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https://www.readbyqxmd.com/read/29781931/ultrasound-assessment-of-ice-ball-formation-by-cryoneurolysis-device-in-an-ex-vivo-model
#1
Adrian Kastler, Hannes Gruber, Elke Gizewski, Alexander Loizides
BACKGROUND AND OBJECTIVES: Real-time ice-ball formation during cryoneurolysis has sparsely been assessed with ultrasound (US). Cryoneurolysis in lower back pain syndrome represents a validated management option in cases of facet joint syndrome. Ultrasound may be a useful tool to perform facet joint cryodenervation. The objective of this study was to assess, ex vivo, the ability of US to assess the ice-ball formation of a cryoneurolysis device. METHODS: Ultrasound assessment of the ice-ball depiction was done using chicken muscle at 22°C in which several freezing cycles were performed with both 2...
May 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29774198/a-rare-cause-of-thoracic-spinal-cord-compression-by-multiple-large-tarlov-cysts
#2
Ahmed-Salem Kleib, Sidi-Mohamed Salihy, Hussein Hamdi, Romain Carron, Outouma Soumaré
Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacral SEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient are discussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking difficulties...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29772754/transitioning-from-acute-to-chronic-pain-an-examination-of-different-trajectories-of-low-back-pain
#3
Robert J Gatchel, Kelley Bevers, John C Licciardone, Jianzhong Su, Ying Du, Marco Brotto
Traditionally, there has been a widely accepted notion that the transition from acute to chronic pain follows a linear trajectory, where an injury leads to acute episodes, subacute stages, and progresses to a chronic pain condition. However, it appears that pain progression is much more complicated and individualized than this original unsupported assumption. It is now becoming apparent that, while this linear progression may occur, it is not the only path that pain, specifically low-back pain, follows. It is clear there is a definite need to evaluate how low-back pain trajectories are classified and, subsequently, how we can more effectively intervene during these progression stages...
May 17, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29770222/recurrent-vertebral-fractures-in-a-young-adult-a-closer-look-at-bone-health-in-type-1-diabetes-mellitus
#4
Eleanor P Thong, Sarah Catford, Julie Fletcher, Phillip Wong, Peter J Fuller, Helena Teede, Frances Milat
The association between type 1 diabetes mellitus (T1DM) and bone health has garnered interest over the years. Fracture risk is known to be increased in individuals with T1DM, although bone health assessment is not often performed in the clinical setting. We describe the case of a 21-year-old male with longstanding T1DM with multilevel vertebral fractures on imaging, after presenting with acute back pain without apparent trauma. Dual-energy X-ray absorptiometry (DXA) revealed significantly reduced bone mineral density at the lumbar spine and femoral neck...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29767395/behavioral-therapy-approaches-for-the-management-of-low-back-pain-an-up-to-date-systematic-review
#5
REVIEW
Kristallia Vitoula, Annalena Venneri, Giustino Varrassi, Antonella Paladini, Panagiota Sykioti, Joy Adewusi, Panagiotis Zis
Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression...
May 16, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29765785/spondylocostal-dysostosis-a-literature-review-and-case-report-with-long-term-follow-up-of-a-conservatively-managed-patient
#6
Brendan R Southam, Adam P Schumaier, Alvin H Crawford
Introduction: Patients with spondylocostal dysostosis (SCD) have congenital spine and rib deformities associated with frequently severe thoracic insufficiency and respiratory compromise. The literature is largely composed of case reports and small cohorts, and there is little information regarding adults with this condition. In this report, we describe the natural history of a conservatively treated patient and include quality-of-life issues such as childbearing, athletic participation, and occupational selection...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29764827/not-so-mass-effect-finding-of-a-remarkable-incidentaloma-in-a-teenager-with-neurofibromatosis
#7
Daniel John Keen, Hannah Norman-Bruce, Salah Mansy
A 13-year-old boy with neurofibromatosis type 1 presented to the emergency department twice in a fortnight with moderate intermittent abdominal pain, radiating to the back and associated with nausea and vomiting. He examined as a well child with a soft abdomen and minimal tenderness. A history of constipation was identified but he failed to respond to a trial of laxatives. Subsequent ultrasound abdomen demonstrated a large mass surrounding the porta hepatis. MRI further characterised a focal, non-aggressive lesion extending from his liver, encapsulating his pancreas, portal vessels and laterally displacing his spleen and left kidney...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29763476/drug-induced-linear-iga-bullous-dermatosis-in-a-patient-with-a-vancomycin-impregnated-cement-spacer
