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Pain Management

Amanda Schenatto Ferreira, Danilo de Oliveira Silva, Liliam Barbuglio Del Priore, Carmen Lucia Gomes Garcia, Matheus Henrique Maiolini Ducatti, Ana Flavia Balotari Botta, Marina Cabral Waiteman, Fábio Mícolis de Azevedo
OBJECTIVES: To investigate pain level and function limitation in adolescent athletes and physically active non-athletes with PFP. DESIGN: Cross-sectional study. SETTING: Adolescent athletes were recruited at a sport center complex. Adolescent non-athletes were recruited from upper secondary schools. PARTICIPANTS: 108 adolescents diagnosed with PFP: 42 adolescent athletes and 66 adolescent non-athletes. MAIN OUTCOME MEASURES: To evaluate the level of pain, a visual analog scale (VAS) was used and to evaluate the overall function, the Knee Outcome in Osteoarthritis Survey (KOOS) was used...
July 11, 2018: Physical Therapy in Sport
Yingming Xu, Kui Zhang, Jinlin Miao, Peng Zhao, Minghua Lv, Jia Li, Xianghui Fu, Xing Luo, Ping Zhu
OBJECTIVE: Pain management is a huge challenge in the treatment of rheumatoid arthritis (RA), and central sensitization is reportedly involved in the development of pain. The current study was undertaken to explore the possible role of N-methyl-D-aspartate receptors (NMDARs) in the spinal mechanism of central sensitization in RA using a collagen-induced arthritis (CIA) model. METHODS: Mechanical hypersensitivity was assessed in C57BL/6 mice, before and after the induction of CIA via administration of chick type II collagen...
2018: PloS One
Zahi Arnon, Asnat Dor, Hadar Bazak, Samuel Attias, Shlomi Sagi, Shoshana Balachsan, Elad Schiff
Background Despite pharmacological interventions, labor pain and anxiety still remain a challenge, and can carry long-term psychological complications. The goal of this study was to assess the effect of reflexology on these symptoms and to explore the physical and psychological components of women's experience associated with this treatment. Methods This qualitative study was conducted in an Israeli university hospital that offers integrative medicine services. Reflexology was offered to laboring women in the hospital, by the medical staff...
July 19, 2018: Journal of Complementary & Integrative Medicine
Fang Hu, Huai-Cun Liu, Dong-Qiang Su, Hai-Jing Chen, Sun-On Chan, Yun Wang, Jun Wang
Nogo-A is a key inhibitory molecule of axon regeneration in oligodendrocytes. However, little is known about its role in adult neurons. In this study, we showed an important function of Nogo-A on regulation of inflammatory pain in dorsal root ganglion (DRG) neurons. In adult rats with complete Freund's adjuvant (CFA) hind paw inflammation, DRG neurons showed a significant increase in Nogo-A expression. Disruption of Nogo-A signaling with Nogo-66 receptor antagonist peptide, Nogo-A blocking antibody, Nogo-A short hairpin RNA, or Nogo-A gene knockout attenuated CFA-induced inflammatory heat hyperalgesia...
July 19, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Shuzhong Liu, Xi Zhou, An Song, Xiangyi Kong, Yipeng Wang, Yong Liu
RATIONALE: Gorham-Stout syndrome in the spine is extremely rare, and there is no standard curative management thus far. The objective of this article is to report a very rare case of Gorham-Stout syndrome of the lumbar and sacral spine with chylothorax and chyloperitoneum successfully treated by combination of vertebroplasty with cement augmentation and medication treatment. We described the clinical characteristics and postoperative therapy of the patient, and reviewed all of the published cases of Gorham-Stout syndrome of the lumbar and sacral spine...
July 2018: Medicine (Baltimore)
Wei Zhu, Xuxia He, Zenan Xia, Jiliang Zhai, Xisheng Weng
RATIONALE: Hemophilic arthropathy (HA) is a crucial morbidity and a major cause of joint pain and disability in patients with hemophilia A. Surgical methods, such as total joint arthroplasty, are of vital importance for end-stage HA treatment, but the feasibility and effects of multi-joint replacement surgery remain debatable. PATIENT CONCERNS: A 24-year-old patient with advanced HA presented multiple joint pain. Physical examination revealed joint tenderness, swelling, and limited activity...
