The Centers for Disease Control and Prevention (CDC) is altering the rules for when health workers who test positive for COVID-19 can return to the job, saying such workers can return after seven days in isolation instead of 10.
The change comes as the U.S. braces for a new wave of coronavirus cases from the heavily contagious omicron variant, which is expected to put new stress on the U.S. health care system.
In a statement, the CDC said that it is recommending a seven-day isolation and quarantine period for workers in that field.
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ASIPP is conducting a survey on the practice patterns of perioperative management covering antiplatelet and anticoagulant therapy in Interventional Pain Management. We last surveyed this topic 10 years ago. We would like to compare the 2011 data to 2021 to see the changes to the practice pattern. Your help is needed to accomplish this!
We recently mailed to you the survey titled Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant in Interventional Pain Management. If you did not complete the survey, please take a few minutes to complete it mail it back to us in the prepaid return address envelope.
If you did not receive the survey, you may download the survey by clicking here. Please complete and e-mail it back to drm@asipp.org or fax to 270.554.5394.
This survey is most important to ASIPP and its members. It will demonstrate how our members practicing Perioperative Management utilize antiplatelet and anticoagulant therapy in pain management procedures. The more members that participate will increase the impact of the survey.
Please complete the survey and mail, e-mail, or fax back as soon as possible.
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Concurrent pain conditions are common in patients who present with chronic low back pain, a new study has concluded.
Researchers at Stanford University found that the combination is associated with significantly worse physical, psychological, social and global health outcomes than for chronic low back pain alone.
“We’ve noticed in our practice that there are certain chronic low back pain patients [who] are more challenging to treat than others,” said Abdullah Sulieman Terkawi, MD, MS, a clinical assistant professor of anesthesiology and pain medicine at the Stanford, Calif., institution. “At the same time, there is growing awareness of chronic overlapping pain syndrome, where patients suffer more than one chronic pain condition.
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Risk to humans seems likely though unconfirmed at this point
About one-third of white-tail deer tested in northeastern Ohio earlier this year were carrying the coronavirus responsible for COVID-19, according to a newly published study.
Out of 360 animals killed and collected by researchers from January to March, 129 were positive for SARS-CoV-2 in PCR testing, reported Andrew Bowman, MS, DVM, PhD, of Ohio State University's College of Veterinary Medicine in Columbus, and colleagues.
Viral gene sequencing indicated that the isolates obtained from these animals were closely related to SARS-CoV-2 variants circulating among humans at the time, the group noted in their paper appearing Thursday in Nature.
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As Omicron surges, the answer could soon be 'for fewer days'
You've gotten your vaccine, you've gotten your booster, and you've been doing all the right things to keep yourself and others around you as healthy as possible during the pandemic.
But as the highly contagious Omicron variant surges in the U.S., public health experts say it's inevitable there will be more breakthrough cases of COVID-19. For the vaccinated and boosted, many of those cases are expected to be mild or asymptomatic.
So, what does that mean for isolation periods that may be disruptive to everyday life and work?
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Many adults at high risk of severe disease could take pill at home to avoid hospitalization
U.S. regulators cleared use of a COVID-19 pill from Merck & Co. and partner Ridgeback Biotherapeutics LP, the latest easy-to-use therapy that infected people can take to keep out of the hospital.
The authorization by the U.S. Food and Drug Administration permits doctors to prescribe the drug, called molnupiravir, to adults at high risk of severe disease shortly after they develop mild to moderate symptoms.
The FDA recommended using the Merck drug only if other authorized drugs aren’t available and medically appropriate. Health experts have raised safety concerns about the Merck drug, which also was less effective in testing than an antiviral from Pfizer Inc. On Wednesday, the FDA cleared the Pfizer pill, Paxlovid, also for people to take at home to try to stay out of the hospital.
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Officials and experts have sounded the alarm over the state of children's mental health as the second pandemic year comes to a close, warning a crisis is emerging - but advocates, hospitals and schools say it may have already arrived.
Short-staffed children's hospitals were slammed with increased emergency department visits for mental health, suicide and self injury cases in the first nine months of 2021 compared to the same period last year.
At the same time, already strained schools with limited resources have been left to face a growing need for mental health assistance as many children returned to in-person school this fall with increased symptoms of depression and anxiety after COVID-19 flipped their worlds upside down.
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Scientists stress that even if the findings of these early studies hold up, any reductions in severity need to be weighed against the fact omicron spreads much faster than delta and is more able to evade vaccines. Sheer numbers of infections could still overwhelm hospitals.
