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Multidisciplinary pain

Davis C Woodworth, Adelle Dagher, Adam Curatolo, Monisha Sachdev, Cody Ashe-McNalley, Bruce D Naliboff, Jennifer S Labus, J Richard Landis, Jason J Kutch, Emeran A Mayer, Richard S Lee, Marsha A Moses, Benjamin M Ellingson
The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network has yielded neuroimaging and urinary biomarker findings that highlight unique alterations in brain structure and in urinary proteins related to tissue remodeling and vascular structure in patients with Urological Chronic Pelvic Pain Syndrome (UCPPS). We hypothesized that localized changes in diffusion tensor imaging (DTI) measurements might be associated with corresponding changes in urinary protein levels in UCPPS. To test this hypothesis, we created statistical parameter maps depicting the linear correlation between DTI measurements (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) and urinary protein quantification (MMP2, MMP9, NGAL, MMP9/NGAL complex, and VEGF) in 30 UCPPS patients from the MAPP Research Network, after accounting for clinical covariates...
2018: PloS One
Zacariah K Shannon, Stacie A Salsbury, Donna Gosselin, Robert D Vining
BACKGROUND: Few studies have investigated patient and provider expectations of chiropractic care, particularly in multidisciplinary settings. This qualitative study explored stakeholder expectations of adding a chiropractor to the healthcare team at a rehabilitation specialty hospital. METHODS: The research methodology was an organizational case study with an inpatient facility for persons recovering from complex neurological conditions serving as the setting. Sixty stakeholders, including patients, families, hospital staff, and administrators, were interviewed or participated in focus groups in June 2015...
December 4, 2018: BMC Complementary and Alternative Medicine
Yu-Mi Im, Tae-Jin Yun, Il-Young Yoo, Sanghee Kim, Juhye Jin, Sue Kim
BACKGROUND: Prenatal diagnosis of fetal congenital heart disease (CHD) is becoming widely available but there is a lack of understanding on such expectant mothers' experiences during pregnancy. This was the first study to investigate the pregnancy experience of Korean mothers with a prenatal fetal diagnosis of CHD. METHODS: In-depth interviews were conducted with 12 mothers regarding their child's prenatal diagnosis of CHD and the adaptive processes during pregnancy...
December 3, 2018: BMC Pregnancy and Childbirth
Sandra Rizo Treviño
Introduction: Chronic diseases are on the rise and are associated with weight gain. Multidisciplinary strategies are required for its control. Methods: The design was descriptive, observational and retrospective. The objectives of this communication were to describe the demographic and clinical characteristics and adverse reactions of overweight and obese people who were consumers of orlistat, attended by a call center during the period 2009 to 2017; and to identify the healthcare professional most consulted by them...
October 16, 2018: Medwave
Cristian Barrientos, Julian Brañes, José-Luis Llanos, Alvaro Martinez, Maximiliano Barahona
Hip replacement is the surgery of the last century due to its impact on the quality of life. A pseudotumour is a rare complication of hip arthroplasty, and it is related to a metal-bearing surface. Pseudotumour is a challenging scenario for hip surgeons due to poor clinical outcomes. The patient consulted for hip pain and paresthesia in the left lower extremity, and analyses showed that the cause was a sizeable intrapelvic pseudotumour. A multidisciplinary team surgery was planned. At first, an infraumbilical approach was made to resect the intrapelvic-retroperitoneum portion of the pseudotumour...
2018: Case Reports in Orthopedics
Per Kjaer, Alice Kongsted, Inge Ris, Allan Abbott, Charlotte Diana Nørregaard Rasmussen, Ewa M Roos, Søren T Skou, Tonny Elmose Andersen, Jan Hartvigsen
BACKGROUND: Clinical guidelines recommend that people with back pain be given information and education about their back pain, advice to remain active and at work, and exercises to improve mobility and physical activity. Guidelines, however, rarely describe how this is best delivered. The aim of this paper is to present the development, theories, and underlying evidence for 'GLA:D Back' - a group education and exercise program that translates guideline recommendations into a clinician-delivered program for the promotion of self-management in people with persistent/recurrent back pain...
