Current medical research and opinion
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Bipolar disorder greatly impacts health-related quality of life (HRQoL), physical and social functioning, employment, and work productivity, and greatly increases health-care utilization and costs. Our objective was to characterize how bipolar disorder impacts HRQoL, work impairment, and health-care utilization and costs. ⋯ Bipolar disorder imposes a tremendous burden on patients and the health-care system, resulting in decreased HRQoL and increased medical and work impairment costs. Limited data suggest that appropriate management can improve HRQoL and functioning while reducing utilization and cost.
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Multicenter Study Clinical Trial
Lidocaine patch 5% and its positive impact on pain qualities in osteoarthritis: results of a pilot 2-week, open-label study using the Neuropathic Pain Scale.
To determine the impact of the lidocaine patch 5% on distinct pain qualities associated with osteoarthritis (OA) through use of the Neuropathic Pain Scale (NPS), an assessment tool designed to assess intensity of various pain qualities (i.e.sharp, dull). ⋯ In patients with moderate-to-severe OA of the knee, 2 weeks of treatment with the lidocaine patch 5% significantly reduces the intensity of pain qualities as measured by all 4 NPS composite measures. Our results coincide with previously reported improvements in pain and physical function in the same patient population, as measured by the Western Ontario and McMaster Universities OA Index. Measuring the various qualities of pain appears to be a valid approach for assessing clinical outcomes in the treatment of OA pain. Pain measures such as the NPS can capture the multi-dimensional properties of a patient's pain experience and may offer clinicians the possibility to identify differential effects of analgesic treatments on various pain qualities associated with OA.
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Multicenter Study Clinical Trial
Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain Scale.
To determine the impact of the lidocaine patch 5% on pain qualities associated with chronic pain from postherpetic neuralgia (PHN), painful diabetic neuropathy (DN), and low-back pain (LBP), using the Neuropathic Pain Scale (NPS). ⋯ The lidocaine patch 5% effectively reduces the intensity of all common pain qualities in patients with moderate-to-severe chronic pain resulting from PHN, painful DN, or LBP. Treatment is well tolerated in combination with other analgesic regimens, with no reports of serious AEs or adverse drug interactions. Assessment scales such as the NPS may offer the possibility to differentiate between various pain states and to assess treatment outcomes for various pain qualities associated with a given pain state.
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To study the local and systemic levels of the tumour necrosis factor-alpha in patients with active uveitis and to determine the implication of TNF-alpha in rheumatological uveitis and to observe if this relationship is more significant in the B27 positive patients. ⋯ The concentration of TNF-alpha in aqueous humour in patients who are HLA-B27 positive is significantly greater than in those who are B27 negative. No significant differences in the concentrations of TNF-alpha in serum or aqueous humour in patients with or without rheumatic diseases were detected. TNF-alpha is a cytokine that may participate actively in the pathogenesis of clinical uveitis.
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Many chronic pain patients have multiple etiologies for their pain, and accurate characterization of pain qualities and pain relief is essential for managing their pain. The ability to utilize a validated tool for assessing pain qualities and for identifying unique analgesic therapy effects on different pain qualities may assist clinicians in devising an appropriate treatment regimen. The Neuropathic Pain Scale (NPS) is a novel pain metric for characterizing pain in 10 dimensions. ⋯ Significant reduction in the intensity of commonly reported pain qualities in patients with neuropathic and non-neuropathic chronic pain due to low-back pain, osteoarthritis, post-herpetic neuralgia, and painful diabetic neuropathy were achieved. The NPS offers clinicians a reliable means to accurately identify pain qualities associated with each individual patient and to target and assess the efficacy of various therapeutic options on those pain components. Utilizing the NPS, the lidocaine patch 5% was effective in treating chronic pain of both neuropathic and non-neuropathic origins suggesting that a given treatment's effect on various pain qualities may be consistent across pain types.