Still, the new studies released Wednesday seem to bolster earlier research that suggests omicron may not be as harmful as the delta variant, said Manuel Ascano Jr., a Vanderbilt University biochemist who studies viruses.
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Scientists at the Walter Reed Army Institute of Research (WRAIR) say they have developed a vaccine that is effective against all the variants of the virus that causes COVID-19, including Omicron and other strains that may not yet exist.
A series of preclinical study results had shown that the vaccine they have developed, known as the Spike Ferritin Nanoparticle (SpFN) COVID-19 vaccine, “not only elicits a potent immune response but may also provide broad protection against SARS-CoV-2 variants of concern as well as other coronaviruses,” researchers in WRAIR’s Emerging Infectious Diseases Branch (EIDB) said in a Dec. 16 statement.
Scientists developed the SpFN nanoparticle vaccine as part of a “forward-thinking pan-SARS strategy that aims to address the current pandemic and acts as the first line of defense against variants of concern and similar viruses that could emerge in the future.”
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To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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Call for
Abstracts & Poster Presentations
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Proposals accepted through March 1st
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A $50 submission fee is required upon completion of the form. |
Questions can be directed to
Savannah Gold at 270.554.9412 ext 4219 or
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After reading the 2022 Abstracts & Poster Presentations guidelines, please complete the form along with the presenter's CV by clicking here.
- Top 3 will present during the general session on the final day.
- Top 10 will present during the abstract breakout session.
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Rapid review and publication in the Pain Physician journal will be extended to the Top 10 authors accepted for meeting presentations.
Click here for Abstract and Poster Presentation
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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| CASE REPORT |
Jose Manuel Gonzalez Mesa, MD, PhD, Pablo Ignacio Iglesias Rozas, MD, Salvador Romero Porras, MD, Francisco Javier Palma Perez, MD,
Marta del Valle Hoyos, MD, Milagros Rivera Perez, MD,
and Jose Cruz Manas, MD
Abstract
BACKGROUND: Lumbar plexopathy is considered a rare complication of minimally invasive endovascular or surgical procedures, but it has not been related to the use of extracorporeal membrane oxygenation (ECMO) so far. In cases of high-intensity neuropathic pain, neuromodulation should be considered early in the treatment.
CASE REPORT: After receiving supportive ECMO therapy for 7 days, a 42-year-old woman developed lumbar plexopathy and high-intensity neuropathic pain and was referred to the pain unit 6 months later. After unsuccessful use of neuropathic drugs, spinal cord stimulation achieved global improvements of 90%. Sixteen months later, the patient continues to be asymptomatic, leading an active life as a mother of 4 children.
CONCLUSIONS: The use of ECMO cannot be said to be the main cause of plexopathy in this case, but a multifactorial approach regarding this issue should be considered. Spinal cord stimulation can provide dramatic relief in localized neuropathic pain.
KEY WORDS: Extracorporeal membrane oxygenation (ECMO), lumbosacral plexopathy, spinal cord stimulation
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| RETROSPECTIVE STUDY |
Hyo Jin Lee, MD, Yong Ho Lee, MD, Ji Hoon Park, MD, PhD,
and JiHee Hong, MD, PhD
Abstract
BACKGROUND: The leakage of cerebrospinal fluid (CSF) can be encountered spontaneously or after procedures such as epidural or spinal anesthesia, intrathecal chemotherapy, CSF tapping, or other various spinal procedures. The leakage of CSF can lead to intracranial hypotension, which is associated with an orthostatic headache. For such patients with this type of headache, an epidural blood patch is the treatment of choice.
OBJECTIVE: The purpose of this study is to compare the clinical features and efficacy of an epidural blood patch for patients with spinal leakage of CSF.
STUDY DESIGN: Retrospective study.
SETTING: University hospital inpatients referred for consultation to the pain clinic
METHODS: Identification of patients with orthostatic headache was performed using the program Clinical Data Warehouse (CDW) v 2.5. Search word in CDW for analysis was “epidural blood patch.” We carefully evaluated the demographics, etiology, clinical features of headache, associated phenomena other than headache, level and types of CSF leakage, and frequencies and outcomes of epidural blood patches. We allocated patients into 2 groups according to the cause of headache: spontaneous intracranial hypotension (group SIH) and post-dural puncture headache (group PDPH).
