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https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#1
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28809936/benefits-and-safety-of-gabapentinoids-in-chronic-low-back-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Harsha Shanthanna, Ian Gilron, Manikandan Rajarathinam, Rizq AlAmri, Sriganesh Kamath, Lehana Thabane, Philip J Devereaux, Mohit Bhandari
BACKGROUND AND OBJECTIVE: Chronic Low Back Pain (CLBP) is very common, with a lifetime prevalence between 51% and 80%. In majority, it is nonspecific in nature and multifactorial in etiology. Pregabalin (PG) and Gabapentin (GB) are gabapentinoids that have demonstrated benefit in neuropathic pain conditions. Despite no clear rationale, they are increasingly used for nonspecific CLBP. They necessitate prolonged use and are associated with adverse effects and increased cost. Recent guidelines from the National Health Service (NHS), England, expressed concerns on their off-label use, in addition to the risk of misuse...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28807742/a-cost-utility-analysis-of-dynesys-dynamic-stabilization-versus-instrumented-fusion-for-the-treatment-of-degenerative-lumbar-spine-diseases
#3
Kan Liu, Wei Sun, Qiang Lu, Jiying Chen, Jiaguang Tang
BACKGROUND: Symptomatic chronic low back and leg pain resulting from lumbar spine degenerative disorders is highly prevalent in China, and for some patients, surgery is the final option for improvement. Several techniques for spinal non-fusion have been introduced to reduce the side-effects of fusion methods and hasten postoperative recovery. In this study, the authors have evaluated the cost-effectiveness of Dynesys posterior dynamic stabilization system (DY) compared with lumbar fusion techniques in the treatment of single-level degenerative lumbar spinal conditions...
August 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28758415/utilization-and-safety-of-onabotulinumtoxina-for-the-prophylactic-treatment-of-chronic-migraine-from-an-observational-study-in-europe
#4
Manjit Matharu, Julio Pascual, Ingela Nilsson Remahl, Andreas Straube, Arlene Lum, Gudarz Davar, Dawn Odom, Lee Bennett, Christina Proctor, Lia Gutierrez, Elizabeth Andrews, Catherine Johannes
Objective To examine treatment utilization patterns and safety of onabotulinumtoxinA for the prophylactic treatment of chronic migraine in routine clinical practice. Background Clinical trials support onabotulinumtoxinA for the prophylaxis of headache in patients with chronic migraine, but real-world data are limited. Design/methods A prospective, observational, post-authorization study in adult patients with chronic migraine treated with onabotulinumtoxinA. Data were collected at the first study injection and approximately every three months for ≤52 weeks for utilization and ≤64 weeks for safety data, and summarized using descriptive statistics...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28750551/midterm-results-of-the-salto-talaris-total-ankle-arthroplasty
#5
Matthew G Stewart, Cindy L Green, Samuel B Adams, James K DeOrio, Mark E Easley, James A Nunley
BACKGROUND: The Salto Talaris total ankle replacement is a modern fixed-bearing implant used to treat symptomatic ankle arthritis with the goals of providing pain relief, restoring mechanical alignment, and allowing motion of the ankle joint. The goal of this study was to report the midterm clinical results of one of the largest cohort of patients in the United States who underwent ankle replacement with this prosthesis. METHODS: This is a review of patients with a minimum of 5 years up to 10 years' follow-up...
July 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28750504/does-myofascial-and-trigger-point-treatment-reduce-pain-and-analgesic-intake-in-patients-undergoing-onabotulinumtoxina-injection-due-to-chronic-intractable-migraine-a-pilot-single-blind-randomized-controlled-trial
#6
Marialuisa Gandolfi, Christian Geroin, Nicola Valè, Fabio Marchioretto, Andrea Turrina, Eleonora Dimitrova, Stefano Tamburin, Anna Serina, Paola Castellazzi, Andrea Meschieri, François Ricard, Leopold Saltuari, Alessandro Picelli, Nicola Smania
BACKGROUND: Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. AIM: To evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA...
