Stress may play a key role in the development of type 2 diabetes in obese black women, U.S. researchers say.

“Much attention has been given to the role of obesity in the development of type 2 diabetes, but stress may be as important in this at-risk population,” study co-author Anastasia Georgiades, of Duke University in Durham, N.C., said in a news release.

The study included 62 healthy, non-diabetic black women who were asked to recall stressful life events. As they did, the researchers measured the women’s levels of blood sugar and epinephrine, the “fight or flight” hormone that’s released in reaction to stress.

Women with high epinephrine levels (25 picograms or more per milliliter of blood) while recalling stressful events and with more belly fat (33 percent or more of total body fat) had significantly higher fasting glucose scores (about 100 milligrams per deciliter) than women with lower epinephrine levels and less belly fat (85 mg/dl). A fasting blood glucose level of 100 mg/dl is considered within the low range of pre-diabetes, and a level of 125 mg/dl is the benchmark for type 2 diabetes.

Women with high epinephrine levels and more belly fat also had bigger increases in blood sugar levels during the stress test.

The findings were to be presented this week at the annual scientific meeting of the American Psychosomatic Society.

“While we don’t fully understand the nature of the association, women with abdominal obesity may be more vulnerable to the impact of stress — causing their body to increase blood sugar production and elevating their risk for diabetes,” Georgiades said.

Further research is needed to determine exactly how epinephrine production affects blood sugar levels in black women. Nearly one in four black women in the United States has type 2 diabetes, according to the American Diabetes Association.

Innocoll’s BUPIVACAINE SURGICAL IMPLANT is a biodegradable and fully bioresorbable matrix of purified fibrillar collagen impregnated with the local anesthetic, bupivacaine, which has been specifically developed and formulated using Innocoll’s proprietary CollaRx sponge technology. It is under development in the US and Europe for the management of post-operative pain following moderate/major abdominal, gynecological, abdominal, thoracic, and orthopedic surgeries.

Post-operative pain is typically controlled with narcotic analgesics such as morphine, but systemic administration of these drugs can result in unfavorable side effects including suppression of breathing, sedation, nausea and vomiting, and can also affect patient recovery. Innocoll’s BUPIVACAINE SURGICAL IMPLANT is intended to provide pain control directly at the surgical site and thus reduce the level of additional analgesia required following surgery. The collagen matrix naturally biodegrades over a few days and the bupivacaine is released to provide local analgesia for up to 96 hours post- operatively. A key feature of Innocoll’s product is the ability to implant it directly into the surgical cavity and at different layers within the wound, such as across the peritoneum incision and directly below the skin incision, which enables localized treatment of both the incisional and deep, visceral pain components normally associated with moderate and major surgery. The bioresorbable nature of the collagen matrix also offers significant clinical benefits and convenience advantages over ambulatory infusion pumps often used to provide continuous, long-term analgesia at the site of a surgical wound.

Innocoll has recently completed a phase 2 clinical trial in patients undergoing hysterectomy surgery in the absence of gynecological cancers at Wexham Park Hospital, Slough, UK. The results of this trial were particularly encouraging, showing evidence of sustained, post-operative analgesia for approximately 96 hours as measured by VAS (visual analogue scale) scores and reduced dependence on systemic morphine administered by PCA (patient- controlled analgesia). This extended action was achieved despite a low total bupivacaine dose (150mg as the hydrochloride salt), which is well below the allowable daily dose and equivalent to that used by some practitioners for a once-off wound infiltration with bupivacaine solution prior to wound closure.

For the planned series of phase 2 multi-centered, controlled clinical trials to be performed in the US, Innocoll has appointed Premier Research Group, a recognized industry leader in clinical research for acute and chronic pain, to co-ordinate up to five trials in a variety of soft and hard tissue procedures; including hysterectomy, herniorrhaphy, open gastrointestinal surgery and orthopedic surgery. The first of these trials that has commenced dosing will compare the analgesic effect of BUPIVACAINE SURGICAL IMPLANT versus a placebo implant and current standard of care in patients undergoing abdominal hysterectomy at eight different US sites. The other phase 2 soft tissue trials in herniorrhaphy and open gastrointestinal surgeries are expected to commence in early 2008.

