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Untreated pain

Kristy Bultema, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike Beck
INTRODUCTION: In the treatment of patients with symptomatic irreversible pulpitis, endodontic debridement is a predictable method to relieve pain. However, there are clinical situations in which emergency care cannot be provided immediately. An unexplored treatment option in these cases may be the use of a long-acting anesthetic to reduce pain in untreated irreversible pulpitis. Some medical studies have shown potential for infiltrations of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, San Diego, CA) to prolong pain relief and reduce opioid use postoperatively...
October 18, 2016: Journal of Endodontics
Meta N Eek, Kate Himmelmann
Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with botulinum neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with CP. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic CP were included in the study, 8 girls and 12 boys (mean age 7...
2016: Frontiers in Human Neuroscience
Susan O Griffin, Liang Wei, Barbara F Gooch, Katherine Weno, Lorena Espinoza
BACKGROUND: Tooth decay is one of the greatest unmet treatment needs among children. Pain and suffering associated with untreated dental disease can lead to problems with eating, speaking, and learning. School-based dental sealant programs (SBSP) deliver a highly effective intervention to prevent tooth decay in children who might not receive regular dental care. SBSPs benefits exceed their costs when they target children at high risk for tooth decay. METHODS: CDC used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 to estimate current prevalences of sealant use and untreated tooth decay among low-income (≤185% of federal poverty level) and higher-income children aged 6-11 years and compared these estimates with 1999-2004 NHANES data...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Atsushi Minatani, Kentaro Uchida, Gen Inoue, Shotaro Takano, Jun Aikawa, Masayuki Miyagi, Hisako Fujimaki, Dai Iwase, Kenji Onuma, Toshihide Matsumoto, Masashi Takaso
BACKGROUND: Calcitonin gene-related peptide (CGRP) is a 37-amino-acid vasodilatory neuropeptide that binds to receptor activity-modifying protein 1 (RAMP1) and the calcitonin receptor-like receptor (CLR). Clinical and preclinical evidence suggests that CGRP is associated with hip and knee joint pain; however, the regulation mechanisms of CGRP/CGRP receptor signaling in synovial tissue are not fully understood. METHODS: Synovial tissues were harvested from 43 participants with radiographic knee osteoarthritis (OA; unilateral Kellgren/Lawrence (K/L) grades 3-4) during total knee arthroplasty...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic
Eosinophilic myocarditis (EM) is a rare and potentially fatal disease if left untreated. Because the disease can have a delayed presentation and can appear even after 2 years, its underlying causes often remain unknown. We report the case of a 63-year-old man with an atypical clinical presentation of hypersensitive EM and significant coronary artery disease, which was confirmed through coronary angiography. The patient was treated with hydrochlorothiazide (12.5 mg once daily for 2 years) and budesonide/formoterol (160/4...
December 2016: Drug Saf Case Rep
Jennifer Singleton, Jonathan A Edlow
Acute back pain is a common presenting complaint in the emergency department that leads to a great deal of resource utilization. The differential diagnosis is long and most cases are caused by benign pathology that will resolve on its own. Imaging is over-used and rarely helps. This article presents an algorithmic approach using red flags in the history and physical examination that will help physicians better identify the small of patients with serious conditions that, if untreated, will result in significant neurological damage...
November 2016: Emergency Medicine Clinics of North America
Amanda C de C Williams, Kirstine Amris
Torture and the conditions under which it is inflicted often leave persistent painful disorders. Because there may be no lasting signs, persistent pain is often misconceived as a somatic representation of psychological distress, also common after torture. This serious failure to understand the nature of persistent pain means that pain is largely overlooked and untreated in torture survivors. We carried out a systematic review on treatments for pain from torture, but found few studies and little use of current understanding and evidence...
October 13, 2016: Medicine, Conflict, and Survival
Brian C Smedick, David van Wyck
Acute compartment syndrome (ACS) involving the leg can occur in association with various traumatic and nontraumatic conditions, and it can have serious longterm consequences when unrecognized or untreated. Nontraumatic causes of ACS, such as those associated with cases of prolonged immobilization and/or extremity compression, can be easily overlooked, and several cases of ACS occurring with prolonged surgical positioning can be found in the literature. We present the case of a 19-year-old Army paratrooper who developed acute anterior and lateral compartment syndrome of the lower extremity after being immobilized in an aircraft for hours with several hundred pounds of equipment compressing his lower extremities...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Hideyuki Maruki, Masato Sato, Toshiaki Takezawa, Yoshiki Tani, Munetaka Yokoyama, Takumi Takahashi, Eriko Toyoda, Eri Okada, Shigehisa Aoki, Joji Mochida, Yoshiharu Kato
We studied the ability of collagen vitrigel material to repair cartilage in vivo when used alone or with transforming growth factor-β (TGF-β). We measured the time course and quantity of TGF-β1 released from the collagen vitrigel in vitro to quantify the controlled release of TGF-β1. Over 14 days, 0.91 ng of TGF-β was released from the collagen vitrigel. Osteochondral defects were made in the femoral trochlear groove in 36 Japanese white rabbits, which were divided into three groups: untreated group (group A), collagen vitrigel-implanted group (group B), and TGF-β1-incorporated collagen vitrigel-implanted group (group C)...
October 12, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Bo Zhu, Yumei Chen, Xiaolu Shen, Xishi Liu, Sun-Wei Guo
BACKGROUND: Recently emerging evidence indicates that endometriotic lesions are wounds undergoing repeated tissue injury and repair (ReTIAR), and platelets induce epithelial-mesenchymal transition (EMT), fibroblast-to-myofibroblast transdifferentiation (FMT), leading ultimately to fibrosis. Due to the commonality of cyclic bleeding as in endometriosis, adenomyotic lesions are also wounds that undergo ReTIAR, and we have recently provided evidence corroborating platelet-induced EMT, FMT and fibrogenesis in adenomyosis...
