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Intrathecal pump

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https://www.readbyqxmd.com/read/29905629/local-vancomycin-effectively-reduces-surgical-site-infection-at-implant-site-in-rodents
#1
Jeffrey S Kroin, Jinyuan Li, Sasha Shafikhani, Kajal H Gupta, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Infected implantable devices represent a clinical challenge, because the customary option is to surgically remove the device, and that is associated with substantial cost and morbidity to the patient, along with patient dissatisfaction with the physician. Although prophylactic systemic antibiotics and sterile technique are the mainstay of prevention of surgical site infection (SSI) after implant, the incidence of SSI remains relatively high. Although some surgeons add local antibiotic at implant site during surgery, there is no scientific research to demonstrate if there is a benefit...
June 13, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29895878/the-dosage-and-administration-of-long-term-intrathecal-baclofen-therapy-for-severe-spasticity-of-spinal-origin
#2
Osamu Kawano, Muneaki Masuda, Tsuneaki Takao, Hiroaki Sakai, Yuichiro Morishita, Tetsuo Hayashi, Takayoshi Ueta, Takeshi Maeda
STUDY DESIGN: Retrospective chart audit. OBJECTIVE: To indicate the appropriate baclofen dosage to control severe spasticity of spinal origin and to develop the optimal administration protocol for long-term intrathecal baclofen (ITB) therapy. SETTING: Department of Orthopaedic Surgery, Spinal Injuries Center, Japan. METHODS: Thirty-four people with spasticity of various spinal origins who were consistently treated at our hospital were included...
June 12, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29889241/long-term-outcomes-using-intrathecal-drug-delivery-systems-in-complex-regional-pain-syndrome
#3
Eric Z Herring, Leonardo A Frizon, Olivia Hogue, Jay U Mejia, Richard Rosenquist, Robert B Bolash, Andre G Machado, Sean J Nagel
Objective: Providing durable long-term pain control for patients with complex regional pain syndrome (CRPS) is challenging. A multidisciplinary approach focused on physical therapy is frequently prescribed, with opioids and invasive procedures reserved for those challenged by functional progression. In this study, we examined the long-term efficacy of intrathecal drug delivery systems (IDDS) in patients with CRPS at our institution. Methods: Patients with CRPS implanted with an IDDS between 2000 and 2013 who had four or more years of continuous follow-up were included in the analysis...
June 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29888384/problems-with-an-intrathecal-pump-in-a-paraplegic-scuba-diver
#4
Brahim Hacene, Nathalie Draulans, Tom Theys
Scuba diving with an intrathecal baclofen pump is encouraged for people with spinal cord injury who are suffering from spasticity. However, the diving depth is limited to 10 metres in this context. Proper physician and patient education in this respect is mandatory since non-compliance can lead to an irreversible loss of drug reservoir capacity due to collapse of the bottom shield. We report such an incident in a paraplegic diver diving to depths down to 30 metres' water.
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29871379/medical-device-related-pressure-injury-in-the-treatment-of-chronic-pain-an-early-sign-of-explantation-in-suspected-infection
#5
Nerea Sanchis-Lopez, Carolina Romero-Garcia, Jose De Andres-Ibanez, Ruth Martinez-Plumed, Pablo Rodriguez-Gimillo, Maria Jose Hernandez-Cadiz, Vincente Abril-Lopez de Medrano
BACKGROUND: Chronic back pain is a prevalent disease and has a high impact in daily life. Implantable devices (IDs) for chronic pain management include spinal cord stimulation (SCS) systems and intrathecal drug delivery (ITDD) pumps. The number of ITDD implants have increased exponentially in the last decade. The number of complications, such as infections, are also more prevalent. Infection management guidelines are needed to standarize our clinical practice and define protocols of explantation...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29860540/intrathecal-baclofen-in-mucopolysaccharidosis-type-ii-hunter-syndrome-case-report
#6
František Horn, Michal Petrík, Dana Dúbravová, Jarmila Hornová, Katrína Brennerová, Vladimír Bzduch
PURPOSE: Intrathecal baclofen administration is commonly used in the treatment of children's spasticity. In general, candidates for baclofen pump are patients with spastic form of cerebral palsy. Intrathecal baclofen in the treatment of spasticity due to a metabolic disorder is rarely reported. METHODS: Authors report on an 11-year-old boy with mucopolysaccharidosis type II (Hunter syndrome) with progressive stiffness and contractures followed by profound loss of joint movement range and tiptoe walking pattern...
