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Posted by john on July 6th, 2007 — in Ultram News
Many people suffer from the debilitating effects of fibromyalgia, which involves chronic widespread muscular pain, fatigue and tenderness. Many people with fibromyalgia also experience symptoms such as fatigue, headaches, irritable bowel syndrome, irritable bladder, cognitive and memory problems (called “fibro fog”), temporomandibular joint disorder, pelvic pain, restless leg, sensitivity to noise and temperature, anxiety and depression.
It is second only to osteoarthritis in frequency of visits to rheumatology clinics, and about 5 percent of women and 0.5 percent of men in the United States will be affected. The majority will be between 30 to 50 years old.
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Although we still have much to learn about fibromyalgia, it is believed patients with it experience pain amplification because of abnormal sensory processing in the central nervous system. This is supported by studies showing multiple physiological abnormalities in patients, including increased levels of substance P in the spinal cord, low levels of blood flow to the thalamus region of the brain and low levels of serotonin.
It has also been suggested fibromyalgia might relate to an abnormality in deep sleep. Abnormal brain waveforms have been found in deep sleep in some patients. Tender points can be produced in normal volunteers by depriving them of deep sleep for a few days. Recent studies show genetics might also be a factor. Here is some information on diagnosis and treatment from rheumatology.org and uptodate.com:
Diagnosis
Unfortunately, there are no “objective markers” — evidence on X-rays, blood tests or muscle biopsies — for this condition, so patients have to be diagnosed based on the symptoms they are experiencing.
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The American College of Rheumatology has established general classification guidelines for fibromyalgia. These guidelines require widespread aching for at least three months and a minimum of 11 out of 18 tender points. However, not all physicians and researchers agree with these guidelines. Some believe the criteria are too rigid and fibromyalgia can be present even if the required number of tender points is not met, while others question how reliable and valid tender points are as a diagnostic tool.
Treatment
Fibromyalgia must be managed as a chronic condition, and should include both medication and non-medication treatments for symptoms. Drug therapy for fibromyalgia largely treats symptoms. Studies indicate the best pharmacological approach for treating pain, and improving disrupted sleep, is low doses of tricyclics including cyclobenzaprine (Flexeril) and amitriptyline (Elavil). Positive results also have been shown with dual reuptake inhibitors (Effexor), duloxetine (Cymbalta), tramadol (Ultram) that work similarly.
Conversely, long-acting opioids are typically not recommended for the treatment of fibromyalgia unless patients are resistant to other therapies. This is not because of issues with dependence, but rather because anecdotal evidence suggests these drugs are not of great benefit to most people with fibromyalgia.
Anti-inflammatory medications will generally work if the patients have associated arthritis.
Recently, researchers studying antiepileptics such as pregabalin (Lyrica) have found these drugs may prove promising for fibromyalgia.
Other therapies
Complementary and alternative therapies can be useful for pain, although these treatments have generally not been well tested. Therapeutic massage to manipulate the muscles and soft tissues of the body may alleviate pain, discomfort, muscle spasms and stress. Similarly, myofascial release therapy, which works on a broader range of muscles, can gently stretch, soften, lengthen and realign the connective tissue to ease discomfort.
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Posted by john on July 2nd, 2007 — in Ultram News
Do you remember John Patterson? Chances are you might not. It’s that whole “out of sight out of mind” thing … and Patterson has been out of sight for the Nationals since early May with what four doctors in four different cities have called a compressed nerve in his elbow. But Patterson is seeking a new treatment to relieve the compression, and is willing to travel again to get it:
Patterson, on the disabled list since May 6, spent the past week visiting four orthopedists in four cities. Their conclusions were all basically the same: Patterson has a compression of the radial nerve in his elbow. The right-hander, though, will travel to Toronto to receive treatment that Manager Manny Acta said has not been approved in the United States. (…) Acta said the treatments Patterson is seeking are similar to those used by Oakland closer Huston Street, who just rejoined the Athletics after spending 18 days in Toronto undergoing a variety of homeopathic treatments.
