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Chronic Pain
This issue of the Physical Medicine and Rehabilitation Clinics of North America deals with strategies for evaluating and treating chronic pain. Physiatrists need skill in managing chronic pain because they encounter it frequently. Some physiatrists focus their clinical practices on patients who have pain as their major reason for seeking health care. These include physiatrists who work at pain centers, and ones who focus on the management of spinal disorders. Other physiatrists treat patients who are disabled by conditions that are not necessarily painful, such as spinal cord injury and stroke.
Source: Physical Medicine and Rehabilitation Clinics of North America - May 1, 2015 Category: Rehabilitation Authors: James P. Robinson, Virtaj Singh Tags: Preface 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

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD, clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT and VAD stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, an...
Source: Stroke - September 22, 2014 Category: Neurology Authors: Biller, J., Sacco, R. L., Albuquerque, F. C., Demaerschalk, B. M., Fayad, P., Long, P. H., Noorollah, L. D., Panagos, P. D., Schievink, W. I., Schwartz, N. E., Shuaib, A., Thaler, D. E., Tirschwell, D. L., on behalf of the American Heart Association Strok Tags: AHA Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

'More adults should be taking statins,' says NICE
Conclusion Despite somewhat hysterical media coverage to the contrary ("millions more to be given statins," according to the Daily Express), nobody will be forced to take statins. If your GP does recommend statins, you should ask them to explain the benefits and risks for you personally of starting statin treatment. You may want to find out more about statins before making up your mind – the NHS Choices Health A-Z information on statins is a good place to start. If you do experience troublesome side effects while taking statins, contact your GP or the doctor in charge of your care. It could be the case that a...
Source: NHS News Feed - July 18, 2014 Category: Consumer Health News Tags: Heart/lungs Medication QA articles Source Type: news

Helping Haiti: Addressing the Burden of Neurologic Disease (P4.292)
CONCLUSIONS: With this nationwide collaborative and interdisciplinary approach, we hope to have a dramatic impact on the perceptions and outcomes of neurologic disease and provide a continuous, but dynamic presence in Port au Prince, Haiti while training physicians, nurses, and other team members in global health perspectives.Disclosure: Dr. Santini has nothing to disclose. Dr. Alessi has received personal compensation for activities with CBS Radio, the National Football League Players Association, and Colonial Cooperative Care. Dr. Jones has nothing to disclose. Dr. Etienne has nothing to disclose. Dr. Hohler has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Santini, V., Alessi, A., Jones, E., Etienne, M., Hohler, A. Tags: Global Health and Infection Source Type: research

Helping Haiti: Addressing the Burden of Neurologic Disease (I10-2.004)
CONCLUSIONS: With this nationwide collaborative and interdisciplinary approach, we hope to have a dramatic impact on the perceptions and outcomes of neurologic disease and provide a continuous, but dynamic presence in Port au Prince, Haiti while training physicians, nurses, and other team members in global health perspectives.Disclosure: Dr. Santini has nothing to disclose. Dr. Alessi has received personal compensation for activities with CBS Radio, the National Football League Players Association, and Colonial Cooperative Care. Dr. Jones has nothing to disclose. Dr. Etienne has nothing to disclose. Dr. Hohler has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Santini, V., Alessi, A., Jones, E., Etienne, M., Hohler, A. Tags: The Global Burden of Neurological Diseases Data Blitz Presentations Source Type: research

Hemiplegic Shoulder Pain: An Approach to Diagnosis and Management
This article develops an effective approach for diagnosis and treatment using the best available evidence to aid practitioners in obtaining optimal results.
Source: Physical Medicine and Rehabilitation Clinics of North America - March 17, 2014 Category: Rehabilitation Authors: John M. Vasudevan, Barbara J. Browne Source Type: research

What Causes Muscle Weakness?
Discussion Muscle tone is the slight tension that is felt in a muscle when it is voluntarily relaxed. It can be assessed by asking the patient to relax and then taking the muscles through a range of motion such as moving the wrists, forearm and upper arm. Muscle strength is the muscle’s force against active resistance. Impaired strength is called weakness or paresis. There are 5 levels of muscle strength. 0 = No muscle contraction detected 1 = Barely detected flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity 4 = Active movement against gravity and some resistance ...
Source: PediatricEducation.org - December 9, 2013 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Occupational Therapy: Cost-Effective Solutions for Changing Health System Needs
This article aligns the discussion of health system transformation with literature identifying the cost-effectiveness of occupational therapy in Canada.
Source: Healthcare Quarterly - January 30, 2013 Category: International Medicine & Public Health Source Type: research

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While pain is neither uncommon nor novel, the concept of central pain (CP) has only recently become a prominent concern in the medical literature. CP results from lesions to the central nervous system caused by conditions such as stroke, multiple sclerosis, epilepsy, Parkinson's disease, and brain and spinal cord injuries. With the incidence of disability from these conditions increasing dramatically worldwide, it is no surprise that the diagnosis and treatment of CP are of growing interest in the fields of pain management, neurology, neurosurgery, and anesthesiology. However, inconsistent and contradictory reporting has e...
Source: Journal of the Neurological Sciences - January 14, 2013 Category: Neurology Authors: Aimee L. Alphonso, Jack W. Tsao Tags: Book Reviews Source Type: research

Post-stroke shoulder pain: Nociceptive or neuropathic?
Acute rehabilitation after stroke can be adversely affected by complications such as pain in the hemiplegic shoulder. The onset of hemiplegic shoulder pain (HSP) can compromise functional gains, and has been shown to contribute to longer term disability . The first systematic study of the incidence of post-stroke shoulder pain (PSSP) found that 40% of patients were affected during the 3–6months following survival of a stroke . In 25% of patients, pain occurred during the first two weeks after stroke . The prognosis at six months, however, appears to be reasonably good, with 80% of patients reporting improvement or comple...
Source: Pain - November 26, 2012 Category: Anesthesiology Authors: Anthony K.P. Jones, Christopher A. Brown Tags: Commentaries Source Type: research

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