June 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29851657/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#7
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
June 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29806077/intrathecal-baclofen-in-metachromatic-leukodystrophy
#8
Nikki Van Der Veldt, Diane F Van Rappard, Laura A Van De Pol, Marjo S Van Der Knaap, Willem Jr Van Ouwerkerk, Jules G Becher, Nicole I Wolf, Annemieke I Buizer
Metachromatic leukodystrophy (MLD) is a rare progressive neurological disorder, often accompanied by motor impairments that are challenging to treat. In this case series, we report the course of treatment with intrathecal baclofen (ITB), aimed at improving daily care and comfort in children and young adults with MLD. All patients with MLD in our centre on ITB treatment for a minimum of 6 months were included (n=10; 4 males, 6 females; mean age 10y 8mo [range 6-24y]). Eight patients had MLD with a predominant spastic movement disorder (sMLD) and two were mainly dyskinetic...
May 27, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29794496/neuromodulation-in-pediatrics-case-series
#9
Eugene Kim, Sean Gamble, Adina Schwartz, Giovanni Cucchiaro
OBJECTIVES: Neuromodulation, particularly intrathecal drug delivery systems and spinal cord stimulators, can be a valuable tool when treating chronic pain in adults. However, there is a paucity of literature regarding its use in pediatrics. MATERIALS: and Methods: We present a series of 14 children and adolescents with intractable pain who received a spinal cord stimulator or a pump for the intrathecal delivery of medications between 2010 and 2016 at our institution...
May 22, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29784823/continuous-intrathecal-orexin-delivery-inhibits-cataplexy-in-a-murine-model-of-narcolepsy
#10
Mahesh K Kaushik, Kosuke Aritake, Aya Imanishi, Takashi Kanbayashi, Tadashi Ichikawa, Tetsuo Shimizu, Yoshihiro Urade, Masashi Yanagisawa
Narcolepsy-cataplexy is a chronic neurological disorder caused by loss of orexin (hypocretin)-producing neurons, associated with excessive daytime sleepiness, sleep attacks, cataplexy, sleep paralysis, hypnagogic hallucinations, and fragmentation of nighttime sleep. Currently, human narcolepsy is treated by providing symptomatic therapies, which can be associated with an array of side effects. Although peripherally administered orexin does not efficiently penetrate the blood-brain barrier, centrally delivered orexin can effectively alleviate narcoleptic symptoms in animal models...
May 21, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#11
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29761017/eleven-years-experience-with-intrathecal-baclofen-complications-risk-factors
#12
Elke Pucks-Faes, Gabriel Hitzenberger, Heinrich Matzak, Elena Fava, Giulio Verrienti, Ilse Laimer, Josef Fritz, Leopold Saltuari
Objective: Treatment with intrathecal baclofen (ITB) is commonly used in patients with severe spasticity. However, complications may occur after implantation of the ITB-device, albeit mainly procedure- and device-related problems. The aim of the study was to assess surgical- as well as catheter- and pump-related complications and define their risk factors. Methods: We retrospectively evaluated all patients with an implanted ITB-device who were treated at the Department of Neurology, Hochzirl Hospital, Zirl, Austria, between 2006 and 2016...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29747017/a-novel-association-between-intrathecal-drug-administration-and-arachnoiditis-ossificans
#13
Max Ward, Antonios Mammis, Maureen T Barry, Robert F Heary
We present a case of delayed progression of adhesive arachnoiditis to arachnoiditis ossificans (AO) in a patient being treated with a high dose polypharmaceutical intrathecal regimen. The patient is a 39-year-old Caucasian male who was implanted with an intrathecal pump in 2006 to control severe low back pain and administered intrathecal pain medication for a period of 10 years. In 2016, he developed new onset radicular pain and worsened sensation in his lower extremities. A CT scan of the lumbar spine at that time demonstrated profound calcification of the arachnoid consistent with a diagnosis of AO...
