Current pain and headache reports
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Curr Pain Headache Rep · Dec 2024
ReviewThe Utilization of Blockchain for Data Security for the Chronic Pain Physician.
The COVID-19 pandemic accelerated the surge in medical data utilization, notably impacting chronic pain management given its enormous economist cost. While the collection and use of data enhances research and care quality, data exchange risks compromising integrity and privacy, exemplified by the Change Healthcare cyberattack. Here, we review the potential of blockchain for the utilization for cybersecurity in the healthcare system with an emphasis on the field of chronic pain. ⋯ Blockchain technology emerges as a potential solution, offering decentralized, secure, and immutable data management. Blockchain ensures transparency, integrity, and data privacy, which is crucial in healthcare. Smart contracts may offer automated, secure management of implantable neuromodulation devices such as spinal cord stimulators and intrathecal pumps. Blockchain's potential in pharmaceutical supply chain integrity is exemplified in preliminary efforts ensuring that the medication retrieved by the patient is indeed the intended medication. Despite limitations such as speed of transactions, blockchain presents innovative avenues for healthcare security and quality improvement, necessitating further development for widespread implementation. Blockchain's applicability is not only applicable to chronic pain management, but can be used in medicine as a whole.
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To review existing literature on biomarkers for post-traumatic headache (PTH). ⋯ Preclinical models and clinical findings have started to elucidate the biology that underlies PTH. Traumatic brain injury results in ionic flux, glutamatergic surge, and activation of the trigeminal cervical complex resulting in the release of pain neuropeptides. These neuropeptides, including calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP), play a key role in the pathophysiology of migraine and other primary headache disorders. Only two studies were identified that evaluated CGRP levels in PTH. Neither study found a consistent relationship between CGRP levels and PTH. One study did discover that nerve growth factor (NGF) was elevated in subjects with PTH. There is no conclusive evidence for reliable blood-based biomarkers for PTH. Limitations in assays, collection technique, and time since injury must be taken into account. There are multiple ideal candidates that have yet to be explored.
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Curr Pain Headache Rep · Dec 2024
ReviewA Review of Remote Monitoring in Neuromodulation for Chronic Pain Management.
Neuromodulation techniques have emerged as promising strategies for managing chronic pain. These techniques encompass various modalities of nerve stimulation, including Spinal Cord Stimulation (SCS), Dorsal Root Ganglion Stimulation (DRG-S), and Peripheral Nerve Stimulation (PNS). Studies consistently demonstrate significant improvements in pain intensity, quality of life, and reduced opioid usage among patients treated with these modalities. However, neuromodulation presents challenges, such as the need for frequent in-person follow-up visits to ensure proper functionality of the implanted device. Our review explored factors impacting compliance in current neuromodulation users and examined how remote monitoring can mitigate some of these challenges. We also discuss outcomes of recent studies related to remote monitoring of neuromodulation. ⋯ While remote monitoring capabilities for neuromodulation devices is an emerging development, there are promising results supporting its role in improving outcomes for chronic pain patients. Higher patient satisfaction, improved pain control, and reduced caretaker burdens have been observed with the use of remote monitoring. This review discusses the current challenges with neuromodulation therapy and highlights the role of remote monitoring. As the field continues to evolve, understanding the importance of remote monitoring for neuromodulation is crucial for optimizing pain management outcomes.
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Curr Pain Headache Rep · Dec 2024
ReviewOptimizing Pain Management in Cardiac Surgery: A Review of Analgesic Adjuvants.
Pain management following cardiac surgery is a critical component in optimizing both short- and long-term patient outcomes, with poor pain management associated with significant acute and chronic opioid use, opioid dependence and a significant rate of opioid related adverse drug events. The significant burden of both acute and chronic pain following cardiac surgery has given rise to the need for multimodel analgesic strategies, to optimize outcomes and minimize side effects. ⋯ While significant research has focused recently on the additive value of peripheral nerve blocks, less emphasis has been given to the value of non-opioid based analgesics in preference to traditional opioid based anesthetic and analgesic strategies. In this review, we examine the evidence for several common analgesics, highlighting the evidence supporting efficacy following cardiac surgery, as well as the safety concerns with each agent. We demonstrate the value of a multimodal analgesic strategy to reduce pain scores and improve patient-centered outcomes, and highlight the need for further studies of combination analgesic strategies.
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Curr Pain Headache Rep · Dec 2024
ReviewPharmacological Treatment of Fibromyalgia Syndrome: A Practice-Based Review.
Fibromyalgia Syndrome (FMS) is a complex chronic pain condition characterized by widespread musculoskeletal pain and numerous other debilitating symptoms. The purpose of this review is to provide a comprehensive overview, based on everyday clinical practice, of the drugs presently employed in the treatment of FMS. ⋯ The treatment of FMS is based on a multimodal approach, with pharmacologic treatment being an essential pillar. The drugs used include tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, other antidepressants, anticonvulsants, myorelaxants, and analgesics. The effectiveness of these medications varies, and the choice of drug often depends on the specific symptoms presented by the patient. Many drugs tend to either address only some domains of the complex FMS symptomatology or have a limited effect on pain. Each treatment option comes with potential side effects and risks that necessitate careful consideration. It may be beneficial to divide patients into clinical subpopulations, such as FMS with comorbid depression, for more effective treatment. Despite the complexities and challenges, the pharmacological treatment remains a crucial part for the management of FMS. This review aims to guide clinicians in prescribing pharmacological treatment to individuals with FMS.