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postoperative pain control in HIV patients

David C Sokal, Philip S Li, Robert Zulu, Quentin D Awori, Stephanie L Combes, Raymond O Simba, Richard Lee, Catherine Hart, Paul Perchal, Hayden J Hawry, Kasonde Bowa, Marc Goldstein, Mark A Barone
OBJECTIVE: To compare clinical profiles of Shang Ring versus conventional circumcisions. DESIGN: Parallel group open-label randomized controlled trial with one-to-one allocations in 2 sites. METHODS: We enrolled HIV-negative men aged 18-54 years in Homa Bay, Kenya, and Lusaka, Zambia and followed them at 2, 7, 14, 21, 28, 42, and 60 days after Shang Ring versus conventional circumcision. We compared the duration of surgery, postoperative pain using a visual analog scale, adverse events rates, time to complete wound healing by clinical assessment, participant acceptability, and provider preferences between circumcision groups...
April 1, 2014: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Sheena Derry, Andrew Sven-Rice, Peter Cole, Toni Tan, R Andrew Moore
BACKGROUND: Topical creams with capsaicin are used to treat peripheral neuropathic pain. Following application to the skin capsaicin causes enhanced sensitivity, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. High-concentration (8%) capsaicin patches were developed to increase the amount of capsaicin delivered; rapid delivery was thought to improve tolerability because cutaneous nociceptors are 'defunctionalised' quickly. The single application avoids noncompliance...
February 28, 2013: Cochrane Database of Systematic Reviews
E Carlos Rodriguez-Merchan
UNLABELLED: The rate of infection following primary total knee arthroplasty (TKA) in the general population is 1% on average. However, in persons with haemophilia (PWH), the mean rate of infection following primary TKA is nearly 8%. QUESTIONS: why is the infection rate higher in persons with haemophilia compared with the general population? what should be done to correct this? A PubMed (MEDLINE) search and a Cochrane Library search were performed. The most important articles as judged by the author were selected for this review...
September 2012: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Sheena Derry, Rosalind Lloyd, R Andrew Moore, Henry J McQuay
BACKGROUND: Topical creams with capsaicin are used to treat pain from a wide range of chronic conditions including neuropathic pain. Following application to the skin capsaicin causes enhanced sensitivity to noxious stimuli, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. There is uncertainty about the efficacy and tolerability of capsaicin for treating painful chronic neuropathies. OBJECTIVES: To review the evidence from controlled trials on the efficacy and tolerability of topically applied capsaicin in chronic neuropathic pain in adults...
2009: Cochrane Database of Systematic Reviews
E C Rodriguez-Merchan
In severely affected haemophilic patients knee and hip arthropathy is a common problem, which can leads to considerable pain and functional deficit. Surgical management, including total knee and hip arthroplasty, can be undertaken if conservative management fails. This paper reviews the functional outcome of arthroplasty in the knee and hip, the postoperative and long-term complications, and the impact of HIV. Although complications are commonly described and the surgery is technically demanding, the results of the author of this paper and the review of the literature suggest that arthroplasty of the hip and knee can be a valuable option in the management of severe haemophilic arthropathy...
November 2007: Haemophilia: the Official Journal of the World Federation of Hemophilia
D Sainsbury
Patients who are addicted to drugs, or are being treated for drug addiction, present a variety of management issues when they attend for dental care. A number of factors are related to the treatment planning and clinical management. Dentists should be aware of these factors in order to manage these patients sensitively and effectively. Important management issues include medical problems associated with drug abuse, dental problems and how drug abuse and its subsequent treatment affect the dentition, behavioural disorders, pain management, and control of cross-infection...
June 1999: New Zealand Dental Journal
K Boggian, H J Leu, J Schneider, M Turina, D Oertle
A 31-year-old male who presented with a true aneurysm of the ascending aorta had for 5 years been seropositive for HIV-1 following intravenous drug abuse. Elective aneurysmectomy was refused. Controls by computerized tomography and echocardiography gave evidence of a progressive dilatation during the following 8 months. In February 1992 a further increase of the aneurysm with severe thoracic pain necessitated an emergency graft implantation. Histopathology of the resected aorta revealed a granulomatous giant cell mesaortitis...
November 19, 1994: Schweizerische Medizinische Wochenschrift
C S Miller, R G Triplett
The carbon dioxide laser is a surgical device increasingly important to dentistry. The advantages of laser use in the treatment of oral disease have been well documented. Such benefits include bloodless incisions, accurate tissue destruction, reduced pain, minimal swelling, excellent hemostasis, and limited postoperative tissue morbidity. Little information exists currently regarding laser use in the management of medically complex patients, most notably patients with infectious diseases. This article reports the use of the carbon dioxide laser for reducing the risks of disease transmission in the surgical management of an human immunodeficiency virus (HIV) seropositive patient...
July 1991: Special Care in Dentistry
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