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Pain and treatment and elderly

Konstantinos N Paterakis, Alexandros G Brotis, Athanasios Paschalis, Alkiviadis Tzannis, Konstantinos N Fountas
Background: Surgical treatment of adult degenerative scoliosis (DS) always remains a challenge and often necessitates complex multilevel surgery via traditional open approaches. However, the severity of the procedure, in association with the fact that many of these patients are at an advanced age with several comorbidities, results in high rate of complications. Therefore, during the last decade, minimally invasive procedures have gained a place in the treatment of this pathology. Our aim is to determine the safety and efficacy of extra lateral lumbar interbody fusion (XLIF) with or without supplemented instrumentation in the treatment of DS...
September 2018: Journal of Spine Surgery (Hong Kong)
Chen-Hui Ni, Huan Li, Chuan-Bao Xia, Yang-Tian Chen
RATIONALE: The case of parasternal diaphragmatic hernia is relatively rare in adults. The best way for the treatment of diaphragmatic hernia is to receive operation, yet which surgical method is the best remains unclear. PATIENT CONCERNS: An elderly woman in the hospital was complaining about upper abdominal pain that was complicated by the parasternal diaphragmatic hernia. Such state was found accidentally in a car accident and diagnosed by a computed tomography (CT) scan...
December 2018: Medicine (Baltimore)
C Sousa-Ribeiro, L N C Tavore, L Anjos-Ramos
Strongyloidiasis is an intestinal parasitosis that occurs in humans infected by Strongyloides stercoralis mostly. At its acute phase, symptoms like constipation, diarrhea and abdominal pain can be observed, but become asymptomatic for a long time, until an immunosuppression will start a hyperinfection and the dissemination of the disease, prevalent on the elderly population in tropical countries. Ivermectina treatment is the currently choice for this disease, due to its great efficacy and the results reported...
December 6, 2018: Acta Tropica
Kaitlin Rascon, Goran Flajc, Carmine De Angelis, Xinli Liu, Meghana V Trivedi, Ekim Ekinci
OBJECTIVE: To review the chemistry, pharmacology, pharmacokinetics, safety, and efficacy of ribociclib (LEE011, Kisqali) in hormone receptor-positive/human epidermal growth factor receptor-2-negative (HR+/HER2-) metastatic breast cancer. DATA SOURCES: A PubMed search was performed using the terms 'Ribociclib', 'Kisqali', and 'LEE011' between May 2018 and November 2018. References of published articles and reviews were also assessed for additional information. STUDY SELECTION AND DATA EXTRACTION: English-language preclinical and clinical studies on the chemistry, pharmacology, pharmacokinetics, safety, and efficacy of ribociclib were evaluated...
December 7, 2018: Annals of Pharmacotherapy
Yu Parfenov, M Vasilevskaya, S Parfenov, K Sapozhnikov, A Kovalenko, V Zaplutanov
The aim of the study was to assess the impact of cytoflavin and bioflavin therapy on the dynamics of clinical and psychophysiological status of patients with Osteochondrosis. 150 patients with osteochondrosis of a backbone were investigated. The patients were divided into two groups using method of randomization: the main group - 75 patients - and control group -75 patients. All patients received a standard treatment (non-steroidal anti-inflammatory drugs, myorelaxants, chondroprotectors, as well as physiotherapy)...
October 2018: Georgian Medical News
Rui Yu, Chengwei Wang, Chuncheng Qu, Jun Jiang, Qinghu Meng, Ji Wang, Shengcheng Wei
OBJECTIVE: The aim of the study was to evaluate the efficacy of microvascular decompression (MVD) and stereotactic gamma knife surgery (GKS) in the treatment of trigeminal neuralgia (TN) in the elderly. PATIENTS AND METHODS: Retrospective analysis of 137 elderly cases with TN underwent MVD, partial sensory rhizotomy (PR) treatment from August 2007 to March 2017 and 56 cases underwent GKS treatment from May 2014 to February 2017 was made, compared the efficacy of MVD and GKS in different age groups...
November 30, 2018: Journal of Craniofacial Surgery
Shunsuke Kamei, Tomoyuki Noguchi, Yoshitaka Shida, Takashi Okafuji, Kota Yokoyama, Fumiya Uchiyama, Hiroshi Nakatake, Tsuyoshi Tajima
OBJECTIVE: To retrospectively analyze the safety and efficacy of percutaneous vertebroplasty (PVP) for patients aged 90 or over. MATERIALS AND METHODS: We analyzed 130 consecutive patients with osteoporotic vertebral fractures who underwent a first-time PVP between May 2015 and September 2017 at our institution. We divided them into the elder patient group aged 90 years or over (n = 21) and the younger patient group under 90 years (n = 109). We compared the two groups' background, treatments, and outcomes using univariate analyzes and the log rank test...
