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Acupuncture for managing phantom-limb syndrome: a systematic review

Bibliographic details: Mannix SM, O'Sullivan C, Kelly GA.  Acupuncture for managing phantom-limb syndrome: a systematic review. Medical Acupuncture 2013; 25(1): 23-42

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Drugs to treat phantom limb pain in those with missing limbs

Various medications have been tried in phantom limb pain but good treatment continues to be unsatisfactory. Whether opioids, N‐methyl D‐aspartate (NMDA) receptor antagonists (e.g. ketamine, memantine, dextromethorphan), anticonvulsants, antidepressants, calcitonin and anaesthetics are effective in improving outcomes that include pain, function, mood sleep, quality of life, satisfaction and safety, in the short‐ and long‐term, remains uncertain. Morphine, gabapentin, and ketamine provided short‐term pain relief but the findings were based mostly on small studies. The results for calcitonin and anaesthetics were variable. Considerable differences in the drugs, methods, designs, outcomes, outcome measures, follow‐ups, analyses, and reporting/presenting of findings made it difficult to combine results for the interventions and outcomes. Results must be interpreted with caution as these relied on a few studies with small numbers of study participants and lacked long‐term efficacy and safety data. Good quality studies with sufficient sample size, longer follow‐ups and with outcomes that are important to patients are needed to make firmer recommendations to enable good advice on the best pain relief for this patient population.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

A systematic literature review of quality of life in lower limb amputees

PURPOSE: To systematically review studies on quality of life (QoL) in lower limb amputees.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Neuropathic Pain: The Pharmacological Management of Neuropathic Pain in Adults in Non-Specialist Settings

This clinical guideline covers the management of neuropathic pain conditions in adults (aged 18 or over) in primary care and secondary care, excluding specialist pain management clinics. The aim of the guideline is to provide clear recommendations to healthcare professionals in non-specialist settings on the treatment and management of neuropathic pain. This includes recommendations on appropriate and timely referral to specialist pain services and/or condition-specific services. In general, regarding neuropathic pain as a ‘blanket condition’, irrespective of the underlying cause, is helpful and practical for both non-specialist healthcare professionals and patients. However, condition-specific recommendations and research recommendations have been made where robust evidence on clinical and cost effectiveness exists for specific conditions, or where the evidence is clearly uncertain. The guideline excludes acute pain arising directly (in the first 3 months) from trauma or orthopaedic surgical procedures.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: March 2010
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Pain in Patients with Polytrauma: A Systematic Review [Internet]

Polytrauma is defined in the VHA Polytrauma Rehabilitation Centers Directive dated June 8, 2005 as: “injury to the brain in addition to other body parts or systems resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability.” The definition of polytrauma has since expanded to include concurrent injury to two or more body parts or systems that results in cognitive, physical, psychological or other psychosocial impairments. Traumatic Brain Injury (TBI) often occurs in polytrauma and in combination with other disabling conditions including amputation, auditory or visual impairments, spinal cord injury (SCI), post-traumatic stress disorder (PTSD), and other mental health conditions.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: September 2008
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Drug Class Review: Long-Acting Opioid Analgesics: Final Update 6 Report [Internet]

We compared the effectiveness and harms of long-acting opioids and of long-acting opioids compared with short-acting opioids in adults with chronic noncancer pain.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2011
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Drug Class Review: Drugs for Fibromyalgia: Final Original Report [Internet]

We compared the effectiveness and harms of tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic reuptake inhibitor, norepinephrine and dopamine reuptake inhibitor, serotonin receptor antagonist, antiepileptic drugs, and skeletal muscle relaxants in adults with fibromyalgia.

Drug Class Reviews - Oregon Health & Science University.

Version: April 2011
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Evidence Map of Acupuncture [Internet]

Many Veterans desire complementary and alternative medicine or integrative medicine modalities such as acupuncture, both for treatment and for the promotion of wellness. However, the effectiveness and adverse events associated with acupuncture are not firmly established. Given the VA's desire to promote evidence-based practice, this evidence mapping project will help provide guidance to VA leadership about the distribution of evidence to inform policy and clinical decision making.

Evidence-Based Synthesis Program - Department of Veterans Affairs.

Version: January 2014
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Drug Class Review: Neuropathic Pain: Final Update 1 Report [Internet]

We compared the effectiveness and harms of anticonvulsants, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors (SNRIs), and the lidocaine patchin adults with neuropathic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2011
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EOS 2D/3D X-ray Imaging System: A Systematic Review and Economic Evaluation

EOS is a biplane X-ray imaging system manufactured by EOS Imaging (formerly Biospace Med, Paris, France). It uses slot-scanning technology to produce a high-quality image with less irradiation than standard imaging techniques.

