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https://www.readbyqxmd.com/read/28508511/clinical-nociceptive-and-psychological-profiling-to-predict-acute-pain-after-total-knee-arthroplasty
#1
I E Luna, H Kehlet, M A Petersen, E K Aasvang
BACKGROUND: Pre-operative identification of high-pain responders for acute pain after total knee arthroplasty (TKA) could lead to targeted analgesic trials and individualized analgesic strategies to improve recovery and potentially reduce the risk of persistent post-surgical pain. The aim of this study was to use simple clinical tests and questionnaires to identify predictive nociceptive and psychological factors for acute post-TKA pain. METHODS: Sixty consecutive TKA patients were included in a prospective descriptive study of pain during a 5-m walk-test 24 h post-operatively as the primary outcome...
May 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#2
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28483506/laparoscopic-repair-of-a-symptomatic-post-cesarean%C3%A2-section-isthmocele-a-video-case-report
#3
Giorgio Aimi, Laura Buggio, Nicola Berlanda, Paolo Vercellini
OBJECTIVE: To describe our technique for laparoscopic management of post-cesarean section isthmocele. DESIGN: Surgical video article. Local Institutional Review Board approval for the video reproduction has been obtained. SETTING: University hospital. PATIENT(S): A 36-year-old patient with a history of two previous cesarean deliveries. She complained of persistent postmenstrual spotting and chronic pelvic pain. At transvaginal ultrasound examination, a cesarean scar defect of 20...
May 5, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28394854/a-role-for-nk-1-neurons-in-the-rostral-ventromedial-medulla-in-the-development-of-chronic-post-thoracotomy-pain
#4
Sergey G Khasabov, Jeffrey Chi-Fei Wang, Donald A Simone, Gary R Strichartz
Thoracotomy results in chronic post-operative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP...
April 5, 2017: Pain
https://www.readbyqxmd.com/read/28393507/-nephrectomies-in-poor-or-non-functioning-kidneys-is-it-the-right-thing-to-do
#5
B Estors, A E Hernández, E Calleja, M D Rodrigo, J Lumbreras, C Marhuenda
AIM OF THE STUDY: To review our management and outcomes of nephrectomies performed in patients with non-functioning kidneys. METHODS: Retrospective analysis of the patients who underwent nephrectomy surgery in our hospital between 2010 and 2014. Data was collected from the patient charts paying special attention to the clinical resolution of the symptoms that motivated surgery. MAIN RESULTS: A total of 18 nephrectomies were performed. Median age was of 6,5 years (range: 11 months to 15 years)...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28385936/unsatisfactory-outcomes-following-unicompartmental-knee-arthroplasty-in-patients-with-partial-thickness-cartilage-loss-a-medium-term-follow-up
#6
T W Hamilton, H G Pandit, A Inabathula, S J Ostlere, C Jenkins, S J Mellon, C A F Dodd, D W Murray
AIMS: While medial unicompartmental knee arthroplasty (UKA) is indicated for patients with full-thickness cartilage loss, it is occasionally used to treat those with partial-thickness loss. The aim of this study was to investigate the five-year outcomes in a consecutive series of UKAs used in patients with partial thickness cartilage loss in the medial compartment of the knee. PATIENTS AND METHODS: Between 2002 and 2014, 94 consecutive UKAs were undertaken in 90 patients with partial thickness cartilage loss and followed up independently for a mean of six years (1 to 13)...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384895/combined-conventional-and-endoscopic-microdebrider-assisted-adenoidectomy-a-tertiary-centre-experience
#7
Amal T Das, S B Prakash, V Priyadarshini
INTRODUCTION: Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy. AIM: To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28323223/robotic-assisted-conservative-excision-of-retrocervical-rectal-deep-infiltrating-endometriosis-a-case-series
#8
Alfredo Ercoli, Emma Bassi, Stefania Ferrari, Daniela Surico, Anna Fagotti, Francesco Fanfani, Fiorenzo De Cicco, Nicola Surico, Giovanni Scambia
Deep infiltrating endometriosis (DIE) is a complex disease that impairs the quality of life and the fertility of women. Colorectal DIE accounts for 70% to 93% of all the intestinal endometriotic sites and frequently needs a surgical approach. However, the indications for the surgical management of this condition are still controversial. From March 2010 to June 2014, we scheduled 33 consecutive patients presenting with retrocervical-rectal DIE of any diameter not involving the mucosa nor producing rectal stenosis > 50% for laparoscopic robotic assisted nerve-sparing rectal nodulectomy (LRN)...
March 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28323139/inflammation-and-post-operative-recovery-in-patients-undergoing-total-knee-arthroplasty-secondary-analysis-of-a-randomized-controlled-trial
#9
A Langkilde, T L Jakobsen, T Q Bandholm, J Eugen-Olsen, T Blauenfeldt, J Petersen, O Andersen
OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial (RCT) of physical rehabilitation ± progressive strength training (PST). We aimed to investigate whether (1) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; (2) PST affects inflammation, and the inflammatory state over time; (3) baseline or surgery-induced inflammation modifies the effect of rehabilitation ± PST on change in 6-min walk test (Δ6MWT); and (4) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA...
