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https://www.readbyqxmd.com/read/28213817/breakthrough-cancer-pain-and-rational-drug-use
#1
Juan Manuel Núñez Olarte
Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain...
February 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28213795/thigh-exploration-for-excision-of-a-transobturator-sling
#2
Alana M Murphy, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Groin pain is a known complication of transobturator mesh placement. The objective of this instructional video is to present the surgical technique used to excise the thigh portion of a sling in a patient with persistent thigh pain after placement of a transobturator sling. METHODS: The featured patient is a 49-year-old woman with a history of bilateral groin pain since undergoing placement of a type one polypropylene transobturator sling...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28213682/mathematical-modelling-of-cytokines-mmps-and-fibronectin-fragments-in-osteoarthritic-cartilage
#3
Michelle Baker, Bindi S Brook, Markus R Owen
Osteoarthritis (OA) is a degenerative disease which causes pain and stiffness in joints. OA progresses through excessive degradation of joint cartilage, eventually leading to significant joint degeneration and loss of function. Cytokines, a group of cell signalling proteins, present in raised concentrations in OA joints, can be classified into pro-inflammatory and anti-inflammatory groups. They mediate cartilage degradation through several mechanisms, primarily the up-regulation of matrix metalloproteinases (MMPs), a group of collagen-degrading enzymes...
February 17, 2017: Journal of Mathematical Biology
https://www.readbyqxmd.com/read/28212666/classical-hodgkin-lymphoma-masquerading-as-chronic-recurrent-multifocal-osteomyelitis-a-case-report
#4
Michael Pham, Steven Ressler, Allison Rosenthal, Katalin Kelemen
BACKGROUND: Hodgkin lymphoma is a hematologic malignancy usually confined to lymphatic structures and commonly associated with constitutional symptoms. Bony involvement and musculoskeletal symptoms are uncommon and typically seen in advanced disease. In this case, we report an unusual presentation of classical Hodgkin lymphoma and highlight diagnostic challenges leading to the misdiagnosis and treatment as chronic recurrent multifocal osteomyelitis. CASE PRESENTATION: A 38-year-old white man presented with lower extremity musculoskeletal pain...
February 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28212261/passage-of-gallstones-into-common-bile-duct-during-laparoscopic-cholecystectomy-is-it-surgeon-s-responsibility
#5
Mohammed Bani Hani, Abdel Rahman Al Manasra, Haitham Qandeel
PURPOSE: Gallstones patients without preoperative history of jaundice, deranged liver function tests, or dilated bile ducts (BD) are unlikely to have BD stones. However, some of these patients in our series underwent endoscopic stone(s) removal after laparoscopic cholecystectomy (LC). We aim to find the incidence, possible intraoperative risk factors, and if the Surgeon can be blamed for this event. MATERIALS AND METHODS: We studied LC cases over 12-year period at our university hospital and identified patients who did not have preoperative risk factors for BD stones but developed postoperative jaundice and/or persistent abdominal pain...
February 16, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28212183/cxcl12-cxcr4-signaling-contributes-to-the-pathogenesis-of-opioid-tolerance-a-translational-study
#6
Chih-Peng Lin, Kai-Hsiang Kang, Huang-Ju Tu, Ming-Yueh Wu, Tzu-Hung Lin, Houng-Chi Liou, Wei-Zen Sun, Wen-Mei Fu
BACKGROUND: Long-term opioid therapy for chronic pain may lead to analgesic tolerance, especially when administered intrathecally, thus preventing adequate pain relief. Discovering drug targets to treat opioid tolerance using a mechanism-based approach targeting opioid-induced neuroinflammation provides new therapeutic opportunities. In this study, we provide translational evidence that CXCL12/CXCR4 signaling contributes to the pathogenesis of opioid tolerance. METHODS: The CXCL12 levels in the cerebrospinal fluid of opioid-tolerant patients were compared with those of opioid-naive subjects...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28211292/clinical-and-functional-outcome-of-open-primary-repair-of-triangular-fibrocartilage-complex-tears-associated-with-distal-radius-fractures
#7
Faisal Johandi, Sreedharan Sechachalam
PURPOSE: We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. METHODS: A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210944/postoperative-imaging-in-arthroscopic-hip-surgery
#8
REVIEW
F Di Pietto, V Chianca, R de Ritis, E Cesarano, A Reginelli, A Barile, M Zappia, L Ginolfi
Arthroscopic surgery of the hip, compared to that of the knee or the shoulder, has only recently been developed in any significant way. Current indications for arthroscopic surgery of the hip include: diagnosis and treatment of lesions symptomatic of the acetabular labrum, femoroacetabular impingement (FAI), chondral lesions, joint infections, lesions of the teres ligament, impingement of the psoas tendon, pathology of the peritrochanteric space, external snapping hip (coxa saltans), and traumatic and atraumatic instability...
