The truth is that screening tests are just like any other drug or medical procedure, with potentially deadly risks that must be balanced with the potential benefits. The same people who would agonize over the decision to take estrogen-replacement therapy, for example, don't think twice before getting a mammogram. However, as the data indicate, they sometimes should. Screening tests can cause harm in two major ways: false-positive diagnoses and unnecessary treatment of benign conditions. Unfortunately, these problems can be masked because a little-known but vital error pervades almost every major study involving screening for deadly diseases, especially cancers—and makes the tests appear better than they really are.http://www.slate.com/id/2154563/fr/nl/
Thursday, November 30, 2006
Tuesday, November 28, 2006
Objectives RCT's work is basically founded on the respect for human rights and the dignity and integrity of each individual. Therefore, it is RCT's proclaimed objective to help alleviate the human suffering resulting from torture – both for the individual, the family members and the community. RCT also aims at preventing torture. RCT seeks to achieve this aim by altering the mechanisms resulting in torture in each country. By preventing torture, we also ensure respect for human rights, social justice and a development towards a society without human suffering.
The objectives are:
- to expose and document torture on a health professional basis
- to develop clinical diagnoses and treatment methods of torture survivors on the basis of systematic examination of the torture survivors and research into torture and organised violence
- to apply the experiences thus achieved in the education and advocacy in order to contribute to the global effort to abolish torture.
RCT aims at achieving the three objectives by:
- running a centre that undertakes clinical research and method development in order to provide knowledge on torture and the form and extent of the after-effects of torture as well as treats and rehabilitates persons who have been subjected to torture
- conducting education and advocacy in order to promote knowledge of the reasons for torture, conventions and laws, treatment methods and prevention of torture
- carrying out project work in the South in co-operation with centres and programmes aiming at treating and rehabilitating torture survivors and preventing torture
Wednesday, November 22, 2006
Suddenly out of the blue she started getting severe headaches.
As they first began around Christmas time she wondered if it was due to yuletide excess, but the headaches became more and more severe. All her husband Fred could do was to sit and watch.
"To actually watch somebody holding their head in their hands and then getting down on their knees on the floor and literally shaking, you think this is not a normal headache," he said.
= = =
At the National Barbara's headaches were diagnosed as cluster headaches.
The pain they cause is thought to be ten times worse than childbirth - they have been nicknamed suicide headaches because of the excruciating pain - like being stabbed in the head with a needle.
Barbara's only chance of getting rid of the pain was to have an operation to implant an occipital nerve stimulator into the back of her head.
= = =
In consultation with Barbara, Mr Watkins had to explain that the operation was relatively new and that he could not predict the outcome.
My impression is that it seems to work in about two out of three people. Of course there is always a slight unknown with something that hasn't been around for a long time.
"We're only really doing it with patients who have chronic headache continuously and where nothing else has worked."
Barbara's operation involved planting two electrodes near the occipital nerves which run up the back of her head, through an incision in the skin in her neck.
The electrodes were then connected to a stimulator - a little like a pacemaker - which was implanted in her abdomen.http://news.bbc.co.uk/2/hi/health/6170246.stm
Tuesday, November 21, 2006
Is Surgery Best Way To Stop Back Pain?, New Major Study Suggests Sometimes People Are Too Quick With Procedure - CBS News
Sunday, November 19, 2006
Statistics show that men are more likely than women to suffer an early death.
Now some advocates and medical scientists are beginning to ask a question that in some circles might be considered politically incorrect: Is men’s health getting short shrift?
The idea, they say, is not to denigrate the importance of women’s health but to focus public attention on the ways in which men may be uniquely at risk — and on what a growing men’s health movement has termed the “health disparity” between the sexes and its most glaring example, a persistent longevity gap that has narrowed but still shortchanges men of five years of life compared with women.
“We’ve got men dying at higher rates of just about every disease, and we don’t know why,” said Dr. Demetrius J. Porche, an associate dean at Louisiana State University’s Health Sciences Center School of Nursing in New Orleans, and the editor of a new quarterly, American Journal of Men’s Health, that will publish its first issue next March.