#8
Kelsie Riemenschneider, Daren A Diiorio, John A Zic, Matthew R Livingood, Jo-David Fine, Jennifer G Powers, Jeffrey P Zwerner, Eric Tkaczyk
Linear IgA bullous dermatosis (LABD) is an autoimmune blistering rash caused by IgA autoantibodies against the epidermal basement membrane zone. It commonly is drug induced, often in association with systemic vancomycin. We report a case of a previously healthy 77-year-old man who developed a diffuse macular rash and hemorrhagic bullae on the left leg 10 days after placement of a vancomycin-impregnated cement spacer (VICS) during a revision knee arthroplasty and initiation of postoperative treatment with intravenous (IV) vancomycin...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#9
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29759063/discontinuation-of-the-pace-plus-trial-problems-in-patient-recruitment-in-general-practice
#10
M Schreijenberg, P A J Luijsterburg, Y D M Van Trier, D Rizopoulos, M A Koopmanschap, L Voogt, C G Maher, B W Koes
BACKGROUND: The PACE Plus trial was a multi-center, double-blinded, superiority randomized controlled trial (RCT) conducted in patients from Dutch general practice to investigate the efficacy of paracetamol and NSAIDs in acute non-specific low back pain (LBP). Because insufficient numbers of patients could be recruited (only four out of the required 800 patients could be recruited over a period of 6 months), the trial was prematurely terminated in February 2017, 6 months after the start of recruitment...
May 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29758581/-managment-of-acute-low-back-pain-without-trauma-an-algorithm
#11
Carolin Melcher, Bernd Wegener, Volkmar Jansson, Wolf Mutschler, Karl-Georg Kanz, Christof Birkenmaier
BACKGROUND: Low back pain is a common problem for primary care providers, outpatient clinics and A&E departments. The predominant symptoms are those of so-called "unspecific back pain", but serious pathologies can be concealed by the clinical signs. Especially less experienced colleagues have problems in treating these patients, as - despite the multitude of recommendations and guidelines - there is no generally accepted algorithm. METHODS: After a literature search (Medline/Cochrane), 158 articles were selected from 15,000 papers and classified according to their level of evidence...
May 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29754321/chronic-low-back-pain-a-mini-review-on-pharmacological-management-and-pathophysiological-insights-from-clinical-and-pre-clinical-data
#12
REVIEW
Thomas S W Park, Andy Kuo, Maree T Smith
Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population...
May 12, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29754188/comparison-of-bilateral-versus-unilateral-decompression-incision-of-minimally-invasive-transforaminal-lumbar-interbody-fusion-in-two-level-degenerative-lumbar-diseases
#13
Yongzhao Zhao, Yanjie Zhu, Hailong Zhang, Chuanfeng Wang, Shisheng He, Guangfei Gu
PURPOSE: To compare the efficacy and safety of two different surgical incisions for minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the management of two-level degenerative lumbar diseases. METHODS: We conducted a retrospective study of 129 patients, who underwent two-level MIS-TLIF for degenerative lumbar diseases from September 2014 to December 2015. Sixty-two patients underwent MIS-TLIF with unilateral long decompression incision (group A) and 67 patients underwent MIS-TLIF with bilateral short decompression incision (group B)...
May 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29753617/patient-factors-associated-with-prolonged-postoperative-opioid-use-after-total-knee-arthroplasty
#14
Robert S Namba, Anshuman Singh, Elizabeth W Paxton, Maria C S Inacio
BACKGROUND: Pain persists in a moderate proportion of patients after total knee arthroplasty (TKA). Identifying patient factors that are associated with persistent pain may lead to improved care. PURPOSE: The purpose of the study was to identify preoperative factors associated with increased opioid prescriptions after TKA. METHODS: A retrospective cohort study of TKAs in an integrated health-care system (January 2008-December 2011) was conducted...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29753112/patients-with-chronic-spinal-pain-benefit-from-pain-neuroscience-education-regardless-the-self-reported-signs-of-central-sensitization-secondary-analysis-of-a-randomized-controlled-multicentre-trial
#15
Anneleen Malfliet, Jeroen Kregel, Mira Meeus, Lieven Danneels, Barbara Cagnie, Nathalie Roussel, Jo Nijs
BACKGROUND: Pain neuroscience education is effective in chronic pain management. Central sensitization (i.e. generalized hypersensitivity) is often explained as underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome. OBJECTIVES: To examine whether patients with more or fewer symptoms of central sensitization respond differently to pain neuroscience education. DESIGN: A secondary analysis of a multicentre, triple-blind randomized controlled trial SETTING: University hospital Ghent and University Hospital Brussels, Belgium...
