October 2014 Briefing - Pain Management

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Here are what the editors at HealthDay consider to be the most important developments in Pain Management for October 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Spinal Surgery Varies by Region in the United States

FRIDAY, Oct. 31, 2014 (HealthDay News) -- Surgery for low back pain caused by spinal stenosis varies depending on where in the United States you live, according to a Dartmouth Atlas Project report.

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Surgeon Type Doesn't Affect Spinal Surgery Complications

FRIDAY, Oct. 31, 2014 (HealthDay News) -- Complication rates are similar for single-level anterior cervical discectomy and fusions, whether the procedure is performed by a neurosurgeon or orthopedic surgeon, according to a study published in the Sept. 15 issue of Spine.

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Almost One in Five Americans Plagued by Constant Pain

FRIDAY, Oct. 31, 2014 (HealthDay News) -- Almost one-fifth of Americans suffer from chronic pain, a large new survey reveals, with the elderly and women suffering the most. The findings were published in the October issue of the Journal of Pain.

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Brain Scans Yield Clues to Chronic Fatigue Syndrome

THURSDAY, Oct. 30, 2014 (HealthDay News) -- There are clear differences in the brains of people with chronic fatigue syndrome and the brains of non-affected people, new research indicates. In the study, published online Oct. 29 in Radiology, patients with chronic fatigue syndrome had less overall white matter than the people who didn't have the condition.

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Fewer Malpractice Claims Paid in the United States

THURSDAY, Oct. 30, 2014 (HealthDay News) -- The number of medical malpractice payments in the United States has dropped sharply since 2002, according to a new study. And compensation payment amounts and liability insurance costs for many doctors declined in recent years. These findings were published online Oct. 30 in the Journal of the American Medical Association.

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Would Alternative Payment Plan Cut Medical Bills?

THURSDAY, Oct. 30, 2014 (HealthDay News) -- New research supports replacing the traditional way of reimbursing doctors for care -- paying for each service provided -- with an alternative system that gives a set amount of money to health care organizations for patient care. The study was published in the Oct. 30 issue of the New England Journal of Medicine.

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Oral Bisphosphonate Use Cuts Risk of Post-Implant Revision Sx

THURSDAY, Oct. 30, 2014 (HealthDay News) -- For patients undergoing total joint replacement, oral bisphosphonate use is associated with a reduction in the risk of revision surgery, according to a study published in the November issue of Arthritis & Rheumatology.

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AMA Code of Ethics Offers Guidance for Physicians

THURSDAY, Oct. 30, 2014 (HealthDay News) -- The American Medical Association (AMA) Code of Ethics and other articles provide guidance for physicians in relation to public health emergencies, according to a report from the AMA.

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Depression Influences Post-Op Satisfaction in Older Patients

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- For older patients undergoing revision lumbar surgery, preoperative depression influences patient satisfaction two years after surgery, according to research published in the Sept. 1 issue of Spine.

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Voters' Views on Affordable Care Act Split Along Party Lines

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Americans' opinions about the Affordable Care Act (ACA) are sharply divided along political lines, according to research published online Oct. 29 in the New England Journal of Medicine. The findings come from 27 public opinion polls conducted by 14 organizations.

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Less Competition Among Docs = Higher Medical Costs

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Competition between medical practices helps keep health care costs lower, according to a study published in the Oct. 22/29 issue of the Journal of the American Medical Association.

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Noneconomic Damages Caps Cut Malpractice Payments by 15%

TUESDAY, Oct. 28, 2014 (HealthDay News) -- Adoption of noneconomic damages caps reduces average malpractice payments by 15 percent, according to research published in the October issue of Health Affairs.

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Prescription Painkillers Fueling Overdose Cases in ERs

TUESDAY, Oct. 28, 2014 (HealthDay News) -- A new report estimates more than two-thirds of emergency department visits for overdoses of narcotic drugs involve prescription medications. The study was published online Oct. 27 in JAMA Internal Medicine.

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New York, New Jersey Ease Ebola Quarantines

MONDAY, Oct. 27, 2014 (HealthDay News) -- Faced with pressure from the White House and criticism from infectious disease experts, the governors of New York and New Jersey have eased their quarantine measures that required all medical workers returning from West Africa who had contact with Ebola patients to be forced into isolation.

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CDC Issues Revised Interim U.S. Guidance on Ebola

MONDAY, Oct. 27, 2014 (HealthDay News) -- Today, the U.S. Centers for Disease Control and Prevention has issued a revision of their Ebola guideline document -- Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure.

