Conditions

Fibromyalgia: Comparative Effectiveness of Drugs

San Jose Care Resource Guide: The study we are linking you to is mostly about  pregabalin (Lyrica) and gabapentin (Neurontin). Study is from the Journal of Pain

The study’s conclusion is not enthusiastic:  “…We conclude that pregabalin and gabapentin are modestly effective for the treatment of fibromyalgia but that their long-term safety and efficacy remain unknown….”

Background:

• Pregablin/Lyrica                       click here for wikipedia article
• Gabapentin/Neurontin        click here for wikipedia article

Another  article from Medscape Today gives more detailed information about what the FDA approved for Fibromyalgia Treatments ”Recent Advances in the Treatment of Pain Associated With Fibromyalgia: FDA-approved Medications” Click here for article

Note the medscape article brings in SNRI ( Serotonin–Norepinephrine Reuptake Inhibitor) like duloxetine, milnacipran

That brings two classes of drug treatment against Fibromyalgia

• anti epileptic
• SNRI
  • The efficacy of SNRI sounds also moderate, click here for expert opinion in PubMed

Conclusions:  Some medicines are there  against fibromyalgia, but with moderate efficacy

Talk to your doctor..

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Severe Migraines: Injections of botulinum toxin (Botox) to prevent chronic migraine sufferers

San Jose Care Resource Guide: Botox has gained traction as a severe chronic migraine treatment. The Wall stree Journal has published an article on this. 

 San Jose Care Resource Guide: So, does it work?   Results are mixed but for some people it might help.

Quoting the WSJ: “…Botulinum toxin is a bacterial protein that scientists say blocks chemicals responsible for muscle contractions and pain….”

Let us go to the FDA’s anouncement of it’s approval of Botox as a treatment for certain kind of  chronic migraines, click here

Quoting the FDA:

“…Migraine usually begins with intermittent headache attacks 14 days or fewer each month (episodic migraine), but some patients go on to develop the more disabling chronic migraine. ….To treat chronic migraines, Botox is given approximately every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. Botox has not been shown to work for the treatment of migraine headaches that occur 14 days or less per month, or for other forms of headache..”

Then again the FDA issued ”Drug Safety”  warnings about botulinum toxin treatments:

“Information for Healthcare Professionals: OnabotulinumtoxinA (marketed as Botox/Botox Cosmetic), AbobotulinumtoxinA (marketed as Dysport) and RimabotulinumtoxinB (marketed as Myobloc)” Click Here for FDA warning

Overview of the litterature:

1. Method of injection of onabotulinumtoxinA for chronic migraine ,  Headache Center of Southern California.  Quoting them:’..have yielded insight into appropriate patient selection, injection sites, dosages, and technique. Initial approaches used a set of fixed sites for the pericranial injections…” Mmmm.., pericranial injections.., that tells you that Botox injections method weeds out your casual migraine sufferers..
2. OnabotulinumtoxinA for treatment of chronic migraine: results from the PREEMPT 2 trial.
3. A double-blind comparison of onabotulinumtoxina (BOTOX) and topiramate (TOPAMAX) for the prophylactic treatment of chronic migraine
   1. ==>” ….OnabotulinumtoxinA and topiramate demonstrated similar efficacy in the prophylactic treatment of CM. Patients receiving onabotulinumtoxinA had fewer Adverse Events and discontinuations..”

Serious treatment for a serious problem

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Possible causes of high blood sugar or hyperglycemia, besides Diabetes.

San Jose Care Resource Guide: “Wrong Diagnosis” is actually a website disseminating medical news. It’s post about possible  hyperglycemia (High Blood Sugar)  has actually a very long and varied list of causes, aside for diabetes.  Click Here for link.

San Jose Care Resource Guide: So if the reason is not diabetes, one could be in for  a  wait before the cause is found….

Talk to your Doctor

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Diabetes: Foot Care Vigilance Is a Must!

