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https://www.readbyqxmd.com/read/29351156/liquid-nitrogen-spray-cryotherapy-is-associated-with-less-postprocedural-pain-than-radiofrequency-ablation-in-barrett-s-esophagus-a-multicenter-prospective-study
#1
Sanjeev S Solomon, Shivangi Kothari, George B Smallfield, Sumant Inamdar, Peter Stein, Viviana A Rodriguez, Adam P Sima, Krystle Bittner, Alvin M Zfass, Vivek Kaul, Arvind J Trindade
GOALS AND BACKGROUND: Two common endoscopic therapies for eradication of dysplastic Barrett's esophagus are radiofrequency ablation (RFA) and liquid nitrogen spray cryotherapy (LNC). There is no data comparing postprocedural pain. This study aimed to compare the incidence of postprocedural pain between the 2 ablation modalities. METHODS: This is a multicenter prospective study in which pain intensity scores and the presence of dysphagia were assessed immediately before and after treatment, 48 hours posttreatment and at 3 weeks posttreatment using validated instruments...
January 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29349381/acute-infection-of-viabahn-stent-graft-in-the-popliteal-artery
#2
S Michael Gharacholou, Marshall Dworak, Ala S Dababneh, Raj Varatharaj Palraj, Michael C Roskos, Scott C Chapman
Peripheral stents are increasingly used for treatment of peripheral arterial disease, yet all implanted devices are potentially at risk for infection. We describe a 51-year-old man who underwent stenting in the femoropopliteal artery and presented 3 days later with leg pain, fever, and evidence of peripheral stigmata of embolization. Blood cultures grew methicillin-resistant Staphylococcus aureus and remained persistently positive despite antibiotic therapy. At surgical exploration, the popliteal artery had essentially been disintegrated by the infection, with only visible stent graft maintaining arterial continuity...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349011/middle-glenohumeral-ligament-abrasion-causing-upper-subscapularis-tear
#3
Paul C Brady, Heather Grubbs, Alexandre Lädermann, Christopher R Adams
The middle glenohumeral ligament (MGHL) typically contributes partially to the anterior stability of the shoulder. In a very limited number of cases, the MGHL can cause abrasion on the upper edge of the subscapularis causing persistent pain symptoms for patients. The condition is exacerbated by internal rotation of the arm. In this Technical Note, we describe this entity and call it the SAM lesion (Subscapularis Abrasion from the MGHL). We present a technique of addressing this lesion.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29348999/open-repair-of-quadriceps-tendon-with-suture-anchors-and-semitendinosus-tendon-allograft-augmentation
#4
Jorge Chahla, Nicholas N DePhillipo, Mark E Cinque, Nicholas I Kennedy, George F Lebus, Filippo Familiari, Gilbert Moatshe, Robert F LaPrade
Quadriceps tendinopathy in an increasingly recognized diagnosis can lead to quadriceps tendon rupture, especially in the older population. It can be caused by repeated micro trauma or also predisposed by systemic diseases such as diabetes mellitus and connective tissue disorders that can in turn lead to extensor mechanism deficits. Although a trial of conservative treatment is advocated, operative treatment should be performed in cases of persistent pain, extension deficit, or complete rupture of the tendon...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29348279/-clinically-suspected-myocarditis-with-pseudoinfarct-presentation-complicated-with-left-ventricular-aneurysm
#5
Annick Haouzi, Ahmed Ahmed
A 51-year-old man presented with chest pain, high troponin level, inflammatory syndrome and ST-segment elevation in the anterior leads. While the transthoracic echocardiogram (TTE) showed anteroseptal hypokinesis and apical akinesis, the coronary angiogram was normal. Cardiac MR demonstrated a typical aspect of myocarditis (multiple areas of mid-myocardial late gadolinium enhancement, sparing the subendocardial layer, along with oedema). The initial diagnosis was clinically suspected myocarditis with pseudoinfarct presentation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29346771/rapid-turnover-of-cortical-ncam1-regulates-synaptic-reorganization-after-peripheral-nerve-injury
#6
Hyoung-Gon Ko, Jun-Hyeok Choi, Dong Ik Park, SukJae Joshua Kang, Chae-Seok Lim, Su-Eon Sim, Jaehoon Shim, Ji-Il Kim, Siyong Kim, Tae-Hyeok Choi, Sanghyun Ye, Jaehyun Lee, Pojeong Park, Somi Kim, Jeehaeh Do, Jihye Park, Md Ariful Islam, Hyun Jeong Kim, Christoph W Turck, Graham L Collingridge, Min Zhuo, Bong-Kiun Kaang
Peripheral nerve injury can induce pathological conditions that lead to persistent sensitized nociception. Although there is evidence that plastic changes in the cortex contribute to this process, the underlying molecular mechanisms are unclear. Here, we find that activation of the anterior cingulate cortex (ACC) induced by peripheral nerve injury increases the turnover of specific synaptic proteins in a persistent manner. We demonstrate that neural cell adhesion molecule 1 (NCAM1) is one of the molecules involved and show that it mediates spine reorganization and contributes to the behavioral sensitization...
