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Pain and treatment and elderly

Natalie Galanina, Razelle Kurzrock
BACKGROUND: The treatment of peripheral T-cell lymphoma (PTCL) after failure of standard therapy represents a significant clinical challenge as the best approach has not been defined. The outcomes of patients with peripheral T-cell lymphoma (PTCL) after relapse, in the absence of hematopoietic stem-cell transplantation, are poor with median overall survival is less than six months. Thus, relapsed/refractory PTCL presents an area of unmet medical need. CASE PRESENTATION: Herein, we report an 84-year old woman with stage IV PTCL with extensive involvement of the bowel and abdominal pain...
October 11, 2018: Cancer Biology & Therapy
Susanne Rösner, Christian Englbrecht, Renate Wehrle, Göran Hajak, Michael Soyka
BACKGROUND: Insomnia is a major public health issue affecting between 6% to 10% of the adult population in Western countries. Eszopiclone is a hypnotic drug belonging to a newer group of hypnotic agents, known as new generation hypnotics, which was marketed as being just as effective as benzodiazepines for this condition, while being safer and having a lower risk for abuse and dependence. It is the aim of the review to integrate evidence from randomised controlled trials and to draw conclusions on eszopiclone's efficacy and safety profile, while taking methodological features and bias risks into consideration...
October 10, 2018: Cochrane Database of Systematic Reviews
Yulia Treister-Goltzman, Tamar Freud, Yan Press, Roni Peleg
Widespread use of cannabis as a drug and passage of legislation on its use should lead to an increase in the number of scientific publications on cannabis. The aim of this study was to compare trends in scientific publication for papers on medical cannabis, papers on cannabis in general, and all papers between the years 2000 and 2017. A search of PubMed and Web of Science was conducted. The overall number of scientific publications in PubMed increased 2.5-fold. In contrast, the number of publications on cannabis increased 4...
October 6, 2018: Population Health Management
G H Sandmann, U Stöckle, T Freude, F M Stuby
PURPOSE OF THE STUDY Fragility fractures of the pelvic ring in the elderly population are a serious problem in orthopaedics. The treatment options range from conservative treatment to diverse operative options. We present a balloon guided new technique of implanting cement augmented screws aiming at improved implant anchorage and reduced cement leakage. MATERIAL AND METHODS We describe a new technique of balloon- guided cement augmented iliosacral screws. After the balloon has been insufflated and contrast medium has been instillated for leakage detection, iliosacral screws can safely be placed with a relevant cement depot...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Isabel Gálvez, Silvia Torres-Piles, Eduardo Ortega
OBJECTIVES: Balneotherapy with mud application (mud therapy) is a common hydrothermal intervention for the treatment and rehabilitation of elderly patients with osteoarthritis, leading to anti-inflammatory effects. The main purpose of this investigation was to study a role for regulatory T cells in these anti-inflammatory effects. The second objective was to assess whether the neutrophil-mediated innate response is affected by these anti-inflammatory effects. METHODS: Thirty-six elderly patients with knee osteoarthritis underwent a 10-day cycle of balneotherapy at a spa center...
October 8, 2018: International Journal of Hyperthermia
Matias Borensztein, Gaston O Camino Willhuber, Maria Lourdes Posadas Martinez, Marcelo Gruenberg, Carlos A Sola, Osvaldo Velan
Study Design: Retrospective analysis. Level of evidence III. Objectives: Low-energy vertebral compression fractures are an increasing socioeconomic problem among elderly patients. Percutaneous vertebroplasty has been extensively used for the treatment of painful fractures because of its effectiveness. However, some complications have been described; among them, new vertebral compression fractures, whether adjacent or not to the treated vertebra, are commonly reported complications (8% to 52%)...
