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https://www.readbyqxmd.com/read/29222573/incidence-and-causes-of-overdiagnosis-of-optic-neuritis
#1
Leanne Stunkel, Nathan H Kung, Bradley Wilson, Collin M McClelland, Gregory P Van Stavern
Importance: Diagnostic error is an important source of medical error. Overdiagnosis of optic neuritis may prompt unnecessary and costly diagnostic tests, procedures, and treatments. Objective: To assess the incidence of and characterize factors contributing to overdiagnosis of acute optic neuritis. Design, Setting, and Participants: In this retrospective clinic-based cross-sectional study of new patient encounters, 122 patients referred for acute optic neuritis at a university-based Midwestern neuro-ophthalmology clinic between January 2014 and October 2016 were studied...
December 7, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29221471/in-home-versus-hospital-preoperative-balance-and-proprioceptive-training-in-patients-undergoing-tkr-rationale-design-and-method-of-a-randomized-controlled-trial
#2
José-María Blasco, Celedonia Igual-Camacho, Sergio Roig-Casasús
BACKGROUND: Severe knee osteoarthritis, as well as the surgical procedure of total knee replacement that aims to reduce its symptoms, cause great deterioration on the proprioceptive system. Taking this fact into account, and considering that balance abilities positively influence the capacity to perform basic functional tasks, this trial aims to find the short and mid-term effects of a preoperative balance and proprioceptive training when conducted by patients undergoing total knee replacement...
December 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#3
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/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#4
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218667/the-novel-trial-natural-orifice-versus-laparoscopic-cholecystectomy-a-prospective-randomized-evaluation
#5
Steven D Schwaitzberg, Kurt Roberts, John R Romanelli, David J Desilets, David Earle, Santiago Horgan, Lee Swanstrom, Eric Hungness, Nathaniel Soper, Michael L Kochman
INTRODUCTION: The evolution of Natural Orifice Translumenal Endoscopic Surgery® (NOTES®) represents a case study in surgical procedural evolution. Beginning in 2004 with preclinical feasibility studies, and followed by the creation of the NOSCAR® collaboration between The Society of American Gastrointestinal and Endoscopic Surgeons and the American Society for Gastrointestinal Endoscopy, procedural development followed a stepwise incremental pathway. The work of this consortium has included white paper analyses, obtaining outside independent funding for basic science and procedural development, and, ultimately, the initiation of a prospective randomized clinical trial comparing NOTES® cholecystectomy as an alternative procedure to laparoscopic cholecystectomy...
December 7, 2017: Surgical Endoscopy
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
#6
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/29215547/hypnosis-as-an-effective-and-inexpensive-option-to-control-pain-in-transcatheter-ablation-of-cardiac-arrhythmias
#7
Umberto Barbero, Federico Ferraris, Milena Muro, Carlo Budano, Matteo Anselmino, Fiorenzo Gaita
: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab...
January 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29214626/a-descriptive-analysis-of-data-from-the-department-of-defense-joint-trauma-system-prehospital-trauma-registry
#8
Stephen G Schauer, Michael D April, Jason F Naylor, Joshua J Oliver, Cord W Cunningham, Andrew D Fisher, Russ S Kotwal
The active battlefield is an environment of chaos and confusion. Depending on the scale of combat, the chaos and confusion often extend into the prehospital combat setting with multiple personnel and units involved in the chain of care of casualties. The chaos of the prehospital combat setting has led to limitations in the availability of data for performance improvement and research. The Department of Defense (DoD) Joint Trauma System (JTS) Prehospital Trauma Registry (PHTR) was developed in conjunction with the updated Tactical Combat Casualty Care (TCCC) card and a TCCC after action report (AAR), and currently serves as the prehospital repository and module of the DoD Trauma Registry (DoDTR)...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29208475/cortical-bone-trajectory-screws-fixation-in-lumbar-adjacent-segment-disease-a-technique-note-with-case-series
#9
Chao-Hsuan Chen, Hsieng-Ming Huang, Der-Cherng Chen, Chih-Ying Wu, Han-Chun Lee, Der-Yang Cho
Lumbar adjacent segment disease after lumbar fusion surgery often requires surgical intervention. However, subsequent surgical treatment often needs to expose and remove all of the previous instruments. This additional surgery leads to significant post-operative pain, muscular fibrosis, poor wound healing and infection, etc. From October 2015 to March 2016, we collected six cases underwent cortical bone trajectory screws fixation with minimal invasive inter-body cage fusion for lumbar adjacent segment disease...
December 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#10
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29205404/a-quilting-subcutaneous-suture-pattern-to-reduce-seroma-formation-and-pain-24-hours-after-midline-celiotomy-in-dogs-a-randomized-controlled-trial
#11
Blake M Travis, Galina M Hayes, K Vissio, H J Harvey, James A Flanders, Julia P Sumner
OBJECTIVE: To determine the influence of a quilting suture pattern tacking the subcutaneous tissues to the deep fascia on complications after midline celiotomy in dogs. STUDY DESIGN: Single-center, randomized, blinded, controlled trial conducted in a veterinary teaching hospital. ANIMALS: Four hundred thirty-two dogs undergoing midline celiotomy for ovariohysterectomy (n = 249) or other abdominal procedures (n = 183). METHODS: Dogs were randomly assigned to (1) a quilting group, subcutaneous tissue with apposition plus tacking to the rectus fascia or (2) a nonquilting group, with apposition of subcutaneous tissue without tacking...