January 16, 2018: Cell Reports
https://www.readbyqxmd.com/read/29346515/a-brain-based-pain-facilitation-mechanism-contributes-to-painful-diabetic-polyneuropathy
#7
Andrew R Segerdahl, Andreas C Themistocleous, Dean Fido, David L Bennett, Irene Tracey
The descending pain modulatory system represents one of the oldest and most fundamentally important neurophysiological mechanisms relevant to pain. Extensive work in animals and humans has shown how a functional imbalance between the facilitatory and inhibitory components is linked to exacerbation and maintenance of persistent pain states. Forward translation of these findings into clinical populations is needed to verify the relevance of this imbalance. Diabetic polyneuropathy is one of the most common causes of chronic neuropathic pain; however, the reason why ∼25-30% of patients with diabetes develop pain is not known...
January 15, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29346235/posttraumatic-stress-in-children-after-injury-the-role-of-acute-pain-and-opioid-medication-use
#8
Aimee K Hildenbrand, Nancy Kassam-Adams, Lamia P Barakat, Kristen L Kohser, Jeffrey A Ciesla, Douglas L Delahanty, Joel A Fein, Lindsay B Ragsdale, Meghan L Marsac
OBJECTIVES: After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29345843/does-the-use-of-epiduroscopic-lysis-of-adhesions-reduce-the-need-for-spinal-cord-stimulation-in-failed-back-surgery-syndrome-a-short-term-pilot-study
#9
S J Tuijp, J Van Zundert, P De Vooght, M Puylaert, R Mestrum, R Heylen, P Vanelderen
BACKGROUND AND AIMS: Persistent low back pain after initially successful surgery that is not attributed to structural deficits, is called failed back surgery syndrome (FBSS). When conservative and minimal invasive therapy fail, the recommended treatment is spinal cord stimulation (SCS). Because epidural fibrosis can be a contributing factor in the majority of FBSS patients, lumbosacral epiduroscopic lysis of adhesions may be considered as a less invasive alternative treatment option. We hypothesized that the use of epiduroscopic lysis of adhesions could reduce the need for SCS...
January 18, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29344875/development-of-a-prognostic-prediction-model-to-determine-severe-dengue-in-children
#10
Priya Sreenivasan, Geetha S, Sasikala K
OBJECTIVE: To develop a prognostic prediction model using the seven warning signs highlighted by WHO revised Dengue fever classification 2009 to determine severe dengue in children. METHODS: In this prospective analytical study conducted in a tertiary care centre, consecutive sampling of all children aged 1mo to 12y admitted with serologically confirmed Dengue was done from May 2015 through August 2016. After excluding 27 patients with co-infections and co-morbidities, 359 patients were followed up daily to assess clinical and laboratory progression till discharge/ death...
January 18, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29343888/medial-femoral-condyle-vascularised-corticoperiosteal-graft-a-suitable-choice-for-scaphoid-non-union
#11
Samir Kumta, Sudhir Warrier, Leena Jain, Rani Ummal, Manik Menezes, Shrirang Purohit
Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting in non-union and persistent wrist pain. Options for scaphoid fracture treatment have been described over several decades, however, none with an optimal solution to achieve union along with good hand function. We describe here, the use of vascularised corticoperiosteal bone grafts from the medial femoral condyle (MFC) as a solution for the difficult problem of scaphoid fracture non-union...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29342473/effectiveness-of-early-adalimumab-therapy-in-psoriatic-arthritis-patients-from-reuma-pt-early-psa
#12
Helena Santos, Mónica Eusébio, Joana Borges, Diana Gonçalves, Pedro Ávila-Ribeiro, Daniela Santos Faria, Carina Lopes, João Rovisco, Ana Águeda, Patrícia Nero, Paula Valente, Ana Rita Cravo, Maria José Santos
Objective To compare outcomes in psoriatic arthritis (PsA) patients initiating adalimumab (ADA), with short- and long-term disease duration and to evaluate the potential effect of concomitant conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or glucocorticoids. Methods Analyses included adult PsA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) between June 2008-June 2016 who received ADA for ≥3 months. Psoriatic Arthritis Response Criteria (PsARC) response, tender and swollen joint count, inflammatory parameters, patient (PtGA) and physician global assessment (PhGA), Disease Activity Score-28 joints (DAS28), and Health Assessment Questionnaire Disability Index (HAQ-DI) were compared between patients with <5 years of disease (early PsA) and those with ≥5 years of disease duration (late PsA)...
October 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/29340793/neuroimaging-findings-in-patients-with-medication-overuse-headache
#13
REVIEW
Tzu-Hsien Lai, Shuu-Jiun Wang
Medication overuse headache (MOH) is a secondary headache syndrome defined as the deterioration of the headache associated with the overuse of analgesics. The prevalence of MOH is 1-2% in the general population and even up to 50% in special clinics. Overuse of abortive medications is highly associated with chronic daily headaches and also a known risk factor for headache evolution. Possible mechanisms include neural plasticity changes such as sensitization and defective endogenous pain inhibition. Psychological studies have suggested dependence, even addiction, in patients with MOH...
