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Interventional pain management

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https://www.readbyqxmd.com/read/29228289/clinical-practice-guideline-for-physical-therapy-assessment-and-treatment-in-patients-with-nonspecific-neck-pain
#1
Jasper D Bier, Wendy G M Scholten-Peeters, J Bart Staal, Jan Pool, Maurits W van Tulder, Emmylou Beekman, Jesper Knoop, Guus Meerhoff, Arianne P Verhagen
The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test)...
December 4, 2017: Physical Therapy
https://www.readbyqxmd.com/read/29227718/training-chiropractic-students-in-weight-management-counseling-using-standardized-patients
#2
Cheryl Hawk, Michael Ramcharan, Carla LeRiche Kruger
OBJECTIVE: The aim of this study was to describe and assess an activity that trained chiropractic students to counsel patients on weight management through the use of standardized patients. METHODS: This was a descriptive study using mixed methods. Students were trained to apply health behavior theory and the transtheoretical model. Standardized patients were given a case to portray with the students. Students had 15 minutes for the encounter. The encounters were assessed in 2 ways: (1) standardized patients answered a brief questionnaire about the students' performance, and (2) students answered a questionnaire about the utility of the intervention...
December 11, 2017: Journal of Chiropractic Education
https://www.readbyqxmd.com/read/29227372/osteofibrous-dysplasia-of-the-tibia-in-children-outcome-without-resection
#3
Daniel Westacott, Peter Kannu, Jennifer Stimec, Sevan Hopyan, Andrew Howard
BACKGROUND: The proposed association between osteofibrous dysplasia and adamantinoma has led some to advocate resection of the entire lesion, which can require major subsequent reconstruction. However, this link remains unproven and there is some support in more recent literature for a less aggressive approach. This study aims to describe our experience managing pediatric tibial osteofibrous dysplasia with such an approach and to report functional outcomes in children treated thus. METHODS: A total of 28 cases of osteofibrous dysplasia in 25 patients were managed at a referral center for pediatric bone tumors with observation in the first instance, then limited surgical intervention if required to address pain and deformity...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29226545/nitrous-oxide-oxygen-mixture-for-analgesia-in-adult-cancer-patients-with-breakthrough-pain-a-randomized-double-blind-controlled-trial
#4
Q Liu, L-L Gao, Y-L Dai, Y-X Li, Y Wang, C-F Bai, G-X Mu, X-M Chai, W-J Han, L-J Zhou, Y-J Zhang, L Tang, J Liu, J-Q Yu
BACKGROUND: The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. METHODS/DESIGN: A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen...
December 11, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29225469/pelvic-vein-incompetence-clinical-perspectives
#5
REVIEW
David M Riding, Vivak Hansrani, Charles McCollum
Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%-30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. In these patients, clinical management focuses on symptom control rather than treatment. It is possible that pelvic vein incompetence (PVI) is a cause of CPP, although the quality of studies investigating an association is generally low...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29225117/rapid-response-events-in-hospitalized-patients-patient-symptoms-and-clinician-communication
#6
Charles A Austin, Summer Choudhury, Taylor Lincoln, Lydia H Chang, Christopher E Cox, Mark A Weaver, Laura C Hanson, Judith E Nelson, Shannon S Carson
CONTEXT: Patients triggering Rapid Response Team (RRT) intervention are at high risk for adverse outcomes. Data on symptom burden of these patients does not currently exist and current symptom management and communication practices of RRT clinicians are unknown. OBJECTIVES: We sought to identify the symptom experience of Rapid Response Team (RRT) patients and observe how RRT clinicians communicate with patients and their families. METHODS: We conducted a prospective, observational study from August - December 2015...
