Increased Use and Large Variation in Strong Opioids and Metamizole (Dipyrone) for Minor and Major Musculoskeletal Injuries Between 2008 and 2018: An Analysis of a Representative Sample of Swiss Workers.

PURPOSE Musculoskeletal (MSK) injuries are a major contributing factor for chronic pain. To date, little is known how pain medication use in MSK injuries has changed over time. We assessed pain medication prescription for MSK injuries in a representative sample of Swiss workers between 2008 and 2018. METHODS Retrospective analysis of the Swiss Accident Insurance Fund (Suva) data. We calculated annual pain medication use, treatment days, and costs associated with pain medication use in minor and major MSK injuries. RESULTS In total, 1,921,382 cases with MSK injuries with ≥ 1 pain medication were analyzed. Whereas MSK injuries with ≥ 1 pain medication increased by 9.4%, we observed a larger increase in metamizole (+ 254%), strong opioids (+ 88.4%), coxibs (+ 85.8%), and paracetamol (+ 28.1%). Strong opioids were increasingly used in minor (+ 91.4%) and major (+ 88.3%) injuries. The increase in metamizole (+ 390.6%) and coxibs (+ 115.5%) was larger in minor injuries compared to major injuries (+ 238.7% and + 80.6%, respectively). Medical expenses decreased in all medications except for strong opioids where a substantial increase was observed (+ 192.4% in minor; + 34% in major injuries). CONCLUSIONS We observed a disproportionate increase in metamizole, strong opioids, coxibs, and paracetamol prescriptions even in minor MSK injuries between 2008 and 2018. Whereas treatment costs decreased for all pain medications, there was a substantial increase in strong opioids. A more liberal prescription practice of opioids conflict with current evidence-based practice recommendations and need to be addressed by physicians and policy makers

Factors influencing pain medication and opioid use in patients with musculoskeletal injuries: a retrospective insurance claims database study

Abstract Opioid use is only recommended in selected cases of musculoskeletal (MSK) injuries. We assessed factors associated with increased opioid use in MSK injuries. In a retrospective analysis of over four million workers with MSK injuries using the Swiss National Accident Insurance Fund (Suva) database, we analyzed risk factors by multivariate logistic regression. Injury severity was associated with pain medication, opioid, and strong opioid use. Whereas fractures, contusions, and ruptures had higher odds for any pain medication use, increased odds for strong opioids were observed in fractures, superficial injuries, and other injuries. Injuries of the shoulders, elbow, chest, back/spine, thorax, and pelvis/hips showed high odds for opioid use (odds ratio (OR) > 2.0). Injuries of the shoulders had higher odds for strong opioid use (OR 1.136; 95% CI 1.040–1.241). The odds for using strong opioids increased from 2008 OR 0.843 (95% confidence interval (CI) 0.798–0.891) to 2018 OR 1.503 (95% CI 1.431–1.578), compared to 2013. Injury severity, type of injury, and injured body parts influenced the use of pain medication and overall opioid use in musculoskeletal injuries. Strong opioids were more often used in fractures but also in superficial and other minor injuries, which indicates that other factors play a role when prescribing strong opioids

Fluid bilayer phase in aqueous mixtures of fatty alcohol and cationic surfactant

International audienceLamellar gel networks are creamy formulations extensively used in cosmetics and pharmaceutics. The basic units of these networks are lipid bilayers assembled from mixtures of fatty alcohols, surfactants and water. Despite being an essential step for the preparation of the dispersions, the nature of the mixtures at high temperature has defied understanding. Here, we show by atomistic molecular dynamics simulations that aqueous mixtures of cetyl (C16OH) and stearyl (C18OH) alcohols, and cetyl-trimethylammonium chloride (CTAC) lead to fluid bilayers, the units of the lamellar Lα phase. By providing a consistent numerical simulation model able to describe the structure and properties of fatty alcohol lamellae stabilized by surfactant, our work paves the way for the elucidation of the forces regulating this family of industrially important gels

La Nuit des ondes gravitationnelles : a multi-site outreach event about gravitational waves

International audienceOn Monday March 20th 2017, an outreach event dedicated to the gravitational waves and their recent discovery by the LIGO-Virgo collaboration took place. Jointly organized by the “Centre National de la Recherche Scientifique” (CNRS) and the “Société Française de Physique » (SFP), it was targeting the general audience with an emphasis on high-school students and teachers. The key feature of this project was to be multi-site, meaning that the event would take place simultaneously in a dozen French cities, plus the French Institute in Firenze (Italy), close to the site of the Virgo experiment. The project was also meant to be interactive, with all sites connected through a videoconference for a Q&A session with scientists, a quiz and finally a conference about astrophysics in the cinema. The event was also broadcasted live on the web, via a webcast system and the social medias. In addition, four contests (science and arts) open to anyone (schools and the general audience) were organized

La Nuit des ondes gravitationnelles : a multi-site outreach event about gravitational waves

International audienceOn Monday March 20th 2017, an outreach event dedicated to the gravitational waves and their recent discovery by the LIGO-Virgo collaboration took place. Jointly organized by the “Centre National de la Recherche Scientifique” (CNRS) and the “Société Française de Physique » (SFP), it was targeting the general audience with an emphasis on high-school students and teachers. The key feature of this project was to be multi-site, meaning that the event would take place simultaneously in a dozen French cities, plus the French Institute in Firenze (Italy), close to the site of the Virgo experiment. The project was also meant to be interactive, with all sites connected through a videoconference for a Q&A session with scientists, a quiz and finally a conference about astrophysics in the cinema. The event was also broadcasted live on the web, via a webcast system and the social medias. In addition, four contests (science and arts) open to anyone (schools and the general audience) were organized

La Nuit des ondes gravitationnelles : a multi-site outreach event about gravitational waves

International audienceOn Monday March 20th 2017, an outreach event dedicated to the gravitational waves and their recent discovery by the LIGO-Virgo collaboration took place. Jointly organized by the “Centre National de la Recherche Scientifique” (CNRS) and the “Société Française de Physique » (SFP), it was targeting the general audience with an emphasis on high-school students and teachers. The key feature of this project was to be multi-site, meaning that the event would take place simultaneously in a dozen French cities, plus the French Institute in Firenze (Italy), close to the site of the Virgo experiment. The project was also meant to be interactive, with all sites connected through a videoconference for a Q&A session with scientists, a quiz and finally a conference about astrophysics in the cinema. The event was also broadcasted live on the web, via a webcast system and the social medias. In addition, four contests (science and arts) open to anyone (schools and the general audience) were organized

La Nuit des ondes gravitationnelles : a multi-site outreach event about gravitational waves

International audienceOn Monday March 20th 2017, an outreach event dedicated to the gravitational waves and their recent discovery by the LIGO-Virgo collaboration took place. Jointly organized by the “Centre National de la Recherche Scientifique” (CNRS) and the “Société Française de Physique » (SFP), it was targeting the general audience with an emphasis on high-school students and teachers. The key feature of this project was to be multi-site, meaning that the event would take place simultaneously in a dozen French cities, plus the French Institute in Firenze (Italy), close to the site of the Virgo experiment. The project was also meant to be interactive, with all sites connected through a videoconference for a Q&A session with scientists, a quiz and finally a conference about astrophysics in the cinema. The event was also broadcasted live on the web, via a webcast system and the social medias. In addition, four contests (science and arts) open to anyone (schools and the general audience) were organized