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https://www.readbyqxmd.com/read/28096589/water-cooled-radiofrequency-neuroablation-for-sacroiliac-joint-dysfunctional-pain
#1
Binay Kumar Biswas, Samarjit Dey, Saumya Biswas, Varinder Kumar Mohan
Sacroiliac (SI) joint dysfunction is a common source of chronic low-back pain. Recent evidences from different parts of the world suggest that cooled radiofrequency (RF) neuroablation of sacral nerves supplying SI joints has superior pain alleviating properties than available existing treatment options for SI joint dysfunctional pain. A 35-year-old male had intractable bilateral SI joint pain (numeric rating scale [NRS] - 9/10) with poor treatment response to intra-articular steroid therapy. Bilateral water cooled = RF was applied for neuroablation of nerves supplying both SI joints...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096194/autologous-cell-therapy-for-peripheral-arterial-disease-systematic-review-and-meta-analysis-of-randomized-non-randomized-and-non-controlled-studies
#2
Mauro Rigato, Matteo Monami, Gian Paolo Fadini
RATIONALE: Critical limb ischemia (CLI) is a life-threatening complication of peripheral arterial disease (PAD). In patients who are ineligible for revascularization procedures, there are few therapeutic alternatives, leading to amputations and death. OBJECTIVE: To provide a systematic review of the literature and a meta-analysis of studies evaluating safety and efficacy of autologous cell therapy for intractable PAD/CLI. METHODS AND RESULTS: We retrieved 19 randomized controlled trials (RCTs; 837 patients), 7 non-randomized trials (338 patients), and 41 non-controlled studies (1,177 patients)...
January 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28088799/use-of-spinal-cord-diffusion-tensor-imaging-to-quantify-neural-ablation-and-evaluate-outcome-after-percutaneous-cordotomy-for-intractable-cancer-pain
#3
Aditya Vedantam, Ping Hou, T Linda Chi, Patrick M Dougherty, Kenneth R Hess, Ashwin Viswanathan
BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain. OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy. METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28072807/occipital-nerve-stimulation-for-refractory-chronic-migraine-results-of-a-long-term-prospective-study
#4
Dolores Rodrigo, Pilar Acin, Pedro Bermejo
BACKGROUND: Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. OBJECTIVES: The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#5
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28067704/intravenous-ketamine-infusions-for-neuropathic-pain-management-a-promising-therapy-in-need-of-optimization
#6
Dermot P Maher, Lucy Chen, Jianren Mao
Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28066521/interventions-to-manage-residual-limb-ulceration-due-to-prosthetic-use-in-individuals-with-lower-extremity-amputation-a-systematic-review-of-the-literature
#7
M Jason Highsmith, Jason T Kahle, Tyler D Klenow, Casey R Andrews, Katherine L Lewis, Rachel C Bradley, Jessica M Ward, John J Orriola, James T Highsmith
Patients with lower extremity amputation (LEA) experience 65% more dermatologic issues than non-amputees, and skin problems are experienced by ≈75% of LEA patients who use prostheses. Continuously referring LEA patients to a dermatologist for every stump related skin condition may be impractical. Thus, physical rehabilitation professionals should be prepared to recognize and manage common non-emergent skin conditions in this population. The purpose of this study was to determine the quantity, quality, and strength of available evidence supporting treatment methods for prosthesis-related residual limb (RL) ulcers...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28062900/melorheostosis-with-recurrent-soft-tissue-components-a-histologically-confirmed-case
#8
Shoichi Hasegawa, Shotaro Kanda, Hiroki Imada, Takehiko Yamaguchi, Toru Akiyama
Melorheostosis is a very rare disorder characterized by irregular cortical thickening seen on radiographs. In this paper, we present a case of melorheostosis with microscopically confirmed soft-tissue components. The patient was a 51-year-old man who complained of severe pain in the lateral aspect of his right knee. The excision of an ossified soft-tissue lesion relieved intractable pain that had lasted 20 years. Microscopically, the cortex of the affected fibula was composed of thick compact bone and the soft-tissue component consisted of dense compact bone without endochondral ossification...
