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pain regional syndrome

G Delvecchio, M G Rossetti, E Caletti, A Arighi, D Galimberti, P Basilico, M Mercurio, R A Paoli, C Cinnante, F Triulzi, A C Altamura, E Scarpini, P Brambilla
BACKGROUND: Somatoform Disorders (SD) are a heterogeneous group of psychiatric syndromes characterized by common symptoms, which may mimic a physical condition but they are not explained by a medical condition. Although the biologic nature of this disorder has been widely accepted, the neuroanatomical correlates characterizing SD are still inconclusive. Therefore, this study aims to explore gray matter (GM) volume alterations in SD patients compared to healthy controls and their possible association with clinical and cognitive measures...
July 20, 2018: Psychosomatics
Scott Nathan Loewenstein, Stephen P Duquette, Joshua M Adkinson
BACKGROUND: Hand surgery dogma suggests that simultaneous surgical treatment of carpal tunnel syndrome (CTS) and Dupuytren's contracture (DC) results in an increased incidence of Complex Regional Pain Syndrome (CRPS). As a result, many surgeons do not perform surgery for the two conditions concurrently. Our goal was to determine the extent of this association. METHODS: We identified all patients undergoing surgical treatment for CTS, DC, or both between April 1982 and March 2017 using the Indiana Network for Patient Care (INPC), a large, multi-institutional, statewide information exchange...
August 11, 2018: Plastic and Reconstructive Surgery
Catherine S Hubbard, Lino Becerra, Nicole Heinz, Allison Ludwick, Tali Rasooly, Anastasia Yendiki, Rina Wu, Neil L Schechter, Samuel Nurko, David Borsook
Alterations in fractional anisotropy (FA) have been considered to reflect microstructural white matter (WM) changes in disease conditions; however, no study to date has examined WM changes using diffusion tensor imaging (DTI) in adolescents with irritable bowel syndrome (IBS). The objective of the present study was two-fold: (1) to determine whether differences in FA, and other non-FA metrics, were present in adolescents with IBS compared to healthy controls using whole-brain, region of interest (ROI)-restricted tract-based spatial statistics (TBSS) and canonical ROI DTI analyses for the cingulum bundle, and (2) to determine whether these metrics were related to clinical measures of disease duration and pain intensity in the IBS group...
July 2018: ENeuro
Ugochi C Okoroafor, Lisa K Cannada
Background: The American Academy of Orthopedic Surgeons (AAOS) has provided Clinical Practice Guidelines (CPG) and Appropriate Use Criteria (AUC) regarding management of distal radius fractures. The purpose of this study was to evaluate current practices in management of distal radius fractures among orthopedic trauma surgeons and to examine adherence to the AAOS criteria. Methods: An online survey was posted and distributed via the Orthopaedic Trauma Association (OTA) website...
2018: Iowa Orthopaedic Journal
Ahmed Abuosa, Jamilah AlRahimi, Nasir Mansour, Ashar Bilal, Atif AlQabbani, Akram Neyaz
A case of a young Saudi patient with a previous diagnosis of bronchial asthma, nasal polyps, and chronic smoker, presented with atypical chest pain, elevated serum troponin and borderline ischemic electrocardiogram (ECG) changes, with no significant regional wall motion abnormalities at bedside echocardiography is reported. The patient was admitted to the coronary care unit for continuous monitoring as possible acute coronary syndrome, non-ST elevation myocardial infarction (STEMI). One hour after admission, the patient had ventricular fibrillation (VF) cardiac arrest that required three DC shocks and amiodarone bolus before returning of spontaneous circulation, which followed the fourth shock...
October 2018: Journal of the Saudi Heart Association
Ozan Beytemür, Ümit Seza Tetikkurt, Serdar Yüksel, Mehmet Öncü
We report a 14-year-old boy who presented with pain in the left foot and ankle for about 9 months. The clinical symptoms of the patient suggested complex regional pain syndrome (CRPS). The radiographs and magnetic resonance imaging studies ravealed a bone tumor in the talus, consistent with an osteoblastoma. The patient underwent operative treatment with curettage and grafting. The complaints of the patient completely resolved by 6 months after surgery, and there was no recurrence at the postoperative 23th month follow-up...
August 9, 2018: Acta Orthopaedica et Traumatologica Turcica
Brett Morgan, Steve Wooden
Management of chronic pain has become a significant challenge for primary care providers, and the population of patients with chronic pain is expected to increase. Common syndromes seen in the primary care setting include myofascial pain syndrome, fibromyalgia, chronic postsurgical pain, complex regional pain syndrome, and painful diabetic neuropathy. This article describes these syndromes and presents current treatment options.