February 16, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28210658/patellar-maltracking-persists-in-adolescent-females-with-patellofemoral-pain-a-longitudinal-study
#9
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Katharine E Alter, Frances T Sheehan
BACKGROUND: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. PURPOSE: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28207665/healthy-physical-activity-levels-below-recommended-thresholds-two-years-after-lumbar-spine-surgery
#10
Carol A Mancuso, Roland Duculan, Federico P Girardi
STUDY DESIGN: Prospective analysis. OBJECTIVE: To quantify physical activity after lumbar surgery and identify spine-related variables associated with not meeting recommended activity thresholds. SUMMARY OF BACKGROUND DATA: National guidelines recommend ≥150 minutes/week of moderate-intensity activity; however, only 52% of the general population meets this threshold. For patients not participating in exercise/sports, ≥1400 kcal/week of energy expenditure, including from walking, is another threshold...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207662/expression-of-mirna-124a-in-cd4-cells-reflects-response-to-a-multidisciplinary-treatment-program-in-patients-with-chronic-low-back-pain
#11
Benjamin Luchting, Jens Heyn, Ludwig Christian Hinske, Shahnaz Christina Azad
STUDY DESIGN: A prospective evaluation of microRNA (miRNA) expression in patients with chronic low back pain (CLBP). OBJECTIVE: The aim of this study was to evaluate whether pain- and T cell-related miRNAs are differentially expressed in CLBP when compared with healthy volunteers and whether these miRNAs may distinguish between responders and nonresponders to a multidisciplinary treatment program. SUMMARY OF BACKGROUND DATA: CLBP is a common health problem worldwide...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207313/continuous-radiotelemetric-monitoring-of-intragastric-ph-in-a-dog-with-peptic-ulceration
#12
Michael B Lane, Jeanne C Larson, Jennifer E Stokes, M Katherine Tolbert
CASE DESCRIPTION A 6-year-old castrated male Boxer was evaluated for a 5-week history of frequent vomiting, melena, and signs of abdominal pain following accidental ingestion of 5 to ten 15-mg meloxicam tablets (approx ingested dose, 3.1 to 6.2 mg/kg [1.4 to 2.8 mg/lb]). CLINICAL FINDINGS Clinical signs persisted despite 3 weeks of treatment with sucralfate (41.8 mg/kg [19 mg/lb], PO, q 8 h) and omeprazole (0.8 mg/kg [0.36 mg/lb], PO, q 24 h). Results of a CBC and serum biochemical analysis were unremarkable...
March 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28204925/circumferential-fusion-for-degenerative-lumbar-spondylolisthesis-complicated-by-distal-junctional-grade-4-spondylolisthesis-in-the-sub-acute-post-operative-setting
#13
Alexander A Theologis, Deeptee Jain, Christopher P Ames, Murat Pekmezci
INTRODUCTION: Surgical management for lumbar stenosis is generally safe and provides significant improvements in pain, disability, and function. Successful lumbar decompression hinges on removing an appropriate amount of lamina and other compressive pathology in the lateral recess. Too little bony decompression can result in persistent pain and disability, while over resection of the pars and/or facets may jeopardize spinal stability. CASE REPORT: In this unique report, we present for the first time an acute iatrogenic grade 4 L5-S1 spondylolisthesis distal to a L3-5 laminectomy and circumferential instrumented fusion due to bilateral iatrogenic L5 pars fractures and its management and clinical outcomes after revision operation...
