Features

Migraine & Headache Is Modern Urban Design Triggering Headaches?

Is Modern Urban Design Triggering Headaches?

The design of buildings has been departing further and further from the rule of nature; more and more stripes appear decade by decade, making the buildings less and less comfortable to look at.

Regulatory Issues Threats Posed by Congressional Acts to National Health Initiatives

Threats Posed by Congressional Acts to National Health Initiatives

Passage of the Consolidated Appropriations Act and of the AHCA leaves large holes in the funding of the proposed national approach to infectious disease control.

Case Studies Case Study: Fever, Low Platelets and Right-Sided Abdominal Pain

Case Study: Fever, Low Platelets and Right-Sided Abdominal Pain

A 66-year-old woman with a history of sarcoidosis and hypertension presents to the ED for 4 days with right-sided abdominal pain, vomiting, fever, and mild diarrhea without blood.

Regulatory Issues Reasons Why the Affordable Care Act is Wrongly Blamed for Increased Premiums

Reasons Why the Affordable Care Act is Wrongly Blamed for Increased Premiums

If the employer's plan is deemed unaffordable, families and individuals now have the ability to purchase insurance at a lower cost through the ACA marketplace.

Migraine & Headache Hemiplegic Migraine: Leveraging Genetic Susceptibilities to Identify Treatment Targets

Hemiplegic Migraine: Leveraging Genetic Susceptibilities to Identify Treatment Targets

While migraine is often triggered by environmental factors such as stress, impaired sleep, and menstruation, recent findings have shed light on the significant genetic influence associated with the disorder.

Regulatory Issues Concerns Over The American Health Care Act

Concerns Over The American Health Care Act

On May 4, 2017, the House of Representatives passed the American Health Care Act by a narrow margin, even though the Congressional Budget Office had not officially reviewed and reported on the bill's impact.

Practice Management Medical Practices: How to Improve Your Collection Rates

Medical Practices: How to Improve Your Collection Rates

A host of factors affect a practice's revenue cycle, but none more important perhaps than the adjusted collection rate.

Treatments Defining Cancer Treatment Cost-Effectiveness

Defining Cancer Treatment Cost-Effectiveness

Value-based care, an increasingly important concept in oncology, is grounded on the relationship between the efficacy and cost of an anticancer drug.

Psychogenic Pain Dr Beth Darnall on Changing Mindset for Pain Relief

Dr Beth Darnall on Changing Mindset for Pain Relief

A negative pain mindset - catastrophizing - undermines pain treatment effectiveness and facilitates structural brain changes that serve to maintain pain and distress.

Practice Management Modern Sexism in Medicine: a Q&A

Modern Sexism in Medicine: a Q&A

We are lagging in terms of regulating work hours and wellness. We are behind in getting help for physicians suffering from addiction and depression. We are behind in demanding better pay, and we continue to tolerate pay cuts despite our rising costs.

Regulatory Issues Direct-to-Consumer Genomic Testing Pros and Cons: Q&A

Direct-to-Consumer Genomic Testing Pros and Cons: Q&A

Cancer Therapy Advisor asked Dr Roberts about the PGen Study and the implications for DTC cancer risk testing in the future.

Practice Management Medical Liability Reform in a Rapidly Changing Healthcare Environment

Medical Liability Reform in a Rapidly Changing Healthcare Environment

Medical liability is one of the most troubling issues in medicine today, resulting in a heavy burden of patient mortality and injury.

Migraine & Headache Arteriovenous Malformations-Related Headache Identification, Treatment

Arteriovenous Malformations-Related Headache Identification, Treatment

The mechanisms underlying the link between unruptured AVM and headache are unclear, and it is difficult to differentiate AVM-associated headaches with headaches of other origins.

Treatments Aspirin Use and Cancer Risk

Aspirin Use and Cancer Risk

Aspirin use and cancer has primarily been evaluated by observational studies, which may have substantial bias.

Practice Management Ways to Improve the Doctor-Patient Relationship

Ways to Improve the Doctor-Patient Relationship

Important aspects of patient care, such as empathy, relationship-building, and dealing with patients' emotions are often given less emphasis in medical schools.