January 16, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29339302/bilateral-ureteral-stent-remove-after-15-years-a-case-report
#14
Stefano Restaino, Francesco Fanfani, Matteo Vittori, Alessandro D'Addessi, Giovanni Scambia, Barbara Costantini
We present the first case of patients with more than 15 years forgotten ureteral stents. A 68-year-old woman affected by cervical cancer, who underwent a radical hysterectomy in 1997 and reported a placement of bilateral ureteral stents. She was admitted in our Hospital for stranguria, dysuria, and lower back pain for 10 days. Preoperative radiological evaluation showed the persistence of ureteral stents. She never removed the stent which had been positioned for a long period of time(since 1997). We proceed to remove in general anaesthesia bilateral stents by urethral cystoscopic...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29338493/challenges-of-peroral-endoscopic-myotomy-in-the-treatment-of-distal-esophageal-spasm
#15
Fraukje Anna-Marie Ponds, André J P M Smout, Paul Fockens, Albert J Bredenoord
OBJECTIVE: Distal esophageal spasm (DES) is a rare motility disorder characterized by premature and rapidly propagated contractions of the distal esophagus. Treatment options are limited and often poorly effective. Peroral endoscopic myotomy (POEM) seems an effective and attractive new treatment option for DES. In this case report we describe some of the difficulties that could arise. MATERIALS AND METHODS: A 84-year old man with therapy-refractory DES and complaints of severe dysphagia and chest pain underwent a POEM procedure under general anesthesia...
January 17, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29335480/novel-analgesic-effects-of-melanin-concentrating-hormone-on-persistent-neuropathic-and-inflammatory-pain-in-mice
#16
Jae-Hwan Jang, Ji-Yeun Park, Ju-Young Oh, Sun-Jeong Bae, Hyunchul Jang, Songhee Jeon, Jongpil Kim, Hi-Joon Park
The melanin-concentrating hormone (MCH) is a peptidergic neuromodulator synthesized by neurons in the lateral hypothalamus and zona incerta. MCHergic neurons project throughout the central nervous system, indicating the involvements of many physiological functions, but the role in pain has yet to be determined. In this study, we found that pMCH-/- mice showed lower baseline pain thresholds to mechanical and thermal stimuli than did pMCH+/+ mice, and the time to reach the maximum hyperalgesic response was also significantly earlier in both inflammatory and neuropathic pain...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29334488/severe-intraocular-pressure-elevation-after-intracameral-healon-5-viscoelastic-support-for-post-operative-hypotony-after-xen-gel-stent-insertion
#17
Alice Bruynseels, Freda Sii, Imran Masood, Peter Shah
PURPOSE: To describe (i) a novel case of severe intraocular pressure (IOP) elevation due to intracameral Healon 5 for management of early post-operative hypotony following XEN Gel Stent insertion and (ii) the management of this complication. METHODS: A case report. RESULTS: A 52-year-old male, with primary open angle glaucoma and suboptimal left IOP control on maximally tolerated medical therapy, was managed with XEN Gel Stent insertion at another tertiary eye unit...
January 12, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#18
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of Anesthesia and Perioperative Medicine
https://www.readbyqxmd.com/read/29332433/slippage-of-tightrope-button-in-syndesmotic-fixation-of-weber-c-malleolar-fractures-a-case-series
#19
Mas'uud Ibnu Samsudin, Ming Quan Wayne Yap, Ang Wei Luong, Ernest Beng Kee Kwek
BACKGROUND: Tightrope fixation is an emerging technique for syndesmotic fixation with promising results. However, our case series highlights the slippage of Tightrope buttons as a complication of suture button syndesmotic fixation of Weber C malleolar fractures using limited contact dynamic compression (LCDCP) plates. METHODS: We report a series of cases from our database in which slippage of the Tightrope button through the LCDCP holes in Weber C malleolar fractures was noted...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29330742/henoch-sch%C3%A3-nlein-purpura-nephritis-initial-risk-factors-and-outcomes-in-a-latin-american-tertiary-center
#20
Izabel M Buscatti, Beatriz B Casella, Nadia E Aikawa, Andrea Watanabe, Sylvia C L Fahrat, Lucia M A Campos, Clovis Artur Silva
The objective of this study was to evaluate prevalence, initial risk factors, and outcomes in Henoch-Schönlein purpura nephritis (HSPN) patients in Latin America. Two hundred ninety-six patients (validated EULAR/PRINTO/PRES HSP criteria) were assessed by demographic data, clinical/laboratorial involvements, and treatments in the first 3 months after diagnosis. They were followed-up in a Latin American tertiary center and were divided in two groups: with and without nephritis. Persistent non-nephrotic proteinuria, nephrotic proteinuria, and acute/chronic kidney injury were also systematically evaluated at 1, 5, 10, and 15 years after diagnosis...
January 13, 2018: Clinical Rheumatology
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