December 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#7
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#8
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29221496/does-intensive-management-improve-remission-rates-in-patients-with-intermediate-rheumatoid-arthritis-the-titrate-trial-study-protocol-for-a-randomised-controlled-trial
#9
Naomi H Martin, Fowzia Ibrahim, Brian Tom, James Galloway, Allan Wailoo, Jonathan Tosh, Heidi Lempp, Louise Prothero, Sofia Georgopoulou, Jackie Sturt, David L Scott
BACKGROUND: Uncontrolled active rheumatoid arthritis can lead to increasing disability and reduced quality of life over time. 'Treating to target' has been shown to be effective in active established disease and also in early disease. However, there is a lack of nationally agreed treatment protocols for patients with established rheumatoid arthritis who have intermediate disease activity. This trial is designed to investigate whether intensive management of disease leads to a greater number of remissions at 12 months...
December 8, 2017: Trials
https://www.readbyqxmd.com/read/29220782/mindfulness-based-interventions-for-chronic-pain-evidence-and-applications
#10
REVIEW
Muhammad Hassan Majeed, Ali Ahsan Ali, Donna M Sudak
Chronic pain is estimated to occur in from 5.5% to 33% of the world's adult population (Gureje et al., 1998). Chronic pain is frequently treated with opiates, which has produced an opiate addiction crisis (Dowell et al., 2016). Several non-pharmacological treatment alternatives can help manage chronic pain. There is moderate evidence that mindfulness-based interventions (MBIs) such as meditation, yoga, and stress reduction lower the perception of pain, increase mobility, improve functioning and well-being. By integrating MBIs and other therapeutic interventions in a multi-disciplinary pain management plan, clinicians can improve treatment outcomes and potentially decrease pain-related medication utilization...
December 5, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29220541/yoga-for-stroke-rehabilitation
#11
REVIEW
Maggie Lawrence, Francisco T Celestino Junior, Hemilianna Hs Matozinho, Lindsay Govan, Jo Booth, Jane Beecher
BACKGROUND: Stroke is a major health issue and cause of long-term disability and has a major emotional and socioeconomic impact. There is a need to explore options for long-term sustainable interventions that support stroke survivors to engage in meaningful activities to address life challenges after stroke. Rehabilitation focuses on recovery of function and cognition to the maximum level achievable, and may include a wide range of complementary strategies including yoga.Yoga is a mind-body practice that originated in India, and which has become increasingly widespread in the Western world...
December 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29220303/locally-aggressive-connective-tissue-tumors
#12
Mrinal M Gounder, David M Thomas, William D Tap
In this review, we highlight the complexities of the natural history, biology, and clinical management of three intermediate connective tissue tumors: desmoid tumor (DT) or aggressive fibromatosis, tenosynovial giant cell tumor (TGCT) or diffuse-type pigmented villonodular synovitis (dtPVNS), and giant cell tumor of bone (GCTB). Intermediate histologies include tumors of both soft tissue and bone origin and are locally aggressive and rarely metastatic. Some common aspects to these tumors are that they can be locally infiltrative and/or impinge on critical organs, which leads to disfigurement, pain, loss of function and mobility, neurovascular compromise, and occasionally life-threatening consequences, such as mesenteric, bowel, ureteral, and/or bladder obstruction...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29220211/percutaneous-image-guided-cryoneurolysis
#13
Ross W Bittman, Gail L Peters, Janice M Newsome, Eric B Friedberg, Jason W Mitchell, Jacquelyn M Knight, J David Prologo
OBJECTIVE: The aim of this article is to review the available evidence regarding image-guided percutaneous cryoneurolysis, with a focus on indications, technique, efficacy, and potential complications. CONCLUSION: Percutaneous image-guided cryoneurolysis is safe and effective for the management of several well-described syndromes involving neuropathic pain. Additional rigorous prospective study is warranted to further define the efficacy and specific role of these interventions...
