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Complex regional pain

Christiane Kruppa, Marcel Dudda, Thomas A Schildhauer, Dominik Seybold
We report the case of a 13-year-old boy, who suffered a posterior hip dislocation from playing soccer. Closed reduction was performed urgently. Because of a nonconcentric hip after closed reduction, further imaging was done. An intra-articular bony fragment was identified. Arthroscopic treatment was performed. Through an anterior portal we were able to locate the intra-articular bony fragment, which was located within the region of the fovea. After lifting of the caudal enfolded labral complex, we were able to remove the fragment...
January 2018: European Journal of Pediatric Surgery Reports
Beatriz Rey, Alejandro Rodríguez, Enrique Lloréns-Bufort, José Tembl, Miguel Ángel Muñoz, Pedro Montoya, Vicente Herrero-Bosch, Jose M Monzo
Neurofeedback is a self-regulation technique that can be applied to learn to voluntarily control cerebral activity in specific brain regions. In this work, a Transcranial Doppler-based configurable neurofeedback system is proposed and described. The hardware configuration is based on the Red Pitaya board, which gives great flexibility and processing power to the system. The parameter to be trained can be selected between several temporal, spectral, or complexity features from the cerebral blood flow velocity signal in different vessels...
July 14, 2018: Sensors
David G Dennison, Charlene L Blanchard, Bassem Elhassan, Steven L Moran, Alexander Y Shin
BACKGROUND: Distal radius fractures are common, and the trend in fixation has included the use of locked volar plating. The duration of splinting required after surgery and the effect splinting has upon outcome of the wrist are not clear. Our aim was to compare outcome of patients treated with early versus late motion protocol after volar plating. METHODS: Thirty-three patients with distal radius fractures were prospectively and randomly enrolled into an early versus late motion study including volar plating of the distal radius fracture...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Massimo Varenna, Chiara Crotti
Complex Regional Pain Syndrome type 1 (CRPS-1) is a disabling painful disease whose hallmark is pain disproportionate to inciting event. CRPS is also characterized by symptoms and signs, such as vasomotor, sudomotor, trophic and motor changes. Therapeutic approach of CRPS-1 still remains a challenge for clinicians treating a disease with potential heavy consequences on patient prognosis. In the past years, the treatment with bisphosphonates (BPs) has gained some success as confirmed by the results of a number of meta-analyses...
July 14, 2018: Rheumatology International
Ingris Peláez-Ballestas, Ysabel Granados, Rosana Quintana, Adalberto Loyola-Sánchez, Flor Julián-Santiago, Celenia Rosillo, Alfonso Gastelum-Strozzi, Jose Alvarez-Nemegyei, Natalia Santana, Adriana Silvestre, Cesar Pacheco-Tena, Mario Goñi, Conrado García-García, Ligia Cedeño, Bernardo A Pons-Éstel
Epidemiological studies in Latin America suggest indigenous people lack proper healthcare for musculoskeletal (MSK) and rheumatic diseases. OBJECTIVES: This study aimed to estimate the prevalence of MSK disorders and rheumatic diseases in eight Latin American indigenous communities, and to identify which factors influence such prevalence using network analysis and syndemic approach. METHODS: This is a cross-sectional, community-based census study according to Community-Oriented Program for the Control of Rheumatic Diseases methodology...
July 14, 2018: Annals of the Rheumatic Diseases
Luiz Augusto Oliveira Belmonte, Thiago César Martins, Daiana Cristina Salm, Aline Armiliato Emer, Bruna Hoffman de Oliveira, Khiany Mathias, Mariana Pereira Goldim, Verônica Vargas Horewicz, Anna Paula Piovezan, Franciane Bobinski, Fabrícia Petronilho, Daniel Fernandes Martins
This study evaluated the effects of continuous and interval running on treadmill on mechanical hyperalgesia in an animal model of chronic post-ischemia pain (CPIP), as well as to analyze the mechanism of action of this effect. Different groups of male Swiss mice with CPIP, induced by 3 hours of paw ischemia followed by reperfusion (IR), ran on the treadmill in different protocols, the speed (10, 13, 16 or 19 m/min), duration (15, 30 or 60 minutes), weekly frequency (3 or 5 times), weekly increase in continuous and interval running speed, were tested...