August 2018: Global Spine Journal
Yoshihito Sakai, Hiroki Matsui, Sadayuki Ito, Tetsuro Hida, Kenyu Ito, Hiroyuki Koshimizu, Atsushi Harada
STUDY DESIGN: This was a cross-sectional electrophysiological study. OBJECTIVE: The main objective of this study was to evaluate electrophysiological activation of lumbar multifidus (LM) and erector spinae (ES) in elderly patients with chronic low back pain (CLBP) classified by LBP developmental mechanisms. SUMMARY OF BACKGROUND DATA: Local and global muscles that function independently for stabilization and moment production, respectively, are crucial for stability and mobility of the lumbar spine...
September 21, 2018: Clinical Spine Surgery
João Pedro Ferraz Montenegro Lobo, Vitorino Veludo Moutinho, António Francisco Martingo Serdoura, Carolina Fernandes Oliveira, André Rodrigues Pinho
Objective: To evaluate the clinical and radiological outcomes of the surgical treatment in patients diagnosed with odontoid fracture who underwent open reduction and internal fixation (ORIF) with screws. Methods: This was a retrospective study with nine patients. Pain (visual analog scale [VAS]) and neurological status (Frankel scale) were assessed. The neck disability index (NDI) and the post-operative cervical range of motion were calculated. The cervical spine was radiologically evaluated (X-ray and CT) pre- and postoperatively...
September 2018: Revista Brasileira de Ortopedia
Masakazu Ishikawa, Kenji Kobayashi, Nobuo Adachi
Femoral avulsion fracture of the posterior cruciate ligament (PCL) is less common compared to the tibial side. Especially, femoral avulsion in an elderly patient is an extremely rare condition. Until now, there is no report that describes its treatment and clinical outcome in elderly patients. We demonstrate an 82-year-old female who presented with osteochondral avulsion fracture of the femoral attachment of the PCL. The osteochondral fragment was fixed with an arthroscopic transfemoral suture technique. After treatment, the pain was improved and the patient achieved previous daily activity within 6 weeks...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Kotaro Sato, Kenya Murakami, Yoshikuni Mimata, Norio Numata, Hideo Shiraishi, Minoru Doita
INTRODUCTION: Although volar locking plates (VLPs) have been exclusively used for unstable distal radius fractures (DRFs), the optimal management of distal ulna fractures (DUFs) remains controversial. Internal fixation using a plate for DUFs might be challenging because of the presence of osteoporotic bone and fragile bone fragments in elderly patients. HYPOTHESIS: We hypothesized that a strategy including VLP fixation for DRFs and non-intervention for DUFs with early wrist mobilization would provide encouraging results in elderly patients...
September 19, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Franziska Saxer, Patrick Studer, Marcel Jakob, Norbert Suhm, Rachel Rosenthal, Salome Dell-Kuster, Werner Vach, Nicolas Bless
BACKGROUND: The relevance of femoral neck fractures (FNFs) increases with the ageing of numerous societies, injury-related decline is observed in many patients. Treatment strategies have evolved towards primary joint replacement, but the impact of different approaches remains a matter of debate. The aim of this trial was to evaluate the benefit of an anterior minimally-invasive (AMIS) compared to a lateral Hardinge (LAT) approach for hemiarthroplasty in these oftentimes frail patients...
September 21, 2018: BMC Geriatrics
Bixin Zheng, Li Song, Hui Liu
RATIONALE: Effective treatments for trigeminal nerve postherpetic neuralgia (PHN) are limited. Adriamycin (doxorubicin) has been applied to the treatment of neuropathic pain. This study reports a new treatment: Adriamycin injected to Gasserian ganglion for an elderly patient with the intractable trigeminal nerve PHN. PATIENT CONCERNS: A 75-year-old man complained of lancing, burning pain in the right mandibular branch of the trigeminal nerve (V3) for 3 months after rash eruption...
September 2018: Medicine (Baltimore)
Wei Wang, Zhen Liu, Jun Liu, Ping Zhen, Xusheng Li, Mingjia Song
Total knee arthroplasty is an effective method for the treatment of end-stage knee osteoarthrosis, which can effectively relieve joint pain and reconstruct the integrity of the joint. Whether the posterior cruciate ligament should be preserved during surgery or not, which is still in dispute. In recent years, posterior cruciate-retaining and substituting total knee prostheses are both applied in clinical practice. Both domestic and international studies have shown that there are no significant difference in patient satisfaction, knee flexion, survival rate of the prosthesis and the main clinical manifestations between two prostheses...