Practice Management Addressing Barriers for Aging LGBTQ Patients

Addressing Barriers for Aging LGBTQ Patients

When working with patients, it is important to consider their sexual orientation and gender identity to ask the right questions and provide the best care possible.

Practice Management Curbside Consulting in Medicine: Legal Boundaries

Curbside Consulting in Medicine: Legal Boundaries

Some courts have ruled that if no medical decision or treatment decision is offered, a physician-patient relationship is not created, and no responsibility for the physician's fate is transferred.

Regulatory Issues Health Law Expert on the Current State of Medical Malpractice: a Q&A

Health Law Expert on the Current State of Medical Malpractice: a Q&A

As US citizens continue to adjust to the changing political landscape, many in the medical field are wondering whether now may be the right time for medical malpractice reform.

Migraine & Headache Vestibular Rehabilitation an Effective Treatment for Vestibular Migraine

Vestibular Rehabilitation an Effective Treatment for Vestibular Migraine

Vestibular rehabilitation was found to ameliorate headache, dizziness, and psychological factors in patients with vestibular migraine or a combination of tension-type headache and dizziness.

Regulatory Issues New Bill to Tackle Antibiotic Resistance

New Bill to Tackle Antibiotic Resistance

Congress will now be addressing the problem of antibiotic resistance with a bill introduced to the US House of Representatives on March 30, 2017.

Rheumatology Rheumatoid Arthritis: Risk Factors, Diagnosis, and Treatment

Rheumatoid Arthritis: Risk Factors, Diagnosis, and Treatment

This article discusses the most prevalent risk factors, as well as the clinical signs and symptoms, associated with RA.

Migraine & Headache Female Reproductive Stages and Migraine

Female Reproductive Stages and Migraine

The estimated overall prevalence of migraine is 18% in women and 6% in men, and the rate is as high as 37% among women during the reproductive years.

Regulatory Issues Improving Care for Medicaid Consumers Under the ACA

Improving Care for Medicaid Consumers Under the ACA

The challenges to providing optimal levels of healthcare for people using Medicaid systems are many-fold.

Practice Management Knowing When to Make a Referral

Knowing When to Make a Referral

Knowing when to make a referral and when to look more carefully into a patient's problems on your own is difficult. However, it is important to consider all options when diagnosing a patient.

AAPM 2017 Annual Meeting Strategies to Prevent the Transition From Postoperative Acute Pain to Chronic Pain

Strategies to Prevent the Transition From Postoperative Acute Pain to Chronic Pain

A number of shortcomings are associated with systematic reviews and meta-analyses of postoperative care.

Chronic Pain Thoracic Outlet Syndrome: Diagnosis, Clinical Management

Thoracic Outlet Syndrome: Diagnosis, Clinical Management

Once a poorly understood and heavily debated disease within cardiovascular medicine, thoracic outlet syndrome has recently been recognized as a more common syndrome than previously thought.

Case Studies Chest Pain Radiating Into the Neck

Chest Pain Radiating Into the Neck

A 44-year-old man presents to his local urgent care clinic for chest pain radiating up into his neck. He states that the pain started 5 hours ago and is gradually getting worse.

Practice Management How to Protect Yourself From Lawsuits Under EMTALA

How to Protect Yourself From Lawsuits Under EMTALA

Under the law, hospitals with EDs must provide for "an appropriate medical screening examination within the capability of the hospital's ED" to determine if an emergency medical condition exists.

Complementary and Alternative Medicine Frankincense Effective on Osteoarthritis Pain

Frankincense Effective on Osteoarthritis Pain

One of the more exciting potential uses of frankincense is in the treatment of cancer.

Practice Management HIPAA Fines to be Accompanied by Corrective Action Plans

HIPAA Fines to be Accompanied by Corrective Action Plans

The Office for Civil Rights in the US Department of Health and Human Services has progressively increased fines for health care providers who experience HIPAA breaches.

Neuropathic Pain Neuropathic Pain Complexity Requires Thoughtful Approach and Combination of Interventions

Neuropathic Pain Complexity Requires Thoughtful Approach and Combination of Interventions

The wide range of etiologies underlying neuropathic pain render it a particularly challenging condition to manage.