May 9, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29751191/can-epidural-contrast-dispersal-pattern-help-to-predict-the-outcome-of-transforaminal-epidural-steroid-injections-in-patients-with-lumbar-radicular-pain
#16
M D Duygu Tecer, Emre Adiguzel, Ozlem Koroglu, Arif K Tan, Mehmet A Taskaynatan
BACKGROUND: To investigate the relationship between epidurographic contrast dispersal patterns and both immediate and short term clinical effectiveness of lumbar transforaminal epidural steroid injections (TFESIs) in patients with radicular back pain. METHODS: Digital database of 64 patients who underwent single-level lumbar TFESI for unilateral lumbar radicular pain were scanned Type of contrast pattern was analyzed by 1 physiatrist and definied as follows: type I (tubular appearance); type II (nerve root visible as a filling defect); or type III (cloudlike appearance)...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29740641/resistance-training-in-addition-to-multidisciplinary-rehabilitation-for-patients-with-chronic-pain-in-the-low-back-study-protocol
#17
Vegard Moe Iversen, Ottar Vasseljen, Paul Jarle Mork, Ida Reitan Berthelsen, Janne-Birgitte Bloch Børke, Gro Falkener Berheussen, Anne Therese Tveter, Øyvind Salvesen, Marius Steiro Fimland
Introduction: Chronic low back pain (LBP) is a major health problem worldwide. Multidisciplinary rehabilitation and exercise is recommended for the management of chronic LBP. However, there is a need to investigate effective exercise interventions that is available in clinics and as home-based training on a large scale. This article presents the design and rationale of the first randomized clinical trial investigating the effects of progressive resistance training with elastic bands in addition to multidisciplinary rehabilitation for patients with moderate to severe chronic LBP...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29730631/effectiveness-of-extrinsic-feedback-for-management-of-non-specific-low-back-pain-a-systematic-review-protocol
#18
Daniel Cury Ribeiro, Aleksandra Katarzyna Mącznik, Stephan Milosavljevic, J Haxby Abbott
INTRODUCTION: Low back pain is the greatest cause of years lived with disability worldwide and is linked with high societal and economic burden. Neuromuscular control impairments are a common clinical presentation in patients with non-specific low back pain. Musculoskeletal physiotherapists commonly use feedback as a part of the management of low back disorders. This systematic review will aim to assess the effectiveness of extrinsic biofeedback for reducing pain, disability and recurrence of pain in patients with non-specific low back pain...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29730460/imaging-for-low-back-pain-is-clinical-use-consistent-with-guidelines-a-systematic-review-and-meta-analysis
#19
Hazel J Jenkins, Aron S Downie, Chris G Maher, Niamh A Moloney, John S Magnussen, Mark J Hancock
BACKGROUND CONTEXT: The problem of imaging patients with low back pain (LBP) when it is not indicated is well recognised. The converse is also possible, although rarely considered. The extent of these two problems is presently unclear. PURPOSE: To estimate how commonly overuse, and also underuse, of imaging occurs in the management of LBP, and how appropriate use of imaging is assessed. DESIGN: Systematic review and meta-analysis PATIENT SAMPLE: Patients with low back pain presenting to primary care...
May 3, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29730359/emerging-trends-in-pain-medication-management-back-to-the-future-a-focus-on-ketamine
#20
REVIEW
Meredith W Crumb, Candace Bryant, Timothy J Atkinson
Providers face many challenges when faced with pain management. Pain is complex, difficult to understand, diagnose, and especially enigmatic to manage. The discovery of non-opioid agents for pain management has become particularly important considering the on-going opioid epidemic. This review is focused on revisiting Ketamine, an agent that has historically been used for anesthesia in new ways to manage pain. Ketamine has unique pharmacologic properties that may prevent the development of pain as well as reduce chronic pain...
May 3, 2018: American Journal of Medicine
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