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Peripheral nerve surgery

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https://www.readbyqxmd.com/read/29922745/first-in-human-randomized-clinical-trials-of-the-safety-and-efficacy-of-tanezumab-for-treatment-of-chronic-knee-osteoarthritis-pain-or-acute-bunionectomy-pain
#1
Patricia A Walicke, Franz Hefti, Roxanne Bales, Shiao-Ping Lu, Jon L Ruckle, Mark T Brown, Christine R West, David L Shelton
Introduction: The neurotrophin nerve growth factor has a demonstrated role in pain transduction and pathophysiology. Objectives: Two randomized, double-blind, placebo-controlled, phase 1 studies were conducted to evaluate safety, tolerability, and analgesic efficacy of single doses of tanezumab, a humanized anti-nerve growth factor monoclonal antibody, in chronic or acute pain. Methods: In the first study (CL001), patients with moderate to severe pain from osteoarthritis (OA) of the knee received a single intravenous infusion of tanezumab (3-1000 μg/kg) or placebo in a dose-escalation (part 1; N = 42) or parallel-arm (part 2; N = 79) study design...
May 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29921534/beagle-sciatic-nerve-regeneration-across-a-30-mm-defect-bridged-by-chitosan-pga-artificial-nerve-grafts
#2
Ye Peng, Kai-Yuan Li, Yu-Fei Chen, Xiao-Jie Li, Shu Zhu, Zheng-Yu Zhang, Xiao Wang, Li-Na Duan, Zhuo-Jing Luo, Jun-Jie Du, Jian-Chang Wang
Longitudinally oriented microstructures are essential for a nerve scaffold to promote the significant regeneration of injured peripheral axons across nerve gaps. In the current study, we present a novel nerve-guiding collagen-chitosan (CCH) scaffold that facilitated the repair of 30 mm-long sciatic nerve defects in beagles. The CCH scaffolds were observed with a scanning electron microscope. Eighteen beagles were equally divided into CCH group, autograft group and non-graft group. The posture and gait of each dog was recorded at 12 and 24 weeks after surgery...
March 22, 2018: Injury
https://www.readbyqxmd.com/read/29913996/the-attenuation-of-pain-behaviour-and-serum-interleukin-6-concentration-by-nimesulide-in-a-rat-model-of-neuropathic-pain
#3
Taraneh Moini Zanjani, Masoumeh Sabetkasaei, Behnaz Karimian, Farzaneh Labibi, Babak Farokhi, Nariman Mossafa
Background Evidence for a role of immune system in hyperalgesic pain states is increasing. Recent work in neuroimmunology suggests that the immune system does more than simply perform its well known functions of recognizing and removing invading pathogens and tumors. Interest in neuroinflammation and neuroimmune activation has grown rapidly in recent years with the recognition of the role of central nervous system inflammatiom and immune responses in the aetiology of pain states. Among various theories, the role of inflammatory responses of the injured nerve has recently received attention...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913846/persistent-pain-sensory-disturbances-and-functional-impairment-after-adjuvant-chemotherapy-for-breast-cancer
#4
Kenneth Geving Andersen, Maj-Britt Jensen, Henrik Kehlet, Rune Gärtner, Lise Eckhoff, Niels Kroman
Background Persistent pain after breast cancer treatment (PPBCT) is a considerable clinical problem affecting between 25 and 60% of breast cancer survivors [1]. Several risk factors have been proposed, among them nerve damage caused by adjuvant treatment [2]. Taxanes used in adjuvant therapy for breast cancer are neurotoxic, and thereby being a potential risk factor for PPBCT and sensory disturbances. However, the long term influence of taxanes on PPBCT is not well documented. Thus, the aim of this study was therefore to compare a nationwide cohort treated with cyclophosphamide and epirubicin + docetaxel (CE + T) versus a nationwide cohort treated with cyclophosphamide, epirubicin and fluoruracil (CEF), in order to assess differences in reporting of PPBCT, sensory disturbances in surgical area, symmetric peripheral sensory disturbances, and functional impairment...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913797/chronic-pain-after-breast-augmentation-is-associated-with-both-signs-of-peripheral-nerve-injury-and-central-nervous-mechanisms
#5
T Kaasa, L Romundstad, A Stubhaug
Background/aims The mechanisms behind chronic postsurgical pain remains unsettled. Quantitative sensory testing and questioning sensory function may help understand mechanisms behind the transition from acute to chronic pain. The aim of this study was to assess these aspects in postsurgical patients with and without chronic postsurgical pain. Methods 116 women, who answered a questionnaire in a four years follow-up study of pain, sensory changes and quality of life after cosmetic breast augmentation surgery [1], were invited to participate in a psychophysical study...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913713/spinal-cord-stimulation-background-and-clinical-application
#6
Kaare Meier
Background Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain refractory to conventional treatment. SCS treatment consists of one or more leads implanted in the epidural space of the spinal canal, connected to an implantable pulse generator (IPG). Each lead carries a number of contacts capable of delivering a weak electrical current to the spinal cord, evoking a feeling of peripheral paresthesia. With correct indication and if implanted by an experienced implanter, success rates generally are in the range of about 50-75%...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913621/the-dqb1-03-02-hla-haplotype-is-associated-with-increased-risk-of-chronic-pain-after-inguinal-hernia-surgery-and-lumbar-disc-herniation
