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Advanced pain treatment

Dennis DiGiorgi, John L Cerf, Daniel S Bowerman
Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications...
2018: Chiropractic & Manual Therapies
Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Makoto Ieguchi, Yoshitaka Ban, Hiroaki Nakamura
Circumscribed solid nodules are common in pulmonary metastases from sarcoma, but cystic pulmonary metastases from sarcomas are extremely rare. An unusual case of a 33-year-old man presenting with left spontaneous pneumothorax in association with cystic pulmonary metastases from an epithelioid sarcoma in the left forearm was discussed in the present study. The patient underwent wide resection of an epithelioid sarcoma in the left forearm 6 years prior. Periodical computed tomography revealed a gradual increase in the number and size of bilateral multiple cystic pulmonary metastases despite repeated chemotherapy treatment...
April 2018: Oncology Letters
Francesco Plotti, Corrado Terranova, Stella Capriglione, Stefania Crispino, Alessandra Li Pomi, Carlo de Cicco Nardone, Roberto Montera, Pierluigi Benedetti Panici, Roberto Angioli, Giuseppe Scaletta
AIMS: The aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III. METHODS: All patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up...
March 14, 2018: International Journal of Gynecological Cancer
C Langdon Fielding
With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease...
April 2018: Veterinary Clinics of North America. Equine Practice
Georgi Tchernev
BACKGROUND: We present to the attention of the medical, dermatological and oncosurgical community data that serves to indicate the indispensability of optimisation of the algorithm and recommendations for diagnosis and surgical treatment of cutaneous melanoma. These recommendations could be referred to different subgroups of patients in different clinical stages as well as to patients with different initial characterisation (histological morphology) of the primary tumours. One step surgery is not a myth, even more, it could prove to be one of the best solutions for some patient collectives with advanced stages of melanoma...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Orçun Çiftci, Kerem Can Yılmaz, Atilla Sezgin, Mehmet Bülent Özin, İbrahim Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Cardiac implantable electrical devices are widely used for patients with advanced heart failure and are usually explanted during orthotopic heart transplant. However, lead fragments and the pulse generator are sometimes left after the procedure. Given the concerns of infectious and thromboembolic complications, their removal is recommended. Herein, we report our experience with cardiac implantable electrical device explantation after orthotopic heart transplant. MATERIALS AND METHODS: We included recipients of heart transplants performed at Başkent University Faculty of Medicine, Department of Cardiovascular Surgery, who underwent lead and pulse generator explantation by manual traction between January 2012 and June 2017...
March 2018: Experimental and Clinical Transplantation
Raoul Saggini, Maurizio Migliorini, Simona Maria Carmignano, Emilio Ancona, Chiara Russo, Rosa Grazia Bellomo
Background: The cause of heel pain among soccer players is multifactorial and is related to repetitive microtrauma due to impact forces involving technical moves, but also the playground, the exercise mode, the recovery time, the climatic conditions and the footwear used. Aim: To investigate the aetiology of plantar heel pain of soccer players with the objective of proposing an example of guidelines for treatment. Methods: We investigated the prevalence and characteristics of inferior heel pain of 1473 professional, semiprofessional and amateur players...
2018: BMJ Open Sport & Exercise Medicine
Mary M Mitchell, Eric D Hansen, Tuo-Yen Tseng, Meng Shen, Cynda Rushton, Tom Smith, Nancy Hutton, Jennifer Wolfe, Lee Bone, Jeanne Keruly, Lawrence Wissow, Amy R Knowlton
CONTEXT & OBJECTIVE: Advance care planning (ACP) rates remain low, especially among people who are HIV positive, disadvantaged, and African American. While ACP can be a sensitive topic for clinicians and patients to discuss, health values clarification can be an important initial step. METHODS: Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, MD, who had histories of illicit drug use...
