Lower-dose diclofenac submicron particle capsules provide early and sustained acute patient pain relief in a phase 3 study.

Background: Non-steroidal anti-inflammatory drugs are prescribed for the treatment of patients with acute pain but use of such analgesics is associated with dose-dependent adverse events (AEs). Diclofenac submicron particle capsules have been developed using SoluMatrix technology to provide analgesia at lower doses than available solid oral dosing forms. Our study evaluated the analgesic efficacy and safety of lower-dose diclofenac submicron particle capsules in patients with acute pain following elective surgery.

Gingival curettage study comparing a laser treatment to hand instruments.

The purpose of this clinical study was to examine nonsurgical treatments of periodontal disease comparing a diode laser to subgingival curettage with conventional hand instruments. The study group comprised 18 patients with moderate periodontal degradation who were treated without local anesthesia. Each quadrant was randomly allocated in a split-mouth design either to treatment with a 810-nm diode laser using an energy of 2 W (test group) or to gingival curettage using hand instruments (control group).

A unified framework for addiction: vulnerabilities in the decision process.

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) changing allostatic set points, (3) euphorigenic "reward-like" signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates.

Reconciling reinforcement learning models with behavioral extinction and renewal: implications for addiction, relapse, and problem gambling.

Because learned associations are quickly renewed following extinction, the extinction process must include processes other than unlearning. However, reinforcement learning models, such as the temporal difference reinforcement learning (TDRL) model, treat extinction as an unlearning of associated value and are thus unable to capture renewal. TDRL models are based on the hypothesis that dopamine carries a reward prediction error signal; these models predict reward by driving that reward error to zero.

Hip pain - a focus on the sporting population.

Background: Patients complaining of 'hip' or 'groin' pain can present a diagnostic and therapeutic challenge for practitioners not only in primary care, but also those in specialist practice.

Objective: This article outlines common patterns of groin and lateral hip pain, and provides a targeted clinical approach to treatment or referral.

Discussion: Common causes of chronic groin pain include osteitis pubis, incipient hernia, adductor tendinopathy and intrinsic hip pathology.

Neck related causes of headache.

Background: Headaches emanating from sources in the cervical spine, so-called cervicogenic headache (CGH), are much more common than is usually thought by practitioners not trained in musculoskeletal medicine.

Objective: This article outlines a basic clinical assessment of the neck which will enable the general practitioner to determine whether or not there is a possible neck source for the presenting headache.

Discussion: The skills of musculoskeletal clinical assessment are relatively simple and easy to acquire, and can ensure that this important clinical entity is not overlooked.

Back pain-clinical assessment.

Background: Low back pain accounts for approximately 5% of all general practice consultations. Although the majority of patients will have somatic low back pain of musculoskeletal origin, vigilance in excluding 'red flag' conditions is paramount. The identification of 'yellow flags', ie.