SJCRG: This article from French hospitals (sciencedirect) about  diabetic foot infections is not good news:

Quoting: “..In spite of being managed at specialized centres that were, in general, following the agreed-upon published guidelines, the prognosis for diabetic foot infection remains poor, with a high rate (48%) of lower-limb amputation”

Caregivers and Care recipients must be vigilant and react quickly: Better waste a doctor’s visit than being sorry..

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Caregiving Skills For Dementia (Lippincott’s Nursing Center)

San Jose Care Resource Guide:  This is a very rich article from the Lipingcott’s Nursing Center on dementia in its various forms. Essentially a class  for nurses , but family caregivers will benefit immensely from the information. Click Here for link

San Jose Care Resource Guide: Here are some of the  topics

• COMMON TYPES OF DEMENTIA
•  NURSING CARE MODELS (Techniques for interaction with a person afflicted with Dementia)
• INTERVENTIONS ( What can be done to improve the situation)
  • Illustrative examples of cases and what was done
  • Responses to specific dementia issues such as
    •  agitation
    • withdrwal
    • apathy

One of the best article we have seen in a long time!

Dementia Caregiving: Poor Skills=Frustration + Depression!

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FDA and Compounded Drugs

SJCRG:  Heard abound  drugs “compounded” by your pharmacist? They are custom made drug combinations made a MD’s orders.

Here is an interesting FDA video about such compounds

Seems that the pharmacy’s credentials are key and that the MD is taking on a lot of responsability. But sometimes there are not too many choices.

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Natalizumab [Tysabri] therapy increases the percentage of patients showing stable or even ameliorated electrophysiological response (pubmed)

San Jose Care Resource Guide: 

In a nutshell: The study, posted in pubmed, is talking about possible improvement of nerve response time. or  evoked potential [WebMD].    As WebMD says , evoked potential is a fancy name for the time it takes for your nerves to respond to stimuli.

Sounds like  healing!

Talk to your Doctor

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Multiple Sclerosis: Endurance Horse Riders Are Riding with MS! (4UALL)

SJCRG: Butter Bea and  Alexandra North are two endurance horse riders with MS

Quoting 4UALL: 

• “….Last year, Butter Bea finished in the top ten, 21 out of 27 races. At the end of the racing season, she ran six races in less than a month, and won five of those six races. After four years of intensive training, Butter Bea has become an endurance machine with a competitive spirit that can be crushing at times.”
•  …. Alexandra North took up the sport of endurance riding in 1995, just a few months before she was diagnosed with multiple sclerosis. She is now in remission, which she credits to endurance riding.

Brave Riders!

Link to  4UALL for the fascinating article.

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Status of Complementary and Alternative Medicines (CAM) and their effectiveness

SJCRG: Here is a link to a study on CAMs   CAM stands for Complementary and Alternative Medicine

The main merit of  the abstract is to give a nice breakdown of the therapies:

Quoting  “…..

1. .. alternative medical systems (eg, traditional Chinese medicine [including acupuncture], naturopathic medicine, Ayurvedic medicine, and homeopathy);
2.  biologic-based therapies (eg, herbal, special dietary, and individual biologic treatments);
3.  energy therapies (eg Reiki, therapeutic touch, magnet therapy, Qi Gong, and intercessory prayer);
4.  manipulative and body-based systems (eg, chiropractic, osteopathy, and massage);
5.  mind-body interventions (eg, meditation, biofeedback, hypnotherapy, and the relaxation response).

              …”

SJCRG: Here is a link to the NCAM’s  (National Center for CAM)  more detailed  take on the various CAM. This a large site covering everything with an eye toward safety

SJCRG: A good example of a subset of NCAM is their CAM and Pain Discussion  

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Darvon and Darvocet Pulled From Market Over Heart Problems

SJCRG: Follow this link to the injuryboard. This is after a FDA request. Seems risks greater than benefits

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