March 8, 2018: Journal of Pain and Symptom Management
Anne-Claire Pierrefeu-Lagrange, Karine Mari, Caroline Hoss, Breda Cullen, Lorraine Nisbet
INTRODUCTION: Dressings are a mainstay for wound management; however, dressing adherence to the wound or periwound area can cause pain and trauma at removal. Dressing-related trauma includes skin reactions, adherence to the wound, and skin stripping. The development of atraumatic wound contact layer dressings has been a major advancement in reducing trauma. OBJECTIVE: This study compares the benefits of a cellulose acetate mesh (CAM) coated with soft silicone versus a flexible polyamide net (FPN) coated with soft silicone...
January 26, 2018: Wounds: a Compendium of Clinical Research and Practice
D Bustamante-Suárez de Puga, R Cebrián-Gómez, E Villegas-Robles, J Sanz-Reig, J Más-Martínez, C M Verdú-Román, M Morales-Santías, E Martínez-Giménez
BACKGROUND: Open «arthrolysis» has been the standard treatment for elbow stiffness, with good results. However, the associated complications of open arthrolysis and the advancements in arthroscopic surgery have allowed including the latter as an additional approach. MATERIAL AND METHODS: Between January 2014 and March 2016, 6 patients with posttraumatic elbow stiffness underwent arthroscopic surgery by the same surgical team. Pre- and post-operative assessment included pain with a numerical visual analogue scale, elbow joint range of motion with a goniometer and the Mayo Elbow Performance Index questionnaire...
September 2017: Acta Ortopédica Mexicana
Lili Xu, Yongxian Wan, Juan Huang, Fangyuan Xu
Objective: The objective of this study is to investigate the clinical efficacy and safety of electroacupuncture and multiple acupoint stimulation in relieving cancer pain in patients with advanced hepatocellular carcinoma. Methods: Sixty-five cases of advanced hepatocellular carcinoma with cancer pain were selected in our hospital and were divided into electroacupuncture multiple acupoint stimulation group (electroacupuncture group) (n = 32) and fentanyl transdermal patch analgesia group (control group) (n = 33) according to analgesic methods and intentions...
January 2018: Journal of Cancer Research and Therapeutics
D Nashan, S Dengler
The spectrum of dermato-oncological emergencies is multifaceted. They are particularly observed in cases with malignant melanoma due to the large number of patients and prolonged survival rates that are associated with new therapies for advanced disease. Dermato-oncological patients present to the hospital with symptoms like nausea and emesis, unexpected neurological deficits, various gastrointestinal problems, and even acute abdomen, acute breathlessness, or hemoptysis. Furthermore, emergencies can be caused by hematological problems like anemia and leukopenia...
March 7, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Gwendolyn Vuurberg, Alexander Hoorntje, Lauren M Wink, Brent F W van der Doelen, Michel P van den Bekerom, Rienk Dekker, C Niek van Dijk, Rover Krips, Masja C M Loogman, Milan L Ridderikhof, Frank F Smithuis, Sjoerd A S Stufkens, Evert A L M Verhagen, Rob A de Bie, Gino M M J Kerkhoffs
This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury...
March 7, 2018: British Journal of Sports Medicine
Aileen Y Chang, Liliana Encinales, Jeffrey M Bethony, Gary L Simon
Supported by the Rheumatology Research Foundation and the NIH (National Center for Advancing Translational Sciences grants UL1-TR-001876 and KL2-TR-001877). We would like to thank Mogami et. al., for sharing their experience with chikungunya virus in the Brazilian context, especially highlighting the possible utility of ultrasound during the sub-acute phase to identify severe or evolving cases of arthritis. Indeed, Doppler ultrasound may be an effective approach to identify patients that might benefit from treatment with disease modifying agents such as methotrexate during the sub-acute phase...
