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Management of chronic pain

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https://www.readbyqxmd.com/read/28934800/comparison-of-intraarticular-pulsed-radiofrequency-and-intraarticular-corticosteroid-injection-for-management-of-cervical-facet-joint-pain
#1
Ji Woon Lim, Yun-Woo Cho, Dong Gyu Lee, Min Cheol Chang
BACKGROUND: Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the management of joint pain. OBJECTIVE: The aim of this study was to evaluate the effect of intraarticular (IA) PRF for the management of cervical facet joint (CFJ) pain...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934799/factors-influencing-the-application-of-a-biopsychosocial-perspective-in-clinical-judgement-of-chronic-pain-interactive-management-with-medical-students
#2
Christopher P Dwyer, Phoebe E McKenna-Plumley, Hannah Durand, Emer M Gormley, Brian W Slattery, Owen M Harney, Padraig MacNeela, Brian E McGuire
BACKGROUND: Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934798/clinical-course-of-cervical-percutaneous-epidural-neuroplasty-in-single-level-cervical-disc-disease-with-12-month-follow-up
#3
Chang Hyun Oh, Gyu Yeul Ji, Dong Ah Shin, Pyung Goo Cho, Seung Hwan Yoon
BACKGROUND: Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented. OBJECTIVE: The purpose of this study was to evaluate the efficacy of cervical PEN for single-level cervical disc disease...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934795/comparisons-of-lesion-volumes-and-shapes-produced-by-a-radiofrequency-system-with-a-cooled-a-protruding-or-a-monopolar-probe
#4
David L Cedeno, Alejandro Vallejo, Courtney A Kelley, Dana M Tilley, Nitesh Kumar
BACKGROUND: Radiofrequency (RF) ablation for denervation has been utilized for decades in chronic pain management. This relies on the proper targeting of the affected nerve which may be obtained by creating an ablation lesion with a shape and volume that optimizes targeting. Various systems designed to improve lesion size are available. These include cooling the active tip (cooled-RF) and protruding the RF electrode outside the active tip (PERF). OBJECTIVES: This study compares lesion volumes of 3 commercially available RF systems: cooled-RF, "V" shaped active cannula and protruding electrode (18 g and 20 g), and monopolar RF (MRF; 16 g, 18 g, and 20 g)...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934791/a-practical-guide-for-treatment-of-pain-in-patients-with-systemic-mast-cell-activation-disease
#5
Stefan Wirz, Gerhard J Molderings
Systemic mast cell activation disease (MCAD, a subclass of mastocytosis), which has a prevalence of around 17% (at least in the German population), is characterized by accumulation of genetically altered dysfunctional mast cells with abnormal release of these cells' mediators. Since mast cells affect functions in potentially every organ system, often without causing abnormalities in routine laboratory or radiologic testing, this disease has to be considered routinely in the differential diagnosis of patients with chronic multisystem polymorbidity of a generally inflammatory and allergic theme...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934790/factors-associated-with-successful-responses-to-transforaminal-balloon-adhesiolysis-for-chronic-lumbar-foraminal-stenosis-retrospective-study
#6
Doo Hwan Kim, Seong-Sik Cho, Yeon-Jin Moon, Koo Kwon, Kunhee Lee, Jeong-Gil Leem, Jin-Woo Shin, Ji Hyun Park, Seong-Soo Choi
BACKGROUND: Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. OBJECTIVE: To evaluate the factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar spinal stenosis. STUDY DESIGN: This is a retrospective observational study...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934785/1-year-results-of-a-randomized-controlled-trial-of-conservative-management-vs-minimally-invasive-surgical-treatment-for-sacroiliac-joint-pain
#7
Julius Dengler Dengler, Djaya Kools, Robert Pflugmacher, Alessandro Gasbarrini, Domenico Prestamburgo, Paolo Gaetani, Eddie van Eeckhoven, Daniel Cher, Bengt Sturesson
BACKGROUND: Low back pain (LBP) emanating from the sacroiliac joint (SIJ) is a common finding. Devices to fuse the SIJ are now commercially available, but high-quality evidence supporting their effectiveness is limited. OBJECTIVES: To compare the safety and effectiveness of conservative management (CM) to minimally invasive sacroiliac joint fusion (SIJF) in patients with chronic LBP originating from the SIJ. STUDY DESIGN: Prospective, multicenter randomized controlled trial...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934780/efficacy-of-cannabis-based-medicines-for-pain-management-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
J Aviram, G Samuelly-Leichtag
