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https://www.readbyqxmd.com/read/29340917/biliary-bypass-with-laparoscopic-choledochoduodenostomy
#1
Joshua K Kays, Leonidas G Koniaris, Daniel P Milgrom, Attila Nakeeb
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#2
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29324503/%C3%AE-asarone-alleviated-chronic-constriction-injury-induced-neuropathic-pain-through-inhibition-of-spinal-endoplasmic-reticulum-stress-in-an-liver-x-receptor-dependent-manner
#3
Yulong Gui, Aiyuan Li, Jie Zhang, Guan Li, Xia Ruan, Qulian Guo, Wangyuan Zou
BACKGROUND: Neuropathic pain is an intractable and complex disease. Recent studies have shown a close relationship between endoplasmic reticulum (ER) stress and neuropathic pain. Here, we investigated the effect of α-asarone, an ER stress inhibitor, on chronic constriction injury (CCI)-induced neuropathic pain. METHODS: Two parts were included in this study. In part 1, rats were assigned to 7 groups: the sham group, the sham + α-asarone 20 mg/kg group, the CCI group, the CCI + vehicle group, the CCI + α-asarone 5 mg/kg group, the CCI + α-asarone 10 mg/kg group, and the CCI + α-asarone 20 mg/kg group...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29318090/c1-2-fixation-approach-for-patients-with-vascular-irregularities-a-case-report
#4
Alireza K Nazemi, Stetson R Bickley, Caleb J Behrend, Jonathan J Carmouche
In posterior spinal fusion (PSF), the vertebral artery is most vulnerable to injury at C1-2. C2 pedicle screws are often placed into the dorsomedial isthmus of C2. Alternative techniques include C2 laminar screws and wiring techniques. A 67-year-old male underwent PSF for persistent severe intractable neck pain and degeneration at C1-2. The patient had an enlarged left vertebral artery with midline migration into the C2 body. This pattern was within one standard deviation of normal; however, it rendered typical placement of a C2 pedicle screw unsafe...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29316566/double-anterior-stereotactic-cingulotomy-for-intractable-oncological-pain
#5
Ido Strauss, Assaf Berger, Shlomit Ben Moshe, Michal Arad, Uri Hochberg, Tal Gonen, Rotem Tellem
BACKGROUND: Stereotactic anterior cingulotomy has been used in the treatment of patients suffering from refractory oncological pain due to its effects on pain perception. However, the optimal targets as well as suitable candidates and outcome measures have not been well defined. We report our initial experience in the ablation of 2 cingulotomy targets on each side and the use of the Brief Pain Inventory (BPI) as a perioperative assessment tool. METHODS: A retrospective review of all patients who underwent stereotactic anterior cingulotomy in our Department between November 2015 and February 2017 was performed...
January 10, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29316547/o-arm-guided-percutaneous-radiofrequency-cordotomy
#6
Ido Strauss, Assaf Berger, Michal Arad, Uri Hochberg, Rotem Tellem
BACKGROUND: Pain is often one of the most debilitating symptoms in patients with advanced oncological disease. Patients with localized pain due to malignancy refractory to medical treatment can benefit from selective percutaneous cordotomy that disconnects the ascending pain fibers in the spinothalamic tract. OBJECTIVES: Over the past year, we have been performing percutaneous radiofrequency cordotomy with the use of the O-Arm intraoperative imaging system that allows both 2D fluoroscopy and 3D reconstructed computerized tomography imaging...
January 10, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29276227/constant-current-vs-constant-voltage-systems-for-temporal-spinal-cord-stimulation-for-intractable-pain
#7
Mayu Ooi, Fujio Yanamoto, Hitoaki Sato, Yumiko Takao, Masako Okada, Moritoki Egi, Satoshi Mizobuchi
Although spinal cord stimulation (SCS) is a useful treatment for chronic intractable pain, the optimal method of stimulation has not yet been established. In this prospective, crossover study, we compared the efficacy of using a constant current (CC) system with that of a constant voltage (CV) system for temporal SCS. Twenty patients were enrolled and divided into two groups. For 10 patients, a CV system was applied on Days 1-5, followed by the use of a CC system on Days 6-10. For the other 10 patients, a CC system was applied for the first five days, followed by a CV system for the subsequent five days...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29245352/effect-of-multiple-intra-articular-injections-of-polynucleotides-on-treatment-of-intractable-knee-osteoarthritis-a-case-report
#8
Jong-Uk Mun, Hyung Rae Cho, Young Soon Choi, Young Uk Kim
RATIONALE: Knee osteoarthritis (KOA) is a chronic joint degenerative disease. Intra-articular injection (IAI) of hyaluronic acid (HA) is widely used to treat KOA. However, some HA injections have no effect at all. Polynucleotides (PN) are recently noted as a valid substitute for HA. PATIENT CONCERNS: A 61-year-old female was admitted to the pain center with symptoms of pain over the knee and warmth feeling with stiffness in the left knee. The patient reported chronic severe pain in the left knee area despite 6 times IAI of HA...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243997/transdural-approach-to-resection-of-retro-odontoid-cysts-in-elderly-patients-report-of-3-cases
#9
Karthik Madhavan, Lee Onn Chieng, Brandon G Gaynor, Allan D Levi
Retro-odontoid cysts that arise from the tectorial membrane are uncommon lesions that can occur in elderly patients. They arise secondary to degenerative changes, including calcium pyrophosphate deposition within the ligaments. Surgical treatment is indicated when these lesions result in intractable pain, instability, and/or myelopathy. Several surgical techniques to treat this condition exist, but the optimal approach in elderly patients with comorbidities remains controversial. Here, the authors present a case series of 3 patients who underwent successful resection of a retro-odontoid lesion performed through a transdural approach...