About one third of women in the US have a hysterectomy by age 60 and each year, more than 600,000 hysterectomies are performed across the country. Other procedures where the product could potentially be used routinely include caesarean section, inguinal hernia repair, open-heart surgery, mastectomy, open gastrointestinal surgery, cholecystectomy, vascular surgery, and various orthopaedic surgeries such as hip and knee replacement, bunionectomy, open fracture repair and certain bone graft procedures. Detailed market research performed independently by L.E.K. Consulting has predicted peak US sales of BUPIVACAINE SURGICAL IMPLANT nearing $310 million.

“This first dosing with our Bupivacaine Implant for the management of post-operative pain follows hot on the heels of other phase 2 and phase 3 trials recently initiated with our topically-applied Gentamicin-Collagen sponge for the treatment of infected diabetic foot ulcers and our Gentamicin Surgical Implant for the prevention of surgical site infection. This certainly marks a very exciting time for Innocoll as we embark upon the dosing of patients in three clinical trials for different products spanning three different therapeutic categories”, said Dr. Michael Myers, Innocoll’s President and CEO.

About Innocoll, Inc.

Innocoll is a privately held, specialty pharmaceutical company focused on biodegradable surgical implants and topically applied healthcare products. It develops and manufactures a range of pharmaceutical products and medical devices using its proprietary collagen-based technologies, CollaRx(R) and Liquicoll(R). Innocoll ‘s lead product, GENTAMICIN SURGICAL IMPLANT, for the treatment and prevention of surgical site infections, is approved for sale in 49 countries in Europe, Latin America, Middle East, Africa and Asia and is marketed under the following trade names; COLLATAMP(R) G, COLLATAMP(R) EG, SULMYCIN(R) IMPLANT, GARAMYCIN(R) SCHWAMM, DURACOL(R), DURACOLL(R), GENTACOL(R), GENTACOLL(R), GARACOL(R), GARACOLL(R), and CRONOCOL(R). In 2005, Innocoll acquired the worldwide marketing rights for this product from Essex Chemis AG, an affiliated company of Schering-Plough Corporation (NYSE: SGP) and in August 2007 sold its marketing rights, with the exception of the US, to EUSA Pharma. Gentamicin Surgical Implant is currently in phase 3 development in the US for the prevention of surgical site infections. Other late stage pharmaceutical products in Innocoll’s development pipeline include CollaRx Gentamicin Topical for the treatment and prevention of infected diabetic foot ulcers and CollaRx Bupivacaine Implant for the management of post-operative pain, both of which are currently in Phase 2 development. For more information, please visit http://www.innocollinc.com.

Innocoll Inc.

http://www.innocollinc.com

According to the study, narcotic prescriptions by ED physicians increased from 23% in 1993 to 37% in 2005. The study found that opioid narcotics were prescribed in 31% of pain-related visits involving whites, 28% involving Asians, 24% involving Hispanics and 23% involving blacks. In addition, the study found that in more than 2,000 visits for kidney stones, whites received narcotics 72% of the time, Hispanic patients received the drugs 68% of the time, and Asian and black patients received the drugs 67% and 56% of the time, respectively. Minorities were slightly more likely than whites to receive aspirin, ibuprofen and similar pain medications, according to the study. The study found racial disparities in ED narcotic prescriptions in both urban and rural hospitals.

Study co-author Mark Pletcher said that the “gaps between whites and nonwhites have not appeared to close at all.” According to the study’s authors, physicians might be less likely to see signs of pain medication abuse among white patients or might be undertreating pain in minorities. Pletcher said that patient behavior also might play a role, adding that minorities “may be less likely to keep complaining about their pain or feel they deserve good pain control” (Johnson, AP/Houston Chronicle, 1/2).

An abstract of the study is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

During the 1990s there was a national focus on the problem of inadequately treated pain, the authors explain. Patients from ethnic/racial minority groups were less likely to receive adequate pain treamtnet in the emergency department. Consequently, nationwide quality improvement initiates were put into practice at the end of the 1990s.

Mark J. Pletcher, M.D., M.P.H., University of California, San Francisco, and team wanted to find out whether opioid prescribing had increased in American emergency departments for patients who were in pain. They also wanted to see what the likelihood is of a non-Hispanic white patient receiving an opioid compared to patients from other racial/ethnic groups. Pain-related visits to U.S. emergency departments were identified using reason-for-visit and physician diagnosis codes from 13 years (1993-2005) of The National Hospital Ambulatory Medical Care Survey.

