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Burn pain management

So Young Joo, Yoon Soo Cho, Sung-Rae Cho, Dohern Kym, Cheong Hoon Seo
PURPOSE: Pain Scrambler therapy is a patient-specific electrocutaneous nerve stimulation device. Burn pruritus is a common form of chronic and disabling neuropathic pain that is often difficult to treat effectively. Pruritus is mediated by histamines, which are effector molecules stored in mast cells and released locally during injury or inflammation. Burn pruritus may be accompanied by peripheral neuropathic pain, which may result from injury to sensory nerves that hampers conductance of neuronal messages along the large A and small C afferent fibers to the spinal cord...
October 15, 2016: Burns: Journal of the International Society for Burn Injuries
Manuel P Pereira, Sebastian Mühl, Esther M Pogatzki-Zahn, Konstantin Agelopoulos, Sonja Ständer
In recent years, measurement of the intraepidermal nerve fiber (IENF) density has gained relevance in the diagnostics of chronic pruritus. This method allows the objectification and quantification of a small-fiber neuropathy, which may manifest clinically with pruritus, pain or dysesthetic sensory symptoms, such as burning, stinging and tingling sensations or numbness. Upon suspicion of a small-fiber neuropathy as a cause for chronic pruritus, targeted diagnostic procedures are essential for the early detection of the neuroanatomical changes...
October 11, 2016: Dermatology and Therapy
Yaron Haviv, Avraham Zini, Yoni Etzioni, Valeri Klitinich, Alex Dobriyan, Yair Sharav, Rafael Benoliel, Galit Almoznino
OBJECTIVE: To identify patient and pain characteristics associated with negative impacts on daily life among patients with chronic orofacial pain (COFP). STUDY DESIGN: Medical records of 200 COFP patients were analyzed. RESULTS: Diagnostic categories included temporomandibular disorders (85; 42.7%), headaches (47; 23.6%), neuropathic pain (37; 18.5%), trigeminal neuralgia (16; 8.0%), and painful posttraumatic trigeminal neuropathy (PTTN) (14; 7...
August 27, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Andrea C Issler-Fisher, Oliver M Fisher, Ania O Smialkowski, Frank Li, Constant P van Schalkwyk, Peter Haertsch, Peter K M Maitz
BACKGROUND: The introduction of ablative fractional CO2 lasers (CO2-AFL) for burn scar management shows promising results. Whilst recent studies have focused on objective scar outcomes following CO2-AFL treatment, to date no data on patient subjective factors such as quality of life are available. METHODS: A prospective study was initiated to analyze the safety and efficacy of the CO2-AFL. Various objective and subjective outcome parameters were prospectively collected from the date of first consultation and follow-up following treatment...
October 1, 2016: Burns: Journal of the International Society for Burn Injuries
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
Kevin C Chung, Sandra V Kotsis, Patricia B Burns, Frank D Burke, E F Shaw Wilgis, David A Fox, H Myra Kim
OBJECTIVE: Rheumatoid arthritis (RA) causes destruction of the metacarpophalangeal (MCP) joints leading to hand deformities, pain, and loss of function. This study prospectively assessed long-term functional and health-related quality of life outcomes in RA patients with severe deformity at the MCP joints. METHODS: RA patients between the ages of 18-80 with severe deformity at the MCP joints were referred to one of the three study sites. Subjects who elected to undergo silicone metacarpophalangeal joint arthroplasty (SMPA) while continuing with medical management were followed in the SMPA cohort...
October 1, 2016: Arthritis Care & Research
Paul C Mayor, Shashikant Lele
Photodynamic therapy (PDT) is a treatment modality used in the management of solid tumor malignancies that employs the use of a photosensitizing agent, a light source and oxygen in order to illicit a direct cytotoxic effect. Its use in gynecologic malignancies is somewhat novel and has been used for palliative and curative intent. At the Roswell Park Cancer Institute, the use of PDT in the management of gynecologic cancers began in the mid 1980s and since that time 35 patients have received PDT as a treatment for recurrent or metastatic cutaneous and vulvar, vaginal, anal, and cervical recurrences...
