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Chronic low back ache

Mona L Martin, Steven I Blum, Hiltrud Liedgens, Donald M Bushnell, Kelly P McCarrier, Noël V Hatley, Abhilasha Ramasamy, Rainer Freynhagen, Mark Wallace, Charles Argoff, Mariёlle Eerdekens, Maurits Kok, Donald L Patrick
We describe the mixed-methods (qualitative and quantitative) development and preliminary validation of the Patient Assessment for Low Back Pain - Symptoms (PAL-S), a patient-reported outcome measure for use in chronic low back pain (cLBP) clinical trials. Qualitative methods (concept elicitation, cognitive interviews) were used to identify and refine symptom concepts and quantitative methods (Classical test theory, Rasch measurement theory) were used to evaluate item- and scale-level performance of the measure using an iterative approach...
February 7, 2018: Pain
Zsolt Bagi, Dieter D Brandner, Phuong Le, David W McNeal, Xi Gong, Huijuan Dou, David J Fulton, Allison Beller, Thuan Ngyuen, Eric B Larson, Thomas J Montine, C Dirk Keene, Stephen A Back
OBJECTIVE: Microvascular brain injury (mVBI) is a common pathologic correlate of vascular contributions to cognitive impairment and dementia (VCID) that leads to white matter injury (WMI). VCID appears to arise from chronic recurrent white matter ischemia that triggers oxidative stress and an increase in total oligodendrocyte lineage cells. We hypothesized that mVBI involves vasodilator dysfunction of white matter penetrating arterioles and aberrant oligodendrocyte progenitor cell (OPC) responses to WMI...
December 28, 2017: Annals of Neurology
Sanghamitra Pati, Subhashisa Swain, Job Metsemakers, J André Knottnerus, Marjan van den Akker
Multimorbidity is increasingly the primary concern of healthcare systems globally with substantial implications for patient outcomes and resource cost. A critical knowledge gap exists as to the magnitude of multimorbidity in primary care practice in low and middle income countries with available information limited to prevalence. In India, primary care forms the bulk of the health care delivery being provided through both public (community health center) and private general practice setting. We undertook a study to identify multimorbidity patterns and relate these patterns to severity among primary care attendees in Odisha state of India...
2017: PloS One
Stefan Stadler, Dierk Endemann, Lars S Maier
Acute myocardial infarction is the second most common cause of mortality in Germany after chronic ischemic cardiac disease. It is essential to think of acute coronary syndrome also in patients who do not present with typical signs (pressure, tightness, pain, or a squeezing or aching sensation in the chest or arms that may spread to the neck, jaw or back) in the general practitioner's practice. Vital signs (blood pressure, heart rate and oxygen saturation) must be measured; an ECG should be recorded and analyzed within ten minutes of first medical contact...
July 2017: Deutsche Medizinische Wochenschrift
Shinsuke Inoue, Mitsuhiro Kamiya, Makoto Nishihara, Young-Chang P Arai, Tatsunori Ikemoto, Takahiro Ushida
We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8-22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71...
2017: Journal of Pain Research
Charles L Loprinzi, Andrea L Cheville
253 Background: cPMP is chronic pain in the front thorax, axilla, and/or upper half of the arm beginning after mastectomy or lumpectomy persisting > 3 months after treatment and presents with pain, allodynia and disability. cPMP occurs in half of all patients with breast cancer and is severe in 13% (Gartner R JAMA 2009). Epidural bupivacaine, memantine, gabapentin or venlafaxine may help prevent cPMP, but there are no established proven treatments. (Shen J, Up to Date 2016) Scrambler therapy (ST) is an FDA-cleared treatment for neuropathic pain supported by multiple trials in over 800 patients with cancer pain, chemotherapy induced neuropathic pain, back pain, and post herpetic neuropathy (PHN)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
P Murali Mohan, H M Huang Saunders, C M Yang, T M Dwyer, J M Farley
1. Male weanling swine were injected daily for up to 14 days with the organophosphate cholinesterase inhibitors, diisopropylfluorophosphate (DFP) or sarin. The clinical signs of poisoning disappeared or were attenuated by 7 days after starting the DFP treatment, indicating the development of tolerance to DFP toxicity. 2. A significant decrease in acetylcholinesterase activity (85-98%) occurred over the course of this treatment followed by a decrease in the maximal density (Bmax) of [3H] quinuclidinyl benzilate ([3H]QNB) and [3H] N-methylscopolamine ([3H]-NMS) binding sites in isolated cells...
June 1988: Journal of Autonomic Pharmacology
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