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https://www.readbyqxmd.com/read/29913713/spinal-cord-stimulation-background-and-clinical-application
#1
Kaare Meier
Background Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain refractory to conventional treatment. SCS treatment consists of one or more leads implanted in the epidural space of the spinal canal, connected to an implantable pulse generator (IPG). Each lead carries a number of contacts capable of delivering a weak electrical current to the spinal cord, evoking a feeling of peripheral paresthesia. With correct indication and if implanted by an experienced implanter, success rates generally are in the range of about 50-75%...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29909775/clenched-fist-syndrome-a-case-report
#2
Trygve Nissen, Rolf Wynn
BACKGROUND: The clenched fist syndrome/psycho-flexed hand, first described in the early 1980s, has not yet entered the major psychiatric textbooks. Curiously, the phenomenon has been illuminated mainly in journals and textbooks on hand surgery. There is a need to examine, describe, and understand this syndrome from a psychiatric perspective. CASE PRESENTATION: We present a case we encountered in an intensive care unit. A 60-year-old white man with schizophrenia, cerebrovascular disease, diabetes mellitus type 2, and peripheral neuropathy, developed rather acutely bilateral clenched fists in the aftermath of a traumatic dislocated hip fracture that was operated on...
June 18, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29896720/stem-cell-therapy-and-type-1-diabetes-mellitus-treatment-strategies-and-future-perspectives
#3
Tahir Farooq, Kanwal Rehman, Arruje Hameed, Muhammad Sajid Hamid Akash
Type 1 diabetes mellitus (T1DM) is classified as an autoimmune disease which progressively results in the depletion of insulin-secreting β-cells. Consequently, the insulin secretion stops leading to hyperglycemic situations within the body. Under severe conditions, it also causes multi-organ diabetes-associated dysfunctionalities notably hypercoagulability, neuropathy, nephropathy, retinopathy, and sometimes organ failures. The prevalence of this disease has been noticed about 3% that has highlighted the serious concerns for healthcare professionals around the globe...
June 13, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29858510/comparison-of-peripheral-nerve-blockade-characteristics-between-non-diabetic-patients-and-patients-suffering-from-diabetic-neuropathy-a-prospective-cohort-study
#4
M Baeriswyl, P Taffé, K R Kirkham, I Bathory, V Rancati, X Crevoisier, S Cherix, E Albrecht
Animal data have demonstrated increased block duration after local anaesthetic injections in diabetic rat models. Whether the same is true in humans is currently undefined. We, therefore, undertook this prospective cohort study to test the hypothesis that type-2 diabetic patients suffering from diabetic peripheral neuropathy would have increased block duration after ultrasound-guided popliteal sciatic nerve block when compared with patients without neuropathy. Thirty-three type-2 diabetic patients with neuropathy and 23 non-diabetic control patients, scheduled for fore-foot surgery, were included prospectively...
June 2, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29808982/diabetic-foot-management-multidisciplinary-approach-for-advanced-lesion-s-rescue
#5
Enrico Brocco, Sasa Ninkovic, Mariagrazia Marin, Christine Whisstock, Marino Bruseghin, Giovanni Boschetti, Raffaella Viti, William Forlini, Antonio Volpe
Diabetic foot is a complication of diabetes affecting 15% of diabetics in their lives. It is associated to diabetic neuropathy and peripheral vascular disease and its incidence has increased. The ulceration is the initial cause of a dramatic process leading, if not correctly treated, to amputations. Both neuropathy, neuro-ischemia and infections have a role in determining healing or worsening of the lesions and 85% of all amputations in diabetic patients are preceded by a foot ulceration deteriorating to a severe gangrene or infection...
May 29, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29649995/the-prevalence-and-systemic-risk-factors-of-diabetic-macular-edema-a-cross-sectional-study-from-turkey
#6
Durgul Acan, Mehmet Calan, Duygu Er, Tugba Arkan, Nilufer Kocak, Firat Bayraktar, Suleyman Kaynak
BACKGROUND: The aim of this study was to evaluate the prevalence of diabetic macular edema (DME) utilizing optical coherence tomography (OCT), and to clarify the effects of the systemic findings and risk factors on the development of DME. METHODS: This cross-sectional study was conducted in the departments of ophthalmology and endocrinology at the Dokuz Eylul University School of Medicine in Izmir, Turkey. The demographics, type and duration of diabetes mellitus, treatment modality, smoking and alcohol consumption habits, as well as the systemic blood pressure, renal functional tests, hemoglobulin A1c level, serum lipid profile, and 24-h urine albumin level were noted and statistically analyzed...