Practice Management Reporting Negative Data in Clinical Trial Results

Reporting Negative Data in Clinical Trial Results

Increasingly, the scientific community is coming to realize the invaluable role that negative outcomes play in the understanding of medicine as a whole.

Practice Management Informed Consent in Medical Research: A Q&A

Informed Consent in Medical Research: A Q&A

New methods of obtaining consent are offering options that can bridge the geographic distances between researcher and participant, while making study information more easily accessible.

Neuropathic Pain Diabetic Neuropathy: Updated Position Statement by the American Diabetes Association

Diabetic Neuropathy: Updated Position Statement by the American Diabetes Association

The American Diabetes Association released an updated position statement on the prevention, detection, and management of diabetic neuropathies.

Neuropathic Pain Assessing Biomarker Validity for Neuropathic Pain

Assessing Biomarker Validity for Neuropathic Pain

A challenge facing clinicians regarding the diagnosis of small fiber neuropathies lies in the scarcity of objective biomarkers.

Regulatory Issues Senator Cruz's Arguments on the Affordable Care Act

Senator Cruz's Arguments on the Affordable Care Act

On February 7, 2017, CNN hosted an interesting debate between Bernie Sanders, Independent senator of Vermont, and Ted Cruz, Republican senator from Texas, regarding the future of the Affordable Care Act.

Opioid Addiction Opioid Prescribing Guidelines for Chronic, Non-Cancer Pain

Opioid Prescribing Guidelines for Chronic, Non-Cancer Pain

The American Society of Interventional Pain Physicians (ASIPP) has issued updated opioid prescribing guidelines for the management of patients with chronic, non-cancer pain.

Rheumatology CMV Connection With RA Cardiovascular Disease Risk: An Expert Interview

CMV Connection With RA Cardiovascular Disease Risk: An Expert Interview

The cause of the RA-CVD link is unclear, although viral infection has been implicated in some studies.

Practice Management Active Medical Device Safety Surveillance

Active Medical Device Safety Surveillance

The large number of recalls of medical devices has pointed to a need for more active monitoring of product performance from the standpoints of both safety and efficacy.

Rheumatology Marine Oil Supplementation for Rheumatoid Arthritis

Marine Oil Supplementation for Rheumatoid Arthritis

Omega-3 fatty acids reduce the production of pro-inflammatory cytokines.

Practice Management FDA Guidance on Medical Product Marketing Communication

FDA Guidance on Medical Product Marketing Communication

The FDA released guidance to establish standards for communications about products.

Fibromyalgia Juvenile Fibromyalgia Pain Treatment Enhanced By Psychosocial Impact Therapies

Juvenile Fibromyalgia Pain Treatment Enhanced By Psychosocial Impact Therapies

Novel psychosocial therapies such as cognitive behavioral therapy that have been effective in adults with fibromyalgia need additional neuromuscular fitness training to overcome catastrophizing and fear of exercise in adolescents.

Mental Illness Suicide Prevention and Intervention: Considering Cultural Differences

Suicide Prevention and Intervention: Considering Cultural Differences

Despite the clear role of culture in suicidal behavior, it is often neglected by clinicians.

Sports & Overuse Injury Accounting for Gender Differences in Concussion Diagnosis and Treatment

Accounting for Gender Differences in Concussion Diagnosis and Treatment

Female athletes at higher risk for concussion and worse related outcomes than male athletes.

Opioid Addiction Identifying Patients With Higher Methadone Dose Requirements

Identifying Patients With Higher Methadone Dose Requirements

Polymorphism at the level of drug receptors, transporters, or other proteins involved in drug metabolism or action may have an impact on the effect of a drug.

Practice Management Are Conflicts of Interest in Patient Advocacy Groups Common?

Are Conflicts of Interest in Patient Advocacy Groups Common?

Patient advocacy organizations serve a number of valuable functions, including funding research, guiding treatment protocols, influencing legislation, and educating patients.

Rheumatology Blueprint for Shared Decision-Making Between Physicians, RA Patients

Blueprint for Shared Decision-Making Between Physicians, RA Patients

Dr Krant discussed some of the issues facing patients with RA.

Regulatory Issues National Academies Report on Health Effects of Cannabis

National Academies Report on Health Effects of Cannabis

In January 2017, the National Academies of Sciences, Engineering, and Medicine released a report titled "The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendation for Research."

