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Ekkehard Grünig, Nicola Benjamin, Tobias J Lange, Ulrich Krueger, Hans Klose, Claus Neurohr, Heinrike Wilkens, Michael Halank, Hans-Jürgen Seyfarth, Matthias Held, Andrew Traube, Michelle Pernow, E Robert Grover, Benjamin Egenlauf, Felix Gerhardt, Thomas Viethen, Stephan Rosenkranz
BACKGROUND: Subcutaneous treprostinil has dose-dependent beneficial effects in patients with severe pulmonary arterial hypertension, but adverse effects like infusion site pain can lead to treatment discontinuation. OBJECTIVES: The objective of this study was to evaluate safety, tolerability and clinical effects of a rapid up-titration dosing regimen of subcutaneous treprostinil using proactive infusion site pain management. METHODS: Effects of rapid up-titration dosing regimen on tolerability and clinical parameters were evaluated in this 16-week, open-label multi-centre study...
October 27, 2016: Respiration; International Review of Thoracic Diseases
Jonathan Casey, Anand Vaidya, Natasha Frank, Joshua A Beckman, Amy Miller
No abstract text is available yet for this article.
October 27, 2016: New England Journal of Medicine
G F Gebhart, Klaus Bielefeldt
Pain involving thoracic, abdominal, or pelvic organs is a common cause for physician consultations, including one-third of chronic pain patients who report that visceral organs contribute to their suffering. Chronic visceral pain conditions are typically difficult to manage effectively, largely because visceral sensory mechanisms and factors that contribute to the pathogenesis of visceral pain are poorly understood. Mechanistic understanding is particularly problematic in "functional" visceral diseases where there is no apparent pathology and pain typically is the principal complaint...
September 15, 2016: Comprehensive Physiology
Nilesh Chande, Cassandra M Townsend, Claire E Parker, John K MacDonald
BACKGROUND: The results from controlled clinical trials investigating the efficacy of azathioprine and 6-mercaptopurine for the treatment of active Crohn's disease have been conflicting and controversial. An updated meta-analysis was performed to assess the effectiveness of these drugs for the induction of remission in active Crohn's disease. OBJECTIVES: The primary objective was to determine the efficacy and safety of azathioprine and 6-mercaptopurine for induction of remission in active Crohn's disease...
October 26, 2016: Cochrane Database of Systematic Reviews
Hui-Kuang Huang, Jung-Pan Wang, Chin-Jung Lin, Yi-Chao Huang, Tung-Fu Huang, Ming-Chau Chang
Good outcomes have been reported after both open and percutaneous surgery to release trigger thumb. This study evaluated short-term and long-term outcomes after treatment of trigger thumb with open or percutaneous release. A total of 126 trigger thumbs in 107 patients were reviewed from 2009 to 2012. Short-term (3 months) and long-term results (2 years) and complications of open release (58 digits) and percutaneous release (68 digits) were recorded and compared. Short-term complications included pain occurring in 9 digits (15...
October 25, 2016: Orthopedics
Ryan A Durfee, Scott A Sabo, G Douglas Letson, Odion Binitie, David Cheong
Metastatic lesions of the acetabulum can be painful and debilitating. First-line treatment is multimodal and consists of disease-specific chemotherapy, osteoclastic inhibitors, analgesics, and radiation therapy. When these therapies fail, surgical intervention usually is indicated and varies from regional defect stabilization to large periacetabular reconstructions that are demanding procedures with high rates of complications. Percutaneous cement augmentation (acetabuloplasty) of lesions in selected patients has been explored as a less invasive method of lesional control...
October 25, 2016: Orthopedics
Mariana Angélica Peixoto de Souza, Jane Fonseca Dias, Fabiane Ribeiro Ferreira, Marisa Cotta Mancini, Renata Noce Kirkwood, Rosana Ferreira Sampaio
The cross sectional study aims to create the patients' profile and understand their demands for seeking public rehabilitation services from Belo Horizonte. Data were analyzed from 516 patients who gained entry into the health care system by means of the Protocol for Identification of Problems for Rehabilitation (PLPR). It allows for gathering information related to one's health and the social context, including a brief functional description (BFD) with 25 items. Most patients were females, mean age of 57 years, and 54% declared to be responsible for the family income...
