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https://www.readbyqxmd.com/read/28527055/cluster-headache-present-and-future-therapy
#1
Massimo Leone, Alessandro Giustiniani, Alberto Proietti Cecchini
Cluster headache is characterized by severe, unilateral headache attacks of orbital, supraorbital or temporal pain lasting 15-180 min accompanied by ipsilateral lacrimation, rhinorrhea and other cranial autonomic manifestations. Cluster headache attacks need fast-acting abortive agents because the pain peaks very quickly; sumatriptan injection is the gold standard acute treatment. First-line preventative drugs include verapamil and carbolithium. Other drugs demonstrated effective in open trials include topiramate, valproic acid, gabapentin and others...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28522185/orofacial-complex-regional-pain-syndrome-pathophysiologic-mechanisms-and-functional-mri
#2
Yeon-Hee Lee, Kyung Mi Lee, Hyug-Gi Kim, Soo-Kyung Kang, Q-Schick Auh, Jyung-Pyo Hong, Yang-Hyun Chun
Complex regional pain syndrome (CRPS) is one of the most challenging chronic pain conditions and is characterized by burning pain, allodynia, hyperalgesia, autonomic changes, trophic changes, edema, and functional loss involving mainly the extremities. Until recently, very few reports have been published concerning CRPS involving the orofacial area. We report on a 50-year-old female patient who presented with unbearable pain in all of her teeth and hypersensitivity of the facial skin. She also reported intractable pain in both extremities accompanied by temperature changes and orofacial pain that increased when the other pains were aggravated...
March 14, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28521018/stereotactic-radiosurgery-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#3
Dustin G Roberts, Nader Pouratian
BACKGROUND: Since the advent of neuromodulation, the role and efficacy of stereotactic radiosurgery (SRS) for chronic pain has not been carefully scrutinized. OBJECTIVE: To perform a systematic review to evaluate the clinical efficacy, both short- and long-term, of SRS for the treatment of chronic intractable pain. METHODS: A systematic search in PubMed, Web of Science, and PsycINFO was performed using keywords and controlled vocabulary. The search included peer-reviewed articles reporting clinical outcomes of SRS for chronic pain with a minimum 3-mo follow-up for nonmalignant and 1 mo for malignant pain...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28520565/use-of-a-tilting-orthopedic-fracture-table-to-facilitate-proper-patient-positioning-during-intrathecal-neurolysis-with-hyperbaric-phenol-a-case-report
#4
Nathaniel H Loo, Gerald Matchett
We describe the case of a 41-year-old woman with metastatic cervical cancer and a large mass eroding into the pelvis and left lumbosacral plexus. The patient had intractable left lower extremity pain refractory to standard therapies, and she elected to undergo intrathecal neurolysis. A diagnostic intrathecal block was performed at the T11-12 interspace followed by intrathecal neurolysis with 6% phenol in glycerin on a subsequent date. During both procedures, we used a tilting radiolucent orthopedic fracture table to maintain strict left lateral-supine positioning...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28514309/a-randomized-controlled-trial-of-botulinum-toxin-a-for-treating-neuropathic-pain-in-patients-with-spinal-cord-injury
#5
Gang Li, Chang-An Lv, Li Tian, Lian-Jin Jin, Ping Sun, Wei Zhao
BACKGROUND: To assess the effect of botulinum toxin A (BTA) for treating neuropathic pain in patients with spinal cord injury (SCI). METHODS: A total of 44 patients with SCI with neuropathic pain were randomly divided into the intervention group and the placebo group, each group 21 patients. The subjects in the intervention group received BTA (200 U subcutaneous injection, once daily) at the painful area, whereas those in the placebo group were administered a saline placebo...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28506184/complications-of-psychotropic-and-pain-medications-in-an-ultrarapid-metabolizer-patient-at-the-upper-1-of-cytochrome-p450-cyp450-function-quantified-by-combinatorial-cyp450-genotyping
#6
Gualberto Ruaño, Karen Larsen, Mohan Kocherla, James Samuel Graydon, Jonathan Kost
A 44-year-old Caucasian woman presented with a history of empirical treatment with 20 pain and psychotropic medications, as well as dual comorbidity of intractable pain and depression. A multiple gain-of-function profile in the CYP450 family of cytochrome P450 (CYP450) drug metabolism isoenzymes was discovered. The patient was a homozygote of suprafunctional alleles for both CYP2D6 ((*)35/(*)35) and CYP2C19 ((*)17/(*)17) genes and functional alleles for CYP2C9 ((*)1/(*)1), which account for aggregate drug metabolism function at the upper 1% of the population...