April 12, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29574036/prognostic-scoring-system-for-patients-undergoing-reconstructive-foot-and-ankle-surgery-for-charcot-neuroarthropathy-the-charcot-reconstruction-preoperative-prognostic-score
#7
David Rettedal, Alissa Parker, Adam Popchak, Patrick R Burns
Charcot neuroarthropathy is a destructive process that occurs in patients with peripheral neuropathy, often due to poorly controlled diabetes mellitus. Surgical reconstruction can be necessary to provide a plantigrade foot that is wound free. A risk of major amputation exists after a Charcot event and after attempted reconstruction. We retrospectively reviewed the data from 34 patients (36 reconstructions) who had undergone reconstructive surgery for Charcot neuroarthropathy. The mean patient age was 56.44 years...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29559406/postoperative-period
#8
(no author information available yet)
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29481409/two-point-discrimination-predicts-pain-relief-after-lower-limb-nerve-decompression-for-painful-diabetic-peripheral-neuropathy
#9
Qi Wang, Zhuang-Li Guo, Yan-Bing Yu, Wen-Qiang Yang, Li Zhang
BACKGROUND: Peripheral nerve decompression surgery has been reported to be effective for pain reduction in patients with painful diabetic peripheral neuropathy. The aim of this study was to characterize which patients may have more pain relief benefits in the lower limbs after nerve decompression surgery. METHODS: A retrospective study was conducted. Pain levels were measured with the Numerical Rating Scale. Treatment effects were classified by either substantial relief (at least 50 percent reduction in Numerical Rating Scale score compared with preoperative Numerical Rating Scale score) or nonsubstantial relief (<50 percent reduction or worse in Numerical Rating Scale score) at 12 months based on established criteria...
March 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29481371/spinal-cord-stimulation-50-years-later-clinical-outcomes-of-spinal-cord-stimulation-based-on-randomized-clinical-trials-a-systematic-review
#10
Nagy Mekhail, Ogi Visnjevac, Gerges Azer, Diana Sue Mehanny, Priya Agrawal, Victor Foorsov
To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29467829/surgical-offloading-procedures-for-diabetic-foot-ulcers-compared-to-best-non-surgical-treatment-a-study-protocol-for-a-randomized-controlled-trial
#11
Aharon S Finestone, Eran Tamir, Guy Ron, Itay Wiser, Gabriel Agar
Background: Diabetic foot ulcers are frequently related to elevated pressure under a bony prominence. Conservative treatment includes offloading with orthopaedic shoes and custom made orthotics or plaster casts. While casting in plaster is usually effective in achieving primary closure of foot ulcers, recurrence rates are high. Minimally invasive surgical offloading that includes correction of foot deformities has good short and long term results. The surgery alleviates the pressure under the bony prominence, thus enabling prompt ulcer healing, negating the patient's dependence on expensive shoes and orthotics, with a lower chance of recurrence...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29462061/visual-loss-following-spine-surgery-what-have-we-seen-within-the-scoliosis-research-society-morbidity-and-mortality-database
#12
Jamal N Shillingford, Joseph L Laratta, Nana O Sarpong, Hasani Swindell, Meghan Cerpa, Ronald A Lehman, Lawrence G Lenke, Charla Fischer
STUDY DESIGN: A retrospective review of the Scoliosis Research Society (SRS) morbidity and mortality (M&M) database. OBJECTIVE: The aim of this study was to investigate visual related complications in spinal deformity patients undergoing spine surgery. SUMMARY OF BACKGROUND DATA: The SRS compiles surgeon-reported complications into an M&M database, tracking postoperative complications including visual loss, neurological deficits, infections, and death...
February 16, 2018: Spine
https://www.readbyqxmd.com/read/29429414/rapidly-progressive-neovascular-glaucoma-following-coronary-artery-bypass-graft-surgery-in-a-patient-with-type-1-diabetes-mellitus-a-case-report
#13
Vasant Raman, Rosemary Lambley
BACKGROUND: Proliferative diabetic retinopathy leading to vitreous hemorrhage, tractional retinal detachment, and neovascular glaucoma is a major cause of severe sight impairment in adults of working age worldwide. Neovascular glaucoma occurs in 2.5% of patients with proliferative diabetic retinopathy, which is difficult to treat and often leads to blindness. Onset of neovascular glaucoma with rapid progression to blindness within a few weeks of a successful coronary artery bypass graft procedure is not known with this clinical entity...