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If Huston Street got the bionic man treatment, there’s no telling what they’ll do to Patterson up in Canada. But he’s already proven that he’s willing to go to great lengths to get healthy and salvage his career. Let’s hope this works for John’s sake, because who knows where he’ll go next, and what they’ll do to him once he’s there.
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Posted by john on June 30th, 2007 — in Ultram News
LAURA BEARD was flipping through a women’s magazine when an advertisement caught her eye. It sounded simple enough: Aim a laser at individual blemishes — in the privacy of one’s home — and the skin will clear up within a day or two.
The cost, $150, gave her only slight pause. If the device worked, it would save her the time and money she spent on acne treatments and dermatologist visits for herself and her daughter. “I have very dry skin, so I have to be careful about using acne remedies with benzoyl peroxide,” says the 53-year-old Memphis woman. “This sounded so positive.”
With the evolution of laser technology, do-it-yourself personal care has entered a new realm. Consumers can now calm acne flare-ups, plump facial wrinkles and restore thinning hair with a variety of hand-held devices. Others in development could treat superficial wounds, relieve pain and remove body hair.
“This field will grow because we have discovered how to channel the power of light and cause reactions in the skin and hair,” says John Carullo, director of marketing for Sunetics, manufacturer of a hair-regrowth device. “It’s quite an exciting industry, and it’s on the verge of exploding.”
Home hair and skin appliances using lasers or, in some cases, heat, can spare consumers from tiresome trips to the doctor’s office and may be less costly, over time, than monthly in-office facials and hair treatments. But they won’t work the same kind of magic that can be conjured up with more high-powered tools. And some may even be a waste of money.
“It’s a matter of degree,” says Dr. Harold Brody, a clinical professor of dermatology at Emory University in Atlanta. “If people are trying to treat mild conditions, it may help. But if it’s something severe, they will need the help of a dermatologist.”
The popularity of in-home treatments mirrors the use of medical devices by physicians, says Dr. Wendy E. Roberts, a Rancho Mirage dermatologist and assistant professor of medicine at Loma Linda University Medical Center. “I think eventually these could be effective for home use,” she says. “But right now, there are questions about the efficacy of some of these systems. There’s a lot of hype.”
Consumers may have especially high expectations for home lasers.
Lasers release a special form of light in a single wavelength; by contrast, normal daylight consists of varying wavelengths. Hot lasers, the kind used by health professionals in the treatment of skin resurfacing and tattoo removal, are high-energy devices that cause heat damage to the skin, triggering a healing response.
Cool lasers are sometimes called low-level lasers or low-level light therapy. This type of laser doesn’t damage tissue and is safe to use at home. They work by passing a beam of light through the skin to reach cells below the skin’s surface and stimulate the body’s natural healing processes. Energy produced by cool lasers appears to prompt the production of collagen and ATP (the energy source needed for cellular functions), promote blood circulation and boost the release of growth factors and the removal of waste products from cells.
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“I sincerely doubt any of these things are so aggressive that they would produce side effects,” says Brody. “But the effectiveness is going to be mild too.”
Consumers may think that Food and Drug Administration clearance means the devices work similarly to those used by doctors. But FDA clearance of this type means only that the manufacturer has submitted some data showing effectiveness for the device’s intended purpose. Usually this means the device is based on similar, proven technology. Devices that do not have FDA clearance may only be proven as safe.
For example, devices to stimulate hair regrowth for balding men have been sold over-the-counter for years although manufacturers couldn’t claim the devices helped regrow hair. The approval in February for the HairMax LaserComb was a milestone because the manufacturer produced scientific data to show the product had some effect in growing hair.
But not every light-based hair and skin device has received FDA clearance.
“Consumers need to ask enough questions to make sure what they are getting is truly efficacious,” says Dr. Mark Solomon, a plastic surgeon in Philadelphia and spokesman for the American Society of Plastic Surgeons. “Over-the-counter devices don’t hurt anybody, so you can sell them. But that doesn’t mean they work.”