RESULTS: The number of patients needing repeated epidural blood patches was significantly higher in the SIH group SIH in the PDPH group (P = 0.007). In the PDPH group, a targeted epidural blood patch was possible in 100% of the cases, whereas it was possible in only 66.7% of the patients in the SIH group, indicated by previous examination (P < 0.001). Forty patients (90.9%) and 17 patients (70.8%) achieved complete recovery from headache after a single epidural blood patch in the PDPH group and SIH group, respectively (P < 0.001).
LIMITATION: The number of patients allocated to each group was not balanced because of the retrospective design.
CONCLUSION: Most patients in the PDPH group required a single epidural blood patch to achieve complete recovery from headache. However, patients in the SIH group required repeated epidural blood patches for complete pain relief.
KEY WORDS: CSF leakage, epidural blood patch, intracranial hypotension, orthostatic headache
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| RETROSPECTIVE STUDY |
Kanishka Rajput, MD, Colin-Beals Reid, MD, David Yanez, PhD, Devina Shiwlochan, MD, Sargis Ohanyan, MD, and Robert Chow, MD
Abstract
BACKGROUND: Perioperative pain management of patients on chronic opioids is challenging. Although experts recommend regional anesthesia and multimodal analgesics for their opioid sparing effects, their use and predictors of use are unknown.
OBJECTIVES: To examine the patterns and predictors of use of regional anesthesia and multimodal analgesics for perioperative pain control of patients on chronic opioids. A secondary objective was to examine the association of patient and surgical factors with 24-hour postoperative opioid use.
STUDY DESIGN: Retrospective cross sectional.
SETTING: Single center tertiary care academic hospital.
METHODS: We studied patients with chronic opioid use undergoing painful operations such as abdominal, gynecologic, breast, orthopedic, spine, amputation, and laparoscopic surgeries. Chronic opioid use was identified using the narcotic score – a score generated from the state prescription drug monitoring database via the NarxCare platform. A narcotic score >= 320 corresponding to a preoperative home dose of approximately 40 milligram morphine equivalents (MMEs) daily, was chosen as a cutoff since the risk of overdose death increases above 40 MMEs. We reported the use of regional anesthesia and >= 3 multimodal analgesics in this cohort (n = 155) and examined the association of this use with patient and surgical factors such as preoperative narcotic score, age, race, comorbidity index, operative time, and intraoperative opioid use. In addition, we examined the association of patient and surgical factors with 24-hour postoperative opioid use.
RESULTS: Out of 2470 patients undergoing painful surgeries between July 2017and- December 2018, 155 patients had a narcotic score >= 320. The median narcotic score was 411 (interquartile range (IQR) 351-520), the median preoperative home MME dose was 67.5 (IQR 32-180) mg daily. Regional anesthesia was used in only 9.7% of cases and was associated with intraoperative opioid used, but not the preoperative narcotic score. Patients receiving 1 SD more MMEs intraoperatively had a higher odds of receiving regional anesthesia (OR = 1.57, 95% CI [1.06, 2.32]). Three or more multimodals were used in 83% of cases. Every 10-point increase in narcotic score and every additional hour of operative time was associated with higher odds of receiving >= 3 multimodals (OR = 1.05, 95% CI [1.00, 1.11] and OR = 1.49, 95% CI [1.11, 1.99] respectively). Total 24-hour post-operative opioid dose was associated with narcotic score, with an 8.6 higher mean MME for every 10-point increase in narcotic score (mean difference = 8.6, 95% CI [4.1, 13.1]). It was also moderately associated with age, where patients an year older received 4.7 MMEs less (mean difference = - 4.7, 95% CI [-9.3, -0.5]).
LIMITATIONS: This was a single center retrospective observational study. We could not adjust for inter-physician or inter-surgery effect on use of regional anesthesia or multimodal analgesics. Since this was one of the first studies to use narcotic scores to identify patients on chronic opioids, comparing the outcomes of interest to a control group was beyond the scope of the current study. Narcotic scores need to be validated to identify chronic opioid use.
CONCLUSIONS: Despite consensus guidelines, regional anesthesia remains underutilized. Multimodals are used frequently and are modestly associated with preoperative narcotic scores.
KEY WORDS: Chronic opioid use, preoperative opioid use, postoperative pain, regional anesthesia, multimodal analgesics, opioid sparing adjuncts, narcotic scores, NARX score
IRB approval: Institutional Review Board (IRB) approval was obtained per the University’s institutional guidelines.
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Norcal Mutual is A-Rated by AM best and is licensed in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
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ASIPP® has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value-added services for independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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up-to-date news related to you, your practice, and your patients!
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