May 16, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28501595/corticolimbic-circuitry-in-the-modulation-of-chronic-pain-and-substance-abuse
#7
REVIEW
Anna M W Taylor
The transition from acute to chronic pain is accompanied by increased engagement of emotional and motivational circuits. Adaptations within this corticolimbic circuitry contribute to the cellular and behavioral maladaptations associated with chronic pain. Central regions within the corticolimbic brain include the mesolimbic dopamine system, the amygdala, and the medial prefrontal cortex. The evidence reviewed herein supports the notion that chronic pain induces significant changes within these corticolimbic regions that contribute to the chronicity and intractability of pain...
May 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28501435/risk-factors-for-cognitive-decline-following-osteoporotic-vertebral-fractures-a-multicenter-cohort-study
#8
Shinji Takahashi, Masatoshi Hoshino, Tadao Tsujio, Hidetomi Terai, Akinobu Suzuki, Takashi Namikawa, Minori Kato, Akira Matsumura, Kazushi Takayama, Hiroaki Nakamura
BACKGROUND: Osteoporotic vertebral fractures (OVFs) are the most common cause of intractable back pain and reduced activities of daily living (ADL), which may affect cognitive function. However, no previous studies have reported a change in cognitive function after OVFs. The purpose was to reveal cognitive function changes after OVFs and investigate the risk factors for cognitive decline. METHODS: Consecutive patients with symptomatic OVFs were enrolled in a prospective multicenter cohort study...
May 10, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#9
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28479215/local-injection-to-sciatic-nerve-of-dex-reduces-pain-behaviors-sgcs-activation-ngf-expression-and-sympathetic-sprouting-in-cci-rats
#10
Jing-Ru Wu, Hui Chen, Deng-Xin Zhang, Kai Jiang, Ying-Ying Yao, Ming-Ming Zhang, Bo Zhou, Jie Wang
Neuropathic pain has become an intractable health threat, with its profound effect on quality of life. Dorsal root ganglia (DRG) is evidenced to play a crucial role in neuropathic pain. The peripheral nociceptive afferents seem to be essential not only to initiate the process of neuropathic pain, but also to maintain and modulate it. Dexmedetomidine (DEX), a highly selective agonist of α2-adrenergic receptor (α2-AR), has provided significant analgesia in neuropathic pain. In the present study, we found that local injection to sciatic nerve of DEX alleviated heat hypersensitivity induced by chronic constriction injury (CCI)...
May 4, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28458593/intravenous-lidocaine-old-school-drug-new-purpose-reduction-of-intractable-pain-in-patients-with-chemotherapy-induced-peripheral-neuropathy
#11
Sandra A S van den Heuvel, Selina E I van der Wal, Lotte A Smedes, Sandra A Radema, Nens van Alfen, Kris C P Vissers, Monique A H Steegers
Background. Treatment of intractable pain due to chemotherapy induced peripheral neuropathy (CIPN) is a challenge. Intravenous (iv) lidocaine has shown to be a treatment option for neuropathic pain of different etiologies. Methods. Lidocaine (1.5 mg/kg in 10 minutes followed by 1.5 mg/kg/h over 5 hours) was administered in nine patients with CIPN, and analgesic effect was evaluated during infusion and after discharge. The immediate effect of lidocaine on pressure pain thresholds (PPT) and the extent of the stocking and glove distribution of sensory abnormalities (cold and pinprick) were assessed...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28455489/st-segment-elevation-myocardial-infarction-with-acute-stent-thrombosis-presenting-as-intractable-hiccups-an-unusual-case
#12
Fan Zhang, Nosakhare Douglas Tongo, Victoria Hastings, Parisa Kanzali, Ziqiang Zhu, Hal Chadow, Shahrokh E Rafii
BACKGROUND Acute coronary syndrome (ACS) can present with atypical chest pain or symptoms not attributed to heart disease, such as indigestion. Hiccups, a benign and self-limited condition, can become persistent or intractable with overlooked underlying etiology. There are various causes of protracted hiccups, including metabolic abnormalities, psychogenic disorders, malignancy, central nervous system pathology, medications, pulmonary disorders, or gastrointestinal etiologies. It is rarely attributed to cardiac disease...