BACKGROUND: The management of chronic pain is a complex challenge worldwide. Cannabis-based medicines (CBMs) have proven to be efficient in reducing chronic pain, although the topic remains highly controversial in this field. OBJECTIVES: This study's aim is to conduct a conclusive review and meta-analysis, which incorporates all randomized controlled trials (RCTs) in order to update clinicians' and researchers' knowledge regarding the efficacy and adverse events (AEs) of CBMs for chronic and postoperative pain treatment...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934779/what-are-the-predictors-of-altered-central-pain-modulation-in-chronic-musculoskeletal-pain-populations-a-systematic-review
#9
Jacqui Clark, Jo Nijs, Gillian Yeowell, Peter Charles Goodwin
BACKGROUND: Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation. OBJECTIVES: To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934765/qualitative-study-the-experience-and-impact-of-living-with-behcet-s-syndrome
#10
Vicky Tai, Karen Lindsay, Joanne L Sims, Fiona M McQueen
AIM: Behcet's syndrome is a rare chronic multisystemic vasculitis of unknown aetiology, is unpredictable and can cause life-threatening complications. This qualitative study aims to explore the experiences of patients living with Behcet's syndrome in New Zealand. METHODS: Eight English-speaking patients participated in in-depth semi-structured interviews about their experiences of living with Behcet's syndrome. Interviews were recorded and transcribed. Data were analysed using a general inductive thematic approach...
September 22, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28933696/a-novel-topical-wound-therapy-delivery-system
#11
Ingrid Herskovitz, Flor E MacQuhae, Luis J Borda, Stephanie Bhagwandin, Juan A Paredes, Thais Polanco, John C Lantis, Paul J Kim, Tania J Phillips, Robert S Kirsner
INTRODUCTION: Wound care dressings have evolved over time, from bandaging to the development of occlusive dressings to negative pressure wound therapy. A novel therapeutic delivery system dressing has been cleared by the United States Food and Drug Administration. This semi occlusive wound dressing has been developed to provide local, continuous delivery of aqueous topical agents, such as therapeutics (anesthetics, antiseptics, antibiotics, steroids, topical beta-blockers, immune modulatory agents, growth factors, and fibrinolytic agents, among others), at a rate of about ¾ mL per day, thus maintaining a hydrated environment and providing topical treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28929914/the-conundrum-of-opioid-tapering-in-long-term-opioid-therapy-for-chronic-pain-a-commentary
#12
Ajay Manhapra, Albert A Arias, Jane C Ballantyne
BACKGROUND: In response to the opioid epidemic and new guidelines, many patients on high-dose long term opioid therapy (LTOT) for chronic pain are getting tapered off opioids. As a result, a unique clinical challenge is emerging: while many on LTOT have poor pain control, functional decline, psychiatric instability, aberrancies and misuse, these issues may often worsen with opioid tapering. Currently, a clear explanation and practical guidance on how to manage this perplexing clinical scenario is lacking...
September 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28929035/porcine-urinary-bladder-matrix-for-management-of-infected-radiation-mastectomy-wound
#13
Yana Puckett, Theophilus Pham, Shirley McReynolds, Catherine A Ronaghan
We present a case report on the successful healing of a Pseudomonas infection wound in a 52-year-old female with morbid obesity, noninsulin dependent diabetes mellitus and a history of tobacco use, who presented with Stage IIIA (T3, N2, Mo) infiltrating ductal carcinoma. The patient received neoadjuvant chemotherapy prior to her bilateral skin-sparing total mastectomies with right axillary sentinel lymphadenectomy. She also had staged reconstruction with temporary breast implants and plans for deep inferior epigastric perforator flaps...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28928577/a-prospective-observational-study-to-evaluate-the-role-of-gabapentin-as-preventive-analgesic-in-thyroidectomy-under-general-anesthesia
#14
Vadakkoot Raghavan Hema, Konnanath Thekkethil Ramadas, Kannammadathy Poulose Biji, Suseela Indu, Aravind Arun
BACKGROUND: Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928498/innovative-application-of-cox-flexion-distraction-decompression-to-the-knee-a-retrospective-case-series
#15
Luigi Albano
OBJECTIVE: The purpose of this study is to introduce the application of Cox flexion distraction decompression as an innovative approach to treating knee pain and osteoarthritis. METHODS: Six months of clinical files from one chiropractic practice were retrospectively screened for patients who had been treated for knee pain. Twenty-five patients met the criteria for inclusion. The treatment provided was Cox flexion distraction decompression. Pre-treatment and post-treatment visual analog pain scales (VAS) were used to measure the results...