July 2018: Medicine (Baltimore)
G Lorimer Moseley, John Baranoff, Ebonie Rio, Mike Stewart, Wayne Derman, Brian Hainline
Persistent pain is common in elite athletes. The current review arose from a consensus initiative by the International Olympic Committee to advance the development of a standardized, scientific, and evidence-informed approach to management. We suggest that optimal management of persistent pain in elite athletes requires an understanding of contemporary pain science, including the rationale behind and implementation of a biopsychosocial approach to care. We argue that athletes and clinicians need to understand the biopsychosocial model because it applies to both pain and the impact of pain with special reference to the sport setting...
July 16, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Nayan Lamba, Tim Fick, Rhishi Nandoe Tewarie, Marike L Broekman
PURPOSE: Leptomeningeal metastases (LM) are a rare, but often debilitating complication of advanced cancer that can severely impact a patient's quality-of-life. LM can result in hydrocephalus (HC) and lead to a range of neurologic sequelae, including weakness, headaches, and altered mental status. Given that patients with LM generally have quite poor prognoses, the decision of how to manage this HC remains unclear and is not only a medical, but also an ethical one. METHODS: We first provide a brief overview of management options for hydrocephalus secondary to LM...
July 18, 2018: Journal of Neuro-oncology
Hosam E Matar, Paula Stritch, Nicholas Emms
PURPOSE: To evaluate clinical outcomes of two-stage revision arthroplasty for managing infected knee arthroplasties in significantly compromised patients (host-C). METHODS: This was a prospective consecutive series of two-stage revisions of infected total knee arthroplasties in host-C-type patients with a minimum 2-year follow-up using objective and patient-reported outcome measures. Thirteen consecutive patients were included and prospectively followed with a median 5-year follow-up (range 2-10)...
July 18, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
M Gabrielle Pagé, Irina Kudrina, Hervé Tchala Vignon Zomahoun, Daniela Ziegler, Pierre Beaulieu, Céline Charbonneau, Jennifer Cogan, Raoul Daoust, Marc O Martel, Andrée Néron, Philippe Richebé, Hance Clarke
BACKGROUND: When patients have been on opioid therapy for more than 90 days, more than half of them continue using opioids years later. Knowing that long-term opioid consumption could lead to harmful side effects including misuse, abuse, and addiction, it is important to understand the risks of transitioning to prolonged opioid therapy to reduce its occurrence. Perioperative and trauma contexts are ideal models commonly used to study such transition. Long-term use of opioids might be associated with transformation of acute pain to chronic, which might be an example of a risk factor...
July 18, 2018: Systematic Reviews
Tom P Walsh, John B Arnold, Angela M Evans, Alison Yaxley, Raechel A Damarell, E Michael Shanahan
BACKGROUND: Obesity and musculoskeletal pain are strongly related, but there is emerging evidence that body fat, not body weight, may be a better indicator of risk. There is, therefore, a need to determine if body fat is associated with musculoskeletal pain as it may improve management strategies. The aim of this systematic review was to investigate the association between body fat and musculoskeletal pain. METHODS: Seven electronic databases were searched from inception to 8th January 2018...
July 18, 2018: BMC Musculoskeletal Disorders
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: Postoperative pain control and enhanced mobilization, muscle strength and range of motion following total knee arthroplasty (TKA) are pivotal requisites to optimize rehabilitation and early recovery. The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary total knee arthroplasty. METHODS: Between January 2016 until August 2016, 280 patients underwent primary TKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 81) or epidural catheter (group SP&EPI, n = 51) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 86) or spinal anesthesia (group SP&LIA, n = 61)...
July 18, 2018: BMC Musculoskeletal Disorders
Kade L Paterson, Kim L Bennell, Tim V Wrigley, Ben R Metcalf, Penny K Campbell, Jessica Kazsa, Rana S Hinman
BACKGROUND: Knee osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability globally, and abnormal knee loading is central to disease pathogenesis. Clinical guidelines recommend clinicians provide advice regarding appropriate footwear for people with knee OA, yet there is little research comparing the effects of different footwear on knee OA symptoms. Research suggests that wearing flat flexible shoes is associated with lower knee joint loads compared to stable supportive shoe styles...
July 18, 2018: BMC Musculoskeletal Disorders
Michał Borys, Klaudia Zyzak, Agata Hanych, Michał Domagała, Piotr Gałkin, Katarzyna Gałaszkiewicz, Agata Kłaput, Kai Wróblewski, Justyna Miękina, Dariusz Onichimowski, Mirosław Czuczwar
BACKGROUND: Current pain assessment and treatment does not address every patient's requirements. Although the Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among patients from different types of hospitals (primary, secondary, and tertiary centers) after similar types of surgeries. We also aimed to determine if there were any differences in pain severity associated with anesthesia technique, type of surgery, and the patient's age and sex...