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Neurophysiological Assessment Aids in Identifying Back Injury

FRIDAY, Oct. 24, 2014 (HealthDay News) -- For patients with lumbosacral disc herniation, neurophysiological tests together with neuroimaging and clinical examination allow for accurate preoperative assessment of injury, according to a study published in the Oct. 1 issue of Spine.

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New York City Health Officials Confirm First Ebola Case

FRIDAY, Oct. 24, 2014 (HealthDay News) -- New York City health officials said Thursday that a health care worker who recently returned from West Africa has tested positive for Ebola. The patient, identified as Craig Spencer, M.D., by city officials, had been working with Doctors Without Borders helping to treat Ebola patients in Guinea, one of three West Africa countries hit hard by the disease.

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Airborne Transmission of Ebola Highly Unlikely

FRIDAY, Oct. 24, 2014 (HealthDay News) -- People face no threat of airborne transmission of Ebola, according to a panel of Ebola experts gathered by the New England Journal of Medicine for an issue briefing Wednesday.

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Use of BMP Doesn't Impact Nonunion Rates Post Spine Fusion

THURSDAY, Oct. 23, 2014 (HealthDay News) -- The use of bone morphogenetic protein (BMP) is not associated with operative nonunion rates after spinal fusion, according to a study published in the Oct. 15 issue of Spine.

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Coworker Response 'Crucial' in Workplace Bullying Resolution

THURSDAY, Oct. 23, 2014 (HealthDay News) -- Targets of workplace bullying can offer chaos, report, or quest narratives about their experiences, and coworker response plays a role in narrative development, according to a study published online Sept. 25 in Management Communication Quarterly.

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U.S. Ranks Last Among Wealthy Nations in Health Care Access

THURSDAY, Oct. 23, 2014 (HealthDay News) -- The U.S. health care system ranks last compared to other industrialized nations when it comes to affordability and patient access, according to a new survey published in the Oct. 23 issue of the New England Journal of Medicine.

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Weight-Loss Surgery May Raise Risk of Severe Headaches

THURSDAY, Oct. 23, 2014 (HealthDay News) -- After weight-loss surgery, some patients may be at risk for developing severe headaches, a new study suggests. The report was published online Oct. 22 in Neurology.

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Americans Report Distrust of Medical Profession

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Americans are less trusting of the medical profession than people in many other countries -- even though they often like their own doctor, according to a new report. The findings were published in the Oct. 23 issue of the New England Journal of Medicine.

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U.S. Residents Back From Ebola-Affected Areas to Be Tracked

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Public health officials plan to actively monitor all U.S. residents returning home from one of the three Ebola-affected nations in West Africa, the U.S. Centers for Disease Control and Prevention announced Wednesday.

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APIC Provides Resources for Ebola Management

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Resources are available to increase protection against Ebola transmission, according to a report from the Association for Professionals in Infection Control and Epidemiology (APIC).

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Depression Tied to Worse Lumbar Spine Surgery Outcomes

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Depressive symptoms are associated with poorer long-term outcome in patients undergoing surgery for lumbar spinal stenosis (LSS), according to research published in the Oct. 1 issue of The Spine Journal.

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Drug Coupons Shrink Patients' Costs Considerably

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Drug coupons could reduce patients' out-of-pocket costs by 60 percent, according to a study published in the October issue of Health Affairs.

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Hospice Doesn't Offset Intensive End-of-Life Ovarian Cancer Care

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Increasing use of hospice in the final days of ovarian cancer does not offset intensive end-of-life care in older women, according to a study published online Oct. 6 in the Journal of Clinical Oncology.

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Hospital Conversion to For-Profit Status Ups Financial Margins

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Hospital conversion to for-profit status is associated with improvements in financial margins, but has no effect on process quality metrics or mortality rates, according to a study published in the Oct. 22/29 issue of the Journal of the American Medical Association.

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Surgical Site Infections Up for Medicaid Patients With Spine Sx

TUESDAY, Oct. 21, 2014 (HealthDay News) -- Patients with Medicaid undergoing spine surgery have increased odds of having a surgical site infection, according to a study published in the Sept. 15 issue of Spine.

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Price Transparency Platform Linked to Lower Claims Payments

TUESDAY, Oct. 21, 2014 (HealthDay News) -- Access to an employer-sponsored private price transparency platform is associated with reduced total claims payments, according to research published in the Oct. 22/29 issue of the Journal of the American Medical Association.

