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persistent post operative pain

Juying Jin, Lihua Peng, Qibin Chen, Dong Zhang, Li Ren, Peipei Qin, Su Min
BACKGROUND: Chronic post-surgical pain (CPSP) remains a major clinical problem which may be associated with impaired activities of daily life and decreased health-related quality of life. Although cesarean section is one of the most commonly performed operations, chronic pain after cesarean delivery has not been well-studied. The purpose of this prospective study was to assess the incidence and risk factors of chronic pain at 3, 6 and 12 months after cesarean delivery. METHODS: We prospectively investigated preoperative demographic and psychological factors, intraoperative clinical factors, and acute postoperative pain in a cohort of 527 women undergoing cesarean section...
October 18, 2016: BMC Anesthesiology
Ashok Kumar Saxena, Geetanjali T Chilkoti, Anand K Chopra, Basu Dev Banerjee, Tusha Sharma
BACKGROUND: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. METHODS: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included...
October 2016: Korean Journal of Pain
Kevin R Stone, Jonathan R Pelsis, Kellen Na, Ann W Walgenbach, Thomas J Turek
PURPOSE: The purpose of this study is to evaluate the clinical outcomes of the articular cartilage paste graft procedure at a minimum of 10 years from surgery. It is hypothesized that articular cartilage paste grafting can provide patients with a durable repair of severe full-thickness osteochondral injuries, measured by persistence of procedure-induced benefit and subjective outcome scores at 10 or more years. METHODS: Seventy-four patients undergoing paste grafting at a mean age of 45...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tae Ho Lee, Jay Ho Jung, Young Kwon Hong
The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%)...
September 2016: Chonnam Medical Journal
Mario G Zotti, Oscar P Brumby-Rendell, Ben McDonald, Tom Fisher, Christovalantis Tsimiklis, Wai Weng Yoon, Orso L Osti
BACKGROUND: Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort. METHODS: Theater records from a single spinal surgeon's practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up...
December 2015: J Spine Surg
Stephan Becker, Alexander Hadjipavlou, Michael H Heggeness
BACKGROUND CONTENT: Lumbar axial back pain arising from degenerative disc disease continues to be a challenging clinical problem whether treated with non-surgical management, local injection, or motion segment stabilization and fusion. PURPOSE: To determine the efficacy of intraosseous basivertebral nerve ablation for the treatment of chronic lumbar back pain in a clinical setting. STUDY DESIGN: Patients meeting predefined inclusion/exclusion criteria were enrolled in a study using RF energy to ablate the basivertebral nerve within the vertebral bodies adjacent to the diagnosed level...
September 1, 2016: Spine Journal: Official Journal of the North American Spine Society
S M Krieg, B Meyer
BACKGROUND: Post-nucleotomy syndrome includes all existing sequelae after surgical nucleotomy for the resection of a lumbar disc herniation, such as axial lumbar back pain and persisting radiculopathy. OBJECTIVES: To describe underlying pathologies and to determine operative treatment options. MATERIALS AND METHODS: Extensive literature research was carried out on Medline. RESULTS: Various devices and approaches have been developed in the last decades...
September 2016: Der Orthopäde
Erin FitzGerald Alaia, Christopher J Burke, Michael J Alaia, Eric J Strauss, Gina A Ciavarra, Ignacio Rossi, Zehava Sadka Rosenberg
OBJECTIVE: To describe the post-surgical imaging appearance and complications of high tibial osteotomy in patients with the iBalance implant system (iHTO; Arthrex, Naples, FL, USA). MATERIALS AND METHODS: Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant review of imaging after 24 iBalance procedures was performed with attention to: correction of varus malalignment, healing at the osteotomy site, resorption of the osteoinductive compound, and complications...