February 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28203763/location-of-persistent-pharyngeal-pain-after-general-anaesthesia
#14
Y Konishi, N Komasawa, H Sano, T Minami
No abstract text is available yet for this article.
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28203506/lymphaticovenous-anastomosis-releases-the-lower-extremity-lymphedema-associated-pain
#15
Makoto Mihara, Hisako Hara, Han Peng Zhou, Shuichi Tange, Kazuki Kikuchi
BACKGROUND: We investigate the effectiveness of lymphaticovenous anastomosis (LVA) in releasing lymphedema-associated pain. METHODS: We performed a retrospective analysis. Subjects of this study included lower extremity lymphedema patients who presented persistent and constant degrees of pain in their lower limbs. LVA was performed under local anesthesia. The preoperative lower extremity pain and postoperative lower extremity pain were surveyed using the visual analog scale on a score from 0 to 10...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#16
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28201840/clinical-response-to-dorsal-duct-drainage-via-the-minor-papilla-in-refractory-obstructing-chronic-calcific-pancreatitis
#17
Chang-Il Kwon, Mark A Gromski, Stuart Sherman, Ihab I El Hajj, Jeffrey J Easler, James Watkins, Lee McHenry, Glen A Lehman, Evan L Fogel
Background and study aims Complete stone removal from the main pancreatic duct might not be achieved in all patients with obstructive chronic calcific pancreatitis. We report our results for endoscopic dorsal pancreatic duct (DPD) bypass of obstructing stones in the ventral pancreatic duct (VPD). Patients and methods 16 patients with obstructive chronic calcific pancreatitis were treated with a DPD bypass. Clinical success was defined as significant pain relief and no hospital admissions for pain management during the ongoing treatment period...
February 15, 2017: Endoscopy
https://www.readbyqxmd.com/read/28198795/presence-of-failed-fracture-implants-in-association-with-lower-extremity-long-bone-nonunion-does-not-portend-worse-outcome-following-nonunion-repair
#18
Deirdre K Regan, Roy I Davidovitch, Sanjit Konda, Arthur Manoli, Philipp Leucht, Kenneth A Egol
OBJECTIVE: The purpose of this study was to determine whether the finding of failed fracture implants in association with lower extremity long bone fracture nonunion portends worse clinical or functional outcome following surgical nonunion repair. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Academic Medical Center. PATIENTS: One hundred eighty-one patients who presented to our institution over a 10-year period and underwent surgical repair of a lower extremity fracture nonunion...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28198563/frequency-and-predictors-of-analgesic-prescribing-in-u-s-nursing-home-residents-with-persistent-pain
#19
Kevin M Fain, G Caleb Alexander, David D Dore, Jodi B Segal, Andrew R Zullo, Carlos Castillo-Salgado
OBJECTIVES: To quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: Individuals aged 65 and older with persistent noncancer pain were identified from a cross-section of all long-stay U...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28197545/active-nerve-regeneration-with-failed-target-reinnervation-drives-persistent-neuropathic-pain
#20
Wenrui Xie, Judith A Strong, Jun-Ming Zhang
Peripheral nerves can regenerate and, when injured, may cause neuropathic pain. We propose that the active regeneration process plays a pivotal role in the maintenance of neuropathic pain. In one commonly used rodent neuropathic pain model, pronounced pain behaviors follow ligation and cutting of the L5 spinal nerve. We found that the injured nerve regenerates into the sciatic nerve and functionally reinnervates target tissues: the regenerated nerve conducts electrical signals, mechanical responses, and tracers between the leg/hindpaw and axotomized sensory ganglion...
January 2017: ENeuro
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