April 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28453433/diagnostic-accuracy-of-selective-3-t-mr-neurography-guided-retroperitoneal-genitofemoral-nerve-blocks-for-the-diagnosis-of-genitofemoral-neuralgia
#13
Jan Fritz, A Lee Dellon, Eric H Williams, Gedge D Rosson, Allan J Belzberg, Frederick E Eckhauser
Purpose To determine if 3-T magnetic resonance (MR) neurography-guided retroperitoneal genitofemoral nerve (GFN) blocks are safe and effective for the diagnosis of genitofemoral neuralgia. Materials and Methods Following institutional review board approval and informed consent, 26 subjects (16 men, 10 women; mean age, 42 years [range, 24-78 years]; mean body mass index, 28 kg/m(2) [range, 20-35 kg/m(2)]) with intractable groin pain were included. By using a 3-T MR imaging system, intermediate-weighted turbo spin-echo pulse sequences, and MR-conditional needles, diagnostic MR neurography-guided GFN blocks were performed in the retroperitoneum...
April 28, 2017: Radiology
https://www.readbyqxmd.com/read/28445862/treatments-of-traumatic-neuropathic-pain-a-systematic-review
#14
Chenglun Yao, Xijie Zhou, Bin Zhao, Chao Sun, Keshav Poonit, Hede Yan
Traumatic neuropathic pain caused by traumatic neuroma has long been bothering both doctors and patients, the mechanisms of traumatic neuropathic pain are widely discussed by researchers and the treatment is challenging. Clinical treatment of painful neuroma is unclear. Numerous treatment modalities have been introduced by experts in this field. However, there is still no single standard recognized treatment.Different forms of treatments have been tested in animals and humans, but pharmacotherapies (antidepressants, antiepileptics) remain the basis of traumatic neuropathic pain management...
April 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28445777/five-year-follow-up-after-laparoscopic-large-nerve-resection-for-deep-infiltrating-sciatic-nerve-endometriosis
#15
Marc Possover
STUDY OBJECTIVE: To report neurologic follow-up of patients after laparoscopic large resection of deep infiltrating endometriosis of the sciatic nerve. DESIGN: Prospective clinical case series (Canadian Task Force classification I). SETTING: Tertiary referral unit specializing in advanced gynecologic surgery and neuropelveology. PATIENTS: All data for patients who underwent laparoscopic surgery for endometriosis of the sciatic nerve between 2004 and 2016 (N = 259) were documented prospectively...
April 23, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28443171/a-prospective-study-of-clinical-and-radiological-outcomes-of-zero-profile-cage-screw-implants-for-single-level-anterior-cervical-discectomy-and-fusion-is-segmental-lordosis-maintained-at-2-years
#16
Saumyajit Basu, Sreeramalingam Rathinavelu
STUDY DESIGN: Prospective cohort study. PURPOSE: To study clinicoradiological parameters of zero-profile cage screw used for anterior cervical discectomy and fusion (ACDF). OVERVIEW OF LITERATURE: Radiological parameters of various implants used for ACDF are available, but those for zero-profile cage are sparse. METHODS: Patients with unilateral intractable brachialgia due to single-level cervical disc prolapse between April 1, 2011 and March 31, 2014 were included...
April 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28442161/zurich-cementless-total-hip-replacement
#17
REVIEW
David Hummel
Total hip replacement (THR) is the gold standard treatment of intractable pain from hip dysplasia. THR procedures are divided into 2 main categories: cemented and cementless, with hybrid a combination. The Zurich Cementless THR system uses a combination of press-fit (acetabular component) and locking screw (femoral component) fixation designed to address the main challenge facing cemented systems (aseptic loosening) while providing the benefit of immediate stability with its novel locking screw implantation system for the femoral stem...
April 22, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28437495/a-practical-guide-to-understanding-and-treating-patellofemoral-pain
#18
John P Fulkerson
There is no shortcut to accurate diagnosis in the patellofemoral pain patient. Most important in the process is a desire and ability to specifically identify the structural and biomechanical origin of pain. This can be elusive and often requires a careful analysis of all factors affecting the patient, including documenting his or her specific history of pain origin and specific treatments to date, and acknowledging the patient's localization of the pain origin. Many patients can pinpoint the site of pain origin when given the time and encouragement to do so...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28435912/one-and-two-level-posterior-lumbar-interbody-fusion-plif-using-an-expandable-stand-alone-interbody-fusion-device-a-varilift-%C3%A2-case-series
#19
Rebecca Barrett-Tuck, Diana Del Monaco, Jon E Block
BACKGROUND: Surgical interventions such as posterior lumbar interbody fusion (PLIF) with and without posterior instrumentation are often employed in patients with degenerative spinal conditions that fail to respond to conservative medical management. The VariLift(®) Interbody Fusion System was developed as a stand-alone solution to provide the benefits of an intervertebral fusion device without the requirement of supplemental pedicle screw fixation. METHODS: In this retrospective case series, 25 patients underwent PLIF with a stand-alone VariLift(®) expandable interbody fusion device without adjunctive pedicle screw fixation...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#20
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
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