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Pain resolution

Sujith Konan, Clive P Duncan, Bassam A Masri, Donald S Garbuz
BACKGROUND: Revision hip arthroplasty for metal-on-metal arthroplasty (MOMA) in the presence of an adverse local tissue reaction (ALTR) has been associated with compromised outcomes. We hypothesized that revision of MOMA for painful micromotion of the cup, in the absence of ALTR, would have a more favorable outcome. METHODS: We reviewed our database for Durom acetabular shell revision with minimum 24 months (24 months to 8 years) follow-up. Patients with a diagnosis of painful micromotion in the absence of pseudotumor was identified...
September 28, 2016: Journal of Arthroplasty
Sara L Zettervall, Eleonora G Karthaus, Peter A Soden, Dominique B Buck, Klaas H J Ultee, Marc L Schermerhorn, Mark C Wyers
OBJECTIVE: Isolated visceral artery dissections are rare entities with no current consensus guidelines for treatment and follow-up. This study aims to evaluate the presentation, management, outcomes, and follow-up practices for patients with isolated visceral artery dissections and to compare those with and without symptoms. METHODS: In this retrospective analysis, we identified all patients with isolated celiac artery and/or isolated superior mesenteric artery dissections at a single institution between September 2006 and December 2014...
October 20, 2016: Journal of Vascular Surgery
Kathleen T Puttmann, Bhagwan Satiani, Patrick Vaccaro
Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult...
October 20, 2016: Vascular and Endovascular Surgery
Sumeja Zahirovic, Faizah Siddique
A 55 year-old African American man presented to the Emergency Room with acute-onset fevers, chills, and bilateral thumb pain, swelling, and redness. MRI revealed extensive cellulitis involving bilateral hands and wrists, along with fluid collection and carpal bone erosion on the left. Given concerns for septic arthritis and osteomyelitis, patient underwent surgical debridement revealing an abscess in the wrist without osteomyelitis. Blood cultures grew Pasteurella multocida. Subsequently, patient noted two pet dogs at home, but no history of bites...
October 21, 2016: Arthritis Care & Research
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Christina Huang Wright, Dorian Kusyk, William S Rosenberg, Jennifer A Sweet
Lymphangiomatosis is a rare congenital disorder that results in multiorgan system lymphatic invasion. Symptoms due to axial skeletal involvement can range from chronic bone pain to severe deformity resulting in radiculopathy, myelopathy, and even paralysis. The authors present a case of lymphangiomatosis of the clivus, C-1, and C-2, resulting in chronic pain. The patient was successfully treated with percutaneous transoral clivoplasty and vertebroplasty, without disease progression or return of symptoms at 2 years...
October 21, 2016: Journal of Neurosurgery. Spine
Lisa M James, Brian E Engdahl, Arthur C Leuthold, Apostolos P Georgopoulos
BACKGROUND: We recently reported that six alleles from class II genes of the Human Leukocyte Antigen (HLA) confer protection from Gulf War Illness (GWI) (Georgopoulos et al., 2015). The most significant effect is exerted on Neurological-Cognitive-Mood (NCM), Pain, and Fatigue symptoms, such that higher number of copies of the protective alleles are associated with lower symptom severity. Here we tested the hypothesis that this effect is exerted by modulating the strength of neural synchronicity...
October 14, 2016: EBioMedicine
David James Osborn, Andy J Martinez, James R Jezior
OBJECTIVE: To assess the efficacy and safety of circumferential cremasteric lysis in the treatment of adult symptomatic retractile testicles. MATERIAL AND METHODS: Retrospective chart review of all patients who had undergone circumferential cremasteric lysis at a single institution by a single surgeon between January 2010 and December 2011. We evaluated etiology, pre- and post-operative pain intensity, post-operative pain alleviation and any surgical complications...
October 17, 2016: Urology
Robert M Van Haren, Lee J Goldstein, Omaida C Velazquez, Jagajan Karmacharya, Arash Bornak
OBJECTIVE: Aortobifemoral bypass has been the gold standard treatment for extensive aortoiliac occlusive disease. Endovascular therapy and stenting of aortic and iliac occlusive lesions has proven to be efficacious, especially when dealing with short segment lesions. Endovascular treatment of TransAtlantic Inter-Society Consensus II (TASC) D aortoiliac occlusive lesions remains a challenge, but a valuable treatment option in poor surgical candidates. We present our operative technique and midterm results in treating TASC D aortoiliac occlusive disease using unibody bifurcated endografts...
October 17, 2016: Journal of Vascular Surgery
Laura Bouché, Maria Panico, Paul Hitchen, Daniel Binet, Federico Sastre, Alexandra Faulds-Pain, Esmeralda Valiente, Evgeny Vinogradov, Annie Aubry, Kelly Fulton, Susan Twine, Susan M Logan, Brendan W Wren, Anne Dell, Howard R Morris
Glycosylation of flagellins is a well recognized property of many bacterial species. In this study we describe the structural characterization of novel flagellar glycans from a number of hypervirulent strains of C. difficile. We used mass spectrometry (nano LC- MS and MS/MS analysis) to identify a number of putative glycopeptides which carried a variety of glycoform substitutions each of which was linked through an initial HexNAc residue to Ser or Thr. Detailed analysis of a LLDGSSTEIR glycopeptide released by tryptic digestion, which carried two variant structures, revealed that the glycopeptide contained, in addition to carbohydrate moieties, a novel structural entity...
