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Specialty: Internal Medicine
Source: Evidence-Based Medicine
Condition: Pain
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Total 16 results found since Jan 2013.
Migraine is a marker for risk of both ischaemic and haemorrhagic stroke
This study summarises the available evidence. Methods Sacco...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Kurth, T. Tags: EBM Aetiology, Epidemiologic studies, Headache (including migraine), Pain (neurology), Stroke Source Type: research
Ultrasound-guided corticosteroid injections for adhesive capsulitis more effective than placebo
Commentary on: Prestgaard T, Wormgoor ME, Haugen S, et al.. Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study. Pain 2015;156:1683–91. Context Adhesive capsulitis (frozen shoulder or painful stiff shoulder) is relatively common. It is idiopathic: known associated factors include trauma, diabetes, prolonged immobilisation, age, stroke and autoimmune disease. While self-limited, pain and decreased range of motion can last up to 2–3 years. Therefore, there is practical value in therapeutic in...
Source: Evidence-Based Medicine - March 21, 2016 Category: Internal Medicine Authors: Lebrun, C. M. Tags: Rehabilitation medicine, Immunology (including allergy), Pain (neurology), Stroke, Radiology, Degenerative joint disease, Musculoskeletal syndromes, Osteoarthritis, Sports and exercise medicine, Clinical diagnostic tests, Radiology (diagnostics), Screenin Source Type: research
Prophylactic dose fondaparinux for 6 weeks in superficial thrombophlebitis of the legs reduces the risk for symptomatic thromboembolic complications
Commentary on: Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 2012;3:CD004982. Context Superficial thrombophlebitis (ST), an inflammatory-thrombotic disorder in a superficial vein, is relatively common and estimated to occur in 1 per 1000 persons.1 The classic symptoms include pain, oedema, erythema and occasionally a palpable cord in the area of the thrombosed vein. Risk factors for ST include surgery, pregnancy and puerperium, female hormones, malignancy, infection, varicose veins, autoimmune disorders and thrombophilia.2 ST is a risk factor for dee...
Source: Evidence-Based Medicine - January 17, 2013 Category: Internal Medicine Authors: DeSancho, M. T., Pastores, S. M. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Pain (neurology), Stroke, Pregnancy, Venous thromboembolism, Renal medicine, Pulmonary embolism, Drugs: musculoskeletal and joint diseases, Dermatology Therapeutics Source Type: research
Long-term aspirin use and neovascular age-related macular degeneration: association or causation?
Commentary on: Liew G, Mitchell P, Wong TY, et al.. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013;173:258–64. Context Aspirin is used by many for temporary pain relief, rheumatological conditions and where indicated, cardioprotection. However, recent findings from observational studies have raised the possibility that regular aspirin use may also increase the risk of some forms of age-related macular degeneration (AMD). Methods Liew and colleagues examined the relationship between long-term, low-dose aspirin use and risk of AMD in an Australian population-based cohort of 2...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Christen, W. G. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Pain (neurology), Stroke, Hypertension, Ophthalmology, Pain (palliative care), Pain (anaesthesia), Diabetes, Health education, Smoking Source Type: research
Ramipril improves walking times and quality of life in patients with stable intermittent claudication
Commentary on: Ahimastos AA, Walker PJ, Askew C, et al.. Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: a randomized controlled trial. JAMA 2013;309:453–60. Context Intermittent claudication (IC) is a common condition that may be associated with significant disability and reduction in quality of life. Pharmacological options for the treatment of the symptoms of this condition are very limited. Naftidrofuryl oxalate is recommended in the National Institute for Health and Care Excellence (NICE) guidelines,1 and while this has been sho...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Brittenden, J. Tags: Health policy, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Health service research Therapeutics Source Type: research
Neither ibuprofen nor steam improves symptom control compared with paracetamol in patients with acute respiratory tract infections in primary care