December 1, 2018: Japanese Journal of Radiology
Umme K Rima, Abu S M Bari, Mohammad Z Hossain, Mohammad A H Khan
Background: Prostate hyperplasia and neoplasia are major illness of men and elderly dogs. Treatment of prostate cancer requires androgen deprivation surgery or therapy to prevent metastases and alleviate pain. Recently, six DNA vaccines have entered clinical trials against prostate cancer in humans with limited success. There is a need for new therapies that delay the establishment of malignancy and prolong survival. Materials and methods: A plasmid DNA vaccine coding for eight gonadotrophin-releasing hormone (GnRH-I) interspersed in eight T-helper epitopes was used...
December 2018: Prostate International
Antonio Pellegrini, Claudio Legnani, Vittorio Macchi, Enzo Meani
INTRODUCTION: Periprosthetic shoulder infections (PSIs) represent a serious complication following shoulder arthroplasty. No consensus exists regarding the optimal option. We conducted a retrospective case-control study to compare the outcomes of 2-stage revision shoulder arthroplasty and those of definitive articulating antibiotic spacer implantation with regards to eradication of the infection, improvement of pain and shoulder function. MATERIALS AND METHODS: Thirty patients treated for an infected shoulder arthroplasty were retrospectively reviewed after a mean follow-up of 8 years (range, 2-10 years)...
November 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Monika Banach, Barbara Miziak, Kinga K Borowicz-Reutt, Stanisław J Czuczwar
As a matter of course, elderly people are more sensitive to both the pharmacological and toxicological effects of pharmacotherapy. A senior's treatment, therefore, requires more attention compared to younger adults. Extended release (ER) formulations of anti-epileptic drugs (AEDs) have been developed to improve safety, efficacy and long-term adherence. In senior patients, ER AEDs are used to treat epilepsy, psychiatric conditions, and neuropathic pain. However, very limited clinical evidence is available on the use of these ER AEDs in these populations...
November 27, 2018: Expert Opinion on Pharmacotherapy
Feng Wang, Lin-Feng Wang, De-Chao Miao, Zhen Dong, Yong Shen
Purpose: The purpose of this study was to compare the clinical efficacy and safety of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with very severe osteoporotic vertebral compression fractures (vsOVCFs). Methods: From September 2012 to September 2015, 57 patients with vsOVCFs who had undergone PVP and PKP surgeries at our medical center were reviewed retrospectively, at least 2 years follow-up. All patients were divided into PVP group (n=31) and PKP group (n=26)...
2018: Journal of Pain Research
Raphael Ouede, Blaise Demine Alexandre, Ayegnon Kouakou Gregoire, Landry Kohou-Kone, Edouard N'guessan, Maurice Gabin Kouacou, Jean-Marcel Ahui Brou, Flavien Kouassi Kendja, Yves Tanauh
This study aims to propose a therapeutic approach for catamenial pneumothorax based on outcomes reported in 18 cases. We conducted a retrospective study of 18 female elderly patients with an average age of 32.2 years who had undergone surgery for right (16 cases) and bilateral catamenial pneumothorax (2 cases) from January 1994 to December 2016. The patients were divided into 3 groups on the basis of the evolution of our surgical capability over time: group 1(G1) from January 1994 to June 2006, group 2 (G2) from July 2006 to February 2008, group 3(G3) from March 2008 to December 2016, these groups were composed of 5, 2 and 11 patients respectively...
2018: Pan African Medical Journal
Amir Sadeghi, Mohammad Amin Shahrbaf, Hamid Asadzadeh Aghdaei, Komeil Esmaeilinejad, Mohammad Reza Zali
Simple renal cysts are one of the most common lesions in elderly. These cysts are usually asymptomatic but when the size of these cysts increase, we would see symptoms such as hypertension, hematuria, flank pain or urinary obstruction. In this study, we explore a case of small bowel obstruction that presented with nausea, repeated vomiting that causes hematemesis, and a submucosal obstructive lesion that was seen in Esophagogastroduodenoscopy (EGD). After endoscopic ultrasound (EUS) evaluation, we detected a large simple renal cyst and approved our diagnosis with CT scan...