January 6, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28057056/right-iliac-vein-thrombosis-mimicking-acute-appendicitis-in-pregnancy-a-case-report
#9
Desmond Aroke, Benjamin Momo Kadia, Christian Akem Dimala, Ndemazie Nkafu Bechem, Larry Tangie Ngek, Simeon Pierre Choukem
BACKGROUND: Right iliac vein thrombosis is uncommon in pregnancy. Nonetheless, when it does occur, its presentation could be very unspecific with important diagnostic challenges and this could have negative therapeutic consequences especially in a resource limited setting. CASE PRESENTATION: The historical, clinical and laboratory data of a 30 year old G2P1001 woman of African ethnicity at 11 weeks of gestation pointed towards a right iliac vein thrombosis missed for an acute appendicitis with subsequent appendectomy and failure to cure...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28041630/the-analgesic-effect-of-orexin-a-in-a-murine-model-of-chemotherapy-induced-neuropathic-pain
#10
Satoshi Toyama, Naohito Shimoyama, Megumi Shimoyama
Orexins are neuropeptides that are localized to neurons in the lateral and dorsal hypothalamus but its receptors are distributed to many different regions of the central nervous system. Orexins are implicated in a variety of physiological functions including sleep regulation, energy homeostats, and stress reactions. Furthermore, orexins administered exogenously have been shown to have analgesic effects in animal models. A type of intractable pain in patients is pain due to chemotherapy-induced peripheral neuropathy (CIPN)...
December 24, 2016: Neuropeptides
https://www.readbyqxmd.com/read/28025994/the-analgesic-effect-of-rolipram-is-associated-with-the-inhibition-of-the-activation-of-the-spinal-astrocytic-jnk-ccl2-pathway-in-bone-cancer-pain
#11
Chi-Hua Guo, Lu Bai, Huang-Hui Wu, Jing Yang, Guo-Hong Cai, Xin Wang, Sheng-Xi Wu, Wei Ma
Bone cancer pain (BCP) is one of the most difficult and intractable tasks for pain management, which is associated with spinal 'neuron-astrocytic' activation. The activation of the c-Jun N-terminal kinase (JNK)/chemokine (C-C motif) ligand (CCL2) signaling pathway has been reported to be critical for neuropathic pain. Rolipram (ROL), a selective phosphodiesterase 4 inhibitor, possesses potent anti-inflammatory and anti-nociceptive activities. The present study aimed to investigate whether the intrathecal administration of ROL has an analgesic effect on BCP in rats, and to assess whether the inhibition of spinal JNK/CCL2 pathway and astrocytic activation are involved in the analgesic effects of ROL...
November 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28025837/ketamine-infusions-for-treatment-refractory-headache
#12
Jared L Pomeroy, Michael J Marmura, Stephanie J Nahas, Eugene R Viscusi
BACKGROUND: Management of chronic migraine (CM) or new daily persistent headache (NDPH) in those who require aggressive outpatient and inpatient treatment is challenging. Ketamine has been suggested as a new treatment for this intractable population. METHODS: This is a retrospective review of 77 patients who underwent administration of intravenous, subanesthetic ketamine for CM or NDPH. All patients had previously failed aggressive outpatient and inpatient treatments...
December 27, 2016: Headache
https://www.readbyqxmd.com/read/28025370/prognosis-after-surgical-treatment-of-trigeminal-neuropathy-with-a-pga-c-tube-report-of-10-cases
#13
Kenji Seo, Makoto Terumitsu, Yuji Inada, Tatsuo Nakamura, Keiji Shigeno, Yutaka Tanaka
OBJECTIVE: Although surgery using a polyglycolic acid-collagen (PGA-c) tube is effective for peripheral nerve injury-induced chronic hand pain, it has not been applied to trigeminal nerve lesions because of the difficult approach. We used a PGA-c tube during surgery for trigeminal neuropathy and evaluated its prognosis based on the outcomes. DESIGN: Case report. SETTING AND PATIENTS: In the dental anesthesia division of a university hospital, 11 patients with severe dysesthesia underwent surgical repair of a damaged lingual nerve (LN) or inferior alveolar nerve (IAN)...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28018130/postthoracotomy-ipsilateral-shoulder-pain-a-literature-review-on-characteristics-and-treatment
#14
REVIEW
Fardin Yousefshahi, Oana Predescu, Melissa Colizza, Juan Francisco Asenjo
Context. Postthoracotomy Ipsilateral Shoulder Pain (IPS) is a common and sometimes intractable pain syndrome. IPS is different from chest wall pain in type, origin, and treatments. Various treatments are suggested or applied for it but none of them is regarded as popular accepted effective one. Objectives. To review data and collect all present experiences about postthoracotomy IPS and its management and suggest future research directions. Methods. Search in PubMed database and additional search for specific topics and review them to retrieve relevant articles as data source in a narrative review article...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28011889/rare-case-of-losartan-induced-cough-complicated-by-rectus-sheath-haematoma-in-a-patient-on-rivaroxaban-therapy
#15
Goutham Talari, Preetham Talari, Joseph Sweigart, Sadiq Ahmed
Spontaneous rectus sheath haematomas and cough secondary to losartan are individually rare conditions. Abdominal wall haematomas present with abdominal pain and abdominal mass. Most patients are managed conservatively; Surgery or embolisation is indicated for shock, infection, rupture into the peritoneum or intractable pain. This is a man aged 65 years presented with dry cough and right-sided abdominal pain. He started losartan a few weeks prior to the onset of cough and had been on rivaroxaban for prior deep venous thrombosis...