December 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29230247/wireless-neuromodulation-for-chronic-back-pain-delivery-of-high-frequency-dorsal-root-ganglion-stimulation-by-a-minimally-invasive-technique
#10
Bart Billet, Roel Wynendaele, Niek E Vanquathem
Objective: To evaluate the analgesic effect of a dorsal root ganglion (DRG) stimulation technology utilizing high-frequency pulse rates to treat intractable chronic back and leg pain. Methods: This case study presents the outcomes, with a novel, wireless, minimally invasive miniature neurostimulator system in a case of chronic back pain. The subject was implanted bilaterally with a Freedom 4A quadripolar electrode array at the L2 dorsal root ganglion. Stimulation was applied using 10 kHz pulse rate and 30 μs pulse width...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29218275/outcomes-of-surgical-excision-and-brachytherapy-in-intractable-keloids
#11
Ahmadreza Taheri, Hojjat Molaei, Mehdi Aghili, Naser Rahmanpanah, Atefeh Mirmohseni
BACKGROUND: Keloids as unusual scars are injury remnants characterized by bizarre cosmetics and painful itching. This study assessed outcomes of surgical excision and brachytherapy in intractable keloids. METHODS: Six patients with 10 keloid lesions were followed up. Surgical excision was done with 1-2 mm margin, and then radiotherapy was undertaken in 3 divided fractions on days 0, 1 and 2 after surgery. Scar improvement was evaluated by patients and observer with scar assessment scale (POSAS)...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#12
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29203312/microvascular-decompression-for-treatment-of-trigeminal-neuralgia-factors-that-predict-complete-pain-relief-and-study-of-efficacy-and-safety-in-older-patients
#13
Sarun Nunta-Aree, Kasemsak Patiwech, Bunpot Sitthinamsuwan
OBJECTIVE: Microvascular decompression (MVD) is an effective method for directly treating the etiology of trigeminal neuralgia (TGN). This study aims to investigate the factors that predict complete pain relief after MVD for treatment of TGN, and to study efficacy and safety in older patients. METHODS: This study was conducted in patients with TGN that were treated by MVD at Siriraj Hospital between 2004 and 2015. Cases with secondary TGN were excluded. Data was gathered from medical records, preoperative magnetic resonance imaging, intraoperative findings, and by telephone in patients lost to follow-up...
December 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29202430/a-retrospective-audit-of-lesion-excision-and-rotation-skin-flap-for-the-treatment-of-intractable-plantar-keratosis
#14
REVIEW
Amir Saipoor, Anthony Maher, Lance Hogg
AIM: The purpose of this study was to evaluate the treatment of plantar skin lesions by excision and rotation skin flap closure with reference to patient satisfaction; patient reported outcomes and complication rates. METHOD: A retrospective audit of 54 consecutive patients who had undergone plantar lesion excision with rotation skin flap between May 2011 and November 2015 under the care of experienced consultant podiatric surgeons. A total of 36 patients were included in this study, 16 were lost to follow up, 2 patients were excluded due to non-related pathology...