October 2016: Ciência & Saúde Coletiva
Silvana Aparecida de Lucca, Eucia Beatriz Lopes Petean
This study's aim was to understand the experience of being the father of a boy diagnosed with Duchenne Muscular Dystrophy (DMD). Eight fathers of 10-year-old or older boys diagnosed with DMD, living in RibeirãoPreto and surrounding cities participated in the study. Interviews included a semi-structured script and data were analyzed according to thematic content analysis. The results show that the confirmation of a DMD diagnosis shocked fathers and was mixed with sorrow, helplessness and hopelessness. Most fathers considered the illness of their child to be a mission sent by God, which helps to alleviate the pain and anguish caused by the disease...
October 2016: Ciência & Saúde Coletiva
Sheila Mara Pedrosa, Mary Lopes Reis, Daniela Tavares Gontijo, Sheila Araújo Teles, Marcelo Medeiros
Objective: the objective of this study was to understand the meaning of the harmful use of crack by people undergoing addiction treatment. Method: qualitative approach of social research on strategic modality was used. Field observation, preparation of field diary and focus groups, and data analysis through the method of interpreting meaning were carried out. Results: the results contributed to the construction of three thematic categories: "The discovery of crack and other drugs" that describes the experimentation with crack and other drugs; "The pain of the pleasure", key category that describes the moments after crack experimentation and that, many times, turns into addiction, which leads the person into a cycle of short periods of attempts at abstinence, relapse, and relentless consumption; and "Return to normal life"...
September 2016: Revista Brasileira de Enfermagem
Gunnar Glauco de Cunto Taets, Nébia Maria Almeida de Figueiredo
Objective: to verify whether comatose patients feel pain during the bed bath nursing procedure. Method: nineteen patients aged 61 ± 17.39 years participated in the study. A quantitative analysis was conducted on the P substance (PS) in the saliva collected before and during a bed bath, using the ELISA method. Program Graph Pad Prisma 6 was used to analyze the data. The verification of normality was made through the Shapiro Wilk test, which determined the choice for the Wilcoxon nonparametric test...
September 2016: Revista Brasileira de Enfermagem
Jean-Daniel Dubois, Vincent Cantin, Mathieu Piché, Martin Descarreaux
Despite an elusive pathophysiology, common characteristics are often observed in individuals with chronic low back pain (LBP). These include psychological symptoms, altered pain perception, altered pain modulation and altered muscle activation. These factors have been explored as possible determinants of disability, either separately or in cross-sectional studies, but were never assessed in a single longitudinal study. Therefore, the objective was to determine the relative contribution of psychological and neurophysiological factors to future disability in individuals with past LBP...
2016: PloS One
Aurelie Thomas, Amy Miller, Johnny Roughan, Aneesa Malik, Katherine Haylor, Charlotte Sandersen, Paul Flecknell, Matthew Leach
Concerns over interactions between analgesics and experimental outcomes are a major reason for withholding opioids from rats undergoing surgical procedures. Only a fraction of morphine injected intravenously reaches receptors responsible for analgesia in the central nervous system. Intrathecal administration of morphine may represent a way to provide rats with analgesia while minimizing the amount of morphine injected. This study aimed to assess whether morphine injected intrathecally via direct lumbar puncture provides sufficient analgesia to rats exposed to acute surgical pain (caudal laparotomy)...
2016: PloS One
James P MacDonald, Pierre A dʼHemecourt, Lyle J Micheli
OBJECTIVE: Young athletes not uncommonly complain of back pain. Many patient-reported outcome measures are used to evaluate back pain, but none have been designed specifically to assess young, athletic patients. The Micheli Functional Scale (MFS) was developed to measure impairment due to back pain in this population. This study examined the reliability, validity, and responsiveness of the MFS used in routine clinical assessments. DESIGN: Retrospective Cohort Study...
