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persistent post operative pain

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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
#1
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/29329140/slit-lamp-needling-of-the-anterior-capsule-for-aqeuous-misdirection-post-hyaloido-zonulectomy-and-iridectomy
#2
Pierre G Mardelli, Marc E Mardelli
INTRODUCTION: We present a case of persistent aqueous misdirection post Ahmed glaucoma valve despite undergoing an anterior vitrectomy with hyaloido-zonulectomy, and iridectomy. CASE REPORT: A 73 year old female 4 months post phaco-trabeculectomy was referred with persistent high IOP. Post-operatively, she developed aqueous misdirection with a flat anterior chamber (AC) but with an IOP of 15▒mm Hg. On presentation her AC was shallow with peripheral iris-cornea touch and IOP was 39▒mm Hg...
January 11, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29325937/histopathological-analysis-of-tamoxifen-on-epidural-fibrosis
#3
Yasar Ozturk, Ismail Bozkurt, Mesut Emre Yaman, Yahya Guvenc, Tolga Tolunay, Deniz Billur, Fatma Kubra Erbay, Salim Senturk, Gokhan Bozkurt
BACKGROUND: Epidural fibrosis is a challenging topic in spinal surgery. This phenomenon constitutes one of the the main reasons behind "post-laminectomy syndrome" or "failed-back surgery syndrome", which leads to persistent back and leg pain in association with compression and/or stretching the nerve root or the dura. The exact mechanism of action in epidural fibrosis is complex and remains uncertain. Excessive deposition of collagen, fibronectin, and dermatan sulfate known as "extracellular matrix", and decrease of tissue cellularity results in epidural fibrosis...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29299474/improvement-in-hamstring-and-quadriceps-muscle-strength-following-cruciate-retaining-single-radius-total-knee-arthroplasty
#4
Jennifer Kurowicki, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Linsen T Samuel, Morad Chughtai, Martin Roche, Peter M Bonutti, Michael A Mont
Background: The ability to reach full functional capacity following total knee arthroplasty (TKA) is reliant on the strength of the quadriceps and hamstring muscles. Weakness of these muscles can persist anywhere from 1 to 3 years post-operatively. There remains considerable controversy as to what factors influence restoration of muscle strength after TKA. Implant designs have been implicated in the ability of patients to recover. Currently there is a paucity of literature available describing the influence of patient characteristics, surgical factors, and clinical outcomes on quadriceps and hamstring muscle strength following TKA with a cruciate-retaining, single radius (SR) implant...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29290334/efficacy-of-manipulation-under-anesthesia-for-stiffness-following-total-knee-arthroplasty-a-systematic-review
#5
REVIEW
Alex Gu, Adam J Michalak, Jordan S Cohen, Neil D Almeida, Alexander S McLawhorn, Peter K Sculco
BACKGROUND: Knee stiffness following primary total knee arthroplasty can lead to unsatisfactory patient outcomes secondary to persistent pain and loss of function. Manipulation under anesthesia (MUA) remains a viable option for treatment of post-operative stiffness. However, the optimal timing and clinical efficacy of manipulation of anesthesia remains unknown. METHODS: A systematic review of the literature was performed to identify studies that reported clinical outcomes for patients who underwent MUA for post-operative stiffness treatment...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29288844/primary-extradural-melanoma-arising-in-cervical-spinal-nerve-root
#6
Cunyi Zou, Wen Cheng, Chen Zhu, Qing Guo, Anhua Wu
BACKGROUND: Primary cervical melanoma is rare; this is especially true of extradural melanoma arising in the nerve root. Characterizing these cases can provide a basis for improved melanoma management. CASE DESCRIPTION: A 42-year-old female patient with numbness and pain in the right shoulder and arm persisting for 5 years was admitted. Preoperative magnetic resonance imaging revealed an epidural ladle-shaped mass shape beyond the C7-T1 intervertebral foramen that resembleda nerve sheath tumor...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29248462/fibroblasts-promote-inflammation-and-pain-via-interleukin-1%C3%AE-induction-of-the-monocyte-chemoattractant-ccl2
#7
Hannah Louise Paish, Nicolas Stewart Kalson, Graham Robert Smith, Alicia Del Carpio Pons, Thomas Edward Baldock, Nicholas Smith, Katarzyna Swist-Szulik, David John Weir, Michelle Bardgett, David John Deehan, Derek Austin Mann, Lee Anthony Borthwick
Fibroblasts persist within fibrotic scar tissue and exhibit considerable phenotypic and functional plasticity. Here, we hypothesized that scar-associated fibroblasts may be a source of stress-induced inflammatory exacerbations and pain. To test this idea we used a human model of surgery-induced fibrosis, total knee arthroplasty (TKA). Using a combination of tissue protein expression profiling and bioinformatics we discovered that many months following TKA the fibrotic joint exists in a state of unresolved chronic inflammation...
