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Horizon Scanning: FDA panel supports extension to use of duloxetine (Cymbalta)

August 27, 2010 by admin · Leave a Comment 

Horizon Scanning: FDA panel supports extension to use of duloxetine (Cymbalta)
Source: Reuters Area: News Reuters reports that a United States Food and Drug Administration (US FDA) advisory panel has supported an extension to the licensed indication for duloxetine (Cymbalta?) to include chronic back pain. The panel voted whether it effectively treated lower-back pain and osteoarthritis and voted 8-5 to approve its use for back pain, however, by a 4-9 vote they found there was insufficient data to support its use in osteoarthritis. The panellists also said there was not enough data to support a stronger 120mg dose over the current 60mg version.   The FDA will consider the advisory panel’s recommendation before making its final approval decision. Reuters notes that FDA officials said they were concerned about the impact of widening approval duloxetine, which…

Leiomyosarcoma of the renal vein

August 24, 2010 by admin · Leave a Comment 

Leiomyosarcoma of the renal vein
Abstract  A 43-year-old woman was referred to our clinic for evaluation of a left retroperitoneal mass. She presented to our internal medicine department complaining of back pain. Computed tomography (CT) scan revealed a left retroperitoneal mass 55 mm in size in the hilum of the left kidney. Enhanced CT scan and magnetic resonance imaging (MRI) disclosed a poorly staining mass. Metaiodobenzylguanidine scintigraphy demonstrated no accumulation in the mass; moreover, endocrinologic examination was normal. Laparoscopic resection of the left retroperitoneal tumor was attempted; however, strong adhesion between the tumor and the left renal vein was encountered. Thus, left nephrectomy after open conversion was performed. Histological findings indicated leiomyosarcoma origin…

Predictors for Long-Term Back Pain and Disability Evaluated

August 22, 2010 by admin · Leave a Comment 

Predictors for Long-Term Back Pain and Disability Evaluated
For patients who miss work with low back pain, persistent disability and pain one year after treatment are associated with baseline pain intensity and degree of disability, diffuse tenderness, health anxiety and fear avoidance, little or moderate exercise, and having made a compensation claim, according to a study in the August issue of The Spine Journal. (Source: Modern Medicine)

Diagnostic Nerve Blocks Costly — And Controversial (CME/CE)

August 15, 2010 by admin · Leave a Comment 

Diagnostic Nerve Blocks Costly — And Controversial (CME/CE)
While some guidelines recommend two diagnostic nerve blocks before radiofrequency treatment for chronic low back pain, a randomized trial showed greater success without use of the prior blocks. (Source: MedPage Today State Required CME)

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Safety and efficacy of a new percutaneously implantable interspinous process device

August 14, 2010 by admin · Leave a Comment 

Safety and efficacy of a new percutaneously implantable interspinous process device
Conclusions  The In-space is a percutaneous treatment option of claudication in patients with lumbar spinal stenosis. Compared with microsurgical decompression surgery, recurrence rate within 1 year is, however, high and the device seems not suitable for the treatment of low back pain. Therefore, the authors suggest that the device should presently be used primarily in controlled clinical trials in order to get more information concerning the optimal indication. Content Type Journal ArticleCategory Clinical ArticleDOI 10.1007/s00701-010-0740-4Authors Sven Rainer Kantelhardt, Technical University Munich Department of Neurosurgery Ismaninger Straße 22 81675 Munich GermanyElisabeth Török, Technical University Munich Department of Neurosurgery Ismaninger Straße…

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Primary carcinoid tumor of the filum terminale—a case report

August 14, 2010 by admin · Leave a Comment 

Primary carcinoid tumor of the filum terminale—a case report
We report here about a 41-year-old patient with recurrent and progressive low back pain and bilateral S1 radiculopathy on admission. The patient underwent hemi-laminectomies of the vertebral bodies L5 and S1 and an en bloc resection of the tumor. Postoperative histopathological examination resulted in a well-differentiated intrathecal neuroendocrine tumor (carcinoid) of the terminal filum. Postoperative staging showed no pathological abnormalities and no tumor recurrence after 6 months. Even though rare, carcinoids should be considered as differential diagnosis of tumors occurring in the CNS. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00701-010-0756-9Authors Amr Abdulazim, BG-University Hospital Bergmannsheil Division of Spinal Cord Injury Bürkle-de-la-C…

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Low back pain and work-related factors among nurses in intensive care units

August 14, 2010 by admin · Leave a Comment 

Low back pain and work-related factors among nurses in intensive care units
Conclusions. A high prevalence of back pain was found in intensive care unit nurses, even though they comprise a very young workforce in Korea.Relevance to clinical practice. Improving nurse staffing, reducing the frequency of night shifts and assessing risk factors in specific intensive care unit specialties are suggested to decrease back pain prevalence. (Source: Journal of Clinical Nursing)

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Deconditioning in chronic low back pain: might there be a relationship between fitness and magnetic resonance imaging findings?

August 12, 2010 by admin · Leave a Comment 

Deconditioning in chronic low back pain: might there be a relationship between fitness and magnetic resonance imaging findings?
Abstract  The presence of persistent low back pain leads to avoidance of daily activities, contributes to further exercise intolerance and subsequent further loss of functional capacity. We sought to search for the relationship between lumbar magnetic resonance imaging findings and deconditioning in a homogeneous subset of patients with low back pain. We studied 20 sedentary, nonsmoking patients with chronic low back pain using symptom-limited cardiopulmonary exercise testing using treadmill breath-by-breath analysis using modified Bruce protocol. Lumbar facet and disc degeneration involving L1-S1 levels were assessed using 1.5 Tesla MRI. The total number of levels involved was positively correlated with age (r = 0.478, P = 0.033). The Pfirrmann grading o…

A little adversity bodes well for those with chronic back pain

August 10, 2010 by admin · Leave a Comment 

A little adversity bodes well for those with chronic back pain
(University at Buffalo) A new study by researchers at the University at Buffalo and the University of California, Irvine, to be published in the September issue of the journal Pain, reveals that, for people with chronic back pain, having a little adversity in your life can be protective and beneficial. (Source: EurekAlert! - Medicine and Health)

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Attitudes, Beliefs And Health Literacy Impact How Patients Manage Chronic Lower Back Pain, According To A New Study Published In PAIN®

July 29, 2010 by admin · Leave a Comment 

Attitudes, Beliefs And Health Literacy Impact How Patients Manage Chronic Lower Back Pain, According To A New Study Published In PAIN®
Approximately 10% of low back pain (LBP) sufferers experience persistent pain and significant disability. In a study published in the August issue of PAIN, a group of Australian researchers investigating the relevance of health literacy in patients with chronic lower back pain (CLBP) found that LBP-related beliefs and behaviors affect a person’s disability more than pain intensity or a standard measure of functional health literacy… (Source: Health News from Medical News Today)

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