Friday, November 17, 2006
That low cortisol levels are found in such maladies as chronic fatigue syndrome, post-traumatic stress disorder, fibromyalgia and atypical depression is not new. However, the study, published in the November issue of Psychophysiology, combined with other findings emerging from a comprehensive project, appear to support the idea that sex hormones tend to separate men from women in their reactions to stress, said Mattie Tops, a postdoctoral research associate in the NeuroInformatics Center at the University of Oregon.The study is the first to demonstrate improvements in fatigue and vigor in healthy female subjects, a finding that "is particularly relevant because of the high prevalence of hypocortisolemic fatigue syndromes in women and the association in healthy women between low morning cortisol levels and complaints of fatigue and muscular pain," Tops and his colleagues wrote in their conclusion.http://www.physorg.com/news82647908.html
At 6 months none of the 8 patients in group 1 had phantom pain, compared with 71% of 7 in group 5 (P < .007). There was no significant stump pain at 6 months in any group.
New painkiller draws mixed reviews from doctors (11-13-06)
The first published studies of Arcoxia, the drug that Merck & Co. hopes will take the place of its withdrawn painkiller Vioxx, are getting mixed reviews from doctors, some of whom say the results do not make a case for the medication's approval.
The critics cite not just Arcoxia's side effects but also that Merck tested it against diclofenac, an older painkiller known to raise heart risks. A fairer comparison would have been to a medicine that does not do that, such as naproxen, sold as Aleve, they say.
"The development program for Arcoxia is fatally flawed," said Dr. Steven Nissen, a Cleveland Clinic cardiologist who formerly headed the Food and Drug Administration's cardiac drug advisory panel. "My advice to the FDA is that they should not approve this drug."
Dr. David Graham, an FDA drug safety expert who has criticized his agency's handling of Vioxx, agreed.
"It's my own suspicion that this study was intentionally designed to minimize the possibility of their having a repeat of what happened with VIGOR," the study that revealed Vioxx's heart risks, he said.http://www.chron.com/disp/story.mpl/headline/nation/4330749.html
Chronology of events surrounding Vioxx, other painkillers (08-19-05)
Vioxx jury awards widow $253 million (08-20-05)
Merck Wins Latest Vioxx Suit (11-15-06)
Thursday, November 16, 2006
Chronic pain affects one in five Canadians. Here in Atlantic Canada, this means almost 500,000 people are suffering. They often can't get the help they need – leaving many in constant, excruciating, dehabilitating pain. Are you one of them?
- Are you waiting months or years to get medical help from a pain specialist?
- Are you having trouble getting the medications you need?
- Are you unable to access proper care that addresses all aspects of your pain?
- Have your tried everything and still can't find help?
You are not alone. Don't suffer in silence. Share Your Story with fellow pain sufferers. And take action – use our simple interactive tool to write a letter to your MLA or MHA demanding improvements in pain care now!
What is the problem?
- Lack of services and treatment options. Depending on where you live you might not be able to get the help you need for Chronic Pain in our region.
- Waiting lists for pain clinics and specialized pain doctors in Atlantic Canada are as long as five years. People are suffering needlessly.
- Many politicians and members of the public are not aware of this issue and the toll it takes on Atlantic Canadians. Pain is a silent epidemic.
What is the solution?
- Provincial governments need to provide more funding and resources to reduce waiting lists for Chronic Pain treatment in Atlantic Canada and improve access to care.
- Provincial governments need to establish a special billing fee code in each province that pays doctors a special rate for treating and managing chronic pain. This will encourage better treatment and more specialization and education of doctors in treating Chronic Pain.
- Provincial governments, medical schools, patients and healthcare professionals need to work together to create education programs to improve the tools, resources and skills of family doctors and pain patients in Atlantic Canada.
- e all need to work together to make chronic pain a key health issue in Atlantic Canada for decision-makers and the public.
Wednesday, November 15, 2006
The Canadian Pain Coalition is a Partnership of patient pain groups, health professionals who care for people in pain, and scientists studying better ways of treating pain. This partnership began in May 2002 as an initiative of the Canadian Pain Society, which remains an active partner.
Our Purpose is to promote sustained improvement in the treatment of all types of pain through:
- Developing educational programs for the public
- Informing government about the needs of the pain community
- Increasing media coverage of pain
Tuesday, November 14, 2006
Scientists use pixels to ease amputees' pain
Academics from the School of Computer Science and School of Psychological Sciences have developed a virtual reality system, which gives the illusion that a person's amputated limb is still there.
The computer system created by Dr Stephen Pettifer and Toby Howard of the School of Computer Science, immerses patients into a life-size virtual reality world.
By putting on a headset, patients will see themselves with two limbs. They can use their remaining physical limb to control the movements of a computer-generated limb, which appears in the 3D computer-generated world in the space of their amputated limb.