December 14, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/29242787/foot-deformities-in-hajdu-cheney-syndrome-a-rare-case-report-and-review-of-the-literature
#8
Ashish B Shah, Breann K Tisano, Osama Elattar, Jackson Rucker Staggers, Sameer Naranje
Introduction: Hajdu-Cheney syndrome (HCS) is a rare autosomal dominant disease characterized by acroosteolysis, wormian skull bones with persistent skull sutures, premature loss of teeth, micrognathia, short stature, hypermobility of the joints, neurologic manifestations such as basilar invagination with subsequent paresthesia, hearing loss, and speech alterations, and osteoporosis with tendency to pathologic fractures of long bones and vertebrae as well as painful hands and feet. Very few cases have been earlier reported in the literature...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#9
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29226029/diagnosis-and-treatment-of-ocular-pain-the-ophthalmologist-s-perspective
#10
REVIEW
Deborah S Jacobs
Purpose of Review: The aim of this review is to help ophthalmologists and other clinicians understand and treat ocular neuropathic pain. Recent Findings: Advances in the field of neurophysiology of ocular sensations explain why some cases of dry eye may represent a pain syndrome rather than a problem related to tear status. Principles related to management of pain syndromes such as persistent post-operative pain and complex regional pain syndrome are relevant to the care of these patients...
2017: Current Ophthalmology Reports
https://www.readbyqxmd.com/read/29181342/early-loosening-of-spinal-rod-in-a-case-of-degenerative-grade-1-spondylolisthesis-treated-with-unilateral-pedicle-screw-fixation-and-transforaminal-cage-for-interbody-fusion
#11
Prasoon Kumar, Vishal Kumar, Rakesh John, Rajbahadur Sharma
Introduction: Unilateral pedicle screw fixation and transforaminal cage for interbody fusion are well-established form of treatment for lumbar spondylolisthesis. It is cost effective and has shown to have a comparable outcome to bilateral pedicle screw fixation. We present a case of unilateral pedicle screw fixation and transforaminal cage for interbody fusion in a patient of Grade 1 Degenerative spondylolisthesis who had an early implant failure, and try to assess the possible events leading to it...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29179907/management-and-outcomes-of-isolated-paediatric-tibial-spine-fractures
#12
A B Scrimshire, M Gawad, R Davies, H George
Paediatric fractures of the tibial spine are relatively rare and controversy remains around how these injuries are best managed (Gans et al., 2014; Hargrove et al., 2004). Consequently most non-specialised paediatric units have limited experience of managing these injuries. This study aims to review the management and outcomes of isolated paediatric tibial spine fractures in a tertiary paediatric orthopaedic centre between 2008 and 2016. Data were collected on patient demographics, mechanism of injury, imaging, Meyers and McKeever grade of injury (Meyers and McKeever), management and outcomes, including Cincinnati and Lysholm-Tegner knee scores at a mean of 36 months post-operatively...
November 16, 2017: Injury
https://www.readbyqxmd.com/read/29100874/can-preoperative-nasal-cultures-of-staphylococcus-aureus-predict-infectious-complications-or-outcomes-following-repair-of-fracture-nonunion
#13
David P Taormina, Sanjit R Konda, Frank A Liporace, Kenneth A Egol
INTRODUCTION: Much has been studied with reference to methicillin resistant Staphylococcus aureus (MRSA) and methicillin sensitive S. aureus (MSSA) colonization and associated outcomes and comorbidities. In the area of Orthopedic surgery, literature predominantly comes from the field of arthroplasty. Little is known about outcomes of fracture and Orthopedic trauma patients in the setting of S. aureus colonization. We believe that MRSA/MSSA colonization in and of itself may be a weak marker for generally poor protoplasm, potentially with complex medical history including previous hospitalization or rehab placement...