December 8, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#14
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29218129/pubic-symphysis-diastasis-a-case-series-and-literature-review
#15
Jaya Jethra Chawla, Devendra Arora, Namrita Sandhu, Megha Jain, Anju Kumari
Separation of pubic symphysis during delivery is a rare complication resulting in considerable and prolonged morbidity for parturient women. The usual presentation is that of something giving way in the region of the symphysis pubis sometimes with an audible crack at the time of delivery. Unbearable pain on moving from side-to-side and on performing any weight-bearing activity (such as walking or climbing stairs) precludes ambulation in the immediate postpartum period. This could be accompanied by disruption of the sacroiliac joint, hemorrhage, or urine incontinence in severe cases...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29217672/digital-ischemia-after-application-of-self-adherent-elastic-wrap-dressing-a-case-series
#16
Christopher A Makarewich, Penelope Lang, Douglas T Hutchinson
Self-adherent elastic wrap dressings are a convenient option to manage pediatric hand and finger injuries. However, when improperly applied, they have the potential to cause devastating complications. We detail in this report 5 cases of dressing-induced ischemic injury to the hand in pediatric patients with a review of the literature. All patients were treated by the senior author between 2007 and 2015 and were retrospectively reviewed for initial injury, frequency of dressing changes, presence of pain, time to evaluation by the orthopedic hand team, treatment, and outcome...
December 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29216390/dose-area-product-values-of-fluoroscopically-guided-pain-management-procedures-comparison-of-a-belgian-teaching-hospital-with-national-diagnostic-reference-levels
#17
Nicolas Hustinx, Arnaud Steyaert, Bernard le Polain de Waroux, Patrice Forget
In 2011, national diagnostic reference levels (DRLs) were proposed for pain management fluoroscopic procedures in Belgium. The primary goal of this work is to compare the dose area product values (DAP) recorded at the Saint-Luc University Hospital to these DRLs. From 2012 to 2015, 7664 interventional pain management procedures (4740 epidural, 2097 medial branch and 807 transforaminal infiltrations) were performed. Uni/multivariable analyses were done regarding the influence of different factors. The fluoroscopy duration and the DAP are lower to the DRLs (p < 0...
December 5, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29215566/multi-family-pediatric-pain-group-therapy-capturing-acceptance-and-cultivating-change
#18
Samantha E Huestis, Grace Kao, Ashley Dunn, Austin T Hilliard, Isabel A Yoon, Brenda Golianu, Rashmi P Bhandari
Behavioral health interventions for pediatric chronic pain include cognitive-behavioral (CBT), acceptance and commitment (ACT), and family-based therapies, though literature regarding multi-family therapy (MFT) is sparse. This investigation examined the utility and outcomes of the Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE) program, which included all three modalities (CBT, ACT, MFT) for youth with chronic pain and their parents. Program utility, engagement, and satisfaction were evaluated via quantitative and qualitative feedback...
December 7, 2017: Children
https://www.readbyqxmd.com/read/29215379/improving-patient-reported-pain-during-radiotherapy-through-nurse-involvement-and-patient-education
#19
Adam L Holtzman, Jodie P Williams, Debra F Hutchinson, Christopher G Morris, Anamaria R Yeung
OBJECTIVES: Pain management during radiotherapy helps assess quality of care. By establishing an intervention to address pain during on-treatment visits (OTVs), we aim to lower patient-reported pain scores. METHODS: A total of 171 patients were included in the analysis: 58 were retrospectively reviewed to provide a control and 113 were prospectively enrolled and evaluated after the intervention. The intervention included (1) a pain management in-service performed with the resident physician and nurses, (2) distribution of pain management educational materials, and (3) nurse consultation for patients with a pain score ≥5 within 2 days of the in-service...
December 6, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29210775/isometric-exercise-to-reduce-pain-in-patellar-tendinopathy-in-season-is-it-effective-on-the-road
#20
Ebonie Rio, Craig Purdam, Michael Girdwood, Jill Cook
OBJECTIVE: To investigate the effectiveness of an isometric squat exercise using a portable belt, on patellar tendon pain and function, in athletes during their competitive season. DESIGN: Case series with no requirements to change any aspect of games or training. The object of this pragmatic study was to investigate this intervention in addition to "usual management." A control or sham intervention was considered unacceptable to teams. SETTING: In-season...
November 27, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
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