So for example, they can use their physical right arm to control the movement of their virtual left arm.
Patients have complex hand-eye coordination and can move their fingers, hands, arms, feet and legs. They can also use their virtual limb to play ball games.
Phantom limb pain or PLP is discomfort felt by a person in a limb that is missing due to amputation. Previous research has found that when a person's brain is 'tricked' into believing they can see and move a 'phantom limb', pain can decrease.
So far, five patients living in the Manchester area – including one who has suffered from PLP for 40 years – have used the virtual reality system over several weeks in a small-scale study.
But this initial project has produced startling results, with four out of the five patients reporting improvement in their phantom limb pain. Some improvements were almost immediate.
The Manchester team's findings were recently presented at a major conference in Denmark on the use of virtual reality for rehabilitation.
Dr Stephen Pettifer, of the School of Computer Science said: "Most people know about 3D graphics and virtual reality from their use in the entertainment industry, in computer games and special effects in films.
"It's very satisfying being able apply the same technology to something that may have a real positive impact on someone's health and well being."
Project leader, Dr Craig Murray of the School of Psychological Sciences, said "Many people who undergo an amputation experience a phantom limb. These are often very painful for the person concerned. They can persist for many years, and are very difficult to treat.
"One patient felt that the fingers of her amputated hand were continually clenched into her palm, which was very painful for her. However, after just one session using the virtual system she began to feel movement in her fingers and the pain began to ease."
Each participant used the system between seven and 10 times over the course of two to three months. Sessions lasted around 30 minutes and involved putting on a special virtual reality headset.
Upper-limb amputees were fitted with a special data glove and had sensors attached to the elbow and wrist joints. Sensors were fitted to the knee and ankle joints of lower-limb amputees. Head and arm movements were also monitored.
The three men and two women who took part in the study were aged between 56 and 65. The group included three arm amputees and two leg amputees, who had lost limbs between one and 40 years ago.
The University of Manchester research team hopes to include a larger number of patients in their future work in order to identify those most likely to benefit from the virtual reality system they have developed.
For more information about the University of Manchester project see http://aig.cs.man.ac.uk/research/phantomlimb/phantomlimb.php
For more information about the International Conference Series On Disability, Virtual Reality And Associated Technologies in Denmark see http://www.icdvrat.reading.ac.uk
"We found a new way to treat a chronic and debilitating form of pain suffered by hundreds of millions of people on Earth," says J. Michael McIntosh, a University of Utah research professor of biology, and research director and professor in the Department of Psychiatry. "It is a previously unrecognized mechanism for treating pain."
The findings are being published the week of Nov. 13 in the online edition of the journal Proceedings of the National Academy of Sciences.
The study in rats found that cone snail toxins named RgIA and Vc1.1 can treat nerve hypersensitivity and pain by blocking a molecule in cells known as the "alpha9alpha10 nicotinic acetylcholine receptor."
Monday, November 13, 2006
of Wall and Melzack's Textbook of Pain, 5th Edition
Edited by Stephen McMahon, PhD & Martin Koltzenburg, MD FRCP
One of the very first references to address pain management in an authoritative and comprehensive fashion, Wall and Melzack's Textbook of Pain is now radically transformed to provide today's most advanced guidance in the field!
More than 125 leading experts document all of the very latest information on the neurophysiology, psychology, and assessment of every type of pain syndrome, and describe today's full range of pharmacologic, surgical, electrostimulative, physiotherapeutic, and psychological management options.
Agency for Healthcare Research and Quality: Effective Health Care for arthritis and non-traumatic joint disorders
1. What is the evidence for benefits and harms of treating osteoarthritis with oral medication(s)? How do these benefits and harms change with dosage and duration of treatment, and what is the evidence that alternative dosage strategies, such as intermittent dosing and drug holidays, affect the benefits and harms of oral medication use?
2. Are there clinically important differences in the harms and benefits of oral treatments for osteoarthritis for certain demographic and clinical subgroups? (Demographic subgroups include age, sex, and race; Co-existing diseases include hypertension, edema, ischemic heart disease, heart failure; PUD; history of previous bleeding due to NSAIDS; Concomitant medication use includes anticoagulants).
3. What is the evidence that the gastrointestinal harms of NSAID use are reduced by co-prescribing of H2-antagonists, misoprostol, or proton pump inhibitors?
4. What are the benefits and safety of treating osteoarthritis with oral medications as compared with topical preparations?