The researchers found that 42% of emergency department visits were pain-related, a total of 156,729 out of 374,891. In 29% of pain-related visits an opioid analgesic was prescribed – the percentage grew from 23% in 1993 to 37% in 2005. However, the researchers found no evidence that the difference in opioid prescribing by race/ethnicity fell over time.

Over the 13 survey years, the researchers found that

– 31% of whites received an opioid prescription for pain related visits
– 23% of blacks received an opioid prescription for pain related visits
– 24% of Hispanics received an opioid prescription for pain related visits
– 28% of Asians and other ethnic/racial groups received an opioid prescription for pain related visits

The differences in opioid prescribing were present, consistently, across different kinds of pain, pain severities, for visits in which pain was the first/second/third reason for the visit, as well as two specific painful diagnoses – long-bone fracture and kidney stones. In fact, as pain severity increased the difference in opioid prescribing between whites and non-whites was larger. For example

– 48% of whites got an opioid prescription for back pain
– 36% of non-whites got an opioid prescription for back pain

– 35% of whites got an opioid prescription for headache
– 24% of non-whites got an opioid prescription for headache

– 32% of whites got an opioid prescription for abdominal pain
– 22% of non-whites got an opioid prescription for abdominal pain

– 40% of whites got an opioid prescription for other pain
– 28% of non-whites got an opioid prescription for other pain

Even after making statistical adjustments for pain severity, and some other factors, the differentials still remained.

Compared to a white patient,

– a black patient is 34% less likely to get an opioid prescription
– a Hispanic patient is 33% less likely to get an opioid prescription
– an Asian/other patient is 21% less likely to get an opioid prescription

The researchers write “Our results suggest that new strategies are needed to understand and improve the quality and equity of management of acute pain in the United States. Future initiatives should continue to monitor pain management quality indicators and processes of care that may contribute to inadequate care, to educate physicians about the importance of adequate pain control, and to promote cultural competence within individual physicians. It is likely, however, that eliminating disparities in pain control will also require nonphysician interventions such as patient-targeted self-efficacy education, nurse-initiated pain-treatment protocols, and other system-level changes to facilitate equitable, systematic, and consistent alleviation of pain in emergency department patients.”

“Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments”
Mark J. Pletcher, MD, MPH; Stefan G. Kertesz, MD, MSc; Michael A. Kohn, MD, MPP; Ralph Gonzales, MD, MSPH
JAMA. 2008;299(1):70-78.
Click here to view Abstract online

The study examined treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005. It found that 31 percent of whites received opioid drugs compared with only 23 percent of blacks and 24 percent of Hispanics. About 28 percent of Asians received the drugs.

In contrast, non-opioid pain relievers, such as acetaminophen and ibuprofen were prescribed much more often to non-whites (36 percent) than to whites (26 percent).

“Studies in the 1990s showed a disturbing racial or ethnic disparity in the use of these potent pain relievers, but we had hoped that the recent national efforts at improving pain management in emergency departments would shrink this disparity,” said Mark Pletcher, MD, a UCSF assistant professor of epidemiology and biostatistics and lead author of the study. “Unfortunately, this is not the case.”

The study results are published in the January 2 issue of the Journal of the American Medical Association (JAMA).

Opioids are narcotic drugs used to treat patients with moderate to severe pain. Their use in emergency rooms increased overall from 23 to 37 percent between 1993 and 2005. National quality improvement guidelines on pain control in 2001 called for increased monitoring of pain status and stressed the need for adequate pain control. Since then, the hospital use of opioids has further increased. The new study is the first to assess national opioid prescribing patterns in the emergency room setting since implementation of the guidelines.

Among the findings:

* Blacks were prescribed opioids at lower rates than other groups for almost every type of pain-related emergency department visit, including back pain, headache, and abdominal pain.

* Differences in prescribing were greatest for people with the worst pain. About 52 percent of whites in severe pain received opioids, compared with 42 percent of Hispanics and 39 percent of blacks.

* Prescribing rates were particularly low for:
- Black and Hispanic children
- Blacks in county and state hospitals
- Asians and other insured by Medicare
- All non-white patients in the Northeast

There is no evidence that non-whites have less severe or different types of pain when they arrive in the emergency department,” Pletcher said. “We think our data indicate that opioids are being underprescribed to minority emergency department patients, especially black and Hispanic patients.”