2016: Cancers
Lingling Fan, Jin Zhu, Xiang Tao, Congjian Xu
OBJECTIVE: This study aimed to analyze the clinicopathologic characteristics, management, and outcome of patients with intraepithelial extramammary Paget's disease of the vulva (EMPDV). MATERIALS AND METHODS: This retrospective study included medical records and pathological slides of 18 female patients with EMPDV between January 2001 and December 2012. Diagnosis was confirmed using conventional hematoxylin and eosin staining. RESULTS: The median age was 65 years...
October 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Hyun Ho Han, Byung Yeun Kwon, Sung No Jung, Suk-Ho Moon
Occupational injuries to digits due to hydrofluoric acid (HFA) are frequently encountered. They have distinctive features, including intense pain, progressive tissue necrosis, and possible bone erosion. To minimize tissue damage, it is of great importance to execute prudent preoperative assessment and determine the correct surgical modality to reconstruct and maintain the function of the hand. However, proper protocols for fingers have not been presented in previous studies. Eight cases with HFA burn to digits were presented to the emergency room...
September 17, 2016: Burns: Journal of the International Society for Burn Injuries
Nabila Rouahi, Zineb Ouazzani Touhami, Hasna Ahyayauch, Nisrin El Mlili, A Filali-Maltouf, Zakaria Belkhadir
BACKGROUND: Cancer is a worldwide health problem and pain is among the most common and unpleasant effects affecting well-being of cancer patients. Accurate description of pain can help physicians to improve its management. Many English tools have been developed to assess pain. Only a limited number of these are applied in Arab countries. Our aim was to assess the quality, the nature and the severity of pain using the short McGill Pain Questionnaire (SF-MPQ) on cancer patients in the National Institute of Oncology (NIO) in Rabat, Morocco...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Joel Norton, Christine Hymers, Penelope Stein, Joanne May Jenkins, Duncan Bew
BACKGROUND: Acute porphyria is historically known as "the little imitator" in reference to its reputation as a notoriously difficult diagnosis. Variegate porphyria is one of the four acute porphyrias, and can present with both blistering cutaneous lesions and acute neurovisceral attacks involving abdominal pain, neuropsychiatric features, neuropathy, hyponatremia, and a vast array of other nonspecific clinical features. CASE REPORT: A 40-year-old man presented to the Emergency Department (ED) as a major trauma call, having been found in an "acutely confused state" surrounded by broken glass...
September 10, 2016: Journal of Emergency Medicine
Mathieu Fontaine, Jacques Latarjet, Jacqueline Payre, Jean-Charles Poupelin, François Ravat
INTRODUCTION: The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. PATIENTS AND METHODS: Cohort study began after favorable opinion from local ethic committee has been collected...
September 6, 2016: Burns: Journal of the International Society for Burn Injuries
Dorothée Girard, Betty Laverdet, Virginie Buhé, Marina Trouillas, Kamélia Ghazi, Maïa M Alexaline, Christophe Egles, Laurent Misery, Bernard Coulomb, Jean-Jacques Lataillade, François Berthod, Alexis Desmoulière
Many wound management protocols have been developed to improve wound healing after burn with the primordial aim to restore the barrier function of the skin and also provide a better esthetic outcome. Autologous skin grafts remain the gold standard in the treatment of skin burn, but this treatment has its limitation especially for patients presenting limited donor sites due to extensive burn areas. Deep burn injuries also alter the integrity of skin-sensitive innervation and have an impact on patient's quality of life by compromising perceptions of touch, temperature, and pain...