March 16, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28316023/transconjunctival-versus-subciliary-approach-to-the-infraorbital-margin-for-open-reduction-of-zygomaticomaxillary-complex-fractures-a-randomized-feasibility-study
#10
Mohammad Waheed El-Anwar, Ezzeddin Elsheikh, Atef M Hussein, Adly A Tantawy, Youssef Mansour Abdelbaki
INTRODUCTION: Although some studies addressed the differences between subciliary and transconjunctival approaches, no previous prospective comparative study on displaced zygomaticomaxillary complex (ZMC) fracture that repaired by three-point internal fixation using also upper gingivolabial incision and upper eye lid incision. So, the effect of these incisions on the comparison was not investigated. PURPOSE: The purpose of this study was to compare transconjunctival and subciliary approaches for open reduction and internal rigid fixation (OR/IF) of ZMC fractures...
June 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28315267/pharmacological-modulation-of-the-sigma-1-receptor-and-the-treatment-of-pain
#11
Manuel Merlos, Javier Burgueño, Enrique Portillo-Salido, Carlos Ramón Plata-Salamán, José Miguel Vela
There is a critical need for new analgesics acting through new mechanisms of action, which could increase the efficacy with respect to existing therapies and reduce their unwanted effects. Current preclinical evidence supports the modulatory role of sigma-1 receptors (σ1R) in nociception, mainly based on the pain-attenuated phenotype of σ1R knockout mice and on the antinociceptive effect exerted by σ1R antagonists on pains of different etiologies. σ1R is highly expressed in different pain areas of the CNS and the periphery (particularly dorsal root ganglia), and interacts and modulates the functionality of different receptors and ion channels ...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#12
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
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/28180101/evaluation-of-complications-after-surgical-treatment-of-thoracic-outlet-syndrome
#14
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/28161752/reversibility-of-nerve-root-sedimentation-sign-in-lumbar-spinal-stenosis-patients-after-decompression-surgery
#15
Christian Barz, Markus Melloh, Lukas P Staub, Sarah J Lord, Harry R Merk, Thomas Barz
PURPOSE: The nerve root sedimentation sign (SedSign) is a magnetic resonance imaging (MRI) sign for the diagnosis of lumbar spinal stenosis (LSS). It is included in the assessment of LSS to help determine whether decompression surgery is indicated. Assessment of the reversibility of the SedSign after surgery may also have clinical implications for the decision about whether or not a secondary operation or revision is needed. This study investigated if lumbar decompression leads to a reversal of the SedSign in patients with LSS and a positive SedSign pre-operatively; and if a reversal is associated with more favourable clinical outcomes...
February 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28158960/dry-needling-combined-with-physical-therapy-in-patients-with-chronic-postsurgical-pain-following-total-knee-arthroplasty-a-case-series
#16
Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Álvaro Vásquez-Rosel, Orlando Paredes-Molina, Antonio Cuesta-Vargas
Study Design Case series. Background This case series describes a combined program of dry needling and therapeutic exercise in a small group of patients with persistent pain following total knee arthroplasty (TKA). Case Description Fourteen patients who underwent TKA had persistent postsurgical pain and myofascial trigger points that were nonresponsive to treatment with conventional physical therapy and/or medication. The patients received a weekly dry needling treatment in combination with therapeutic exercises for 4 weeks...
March 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28155832/predicting-persistent-unclear-pain-following-primary-total-knee-arthroplasty
#17
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/28031515/percutaneous-radiofrequency-ablation-for-osteoid-osteoma-under-guidance-of-threedimensional-fluoroscopy
#18
Yavuz Arıkan, Umut Yavuz, Osman Lapcin, Sami Sökücü, Bilge Özkan, Yavuz Kabukçuoğlu
PURPOSE: To evaluate the outcome of percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy in 17 patients with osteoid osteoma. METHODS: Records of 11 male and 6 female consecutive patients aged 4 to 28 (mean, 13.8) years who underwent radiofrequency ablation under guidance of 3-dimensional fluoroscopy for osteoid osteoma and were followed up for a mean of 15.8 (range, 12-28) months were reviewed. All patients had been treated with analgesics but failed to achieve lasting pain relief...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28018824/pericarditis-in-a-child-with-an-intrapericardial-bronchogenic-cyst
#19
Tim Attmann, Christina Grothusen, Carsten Rickers, Peter Dütschke, Hans-Heiner Kramer, Jens Scheewe
Background An intrapericardial bronchogenic cyst (IBC) is a rare congenital malformation seemingly asymptomatic in most subjects. Case Description A 9-year-old boy presented with persistent chest pain and fever. Imaging revealed a large pericardial effusion with a tumor located at the left atrial appendage extending behind the great vessels. Mass rupture with scattered mucoid debris was found intra-operatively. The tumor was excised and the IBC was confirmed by immunohistochemistry. A postcardiotomy syndrome occurred four weeks post-operative...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/27999926/results-of-arthroscopic-treatment-in-unresolved-osgood-schlatter-disease-in-athletes
#20
Esra Circi, Tahsin Beyzadeoglu
AIM OF THE STUDY: In this study we aimed to determine outcomes following arthroscopic ossicle excision in athletes with unresolved Osgood-Schlatter disease (OSD). METHOD: Arthroscopy was performed on 11 patients (11 knees) with OSD between September 2008 and November 2014. Surgical treatment inclusion criteria were determined as: failure of conservative treatment; isolated pain over the tibial tubercle and distal patellar tendon; pain limiting sporting performance at a competitive level...
February 2017: International Orthopaedics
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