2018: Gastroenterology and Hepatology From Bed to Bench
Ramani Vijayan, Gauhar Afshan, Khalid Bashir, Mary Cardosa, Madhur Chadha, Pongparadee Chaudakshetrin, Khin Myo Hla, Muralidhar Joshi, Francis O Javier, Asif Gul Kayani, Andi Takdir Musba, Sasikaan Nimmaanrat, Dwi Pantjawibowo, Jocelyn C Que, Palanisamy Vijayanand
Background: The supply of controlled drugs is limited in the Far East, despite the prevalence of health disorders that warrant their prescription. Reasons for this include strict regulatory frameworks, limited financial resources, lack of appropriate training amongst the medical profession and fear of addiction in both general practitioners and the wider population. Consequently, the weak opioid tramadol has become the analgesic most frequently used in the region to treat moderate to severe pain...
2018: Journal of Pain Research
Grace H Lo, Jing Song, Timothy E McAlindon, Gillian A Hawker, Jeffrey B Driban, Lori Lyn Price, Charles B Eaton, Marc C Hochberg, Rebecca D Jackson, C Kent Kwoh, Michael C Nevitt, Dorothy D Dunlop
OBJECTIVE: Validation of a symptom measure for early knee OA may help identify new treatments and modifiable risk factors. Symptom measures that consider pain in the context of activity level may provide better discrimination than pain alone. Therefore, we aimed to compare sensitivity to change for radiographic progression between Ambulation Adjusted Score for Knee pain (AASK), which accounts for self-reported ambulation, and Western Ontario McMaster Osteoarthritis (WOMAC) knee pain score...
November 12, 2018: Clinical Rheumatology
Kazunori Ono, Kenji Yanishi, Makoto Ariyoshi, Satoshi Kaimoto, Motoki Uchihashi, Keisuke Shoji, Satoaki Matoba
BACKGROUND: Therapeutic angiogenesis with basic fibroblast growth factor (bFGF) with atelocollagen was confirmed in a study using a limb ischemia mouse model. Because the number of elderly patients with critical limb ischemia (CLI) is increasing, particularly that caused by arteriosclerosis obliterans (ASO), the development of less invasive angiogenesis therapies desired. Methods and Results: This first-in-man clinical study was designed to assess the safety and efficacy of i.m. injection of bFGF with atelocollagen...
November 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Giuseppe Marongiu, Stefano Congia, Marco Verona, Massimo Lombardo, Daniele Podda, Antonio Capone
INTRODUCTION: Standard radiographs are still considered as the gold standard for the early assessment of thoraco-lumbar osteoporotic vertebral fractures (OVFs), although several studies demonstrated superior accuracy of magnetic resonance imaging (MRI) in the diagnostic process of OVFs. The aim of this study was to quantify the misdiagnosis rate of OVFs and analyse the impact of MRI on early diagnosis and classification, compared to standard radiographs alone. MATERIALS AND METHODS: A total of 173 patients were enrolled in this study...
November 2018: Injury
Kruten M Patel, Brian A Handal, William K Payne
INTRODUCTION: Early intervention in femoral neck stress fractures (FNSFs) can be self- limiting, but they have an insidious presentation. High index of suspicion for an occult fracture is necessary to avoid bilateral progression and/or operative interventions. CASE PRESENTATION: A 83-year-old female, non-athlete, presents with multiple comorbidities and progressive bilateral FNSFs. Initially the patient presented with groin pain and radiographs demonstrated a non-displaced compression type fracture of the right femoral neck without any inciting events...
October 31, 2018: International Journal of Surgery Case Reports
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Lidija Gović-Golčić
Introduction: Opioids are the most important drugs in treating pain in palliative care patients. Transdermal formulations are especially useful due to their noninvasive nature and minimal interference in daily life. However, studies have shown a controversial relationship of opioids to survival and a rise in deaths associated with the use of transdermal opioids. Although applying precise doses is paramount, we have no clear recommendations for the exact equianalgesic ratio for buprenorphine patch and no recommendation for the type of transdermal opioid to use in hospice...
2018: Pain Research and Treatment
Andrzej Zyluk, Piotr Puchalski
The case of a patient suffering from Alzheimer's disease who sustained epiphyseal, severely dislocated fractures of the distal radius and ulna is reported. As the patient was incapacitated and attempts to contact her curator failed, the decision was made on a conservative treatment of the fractures. This treatment eventually failed and resulted in malunion with exposure of bone fragments above the skin. After obtaining informed consent from her curator, a corrective osteotomy was performed using an original method, followed by fixation of bone fragments in almost anatomical position by intramedullary K wires...
September 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
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