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AAPM E-NEWS Join AAPM's Discussion Forum “I have read dozens of different opinions on the number of steroid exposures/ number of mgs that a patient should have in a year. Does anyone have the literature source for these suggestions? I guess it comes from the Rheumatology literature, but I have never seen a peer reviewed article." - Member, Knoxville, TN Post your comments... 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? Post your position in the AAPM Career Center and reach more than the 2,400 members of AAPM. The network reaches beyond 30,000 professionals in healthcare. FEATURED JOBS: Pain Management Position Northridge, California Board-Certified Pain or Sleep Mgt. Specialist Bluffton, South Carolina PM&R Physician w/Pain Medicine Fellowship Bozeman, Montana 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. Back to top 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... Back to top 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] 4 easy ways to order: Phone: 847-375-4731 Fax: 847-375-6477 Email: [email protected] Mail: AAPM P.O. Box 839 Glenview, IL 60025-0839 ORDER FORM 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... Back to top 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 ... Back to top 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... Back to top 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... Back to top 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... Back to top 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. AAPM on Social Networking Sites Join the AAPM Linked-In Group and become a "fan" of AAPM on 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... Back to top 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... Back to top 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... Back to top Click here to unsubscribe. American Academy of Pain Medicine 8735 W. Higgins Road, Suite 300, Chicago, IL 60631 847/375-4731 847/375-6477 Fax [email protected] www.painmed.org