Migraine & Headache Homeostasis-related Headaches

Homeostasis-related Headaches

Although the underlying pathophysiology of homeostasis-related headaches is not yet clearly defined, the nervous and endocrine systems are thought to be involved through the maintenance of homeostasis.

Practice Management Integrating Sexual Health in Clinical Care

Integrating Sexual Health in Clinical Care

Healthcare education lacks the fundamentals required to properly address sexual health, leaving providers poorly prepared to support patients.

Practice Management Patient EHR Access: Barriers and Benefits

Patient EHR Access: Barriers and Benefits

Healthcare providers are increasingly offering patients access to their own electronic health records via online portals.

Rheumatology Neurostimulation to Target the Inflammatory Reflex in Rheumatoid Arthritis

Neurostimulation to Target the Inflammatory Reflex in Rheumatoid Arthritis

Vagus nerve stimulation inhibits cytokine production and reduces inflammation, and may be effective for a subset of RA patients.

Neuropathic Pain Intrathecal Therapy for Pain: Updated Guidelines

Intrathecal Therapy for Pain: Updated Guidelines

The Polyanalgesic Consensus Conference updated guidelines regarding the treatment of pain via intrathecal therapy.

Practice Management Keeping up With Business Associate Agreements

Keeping up With Business Associate Agreements

HIPAA clearly states providers should have business associate agreements with vendors that receive, maintain, or transmit protected health information.

Migraine & Headache Ten Steps to Successfully Treat Chronic Daily Headache

Ten Steps to Successfully Treat Chronic Daily Headache

A recent article outlined a 10-step program to assist clinicians in diagnosing and treating chronic daily headache.

Practice Management Curbing Depression in Medical Students

Curbing Depression in Medical Students

"The main changes needed in medical education are primarily structural with pass/fail grading and reduction in class time and amount of information being taught."

Practice Management Maximizing Revenues and Preparing for Payor Changes: Expert Q&A

Maximizing Revenues and Preparing for Payor Changes: Expert Q&A

Joining an Independent Physician Association or an Accountable Care Organization to facilitate data collection, reporting, and coordination of care.

Practice Management Medical Education: Improving Learning and Evaluation for Residents

Medical Education: Improving Learning and Evaluation for Residents

In a recent issue of JAMA focused on medical education, researchers and physicians explore what's working and what's not in medical education.

Practice Management Artificial Intelligence in Medicine: Where We Are and Where We're Going

Artificial Intelligence in Medicine: Where We Are and Where We're Going

From tracking growth to scanning X-rays to reviewing pathology slides, to estimating gestational age from an ultrasound to interpreting whole genome sequences for variants with clinical impact, AIM is going to change the value proposition of clinicians.

Practice Management How Will the Trump Administration Affect the ACA?

How Will the Trump Administration Affect the ACA?

The ACA is likely to be partially or fully repealed, though it is uncertain how physician practices and the benefits of the 20 million newly-insured will be affected.

Chronic Pain Compassion and Chronic Pain

Compassion and Chronic Pain

Compassion directed to self is gaining acceptance as a potential therapeutic modality to complement existing treatment options for chronic pain.

Trauma Pain Differential Diagnosis for TBI, PTSD: a Case for Single-Photon Emission Computerized Tomography

Differential Diagnosis for TBI, PTSD: a Case for Single-Photon Emission Computerized Tomography

The opportunity exists to radically change the way medicine approaches TBI.

Diabetic Neuropathy An Overview of Diabetic Peripheral Neuropathy

An Overview of Diabetic Peripheral Neuropathy

Symptoms of diabetic peripheral neuropathy include lower-extremity weakness, in addition to tingling, pain and burning.

Practice Management Bridging Gaps in Patient Access to Rheumatologists With Telemedicine

Bridging Gaps in Patient Access to Rheumatologists With Telemedicine

Telerheumatology can improve healthcare access, patient outcomes, and costs

Oral & Maxillofacial Pain Cloves for Oral Cavity Pain

Cloves for Oral Cavity Pain

Researchers have found that the main mechanism of action of clove oil is on cell membrane damage.