The American Cancer Society has warned that low-level light therapy products in particular are being touted for conditions for which there is little or no proof that they help, such as pain relief, inflammation, smoking cessation, herpes, high blood pressure and migraines.
But the devices are becoming more visible in the marketplace. Sunetics is marketing its laser hair brush for $399. Next month the firm will also begin selling the device with a removable head that can be replaced with one of four attachments (each costing $250) for use on acne, facial wrinkles, skin pigmentation and pain relief/wound healing. Each attachment contains a diode that produces a specific wavelength of light targeted to treat a particular condition, Carullo says.
Although there is some research supporting the effects of low-level laser therapy for hair regrowth and acne, there is little or no data to support other uses, Roberts says.
Consumers should seek a doctor’s advice for persistent skin or hair problems, Brody says. A home device could lighten a skin lesion that is actually a melanoma skin cancer or remove scaling skin, the symptom of another type of skin cancer.
“Safety is paramount,” he says. “You don’t want to delay a diagnosis.
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Posted by john on June 25th, 2007 — in Ultram News
Among women who complain of heavy periods, it’s often the pain that accompanies menstruation — not the heaviness itself — that bothers them the most, UK researchers report.
Given that some treatments can exacerbate other potentially problematic aspects of menstruation, such as irregularity, it’s important for women to think carefully about what aspects of menstruation are most bothersome for them, Dr. Miriam Santer of the University of Edinburgh Medical School, the study’s lead author, told Reuters Health.
“Sometimes people haven’t thought that through in their own minds, they haven’t made the distinction themselves,” Santer said in an interview. “It’s important when it comes to making treatment decisions.”
Many women have heavy bleeding during menstruation, but some experience this as a problem while others don’t, she and her colleagues note in their report. To better understand the concerns of these women, they surveyed 2,833 women ages 25 to 44 years, 906 of whom reported heavy or very heavy periods. They also conducted in-depth interviews with 32 of these women.
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When asked what bothered them the most about their periods, the women who menstruated heavily reported pain most frequently, followed by heaviness, moodiness or tiredness, irregularity and other timing problems, such as unpredictable duration and spotting.
The type of work women did played a major role in how problematic heavy menstruation was for them, Santer and her colleagues noted; specifically, how easily they were able to access toilet facilities and to rest if necessary. “The impact varies enormously,” Santer said.
Non-steroidal anti-inflammatory drugs (NSAIDs) can help women with both period pain and menstrual heaviness, Santer noted, while a new type of progesterone-releasing birth control device that is implanted into the uterus can reduce menstrual heaviness, but may increase irregularity.
Women should “make sure they have really thought through what is bothering them the most and to be as aware as possible of the different treatment options,” Santer added, noting that for many, a simple strategy such as taking NSAIDs for pain relief during menstruation may be enough.
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Posted by john on June 23rd, 2007 — in Ultram News
Equioxx (firocoxib), a non-steroidal anti-inflammatory drug (NSAID) for use in horses, is now available from Merial. Equioxx is delivered as a paste (similar to paste dewormer) and is FDA-approved for treating joint pain in horses. Equioxx was approved by the FDA after field trials demonstrated its ability to relieve joint pain and inflammation associated with osteoarthritis in horses. Another trial showed the drug’s ability to improve the mobility of treated horses.
Osteoarthritis is known to affect horses of all ages, including the very young. The onset of the disease is commonly due to one or more of the following factors: trauma to the joint, conformation faults, immobilization, improper shoeing, and age.
“Osteoarthritis is a degenerative disease that can negatively affect a horse’s performance and lead to early retirement,” said Peter Hanson, DVM, PhD, Dipl. ACVS, executive director of pharmaceutical research and development projects at Merial. “In trials, Equioxx had impressive results reducing pain and inflammation associated with osteoarthritis. It is a long-awaited NSAID paste designed specifically for horses that has an excellent safety profile.”
Over the years, there has been growing concern about the safety of NSAIDs. Equioxx was also subjected to extensive safety testing in addition to the many horses involved in field studies. A targeted study involving 30 horses of various breeds and sizes evaluated clinically-relevant side effects of using firocoxib to determine the safety profile of the drug. In the study, horses receiving the normal recommended dose did not experience any treatment-related side effects.
