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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/28204925/circumferential-fusion-for-degenerative-lumbar-spondylolisthesis-complicated-by-distal-junctional-grade-4-spondylolisthesis-in-the-sub-acute-post-operative-setting
#3
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/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#4
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/28198563/frequency-and-predictors-of-analgesic-prescribing-in-u-s-nursing-home-residents-with-persistent-pain
#5
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/28197544/plasticity-in-brainstem-mechanisms-of-pain-modulation-by-nicotinic-acetylcholine-receptors-in-the-rat
#6
Francis J Jareczek, Stephanie R White, Donna L Hammond
Individuals with chronic pain may be driven to smoke more because the analgesic efficacy of nicotine diminishes. To determine whether persistent pain diminishes the actions of a nicotinic acetylcholine receptor (nAChR) agonist in pain modulatory pathways, we examined the effects of epibatidine in the rostral ventromedial medulla (RVM) of rats with and without inflammatory injury induced by intraplantar injection of complete Freund's adjuvant (CFA). In uninjured rats, epibatidine produced a dose-dependent antinociception that was completely blocked by dihydro-β-erythroidine (DHβE; α4β2 antagonist) and partially blocked by methyllycaconitine (MLA; α7 antagonist)...
January 2017: ENeuro
https://www.readbyqxmd.com/read/28197352/vulvovaginal-infralevator-haematoma-mimicking-the-second-stage-of-labour
#7
J O Awoleke, O M Ipinnimo
Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful "bearing down" efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28185925/modest-amounts-of-voluntary-exercise-reduce-pain-and-stress-related-outcomes-in-a-rat-model-of-persistent-hind-limb-inflammation
#8
M H Pitcher, F Tarum, I Z Rauf, L A Low, M C Bushnell
: Aerobic exercise improves outcomes in a variety of chronic health conditions, yet the support for exercise-induced effects on chronic pain in humans is mixed. While many rodent studies have examined the effects of exercise on persistent hypersensitivity, the vast majority employed forced exercise paradigms that are known to be highly stressful. Since stress can also produce analgesic effects, we studied how voluntary exercise, known to reduce stress in healthy subjects, alters hypersensitivity, stress and swelling in a rat model of persistent hind paw inflammation...
February 6, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28183561/audit-of-postoperative-pain-management-after-open-thoracotomy-and-the-incidence-of-chronic-postthoracotomy-pain-in-more-than-500-patients-at-a-tertiary-center
#9
G Niraj, A Kelkar, Vipul Kaushik, Yee Tang, Danny Fleet, Frances Tait, Theresa Mcmillan, Sridhar Rathinam
STUDY OBJECTIVE: To evaluate the quality of postoperative pain relief during the first 3 days after surgery and to evaluate with the incidence of persistent pain at 6 months after surgery. DESIGN: Retrospective single-center audit. SETTING: University hospital. PATIENTS: Five hundred four patients who underwent thoracotomy. INTERVENTIONS: Review of patient records, questionnaire, and telephone review...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28180101/evaluation-of-complications-after-surgical-treatment-of-thoracic-outlet-syndrome
#10
Mohammad Ali Hosseinian, Ali Gharibi Loron, Yalda Soleimanifard
BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. METHODS: In this study, 448 patients with symptoms of TOS were assessed...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28178071/recommendations-for-a-first-core-outcome-measurement-set-for-complex-regional-pain-syndrome-clinical-studies-compact
#11
Grieve Sharon, Perez Roberto Sgm, Birklein Frank, Brunner Florian, Bruehl Stephen, Harden R Norman, Packham Tara, Gobeil Francois, Haigh Richard, Holly Janet, Terkelsen Astrid, Davies Lindsay, Lewis Jennifer, Thomassen Ilona, Connett Robyn, Worth Tina, Vatine Jean-Jacques, McCabe Candida S
Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS.In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populationsThe development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process...