Health Technology Assessment - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: March 2012

Anti-nerve growth factor in the treatment of low back pain and radiculopathy: a systematic review and a meta-analysis

BACKGROUND: Low back pain with or without radiculopathy is an important cause of disability and economic expenditure. However, many patients are not meeting optimal pain control through existing treatments. Recent studies have linked nerve growth factor (NGF) and the pathophysiology of persistent pain. Anti-NGF could be an alternative drug treatment for low back pain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects

The review concluded that opioids are superior to placebo for pain relief and functional outcomes in all types of chronic noncancer pain; non-opioids are superior to weak opioids for functional outcomes; strong opioids are superior to non-opioids for pain relief; and constipation and nausea occur more commonly with opioids. The conclusion appears reliable according to the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Ketamine in chronic pain management: an evidence-based review

This review assessed the effectiveness of ketamine for chronic pain. The authors concluded that there is moderate to weak evidence about ketamine and that further controlled trials are required. The lack of a validity assessment and the inadequate reporting of the methods used to conduct the review hamper an assessment of the evidence. The studies were generally of a poor quality, so the evidence is weak.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Anticonvulsants for tinnitus

Tinnitus is the perception of sound or noise in the absence of external acoustic stimulation. It is a common and potentially distressing symptom for which no adequate therapy exists. The pathophysiology of tinnitus has been compared to phantom limb pain therefore anticonvulsant drugs have been proposed as a possible therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Lacosamide for neuropathic pain and fibromyalgia in adults

Antiepileptic drugs like lacosamide are commonly used for treating neuropathic pain, usually defined as pain due to damage to nerves. This would include postherpetic neuralgia (persistent pain experienced in an area previously affected by shingles), painful diabetic neuropathy, nerve injury pain, phantom limb pain and trigeminal neuralgia; fibromyalgia also responds to some antiepileptic drugs. This type of pain can be severe and long‐lasting, is associated with lack of sleep, fatigue, depression and a reduced quality of life. This review included five studies in painful diabetic neuropathy (1863 participants) and one in fibromyalgia (159 participants). In people with painful diabetic neuropathy, lacosamide had only a modest effect, with a specific effect due to its use in 1 person in 10. This is a minor effect and may be an over‐estimate due to use of the last observation carried forward method for analysis. There was insufficient information in fibromyalgia to draw any conclusions about the effect of lacosamide. There was no significant difference between lacosamide and placebo for participants with any, or a serious, adverse event, but there were significantly more adverse event withdrawals with lacosamide. Regulatory authorities have not licensed lacosamide for treating pain based on evidence presently available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Assessment and Management of Acute Pain in Adult Medical Inpatients: A Systematic Review [Internet]

Poor pain management in surgical settings is known to be associated with slower recovery, greater morbidity, longer lengths of stay, lower patient satisfaction, and higher costs of care, suggesting that optimal pain care in these settings is of utmost importance in promoting acute illness management, recovery, and adaptation. VA/DoD Clinical Practice Guidelines have been developed for the management of acute post-operative pain, although the basis for many of the recommendations was by expert consensus rather than empirical evidence.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: April 2008
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Pain (PDQ®): Health Professional Version

Expert-reviewed information summary about pain as a complication of cancer or its treatment. Approaches to the management and treatment of cancer-associated pain are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: September 3, 2014

Bacterial Meningitis and Meningococcal Septicaemia: Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care

This guideline covers bacterial meningitis and meningococcal septicaemia, focusing on management of these conditions in children and young people aged younger than 16 years in primary and secondary care, and using evidence of direct relevance to these age groups where available.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2014

Drug Class Review: Antiepileptic Drugs for Indications Other Than Epilepsy: Final Report Update 2 [Internet]

Antiepileptic drugs have been used beyond treatment of seizure disorders since the 1960s. As new antiepileptic drugs have become available, there has been interest in how they compare with older therapies (carbamazepine, phenytoin, and valproate) and each other in disorders where conventional pharmacotherapy has typically been suboptimal and limited by drug-related toxicity. The objective of this report is to evaluate the comparative effectiveness and harms of antiepileptic drugs used for bipolar disorder, fibromyalgia, migraine prophylaxis, and chronic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
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