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“We’re excited to offer veterinarians a new choice for osteoarthritis pain relief that’s backed by clinical and field studies involving so many horses,” Hanson said.
According to study results, Equioxx is absorbed quickly and provides lasting pain relief. One study showed that firocoxib was maintained at adequate blood levels after one dose to ensure optimum effectiveness until the next dose 24 hours later.
Equioxx is approved for up to 14 days of use for the control of pain and inflammation associated with equine osteoarthritis, and it is a prescription product available through a veterinarian. Each syringe of Equioxx is enough to treat a 1,250-pound horse and is marked in 250-pound increments.
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Posted by john on June 17th, 2007 — in Ultram News
Most of us duck and run when it comes to bees, but there are people who look forward to a sting or two, or three, or more.
These people are undergoing bee venom therapy, which has become a popular alternative to acupuncture for a host of painful conditions including arthritis, rheumatism and gout, asthma and pre-menstrual tension.
Some proponents claim the therapy also relieves male impotence, the symptoms of psoriasis, epilepsy and depression, and the pain of cancer.
Some are confident enough to catch bees and let them sting the afflicted area themselves. But it is wiser to have the therapy under the supervision of experts, a service some bee farms offer.
The owner of one bee farm says it is important for clients to be tested first to check the reaction to the venom. A allergic reaction can be fatal.
Yazid Mohamad, who has had arthritis for years, goes to a bee farm for treatment.
“I read about bee venom therapy and tried it on my own. It works for me, and I have introduced it to many of my friends,” he said.
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“The stings are much less painful than a jab. The venom injected into my knees and finger joints relieves my pain within 15 minutes and lasts for at least a day.”
Bee venom contains more than 40 active substances, including the protein melittin, which stimulates cortisol production by the adrenal glands, which is a natural anti-inflammatory.
The venom also contains “Peptide 401″ which is believed to be 100 times more powerful than synthetic cortico-steroids.
A gout patient, Zaidi Ramli, said he was sceptical about the therapy but felt great relief after trying two bee stings on each of his knees.
“The pain of the bee stings is nothing compared to the pain from my gout. I now regularly have three stings on each knee, and I believe the venom has neutralised the uric acid in my knees,” he said.
A pincer is used to catch caged bees, which are then applied to the painful area. Once the bee has stung, it dies and the stinger is removed.
The venom provokes an immune response. The red, swollen weal draws blood to the site of the stings and activates the body’s healing process. After 30 seconds or so the pain recedes, followed by a warm feeling.
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Posted by john on June 13th, 2007 — in Ultram News
NeurogesX has achieved its endpoint in a phase III trial of its experimental skin patch in postherpetic neuralgia, a painful complication of shingles.
The study evaluated the effect of a single application of NGX-4010, the company’s novel dermal patch, on pain due to postherpetic neuralgia (PHN). The primary endpoint in this phase III trial was achieved, demonstrating a statistically significant reduction in pain over an eight-week period. The reduction of pain was sustained over 12 weeks.
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AdvertisementLead trial investigator, Dr Misha-Miroslav Backonja, said: “We believe that NGX-4010’s unique profile has the potential to provide a meaningful therapeutic alternative to traditional therapies that need to be taken daily, most of which have systemic side effects.”
According to the Centers for Disease Control, there are approximately one million cases of shingles in the US each year, and approximate one in five shingles sufferers go on to develop PHN. People with PHN experience pain and increased sensitivity of the skin that can persist for many years.
NeurogesX plans to complete a confirmatory phase III trial in PHN in the second half of 2007 and expects to submit marketing applications to the European Medicines Agency in 2007 for European Union approval and to the FDA in 2008.
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Posted by john on June 10th, 2007 — in Ultram News
Indo-Asian News Service
New York: Always choose safest pain killer first to get rid of pain because some painkiller drugs may raise risk of heart attack or stroke, new research suggests.