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CDC: 'Think Ebola' and 'Care Carefully'

TUESDAY, Oct. 21, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has issued updated guidelines for the use of personal protective equipment (PPE) by health care workers when caring for patients with Ebola, along with a reminder to health care workers to "Think Ebola" and to "Care Carefully."

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Law Requiring Release of Health Information Upheld

TUESDAY, Oct. 21, 2014 (HealthDay News) -- A state law that requires plaintiffs to release relevant protected health information before proceeding with allegations of medical liability has been upheld by a federal appeals court, according to the American Medical Association (AMA).

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Viewpoint: Getting United States Prepared for Ebola Outbreak

MONDAY, Oct. 20, 2014 (HealthDay News) -- A case of delayed Ebola diagnosis in Dallas and subsequent infection of health care workers has highlighted the lack of preparedness for a U.S. outbreak of the disease, according to a viewpoint piece published online Oct. 17 in the Journal of the American Medical Association.

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New MCAT Shifts Focus, Will Include Humanities

MONDAY, Oct. 20, 2014 (HealthDay News) -- The Medical College Admission Test (MCAT) has been revised, and the latest changes, including more humanities such as social sciences, are due to be implemented next April, according to a report from the Association of American Medical Colleges (AAMC).

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Volume of Patient-to-Doc E-mails Up From 2001 to 2010

FRIDAY, Oct. 17, 2014 (HealthDay News) -- From 2001 to 2010 the volume of patient-to-physician electronic messages increased, but the rate per-capita stabilized, according to research published in the October issue of Health Affairs.

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Obama Appoints Ron Klain As 'Ebola Czar'

FRIDAY, Oct. 17, 2014 (HealthDay News) -- President Barack Obama on Friday appointed Ron Klain, a former chief of staff to Vice President Joe Biden, as Ebola "czar" to oversee the federal government's response to the presence of virus in the United States.

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Specialized Care Centers May Be Needed to Contain Ebola

FRIDAY, Oct. 17, 2014 (HealthDay News) -- Specialized medical centers may be necessary to adequately treat and contain the Ebola virus in the United States, according to an ideas and opinions piece published online Oct. 16 in the Annals of Internal Medicine.

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Many Docs Believe Mobile Health Apps Can Improve Patient Care

FRIDAY, Oct. 17, 2014 (HealthDay News) -- A Manhattan Research survey recently found that many physicians believe digital communication technologies, including mobile apps, can be used to improve patient outcomes, according to an article published Oct. 8 in Medical Economics.

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Ebola Workshop Scheduled for Nov. 3 in Washington, D.C.

THURSDAY, Oct. 16, 2014 (HealthDay News) -- At the request of the U.S. Department of Health and Human Services, the Institute of Medicine and the National Research Council will host a workshop to discuss research needed to prepare for handling the occurrence of Ebola virus disease in the United States, according to a press release from the National Academies.

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Limiting Malpractice Claims May Not Curb Costly Medical Tests

THURSDAY, Oct. 16, 2014 (HealthDay News) -- Malpractice reform may not keep physicians from ordering unnecessary and expensive tests, according to a study published in the Oct. 16 issue of the New England Journal of Medicine.

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Change in Doc, Public Attitudes Needed to Cut Overtreatment

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- Reform of malpractice laws as well as inclusion of patients in medical decision making may help reduce overdiagnosis and overtreatment, according to an article published online Oct. 14 in The BMJ.

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IBD Linked to Worse Prognosis After Myocardial Infarction

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- For patients after first-time myocardial infarction (MI), inflammatory bowel disease (IBD) is associated with worse prognosis, according to a study published online Oct. 14 in Circulation: Cardiovascular Quality and Outcomes.

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Second Health Care Worker in Dallas Tests Positive for Ebola

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- A second health care worker who helped treat a patient who died of Ebola last week at a Dallas hospital has tested positive for the disease, health officials said Wednesday morning.

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CDC Takes Steps Toward Hospital Preparedness for Ebola

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has sent new resources to Dallas to support the highest standard of infection control, according to a news release issued by the organization Tuesday.

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Resident Proficiency in High-Value Care Is Hard to Test

TUESDAY, Oct. 14, 2014 (HealthDay News) -- The high-value care (HVC) subscore on the Internal Medicine In-Training Examination (IM-ITE) helps assess resident knowledge of HVC, but additional tools are needed to measure proficiency in practice, according to research published online Oct. 14 in the Annals of Internal Medicine.

