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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27912944/effect-of-li4-and-bl32-acupressure-on-labor-pain-and-delivery-outcome-in-the-first-stage-of-labor-in-primiparous-women-a-randomized-controlled-trial
#2
Giti Ozgoli, Sedigheh Sedigh Mobarakabadi, Reza Heshmat, Hamid Alavi Majd, Zohreh Sheikhan
OBJECTIVE: This study examines and compares the effect of LI4 and BL32 acupressure with each other and control group on labor pain and delivery outcomes. DESIGN: In this randomized controlled trial, 105 primiparous women in active phase of first-stage of labor were equally assigned to two experimental groups [acupressure on LI4 (n=35) or BL32 (n=35)] and a control group (n=35). INTERVENTIONS: The experimental groups received routine labor care and acupressure in LI4 or BL32 points in three cervical dilatations (4-5, 6-7, and 8-10cm)...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27912788/osteoid-osteoma-of-the-acetabulum-successfully-treated-with-computed-tomography-guided-resection-and-ablation-using-a-standard-electrosurgical-generator-a-case-report
#3
Kazutaka Kikuta, Sota Oguro, Tatsuya Yamamoto, Tetsuya Sekita, Sayaka Yamaguchi, Michiro Susa, Kazumasa Nishimoto, Masanori Inoue, Seishi Nakatsuka, Aya Sasaki, Kaori Kameyama, Masaya Nakamura, Morio Matsumoto, Hideo Morioka
BACKGROUND: Osteoid osteoma accounts for approximately 10% of all benign bone tumors. The most common sites of osteoid osteoma are the subcortical shaft and metaphyses of long bones, but any other skeletal bone site can be involved. The acetabulum is a rare site according to past reports. This site presents challenges to optimal management because it is anatomically difficult to approach, and because its rarity leads to limited experience with therapeutic procedures. Here, we report for the first time a rare case of osteoid osteoma in the acetabulum that was successfully treated via resection of the nidus and ablation using a standard electrosurgical generator under computed tomographic guidance...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27910725/an-over-the-counter-central-sensitization-therapy-a-chronic-back-pain-registry-study-of-pain-relief-medication-use-and-their-adverse-effects
#4
Richard Staelin, Sree N Koneru, Ian M Rawe
AIM: Back pain, the most prevalent musculoskeletal chronic pain condition, is usually treated with analgesic medications of questionable efficacy and frequent occurrence of adverse side effects. OBJECTIVE: The objective was to determine the effectiveness of the ActiPatch medical devices in reducing chronic back pain, document medication related adverse side effects and establish their impact on quality of life. METHODS: Upon completing a 7-day trial, subjects were contacted via email with an assessment form using the Constant Contact email program...
December 2, 2016: Pain Management
https://www.readbyqxmd.com/read/27910257/neurostimulation-for-postsurgical-analgesia-a-novel-system-enabling-ultrasound-guided-percutaneous-peripheral-nerve-stimulation
#5
Brian M Ilfeld, Stuart A Grant, Christopher A Gilmore, John Chae, Richard D Wilson, Amorn Wongsarnpigoon, Joseph W Boggs
While neurostimulation-stimulation of the nervous system using electrical current-has been used to treat chronic pain, its use treating postsurgical pain has been limited. Here we report on the clinical application of a novel investigational lead to provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously using ultrasound guidance within 0.5 to 3.0 cm of the femoral and/or sciatic nerve(s). With the delivery of current, pain decreased an average of 63% at rest, with 4 of 5 subjects having relief of >50%...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27910087/menstrual-migraine-and-treatment-options-review
#6
REVIEW
Kasra Maasumi, Stewart J Tepper, Jennifer S Kriegler
OBJECTIVE: A review of treatment options for menstrual migraine. BACKGROUND: Migraine affects ∼30 million people in the US. A subset of female migraineurs have migraines that are mainly associated with menstruation. Menstrual migraine (MM) is divided into pure MM and menstrually related migraine. Pure MM attacks occur only with menstruation and have a prevalence of 1%. Menstrually related migraine has a prevalence of 6-7%, and occurs both during menstruation as well as during the rest of the cycle...
December 2, 2016: Headache
https://www.readbyqxmd.com/read/27909658/minimally-invasive-surgery-for-lumbar-synovial-cysts-with-coexisting-degenerative-spondylolisthesis
#7
Daniel R Denis, Daniel Hirt, Saumya Shah, Daniel C Lu, Langston T Holly
BACKGROUND: About one third of lumbar synovial cysts are associated with degenerative spondylolisthesis. Segmental instability is thought to contribute to the pathogenesis and recurrence of synovial cysts and lumbar fusion has been advocated as a treatment of choice in the presence of spondylolisthesis. In patients with spondylolisthesis, minimally invasive resection of lumbar synovial cysts, without fusion, could minimize surgically induced segmental instability while providing good pain relief...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909152/involvement-of-mesolimbic-dopaminergic-network-in-neuropathic-pain-relief-by-treadmill-exercise-a-study-for-specific-neural-control-with-gi-dreadd-in-mice
#8
Kenta Wakaizumi, Takashige Kondo, Yusuke Hamada, Michiko Narita, Rui Kawabe, Hiroki Narita, Moe Watanabe, Shigeki Kato, Emiko Senba, Kazuto Kobayashi, Naoko Kuzumaki, Akihiro Yamanaka, Hiroshi Morisaki, Minoru Narita
BACKGROUND: Exercise alleviates pain and it is a central component of treatment strategy for chronic pain in clinical setting. However, little is known about mechanism of this exercise-induced hypoalgesia. The mesolimbic dopaminergic network plays a role in positive emotions to rewards including motivation and pleasure. Pain negatively modulates these emotions, but appropriate exercise is considered to activate the dopaminergic network. We investigated possible involvement of this network as a mechanism of exercise-induced hypoalgesia...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#9
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27909032/midterm-outcomes-of-polyvinyl-alcohol-hydrogel-hemiarthroplasty-of-the-first-metatarsophalangeal-joint-in-advanced-hallux-rigidus
#10
Timothy R Daniels, Alastair S E Younger, Murray J Penner, Kevin J Wing, Sara Lyn Miniaci-Coxhead, Ellie Pinsker, Mark Glazebrook
BACKGROUND: Hallux rigidus is the most common arthritic condition of the foot. A randomized clinical trial of first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 years postoperation, with no cases of implant fragmentation, wear, or bone loss. We prospectively determined 5-year outcomes of first MTP hemiarthroplasty with the PVA hydrogel implant...