December 3, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29205150/a-pragmatic-multicentre-randomised-controlled-trial-comparing-stapled-haemorrhoidopexy-with-traditional-excisional-surgery-for-haemorrhoidal-disease-the-ethos-study
#12
Angus Jm Watson, Jonathan Cook, Jemma Hudson, Mary Kilonzo, Jessica Wood, Hanne Bruhn, Steven Brown, Brian Buckley, Finlay Curran, David Jayne, Malcolm Loudon, Ramesh Rajagopal, Alison McDonald, John Norrie
BACKGROUND: Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remains as to which of these surgical procedures is the most clinically effective and cost-effective...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29200944/cost-utility-analysis-of-cervical-therapeutic-medial-branch-blocks-in-managing-chronic-neck-pain
#13
Laxmaiah Manchikanti, Vidyasagar Pampati, Alan D Kaye, Joshua A Hirsch
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29199999/effect-of-inhalation-aromatherapy-on-procedural-pain-and-anxiety-after-needle-insertion-into-an-implantable-central-venous-port-catheter-a-quasi-randomized-controlled-pilot-study
#14
Ezgi Mutluay Yayla, Leyla Ozdemir
BACKGROUND: Needle insertion into an implantable central venous port catheter may lead to procedural pain and anxiety in cancer patients. OBJECTIVE: The aim of this study was to determine the effects of inhalation aromatherapy on procedural pain and anxiety after needle insertion into an implantable central venous port catheter. METHODS: This study included 123 cancer patients who were scheduled to undergo chemotherapy. Patients were randomly assigned to either the lavender group (n = 41), the eucalyptus group (n = 41), or a control group (n = 41)...
December 2, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/29199767/oxcarbazepine-for-neuropathic-pain
#15
REVIEW
Muke Zhou, Ning Chen, Li He, Mi Yang, Cairong Zhu, Fengbo Wu
BACKGROUND: Several anticonvulsant drugs are used in the management of neuropathic pain. Oxcarbazepine is an anticonvulsant drug closely related to carbamazepine. Oxcarbazepine has been reported to be efficacious in the treatment of neuropathic pain, but evidence from randomised controlled trials (RCTs) is conflicting. Oxcarbazepine is reportedly better tolerated than carbamazepine. This is the first update of a review published in 2013. OBJECTIVES: To assess the benefits and harms of oxcarbazepine for different types of neuropathic pain...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29197180/acupuncture-for-neuropathic-pain-in-adults
#16
REVIEW
Zi Yong Ju, Ke Wang, Hua Shun Cui, Yibo Yao, Shi Min Liu, Jia Zhou, Tong Yu Chen, Jun Xia
BACKGROUND: Neuropathic pain may be caused by nerve damage, and is often followed by changes to the central nervous system. Uncertainty remains regarding the effectiveness and safety of acupuncture treatments for neuropathic pain, despite a number of clinical trials being undertaken. OBJECTIVES: To assess the analgesic efficacy and adverse events of acupuncture treatments for chronic neuropathic pain in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, four Chinese databases, ClinicalTrials...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29192423/bisphosphonates-for-paget-s-disease-of-bone-in-adults
#17
REVIEW
Luis Corral-Gudino, Adrian Jh Tan, Javier Del Pino-Montes, Stuart H Ralston
BACKGROUND: Bisphosphonates are considered to be the treatment of choice for people with Paget's disease of bone. However, the effects of bisphosphonates on patient-centred outcomes have not been extensively studied. There are insufficient data to determine whether reducing and maintaining biochemical markers of bone turnover to within the normal range improves quality of life and reduces the risk of complications. OBJECTIVES: To assess the benefits and harms of bisphosphonates for adult patients with Paget's disease of bone...
December 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29189304/interventional-pain-procedures-in-physical-medicine-and-rehabilitation-residencies
#18
Sanjeev Agarwal, Caitlin Cicone, Philip Chang
Exposure to interventional pain procedures is now a required component of training in physical medicine and rehabilitation (PM&R) residencies as mandated by the Accreditation Council for Graduate Medical Education (ACGME). Data regarding resident exposure and competency in these procedures remains limited. Objectives were to determine the volume and type of exposure PM&R residents have to interventional pain procedures and to obtain faculty-perceived opinions regarding competency of incoming fellows as it pertains to interventional pain management...
November 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29184439/ultrasound-guided-rectus-sheath-block-caudal-analgesia-or-surgical-site-infiltration-for-pediatric-umbilical-herniorrhaphy-a-prospective-double-blinded-randomized-comparison-of-three-regional-anesthetic-techniques
#19
Lance M Relland, Joseph D Tobias, David Martin, Giorgio Veneziano, Ralph J Beltran, Christopher McKee, Tarun Bhalla
Background: Umbilical hernia repair is a common pediatric surgical procedure. While opioid analgesics are a feasible option and have long been a mainstay in the pharmacological intervention for pain, the effort to improve care and limit opioid-related adverse effects has led to the use of alternative techniques, including regional anesthesia. The current study prospectively compares the analgesic efficacy of three techniques, including caudal epidural blockade, peripheral nerve blockade, and local wound infiltration, in a double-blinded study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29178917/the-influence-of-surface-emg-triggered-multichannel-electrical-stimulation-on-sensomotoric-recovery-in-patients-with-lumbar-disc-herniation-study-protocol-for-a-randomized-controlled-trial-reco
#20
Sara Lener, Christoph Wipplinger, Sebastian Hartmann, Wolfgang N Löscher, Sabrina Neururer, Matthias Wildauer, Claudius Thomé, Anja Tschugg
BACKGROUND: Intervertebral disc degeneration is one of the most common reasons for chronic low back pain and sensomotoric deficits, often treated by lumbar sequestrectomy. Nevertheless, the prognostic factors relevant for time and quality of recovery, of the surgical procedure, relative to conservative treatment, remain controversial and require further investigation. Surface electrical stimulation (SES) may be an influential intervention, already showing positive impact on motor and sensory recovery in different patient groups...
November 25, 2017: Trials
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