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Chronic intractible pain

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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
#1
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/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#2
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/29198673/pain-control-glucose-control-and-quality-of-life-in-patients-with-chronic-pancreatitis-after-total-pancreatectomy-with-islet-autotransplantation-a-preliminary-report
#3
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/29190962/wu-tou-decoction-attenuates-neuropathic-pain-via-suppressing-spinal-astrocytic-il-1r1-traf6-jnk-signaling
#4
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/29161336/efficacy-of-electrical-stimulation-of-the-occipital-nerve-in-intractable-primary-headache-disorders-a-systematic-review-with-meta-analyses
#5
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
https://www.readbyqxmd.com/read/29111493/lateral-cutaneous-nerve-entrapment-syndrome-lacnes-a-previously-unrecognized-cause-of-intractable-flank-pain
#6
R C Maatman, N E Papen-Botterhuis, M R M Scheltinga, R M H Roumen
BACKGROUND AND AIMS: Chronic abdominal pain may occasionally be due to terminal endings of intercostal nerves (ACNES, abdominal cutaneous nerve entrapment syndrome) that are entrapped in the abdominal wall. Spontaneous neuropathic flank pain may also be caused by involvement of branches of these intercostal nerves. Aim is to describe a series of patients with flank pain due to nerve entrapment and to increase awareness for an unknown condition coined Lateral Cutaneous Nerve Entrapment Syndrome (LACNES)...
October 27, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29104252/pharmacological-regulation-of-neuropathic-pain-driven-by-inflammatory-macrophages
#7
REVIEW
Norikazu Kiguchi, Daichi Kobayashi, Fumihiro Saika, Shinsuke Matsuzaki, Shiroh Kishioka
Neuropathic pain can have a major effect on quality of life but current therapies are often inadequate. Growing evidence suggests that neuropathic pain induced by nerve damage is caused by chronic inflammation. Upon nerve injury, damaged cells secrete pro-inflammatory molecules that activate cells in the surrounding tissue and recruit circulating leukocytes to the site of injury. Among these, the most abundant cell type is macrophages, which produce several key molecules involved in pain enhancement, including cytokines and chemokines...
November 1, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28993994/efficacy-and-factors-determining-the-outcome-of-dorsal-root-entry-zone-lesioning-procedure-drezotomy-in-the-treatment-of-intractable-pain-syndrome
#8
Nontaphon Piyawattanametha, Bunpot Sitthinamsuwan, Pramote Euasobhon, Nantthasorn Zinboonyahgoon, Pranee Rushatamukayanunt, Sarun Nunta-Aree
BACKGROUND: Chronic pain is a disabling condition that adversely affects patient quality of life. The dorsal root entry zone lesioning procedure (DREZotomy) is a modality used to treat intractable pain caused by insults to neural structures. This study aimed to investigate the efficacy of and the factors that determine the outcome of microsurgical DREZotomy (MDT). METHOD: All consecutive patients who underwent MDT for treatment of intractable pain during September 2008 to December 2016 were enrolled...
December 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28993112/hospitalization-due-to-acute-exacerbation-of-chronic-pain-an-intervention-study-in-a-university-hospital
#9
Daniel W Wheeler, Sara Kinna, Andrew Bell, Peter J Featherstone, David J Sapsford, Sam P Bass
BACKGROUND AND AIMS: Hospitalization as a result of acute exacerbation of complex chronic pain is a largely hidden problem, as patients are often admitted to hospital under a variety of specialities, and there is frequently no overarching inpatient chronic pain service dedicated to their management. Our institution had established an inpatient acute pain service overseen by pain physicians and staffed by specialist nurses that was intended to focus on the management of perioperative pain...
