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pain manageent

C Esposito, M Escolino, B Troncoso Solar, R Iacona, R Esposito, A Settimi, I Mushtaq
OBJECTIVES: To document the imaging follow-up of laparoscopic partial nephrectomy (LPN) in children and to investigate the natural history of cystic lesions post-LPN. MATERIALS AND METHODS: We reviewed the US imaging reports performed during follow-up in 125 children (77 girls, 48 boys - average age 3.2 years) underwent LPN in 2 centers of pediatric surgery in the period 2005-2015. RESULTS: Transperitoneal approach was adopted in 83 cases while retroperitoneoscopy in 42 cases...
October 25, 2016: BJU International
Emmanuelle Chaléat-Valayer, Angélique Denis, Kariman Abelin-Genevois, Amélie Zelmar, Fabienne Siani-Trebern, Sandrine Touzet, Alain Bergeret, Cyrille Colin, Jean-Baptiste Fassier
OBJECTIVE: Low-back pain (LBP) is a common and recurrent condition, but the evidence is scarce about effective strategies to prevent recurrence and disability in the longer term. This study investigated the effect of a light exercise program, initiated in the workplace and continued at home, in reducing recurrence of LBP episodes among healthcare workers. METHODS: A total of 353 healthcare workers from ten hospitals were enrolled in a randomized controlled trial (RCT) and were randomized to the intervention or control groups, the latter of which received usual care...
October 3, 2016: Scandinavian Journal of Work, Environment & Health
Billy Sin, Kimberly Koop, Michelle Liu, Jun-Yen Yeh, Pardeep Thandi
BACKGROUND: The efficacy, safety, opioid-sparing effects, and cost-benefit analyses of intravenous (IV) acetaminophen (APAP) in treating renal colic remain controversial. STUDY QUESTION: To evaluate the safety, efficacy, opioid-sparing effects, and cost-benefits of IV APAP in patients who present with renal colic in the emergency department (ED). DATA SOURCES: We systematically searched PubMed (January 1970 to April 2016). STUDY DESIGN: Randomized controlled trials which evaluated IV APAP for renal colic in the ED were eligible...
October 24, 2016: American Journal of Therapeutics
Nagy A Mekhail, Emad Estemalik, Gerges Azer, Kristina Davis, Stuart J Tepper
BACKGROUND: A recent multicenter study presented 52-week safety and efficacy results from an open-label extension of a randomized, sham-controlled trial for patients with chronic migraine (CM) undergoing peripheral nerve stimulation of the occipital nerves. We present the data from a single center of 20 patients enrolled at the Cleveland Clinic's Pain Management Department. METHODS: In this single center, 20 patients were implanted with a neurostimulation system, randomized to an active or control group for 12 weeks, and received open-label treatment for an additional 40 weeks...
October 25, 2016: Pain Practice: the Official Journal of World Institute of Pain
Trudy Klomp, Anke B Witteveen, Ank de Jonge, Eileen K Hutton, Antoine L M Lagro-Janssen
INTRODUCTION: Many pregnant women are concerned about the pain they will experience in labor and how to deal with this. This study's objective was to explore women's postpartum perception and view of how they dealt with labor pain. METHODS: Semistructured postpartum interviews were analyzed using the constant comparison method. Using purposive sampling, we selected 17 women from five midwifery practices across the Netherlands, from August 2009 to September 2010...
October 25, 2016: Journal of Psychosomatic Obstetrics and Gynaecology
Sebastian Schneider, Davide Provasi, Marta Filizola
Substantial attention has recently been devoted to G protein-biased agonism of the µ-opioid receptor (MOR) as an ideal new mechanism for the design of analgesics devoid of serious side effects. However, designing opioids with appropriate efficacy and bias is challenging because it requires an understanding of the ligand binding process and of the allosteric modulation of the receptor. Here, we investigated these phenomena for TRV-130, a G protein-biased MOR small-molecule agonist that has been shown to exert analgesia with less respiratory depression and constipation than morphine, and that it is currently being evaluated in human clinical trials for acute pain management...