September 2018: Nursing Clinics of North America
Clémentine Brun, Nicolas Giorgi, Anne-Marie Pinard, Martin Gagné, Candida S McCabe, Catherine Mercier
Chronic pain is often accompanied by patient reported distorted body perception and an altered kinesthesia (referring to the senses of limb position and limb movement), but the association between these deficits is unknown. OBJECTIVES: 1- to assess body perception, and the senses of limb position and limb movement in Complex Regional Pain Syndrome (CRPS); 2- to test whether these variables are related to each other and to pain intensity. Thirteen upper limb CRPS (mean pain intensity: 4...
August 9, 2018: Journal of Pain: Official Journal of the American Pain Society
Francesco Brigo, Alberto Vogrig, Arianna Bratti, Veronica Tavernelli, Raffaele Nardone, Eugen Trinka
Epilepsia partialis continua (EPC) is a rare form of focal status epilepticus. We describe a 22-year-old woman with EPC manifesting with isolated toe movements, prevalent over the left side and initially misdiagnosed as psychogenic, clinically almost indistinguishable from those observed in "painful legs and moving toes syndrome". The continuous involuntary movements with EMG correlates of twitches lasting <100 ms, the sharp waves over fronto-central regions on EEG, and the marked asymmetry in somatosensory evoked potentials with higher cortical amplitude over the right side following peripheral stimulation over the left foot confirmed the epileptic nature of the symptoms, leading to the diagnosis of EPC...
August 10, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
Leidiane Mazzardo-Martins, Daiana Cristina Salm, Elisa C Winkelmann-Duarte, Júlia Koerich Ferreira, Daniela Dero Lüdtke, Kamilla Pamplona Frech, Luiz Augusto Oliveira Belmonte, Verônica Vargas Horewicz, Anna Paula Piovezan, Francisco José Cidra-Filho, Ari Ojeda Ocampo Moré, Daniel Fernandes Martins
Complex regional pain syndrome (CRPS) is a disorder that involves abnormal inflammation and nerve dysfunction frequently resistant to a broad range of treatments. Peripheral nerve stimulation with electroacupuncture (EA) has been widely used in different clinical conditions to control pain and inflammation; however, the use of EA in the treatment of CRPS is under investigation. In this study, we explore the effects of EA on hyperalgesia and edema induced in an animal model of chronic post-ischemia pain (CPIP model) and the possible involvement of endothelin receptor type B (ETB ) in this effect...
August 10, 2018: Pflügers Archiv: European Journal of Physiology
Christopher A J Webb, T Edward Kim
Acute pain management is an expanding perioperative specialty and there is a renewed focus on implementing and developing an acute pain service (APS) in nonacademic hospitals (ie, "private practice"). An anesthesiologist-led APS can improve patient care by decreasing perioperative morbidity and potentially reducing the risk of chronic postsurgical pain syndromes. Elements of a successful APS include multidisciplinary collaboration to develop perioperative pain protocols, education of health care providers and patients, and regular evaluation of patient safety and quality of care metrics...
September 2018: Anesthesiology Clinics
Tami Bar-Shalita, Anatoly Livshitz, Yulia Levin-Meltz, Debbie Rand, Lisa Deutsch, Jean-Jacques Vatine
OBJECTIVE: Complex Regional Pain Syndrome (CRPS), a chronic pain condition, develops mainly after limb trauma and severely inhibits function. While early diagnosis is essential, factors for CRPS onset are elusive. Therefore, identifying those at risk is crucial. Sensory modulation dysfunction (SMD), affects the capacity to regulate responses to sensory input in a graded and adaptive manner and was found associated with hyperalgesia in otherwise healthy individuals, suggestive of altered pain processing...
2018: PloS One
Emma Sturm, Alex Tai, Belinda Lin, Jason Kwong, Eugene Athan, Benjamin P Howden, Richard D Angliss, Rafik Asaid, James Pollard
BACKGROUND: Hypervirulent strains of Klebsiella pneumoniae are a recognized cause of a distinct invasive syndrome that results in pyogenic liver abscesses and metastatic complications, particularly in the Asia Pacific region. Reports of hypervirulent K.pneumoniae in Europe, the Americas and Australia indicate worldwide spread. We present a case of multi-focal osteomyelitis, a rarely described complication of hypervirulent K.pneumoniae in the medical literature. The prevalence of this condition in countries outside Asia may be expected to rise with increasing travel...
