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December 10, 2010 - Your Latest News on the Specialty of Pain
Medicine
LATEST NEWS from the American Academy of Pain Medicine
Annual Meeting--Keynote Plenary Speaker Announced
• Register Now - $100 Early Bird Discount
Practice Management & Coding Updates
Pain Research in the News
Pain Treatments/Trials in the News
Controlled Substances: News & Views
Industry News
Pain News
Pain Abstracts in the News
PubMed Pain Abstracts
NIH Clinical Studies & Trials
Annual Meeting
Register Now
for AAPM's 27th Annual
Meeting
in National Harbor, MD
March 24-27, 2011
Pre-meeting activities begin
Wednesday, March 23rd
Pain Medicine, D.C.
The Governing Voices of Pain:
Medicine, Science, and Government
AAPM's 27th Annual Meeting
Pain Medicine, D.C.
The Governing Voices of Pain: Medicine, Science, and Government
March 24 - 27, 2011 in National Harbor, MD
Pre-meeting activities begin Wednesday, March 23rd
Regina E. Herzlinger to Deliver Keynote Plenary Address at
AAPM's 2011 Annual Meeting
Regina E. Herzlinger, Professor at the Nancy R. McPherson
Professor of Business Administration at the Harvard Business
School, will deliver the keynote plenary address at the American
Academy of Pain Medicine's 27th Annual Meeting, Pain Medicine,
DC, in National Harbor, MD, March 24 - 27, 2011. Professor
Herzlinger is widely recognized for her innovative research in
health care, including her early predictions of the unraveling of
managed care and the rise of consumer-driven health care and health care
focused factories, two terms that she coined. Money has dubbed her the
"Godmother" of consumer-driven health care. Read more...
Early Bird Special! Register now through January 31, 2011 and receive
$100 off your registration.
Prebook your Hotel Reservations now.
Annual Meeting Registration is now live!
AAPM Online Medical
Education Now Available
From the 26th Annual
Meeting
Advancing the Science and Practice of
Pain Medicine in a Changing Healthcare
Environment
♦ Quality PRA Category 1
Qualified Pain Education by Top
Experts and Researchers in the
Field of Pain Medicine.
For more information...
Seeking a Pain Specialist?
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Read this month's
President's Message
Visit PainPoints
Pain Medicine's new blog, and read
posts by AAPM's Director at Large,
Gilbert Fanciullo MD, MS.
AAPM Releases
Pain Position
Paper
Plenary Proceedings of the
24th Annual Meeting
Plenary Proceedings of the 24th
Annual Meeting contains exciting,
forward thinking perspectives currently
driving the emerging field of pain
medicine.
Order your copy TODAY
Price: $79
View AAPM's 2011 Annual Meeting Schedule-at-a-Glance.
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Practice Management & Coding Updates
CODING & REIMBURSEMENT UPDATES
One-Year SGR Fix Now Needs Only Presidential Okay
December 9, 2010 [Source: MedPage Today]
Congress passed the Medicare and Medicaid Extenders Act of 2010 (HR 4994),
blocking the impending 25 percent cut in the Medicare pay rate through 2011.
The bill now awaits President Obama’s signature. Full story...
PRACTICE MANAGEMENT
Congress Passes Bill That Helps Clarify Scope of Red Flags Rule
December 7, 2010 [Source: American Medical Association]
The Red Flag Program Clarification Act of 2010 (S 3987) recently passed by
Congress supports the AMA’s long-standing argument to the FTC that a
physician should not be considered a creditor under the red flag rule. President
Obama is expected to sign the bill into law. Full story...
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Pain Research in the News
Research from Federal University Provide New Insights into
Muscle Pain
December 8, 2010 [Source: TherapeuticsDaily]
Researchers in Brazil found that an injection of Interleukin-6 (IL-6), an
inflammatory cytokine known to modulate muscle pain, into mice gastrocnemius
muscle evoked a time-and dose-dependent mechanical hyperalgesia. This
provides new evidence that IL-6 exerts a relevant role in the development and
maintenance of muscular hyperalgesia. Full story...