October 25, 2016: Biochemistry
Rawan Al-Yousef, Ahmad Almarzouq, Saad Aldousari
INTRODUCTION AND OBJECTIVES: Ectopic pelvic kidneys with renal stones are challenging to treat. We report our experience in managing a case of ectopic pelvic kidney with a pelvic stone by robotic pyelolithotomy after failure of flexible ure¬teroscopy. MATERIALS AND METHODS: A 46-year old male with 2 months history of vague lower abdominal pain was found to have on Computed Tomography scan a left ectopic pelvic kidney with a 12mm stone in an anomalous renal pelvis...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Prasad Wagle, Kamal Sunder Yadav, Priyanka Akhilesh Sali, Raman Garg, Paresh Varty
BACKGROUND: Pancreatico-enteric anastomotic (PEA) stenosis is one of the late complications following pancreaticoduodenectomy (PD) and reported for benign diseases. Literature for PEA stenosis following PD for malignancy is very limited due to low survival. MATERIAL AND METHODS: Patients undergoing surgery for symptomatic, recurrent, obstructive pancreatitis due to PEA stenosis following PD for malignancy were retrospectively identified from the authors' prospective database between January 1997 and December 2014...
October 24, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Howard Y Park, Sara K Yang, William L Sheppard, Vishal Hegde, Stephen D Zoller, Scott D Nelson, Noah Federman, Nicholas M Bernthal
Aneurysmal bone cysts (ABCs) are benign bone lesions arising predominantly in the pediatric population that can cause local pain, swelling, and pathologic fracture. Primary lesions, which constitute roughly two thirds of all ABCs, are thought to be neoplastic in nature, with one third of ABCs arising secondary to other tumors. Diagnosis is made with various imaging modalities, which exhibit characteristic features such as "fluid-fluid levels," although biopsy is critical, as telangiectatic osteosarcoma cannot be excluded based on imaging alone...
October 24, 2016: Current Reviews in Musculoskeletal Medicine
Farahnaz Golriz, Lane F Donnelly, Sridevi Devaraj, Raj Krishnamurthy
BACKGROUND: Until recently scurvy has been viewed in developed countries as a disease of the past. More recently there have been reports of case series of children with scurvy who have had a delayed diagnosis after an extensive diagnostic workup that included imaging. Most of these children have had underlying neurologic conditions such as autism. OBJECTIVE: To review the medical records of children diagnosed with vitamin C (ascorbic acid) deficiency based on serum ascorbic acid levels at a large pediatric health care system, to determine imaging findings and utility of imaging in management, and to identify at-risk pediatric populations...
October 24, 2016: Pediatric Radiology
Jeong-Min Hong, Eunsoo Kim, Hae-Kyu Kim, Do-Won Lee, Ji-Seok Baik, Ji-Youn Lee
INTRODUCTION: Interstitial lung disease (ILD), which is the most common form of respiratory involvement of Sjȍgren syndrome (SS), is highly associated with postoperative pulmonary complications after surgery. We report the successful anesthetic management of a cervical cancer patient with SS and ILD under combined spinal-epidural anesthesia (CSE) to avoid postoperative pulmonary complications. CASE DESCRIPTION: A 41-year-old woman with SS complicated by recently progressive ILD was scheduled for an elective radical hysterectomy under the diagnosis of cervical cancer...
2016: SpringerPlus
Zahab S Ahsan, Michael Rivlin, Jesse B Jupiter
Ulnar styloid impaction syndrome involves repetitive friction between an excessively long ulnar styloid and the carpus, resulting in chondromalacia, synovitis, and pain. The arthroscopic diagnosis, evaluation, and management of this syndrome are not well characterized. We present a patient with chronic wrist pain of unknown origin, culminating with arthroscopic findings demonstrating substantial loss of articular cartilage on both the lunate and triquetrum. The patient successfully underwent operative ulnar styloid excision, ultimately resolving chronic wrist pain symptomology...
November 2016: Journal of Wrist Surgery
Aude Le Corre, Kym Phuong Huynh, Rasmeet Singh Dhaliwal, Gregory Ian Bain
Background Single-photon emission computed tomography and computed tomography (SPECT/CT) is a hybrid diagnostic imaging modality that allows clinicians to integrate their diagnostic evaluations and deliver a definitive diagnosis in musculoskeletal disorders. Specifically, in identification of osseous pathology, the conventional bone scan delivers greater specificity compared with magnetic resonance imaging (MRI). However, use of SPECT/CT enhances the sensitivity and specificity. Use of this modality denotes the possibility to specify the lesion more accurately and precisely while grading the activity according to osseous structural changes...