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Health Officials Reviewing Ebola Procedures at Dallas Hospital

MONDAY, Oct. 13, 2014 (HealthDay News) -- Federal and local health officials said Monday that they were re-examining infection-control efforts at the Dallas hospital where a nurse contracted Ebola while caring for America's first diagnosed victim of the deadly disease.

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Texas Hospital Worker Tests Positive for Ebola

MONDAY, Oct. 13, 2014 (HealthDay News) -- A health care worker who helped treat the Liberian man who died of Ebola in a Dallas hospital last week has tested positive for the virus, public health officials reported Sunday.

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FDA: Akynzeo Approved for Chemo-Related Nausea/Vomiting

FRIDAY, Oct. 10, 2014 (HealthDay News) -- The combination drug Akynzeo (netupitant and palonosetron) has been approved by the U.S. Food and Drug Administration to treat nausea and vomiting among people undergoing chemotherapy, the agency said Friday in a news release.

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Surgeons Vary in Treatment of Recurrent Herniated Disc

FRIDAY, Oct. 10, 2014 (HealthDay News) -- A recent survey shows differences among spine surgeons in the United States in preferences for surgical treatment of recurrent lumbar disc herniation. The results of the survey were research published in the Oct. 1 issue of The Spine Journal.

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Specialty Drugs May Be Worth the Higher Costs

FRIDAY, Oct. 10, 2014 (HealthDay News) -- Despite high costs, specialty drugs may provide value that balances the price difference compared with traditional drugs, according to research published in the October issue of Health Affairs.

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Americans Increasingly Anxious About Ebola

FRIDAY, Oct. 10, 2014 (HealthDay News) -- One-quarter of Americans now view Ebola as a major public health threat to the United States, with many saying they'd change their travel plans due to Ebola fears, a new Harris Poll/HealthDay survey reveals.

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Five Major U.S. Airports to Screen Travelers for Ebola

THURSDAY, Oct. 9, 2014 (HealthDay News) -- Five major U.S. airports will begin screening travelers entering the country from the three West African nations hit hardest by the ongoing Ebola epidemic, federal health officials announced Wednesday.

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Timing of Epidural May Be Best Left Up to Expectant Mother

THURSDAY, Oct. 9, 2014 (HealthDay News) -- The best time to give an epidural is likely when a woman asks for it, although the effect of early epidural on the length of time to reach full cervical dilation is unclear, according to a review published online Oct. 9 in The Cochrane Library.

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Modified ACR Criteria Effective for Fibromyalgia Diagnosis

THURSDAY, Oct. 9, 2014 (HealthDay News) -- The 2011 modification of the 2010 American College of Rheumatology (ACR) preliminary criteria for the diagnosis of fibromyalgia (2011ModCr) has acceptable diagnostic accuracy compared with the 1990 ACR criteria, according to research published in the September issue of Arthritis Care & Research.

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Reducing Residency Work Hours Doesn't Affect Patient Outcomes

THURSDAY, Oct. 9, 2014 (HealthDay News) -- Duty-hour reforms have not adversely affected hospital mortality or length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during residency, according to research published in the October issue of Health Affairs.

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Risk of Upper GI Bleeding Varies for Drug Combinations

WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin or cyclooxygenase-2 (COX-2) selective inhibitors with other drugs can increase the risk of upper gastrointestinal bleeding (UGIB), and the magnitude of interaction varies according to drug combination, according to a study published in the October issue of Gastroenterology.

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Dallas Ebola Patient Has Died, Hospital Officials Confirm

WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Thomas Eric Duncan, the Liberian national who was the first person diagnosed with Ebola in the United States, died Wednesday morning at Texas Health Presbyterian Hospital in Dallas.

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CDC: U.S. Life Expectancy Hits Record High of Nearly 79 Years

WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Average life expectancy in the United States reached an all-time high of 78.8 years in 2012, the U.S. Centers for Disease Control and Prevention reported Wednesday. For people 65 years old in 2012, life expectancy was an additional 19.3 years, up slightly from the year before. Women age 65 and older in 2012 can expect to live another 20.5 years, while men may get around an additional 18 years.

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AAFP Urges Docs to Check Accuracy of Open Payments Data

WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- The American Academy of Family Physicians (AAFP) urges family doctors to check the accuracy of the first set of data published by the Centers for Medicare & Medicaid Services (CMS) Open Payments transparency program.