July 18, 2018: BMC Anesthesiology
Christian P Both, Jörg Thomas, Philipp K Bühler, Achim Schmitz, Markus Weiss, Tobias Piegeler
BACKGROUND: Due to its potential beneficial effects, intra- and postoperative application of intravenous lidocaine has become increasingly accepted over the last couple of years, e.g. in patients undergoing laparoscopic surgical procedures. Based on its beneficial properties, lidocaine was introduced to the standard of care for all pediatric laparoscopic procedures in our institution in mid-2016. In contrast to adult care, scarce data is available regarding the use of perioperative intravenous lidocaine administration in children undergoing laparoscopic procedures, such as an appendectomy...
July 18, 2018: BMC Anesthesiology
Katherine Hadlandsmyth, Kenda R Stewart, Monica B Paez, Melissa Steffen, Molly Meth, Heather Schacht Reisinger, Hilary J Mosher
Objective: To elucidate perspectives on opioids and opioid use from hospitalized veterans with comorbid chronic pain using qualitative methods. Design: This was an analysis of individual qualitative interviews. The semistructured interview guide was developed by a hospitalist with clinical expertise in pain treatment with guidance from a medical anthropologist. Interviews aimed to understand participants' experiences of chronic pain. Setting: A Midwestern Veterans Health Administration inpatient hospital unit...
July 17, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Marcelo Alcantara Holanda, Renata Dos Santos Vasconcelos, Juliana Carvalho Ferreira, Bruno Valle Pinheiro
Patient-v entilator asynchrony (PVA) is a mismatch between the patient, regarding time, flow, volume, or pressure demands of the patient respiratory system, and the ventilator, which supplies such demands, during mechanical ventilation (MV). It is a common phenomenon, with incidence rates ranging from 10% to 85%. PVA might be due to factors related to the patient, to the ventilator, or both. The most common PVA types are those related to triggering, such as ineffective effort, auto-triggering, and double triggering; those related to premature or delayed cycling; and those related to insufficient or excessive flow...
July 16, 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Juan Pablo Herrera-Escobar, Michel Apoj, Christina Weed, Alyssa Fitzpatrick Harlow, Syeda Sanam Al Rafai, Elizabeth Lilley, George Kasotakis, Karen Brasel, Haytham Ma Kaafarani, George Velmahos, Ali Salim, Adil Hussein Haider
BACKGROUND: Chronic pain after trauma is associated with serious clinical, social, and economic burden. Due to limitations in trauma registry data and previous studies, the current prevalence of chronic pain after trauma is unknown, and little is known about the association of pain with other long-term outcomes. We sought to describe the long-term burden of self-reported pain after injury, and determine its association with positive screen for posttraumatic stress disorder (PTSD), functional status, and return to work...
July 17, 2018: Journal of Trauma and Acute Care Surgery
Venkatesan Thiruvenkatarajan, Hillen Cruz Eng, Sanjib Das Adhikary
PURPOSE OF REVIEW: To provide an update on new strategies for pain management after rib fractures utilizing regional analgesia. RECENT FINDINGS: Pain management for patients with rib fractures can be very challenging. Traditionally, intravenous patient-controlled analgesia (IVPCA) with opioids, epidural, and paravertebral blocks have been used. These techniques, however, may be contraindicated or have limited application in certain patient populations. Recently, ultrasound-guided myofascial plane blocks such as the erector spinae plane (ESP) block and the serratus anterior plane (SAP) block have emerged as alternatives; providing excellent analgesia with minimal side effects...
July 16, 2018: Current Opinion in Anaesthesiology
Robert Diaz, Allison H Stoll, Monica E Rho, Cheri A Blauwet
Shoulder pain in wheelchair users that participate in competitive adaptive sports can be a troublesome condition. Shoulder pain not only affects athletic performance but also affects functional activities such as wheelchair propulsion and weight bearing during transfers. Managing pain in these athletes thus presents a unique challenge because of the difficulty in achieving relative rest and the need to modify athletic shoulder-focused rehabilitation strategies. In all athletes, it is vital to establish an early, accurate diagnosis and optimize conservative treatment before considering surgical interventions to avoid excessive shoulder-related morbidity, loss of function, and, worse, loss of independence...
August 2018: American Journal of Physical Medicine & Rehabilitation
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