February 12, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29409817/botulinum-toxin-treatment-of-pain-syndromes-an-evidence-based-review
#14
Yasaman Safarpour, Bahman Jabbari
This review evaluates the existing level of evidence for efficacy of BoNTs in different pain syndromes using the recommended efficacy criteria from the Assessment and Therapeutic Subcommittee of the American Academy of Neurology. There is a level A evidence (effective) for BoNT therapy in post-herpetic neuralgia, trigeminal neuralgia, and posttraumatic neuralgia. There is a level B evidence (probably effective) for diabetic neuropathy, plantar fasciitis, piriformis syndrome, pain associated with total knee arthroplasty, male pelvic pain syndrome, chronic low back pain, male pelvic pain, and neuropathic pain secondary to traumatic spinal cord injury...
June 1, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29338755/hyperhomocysteinemia-in-bilateral-anterior-ischemic-optic-neuropathy-after-conventional-coronary-artery-bypass-graft-a-case-report
#15
A Niro, G Sborgia, A Sborgia, G Alessio
BACKGROUND: The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors could underlie anterior ischemic optic neuropathy. In this case, we report a rare presentation of a bilateral anterior ischemic optic neuropathy after coronary artery bypass graft and speculate on the preoperative hyperhomocysteinemia as an independent risk factor for anterior ischemic optic neuropathy...
January 17, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29321796/heart-rate-variability-a-new-tool-to-predict-complications-in-adult-cardiac-surgery
#16
Antonio Nenna, Mario Lusini, Cristiano Spadaccio, Francesco Nappi, Salvatore Matteo Greco, Raffaele Barbato, Elvio Covino, Massimo Chello
Heart rate variability (HRV) refers to the variations between consecutive heartbeats, which depend on the continuous modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. HRV has been shown to be effective as a predictor of risk after myocardial infarction and an early warning sign of diabetic neuropathy, and in the cardiology setting is now recognized to be a useful tool for risk-stratification after hospital admission and after discharge. Recent evidences suggest that HRV analysis might predict complications even in patients undergoing cardiac surgery, and the present review summarizes the importance of HRV analysis in adult cardiac surgery and the perspectives for HRV use in current clinical practice...
November 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29216795/oxidative-stress-and-prolidase-enzyme-activity-in-the-pathogenesis-of-primary-varicose-veins
#17
İlker Akar, İlker İnce, Cemal Aslan, İsmail Benli, Osman Demir, Nuray Altındeger, Abdullah Dogan, Mehmet Ceber
Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. The aim of this study is to evaluate the oxidative stress at venous insufficiency and to provide preliminary knowledge about the role of prolidase enzyme in varicose vein formation...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29184605/the-risk-of-ischemic-optic-neuropathy-post-phacoemulsification-cataract-surgery
#18
Mousa Victor Al-Madani, Nancy Khalaf Al-Raqqad, Naser Abdallah Al-Fgarra, Amal Mousa Al-Thawaby, Ahmed Abdelra'of Jaafar
Introduction: The aim was to study the risk of non arteritic ischemic optic neuropathy after phacoemulsification cataract surgery. Methods: This study was conducted at King Hussein Medical Center during the period between January 2015 and July 2016. Patients attending ophthalmology clinic complaining of decreased vision due to lens opacity were evaluated. Patients were divided into two groups. First group included patients with no medical illness and second group included patients with diabetes mellitus, hypertension or hyperlipidemia...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29154506/evaluation-of-major-and-minor-lower-extremity-amputation-in-diabetic-foot-patients
#19
Fırat Ozan, Kaan Gürbüz, İlhami Çelik, Zehra Beştepe Dursun, Erdal Uzun
Background/aim: We evaluated the existing risk factors with clinical results in patients who underwent major and minor amputation of the lower extremity as a result of diabetic foot ulcers (DFUs). Materials and methods: We retrospectively studied 107 patients who had undergone lower extremity amputation. The patients were divided into minor (Group 1, n = 75) and major (Group 2, n = 32) amputation groups. On clinical evaluation, the type of surgery performed, smoking history, comorbidities, duration of diabetes mellitus (DM) diagnosis, duration of DFU presence, peripheral neuropathy, peripheral arterial disease, results of deep tissue culture, length of hospitalization, and blood parameters were investigated...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29068902/optimization-of-surgical-outcome-in-lower-extremity-nerve-decompression-surgery
#20
Willem D Rinkel, Jasper L de Kleijn, Joanne F M Macaré van Maurik, J Henk Coert
BACKGROUND: There is still debate regarding whether the surgical release of entrapped lower extremity nerves reduces complaints of associated neuropathy and results in gain of sensory function. The aim of this study was to investigate which factors are associated with a favorable surgical outcome, by follow-up of patients previously participating in a randomized controlled trial. METHODS: The authors evaluated the 5-year follow-up of diabetic patients previously participating in the Lower Extremity Nerve Entrapment Study (LENS)...
February 2018: Plastic and Reconstructive Surgery
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