October 6, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28955294/real-time-classification-of-non-weight-bearing-lower-limb-movements-using-emg-to-facilitate-phantom-motor-execution-engineering-and-case-study-application-on-phantom-limb-pain
#10
Eva Lendaro, Enzo Mastinu, Bo Håkansson, Max Ortiz-Catalan
Phantom motor execution (PME), facilitated by myoelectric pattern recognition (MPR) and virtual reality (VR), is positioned to be a viable option to treat phantom limb pain (PLP). A recent clinical trial using PME on upper-limb amputees with chronic intractable PLP yielded promising results. However, further work in the area of signal acquisition is needed if such technology is to be used on subjects with lower-limb amputation. We propose two alternative electrode configurations to conventional, bipolar, targeted recordings for acquiring surface electromyography...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28928366/fibromyalgia-and-microglial-tnf-%C3%AE-translational-research-using-human-blood-induced-microglia-like-cells
#11
Masahiro Ohgidani, Takahiro A Kato, Masako Hosoi, Makoto Tsuda, Kohei Hayakawa, Chie Hayaki, Rie Iwaki, Noriaki Sagata, Ryota Hashimoto, Kazuhide Inoue, Nobuyuki Sudo, Shigenobu Kanba
Fibromyalgia is a refractory disease characterized by chronic intractable pain and psychological suffering, the cause of which has not yet been elucidated due to its complex pathology. Activation of immune cells in the brain called microglia has attracted attention as a potential underlying pathological mechanism in chronic pain. Until recently, however, technological and ethical considerations have limited the ability to conduct research using human microglia. To overcome this limitation, we have recently developed a technique to create human-induced microglia-like (iMG) cells from human peripheral blood monocytes...
September 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#12
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28902127/altered-gene-expression-of-rnf34-and-pacap-possibly-involved-in-mechanism-of-exercise-induced-analgesia-for-neuropathic-pain-in-rats
#13
Shintaro Yamaoka, Yusuke Oshima, Hideki Horiuchi, Tadao Morino, Masayuki Hino, Hiromasa Miura, Tadanori Ogata
Despite the availability of several modalities of treatment, including surgery, pharmacological agents, and nerve blocks, neuropathic pain is often unresponsive and sometimes progresses to intractable chronic pain. Although exercise therapy is a candidate for treatment of neuropathic pain, the mechanism underlying its efficacy has not been elucidated. To clarify the molecular mechanism for pain relief induced by exercise, we measured Rnf34 and Pacap mRNA levels in the spinal cord dorsal horn of SNL rats, a model of neuropathic pain...
September 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28895017/total-pancreatectomy-with-islet-autotransplantation-for-acute-recurrent-and-chronic-pancreatitis
#14
REVIEW
Varvara A Kirchner, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Joshua J Wilhelm, Sarah J Schwarzenberg, Martin L Freeman, Melena D Bellin
PURPOSE OF REVIEW: The first total pancreatectomy and islet autotransplantation (TP-IAT) was performed for chronic pancreatitis in 1977 with the goal to ameliorate the pain and simultaneously preserve islet function. We reviewed the recent medical literature regarding indications, patient suitability, current outcomes, and challenges in TP-IAT. RECENT FINDINGS: Current indications for TP-IAT include intractable pain secondary to chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP) with failed medical and endoscopic/surgical management...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28894809/tympanic-plexus-neurectomy-for-intractable-otalgia
#15
Daniel S Roberts, Alisa Yamasaki, Ahmad R Sedaghat, Daniel J Lee, Edward Reardon
OBJECTIVE: The goal of this study was to analyze whether tympanic plexus neurectomy is a successful surgical option in patients with intractable otalgia. STUDY DESIGN: A retrospective single institution study from the experience of two surgeons was conducted. METHODS: Records of adult patients with intractable unilateral otalgia of likely glossopharyngeal origin were reviewed, with institutional review board approval. Patients who responded to a tympanic plexus block were considered for tympanic neurectomy...