The study was not designed to determine the causes of these ethnic disparities in care, and they are likely to complex, Pletcher said. The authors call for ongoing education of physicians and nursing staff on treatment of pain, and promotion of cultural awareness. They also call for more education of patients to advocate for their own pain control.

The paper suggests that changes in systems for pain management in the emergency department may be required, such as use of protocols allowing nurses to initiate pain control measures.

The study draws on data compiled by the National Hospital Ambulatory Medical Care Survey conducted by the Census Bureau. The researchers analyzed nearly 375,000 emergency room visits over 13 years. About 42 percent of these visits were for pain.

“The gaps and barriers identified among healthcare providers include a substantial lack of awareness about the disorder and a lack of confidence in the ability of the physicians to diagnosis it. As a result, misdiagnosis, fragmentation of patient care, and an increased cost of care are plaguing the management of fibromyalgia syndrome,” said I. Jon Russell, MD, PhD, Associate Professor of Medicine at The University of Texas Health Science Center at San Antonio and Director of the University Clinical Research Center. “Each of these barriers contributes to poor patient care and outcomes. Ideally, the management of patients with fibromyalgia syndrome should be individualized, multimodal, multidisciplinary, and should be expected to extend over weeks to months with a continuum of care during that time,” added Dr. Russell.

The goal of the ACFE is to bring together a multidisciplinary group of national thought leaders in the area of fibromyalgia syndrome to provide insight into the core issues that cause physicians’ barriers to patient care, and together deliver strategic direction in addressing those barriers. Current members include Misha-Miroslav Backonja, MD, Robert Bennett, MD, Michael Clark, MD, MPH, Daniel Clauw, MD, Don Goldenberg, MD, Rakesh Jain, MD, MPH, Kim Dupree Jones RN, PhD, FNP, Lynne Matallana, President of NFA, Bill McCarberg, MD, FABPM, Philip J. Mease, MD, Harvey Moldofsky, MD, FRCPC, I. Jon Russell, MD, PhD, Dennis Turk, PhD, David A. Williams, PhD and Patrick Wood, MD.

The council represents the areas of rheumatology, psychiatry, primary care, neurology and nursing as well as other healthcare groups and thus presents a platform offering insight from multiple perspectives. The council will also address needs in other disease areas that have similar clinical features, for example chronic fatigue syndrome, chronic headache, and temporomandibular joint syndrome,

“Having a group of such pre-eminent thought leaders provide such input and direction will allow the development of much needed evidence-based education in the area of fibromyalgia syndrome,” states Seanne Murray, CEO of MJ Consulting Group, who jointly developed the ACFE with the National Fibromyalgia Association (NFA), and Gullapalli and Associates (G&A).

About the National Fibromyalgia Association

The NFA, founded in 1997 by Lynne Matallana, is the largest nonprofit organization dedicated to decreasing the burden of fibromyalgia through education, research and patient advocacy. The NFA leads a national and international effort to create a voice for providers, researchers and patients who deal with fibromyalgia by leading the development and support of educational activities, awareness events, fibromyalgia research, media coverage, and facilitation of increased collaboration between patients and providers. The NFA’s philosophy is to help empower all stakeholders in fibromyalgia and to provide them with a new level of hope for the future.

National Fibromyalgia Association

About MJ Consulting Group

MJ Consulting Group (“MJ”) collaborates with academic centers of excellence, non-profit associations, and medical education companies dedicated to advancing medical education. While reinforcing a collaborative approach, MJ’s goal is to raise awareness of and foster dialogue about solutions to address educational gaps and needs among healthcare providers. MJ identifies, develops and manages collaborative relationships with established organizations, educational partners and channels to develop communication strategies designed to address key educational gaps and needs among healthcare providers. As a facilitator in the medical education industry, its mission is to deliver clearly defined communications strategies aimed to improve the knowledge, skills and clinical behavior of healthcare providers through proven health education models thus impacting patient care and outcomes.

MJ Consulting Group

About G&A

Gullapalli & Associates (G&A) is a consulting firm specializing in facilitating strategic collaboration between key stakeholders in the medical education community. G&A facilitates the development of integrated educational initiatives through evidence based health education models, ensuring consistent educational strategy, goals, and objectives across multiple channels. G&A also identifies and manages a range of educational collaborative partners, channels, and resources to enhance the educational impact of the services provided.