July 10, 2018: Journal of Pain: Official Journal of the American Pain Society
Semih Gungor, Jasmit Brar
RATIONALE: Evidence from cadaveric studies note that the sympathetic nerves from the second and third thoracic ganglia bypass the stellate ganglion in 20% of the population. We present a novel alternative technique for sympathetic blockade of upper extremity via thoracic epidural approach. PATIENT CONCERNS: The patient-reported anxiety about "the placement of the needle in the front of the neck" and severe pain secondary to complex regional pain syndrome...
July 2018: Medicine (Baltimore)
Peter D Drummond, Natalie Morellini, Philip M Finch, Frank Birklein, Lone F Knudsen
The aim of this study was to determine whether upregulated cutaneous expression of α1-adrenoceptors (α1-AR) is a source of pain in patients with complex regional pain syndrome (CRPS). Immunohistochemistry was used to identify α1-AR on nerve fibres and other targets in the affected and contralateral skin of 90 patients, and in skin samples from 38 pain-free controls. The distribution of α1-AR was compared between patients and controls, and among subgroups of patients defined by CRPS duration, limb temperature asymmetry and diagnostic subtype (CRPS I versus CRPS II)...
July 2, 2018: Pain
Xiaoyou Shi, Tian-Zhi Guo, Wenwu Li, Peyman Sahbaie, Kenner C Rice, Agnieszka Sulima, J David Clark, Wade S Kingery
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: This study tested the hypothesis that ad lib running wheel exercise in a tibia fracture model of complex regional pain syndrome can reverse hindlimb nociceptive sensitization and inflammation in mice. METHODS: Three weeks after tibia fracture, the cast was removed and hindlimb von Frey thresholds and unweighting were tested; the mice were then randomized to either ad lib access to a running wheel for 4 weeks or no wheel access...
July 10, 2018: Anesthesiology
Ye-Ha Jung, Hyeonjin Kim, So Yeon Jeon, Jeong Min Kwon, Won Joon Lee, Yong Chul Kim, Joon Hwan Jang, Soo-Hee Choi, Jun-Young Lee, Do-Hyung Kang
Objective: The aim of this study was to find peripheral biomarkers and central metabolites affecting neuroinflammation in complex regional pain syndrome (CRPS) patients using [11C]-(R)-PK11195 positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). Methods: Using MRS and PET, we measured associations between neurometabolites and neuroinflammation in 12 CRPS patients and 11 healthy controls. Also, we investigated various peripheral parameters that may affect neuroinflammation in CRPS...
July 6, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Maria Grazia Benedetti, Lorenzo Cavazzuti, Massimiliano Mosca, Isabella Fusaro, Alessandro Zati
OBJECTIVE: The study aimed to evaluate the efficacy of Bio-Electro-Magnetic-Energy-Regulation (BEMER) magneto-therapy on pain and functional outcome in complex regional pain syndrome type I (CRPS-I). We hypothesized that BEMER therapy, based on its declared effects on microcirculation, could be beneficial in the treatment of this condition. METHODS: This was a randomized controlled double-blind pilot study that included 30 patients with CRPS-I. Patients were divided into two groups: a study group, in which the rehabilitation program was combined with BEMER therapy for 10 consecutive days, and a control group, in which the rehabilitation program was combined with a sham BEMER treatment...
July 9, 2018: Physiotherapy Theory and Practice
Marco Solcà, Roberta Ronchi, Javier Bello-Ruiz, Thomas Schmidlin, Bruno Herbelin, François Luthi, Michel Konzelmann, Jean-Yves Beaulieu, François Delaquaize, Armin Schnider, Adrian G Guggisberg, Andrea Serino, Olaf Blanke
OBJECTIVES: To develop and test a new immersive digital technology for complex regional pain syndrome (CRPS) that combines principles from mirror therapy and immersive virtual reality and the latest research from multisensory body processing. METHODS: In this crossover double-blind study, 24 patients with CRPS and 24 age- and sex-matched healthy controls were immersed in a virtual environment and shown a virtual depiction of their affected limb that was flashing in synchrony (or in asynchrony in the control condition) with their own online detected heartbeat (heartbeat-enhanced virtual reality [HEVR])...
July 6, 2018: Neurology
Xiaonan Dong, Min Tang, Qi Sun, Shu Zhang
BACKGROUND: Ablation within the pulmonary sinus of Valsalva (PSV) becomes increasingly common in certain ventricular outflow arrhythmia. Understanding the regional anatomy is intensively concerned to avoid procedure complications. PURPOSE: To describe the anatomic relationships of PSV to its adjacent structures using computed tomographic coronary angiograms (CTCA). METHODS: We studied 145 patients (77 males, age 47 ± 18 years) investigated for chest pain with CTCA...