May 25, 2018: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Caterina Ambrosi, Charles Zaiontz, Giuseppe Peragine, Simona Sarchi, Francesca Bona
AIM: The aim of this study was to verify dog-assisted therapy's effectiveness on depression and anxiety in institutionalized elderly. Patients' illness perception was examined to identify core beliefs regarding mood, personal control, and illness coherence because they can affect treatment compliance. Subjective perception of pain, social interaction, and setting-bound observable variables were also studied. METHODS: This study involved a randomized sample of institutionalized patients 65 years of age and older; the treatment group had 17 subjects and the control group had 14 subjects...
September 16, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Renee Meyer, Paul G Werthmann, Gunver S Kienle
BACKGROUND: Colonic diverticula develop in at least 60% of elderly patients. Less than 25% of these develop diverticulitis. Recurrent episodes are experienced by about 13% of the symptomatic patients. The effect on prevention of recurrent diverticulitis of currently used therapies is controversial. Surgical colon resection is used in some patients in emergency or to prevent future episodes and complications. Carpellum Mali comp. (Juglans regia, Testa; Pirus malus, Carpellum) and Kalium aceticum comp...
October 2018: Complementary Therapies in Medicine
Jörg Nowotny, Sebastian Löbstein, Achim Biewener, Guido Fitze, Philip Kasten
BACKGROUND: Chondral or osteochondral lesions, post-traumatic contracture and loose bodies of the elbow are often associated with chronic pain, stiffness, repetitive swelling and joint blockages. Therefore, arthroscopy of the elbow is often used in the elderly for the treatment of osteochondral defects or arthrolysis. There are only a few reports and studies about arthroscopic therapy of the elbow in children and adolescents. This study assesses the clinical outcome of arthroscopic therapy in this age group...
September 15, 2018: European Journal of Medical Research
Daniel C Austin, Michael T Torchia, Niki H Cozzolino, Lauren E Jacobowitz, John-Erik Bell
OBJECTIVES: We sought to compare range of motion, clinical outcome scores, and complications after reverse total shoulder arthroplasty (RSA) and hemiarthroplasty (HA) in geriatric patients with acute proximal humerus fractures. DATA SOURCES: We searched MEDLINE (1946-2017), EMBASE (1947-2017), the Cochrane Central Register of Controlled Trials (1898-2017) and in October 2017. No limits were used in the database search. We also manually reviewed reference lists of included studies...
August 23, 2018: Journal of Orthopaedic Trauma
Adam M Johannsen, John G Costouros
Background: The management of Type-II superior labral tears (SLAP) of the shoulder remains a controversial topic. Treatment ranges from non-operative management to surgical management including SLAP repair, biceps tenotomy, and biceps tenodesis. An optimal treatment algorithm has yet to reach universal acceptance. Objective: The goal of this paper was to provide a treatment algorithm for the management of Type-II SLAP tears based on current literature and expert opinion...
2018: Open Orthopaedics Journal
Marek Zubrzycki, Andreas Liebold, Christian Skrabal, Helmut Reinelt, Mechthild Ziegler, Ewelina Perdas, Maria Zubrzycka
Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain...
2018: Journal of Pain Research
Imke Galazky, Christina Caspari, Hans-Jochen Heinze, Joerg Franke
PURPOSE: This observational study was aimed at quantification of low back pain (LBP) in Parkinsonian patients and its morphological correlation. BACKGROUND: Parkinson's disease (PD) is a common disabling condition in the elderly population. Parkinsonian patients frequently are troubled by LBP. Causes for LBP in PD are muscular imbalances by the movement disorder itself and skeletal degeneration. METHODS: Ninety-seven PD patients and 97 controls were inquired about low back pain through the Oswestry Low Back Pain Disability Questionnaire and visual analogue scales...
September 8, 2018: European Spine Journal
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