Gullapalli & Associates

“The gaps and barriers identified among healthcare providers include a substantial lack of awareness about the disorder and a lack of confidence in the ability of the physicians to diagnosis it. As a result, misdiagnosis, fragmentation of patient care, and an increased cost of care are plaguing the management of fibromyalgia syndrome,” said I. Jon Russell, MD, PhD, Associate Professor of Medicine at The University of Texas Health Science Center at San Antonio and Director of the University Clinical Research Center. “Each of these barriers contributes to poor patient care and outcomes. Ideally, the management of patients with fibromyalgia syndrome should be individualized, multimodal, multidisciplinary, and should be expected to extend over weeks to months with a continuum of care during that time,” added Dr. Russell.

The goal of the ACFE is to bring together a multidisciplinary group of national thought leaders in the area of fibromyalgia syndrome to provide insight into the core issues that cause physicians’ barriers to patient care, and together deliver strategic direction in addressing those barriers. Current members include Misha-Miroslav Backonja, MD, Robert Bennett, MD, Michael Clark, MD, MPH, Daniel Clauw, MD, Don Goldenberg, MD, Rakesh Jain, MD, MPH, Kim Dupree Jones RN, PhD, FNP, Lynne Matallana, President of NFA, Bill McCarberg, MD, FABPM, Philip J. Mease, MD, Harvey Moldofsky, MD, FRCPC, I. Jon Russell, MD, PhD, Dennis Turk, PhD, David A. Williams, PhD and Patrick Wood, MD.

The council represents the areas of rheumatology, psychiatry, primary care, neurology and nursing as well as other healthcare groups and thus presents a platform offering insight from multiple perspectives. The council will also address needs in other disease areas that have similar clinical features, for example chronic fatigue syndrome, chronic headache, and temporomandibular joint syndrome,

“Having a group of such pre-eminent thought leaders provide such input and direction will allow the development of much needed evidence-based education in the area of fibromyalgia syndrome,” states Seanne Murray, CEO of MJ Consulting Group, who jointly developed the ACFE with the National Fibromyalgia Association (NFA), and Gullapalli and Associates (G&A).

About the National Fibromyalgia Association

The NFA, founded in 1997 by Lynne Matallana, is the largest nonprofit organization dedicated to decreasing the burden of fibromyalgia through education, research and patient advocacy. The NFA leads a national and international effort to create a voice for providers, researchers and patients who deal with fibromyalgia by leading the development and support of educational activities, awareness events, fibromyalgia research, media coverage, and facilitation of increased collaboration between patients and providers. The NFA’s philosophy is to help empower all stakeholders in fibromyalgia and to provide them with a new level of hope for the future.

National Fibromyalgia Association

About MJ Consulting Group

MJ Consulting Group (“MJ”) collaborates with academic centers of excellence, non-profit associations, and medical education companies dedicated to advancing medical education. While reinforcing a collaborative approach, MJ’s goal is to raise awareness of and foster dialogue about solutions to address educational gaps and needs among healthcare providers. MJ identifies, develops and manages collaborative relationships with established organizations, educational partners and channels to develop communication strategies designed to address key educational gaps and needs among healthcare providers. As a facilitator in the medical education industry, its mission is to deliver clearly defined communications strategies aimed to improve the knowledge, skills and clinical behavior of healthcare providers through proven health education models thus impacting patient care and outcomes.

MJ Consulting Group

About G&A

Gullapalli & Associates (G&A) is a consulting firm specializing in facilitating strategic collaboration between key stakeholders in the medical education community. G&A facilitates the development of integrated educational initiatives through evidence based health education models, ensuring consistent educational strategy, goals, and objectives across multiple channels. G&A also identifies and manages a range of educational collaborative partners, channels, and resources to enhance the educational impact of the services provided.

Gullapalli & Associates

Dr Esra Ogru, Executive Vice President of Research and Development at Phosphagenics, said these results support Phosphagenics’ aims to be the first to commercialise a sustainedrelease oxycodone patch for the management of chronic pain.

“Oxycodone, with worldwide annual sales of more than $US 1 billion, is more potent than morphine with fewer adverse effects; however, oxycodone is not available transdermally due to serious issues relating to skin sensitisation and irritation,” Dr Ogru said.