Saturday, November 11, 2006
Doctors using Google to diagnose illnesses
The internet search engine Google has added another impressive string to its bow - by helping doctors diagnose illnesses, according to a new study.
Researchers found that almost six-in-10 difficult cases can be solved by using the world wide web as a diagnostic aid.
Doctors fight disease by carrying about two million facts in their heads but with medical knowledge expanding rapidly, even this may not be enough.
Misdiagnosis is still a common occurrence in the medical profession despite all the tools available such as the blood tests and state of the art scanning equipment.
Studies of autopsies have shown doctors seriously misdiagnose fatal illnesses about 20 per cent of the time.
So millions of patients are being treated for the wrong disease. And the more astonishing fact may be that the rate has not really changed since the 1930s.
So a team at the Princess Alexandra Hospital in Brisbane identified 26 difficult diagnostic cases published in the New England Journal of Medicine last year, including obscure conditions such as Cushing's syndrome and Creutzfeldt-Jakob disease.
They selected three to five search terms from each case and did a Google search while blind to the correct diagnoses. Google gives users quick access to more than three billion medical articles.
The researchers then selected and recorded the three diagnoses that were ranked most prominently and appeared to fit the symptoms and signs, and compared the results with the correct diagnoses as published in the journal.
Google searches found the correct diagnosis in 15 (58 per cent) of cases. Respiratory and sleep physician Dr Hangwi Tang, who led the study, said: "Doctors adept at using the internet use Google to help them diagnose difficult cases.
"As described in the New England Journal of Medicine, a doctor astonished her colleagues including an eminent professor by correctly diagnosing IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X linked) syndrome.
She admitted that the diagnosis 'popped right out' after she entered the salient features into Google."
The researchers, whose findings are published online by the British Medical Journal, suggest Google is likely to be a useful aid for conditions with unique symptoms and signs that can easily be used as search terms.
But they stress the efficiency of the search and the usefulness of the retrieved information depend on the searchers' knowledge base.
Dr Tang added: "Doctors and patients are increasing proficient with the internet and frequently use Google to search for medical information.
"Twenty five million people in the United Kingdom were estimated to have web access in 2001, and searching for health information was one of the most common uses of the web.
"Computers connected to the internet are now ubiquitous in outpatient clinics and hospital wards. Useful information on even the rarest medical syndromes can now be found and digested within a matter of minutes.
"Our study suggests that in difficult diagnostic cases, it is often useful to 'google for a diagnosis'. Web based search engines such as Google are becoming the latest tools in clinical medicine, and doctors in training need to become proficient in their use."
Pain so often is accompanied by loss—loss of function, loss of employment, loss of money, loss of friends and relationships to name just a few—it’s no wonder that people in chronic pain have an increased incidence of depression, anxiety, and sleep disturbances. It is natural to feel emotions ranging from fear, anger, denial, disappointment, guilt, and loneliness to hope and optimism. Every person reacts differently to pain at different times, which can make relationships and pain control difficult. The effect emotions and psychosocial well being have on pain cannot be ignored as emotions have a direct effect on your health. Taking care of the emotional aspects of chronic pain is necessary to treat your overall pain condition.
The articles listed below offer insight into the psychology of pain and the options available to persons in pain and hopefully the reassurance that you are not alone.
The Relationship Between Pain, Depression and Mood: An Interview with Rollin Gallagher, MD, MPH
Dr. Gallagher discusses the relationship between mood and pain, available treatments, and the things a person in pain can do to mitigate his or her depression.
The Link Between Pain and Depression
Pain and depression are inexorably linked in a complex way in your brain. Pain and pain-related disability affect mood — mood affects pain and pain-related disability. To successfully treat your chronic pain, you and your physician need to examine the emotional factors that may influence your pain level and physical disability. Read more about how pain and depression are connected and how to recognize symptoms in yourself.
Looking Beyond the Pain: The Role of Psychological Assessment in Medical Treatment
Don’t be offended if your doctor asks questions about your mental state—part of treating pain is relieving emotional symptoms related to pain. Conditions like anxiety and depression significantly affect how well a patient responds to pain treatment. Learn more about the important role psychological assessment plays in treating pain.
Pain and Depression
This article is adapted from a lecture given by NPF Board member Dr. Michael Loes.
Psychological Factors Related to Pain
Dr. Mark Disorbio outlines how pain is both a physical and psychological experience.
Friday, November 10, 2006
Wed, Nov 8 2006 3:43 pm
If this is a duplicate message I am sorry.
