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Pain management modalities

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https://www.readbyqxmd.com/read/28819602/fracture-dislocation-of-shoulder-with-brachial-plexus-palsy-a-case-report-and-review-of-management-options
#1
Sameer Rathore, Srinivas Kasha, Srinivas Yeggana
INTRODUCTION: Injuries causing fracture dislocation of shoulder and brachial plexus palsy are extremely rare. As per authors' knowledge, three part fracture of proximal humerus with shoulder dislocation and brachial plexus palsy has not been reported in the literature. CASE PRESENTATION: A 53 year old female sustained a three part fracture of right proximal humerus along with dislocation of shoulder joint and brachial plexus palsy following a fall from a flight of stairs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28818631/topical-medical-cannabis-tmc-a-new-treatment-for-wound-pain-three-cases-of-pyoderma-gangrenosum
#2
Vincent Maida, Jason Corban
Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28808515/palpitations-as-a-presenting-feature-of-multisystem-sarcoidosis
#3
Richie Manikat, Julieta Gilson, Mahesh Krishnamurthy, Koroush Khalighi
Introduction: Sarcoidosis is described as a systemic condition characterized by non-caseating granulomas in multiple organs. In this report, we present an unusual manifestation of cardiac sarcoidosis and review management strategies. Case presentation: A 29-year-old African-American man presented with weight loss, fatigue, dyspnea, palpitations, night sweats, painless left eye redness and bilateral leg pain over the course of three months. His physical exam revealed left conjunctival congestion and bilateral crackles on auscultation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28805107/effects-of-high-frequency-repetitive-transcranial-magnetic-stimulation-on-reducing-hemiplegic-shoulder-pain-in-patients-with-chronic-stoke-a-randomized-controlled-trial
#4
Gyu-Sik Choi, Min Cheol Chang
OBJECTIVE: To examine whether high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS), applied over the primary motor cortex of the affected hemisphere, could be used to manage hemiplegic shoulder pain (HSP). METHODS: Twenty-four chronic stroke patients with chronic HSP, randomly assigned into the rTMS group (10 sessions of high-frequency stimulation) or the sham group (sham stimulation), was performed. The Numeric Rating Scale (NRS) was used to evaluate the intensity of pain at pre-treatment, and at one day, and one, two, and four weeks after treatment...
August 12, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28800711/getting-better-or-getting-well-the-patient-acceptable-symptom-state-pass-better-predicts-patient-s-satisfaction-than-the-decrease-of-pain-in-knee-osteoarthritis-subjects-treated-with-viscosupplementation
#5
Thierry Conrozier, Matthieu Monet, Anne Lohse, Raghu Raman
Background In the management of knee osteoarthritis (OA), patient-reported-outcomes (PROs) are being developed for relevant assessment of pain. The patient acceptable symptom state (PASS) is a relevant cutoff, which allows classifying patients as being in "an acceptable state" or not. Viscosupplementation is a therapeutic modality widely used in patients with knee OA that many patients are satisfied with despite meta-analyses give conflicting results. Objectives To compare, 6 months after knee viscosupplementation, the percentage of patients who reached the PASS threshold (PASS +) with that obtained from other PROs...
August 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#6
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28791247/the-endovascular-management-of-a-3-5-cm-gastroduodenal-artery-aneurysm-presenting-with-gastritis-and-recurrent-pancreatitis
#7
Baraa Zuhaili, Robert G Molnar, Nitin G Malhotra
Visceral artery aneurysms (VAAs) are a rare entity. Within this subset of aneurysms, gastroduodenal artery (GDA) aneurysms represent an even more rare occurrence. We present a case report of treating GDA aneurysm on semi-elective basis followed by literature review of the clinical presentation and mainstream treatment modalities. GO is a 65-year-old male, with 6-month history of recurrent epigastric pain. He was found to have acute pancreatitis and an adjacent 3.5-cm GDA aneurysm. After conservative treatment of pancreatitis, the aneurysm was treated with coil embolization of the sac and GDA...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28782082/utility-of-imaging-in-risk-stratification-of-chest-pain-in-women
#8
REVIEW
Emily S Lau, Amy Sarma
Recent decades have seen a growing recognition that the understanding of sex differences in cardiovascular disease (CVD) is vital to optimal diagnosis and management, particularly of women (Mosca et al. Circulation 124:2145-54, 2011). There is simultaneously an increasing appreciation of the multifactorial nature of ischemic heart disease (IHD) in many patients, in whom disease may extend beyond the epicardial coronaries. While obstructive coronary artery disease (CAD) remains underdiagnosed in women and still represents a major burden of disease, women also present with nonobstructive CAD more commonly than men (Patel et al...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28776638/a-novel-combination-of-peripheral-nerve-blocks-for-arthroscopic-shoulder-surgery
#9
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
August 4, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28774219/nonoperative-management-and-rehabilitation-of-osteitis-pubis-pubic-bone-stress-in-professional-soccer-players-a-report-of-5-cases
#10
Stephen S McAleer, Ed Lippie, Darcy Norman, Helge Riepenhof
Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting and cutting are the dominant movements. Little literature exists regarding non-operative rehabilitation strategies for the condition and the outcome of conservative treatment has not been documented. Case Description Five professional and aspiring professional soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment...
August 3, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28770156/platelet-rich-fibrin-in-the-management-of-established-dry-socket
#11
Srinivas Chakravarthi
OBJECTIVES: Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. MATERIALS AND METHODS: Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF...