July 6, 2018: Journal of Cardiovascular Electrophysiology
Semih Gungor, Rohit Aiyer
RATIONALE: To present an unusual extrapyramidal motor response occurring after a sympathetic block in CRPS and its successful treatment with diphenhydramine. PATIENT CONCERNS: Severe pain related to Complex Regional Pain Syndrome type 1 interfering with activities of daily living. DIAGNOSES: Complex Regional Pain Syndrome type 1. INTERVENTIONS: We report a video case reports of two patients with a diagnosis of CRPS type-I...
June 2018: Medicine (Baltimore)
Graeme Matthewson, Samuel Larrivee, Tod Clark
Perilunate fracture dislocations are a rare but devastating injury, which is often missed on initial presentation leading to significant delays in treatment. With the delay in treatment and a high energy mechanism of injury, patients are at increased risk of developing complex regional pain syndrome following trauma. In this report, we review the case of a 57-year-old left-hand dominant female who presented to a clinic with a five-and-a-half-week-old transtriquetral, perilunate fracture dislocation with comminution of the scaphoid facet...
2018: Case Reports in Orthopedics
Bruno Frediani, Andrea Giusti, Gerolamo Bianchi, Luca Dalle Carbonare, Nazzarena Malavolta, Luca Cantarini, Gianantonio Saviola, Luigi Molfetta
INTRODUCTION: Clodronic acid is a non-nitrogen-containing bisphosphonate largely used from some decades in the prevention and treatment of postmenopausal and secondary osteoporosis. In addition to antiresorptive activity, clodronate has shown anti-inflammatory and analgesic properties, and modulatory effects on bone and cartilage metabolism. EVIDENCE ACQUISITION: A literature review has been conducted to characterize the mechanism of action of clodronate and to retrieve available evidence about the use of clodronate in primary and secondary osteoporosis, and its potential role in other musculoskeletal conditions and orthopedic surgery...
August 2018: Minerva Medica
Corey McGee, Jennifer Skye, Ann Van Heest
BACKGROUND: Distal radius fractures (DRF) account for nearly one-fifth of all fractures in older adults, and women experience them 5× as often as men. Most DRF occur with low impact injuries to the wrist with an outstretched hand, and are often managed via closed treatment and cast immobilization. Women sustaining a DRF are at risk for upper limb immobility, sensorimotor changes, edema and type I complex regional pain syndrome (CRPS). Since CRPS onset is likely influenced by alterations in the brain's somatosensory region, a rehabilitation intervention, Graded Motor Imagery (GMI), aims to restore cortical representation, including sensory and motor function, of the affected limb...
June 26, 2018: BMC Musculoskeletal Disorders
Masood Akhtar Malik, Muhammad Nasir Jamil, Umar Farooq, Malik Furqan Mahmood
BACKGROUND: Renal stone disease affects a large population of the world and surgical management is the main stay treatment for larger stones. In comparison to open procedures, percutaneous nephrolithotomy (PCNL) has been known to offer almost similar stone clearance with least patient morbidity. The study was done with the objectives to evaluate our initial experience of PCNL in the management of nephrolithiasis in Abbottabad. METHODS: A case series study was carried out at a private hospital, Valley Medical Complex, Abbottabad, including the 35 patients undergoing PCNL from January 2015 to February 2016...
April 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Constanze Hausteiner-Wiehle, Peter Henningsen
No abstract text is available yet for this article.
August 2018: Journal of Psychosomatic Research
João Torrinha Jorge, Ana Ferrão, Sandra Alves, Ruben Caetano, Frederico Teixeira
Background  The treatment of chronic scapholunate instability is yet a controversial topic. Arthroscopic reduction-association scapholunate technique is a minimally invasive option in which a stable pseudoarthrosis at the scapholunate joint is obtained, allowing some degree of movement while maintaining the normal alignment of the wrist. The purpose of this study was to review the results of arthroscopic reduction-association scapholunate with an absorbable screw. Methods  We retrospectively evaluated patients with dynamic or static, but reducible, chronic scapholunate instability who underwent arthroscopic reduction-association scapholunate between 2012 and 2015...
July 2018: Journal of Wrist Surgery
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