November 29, 2018: BMC Musculoskeletal Disorders
Charlotte Mallon, Rachael Gooberman-Hill, Ashley Blom, Michael Whitehouse, Andrew Moore
Knee replacement is a common preference sensitive quality-of-life procedure that can reduce pain and improve function for people with advanced knee arthritis. While most patients improve, knee replacement surgery has the potential for serious complications. Prosthetic knee infection is an uncommon but serious complication. This study explored the impact of cases of prosthetic knee infection on surgeons' personal and professional wellbeing. Qualitative telephone interviews were conducted with consultant orthopaedic surgeons who treated patients for prosthetic knee infection in one of six high-volume NHS orthopaedic departments...
2018: PloS One
Lidija Bach-Rojecky, Dalia Vađunec, Katarina Žunić, Jelena Kurija, Sara Šipicki, Ryan Gregg, Ivan Mikula, Dragan Primorac
Successful pain management requires the delivery of analgesia with minimal risk of adverse drug reactions. Nonsteroidal anti-inflammatory drugs and opioids remain the mainstay of treatment for the majority of patients. Unfortunately, almost 50% of all patients experience inadequate pain relief and serious side effects. Allelic variants in genes coding for target proteins, transporters and enzymes, which govern analgesic drugs action and their fate in the organism, might explain inter-individual variability in pain severity and in drug-induced pain relief and toxicities...
November 28, 2018: Personalized Medicine
Rainer Freynhagen, Harold Arevalo Parada, Carlos Alberto Calderon-Ospina, Juythel Chen, Dessy Rakhmawati Emril, Freddy Fernandez Villacorta, Hector Franco, Kok-Yuen Ho, Argelia Lara-Solares, Carina Ching-Fan Li, Alberto Mimenza Alvarado, Sasikaan Nimmaanrat, Maria Dolma Santos, Daniel Ciampi de Andrade
Despite having been referenced in the literature for over a decade, the term 'mixed pain' has never been formally defined. The strict binary classification of pain as being either purely neuropathic or nociceptive once left a good proportion of patients unclassified; even the recent adoption of 'nociplastic pain' in the IASP Terminology leaves out patients who present clinically with a substantial overlap of nociceptive and neuropathic symptoms. For these patients, the term 'mixed pain' is increasingly recognized and accepted by clinicians...
November 27, 2018: Current Medical Research and Opinion
John F Jarrell, George A Vilos, Catherine Allaire, Susan Burgess, Claude Fortin, Robert Gerwin, Louise Lapensee, Robert H Lea, Nicholas A Leyland, Paul Martyn, Hassan Shenassa, Paul Taenzer
OBJECTIVE: To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies...
November 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Donna Eastwood, Neil Manson, Erin Bigney, Mariah Darling, Eden Richardson, Richard Paixao, Tracy Underwood, Kate Ellis, Edward Abraham
BACKGROUND CONTEXT: Patient expectations have been demonstrated to influence recovery following spine surgery. Addressing patient expectations specifically in regards to pain and post-surgical healing is an important factor in improving recovery patterns. Pre-surgical education can potentially help manage patient expectations. PURPOSE: The primary objective was to determine if participation in a single preoperative multidisciplinary educational session would result in reduced patient dissatisfaction with surgical expectations...
November 21, 2018: Spine Journal: Official Journal of the North American Spine Society
Josefine Letzel, Felix Angst, Martin B Weigl
BACKGROUND: In contrast to the large evidence of the effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) in chronic low back pain, little is known about the effects of MBR in chronic neck pain (CNP). AIM: To quantify short-term and 12-month effects of a 3-week CNP-specific MBR program. DESIGN: Naturalistic prospective observational cohort study with intraindividual control of effects. SETTING: Outpatient clinic at a tertiary physical medicine and rehabilitation centre...
November 21, 2018: European Journal of Physical and Rehabilitation Medicine
Martin Urner, Bruno L Ferreyro, Ghislaine Douflé, Sangeeta Mehta
The paradigm of supportive care of patients who are critically ill has changed significantly over the past 20 years. Patients on mechanical ventilation are no longer heavily sedated; the goal is a comfortable patient who can interact with health-care professionals and with their family members. Systematic, regular assessment of the patient for pain, anxiety, and sleep deprivation allows early recognition of these distressing symptoms. Appropriate treatment of patients' symptoms should be based on a multi-modal pharmacologic and non-pharmacologic approach...
