New Study Highlights Risks of Combining Benzodiazepines and Opioids

 

Although prescribing benzodiazepines concurrently with opioid analgesics has been shown to raise the risk for fatal overdose, new research documents a risk that is four times that of opioids taken alone, and even at low doses. The new study was published online in the British Medical Journal (2015;350:h2698).

Additionally, the authors found a dose-dependent association with overdose risk. This may “help prioritize how we address this risk,” said Roger Chou, MD, professor in the Departments of Medicine and Medical Informatics and Clinical Epidemiology at Oregon Health & Science University (OHSU) School of Medicine, and a staff physician in the Internal Medicine Clinic at OHSU, in Portland, who was not involved in the research. “Meaning, you can start by identifying patients on high doses of benzos, and go from there.”

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Acupuncture Relieves Irritable Bowel Syndrome

 

Acupuncture alleviates irritable bowel syndrome (IBS). Researchers from the Heilongjiang University of Chinese Medicine investigated the efficacy of electroacupuncture for the treatment of IBS. A comparison group in the clinical trial received oral administration of pinaverium bromide. The acupuncture treatment group demonstrated an 86.7% improvement rate. The drug group demonstrated a 50% improvement rate.

Chinese herbal medicine has also been shown effective for the treatment of IBS in modern research. The Journal of the American Medical Association (JAMA) published the findings of a randomized double-blinded placebo-controlled trial noting that Chinese herbal medicine “offer(s) improvements in symptoms for some patients with IBS.” The study represents a joint effort by gastroenterologists and herbalists.

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Liposomal Bupivacaine After TKA Reduces Hospital Stay

 

Patients receiving liposomal bupivacaine (Exparel, Pacira) injection after total knee arthroplasty (TKA) spent less time in the hospital and were significantly less likely to need to go to a rehabilitation center after discharge, a recent study found.

Patients given liposomal bupivacaine spent a half-day less in the hospital than those administered routine, opioid-based pain medications, according to the review of patient records by researchers at Philadelphia College of Osteopathic Medicine; Plano Orthopedics and Sports Medicine, in Texas; and the Rubin Institute for Advanced Orthopedics at the Sinai Hospital of Baltimore.

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Acupuncture Boosts Paroxetine Antidepressant Effects

 

Acupuncture increases the effectiveness of paroxetine (Paxil, Aropax) for the treatment of depression. Researchers from the Beijing University of Chinese Medicine conducted a controlled investigation and found that both manual and electroacupuncture significantly increase the total effective rate of paroxetine.

Prior research by Qu et al. finds acupuncture effective for enhancing the effects of paroxetine for the treatment of major depression. The Beijing University of Chinese Medicine researchers build on these findings by demonstrating that acupuncture enhances the effects of paroxetine for the treatment of mild and moderate level depression.

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A Pained Life: Teaching the Reality of Pain

By Carol Levy, Columnist

Excedrin, which makes an over-the-counter pill for migraine sufferers, has a wonderful TV ad.

A sufferer wanted to show her mother what she sees and experiences when she has a migraine. Excedrin developed a simulator that does exactly that

The mother puts on the device and sees the visual disturbances her daughter sees when she has a migraine attack. As she removes the device the mother turns to her daughter, hugs her and says, “I'm so sorry. I didn’t know.”

How wonderful, I thought. If only...

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Acupuncture Moves Stool, Relieves Constipation

 

Clinical trials demonstrate that acupuncture relieves chronic constipation and produces greater long-term patient outcomes than drugs.

Chengdu University of Traditional Chinese Medicine researchers find true acupuncture more effective than sham acupuncture for the relief of constipation. In another study by Yang et al., acupuncture combined with herbal medicine relieves constipation in the elderly and demonstrates superior patient outcomes to pharmaceutical medications. Acupuncture plus herbs produced a high total effective rate and very low relapse rate. Let’s take a look at the results of the investigations.

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Peripheral Brain Derived Neurotrophic Factor Precursor Regulates Pain as an Inflammatory Mediator

 

Abstract
The precursor of brain derived neurotrophic factor (proBDNF), the unprocessed BDNF gene product, binds to its receptors and exerts the opposing biologic functions of mature BDNF. proBDNF is expressed in the peripheral tissues but the functions of peripheral proBDNF remain elusive.

Here we showed that proBDNF and its predominant receptor, p75 pan-neurotrophin receptor were upregulated in the nerve fibers and inflammatory cells in the local tissue in inflammatory pain. Neutralization of proBDNF by polyclonal antibody attenuated pain in different models of inflammatory pain. Unilateral intra-plantar supplementation of proBDNF by injecting exogenous proBDNF or ectopic overexpression resulted in pain hypersensitivity and induced spinal phosphorylated extracellular signal-regulated kinase activation. Exogenous proBDNF injection induced the infiltration of inflammatory cells and the activation of proinflammatory cytokines, suggesting that inflammatory reaction contributed to the pro-algesic effect of proBDNF.

Finally, we generated monoclonal anti-proBDNF antibody that could biologically block proBDNF. Administration of monoclonal Ab-proBDNF attenuated various types of inflammatory pain and surgical pain. Thus, peripheral proBDNF is a potential pain mediator and anti-proBDNF pretreatment may alleviate the development of inflammatory pain.

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The Opiate Epidemic - Free Access Article Collection

 

The opioid epidemic has been characterized by unprecedented increases in prescription and nonmedical pharmaceutical opioid use, heroin and pharmaceutical opioid use disorders, and associated deaths.

As a result, on a daily basis, practitioners in a wide range of clinical settings are now confronted with the difficulties of managing opioid medications and opioid use disorders, often in conjunction with chronic pain syndromes.

Unfortunately, practitioners may not have been taught the skills necessary to integrate risk reduction, addiction assessment, and treatment into routine clinical practice.

Further, there is an inadequate number of providers with the inclination and expertise to treat opioid use disorders to meet the current need for treatment.

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Acupuncture Improves General Anesthesia Recovery After Surgery

 

Researchers conclude that acupuncture for gynecologic laparoscopy patients reduces general anesthesia dosage requirements, decreases post-surgical pain, and improves the time to wake and time to fully alert after surgery.
 
In a controlled investigation, acupuncture patients scored better in many other indices as well. Patients having received acupuncture during surgery had increased stability of the heart beat and improved blood pressure upon waking.

The results were achieved by applying electroacupuncture to two acupuncture points located on hand and forearm.

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Acupuncture doubles the chances of getting pregnant through IVF

 

Acupuncture may double the chances of a woman conceiving with IVF, a study has found.

Among couples undergoing the fertility treatment, the likelihood of pregnancy was greatly improved if the woman also had acupuncture.

Scientists at Homerton University Hospital studied 127 women aged between 23 and 43, on their first or second cycle of IVF.

They were split into two groups – one having four sessions of acupuncture while undergoing IVF, and the other having none.

Among the treatment group, 46.2 per cent conceived – more than twice as many as in the other group, where only 21.7 per cent of the women became pregnant.

The needle technique was used before any eggs were retrieved from the woman’s body – and then again before and after the fertilised embryo was implanted.




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