#7
C A Dominguez, M Kalliomäki, U Gunnarsson, A Moen, G Sandblom, I Kockum, E Lavant, T Olsson, F Nyberg, L J Rygh, C Røe, J Gjerstad, T Gordh, F Piehl
Neuropathic pain conditions are common after nerve injuries and are suggested to be regulated in part by genetic factors. We have previously demonstrated a strong genetic influence of the rat major histocompatibility complex on development of neuropathic pain behavior after peripheral nerve injury. In order to study if the corresponding human leukocyte antigen complex (HLA) also influences susceptibility to pain, we performed an association study in patients that had undergone surgery for inguinal hernia (n = 189)...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29911649/systemic-administration-of-wy-14643-a-selective-synthetic-agonist-of-peroxisome-proliferator-activator-receptor-alpha-alters-spinal-neuronal-firing-in-a-rodent-model-of-neuropathic-pain
#8
Bright N Okine, Clare Spicer, Paul Millns, Andrew Bennett, Victoria Chapman
Background and aims The clinical management of chronic neuropathic pain remains a global health challenge. Current treatments are either ineffective, or associated with unwanted side-effects. The development of effective, safe therapies requires the identification of novel therapeutic targets using clinically relevant animal models of neuropathic pain. Peroxisome proliferator activated receptor alpha (PPARα), is a member of the nuclear hormone family of transcription factors, which is widely distributed in the peripheral and central nervous systems...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29905630/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-neuromodulation-of-the-sciatic-nerve-for-postoperative-analgesia-following-ambulatory-foot-surgery-a-proof-of-concept-study
#9
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
June 13, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29901585/abdominal-peripheral-nerve-block-as-the-only-anesthetic-technique-for-totally-extraperitoneal-endoscopic-inguinal-hernia-repair-two-case-reports
#10
Woojin Kwon, Seunguk Bang, Hyojung Soh, Won Jun Jeong, Sang Chul Lee, Byung Jo Choi
RATIONALE: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29897635/iridotomy-to-slow-progression-of-visual-field-loss-in-angle-closure-glaucoma
#11
REVIEW
Jimmy T Le, Benjamin Rouse, Gus Gazzard
BACKGROUND: Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. Obstruction of the anterior chamber angle blocks drainage of fluids (aqueous humor) within the eye and may raise intraocular pressure (IOP). Elevated IOP is associated with glaucomatous optic nerve damage and visual field loss. Laser peripheral iridotomy (often just called 'iridotomy') is a procedure to eliminate pupillary block by allowing aqueous humor to pass directly from the posterior to anterior chamber through use of a laser to create a hole in the iris...
June 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29896991/large-retroperitoneal-schwannoma-a-rare-cause-of-chronic-back-pain
#12
Milan Radojkovic, Dragan Mihailovic, Miroslav Stojanovic, Danijela Radojković
Schwannomas are tumours that arise from Schwann cells of the peripheral nerve sheath and rarely occur in the retroperitoneum. We report a 45-year-old woman who presented with a 2-year history of continuous progressive right-sided lower back and dull flank pain radiating into her posterolateral thigh. Abdominal magnetic resonance imaging showed a homogenous soft-tissue tumour with thick capsular lining, which lay in the right retroperitoneum. The tumour was removed at surgery. A histological examination confirmed the diagnosis of benign encapsulated cellular schwannoma...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29894344/peripheral-nerve-block-provides-effective-analgesia-for-a-patient-with-peripheral-nerve-hyperexcitability-syndrome-isaacs-syndrome-case-report
#13
Akinori Asai, Eisuke Kako, Tatsuya Hasegawa, Kazuya Sobue
Isaacs syndrome is a rare peripheral nerve hyperexcitability syndrome. The painful discharges in Isaacs syndrome are abolished by the blockade of the neuromuscular junction but not by peripheral nerve blocks (PNB). However, the efficacy of PNB for intraoperative and postoperative analgesia among those with Isaacs syndrome is unknown. A 41-year-old woman with Isaacs syndrome underwent open reduction and internal fixation of radius fractures. Ultrasound-guided bilateral axillary brachial plexus blocks were performed, followed by general anesthesia...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29886296/intradural-ganglioneuroma-mimicking-lumbar-disc-herniation-case-report
#14
Cristina Barrena López, Beatriz De la Calle García, Rosario Sarabia Herrero
Ganglioneuroma (GN) is a slow-growing tumor originating from the neural crest-derived cells, which form the sympathetic nervous system. These tumors can affect anywhere along the peripheral autonomic ganglion sites, being most commonly found in the mediastinum and retroperitoneum. Spinal GNs are extremely rare and, so far, only 1 case arising from a lumbar nerve root has been reported in English literature. GNs are often asymptomatic, and the majority of them, are found incidentally in healthy subjects. Due to its slow growth, symptoms may result from the compressive effect of the tumor...