The American Heart Association (AHA) has step by step recommendations that can help you choose a pain reliever that’s good for both the heart and stomach, reports the June 2007 issue of the Harvard Heart Letter.
It suggests starting with Aspirin or Acetaminophen (Tylenol) to quell muscle or joint pain. Aspirin is good for the heart and Acetaminophen doesn’t affect blood clotting.
If they don’t work, the next step for most people would be a Non-steroidal anti-inflammatory drugs (NSAID). Try Naproxen (Aleve) first, then Ibuprofen (Advil), the association said.
Next is Diclofenac, but more caution is needed with this drug (which is available only by prescription). Celebrex, the only drug in the class known as COX-2 inhibitors that remains on the market, should be the last resort for managing pain.
In addition to the side effect of increasing the risk of clots in the bloodstream, COX-2 inhibitors can also reduce blood flow through the kidneys and raise blood pressure.
For short-term pain in some people, a narcotic pain reliever such as Tramadol (Ultram), Codeine, or Fentanyl (Actiq, Duragesic) may be an option.
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The Harvard Heart Letter notes that one shouldn’t be afraid of taking Aspirin, Tylenol, Advil, or Aleve for occasional aches and pains.
But if you need a pain reliever several times a week, pay closer attention to your choices and talk with your doctor, said health portal News Medical.
Earlier researchers at Oxford University led by Colin Baigent had found serious vascular events in patients on non-steroidal anti-inflammatory drugs (NSAIDs).
NSAIDs are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. They are standard drugs used to treat chronic pain in conditions such as arthritis.
They include Ibuprofen, Diclofenac, COX-2s and Naproxen. The researchers had found that the odds of a heart attack or stroke increased by 42 percent that in patients taking COX-2s as compared with those administered placebo.
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Posted by john on June 5th, 2007 — in Ultram News
NEW YORK — Biovail Corp. stock moved up Friday after the government delayed approval of a competitor’s drug.
The Food and Drug Administration said Labopharm Inc. did not provide enough data on its painkiller Tramadol. The FDA said Labopharm did not analyze data related to patients who dropped out of its studies, and sent the company a second approvable letter.
CIBC World Markets analyst Joseph Walewicz said the delay would help sales of Biovail’s painkiller Ultram ER. He said Ultram will play an important role for Biovail until other products in its pipeline reach the market.
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“As a result of the early arrival of a generic version of Wellbutrin XL, Ultram ER has become Biovail’s key growth driver in the short term, until other pipeline products can kick in,” he said. “Thus, a competitor’s stumble is particularly opportune for Biovail.”
Ultram sales brought in $30 million in revenue in the Canadian company’s fiscal first quarter.
Biovail stock gained $1.18, or 4.9 percent, to $25.44.
Labopharm shares plunged $3.17, or 50.1 percent, to $3.14. The stock fell as low as $2.83, its lowest point in more than a year of public trading.
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Posted by john on June 2nd, 2007 — in Ultram News
Biovail Corp. stock moved up Friday after the government delayed approval of a competitor’s drug.
The Food and Drug Administration said Labopharm Inc. (nasdaq: DDSS - news - people ) did not provide enough data on its painkiller Tramadol. The FDA said Labopharm did not analyze data related to patients who dropped out of its studies, and sent the company a second approvable letter.
CIBC World Markets analyst Joseph Walewicz said the delay would help sales of Biovail (nyse: BVF - news - people )’s painkiller Ultram ER. He said Ultram will play an important role for Biovail until other products in its pipeline reach the market.
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“As a result of the early arrival of a generic version of Wellbutrin XL, Ultram ER has become Biovail’s key growth driver in the short term, until other pipeline products can kick in,” he said. “Thus, a competitor’s stumble is particularly opportune for Biovail.”
Ultram sales brought in $30 million in revenue in the Canadian company’s fiscal first quarter.
Biovail stock gained $1.18, or 4.9 percent, to $25.44.
Labopharm shares plunged $3.17, or 50.1 percent, to $3.14. The stock fell as low as $2.83, its lowest point in more than a year of public trading.
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