May 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29729779/interventional-anesthetic-methods-for-pain-in-hematology-oncology-patients
#14
REVIEW
Holly Careskey, Sanjeet Narang
This article reviews anesthetic interventional approaches to the management of pain in hematology and oncology patients. It includes a discussion of single interventions including peripheral nerve blocks, plexus injections, and sympathetic nerve neurolysis, and continuous infusion therapy through implantable devices, such as intrathecal pumps, epidural port-a-caths, and tunneled catheters. The primary objective is to inform members of hematology and oncology care teams regarding the variety of interventional options for patients with cancer-related pain for whom medical pain management methods have not been effective...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29614489/hyperbaric-oxygen-therapy-as-adjuvant-treatment-for-hardware-related-infections-in-neuromodulation
#15
Jiri Bartek, Simon Skyrman, Michael Nekludov, Tiit Mathiesen, Folke Lind, Gaston Schechtmann
BACKGROUND: In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal. OBJECTIVE: To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections. METHODS: Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden)...
April 3, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29574822/balancing-the-benefits-of-intrathecal-baclofen-pump-surgery-with-potential-postoperative-complications
#16
Kristin Buxton
No abstract text is available yet for this article.
March 25, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29572808/readmission-and-complications-within-30-days-after-intrathecal-baclofen-pump-placement
#17
Sandi K Lam, Rory R Mayer, Aditya Vedantam, Kristen A Staggers, Dominic A Harris, I-Wen Pan
AIM: To describe 30-day outcomes after intrathecal baclofen (ITB) pump placement in children and identify risk factors for readmission, reoperation, and perioperative complication using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHOD: Patients aged 0 to 18 years who underwent ITB pump placement (2012-2014) comprised the study cohort defined in the database. Multivariate regression analysis was performed using preoperative and perioperative data from the American College of Surgeons' NSQIP-P database...
March 23, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29570548/intrathecal-baclofen-therapy-prior-to-spinal-fusion-for-patients-with-gross-motor-function-classification-system-iv-v-cerebral-palsy
#18
Kristin Buxton, Rachel Difazio, Ann Morgan, Margaret McCabe, Peter W Forbes
BACKGROUND: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described. This study sought to compare postoperative recovery, including complications, in patients using ITB therapy with those with no ITB therapy...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29558941/perturbing-chondroitin-sulfate-proteoglycan-signaling-through-lar-and-ptp%C3%AF-receptors-promotes-a-beneficial-inflammatory-response-following-spinal-cord-injury
#19
Scott Dyck, Hardeep Kataria, Arsalan Alizadeh, Kallivalappil T Santhosh, Bradley Lang, Jerry Silver, Soheila Karimi-Abdolrezaee
BACKGROUND: Traumatic spinal cord injury (SCI) results in upregulation of chondroitin sulfate proteoglycans (CSPGs) by reactive glia that impedes repair and regeneration in the spinal cord. Degradation of CSPGs is known to be beneficial in promoting endogenous repair mechanisms including axonal sprouting/regeneration, oligodendrocyte replacement, and remyelination, and is associated with improvements in functional outcomes after SCI. Recent evidence suggests that CSPGs may regulate secondary injury mechanisms by modulating neuroinflammation after SCI...
March 20, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29543644/intrathecal-drug-delivery-systems-for-refractory-pancreatic-cancer-pain-observational-follow-up-study-over-an-11-year-period-in-a-comprehensive-cancer-center
#20
Gabriel Carvajal, Denis Dupoiron, Valerie Seegers, Nathalie Lebrec, François Boré, Pierre-Yves Dubois, Damien Leblanc, Thierry Delorme, Sabrina Jubier-Hamon
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France...
June 2018: Anesthesia and Analgesia
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