July 27, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28730167/the-clinical-characteristics-of-patients-with-chronic-idiopathic-anal-pain
#7
Weiming Mao, Xiujun Liao, Wenjing Wu, Yanyan Yu, Guangen Yang
The aim of this study was to investigate the clinical characteristics, treatment outcomes and psychological distress in patients with chronic idiopathic anal pain. The study was conducted on patients referred to Hangzhou Third Hospital for chronic anal pain from January, 2010 to December, 2014. Patient demographics, clinical history, anorectal physiology, and radiological imaging data were recorded for all patients. The treatment outcome was noted for patients treated and followed up for more than 6 month at the present unit...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#8
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28725617/post-vasectomy-pain-syndrome-diagnosis-management-and-treatment-options
#9
REVIEW
Varsha Sinha, Ranjith Ramasamy
Vasectomy is the most effective form of sterilization for men. With approximately 500,000 vasectomies performed each year in the United States, 1-2% of these patients will experience chronic testicular pain for greater than three months after the procedure. Post-vasectomy pain syndrome (PVPS) is diagnosis of exclusion, and may be caused by direct damage to spermatic cord structures, compression of nerves in the spermatic cord via inflammation, back pressure from epididymal congestion, and perineural fibrosis...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28718248/outcome-of-0-2-glyceryltrinitrate-cream-versus-2-diltiazem-cream-in-the-treatment-of-chronic-anal-fissure
#10
Muhammad Siddique Khan, Ismail Akbar, Junaid Zeb, Salman Ahmad, Ajmal Khan
BACKGROUND: Anal fissure is a linear tear in the distal anal canal resulting from persistent hypertonia and spasm of the internal sphincter which results in mucosal ischemia. We have conducted a study in order to compare the outcome of 0.2% glyceryl trinitrate cream versus 2% diltiazem cream in the treatment of chronic anal fissure. METHODS: This randomized controlled trial (RCT) was carried out in the Department of Surgical "B" unit, at Ayub Teaching Hospital, Abbottabad, Pakistan from 15th June 2012 to 15th May 2015...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28693374/john-f-kennedy-s-back-chronic-pain-failed-surgeries-and-the-story-of-its-effects-on-his-life-and-death
#11
T Glenn Pait, Justin T Dowdy
The 35th president of the United States, John F. Kennedy (JFK), experienced chronic back pain beginning in his early 20s. He underwent a total of 4 back operations, including a discectomy, an instrumentation and fusion, and 2 relatively minor surgeries that failed to significantly improve his pain. The authors examined the nature and etiology of JFK's back pain and performed a detailed investigation into the former president's numerous medical evaluations and treatment modalities. This information may lead to a better understanding of the profound effects that JFK's chronic back pain and its treatment had on his life and presidency, and even his death...
July 11, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28683056/vital-signs-changes-in-opioid-prescribing-in-the-united-states-2006-2015
#12
Gery P Guy, Kun Zhang, Michele K Bohm, Jan Losby, Brian Lewis, Randall Young, Louise B Murphy, Deborah Dowell
BACKGROUND: Prescription opioid-related overdose deaths increased sharply during 1999-2010 in the United States in parallel with increased opioid prescribing. CDC assessed changes in national-level and county-level opioid prescribing during 2006-2015. METHODS: CDC analyzed retail prescription data from QuintilesIMS to assess opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015...
July 7, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28676067/chronic-scrotal-pain-in-young-adults
#13
Misgav Rottenstreich, Yuval Glick, Ofer Natan Gofrit
OBJECTIVE: Chronic scrotal pain (CSP) is a common and well recognized symptom of young males presenting to primary care units. Historically, CSP is defined as a testicular pain lasting for over 3 months. However, its etiology and outcome are poorly understood and its management is largely empirical. This study was conducted to examine the frequency, spectrum of pathology and outcome of CSP among young adults. RESULTS: The medical records of 382,036 young males were reviewed for anamnestic information, physical findings, primary care physician decisions, and final outcome...