Commentary on: Little P, Moore M, Kelly J, et al.. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ 2013;347:f6041. Context The achievement of symptom control in patients with respiratory infections is an ongoing challenge, particularly within primary care. Patients and clinicians often view antibiotics, alongside other supportive medication, as the most expeditious intervention to achieve this goal. While we have learnt that antibiotics provide only very limited benefit in cases when bacterial infection is not suspected,1 2 the effe...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Schuetz, P. Tags: General practice / family medicine, Influenza, Otitis, Pain (neurology), Stroke, Ischaemic heart disease, Pain (palliative care), Drugs: musculoskeletal and joint diseases, Ear, nose and throat/otolaryngology Therapeutics Source Type: research
Trial suggests yoga and exercise lead to modest improvements in menopause-related quality of life: longer term studies are needed
Commentary on: Reed SD, Guthrie KA, Newton KM, et al.. Menopausal quality of life: RCT of yoga, exercise, and omega-3 supplements. Am J Obstet Gynecol 2014;210:244.e1–11. Context Since publication of the Women's Health Initiative Study, the potential benefits of non-pharmacological therapies for menopause-related symptoms have gained increased interest among midlife women, clinicians and researchers.1 Interventions requiring behavioural change have yielded mixed outcomes, owing to small sample sizes, a variety of outcome measures, lack of control groups and limited follow-up.2–4 Methods To assess the effects of...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Woods, N. F. Tags: Pain (neurology), Sleep disorders (neurology), Stroke, Menopause (including HRT), Anxiety disorders (including OCD and PTSD), Mood disorders (including depression), Sleep disorders, Sleep disorders (respiratory medicine) Therapeutics Source Type: research
Low failure rate reported of diagnosis algorithm for suspected upper extremity deep vein thrombosis
Commentary on: Kleinjan A, Di Nisio M, Beyer-Westendorf J, et al.. Safety and feasibility of a diagnostic algorithm combining clinical probability, d-dimer testing and ultrasonography for suspected upper extremity deep venous thrombosis: a prospective management study. Ann Intern Med 2014;160:451–7. Context Upper extremity deep vein thrombosis (UEDVT) is an infrequent type of venous thromboembolism with an estimated incidence of 0.4–1 case per 10 000 persons.1 UEDVT may cause pulmonary embolism but this risk is lower than with lower extremity DVT. Accurate ruling out of UEDVT is mandatory in order to avert...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Delluc, A., Wells, P. S. Tags: EBM Diagnosis, Drugs: cardiovascular system, Pain (neurology), Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Radiology (diagnostics) Source Type: research
Study concludes L. reuteri not effective for infant colic, but findings may be limited by participants' heterogeneity
Commentary on: Sung V, Hiscock H, Tang ML, et al.. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ 2014;348:g2107. Context Colic is a common problem in healthy, thriving infants that is associated with excessive crying over a regular period during the day and is sustained for the first few months of life.1 Colic affects between 5% and 19% of young infants, remains difficult to treat and may result in significant psychosocial consequences. Despite 40 years of research, the aetiology of infantile colic remains elusive. Recently, the composition of in...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Indrio, F. Tags: Clinical trials (epidemiology), Immunology (including allergy), Pain (neurology), Stroke, Childhood nutrition, Pregnancy, Child and adolescent psychiatry, Mood disorders (including depression) Therapeutics Source Type: research
Psychological therapies help reduce headache and non-headache pain in children and adolescents
Commentary on: Eccleston C, Palermo TM, Williams AC, et al.. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2014;5:CD003968. Context Chronic and recurrent pain, especially in the head, abdomen and limbs affects up to 30% of children and adolescents.1 Pain can be severely disabling, disrupting school and social activities and if left untreated, may extend towards adulthood. Increasing evidence shows that psychological factors are pivotal in the transition from acute to chronic disabling pain. As a result, psychological interventions have been ...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Vlaeyen, J. W. S., Gatzounis, R. Tags: Palliative care, Clinical trials (epidemiology), Headache (including migraine), Pain (neurology), Stroke, Child and adolescent psychiatry, Complementary medicine Therapeutics Source Type: research
Invasive revascularisation in patients with moderate intermittent claudication provides a significant improvement in quality of life compared with conservative treatment
