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https://www.readbyqxmd.com/read/28340312/a-preliminary-investigation-on-the-effect-of-extracorporeal-shock-wave-therapy-as-a-treatment-for-neurogenic-heterotopic-ossification-following-traumatic-brain-injury-part-ii-effects-on-function
#1
J E Reznik, E Biros, Y Sacher, O Kibrik, S Milanese, S Gordon, M P Galea
INTRODUCTION: Neurogenic heterotopic ossification (NHO) occurs as a complication of traumatic brain injury (TBI). Management of clinically significant NHO remains variable. Complications of mature NHO include limitation of mobility. The effect of the extracorporeal shock wave therapy (ESWT) on range of motion at hip and knee, and function in patients with TBI with chronic NHO was investigated. METHODS: A series of single-case studies applying ESWT to chronic NHO at the hip or knee of 11 patients with TBI were undertaken at a rehabilitation hospital...
March 24, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28340246/considerations-on-glycaemic-control-in-older-and-or-frail-individuals-with-diabetes-and-advanced-kidney-disease
#2
Nicolae Mircea Panduru, Ionut Nistor, Per-Henrik Groop, Wim Van Biesen, Ken Farrington, Adrian Covic
The increasing prevalence of chronic kidney disease (CKD) and diabetes over the last decade has resulted in increasing numbers of frail older patients with a combination of these conditions. Current treatment guidelines may not necessarily be relevant for such patients, who are mostly excluded from the trials upon which these recommendations are based. There is a paucity of data upon which to base the management of older patients with CKD. Nearly all current guidelines recommend less-tight glycaemic control for the older population, citing the lack of proven medium-term benefits and concerns about the high short-term risk of hypoglycaemia...
March 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340203/been-there-done-that-the-experience-of-acting-as-a-young-adult-mentor-to-adolescents-living-with-chronic-illness
#3
Sara Ahola Kohut, Jennifer Stinson, Paula Forgeron, Stephanie Luca, Lauren Harris
To explore the perceived benefits and challenges of acting as a young adult peer mentor to adolescents with chronic illness.   A qualitative descriptive study, using interviews and a focus group, explored the perceptions of young adult peer mentors following participation in the iPeer2Peer program, a Skype-based peer-mentorship program for adolescents with chronic illness. Interviews and focus group data were transcribed and analyzed using inductive content analysis.   Ten peer mentors (20.00 ± 1...
March 16, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#4
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340111/assessment-of-patient-reported-outcome-instruments-to-assess-chronic-low-back-pain
#5
Abhilasha Ramasamy, Mona L Martin, Steven I Blum, Hiltrud Liedgens, Charles Argoff, Rainer Freynhagen, Mark Wallace, Kelly P McCarrier, Donald M Bushnell, Noël V Hatley, Donald L Patrick
Objective. : To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims. Design. : Literature review of existing PRO measures. Methods. : Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339989/pain-management-strategies-and-health-care-use-in-community-dwelling-individuals-living-with-chronic-pain
#6
Elizabeth G Mann, Ana Johnson, Ian Gilron, Elizabeth G VanDenKerkhof
Objective. : To describe factors associated with high clinic and emergency room (ER) use among individuals with chronic pain. Design. : This study is part of a larger cross-sectional survey on the epidemiology of chronic pain in Canada. The current analysis was guided by the Andersen-Newman Service Utilization Model. Methods. : Respondents (N = 702) were grouped into high (top 10%) and low (bottom 90%) users based on the number of visits made to clinics and ERs over the past year...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339928/opioid-use-in-chronic-pain-patients-with-chronic-kidney-disease-a-systematic-review
#7
Vittal R Nagar, Pravardhan Birthi, Sara Salles, Paul A Sloan
Objectives. : To investigate the prevalence of chronic pain and opioid management among patients with chronic kidney disease (CKD). Design.:  Systematic review. Methods.:  A systematic search was performed, including citations from 1960 to May 2015. The review highlights methodological quality assessment of the selected studies; prevalence of pain; type, dose, and reason for opioid use; effectiveness of pain control and associated adverse effects of opioids in CKD patients...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#8
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339739/unabated-occupational-risk-in-a-patient-with-rheumatoid-pulmonary-fibrosis
#9
V K Holden, S J Kligerman, T G Hastings, S E Hines
Background: This case highlights the importance of considering hypersensitivity pneumonitis (HP) in the differential diagnosis of interstitial lung disease (ILD) and of obtaining an occupational history so that remediable risk factors may be identified and managed. Aims: To report a case of a chicken sexer with severe rheumatoid arthritis (RA) who developed progressively worsening dyspnoea and restrictive lung disease associated with pulmonary fibrosis. Methods: Clinical investigation included physical examination, occupational history, pulmonary function tests (PFTs), chest imaging and bronchoalveolar lavage (BAL), as well as serological tests including standard IgE bird feather mixture and local IgG precipitin preparation to chicken excrement...