August 7, 2018: BMC Infectious Diseases
Lauren M Poe, Christopher M Sobey
A 59-year-old man presented 7 months after coronary artery bypass with continued bilateral axillary pain. His symptoms progressed over a period of months to allodynia, edema, erythema, decreased range of motion, and skin changes consistent with complex regional pain syndrome type I. After failing multiple treatment options, the patient underwent a trial of spinal cord stimulation. Leads positioned in the posterior epidural space from the seventh cervical to the third thoracic vertebral levels resulted in complete paresthesia coverage of his truncal chronic regional pain syndrome (CRPS) and the stimulation was associated with almost complete resolution of CRPS...
August 6, 2018: A&A practice
Corey W Hunter, Dawood Sayed, Timothy Lubenow, Timothy Davis, Jonathan Carlson, Jeffery Rowe, Ralph Justiz, Tory McJunkin, Timothy Deer, Pankaj Mehta, Steven Falowski, Leo Kapural, Jason Pope, Nagy Mekhail
INTRODUCTION: Dorsal root ganglion stimulation (DRGS) is a powerful tool in the treatment of chronic, neuropathic pain. The premise of DRGS is similar to that of conventional spinal cord stimulation (cSCS), however, there is more variability in how it can be utilized. While it is this variability that likely gives it its versatility, DRGS is not as straightforward to implement as cSCS. The purpose of this study was to assess the efficacy of DRGS on a broad number of diagnoses, determine which dorsal root ganglia were associated with better outcomes for particular body parts/diagnoses, and evaluate what factors/parameters were associated with higher rates of trial success...
August 7, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Ryan Adams, Sarah Herrera-Nicol, Arthur L Jenkins
Background  Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, 3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion...
July 2018: Journal of Neurological Surgery Reports
Frank J P M Huygen, Liong Liem, Harold Nijhuis, William Cusack, Jeffery Kramer
OBJECTIVES: Dorsal root ganglion (DRG) stimulation is a recent neuromodulation option that has delivered safe, effective pain relief for a number of etiologies. This prospective observational study was intended to establish the effectiveness of this treatment in a typical real-world clinical context. MATERIALS AND METHODS: Participants with chronic, intractable pain of the trunk or lower limbs were recruited from multiple pain clinics in the Netherlands. Subjects were trialed and implanted with DRG stimulation systems...
August 5, 2018: Neuromodulation: Journal of the International Neuromodulation Society
S Roulet, G Bacle, J Guéry, B Charruau, E Marteau, J Laulan
The goal of this study was to assess the recurrence of Dupuytren's disease and the stability of the functional result after fasciectomy combined with the McCash open-palm technique. From 1989 to 1999, 56 consecutive patients were surgically treated for Dupuytren's disease. In 2003, 40 of these operated patients were reviewed by an independent evaluator; 12 patients were Tubiana stage 1, 16 stage 2, 9 stage 3 and 3 stage 4. Twenty-one of them were reviewed again in 2016 by a second evaluator who was unaware of the clinical results in 2003...
August 2, 2018: Hand Surgery and Rehabilitation
Trent M Gause, John J Nunnery, Abhinav B Chhabra, Brian C Werner
BACKGROUND: The goals of the study were to: (1) evaluate trends in preoperative and prolonged postoperative narcotic use in carpal tunnel release (CTR); (2) characterize risks for prolonged narcotic use; and (3) evaluate narcotic use as an independent risk factor for complications following CTR. METHODS: A query of a large insurance database from 2007-2016 was conducted. Patients undergoing open or endoscopic CTR were included. Revision surgeries or patients undergoing median nerve repair at the forearm, upper extremity fasciotomies, or with distal radius fractures were excluded...
August 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Jose Armando Gonzales Zamora, Yogeeta Varadarajalu
Cryptococcosis is a fungal infection that is typically associated with acquired immunodeficiency syndrome (AIDS). The advent of highly active antiretroviral therapy has decreased the frequency of this infection, but has led to the emergence of atypical cases of immune reconstitution inflammatory syndrome (IRIS). Here, we describe the case of a 40-year-old man who was diagnosed with HIV infection and cryptococcal meningitis. He was successfully treated with antifungals and then started antiretroviral therapy...
July 28, 2018: Diseases (Basel)
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