Chronic Pain How THC Affects the Dopamine System

How THC Affects the Dopamine System

Recent studies show that THC consumption affects the dopamine system.

Regulatory Issues What the FDA Can Do to Help Bring Improved Pain Medicines to the Market

What the FDA Can Do to Help Bring Improved Pain Medicines to the Market

Dr Katz formulated 10 recommendations for the FDA, 3 of which he detailed during his presentation.

Chronic Pain On the Need to Update the Definition of Pain

On the Need to Update the Definition of Pain

While many studies have elucidated some of the intricacies of the chronic pain experience, the definition of pain has not adapted to current knowledge.

Neuropathic Pain Guidelines for the Management of Restless Legs Syndrome

Guidelines for the Management of Restless Legs Syndrome

In the new guidelines, the authors aimed to examine the available data to clarify which pharmacologic and non-pharmacologic treatments are safe and effective for RLS.

Chronic Pain The Influence of Cognitive Processes on Pain Perception

The Influence of Cognitive Processes on Pain Perception

Pain relief through distraction suggests that pain experience can be modified, and highlights the influence cognitive processes have on pain perception.

Regulatory Issues The Issues With Clinical Studies That Impede the Development of New Pain Drugs

The Issues With Clinical Studies That Impede the Development of New Pain Drugs

Drug development faces 2 major issues: pre-clinical animal efficacy studies do not accurately predict human efficacy, and clinical trials often wrongly fail to show drug efficacy.

Chronic Pain Human Studies That Are Advancing Pain Management

Human Studies That Are Advancing Pain Management

Basic research has made vital contributions to all aspects of medical care, including our understanding of pain pathophysiology.

Migraine & Headache Diagnosing and Treating Medication Overuse Headache

Diagnosing and Treating Medication Overuse Headache

Non-medication approaches such as biofeedback and cognitive behavioral therapy may be helpful adjunct therapies and may help with more long-term coping strategies.

Chronic Pain Classifying Chronic Pain Using the American Pain Society's Taxonomy

Classifying Chronic Pain Using the American Pain Society's Taxonomy

Improved classification of chronic pain offers the opportunity to more effectively blend psychological intervention with a biomedical approach to manage chronic pain.

Treatments Pain: a Tale of 3 Systems

Pain: a Tale of 3 Systems

"To understand pain, we need to understand the interaction between the immune, endocrine and nervous systems."

Practice Management Liberalizing Access to Biobanks to Benefit Genomic Research

Liberalizing Access to Biobanks to Benefit Genomic Research

The greater interconnection of biobanks and researchers leads not only to enhanced statistical power, but to greater genetic diversity, expanding the number of people affected by this grand project.

Rheumatology Obesity and Arthritis Outcomes

Obesity and Arthritis Outcomes

Even slight reductions in body weight can improve pain and mobility in patients with arthritis.

Chronic Pain Assessing and Treating Insomnia-Chronic Pain Comorbidities

Assessing and Treating Insomnia-Chronic Pain Comorbidities

A Pain-Related Beliefs and Attitudes about Sleep scale assesses attitudes about sleep among individuals with chronic pain.

Treatments Five New Technologies for Pain Management

Five New Technologies for Pain Management

We explore 5 technologies recently developed to manage pain.

Psychogenic Pain Understanding Fear and Anxiety to Develop Adequate Treatments

Understanding Fear and Anxiety to Develop Adequate Treatments

Fear avoidance has been implicated in the transition from acute to chronic pain. In this model, conditioning contributes to the perpetuation of pain, and it is thought that disruption of conditioning would lead to the path of recovery.

Opioid Addiction The Pros and Cons of 12-Step Groups to Treat Opioid Addiction

The Pros and Cons of 12-Step Groups to Treat Opioid Addiction

"I believe that the best care is individualized care. And the most effective approach is sometimes whatever the patient will actually do," concluded Melanie Storrusten, LCSW.

Chronic Pain Empathy, Exercise, Yoga and Chronic Pain

Empathy, Exercise, Yoga and Chronic Pain

Dr Bushnell suggests practicing yoga, as long-term yogis have higher pain tolerance and increased gray matter—including in pain-modulating brain areas—compared with that of non-practitioners.

