RESEARCH NEWS Devan H, Godfrey HK, Perry MA, et al. Current practices of health care providers in recommending online resources for chronic pain self-management. Journal of Pain Research | August 13, 2019 CONCERNS OVER OSTEOPOROTIC MEDICATION APPEAR UNFOUNDED Through a meta-analysis of 38 randomized clinical trials involving 101,642 participants that assessed drug therapies for osteoporosis, researchers determined whether randomized clinical trials showed that treatment with bisphosphonates, especially zoledronate, was correlated with decreased mortality rates. Between all drug treatments, no important relation for osteoporosis and the overall mortality rate was evident, and no meaningful relationship between clinical trials of bisphosphonate treatment and overall mortality was noted. Moreover, clinical trials of zoledronate treatment demonstrated no relationship with the overall mortality rate, though, for heterogeneity of the results, evidence existed. Thus, bisphosphonate treatment may not be related to decreased overall mortality rates in addition to reduced fracture risk and should only be suggested to reduce fracture risk. Cummings SR, et al. Association between drug treatments for patients with osteoporosis and overall mortality rates: A meta-analysis. JAMA | August 23, 2019 HOWEVER, CONCERNS OVER NSAID’S GROW, THIS TIME FOR NEPHROTIC SYNDROME. In this matched case-control study, researchers examined the link between NSAID use and the risk of nephrotic syndrome via using the UK primary care database. Patients with a first diagnosis of nephrotic syndrome comprised cases. Patients without nephrotic syndrome served as controls. Based on cyclooxygenase enzyme selectivity and chemical groups, the investigators categorized NSAID exposure as either current, recent, or past use. According to findings, the use of conventional NSAIDs was related to a higher risk of nephrotic syndrome starting from at least 2 weeks of exposure, as well as for recent and past exposure up to 2 years prior to the diagnosis of nephrotic syndrome. Mainly acetic acid and propionic acid derivatives seemed to be responsible for this higher risk. Bakhriansyah M, et al. Risk of nephrotic syndrome for non-steroidal antiinflammatory drug users. Clinical Journal of the American Society of Nephrology | August 19, 2019
MORE ON NSAIDS AND CARDIOVASCULAR DISEASES. The authors sought to disentangle the role of NSAIDs in the increased risk of CVD among OA patients. To this end they conducted a longitudinal study based on linked health administrative data (HAD) from British Columbia, Canada. From a population based cohort of 720,055 British Columbians, they matched on age and sex to assemble 7,743 Osteoarthritis (OA) patients and 23,229 non OA controls. They found that people with OA had a higher risk of developing CVD compared to people without OA. Approximately 41% of the total effect of OA on increased CVD risk was mediated through NSAID. Among the secondary outcomes, the proportion mediated through NSAID was 23%, 56% and 64% for CHF, IHD and stroke, respectively. Atiquazzaman et al. Role of Non Steroidal Anti Inflammatory Drugs (NSAIDs) in the Association between Osteoarthritis and Cardiovascular Diseases: A Longitudinal Study. Arthritis & Rheum. 2019. TIME TO RETHINK LASLETT’S CRITERIA FOR DETECTING SIJ PROBLEMS... Participants underwent fluoroscopically guided SIJ intra-articular injection with 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg. Patients’ pain was assessed via 0–10 NRS pre-injection and immediately post-injection to determine positive anaesthetic response to the injection. Six physical exam manoeuvres (thigh thrust, Geanslen’s test, FABER test, distraction test, compression test, and sacral thrust) were performed pre-injection and 15 minutes post-injection. The results of these SIJ physical exam manoeuvres were evaluated singly and in combinations for diagnostic power in relation to a positive anaesthetic response (>80% relief) to the injection. No association was found between a single SIJ physical exam manoeuvre or combination of manoeuvres and anaesthetic response to the injection. The authors concluded that in this cohort, patient physical exam manoeuvres to identify intra-articular SIJ pain did not demonstrate diagnostic value when compared with the reference standard of an intra-articular anaesthetic block.
And Furthermore... LIFESTYLE AND CANCER INCIDENCE AND MORTALITY RISK In this prospective study using two Swedish cohorts— the Malmö Diet and Cancer Study (N=25,604) and the Malmö Preventive Project (N=16,216)— researchers assessed the magnitude of the link between a favourable lifestyle (based on non-smoking, normal-weight, absence of excessive drinking, regular physical activity, and healthy diet) and cancer incidence and mortality risk by using Cox regression stratified by family history of cancer (all types). A 22% and 40% lower risk of cancer incidence and mortality, respectively, was observed in relation to a favourable lifestyle vs an unfavourable lifestyle. Family history did not significantly modify these links, but subjects with ≥ 2 affected first-degree relatives exhibited a null link between lifestyle and cancer incidence. Overall, attenuated cancer incidence and mortality risk in the general population may be achieved by improving adherence to cancer prevention recommendations. Drake I, et al. Lifestyle and cancer incidence and mortality risk depending on family history of cancer in two prospective cohorts. International Journal of Cancer | May 15, 2019. TAX A SUGAR-SWEETENED BEVERAGE AND WATCH THE SALES FALL . . . . Researchers examined how beverage prices and volume of sales were influenced by the implementation of a beverage excise tax on sugar-sweetened and artificially sweetened beverages, which took effect in Philadelphia in 2017. According to findings, the beverage excise tax on sugar-sweetened and artificially sweetened beverages led to a significant rise in beverage prices and a significant decrease in volume sales of
Schneider et al. Validity of Physical Exam Manoeuvres in the Diagnosis of Sacroiliac
taxed beverages, although purchases in
Joint Pathology. Pain Medicine, 2019.
changes in sales volume.
neighbouring areas partially offset the Roberto CA, et al. Association of a beverage tax on sugar-sweetened and artificially sweetened beverages with changes in beverage prices and sales at chain retailers in a large urban setting. JAMA | May 16, 2019
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CA NEWS SEPTEMBER 2019