October 2016: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28888796/laparoscopic-treatment-of-gastroparesis-a-single-center-experience
#16
Kotaro Wakamatsu, Federico Perez Quirante, Lisandro Montorfano, Emanuele Lo Menzo, Yasuyuki Seto, Raul J Rosenthal
BACKGROUND: Gastroparesis (GP) is a chronic disorder of gastric motility with delayed gastric emptying. Gastric electrical stimulator (GES) implantation and Roux-en-Y gastric bypass (RYGB) are surgical options for medically refractory GP. OBJECTIVE: Evaluate operational outcomes and symptom improvement of patients with diabetic (DM) and idiopathic (IP) GP. SETTING: University Hospital, United States. METHODS: A retrospective chart review was performed of all patients who underwent surgical treatment of GP from February 2003 to December 2014...
July 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28867384/downregulations-of-trpm8-expression-and-membrane-trafficking-in-dorsal-root-ganglion-mediate-the-attenuation-of-cold-hyperalgesia-in-cci-rats-induced-by-gfr%C3%AE-3-knockdown
#17
Lin Su, Ruichen Shu, Chengcheng Song, Yonghao Yu, Guolin Wang, Yazhuo Li, Changxiao Liu
BACKGROUND: Cold hyperalgesia is an intractable sensory abnormality commonly seen in peripheral neuropathies. Although glial cell line-derived neurotrophic factor family receptor alpha3 (GFRα3) is required for the formation of pathological cold pain has been revealed, potential transduction mechanism is poorly elucidated. We have previously demonstrated the contribution of enhanced activity of transient receptor potential melastatin 8 (TRPM8) to cold hyperalgesia in neuropathic pain using a rat model of chronic constriction injury (CCI) to the sciatic nerve...
September 1, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28862789/creating-a-strain-relief-loop-during-s1-transforaminal-lead-placement-for-dorsal-root-ganglion-stimulation-for-foot-pain-a-technical-note
#18
Valery van Velsen, Noud van Helmond, Kenneth B Chapman
Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop on the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation on the S1 level using a transforaminal approach that we employed in a 45-year old patient with intractable foot pain...
September 1, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28843150/neuroprotective-effect-of-liquiritin-against-neuropathic-pain-induced-by-chronic-constriction-injury-of-the-sciatic-nerve-in-mice
#19
Meng-Ting Zhang, Bing Wang, Yi-Na Jia, Ning Liu, Peng-Sheng Ma, Shuai-Shuai Gong, Yang Niu, Tao Sun, Yu-Xiang Li, Jian-Qiang Yu
Managing of neuropathic pain remains clinically challenging because the existing pharmacotherapies are either ineffective or non-specific. Therefore, developing novel alternatives is essential for better treatment. Liquiritin is an active component extracted from Glycyrrhizae radix and has potential neuroprotective action. This study aimed to investigate the protective efficacy of liquiritin on chronic constriction injury (CCI)-induced neuropathic pain in mice. Liquiritin (30, 60, and 120mg/kg) and pregabalin (40mg/kg) were administered intragastrically for 7 consecutive days starting on the 8th day post-surgery...
November 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28840390/laparoscopic-mesh-removal-for-otherwise-intractable-inguinal-pain-following-endoscopic-hernia-repair-is-feasible-safe-and-may-be-effective-in-selected-patients
#20
G D Slooter, W A R Zwaans, C W Perquin, R M H Roumen, M R M Scheltinga
BACKGROUND: Laparoscopic inguinal hernia repair is preferred over an open technique because of reduced recovery time, favorable cost effectiveness, and less chronic postoperative inguinal pain. Nevertheless, some patients develop a nociceptive inguinal pain syndrome possibly related to the presence of the mesh. This is the first study describing feasibility, safety, and effectiveness of laparoscopic mesh removal in patients with chronic pain after endoscopic hernia repair. METHODS: Pre- and intraoperative data of chronic pain patients scheduled for endoscopic mesh removal were prospectively collected by a standard evaluation form...
August 24, 2017: Surgical Endoscopy
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