October 10, 2016: Reproductive Biology and Endocrinology: RB&E
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
Odile Sauzet, Maren Kleine, John E Williams
BACKGROUND: Given the prevalence of untreated pain among cancer patients, there have been calls for more and better research in the domain. Increasingly, calls for less waste and more optimal use of trial data collected are being made. Waste of data includes non-optimal statistical analysis and non-presentation of interpretable effect size as a measure of effectiveness of an intervention which also enable comparisons across studies. METHODS: We reviewed the recent literature on randomised trials on longitudinal cancer pain to identify sources of loss of data information by collecting material on the nature of outcomes collected, analysed, the method of analysis and what was presented as a result of the trial...
October 6, 2016: BMC Cancer
Xiangdi Yu, Fangxiang Zhang, Bingning Chen
BACKGROUND: Acupuncture and related techniques are used worldwide to alleviate pain; however, their mechanisms of action are still not fully understood. In the present study, we investigated the effect of transcutaneous electrical acupuncture point stimulation (TEAS) at different frequencies in a chronic constriction injury (CCI) model of neuropathic pain in rats. METHODS: CCI was induced by ligating the common sciatic nerve, which produced neuropathic pain. 18 male Sprague-Dawley rats with CCI were randomly divided into three groups (n=6 each) that remained untreated (CCI group) or received TEAS at high frequency (CCI+TEAS-H group) or TEAS at low frequency (CCI+TEAS-L group)...
October 4, 2016: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
Bojan B Petrovic, Tamara O Peric, Dejan L J Markovic, Branislav B Bajkin, Djorde Petrovic, Duska B Blagojevic, Sanja Vujkov
The aim of this study was to examine the factors affecting oral health status among intellectually disabled individuals in Serbia. The sample population was categorized according to age, sex, living arrangements, general health and the level of intellectual disability (ID). The diagnosis of dental caries was performed using the DMFT/dmft criteria. The oral hygiene and gingival health were assessed with the plaque index (Silness&Löe) and gingival index (Löe&Silness), respectively. Descriptive analysis, step-wise and logistic regression were performed to analyze related influential factors for caries presence, number of extracted teeth, teeth restored, the oral hygiene level and the extent of gingival inflammation...
September 30, 2016: Research in Developmental Disabilities
Claudia Deckers, Bart H W Schreuder, Gerjon Hannink, Jacky W J de Rooy, Ingrid C M van der Geest
BACKGROUND AND OBJECTIVES: Both enchondroma and atypical cartilaginous tumors (ACT) are not considered malignant, so inactive and asymptomatic tumors might not need surgery. To the best of our knowledge, this is the first study that has been done to evaluate the natural course of conservative-treated enchondroma and ACT in the long bones. METHODS: For this retrospective study, we analyzed the results of patients in whom we refrained from surgery and only regularly performed radiological follow-up of the tumor...
October 3, 2016: Journal of Surgical Oncology
Justin Stull, Suneel Bhat, Andrew J Miller, Ryan Hoffman, Mark L Wang
Compartment syndrome is an orthopedic emergency with a multitude of etiologies. Although it is most commonly associated with trauma to the extremity, hematoma and infection are 2 rare etiologies of insidious compartment syndrome. Proteus mirabilis is an opportunistic gram-negative species that can infect the respiratory tract, urinary tract, and open wounds. The authors present the case of a 69-year-old woman who developed tissue necrosis and compartment syndrome secondary to an untreated hematoma infected by P mirabilis...
September 29, 2016: Orthopedics
Cielito C Reyes-Gibby, Jian Wang, Mary Rose T Silvas, Robert K Yu, Ehab Y Hanna, Sanjay Shete
Pain is often one of the first signs of squamous cell carcinoma of the head and neck (HNSCC). Pain at diagnosis is an important prognostic marker for the development of chronic pain, and importantly, for the overall survival time. To identify variants influencing severe pre-treatment pain in 1,368 patients newly diagnosed with HNSCC, we conducted a genome-wide association study based on 730,525 tagging SNPs. The patients were all previously untreated for cancer. About 15% of the patients had severe pre-treatment pain, defined as pain score ≥7 (0 = "no pain" and 10 = "worst pain")...
September 27, 2016: Scientific Reports
Richard Lawson, James Ryan, Frederic King, Jo Wern Goh, Eszter Tichy, Kevin Marsh
BACKGROUND AND OBJECTIVES: Opioid-induced constipation (OIC) is the most common adverse effect reported in patients receiving opioids to manage pain. Initial treatment with laxatives provides inadequate response in some patients. Naloxegol is a peripherally acting µ-opioid receptor antagonist used to treat patients with inadequate response to laxative(s) (laxative inadequate responder [LIR]). A cost-effectiveness model was constructed from the UK payer perspective to compare oral naloxegol 25 mg with placebo in non-cancer LIR patients receiving opioids for chronic pain, and a scenario analysis of naloxegol 25 mg with rescue laxatives compared with placebo with rescue laxatives in the same patient population...
September 23, 2016: PharmacoEconomics
Laura K Case, David Brang, Rosalynn Landazuri, Pavitra Viswanathan, Vilayanur S Ramachandran
While most people take identification with their body for granted, conditions such as phantom limb pain, alien hand syndrome, and xenomelia suggest that the feeling of bodily congruence is constructed and susceptible to alteration. Individuals with xenomelia typically experience one of their limbs as over-present and aversive, leading to a desire to amputate the limb. Similarly, many transgender individuals describe their untreated sexed body parts as incongruent and aversive, and many experience phantom body parts of the sex they identify with (Ramachandran, 2008)...
September 19, 2016: Archives of Sexual Behavior
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