View related article from the Department of Sports Sciences, Northumbria
University, UK...
View related article from the University of Extremadura, Spain...
Drug Prevents Post-Traumatic Stress Syndrome
December 6, 2010 [Source: Northwestern University Feinberg School of Medicine]
Researchers at Northwestern University Feinberg School of Medicine identified
for the first time the molecular cause for post-traumatic stress syndrome. The
syndrome was prevented from occurring when the newly developed drugs
MPEP and MTEP were injected into the hippocampus of mice within five hours
of a traumatic event. Full story...
Stress and Neck Pain More Common in Women Than Men
December 6, 2010 [Source: Alpha Galileo]
According to researchers at the University of Gothenburg in Sweden, neck pain
was more common among women than men, irrespective of occupation or age,
with perceived stress appearing to play a role in the development of neck pain,
as well as other psychosocial factors. Full story…
U of T Researcher Discovers Way to Zip Away Chronic Pain
December 3, 2010 [Source:University of Toronto]
University of Toronto researchers suggest that blocking the effect of protein
kinase M zeta (which plays a role in storing "memories" of pain and therefore
enhances the sensation of pain) through the use of a selective inhibitor called
zeta-pseudosubstrate inhibitory peptide, or ZIP, blocked the behavioral
sensitization and nerve injury related to chronic pain. Full story...
View related article in PLoS ONE...
View related article in NIH Public Access in Science Signaling...
Breast Pain Indicates Possibility of Cancer, Study Finds
December 2, 2010 [Source: DiagnosticImaging]
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Due to the limited literature and controversy regarding diagnostic imaging for
women with breast pain, researchers at the University of Michigan conducted a
retrospective study of 500 consecutive women referred to breast imaging for
isolated breast pain, The study found that eight of the 500 women seeking
breast exams for breast pain were diagnosed with breast cancer, of which three
were acute and five were subsequent. Full story...
Workers With Low Back Pain Benefit From Integrated Care
December 1, 2010 [Source: HealthDay News]
A new study published in the British Medical Journal examined the cost of
treating chronic low back pain through an integrated approach to care
compared to traditional medical care. The study found that after one year, the
total costs in the integrated care group were $20,477, compared with $28,736
for the traditional medical care group. The integrated care group included
workplace assessments, treatment with graded exercise, and reassurance that
despite pain, it was safe to move while increasing activity levels. Full story... View original article in British Medical Journal...
Better Outcomes Seen With Early Rheumatoid Arthritis Diagnosis
November 30, 2010 [Source: HealthDay News]
PATIENT INFORMATION
Patient Education Videos
Now Available Online
Online videos are now available in the
Patient Center section of the AAPM
website for your patients to view:
View "Finding Relief: Pain
Management for Older Adults" video
View "Managing Chronic Pain, A
Guide for Patients" video
Educational Booklet and
DVD
Copies of the new educational booklet
and DVD, Finding Relief: Pain
Management for Older Adults are
available to members free of charge,
with the addition of a modest shipping
fee. To request copies of this resource
email: [email protected].
UPDATES
The AAPM Power Point
Researchers at the Leiden University Medical Center in The Netherlands, found
that patients who delay longer than 12 weeks between the first symptoms of
rheumatoid arthritis and seeing a rheumatologist have a joint destruction rate
1.3 times higher than patients assessed within 12 weeks. These patients also
had a lower chance of achieving a sustained DMARD-free remission. Full
story...
View European Recommendations Concerning DMARDS in Annals of the
Rheumatic Diseases, the EULAR Journal...