July 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28657698/mental-and-physical-health-conditions-in-us-combat-veterans-results-from-the-national-health-and-resilience-in-veterans-study
#14
Melissa M Thomas, Ilan Harpaz-Rotem, Jack Tsai, Steven M Southwick, Robert H Pietrzak
Objective: To identify sociodemographic and military characteristics of combat-exposed and non-combat-exposed veterans in the United States and to compare rates of mental and physical health conditions in these populations. Methods: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative survey of 1,480 US veterans conducted September-October 2013. Poststratification weights were applied to analyses to permit generalizability of results to the US veteran population...
June 22, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28652205/opioid-analgesics-administered-for-pain-on-the-inpatient-pediatric-setting
#15
Gary A Walco, Nancy Gove, Jennifer Phillips, Steven J Weisman
This study aimed to describe utilization of opioid medications among infants, children, and adolescents on the inpatient setting. These data are needed to guide clinical trials and improve research methodologies, as well as to inform more about possible sources of opioid misuse in the United States. A retrospective chart review was conducted covering a span of one year, with a special focus on the prescription of opioids for long-term treatment of chronic pain. Opioid medications were prescribed for less than 5 days in the overwhelming majority (75%) of patients...
June 23, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28648165/-psychosocial-treatment-of-pain-at-general-practitioners-and-in-specialist-pain-treatment-units
#16
Gitte Handberg
Patients with complex chronic pain conditions are often difficult to treat with analgesia alone. Psychosocial intervention is needed to help them gain control and find an appropriate level of activity. This article summarizes the possibilities of psychosocial treatment of pain patients at the general practitioners and in specialist units of multidisciplinary pain treatment. The theoretical frame used is cognitive behavioural therapy. In practice, psychoeducation, mindfulness, and relaxation exercises are introduced to the patients to help them with daily life activity and work...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28569130/meta-analysis-of-electroacupuncture-in-cardiac-anesthesia-and-intensive-care
#17
Sven Asmussen, Rene Przkora, Dirk M Maybauer, John F Fraser, Filippo Sanfilippo, Kristofer Jennings, Michael Adamzik, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28560220/medical-and-surgical-treatment-of-hidradenitis-suppurativa-a-review
#18
REVIEW
Nicolò Scuderi, Ambra Monfrecola, Luca Andrea Dessy, Gabriella Fabbrocini, Matteo Megna, Giuseppe Monfrecola
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%. The central pathogenic event in HS is believed to be the occlusion of the upper part of the folliculopilosebaceous unit, leading to the rupture of the sebofollicular canal with the consequent development of perifollicular lymphohistiocytic inflammation. The HS treatment choices are influenced by disease severity and its individual subjective impact, involving both medical and surgical interventions...
May 2017: Skin Appendage Disorders
https://www.readbyqxmd.com/read/28546770/reduced-gabaergic-neuronal-activity-in-zona-incerta-causes-neuropathic-pain-in-a-rat-sciatic-nerve-chronic-constriction-injury-model
#19
Hyeong Cheol Moon, Young Seok Park
PURPOSE: The zona incerta (ZI) is below the ventral tier of the thalamus and has a strong influence selectively in higher-order thalamic relays. Although neuropathic pain has been suggested to result from reduced gamma-aminobutyric acid (GABA) and GABAergic signaling in the ZI, the mechanisms remain unclear. Here, the role of GABA and GABAergic signaling was investigated in the ZI in neuropathic pain using sciatic nerve chronic constriction injury (CCI) rats. MATERIALS AND METHODS: Single-unit neuronal activity was recorded, and microdialysis was performed in the ZI of CCI rats and sham-treated rats in vivo...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#20
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
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