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persistent post operative pain

Aifen Liu, Xiaopeng Wang, Hui Wang, Guoyi Lv, Yize Li, Hongmei Li
The interaction of remifentanil with glutamate systems has an important role in remifentanil-induced thermal and mechanical hyperalgesia. A previous study by our group suggested that the trafficking and function of glutamate receptor 1 (GluR1) subunits contributes to remifentanil-induced hyperalgesia by regulating the phosphorylation of GluR1 in dorsal horn neurons. The present study demonstrated that δ opioid receptor (DOR) inhibition prevented thermal and mechanical hyperalgesia, which was induced by remifentanil infusion via attenuating GluR1 subunit trafficking and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) function in dorsal horn neurons...
February 2018: Experimental and Therapeutic Medicine
JaeSang Ko, Se Kyung Kim, Dong Eun Yong, Tae-Im Kim, Eung Kweon Kim
RATIONALE: Infectious keratitis is a relatively uncommon but potentially sight-threatening complication of laser in situ keratomileusis (LASIK). Mycobacterial keratitis is usually regarded as late onset keratitis among post-LASIK keratitis. There has been no documented case of Mycobacterium intracellulare post-LASIK keratitis of a long-latent period. PATIENT CONCERNS: A 36-year-old man was referred to our out-patient clinic, for persistent corneal epithelial defect with intrastromal infiltration...
December 2017: Medicine (Baltimore)
Tahleesa Cuda, Ronny Gunnarsson, Alan de Costa
BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC. METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library...
January 31, 2018: BMC Gastroenterology
Sinem Sari, Betul Kozanhan, Ayse Ilksen Egilmez, Aykut Soyder, Osman Nuri Aydin, Fabrizio Galimberti, Daniel Sessler, Alparslan Turan
BACKGROUND AND OBJECTIVES: Fluctuations of female sex hormones during menstrual cycle influence pain perception. Endogenous pain inhibition is impaired in follicular phase of menstrual cycle. We tested the primary hypothesis that the women having surgery during their follicular phase have more acute pain and require higher opioids than those in the luteal phase, and secondarily we tested that women who have surgery during their follicular phase have more incisional pain at 3 month postoperatively...
January 16, 2018: Revista Brasileira de Anestesiologia
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
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
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
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
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
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
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
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
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
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
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
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...
February 2018: Injury
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
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
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
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
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