Pain
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Opioids Not Better for Chronic Back Pain
Chronic use of opioids for management of back pain is controversial and hotly debated. This randomized trial showed no benefit of opioids over multimodality non-opioid treatments, consistent with many other observational studies.
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Differences Between Type 1 and Type 2 Diabetic Neuropathy
Microstructural nerve damage in distal symmetric diabetic neuropathy differs between subjects with type 1 diabetes (T1D) and type 2 diabetes (T2D). The predominant nerve lesions in T1D correlated with hyperglycemia and nerve conduction impairment, while the predominant lesions in T2D correlated with dyslipidemia.
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Postpartum Headache May Be a Symptom of a Serious Problem
Consultation for acute postpartum headache resulted in the diagnosis of a secondary cause of headache in almost three out of four women, with almost half of the secondary headaches due to a hypertensive disorder of pregnancy or to cerebrovascular disease.
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Pain in Anti-MAG Neuropathy
Most patients with anti-MAG neuropathy complain of painful paresthesias or dysesthesias, but unlike diabetic neuropathy, these symptoms are not severe and do not affect quality of life as much as motor weakness.
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Migraine With Aura, Stroke Risk, and Biomarkers
A longitudinal cohort study of twins found no increased stroke risk related to migraine overall, but there was a modestly increased risk for stroke related to migraine with aura. Familial factors and vascular biomarkers associated with migraine with aura may explain its correlation with vascular disease.
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Deep Brain Stimulation May Offer Hope in Treating Post-stroke Pain
This trial of deep brain stimulation of the ventral striatum/anterior limb of the internal capsule improved several measures of the affective sphere of pain in those suffering from post-stroke pain, despite no significant improvement seen in the pain disability index.
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Migraine and the Blood-brain Barrier
During spontaneous attacks of migraine with visual aura, magnetic imaging studies indicate that the blood-brain barrier remains intact and the pons is activated.
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Spinal Manipulative Therapy for Acute Low Back Pain
Spinal manipulative therapy for acute low back pain may provide some benefit, but carries a significant risk of treatment-associated pain.
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Medication for Acute Low Back — A Randomized Clinical Trial
In a trial comparing naproxyn alone to combinations with cyclobenzaprine or oxycodone/acetaminophen in patients with acute low back pain, there was no difference in outcome after 1 week.
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Is Early MRI Warranted for Back Pain in the Elderly?
In an analysis of a large dataset from several large integrated health care systems of patients older than 65 years of age with new-onset low back pain, early spine imaging did not alter management or outcomes, but added considerable cost to their care.