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There is growing anticipation in the headache community about the arrival of a variety of monoclonal antibodies that target the calcitonin gene-related peptide (CGRP) pathway to prevent migraine headaches. CGRP is involved in the pathophysiology of migraine. Levels of CGRP are elevated during migraine attacks and decrease with resolution of the attacks. Several pharmaceutical companies […]
Read MoreA total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. […]
Read MorePublished in Int J Urol. 2014 Jun 26. Authors: Lunacek A et al OBJECTIVE: To assess the most effective local analgesia during transrectal ultrasound-guided prostate biopsy. METHODS: A total of 123 consecutive patients undergoing transrectal ultrasound-guided prostate biopsy for elevated prostate-specific antigen levels and/or a suspicious digital rectal examination were randomized to three groups. Patients […]
Read MorePublished in Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1090-4 Authors: Dewhirst E et al PURPOSE: Despite the brevity of the procedure, bilateral myringotomy and tympanostomy tube placement (BMT) can result in significant postoperative pain and discomfort. As the procedure is frequently performed without intravenous access, non-parenteral routes of administration are frequently used for analgesia. The current […]
Read MoreI am often asked for a simple, effective, no-nonsense approach to goal setting that can be used by anyone, anywhere, anytime. What follows is what I affectionately call the Six Step Makeover. It’s a simple process that’s easy to learn, easy to apply, and easy to get results from. Follow it to the letter and […]
Read MorePublished in Surg Laparosc Endosc Percutan Tech. 2014 Jun 6 Authors: Zhao YJ et al Abstract We aim to assess efficacy and safety of remifentanil or sulfentanyl combined with propofol during painless gastroscopic examination in patients. In this study, 270 patients were randomly divided into 3 groups: propofol was given only in group P; propofol […]
Read MorePublished in N Engl J Med. 2014 Jul 3;371(1):11-21 Authors: Friedly JL1 et al BACKGROUND: Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis, a common cause of pain and disability in older adults. However, rigorous data are lacking regarding the effectiveness and safety of these injections. METHODS: In a double-blind, […]
Read MorePublished in Pain. 2014 Jun 28. pii: S0304-3959(14)00308-X. doi: 10.1016/j.pain.2014.06.019 Authors: Crosby ND et al Abstract Cervical facet joint injury induces persistent pain and central sensitization. Preventing the peripheral neuronal signals that initiate sensitization attenuates neuropathic pain. Yet, there is no clear relationship among facet joint afferent activity, development of central sensitization, and pain, which […]
Read MoreTalking to employees about performance problems, attendance issues or an upcoming layoff can be awkward and difficult. But there are steps you can take to make those types of conversations easier for you—and your employees. Leaders are often placed in situations that require difficult conversations. It’s quite common to put off these painful encounters because […]
Read MorePublished in Anesthesiology. 2014 Jul;121(1):52-8 Authors: Savilampi J et al BACKGROUND: Remifentanil is widely used for monitored anesthesia care in spontaneously breathing patients. However, the authors’ previous studies have shown that remifentanil induces subjective swallowing difficulties, which may increase the risk of aspiration. METHODS: Twenty-five healthy volunteers participated in a double-blind, randomized, crossover trial at […]
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