue, 08 Sep 2009 23:00:00 +0100 2775937 http://www.medworm.com/index.php?rid=2763355&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FOther-Lib-Updates%2FSPC-Changes%2FDynastat-parecoxib-20mg--40mg-Powder-for-Solution-for-Injection-Dynastat-20mg--40mg-Powder--Solvent-for-Solution-for-Injection---Revised-SPC%2F Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.4 (special warnings and precautions for use) has been updated. Some reports of Stevens-Johnson syndrome have been reported through post marketing surveillance in patients receiving parecoxib, it has been added that some of these were fatal. Again, fatal reports has been added to the statement that toxic epidermal necrolysis has been reported. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2763355 Thu, 03 Sep 2009 23:00:00 +0100 2763355 http://www.medworm.com/index.php?rid=2759398&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F03%2FCare-Quality-Commission-annual-report-on-the-safer-management-of-controlled-drugs-2008%2F Source: Care Quality Commission (CQC) Area: News The Care Quality Commission has published its second annual report on the regulation of controlled drugs, covering the year ended 31st December 2008. (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2759398 Wed, 02 Sep 2009 23:00:00 +0100 2759398 http://www.medworm.com/index.php?rid=2759397&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---September%2F03%2FMHRA-issues-new-advice-on-OTC-analgesics-containing-codeine%2F Source: MHRA Area: News The MHRA has issued new advice on over-the-counter (OTC) medicines containing codeine and dihydrocodeine (DHC) to minimise the risk of overuse and addiction following recent advice from the Commission on Human Medicines (CHM). The package of measures are:   . All indications related to colds, flu, coughs and sore throats, and references to minor painful conditions will be removed.   . The remaining list of indications will be for the short term treatment of acute, moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone.   . Patient information leaflets (PIL) and labels will state that the products are for short term use only (up to 3 days) for the treatment of moderate, acute pain, and that the produc... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2759397 Wed, 02 Sep 2009 23:00:00 +0100 2759397 http://www.medworm.com/index.php?rid=2748592&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FGuidelines%2FCKS-topic-review-Headache%2F Source: CKS Area: Evidence > Guidelines This Topic Minibite from the Clinical Knowledge Service (CKS) covers the assessment of children and adults with undiagnosed headache. It provides diagnostic criteria for the common headache disorders and for some of the less common headache disorders.   Separate Topic Minibites cover the management of cluster headaches, medication overuse headaches, and tension-type headache (see links below). (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2748592 Mon, 24 Aug 2009 23:00:00 +0100 2748592 http://www.medworm.com/index.php?rid=2748593&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FPatient-Safety%2FAdverse-effects-of-medical-cannabinoids-a-systematic-review%2F Source: DARE Area: Evidence > Patient Safety CRD Summary: This systematic review aimed to assess the safety of medical cannabinoids. The authors concluded that short-term use of medical cannabinoids appears to increase the risk of non-serious adverse events, but that risks associated with long-term use were poorly reported. Overall this was a well conducted systematic review and the authors' conclusions are likely to be reliable.   [The cannabinoid preparations investigated were oral ?-9-tetrahydrocannabinol, oral ?-9-tetrahydrocannabinol-cannabidiol or oromucosal ?-9-tetrahydrocannabinol-cannabidiol. ]   CRD Commentary: This review addressed a clear question and was supported by appropriate inclusion criteria. The authors searched electronic databases and reference list... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2748593 Sun, 23 Aug 2009 23:00:00 +0100 2748593 http://www.medworm.com/index.php?rid=2748594&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FComplementary-Medicine%2FEfficacy-of-complementary-and-alternative-medicine-therapies-in-relieving-cancer-pain-a-systematic-review%2F Source: DARE Area: Evidence > Complementary Medicine CRD Summary: The review concluded there was some evidence of short term benefit for the relief of cancer pain with hypnosis, imagery, support groups, acupuncture and healing touch but, due to the paucity of rigorous trials, no interventions can be recommended. The reliability of the authors' cautious conclusions is uncertain due to lack of reporting of review methods and poor quality evidence.   [The CAM therapies in the included studies included acupuncture, music, psychological support, cognitive behavioural therapy (CBT), hypnosis, relaxation and guided imagery, HESA-A herbal remedy, Ai-Tong-Ping capsules, massage, aromatherapy and healing touch/Reiki. ]   CRD Commentary: Inclusion criteria were clearly defined for ... NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2748594 Thu, 20 Aug 2009 23:00:00 +0100 2748594 http://www.medworm.com/index.php?rid=2748595&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---August%2F14%2FReview-Diagnosis-and-management-of-neuropathic-pain%2F Source: BMJ Area: News This BMJ review on the recognition and management of neuropathic pain addresses the following questions:   . What is neuropathic pain and who gets it? . How common is neuropathic pain? . How does neuropathic pain present in clinical practice? . How is neuropathic pain diagnosed? . What are the personal and societal costs of neuropathic pain? . What is a sensible therapeutic approach for patients with neuropathic pain? . What are the recommendations from clinical guidelines and algorithms? . Is there a role for non-pharmacological treatments? . What should future research address? (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2748595 Thu, 13 Aug 2009 23:00:00 +0100 2748595 http://www.medworm.com/index.php?rid=2748596&cid=s_38914_5_f&fid=38914&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FNews%2F2009---August%2F11%2FCentral-post-stroke-pain-clinical-characteristics-pathophysiology-and-management%2F Source: Lancet Neurology Area: News The Lancet Neurology has featured a review on the clinical characteristics and management of central post-stroke pain (CPSP), a neuropathic pain syndrome that can occur after a cerebrovascular accident. This syndrome is characterised by pain and sensory abnormalities in the body parts that correspond to the brain territory that has been injured by the cerebrovascular lesion.   The following topics are discussed: . Epidemiology of CPSP . Clinical characteristics of CPSP . Diagnostic measures . Pathophysiology: possible mechanisms . Management of CPSP using antidepressants, anticonvulsants, opioids, and neurostimulation therapy (Source: NeLM - Pain control) NeLM - Pain control organizations http://www.medworm.com/rss/comments.php?id=2748596 Mon, 10 Aug 2009 23:00:00 +0100 2748596