November 2016: Journal of Wrist Surgery
Nishrutha Karthik, Karthik Gnanapandithan
Cocaine abuse is frequent in patients visiting the emergency department. The knowledge of the cardiovascular complications of cocaine is excellent among physicians. However the awareness regarding its abdominal complications, the most important of which include gastroduodenal perforation, bowel ischemia and splenic rupture is less adequate. We report a 58-year-old with cocaine use who presents with upper abdominal pain and a rapidly worsening clinical status. He was found to have atraumatic splenic rupture causing a hemoperitoneum that was managed by intervention radiology guided splenic artery embolization...
August 8, 2016: Clinics and Practice
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
Anand Veeravagu, Amy Li, Lawrence M Shuer, Atman M Desai
BACKGROUND: Osteochondromas are the most frequent benign bone tumors, but only rarely occur along the spinal column and even more rarely induce symptoms from spinal cord compression. CASE DESCRIPTIONS: We report two adult patients, both with a history of hereditary multiple exostoses, who presented with cervical myelopathy secondary to osteochondromas. The first patient is a 22-year-old male with numbness and weakness of his right upper limb and neck pain. Radiological images revealed a bony tumor arising from the C3 lamina with evidence of severe spinal cord compression...
October 21, 2016: World Neurosurgery
P Noufi, E Khoury, E Ayoub, N Naccache, S Richa
OBJECTIVES: Use of chronic opioid therapy has increased substantially over the past few years, even though opioid therapy is associated with potentially serious harms, including opioid-related adverse effects and outcomes. Prescription of opioids for chronic pain, particularly nonmalignant chronic pain, remains controversial. In the midst of this controversy, patterns of actual prescription and influences on these patterns are not well understood. This study aims to describe the frequency of prescription of opioid analgesics in a university hospital, the attitudes of doctors towards this category of drugs, and the follow-up modalities of patients taking these drugs...
October 21, 2016: L'Encéphale
Haiyong Chen, Zhipeng Ning, Wing Lok Lam, Wai-Yee Lam, Ying Ke Zhao, Jerry Wing Fai Yeung, Bacon Fung-Leung Ng, Eric Tat-Chi Ziea, Lixing Lao
Analgesic effects of acupuncture have been extensively studied in various clinical trials. However, the conclusion remains controversial, even among large scale randomized controlled trials. This study aimed to evaluate the association between the conclusion of the trials and the types of control used in those trials via systematic review. Published randomized controlled trials of acupuncture for pain were retrieved from electronic databases (Medline, AMED, Cochrane libraries, EMBASE, PsycINFO, Clinicaltrials...
October 2016: Journal of Acupuncture and Meridian Studies
Maryam Abolhasani, Sareh Salarinejad, Mohammad Kazem Moslemi
INTRODUCTION: Ewing sarcoma/Primitive neuroectodermal tumor of the kidney (ES/PNET) is a member of Ewing's sarcoma family, occurring in young adults and has aggressive clinical behavior and poor prognosis. However, its discrimination from the renal cell carcinoma (RCC) is very difficult preoperatively. We present three cases of this rare disease that were managed in two academic centers. PRESENTATION OF CASES: Herein we report three cases of ES/PNET of the kidney, 2 young men complaining of right flank pain and gross hematuria and one young woman complaining of left subcostal pain...
October 18, 2016: International Journal of Surgery Case Reports
Robert Froud, Shilpa Patel, Dévan Rajendran, Philip Bright, Tom Bjørkli, Rachelle Buchbinder, Sandra Eldridge, Martin Underwood
BACKGROUND: Increasing patient-reported outcome measures in the 1980s and 1990s led to the development of recommendations at the turn of the millennium for standardising outcome measures in non-specific low back pain (LBP) trials. Whether these recommendations impacted use is unclear. Previous work has examined citation counts, but actual use and change over time, has not been explored. Since 2011, there has been some consensus on the optimal methods for reporting back pain trial outcomes...
2016: PloS One
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