December 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/28007291/-complex-regional-pain-syndrome-a-review
#16
Berenice Carolina Hernández-Porras, Ricardo Plancarte-Sánchez, Silvia Alarcón-Barrios, Marcela Sámano-García
BACKGROUND: Complex regional pain syndrome is characterized by spontaneous or induced pain disproportionate in relation to the initial event and is accompanied by a variety of regional and motor disturbances, leading to a variety of clinical presentations. It is often associated with surgery and minor trauma. PATHOPHYSIOLOGY: Three mechanisms are postulated: changes secondary to post traumatic inflammation, peripheral vasomotor dysfunction and structural and functional changes of the central nervous system as a result of maladaptation...
December 19, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28000186/-value-of-anorectal-manometry-in-defecation-disorders-and-its-clinical-interpretation
#17
Shuqing Ding
Bowel dysfunction affected by functional factors, mechanical factors or surgical damage may lead to constipation, fecal incontinence and other overlapped symptoms, which is only the tip of the iceberg. Anorectal manometry can provide combined dysfunction information of four subtypes, including sphincter dysfunction, dyssynergic defecation, sensory disability and insufficient rectal expel force, which are underlying pathophysiology of defecation dysfunction. Anorectal manometry can be helpful in optimizing protocol or predicting success in pelvic floor dyssynergic syndrome of defecation, fecal incontinence or anorectal pain, stoma closure and pediatric intractable constipation...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27994479/transsacrococcygeal-approach-to-ganglion-impar-radiofrequency-application-for-the-treatment-of-chronic-intractable-coccydynia
#18
Cemil Adas, Ugur Ozdemir, Huseyin Toman, Nurettin Luleci, Emel Luleci, Hilal Adas
OBJECTIVE: Coccydynia is defined as pain in the coccygeal region. Among the many causes of coccydynia, the most common cause is trauma as a result of falling on the buttocks, repetitive microtrauma, or childbirth. Several methods are currently used for the treatment of coccydynia, including nonsteroidal anti-inflammatory drugs, intrarectal manipulation, epidural injections, ganglion impar blocks, and radiofrequency treatment (RFT). Wemm and Saberski used the transacrococcygeal methods to reduce tissue trauma...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27989968/superior-cluneal-nerve-entrapment-neuropathy-and-gluteus-medius-muscle-pain-their-effect-on-very-old-patients-with-low-back-pain
#19
Rinko Kokubo, Kyongsong Kim, Toyohiko Isu, Daijiro Morimoto, Naotaka Iwamoto, Shiro Kobayashi, Akio Morita
OBJECTIVE: In the very elderly, their general condition and poor compliance with drug regimens can render the treatment of low back pain (LBP) difficult. We report the effectiveness of a less invasive treatment for intractable LBP from superior cluneal nerve entrapment neuropathy (SCN-EN) and gluteus medius muscle (GMeM) pain. PATIENTS AND METHODS: Between April 2013 and March 2015, we treated 17 consecutive elders with LBP and buttock- and leg pain (BuP, LP). They were 4 men and 13 women ranging in age from 85 to 91 years (mean 86...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27959284/the-proposed-use-of-cervical-spinal-cord-stimulation-for-the-treatment-and-prevention-of-cognitive-decline-in-dementias-and-neurodegenerative-disorders
#20
Nestor D Tomycz
Cervical spinal cord stimulation is a well-established treatment for intractable neuropathic upper extremity pain. More than 20years ago it was demonstrated that cervical spinal cord stimulation could engender an increase in cerebral blood flow. Cerebral blood flow has been shown to be decreased in many patients with dementia and in various neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Furthermore, there is evidence that reduced cerebral blood flow worsens neurodegenerative disease and may also predict which patients progress from mild cognitive impairment to full blown Alzheimer's disease...
November 2016: Medical Hypotheses
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