September 28, 2017: Foot
https://www.readbyqxmd.com/read/29199500/management-of-a-rare-case-of-posterior-condylar-canal-dural-arteriovenous-fistula-presenting-with-subarachnoid-haemorrhage-a-case-report-and-review-of-literature
#15
Somorendra Singh Shambanduram, Leve Joseph Devarajan Sebastian, Nishchint Jain, Ajay Garg, Shailesh B Gaikwad
Posterior condylar canal dural arteriovenous fistula (PCC dAVF) is a rare entity with only three cases having been reported so far in the English literature. We describe the clinical presentation, imaging, and endovascular management of an elderly man with left PCC dAVF presenting with subarachnoid haemorrhage (SAH). Endovascular management of such cases requires thorough understanding of the vascular anatomy around the craniovertebral junction (CVJ) and variable bridging vein draining patterns. The fistula in our case was fed by the posterior meningeal branch of the left vertebral artery and was draining through a dilated and tortuous medullary bridging vein into the antero-lateral pontomedullary venous system...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29198673/pain-control-glucose-control-and-quality-of-life-in-patients-with-chronic-pancreatitis-after-total-pancreatectomy-with-islet-autotransplantation-a-preliminary-report
#16
J Solomina, J Gołębiewska, M R Kijek, A Kotukhov, P J Bachul, L Basto, K Gołąb, E Konsur, K Cieply, N Fillman, L-J Wang, C C Thomas, L H Philipson, M Tibudan, A Dębska-Ślizień, J Fung, A Gelrud, J B Matthews, P Witkowski
BACKGROUND: Total pancreatectomy (TP) is offered as a last treatment option for pain relief in patients with chronic pancreatitis. Concurrent islets autotransplantation (TP-IAT) may improve glucose control. METHODS: We analyzed results in 20 recent patients who underwent TP-IAT at The University of Chicago. The median observation period was 28 months (2-38). Data were collected prospectively then analyzed retrospectively. RESULTS: The number of patients requiring opioids daily for pain control decreased from 16 (80%) prior to surgery to 2 (13%) 1 year after, with only 1 (6...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29196860/role-of-thrombin-in-soluble-thrombomodulin-induced-suppression-of-peripheral-hmgb1-mediated-allodynia-in-mice
#17
Ryuichi Tsujita, Maho Tsubota, Yusuke Hayashi, Haruka Saeki, Fumiko Sekiguchi, Atsufumi Kawabata
High mobility group box 1 (HMGB1), a nuclear protein, once released into the extracellular space under pathological conditions, plays a pronociceptive role in redox-dependent distinct active forms, all-thiol HMGB1 (at-HMGB1) and disulfide HMGB1 (ds-HMGB1), that accelerate nociception through the receptor for advanced glycation endproducts (RAGE) and Toll-like receptor 4 (TLR4), respectively. Thrombomodulin (TM), an endothelial membrane protein, and soluble TM, known as TMα, promote thrombin-mediated activation of protein C and also sequester HMGB1, which might facilitate thrombin degradation of HMGB1...
December 1, 2017: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
https://www.readbyqxmd.com/read/29190962/wu-tou-decoction-attenuates-neuropathic-pain-via-suppressing-spinal-astrocytic-il-1r1-traf6-jnk-signaling
#18
Chao Wang, Xiangying Kong, Chunyan Zhu, Chunfang Liu, Danni Sun, Qionghong Xu, Zhiyun Mao, Qingxia Qin, Hongchang Su, Danqiao Wang, Xiaoliang Zhao, Na Lin
Neuropathic pain (NP) caused by nerve injuries continues to be an intractable challenge due to inadequate therapeutic strategies. Recent study demonstrated glia-induced neuro-inflammation in the spinal cord, especially the activation of astrocytes, plays an essential role in the development of NP, which opens new avenues for NP treatment. In this study, we explored the anti-hyperalgesia properties of Wu-tou decoction (WTD) and showed that WTD potently attenuates mechanical allodynia and heat hyperalgesia in lumbar 5 (L5) spinal nerve ligation (SNL)-induced NP without noticeable side effect or affecting basal pain perception of mice...
November 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29165656/limited-midline-myelotomy-for-intractable-visceral-pain-surgical-techniques-and-outcomes
#19
Aditya Vedantam, Dhanalakshmi Koyyalagunta, Brian Mendoza Bruel, Patrick M Dougherty, Ashwin Viswanathan
BACKGROUND: Limited midline myelotomy targets the midline nociceptive pathway for intractable visceral pain. Multiple techniques are available for limited midline myelotomy; however, outcome data for each technique are sparse. OBJECTIVE: To review our experience with open and percutaneous approaches for limited midline myelotomy for intractable visceral pain. METHODS: Patients who underwent limited midline myelotomy for intractable visceral pain were reviewed...
November 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29161336/efficacy-of-electrical-stimulation-of-the-occipital-nerve-in-intractable-primary-headache-disorders-a-systematic-review-with-meta-analyses
#20
Robert T Cadalso, John Daugherty, Caron Holmes, Saravanan Ram, Reyes Enciso
AIMS: To determine the efficacy of occipital nerve stimulation (ONS) in reducing the intensity, duration, and frequency of medically intractable primary headaches. METHODS: A systematic review was carried out by searching three electronic databases: the Cochrane Library, MEDLINE via PubMed, and Web of Science. Randomized controlled trials (RCTs) and case series were eligible for inclusion. RCTs were assessed for quality of evidence by using the Cochrane Risk of Bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tools...
November 21, 2017: Journal of Oral & Facial Pain and Headache
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