Changes in Mouse Brain Associated With Morphine Tolerance
November 2010 [Source: Pain Medicine News]
A recent study suggests that after chronic morphine administration, the
abundance of the mu-opioid receptor (MOR) and the delta-opioid receptor
(DOR) increases in the central nervous system regions involving pain
processing in the mouse brain. This may be a potential therapeutic target for
treating chronic pain and addiction. Full story...(log-in required) View abstract in PubMed.gov...
View related article in AAPS Journal...
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Pain Treatments/Trials in the News
Under Suspicion: Painkiller Ziconotide Could Increase Suicidal
Ideation
December 4, 2010 [Source: ScienceDaily]
German researchers presume that ziconotide, introduced as a safe alternative
to morphine, may not only suppress the transmission of pain stimuli, but also
deteriorate the frame of mind and could simultaneously reduce anxiety and
Presentation on the
Federal Regulations for
Prescribing has been
updated effective
11/01/2010.
View this new presentation.
Revised AAPM Ethics
Charter
Includes statement on conflicts of
interest.
impulse control, promoting suicidal tendencies in vulnerable patients. Full
story...
View pharmacology review in Neuropsychiatric Disease and Treatment...
Naproxcinod Helps in Hip OA
December 3, 2010 [Source: MedPage Today]
Researchers in Germany found that in patients with hip osteoarthritis who were
randomized to receive naproxcinod, their pain scores fell from a mean of 66.25
out of 100 by a least square mean of –25.81 (95% CI –29.17 to –22.44),
compared to those receiving the placebo which changed -17.97 (95% CI –21.27
to –14.67, P<0.0001). Naproxcinod, a cyclooxygenase-inhibiting nitric oxide
donators, is part of a new class of drugs that was developed to minimize the
adverse effects of long-term NSAIDs use. Full story...
View related article in Arthritis Care & Research...
View related article in the Annals of the Rheumatic Diseases, the EULAR
Journal...
Pharmaceuticals Release Sativex® Enters Phase III Clinical
Program in Cancer
November 23, 2010 [Source: ClinicaSpace]
Need Facts on Pain?
Updated: Visit AAPM's "Facts on
Pain" section in the Patient Center of
the AAPM website, which now
includes detailed references to each
fact. These are helpful to have on
hand for media calls. Read more...
Affiliate Membership
Are the members of your pain team
AAPM members?
Affiliate membership information...
The American Board of
Pain Medicine (ABPM) is
committed to the certification of
qualified physicians in the field of pain
medicine. Visit abpm.org to view
ABPM's mission, vision, and
objectives.
Pain Medicine:
December, 2010
Highlights:
EDITORIAL
The Emerging Use of Botulinum
Toxins for the Treatment of
Neuropathic Pain
PAIN & AGING SECTION
The Utility of the Short Version of the
After successful Phase II trials of Saltivex®, Phase III will evaluate the efficacy
and safety of Sativex® versus placebo. This investigational new product is
composed of CBD (cannabidiol) and THC (delta 9 tetrahydrocannabinol) for the
treatment of pain in patients with advanced cancer with inadequate analgesia
during optimized chronic opioid therapy and is administered as a metered dose
oro-mucosal spray. Full story...
View related article in Diabetes Care ...
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Controlled Substances: News & Views
Fuisz Pharma Releases Clinical Photos of Its Opioid Abuse
Detection System
December 6, 2010 [Source: PRNewswire]
Fuisz Pharma released clinical photos to help detect opioid abuse through
snorting in a standard nasal otoscopic exam. A food safe dye is used in the
tablets, causing temporary nasal staining that can be detected at 12, 24 and 48
hours. Full story...
Prescriptions for Teens and Young Adults on the Rise
November 29, 2010 [Source: University of Rochester]
Young adults are prescribed a controlled prescription medication at
approximately one out of every six visits, according to a recent study in
Pediatrics. The study examined clinical visits by classification of drug
prescribed, type of visit, place of visit and demographic and geographic factors.
Full story...
View original article in Pediatrics...