June 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29885668/chronic-constriction-injury-induced-microrna-146a-5p-alleviates-neuropathic-pain-through-suppression-of-irak1-traf6-signaling-pathway
#15
Zhiyao Wang, Fan Liu, Min Wei, Yue Qiu, Chao Ma, Le Shen, Yuguang Huang
BACKGROUND: microRNA-146a-5p (miRNA-146a-5p) is a key molecule in the negative regulation pathway of TLRs and IL-1 receptor (TIR) signaling. Our recent study demonstrated that MyD88-dependent signaling pathway of TIR in the dorsal root ganglion (DRG) and spinal dorsal horn (SDH) plays a role in peripheral nerve injury-induced neuropathic pain. However, it was not clear whether and how miRNA-146a-5p regulates the TIR pathway of DRG and SDH in the development of neuropathic pain. METHODS: The sciatic nerve chronic constriction injury (CCI) model of rat was used to induce chronic neuropathic pain...
June 9, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29883816/case-series-malignant-peripheral-nerve-sheath-tumor-in-the-course-of-the-mandibular-nerve
#16
Probst Monika, Koerdt Steffen, Ritschl Lucas Maximilian, Bissinger Oliver, Liesche Friederike, Gempt Jens, Meyer Bernhard, Burian Egon, Lummel Nina, Kolk Andreas
OBJECTIVE: Malignant peripheral nerve sheath tumors (MPNST) are infiltrating, aggressive tumors belonging to the group of soft tissue sarcomas. This report refers to three patients with a tumorous swelling in the entire inferior alveolar nerve (IAN) with similar disease courses suspect for a MPNST, which is particularly rare in the trigeminal nerve. METHODS: Diagnostic tools, surgical proceedings and reconstructive procedures were highlighted. Three male patients (58-68 years), who suffered from numbness, pain and mild swelling in the sensation area served by the mental nerve presented at the department of oral and maxillofacial surgery and underwent diagnostic workup including CT, MRI, F18-PET-CT, as well as a biopsy of the clinical visible tumor mass with histopathological and molecular pathological analysis...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29872336/dexmedetomidine-attenuates-persistent-postsurgical-pain-by-upregulating-k-cl-cotransporter-2-in-the-spinal-dorsal-horn-in-rats
#17
Shuhong Dai, Yu Qi, Jie Fu, Na Li, Xu Zhang, Juan Zhang, Wei Zhang, Haijun Xu, Hai Zhou, Zhengliang Ma
Background: Dexmedetomidine (DEX) could have an analgesic effect on pain transmission through the modulation of brain-derived neurotrophic factor (BDNF). In addition, KCC2-induced shift in neuronal Cl- homeostasis is crucial for postsynaptic inhibition mediated by GABAA receptors. Accumulating evidence shows that nerve injury, peripheral inflammation and stress activate the spinal BDNF/TrkB signal, which results in the downregulation of KCC2 transport and expression, eventually leads to GAGAergic disinhibition and hyperalgesia...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29869289/m-socolovsky-l-rasulic-r-midha-d-garozzo-manual-of-peripheral-nerve-surgery-from-the-basics-to-complex-procedures-thieme-verlag-new-york-stuttgart-delhi-rio-de-janeiro-2017-238-pp-267-figs-270-0-mm-softcover-geb-eur-d-149-99-eur-a-154-20-chf-172-00-isbn-978
#18
https://www.readbyqxmd.com/read/29865022/neuromas-in-patients-with-peripheral-nerve-injury-and-amputation-an-ongoing-study
#19
N S Buch, E Qerama, N B Finnerup, L Nikolajsen
Background and aims Injury to peripheral nerves associated with trauma, amputation, or surgery may lead to the formation of neuromas that can cause severe pain. Unfortunately, neuromas are frequently refractory to medical and surgical treatment. This ongoing study examines whether neuromas are more frequent in patients experiencing pain after peripheral nerve injury or amputation than in patients without pain. Methods In this observational cohort study, 80 patients with peripheral nerve injury or amputation will be recruited...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29863609/inhibition-of-fatty-acid-amide-hydrolase-improves-depressive-like-behaviors-independent-of-its-peripheral-antinociceptive-effects-in-a-rat-model-of-neuropathic-pain
#20
Hai-Xia Jiang, Bo-Wen Ke, Jin Liu, Gang Ma, Ke-Rong Hai, De-Ying Gong, Zheng Yang, Cheng Zhou
BACKGROUND: Neuropathic pain is often associated with depression. Enhancing endocannabinoids by fatty acid amide hydrolase (FAAH) inhibitors relieves neuropathic pain and stress-induced depressive-like behaviors in animal models. However, it is unclear whether FAAH inhibitor can relieve neuropathic pain-induced depression by or not by its antinociceptive effects. METHODS: Adult male Wistar rats with chronic constriction injury (CCI) to the sciatic nerve were treated with the systemic FAAH inhibitor URB597 (5...
May 31, 2018: Anesthesia and Analgesia
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