February 23, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28339737/a-novel-chronic-opioid-monitoring-tool-to-assess-prescription-drug-steady-state-levels-in-oral-fluid
#10
Naum Shaparin, Neel Mehta, Frank Kunkel, Richard Stripp, Damon Borg, Elizabeth Kolb
Objective. : Interpretation limitations of urine drug testing and the invasiveness of blood toxicology have motivated the desire for the development of simpler methods to assess biologically active drug levels on an individualized patient basis. Oral fluid is a matrix well-suited for the challenge because collections are based on simple noninvasive procedures and drug concentrations better correlate to blood drug levels as oral fluid is a filtrate of the blood. Well-established pharmacokinetic models were utilized to generate oral fluid steady state concentration ranges to assess the interpretive value of the alternative matrix to monitor steady state plasma oxycodone levels...
February 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339524/chronic-illness-self-management-a-mechanism-behind-the-relationship-between-neighbourhood-social-capital-and-health
#11
Geeke Waverijn, Monique Heijmans, Peter P Groenewegen
: Neighbourhood social capital might provide resources that can benefit chronic illness self-management. Improved self-management is a possible mechanism behind the relationship between neighbourhood social capital and health of people with chronic illness. : To test this mechanism, we collected data on self-management and self-rated health among a sample of 2091 people with chronic illness in 2013. Data on neighbourhood social capital were collected among 69 336 people in 3425 neighbourhoods between May 2011 and September 2012...
October 19, 2016: European Journal of Public Health
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#12
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339444/a-review-of-long-term-pain-relief-after-genicular-nerve-radiofrequency-ablation-in-chronic-knee-osteoarthritis
#13
Ferdinand Iannaccone, Samuel Dixon, Andrew Kaufman
BACKGROUND: Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. STUDY DESIGN: Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB)...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339433/management-of-neuropathic-chronic-pain-with-methadone-combined-with-ketamine-a-randomized-double-blind-active-controlled-clinical-trial
#14
Flavia Karine Rigo, Gabriela Trevisan, Maria C Godoy, Mateus Fortes Rossato, Gerusa D Dalmolin, Mariane A Silva, Mirian S Menezes, Wolnei Caumo, Juliano Ferreira
BACKGROUND: Methadone and ketamine are used in neuropathic pain management. However, the benefits of both drugs association are uncertain in the treatment of neuropathic pain. OBJECTIVE: Our primary objective was test the hypothesis that oral methadone combined with oral ketamine is more effective than oral methadone or ketamine alone in reducing neuropathic pain. STUDY DESIGN: We conducted a randomized, double blind, active-controlled parallel-group clinical trial...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339432/bipolar-versus-unipolar-intraarticular-pulsed-radiofrequency-thermocoagulation-in-chronic-knee-pain-treatment-a-prospective-randomized-trial
#15
Ersel Gulec, Hayri Ozbek, Sinan Pektas, Geylan Isik
BACKGROUND: Chronic knee pain is a major widespread problem causing significant impairment of daily function. Pulsed radiofrequency has been shown to reduce severe chronic joint pain as a non-pharmacological and less invasive treatment method. OBJECTIVE: We aimed to compare the effectiveness of unipolar and bipolar intraarticular pulsed radiofrequency methods in chronic knee pain control. STUDY DESIGN: Prospective, randomized, double-blind study...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#16
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339430/comparative-effectiveness-review-of-cooled-versus-pulsed-radiofrequency-ablation-for-the-treatment-of-knee-osteoarthritis-a-systematic-review
#17
Anita Gupta, Daniel P Huettner, Matthew Dukewich
BACKGROUND: Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. OBJECTIVE: This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339429/comparing-the-efficacy-of-surgery-and-medical-therapy-for-pain-management-in-endometriosis-a-systematic-review-and-meta-analysis
#18
Shahla Chaichian, Ali Kabir, Adolfazl Mehdizadehkashi, Khaled Rahmani, Mehrdad Moghimi, Bahram Moazzami
BACKGROUND: Pain is considered as one of the main symptoms of endometriosis. The treatment for endometriosis remains controversial. OBJECTIVES: The aim of this study is to compare the effect of medical or surgical treatments for pain-relief in patients with endometriosis. STUDY DESIGN: Systematic review and meta-analysis. SETTING: Published papers about evaluating pain treatment in endometriosis in PubMed, Scopus, and Google Scholar...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#19
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339288/the-proximal-tibiofibular-joint-a-biomechanical-analysis-of-the-anterior-and-posterior-ligamentous-complexes
#20
Daniel Cole Marchetti, Gilbert Moatshe, Brian M Phelps, Kimi D Dahl, Marcio Balbinotti Ferrari, Jorge Chahla, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Dislocation of the proximal tibiofibular joint is a complex injury that is often overlooked or misdiagnosed. Surgical management is recommended for severe acute or for chronic symptomatic instability of the proximal tibiofibular joint. Although the anterior ligamentous complex has been reported to be stronger than the posterior complex, biomechanical data are lacking. PURPOSE: To determine the ultimate load of the anterior and posterior ligamentous complexes of the proximal tibiofibular joint to determine optimal graft selection...
March 1, 2017: American Journal of Sports Medicine
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