December 2018: Respiratory Care
Vaishali Patel, Field Willingham
Chronic pancreatitis (CP) may remain undiagnosed for years until patients exhibit manifestations, such as pain and exocrine or endocrine insufficiency. Some patients with CP develop serious complications, such as malignancy or peripancreatic fluid collections. Considering CP in at-risk patients such as those with a long-standing history of alcohol or tobacco use is key to establishing the diagnosis. Management involves reducing and eliminating exposures, dietary modification, treatment of pancreatic insufficiency, assessing for complications, and surveillance for neoplasia...
January 2019: Medical Clinics of North America
Elena Boccuzzi, Valentina A Ferro, Bianca Cinicola, Paolo M Schingo, Luisa Strocchio, Umberto Raucci
Leukemia is the most common childhood malignancy, and it is often characterized by pallor, fatigue, cytopenia, and organomegaly; sometimes musculoskeletal symptoms, mainly characterized by diffuse bone pain in the lower extremities, are the onset clinical characteristics of the disease. In these cases, the disease may initially be misdiagnosed as reactive arthritis, osteomyelitis, or juvenile idiopathic arthritis delaying appropriate diagnosis and management. Even if leukopenia, thrombocytopenia, and a history of nighttime pain are reported to be the most important predictive factors for a pediatric leukemia, blood examinations can sometimes be subtle or within normal limits, and this represents a further diagnostic difficulty...
November 19, 2018: Pediatric Emergency Care
Julia Hackett, Lucy Ziegler, Mary Godfrey, Robbie Foy, Michael I Bennett
BACKGROUND: Primary health care teams are key to the delivery of care for patients with advanced cancer during the last year of life. The Gold Standards Framework is proposed as a mechanism for coordinating and guiding identification, assessment, and support. There are still considerable variations in practice despite its introduction. The aim of this qualitative study is to improve understanding of variations in practice through exploring the perspectives and experiences of members of primary health care teams involved in the care of patients with advanced cancer...
November 20, 2018: BMC Family Practice
Piotr Tederko, Marek Krasuski, Beata Tarnacka
OBJECTIVES: To present a synopsis of evidence on the efficacy of rehabilitation after cervical disk surgery performed for neck pain and radiculopathy. DATA SOURCES: The databases of Medline, EMBASE, and Cochrane Central were searched for studies reporting effects of rehabilitation interventions in patients undergoing surgery due to cervical disk disease with pain and radicular syndrome, published before 31 August 2018. REVIEW METHODS: Project was registered with PROSPERO database (number CRD42018085937)...
November 21, 2018: Clinical Rehabilitation
Serge Makarenko, Vincent Ye, Ryojo Akagami
Background  Trigeminal schwannomas are the second most common among intracranial schwannomas. These can arise from anywhere between the root and the distal extracranial branches of the trigeminal nerve. Clinical presentation depends on location and size, including but not limited to facial hypesthesia or pain, headaches, dizziness, ataxia, and diplopia. Literature is strikingly scant discussing the natural history of these lesions, while the treatment goals are heavily dependent on tumor presentation. Management decisions must be individualized to each tumor and each patient, while attempting to maximize the quality of life...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Michael H Baumann, Theresa A Kopajtic, Bertha K Madras
The United States is experiencing an epidemic of opioid overdose deaths. Many of the recent fatalities are associated with illicitly manufactured fentanyl, which is being added to heroin and counterfeit pain pills. The crisis is further exacerbated by the emergence of an increasing number of novel synthetic opioids (NSOs), including various fentanyl analogs and non-fentanyl compounds that display potent agonist actions at the μ-opioid receptor. Importantly, most users are unaware of their exposure to fentanyl and NSOs...
December 2018: Trends in Pharmacological Sciences
Kohei Arimizu, Gen Hirano, Chinatsu Makiyama, Mioko Matsuo, Takakazu Sasaguri, Akitaka Makiyama
BACKGROUND: Nuclear protein in testis (NUT) carcinoma (NC) is a rare epithelial malignancy characterized by rearrangement of the NUT gene on chromosome 15. If NC is not suspected, it is often diagnosed as other malignancies. We present the case of NC of the nasal cavity that responded to a chemotherapy regimen for Ewing's sarcoma family of tumors (ESFT). CASE PRESENTATION: A 49-year-old male presented with epistaxis and pain in the left eye. The patient had a tumor in the left nasal cavity at initial visit and it was biopsied...
November 19, 2018: BMC Cancer
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