Pain practice : the official journal of World Institute of Pain
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To evaluate changes in health-care resource use and costs after initiating pregabalin or duloxetine in employees with fibromyalgia (FM). ⋯ The changes in health resource utilization and costs after initiation of pregabalin were not significantly different than the changes observed after initiation of duloxetine. These results not only demonstrate an overall similarity of resource utilization, but also suggest cost neutrality between pregabalin and duloxetine.
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Randomized Controlled Trial Clinical Trial
The relation between the duty cycle and anesthetic effect in lidocaine iontophoresis using alternating current.
We assessed the effect of the duty cycle on the anesthetic effect during lidocaine alternating current (AC) iontophoresis. A solution of 2% lidocaine was delivered to the medial antecubital skin for 20 minutes using AC iontophoresis with a duty cycle of 60%, 70%, or 80%. ⋯ TT were significantly elevated at 0 minutes in the group treated with a 60% duty cycle. The anesthetic effect was significantly enhanced in a duty cycle-dependent manner.
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Meralgia paresthetica (MP) is a neurological disorder of the nervus cutaneous femoris lateralis (lateral femoral cutaneous nerve) (LFCN) characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. Medical history and neurological examination are essential in making the diagnosis. However, red flags such as tumor and lumbar disc herniations must be ruled out. ⋯ Anatomical variants of the LFCN occur in a quarter of patients and may be the reason for negative response to diagnostic blocks. For interventional treatment of MP, such as local injection with anesthetics and corticosteroids or pulsed radiofrequency treatment of the LFCN, the evidence is limited. In particular, pulsed radiofrequency treatment of the LFCN should only take place in a study context.
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Comparative Study
Comparison of medication adherence and healthcare costs between duloxetine and pregabalin initiators among patients with fibromyalgia.
To examine and compare medication adherence and direct healthcare costs between duloxetine and pregabalin initiators among patients with fibromyalgia. ⋯ Fibromyalgia patients on duloxetine had significantly higher medication adherence, but significantly lower direct healthcare costs than those on pregabalin.
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Drug-drug interactions (DDIs) have been defined as two or more drugs interacting in such a way that the effectiveness and/or toxicity of one or all drugs are changed. Patients taking more than one drug metabolized through the cytochrome P450 (CYP450) enzyme system, including some, but not all, opioids experience a drug-drug exposure (DDE), which may result in a potentially dangerous DDI. Using a retrospective analysis of a large commercial claims database and a Medicare database, we evaluated DDEs that have the potential to cause DDIs among chronic low back pain (cLBP) patients on long-term opioid analgesia, which metabolizes through the CYP450 enzyme system, concomitant with other CYP450-metabolized drug(s). ⋯ In general, the prevalence of DDEs was fairly consistent across age ranges in this population. This study suggests that DDEs are common in the cLBP population. When selecting an opioid to treat cLBP, physicians should consider the potential for exposure of these patients to drugs that might unfavorably interact and, for that reason, the use of opioids that do not rely on the CYP450 system as their primary means of metabolism might be worthy of consideration.