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Industry News
Pfizer CEO Calls It Quits
December 6, 2010 [Source: NPR News]
Pfizer announces the retirement of the company’s Chairman and Chief
Executive, Jeff Kindler, who joined Pfizer a little over four years ago. Full
story...
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Depression Anxiety Stress Scales
(DASS-21) in Elderly Patients with
Persistent Pain
OPIOIDS, SUBSTANCE ABUSE &
ADDICTIONS SECTION
Crossroads of Pain and Addiction
NEUROPATHIC PAIN SECTION
Complex Regional Pain Syndrome
Type II Associated with Lumbosacral
Plexopathy: A Case Report
ACUTE PAIN SECTION
Safety of Multiple-Dose Intravenous
Acetaminophen in Adult Inpatients
View all topics slated for the
December issue of Pain Medicine
Journal or go to the Library section of
the AAPM website for more
information.
MEMBERSHIP
AAPM Membership Renewals
Membership renewals are currently
being sent out. Don't miss the
opportunity to continue being a part of
the primary organization for physicians
practicing in the specialty of pain
medicine. As a member you will
continue to receive the AAPM ENews, Pain Medicine, the official
journal of AAPM, as well as
representation and advocacy in
Washington DC, up-to-date coding
information, discounts on AAPM's
Annual Meeting, and a host of other
member benefits.
Pay dues online or for phone
assistance, please call customer
service at 847/375-4731.
Bring in a new, paid, active AAPM
member and receive the Plenary
Proceedings of the 24th Annual
Meeting, which contains exciting,
forward thinking perspectives currently
driving the emerging field of pain
medicine. A $79 value. Contact
[email protected] to
receive your thank you for referring a
new AAPM.
With membership at an
unprecedented level, more than 2,400
physicians and their pain teams are
part of this premier medical specialty
society, practicing in pain medicine
from origins in anesthesiology,
neurosurgery, neurology, physiatry,
Pain News
The First National Pain Medicine Summit—Final Summary Report
Philipp M. Lippe MD, FACS, Charles Brock MD, Jose David MD, Ronald Crossno MD, Stuart Gitlow MD
The AMA Section Council Pain Summit was part of the pre-meeting activities of
the AMA's Interim House of Delegates meeting held November 5, 2009 in
Houston, Texas.
View the Final Summary Report in Pain Medicine...
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Pain Abstracts in the News
Buprenorphine Enhances and Prolongs the Postoperative
Analgesic Effect of Bupivacaine in Patients Receiving
Infragluteal Sciatic Nerve Block
December 2010 [Source: Anesthesiology]
Abstract: Background: Results from previous studies have shown favorable
effects from the addition of buprenorphine to local anesthetics used for
interscalene or axillary perivascular brachial plexus blocks. The main objective
of the current study was to determine whether addition of buprenorphine could
enhance bupivacaine analgesia after infragluteal sciatic nerve block.
Read more...
View related article in Journal of Postgraduate Medicine...
Paracetamol (acetaminophen) With or Without an Antiemetic for
Acute Migraine Headaches in Adults
November 10, 2010 [Source: Cochrane Review]
Abstract: Background: Migraine is a common, disabling condition and a burden
for the individual, health services and society. Many sufferers choose not to, or
are unable to, seek professional help and rely on over-the-counter analgesics.
Co-therapy with an antiemetic should help to reduce nausea and vomiting
commonly associated with migraine.
Read more...
Replicability and Reliability of Pain Assessment Forms in
Geriatrics
November 15, 2010 [Source: Archives of Gerontology and Geriatrics]
Abstract: Aim of the study was to investigate the replicability and reliability of
the multi-dimensional health assessment questionnaire (MDHAQ) and visual
analog scale (VAS) in young and elderly individuals with chronic pain.
Ambulatory patients, 20 of them aged above 65 years and complaining about
chronic pain and 20 patients with the age of 40 and younger working in a
factory were assessed with VAS and MDHAQ.