“Our trial results show that TPM can deliver oxycodone through the skin in a sustainedrelease formulation without causing skin irritation.”

This trial, which was conducted by CMAX (an independent clinical research organisation located at the Royal Adelaide Hospital) was a single-centre, single-blinded, pharmacokinetic trial in 16 healthy subjects. The trial endpoints were to evaluate the safety and tolerability of the TPM/Oxycodone formulation and the ability of the TPM technology to deliver oxycodone into the body.

The oxycodone, administered as a single transdermal application, was safe with no adverse events reported. Oxycodone was detected in the subjects for at least 48 hours. The results demonstrate that the formulation is bioavailable and effective in delivering oxycodone into the body.

A collaborative program is now under way with a world leading patch development company to incorporate the current formulation into a patch system. Plans are also underway to undertake a pivotal clinical study in the first half of 2008.

Dr Esra Ogru said that developing its pain relief pipeline builds on the success of previous transdermal clinical trials and provides a platform for the development of many other products.

Mr Harry Rosen, President and CEO said: “Completing this Phase 1 trial was an important milestone for our pain management program. We are delighted to have successfully completed this trial and look forward to progressing to the next phase”.

About Phosphagenics Limited

Phosphagenics is a Melbourne-based, globally driven biotechnology company focused on the discovery of new and cost effective ways to enhance the bioavailability, activity, safety and delivery of proven pharmaceutical and nutraceutical products.

Phosphagenics’ core technology is built around the science and application of phosphorylation, a process where the addition of a phosphate group has been found to enhance the bioavailability, activity and safety of existing pharmaceuticals and nutraceuticals, as well as to assist in the production of drug delivery platforms.

Phosphagenics’ shares are listed on the Australian Stock Exchange (POH) and the London Stock Exchange’s Alternative Investment Market (PSG). An ADR – Level 1 program was established in the U.S. with The Bank of New York Mellon (PPGNY) for U.S. investors to trade in Phosphagenics’ stock on the ‘over-the-counter’ market. In July 2007, this was upgraded to the International OTCQX, a new premium market tier in the U.S. for international exchange-listed companies, operated by Pink Sheets, LLC.

Phosphagenics Limited

Fibromyalgia is a chronic pain condition thought to result from neurological changes in how patients perceive pain, specifically, a heightened sensitivity to stimuli that are not normally painful. Many healthcare providers lack confidence in diagnosing fibromyalgia and are reluctant to diagnose patients with the condition.

The “Circle of Care” initiatives will commence with a planning meeting bringing together leading fibromyalgia clinicians, researchers and patients all under the auspices of the collaborative. A consensus statement defining the educational needs and appropriate management statements for patients with fibromyalgia is the goal. The three educational initiatives will consist of: a series of institutional and community based satellite broadcasts to 7,000 US hospitals and community health centers, a national series of workshops in major metropolitan cities and academic medical centers, and a national series of debate- based meetings focused on the multidisciplinary care and management of fibromyalgia. This integrated approach will provide multiple points of access, resources and tools estimated to reach over 250,000 healthcare providers.

“The ‘Circle of Care’ collaborative developed these initiatives with the intent to provide education through an integrated and multi-interventional approach, permitting healthcare providers to interact and share their knowledge and best practices through various programs and media”, said Lynne Matallana, founder and President of the NFA. Dr. Victor Marrow of The Johns Hopkins Office of Continuing Medical Education adds, “Our mission is to educate physicians nationwide, and the prevalence of fibromyalgia and its misunderstanding by healthcare professionals makes this a very important area for Hopkins CME.”

The need for education is reinforced by a recent NFA survey of healthcare providers which showed that approximately one in three respondents who are knowledgeable about fibromyalgia incorrectly classify the condition as an autoimmune disease (32%) or a type of arthritis (28%). For most healthcare specialties surveyed, less than one-third of physicians were “extremely/very confident” in their ability to diagnose the disorder.

“Physician education is vital to understanding this illness and how therapies can help improve the quality of life in patients suffering from this disease that affects over 6 to 10 million people” states Dan Clauw, MD, Associate Dean for Clinical and Translational Research, Professor of Internal Medicine and Director of Chronic Pain and Fatigue Center at the University of Michigan Institute for Clinical and Health Research.