August 4, 2016: Skeletal Radiology
J S Springer, P Karlsson, C S Madsen, B Johnsen, N B Finnerup, T S Jensen, L Nikolajsen
BACKGROUND: Persistent pain is frequent after thoracotomy, with a reported prevalence of up to 60%. It remains unclear why some patients develop pain, whereas others do not. We therefore examined patients with and without pain after thoracotomy to identify pathophysiological contributors to persistent pain. METHODS: Twenty patients with persistent pain, 12 patients without pain and 20 healthy controls underwent detailed functional and structural assessment including psychometric and neuropathic pain questionnaires, bedside examination for pinprick hyperalgesia and brush allodynia, quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain, measurement of capsaicin-evoked flare response, intradermal nerve density as determined by skin biopsies and laser- and heat-evoked potentials...
July 28, 2016: European Journal of Pain: EJP
Nikolaos Patelis, Georgios Karaolanis, Georgios N Kouvelos, Collin Hart, Sean Metheiken
Peripheral arterial disease is a widely prevalent atherosclerotic occlusive disorder. Symptoms commence with exercise-induced pain in the lower extremities, known as claudication. Despite the fact that exercise has been shown to improve fibrinolytic profile some patients, the effect of exercise on coagulation and fibrinolysis cascades in claudicants has not been comprehensively defined. Literature search in English language yielded 13 studies of exercise on claudicants, including 420 patients. Claudicants tend to have a higher coagulation activity at rest compared to healthy individuals, a trend that persists even after exercise...
September 2016: Experimental Biology and Medicine
Mohammed Muneer, Ali Alkhafaji, Ayman El-Menyar, Talal Al-Hetmi, Habib Al-Basti, Hassan Al-Thani
Intravascular glomus tumor in the forearm is very rare and usually presents with persistent pain and focal tenderness. The diagnosis of this condition can be easily missed or delayed. There is no successful treatment so far other than surgical excision in most of cases. We presented a 45-year-old female presented with intravascular glomus tumor in her left forearm. The swelling was excised and the post-operative course was uneventful. Intravascular glomus tumor of the forearm is extremely rare and the persistent pain and tenderness are very suspicious...
2016: Journal of Surgical Case Reports
P R de Reuver, A H van Dijk, S Z Wennmacker, M P Lamberts, D Boerma, B L den Oudsten, M G W Dijkgraaf, S C Donkervoort, J A Roukema, G P Westert, J P H Drenth, C J H van Laarhoven, M A Boermeester
BACKGROUND: Five to 22 % of the adult Western population has gallstones. Among them, 13 to 22 % become symptomatic during their lifetime. Cholecystectomy is the preferred treatment for symptomatic cholecystolithiasis. Remarkably, cholecystectomy provides symptom relief in only 60-70 % of patients. The objective of this trial is to compare the effectiveness of usual (operative) care with a restrictive strategy using a standardized work-up with stepwise selection for cholecystectomy in patients with gallstones and abdominal complaints...
2016: BMC Surgery
Sachin Malde, Néha Sihra, Sahar Naaseri, Marco Spilotros, Eskinder Solomon, Mahreen Pakzad, Rizwan Hamid, Jeremy L Ockrim, Tamsin J Greenwell
OBJECTIVE: To assess the presenting features and medium-term symptomatic outcomes in women having excision of urethral diverticulum with Martius labial fat pad (MLFP) interposition. PATIENTS AND METHODS: We reviewed our prospective database of all female patients having excision of a symptomatic urethral diverticulum between 2007 and 2015. Data on demographics, presenting symptoms and clinical features were collected, as well as postoperative outcomes. RESULTS: In all, 70 women with a mean (range) age of 46...
July 13, 2016: BJU International
Grainne Colgan, Mike Walsh, Damien Bennett, John Rice, Timothy O'Brien
OBJECTIVE: The purpose of this study was to systematically evaluate the sagittal kinematic and kinetic gait patterns in patients in this early post-operative period, to describe them and to better understand the deficiencies in that gait pattern that may help to develop targeted rehabilitation strategies. METHODS: This study evaluated early gait patterns in 10 patients with isolated unilateral hip osteoarthritis who were post-operative for total hip replacement...