Read more...
The following posters were presented at the recent American
Society of Regional Anesthesia and Pain Medicine Meeting,
November 18-21, 2010
Vertebroplasty and Kyphoplasty Successfully Reduce Pain in
Cancer Patients with Vertebral Compression Fractures
November 18, 2010 [Source: American Society of Regional Anesthesia and Pain Medicine]
Authors: Allen W Burton, MD, Houston, TX, Anh Dang, MD, Houston, TX; Tito
Mendoza, PhD, Houston, TX; Marco Perez-Toro, MD, Houston, TX; Joseph
Ting, DO, Houston, TX
Results from a review of 407 cancer patients with vertebral compression
fractures (VCFs), whether pathologic or osteoporotic, found that of the 142
and psychiatry. For more than 25
years, the American Academy of Pain
Medicine (AAPM) has provided
education, training, advocacy and
research in the specialty of pain
medicine. Consider joining AAPM
today and become part of this growing
medical specialty society. Visit
www.painmed.org for more
information.
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Facebook
patients that underwent vertebroplasty (VP) and/or kyphoplasty (KP), the
procedure was relatively safe, well tolerated and successfully reduce pain in
cancer patients with vertebral compression fractures.
Read more...
Removing Polyethylene Glycol from Methylprednisolne Makes
Suspension Safer for Intrathecal Use
November 18, 2010 [Source: American Society of Regional Anesthesia and Pain Medicine]
Authors: Kenneth D. Candido, M.D., Chicago, IL, Nebojsa Nick Knezevic, M.D.,
Ph.D., Chicago, IL; Jessen J. Mukalel, M.D., Chicago, IL; Ivana Knezevic, M.D.,
Chicago, IL
Authors report that keeping a vial of methylprednisolone acetate (MPA)
suspension inverted for more than two hours, greatly reduced the concentration
of polyethylene glycol (PEG), which they believe will reduce the risk of
complications, and should be considered in patients with postherpetic neuralgia
refractory to other treatments.
Read more...
A Review of the Long-Term Efficacy of Intrathecal Morphine
Using a Low Dose Trialing Protocol
November 18, 2010 [Source: American Society of Regional Anesthesia and Pain Medicine]
Authors: Michael E. Harned, M.D., Lexington, KY, Jay S. Grider, D.O., Ph.D.,
Lexington, KY
The authors report on the long-term efficacy of 22 patients who were trialed
using a low-dose morphine protocol for the delivery of intrathecal opioids,
currently being managed with intrathecal drug delivery systems (IDDS), and
found that it appears that the efficacy of IDDS using low dose morphine is
maintained for at least 12 months.
Read more...
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PubMed Pain Abstracts
The following abstracts are posted at PubMed.gov
Pharmacotherapy of Low Back Pain: Targeting Nociceptive and
Neuropathic Pain Components
Curr Med Res Opin. 2010 Nov 18. [Epub ahead of print]
Morlion B., University Hospitals Leuven, Leuven, Belgium.
Abstract: Abstract Aim: To review pharmacological management of chronic low
back pain (LBP), with respect to management of nociceptive and neuropathic
components. Methods: Studies were identified by a PubMed search of Englishlanguage papers from the last 10 years, with additional hand searches of
relevant reviews. Discussion: Paracetamol, non-steroidal anti-inflammatory
drugs and cyclo-oxygenase-2 inhibitors target the nociceptive component of
chronic LBP, and do not affect neuropathic pain mechanisms.
PMID: 21083513 [PubMed - as supplied by publisher]
Read more...
Opioid Therapy for Osteoarthritis and Chronic Low Back Pain
Postgrad Med. 2010 Nov;122(6):87-97.
Altman RD, Smith HS., Department of Rheumatology and Immunology, David
Geffen School of Medicine, University of California, 1000 Veteran Ave., Los
Angeles, CA 90024.