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Tips Provided for Maximizing Use of Patient Portals

WEDNESDAY, Oct. 8, 2014 (HealthDay News) -- Patient portals should be designed to meet patient priorities and promoted in order to maximize their use and boost practice efficiency, according to an article published Oct. 1 in Medical Economics.

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Obama Considers Tighter Ebola Screening for Travelers

TUESDAY, Oct. 7, 2014 (HealthDay News) -- President Barack Obama said Monday that his administration is preparing additional screening measures to prevent the Ebola epidemic in West Africa from gaining a foothold in the United States.

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CDC Team Assisting Ebola Response in Dallas

MONDAY, Oct. 6, 2014 (HealthDay News) -- Experts from the U.S. Centers for Disease Control and Prevention have arrived in Texas and are working closely with Texas state and local health departments to investigate the first Ebola case in the United States, according to a news release issued by the agency.

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Gout Independently Associated With Diabetes Risk

MONDAY, Oct. 6, 2014 (HealthDay News) -- Gout appears to increase the risk of type 2 diabetes, especially in women, according to a study published online Oct. 2 in the Annals of the Rheumatic Diseases.

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States Encouraged to Use Physician Assistant Workforce

MONDAY, Oct. 6, 2014 (HealthDay News) -- Physician assistants (PAs) have an important role in the provision of health care and their role should be encouraged by appropriate state legislation, according to a report from the National Governors Association.

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Impact of Physician Payments Sunshine Act Discussed

MONDAY, Oct. 6, 2014 (HealthDay News) -- The Physician Payments Sunshine Act is causing concern for manufacturers and providers, as well as physicians, according to a health policy brief published online Oct. 2 in Health Affairs.

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Physician Payments Found Not to Favor Procedures

FRIDAY, Oct. 3, 2014 (HealthDay News) -- The Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule does not systematically provide higher valuation of physician work per unit time for procedure/test codes than for evaluation and management (E/M) codes, according to a study published online Sept. 18 in the Annals of Surgery.

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Walking Protects Against Functional Limitation in OA

FRIDAY, Oct. 3, 2014 (HealthDay News) -- For individuals with or at risk of knee osteoarthritis, walking is associated with reduced incidence of functional limitation over two years, according to a study published in the September issue of Arthritis Care & Research.

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Medical Errors Should Be Used to Improve Patient Care

THURSDAY, Oct. 2, 2014 (HealthDay News) -- Medical errors occur and should be used to help improve medical processes, according to a report from the American Medical Association.

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CDC: Heroin Overdose Deaths Doubled in Much of U.S.

THURSDAY, Oct. 2, 2014 (HealthDay News) -- Deaths from heroin overdoses doubled from 2010 to 2012, according to research published in the Oct. 3 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Providers Received Billions From Drug/Device Companies

THURSDAY, Oct. 2, 2014 (HealthDay News) -- About 546,000 doctors and 1,360 teaching hospitals in the United States received billions of dollars from drug and medical device makers in the second half of 2013, according to data released Tuesday by the Centers for Medicare & Medicaid Services. The financial benefits ranged from research grants to trips, and totaled nearly $3.5 billion from August through December last year, the Associated Press reported.

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Hydrocodone Combo Products Reclassified As Schedule II

THURSDAY, Oct. 2, 2014 (HealthDay News) -- A new rule taking effect Oct. 6 reclassifies hydrocodone combination products as Schedule II controlled substances, which will impact prescribing practices for these products, according to a report from the federal Drug Enforcement Administration (DEA).

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Periarticular Injection Superior to Epidural Analgesia in TKA

WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- For patients undergoing total knee arthroplasty, periarticular injection is superior to epidural analgesia for pain control, according to a study published in the Sept. 3 issue of The Journal of Bone & Joint Surgery.

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High Salt Intake + Smoking May Up Risk of Rheumatoid Arthritis

WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Although no link has been found between sodium intake and risk of developing rheumatoid arthritis (RA), there might be an increased risk for RA among smokers with high sodium consumption, according to research published online Sept. 10 in Rheumatology.

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Burnout on the Job Isn't Just About the Work

WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Work, non-work, and individual factors explain a considerable part of psychological distress, depression, and emotional exhaustion, according to a study published online July 24 in Social Psychiatry and Psychiatric Epidemiology.

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CDC Confirms First Patient Diagnosed With Ebola in U.S.

WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- The first confirmed case of Ebola has surfaced in the United States, involving a man who recently flew here from Liberia, federal health officials from the U.S. Centers for Disease Control and Prevention announced late Tuesday.

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