October 7, 2016: Journal of Biological Chemistry
Mostafa Jafari, Donya Farrokh, Najmeh Mohammadpanah
Sarcoidosis is a multi-system inflammatory disorder of unknown etiology that is manifested by the presence of non-caseating granulomas. Multiple pulmonary nodules are rare presentations of sarcoidosis. We report a case of nodular sarcoidosis in a young male of Middle-East origin who had initially presented with bilateral painful ankle edema. His chest X-ray showed multiple bilateral pulmonary nodules. A high resolution computed tomography scan of the chest demonstrated multiple pulmonary nodular lesions and also mediastinal and hilar lymphadenopathy...
August 2016: Electronic Physician
Jinge Yang, Dan Wu, Yong Tang, Huabei Jiang
Acupuncture has been an effective treatment for various pain in China for several thousand years. However, the mechanisms underlying this mysterious ancient healing are still largely unknown. Here we applied photoacoustic microscopy (PAM) to investigate brain hemodynamic changes in response to electronic acupuncture (EA) at ST36 (Zusanli). Due to the high optical absorption of blood at 532 nm, PAM could sensitively probe changes in hemoglobin concentration (HbT, i.e., cerebral blood volume [CBV]) of cortical regions in high resolution...
October 18, 2016: Journal of Biophotonics
T V K Herregods, A J P M Smout, J L S Ooi, D Sifrim, A J Bredenoord
BACKGROUND: With the advent of high-resolution manometry (HRM), a new diagnosis, jackhammer esophagus, was introduced. Little is known about this rare condition, and the relationship between symptoms and hypercontractility is not always straightforward. The aim of our study was to describe a large cohort of patients with jackhammer esophagus and to investigate whether manometric findings are associated with the presence of symptoms. METHODS: All patients from 06, 2014 until 12, 2015 seen at two tertiary centers with at least one hypercontractile swallow (distal contractile integral [DCI] >8000 mm Hg/s/cm) on HRM were analyzed...
October 17, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Marc A Bouffard, Wayne T Cornblath, Joseph F Rizzo, Michael S Lee, Lindsey B DeLott, Eric R Eggenberger, Nurhan Torun
BACKGROUND: Transient monocular vision loss (TMVL) is an alarming symptom owing to potentially serious etiologies such as thromboembolism or giant cell arteritis. Our objective is to describe the phenomenon of TMVL present on awakening, which may represent a distinct and benign entity. METHODS: We performed a retrospective observational case series of 29 patients who experienced TMVL on awakening. Patients who described monocular dimming or blackout of vision were included, and those with blurred vision, concurrent eye pain, and binocular vision loss were excluded...
September 29, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Andrea K Murray, Tonia L Moore, Elizabeth Wragg, Holly Ennis, Andy Vail, Graham Dinsdale, Lindsay Muir, Christopher E M Griffiths, Ariane L Herrick
OBJECTIVES: Systemic sclerosis (SSc)-related digital ulcers (DU) cause significant pain and disability and are often a primary endpoint in clinical trials. However, their pathophysiology has been little studied. The objectives of this prospective study were to determine whether laser Doppler imaging (LDI) and thermography can identify ischaemic components in both fingertip and extensor surface DU and assess ulcer healing. METHODS: Patients prospectively reported new DU over a year...
September 2016: Clinical and Experimental Rheumatology
Emanuel A Shapera, Vinay K Rai
Proper surgical management of anal fistula demands sound clinical judgment and extraordinary care to prevent incontinence and adequate postoperative pain control and provide satisfactory resolution to optimize quality of life. Fecal incontinence can be a devastating complication of procedures performed for fistula in ano. We report a unique case in which temporary incontinence (for less than 4 days) followed injection of liposomal bupivacaine for postoperative pain control after draining seton placement for fistula in ano...
2016: Case Reports in Surgery
Fernando Salvador, Elena Sulleiro, Adrián Sánchez-Montalvá, Carmen Alonso, Javier Santos, Isabel Fuentes, Israel Molina
BACKGROUND: Blastocystis spp. are among the most frequently observed intestinal parasites in humans. Despite the discovery of Blastocystis approximately 100 years ago, limited information is available regarding its pathogenesis, genetic diversity, and available treatment options. The aim of this study was to describe the epidemiological and clinical characteristics of patients with Blastocystis sp. infections diagnosed at Vall d'Hebron University Hospital (Barcelona, Spain). METHODS: A retrospective observational study was performed which included all adult patients who attended Vall d'Hebron University Hospital from February 2009 to March 2014 that had Blastocystis sp...
October 14, 2016: Parasites & Vectors
Ognjen Visnjevac, Shrif Costandi, Bimal A Patel, Girgis Azer, Priya Agarwal, Robert Bolash, Nagy A Mekhail
BACKGROUND: Complex regional pain syndrome (CRPS) is a painful, debilitating affliction that is often difficult to treat. It has become common international practice to use spinal cord stimulation (SCS) for the treatment of CRPS as other therapies fail to provide adequate relief, quality of life, or improvement in function. This comprehensive outcome-specific systematic review of the use of SCS for CRPS was performed to elucidate the available evidence with focus on clinically relevant patient-specific outcomes...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Michele R Colonna, Giuseppe Tallarida, Francesco Stagno d'Alcontres, Salvatore Noto, Aurora Parodi, Alberto Tagliafico
Five years after both right ulnar and median nerve decompression for paraesthesias and palsy, a patient, coming from Nigeria but living in Italy, came to our unit claiming to have persistent pain and combined median and ulnar palsy. Under suspicion of leprosy, skin and left sural nerve biopsy were performed. Skin tests were negative, but Schwann cells resulted as positive for acid-fast bacilli (AFB), leading to the diagnosis of Pure Neuritic Leprosy (PNL). The patient was given PB multidrug therapy and recovered from pain in two months...
2016: Case Reports in Neurological Medicine
Rajashree Madabushi, Anil Agarwal, Saipriya Tewari, Sujeet K S Gautam, Sandeep Khuba
Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria...
October 2016: Korean Journal of Pain
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