Migraine & Headache Research Update on Alternative Migraine Treatments

Research Update on Alternative Migraine Treatments

Spinal cord stimulation, neurotechnology, acupuncture, neurostimulation: all effective in treating migraine, headaches.

Practice Management Women Doctors Code Less, Get Lower Reimbursements

Women Doctors Code Less, Get Lower Reimbursements

A study suggests that female physicians do not use as many codes as their male counterparts, resulting in a reimbursement gap.

Chronic Pain Updated Guidelines on Neurostimulation for Chronic Pain by the European Academy of Neurology

Updated Guidelines on Neurostimulation for Chronic Pain by the European Academy of Neurology

The lack of evidence base for treating chronic pain with neurostimulation resulted in the development of guideline recommendations based on systematic review and meta-analysis of published studies.

Rheumatology Assessing Risk for Cardiovascular Disease in Rheumatoid Arthritis

Assessing Risk for Cardiovascular Disease in Rheumatoid Arthritis

Rheumatology Advisor speaks with Erin Michos, MD, cardiologist at Johns Hopkins School of Medicine, and Eric Matteson, MD, rheumatologist at Mayo Clinic, about refining cardiovascular risk assessment in patients with rheumatoid arthritis.

Chronic Pain Neuroimaging: Applications in Chronic Pain Management

Neuroimaging: Applications in Chronic Pain Management

In the past decade, brain imaging studies have shed light on the neural correlates of pain perception and pain modulation, and recently have also begun to clarify the neural mechanisms that underlie different pain sensations. New developments in functional, structural and neurochemical imaging have advanced understanding of chronic pain, and may help predict individuals with acute pain who are likely to progress to chronic pain.

Pain Comorbidities Dealing With Suicidality-Associated Psychological Pain

Dealing With Suicidality-Associated Psychological Pain

"The clinician's role is to understand the nature, magnitude, intensity, and frequency of that pain."

Chronic Pain Precision Medicine for Chronic Pain

Precision Medicine for Chronic Pain

An emerging clinical strategy for personalized pain management.

AAPM 2015 Stress, the Microbiota and Visceral Pain

Stress, the Microbiota and Visceral Pain

A high proportion of individuals with IBS have comorbid anxiety and depression affecting the HPA axis and microbiota.

Neck Pain Artificial Disc Replacement in 2-Level Cervical Disease: Long Term Outcomes

Artificial Disc Replacement in 2-Level Cervical Disease: Long Term Outcomes

Preservation of motion in the cervical spine

Chronic Pain Mechanisms of Mindfulness Meditation-Induced Analgesia

Mechanisms of Mindfulness Meditation-Induced Analgesia

Common brain regions activated during meditation and pain

Home Lowering Rheumatoid Arthritis Risk in Highly Susceptible Populations Through Patient Education

Lowering Rheumatoid Arthritis Risk in Highly Susceptible Populations Through Patient Education

Assessing epidemiologic and genetic factors among individuals with positive family history of RA may identify those suitable for RA prevention strategies

Chronic Pain New Guideline Issued on Chronic Pain Management in Adult Cancer Patients

New Guideline Issued on Chronic Pain Management in Adult Cancer Patients

New guideline addresses cancer-related chronic pain

Practice Management HIPAA Advocates Protection of Anonymity When Sharing Data With Others

HIPAA Advocates Protection of Anonymity When Sharing Data With Others

Practices should review the list of 18 identifiers and remove each item before sharing data.

Migraine & Headache Functional Neural Connectivity Underlying Pain Experienced in Migraine, Dysmenorrhea

Functional Neural Connectivity Underlying Pain Experienced in Migraine, Dysmenorrhea

Results from studies evaluating various pain modalities indicate alterations within and between resting state functional networks.

Chronic Pain Guidance for Treatment Selection for Severe, Refractory Chronic Pain

Guidance for Treatment Selection for Severe, Refractory Chronic Pain

Intrathecal therapy represents a valuable option for many patients with severe, refractory chronic pain.

Practice Management American Pain Society Issues Guidance on Medical Marijuana for Pain

American Pain Society Issues Guidance on Medical Marijuana for Pain

Advising patients on strains, explaining limitations

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