October 31, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/29078686/uniportal-video-assisted-thoracoscopic-surgery-in-hemothorax
#14
REVIEW
Stefano Sanna, Luca Bertolaccini, Jury Brandolini, Desideria Argnani, Marta Mengozzi, Alessandro Pardolesi, Piergiorgio Solli
The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29075936/local-anesthetic-delivery-via-surgical-drain-provides-improved-pain-control-versus-direct-skin-infiltration-following-axillary-node-dissection-for-breast-cancer
#15
Muska Khpal, James R C Miller, Zika Petrovic, Delilah Hassanally
BACKGROUND: Axillary node dissection has a central role in the surgical management of breast cancer; however, it is associated with a significant risk of lymphoedema and chronic pain. Peri-operative administration of local anesthesia reduces acute and persistent post-surgical pain, but there is currently no consensus on the optimal method of local anesthetic delivery. METHODS: Patients undergoing axillary dissection for breast cancer were randomly assigned to receive a one-off dose of levobupivacaine 0...
October 26, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29066932/efficiency-of-spinal-anesthesia-versus-general-anesthesia-for-lumbar-spinal-surgery-a-retrospective-analysis-of-544-patients
#16
John T Pierce, Guy Kositratna, Mark A Attiah, Michael J Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Paul J Marcotte, W Andrew Kofke, William C Welch
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29023635/intermittent-gait-disturbance-in-idiopathic-normal-pressure-hydrocephalus
#17
Y Nikaido, Y Kajimoto, A Tucker, K Kuroda, H Ohno, T Akisue, R Saura, T Kuroiwa
OBJECTIVES: We identified intermittent gait disturbance (IGD) observed in the mild stage of idiopathic normal pressure hydrocephalus (iNPH). The first purpose of this study was to clarify the temporal gait profile of IGD during long-distance gait. The second purpose was to confirm the difference in treatment effect after cerebrospinal fluid (CSF) shunting in patients with and without IGD. MATERIALS AND METHODS: Fourteen consecutive iNPH patients with mild gait disturbance with a timed up-and-go (TUG) of <20 seconds were prospectively enrolled in the study...
October 11, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29021888/a-good-short-term-outcome-in-delayed-decompression-of-cauda-equina-syndrome-in-klebsiella-pneumoniae-spinal-epidural-abscess-a-case-report
#18
J Hanifah, J Joehaimey, M I Yusof
Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28940665/prediction-of-persistent-post-operative-pain-pain-specific-psychological-variables-compared-with-acute-post-operative-pain-and-general-psychological-variables
#19
C Horn-Hofmann, J Scheel, V Dimova, A Parthum, R Carbon, N Griessinger, R Sittl, S Lautenbacher
BACKGROUND: Psychological variables and acute post-operative pain are of proven relevance for the prediction of persistent post-operative pain. We aimed at investigating whether pain-specific psychological variables like pain catastrophizing add to the predictive power of acute pain and more general psychological variables like depression. METHODS: In all, 104 young male patients undergoing thoracic surgery for pectus excavatum correction were studied on the pre-operative day (T0) and 1 week (T1) and 3 months (T2) after surgery...
September 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28934803/two-interesting-cases-of-meralgia-paraesthetica
#20
Christopher David Jones, Luke Guiot, Mark Portelli, Timothy Bullen, Paul Skaife
Meralgia paraesthetica (MP) is a condition originally described by Bernhardt in 1878 and was eventually named by Roth in 1895. It is caused by compression of the lateral femoral cutaneous nerve (LFCN) resulting in varying types of discomfort. Severity of the symptoms can range from mildly uncomfortable to painfully disabling. In this article we discuss 2 patients with a LFCN injury occurring as a result of laparoscopic ventral rectopexy (LVR). The first patient is a 46-year-old female who reported pain and dysesthesia in the left groin and the anterolateral thigh, 2 days post LCR...
September 2017: Pain Physician
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