February 4, 2017: Pain
https://www.readbyqxmd.com/read/28176921/increased-local-expressions-of-cx3cl1-and-ccl2-are-related-to-clinical-severity-in-lumbar-disk-herniation-patients-with-sciatic-pain
#12
Zhen-Yu Peng, Rui Chen, Zuo-Zhong Fang, Bin Chen, Zhi-Hua Wang, Xi-Yang Wang
BACKGROUND: Chemokines have been identified to be involved in the modulation of pain through both peripheral and central mechanisms. However, the role of chemokines in lumbar disk herniation (LDH) with sciatic pain remains unknown. OBJECTIVE: The current study was performed to explore the expression of two most commonly studied chemokines CX3CL1 and CCL2 and assess their associations with clinical severity in LDH patients with sciatic pain. METHODS: The soft tissues around nerve root (STANR), annulus fibrosus (AF), and nucleus pulposus (NP) biopsies were obtained from 36 LDH patients with chronic sciatic pain and 10 scoliosis patients (painless controls)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28164254/utility-of-18f-sodium-fluoride-pet-ct-imaging-in-the-evaluation-of-postoperative-pain-following-surgical-spine-fusion
#13
D Pouldar, S Bakshian, R Matthews, V Rao, M Manzano, S Dardashti
STUDY DESIGN: A retrospective case review of patients who underwent 18F sodium fluoride PET/CT imaging of the spine with postoperative pain following vertebral fusion. OBJECTIVE: To determine the benefit of 18F sodium fluoride PET/CT imaging in the diagnosis of persistent pain in the postoperative spine. The diagnosis of pain generators in the postoperative spine has proven to be a diagnostic challenge. The conventional radiologic evaluation of persistent pain after spine surgery with the use of plain radiographs, MRI, and CT can often fall short of diagnosis in the complex patient...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28162641/-400-single-lead-spinal-cord-stimulation-of-the-c2-c5-nerve-roots-for-persistent-pain-secondary-to-schwannoma-resection
#14
C Reeves, E Galang, J Frye, L Kelleher, B Torres
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28162561/-324-experimental-persistent-pain-alters-loss-aversion-and-the-influence-of-physiological-responses-during-complex-decision-making
#15
B Furl, F Rassu, D Worthy, A Morgado, M Meagher
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28162333/-526-a-brief-psychological-intervention-targeting-persistent-pain-prevention-following-mastectomy-or-lumpectomy-a-pilot-investigation
#16
K Hadlandsmyth, L Dindo, S Sugg, R Wajid, M Zimmerman, B Rakel
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28158960/short-term-clinical-effects-of-dry-needling-combined-with-physical-therapy-in-patients-with-chronic-postsurgical-pain-following-total-knee-arthroplasty-case-series
#17
Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Álvaro Vásquez Rosel, Orlando Paredes Molina, Antonio Cuesta-Vargas
Study Design Case series. Background The purpose of this case series is to describe a combined program of dry needling (DN) and therapeutic exercise in a small group of patients with persistent pain post total knee arthroplasty. Case Description Fourteen total knee arthroplasty patients with persistent post-surgical pain and myofascial trigger points non-responsive to treatment with conventional physical therapy or medications received dry needling treatment in combination with therapeutic exercises for four weeks...
February 3, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28158161/factors-affecting-delayed-union-of-vertebral-fractures-following-percutaneous-kyphoplasty
#18
Xin He, YiBin Meng, YunFei Huang, DingJun Hao, QiNing Wu, JiJun Liu
BACKGROUND: Although percutaneous kyphoplasty (PKP) could achieve rapid pain relief for the elderly with osteoporotic vertebral compression fracture (OVCF), some patients still had risks of suffering vertebrae delayed union which led to persisting pain and vertebral collapse. Preventing the delayed vertebral union could reduce the further morbidities and medical costs for patients with OVCF after PKP. OBJECTIVES: To explore the factors involved in delayed vertebral union after PKP in patients with OVCF...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28155832/predicting-persistent-unclear-pain-following-primary-total-knee-arthroplasty
#19
Paweł Chodór, Jacek Kruczyński
Chronic post-surgical pain can be a considerable issue for patients undergoing primary total knee arthroplasty. According to the literature, persistent knee pain is experienced by up to 44% of patients. Most studies on total knee arthroplasty (TKA) outcomes have mainly investigated the biomechanics or function of the operated knee, but chronic pain has never been a primary issue. In recent years several possible predictors of chronic postsurgical pain have been investigated and eventually identified. A younger age, female gender, psychological distress, preoperative pain duration and intensity were all reported to influence chronic postoperative pain rates after total knee arthroplasty...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28155827/bilateral-osteonecrosis-of-the-femoral-and-humeral-heads-after-short-term-corticosteroid-therapy-a-case-study
#20
Tarek Ahmed El Gamal, Ahmed El-Bakoury, Amanda Hawkins, Moham Ed AlTayeb Mussa, Tam Er Ahmed Sweed, Sam Eh Samir Ansara
Steroid induced osteonecrosis is a devastating injury that usually requires rebuild of the joint, with the femoral and the humeral head being most commonly affected. Steroid therapy is the most common reported cause of atraumatic osteonecrosis. The Collaborative Osteonecrosis Group Study confirmed that steroids are the primary cause of multi-focal osteonecrosis in 91% of the cases. Osteonecrosis is considered multifocal when three or more joints are involved. We report a rare case of bilateral steroid-induced osteonecrosis of the proximal femora and humeri nine months after a short course of intravenous methylprednisolone for treatment of multiple myeloma...
March 23, 2016: Ortopedia, Traumatologia, Rehabilitacja
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