Commentary on: Nordanstig J, Taft C, Hensäter M, et al. Improved quality of life after 1 year with an invasive versus a noninvasive treatment strategy in claudicants: one-year results of the Invasive Revascularization or Not in Intermittent Claudication (IRONIC) Trial. Circulation 2014;130:939–47 . Context In cases of severe intermittent claudication (IC), successful revascularisation provides significant symptomatic improvement. In cases of mild IC, revascularisation has exceedingly high risks. The choice between invasive revascularisation and non-invasive treatments for moderate severity IC is often diffi...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Kurklinsky, A. K. Tags: Epidemiologic studies, Pain (neurology), Stroke Therapeutics/Prevention Source Type: research
Angina may trump ischaemia in predicting stable coronary artery disease outcomes, but most cardiovascular events occur in patients without angina or asymptomatic ischaemia
Commentary on: Steg PG, Greenlaw N, Tendera M, et al., Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (CLARIFY) Investigators. Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry. JAMA Intern Med 2014;174:1651–9 . Context The presence of angina portends a poor prognosis. Greater attention has recently been directed to asymptomatic ischaemia, the severity of which plays a role in development of chest pain1 and is a robus...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Kones, R., Rumana, U. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Pain (neurology), Stroke, Interventional cardiology, Ischaemic heart disease Source Type: research
Low to moderate quality evidence demonstrates the potential benefits and adverse events of cannabinoids for certain medical indications
Commentary on: Whiting PF, Wolff RF, Deshpande S, et al.. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 2015;313:2456–73. Context As of September 2015, 23 states and the District of Columbia in the USA legalised the medicinal use of marijuana, underscoring the need for physicians to understand the science underlying medical marijuana as well as the practical issues associated with it. For years policymakers, scientists and physicians alike have debated the potential risks associated with marijuana use.1 Now marijuana's utility as a treatment for certain medical indications has taken focus....
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Hill, K. P., Hurley-Welljams-Dorof, W. M. Tags: Sexual transmitted infections (viral), Clinical trials (epidemiology), General practice / family medicine, Genetics, Immunology (including allergy), HIV/AIDS, Drugs: CNS (not psychiatric), Pain (neurology), Sleep disorders (neurology), Stroke, Ophthalmolo Source Type: research
Supplemental oxygen in patients without hypoxia in ST segment elevation myocardial infarction increases myocardial injury and infarct size
Commentary on: Stub D, Smith K, Bernard S, et al.. AVOID Investigators. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation 2015;131:2143–50. Context In patients with ST segment elevation myocardial infarction (STEMI), timely reperfusion, best obtained with primary percutaneous coronary intervention (pPCI), is a mainstay to reduce infarct size (IS) and improve clinical outcome. Routine oxygen administration in normoxic patients with STEMI before pPCI, while mentioned by international guidelines,1 is not supported by randomised evidence. Stub and colleagues performed the AVOID study to compare...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Crimi, G. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Pain (neurology), Stroke, Interventional cardiology, Ischaemic heart disease, Drugs: respiratory system Therapeutics/Prevention Source Type: research
In individuals at intermediate risk for cardiovascular disease, treatment with rosuvastatin but not candesartan plus hydrochlorothiazide lowers cardiovascular disease event rates
Commentary on: Lonn EM, Bosch J, López-Jaramillo P, et al.. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med 2016;374:2009–20 . Yusuf S, Bosch J, Dagenais G, et al. Cholesterol lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med 2016;374:2021–31. Context Cardiovascular diseases (CVD) are the number one cause of death globally: more people die annually from CVDs than from any other cause.1 The incidence of CVD rises progressively with increasing blood pressure (BP) and with increasing levels of total and low density lipoprotei...
Source: Evidence-Based Medicine - November 22, 2016 Category: Internal Medicine Authors: LeFevre, M. Tags: Drugs: cardiovascular system, Pain (neurology), Stroke, Hypertension, Ischaemic heart disease Therapeutics/Prevention Source Type: research