October 7, 2016: Tissue Engineering. Part B, Reviews
Anna Ghizzani, Piersante Sestini
BACKGROUND: Sexual pain is frequently seen in gynecological practice as a consequence of lower tract pathology. When organic causes are ruled out we must think of a functional pain syndrome such as the genital pelvic pain/penetration disorder (GPPD) whose diagnostic criteria are defined by the Diagnostic and Statistic Manual-5; these criteria describe both vaginismus and vulvodynia that present themselves with somewhat different clinical dimensions and require different treatments. Even if gynecologists do not usually manage functional sexual pain, they can easily reach the differential diagnosis through the sexual pain anamnesis because some symptoms are specific of one or the other condition...
September 8, 2016: Minerva Ginecologica
Muhammad Sohail, Muhammad Mustehsan Bashir, Hamid Hussain Ansari, Farid Ahmad Khan, Noreen Assumame, Nukhbat Ullah Awan, Asad Aizaz Chatha
OBJECTIVES: To describe the characteristics and outcome of management of vascular malformations of lip. PLACE AND DURATION OF STUDY: The Department of Plastic Surgery and Burn Unit, King Edward Medical University, Mayo Hospital, Lahore, from January 2009 to December 2013. METHODS: A prospective case series of 38 patients with vascular malformation of lip was performed. Demographic information and clinical features were noted. Treatment employed, complications, functional, and cosmetic outcome were recorded...
September 2016: Journal of Craniofacial Surgery
Rachel Myers, Jeanette Lozenski, Matthew Wyatt, Maria Peña, Kayla Northrop, Dhaval Bhavsar, Anthony Kovac
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients...
August 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Faraína Rodrigues Vasconcelos Franco, Luciano Alberto Castro, Maria Cristina Borsatto, Erika Aparecida Silveira, Rejane Faria Ribeiro-Rotta
BACKGROUND: Burning mouth syndrome (BMS) is a chronic pain disorder that is difficult to diagnose and refractory to treatment; it is more prevalent in pre- and postmenopausal women. Acupuncture and auriculotherapy have been suggested as options for the treatment of pain because they promote analgesia and allow for the reduction of symptoms with lower doses of drugs; this leads to greater patient compliance with treatment and has a positive effect on quality of life. Clinical trials investigating the effectiveness of acupuncture in the treatment of BMS are scarce in the literature...
September 1, 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Kathleen Yin, Jennifer R Deuis, Richard J Lewis, Irina Vetter
Burn injury is a cause of significant mortality and morbidity worldwide and is frequently associated with severe and long-lasting pain that remains difficult to manage throughout recovery. We characterised a mouse model of burn-induced pain using pharmacological and transcriptomic approaches. Mechanical allodynia elicited by burn injury was partially reversed by meloxicam (5 mg/kg), gabapentin (100 mg/kg) and oxycodone (3 and 10 mg/kg), while thermal allodynia and gait abnormalities were only significantly improved by amitriptyline (3 mg/kg) and oxycodone (10 mg/kg)...
2016: Molecular Pain
Ibrahim Khansa, Bridget Harrison, Jeffrey E Janis
BACKGROUND: Scars represent the visible sequelae of trauma, injury, burn, or surgery. They may induce distress in the patient because of their aesthetically unpleasant appearance, especially if they are excessively raised, depressed, wide, or erythematous. They may also cause the patient symptoms of pain, tightness, and pruritus. Numerous products are marketed for scar prevention or improvement, but their efficacy is unclear. METHODS: A literature review of high-level studies analyzing methods to prevent or improve hypertrophic scars, keloids, and striae distensae was performed...
September 2016: Plastic and Reconstructive Surgery
N S Russell, E van Werkhoven, S B Schagen
PURPOSE: Skin toxicity is a common effect from radiotherapy, although difficult to predict on an individual basis, and there is little evidence-based management. This study aimed to quantify inter-patient variation in patient-reported outcome measures for radiation-induced skin reactions (RISR) to enable the determination of the number of patients required for adequate power in a comparative trial of RISR management strategies. METHODS: The study included 154 patients scheduled to receive breast cancer radiotherapy...
August 24, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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