Medical Bulletin 4/January/2023

Here are the top medical news for the day:

Lack of effectiveness of antidepressants used increasingly for chronic pain, finds study

New research has found some antidepressants may be effective in treating certain chronic pain conditions, but others lack convincing evidence on their effectiveness. An international team of researchers, has found that some classes of antidepressants were effective in treating certain pain conditions in adults, but others were either not effective, or the effectiveness was unknown. The researchers say the results show that clinicians need to consider all the evidence before deciding to prescribe antidepressants for chronic pain management.

Antidepressants may have unpleasant side effects that patients may wish to avoid. The review examined 26 systematic reviews from 2012 to 2022 involving over 25,000 participants. This included data from eight antidepressant classes and 22 pain conditions. Serotonin-norepinephrine reuptake inhibitors (SNRI) antidepressants such as duloxetine were found to be effective for the largest number of pain conditions, such as back pain, knee osteoarthritis, postoperative pain, fibromyalgia, and neuropathic pain (nerve pain).

Reference:

Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews,BMJ,DOI: https://doi.org/10.1136/bmj-2022-072415.

AJR systematic review and meta-analysis on MRI surveillance for postsurgical musculoskeletal soft-tissue sarcomas

According to an accepted manuscript published in ARRS' American Journal of Roentgenology (AJR), MRI-based surveillance after surgical treatment of musculoskeletal soft-tissue sarcomas (STS) shows utility for detecting clinically occult local recurrences (LRs), potentially improving patient outcomes.

In this AJR systematic review and meta-analysis, Gorelik et al. systematically searched multiple electronic databases through November 2022 for controlled trials and cohort studies on the usefulness of MRI-based surveillance for musculoskeletal STS. A total of 4,821 unique titles and abstracts were identified. After screening for eligibility and snowball sampling, 19 studies were included; all were retrospective cohorts.

Reference:

Usefulness of MRI-based local surveillance after surgical treatment of musculoskeletal soft-tissue sarcomas: A systematic review and meta-analysis,American Journal of Roentgenology,doi 10.2214/AJR.22.28865