The NFA survey also stated that less than 20% of fibromyalgia cases are diagnosed and drug treated. Currently 50% of fibromyalgia patients remain undiagnosed at any time while a correct diagnosis may take as long as 5 to 8 years from the disease onset. “With the approval of drugs specifically for fibromyalgia, clinicians are excited about the newly available treatment options. These initiatives will help ensure that clinicians understand how to incorporate drug and non-drug therapies together to lead to overall better management of fibromyalgia,” added Dr. Clauw.

The “Circle of Care” collaborative will work with MJ Consulting Group and Gullapalli and Associates, consulting firms that specialize in the development of educational strategies for healthcare providers. Both organizations will oversee the development and facilitation of the educational initiatives and provide their analysis on how these initiatives translate research into clinical practice.

About the National Fibromyalgia Association

The NFA, founded in 1997 by Lynne Matallana, is the largest nonprofit organization dedicated to addressing and decreasing the burden of fibromyalgia through education, research and patient advocacy. The NFA’s philosophy is to help empower all stakeholders in fibromyalgia and to provide them with a new level of hope for the future.

http://www.fmaware.org

Johns Hopkins School of Medicine

In July 2007, U.S. News & World Report ranked The Johns Hopkins Hospital #1 among American hospitals for the 17th consecutive year. Johns Hopkins remains the nation’s leading medical school recipient of research funds from the National Institutes of Health. In 2006, the Johns Hopkins Office of CME received “Accreditation with Commendation” for 6 years, the highest ranking issued by the ACCME. Hopkins CME has been recognized as a center for “Best Practices” as a resource to ACCME-accredited providers.

http://www.hopkinscme.net

The Institute for Johns Hopkins Nursing

The Institute for Johns Hopkins Nursing designs and delivers leading-edge continuing education for nurses. The Institute accesses the expertise of world-renowned faculty, researchers and educators from both The Johns Hopkins University School of Nursing and Johns Hopkins Hospital.

http://www.ijhn.jhmi.edu

About MJ Consulting Group

MJ Consulting Group (“MJ”) collaborates with academic medical centers of excellence, non-profit associations and medical education companies dedicated to advancing medical education. MJ’s mission is to deliver communications strategies that improve the knowledge, skills and clinical behavior of healthcare providers and raise awareness of educational gaps and needs to positively impact patient care and outcomes.

http://www.mjconsultinggroup.com

About G&A

Gullapalli & Associates (G&A) is a consulting firm specializing in facilitating strategic collaboration between key stakeholders in the medical education community. G&A facilitates the development of integrated educational initiatives through evidence based health education models, ensuring consistent educational strategy, goals, and objectives across multiple channels.

http://www.gullapalliandassoc.com

Intraoperative awareness occurs when a patient becomes conscious but remains paralyzed during an operation. “It is a variety of sensations, all the way from a fleeting recall of something that might have happened in the beginning or the end of the operation progressing in severity all the way to the horrible experience that’s portrayed in the movie,” Guidry said in a recent MUSC video interview on anesthesia awareness. Although studies show that instances of anesthetic awareness occur in only 0 .1% of procedures, Guidry says that anesthesiologists should try to do all they can to prevent any occurrence of this condition.

Dr. Guidry would like to use medical expertise and safety precautions to bring the number of awareness instances down. “I don’t think we can absolutely prevent it, but we can decrease its incidence,” he said. Doctors and surgeons at MUSC often use “level of consciousness” monitors during procedures requiring anesthesia. These monitors give doctors a guide to the depth of anesthesia that the patient is experiencing.

For patients who have a fear of general anesthesia after viewing Awake, Guidry also suggests a meeting with an anesthesiologist to discuss the procedure and prescriptions the patient is currently on. The doctor also recommends that the patient has a very frank and honest discussion about use of recreational drugs or alcohol, as they can inhibit the anesthesia.

Guidry joined the faculty of MUSC in 2007 and is the former President of the American Society of Anesthesiologists and American Board of Anesthesiology. He is currently the director of the American Board of Medical Specialties and the Foundation for Anesthesia Education and Research.

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the south. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC is home to over 3,000 students and residents, as well as nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the University and its affiliates have collective budgets in excess of $1.3 billion per year. MUSC operates a 600 bed medical center, which includes a nationally recognized Children’s Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services visit http://www.musc.edu or http://www.muschealth.com.