Journal of pain & palliative care pharmacotherapy
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The various institutes and offices of the National Institutes of Health (NIH) publish a range of public information articles on pain and its management. The National Institute of Neurological Disorders and Stroke (NINDS) updated its public information on chronic pain last august. That information is available to the public and clinicians will find it useful to learn what the information to which their patients have ready access via the World Wide Web. The most recent NINDS description of chronic pain is presented.
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J Pain Palliat Care Pharmacother · Jan 2008
Randomized Controlled Trial Comparative StudyA pilot phase II randomized, cross-over, double-blinded, controlled efficacy study of octreotide versus hyoscine hydrobromide for control of noisy breathing at the end-of-life.
Noisy breathing at the end of life (noisy breathing ("NB") occurs in up to 90% of people. Interventions have not been systematically evaluated. There has been clinical observation coupled with a proposed mechanism of effect that supports a role for octreotide in management of NB. ⋯ There was no difference in the median time to administration of the second medication (3 hours). Two participants in each arm had a 2 category reduction of intensity after the second medication. Although feasible to consent and study this population in a way that respects autonomy and dignity even in the terminal hours of life, this pilot study suggests reconsideration of the pharmacological interventions (choice of agents, dosing, timing of dosing and pharmacokinetic profiles), standardizing of non-pharmacological care; and ways to measure directly family distress before further randomized studies for this symptom.
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The top-line findings, arranged by date, from major national pain surveys published in 2005 and 2006 are reviewed. This report supplements the report on surveys published between 1996 and 2004 that appeared in Volume 21, Number 4, of the Journal.
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J Pain Palliat Care Pharmacother · Jan 2008
Comparative StudyThe NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT).
Americans continue to spend millions of dollars annually on glucosamine and chondroitin for symptoms of osteoarthritis. These agents are classified as dietary supplements, not as drugs, per se. Therefore, they do not meet the requirements of the FDA to be classified as drugs. ⋯ For a subset of participants with moderate-to-severe pain, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared with placebo, about 79% had a 20% or greater reduction in pain versus about 54% for placebo. According to the researchers, because of the small size of this subgroup these findings should be considered preliminary and need to be confirmed in further studies. For participants in the mild pain subset, glucosamine and chondroitin sulfate together or alone did not provide statistically significant pain relief.