Abstract: Background Chronic low back pain (CLBP) and osteoarthritis (OA) of
any joint are highly prevalent, occurring in > 50% of US adults aged ≥ 60 years.
Opioids are prescribed more frequently for CLBP and OA than for any other
noncancer pain, and the judicious use of opioids is recommended by treatment
guidelines for the management of CLBP and OA pain. PMID: 21084785
[PubMed - in process]
Read more...
Fentanyl Sublingual: in Breakthrough Pain in Opioid-Tolerant
Adults with Cancer
Drugs. 2010 Dec 3;70(17):2281-8. doi: 10.2165/11200910-000000000-00000.
Chwieduk CM, McKeage K.
Adis, a Wolters Kluwer Business, Auckland, New Zealand.
Abstract: Fentanyl is a potent opioid with a short duration of action. Fentanyl
sublingual has been formulated as a rapidly disintegrating tablet that is quickly
absorbed, producing a fast onset of analgesia. In two randomized, double-blind
clinical trials, fentanyl sublingual as single fixed or titrated doses reduced pain
intensity during breakthrough pain episodes to a significantly greater extent
than placebo in opioid-tolerant cancer patients.
PMID: 21080744 [PubMed - in process]
Read more...
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NIH Clinical Studies & Trials
The following studies and trials are posted at ClinicalTrials.gov
Safety and Effectiveness of Repeated Administration of QUTENZA
Patches for Treatment of Pain Caused by Nerve Damage (STRIDE)
This study is currently recruiting participants.
First Received: December 1, 2010
Sponsor: Astellas Pharma Inc
Information provided by: Astellas Pharma Inc
ClinicalTrials.gov Identifier: NCT01252160
Stated Purpose: In this study all patients will be treated with the same
medicine, the QUTENZA patch. Subjects will receive up to 6 QUTENZA patch
applications over 12 months.
Read more...
Lidocaine and Outpatient Gynecologic Laparoscopy
This study is currently recruiting participants.
First Received: November 27, 2010
Sponsor: Northwestern University
Principal Investigator: Gildasio De Oliveira, MD, Northwestern University
Information provided by: Northwestern University
ClinicalTrials.gov Identifier: NCT01250002
Stated Purpose: Although ambulatory gynecological laparoscopy is considered
to be a minimally invasive surgical procedure, only 60% of patients undergoing
this procedure are satisfied with postoperative pain control (1). Postoperative
pain can lead to physiological, immunological and psychological derangements
in patients (2,3). It also has been shown to be the most common cause of
hospital admission after outpatient surgery (4).
Read more...
The Effect of Nasal Carbon Dioxide in the Treatment of Moderate
to Severe Migraine
This study is not yet open for participant recruitment.
First Received: December 2, 2010 Last Updated: December 3, 2010
Sponsor: Capnia, Inc.
Study Chair: Peter M Bertrand, DDS National Naval Medical Center, Bethesda
Information provided by: Capnia, Inc.
ClinicalTrials.gov Identifier: NCT01253915
Stated Purpose: This multi-center, double-blind, placebo-controlled, parallel
group trial carbon dioxide in the treatment of moderate to severe migraine. At
approximately 8 US sites, approximately 450 patients who meet the eligibility
criteria will be randomized to active or placebo in a 1:1 ratio to ensure that 400
patients will treat at least one moderate to severe migraine with the study drug.
Read more...
Efficacy and Safety of Acetaminophen, Aspirin and Caffeine With
Sumatriptan in the Acute Treatment of Migraine
This study is currently recruiting participants.
First Received: November 23, 2010 Last Updated: December 6, 2010
Sponsor: Novartis
Information provided by: Novartis
ClinicalTrials.gov Identifier: NCT01248468
Stated Purpose: The main purpose of this study is to compare the efficacy and
safety of aspirin, acetaminophen and caffeine (AAC) with sumatriptan and
placebo in the acute treatment of migraine.
Read more...
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