November 30, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27908277/comparison-of-unilateral-and-bilateral-percutaneous-vertebroplasty-for-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analysis
#11
Haolin Sun, Chunde Li
BACKGROUND: The aim of this meta-analysis is to examine the safety and effectiveness of unilateral percutaneous vertebroplasty (PVP) for treatment of osteoporotic vertebral compression fractures (OVCFs) compared with that of bilateral treatment. METHODS: The multiple databases including PubMed, Springer, EMBASE, OVID, and China Journal Full-text Database were adopted to search for relevant studies in English or Chinese, and full-text articles involving comparison of unilateral and bilateral PVP surgery were reviewed...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#12
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906940/a-new-technique-for-the-treatment-of-lumbar-facet-joint-syndrome-using-intra-articular-injection-with-autologous-platelet-rich-plasma
#13
Jiuping Wu, Zhenwu Du, Yang Lv, Jun Zhang, Wei Xiong, Ruiqiang Wang, Rui Liu, Guizhen Zhang, Qinyi Liu
BACKGROUND AND OBJECTIVES: Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Therefore, we attempt to seek a new injectable material, autologous platelet rich plasma (PRP), to treat lumbar facet syndrome, as well as to assess its therapeutic effectiveness and safety...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906939/a-new-radiofrequency-ablation-procedure-to-treat-sacroiliac-joint-pain
#14
Jianguo Cheng, See Loong Chen, Nicole Zimmerman, Jarrod E Dalton, Garret LaSalle, Richard Rosenquist
BACKGROUND: Low back pain may arise from disorders of the sacroiliac joint in up to 30% of patients. Radiofrequency ablation (RFA) of the nerves innervating the sacroiliac joint has been shown to be a safe and efficacious strategy. OBJECTIVES: We aimed to develop a new RFA technique to relieve low back pain secondary to sacroiliac joint disorders. STUDY DESIGN: Methodology development with validation through prospective observational non-randomized trial (PONRT)...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906933/anterior-cingulotomy-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#15
Justin Sharim, Nader Pouratian
BACKGROUND: Anterior cingulotomy for chronic pain aims to modulate patients' attention or emotional reaction to pain rather than to modulate pain intensity. OBJECTIVES: To evaluate the clinical efficacy, both short- and long-term, of anterior cingulotomy in the treatment of chronic pain. STUDY DESIGN: Systematic review. SETTING: This systematic review assessed studies reporting anterior cingulotomy for the treatment of chronic pain...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905525/inhibition-of-cystathionine-%C3%AE-synthetase-suppresses-sodium-channel-activities-of-dorsal-root-ganglion-neurons-of-rats-with-lumbar-disc-herniation
#16
Jun Yan, Shufen Hu, Kang Zou, Min Xu, Qianliang Wang, Xiuhua Miao, Shan Ping Yu, Guang-Yin Xu
The pathogenesis of pain in lumbar disc herniation (LDH) remains poorly understood. We have recently demonstrated that voltage-gated sodium channels (VGSCs) in dorsal root ganglion (DRG) neurons were sensitized in a rat model of LDH. However, the detailed molecular mechanism for sensitization of VGSCs remains largely unknown. This study was designed to examine roles of the endogenous hydrogen sulfide synthesizing enzyme cystathionine β-synthetase (CBS) in sensitization of VGSCs in a previously validated rat model of LDH...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27904951/pre-emptive-injection-of-peri-articular-multimodal-drug-for-post-operative-pain-management-in-total-knee-arthroplasty-a-double-blind-randomized-clinical-trial
#17
Mahdi Motififard, Ali Omidian, Sajad Badiei
PURPOSE: Severe post-operative pain is one of the main problems after total knee arthroplasty. In this study, we investigated the effect of a peri-articular multimodal drugs injections pre-emptively on post-operative pain control and knee functions following total knee arthroplasty. METHODS AND MATERIALS: This study was a double-blind randomized clinical trial. Eligible cases including 137 patients-aged 30 to 80 years old-were randomly divided into one of two groups: the drug group received a cocktail consisting of bupivacaine hydrochloride, morphine sulphate, epinephrine, and ketorolac...
November 30, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#18
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27904817/transitional-vertebra-and-spina-bifida-occulta-related-with-chronic-low-back-pain-in-a-young-patient
#19
Maryam Kundi, Maham Habib, Sumbal Babar, Asif K Kundi, Salman Assad, Amjad Sheikh
Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively...
October 19, 2016: Curēus
https://www.readbyqxmd.com/read/27904732/arthroscopic-excision-of-an-intraarticular-osteoid-osteoma-in-the-distal-femur
#20
Suk Kang, Young Sung Kim, Ho Min Lee, Min Young Lee, Jong Pil Kim
An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained...
December 2016: Clinics in Orthopedic Surgery
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