MedGenMed : Medscape general medicine
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Randomized Controlled Trial
Lysine clonixinate vs naproxen sodium for the acute treatment of migraine: a double-blind, randomized, crossover study.
The process of inflammation is crucial in migraine, and several nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in the treatment of migraine attacks. Despite their efficacy, the routine use of NSAIDs is limited by side effects as well as incomplete efficacy in some patients. Among the available options, lysine clonixinate (LC) and naproxen sodium (NS) have proved effective in migraine. The aim of this study was to compare the efficacy and tolerability of oral formulations of LC and NS in the treatment of moderate or severe migraine attacks, with a double-blind, crossover design. ⋯ Although this study did not include a placebo arm, which impairs any definitive efficacy claims, we found LC and NS to be similarly effective and well tolerated in patients presenting moderate or severe attacks of migraine.
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Chronic pain is a frequent medical condition that has a significant impact on patients, including their ability to function and enjoy life. In addition, chronic pain has a substantial economic impact on the workplace and costs of healthcare. ⋯ By understanding those times of day and activities that may precipitate severe episodes of pain, tailored opioid treatment plans can be developed that manage pain, improve patient functionality, and minimize side effects. Recently developed rapid-onset opioid formulations should be considered as part of the chronic pain management strategy in addition to more traditional long-acting, sustained-release formulations and short-acting, normal-release formulations.
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Injuries from marine life encompass a wide spectrum, from mild stings to severe bites. Fortunately most of the injuries are mild, although some may be significant, resulting in death. Most of these injuries can be treated by family physicians with a knowledge of the cause of the pathology. ⋯ Coral, sea bathers eruption, and swimmer's itch require thorough scrubbing and irrigation. Sea snakes, cone shells, and venomous fish possess a neurotoxin that requires close monitoring in the event of cardiopulmonary collapse. All of these injuries require tetanus status monitoring and consideration of coverage for infectious sequelae.