August 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/28927228/management-of-chronic-pain-through-pain-management-programmes
#16
I R Wilson
Introduction: Chronic pain carries significant impact and is difficult to treat with limited success. Pain management programmes (PMPs) use cognitive behavioural therapy (CBT)-based multidisciplinary rehabilitative approaches to drive functional improvement. Sources of data: A search was conducted using Medline and the Cochrane Library to identify published literature about PMPs or CBT to treat chronic pain. Areas of agreement: PMPs have significant benefit on functioning for some patients but relatively little impact on the pain...
September 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28924519/acute-pericarditis-descriptive-study-and-etiology-determination-in-a-predominantly-african-american-population
#17
Ahmad Awan, Fasil Tiruneh, Priscilla Wessly, Akbar Khan, Hasan Iftikhar, Sydney Barned, Daniel Larbi
INTRODUCTION ---Acute pericarditis is the most commonly encountered manifestation of pericardial disease (incidence: 0.2 percent to 0.5 percent in hospitalized patients). However, data regarding manifestations, workup, and the management of acute pericarditis in the African American population is lacking. This study aims to collect and analyze more clinical data related to acute pericarditis in this understudied population. METHODOLOGY We conducted a retrospective chart review of all patients managed for acute pericarditis at a university hospital serving a predominantly African American population...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/28924009/site-specific-regulation-of-p2x7-receptor-function-in-microglia-gates-morphine-analgesic-tolerance
#18
Heather Leduc-Pessah, Nicholas L Weilinger, Churmy Y Fan, Nicole E Burma, Roger J Thompson, Tuan Trang
Tolerance to the analgesic effects of opioids is a major problem in chronic pain management. Microglia are implicated in opioid tolerance, but the core mechanisms regulating their response to opioids remain obscure. By selectively ablating microglia in the spinal cord using a saporin-conjugated antibody to Mac1, we demonstrate a causal role for microglia in the development, but not maintenance, of morphine tolerance in male rats. Increased P2X7 receptor (P2X7R) activity is a cardinal feature of microglial activation, and in this study we found that morphine potentiates P2X7R-mediated Ca(2+) responses in resident spinal microglia acutely isolated from morphine tolerant rats...
September 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28923678/a-case-report-on-gastric-volvulus-of-a-17-years-old-boy-from-bangladesh
#19
M Tasdik Hasan, S M Tajdit Rahman, Hasan M Shihab, Hassan Rushekh Mahmood, Tanni Chowdhury, Quamrul Akhtar Sanju
INTRODUCTION: Gastric volvulus is a rare and true surgical emergency which is life threatening if not recognized and treated quickly. There have been approximately 300 reported cases globally till now. This condition most often occurs during 5th decade of life but there are over 100 reported pediatric cases also. This following rare incidence was such a case of a young patient in Bangladesh. It was the first case of gastric volvulus managed by the surgery department of the concerned hospital...
September 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28923307/association-between-opioid-use-and-risk-of-erectile-dysfunction-a-systematic-review-and-meta-analysis
#20
REVIEW
Shankun Zhao, Tuo Deng, Lianmin Luo, Jiamin Wang, Ermao Li, Luhao Liu, Futian Li, Jintai Luo, Zhigang Zhao
BACKGROUND: Opioid analgesics have been widely used to relieve chronic pain conditions; however, a connection between opioid analgesic administration and increased susceptibility to erectile dysfunction (ED) has been hypothesized. AIM: To evaluate whether opioid use was a risk factor for ED in a systematic review and meta-analysis. METHODS: The PubMed, Cochrane Library, and Embase databases were searched to identify eligible studies concerning opioid use and risk of ED from inception to April 2017...
September 8, 2017: Journal of Sexual Medicine
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