September 2016: Journal of Orthopaedics
Peter M Formby, Scott C Wagner, Daniel G Kang, Gregory S Van Blarcum, Ronald A Lehman
BACKGROUND CONTEXT: As war injury patterns have changed throughout Operations Iraqi and Enduring Freedom (OIF and OEF), a relative increase in the incidence of complex lumbosacral dissociation (LSD) injuries has been noted. Lumbosacral dissociation injuries are an anatomical separation of the spinal column from the pelvis, and represent a manifestation of severe, high-energy trauma. PURPOSE: This study aimed to assess the clinical outcomes of combat-related LSD injuries at a mean of 7 years following operative treatment...
June 22, 2016: Spine Journal: Official Journal of the North American Spine Society
T Blázquez Martín, E Iglesias Durán, M San Miguel Campos
OBJECTIVE: To evaluate the percentage of complications associated with ankle and hindfoot arthroscopy in our hospital and to compare the results with those reported in the literature. MATERIAL AND METHOD: A retrospective descriptive review was conducted on the complications associated with ankle and hindfoot arthroscopy performed between May 2008 and April 2013. A total of 257 arthroscopy were performed, 23% on subtalar joint, and 77% of ankle joint. An anterior approach was used in 69%, with 26% by a posterior approach, and the remaining 5% by combined access...
June 13, 2016: Revista Española de Cirugía Ortopédica y Traumatología
Shardul Madhav Soman, Bhavik Nandubhai Patel, Pratik Dineshbhai Shah
INTRODUCTION: It is uncommon for hand surgeons to diagnose and treat persistent post-traumatic radius fracture on the lines of tuberculosis infection even in developing countries especially when the clinical picture resembles more of a complex regional pain syndrome (CRPS). Although it works for many patients, some conditions that affect the wrist don't fall in this category and worsen with this treatment practice. We present a patient who had an extra articular distal radius fracture treated initially with percutaneous pinning and was treated as CRPS for the next ten months by local physician...
October 2015: Journal of Orthopaedic Case Reports
Margaret B Schache, Jodie A McClelland, Kate E Webster
BACKGROUND: Total knee arthroplasty (TKA) is effective in reducing pain and improving function for end-stage knee osteoarthritis. However, muscle weakness and functional limitations persist despite assistance from post-operative rehabilitation programs that traditionally focus on quadriceps strengthening and range of movement exercises. Hip abductor muscle weakness is evident in knee osteoarthritis and hip muscle strengthening reduces knee pain in this group. Following TKA, people with weak hip abductor strength perform more poorly on measures of physical function...
2016: BMC Musculoskeletal Disorders
Niamh Moloney, Jennie Man Wai Sung, Sharon Kilbreath, Elizabeth Dylke
PURPOSE: This study investigated (1) the prevalence of pain following breast cancer treatment including moderate-to-severe persistent pain and (2) the association of risk factors, present 1 month following surgery, with pain at 21 months following surgery. This information may aid the development of clinical guidelines for early pain assessment and intervention in this population. METHODS: This study was a retrospective analysis of core and breast modules of the European Organisation for Research and Treatment of Cancer (EORTC) questionnaire from 121 participants with early breast cancer...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
A Pazderska, S Crowther, P Govender, K C Conlon, M Sherlock, J Gibney
UNLABELLED: Avascular necrosis (AVN) is a rare presenting feature of endogenous hypercortisolism. If left untreated, complete collapse of the femoral head may ensue, necessitating hip replacement in up to 70% of patients. The majority of the described patients with AVN due to endogenous hypercortisolaemia required surgical intervention. A 36-year-old female, investigated for right leg pain, reported rapid weight gain, bruising and secondary amenorrhoea. She had abdominal adiposity with violaceous striae, facial plethora and hirsutism, atrophic skin, ecchymosis and proximal myopathy...
2016: Endocrinology, Diabetes & Metabolism Case Reports
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