June 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28764270/feasibility-and-complications-of-spinal-anaesthesia-in-percutaneous-nephrolithotomy-our-experience
#12
Manoj Kamal, Pradeep Sharma, Geeta Singariya, Rajesh Jain
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is the treatment modality used for the extraction of large renal stones, or multiple calculi or stones resistant to shock wave lithotripsy. The General Anaesthesia (GA) is the standard modality for PCNL. However, few studies conclude that Spinal Anaesthesia (SA) can be an alternative method of anaesthesia with similar incidence of complications. AIM: In our study we evaluated the feasibility of spinal anaesthesia in terms of intraoperative and postoperative results in patients undergoing PCNL...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762070/systematic-review-probiotics-for-functional-constipation-in-children
#13
REVIEW
Katarzyna Wojtyniak, Hania Szajewska
We updated our 2010 systematic review on the efficacy of probiotics in the treatment of constipation in children. The MEDLINE, EMBASE, and Cochrane Library databases; clinical trial registries; and reference lists of included studies were searched to February 2017 for randomized controlled trials (RCTs) performed in children, with no language restriction. The primary outcome measure was treatment success, as defined by the investigators. We included seven RCTs with a total of 515 participants. Included trials were heterogeneous with respect to study population, probiotic strains, dosages, study duration, and follow-up...
August 1, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28761039/atrio-esophageal-fistula-a-case-series-and-literature-review
#14
Craig A Schuring, Luke J Mountjoy, Ashley B Priaulx, Robert J Schneider, Hayden L Smith, Geoffrey C Wall, Dipen Kadaria, Amik Sodhi
BACKGROUND Percutaneous catheter radiofrequency ablation (RFA) and cryoablation of the left atrium and pulmonary vein ostia have become successful therapeutic modalities in the management of atrial fibrillation. Atrio-esophageal fistula is a rare complication. Awareness of complication risk is imperative because without prompt diagnosis and urgent surgical intervention, the outcome is often fatal. We present 3 cases of atrio-esophageal fistula following percutaneous catheter radiofrequency ablation (RFA). CASE REPORT Case 1: A 72-year old white male presented 27 days after percutaneous RFA for atrial fibrillation with fever, altered mental status, and melena...
August 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28757835/pain-relief-following-thoracic-surgical-procedures-a-literature-review-of-the-uncommon-techniques
#15
REVIEW
Tariq Alzahrani
Thoracic surgical procedures can be either thoracotomy or thoracoscopy. In thoracotomy, the incision could be either muscle-cutting or muscle-sparing incision. The posterolateral thoracotomy incision is used for most general thoracic surgical procedures. This incision, which involves division of the latissimus dorsi and serratus anterior muscles, affords excellent exposure of the thoracic cavity. However, it is associated with significant morbidity, including impaired pulmonary function, postoperative chest pain, and restricted arm and shoulder movement...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28750962/conservative-management-of-temporomandibular-dysfunction-a-literature-review-with-implications-for-clinical-practice-guidelines-narrative-review-part-2
#16
REVIEW
Raymond Butts, James Dunning, Ron Pavkovich, Jersey Mettille, Firas Mourad
The effective management of temporomandibular dysfunction (TMD) requires a thorough understanding of the pathoanatomic factors that drive the underlying condition. After reviewing the etiology associated with TMD in Part 1 of this narrative review, the temporomandibular joint capsule, articular disc and muscles of mastication emerged as key players. (http://dx.doi.org/10.​1016/​j.​jbmt.​2017.​05.​017) Part 2 focuses on conservative treatment strategies best able to reduce the pain and disability associated with TMD...
July 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28750144/therapy-of-ulcus-cruris-of-venous-and-mixed-venous-arterial-origin-with-autologous-adult-native-progenitor-cells-from-subcutaneous-adipose-tissue-a-prospective-clinical-pilot-study
#17
A Konstantinow, A Arnold, K Djabali, W Kempf, J Gutermuth, T Fischer, T Biedermann
BACKGROUND: The stromal vascular fraction (SVF) of adipose tissue consists of cellular subpopulations with distinct regenerative potential. OBJECTIVE: To investigate the regenerative capacities of autologous SVF cells in the treatment of chronic leg ulcers of venous (VLU) and arterial-venous (AVLU) origin. METHODS: Multimorbid ulcer patients received a singular topical treatment with 9-15x10(6) SVF cells, separated from abdominal lipoaspirates by digestion with collagenase and dispase and applied immediately after isolation...
July 27, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28748117/epidemiology-pathophysiology-and-management-of-uric-acid-urolithiasis-a-narrative-review
#18
REVIEW
A Abou-Elela
An in-depth comprehension of the epidemiology as well as pathophysiology of uric acid urolithiasis is important for the identification, treatment, and prophylaxis of calculi in these patients. Persistently low urinary pH, hyperuricosuria, and low urinary volume are the most important factors in pathogenesis of uric acid urolithiasis. Other various causes of calculus formation comprises of chronic diarrhea, renal hyperuricosuria, insulin resistance, primary gout, extra purine in the diet, neoplastic syndromes, and congenital hyperuricemia...
September 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#19
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739400/intraoperative-and-postoperative-pain-in-cataract-surgery
#20
REVIEW
Jed H Assam, Ashlie Bernhisel, Amy Lin
Technologic improvements in cataract surgery have not only improved visual outcomes, but also have minimized intraoperative and postoperative pain. We review the mechanisms, risk factors, and management of intraoperative and postoperative pain. Summaries of less common sources of physiologic pain have been included to reinforce recognition of when pain represents an expected physiologic reaction to surgery as opposed to signaling a more serious complication. We also discuss various current and emerging anesthetic and analgesic modalities...
July 21, 2017: Survey of Ophthalmology
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