Tag Archives: research

Evidence for Health Decision Making — Beyond RCTs

Evidence for Health Decision Making — Beyond Randomized, Controlled Trials — NEJM

A core principle of good public health practice is to base all policy decisions on the highest-quality scientific data, openly and objectively derived.

Although randomized, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources.   Continue reading

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A Sound Approach to Pain Relief?

A Sound Approach to Pain Relief? | Pain Research Forum – Sep 2017

Traditionally, local anesthetics are used in the treatment of acute pain but are often administered as a single, large injection and work only for a relatively brief time.

A new study aims to overcome this limitation with a novel delivery platform for local anesthetics that enables on-demand pain relief whose timing, intensity, and duration can be controlled.

The researchers, led by Daniel Kohane, Boston Children’s Hospital, Harvard Medical School, US, used liposomes, which are small sacks of phospholipid molecules surrounding an aqueous solution, to encapsulate the sodium channel blocker and local anesthetic tetrodotoxin (TTX) along with protoporphyrin IX (PPIX); the latter is a “sonosensitizer” that makes the liposome sensitive to effects of sound.  Continue reading

What We Mean by Evidence-Based Medicine

What We Mean When We Say Evidence-Based Medicine – The New York Times– Dec. 27, 2017 – By Aaron E. Carroll

In medicine, the term “evidence-based” causes more arguments than you might expect. The mission of “evidence-based medicine” is surprisingly recent.

Before its arrival, much of medicine was based on clinical experience. Doctors tried to figure out what worked by trial and error, and they passed their knowledge along to those who trained under them.

Considering the current proliferation of guidelines for all kinds of medical care, perhaps the old method wasn’t so bad…   Continue reading

Different Disorders, Same Pain

Brain Changes May Explain Chronic Pain Symptoms in Different Disorders – August 23, 2017 In Fibromyalgia, Newsby Patricia Inacio, PhD

Even though fibromyalgia and urological chronic pelvic pain syndrome (UCPPS) are different disorders, new research suggests that patients suffering from these conditions may actually share alterations to the brain, perhaps explaining why certain UCPPS patients exhibit fibromyalgia characteristics, such as widespread pain.

The study “Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study” was published in the journal Pain.   Continue reading

How Do We Know What Treatment Works?

How Do We Know What Treatment Works? – National Pain Report

We’re often told that alternative medicine is unproven and pharmacological treatments are well validated. Is this true?

It’s important for patients to understand

  • the many factors that go into creating the body of medical evidence available,
  • the degree of reliability of that information, and
  • its applicability to their specific situation.

I used to believe that “evidence-based medicine” was a good idea. Then I began noticing how poorly designed and numerically manipulated so much of the research is.  Continue reading

Novel Opioid: Faster Onset & Fewer Adverse Events

Novel Opioid Has Faster Onset of Pain Relief, Leads to Fewer Adverse Events – Pain Medicine News – Oct 2017 – by Chase Doyle

An investigational agent designed to improve conventional opioid pharmacology has demonstrated efficacy and safety, as well as onset of action, in a pair of pivotal trials.

Compared with placebo, patients receiving IV oliceridine (TRV130, Trevena), a novel mu-receptor G protein pathway–selective (mu-GPS) modulator, experienced superior relief following bunionectomy or abdominoplasty

Oliceridine also showed favorable trends in respiratory safety and upper gastrointestinal tolerability compared with morphine. Continue reading

Research: Lab Mice not like Wild Mice not like Humans

The comparative immunology of wild and laboratory mice, Mus musculus domesticus : Nature Communications – May 2017

We often forget that much health research is performed on what is supposed to be a functionally equivalent species: the lab mouse.

This article details the differences found between immune systems that are exposed to “real life” versus those isolated in a lab. I believe this might also apply to humans who grow up too sheltered from the environment.

Wild mice are immunologically different from laboratory mice. Continue reading

Connections in the Brain: It’s All About the Astrocytes

Connections in the Brain: It’s All About the Astrocytes – OCT 17, 2017 By Brenda Kelley Kim

When it comes to brain function, it’s all about the connections. The brain contains billions of neurons that communicate with each other.

This network of cells has to be able to connect and share messages, otherwise, the entire body is disrupted since the brain is the command center for everything we do.

Neurons are the workhorses of the brain, but they aren’t the only cell in the picture.   Continue reading

Science is often flawed. It’s time we embraced that.

Science is often flawed. It’s time we embraced that. – Vox – by Julia Belluz and Steven Hoffman on May 13, 2015

In his book Derailed, about his fall from academic grace, the Dutch psychologist Diederik Stapel explained his preferred method for manipulating scientific data in detail that would make any nerd’s jaw drop:

“I preferred to do it at home, late in the evening… I made myself some tea, put my computer on the table, took my notes from my bag, and used my fountain pen to write down a neat list of research projects and effects I had to produce…. Subsequently I began to enter my own data, row for row, column for column…3, 4, 6, 7, 8, 4, 5, 3, 5, 6, 7, 8, 5, 4, 3, 3, 2. When I was finished, I would do the first analyses. Often, these would not immediately produce the right results. Back to the matrix and alter data. 4, 6, 7, 5, 4, 7, 8, 2, 4, 4, 6, 5, 6, 7, 8, 5, 4. Just as long until all analyses worked out as planned.”  

Continue reading

Inflammation trains the skin to heal faster

Inflammation trains the skin to heal faster | EurekAlert! Science News

Scars may fade, but the skin remembers. New research from The Rockefeller University reveals that wounds or other harmful, inflammation-provoking experiences impart long-lasting memories to stem cells residing in the skin, teaching them to heal subsequent injuries faster.

These stem cells, which replenish the skin’s outer layer take their cue from inflammation, the body’s own response to injury or infection.

The first bout of inflammation sensitizes these cells: the next time they sense it coming on, they respond more rapidly.  Continue reading