I have been (mostly) a lurker in this group for many years. I am in
chronic pain do to an accident on the Atlantic Cit Expwy in 1998. I
have had two Spinal Fusions-lumbar and am on
the following pain meds: Duragesic Patch 100 mcg 1 every other day,
Oxcycontin ER 80 mg 4Xday, Oycodone 5 mg 4x day BT & lidocaine 3%
patch 2-3 every night for 12 hours. If you could get me back into the
grup I wold really appreciate it, I am not too literate on the Web but
especially during Flare ups when I can do nothing it helps to be able
to read your discussions. Thank you very much.
Wed, Nov 8 2006 8:44 pm
dianewil...@... wrote: "stuff!'
WELCOME diane, welcome. Sorry about your pain, yet this is to be one
one of the best places if you have any.
Wed, Nov 8 2006 9:53 pm
hi! your here, just post away like you just did, welcome, how can we
help you? have a pain free evening...joe
Not all pain is alike.
We've all experienced pain at one time or another. Sharp, dull, quick, recurring. However you describe it, pain technically fits into one of 2 categories – acute or chronic. Acute pain is pain that hits you suddenly – after falling from a ladder, being tackled on the football field or lifting a load that is just too heavy, for example. Acute pain comes on quickly and often leaves just as quickly. But chronic pain is different.
Are you suffering from chronic pain?
According to the American Chronic Pain Association, chronic pain is pain that continues a month or more beyond the usual recovery period for an injury or illness, or that goes on for months or years due to a chronic condition. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap – a sprained back or serious infection – or there may be an ongoing cause of pain – arthritis or cancer. But you may suffer chronic pain in the absence of any past injury or evidence of body damage. And you live with it. Day in and day out. Perhaps working extra hard to get out of bed each morning. And struggling to do all the little things – like tying your shoes, climbing the stairs or lifting your child or grandchild.
Two common chronic conditions.
This site was designed to teach you more about chronic pain, and takes a closer look at 2 very common types – chronic back pain and chronic osteoarthritis pain. Only your doctor can diagnose chronic pain. But you can help manage it, and find appropriate treatments once and for all.
Thursday, November 09, 2006
Back Sense By Dr. Ronald D. Siegel, Michael H. Urdang And Dr. Douglas R. JohnsonCharts and Exercises from Back Sense
A number of readers have asked us to provide online copies of the charts and participatory exercises in the Back Sense program so that they could easily make copies of them. We are providing them here in Adobe Acrobat (PDF) format, so that they can be printed on almost any computer system.
Vilayanur Ramachandran has been called a Sherlock Holmes of neuroscience. Director of the Center for Brain and Cognition at the University of California, San Diego, and adjunct professor at the Salk Institute for Biological Studies in La Jolla, California, Ramachandran has brilliantly sleuthed his way through some of the strangest maladies of the human mind. He has done this by marrying simple tools such as mirrors and cotton swabs with an insatiably inquisitive mind and a tonic sense of humor.
One of the areas in which he has made some of his greatest strides is in the arena of phantom limbs, in which amputees and even those born without one or more limbs feel pain and other sensations in their missing body parts. Here, read Ramachandran's vivid descriptions of his experiences with phantom-limb patients and how he has managed to understand their singular dilemmas and thereby help them.
Help your doctor – and yourself.
Before you and your doctor can effectively treat your pain, your doctor will need to understand exactly what it is you're feeling. The Pain Profiler can help you summarize your pain in a clear, concise way. Take just a couple of minutes to answer the step-by-step questions. Then take your printable profile with you to your appointment.
Tuesday, November 07, 2006
'Neuroethics' is the ethics of neuroscience, analogous to the term 'bioethics' which denotes the ethics of biomedical science more generally.
Neuroethics encompasses a wide array of ethical issues emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience, affective neuroscience).
These include ethical problems raised by advances in functional neuroimaging, brain implants and brain-machine interfaces and psychopharmacology as well as by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence.
In ancient Rome, patients with unbearable head pain were sometimes treated with jolts from the electricity-producing black torpedo fish, or electric ray.
Recently, electrical or electromagnetic devices that hark back to the head-zapping torpedo fish have come into vogue among the country’s most prominent migraine researchers. Two different kinds of stimulatory devices are now in large-scale clinical trials for possible use in patients with the most severe migraine cases. Many researchers believe that such devices are likely to play a greater role in migraine treatment in the future.