November 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Claudiu T Supuran
The enzyme carbonic anhydrase (CA, EC is found in numerous organisms across the tree of life, with seven distinct classes known to date. CA inhibition can be exploited for the treatment of edema, glaucoma, seizures, obesity, cancer and infectious diseases. A myriad of CA inhibitor (CAI) classes and inhibition mechanisms have been identified over the past decade, mainly through structure-based drug design approaches. Five different CA inhibition mechanisms are presently known. Areas covered: Recent advances in structure-based CAI design are reviewed, with periodic table-based organization of inhibitor classes...
October 26, 2016: Expert Opinion on Drug Discovery
Zhijun Li, Matthew D Muller, Jianli Wang, Christopher T Sica, Prasanna Karunanayaka, Lawrence I Sinoway, Qing X Yang
PURPOSE: To evaluate the dynamic characteristics of T2* -weighted signal change in exercising skeletal muscle of healthy subjects and peripheral artery disease (PAD) patients under a low-intensity exercise paradigm. MATERIALS AND METHODS: Nine PAD patients and nine age- and sex-matched healthy volunteers underwent a low-intensity exercise paradigm while magnetic resonance imaging (MRI) (3.0T) was obtained. T2*-weighted signal time-courses in lateral gastrocnemius, medial gastrocnemius, soleus, and tibialis anterior were acquired and analyzed...
October 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
Manigandan Subramanyam Thyagarajan, Khalid Sharif
Space occupying liver lesions usually present with abdominal pain or abnormal physical findings, such as a palpable abdominal mass or distention. Liver lesions identified in children include benign and malignant neoplasms, inflammatory masses, cysts and metastatic lesions. Two-thirds of liver lesions in children are malignant. Hepatoblastoma accounts for two-thirds of malignant liver tumors in children. Benign lesions of the liver in children include vascular lesions, hamartomas, adenomas, and focal nodular hyperplasia...
October 25, 2016: Indian Journal of Pediatrics
Anita Balázs, Zoltán Mészár, Krisztina Hegedűs, Annamária Kenyeres, Zoltán Hegyi, Klaudia Dócs, Miklós Antal
The superficial spinal dorsal horn is the first relay station of pain processing. It is also widely accepted that spinal synaptic processing to control the modality and intensity of pain signals transmitted to higher brain centers is primarily defined by inhibitory neurons in the superficial spinal dorsal horn. Earlier studies suggest that the construction of pain processing spinal neural circuits including the GABAergic components should be completed by birth, although major chemical refinements may occur postnatally...
October 25, 2016: Brain Structure & Function
Masaki Takao, Takashi Nishii, Takashi Sakai, Nobuhiko Sugano
PURPOSE: Rotational acetabular osteotomy (RAO) is used to treat developmental hip dysplasia (DDH). It requires detailed anatomical knowledge of the pelvic anatomy and three-dimensional cognitive skills. We addressed whether a computer navigation system combined with a preoperative computed tomography-based plan enabled surgeons to perform RAO safely and reliably through a mini-incision regardless of their level of experience with performing osteotomies. METHODS: We enrolled 24 patients (25 hips) with DDH (radiographic grade 0 or 1 osteoarthritic changes: Tönnis classification)...
October 25, 2016: International Journal of Computer Assisted Radiology and Surgery
J Schmolders, S Koob, P Schepers, P H Pennekamp, S Gravius, D C Wirtz, R Placzek, A C Strauss
PURPOSE AND OBJECTIVE: Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used...
October 25, 2016: Archives of Orthopaedic and Trauma Surgery
B Hohendorff, J Franke, C K Spies, L P Müller, C Ries
OBJECTIVE: Arthrodesis of the proximal interphalangeal joint of fingers in a functional and pain-free position. INDICATIONS: Primary and secondary osteoarthritis, traumatic joint destruction, posttraumatic malposition, instability, joint destruction due to infection, irreparable extensor and/or flexor tendon lesion, recurrent flexion deformity in Dupuytren's disease, arthritis (e. g., rheumatoid arthritis, psoriatic arthritis), failed resection arthroplasty, failed prosthesis, congenital disorder (e...
October 25, 2016: Operative Orthopädie und Traumatologie
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