March 7, 2018: Arthritis & Rheumatology
Omar Toumi, Mohamed Ali Chaouch, Abdesslem Ghedira, Ibtissem Korbi, Mohamed Nasr, Faouzi Noomene, Khadija Zouari, Randa Salem, Badii Hamida, Mondher Golli
INTRODUCTION: Congenital bile duct cysts (CBDC) is a rare congenital malformation. It results from an anomaly of the biliopancreatic junction (AJBP). This condition is often diagnosed at a young age. Although, it can be asymptomatic and discovered only at an advanced age. The aim of our work was to describe the diagnosis, therapeutic and evolutionary aspects of BVCD through a series of 11 cases diagnosed in adult cases. METHODS: This is a descriptive, retrospective and monocentric study...
June 2017: La Tunisie Médicale
Masood Umer, Yasir Mohib, Muhammed Atif, Muhammad Nazim
Background: Renal cell carcinoma account for 3% of all cancers, with peak incidence between 60 and 70 years of age predominantly affecting male population. Renal carcinoma is the most common malignancy of kidney constitutes for 80-90% of renal neoplasm with an overall 45% five years survival rate. Majority are diagnosed incidentally during investigation for other disease process of abdomen. Classical triad of gross hematuria, pain and palpable mass in abdomen is rare accounting to only 6-10%...
March 2018: Annals of Medicine and Surgery
Sayam Dubash, Dennis McGonagle, Helena Marzo-Ortega
Axial spondyloarthritis (axSpA) is a chronic inflammatory condition that encompasses ankylosing spondylitis (AS) as well as non-radiographic axial disease (nr-axSpA) and can lead to chronic pain, structural damage and disability. The introduction of tumour necrosis factor inhibitor (TNFi) drugs for AS heralded a new era of drug therapeutics for what was previously a largely untreatable disease. This has now been expanded with the licensing of secukinumab, an interleukin 17A (IL-17A) inhibitor for the treatment of AS...
March 2018: Therapeutic Advances in Chronic Disease
Deborah Negus, Christine Ahn, William Huang
Hidradenitis suppurativa is a chronic, inflammatory disease characterized by painful nodules, abscesses, and sinuses in the intertriginous areas, with significant associated comorbidities. The pathogenesis remains unclear, although advances have been made in understanding the disease process. Management of the disease is challenging, with a wide range of treatment options available with variable clinical response. Areas covered: This review discusses the most updated studies on the complex pathogenic mechanisms of hidradenitis suppurativa and the relevant literature on the current treatment options for this condition...
March 6, 2018: Expert Review of Clinical Immunology
Toshihiro Fukui
Background: Both acute aortic dissection and ruptured aortic aneurysm are leading causes of death in cardiovascular disease. These life-threatening conditions have recently been categorized as acute aortic syndrome. This review describes the etiology, clinical presentation, and therapeutic options for acute aortic syndrome including acute aortic dissection and ruptured aortic aneurysm. Main body: Several diagnostic tools for detecting these critical conditions have been developed including computed tomography, ultrasonography, magnetic resonance imaging, and laboratory tests...
2018: Journal of Intensive Care
Qiang Liu, Lu-Lu Gao, Ya-Liang Dai, Yu Wang, Hai-Xia Wang, Xiang-Jiang Luo, Xiao-Min Chai, Guo-Xia Mu, Xiao-Yan Liang, Xi Zhang, Juan Liu, Jian-Qiang Yu, Yu-Xiang Li
Breakthrough pain is an extremely painful symptom that impairs quality of life in cancer patients. It negatively impacts their emotional wellbeing, physical function, and mental health. The aim of this study is to use a qualitative methodology to examine the perception of cancer patients with breakthrough pain in the Northwest of China. A semi-structured, face-to-face interview was conducted with nine cancer patients who experienced breakthrough pain; and a qualitative content analysis was performed. Five themes were generated: (1) sufferings from breakthrough cancer pain, (2) hopelessness and helplessness, (3) perception of breakthrough cancer pain and analgesia, (4) strong as a Chinese, and (5) support needed from health care system...
March 2, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
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